The 20 sep 2008 episode focused partially on

orthopaedic surgeon Steve Mannion, who has devoted his life to working in far-flung and under-resourced corners of the world using "forgotten techniques" like the ponseti club foot treatment (for children) ulcer healing and skin restoration without buying graft tissue.

Emma sums up my thoughts.

http://www.hsj.co.uk/emma-dent-is-humbled-by-medical-ingenuity/1841263.article

I can't really find a link to it, but it's on bbc HD on the 26th (whatever bbc HD is lol)

I am mentioning it because I found it extremely interesting.

For a 'lay' person, I was amazed to see steve mannion avoid cutting wedges of bone to realign club foot on children and instead just using progressive, slow, but long-term twisting. Within about 2 months, the club foot (due to spongy bones on young children) is totally cured. For the adults, he was cutting wedges of bone to re-align the ankle and that certainly worked as well.

He also mixed vaseline, glycerin and sugar (a first world war technique) to make a blend which could be applied to ulcerated, smelling tissue..
Due to the properties of each being blended into one super paste, the ulcer would be cured, the smell would go, the pain would fade away and the tissue would fully heal. I think the paste had to be changed every so often, although I can't remember.

Also, I loved the skin graft technique. He would cut an elipsoid of skin from somewhere unseen, cut it up into pieces and then evenly space these pieces over a skinless wound of about 4 x the size or more. Applying a dressing etc would allow the skin to grow and fill the gaps, amazing.................

Of course, I await your comments telling me that the skin graft method has been common knowledge for years but, the skin companies would rather delete it from history if they could..................especially at $750 million per foreskin.......................(as per my previous post thanks to Jim's link to http://www.acroposthion.com/

I have learned so much from you in a short time, Jim and Paul.

Well, none of these techniques are "new" or indeed, not commonly used in current surgical practice. For skin grafting, we currently use a gadget colloquially called a "mesher" (or "expander") which slots the graft skin in a regular interleaved pattern, allowing it to easily stretch to four times the original area. It's a sort of flat "mill" vaguely reminiscent of a tiny version of the old hand-cranked Gestetner duplicator. "Meshing" also prevents the build-up of exudate under the graft which would prevent it "taking" and a pressure dressing to hold the graft in place is mandatory.

The graft materials derived from foreskin would be generally used in a limited area of practice; the treatment of severe burns or severe trauma. I suppose there is no shortage of that in the US.

According to my training, splinting for club foot is the standard treatment, though it is possible surgery might be called for in a few cases. Clearly in poorer conditions, there will be a tendency to use non-surgical methods in a much greater proportion of cases.

The Vaseline, glycerine and sugar is not too distant to the Zinc and Castor Oil that you see me recommend frequently here. For "Boils" and the like, the mix I continue to recommend is Epsom Salts (magnesium sulphate) and glycerine, trademarked "Magnoplasm", whilst an older version (which has sat on my shelf untouched for over 22 years) is Icthammol and glycerine.

Thanks for replying, Paul.

I have added your information to my brain database, although I hope it does not misfiled somewhere amongst the neural net of webs..

I would still like to think that the glycerin, vaseline and sugar mix is superior to the zinc/castor oil combo or am I missing something?