Biomedical subjects
Publications and source records attributed to A Anseeuw.
The authors discuss the history and use of injections of paraffin, silicone, and collagen for soft-tissue contouring. The structure and uses of collagen are described with particular reference to Zyderm Collagen Implant, a highly purified bovine collagen.
A familial dermatoglyphic study of 25 syndactyly type I patients and 53 unaffected first-degree relatives showed a significant increase of complex fingertip patterns in the patients and in their relatives as well. An embryonic link between the formation of complex fingertip patterns and syndactyly type I is postulated. The study contributes new data on the hereditary transmission of syndactyly type I which cannot be used for individual genetic counseling. Calculation of the recurrence risk is difficult in view of the reduced penetrance of the gene.
Based upon our experience with 459 skin and soft tissue defects of the lower extremities, of which 326 were covered surgically, the different etiologies of these defects are listed and the factors influencing the choice of a method of coverage are discussed. The advantages and disadvantages of the different reconstructive methods are reviewed and illustrated with representative cases.
In this paper the indications, the technique and our personal experience with 45 subcutaneous mastectomies (S.C.M.) are reviewed. A bilateral S.C.M. is mainly a prophylactic operation, indicated in patients with premalignant breast disease and in high risk patients with widespread fibrocystic disease. A unilateral S.C.M. is indicated in patients who have already had a mastectomy for carcinoma and whose remaining breast has an increased risk for also developing a carcinoma. The technique which we nowadays prefer, consists of a S.C.M. with immediate submuscular prosthetic reconstruction. The operation is done through a transverse incision for small non ptotic breasts and following a Mc Kissock reduction mammoplasty pattern for large ptotic breasts. The nipple-areola complex is transposed on a wide dermal pedicle. Both the subcutaneous and submuscular spaces are drained and early postoperative mobilisation of the prosthesis is advised. Our experience with 45 subcutaneous mastectomies is reviewed. The complications have been few and occurred mainly in earlier cases where the prosthesis was inserted subcutaneously. Neither necrosis nor circulatory embarrassment of nipple-areola complex were encountered.
Based upon our own experience with 70 surgical procedures for 49 primary decubitus ulcers, 17 complications and 7 recurrences in 31 paraplegics, and upon the techniques described in the literature, the different reconstructive methods and their advantages and disadvantages are discussed and illustrated with representative cases. The surgical reconstruction of decubitus ulcers requires a thorough planning and an atraumatic surgical technique. Nevertheless complications are not seldom and recurrences are possible.
The evolution in the concept of flap transplantation is reviewed. Better knowledge of the vascular supply of skin and muscle has made possible the evolution from random skin flaps to axial skin flaps, muscle flaps, myocutaneous and fasciocutaneous flaps and free flaps. Pedicled flaps remain a very valuable alternative to free flaps as they are easier and more expedient to execute. Our experience with 35 pedicled muscle flaps and 23 pedicled myocutaneous flaps for reconstruction of difficult defects all over the body is reviewed. The overall results have been very satisfactory as in this entire series only two partial necroses occurred in the muscle flaps, of which one in a distally based soleus muscle flap. Except for three superficial skin losses which healed spontaneously, no flap necrosis occurred in our series of myocutaneous flaps. In two crossleg myocutaneous flaps, two stages were necessary. In one myocutaneous pectoralis flap, the pedicle was sectioned in a second stage and also transferred to the face in order to bring in additional tissue. The other reconstructions were on stage operations.