Biomedical subjects
Publications and source records attributed to A DeFranzo.
A pseudolipoma is a benign fatty tumor whose etiology is undetermined but is postulated to be secondary to a tear in Scarpa's fascia resulting in herniation of deeper fat through Scarpa's layer. We report ten cases of trauma that resulted in pseudolipoma formation. The literature is reviewed and treatment options are discussed.
Penile revascularization via inferior epigastric dorsal penile artery bypass is a treatment option for men with vasculogenic impotence due to proximal segmental arterial occlusion. Various diagnostic tests have been used to identify arterial vascular disease but pudendal arteriography remains the gold standard anatomical study. Unfortunately, more than 80% of impotent men have significant variations in penile arterial anatomy, and proximal arterial occlusions may prevent adequate visualization of the intrapenile arteries. We have found that intraoperative penile arteriography performed through the dorsal penile artery facilitates the planning of the arterial anastomosis to ensure adequate blood flow to the corpora cavernosum. The indications and technique of intraoperative penile arteriography are described.
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Pedicled cross-extremity flaps for wound coverage have been replaced, in most cases, by free tissue transfer. Classically, cross-leg flaps have been problematic because of difficulties with immobilization and positioning of the extremities from the time of initial coverage to detachment. Three children with severe foot and ankle trauma had cross-extremity flaps using linkage of bilateral lower-extremity external fixators in place of traditional casting. Cross-leg flaps were used in two patients, and a cross-foot flap was applied in one. Each flap survived completely, and the linking fixators were disassembled at the time of flap detachment. No complications were related to the donor site or the flap itself or were caused by the fixation. Lower-extremity range of motion was regained rapidly, and each patient resumed essentially normal gait and activity. Addition of external-fixator stabilization aids greatly in wound care, as well as general ease of patient mobility and positioning. External fixation facilitates the use of cross-extremity flaps in pediatric patients in whom free tissue transfer may not be optimal.