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Biomedical subjects

A Ferreres

Publications and source records attributed to A Ferreres.

11 recordsLinked to original sources
PubMed2000

Is the reversed fourth dorsal metacarpal flap reliable?

We have carried out a study to determine if a flap based on vessels in the fourth metacarpal space could be used safely. We studied ten fresh cadaver specimens and used the flap in nine patients. In the anatomical study, we confirmed the presence of a suitable artery in nine out of the ten hands, arising from a piercing artery at the metacarpal bases, running distally under the fascia. The pivot point is located at the metacarpal heads, where the artery anastomoses to palmar branches and dorsal digital branches. In the clinical setting, the flap was reliable in eight patients. There was one case of flap necrosis. The flap seems to be reliable but several technical points are stressed to avoid complications.

Cadaver↗
PubMed1998

The feasibility of laparoscopic cholecystectomy in patients with previous abdominal surgery.

A retrospective study was carried in 1500 patients submitted to elective laparoscopic cholecystectomy to ascertain its feasibility in patients with previous abdominal surgery. In 411 patients (27.4%) previous infraumbilical intraperitoneal surgery had been performed, and 106 of them (7.06%) had 2 or more operations. Twenty five patients (1.66%) had previous supraumbilical intraperitoneal operations (colonic resection, hydatid liver cysts, gastrectomies, etc.) One of them had been operated 3 times. In this group of 25 patients the first trocar and pneumoperitoneum were performed by open laparoscopy. In 2 patients a Marlex mesh was present from previous surgery for supraumbilical hernias. Previous infraumbilical intraperitoneal surgery did not interfere with laparoscopic cholecystectomy, even in patients with several operations. There was no morbidity from Verres needle or trocars. In the 25 patients with supraumbilical intraperitoneal operations, laparoscopic cholecystectomy was completed in 22. In 3, adhesions prevented the visualization of the gallbladder and these patients were converted to an open procedure. In the 2 patients Marlex mesh prevented laparoscopic cholecystectomy because of adhesions to abdominal organs. We conclude that in most instances previous abdominal operations are no contraindication to laparoscopic cholecystectomy.

Abdomen↗
PubMed1996

Relation between postoperative infections and gallbladder bile leakage during laparoscopic cholecystectomies.

BACKGROUND: In 1,577 laparoscopic cholecystectomies, 111 due to acute and 1,466 due to chronic cholecystitis, the incidence of intraoperative gallbladder rupture and its relationship with abdominal wound infections were evaluated. METHODS: A sampling test for binomial proportions and a binomial approximation test for discrete data were employed for statistical analysis. Gallbladder accidental opening took place in 250 (19%) out of the 1,466 chronic and in 44 (40%) out of the 111 acute cholecystitis, disclosing a statistically significant difference (p < 0.01). Postoperatively, there were 32 (2%) surgical wound infections, 17 (1.3%) in the absence of gallbladder injury and 15 (5%) when gallbladder injury was observed, likewise showing a statistically significant difference (p < 0.05). RESULTS: It should be pointed out that all 32 wound infections involved the umbilical incision, of which 3 with chronic suppuration required reintervention where remnants of stones were found in the parietal route. The seven with symptomatic abdominal fluid resolved without specific treatment. As regards the seven intraabdominal infections, two remitted with antibiotics and five required percutaneous drainage. There was no significant correlation between the presence of cavity fluid abdominal collections or infections and bile spillage. CONCLUSION: Gallbladder injury proved more frequent in laparoscopic cholecystectomies performed due to acute cholecystitis, while bile spillage increased the incidence of umbilical wound infection, particularly in the presence of remnants of stones, but there was no correlative increase in the incidence of intraabdominal collections or infections.

Acute Disease↗
PubMed1995

Wrist denervation. Anatomical considerations.

In 1966, Wilhelm published a technique of denervation of the wrist joint based on his own anatomical studies of 1958. Other authors have published their experience in wrist denervations with similar results, but there are some discrepancies in descriptions of the innervation of the wrist. We have studied the innervation of the wrist by dissection under magnification on 20 cadaver limbs and by histological examination of five human foetal wrists. Based in our anatomical findings, we have demonstrated that Wilhelm's technique does not achieve total denervation of the wrist.

Cadaver↗
PubMed1995

Wrist denervation. Surgical considerations.

We have analyzed the results of 22 total wrist denervations following Wilhelm's technique and a series of 30 patients treated with denervation of the posterior interosseous nerve alone. Results of denervation have been classified depending on the pain (visual analogue scale) as other parameters (mobility and strength) have not been found to have any statistical significance. Results after partial denervation are worse than results achieved by total denervation.

Adult↗
PubMed1992

[Total denervation of the wrist. Apropos of 50 cases].

Fifty patients who underwent a total denervation of the wrist were reviewed after an average of 5 years post-operatively. The main aetiology was diffuse osteo-arthritis secondary to scaphoid nonunion (44 per cent) and Kienbock's disease, stage IV (22 per cent). This resulted in pain and functional disability. Another surgical procedure was carried out in 40 per cent of patients. Post-operative complications included one painful neuroma and 3 patients complained of radial nerve paraesthesia. Pain was improved in 36 of the 50 patients with an average score of 72 over a scale of 100. There was no significant change in power or range of movement.

Carpal Bones↗
PubMed1990

Aseptic necrosis of the sternal end of the clavicle Friedrich's disease.

A case of aseptic necrosis of the medial segment of the clavicle with X-ray images of fragmentation and few clinical symptoms is presented. This condition develops spontaneously and leads to early sternoclavicular osteoarthritis. The benign nature of the disease and the absence of treatment make it important to establish the correct diagnosis, differentiating it from other disorders in this area.

Adolescent↗
PubMed1990

Isolated posterior dislocation of the head of the radius in an adult. A case report.

A case of isolated posterior dislocation of the head of the radius is presented. It is a rare entity and, to our knowledge, only 3 adult cases have been published. The mechanism responsible is a fall on the hand with the elbow semiflexed and pronated. A simple reduction is made after an early diagnosis. After a short period in a cast, complete recovery can be expected.

Accidental Falls↗