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Biomedical subjects

A Udesen

Publications and source records attributed to A Udesen.

5 recordsLinked to original sources

Monitoring of free TRAM flaps with microdialysis.

The aim of this investigation was to follow the metabolism of free TRAM flaps using microdialysis. Microdialysis is a new sampling technique that provide opportunities to follow the biochemistry in specific organs or tissues. A double-lumen microdialysis catheter or probe, with a dialysis membrane at the end, is introduced into the specific tissue. Perfusion fluid is slowly pumped through the catheter and equilibrates across the membrane with surrounding extracellular concentrations of low molecular weight substances. The dialysate is collected in microvials and analyzed by an instrument using very small volumes. Glucose, glycerol, and lactate concentrations were measured in the flaps and compared with those in a reference catheter that was placed subcutaneously in the femur. The investigation continued 72 hr postoperatively. The study group consisted of 14 women who underwent reconstruction with a free TRAM flap, and one woman with a double TRAM flap. During flap ischemia, the concentration of glucose was reduced, while the lactate and glycerol levels increased. The differences between the flaps and controls were statistically highly significant. After reperfusion of the flaps, the concentrations of glucose, lactate, and glycerol approached normal. One flap failed because of an arterial anastomosis thrombosis. This was clearly demonstrated by the samples from the microdialysis: the concentration of glucose fell to an unmeasurable level; the concentration of lactate increased for a period before it stopped due to lack of glucose; and the concentration of glycerol increased to a very high level, probably because ischemia caused damage to the cell membranes of which glycerol is an important part. The authors concluded that microdialysis can detect ischemia in free flaps at an early stage, making early surgical intervention possible.

Breast Neoplasms↗

Microvascular free flaps in the treatment of defects of the lower legs.

Thirty-four microvascular free flaps were used to treat defects in the lower extremities after injuries. Twenty patients (74%) had severe open fractures (Gustilo type III B & C). Latissimus dorsi (n = 16) and iliac osteocutaneous (n = 7) flaps were most commonly used for coverage, and the overall failure rate was 9% (3/34). At follow up 29 of the patients (94%) had a reduced range of movement of the ankle, nine (29%) had some swelling and oedema, and 13 (42%) had occasional pain in the leg. Sixteen (52%) of the patients were limping, but 26 (84%) could walk one kilometre or more with no problems. No legs were amputated. The unemployment rate increased from 1/34 (3%) to 6/31 (19%) at follow up. Twenty-seven (87%) of our patients were satisfied with the results, despite the considerable and persistent limitation of function, and the increase in the unemployment rate.

Adolescent↗

[Breast reduction surgery. County of Velje--a 12-year follow-up study].

A questionnaire investigation of 299 women treated operatively over a 12-year period for breast hypertrophy in four general surgical units is presented. Different surgical techniques were used, and in one of the departments one plastic surgeon performed the operations. The results of the different techniques were compared. All techniques gave good physical relief. Pers & Bretteville-Jensen's technique proved to be better in maintaining the sensitivity of the nipple, but a higher incidence of complications occurred. With McKissock's, Strömbeck's and Bames-Ragnell's techniques all scars end up looking like an anchor. These methods are preferred by most women, in spite of a higher risk of losing the sensitivity of the nipple. Significantly more women who had undergone reduction mammaplasty with the Pers & Bretteville-Jensen technique, which ends up with a horizontal scar across the breast, regretted the operation. The cosmetic results were very important for the patients, and a more uniform treatment of the patients might be preferred.

Denmark↗

[Breast reduction by Orlando's method. A questionnaire study].

A questionnaire investigation involving 74 women who had been submitted to breast reduction by Orlando's method revealed that the preoperative physical and psychological complaints of the patients had been practically completely eliminated. The total frequency of complications was 9.9%. This figure must be regarded in the light of the high frequency of overweight patients (78.4%). The frequency of complications was as in other comparable materials with high frequencies of overweight patients. Complete necrosis of the nipple did not occur. The operative method proved good as regards retention of the sensitivity of the nipple as this was retained in 86% of the breasts. Despite the fact that 2/3 of the patients complained of scar problems, 90.5% of the patients considered that the final cosmetic result was satisfactory. Improvement in the quality of the scar should be given high priority and overweight should be eliminated preoperatively.

Adolescent↗

[Burn injuries due to fireworks during New Year holiday. A 10-year case load].

Minor burns due to fireworks which are treated in the Casualty Department have remained constant during the past ten years. The injured patients are boys and young men between 7-19 years. Boys are injured ten times as frequently as girls. The commonest sites of injuries are the upper limbs, the head and neck. The number of patients admitted to hospital on account of serious burns has increased. These are most frequently caused by clothes catching fire from fireworks which have been hidden under outer clothes or in trouser pockets. In order to avoid the serious burns caused by burning clothes, it is recommended that fireworks should not be concealed under clothes but carried away from the body possibly in a container made of non-inflammable material.

Accident Prevention↗