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Biomedical subjects

B Fernando

Publications and source records attributed to B Fernando.

8 recordsLinked to original sources
PubMed1992

Grip strength before and after carpal tunnel decompression.

We prospectively studied preoperative and postoperative grip and pinch strength in 21 patients having 30 consecutive median nerve decompressions for carpal tunnel syndrome. All procedures were done by one surgeon. Each hand operated on served as its own control and was studied by the same therapist preoperatively and at monthly intervals for 6 months after the procedure. An initial decline in both grip and pinch strength was noted in most hands during the first postoperative month. Eighty percent or more grip strength was regained in 65% of the hands at 2 months and in 81% at 3 or more months. In those hands (65%) that regained at least 100% of their preoperative grip strength at 3 or more months, there was an average increase in maximal grip of 56%, as compared with an average decrease of 20% in the remaining hands (35%).

Adult↗
PubMed1989

Management of scaphoid fractures: a review and update.

The scaphoid is the most commonly injured carpal bone. Almost half of all bony wrist injuries involve the scaphoid. Treatment is controversial and, when inadequate, can result in a painful nonunion or degenerative radiocarpal arthritis. Fracture of the scaphoid occurs most often in young adult men, with a peak incidence between the ages of 15 and 30 years. The scaphoid is less susceptible to fracture during the phase when it is mostly cartilaginous, thus making scaphoid fracture rare in childhood. In this article, we review current treatment of fracture of the scaphoid and examine controversial topics in its management.

Adolescent↗
PubMed1989

Plasma lidocaine levels during augmentation mammaplasty and suction-assisted lipectomy.

Many plastic surgical procedures are dependent on or aided by the use of local anesthetics. Drug toxicity, although uncommon, is the most feared complication of this technique. There are multiple factors that lead to varying drug levels. These include drug concentration, speed of injection, rate of degradation, total dosage, site of injection or application, rate of administration, and the adjunctive use of vasoconstrictors. This study evaluates the use of subcutaneously injected lidocaine in patients undergoing suction-assisted lipectomy and augmentation mammaplasty. Lidocaine in the concentration of 0.5% containing either 1:100,000 or 1:200,000 epinephrine was used in doses up to 500 mg. Serial lidocaine levels were then obtained up to 1 1/2 hours after injection utilizing two different assay techniques. Our findings demonstrate consistently nondectable serum lidocaine levels despite the use of doses in excess of recommended "safe" amounts. This suggests that under specific circumstances and with certain operative procedures, lidocaine dosing can be liberalized.

Adipose Tissue↗
PubMed1988

A case study of pyoderma gangrenosum.

Pyoderma gangrenosum is a rare neutrophilic dermatosis seen initially as painful pustules or bullae on the skin that rapidly ulcerate and have a characteristic raised, purplish areola surrounding them. It is often associated with inflammatory bowel disease and less commonly with other systemic diseases, such as myelofibrosis, rheumatoid arthritis, and chronic active hepatitis. Pyoderma gangrenosum involving the hand is a rare entity, with only two previous cases reported in the literature. This article describes a patient with myelofibrosis in whom pyoderma gangrenosum of the hand developed after she underwent splenectomy.

Aged↗
PubMed1988

Miniature implantable laser Doppler probe monitoring of free tissue transfer.

A 2.5-mm fiber-optic laser Doppler flowmetry probe has been applied in an experimental dog model as well as in 5 clinical cases to provide continuous readout of deep tissue perfusion. The rectus abdominis muscle in the dog was used for the experimental verification of the probe, which has a linear correlation with flow rate and a rapid response (6 seconds) to arterial occlusion and venous occlusion (20 seconds). Four of the 5 free tissue transfers survived with the laser Doppler instrument correctly identifying the lack of flow, both intraoperatively and postoperatively, in the failed flap. This probe greatly extends the versatility of laser Doppler flow measurement in the clinical setting and may be nearly an ideal probe for monitoring free tissue transfer, particularly muscle.

Animals↗
PubMed1988

Closure of a sternal defect with the rectus abdominis muscle after sacrifice of both internal mammary arteries.

Infections of the median sternotomy incision are relatively uncommon. Successful treatment of this serious complication consists of adequate surgical debridement and obliteration of mediastinal dead space using the pectoralis major muscle, or the rectus abdominis muscle or both. The recent use of internal mammary artery grafts has created a new problem in closure of defects involving the lower one-third of the sternum. Under these circumstances the use of the rectus abdominis muscle is believed to be contraindicated. To date omental transposition remains the only alternative in therapy. A case of sternal dehiscence after coronary artery bypass surgery is described. Bilateral internal mammary artery grafts were used. A rectus abdominis flap based primarily on the eighth anterior intercostal perforator was transposed into the defect. The wound healed uneventfully after initial loss of a 3-cm portion of the skin graft. Success of this flap based on intercostal perforators is postulated to be secondary to a "delay" phenomenon related to prior division of the dominant blood supply.

Abdominal Muscles↗
PubMedDate not supplied

Audit of the relationship between episiotomy and risk of major perineal laceration during childbirth.

The beneficial effect of mediolateral episiotomy in reducing major perineal lacerations during childbirth has been questioned. In a test of the hypothesis of no association between episiotomy and the incidence of major perineal lacerations, the incidence of major perineal laceration was determined in three cohort groups in one maternity unit between 1984 and 1991. Among those undergoing non-instrumental delivery, no reduction in the incidence of major lacerations could be demonstrated following episiotomy. Among those undergoing episiotomy, the incidence of major lacerations was significantly higher following instrumental delivery.

Episiotomy↗