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B J Michelow

Publications and source records attributed to B J Michelow.

4 recordsLinked to original sources
PubMed1991

Double-pedicle TRAM flap for unilateral breast reconstruction.

Autogenous breast reconstruction with the pedicled TRAM flap has been employed in 500 patients in our series. We have developed and refined indications for use of the single-pedicle TRAM flap and double-pedicle TRAM flap in unilateral breast reconstruction. In our experience with 341 unilateral breast reconstructions, we used a double-pedicle TRAM flap 19 percent of the time; however, in our most recent 50 unilateral modified radical mastectomy reconstructions, the double-pedicle technique has been employed 60 percent of the time. In general, when a TRAM flap is chosen for unilateral reconstruction of a modified radical mastectomy defect, we feel the single-pedicle TRAM flap is the procedure of choice. Carefully selected patients will benefit from the added safety of a double-pedicle TRAM procedure. The indications for the double-pedicle TRAM flap, the technique, and our results are described in detail.

Abdominal Muscles↗
PubMed1990

TRAM flap safety optimized with intraoperative Doppler.

Anatomic studies have clearly documented the variable position of the deep superior epigastric vessels in the rectus abdominis muscle. In our opinion, only that part of the rectus abdominis muscle containing the vascular pedicle should be transposed with the TRAM flap. The Doppler probe provides a simple method of identifying the dominant intramuscular vascular axis. It consistently alerts the surgeon to any unusual position of a vessel at the costal margin or within the rectus abdominis muscle. This knowledge enables a conservative yet safe dissection of the vascular pedicle, rectus abdominis muscle, and its sheath. This in turn will enable a competent abdominal closure. The Doppler technique is safe, simple, quick, noninvasive, familiar to most surgeons, and applicable to all patients.

Abdominal Muscles↗
PubMed1987

Penetrating cardiac injuries: selective conservatism--favorable or foolish?

In a current review of the literature regarding the management of patients with suspected penetrating cardiac injuries there appears to be no place for conservative management. Nine patients with penetrating cardiac injuries were successfully treated conservatively and are reported. This series aims to emphasize the point that there is a place for conservative management of selected cases.

Adult↗