Transcutaneous electrical nerve stimulation (TENS) in ischemic tissue.
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Biomedical subjects
Publications and source records attributed to B Körlof.
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A series of 100 women had been surgically treated for breast cancer and reconstructed by implantation of a submuscular prosthesis. The patients intensely desired the procedure and were supposed to have a realistic anticipation concerning the results. There was one late extrusion of prosthesis and one prosthesis was removed because of a local recurrence. Six patients had local or distant recurrences. Breast reconstruction was not a disadvantage in the treatment of these recurrences. In 48% of the cases the patients thought that the reconstructed breast was harder than desired. The corresponding figure for the independent examiner was 31%. After breast reconstruction, ipsilateral arm complications increased in number or severity by about 5%. In 82%, life-style and in 53%, social relations had improved after breast reconstruction. One of the 100 patients regretted the reconstruction and three were indifferent to it. For 14 patients it was so important as to be possibly psychologically vital.
Defects in the mandible after tumor surgery were reconstructed with split-rib grafts in 23 patients. Twenty of the patients were preoperatively irradiated with fractioned radiotherapy, ranging from 40 to 85 gray. Partial sequestration appeared in five patients. The ingrowth of the transplant was examined with technetium scintigraphy. Satisfactory cosmetic and functional results were achieved in the great majority of the patients. Split-rib grafting is recommended for reconstruction of the mandible as a safe procedure with little increased operation time and morbidity for the patient and good functional and cosmetic results.
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Acne keloidalis is characterized by infected keloid-like nodules in the short-cut nuchal region probably caused by recurving, ingrowing hairshafts. A case with a deep, partial-thickness burn of the hair-bearing part of the face of a man is reported. After healing, the patient started shaving himself thus inducing a severe state of acne keloidalis. It seems advisable in males not to shave during the first eight eight to ten months after a partial-thickness burn of the face in order to avoid this troublesome condition.
The 99Tcm-DP accumulation in split ribs grafted to six cases of partially resected mandibles was examined by scintigraphy at different time intervals after operations and found to be higher than in normal facial bones. The accumulation was highest around one month after the grafting procedure, and later decreasing. Differences between bone chips, split ribs and unsplit ribs are described. Bone scintigraphy is assumed to be of value in following the metabolic state of bone grafts.
Four cases by high voltage electricity are reported. Particular interest is taken in describing initial conservative treatment of injuries where the entrance of the current has been through the head, followed by surgical excision and flap surgery. This procedure had an uneventful postoperative course. Other methods comprising an earlier excision and revitalizing flap coverage over the necrotic bone thereby avoiding later bone grafting are being discussed and may be preferable. A decrease in high voltage injuries has been noticed during the last ten-year period compared to earlier data (5.5% down to 1.4%). This may well be partially explained by improved precautionary measures, but children are still prominent among the injured. All the children were injured while playing around railroad areas.
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Direct wound closure with or without flap-plasty after vulvectomy gives satisfactory cosmetic and functional results. Split thickness skin-grafts seem to be of limited value in the repair of the defects.
The Hoffman transfixation equipment for fracture fixation gives simultaneously an excellent fixation of a flap in cross-leg procedures. Because of these favourable results in 42 cases this method for the fixation of the extremities in predicle flap procedures is recommended. It is possible to divide the flaps much earlier than is customary. In this material half of the flaps were divided on the 14th day or earlier. One or two preoperative flap delays are recommended. The method produces safer and faster healing of the flap.
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