PubMed Health⌕ Search

Biomedical subjects

B M Achauer

Publications and source records attributed to B M Achauer.

At least 109 records · Page 6Linked to original sources
PubMed1979

Transcutaneous PO2 monitoring of flap circulation following surgery.

In a series of rabbit experiments, tcPO2 was found to be a very sensitive indicator of flap viability, reflecting minute-to-minute changes in physiology. It is safe, reproducible, and easily verified by comparing flap tcPO2 to a control site and by measuring response to increased FIO2. Transcutaneous PO2 measurements should prove a valuable tool in flap research and in monitoring pedicle flaps and microvascular tissue transfers.

Animals↗
PubMed1978

Genesis of a replantation program.

Development of a replantation program entails establishment of microsurgical skills in the laboratory, training in clinical microvascular technics, supervision, if possible, in the first microvascular free flaps, and close liaison with supporting personnel who transport patients, care for them acutely, and carry out their rehabilitation. Of twenty-six replantations or revascularizations (14 incomplete and 12 complete), twenty-three were successful. The three failures (1 complete and 2 incomplete procedures) were all digits, and each was part of a multiple digit injury.

Amputation, Traumatic↗
PubMed1977

Free osteocutaneous flap from a rib to the tibia.

A large bony defect of the tibia, covered with thin unstable scar, was repaired successfully with a free osteocutaneous flap composed of 10 cm of the ninth rib with a 9 X 6 cm area of overlying muscle and skin. Microvascular anatomoses were done between the intercostal vessels in the transplant and the anterior tibial vessels in the recipient area.

Adult↗
PubMed1976

Burns of the foot.

The most severe trauma a patient can sustain is a major burn. When a person is seriously burned, initial care begins with maintaining an adequate airway and adequate blood volume and urinary output by intravenous fluids. After the patient has been stabilized, the wound is of primary importance, and postage stamp split thickness grafts are used for skin coverage. When these are secure and a maximal range of motion has been obtained, reconstructive procedures should be started.

Burns↗
PubMedDate not supplied

Determination of burn depth with noncontact ultrasonography.

Early excision and grafting is the current treatment of choice for deep dermal and full-thickness burn wounds that will not heal spontaneously within 3 weeks. The time needed for the burn wound to heal is estimated with clinical assessment of the burn depth; this is often an inaccurate method. Therefore we have developed a new and unique noncontact ultrasonographic method to estimate burn depth. This study was designed to determine the practical utility and accuracy of noncontact ultrasonography for the assessment of burn depth. Seventy-eight burn sites and 42 normal skin sites (control sites) of 15 patients (age, 18-63 years) with burns of 2% to 35% total body surface area were evaluated. The burn sites were scanned with a prototype noncontact ultrasonographic system 1 and 3 days after the burn injuries. The probe was held 1 inch from the skin, and the time spent on each site was approximately 5 minutes. The ultrasonographic results were interpreted by an investigator who was blinded to the clinical findings. Clinical assessment of the burn wounds was made on the same days by 2 experienced physicians who were blinded to the results of the ultrasonography. The investigators were asked to categorize the burn wounds into those that would heal within 3 weeks and those that would not. With this method, we were able to visualize the epidermis, dermis, and dermal-fat interface in normal skin. The destruction of the dermal-fat interface was interpreted as a deep burn, which would not heal within 3 weeks. The overall accuracy of the noncontact ultrasonography in the prediction of which burn wounds would heal within 3 weeks was 96%. The results of this study show that noncontact ultrasonography will allow for the rapid evaluation of burn depth with high accuracy, without contacting the patient, and without causing pain or discomfort.

Adult↗
PubMedDate not supplied

Burn depth evaluation with fluorometry: is it really definitive?

Clinical evaluation of burn depth soon after injury is subjective, based on gross visual assessment. Previous investigators have quantified this process using fluorometry. Their studies show fluorescein levels in full-thickness burns to be far below control levels and partial-thickness burns to be about 60% of nonburned skin. In both rat and human models, 59 burn sites (eight rats) and 37 burn sites (seven patients) were assessed. Readings were taken for three hours on the rats and one hour on the patients during the first 48 hours, and the procedure was repeated for five days postburn. Maximum values during these periods were determined for burn and nonburn sites, and background levels were subtracted from these values. The rate of fluorescein uptake and the peak times for burn and nonburn sites were then compared. Actual depth of burn was determined by whether or not healing had occurred. The results showed no significant difference between partial-thickness and full-thickness burns using fluorometry, as standard deviations in both models for both depths of burn were large. Therefore, fluorometry did not provide a definitive evaluation of burn depth. These results differ from those reported by previous investigators.

Animals↗
PubMedDate not supplied

Burn excision with intraoperative vasopressin.

Reducing blood flow to the skin during burn wound excision should decrease blood loss, which remains a major problem during primary excision of large burns. This clinical investigation demonstrates that arginine-vasopressin appears to reduce intraoperative blood loss and is relatively free of complications. This treatment has potential benefits for the patient with small burns as well. The amount of banked blood required could be greatly reduced, thus decreasing the risks of transfusion and the cost of burn care.

Adult↗
PubMedDate not supplied

Reconstructive allotransplantation: considerations regarding integumentary/musculoskeletal grafts, cyclosporine, wound coverage in thermal injury, and the immune response.

With the advent of cyclosporine, a powerful and selective immunosuppressant, comes resurgence of a long-sought goal: to transplant modules of allointegumentary/musculoskeletal tissues or components thereof for the repair of peripheral tissue defects. Because these modules of integumentary and/or musculoskeletal tissue are actually composites of various tissues, they are also known as composite tissue allografts. The immediate goal of the studies reviewed herein is to lay the foundation in transplant immunobiology for the clinical exploitation of composite tissue allografts. The objective of these continuing studies is to induce permanent acceptance of composite tissue allografts. The value of such grafts lies in their potential for complete functional and cosmetic restoration in the surgical reconstruction of tissue after full-thickness burn injury. The initial results of basic experiments with cyclosporine are extremely encouraging in regard to the clinical potential for integumentary/musculoskeletal grafts in reconstructive allotransplantation.

Burns↗