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Biomedical subjects

B M O'Brien

Publications and source records attributed to B M O'Brien.

At least 127 records · Page 7Linked to original sources

Results of the use of autotransplantation of the intraabdominal testis using microsurgical vascular anastomosis.

This study indicates that where facilities are available, the use of autotransplantation of the intraabdominal testis with microsurgical anastomosis to vessels of the groin is an acceptable, and possibly the best, alternative to orchidectomy for the intraabdominal testis. It is certainly justifiable in the case of the bilateral intraabdominal testis but in the case of the unilateral intraabdominal testis with a normally descended and apparently normal testis in the opposite hemiscrotum, the incresed incidence of neoplasia in intraabdominal testes should be taken into account in the decision on the method of treatment.

Adolescent

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.

Thumb reconstruction requires accurate functional and esthetic approximation to the original. Accepted methods generally have some deficiencies, particularly in appearance, and frequently the secondary morbidity is unacceptable. A method of thumb reconstruction with the use of an iliac crest bone graft and a free neurovascular "wrap-around" flap from the big toe is described that combines the attributes of previous methods without their secondary morbidity.

Adult

The surgical repair of amputations of the thumb.

Twenty-four thumb mutilations have been repaired by using either whole toe transfers or portions of the big toe for reconstruction. The hallux has many of the properties uniquely suitable for thumb reconstruction. Its total sacrifice, however, leaves a significant defect in the foot, and it is usually too big to look convincing as a thumb. Essential portions of it can be transferred without undue deformity in the foot, and these, in combination with an iliac crest bone graft, can be modelled into a most aesthetic and functional thumb.

Amputation, Traumatic

The histopathology of microlymphaticovenous anastomosis.

Histopathological studies are described on 30 biopsy specimens of lymphaticovenous anastomoses ranging from two days to eight months following operation. Sixteen were patent and 14 were occluded. It was observed that in the non-patent specimens occlusion stemmed from the venous component. The prime determining factor in the success of the anastomosis was the achievement of correct apposition of the cut edges of the vessels, and this was directly dependent on the number and spacing of the sutures as well as the tension applied at their insertion. Correct apposition is more easily achieved with these delicate thin-walled vessels by better visualization afforded by the use of the operating microscope and appropriate instrumentation. The slow rate of repair in this situation is emphasized.

Animals

Patency rates in end to side anastomoses in the rabbit.

It is suggested that more widespread use of the end to side microvascular suturing technique should be made, especially in arteries. A simple experimental practice model in the rabbit is suggested. Patency rates comparable to end to end anastomosis can be achieved.

Animals

The effects of suturing technique and vessel size on patency after microarterial repair.

According to most of the literature, sutures for microarterial repair must include the intima to prevent an "intimal flap" and occlusion of the anastomosis. Some authors have said that vessel diameter affects patency rate. This study was designed to evaluate these two statements. The femoral arteries (about 1.0 mm in diameter), the epigastric arteries (about 0.5 mm), and the central ear arteries (about 0.5 mm) of rabbits were studied. Alternate arteries were repaired using conventional suturing techniques or sutures which included the adventitia and media but excluded the intima. The patency rate in the 1 mm or 0.5 mm vessels was not affected by inclusion or exclusion of the intima from the microarterial repair. The patency rate for conventionally repaired arteries 1 mm in diameter was significantly higher than that for 0.5 mm arteries.

Abdominal Muscles

Lymphaticolymphatic anastomosis.

Lymphaticovenous anastomosis has proved valuable in the treatment of obstructive lymphedema. Histological studies of this anastomosis have shown the lymphatic component to be almost inactive in anastomotic healing. In order to clarify the role of the lymphatics, experimental lymphaticolymphatic anastomoses were performed in canine femoral lymphatics. The technique developed calls for eight to ten 19 mu sutures to prevent vessel wall collapse, and preservation of the vasa vasorum. Vessels were harvested from one hour to six weeks after anastomosis. Scanning electron microscopy and conventional light histology revealed the lymphatics to have active healing of the intima with complete reendothelialization by two weeks. The techniques developed in this study are directly applicable to human lymphaticovenous anastomosis.

Animals