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Biomedical subjects

B Sundell

Publications and source records attributed to B Sundell.

15 recordsLinked to original sources
PubMed1992

The impact of adjuvant radiotherapy and cytotoxic chemotherapy on the outcome of immediate breast reconstruction by tissue expansion after mastectomy for breast cancer.

In an attempt to evaluate the impact of radiation therapy and cytotoxic chemotherapy on the outcome of immediate breast reconstruction by tissue expansion after mastectomy a prospective study on 32 patients was performed. The radiation therapy significantly worsened the surgical outcome, because the irradiated patients more often had pectoral muscle stiffness making the expansion more painful and the reconstructed breast too small, hard and with insufficient ptosis to obtain a natural breast mould. These results indicate that this technique should be avoided in patients likely to receive postoperative adjuvant cytotoxic chemotherapy and radiation therapy, thus reducing the indication to a small group of patients undergoing mastectomy for widespread ductal carcinoma in situ.

Adult↗
PubMed1992

Treatment of solitary plasmacytoma of the femur. A case report.

In radical tumour surgery the inevitable bone loss is considerable. If in addition the local tissues at the tumour site have been damaged by radiation therapy, massive endoprosthesis or even amputation should be considered. In cases with large bone loss, a vascularized fibular graft is one possibility to bridge the resected region. A case of a young man with a solitary plasmacytoma of the upper femoral diaphysis is presented. The lesion was reoperated 3 years after the primary diagnosis with resection of the non-ossified tumour site and reconstruction with a vascularized fibular graft.

Adult↗
PubMed1991

The return of sensitivity to cold, warmth and pain from excessive heat in free microvascular flaps.

Recovery of sensitivity to cold, warmth and pain caused by excessive heat in various types of free microvascular flaps was studied psychophysically in 27 patients who had undergone such operations four months to four years earlier. A thermal stimulator based on the Peltier principle and controlled by a microprocessor was used to measure the sensitivity to temperature in the transplants. The results were compared with the measured thresholds in the opposite sites in corresponding normal body areas. The present study showed that sensitivity to cold, warmth, and pain caused by excessive heat did return to some free microvascular flaps. According to the measurements the sensation started to return after 6 months in some flaps, and all types of thermal stimuli were felt by one patient as early as 10 months after operation. The return was more pronounced in younger people and in smaller flaps. If the hands, feet, or head defects were reconstructed with a thin skin flap (posterior aspect of thigh, dorsum of foot, or subscapular) the recovery of sensitivity was verified. Sensation returned to the musculocutaneous and osteomusculocutaneous transfers if they were on the hands or the head, or if they were sutured to healthy tissue with normal sensation. The main advantage of the psychophysical sensory testing method that we used is that it gave exact numerical data that made it possible to compare results among the different patient groups and even those obtained at different clinics and laboratories.

Adolescent↗
PubMed1989

Recovery of sensation in free flaps.

A clinical study of touch, pain, warm and cold stimuli and two-point discrimination was performed in 27 free flaps four months to four years after the microsurgical procedure. There were 5 free skin flaps (2 with nerve suture), 15 musculocutaneous, 4 muscle-covered with split skin grafts and 3 osteomusculocutaneous flaps transplanted to various sites on the body. The results show full or nearly full recovery of touch and pain sensation in all free skin flaps. The musculocutaneous and osteomusculocutaneous free flaps developed good sensation if firmly grown onto the healthy recipient skin with normal sensation. Muscle flaps covered with split skin grafts and all flaps surrounded by scar tissue had a clinical absence of sensation. This study and our earlier findings of the regeneration of nerves in free skin grafts, in skin flaps and in experimental free flaps, lead us to suggest that the healthy denervated skin of the free flap provides a strong neurotrophic stimulus to the cut cutaneous nerves in the edges of the recipient skin. Cutaneous nerves freely regenerate in the loose subcutaneous tissue of the flap. We therefore conclude that all free flaps with skin islands have a potential for developing sufficient protective touch and pain sensation and even some superficial sensitivity.

Adolescent↗
PubMed1989

[Reconstruction of the foot using free flaps].

Microvascular free-flap reconstruction of the foot was performed during a seven-year period in 25 patients to repair soft tissue loss caused mainly by traumatic injury. A scapular flap was used in fifteen cases, a dorsalis pedis in three, a radial forearm in two, a latissimus dorsi in two, and a gluteal thigh, rectus abdominis and tensor fascia lata each in one case. Two flaps were lost because of postoperative vascular complications. Soft-tissue stability was excellent or good in all of the seven patients with a successful free-flap transfer to the non-weightbearing part of the foot and in eleven of the sixteen patients with a flap on the weightbearing part of the foot. Four patients had frequent superficial ulcerations of the graft but only one flap was completely unstable. Sixteen patients had normal or near normal ability to walk. Significant gait problems in seven patients were caused by skeletal deformity of the reconstructed foot or other associated injuries of the lower limb rather than the reconstruction itself. The best fit and contour was provided by thin skin flaps such as the dorsalis pedis and radial forearm flaps while the scapular flap offered a more inconspicuous donor site and could be used to cover large defects. Sensibility of the flaps assessed by clinical methods was less than normal in all cases. Good sensibility was found in the flaps of two children, fair in six, poor or very poor in fifteen, and two flaps had no sensibility. The level of sensibility was not related to the soft-tissue stability of the flap.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1979

Transposition of muscle flaps for covering exposed bone in the leg.

A muscle transposition technique for reconstruction of soft tissue loss and skin defects with exposed bone in the leg is described. Reconstruction with muscle flaps and freee skin grafts is a reliable and convenient one-stage operation. The gastrocnemius and soleus muscles were used to cover the upper and middle third of the leg. The method was used in 13 patients, and there were 3 failures in the series because of the impaired vascularity of the injuried leg. In 7 cases, including one failure, the soft tissue injury was associated with compound fractures. No functional disability was observed in the leg, ankle or foot after successful transposition of the muscle flap.

Adolescent↗
PubMed1976

The effect of dextranomer (Debrisan) on hand burns. A preliminary report on a new method in the treatment of hand burns.

Dextranomer (Debrisan, Pharmacia, Uppsala, Sweden) is synthetized by cross-linking of dextran chains with epichlorohydrin. It is an insoluble hydrophilic substance which is suitable for topical treatment of secreting wounds, such as burns. Thirteen patients with 17 burned hands were treated. The result of the treatment - decrease in pain, healing time and improved hand function - was registered clinically. No crust was formed. The risk of permanent restriction in range of movements decreased, since the treated hands were soft and mobile throughout the entire period of treatment. All hands treated recovered full mobility. Physiotherapy could be performed daily. No infection appeared because exudate and bacteria were continuously removed from the treated area. Pain rapidly decreased. No side reactions were observed.

Adolescent↗
PubMed1976

Late complications of scalding in children: treatment and prevention.

Children between the ages 1 to 3 years are particularly prone to burns by their constant desire to pull down containers of hot fluids. The resulting burns produce serious complications such as hypertrophic scars and scar contractures, which can be severe enough to cause growth disturbances. A series of 31 cases of these accidents resulting in the above sequelae was investigated. These complications are however the end result of a chain of unfortunate events any or all of which could have been avoided. Usually the scald could have been prevented by greater vigilance on the part of the parents. Once late complications have developed, excision of the scar tissue and subsequent skin grafting or other reconstructive procedure should be performed. However, in spite of satisfactory results, these complications have a tendency to recur during the growth period.

Burns↗
PubMed1976

Repair of skin and soft tissue loss of the lower leg with cross-leg flaps.

Forty patients with severe leg injuries associated with skin or soft tissue loss were treated. Cross-leg flaps were used. The flaps healed well. Special attention was paid to the pre- and postoperative periods of disability of the patients. The former were very long (37.7 months) compared to the latter (10.5 months) which ceased when the patient became fit for work.

Child↗