Biomedical subjects
Publications and source records attributed to C L Puckett.
Forty-six patients with ulnar artery thrombosis were evaluated. A comparison of the results was made between those patients who were treated by sympathectomy and those in whom we attempted to reestablish the blood flow. A reverse vein graft was often used in the latter group. Based on the results of this study, we believe the preferred method of treatment for ulnar artery thrombosis is an attempt at the reestablishment of blood flow.
A technique for construction of external male genitalia in a transsexual patient is presented in detail. The McGregor groin flap is used for penile construction, and the Scott inflatable prosthesis is used to produce an erection. The shape of the penis is improved by secondary local excisions, and the clitoris is bivalved and inserted at the base of the penis to allow sexual sensation. The appearance and the function of the constructed genitalia have been deemed quite satisfactory by this transsexual patient.
The psychosocial deformity associated with total lack of facial animation (as seen in Möbius syndrome) is an extremely crippling situation. This inability to show happiness, sadness, or anger by facial expression frequently results in severe introversion and a reclusive personality. Restoration of even a minimal degree of controlled facial movement is beneficial. Recent experience in the treatment of two patients with this syndrome using both dynamic and static procedures has been most rewarding. Operating simultaneously on both sides of the face poses some problems that are different from those in teh patient with unilateral paralysis. The operative details are described, with preoperative and postoperative evaluation.
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We have done subpectoral augmentations on 100 women to enlarge the small or hypomastic breast to a pleasing degree. These operations were performed in a major hospital operating room, under local anesthesia, on an ambulatory basis. No complications were encountered. Our goal, and that of our patients, was to enlarge the small breast to a pleasing degree which would harmonize with the body contour and form, and to maintain the natural consistency of the breast and the normal sensation of the nipple and the breast as a whole. This goal was reached and our patients have been appreciative and pleaded. There was no postoperative weakness of the pectoralis muscle, and we have seen no evidence of capsule contracture. The group represents about one percent of our overall experience with augmentation mammaplasty.
A patient is presented who presumably had multiple drugs injected intra-arterially in the right hand. Clinical signs and angiographic evidence of severe vascular insufficiency were well demonstrated. Therapy with fibrinolysin, reserpine, and heparin was followed by a return of normal circulation.
Sixteen patients with refractory primary and secondary lymphedema have had multifilament Teflon wick lymphangioplasties during the past 10 years. There were no operative deaths or operative complications. All patients experienced an early reduction of their edema, with objective improvement lasting 6 months to 5 years. The average duration of benefit was 13 months. Subjective improvement has lasted to 7 years. Lymphangioplasty is simple, virtually free of complications, and offers periods of control of edema and cellulitis that compare favorably with those obtained by other operative procedures. It should be considered for the management of patients with incapacitating lymphedema, especially those patients with a limited life expectancy.
We present a simple operation, performed under local anesthesia, to restore essential movement to the side of a lower lip paralyzed by injury to the mandibular branch of the facial nerve. The operation consists of a limited lateral resection of the paralyzed lower lip, plus transposition of the segment of orbicularis muscle from the paralyzed lower lip to the normal upper lip, through a subcutaneous tunnel.
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