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Biomedical subjects

C R Hartrampf

Publications and source records attributed to C R Hartrampf.

36 records · Page 2Linked to original sources
PubMed1986

Conservative treatment for breast cancer. Complications requiring reconstructive surgery.

Women who select conservative treatment for carcinoma of the breast (tumor excision followed by supervoltage radiation therapy) place a premium on breast preservation and aesthetics. When local control fails and they require a mastectomy, or when the aesthetic appearance is unacceptable, they may request breast reconstruction. The goal of this study is to evaluate a series of 10 patients who required reconstructive breast surgery after complications of conservative treatment. Patient classification: I. Breast or chest wall necrosis (3). II. Breast fibrosis and gross asymmetry (3). III. Local recurrence of breast cancer (5). IV. Positive margins after the initial lumpectomy (1). The mean age was 34 years. Radiation dosage average was 5252 rads with two patients receiving iridium-192 implant boosts. The reconstructive management was complex and usually required a major musculocutaneous flap because of the radiation effects.

Adult↗
PubMed1984

Cleft lip type nasal deformity: definitive repair.

The problem of the cleft lip nasal deformity is one of understanding the specific anatomical defect and providing proper correction. Each may depend on good exposure. This article is not intended to review the literature, but rather to make a statement in this regard. An approach is taken which outlines the nature of the typical deformity and a method of definitive correction with the aid of a midface avulsion flap for total exposure. Cases are presented for illustration. This technique can be used with other associated corrective maneuvers simultaneously as appropriate (such as repair of fistulae, septal corrections, floor changes, and so on). The exposure principle can be adapted to many difficult midface or nasal surgical needs.

Adolescent↗
PubMed1984

Abdominal wall competence in transverse abdominal island flap operations.

This study critically evaluates the abdominal wall in 82 patients following breast and chest wall reconstruction using the transverse abdominal island flap operation. Experience with these patients led to an awareness of the important muscle and ligamentous structures in the anterior abdominal wall. An operative procedure is presented for selective harvesting of the transverse abdominal island flap in a manner that preserves viability of the flap and at the same time reestablishes abdominal competence.

Abdominal Muscles↗
PubMed1984

A dermal-fat flap for nipple reconstruction.

A refinement in technique for nipple reconstruction utilizing local tissue is described. The operation has been performed on 31 patients who have previously undergone the transverse abdominal island flap breast reconstruction. The longest follow-up is 12 months. Preliminary results appear excellent with desired nipple size and projection.

Adipose Tissue↗
PubMed1983

Tailoring of the new breast using the transverse abdominal island flap.

In the past 2 years we have moved from a period of amazement to an era of refinement in breast reconstruction using the transverse abdominal island flap (Fig. 9). It is essential that more effort be concentrated on improving the shaping of the new breast once the flap is brought safely to the chest. Important elements of this shaping include: Thorough preoperative planning. Use of the contralateral rectus pedicle. Discarding of skin from the scar to the inframammary line on the chest wall. Understanding of the tissue needed for each quadrant of the new breast. Proper orientation of the flap on the chest wall. Initial pivot suture around which the flap is shaped. Avoidance of excessive internal suturing. While we believe the preceding principles to be fundamental to the creation of the new breast using this flap, each surgeon must utilize his or her own creativity, insight, and training to maximize the tremendous advantage of versatility that this flap provides.

Breast↗
PubMed1982

Breast reconstruction with a transverse abdominal island flap.

A rectus abdominis musculocutaneous island flap for breast reconstruction following mastectomy is presented. The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy. Cadaver dissections are shown, demonstrating the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap. The surgical technique is demonstrated and representative patients are shown.

Abdominal Muscles↗
PubMed1981

Surgical management of heel ulcers--a comprehensive approach.

Reconstruction of the ankle, heel, and foot remains a challenging, often frustrating problem for surgeon and patient alike. Little local soft tissue is available for the reconstruction, and often the underlying disorder precludes use of some procedures. The ankle and the heel are vital musculoskeletal structures, responsible for shock absorption, weight-bearing, and locomotion, and their dysfunction inflicts discomfort and disability on the individual that commonly lasts many months or even over a year. Soft tissue defects on the weight-bearing versus the nonweight-bearing surfaces present two quite different problems. Many surgical modalities, beginning with a skin graft and ending with microvascular transplantation of sensile tissues, are now available to the reconstructive surgeon for resurfacing the sole of the foot. We present a classification of heel ulcers based on their etiology, location, size, and the status of the peripheral circulation; offer new operative modalities and update the operations already available; and suggest an orderly approach to selecting an operation for reconstructing the foot.

Adolescent↗
PubMedDate not supplied

Breast reconstruction: progress in the past decade.

There have been numerous advances in breast reconstruction techniques of the past decade. The disappearance of the radical mastectomy along with the increased frequency of smaller tumor detection have contributed significantly to these changes. Furthermore, reliable studies have shown that breast reconstruction does not interfere with extirpative surgery or delay postoperative adjuvant therapy if indicated. Studies such as these have led increasing numbers of women to elect immediate breast reconstruction as opposed to delaying that reconstruction for months or even years after the tumor extirpation. The advent of successful breast reconstruction using autogenous tissue provided the most radical change to reconstructive techniques over the past 10 years. The TRAM (transverse rectus abdominis myocutaneous) flap was the first of these techniques to be introduced and has rapidly assumed a position of prominence among those techniques chosen for breast reconstruction. The LTTF (lateral transverse thigh flap) and the buttock flap, while requiring microsurgical technique, are important alternatives for those patients who choose autogenous tissue breast reconstruction and should be presented to women during the discussion of alternatives for breast reconstruction. Implant technology has continued to improve with the introduction of the tissue expander, the most important addition in the past decade. Investigations are currently underway to provide a long-term tissue expander that does not have to be removed and replaced by a permanent implant. The ultimate end result would be to create a more normal breast shape without firmness. And the use of stacked or directional expanders may allow more freedom in creation of the new breast shape to conform to the opposite side. Finally, nipple areola reconstruction has improved significantly as the tissues of the breast mound itself are used for the new nipple and areola, thereby avoiding the transfer of grafts from distant sites which do not generally maintain their size or projection over time.

Adult↗