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C W van Way

Publications and source records attributed to C W van Way.

3 recordsLinked to original sources
PubMed1994

A comparison of nerve grafting and tissue expansion techniques in the rat.

This study compares nerve repair following tissue expansion with nerve repair using an interposed graft in the rat. Group I had expansion conducted over 2 weeks at 40 mmHg. A 4 mm segment was excised from the lengthened nerve and repaired primarily. Group II had a 4 mm segment of nerve excised and then replaced as an interposition graft. Group III was sham-operated controls. Thirteen weeks postoperatively, all animals were evaluated using walking track analysis. Thirty-five rats finished the study: Eleven in group I, 10 in group II, and 14 in group III. The Sciatic Functional Index (SFI) was calculated for each group as follows: group I, -57 +/- 11 (mean +/- standard deviation); group II, -59 +/- 25; group III, -13 +/- 6.5. The control group was significantly better than either experimental group (P < 0.01). The two experimental groups were not statistically different. Nerve repair following expansion allowed only one coaptation to be used. Functional results were the same as with interposition grafting. Repair by the expansion technique would eliminate the need to harvest a nerve graft, and the subsequent donor defect.

Animals↗
PubMedDate not supplied

Venous gas embolism associated with argon-enhanced coagulation of the liver.

Argon-enhanced coagulation (AEC) is a method for operative coagulation of tissues that utilizes a jet of argon gas encompassing an electrofulguration arc. Concern has been raised that the argon jet may produce harmful venous gas embolization. Two questions were addressed by this study. First, does AEC result in generation of venous gas emboli, and if so, what is the influence of gas flow rate and coagulation power on the amount of gas emboli generated? Second, does the amount of venous gas emboli generated by AEC produce harmful hemodynamic effects? Two AEC units were evaluated during coagulation of cut sections of the liver in pigs. The number of gas emboli generated was measured by an ultrasonic Doppler flow cuff placed around the caudal vena cava. Hemodynamic variables measured following AEC included systemic and pulmonary arterial pressure, pulmonary wedge pressure, and cardiac output by thermodilution. Venous gas emboli were produced during AEC of the liver. The number of gas emboli generated increased with increasing gas flow rates, but was not affected by coagulation power. No change in any of the measured hemodynamic variables was observed following AEC of the liver. The following recommendations were made: (1) Surgeons using AEC should select an argon flow rate as low as feasible to clear a bleeding tissue surface of blood and debris. (2) Although AEC seems to be associated with tolerable amounts of venous gas embolism, surgeons and anesthesiologists should be aware that the potential for harmful venous gas embolism exists. (3) In patients where extensive use of AEC is planned, appropriate monitoring and precautions for gas embolism should be undertaken.

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