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Biomedical subjects

D J Hodgkinson

Publications and source records attributed to D J Hodgkinson.

At least 19 recordsLinked to original sources

Reconstruction of the upper lip with lip switch (Abbe flap reconstruction).

The lip switch operation (Abbe) is useful for full thickness defects of the upper lip. Careful design of the flap with pedicle take-down and inset of the flap after 2 weeks, leads to a predictably good reconstructive result. The flap is most useful for 30-50% full thickness defects of the upper lip.

Basal Cell Carcinoma

The use of mimetic musculature in facial reconstruction.

Skin malignancy of all types is prevalent in Australia and the incidence is rising. Reconstruction of post-surgical excision defects in the face can be facilitated by the use of myocutaneous flaps using facial mimetic musculature. The mimetic musculature can be partially sacrificed without the loss of discernible facial tone or expression. Examples of their use include the frontalis, orbicularis oculi, nasalis, procerus, levator labii superioris, mentalis, orbicularis oris, platysma and SMAS. Myocutaneous flaps in the face enjoy the same advantages of increased skin viability as they do elsewhere in the body. Their use in the face is superior to the cosmetic results obtained by skin grafting alone or distant skin flap giving better colour match, increased vascularity and appropriate bulk when subcutaneous tissues and muscles have also been sacrificed in the initial extirpation of the skin malignancy.

Adult

The olecranon bone graft for nasal augmentation.

The olecranon bone graft offers an alternative to the cranial bone when autogenous material is preferred in the repair of moderate deficiencies of the nasal dorsum. The predictably thick cortex of the olecranon allows the crafting of a customized implant, and minimal donor site morbidity makes it a safe alternative to the cranial graft.

Adult

Chest wall deformities and their correction in bodybuilders.

Torn pectoralis major muscles are either treated acutely by orthopedic surgeons or, if neglected, result in deformities of the pectoralis muscle. These deformities are visible, with pectoralis muscle asymmetry, especially on muscle contraction. Bodybuilders prone to this injury accentuate the asymmetry by contracting the pectoralis muscles together. Late repair is not usually possible, and cosmetic improvement relies on removing the bulging, unattached muscles or camouflaging the underlying exposed ribs with a customized implant. Similar customized implants are used to repair pectus excavatum. Techniques must take into consideration the desire for accentuation of the pectoralis muscle with minimal visible scarring. The surgeon and the anesthesiologist should be aware of the possibility of anabolic steroid ingestion in the male body-builder.

Adolescent

Medial thighplasty, prevention of scar migration, and labial flattening.

As more people seek body contour surgery spurred on by the media's great interest in suction lipectomy and the seemingly increasing numbers of satisfied patients, we should re-examine an area where results of body contour surgery have been less satisfying, the inner thigh. In those patients whose problem remains skin flabbiness rather than excessive fat, either alone or after successful or partially successful suction lipectomy, an inner-thigh procedure is indicated.

Cicatrix

Scrotal reconstruction for giant inguinal hernias.

Giant inguinal hernias require special consideration for repair of the abdominal wall. The associated greatly thickened, enlarged scrotum should be discarded and a neoscrotum should be reconstructed from the uninvolved perineal-scrotal skin. A cloverleaf design flap is used for this reconstruction.

Abdominal Muscles

Aesthetic vaginal labioplasty.

Labia minora that protrude past the labia majora are aesthetically and functionally unsatisfactory to some women. Historically, female circumcision has been practiced in Islamic/Arabic countries for many centuries and is still commonly practiced in these countries. Three case reports present middle-aged women who were dissatisfied with the size and protuberance of the labia minora, and an aesthetic labioplasty was performed in these three women. The technical aspects of this procedure are outlined, and a representative case with 3-month follow-up is presented pictorially.

Adult

Subungual osteochondroma.

Subungual osteochondromas are rare tumors that occur in the toes and fingers. This case report of a large subungual tumor of the right ring finger demonstrates the classic radiologic features and successful management of a large tumor by complete excision of the nail bed and the tumor and reconstruction of the distal nail bed with a split-thickness nail bed graft from the great toe.

Chondroma

Umbilicoplasty: conversion of "outie" to "innie".

The protuberant "outie" umbilicus is regarded by some patients to be unattractive and undesirable. Surgical conversion of the protuberant umbilicus to a tubular structure is accomplished by excising the mass of umbilical scar and utilizing 2 skin flaps, one to line the reconstructed tube and the other to form the superior hood of the tubular "innie" umbilicus.

Humans

Muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction.

Four cases of forearm defects requiring reconstruction are presented to demonstrate the usefulness of muscle musculocutaneous and fasciocutaneous flaps in forearm reconstruction. The forearm is divided into four zones--cubitoolecranon, proximal and middle one-third, distal one-third, and wrist--for purposes of discussing the scope of these different flaps. Muscle flaps are useful for defects in all zones except the distal forearm, where fasciocutaneous flaps are available; however, the superficial forearm muscles and tendons should be included to prevent interference with fascial blood supply.

Adult

Scrotal reconstruction for giant inguinal hernias.

A case of inguinal hernia with massive scrotal enlargement is presented. Walking and voiding had become extremely difficult for the patient; only one testicle could be palpated, and the penis could not be delivered from the scrotal mass. Surgical reduction of the massive hernia was accomplished. The right testis with its spermatic cord had to be sacrificed; the left one was normal, although the cord was elongated. The main bulk of the enlarged scrotum was excised, and a neoscrotum was created from perineal skin; orchiopexy on the left was carried out. Healing has been uneventful.

Aged