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Biomedical subjects

D J Millay

Publications and source records attributed to D J Millay.

6 recordsLinked to original sources
PubMed1991

Vasoconstrictors in facial plastic surgery.

The effectiveness of local anesthetics is improved by the addition of a vasoconstrictor with an increased duration of action and the ability to decrease both systemic toxic reactions and local bleeding. Epinephrine, the standard drug for vasoconstriction, has some limitations due to potential cardiac and local toxic effects. Using an animal model, we compared the effects of various concentrations of epinephrine and two other vasoconstrictors, phenylephrine hydrochloride and felypressin, on local blood flow. We also examined the local effects of bupivacaine hydrochloride and ropivacaine hydrochloride, a new local anesthetic. We found that felypressin was as effective a vasoconstrictor as epinephrine, with fewer potential toxic reactions. Phenylephrine (Neo-Synephrine), on the other hand, was less effective, with a shorter duration of action. As expected, bupivacaine produced vasodilation, while ropivacaine was found to have vasoconstrictive properties.

Amides↗
PubMed1990

Demineralized bone. Implant resorption with long-term follow-up.

The osteoinductive properties of demineralized bone have stimulated its use in facial skeletal augmentation and reconstruction. Demineralized bone has been shown to induce phenotypic conversion of mesenchymal cells into osteoblasts, with bone formation within 29 days (osteoinduction). In this clinical study, 75 demineralized bone implants were followed up from 1 to 48 months (average follow-up, 14.3 months). There were 41 major dorsal implants, with an average degree of resorption of 50.7%. Eight dorsal implants were followed up for more than 24 months, with an 82.5% degree of resorption. Overall resorption for all implants was 49%. Major factors contributing to implant resorption included lack of surrounding mesenchymal cells and inadequate contact between host tissue and bone-inducing surface area. Other factors included infection, poor vascularity, and compression of the implant. Demineralized bone has an unacceptably high resorption rate and should only be used in highly selective cases where the implant can be positioned in a site rich in primitive mesenchymal or bone-forming cells.

Bone Density↗
PubMed1989

Ptosis and blepharoplasty surgery.

Acquired senile ptosis of the upper eyelid is a common condition in the elderly population and is often accompanied by varying amounts of dermatochalasis, which may mask its presence. Blepharoplasty of the ptotic lid, without repair of the ptosis, may result in exaggeration of the drooping eyelid postoperatively. Acquired senile ptosis is produced by dehiscence or disinsertion of the levator aponeurosis and is characterized by a high or absent eyelid crease, thinning of the upper eyelid tissue, and normal levator function. Frequent causes of acquired ptosis include dermatochalasis, eyelid edema from trauma or allergies, previous ocular surgery, or use of contact lenses. When discovered, repair of the ptosis should be performed at the time of blepharoplasty to produce the best functional and cosmetic result. It is important for every surgeon who performs blepharoplasties to be aware of the presentation and management of acquired senile ptosis for consistent surgical results.

Aged↗
PubMed1987

Wound healing and the Shaw scalpel.

The Shaw heated scalpel is now widely used in head and neck surgery because it provides better hemostasis intraoperatively. Concerns persist over the immediate and long-term effects of this instrument on wound healing. This study compares heated and unheated Shaw scalpel incisions in the skin of 7-week-old piglets. Tensile strength measurements and histologic evaluations were made at frequent intervals up to nine weeks after incision. Histologic studies showed no differences in the two groups at any time in the study. Tensile strength of wounds was significantly less two weeks after incision in the Shaw scalpel group, but following that time, the wounds increased in strength, and by seven weeks, the two groups were equal in this respect. Thus, we conclude that the Shaw scalpel wounds in pigs are, ultimately, similar to standard scalpel wounds, although there is a period of diminished tensile strength.

Animals↗