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Biomedical subjects

D M Wise

Publications and source records attributed to D M Wise.

15 recordsLinked to original sources
PubMed1999

The role of plastic surgery in the management of airway obstruction.

A patient with the rare genetic disease of mitochondrial oxidative phosphorylation is presented. The phenotypic presentation included localized, idiosyncratic lipodystrophy that caused life-threatening respiratory obstruction. Plastic surgical excision and suction-assisted lipoplasty of huge deposits of fat and skin led to marked improvement in patient posture and ventilation. This rare disorder, stages of treatment, and salient references are discussed.

Adipose Tissue↗
PubMed1983

Familial hemifacial microsomia.

Hemifacial microsomia, a relatively distinct clinical form in the Facio-Auriculo-Vertebral Spectrum is generally thought to be a sporadic event, although infrequent familial occurrences have been reported. In this communication, we describe a family with three males and two females in two successive generations affected with hemifacial microsomia. The pedigree is most compatible with autosomal dominant inheritance, although X-linked dominant or multifactorial inheritance cannot be excluded.

Ear, External↗
PubMed1982

The groin flap in severe hand injuries.

We reviewed 27 patients who required 28 groin flaps for repair of hand injuries. Flap necrosis due to ischemia developed in 18% of the patients. Flap ischemia did not develop after elevation of the flap or partial division of the pedicle. All flap necroses occurred after final (total) division of the pedicle (p less than 0.05). Flap necrosis was more common following immediate insetting of the flap than after delaying the inset, but this difference was not statistically significant. Flap necrosis did not develop if the pedicle was divided in two stages, with the first stage consisting of either preliminary ligation of the superficial circumflex iliac vessels or full-thickness division of a portion of the width of the flap. Our complication rate was much lower than that previously reported for groin flaps.

Adolescent↗
PubMed1981

Lacrimal gland adenoid cystic carcinoma: intracranial and extracranial en bloc resection.

Adenoid cystic carcinoma of the lacrimal gland is a rare tumor, although it is the malignancy most frequently arising in the gland. Treatment has been unsuccessful generally, with a 15-year survival of less than 20 percent. Our experience with this tumor in a 61-year-old woman has led to a proposal for therapeutic management based on awareness of the lesion's natural history, an understanding of regional anatomy, and familiarity with therapies reported in the literature. The feasibility of adequate tumor ablation is determined from preoperative evaluation, including CT scan, initial exploratory craniotomy, and frozen-section examination of the cranial nerves transversing the orbit. Once resectability is confirmed, "curative" intracranial and extracranial en bloc resection is performed, including the tumor, the lacrimal gland, and all contiguous structures. The defect is immediately resurfaced with and "ice cream cone" forehead flap in anticipation of adjuvant radiotherapy. An orbital prosthesis is fitted as soon as the radiation reaction subsides, and a postablative CT scan is obtained as the baseline for follow-up. It remains to be seen whether this application of the technology of CT scanning and the techniques of craniofacial surgery will improve the prognosis for adenoid cystic carcinoma arising in the lacrimal gland.

Carcinoma, Adenoid Cystic↗
PubMedDate not supplied

Keloid scar of the face.

Although all the consultants agreed that this patient deserved to be treated, they disagreed as to the method. Dr. Wise suggested excision of the scar with postoperative irradiation. Dr. Thomas would excise the scar, inject the lesion with steroids intraoperatively and postoperatively, and apply a pressure dressing. Dr. Cook would not operate at all and favored intralesional injection of steroids. When used, Kenalog was the steroid preparation of choice. Dr. Wise would not use steroids in this situation because of the possible complications of skin atrophy, change in pigmentation, and telangiectasias. Dr. Thomas would avoid low-dose irradiation for fear of inducing a head and neck malignancy. Dr. Cook would avoid all surgical intervention, believing that it would only compound the present problem. All consultants agreed that the patient deserved close follow-up, and that he was at risk for similar scar formation in the future. They also pointed out the genetic predisposition for his offspring to have similar problems.

Adult↗