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Biomedical subjects

E H Schmitt

Publications and source records attributed to E H Schmitt.

5 recordsLinked to original sources

Experience with one hundred consecutive free flaps.

Our first 100 free flap operations are reviewed. The location and cause of the defects requiring free flaps, the flaps used, and the outcome are tabulated. The lower leg was the most common site of defect. Osteomyelitis and trauma were the most common causes. The latissimus dorsi and tensor fascia lata were the most useful flaps. Of the 15 patients with failed flaps, wound closure was accomplished by other methods in 13 and 2 underwent amputation. One of the patients with a successful free flap ultimately underwent amputation because of recurrent osteomyelitis.

Adolescent↗

Vascularized muscular and musculocutaneous flaps for management of osteomyelitis.

Thirty-three cases of recalcitrant osteomyelitis treated by free tissue transfer are reviewed. The immediate success rate was 76 per cent; however, on follow-up for at least 1 year, there was a 12 per cent rate of recurrent drainage. The authors conclude that this is a good operation for this problem but that it is not a panacea because if followed long enough, a significant number of patients will develop recurrent drainage.

Adult↗

Surgical treatment of radiation induced injuries of the intestine.

In the patient who has received high dose irradiation of the pelvis and abdomen, all abdominopelvic operations should be avoided, unless it is absolutely essential. Persisting obstruction, hemorrhage, intestinal perforation with peritonitis and with abscess and fistula formation are valid indications for surgical intervention. Ninety-three patients have been operated upon for these complications after irradiation. Some anastomotic dehiscence occurred in ten patients. Six operative deaths occurred. Of the 93 patients, 65 were managed by means of complete resection of the involved segment of intestine, followed by restoration of intestinal continuity by means of an end-to-end anastomosis. This is the treatment of choice when the involved area can be safely resected. In the absence of actual intestinal necrosis and when segments of strictured small intestine are adherent deep in the pelvis, and intestinal bypass procedure may represent the treatment of choice. This was accomplished in 20 patients, two of whom eventually required a second operation for resection of the bypassed segment of intestine.

Adult↗

Is coronary artery bypass in the community hospital justifiable?

Coronary artery bypass can be performed at the community hospital level with results comparable to those in major university centers. Four hundred and ninety-seven patients were operated on between 1970 and 1976 with an overall early mortality of 4.4% (2.6% for coronary artery bypass only) and improvement in the quality of life in 88% of patients.

Adult↗