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Biomedical subjects

E Kiffner

Publications and source records attributed to E Kiffner.

17 recordsLinked to original sources

Efficacy and tolerance of a new gentamicin collagen fleece (Septocoll) after surgical treatment of a pilonidal sinus.

OBJECTIVE: Pilonidal sinus is common. It causes substantial loss of working hours. The major disadvantage of open wound treatment is the long time required for healing. Primary wound closure is on the other hand often followed by infection. A controlled, multicentre trial was carried out to evaluate the efficacy of a new gentamicin collagen fleece (Septocoll) combined with primary closure. PATIENTS AND METHODS: One hundred and three patients (88 men, 15 women, median age 30 years) were included. Fifty-one were randomised to gentamicin fleece plus primary closure (Genta Group), and 52 patients to open treatment alone (Open Group). RESULTS: The median interval to wound healing was 17 days in the Genta group and 68 days in the Open group (P = 0.0001, log-rank test). Two patients in Group 1 developed infection within the first two weeks, requiring reopening of the wound, with primary wound healing occurring in 73%. Failure of primary healing (27%) was usually due to seroma or spontaneous dehiscence which subsequently healed. CONCLUSION: The combination of gentamicin collagen fleece (Septocoll) with primary closure resulted in a shorter period to healing than the open technique without unwanted effects.

Adolescent↗

[Treatment of inguinal hernia using laparoscopy. Clinical experiences apropos of 300 cases].

300 laparoscopic treatments of inguinal hernia repair have be done in our hospital between may 1992 and juin 1994. 134 times we have seen a median hernia and 166 times a lateral one. In 44 patients (14%) we did the repair of hernia for bilateral disease. In 66 cases we underwent for recidive; 55 times after hernia repair by the Bassini technique or Shouldice technique, and only 8 times after laparoscopic repair. In 1.4% we have seen early recidivism, no more then in the classical technique. Of course philosophy of this technique is very different to the traditional repair of inguinal hernia, but the encouraging results, important decrease of pain after surgery and the early uptake of normal activity are the reasons why we use this technique for nearly all recidivism of hernia repair and even for a great number of important hernias.

Early Ambulation↗

[Laparoscopic laser cholecystectomy].

In an ex vivo- and an animal study a Holmium-YAG laser, a Nd:YAG laser and a CO2 laser were examined. For laparoscopic cholecystectomy the pulsed Holmium:YAG laser proved to be the best instrument. Dissecting and haemostatic effects were connected when working with a power of 4 watts. Dissected area per minute was 112 mm2, gallbladder dissection (15 cm2) can be performed in 13 min. In the animal study the cholecystectomy lasted 30 min on average when the Holmium:YAG laser was used. Bleeding was not observed, development of smoke was tolerable.

Cholecystectomy, Laparoscopic↗

Parathyroid localization.

Twenty-nine consecutive patients with suspected primary hyperparathyroidism were examined preoperatively using ultrasound, sonographically guided fine needle aspiration, and aspirate immunostaining for PTH. In 25 patients, localization of enlarged parathyroid glands was successful. In 2 patients, the tumors were located retrosternally and, thus, could not be detected by ultrasound. One patient had a multinodular goiter which impeded localization. In 1 patient with renal osteodystrophy, 2 enlarged parathyroid glands in the neck were not visualized preoperatively. Cytology was not diagnostic, although some cytological features were suggestive of parathyroid cells. Immunostaining of the aspirated smears for PTH, however, correctly diagnosed all preoperatively localized lesions. Ultrasound should be the routine procedure of choice for preoperative localization of abnormal parathyroid glands in primary hyperparathyroidism. Fine needle aspiration and immunocytochemistry can supply confirmation, if necessary.

Adolescent↗

[Reduction mammaplasty].

The Strömbeck reduction mammaplasty is a widely standardized technique with great safety leading to predictably good results if the principles are regarded. The most important point is the position of the nipple. An individual shape of the future breast can be achieved by different positions of the standard Strömbeck pattern or by variation of the pattern itself. The procedures are described and illustrated by the results, showing that the standardized method leaves enough room for individual variations.

Adolescent↗

[Medullary carcinoma of the thyroid (author's transl)].

The medullary carcinoma of the thyroid plays a special role among the thyroid carcinomas due to his histiogenesis and endocrinologic behaviour. The symptoms like familiar occurrence, simultaneous pheochromocytoma, calcitonin-production, para-neoplastic syndroms with ACTH-production and the commonly associated diarrhea are discussed. The biological behavior of the tumor is presented reviewing the literature.

Adult↗

[Dermolipectomy for the reduction of redundant skin and local lipodystrophy].

Operative techniques by Pitanguy for abdominoplasty and fat reduction in trochanteric lipodystrophy and their results are presented. In comparison to most other procedures this technique shows the following advantages: low and horizontal final scar; the possibility to remove periumbilical fat and skin by transposition of the umbilicus; a diastasis of the mm.recti can be corrected and infraumbilical scars can be removed. The technique of excision described by Pitanguy for reduction of trochanteric fat is a simple and safe procedure leading to satisfying cosmetic results. During the past 18 months we treated 20 patients using Pitanguys technique. The results are definitely better than those achieved with other methods.

Abdomen↗

[Experiences with Epigard, a synthetic skin substitute, in the treatment of skin defects].

Epigard, a reticulated polyurethane foam laminated to a microporous polypropylene film, has been developed as a substitute for homograft and heterograft skin. After preliminary studies in animals, its clinical advantages and limitations were evaluated in 134 hospitilized patients with burn injuries and other skin defects. Examples for its indications are demonstrated and discussed. It is concluded that Epigard provides a satisfactory substitute for skin grafts with major advantages for ready availability, sterility and reduced cost.

Adult↗