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Biomedical subjects

E Robotti

Publications and source records attributed to E Robotti.

At least 19 recordsLinked to original sources
PubMed2000

The distally based superficial sural flap: our experience in reconstructing the lower leg and foot.

The treatment of soft-tissue defects of the lower third of the leg and foot is often an awkward problem to tackle because of the frequent involvement of muscle, tendon, and bone, which is caused by the thinness and poor circulation of the skin covering them and by the small quantity of local tissue available for reconstruction. The authors present their experience with the use of sural flaps for the treatment of small- and medium-size defects of the distal region of the lower limb. The flap used was a distally based fasciocutaneous flap raised in the posterior region of the lower two thirds of the leg. Vascularization was ensured by the superficial sural artery, which accompanies the sural nerve together with the short saphenous vein. The authors treated 18 patients (12 men and 6 women) from May 1997 to August 1999 at the Division of Plastic Surgery, University of Turin, Italy. Superficial necrosis without involvement of the deep fascia (which was grafted 1 month later) occurred in 1 patient of the 18 treated. In another 2 patients, defects were found in the flap margins, but no additional surgical revision was necessary, and recovery occurred by secondary intention. In every patient the sural flaps provided good coverage of the defects, both from a functional and an aesthetic point of view. The major advantages of this flap are its easy and quick dissection. Because the major arterial axis is not sacrificed, this flap can be used in a traumatic leg with damaged major arteries.

Adult↗
PubMed1999

The effect of pulsed electromagnetic fields on flexor tendon healing in chickens.

This study was designed as a pilot investigation of the effect of pulsed electromagnetic fields (PEMF) stimulation on early flexor tendon healing in a chicken model using a similar stimulus to that used clinically. The PEMF used caused a decrease in tensile strength and an increase in peritendinous adhesions.

Analysis of Variance↗
PubMed1998

Distally based fasciocutaneous flaps: a versatile option for coverage of difficult war wounds of the foot and ankle.

Early reconstructive treatment of war-related lower extremity injuries can be feasible even when evacuation to ideal tertiary facilities is impossible. However, in such instances, lengthy procedures considered "state of the art" in the everyday civilian practice of plastic surgery are often impractical, and alternative options need to be sought. Undelayed distally based fasciocutaneous flaps of the leg have recently been used in 12 cases of extensive defects of the foot due to antipersonnel mine injuries. All patients, treated during the conflict in Bosnia-Herzegovina, were smokers and were between 17 and 45 years of age. No preoperative arteriography or Doppler was available. One flap was totally lost, and two others suffered tip necrosis. All other cases healed uneventfully. We were impressed at the reliability of distally based fasciocutaneous flaps, even with length-to-width ratios of up to 5:1, and even after distal deepithelialization or tubing of the pedicle. The whole foot can be reached when the appropriate lateral or medial based flap is selected. Obvious disadvantages are the grafted secondary defect of the leg and the lack of sensation, although the latter is a common feature shared by most other flaps to the foot. Also, free-muscle transfer is preferable for very deep defects with extensive bone loss. However, for the ease of dissection, versatility, and short operating time, distally based fasciocutaneous flaps find a definite place in reconstructive trauma surgery.

Adolescent↗
PubMed1995

Brachial plexus surgery. An historical perspective.

Clinical observations on brachial plexus palsy belong to the last decades of the 19th century. True brachial plexus surgery is even more recent, starting with the beginning of this century. Surgical endeavors on the plexus have been varied and have met with alternating fortunes, undertaken by surgeons in a fascinating blend of sheer enthusiasm and deep pessimism.

Brachial Plexus↗
PubMed1993

Carbofilm-covered prostheses in plastic surgery: preliminary observations.

The optimal interface between an implant and the host organism is that which minimizes uncontrolled and irregular growth of fibrous tissue around the foreign material. One way to achieve this goal is to coat the outer surface of the implant with a biocompatible material. A thin film of turbostratic carbon (Carbofilm, Sorin Biomedica, Saluggia, Italy) can be applied as a thin coating on tissue expanders and breast implants made of silicone elastomers. The success of biologic trials with such implants in rats and cytologic studies with murine and human fibroblasts encouraged us to employ the Carbofilm technology in clinical situations. Preliminary results indicate that Carbofilm-coated implants satisfy the requirements of an ideal alloplastic material and induce a minimal periprosthetic inflammatory reaction, with the formation of a thin, soft, pliable, fibrous capsule around coated gel-filled silicone implants.

Animals↗
PubMed1992

[Angioma of a finger: the usefulness of a graft from the hypothenar eminence for covering the defect].

Skin grafting remains the simplest option when bone is not exposed in soft tissue losses of the digits of the hand. As opposed to traditional donor sites, a split-thickness skin graft from the hypothenar eminence provides specialized skin similar to the one to be replaced. The graft remains elastic and soft in follow-up, without hyperpigmentation, hyperkeratosis, fissuring and hypertrophic scarring at the margins. As well as in acute trauma situations, the use of split-thickness skin grafting from the hypothenar eminence can also be extended to resurfacing defects in elective hand surgery. As an example, we describe a case of an ulcerated capillary hemangioma on the dorsal surface of the fifth digit at the distal interphalangeal joint.

Adult↗
PubMed1992

Early single-stage repair of complex craniofacial trauma.

The traditional surgical management of complex craniofacial injuries is performed in three stages: immediate craniotomy, orbitofacial repair in 7 to 10 days, and cranioplasty delayed 6 to 12 months because of the perceived risks of infection and prolonged anesthesia in the head-injured patient. Cosmetic considerations have always played a secondary role; however, there are reports that suggest that bone fragments and grafts can be safely placed even in contaminated wounds. In addition, advances in neuroanesthetic technique allow for prolonged administration of anesthesia without untoward effects on the patient. The purpose of this prospective study was to determine if early single-stage repair of complex craniofacial injuries could be accomplished with acceptable morbidity and mortality. In this study, 13 patients (9 men, 4 women) ranging in age from 3 to 53 years, with Glascow Coma Scale scores of 10 to 15, all had a combined single-stage repair of their complex craniofacial injuries within 24 hours of their trauma. After initial assessment and resuscitation, all patients were evaluated with computerized tomography of the face and head before surgery. Bicoronal skin flaps were used for maximum exposure for frontal sinus exenteration as well as dural repair, cortical debridement, and calvarial reconstruction. Dural grafts were necessary in 12 of 13 patients (92%), and supplementary bone grafting was required in 9 of 13 patients (69%), of which 3 of the 9 (33%) had iliac bone grafts, where split calvarial grafts were used in the other 6 of 9 (67%). No artificial cranioplasty material was used.(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed1990

[The use of a topical antibacterial agent (silver sulfadiazine) on soft-tissue wounds].

Reducing the quantitative level of bacterial contamination in an open, acute or chronic, soft tissue wound below the critical level of 10(5) bacteria per gram of viable tissue is essential to delayed primary closure. First step in the management of the contaminated or infected wound is accurate local debridement, preferably with pulsating jet irrigation. Topical antibacterial agents, specifically silver sulfadiazine cream, are then usefully employed to reduce the bacterial count. Contrary to systemic antibiotics, these agents penetrate adequately into the open, granulating wound with a direct bacteriostatic or bactericidal action on a wide spectrum of gram positive and negative organisms, without the effect of local tissue injury typical of topical antiseptics. The use of topical antibacterials, traditionally confined to the treatment of the burn wound, the open "difficult" wound for excellence where control of local infection is first priority, provides a rapid local reduction of the bacterial level and paves the way to the final goal of primary delayed closure of the wound, either direct or with the use of grafts or local, distant, or free flaps.

Acute Disease↗
PubMed1990

[Treatment of traumatic oto-hematoma with transfixed compression sutures].

The effective early treatment of oto-hematoma is important so as to prevent reaccumulation of fluid and the typical chronic "cauliflower ear" deformity. A simple method of treatment with the use of transfixed tie-through compression mattress sutures, incorporating bolster dressings on both surfaces of the ear, following drainage of the hematoma via a small skin incision, is presented. This allows an optimal immobilisation of the skin over underlying cartilage for 7-10 days, preventing the reaccumulation of fluid with subsequent thickening and fibrosis, frequent complications of the other current methods of treatment.

Ear Diseases↗
PubMed1990

[Total and subtotal amputation of the finger tip in children: opportunity to attempt a repositioning].

A case of subtotal traumatic amputation of the tip of the left thumb, at the level of midshaft of the distal phalanx, in a seven years old boy, with interruption of the neurovascular bundles, associated fracture, and residual presence of a mere bridge of volar skin, is presented. The treatment consists of irrigation and debridement, repositioning of the fragment, fixation of the fracture with a 25 gauge needle and suturing of the skin. The final functional and aesthetic result appears optimal, with full survival of the distal fragment, which to practical purpose behaves like a composite graft, with some additional contribution to venous drainage provided by the residual bridge of tissue. Compared to the other possible surgical techniques, all requiring the use of grafts or flaps, the attempt of repositioning of the distal fragment after total or subtotal amputation of a fingertip, especially in a child, appears always well justified and worthwhile.

Amputation, Traumatic↗