Biomedical subjects

E S O'Broin

Publications and source records attributed to E S O'Broin.

5 recordsLinked to original sources

PubMed1999

Posterior plagiocephaly: proactive conservative management.

The pathology, diagnosis and management of posterior plagiocephaly remains highly controversial. While the rationale for surgical management of true lambdoid synostosis is undisputed, opinions vary greatly on how to manage severe, unresolving, non-synostotic cases. We reviewed 39 cases of posterior plagiocephaly, 37 of which were treated conservatively. Of these, 34 patients had a significant improvement over the following year with sleep posture modification and/or physiotherapy. While only eight cases returned to complete normality, the remainder had deformities that were deemed mild by both mothers and surgeons, and did not merit surgery. Defining recalcitrant cases remains elusive as standard imaging is often unhelpful. While 3-D CT offers a much more accurate diagnosis of true lambdoid synostosis with bony union and allows objective assessment of the deformity, serial scans involve radiation doses that are difficult to justify. Clinical follow-up is the only reliable method at present.

Craniofacial Abnormalities↗

PubMed1997

Cloverleaf skull anomaly with extreme orbitostenosis.

A neonate presented with cloverleaf skull anomaly and severe proptosis requiring urgent cranioplasty to attain eyelid closure. Despite this, she experienced exposure keratitis and corneal perforations. A ventriculoperitoneal shunt was performed subsequently to relieve hydrocephalus, but respiratory problems eventually led to her death at 6 months. This case highlights the complexity of the problems encountered in the cloverleaf skull anomaly, and a brief review discussing its management is included. Despite improvements in treatment of this condition, the overall prognosis remains poor.

Acrocephalosyndactylia↗

PubMed1997

Titanium mesh and bone dust calvarial patch during cranioplasty.

A technique of filling calvarial defects using bone dust reinforced with titanium Micro Mesh (Leibinger) was investigated using plain x-ray films and computed tomography (CT) in seven consecutive patients (age range, 7-21 years). The aim of our study was to assess whether, in the presence of the titanium, bone dust harvested with a power burr promotes persistent ossification that is comparable with adjacent bone. The mesh was localized by standard skull plain x-ray films, and orthogonal CT scans were obtained at between 9 and 18 months post-operatively. An ultrahigh-resolution algorithm was used to detect neoossification on either side of the Micro Mesh (1-mm collimation, 330-mA and 120 KV(p) at the center of 400 HU, and window width of 2000 Hu). The mesh induced minimal streak artifact. Virtually no new bone formation was seen. It appears that bone dust was completely reabsorbed in this patient group even in the presence of semi-rigid fixation.

Absorption↗

PubMed1996

Absorbable skin graft staples: a clinical trial using Graftac-X.

Skin stapling devices are a quick, effective method for securing skin grafts in burns patients. Removal of staples can be painful, often requiring a general anaesthetic. This problem has led to the recent development of absorbable staples which extrude with time. A prospective controlled clinical trial was performed on 20 burns patients comparing absorbable skin tacks with stainless steel staples. An area of at least 50 cm2 was grafted in each patient, half of which was secured with absorbable tacks and half with stainless steel staples. Each patient therefore acted as his/her own control. The presence of infection, haematoma and graft take using a grided cellophane sheet were assessed at one week. Infection and excess scarring at tack sites were assessed at one month. A statistically significant difference was not found between either group. In our hands absorbable skin staples have proven to be a reliable method of securing skin grafts.

Adult↗

PubMed1995

Absorbable sutures in tendon repair. A comparison of PDS with prolene in rabbit tendon repair.

The risks of foreign implantation may be avoided in tendon repair by the use of absorbable sutures, for example polydioxanone. In this study, the in vivo tensile strength half-life of 4/0 polydioxanone was found to be approximately 4 weeks. Using a rabbit model, we compared polydioxanone tendon repairs with polypropylene tendon repairs. Unilateral flexor digitorum longus repairs were performed on 46 rabbits using either polydioxanone or polypropylene. Tendons were harvested at 3 days, 2 weeks and 4 weeks and the tensile breaking strengths were obtained. 30 intact rabbit flexor digitorum longus tendons and 20 freshly repaired tendons were also tested. By 4 weeks, the repair strength had increased eight-fold from approximately 20 N to 166 N. The sutures made little contribution to the overall strength of a 4-week-old repair. There was no significant difference between polydioxanone and polypropylene repairs at any stage. These results show that polydioxanone repairs were as strong as polypropylene during the first critical weeks of tendon healing.

Absorption↗