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Biomedical subjects

F Gottrup

Publications and source records attributed to F Gottrup.

At least 19 recordsLinked to original sources
PubMed1992

Comparison of self reported and observed length, width, and colour of scar tissue.

To evaluate the reliability of self assessment as a substitute for follow up, 30 self reported assessments of length, width, and colour of abdominal scars were compared with those of clinicians. The degree of disagreement between patients and medical observers was not significant. We conclude that as long as instructions to patients are unambiguous, reliable information may be obtained by postal inquiry. Self reported measurements may thus replace time-consuming follow up visits in studies on the influence of various factors on scar tissue.

Abdomen↗
PubMed1991

Arteriovenous shunting and regional blood flow in myocutaneous island flaps: an experimental study in pigs.

In eight pigs, total blood flow, regional capillary blood flow distribution, and arteriovenous (AV) shunting were studied during the first 4 postoperative hours after elevation of a myocutaneous rectus abdominis island flap. Capillary blood flow and AV shunting were measured using radioactive microspheres before flap creation and 1 and 4 hours after surgery. Total blood flow, measured continuously as venous outflow, increased in the first postoperative hour (p less than 0.05). Elevation of the flap caused a slight decrease in skin capillary blood flow (p less than 0.05), whereas muscular capillary blood flow increased (p less than 0.01). AV shunting accounted for 50 percent of the total flap blood flow, whereas it was negligible in the abdominal wall prior to flap elevation. Thus stalk blood flow, skin appearance, and skin temperature may be poor indicators of nutritional capillary perfusion. However, the clinical and nutritional consequences of these findings remain to be established.

Analysis of Variance↗
PubMed1991

Gastric and colonic oxygen tension measured with a vacuum-fixed oxygen electrode.

A new electrode system for determination of visceral oxygen tension is presented. The system consists of a transcutaneous oxygen electrode (E5242 Radiometer A/S. Copenhagen), which is screwed into a suction ring and fixed to the organ by applying a vacuum. The electrode membrane is then in contact with the organ surface via a fluid layer with a thickness of a few micrometres, without interference from atmospheric air and without mechanical disturbance of the membrane. The electrode system was tested on the gastric and colonic wall in six pigs. As reference, a silicone tonometer was placed subserously beneath the vacuum-fixed electrode. The silicone tonometer was connected to a second transcutaneous oxygen electrode. The tissue oxygen tension was changed by subjecting the animals to various inspiratory concentrations of oxygen and to hypovolaemia. The oxygen tension measured by the vacuum-fixed electrode (PO2vac) was compared with the oxygen tension measured by the tonometer (PO2tono). A good correlation was demonstrated between PO2vac and PO2tono, the correlation coefficient being 0.8619, confirming that the suction-fixed oxygen electrode measures tissue oxygen. The lowest possible vacuum to hold the electrode unit in place was between 4.0 and 6.7 kPa. Provided the measuring time did not exceed 3 min. vacuum had only slight influence on the measured oxygen values. The mean change in PO2vac induced by varying the vacuum from 7 to 26 kPa, and 26 to 7 kPa, was only +0.23 kPa (-1.2 to +1.9) and +0.19 kPa (-0.3 to +1.3), respectively. The mean stabilization time, defined as the time from electrode application until achieving 95% of the equilibration value, was 66 sec (SEM, 3.4 sec) and 57 sec (SEM, 3.0 sec) on the gastric and colonic wall, respectively. The measured values of PO2vac varied significantly between different areas on the gastric wall (p less than 0.001). When several surface measurements were performed throughout the investigated area, the mean oxygen tension approached the oxygen tension measured by the tonometer. It is concluded that the vacuum-fixed electrode constitutes a reliable, easy and, noninvasive method for measurements of the oxygen tension in the gastric and colonic tissue.

Animals↗
PubMed1991

The effect of electrical current on healing skin incision. An experimental study.

The effect of electrostimulation on healing of a 6 cm long incision on the dorsum of rats was investigated. Postoperative stimulation was given with direct current (DC) to ten rats, and with alternating current (AC) to ten. Non-stimulated controls were used for each group. The words were biomechanically and biochemically tested three days after the final stimulation. Both DC and AC stimulation caused significant increase of the collagen content around the incision line compared with controls, but the collagen increase did not affect the tensile strength or the energy absorption. Electrostimulation of short duration is concluded to have a minor but significant enhancing effect on the formation of collagen in clean surgical wounds, but no effect on mechanical wound strength in the early postoperative period.

Animals↗
PubMed1991

Tissue oxygen tension in myocutaneous flaps. Correlation with blood flow and blood gases.

The relationship between tissue oxygen tension (PO2) and blood flow, blood gas tensions, oxygen delivery, and oxygen consumption was investigated in myocutaneous island flaps in 24 pigs. The tissue PO2 was measured by the silicone rubber tonometer technique. Capillary blood flow was increased during the first 3-4 hours after implantation of tonometers and they must, therefore, be implanted 3-4 hours before use. After raising the flap, mean (SEM) total flap blood flow increased from 11.2 (0.8) ml/min to 16.0 (1.3) ml/min within the first three hours. Mean (SEM) subcutaneous tissue PO2 decreased from 9.5 (0.6) kPa to 5.2 (0.7) kPa over six hours after the procedure, whereas muscle PO2, blood oxygen tension, and arteriovenous oxygen difference were unchanged. Hence, both the supply to, and use of oxygen in, the flap increased. Muscular and subcutaneous oxygen tensions were about 3 and 1 kPa, respectively, lower than venous oxygen tension. Tissue PO2 did not correlate with blood flow, blood oxygen tensions, arteriovenous differences in oxygen tension, or with oxygen supply in a cross section of animals. Tissue PO2 seems to reflect accurately the balance between oxygen supply and consumption, which might be the most useful indicator for continuous flap monitoring.

Animals↗
PubMed1991

Continuous direct tissue oxygen tension measurement. A new application for an intravascular oxygen sensor.

An oxygen tension measurement equipment, developed for continuous intravascular monitoring was tested as a direct tissue oxygen tension meter. The sterile disposable oxygen probe consists of a Clark type polaro-graphic bipolar electrode placed in a 5 cm long flexible polyethylene catheter (OD 0.55 mm). The probe is easily placed, e.g. in subcutaneous tissue or muscle, with the aid of an introduction needle. In vitro measurements as well as subcutaneous and intramuscular readings were performed. The animals were subjected to various experimental conditions such as different inspiratory oxygen fractions, hypovolemia, and circulatory impairment. Results were comparable to those obtained with previously used and well characterized tissue oxygen tension measurement equipment. The clinical applicability of the oxygen sensor for tissue oxygen measurement was assessed in one patient by 40 hours' surveillance in a free myocutaneous flap. The procedure was simple and implied minimal discomfort for the patient.

Animals↗
PubMed1990

[Conjunctival oxygen tension. Testing oxygen tension measurement of the conjunctiva].

A new apparatus which can measure oxygen tension and temperature in the conjunctiva was tested and compared with measurements of transcutaneous and arterial oxygen tension in eight volunteers in connection with normal oxygen tension, hypoxia and hyperoxia. In hypoxia, the conjunctival oxygen tension was found to be better correlated to and in better agreement with arterial oxygen tension than transcutaneous oxygen tension. The advantages with conjunctival oxygen measurements are continuous measurements in easily accessible and well vascularized tissue with the same arterial supply as the brain. In contrast to transcutaneous measurement, the new method does not require warming of the tissue as the conjunctiva is oxygen permeable.

Blood Gas Analysis↗
PubMed1990

Tissue oxygen tension measurement for monitoring musculocutaneous and cutaneous flaps.

In pigs, latissimus dorsi musculocutaneous island flaps and buttock skin island flaps were raised. Subcutaneous (PscO2) and intramuscular oxygen tension (PimO2) were measured using a non-heated needle electrode before, during and after repeated occlusion of the supplying artery or the draining vein. During arterial and venous occlusion, the tissue oxygen tension in the musculocutaneous flap dropped rapidly. A plateau was reached after 15 min. After arterial occlusion the mean value was 20 mmHg (SEM = +/- 5 mmHg, N = 6) in the subcutis and 16 mmHg in the muscle (SEM = +/- 4 mmHg, N = 10). After venous occlusion the mean value was 11 mmHg (SEM = +/- 3 mmHg, N = 6) in the subcutis. In the skin flap the drop of PscO2 was slower, and after 30 min of arterial occlusion the mean value was 29 mmHg (SEM = +/- 9 mmHg, N = 6). This study has shown that tissue oxygen tension measurement can be used as a sensitive indicator of acute impairment of the supplying vessels in island flaps. The method seems to have potential for monitoring free tissue transfers. A comparable decrease in PscO2 was found for arterial and venous impairment.

Animals↗
PubMed1989

[Early resuturing after abdominal wound infection under prophylactic metronidazole and ampicillin].

A randomized double-blind investigation was undertaken to assess the effect of treatment with metronidazole and ampicillin in patients with subcutaneous wound infection after laparotomy and early resuture. The wounds were closed in the fourth day and the antibiotic cover lasted from one to four days. None of the patients developed signs of sepsis or new abscesses. All of the wounds healed primarily but there were slight defects in two patients. These did not require surgical treatment. It is concluded that early closure of infected wounds after laparotomy may be undertaken under metronidazole and ampicillin cover and that treatment for one day is sufficient.

Ampicillin↗
PubMed1989

Management of severe incisional abscesses following laparotomy. Early reclosure under cover of metronidazole and ampicillin.

Patients developing severe incisional abscesses following laparotomy were treated with incision and drainage followed by early reclosure under antibiotic cover with metronidazole and ampicillin anhydricum. Patients with subcutaneous abscesses were randomized into two groups that were treated with antibiotics for one day (n = 23) or four days (n = 27). These patients all underwent reclosure four days later. In a third group of patients (n = 14) abscesses had developed down to, but not through, the peritoneum. These patients received antibiotic treatment for four days and underwent reclosure a mean of 5 1/2 days later (range, four to eight days). No abscesses reappeared in any group and all wounds healed by first intention. Five patients healed totally, with minor defects, but there was no need for surgical intervention. We conclude that the early reclosure technique is a safe procedure under antibiotic cover with metronidazole and ampicillin. One day and four days of antibiotic treatment are equally safe in patients with subcutaneous abscesses.

Abscess↗
PubMed1989

Tissue oxygen tension in random pattern skin flaps during normovolemic hemodilution.

We investigated the effect of progressive normovolemic hemodilution with Dextran 70 on subcutaneous tissue oxygen tension (PscO2) in canine random pattern flaps and in adjacent intact skin. PscO2 was measured polarographically in implanted oxygen-permeable Silastic catheters. The mean PscO2 of 5.7 kPa in intact subcutis at hematocrit (HCT) 40 was maintained or insignificantly improved during hemodilution to a HCT of 14. The mean flap PscO2 of 3.1 kPa at HCT 40 was maintained down to HCT 20. Most flap measuring sites exhibited a PscO2 improvement in an individual HCT range at some point during hemodilution. The increment in PscO2 tended to be relatively greater and to occur at lower Hct values in locations with more severe ischemia initially. Central hemodynamics were characterized by a lowered total peripheral resistance and an increased cardiac output, whereas systemic and pulmonary arterial blood pressures and central venous pressure remained essentially unchanged.

Animals↗
PubMed1989

Effect of hemorrhage and resuscitation on subcutaneous, conjunctival, and transcutaneous oxygen tension in relation to hemodynamic variables.

Subcutaneous (PscO2), conjunctival (PcjO2), and transcutaneous (PtcO2) oxygen tension values were measured in anesthetized dogs subjected sequentially to hemorrhage and reinfusion of the shed blood. Intravascular pressure, hemodynamic variables, and oxygen transport variables were measured simultaneously. During hemorrhage, PscO2 was the first of the PO2 measurements, and among the first set of hemodynamic variables that differed significantly from control values. During continuous bleeding, PscO2 and PcjO2 fell rapidly, the decline of PscO2 and PcjO2 was similar and significantly higher than that found for PtcO2. After reinfusion of shed blood, PscO2 was the last of PO2 measurements, and among the last set of hemodynamic variables, to return to control values. While PaO2 remained constant, PvO2 decreased significantly during hemorrhage and normalized during resuscitation. Unheated instruments for measuring PscO2 and PcjO2 are reliable indicators of peripheral perfusion during hemorrhage and resuscitation. Subcutaneous oxygen monitoring, in particular, seems capable of assessing early blood loss and adequacy of resuscitation after acute hemorrhage, and may be clinically useful.

Animals↗
PubMed1989

Characterization of the silicone tonometer using a membrane-covered transcutaneous electrode.

A new oxygen tonometry system consisting of a silicone tube, highly permeable to O2 and CO2 is described. The silicone tube was connected to a membrane-covered transcutaneous oxygen electrode (E5242 Radiometer A/S, Copenhagen, Denmark) via an airtight polycarbonate chamber, and flushed with isotonic saline equilibrated with atmospheric air. The present tonometer system offers certain advantages compared with other systems: continuous reading, minimal oxygen consumption, furthermore the system is thermostated and is insensitive to movement. The tonometry system was tested in vitro for characterization of a silicone tube (Coroplast, Fritz Müller KG, Wuppertal, FRG) 1.0 mm in inner diameter and 1.5 mm in outer diameter. The experiments showed that the oxygen tension measured at the electrode after passage of the tonometer approached the oxygen tension outside the tonometer when the length of the tonometer was increased and when the flushing rate of saline through the tonometer was decreased. The time taken for the flushing solution to reach an equilibrium with the oxygen tension outside the tonometer increased with increasing tonometer length, and decreased with increasing flushing rate. Changing the difference between oxygen partial pressure in the flushing solution and the oxygen partial pressure outside the tonometer tube did not influence the relative equilibration value and the equilibration time. When a pO2 value is measured by the electrode, the exact oxygen tension outside the tonometer tube, for every given length of the tonometer and flushing rate through the tonometer can be read from our calibration curves.

Blood Gas Monitoring, Transcutaneous↗
PubMed1989

The effect of cigarette smoking on wound healing.

To see if there was any difference in the skin healing of smokers as opposed to non-smokers we studied 120 women admitted consecutively for laparotomy sterilisation. The method of skin suture was standardised. We compared width, length, and colour of the scars, and assessed the overall cosmetic result using a scoring system in 69 smokers and 51 non-smokers. When the incision was in the midline the scars in the smokers measured 7.4 mm averagely as compared with 2.7 mm in non-smokers (p less than 0.02). There was a corresponding tendency in transverse incisions. When the colour was compared, 26% of smokers had light coloured scars compared with 12% of non-smokers (p less than 0.05). There were no differences between the groups when dark coloured scars were assessed. Overall, using the scoring system, smokers had significantly worse cosmetic results than non-smokers.

Abdomen↗
PubMed1988

Continuous monitoring of tissue oxygen tension during hyperoxia and hypoxia: relation of subcutaneous, transcutaneous, and conjunctival oxygen tension to hemodynamic variables.

Subcutaneous, transcutaneous, and conjunctival oxygen tensions (PscO2, PtcO2, and PcjO2, respectively) were measured in anesthetized dogs subjected sequentially to normoxia, hyperoxia, and hypoxia. Intravascular pressure, hemodynamic and oxygen transport variables were measured simultaneously. PtcO2 and PcjO2 closely paralleled PaO2 during normoxia, hyperoxia, and hypoxia over a wide range of arterial oxygen tensions. PtcO2 was reliable over the widest range of PaO2, with a correlation coefficient of .94. The PcjO2/PaO2 index fell at very low PaO2. The PscO2/PaO2 index decreased at both very low and very high PaO2. Only minor changes were found in hemodynamic and oxygen transport variables during hyperoxia. During hypoxia, however, cardiac output and other central hemodynamic measurements increased, while PscO2, PtcO2, and PcjO2 fell. Oxygen delivery and oxygen consumption were maintained or only slightly changed during hypoxia. All three continuous measurements of oxygen tension are reliable indices of PaO2 over a wide range under normovolemic conditions. The instruments for measuring PscO2 and PcjO2 are unheated and therefore may have advantages for human application.

Animals↗