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Biomedical subjects

F S Browning

Publications and source records attributed to F S Browning.

6 recordsLinked to original sources

Experience with the Fowler Stephens and microvascular procedures in the management of intraabdominal testes.

The Fowler Stephens operation and microvascular procedures were compared for the management of 23 intra-abdominal testes in 15 boys, 7 of whom had the prune belly syndrome. The Fowler Stephens operation was used for 15 testes (4 single-stage and 11 two-stage) and microvascular transfer was used for 8 testes. Eleven testes treated by the Fowler Stephens procedure (73%) and 7 treated by microvascular procedures (88%) were viable and intrascrotal after an average follow-up of 3.0 years, giving an overall success rate of 78%. Eight of 9 post-pubertal testes were biopsied. Severe maturational arrest was evident in all and carcinoma in situ was present in one.

Abdomen

Microvascular second toe transfer for digital reconstruction.

Reconstruction of a severely damaged hand, with multiple amputations of digits, presents a difficult reconstructive problem. The development of a safe method of transfer of the great toe for thumb reconstruction, using the dorsalis pedis artery and the saphenous vein, suggested the possibility of one-stage microvascular transfer of the second toe for reconstruction of fingers. In two patients a one-stage transfer of the second toe was done to replace an index finger and in another for restoration of part of the left ring finger. The transplants survived without anticoagulants and vessel complications were not encountered. Sensory return was adequate and a significant improvement in function was achieved.

Accidents, Occupational

Microlymphaticovenous anastomoses for obstructive lymphedema.

Microlymphatic surgery appears to have a worthwhile clinical application in the treatment of secondary obstructive lymphedema. We prefer 3 or more lymphaticovenous anastomoses at, or above, the elbow; otherwise ablative procedures are recommended. In the selected cases there are some advantages of anastomoses over surgical reduction procedures: (1) the incidence of postoperative cellulitis is significantly less; (2) the microlymphatic techniques are applicable to both upper and lower limbs and perhaps could be extended to localized cases of obstructive lymphedema following trauma and congenital constriction bands. Considerable experience in microvascular surgery is required for doing this type of work. A long-term evaluation of the results of microlymphatic surgery in obstructive secondary lymphedema is required before judging its potential--especially in view of the fluctuating history of lymphedema--but the results reported are encouraging.

Adult