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Biomedical subjects

G H Müller

Publications and source records attributed to G H Müller.

At least 19 recordsLinked to original sources
PubMed1990

Heart transplantation model as an immunological monitor.

Various techniques have been described for the heart model, from which we standardized two. These are simple to perform and offer the possibility of a precise determination of rejection times. This is an advantage compared to other models, such as the kidney model, which is still in use, a rejection reaction, the recipient stays alive, making the recipient available for further experiments. One disadvantage of the heart model is that histological examinations are impossible without disturbing the heart function. Thus far, responsible laboratory parameters for rejection reactions could not be differentiated for confirmation of subjective diagnoses. However, we consider this model to be useful in investigating immunological questions.

Animals↗
PubMed1990

Repair of salivary fistulae after laryngectomy.

A new surgical technique is described for the repair of salivary fistulae. It has been used in three patients. The fistulae occurred after laryngectomy and had been unsuccessfully treated with local and regional flaps. The principle of the technique is to use a bipedicled jejunal patch as a free microvascular transfer. One patch is used for reconstruction of the pharynx and after excising the mucosa the skin defect is closed with the other patch. The mucosa is excised to expose the muscle and to create a recipient site for a split skin graft.

Humans↗
PubMed1989

[Radial forearm flap. Its versatile application in plastic surgery reconstruction of the head and neck].

The radial forearm flap is a versatile tissue transfer in the head and neck. It can be raised either from the distal or the proximal aspect of the volar forearm, and can also include the whole volar forearm skin. The flap is ideal for reconstruction of superficial defects in the head and neck, for the pharynx and oral cavity, as well as for skin defects of the face and the neck. The distal flap is thin and pliant due to the small amount of subcutaneous tissue and the fairly long vascular pedicle. A proximal flap is more bulky due to subcutaneous fat. Since the vascular pedicle of the distal flap is very long, it can also be anastomosed in the contralateral neck. Different applications and indications for the tissue transfer of the radial forearm flap are presented.

Combined Modality Therapy↗
PubMed1988

[Microvascular tissue transplantation of the ear, nose and throat].

Free tissue transfers are a versatile method of reconstruction in head and neck surgery. In the pharynx and oral cavity the functional result dictates the choice of flap. For these sites thin and pliant fasciocutaneous flaps are ideal tissue transfers, and we favour the radial forearm flap which is raised from the distal volar forearm. This flap is easy to dissect and the donor defect, which is grafted with split skin, does not inconvenience the patient. For reconstruction of thicker defects we prefer bulky myocutaneous flaps such as the latissimus dorsi, which has a reliable pedicle of adequate length. The rectus abdominis flap, if taken with peritoneum, is useful for reconstruction of large cheek defects involving all layers; the peritoneum replaces the oral mucosa. For hypopharyngeal reconstruction the free jejunal loop has advantages compared with local skin or myocutaneous flaps, since it is a one-stage procedure with a low rate of post-operative fistulae. In some cases of reconstruction of the oral cavity and oropharynx we have used a jejunal patch, but in general we prefer the radial forearm flap, since it is more resistant to mechanical trauma. The advantage of a free tissue transfer is its excellent blood supply, which makes it possible to apply these flaps in irradiated and infected tissue. It is important in microvascular tissue transfer to choose an appropriate flap for the size and depth of the resection. It is only necessary to be familiar with those transfers most commonly used in this region.

Bone Transplantation↗
PubMed1988

[Experimental studies of vascular replacement in microsurgery].

There is a need for vessel substitute material in microsurgery. Currently autologous pieces of vessel are used. An experimental study in the rat model was undertaken to test the practicability of two different PTFE-prostheses (Goretex) of 1 and 2 mm in diameter and of different lengths. Results show an excellent patency rate of short grafts in high-flow vascular system. In contrast microvascular prostheses used in a low-flow vascular system were patent only for a short time.

Animals↗
PubMed1987

[Musculocutaneous flap-plasty for reconstruction of large chest wall defects following tumor therapy].

A series of 12 consecutive chest wall reconstructions during 1986 was reviewed. There were 9 musculocutaneous flaps: 7 latissimus dorsi (one microvascular free flap) and 2 rectus abdominis muscles. Despite some complications (postop. bleeding, paradoxical motion of the chest) the use of myocutaneous flaps seems to be the therapy of choice for large chest wall defects, especially in infected areas and after irradiation therapy.

Adult↗
PubMed1987

[Retrograde or orthograde anatomic perfusion of the free forearm flap?].

The free forearm flap is ideal for vascularized tissue transfer because of its large vessels and multiple nerve supply. In the case presented a distally based forearm flap on a long vascular pedicle was employed relying on a reversed blood flow. Unfortunately the reversed venous flow did not develop and therefore in order to provide a venous drainage an autologous vein graft was used.

Adult↗
PubMed1987

[Special vascular anastomoses for microsurgery].

Various techniques for vessel anastomoses in microvascular surgery are described. Using modified techniques, safe vascular anastomoses can be achieved even in relatively inaccessible sites. Techniques to overcome problems caused by differing vessel diameters are also shown. End-to-end and end-to-side anastomoses using continuous sutures and single sutures are described. To simplify anastomoses of multiple vessels--for example in the case of a radial forearm flap or dorsalis pedis flap--techniques are described which allow larger anastomoses in simple end-to-end and end-to-side connections.

Anastomosis, Surgical↗