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Biomedical subjects

G H Wilkes

Publications and source records attributed to G H Wilkes.

10 recordsLinked to original sources
PubMed2003

Revising the troublesome stoma: combined abdominal wall recontouring and revision of stomas.

PURPOSE: Despite preoperative siting and maturation of stomas, some patients may have poor stoma function because of redundant pannus, scars, creases, and parastomal or incisional hernias. In these patients, a combined abdominoplasty and stoma revision may be helpful. The object of this manuscript is to report our preliminary results. METHODS: Eight patients (mean age, 48 years; female/male ratio, 7/1) undergoing this procedure are reported. Five patients had inflammatory bowel disease, two had malignancies, and one had multiple sclerosis with bladder and bowel involvement. Patients were contacted at two months to two years follow-up to assess functional outcome and satisfaction with the procedure. RESULTS: Indications for surgery were difficulty maintaining an appliance (n = 7), frequent stool leakage (n = 6), and skin irritation (n = 4). Multiple surgeries (n = 4), skin creases (n = 3), scarring (n = 2), large weight loss (n = 4), and hernias (n = 5) were contributing factors. At surgery five patients had hernias repaired (3 parastomal, 2 incisional), three had stomas resited, and three underwent resections for Crohn's disease. One patient developed a seroma postoperatively. At follow-up six patients were able to maintain an appliance for at least four days, whereas one changed the appliance every three days because of personal preference. None experience stool leakage. All reported a dramatic improvement in body image. CONCLUSION: Combined stoma revision and abdominoplasty can be performed safely and leads to improved functional results and outcome.

Abdominal Muscles↗
PubMed1996

Autogenous soft-tissue procedures and osseointegrated alloplastic reconstruction: their role in the treatment of complex craniofacial defects.

Between 1990 and 1994, twenty-seven patients with extraoral craniofacial defects were treated at the Craniofacial Osseointegration and Maxillofacial Prosthetic Rehabilitation Unit in Edmonton. Fourteen patients required management by a combination of alloplastic and autogenous techniques to optimize their reconstructive result. Autogenous soft-tissue procedures were performed almost twice as often in patients whose deformity was the result of trauma. Autogenous soft-tissue procedures included soft-tissue expansion, static facial slings, free and pedicled vascularized bone grafts, eyebrow reconstruction, brow lifts, and scar revisions. These reconstructive procedures are illustrated in three cases.

Adult↗
PubMed1994

Osseointegrated alloplastic versus autogenous ear reconstruction: criteria for treatment selection.

Fifty-five patients with major ear deformities were reconstructed during the period 1982-1993 with autogenous tissue. Fourteen patients were reconstructed with osseointegrated auricular prostheses during the period 1989-1993. Both procedures were done at the same institution by the same surgeon. The advantages and disadvantages of each approach were considered, and our criteria for treatment selection were developed. Our main indications for autogenous reconstruction include classical microtia, relatively normal lower one-third of the ear, patient preference, and less compliant patients. The main indications for osseointegrated alloplastic reconstruction include following major cancer extirpation, poor local tissue, absence of the lower half of the ear, salvage following unsuccessful autogenous reconstruction, and poor operative risks. Because of their success, osseointegrated auricular reconstructions should be added to the armamentarium of the reconstructive surgeon.

Adolescent↗
PubMed1994

Craniofacial osseointegration.

Craniofacial osseointegration has been hailed as the most significant advance in maxillofacial prosthetic restoration over 25 years. It provides a particularly unfortunate group of patients, who previously may have had few treatment options, with new reconstructive opportunities. This paper outlines the surgical and prosthetic techniques of craniofacial osseointegration. Treatment outcomes in terms of individual implant success rates are described and the role of hyperbaric oxygen is considered. The need for future avenues of development are also discussed. Craniofacial implants have become an integral part of the treatment options available for head and neck reconstruction. It is important that this care is provided within a multidisciplinary clinical-research environment.

Ear↗
PubMed1993

Craniofacial osseointegration: the Canadian experience.

A survey was undertaken to determine the number of centers in Canada with an active involvement in extraoral osseointegration. It was found that six centers had placed 222 implants in 91 patients in Canada. The individual implant success rates for the Canadian experience were compared with the published Swedish and United States' experience. The Canadian experience is combined with the Swedish and United States' experience to provide retrospective multinational multicenter data. The data given should be viewed as providing trends only and not as definitive expectations of predictable success rates. The success rates are considered likely to change with time as the number of patients treated increases and the duration of follow-up is extended. The mastoid region in nonradiated patients is considered to provide a high degree of predictable individual implant success. The success rates in radiated patients yield far lower success rates, which vary with anatomic location. The criteria for success in using craniofacial implants need to be defined and should reflect the differences between extraoral and intraoral implants.

Canada↗
PubMed1985

The long-term survival of onlay bone grafts--a comparative study in mature and immature animals.

Onlay bone grafting was studied with regard to age of the animal and type of bone graft used (membranous bone or endochondral bone with or without periosteum, and decalcified homograft). The bone grafts were placed in the nasal dorsum in a group of mature and immature New Zealand rabbits. Volume displacement studies were carried out. Graft survival was greatest in membranous bone and least in endochondral grafts. There was significantly greater absorption of endochondral grafts in immature animals than in the mature group. Presence or absence of periosteum did not make a significant difference in graft survival.

Absorption↗
PubMed1982

Incorporation of the W-plasty in repair of macrostomia.

Macrostomia is an uncommon deformity, the features of which have been outlined. The importance of accurate preoperative marking of the normal landmarks and three-layered repair are stressed. Our technique combines triangular mucosal flaps at the commissure, reconstruction of the oral and buccal musculature, and skin closure using a W-plasty. This skin closure results in a less conspicuous scar while still preventing lateral drift of the commissure. We feel this is an effective surgical procedure that yields consistent clinical results.

Humans↗
PubMed1981

Juri scalp flap.

Explore the source record for details and available documents.

Female↗