G S Terrell | PubMed Health

PubMed1994

An experimental model to study the blink reflex.

A model to study the blink reflex in the experimental setting has been established. The behavioral, electrophysiologic, pathologic, and surgical methods and results obtained parallel those utilized and observed in the human and simulate the problem of facial paralysis. The observation that the blink can be elicited in an animal model, with the same stimuli as in humans, strengthens the value of this model, as do the similarities seen in the electrophysiologic recordings of NCV studies. The dual innervation of the rat eye sphincter allows application of the principle of selectively neurectomizing eye branches and "borrowing" motor-nerve fibers from the normal side, without causing eye-sphincter paralysis, a concept employed extensively in cross-facial nerve-grafting procedures in humans with facial paralysis.

Anastomosis, Surgical↗

PubMed1992

Axillary versus combined axillary and pectoral drainage after modified radical mastectomy.

Initial attempts to obliterate dead space and minimize fluid accumulation in patients after mastectomy using closed suction drainage, used insertion of a single axillary drain. Today, surgeons often insert two drains in the postoperative wound, one in the axilla and the other beneath the pectoral flaps. The current study was done to determine whether or not there is an advantage in using two drains rather than a single axillary drain after mastectomy. A randomized, clinical trial was conducted with 84 women undergoing modified radical mastectomy. Thirty-seven patients had one axillary drain and 47 had two drains placed postoperatively, one in the axilla and the other beneath the pectoral flaps. Follow-up results were obtained four weeks postoperatively for complication data, including seroma and hematoma formation, flap necrosis and infection. The average total drainage was 870.4 milliliters per patient in the group with one drain and 997.4 milliliters per patient in the group with two drains (p value not significant). The overall complication rate in the group with one drain was 35.0 percent compared with a rate of 31.9 percent for all complications observed in the group with two drains. These differences did not reach statistical significance. Comparing the frequency of each complication in the two groups again showed no significant difference. However, the data suggest a trend toward an increased incidence of flap necrosis in the group with two drains that used a drain beneath the pectoral flaps. Use of a single axillary drain after modified radical mastectomy seems to result in no increase in postoperative complications, is less costly and may assist in reducing the incidence of flap necrosis.

Adult↗