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Biomedical subjects

Gary S Rogers

Publications and source records attributed to Gary S Rogers.

7 recordsLinked to original sources
PubMed2006

Prospective, randomized, blinded study of a new wound closure film versus cutaneous suture for surgical wound closure.

BACKGROUND: Wound closure devices include sutures, tissue adhesives, adhesive strips, and staples. Recent studies suggest no differences between various tissue adhesives and sutures for dehiscence, infection, and satisfaction when assessed by patients or surgeons. To date, no studies have investigated ClozeX, a novel adhesive strip, for closure of surgical incisions. OBJECTIVE: To compare surgical wounds repaired with ClozeX versus suture. METHODS: A prospective, randomized study was conducted, in which 15 patients with surgical incisions were allocated to closure with ClozeX on half of the wound and monofilament suture on the other half. Physician satisfaction with blinded assessment, patient satisfaction, complication rates, and closure times were recorded. RESULTS: Application with ClozeX was faster than with suture (p=.007). There were no complications in either group. Sixty-nine percent of the patients gave ClozeX a higher satisfaction score (p=.02). More physicians were satisfied with the ClozeX half than with the suture half (p=.007). CONCLUSIONS: This pilot study demonstrates ClozeX to be a safe and effective closure device. The cosmetic outcome seems to be at least as good as simple running suture. Physicians and patients were generally more satisfied with ClozeX. No difference was found in the rate of dehiscence or infection between the groups.

Adolescent↗
PubMed2005

Clinical recognition of actinic keratoses in a high-risk population: how good are we?

BACKGROUND: Actinic keratoses (AKs) are dysplastic epidermal lesions considered to be potential precursors of squamous cell carcinoma. Most AKs are diagnosed clinically and are rarely confirmed histologically. High interobserver variation exists among dermatologists for the diagnosis of AKs. Previous studies of the positive predictive value of the diagnosis of AKs have yielded rates as high as 94%. This study evaluates the rate at which histologic analysis confirms the clinical impression (positive predictive value) of AKs in patients with a history of skin cancer. OBSERVATIONS: Seventeen (74%) of 23 lesions with classic features of AKs, as determined by 3 dermatologists, were confirmed as AKs histologically. These were lesions that would ordinarily not be biopsied. Of the 6 misdiagnoses, 5 (83%) were skin cancer, most often squamous cell carcinoma. CONCLUSIONS: The positive predictive value of 74% for the diagnosis of AKs in this study is substantially lower than that of 2 previous studies, suggesting that physicians may be misdiagnosing many patients with classic features of AKs. Most misdiagnosed cases were forms of skin cancer. These preliminary data suggest that the threshold for biopsy of suspect lesions in patients with a history of skin cancer should be low and warrant further evaluation.

Adult↗
PubMed2005

Excision of malignant melanoma overlying a pacemaker.

BACKGROUND: With the increasing number of patients with implantable cardiac devices, dermatologic surgeons must be increasingly familiar with the types of devices and potential interference by surgical procedures. OBSERVATIONS: We report the excision of a 1 cm malignant melanoma in situ occurring on the skin directly overlying the patient's pacemaker. CONCLUSIONS: Successful excision of malignant lesions in the setting of implantable cardiac devices requires an understanding of pacemaker implantation anatomy following well-established guidelines for electrosurgery in the setting of implantable cardiac devices and careful coordination with cardiac and anesthesia specialists.

Aged↗
PubMed2004

Local melanoma recurrence: a clarification of terminology.

BACKGROUND: The current medical literature contains multiple different meanings for the term "local melanoma recurrence." Confusion regarding locally persistent and locally metastatic disease makes interpretation and analysis of previously published reports difficult if not impossible. OBJECTIVE: The objective was to present a more precise definition of local melanoma recurrence. METHODS: A case is reported and the literature is reviewed. CONCLUSION: Owing to the myriad of different definitions that exist in the medical literature, the term "local melanoma recurrence" is ambiguous and at times misleading. Melanoma that recurs locally from persistence of tumor at the resection margins has a vastly different prognosis than recurrence developing from local (satellite) metastases adjacent to the surgical resection site. We propose the use of the terms "persistent melanoma" and "local metastasis" as more precise and predictive of a patient's prognosis.

Diagnosis, Differential↗
PubMed2004

Robot-assisted minimally invasive surgery: the importance of human factors analysis and design.

Success in robotic minimally invasive surgery (MIS) has been limited despite the innovations in robotic technology for surgical applications. Human factors engineering approach to the design and implementation of this technology is major to improving system performance and patient safety. The engineering discipline of human factors involves the study of factors and development of tools that enable human interaction with systems in a safe and effective manner. Human factors contribution is important to the product design life cycle, as it supports the design of a product capable of supporting, extending, and transforming user work in a cost-effective and timely fashion. A framework for modelling the interaction between the surgeon and technology in MIS is presented. This approach allows for identification of requirements and constraints at the physical, functional, and cognitive levels, which in turn guides the design of the technology and its interface. The human factors approach is expected to increase the effectiveness of the technology when deployed.

Clinical Competence↗
PubMed2002

Prognostic factors.

The American Joint Committee on Cancer has recently revised the staging system for melanoma. In this article, prognostic factors for melanoma are discussed in order of significance as outlined by the new staging system. In addition, other historically relevant prognostic factors are reviewed. The article concludes with a discussion of new technology, which may aid in the future staging of melanoma patients.

Adolescent↗