Biomedical subjects

Gerard E Seery

Publications and source records attributed to Gerard E Seery.

3 recordsLinked to original sources

PubMed2004

Deep plane fixation in integumental surgery.

BACKGROUND: Standard wound closure techniques are prone to complication in the presence of tension. OBJECTIVE: To show that deep plane fixation (DPF), a surgical modality based on limited undermining and strategic placement of DPF sutures, affects tension-reduced closure in wounds that would otherwise require skin grafts/flaps or tissue expansion. METHODS: The study is based on an analysis of over 2000 scalp operations. RESULTS: Two groupings of identical sagittal scalp reductions were done. DPF was used in one and not the other. In the series with DPF, reduced tension closure was consistently possible, as was significantly increased excision, relative to the series without DPF. CONCLUSIONS: DPF narrows the wound base and channels tension forces from superficial to deep and/or nonundermined tissues (where they harmlessly dissipate). This allows relatively increased tissue excision and tension-reduced closure.

Alopecia↗

PubMed2002

Hair transplantation: management of donor area.

BACKGROUND: Hair transplantation entails the removing of a strip of permanent hair from the occipital scalp and reimplanting it piecemeal into the recipient area. Methodologies for effecting this are reasonably complex and have undergone many changes and improvements over the years. The simplest part of hair transplantation, at least in theory, is the removal of the donor strip and closure of the resultant defect. Unfortunately, however, the improvements that have taken place in hair transplantation in general have not spilled over into improved donor area outcomes. Unsightly donor scars and fibrosis are still not only with us, but are possibly even more pervasive than ever. One explanation given for deteriorated donor sites is the harvesting of relatively greater numbers of grafts. But is this the whole story? OBJECTIVE: To describe some technical aspects of donor area management consistent with harvesting the best possible donor strip, while leaving an inconspicuous scar and preserving the viability of the residual tissues for subsequent harvesting. METHODS: In 1994 a clinical research project designed to determine what technical surgical modalities are optimal for excising and reconstructing scalp tissues was commenced. This was done with particular reference to the donor area in hair transplantation. The study involved more than 1000 scalp operations using various techniques and instrumentation, and comparing and contrasting results. RESULTS: The best results were obtained when tissues were least traumatized. Tension generated at wound closure was found to be the main culprit in determining less than optimal residual donor sites. CONCLUSION: Notably improved postharvesting donor sites are most likely to result when measures are taken to ensure minimal trauma by taking definitive steps to combat tension in the tissues. Modest undermining combined with deep plane fixation facilitates channeling of tension vector forces from at-risk superficial tissues into nonundermined tissues and deep tissues, each of which is optimally equipped to withstand the adverse consequences of tension.

Cicatrix↗

PubMed2002

Surgical anatomy of the scalp.

BACKGROUND: The goal of complication-free scalp surgery remains elusive. Wide unsightly scars, stretch-atrophied hypesthetic, poorly vascularized tissues and distorted hair patterns are still commonly seen and appear to be largely refractory to remedial surgery. OBJECTIVE: To establish technical guidelines for scalp surgery most compatible with maximum functional/cosmetic benefit and complication-free results. METHODS: More than 3000 scalp operations, done personally, were reviewed. These covered the entire spectrum of plastic and reconstructive surgery and hair restoration procedures including more than 700 clinical surgical investigative procedures with pericranial flaps, subgaleal and subperiosteal scalp reductions, and deep plane fixation procedures. RESULTS: Notably improved scalp surgery outcomes resulted from the application of data derived from study of the surgical anatomy of the scalp. Unsightly scars, distorted hair patterns, hypesthetic poorly vascularized tissues, and distorted hair patterns were largely avoided. CONCLUSION: An understanding of the surgical anatomy of the scalp is a cornerstone on which complication-free scalp surgery is based.

Biomechanical Phenomena↗