[Pre-invasive tumors and precancerous conditions of the breast: subcutaneous mastectomy and reconstruction-plasty. Indications and results].
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Biomedical subjects
Publications and source records attributed to H Bohmert.
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Rats were subjected to burns extending to 15% of their body surface. Enzyme activities were measured by a slightly modified Barrett technique between the 12th and 18th day after the burn injury. A statistically significant activation of acid proteolytic enzymes, in relation to mg protein, was seen in liver, spleen, kidney and stomach. In relation to grams fresh weight, an activation was seen in the kidney. Necrotic skin subsequent to burn injury showed a marked rise in activation compared with the skin of the control group, as well as with the skin of the burned animals. Increased enzyme contents were also detected in the intact skin of burned animals, compared with the skin of the control group.
The Strömbeck reduction mammaplasty is a widely standardized technique with great safety leading to predictably good results if the principles are regarded. The most important point is the position of the nipple. An individual shape of the future breast can be achieved by different positions of the standard Strömbeck pattern or by variation of the pattern itself. The procedures are described and illustrated by the results, showing that the standardized method leaves enough room for individual variations.
It could be shown that beside the non-absorbable synthetic suture material (Polypropylene) for the subcuticular continuous skin suture absorbable synthetic suture material (Polyglactin 910) is suitable for the buried subcuticular skin suture to obtain good esthetic scars in plastic surgery. Experiences with Polyglactin 910 in over 300 patients are presented. In no case wound healing was disturbed as a result of the suture material. Further application will give more information about the usefulness of the absorbable synthetic suture material Polyglactin 910 for the buried subcuticular skin suture.
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In 8 patients the method of transcutaneous pO2-monitoring, developed by Huch and Lübbers, is applied for the determination of the viability of ischemic skin areas of the transplant. Its usefulness is proven. The problem of arterial and tissue pO2-monitoring is explained. According to our experiences of about 6 months this qualitative method seems to be useful in plastic surgery. An important possibility to apply the transcutaneous pO2-monitoring is the postoperative control of free skin flaps transplanted by microvascular anastomoses to indicate early enough the beginning tissue hypoxia by a warning system. Further results with the method shall be reported.
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Operative techniques by Pitanguy for abdominoplasty and fat reduction in trochanteric lipodystrophy and their results are presented. In comparison to most other procedures this technique shows the following advantages: low and horizontal final scar; the possibility to remove periumbilical fat and skin by transposition of the umbilicus; a diastasis of the mm.recti can be corrected and infraumbilical scars can be removed. The technique of excision described by Pitanguy for reduction of trochanteric fat is a simple and safe procedure leading to satisfying cosmetic results. During the past 18 months we treated 20 patients using Pitanguys technique. The results are definitely better than those achieved with other methods.
Epigard, a reticulated polyurethane foam laminated to a microporous polypropylene film, has been developed as a substitute for homograft and heterograft skin. After preliminary studies in animals, its clinical advantages and limitations were evaluated in 134 hospitilized patients with burn injuries and other skin defects. Examples for its indications are demonstrated and discussed. It is concluded that Epigard provides a satisfactory substitute for skin grafts with major advantages for ready availability, sterility and reduced cost.
Crohn's regional ileitis, which is differentiated into acute, chronic uncomplicated and chronic complicated forms, is seen to have a high complication rate in the long run. It is the fistulae to sections of the intestine which are not primarily diseased, the fistulae to the bladder, vagina and retroperitoneal space, fistulae opening on the abdominal wall and perianal fistulae which make the primary condition a serious disease. In the chronic stage, an adequate resection of the intestine in good time can lead to healing. Detour anastomoses which leave behind the affected section of the intestine gives poor results.
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