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Biomedical subjects

H Furnas

Publications and source records attributed to H Furnas.

12 recordsLinked to original sources
PubMed1992

Postprandial Aeromonas hydrophila cultures and antibiotic levels of enteric aspirates from medicinal leeches applied to patients receiving antibiotics.

Increasing use of medicinal leeches has been accompanied by increasing numbers of reports of Aeromonas hydrophila infections after leech application on or near damaged tissue. We examined the enteric contents of postprandial leeches after their application to patients receiving antibiotics. We found measurable levels of antibiotic in the leech enteric contents, and in leeches applied to patients receiving an antibiotic effective against Aeromonas hydrophila, there was a significant decrease in positive Aeromonas enteric cultures. Suppression of leech enteric bacteria by antibiotic administration to the patient may be an effective strategy to prevent invasive infection by Aeromonas hydrophila as well as bacterial colonization of devitalized tissue that could be the source of late infection. Clinical studies will be required to clarify whether suppression of leech enteric flora results in a decrease in infections associated with leech use.

Aeromonas hydrophila↗
PubMed1991

Microsurgical tissue transfer in patients more than 70 years of age.

Between 1982 and 1989, three women and seven men older than 70 years of age underwent elective free-tissue transfer. Nonhealing wounds of 1 scalp, 2 upper extremities, and 7 lower extremities were covered with 3 serratus anterior, 3 latissimus dorsi, 2 gracilis, and 2 lateral arm flaps. Major coincidental medical problems included hypertension, congestive heart failure, chronic obstructive pulmonary disease, coronary artery disease, diabetes mellitus, metastatic lung cancer, tachyarrhythmias, syncope, elevated liver function tests, and previous arterial bypass in the affected lower extremity. One flap failed and 2 others were compromised by venous thromboses but salvaged by reoperation. There were no major anesthetic complications. This series demonstrates that elective free-tissue transfers can be safely performed in patients older than 70 years of age.

Age Factors↗
PubMed1991

Monitoring in microvascular surgery.

The importance of monitoring in microvascular surgery is underscored by the high reported salvage rates of failing free flaps and replants. In this overview, we begin by defining the physiology of ischemic tissue with emphasis given to the no-reflow phenomenon and the secondary critical ischemia times. Based on the physiological changes accompanying ischemia, several variables are defined that can be monitored to reflect the vascular state of a free flap or replant. Multifarious monitoring systems are then reviewed, including clinical observation, temperature, isotope clearance, ultrasonic Doppler, laser Doppler, transcutaneous oxygen tension, reflection plethysmography, dermofluorometry, pH, electromagnetic flowmetry, serial hematocrits, interstitial fluid pressure, and magnetic resonance imaging.

Humans↗
PubMed1990

Scalp reconstruction by microvascular free tissue transfer.

We report on a series of patients with scalp defects who have been treated with a variety of free flaps, spanning the era of microvascular free tissue transfer from its incipient stages to the present. Between 1971 and 1987, 18 patients underwent scalp reconstruction with 21 free flaps: 11 latissimus dorsi, 3 scalp transfers between identical twins, 3 groin, one combined latissimus dorsi and serratus anterior, two serratus anterior, and one omentum. These flaps were used to cover scalp defects resulting from burns, trauma, radiation, and tumors in patients ranging from 7 to 79 years of age. Follow-up has ranged from 3 weeks to 7 years. All of our flaps survived and covered complex defects, many of which had failed more conservative attempts at cover. One patient received radiation therapy to his flap without unfavorable sequelae. This experience began with a pioneering omental flap and includes cutaneous and muscle flaps. The latissimus dorsi is our first choice for free flap reconstruction of extensive, complicated scalp wounds because of its large size, predictable blood supply, ease of harvesting, and provision of excellent vascularity to compromised beds.

Adolescent↗
PubMed1990

Microsurgical transfer of the rectus abdominis muscle using the superior epigastric vessels.

A microsurgical transplant of the rectus abdominis muscle based on its superior pedicle is described. This procedure represents a salvage maneuver used in a patient in whom the inferior pedicle was found to have been previously injured. Vessels of adequate caliber and a pedicle of sufficient length were found by dissecting the superior epigastric pedicle to the level of the costal margin. In cases in which rectus flap harvest is complicated by a damaged deep inferior epigastric pedicle, we recommend exploration of the superior pedicle before abandoning the flap.

Abdominal Muscles↗
PubMed1990

Complications with the use of an axillary roll.

An axillary roll is frequently used to prevent brachial plexus compression when operating on a patient in the lateral decubitus position. Two complications resulting from the use of an axillary roll are described. Such complications can be avoided by placing a small roll under the upper chest rather than the axillary region.

Adult↗
PubMed1983

Angular artery flap for total reconstruction of the lower eyelid.

An island flap of the skin and soft tissues of the nasojugal fold and lip can be based on the superior end of the angular artery. This flap, lined with mucous membrane, was a satisfactory means of reconstructing the lower eyelid in a patient with inadequate skin for a cheek flap. A disadvantage was the need to trim the bulkiness of the flap in subsequent stages.

Aged↗
PubMedDate not supplied

Microvascular tissue transfer in paediatric patients: analysis of 106 cases.

We report a series of 106 microvascular transplants performed in paediatric patients between 1973 and 1989. Eighty-eight percent of these flaps were successful. Two of the 13 failed flaps (1.9%) in this series were lost because of small vessel size. Otherwise, success rates (93% in the last 5 years) and complications were comparable to our adult cases. No growth-related complications were noted either in recipient or donor sites. We conclude that microvascular transplantation is a reliable procedure in children.

Adolescent↗