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Biomedical subjects

H H Werner

Publications and source records attributed to H H Werner.

11 recordsLinked to original sources
PubMed1988

Results after implantation of gelatine-impregnated bifurcated grafts.

In two randomized prospective trials grafts impregnated with gelatine were compared to those not impregnated. In the first trial a double-velours graft (n = 50) was compared with a graft without velours trimming (n = 50) implanted in the aorto-iliac bifurcation. One half of the grafts in both groups were gelatine-impregnated. In the second trial 24 grafts without velours trimming (Cooley II, Meadox), 24 grafts manufactured by a new warp-knitting procedure without velours trimming (Protegraft 2000, B. Braun AG) and 24 identical grafts of B. Braun AG but with gelatine impregnation were evaluated. Gelatine-impregnated or not the grafts without velours showed no satisfying results. An elevated intraoperative bleeding incidence and a low two-years-patency rate of 64% were noted. On the other hand all double-velours grafts, gelatine-impregnated or not, showed a 100% patency rate two years after implantation. In the second trial a slight reduction in intraoperative blood loss was noted when using the gelatine-impregnated grafts.

Aorta, Abdominal↗
PubMed1984

[Need for randomizing microvascular surgical experiments for testing new prosthesis material, with special reference to personal surgical errors from a morphological viewpoint].

In the examination of material involving two microvascular prostheses of different nature the need is discussed of randomising experimental series to achieve a self-critical control of operative dexterity in microsurgical techniques and to exclude eventual errors arising and influencing the results. A comparison was made of two polyurethane prostheses, one porous (n = 15), and the other covered internally with a smooth silicon layer (n = 15). They were implanted using microsurgical techniques into the infrarenal portion of the abdominal aorta in rats. The main criterion for successful implantation was a patency over a prolonged period of observation lasting a maximum of 407 days. The porous prosthesis showed the best results. Most frequent complications were early thrombosis and technical faults demonstrated by histology. Therefore, the distribution through prospective randomisation of good and bad results based on technical errors enhances the significance of material analysis.

Animals↗
PubMed1983

The use of microvascular graft as an arterial substitute in the abdominal aorta of the rat.

The purpose of this study was to compare by means of microsurgical techniques a porous with an interiorly smooth siliconized vascular graft. Compatibility and patency of the graft were examined in a long term follow-up. A microvascular prosthesis with a particular fibrous texture was used. The fibres consisted of polyurethane (PUR), a new prosthetic material. The lumen of the prosthesis measured 1.6 mm; the outer diameter was 2.4 mm. In group A an in- and exteriorly microporous graft was applied; in group B the inner surface of the prosthesis was smoothed by a silicon layer. 30 SPF-Wistar rats were randomized in group A (n = 15) and B (n = 15), and both prosthetic materials were implanted as a substitute for an infrarenal part of the abdominal aorta. Monofile suture material (MirafilR--DR 5) size 10:0 was used for the anastomosis. The mean pressure of the aorta amounted to 108 +/- 30 mm Hg. After 4 +/- 2 months the total survival rate was 77% (n = 23): in group A, 80% (n = 12); in group B, 73% (n = 11). Cause of death was early thrombosis due to technical mistakes. The following results were obtained by angiography: highest patency--group A, 8; group B, 1; constriction--group A, 6; group B, 9; occlusion--group A, 1; group B, 4; total--group A, 15; group B, 14; 1 angiography technically failed. Arterial substitution in the abdominal aorta of the rat by PUR-grafts is possible and is a suitable model for further experiments.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1983

The pathology of congenital metatarsus varus. A post-mortem study of a newborn infant.

A case of congenital metatarsus varus from an autopsy of a newborn infant was explored. Contracture of the anterior tibialis muscle was present as well as alterations in size and shape of the first cuneiform bone. Furthermore, subluxations in the fore- and midfoot were observed, especially round the first cuneiform bone. It is concluded that congenital metatarsus varus may be classified as a subluxation followed by secondary bone changes and contractures in the soft tissues.

Foot Deformities, Congenital↗
PubMed1983

[Immediate postoperative enteral feeding with an elemental diet (Survimed) using a new application form of the so-called fine needle catheter jejunostomy. A prospective study].

In a prospective study (n = 50) the clinical usefulness of a fine-needle-catheter-jejunostomy based on the method of Delany et al. [1] was studied. In all cases the jejunostomy was inserted intraoperatively without difficulty and without complication. The set used (Intestofix) consisted of one polyurethan-catheter (75 cm length), 2.1 mm inner diameter) and of two hollow needles constructed as split-cannulas. This system has been proved in our study to be simple, rapid and safe. Patient's tolerance of the feeding was, however, unsatisfactory; diarrhea occurred on the 5th postoperative day in 35% of all patients, in addition we observed inconvenient belching (42.5%) and sensation of repletion (25%). There may be different causes for these uncomfortable symptoms; for example application schedule or the composition of food. We think that the operation itself exerts an important influence upon patient's tolerance because patients without operation but under the same conditions tolerate the nutrition via jejunostomy better than those in our study (with concomitant operation).

Catheterization↗
PubMed1983

[Internal intestinal splinting with a soluble tube for the prevention of recurrent adhesion ileus].

An absorbable, non-toxic, easy gliding, cross-linked gelatine tube has been developed to prevent and to treat chronical adhesion ileus. The tube is patterned upon the interior intestinal splinting with long tubes. By doing a small enterotomy it was possible to splint the whole intestine in pigs or endangered parts within a few minutes. The flexible gelatine tube does not kink and is melting off from the surface. It prevents the intestine from kinking and does not cause any lesions even on previously damaged intestinal walls. Possible complications seen by insertion and extraction of conventional tubes were not observed.

Animals↗
PubMed1976

[Improved control of the pressure during use of the Sengstaken-Blakemore tube].

For the control of acute hemorrhage from esophageal varices by balloon tamponade a proper application of the Sengstaken-Blakemore tube is necessary to arrest bleeding and to minimize complications. A simple modification of the pressure measurement used up to now is described with other suitable applications. By this modified technique a correct pressure can be kept in the esophageal balloon spontaneously; its ease in handling in intensive care makes for better results in emergency management of balloon-tamponade in treatment of acute bleeding from esophageal varices.

Acute Disease↗
PubMed1975

Congenital metatarsus varus. On the advantages of early treatment.

Among 212 infants with congenital metatarsus varus 84 (39.6 per cent) of the infants were treated. Only the treated group is considered in the analysis. Daily manipulative therapy was given followed by fixation in elastic bandage or splint. The manipulations aimed at correcting the adduction of the fore part of the foot, as well as the increased valgus of the heel. In 68 infants treatment was instituted before one year of age. The results were good in 65 of these patients and correspondingly good results were obtained in 15 out of 16 patients treated at more than one year of age. Subluxation in the fore- and midfoot and bony incongruity present at birth are offered as a possible explanation for lack of spontaneous recovery before weightbearing as well as the occurrence of resistant cases. Spontaneous improvement may take place during childhood and may be explained by the influence of the position of the heel during weightbearing.

Child, Preschool↗
PubMedDate not supplied

Congenital metatarsus varus. A suggestion for a possible mechanism and relation to other foot deformities.

The pathogenesis of metatarsus varus was investigated by a series of dissections of 14 normal feet of stillborn or infants who died during the perinatal period. The deformity could not be produced without the surgical incisions described below. A valgus position of the hindfoot was produced by maximal dorsiflexion of the foot. The deformity of the fore part of the foot could not be produced even by extreme traction on the tibialis anterior tendon even after capsulotomy of the first tarsometatarsal joint. Only extensive capsulotomies in the tarsometatarsal joints distal to the joint of Chopart made it possible to displace the bones into the position analogous to metatarsus varus. It is suggested that metatarsus varus may be a deformity which occurs on a maximally dorsiflexed foot and that the primary mechanism of the forefoot deformity is a subluxation in the fore part of the foot. Secondary contractures of the soft tissues, and adaptive bone changes offer a possible explanation for lack of spontaneous recovery as well as the difficulties encountered in treating late cases.

Female↗