Biomedical subjects
Publications and source records attributed to H J Bargmann.
A case of heterotopic replantation of the metacarpus is demonstrated. This procedure shows the successful primary reconstruction of a severely injured hand. The result seventeen months after the injury is shown. The patient is rehabilitated and is able to manage basic activities of daily living.
The female breast can be reduced by a number of operative techniques. Their goal is to transform different deformities into a so-called ideal form. The ideal form is obtained by small changes such as fixing the nipple's position in relation to predetermined anatomical marks. Under certain conditions we have to deviate from the ideal form. In these cases the operative method used is not determined by the deformity but by the desired form. Reduction mammoplasty techniques are just variations of a single method whose principles still need to be defined.
The reconstruction of a part of the body that has lost or inhibited function has been the most important aspect of reconstructive surgery in the past. Because of the existence of better techniques and the patient's wish for social reintegration, the plastic surgeon today is forced to consider the aesthetic results of his work more than in the past. Sometimes microsurgical procedures in reconstructive surgery are the only chance for the patient to be healed or palliated. Experience with more than 350 free tissue transfers gave us the opportunity to estimate the value of a donor flap with respect to the requirements of the receiving site. To satisfy the high aesthetic demands in these cases, it was necessary for the right place and shape the flap to fit as closely as possible, even if further corrections were necessary to achieve a satisfactory result. The transfer of latissimus dorsi and radial forearm flaps to the face and lower leg is discussed in cases of tumorous diseases and severe injuries of young and old patients.
The attempt to achieve symmetrical harmonious facial expression represents a complex surgical challenge, necessitating an individualized approach. Clinical investigations and laboratory experiments have demonstrated how to better reconstruct a "smile." In long-standing deformities, ipsilateral or crossfacial nerve grafting followed by functional muscle transfer in a 2-stage procedure seems to give the most acceptable results; however, hypoglossal-facial anastomosis and dynamic muscle techniques such as temporal muscle transposition and others can result in adequate functional reconstruction. The development of these techniques with special emphasis on those made during the last 10 years is discussed and compared with our own experiences.