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Biomedical subjects

H M Tschopp

Publications and source records attributed to H M Tschopp.

16 recordsLinked to original sources
PubMed1999

Quantitative assessment of microhemodynamics in ischemic skin flap tissue by intravital microscopy.

Skin flaps are susceptible to ischemia, which may result in tissue necrosis particularly in areas deprived of their original anatomic blood supply. The pathophysiology of skin flap failure has been debated for many years, but due to methodological insufficiencies, every proposed theory has remained hypothetical. The aim of this study was to gain more evidence for the mechanisms involved in flap ischemia by assessing quantitatively hemodynamic parameters such as diameter, flow velocity, and volume flow in the microcirculation of a flap. To this end the authors developed a new island flap on the back of Syrian golden hamsters that allowed intravital microscopic investigation. The flap included an extended portion, which was deprived of its original anatomic blood supply. One hour after flap dissection, blood flow was 42% to 66% lower in all microvessels in the extended area than in the anatomically perfused part of the flap (p<0.05). In the entire microvasculature, a significant gradual decline of blood flow was observed over time. Any blood flow reduction was caused to a major extent by diminished flow velocity. At all times, microvascular diameters were slightly larger in the extended portion of the flap than in the anatomically perfused portion of the flap. The authors conclude that their new model is a unique tool for investigating microhemodynamic mechanisms involved in flap ischemia. This study reveals hypoperfusion of extended flap tissue, which is attributed to diminished arterial perfusion pressure but not to vasoconstriction or arteriovenous shunting.

Animals↗
PubMed1989

[Local late sequelae following breast saving therapy of breast cancer: problem cases and possibilities for their correction].

The variety of deformities seen after local tumorectomy and postoperative radiotherapy in small breast cancers is shown. Most of the unfavorable results are due to surgical errors or improper radiotherapy, and could therefore be avoided. Late asymmetry due to soft tissue defect of fibrosis of the irradiated breast can be corrected by uni- or bilateral asymmetric reduction mammoplasty. Musculocutaneous flaps as the latissimus dorsi or the rectus abdominis can not only cover safely big defects after removal of a radionecrosis but also lead to a satisfactory cosmetic result.

Breast Neoplasms↗
PubMed1988

"The open sky rhinoplasty" for correction of secondary cleft lip nose deformity, Technique and recent results.

The typical nose deformity after cleft-lip repair still represents great challenge for the plastic surgeon in this field. Many methods have been designed in attempts to correct the deformity, either during primary closure of the lip or as a secondary procedure when growth of the nose is complete. In this paper the author's own technique of secondary rhinoseptoplasty in cleft-lip patients is presented. The different cartilaginous and osseous structures are approached through a transcolumellar incision and the skin of the nose completely reflected upwards. This so-called "open sky view" gives a total perspective on the entire pathology of the cleft-lip nose deformity and makes it possible to correct it accordingly. Emphasis is put on some important surgical manoeuvers. Recent results are presented and the pros and cons of this procedure discussed.

Adult↗
PubMed1981

[Free contralateral index finger pollicization].

A mutilating explosion injury of a dominant hand with amputation of thumb and index rays, loss of middle and ring fingers, and amputation through the proximal phalanx of the small finger was treated in four stages. The main step of functional restoration consisted in microsurgical transfer of the contralateral index ray for reconstruction of the thumb. Utilizing the principles of pollicization, pinch and grasp of wide amplitude were successfully restored. The rationale of this unusual plan of reconstruction is explained.

Adult↗
PubMed1979

[Principles of treating facial fractures].

The therapy of facial fractures is aimed at an early definitive treatment. Exact repositioning of the fragments is first achieved by setting the right occlusion. Intermaxillary fixation is then performed by interdental arch bars reenforced with acrylic material and intermaxillary rubber bands or wire. The middle third of the face is mainly subjected to static forces. Fractures in this area are therefore set and fixated with interosseous wire ligatures. Craneofacial suspension is carried out by means of a craneofixateur extern. Fractures of the mandible are treated differently. In order to counteract the strong dynamic forces internal fixation is necessary using compression plates in combination with tension bands. Another modality of treatment by a specially designed plate with excentric gliding holes renders the tension bands superfluous since it is capable of applying compression forces also at the dental area. In fractures with osseous defects long plates are used which stabilize the mandibular arch. If the articular prominence is missing these plates may be applied with a capitular end in order to reconstruct the articulation.

Bone Plates↗
PubMed1978

The tongue flap for reconstruction in a case of Möbius syndrome. A case report.

This paper deals with the extension of the tongue flap technique for reconstruction of deficient perioral structures in a case of Möbius syndrome. Some important surgical considerations, such as the vascularisation of the tongue, design of the flap, location of the flap base etc, are discussed and the operative procedures and the result are demonstrated.

Abnormalities, Multiple↗
PubMed1976

[Functionally stable osteosynthesis of the mandible by means of an excentric-dynamic compression plate. Results of a follow-up of 25 cases].

The stability of internal fixation is enhanced by axial compression on the fracture ends. If internal fixation of the mandible is achieved by a compression plate at the lower border of the mandible (compression side), distraction of the fracture ends on the occlusal side occurs which has to be counteracted without damaging the roots of the teeth on the occlusal side (traction side) or without damaging the inferior alveolar nerve. From experiments on models it was seen that an acceptable solution to this problem is given by the use of the combined compression plate and tension band plate or the "Excentric Dynamic Compression Plate" (EDCP). In this paper 25 clinical cases of internal fixation of the mandible by means of the EDCP are examined and discussed. The following relevant facts were reviewed on all patients: -- kind of trauma -- age -- dentition -- localization of the fracture -- local and general additional injuries -- time of operation -- material used for internal fixation -- type of occlusal immobilisation during operation -- use of antibiotics -- skin closure -- mobilisation -- hospital stay -- duration of work disability -- complications -- scarring -- neurological disablement -- malocclusion In this paper emphasis is layed upon internal fixation by means of the EDCP. The clinical evaluation of the 25 cases clearly demonstrates that the main indication for internal fixation with the EDCP is given in fractures of the horizontal ramus of the mandible, because in this localisation the plate has to be applied beneath the inferior alveolar nerve. A further indication for internal fixation with the EDCP are fractures of the angle of the mandible. In these cases the tension band principle by means of a tension banc archbar or a tension band plate cannot be applied, because of missing teeth on the proximal fragment, or a non erupted wisdom tooth. These indications can be summarized as follows: -- In fractures of the angle of the mandible--when ever possible compression plate and tension band plate, otherwise EDCP -- In fractures of the horizontal ramus--EDCP -- In fractures of the mandibular front--DCP.

Bone Plates↗