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Biomedical subjects

H P Giele

Publications and source records attributed to H P Giele.

9 recordsLinked to original sources
PubMed2003

Tie-overs under pressure.

Dressings tied over skin grafts reduce the size of dead space, prevent haematoma formation, and immobilize the grafts [McCarthy, Plastic Surgery, 1990]. Their mechanism of action was thought to include the application of pressure to the bed and stabilization of the graft and dressing. A quantitative analysis of the pressure exerted by these dressings has never been reported [Wolf at al., Ann Plast Surg 40 (1998) 149]. This study measures the pressure exerted by tie-over dressings at the graft-bed interface and finds that no significant pressure is exerted.

Bandages↗
PubMed2001

Prevention of the parrot beak deformity in fingertip injuries.

The nail is supported by the dorsal tuft of the terminal phalanx. Following distal fingertip trauma, varying amounts of nail support may be lost resulting in the nail curving palmarwards. This curvature is dependent upon the degree of bony loss, the amount of remaining nail bed and the degree of scar contracture at the hyponychial-pulp interface. The parrot beak or hooked nail deformity is most commonly caused by tight closure of a fingertip amputation and excessive palmar tension at the hyponychial-pulp suture line. A simple technique using a hypodermic needle, that eliminates tension from the suture line at the fingertip pulp-hyponychial interface and prevents hooked nail deformity is described. This allows healing to take place without any palmarwards pull of the scar and a subsequent parrot beak deformity.

Finger Injuries↗
PubMed1997

Direct measurement of cutaneous pressures generated by pressure garments.

Pressure garments are the mainstay of burn scar management despite limited scientific evidence. This study demonstrates a simple method of directly measuring the cutaneous pressures generated by a pressure garment. The results show pressure garments generate an increase in subdermal pressures in the range 9-90 mmHg depending on the anatomical site. Garments over soft sites generate pressures ranging from 9 to 33 mmHg. Over bony prominences the pressures range from 47 to 90 mmHg. This method is believed to be more representative of the pressures generated than the interpositional techniques that measure garment-skin interface pressure, as it avoids garment distortion, the interference effect of the measurement device (size, conformation, area) and directly measures subdermal pressures. The method should be useful for larger research projects on pressure therapy and also for clinical management of pressure garments in the treatment of hypertrophic scar.

Bandages↗
PubMed1996

Warm ischaemia time in a model for small bowel transplantation.

Intestinal transplantation is associated with high rates of mortality and morbidity. This paper details our initial experience with 82 heterotopic small bowel transplants based upon the original rat model described by Monchik and Russell (Surgery 70:693-702, 1971). A key issue associated with mortality was a warm ischaemia time of more than 40 min (P < 0.01). Sixty-eight percent of the recipients (44/65) survived for more than 24 hr when the warm ischaemia time of the donor bowel was reduced to less than 40 min. Investigators establishing an animal model of heterotopic small bowel transplantation should pay particular attention to the warm ischaemia time of the donor bowel.

Animals↗
PubMed1994

Flushing the vessel ends: the effect on ischemic free flap survival.

During vascular anastomosis of experimental ischemic free flaps it is common to observe that stagnant blood in the vessel ends has clotted. A study was performed to investigate if flushing away the stagnant blood on division of the vessels would increase flap survival. Flushing did not influence flap survival. Clinically, clot is rarely seen, except in conditions of prolonged ischemia or damaged vessels. Current surgical practice does not involve flushing the vessel ends upon division of the vessels and this approach is affirmed by our results.

Anastomosis, Surgical↗
PubMed1994

Management of full thickness burns to lactating breasts.

A 19-year-old female sustained 8 per cent full thickness petrol flame burns to the neck, chest, breasts, upper abdomen and portions of the right upper limb. The patient had been breast-feeding until the time of the injury. Following assessment of the risks of potential complications such as engorgement, hyperprolactinaemia, mastitis, milk fistulae, glandular loss, scarring and nipple distortion, surgical tangential excision was delayed until bromocriptine produced cessation of lactation and breast involution occurred. This case report demonstrates that consideration of the potential problems in burns to the lactating breasts and prophylactic management can lead to successful healing and probable restoration of function.

Adult↗
PubMedDate not supplied

Early use of pressure masks to avoid facial contracture during the pregrafting phase.

This article introduces the concept of early application of pressure therapy as a form of splinting in the pregrafting phase. It is based on the principles of (1) the use of pressure therapy to reduce contraction and hypertrophic scar formation and (2) the knowledge that most wound contraction occurs within the initial few weeks of healing. This idea has most application in facial burns, where wound contraction can be disfiguring and functionally disabling, and in situations where unavoidable delay in debridement and grafting may be present. The idea is illustrated with a case report.

Adolescent↗