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Biomedical subjects

H Riediger

Publications and source records attributed to H Riediger.

9 recordsLinked to original sources
PubMed2004

[The non-healing wound].

The most common chronic wounds are pressure ulcers, diabetic ulcers, arterial occlusive disease and venous ulcers. The therapeutic aim after appropriate diagnostic work-up is causal treatment. Pressure relief, revascularisation or compression head the list of potential measures. Apart from local factors such as infection or necrosis, systemic factors such as patient compliance, renal insufficiency and immunosuppression are of relevance. If there is a chance of healing, wound management comprises repeated debridement and wet dressings. In the presence of an infection, local antiseptic treatment is indicated. In the individual case, wound stimulation can be supported by protease inhibitors, growth factors or tissue engineering. Definitive wound closure is achieved by epithelial migration from the margins of the wound, or by plastic surgery. Regular documentation of the course and success of wound healing is mandatory. In the wound care center, surgical disciplines, diabetology, dermatology and diagnostic work-up are coordinated, and liaison with the family doctor and home care providers practiced. This wound healing concept successfully heals approximately 80% of the cases of chronic wounds in 18.8 months (mean healing duration 4.8 months).

Adult↗
PubMed2004

[Prophylactic splenectomy for splenic vein thrombosis in patients undergoing resection for chronic pancreatitis].

AIM: Chronic pancreatitis (CP) is the leading cause of splenic vein thrombosis (SVT). SVT occurs in about 15 % of patients with CP. The risk of variceal bleeding in SVT is approximately 10 %. Splenectomy is indicated in symptomatic SVT but its role in asymptomatic SVT is discussed controversially. Aim of our study was to evaluate the outcome of splenectomy performed during pancreatic resection in patients with CP and asymptomatic SVT. METHODS: 33 of 198 patients undergoing resection for CP underwent concomitant prophylactic splenectomy for asymptomatic SVT. Perioperative data were compared in the groups of patients with or without splenectomy. Follow-up was complete in 84 % (average 31 months). RESULTS: Median operative time, postoperative morbidity, reoperation rate and mortality were not different in patients with or without splenectomy. The median number of blood units transfused was higher in patients with prophylactic splenectomy (6 vs 4 units; p < 0.01). One complication of splenectomy (postoperative bleeding) occurred (3 %). During follow-up no variceal bleeding, no episode of postsplenectomy sepsis or thrombosis due to temporary thrombocytosis occurred. CONCLUSIONS: Complications of prophylactic splenectomy are rare and less frequent than reported episodes of variceal bleeding. In the presence of asymptomatic SVT splenectomy should be considered during pancreatic resection to facilitate surgery and to avoid further variceal bleeding.

Chronic Disease↗
PubMed2002

[Pancreatic leakage after pancreas resection. An analysis of 345 operated patients].

INTRODUCTION: Complications after pancreatic resections remain frequent despite a decreasing mortality. Pancreatic leakages represent a relevant part of those complications but data on risk factors for their occurrence are rare. We analyzed our experience with incidence, clinical course, and risk factors of pancreatic leakage in a large patient group. METHODS: We analyzed the prospectively documented perioperative data of 345 patients with pancreatic resections carried out between 1994 and 2001. Main indications for surgery were chronic pancreatitis (57%) and malignant tumors (37%). The following operations were performed: Whipple's operation 15%, pylorus-preserving pancreaticoduodenectomy 53%, duodenum-preserving pancreatic head resection 19%, and distal pancreatic resection 13%. Risk factors were analyzed using uni- and multivariate methods. RESULTS: Postoperative mortality and complication rate were 2.9% and 41%, respectively. A pancreatic leakage occurred in 9.9%. In the majority of patients, pancreatic leakage was asymptomatic and controlled by prolonged drainage. However, one fourth of the patients with pancreatic leakage required reoperation. The mortality of pancreatic leakage was 12%. No patient with chronic pancreatitis died as a consequence of pancreatic leakage. Impaired preoperative renal function was the only risk factor for the occurrence of postoperative pancreatic leakage. CONCLUSIONS: Although easily managed in the majority of cases, pancreatic leakage still represents a relevant postoperative complication after pancreatic resection, especially in patients with malignant disease. Because of an increased risk of developing pancreatic leakage, an impaired renal function should be considered specifically in the perioperative management of the patients.

Adolescent↗
PubMed2001

[Network of surgical wound centers using a new electronic data processing documentation system].

UNLABELLED: Care of chronic wounds is of enormous medical, social and economic importance. Nevertheless there is a lack of epidemiological and economical data. A network of ten wound care centers was created and data were documented in a new computerized wound documentation system. METHODS: Treatment was performed according to a comprehensive and standardized wound care protocol. The new documentation system is a network-capable solution. Digital images and planimetry as well as patient and wound related data are recorded. RESULTS: During the first year the ten centers treated and documented already 3281 wounds. There is a wide spectrum of different chronic wounds treated in the participating centers. Despite of long wound duration of several wounds with a median of 5 weeks (range 0-62 years), the healing rate was 80% within 455 days. CONCLUSION: Large amounts of data can be collected and scientifically evaluated in the wound net. This is realized by a new computerized documentation system, which was integrated into the clinical routine and enables clear and standardized documentation. Therefore even large multicenter therapy studies may be performed easily in the wound net and economical data could be collected.

Chronic Disease↗
PubMed2001

[Distal pancreatic resection--indications, techniques and complications].

AIM: Description of the indications, surgical technique and postoperative complications of distal pancreatic resection. METHODS: We analyzed the prospectively documented perioperative data of 41 patients undergoing distal pancreatectomy between 1994 and 2001. Indications for resection were chronic pancreatitis (n = 21), malignant or benign tumors (n = 19) and others (n = 1). RESULTS: Median operation time was 4.5 hours, a Y-Roux-pancreaticojejunostomy was performed in 66 %. Further organs were resected in 93 %, most frequently in form of splenectomy. A malignant vascular invasion led to positive resection margins in three patients. Mortality was 2 %. Postoperative complications occurred in 41 % with 15 % revealing pancreatic leakage. A relaparotomy was carried out in 20 %. Pancreatic leakage was more frequently seen in the first part of the study period and after oversewing of the pancreatic stump. A new onset diabetes occurred postoperatively in 6 % of the patients. CONCLUSIONS: Distal pancreatectomy can be carried out with low mortality, despite a high complication rate. The probability of postoperative diabetes is low. The frequency of pancreatic leakage may be reduced significantly by increasing hospital experience. The management of the pancreatic stump by pancreatojejunostomy should be considered in patients with a high risk of pancreatic leakage.

Adenocarcinoma↗
PubMed1995

[The traumatized shoulder in computerized and magnetic resonance tomography].

Diagnosis of traumatic changes of the shoulder can be achieved by several invasive and nonivasive radiological procedures allowing visualization of bony and/or soft tissue structures. With reference to 74 shoulder examinations CT, CT-arthrography, and MRI were reviewed and their value for further treatment assessed. Since joint effusions occurred in nearly all cases of glenoid and rotator cuff lesions, a cost-effective strategy for diagnosing traumatic changes of the shoulder is presented.

Arthrography↗
PubMed1994

[Color velocity imaging for diagnosis in kidney transplants. Methods for interpretation of color coding].

Colour velocity imaging is a new technique in the field of colour-coded sonographic flow measurement. It measures blood flow directly by analysing ultrasound pulses' running time and has advantages over colour Doppler systems. Colour velocity imaging's colour code detects changes in arterial blood flow. Therefore it can be used in the diagnosis of kidney allografts in the same way as duplex ultrasound. Using the presented methods of colour interpretation, sensitivity of 66.6-100% and specificity of 72.7-91.7% are attained. Thus colour velocity imaging combines the attributes of duplex ultrasound and colour Doppler ultrasound.

Blood Flow Velocity↗
PubMed1994

[Flow time analysis in sonographic flow measurements: an in vitro measurement for testing their accuracy].

Flow-time analysis is a new technique for colour coded sonographic flow measurements. The measurements depend on a pattern of ultrasound pulses and have some significant advantages compared with Doppler procedures. The accuracy of the method and possible sources of error have been studied under experimental conditions. Measurements on continuous blood flow showed a correlation of r > 0.99 for duplex sonography and of r > 0.93 for flow-time analysis. For this method, the colour coding parameters must be optimal in order to achieve high accuracy. Under these conditions quantitative measurement of pulsatile flow also becomes possible during colour mode.

Color↗