Biomedical subjects
Publications and source records attributed to J A Hobby.
The serratus anterior/rib composite flap can be used alone or in combination with a latissimus dorsi myocutaneous flap in mandibular reconstruction. The combined flap is particularly useful in reconstructing large anterior mandibular defects, and 4 cases are described which illustrate its use both as a pedicled flap and as a free tissue transfer.
In order to produce the characteristic color of the nipple-areola complex and in unilateral reconstructions to match the other side, a modified tattooing method has been introduced. The quite different requirements between reconstruction and ornamental studio tattooing can only be satisfied by different techniques. For the first time, pigment particles have been suspended in a gel rather than adsorbed on an opaque mineral. Our porcine study has shown how the pigment is distributed in the dermis without penetration of the gel particles. The first 16 of the authors' 29 patients have been reviewed with an analysis of their appearance. Using this new method, a third achieved a completely natural appearance and two-thirds were judged to be intermediate, compared with an unnatural, although sometimes acceptable, result in all the earlier conventional tattoos.
The association of turban tumour with other dermal cylindromas in the parotid gland is very rare. Another case is reported in which the hereditary nature of the disease is discussed and certain aspects of the treatment and management of these cases are considered.
An experimental dorsal rat skin flap which produces a consistent pattern of necrosis is described. As judged by the area of necrosis in this flap, short post-operative courses and several vasodilator agents failed to increase flap survival. However it is not possible to conclude from this that those agents did not influence small vessel blood flow. Necrotic flaps in rats may not be the most appropriate models in which to test the effect of vasodilator agents.
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We have demonstrated the absence of tissue fibrinolytic activator for 11 days following the transplantation of vascular grafts in dogs. The lack of a local tissue fibrinolytic activator (to dissolve intravascular thrombi) is suggested as an etiological factor in losses which occur during the first 11 days after digital replantation.
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Fucidin is useful against ;antibiotic-resistant staphylococci' which are a major problem in causing shunt site infections in patients on chronic intermittent haemodialysis for end-stage renal failure. A new form of intravenous fucidin has been used in vivo in three patients on haemodialysis, and also in experiments in vitro in order to assess its dialysing properties. The experiments in vitro show that some fucidin does cross the dialyser membrane but, in the patients studied, adequate serum levels were maintained throughout a 10-hour haemodialysis. A single intravenous dose of Fucidin is, therefore, adequate for treating ;antibiotic-resistant' staphylococcal infections in patients during haemodialysis.
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