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Biomedical subjects

J C Bruck

Publications and source records attributed to J C Bruck.

At least 19 recordsLinked to original sources
PubMed1998

[Tumor-related arthrodesis. Reconstruction of the shoulder contour using a free TRAM (Transverse Rectus Abdominis Musculocutaneous) flap].

Upper arm bone- and shoulder resection due to cancer have to be performed under oncologic criteria. Soft tissue however may not be sufficient to safely cover a following arthrodeses. To avoid perforation and reconstruct a normal shoulder contour a free myocutaneous TRAM-flap was employed and its vessels anastomosed to branches of A. and V. brachialis. Incorporating the facia and an island of M. rectus abdominis proved to safely cover the arthrodetic material and shape the bulk of the flap, allowing to reconstruct the desired contour. Good vascularisation postoperatively preserved tissue stability and volume and thus safely restored normal shoulder contour even in a long time review.

Abdominal Muscles↗
PubMed1998

[Breast reconstruction with the free microvascular abdominal flap. Accessory reconstruction or gold standard?].

Long time results of breast reconstruction after ablative surgery with skin expander and prothesis is perceived as unsatisfactory by most patients. Breast reconstruction with autologous tissue however is connected with a high technical expenditure and especially in the case of the free TRAM-flap connected with the risk of total loss of the transplanted tissue. In view of the total effort in secondary interventions, and reduction of the collateral side, the autologous reconstruction proves to need less time, resources and hospital admissions already after a 2 year period. Minor revisions mark the long time course of breast reconstruction with expander and prothesis. Judging by the patients themselves they prefer the reconstruction with autologous tissue and in this subgroup microsurgical reconstruction yields the better results to the patient. Review shows that the microsurgical procedure allows the transfer of larger volumes and better positioning of the breast including a physiologic breast ptosis. TRAM-flap donorsites seem to yield equal results in dynamic as well as static exercise regardless of the microsurgical or pedicled technique. The review of our own 48 patients with 50 TRAM-flaps coincide with the review of the current literature.

Breast Neoplasms↗
PubMed1995

Treatment of partial thickness burns of the hand with the preshaped, semipermeable Procel Burn Cover: results of a multicentre study in the burn centres of Berlin, Duisburg and Munich.

The results of a prospective clinical study conducted in three German burn centres are reported. The subject of the evaluation was to show the effectiveness of a new, preshaped, semipermeable burn dressing that is resistant to fluids and bacteria but highly permeable to vapour. The dressing was used in conjunction with 1 per cent silver sulphadiazine cream in treating partial thickness burns of the hand. In 49 patients, 72 partial thickness burned hands were treated. The application proved to be very easy. The time for a dressing change was short (5-10 min). The duration of treatment was 13 days on average. Complications due to infections did not occur. Because of the semipermeable properties of the dressing material, skin macerations occurred in only a few instances (13 per cent) as a result of inappropriate cream application or extremely high exudation rates, and these did not adversely affect the healing process. Patients achieved the ability to perform activities of daily living early with positive results for the patients, the physician and the nursing team.

Adolescent↗
PubMed1992

[Pyoderma gangraenosum--a rare complication after breast reduction].

Applying standardized and sound operative techniques, impaired wound healing following reduction mammoplasty is rare. A postoperative case of pyoderma gangraenosum is reported. This necrotizing skin disorder seemed at first to be a postoperative bacterial infection, but correct diagnosis was finally made histopathologically. The clinical course, etiology, diagnostic findings, and therapy are discussed and a review of the literature is presented.

Adult↗
PubMed1991

More arguments in favor of myocutaneous flaps for the treatment of pelvic pressure sores.

The use of myocutaneous flaps for the treatment of pelvic pressure sores is well accepted, yet there are still unanswered questions about why myocutaneous flaps are clinically superior to skin flaps. An experiment involving 16 pigs revealed new data on the diffusion of infection through myocutaneous and cutaneous flaps, showing that the muscles can act as a barrier against such infection. In 51 patients seen consecutively in 1988, osseous specimens of the infected bottom of the decubital ulcers were taken. There was florid osteomyelitis in 65.9% of all specimens, further emphasizing the importance of muscle flaps in the treatment of pelvic pressure sores when infection is still present. The fate of 16 transposed gluteus maximus muscles was monitored by electromyography postoperatively; 15 still showed voluntomotoricity up to 7 months after transposition.

Adipose Tissue↗
PubMed1991

Repair of the upper eyelid by means of the prepuce after severe burns.

Burns to the eyelid often constitute difficult problems for reconstruction or repair. Functional and aesthetic aspects have to be considered, and suitable donor sites are not readily available in severely burned patients. In male patients, the prepuce yields an almost ideal skin for eyelid repair because of its high elasticity and adequate texture. Two patients with repair of both upper eyelids using the prepuce are demonstrated. The color match of this skin graft is satisfying. If both layers of the prepuce are transplanted, they yield enough tissue to cover both upper eyelids. This method seems to be an adequate method of reconstruction of burned eyelids in severely burned male patients when the usual donor sites for skin grafts are not available.

Adult↗
PubMed1991

[Electromyographic studies of myocutaneous sliding flaps for the covering of sacral decubitus ulcer].

Gluteus maximus myocutaneous sliding flaps from one or both sides are useful in covering deep, usually infected sacral pressure sores. Although skin is known to tolerate higher pressure in the covered area, muscle offers far better conditions for flap healing of infected defects. In spite of excellent early results, the long-term fate of the transposed muscle remains uncertain. An electromyography study was performed on eleven patients out of 29 with sliding gluteus maximus myocutaneous flaps in periods up to seven months after surgery. Our results show that signs of denervation parallel reinnervation and functional integrity of the transposed muscle.

Adult↗
PubMed1991

[Skin replacement after electric burns].

Skin reconstruction following electrical injuries is characterized by the difficulty of early diagnosis. There are two forms of tissue damage: (1) thermal trauma, (2) damage of cells due to high field strengths. For the diagnosis of macroskopically undetectable damage we use scintigraphy with technetium pyrophosphate and quantitative histological examination of the necrosis. After efficient debridement split thickness skin graft is only feasible in a few cases. Sometimes local flaps from areas without any tissue damage can be employed but mostly microvascular free flaps are used to cover the defect.

Burns, Electric↗
PubMed1990

The serratus anterior osteocutaneous free flap.

Microvascular transfer of the rib as an osteocutaneous or osseous free flap based on the thoracic branch of the thoracodorsal artery is described. A review of the literature revealed various patterns of rib vascularization in different areas of the body from the periosteum and the endosteal vessels. Reversing the blood flow in the transcortical vessels of the rib is reported to be possible. Injection studies showed a reliable connection between the thoracic branch of the thoracodorsal artery and the endosteal vessels of the sixth and seventh ribs at the origin of the anterior serratus muscle. This approach to free rib transfer has proved to be quick, easy, and reliable in various clinical applications.

Adult↗
PubMed1990

[Regeneration of bone following thermal injury].

In an animal experiment we could prove, that a spontaneous regeneration of periosteum on thermally injured bone is not to be seen within three month, when the bone is covered by soft tissue only. Using a periosteal flap to cover a burned bone, regeneration could be observed from the endosteum and the periosteum alike. After making the bone with a fluorescent labels, paths and velocity of bony regeneration could be defined.

Animals↗
PubMed1990

[Indication for and results of the application of glycerol-preserved homologous split-thickness skin following burns].

Since 1983 the treatment of second-degree burns with glycerol-conserved allogenic split-thickness skin grafts is published. In case of actual problems with AIDS the gathering of split-thickness skin was modified and a new method for gaining split-thickness skin of organ-donors created to prevent the virus transfer. Because of these high security in contagiousness the skin graft transplantation with allogenic glycerol-conserved donor-skin in case of second-degree-burns was standardized in the Berlin Burn Center. To prevent the formation of granulation tissue after second-degree burns a tangential debridement of necrotic corium will be done in 1/10 mm thick slices on the third posttraumatic day and the defects covered with 1:1.5 mesh grafts extended. The results of 267 patients in 1988 and 1989, who were treated in accordance to this regimen, will be demonstrated. In 11% of cases the alloplastic skin graft in adults was not rejected 6 month after transplantation and in 2% of cases the depth of burn was not estimated properly and hypertrophic scars had to be excised and covered with autogenous split-thickness skin. General second-degree-burn healed after debridement and covering with allogeneic split-thickness skin without formation of hypertrophic scars.

Adult↗
PubMed1990

[Therapy of 2d degree burns with homologous split skin with special reference to HIV transmission].

The treatment of second degree burn wounds with glycerol conserved homografts yields good results in comparison with other techniques. However HIV-infection by this way has been reported. Apart from a description of the method of conservation and processing a method is outlined to avoid this path of HIV-infection. The kidney recipients of the respective organ donation is tested 3 month after the transplantation. This regimen nearly eliminates HIV-transfer by the use of glycerol conserved homografts and merits the extra effort in the treatment of second degree burn wounds.

Acquired Immunodeficiency Syndrome↗
PubMed1989

[Morel-Fatio temporary management of the paretic eyelid].

Various alloplastic materials have been used to reestablish proper function of paretic upper eyelids. Modifying Morel-Fatio's method, the spring had been bent in a W-fashion and located in such a position that three dimensional movement of the lower branch was possible. Complications of the original method like swelling and perforation could be explained by occasional allergies against chromium and nickel. Therefore we used a new titan-molybdaen alloy, which has a slightly higher elasticity modul than the chrom-nickel alloy. The new material's characteristics correlate well with our own in vivo measurements of the strength of the levator palpebrae superioris muscle. Clinical observations during the last 3.5 years show an improvement by the use of the titan-molybdaen alloy for the durability of elasticity as well as for tissue compatibility.

Biomechanical Phenomena↗
PubMed1988

[Early pressure on the gluteus maximus rotation flap in sacral decubitus ulcer].

The myocutaneous gluteus maximus flap in V-Y technique has become the workhorse for covering extensive sacral pressure sores. clinical experience indicates that this flap can sustain pressure prior to the usual three week period. Transcutaneous pO2 measurements permitted us to follow the flaps perfusion and to develop a new mobilization regimen. Patients can lie in the supine position for 30 minutes immediately after surgery for two hourly intervals. Three days postoperatively the usual two-hour repositioning can be resumed. This regimen represents a considerable improvement for paraplegics and has shown a comparable complication rate in 18 cases.

Graft Survival↗
PubMed1987

Facial mimics and the coronal brow lift.

The classic rhytidectomy leaves the upper third of the face without improvement. Yet the eye-eyebrow region is the most influential in determining facial expressions. There is only a narrow range of positions of the eyebrows in which they are perceived as attractive. The influence of the coronal browlift on facial mimics is discussed as it seems to be a way to predictably reposition the eyebrows and improve crow's feet and forehead, and glabellar wrinkles at the same time. The results of 56 patients surveyed 1-3 years postoperatively are presented.

Eyebrows↗
PubMed1987

Galactorrhea: a rare complication following reduction mammaplasty.

A case of galactorrhea immediately following a reduction mammaplasty is presented. Prolactin levels were elevated postoperatively and could be reduced to normal by a prolactin inhibitor. No other disease or disorder could be found. Based on a review of the literature, it seems that various factors have to contribute to galactorrhea, including stress-related prolactin secretion, rebound phenomenon after discontinuation of birth control pills, and hypersensitivity to prolactin receptors. Their coincidental occurrence, resulting in abundant milk production after surgery, is discussed.

Adult↗
PubMed1986

[Report of experience in 424 burn injuries 1970 to 1982].

Third-degree burn management with state-of-the-art surgery and intensive care technique has been available in Innsbruck since 1969. This statistical survey covers the period 1970 to 1982, with follow-ups on a total of 424 burn patients. Dividing the study into two periods, namely 1970-1976 and 1977-1982, permits a critical assessment of progress in burn management. A comparison of our results with those from other prominent burns units shows that the survival rate is considerably lower in Innsbruck, especially in the case of patients with burns of over 60% of body surface area. It is essential that similar burns units should be set up elsewhere in Austria.

Adolescent↗