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Biomedical subjects

J G Kenney

Publications and source records attributed to J G Kenney.

16 recordsLinked to original sources
PubMed1990

The dartos musculocutaneous island flap in urethral reconstruction.

Reconstruction of the burned penile urethra has received scant attention in the surgical literature. Techniques used in repairing congenital hypospadias may not be applicable in this situation. We describe a dartos musculocutaneous island flap used to reconstruct the distal burned penile urethra in a 13-year-old boy who sustained burns to 85% of his total body surface area. Reconstruction was completed in one surgical procedure, and at two-year follow-up good results were demonstrated.

Adolescent↗
PubMed1990

Single-donor fibrin glue for hand burns.

Early tangential excision sometimes results in considerable blood loss, prolonged operative time, and partial loss of the graft secondary to hematoma formation. Previous reports document positive hemostatic effects and improved skin fixation with fibrin "glue." The commercial preparation used in Europe, however, has not been approved by the United States Food and Drug Administration because of the high risk of hepatitis and human immunodeficiency virus transmission. Using a method developed at the University of Virginia, we applied single-donor fibrin glue as an adjunct in early excision and grafting in 16 patients (26 hands). The overall graft take was 99%. In all patients, better adherence of the split-thickness graft to the recipient bed, during and immediately after application, was noted. We have observed no negative effects with regard to infection or healing. We recommend the use of single-donor fibrin glue to reduce operative blood loss, improve survival and ease of graft application, and possibly to accelerate healing.

Adult↗
PubMed1987

Recognizing the temporomandibular joint ganglion.

A case report of a cystic preauricular mass that changed in size and position with jaw movement is presented. This tumor proved to be a ganglion of the temporomandibular joint (TM) cyst, which is relatively rare. When a preauricular mass retrudes into the masseter muscle in jaw opening, pathological conditions associated with the TMJ should be considered. Ganglion cysts of the TMJ are a benign pathological entity which can mimic parotid tumors. Temporomandibular joint radiography and perhaps ultrasonography of the region are useful in the preoperative evaluation of preauricular masses. The TMJ ganglion cyst can be successfully treated by direct excision and repair of the joint capsule. This approach avoids the potential morbidity of a superficial parotidectomy.

Female↗
PubMed1987

Pediatric burns.

Burns are the second most common cause of death in childhood. More than half of pediatric burns are partial-thickness scald burns; the majority occur in the kitchen. Generally, minor burns may be treated on an outpatient basis, while moderate burns are treated in a community hospital. Children with major burns should be transferred to a regional burn unit as soon as possible after stabilization, provision of fluids and, if necessary, intubation.

Age Factors↗
PubMed1986

Antimicrobial treatment of minor soft tissue lacerations: a critical review.

This article is a collective review of all the prospective clinical studies that assessed the therapeutic value of antibiotics in minor soft tissue lacerations. This review critically evaluates each study that tests the hypothesis that antibiotic treatment reduces the incidence of infection. Even though the design of each of the studies was scientifically inadequate, important factors were identified that influenced the incidence of infection. On the basis of this collective review as well as other studies, indications for antibiotic therapy of minor soft tissue lacerations have been identified. Future clinical studies must be designed to test more precisely the validity of these recommendations.

Adult↗
PubMed1986

Toxic epidermal necrolysis.

Toxic epidermal necrolysis (TEN) is a symptom complex characterized by a devastating skin disorder, erosive involvement of two or more mucous membranes, and severe constitutional symptoms. The disorder shares features with erythema multiforme and is thought to be an expression of the syndrome. Although a wide range of etiologic factors have been incriminated in TEN, only a few cases have provided convincing evidence of a direct causal link. Most cases of TEN have been associated with drug administration.

Adolescent↗
PubMed1985

The arcuate skin staple: its influence on pain of staple penetration and removal.

The purpose of this study was to measure the degree of pain elicited by either staple implantation and by removal in human subjects. Included in the study were conventional rectangular staples and the new arcuate staples. The pain associated with staple implantation was significantly greater than that associated with staple removal. The configuration of the staple did not influence the magnitude of pain associated with either staple implantation or staple removal.

Equipment Design↗
PubMed1985

Innovations in skin suture removal.

A cutting forceps and suture removal scissors have been specially designed for removal of percutaneous sutures. Our clinical experience with these instruments indicate that they facilitate removal of percutaneous sutures in the surgical patient.

Dermatologic Surgical Procedures↗
PubMed1985

Lawnmower injuries in children: lower extremity reconstruction.

Power lawnmower accidents are one of the most frequent causes of mutilating injuries in pediatric patients. Guidelines for the optimal surgical management of children differ from adult patients by several key anatomic, physiologic, and rehabilitative features. Small blood vessels in children less than 2 years old may prohibit microvascular surgery. Older children with larger vessels are often better candidates for microvascular flaps than their adult counterparts. Pediatric patients also resist recurrent ulceration of foot skin grafts, tolerate prolonged immobilization, and are rehabilitated more readily than adults. In considering these facts, we outlined an algorithm for surgical reconstruction. Split-thickness skin grafts are generally the first choice for coverage. The medial gastrocnemius is the workhorse of the knee and upper third leg. The soleus provides coverage for the middle third leg; microvascular flaps are used for large lower third leg defects. Crossleg fasciocutaneous flaps are good alternatives when microsurgery is not feasible. When possible, the weight-bearing surface of the foot should be covered with local vascularized sensate flaps; larger defects may require free flaps, crossleg, or gluteal-thigh flaps. Excellent functional rehabilitation has been achieved in our young patients through the combined efforts of the trauma service, plastic and orthopedic surgery, and physical and occupational therapy services.

Accidents↗
PubMed1985

Lightning injuries.

Lightning causes more deaths than any other weather phenomenon. It is an electrical current that will choose the shortest paths between the contact points of the human body and may involve vital structures in its pathway. Almost every organ system can be injured by the electrical current of lightning. A broad spectrum of complications resulting from damage to the various organ systems has been reported. The sequelae peculiar to this specific type injury will dictate the choice of therapy.

Bone and Bones↗
PubMedDate not supplied

Fractures in women lacrosse players: preventable injuries.

Women field-lacrosse players, except the goalkeeper, do not wear protective equipment and are therefore susceptible to bony injuries by either the lacrosse stick or ball. The purpose of this article is to document one case of a finger fracture and another of a nasal fracture caused by an impact injury from lacrosse sticks in women field-lacrosse players. The Consumer Product Safety Commission estimates that 73.6% of the fractures in women field-lacrosse players that occur annually are located in the head, face, hand, or fingers. These injuries could be easily prevented by protective equipment (face mask or helmet) or gloves.

Adolescent↗
PubMedDate not supplied

Pulse oximetry for vascular monitoring in burned upper extremities.

The reliability and accuracy of pulse oximetry as a monitoring device in deep superficial and full-thickness circumferential burns of the upper extremity were evaluated clinically. Pulse oximetry was correlated with the laser Doppler flowmeter experimentally in healthy volunteers. By continuously monitoring oxygen saturation levels, the pulse oximeter detected extremity hypoxia before it resulted in an adverse outcome. Extremities exhibiting oxygen saturation above 95% were treated with early excision and skin grafting without escharotomy. Extremities with O2 saturations of less than 95% underwent immediate escharotomy with return to normal saturation levels. The pulse oximeter is easy to use by nursing personnel; is noninvasive and accurate; and displays the oxygen saturation level within seconds.

Arm↗
PubMedDate not supplied

Application of single-donor fibrin glue to burns.

Early tangential excision and immediate grafting of the burn-injured patient has been shown to be effective. Along with the use of this technique, however, comes the potential for significant blood loss, prolonged operative time, and partial loss of graft due to underlying hematoma formation. Based on experience using a pooled fibrinogen preparation, European and Japanese surgeons have provided evidence for the positive hemostatic and skin transplant fixation effects of fibrin glue. This commercial preparation, however, has not been approved by the U.S. Food and Drug Administration for use in the United States because of high risk of hepatitis and HIV transmission. Using a method of preparing highly concentrated fibrinogen utilizing standard blood bank techniques developed at the University of Virginia, we have applied single-donor fibrin glue as an adjunct in the early excision and grafting of 26 patients. Since we have been using fibrin glue, we have noted a marked reduction in operative blood loss and time involved in obtaining hemostasis. Additionally, we have found the application of the grafts to be facilitated by the "stickiness" of the recipient bed. In follow-up, grafts applied utilizing the fibrin glue technique have proceeded to uncomplicated wound healing with an overall 98% graft take.

Adult↗
PubMedDate not supplied

Tissue-expanded radial forearm free flap in neck burn contracture.

Neck contracture after burn injury can result in severe functional as well as aesthetic deformities. Contracture can recur even after wide and complete release and full-thickness skin grafting. Recurrence is partly due to the inherent difficulties in both early postoperative immobilization and the required long-term splinting. When adjacent tissues are also burned, adequate local tissue for reconstruction may not be available; therefore, free-tissue transfer may be necessary. The large surface area that is required after adequate release may be provided by tissue expansion before free-tissue transfer. In the case presented the use of tissue-expanded radial forearm free flap for the reconstruction of a recurrent neck contracture is described.

Adult↗