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Biomedical subjects

J G Mosley

Publications and source records attributed to J G Mosley.

At least 19 recordsLinked to original sources
PubMed1995

Use of a semipermeable polyamide dressing over skin grafts to venous leg ulcers.

A polyamide semipermeable mesh interface placed over a skin graft allows absorption of exudate and soaking of the graft with an antiseptic solution. Forty-five patients with large venous leg ulcers (more than 100 cm2) were treated by a split skin graft covered by a polyamide mesh. The mean time to healing and graft take was compared with those of a similar group of 30 patients whose graft was not protected by an interface. The mesh significantly shortened the mean time for complete healing from 41 to 32 days.

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PubMed1995

Evaluation of vascular and metabolic deficiency in patients with large leg ulcers.

A consecutive series of 50 patients with large leg ulcers (surface area > 100 cm2) were investigated for evidence of arterial, venous and nutritional problems. Arterial insufficiency was found in 34%, venous reflux in 50%. A group of eight patients had no arterial or venous problem but had serious deficiencies of vitamin C and zinc. Arterial bypass was performed successfully in 15 of the 17 patients with arterial disease. All patients had a mesh split-skin graft. The 25 with venous incompetence had compression bandaging; in these patients the ulcer had healed on discharge but 10 had recurrent ulceration within 6 months. The leg ulcers in patients with corrected arterial insufficiency healed significantly more rapidly than those with venous incompetence. The ulcers in those with nutritional deficiency healed promptly after skin grafting and correction of the deficiency. It is important to be aware of arterial insufficiency and nutritional deficiency in patients with leg ulcers, as such deficiencies may contribute to the non-healing of an apparently straightforward leg ulcer.

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PubMed1993

Use of management techniques to control elective surgery.

From January 1989 the new outpatients seen each year have been restricted to 1,540. It was predicted that this would create 770 intermediate equivalents of operating time. Throughout 1991 and 1992 each patient seen in Outpatients was given a scheduled date for his/her operation. During 1992 89 per cent of patients listed were operated upon on the planned date.

Appointments and Schedules↗
PubMed1993

An explanation of the role of individual performance review in surgical training.

The consultant's success depends upon his/her staff. If the consultant is to provide a more efficient service the staff must be encouraged to develop and supplement their own skills. Individual Performance Review (IPR) is a technique that has been introduced to develop the managerial skills of NHS staff. However, its considerable benefits have not yet been extensively applied in clinical specialties. This article describes the current role of IPR and appraisal interviews in the process of training surgical house officers and senior house officers in a district hospital.

Consultants↗
PubMed1990

The distribution of aztreonam in serum, bile, skin and subcutaneous tissues in patients undergoing cholecystectomy.

The distribution of aztreonam was measured in patients undergoing elective cholecystectomy. In 14 patients 2 g aztreonam was injected preoperatively and the concentration of the antibiotic was assessed in the bile from the gall bladder and common bile duct, subcutaneous tissues and serum. Samples from bile and any wound discharge were cultured and sensitivities determined. The antibiotic reached bactericidal levels in the common bile duct within 30 min of injection and such levels were maintained in skin and gall bladder for at least 4 h after injection. Aztreonam was highly effective against the Gram-negative organisms that were cultured in bile but was less effective against Enterococcus faecalis.

Aztreonam↗
PubMed1990

Mesenteric arteritis.

Four patients are presented with small bowel infarction secondary to a vascular arteritis. In three patients there was a history of rheumatoid arthritis. In each patient infarcted bowel was resected and a primary anastomosis performed. In one patient the anastomosis broke down and she subsequently died. One patient died from a disseminated rectal tumour three years later. The remaining patients remain well. If operated on early, intestinal infarction due to arteritis has a good prognosis.

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PubMed1986

A 5 year follow-up of Dacron femoropopliteal bypass grafts.

Over a 5 1/2 year period, 66 Dacron femoropopliteal grafts were performed for patients with an absent or unsuitable long saphenous vein. The minimum follow-up has been 6 months and cumulative patency was 50 per cent at 5 years. Twenty-five patients had critical ischaemia (preoperative Doppler ankle pressure less than 40 mmHg) and 41 patients had severe ischaemia (pre-operative ankle pressure greater than 40 mmHg). The procedure significantly improved ankle pressures in both groups and this was maintained at follow-up. In the group of 25 patients with critical ischaemia there were three operative deaths and in 10 the graft subsequently occluded, precipitating an amputation. In the group of forty-one patients with severe ischaemia, there was one operative death and in two patients the graft occluded at 18 and 24 months. In this small series there was no significant difference in patency, whether the graft was placed to the popliteal artery above or below the knee joint, or whether the popliteal had less than three patent branches at its trifurcation.

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PubMed1985

Assessment of myocardial function before aortic surgery by radionuclide angiocardiography.

A consecutive series of 41 patients undergoing elective aortic surgery had pre-operative assessment of cardiac function by radionuclide angiocardiography. Their subsequent progress was monitored. There were 4 patients whose pre-operative left ventricular ejection fraction was less than 30 per cent and 3 of these patients died of cardiac failure postoperatively. There was only 1 death from cardiac failure amongst the 37 patients whose pre-operative left ventricular ejection fraction was less than 30 per cent. Radionuclide angiocardiography is an accurate indicator of myocardial function of patients before major aortic surgery.

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PubMed1985

The role of percutaneous transluminal angioplasty for atherosclerotic disease of the lower extremities.

A consecutive series of 62 patients (74 symptomatic limbs) were admitted with atherosclerotic disease of the legs in a 6-month period from 1st July 1982. All patients had an arteriogram under local anaesthetic the day after admission and if possible a transluminal balloon dilatation was performed. If dilatation failed an operation was performed the following day. Dilatation was successful in 13 of 23 lesions above the inguinal ligament and significantly improved the Doppler foot pressures from 84 to 120 mmHg. Dilatation was only successful in 17 of 51 lesions below the inguinal ligament and 40% of these had re-occluded within 6 months. Transluminal dilatation is an important advance for stenotic lesions of the distal aorta and iliacs but its place is limited for the more common lesions in the superficial femoral artery.

Adult↗
PubMed1983

Long term results of 66 femoral-to-femoral by-pass grafts: a 9-year follow-up.

Over an 8-year period, 66 femoral-to-femoral grafts were performed for unilateral iliac artery disease. The grafts were inserted retropubically with an operative mortality of 4.5 per cent. The minimum follow-up has been 12 months and cumulative patency 80 per cent at 6 years. Sixteen patients had critical ischaemia (preoperative Doppler ankle pressure less than 40 mmHg) and 50 patients had severe ischaemia (preoperative ankle pressure greater than 40 mmHg). The graft significantly improved initial ankle pressures and this improvement was maintained at late follow-up (average 45 months). There was no evidence of a detrimental effect on the donor limb. Long term patency was adversely affected if there was preoperative critical ischaemia, a woven Dacron prosthesis was used or the patient continued to smoke.

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