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Biomedical subjects

J M Peres

Publications and source records attributed to J M Peres.

5 recordsLinked to original sources
PubMed1994

[The "extreme" brachial flap: a distal pedicled use of an external brachial flap. Preliminary report].

The authors present a new application of the procedure they called the "reverse flow YV pedicle extension" which allows a very distal pedicled mobilisation of the lateral arm flap. Until now, only the distally based lateral arm flap and the ulnar recurrent fascicutaneous island flap could to be transferred distally but reached only the proximal third of the forearm. In our experience these flaps did not seem to be very reliable. Lengthening of the lateral arm flap pedicle using the lateral triceps artery (branch arising from the profunda brachii artery) allows the lateral arm flap to be transferred beyond the distal third of the forearm. This so-called "extreme" lateral arm flap has advantages and disadvantages which are discussed in this paper. We consider cutaneous or osteocutaneous reconstructions of the forearm to be the best indication for this flap. Our first clinical case is reported.

Accidents, Traffic↗
PubMed1994

[Humeral lengthening after replantation of the upper limb].

INTRODUCTION: The authors have applied the method of progressive lengthening to correct upper limb discrepancy resulting from arm reimplantation in a young female adult. MATERIAL: Following a motor vehicle accident, a twenty one years old female had her right arm sectioned. Four hours after the accident, the limb was reimplanted with 10 cm shortening of the humeral shaft, to allow direct nerve suture. Sixteen months later, she had excellent functional recovery, but was annoyed by the aesthetic appearance of her short arm. Humeral lengthening was undertaken. METHOD: The authors used a special external fixation device Orthofix (Verona, Italy) and a proximal corticotomy was performed. RESULT: Progressive callus distraction allowed 10 cm lengthening without any loss of function in 10 months; aesthetic appearance was greatly improved. DISCUSSION: Limb reimplantation necessitates substantial bone shortening to protect soft tissue sutures. Functional recovery and aesthetic tolerance are classically good but in this case, aesthetic tolerance was poor. The progressive humeral lengthening was uneventful and allowed excellent outcome, in this young girl, despite distraction of the sutured nerve. CONCLUSION: This technique should be used prudently.

Accidents, Traffic↗
PubMed1994

[Transsexualism: surgical aspects. An experience of the plastic surgical unit's in Bordeaux].

After briefly reviewing the history of transsexual surgery, the authors explain their technical choices and present their experience based on a series of 19 patients, 11 male transsexuals and 8 female transsexuals. The results are analysed. The potential complications of surgery in female transsexuals are those of microsurgical techniques aggravated by treatment with testosterone, as well as urethral fistulae and strictures. In addition to prevention of thromboses, the authors palliate these complications by ulnar elongation of the radial forearm flap in order to minimise the factors responsible for urethral fistulae, combined with enlargement of this flap to decrease the risk of stricture. The complications in male transsexuals essentially consist of rectoneovaginal fistulae. Problems of the depth of the neovagina are also important. Two rectoneovaginal fistulae were observed in this series of 11 patients, both treated medically. The unit's experience in this field will be continued in order to further improve the results.

Adult↗
PubMed1991

[Internal plantar flap on external plantar pedicle: a technique for the coverage of the whole surface of the foot. Initial report].

The authors present a new type of the classical medial plantar flap which derives its main blood supply from the medial plantar artery, a terminal branch of the posterior tibial artery. Our approach concerning flap dissection has not been modified, but the vascular supply of the flap has been shifted and a reverse blood flow coming from the lateral plantar artery is created after dividing the posterior tibial artery just proximal to its distal bifurcation. The reverse flow medial plantar artery island flap survival is ensured by rich anastomoses that usually occur between the dorsalis pedis and lateral plantar arteries. However, the venous return is also ensured by a reverse flow as in the case of lateral plantar artery. In addition, this flap presents a wide arc of rotation that is suitable for a variety of local defects, allowing cover of the foot. This new technique mainly provides a perfect indication for cover of distal weight bearing area defects of the foot when the distally based plantar flap is not possible for anatomical aberrations and/or in the presence of an unreliable blood supply of the flap itself. Moreover, it deserves a general description of a new type of flap pedicle design that we denote by the term "reverse flow Y-V extended flap pedicle". We intend to provide the readers with more details concerning clinical applications of this new surgical procedure.

Adult↗