Biomedical subjects
Publications and source records attributed to J Q Cook.
A case of delayed infection following the use of split-cranial bone graft is presented. Trauma and bacterial contamination of the donor area six months before harvest were the likely causes. We advise caution and the use of alternate donor sites in cases where a history of previous contaminating trauma exists, even if the cranial bone is clinically completely healthy.
We investigate whether the application of liposuction to the nasolabial region is a useful adjunct to the rhytidectomy procedure. We have devised a system to grade the severity of the depth and the length of the nasolabial folds pre- and postoperatively. This grading system was used to evaluate the nasolabial region in 60 consecutive patients who underwent rhytidectomy. We compared two subgroups: those who underwent rhytidectomy alone (Group I) and those who underwent rhytidectomy augmented by liposuction in the region of the nasolabial folds (Group II). A change in the length of the fold occurred in 2% of Group I and in 30% of Group II. A change in depth of the fold occurred in 12% of Group I and in 70% of Group II. These results suggest that suction-assisted lipectomy consistently improves the results of rhytidectomy in the region of the nasolabial fold.
The ring technique for end-to-side microvascular anastomosis employs a resorbable polyglycolic acid ring to prevent stenosis and spasm at the anastomotic site. In 20 rats, the ring technique was compared with the conventional technique for constructing end-to-side anastomoses between the femoral (0.9-1.1 mm) and superficial epigastric (0.3-0.4 mm) arteries. The ring technique proved superior to the conventional end-to-side technique both in speed of execution and in patency at 3-4 weeks (100% vs 70%). Grossly and microscopically, the ring was completely resorbed at 3 wk.
A rotational technique to manipulate microsurgical instruments has several advantages. Tremor is suppressed, the hands remain relaxed for long periods of time, and the nondominant hand is able to play a more active role in the operation. The fundamentals of rotational technique are discussed.
Since few comprehensive statistics on results of rhinoplasties have been published since Klabunde and Falces' article [1] in 1964, a retrospective study of 200 consecutive patients was undertaken. These patients underwent rhinoplasty by a single surgeon and were followed for a minimum of six months. A separate reviewer studied patient satisfaction, physician satisfaction, rate of revision, and type of complications, including obstruction of airway, nasal deformity, hematoma, infection, hemorrhage, and psychological reactions. The incidence of infection, hemorrhage, and revisions has lessened in the past fifteen years. Patients not referred by a physician were more than twice as likely to be dissatisfied as those who were physician-referred (p less than 0.005). A higher percentage of female patients was dissatisfied than of male patients (p less than 0.05). The incidence of dissatisfaction increased significantly among patients in their fifth decade as compared with that in younger patients (p less than 0.01). No statistically significant difference was found in the incidence of dissatisfaction among single, married, widowed, or divorced patients.
A large, nondelayed thoracoepigastric flap extending 6 cm beyond the posterior axillary line was used to cover an extensive electrical injury of the right upper extremity.