Biomedical subjects
Publications and source records attributed to J Schrudde.
Special attention is given to skin defects of the most various etiologies and sizes, anomalies of the breast, or skin dysplasia in the breast region. The slide-swing plasty technique is shown to offer a means of closing breast skin defects of various etiologies and sizes or to reconstruct the breast.
The "Prune Belly"-syndrome consists of a triad of anomalies: absence or hypoplastic musculature of the abdominal wall, bilateral cryptorchidism, and dilatation of the urinary tract. A surgical method of construction of the abdominal wall in such a case with a missing rectus abdominis is reported.
Numerous methods have been described to reconstruct lower lip defects. A further method is presented which is suitable for lateral defects of the lower lip and employs a transposition flap similar to Goldstein's method.
This article deals with defects in the face. A cervical flap called the angle-rotation flap was created by Schrudde 16 years ago to cover defects such as scarred skin after deep burn injuries as well as skin and subcutaneous defects following removal of dysplastic skin or after accidents. Indications and the method are described.
Surgery for gynecomastia is primarily aimed at the complete removal of the breast tissue and the reconstruction of the normal breast and chest contour while leaving minimal telltale signs of the surgery. Dufourmentel and Webster described a technique that placed the incision along the border of the nipple-areola complex. The aesthetic results are good by smaller and moderate cases of gynecomastia. The surgical correction of the larger cases requires the correction of both glandular tissue and skin. The concentric circle operation - described by Schrudde - permits the complete removal of breast tissue and corrects the skin redundancy. The periareolar operative scar is relatively inconspicuous. Our technique and the results are described.
The popular breast reconstruction using a prosthetic implant has many disadvantages. Severe capsular contracture, for example, leads to breast deformities associated with pain. The development of many new types of prosthesis has not solved the fundamental problem. We therefore think it is better to reconstruct a female breast with a dermo-fat flap than a prosthesis. In this article we describe the indication and surgical techniques of our procedure to reconstruct a female breast.
A retrospective presentation of the development of surgical treatment for pressure sores is given. Experimental research is described for the etiology and pathogenesis of decubital ulcers. Typical localizations and predisposing factors for pressure sores are mentioned.
The author presents a history of the surgery of local adiposity and discusses his technique of lipexheresis for localized accumulations of fat in the lower part of the female body. Also included are indications and complications.
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Subcutaneous mastectomy is a recognised form of curative treatment in cases of carcinoma lobulare in situ and of any atypical proliferative mastopathy. Moreover a subcutaneous mastectomy should be recommended for these patients when multiple biopsies have been performed and long-term mammographic supervision is no longer possible. By using all the existing skin and subcutaneous tissue a good aesthetic result can be achieved and prostheses should only be used in cases where the existing tissues cannot provide an adequate breast reconstruction. The operative technique developed by Schrudde is described and the results of 250 cases are presented.
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The value of rhytidectomy as a preventive measure is principally shown in the psychological sphere. It restores the patient's self-confidence and consequently a natural demeanor and secures social and professional advantages in addition. If this surgery is to have a preventive character it must deal with the first signs and consequently be instituted in stages. Even smaller measures like blepharoplasty can alter the entire expression positively. Interventions in the periorbital and forehead regions are very advantageous for the appearance. In some cases rhytidectomy should be supplemented by further measures as eg nasal correction and dermabrasion to achieve a really positive effect.
The results of the slide-swing plasty are reviewed over a period of 16 years. A total of 1,308 patients were analyzed with regard to location and etiology. The slide-swing plasty has proved successful in practice. Its great advantage consists in the possibility of closing large defects without skin grafting. Compared to other methods, the slide-swing plasty offers additional possibilities concerning location and size. Furthermore, regional anatomic peculiarities can add to the possibilities of this procedure. Not the least interesting is the direct closing of the donor site.
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To achieve a re-contouring of the lower extremities the conservative methods of the local slide plasty, the Z-plasty and the slide swing plasty in combination with subcutaneously pedicled fat flaps as single or combined measures proofed satisfying. As far as the general extend and the localization of the defect admits, those measures may be superior to the free and musculo-cutaneous flaps in respect to esthetically good results. Several cases may demonstrate those possible methods. Besides the technical know-how, a well based planning in connection with a specific valuation of the different operative methods are the fundamental necessities for a satisfying result.
A basic aim of photographic documentation of clinical cases is to compare these cases with each other. Some examples illustrate possible misinterpretations due to inadequate or variable photographic conditions. To assess postoperative results is possible only in exact comparative photography. Depending upon specific problems, the required conditions are variable. Nevertheless, some general rules can be formulated. They should be applied in a photographic documentation of clinical cases.
A method for subcutaneous mastectomy and reconstruction is described. To the patients the results of this method are pleasing. A specific advantage of this method is, that only in 20, 15% of these cases in recent years, we used silicone prosthesis for augmentation. An analysis of 333 cases showed some frightening facts: in 9,26% an invasive carcinoma was found. Furthermore, in 4,44% a lobular carcinoma in situ was found. A preoperative diagnosis was made, only in four of these fourty patients. Therefore, it can be stated that - as reconstruction possibilities by plastic surgery standards are good - a generally restrictive point of view towards the indications to subcutaneous mastectomy should be given up.
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