Tissue oxygenation measurement: a directly applied Clark-type electrode in muscle tissue.
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Biomedical subjects
Publications and source records attributed to K E Bos.
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Immediate reintervention is necessary when vascular insufficiency is suspected in free bone transfers. We tested the reliability of the laser doppler bone probe in recording steady state and arterial and venous occlusion. During steady state the flux signal was not constant but fluctuated. During arterial occlusion an immediate and reproducible decrease in flux signal was seen. No evident changes were seen during venous occlusion. These results have clinical importance in monitoring free bone transfers.
A very large neurilemmoma of more than 15 years duration, arising from the anterior interosseous nerve, is reported. To our knowledge, this is the largest ever described. While the symptoms and all other diagnostic findings suggested that the neurilemmoma originated from the median nerve, it needed angiography to provide the final diagnosis.
Sixteen patients (eight females and eight males) who underwent microsurgical free tissue transfers for head and neck reconstruction are reviewed. In this series, the flap reconstruction was completed on eleven patients with extra-oral defects and five with intra-oral defects. Split thickness skin graft coverage was used in all cases. The rectus abdominis free muscle flap was used in nine patients and the latissimus dorsi free muscle flap in seven patients. The choice of tissue reconstruction was decided by the size of the surgical defect. There were no failures of the tissue transfers and skin grafts. In skilled hands, free tissue transfer provides a reliable method of head and neck reconstruction, with a low incidence of recipient and donor site complications. In extra-oral defects, coverage of free muscle transfer with split thickness skin grafts, results in a better colour match than musculocutaneous flaps, and complements the appearance and pliability of the free muscle flap.
The case history is presented of a patient in whom the anterior tibial artery was clearly perforated by the distal pin of an external fixation device. This necessitated a dorsal pedis free flap instead of transposition of the flap to cover a degloved heel and sole. Review of the literature showed only a few case reports on vascular damage, suggesting that this complication is uncommon. In most cases, secondary erosion seems to be the cause, but as noticed by us direct arterial and/or venous damage is possible.
In these experiments the reliability of bone scintigraphy with 99mTc diphosphonate, to assess anastomotic patency and the viability of revascularized composite fibular grafts, was studied. It was shown that bone scintigraphy is very useful for the diagnosis of anastomotic patency, but only in the first postoperative weeks. Bone scintigraphy gives no information on the viability of bone grafts.
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