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K Van de Sijpe

Publications and source records attributed to K Van de Sijpe.

5 recordsLinked to original sources

A simple new technique for neo-umbilicoplasty.

This article describes a new technique for reconstruction of the umbilicus. The technique used simply originated from a few clinical cases in which we were confronted with an absent or destroyed umbilicus. Previously described techniques for neo-umbilicoplasty were unsatisfying or seemed too complex in our hands. We introduce this easy, safe and reproducible technique which in our experience resulted in a very acceptable newly formed umbilicus.

Female↗

Do pre-operative abdominal exercises prevent post-operative donor site complications for women undergoing DIEP flap breast reconstruction? A two-centre, prospective randomised controlled trial.

The deep inferior epigastric perforator (DIEP) flap is the gold standard for breast reconstruction using abdominal tissue. Unlike the transverse rectus abdominis myocutaneous (TRAM) flap, no rectus abdominis muscle is removed with the flap, but intra-muscular scarring can still cause post-operative complications. Strong abdominal muscles have been advocated as a prerequisite for surgery, but without any evidence as to the potential benefits. This study aimed to investigate the effect of pre-operative abdominal exercises on inpatient pain levels, length of hospital stay, post-operative abdominal muscle strength and function following a DIEP flap.Ninety-three women undergoing delayed breast reconstruction with a DIEP flap between October 1999 and November 2000 were randomly allocated to either a control or exercise group. The exercise group performed pre-operative exercises using the Abdotrim abdominal exerciser. Pre-operatively, outcome measures included trunk muscle strength measured on an isokinetic dynamometer, SF-36, rectus muscle thickness measured using ultrasound, and submaximal fitness. Post-operative pain and length of hospital stay were recorded. Subjects were reassessed using the same outcome measures 1 year post-operatively. There was a statistically significant increase in static (isometric) muscle strength and thickness pre-operatively for the exercise group. One year following surgery, there was a significant decrease in dynamic (concentric and eccentric) flexion strength for both groups, although the clinical significance of this is questionable as the majority of women had returned to pre-operative fitness and the surgery had no impact on functional activities. The static flexion strength of the control group was reduced at 1 year, whereas it was maintained in the exercise group, although this was not statistically significant. One third of women in the control group complained of functional problems or abdominal pain post-operatively compared to one fifth of the exercise group. Overall, the DIEP flap had no major impact on abdominal muscle strength for either group, demonstrating its superiority over the TRAM flap. There was no statistically significant benefit to the exercise group of the pre-operative exercises 1 year following surgery. However, there was a subjective benefit, albeit statistically nonsignificant, in terms of reduced functional problems post-operatively and improved well-being prior to surgery.

Abdominal Muscles↗

A 25-year study of emergency surgical admissions.

BACKGROUND: Numbers of emergencies are increasing, but no comprehensive data are available for emergency surgical admissions. This study documents the changes over 25 years in a district general hospital. METHODS: Details of all general surgical (including urological) emergency admissions were analysed for every fourth calendar year from 1974 to 1998. RESULTS: A total of 19,931 patients were admitted during the 7 years studied, rising from 2137 in 1974 to 3578 in 1994 (3377 in 1998). Mean age increased from 47.9 years to 52.6 years while mean length of stay fell from 9.5 days to 5.3 days. Hospital mortality decreased from 6.6% to 3.7%. When calculated per 100,000 population, the increase in admission rate was significant (P < 0.001) but bed requirements did not increase despite the increase in workload. Several diagnoses became significantly more frequent (ruptured aortic aneurysm, gallstones, constipation, cutaneous abscess, diverticular disease, gastroenteritis, non-specific abdominal pain, pilonidal sinus and urinary diagnoses). Appendicitis and non-malignant intestinal obstruction became significantly less common. CONCLUSIONS: This study has documented a progressive increase in surgical admissions. Despite increasing age of patients, lengths of stay and hospital mortality have decreased.

Age Distribution↗

[Surgical management of complete Tossy III acromioclavicular joint dislocation with the Bosworth screw or the Wolter plate. A critical evaluation].

The long-term results with an average of 4.3 years of 87 patients with an AC-dislocation grade III according to Tossy, treated operatively with a Bosworth screw or a Wolter plate are described and submitted to critical evaluation. Of the patients 16% had implant failures. Redislocation was seen in 25% of the patients, calcifications in 39% and arthritis in 41%. The end-result was good or excellent in 60% of the patients and fair or bad in 40%. The only factor, influencing the end result was the redislocation rate (p < 0.05). These moderate results surprised and disappointed us. They made us conclude that the grade III acromioclavicular dislocation is no absolute indication for surgical treatment, as is often suggested in literature. No significant differences could be revealed between both surgical techniques.

Acromioclavicular Joint↗