Biomedical subjects

L Colen

Publications and source records attributed to L Colen.

4 recordsLinked to original sources

PubMed2001

Soft tissue reconstruction for the heel and plantar foot.

Soft tissue resurfacing after the ravages of injury or disease continues to be a formidable problem. A thorough understanding of the biomechanics of ambulation and the way in which weight is distributed over the sole of the foot is key to successful outcomes. Soft tissue repair has evolved from the simple filling of holes to a much more sophisticated approach. A plantar-grade foot that distributes the patient's weight in a uniform manner should be the goal. If this can be done without increasing the energy expenditure of ambulation, then surgeons certainly have done our patients an excellent service. Surgeons must not overlook the tendon imbalances and bony deformities that can accompany the effects of disease or trauma. The more complex soft tissue repair may not always be in the patient's best interests. Surgeons should use the simplest approach that can restore the limb to as close to its preinjury level of function as possible. A coordinated approach with plastic surgery, orthopedic surgery, vascular surgery, and podiatric surgery should be the standard of care for patients requiring plantar soft tissue repair.

Amputation, Surgical↗

PubMed1992

Free flaps in the elderly.

Microsurgical transfer of tissue has become a primary tool of the reconstructive surgeon. The elderly, as a growing segment of our society, are requiring free-tissue transfers in proportion to their numbers. To investigate the potential morbidity of free-tissue transfers in the elderly, we studied consecutive populations of 31 patients above the age of 65 years and 90 patients below the age of 65 years. Complication rates were 65 and 49 percent, respectively. Premorbid medical conditions were present in 87 percent of patients 65 years and older and in 72 percent of those under 65 years. Medically related complications in free-tissue transfers, previously unreported in the literature, were 35 percent in the elderly group and 10 percent in the younger group. Wound-healing complications were seen in equal proportions between groups. The rates of wound and medically related complications observed in the elderly group were nearly double those observed in the younger group; however, after correction for the presence of preexisting medical conditions, no significant differences were seen between the two groups. These observations suggest that age alone is not a variable in risk for free-tissue transfers. Elective microsurgery can be performed in the elderly patient with a high expectation of success.

Adolescent↗

PubMed1987

Preoperative assessment of the peripheral vascular disease patient for free tissue transfers.

Lower extremity reconstruction or salvage in patients with severe peripheral vascular disease is a unique challenge, requiring knowledge of the vascular anatomy, including the location of intraluminal irregularities and stenoses. In a retrospective study that includes four case reports, the authors describe the impressive ability of the Duplex imaging system, to assist in the proper selection of recipient vessels and of those areas within the vessels most suitable for anastomoses.

Arteries↗

PubMed1985

Functional assessment of ray transfer for central digital loss.

Nineteen patients who had ray transposition for central digital loss were evaluated retrospectively with regard to postoperative function and appearance. Pinch and grip recoveries were better in patients with small-to-ring finger transfers than in those with index-to-long finger transfers. Total average pinch recovery measured 83.3% of the nonoperated side. Total grip recovery was 80.2% of the nonoperated side. Average ranges of motion for all transferred digits were 77.6 degrees (metacarpophalangeal joint), 87.6 degrees (proximal interphalangeal joint), and 80.8 degrees (distal interphalangeal joint). Overall results judged by a five-component assessment scale were excellent.

Adolescent↗