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Biomedical subjects

L F Elliott

Publications and source records attributed to L F Elliott.

28 records · Page 2Linked to original sources
PubMed1987

The anatomy of the pectoral nerves and its significance to the general and plastic surgeon.

It has previously been shown that in 62% of patients the medial pectoral nerve courses through the pectoralis minor muscle to innervate the lower half or two thirds of the pectoralis major muscle. In the other 38% of patients, the medial pectoral nerve exits around the lateral aspect of the pectoralis minor muscle. The lateral pectoral nerve courses on the undersurface of the pectoralis major muscle, innervating the proximal one third or more of the muscle. Consequently, when the pectoralis minor muscle is removed in a modified radical mastectomy, or dissection between the two muscles is performed, there is partial deinnervation of the pectoralis major muscle with partial atrophy and a decrease in size. Further, if the lateral pectoral nerve also is injured or removed, it can result in total deinnervation of the pectoralis major muscle with more severe atrophy and fibrosis of the muscle. In cosmetic augmentations, when the breast implant is placed behind the pectoralis major muscle, that muscle is partially deinnervated. In this clinical situation, this is believed to be advantageous because it allows the breast to project better. This paper details the anatomy of the pectoral nerves and discusses the clinical implications of surgery in this region as it relates to the size and function of the pectoral muscles.

Breast↗
PubMed1985

Extended myofascial thigh flaps for repair of large full-thickness abdominal wall defects.

The large, full-thickness abdominal wall defect encompassing the upper and lower quadrants can test the surgeon's ingenuity in providing definitive repair. Two cases are reported of this type of abdominal wall defect closed in one stage using an extended tensor fascia lata myofasciocutaneous flap and an extended rectus femoris myofascial flap, respectively. In addition, a fresh cadaver dye injection study demonstrates the extensive circulatory pattern of these flaps.

Abdominal Muscles↗
PubMed1983

Tailoring of the new breast using the transverse abdominal island flap.

In the past 2 years we have moved from a period of amazement to an era of refinement in breast reconstruction using the transverse abdominal island flap (Fig. 9). It is essential that more effort be concentrated on improving the shaping of the new breast once the flap is brought safely to the chest. Important elements of this shaping include: Thorough preoperative planning. Use of the contralateral rectus pedicle. Discarding of skin from the scar to the inframammary line on the chest wall. Understanding of the tissue needed for each quadrant of the new breast. Proper orientation of the flap on the chest wall. Initial pivot suture around which the flap is shaped. Avoidance of excessive internal suturing. While we believe the preceding principles to be fundamental to the creation of the new breast using this flap, each surgeon must utilize his or her own creativity, insight, and training to maximize the tremendous advantage of versatility that this flap provides.

Breast↗
PubMed1982

Leg ulcer. Conservative management or surgical treatment?

In a specific indigent socioeconomic setting, the nonsurgical management of 65 patients with chronic leg ulcers resulted in 59 cures. There were 42 patients (67%) with postphlebitic syndrome. Twenty-two patients (33%) had varicose veins (eight had postoperative vein stripping), 14 (22%) had deep-vein thrombosis, and 11 (15%) had associated neurological problems. Fifty-six patients (86%) were treated with pressure dressings that were changed once a week in an outpatient clinic, seven patients wore skintight plaster casts for variable periods of time, and two patients had split thickness skin grafts plus lumbar sympathectomies. In more than two thirds of the patients, the ulcers healed. In another 17 patients (26%), a satisfactory response to treatment was observed. In only six patients did therapy fail. Failures were attributed to the multiple medical and surgical problems of the patients or their lack of cooperation. Nonsurgical treatment of venous stasis ulcer is inexpensive and effective.

Adult↗
PubMed1982

The extrahepatic biliary tract injury: perspective in diagnosis and treatment.

Nonsurgical trauma to the extrahepatic biliary tract is being reported with increasing frequency. There has been no recent review of the management of these injuries. Forty patients over the past twelve years at Charity Hospital, New Orleans, were studied. The 10% mortality rate was due to associated injuries. Tangential injuries were best managed by suture closure and T-tube drainage. Biliary-enteric anastomoses were most successful in the treatment of complete transections. Delayed diagnosis is not uncommon, and new methods of diagnosis are discussed. Injuries of this nature are responsible for high morbidity rates due to fistula or stricture formation. Successful management of these injuries is vital, even in those patients with more severe associated injuries.

Adolescent↗
PubMed1976

Bacteria in the air of housed Swine units.

Two housed, swine-growing-finishing units were studied for numbers of total bacteria, fecal coliforms, Staphylococcus, and Salmonella in the air. At 30.5 and 122 cm from the floor, total colony-forming particles, as tested, averaged 3.4 x 10 and 1.3 x 10/m of air, respectively; whereas fecal coliform counts averaged 24 x 10 and 1.9 x 10/m of air, respectively. Only 41% of the organisms growing on Staphylococcus 110 medium tested as Staphylococcus. Of 458 Staphylococcus isolates, 5 were coagulase-positive. No Salmonella were detected in the air of the units tested.

Journal Article↗
PubMed1972

Ammonium, nitrate, and total nitrogen in the soil water of feedlot and field soil profiles.

A level feedlot, located in an area consisting of Wann silt loam changing with depth to sand, appears to contribute no more NO(3) nitrogen, NH(4) nitrogen, and total nitrogen to the shallow water table beneath it than an adjacent cropped field. Soil water samples collected at 46, 76, and 107 cm beneath the feedlot surface generally showed NO(3) nitrogen concentrations of less than 1 mug/ml. During the summer months, soil water NO(3) nitrogen increased at the 15-cm depth, indicating that nitrification took place at the feedlot surface. However, the low soil water NO(3) nitrogen values below 15 cm indicate that denitrification takes place beneath the surface.

Journal Article↗
PubMedDate not supplied

Breast reconstruction: progress in the past decade.

There have been numerous advances in breast reconstruction techniques of the past decade. The disappearance of the radical mastectomy along with the increased frequency of smaller tumor detection have contributed significantly to these changes. Furthermore, reliable studies have shown that breast reconstruction does not interfere with extirpative surgery or delay postoperative adjuvant therapy if indicated. Studies such as these have led increasing numbers of women to elect immediate breast reconstruction as opposed to delaying that reconstruction for months or even years after the tumor extirpation. The advent of successful breast reconstruction using autogenous tissue provided the most radical change to reconstructive techniques over the past 10 years. The TRAM (transverse rectus abdominis myocutaneous) flap was the first of these techniques to be introduced and has rapidly assumed a position of prominence among those techniques chosen for breast reconstruction. The LTTF (lateral transverse thigh flap) and the buttock flap, while requiring microsurgical technique, are important alternatives for those patients who choose autogenous tissue breast reconstruction and should be presented to women during the discussion of alternatives for breast reconstruction. Implant technology has continued to improve with the introduction of the tissue expander, the most important addition in the past decade. Investigations are currently underway to provide a long-term tissue expander that does not have to be removed and replaced by a permanent implant. The ultimate end result would be to create a more normal breast shape without firmness. And the use of stacked or directional expanders may allow more freedom in creation of the new breast shape to conform to the opposite side. Finally, nipple areola reconstruction has improved significantly as the tissues of the breast mound itself are used for the new nipple and areola, thereby avoiding the transfer of grafts from distant sites which do not generally maintain their size or projection over time.

Adult↗