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Biomedical subjects

L Ostrup

Publications and source records attributed to L Ostrup.

12 recordsLinked to original sources
PubMed2000

Utility of an intervention scoring system in documenting effects of changes in burn treatment.

The consequences of the introduction of a program of consistent use of topical antimicrobials and early aggressive excision of deep burn wounds by utilizing a comprehensive, computerized patient registry/therapeutic intervention scoring system, were investigated. Prospectively, the clinical course, mortality, outcome and hospital costs were compared for the year preceding (89 patients) and the 4 years following (226 patients) the introduction of the new treatment program. It was found that mortality decreased from 10.1 to 4.6% after change in therapy (P<0.001), despite an increase in mean burn extent. The length of hospital stay per % burn surface area declined from 1.2 to 1.0 days (P<0.001). The number and complexity of therapeutic interventions and the associated costs, also declined. Patients in the new treatment program had a better level of physical and psychosocial function at follow up. In conclusion, the introduction of a program of consistent use of topical antimicrobials and early, aggressive surgical excision was associated with an improved outcome at lesser cost. The combined registry-intervention scoring system permits ready analysis of results using data entered on a daily, near-real time basis.

Adult↗
PubMed1993

Lip and nose morphology in patients with unilateral cleft lip and palate from four Scandinavian centres.

Sixty patients with unilateral cleft lip and palate were compared for lip and nose appearance. All patients were photographed from an anteroposterior and a basal view at 7-10 years of age. The photographic registration method was tested for validity and accuracy. Although the four groups of 15 patients each were treated according to different protocols, many similarities were found with shorter lip heights at the cleft side and inclination of the rima oris. Asymmetry of nose and retropositioning at the cleft side naris were generally seen. Significantly straighter noses were demonstrated in the group treated with a two-stage lip nose operation combined with nose plugs, and the two groups where vomer flaps were used showed the greatest deviation of the nose.

Child↗
PubMed1992

Team approach to tibial fracture. 37 consecutive type III cases reviewed after 2-10 years.

During a 10-year period, we managed 35 patients with 37 cases of Type III open tibial fractures, 15 cases within 1 week and 22 as late referrals. In all cases, simultaneous assessment and management by a microvascular and an orthopedic surgeon were mandatory throughout the treatment period. 6 of the 15 acute cases had a primary amputation. Of the remaining 31 cases, limb salvage was possible in 27. 31 flaps, pedicle and microvascular free flaps were used. Major complications occurred in 6 cases, but in 27 cases infection-free solid union was obtained. At long-term follow-up, average 5 years, the function was good or acceptable in 23 cases. We conclude that: (1) patients with Type III tibial injuries should preferably be transferred within a week after injury to a hospital where major reconstructive procedures are commonly performed, (2) early soft tissue coverage is essential in the management of these injuries, (3) unilateral external fixation should be the preferred technique of stabilization, and, finally, (4) plastic surgery expertise is important in management of severe tibial fractures.

Adolescent↗
PubMed1991

Regional hyperthermic perfusion with melphalan after surgery for recurrent malignant melanoma of the extremities. Swedish Melanoma Study Group.

A prospective randomized trial testing regional hyperthermic perfusion with melphalan has been conducted. Sixty-nine patients with recurrent malignant melanoma of the extremities were randomly allocated to surgery (36 patients) or surgery plus regional perfusion (33 patients). Prognostic variables concerning primary tumor as well as the recurrent disease were evenly distributed in the groups, excluding any bias in the randomization. Median tumor-free survival after randomization was 17 months in the perfusion group and 10 months in the control group. There were 15 locoregional recurrences in the perfusion group and 24 in the control group. The tumor-free survival curve was significantly (P = .044) better for the perfusion group than for the control group. Median survival time after randomization was 57 months in the perfusion group and 35 months in the control group. This difference was not significant. One patient died within 1 month after perfusion of pulmonary embolism. Regional hyperthermic perfusion after surgery of recurrent malignant melanoma should only be recommended in prospective and controlled trials, until its value has been proven in several randomized studies.

Adult↗
PubMed1991

Craniofacial and occlusal characteristics in unilateral cleft lip and palate patients from four Scandinavian centres.

Craniofacial morphology and dental occlusion were studied at early school age in 15 consecutive patients with unilateral cleft lip and palate from each of four Scandinavian cleft centres. Treatment differed mainly in the techniques of palatal repair. Push-back closure of the palate particularly impaired maxillary development, which resulted in an increased incidence of crossbite and reduced intercanine distance when compared with patients who had been operated on by the von Langenbeck method or in whom the anterior palate had not yet been closed.

Cephalometry↗
PubMed1990

Preoperative antibiotics and capsular contracture in augmentation mammaplasty.

The main drawback with augmentation mammaplasty using implants is capsular contracture. The cause of this complication is still unknown. Silicone particles, hematoma, and bacterial contamination are some of the etiologic factors discussed. In this randomized, double-blind study on 76 breast-augmented women, 50 percent of the patients had preoperative prophylaxis with benzylpenicillin and dicloxacillin. Bacteria samples were taken intraoperatively. The number of negative cultures increased significantly with antibiotic prophylaxis. In four follow-ups during the first postoperative year, the rate of contractures was evaluated by subjective and objective methods. The results showed no statistically significant difference between the placebo and the antibiotic group with respect to the incidence of capsular contracture.

Adult↗
PubMed1990

Microvascular anastomoses in irradiated vessels: a comparison between the Unilink system and sutures.

A new mechanical device (the Unilink system) was compared to conventional suture anastomoses in irradiated microvessels. Twenty rabbits received a single radiation dose of 20 Gy from a 7-MeV electron source through an anterior neck field. One and 6 months following irradiation, the carotid arteries and facial veins were divided and anastomosed on one side with the Unilink system and on the other side with suture technique. At sacrifice 4 weeks postoperatively, all vessels were evaluated for patency and histologic changes associated with radiation and anastomotic trauma. Histology disclosed severe radiation changes. Also, intimal hyperplasia was consistently found at the anastomotic sites in the arteries, while it was totally absent in the venous anastomoses. Occlusive thrombosis was found in two arteries, one anastomosed with the Unilink system and one sutured. Two other arteries, one from each group, had subtotal occlusions at the anastomotic site. No occlusions occurred in any of the venous anastomoses. The overall patency in this study was 97.5 percent, with no difference between the two techniques.

Anastomosis, Surgical↗
PubMed1989

Microvenous grafts to arterial defects. The use of mechanical or suture anastomoses.

A mechanical microvascular anastomotic device, the Unilink system, was compared with sutures in terms of patency, anastomotic time, and histologic changes when a microvenous graft is placed in an arterial defect. Twenty rabbits underwent grafting of a 1.0-cm defect in both carotid arteries with a 1.5-cm reversed femoral vein graft. Anastomoses were performed with the Unilink system on one side and sutures on the other. Animals were killed at 2 weeks (10 animals) and 16 weeks (10 animals) with the vein grafts being assessed with clinical patency tests and then fixated for histologic evaluation. All 20 grafts (100%) interposed with the Unilink system were fully patent while 17 (85%) of the 20 grafts interposed with sutures were fully patent. The grafting procedure with the Unilink anastomoses averaged 12.5 minutes while the sutured anastomoses averaged 41.9 minutes. No differences in the histologic appearance of the vein grafts were noted between the two types of anastomoses. All grafts showed endothelialization at 2 weeks with intimal hyperplasia or "arterialization" being a constant finding.

Anastomosis, Surgical↗
PubMed1989

Strength of microvascular anastomoses: comparison between the unilink anastomotic system and sutures.

The Unilink system, a mechanical anastomotic device, was compared with standard suture techniques in terms of anastomotic strength under conditions of uniaxial loading. Twenty-five rabbits underwent Unilink and suture anastomosis of both carotid arteries and facial veins. Animals were sacrificed at 1 hour (five animals), 2 weeks (10 animals), and 16 weeks (10 animals), and all vessels were tested by constant loading in a material testing machine. The maximum load required to disrupt the anastomosis as well as the site of vessel failure were recorded. All 100 anastomoses were fully patent as evaluated by clinical testing. At 1 hour and 2 weeks, the Unilink arterial anastomoses were consistently and significantly stronger than the sutured anastomoses. At 16 weeks the sutured arterial anastomoses were significantly stronger than Unilink. The Unilink anastomoses, however, remained approximately 50% stronger than unoperated normal vessels. No statistical differences were observed in the strength of venous anastomoses at any of the intervals tested. There were no statistical differences in the sites of failure of the vessels under loading (i.e., at the anastomosis or proximal or distal to it) between the two techniques.

Anastomosis, Surgical↗
PubMed1984

The need for replantation surgery after traumatic amputations of the upper extremity--an estimate based upon the epidemiology of Sweden.

Reports in the literature give different views of the frequency of serious amputation injuries of the upper extremity. In Sweden the vast majority of work injuries are registered by the Swedish Labour Market Insurance. All registered serious amputation injuries of the upper extremity in Sweden (8 million inhabitants) during 1979 were investigated in this study. For comparison the frequency of all amputation injuries (work and leisure) of the upper extremity in a county of Sweden (0.4 million inhabitants) during five years (1976-1980) were studied. The overall (work and leisure) incidence in Sweden is fourteen serious amputation injuries of the upper extremity per million inhabitants annually, i.e. a total number in the country of 110 cases per year. The frequency is lower in the areas of the largest cities and substantially higher in regions with sawmills, mechanical industry and/or agriculture. Thus, estimation of the total incidence based upon single counties or smaller regions may be misleading. Replantation would have been technically possible in more than 70% of the cases, but attempts at replantation were only carried out in less than 10% of the serious cases. This study emphasizes the importance of a referral of all patients with a suitable injury of the upper extremity to microsurgically trained handsurgeons.

Accidents, Occupational↗