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Biomedical subjects

L Scheker

Publications and source records attributed to L Scheker.

7 recordsLinked to original sources
PubMed1994

Regional anaesthesia and subsequent long-term pain.

The incidence of long-term pain (between 1 and 48 weeks and at 2 year follow-up) unrelated to the surgical site following either regional brachial plexus or general anaesthesia was determined. In 834 patients with regional anaesthesia, the incidence (11.1%) was significantly higher than in the 86 patients with general anaesthesia (3.6%; P = 0.03). The incidence of pain was not significantly different among four common techniques of positioning the needle tip in the axillary sheath (9.9 to 11.1%). Parascalene blocks had a slightly but not significantly higher rate (16.3%). A regional re-block was not associated with a higher incidence when compared to those blocked only once. A more distal local re-block was associated with a higher incidence of pain (23%). 2 years post-operatively, 0.5% of patients had pain related to the regional block. A significant proportion of patients developed some long-lasting post-operative pain following regional brachial plexus anaesthesia, although ultimate morbidity was minimal.

Anesthesia, Conduction↗
PubMed1991

Sensory and motor fiber differentiation with Karnovsky staining.

We examined four acetylthiocholine methods based on Karnovsky's procedure--two fast-acting requiring 1 hour and two slow-acting requiring 24 hours. We compared these with our modification, which requires less than an hour and is simple to use. Rabbit sciatic nerves and spinal cords were used to compare methods. Our modification showed clearer differentiation than other fast-acting methods and staining identical to slow-acting methods. In blind examination of radial nerve specimens stained with our method, motor and sensory fascicles were correctly identified, showing sensitivity and specificity of 100%. In 12 clinical cases, our method produced staining in the proximal stump as long as 16 months after injury and in the distal stump as long as 5 days after injury. In 10 of 12 patients, this staining helped in aligning motor fascicles to motor fascicles and sensory fascicles to sensory fascicles.

Acetylthiocholine↗
PubMed1988

Emergency free flaps to the upper extremity.

Thirty-one emergency free flaps were applied to the upper extremities of patients who ranged in age from 16 to 57 years. The size of the skin defects ranged from 13 to 540 square centimeters, with an average of 145 square centimeters. A variety of flaps were used, including 14 lateral arm, seven groin, five latissimus, three first web space of the foot, one scapular and one medial arm. In patients with small defects, the operative time ranged from 3 to 9 hours, with an average of 4 hours and 54 minutes. The hospital stay was never longer than 4 days. In patients with medium size defects, the operating time ranged from 3 to 18 hours, with an average of 7 hours and 45 minutes. The hospital stay averaged 7.4 days. In large defects in which extensive reconstruction was undertaken before flap application, the operative time ranged from 3 to 20 hours, with an average of 11 hours and 54 minutes. The average hospital stay was 11.8 days. Twenty-nine of the 31 flaps survived in their entirety (93.5%). In one of the successful flaps (3.2%), exploration was required after the patient left the operating room. Severe infection occurred in only one case, that being one of the two flap failures. Twenty-seven of the 31 patients returned to work, 18 of them to their original employment.

Adolescent↗
PubMed1983

Upper extremity replantation.

The most important determinants of the functional ability of an amputated part are proper patient selection and the recognition of vascular compromise. Ideally, a well-performed anastomosis should need no pharmacologic assistance, but the ideal is often the exception. The authors present an empirical approach to use of anticoagulation medication.

Amputation, Traumatic↗
PubMed1982

Muscle and myocutaneous flaps on the lower limb.

Defects of the lower limb can be repaired in several ways and a very satisfactory closure can be obtained using muscular and myocutaneous flaps. The soleus muscle, both heads of the gastrocnemius muscle, the peroneus brevis muscle and the flexor hallucis longus muscle can all be used, the choice depending on the site of the defect.

Adolescent↗