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Biomedical subjects

M Pannier

Publications and source records attributed to M Pannier.

At least 19 recordsLinked to original sources
PubMed2006

[Anatomic study and clinical application of the skin paddle of the serratus anterior free flap].

SUBJECT: Several authors used musculocutaneous free flaps of serratus anterior. However, the localization and dimensions of its skin paddle are not clearly defined in the literature. Thus, we realized an anatomical study trying to prove the reality of this skin paddle and its localisation, before considering clinical applications. PATIENT AND METHODS: Twenty-six dissections on 13 fresh anatomical subjects were realized. The protocol consisted in catheterization the thoracic branch of the thoracodorsal artery to inject a mixture of iodized product and methylene blue. The results were obtained by direct measurement of the blue cutaneous area and by radiographic evaluation of the radiopaque area, compared to reproducible anatomical reference marks. RESULTS: Twenty-five dissections were interpretable with superposable results. The skin paddle was always located compared to the 5th, 6th and 7th ribs between the anterior axillary line and the mamelonnary line. The area of the skin paddle was 11,75 cm of length (10-14), 10,75 cm of width (9-12) and 125 cm(2) from surface (110-140). Then, we realized between January and December 2003 several clinical applications of this anatomical study. We report 12 cases of free flaps of serratus anterior with skin paddle for the monitoring of the flap (4 musculocutaneous, 5 osteo-musculo-cutaneous, 3 of fascia with skin paddle). CONCLUSION: This study comes to the support from the anatomical observations from Salmon, the per-operational observations of several authors and our own clinical experiment. It certifies the autonomy of cutaneous vascularization by branches resulting from the surface fascia of the muscle. It specifies the localization and dimensions of the skin paddle of the serratus anterior flap in its muscular, osteo-muscular or fascial form, which still increases its versatility of use.

Adolescent↗
PubMed2005

Cement burns: retrospective study of 18 cases and review of the literature.

SUBJECT: Cement is increasingly used in the construction industry, but the occurrence of cement burns is rarely reported. This retrospective study concerns patients treated for cement burns in our unit between 1997 and 2002. MATERIALS AND METHODS: Eighteen patients 18-64 years of age, treated previously in our unit for cement burns, were interviewed by telephone for evaluation. RESULTS: The mean time since treatment was 39 months. Burns were predominantly seen on the lower limbs, and a third occurred during an accident on the job. All deep burns were excised, and 16 patients received grafts. Mean hospital stay was 10 days, and mean sick leave 2 months. Our study indicated that all patients were poorly informed about cement-related risks. DISCUSSION: Surgical treatment of full-thickness cement burns at diagnosis enables rapid healing with a minimum of sequelae and reduces the high socioeconomic costs resulting from these lesions. CONCLUSION: This study indicates once again the need to improve preventive measures; which are very often inadequate because of lack of awareness of risks.

Adolescent↗
PubMed2005

[The serratus anterior free flap in limb reconstruction. About 30 cases].

Between 2001 and 2003, 30 serratus anterior free flaps have been realized in our unit for reconstruction of lower limb. The flaps were indicated for repair of traumatic soft tissue defect in 19 cases, for chronic wound in six cases, for purpura fulminans in two cases, for pressure sore in one case and after tumor resection in 1 case. There were 29 patients: 25 males and four females. They ranged in age from 5 to 64 years. The size of the soft tissue defects ranged between 15 and 180 cm(2). Four different types of serratus anterior flaps were used: 20 muscle flaps ; four myocutaneous flaps ; five costo-osteomuscular flap ; one costo-osteomyocutaneous flap . In all cases we used osteo flap (8 th rib) in order to restore bone defect, which ranged from 9 to 15 cm. Necrosis occurred in two flaps because of venous thrombosis. The functional outcome was good for all patients and the aesthetic sequelae at the donor site were considered as minor. The serratus anterior flap can be used in many different ways: different kinds of flaps (osteo-cutaneous-muscle); very variable size of flap (15 to 180 cm(2) in our series) , different length of pedicle possible. Because of his versatility and his absence of major functional or aesthetic sequelae the serratus anterior free flap has become day by day our favourite option in limb reconstruction.

Adolescent↗
PubMed2005

[The orbitonasolabial flap. Anatomical and clinical study].

How to use the orbitonasolabial flap in vascular island thanks to his pedicle based an angular vessel. An anatomic study based on 11 cadavers allows to check the existence of a constant pedicle. This flap was used on 6 patients aged 62 to 90 years old on an average period of 16 months to fill up jugular, orbital, nasolabial and inner canthal defects. Two complications have occurred, a superficial necrosis of the lower part of the flap having spontaneously healed and an ectropion on a senile part. It has been necessary to degrease a second time in 50% of the cases. Nevertheless, the flap can be considered reliable and able to cover tissue defect in the central facial region with minor aesthetic and functional sequel on the donor site.

Aged↗
PubMed2004

[The "vessel case flap". About one case in the lower limb].

The authors report an atypical case of lower limb repair in a 69-year-old patient, who presented a closed fracture of the tibia initially fastened with a plate. Skin necrosis developed after osteosynthesis, exposing the plate and the fracture bone. Because of the vascular state of the patient (smoking, arteritis, diabetes), any microsurgical procedure seemed likely to fail. The incisions previously performed contraindicated any form of pedicle flap in the leg area. An original solution was then proposed, involving the long extensor muscle of the great toe pedicled proximally on the anterior tibial artery. After six months of follow-up, healing and bone consolidation have been achieved. The interest of this exceptional technique is considered with respect to therapeutic choices for lower limb repair.

Aged↗
PubMed2004

[Anatomical study of the nerve supply of the trapeziometacarpal joint. Fifteen dissections].

PURPOSE OF THE STUDY: When the radiological signs are minimal in patients with a painful carpal syndrome involving the trapeziometacarpal joint (TMCJ), selective articular denervation can be proposed as an alternative after failure of conservative treatment. Results have been variable, sometimes disappointing, suggesting the anatomic basis of denervation should be revisited. The purpose of this work was to study the nerve supply to the TMCJ in order to acquire the indispensable elements necessary for performing effective selective articular denervation. MATERIAL AND METHODS: This anatomical study was performed by dissection under magnification (4.5-x350) of 15 upper limb cadaver specimens. The median nerve, its thenar and volar cutaneous branches and the terminal sensorial branches of the radial nerve were dissected. Articular branches to the TMCJ were carefully identified. Histological samples were taken to verify the neurological nature of the elements dissected. RESULTS: All TMCJs dissected exhibited radial and median nerve supply. Branches of the median nerve predominated in number and caliber. The volar cutaneous branch gave rise to articular branches in eleven dissections and the thenar branch gave rise to articular branches via a retrograde arciform trajectory between the short abductor and the opponens digiti pollicis in thirteen. For five dissections, the TMCJ branches arose directly from the median nerve within the carpal tunnel. At histological analysis the dissected elements were identified as nerves. DISCUSSION: There have been few anatomic studies concerning the nerve supply of the TMCJ. Unlike the findings reported by Cozzi in 1960, we did not find the dorsal sensorial branch of the radial nerve to play an exclusive or preponderant role in the innervation of the TMCJ. The median nerve supply to the TMCJ appeared to be more significant, particularly for the volar cutaneous and especially thenar branches. CONCLUSION: Total and definitive selective denervation of the TMCJ appears to be a most difficult procedure which would require a very wide access and extensive dissection, including the thenar branch which would raise the risk of significant complications.

Cadaver↗
PubMed2004

A silver sulphadiazine-impregnated lipidocolloid wound dressing to treat second-degree burns.

OBJECTIVE: To evaluate the efficacy and tolerance of Urgotul SSD dressing (Laboratoires Urgo) in the treatment of second-degree burns. METHOD: This was a national multicentre phase III non-comparative open-label prospective study involving 10 burns units. The 41 subjects were non-immunosuppressed adults with second-degree thermal burn(s), which were clinically non-infected, less than 24 hours old, had a surface area less than 500 cm2 and warranted the local use of silver sulphadiazine. For four weeks, subjects were followed up weekly with a clinical assessment, bacteriological swabs and photographic recording. RESULTS: Of the 41 patients, 24 healed within a mean of 10.8 days and 13 had a skin graft on the study burn within a mean of 11.5 days. There were four premature study withdrawals. The total number of cumulative treatment days was 445, and 298 treatments were performed (including 257 dressing changes). Mean dressing wear time was 1.73 days. None of the subjects acquired a secondary infection. Researchers took 121 bacteriological samples, and wound colonisation with Staphylococcus aureus was found in only one patient. At follow-up nursing staff reported that dressing acceptability was good. CONCLUSION: Use of Urgotul SSD led to a good wound outcome--wounds healed or were grafted.

Adult↗
PubMed2003

[Surgical treatment of facial lipoatrophy].

The lipodystrophy syndrome is one of the major event of potent antiretroviral therapy. This treatment results in lipoatrophy, lipohypertrophy or mixed syndrome. Lipoatrophy is characterized by a loss of subcutaneous fat. The psychological impact may be severe when it is localized at the face. The aim of this study was to show the possibilities of improve lipoatrophy by autologuous fatty tissue transplantation with the Coleman method. Since december 1999 we have a plastic surgery consultation for lipodystrophy. From December 1999 to march 2002 we have seen 87 patients in consultation and 29 patients have been treated for facial lipoatrophy with Coleman method. The patients were evaluated clinically and with serial photography at 1 and 6 months post operatively. Coleman method is the ideal treatment for facial lipoatrophy in HIV infected patients. This technique is reliable and preliminary results show durability of fat graft after 6 months. Nevertheless, Coleman method is restricted by fat availability and can not be used for all lipoatrophy.

Adipose Tissue↗
PubMed2002

[Efficacy and tolerance of Algosteril (calcium alginate) versus Jelonet (paraffin gauze) in the treatment of scalp graft donor sites in children. Results of a randomized study].

Split skin graft is frequently needed in the treatment of burned patients. Scalp is often free of burns. Due to its good skin quality and important surface, scalp is a very interesting skin donor site, specially in case of children. A controlled, randomised clinical trial was carried out in 10 French Plastic Surgery or Burns Units. It assessed the efficacy and the acceptability of calcium alginate dressing (Algosteril) versus paraffin gauze dressing (Jelonet) in the treatment of scalp donor sites in children. 67 children (mean age 54 months) entered the study, 34 in the alginate group and 33 in the control group. Follow-up visits were on day 2/d3, d5/d6, Day complete healing, d30 and d60 after surgery. The two groups were comparable on inclusion (demographic characteristics, burn nature and surface, donor site surface and thickness of split skin graft). The mean healing time was 10 and 11 days for Algosteril and Jelonet group respectively (ns). The quality of the newly formed tissue was estimated to permit a sooner skin reharvesting in the Algosteril group than in the control group (p = 0.003). Bleeding through dressing was significantly less important in the Algosteril group (p = 0.02). Changes were considered by investigators less painful with Algosteril on day complete healing (p = 0.0096). Hair growth is homogenous in both groups on day 30 and day 60 (ns). These results showed that scalp is a very interesting skin donor site and that Algosteril is of a real interest in donor site treatment.

Alginates↗
PubMed2002

Urgotul: a novel non-adherent lipidocolloid dressing.

Urgotul belongs to a new class of non-adherent dressings: the lipidocolloid dressings. It is composed of an open weave polyester mesh impregnated with hydrocolloid polymers dispersed within petrolatum. The first clinical trial data are presented. Efficacy and safety were evaluated in a multicentre non-comparative trial involving 92 patients treated to healing or up to 4 weeks. Adult outpatients with acute wounds (n = 34), leg ulcers (n = 24), other chronic wounds (n = 14) or with second-degree burns (n = 20) were included. Results showed 32.4% (n = 11) of the acute wounds, 12.5% (n = 3) of the leg ulcers and 14.3% (n = 2) of the other chronic wounds completely healed before 4 weeks. Surface areas decreased on average by 76.4%, 63.5% and 44.2% at study endpoint respectively. For burns, 19 patients healed (95%) within 5-19 days. A total of 771 dressing changes were performed during the course of the study. Dressing application was considered as easy or very easy in 90% or more of the changes and there was no difficulty in removing the dressing in about 95% of the cases. Safety was good with five reports of a transitory local adverse event, probably dressing-related, being observed, two patients (2.2%) prematurely stopped treatment because of moderate periwound erythema. Urgotul is a highly promising new dressing which is currently undergoing further comparative clinical evaluation.

Adult↗
PubMed2001

[Physiology and pharmacology of lacrymal and salivary secretions].

Salivary and lacrymal glands have secretory mechanisms similar to those of other exocrine glands. Saliva results from two different but integrated processes i.e. hydroelectrolytic transport and protein secretion by regulated exocytosis. Both cellular processes are regulated by the autonomic nervous system with complementary effects without antagonism, and parasympathetic innervation predominates. Signal transduction mechanisms in salivary cells include: increases in cytosolic calcium, cyclic AMP and cyclic GMP. The tear film consists of three layers: mucous inner layer, middle aqueous layer, and outer lipid layer. Each layer secretion is strongly regulated. Aqueous layer secretion is controlled by autonomic nervous system and signal transduction depends from cyclic AMP and intracellular calcium levels. A review of drugs used in France modulating lacrymal and salivary secretions is proposed.

Adenosine Monophosphate↗
PubMed2001

Distally based sural fasciomuscular flap: anatomic study and application for filling leg or foot defects.

Since 1995, the authors have created 32 distally based superficial sural artery flaps based on the vascular axis of the sural nerve. The creation of the first 18 flaps permitted the authors to view perforators that issued from the gastrocnemius muscles to the vascular axis of the sural nerve. This led to the development of an anatomic study involving 25 cadaveric dissections to establish a relationship between the gastrocnemius muscles and the vascular axis of the sural nerve, with two to three constant and direct perforators from the gastrocnemius to the neurovascular axis. In this article, the technique for harvesting this new muscular flap is described. Between June of 1997 and March of 1998, three patients underwent flap operations. Two fasciomyocutaneous flaps and one fasciomuscular flap were created and were followed by uncomplicated postoperative courses in terms of flap viability and donor sites. In all cases, the flap created was designed to fill bone defects of the leg (one case) or of the foot (two cases). The results were considered to be excellent and stable over time, with follow-up periods ranging from 9 months to 18 months in duration.

Adult↗
PubMed2000

EPR probes with well-defined, long distances between two or three unpaired electrons

The synthesis of rod- and star-shaped compounds carrying two or three spin labels as end groups is described. The unpaired electrons are 2.8-5.1 nm apart from each other. The shape-persistent scaffolds were obtained through Pd-Cu-catalyzed alkynyl-aryl coupling and Pd-Cu-catalyzed alkyne dimerization in the presence of oxygen using p-phenyleneethynylene as the basic shape-persistent building block. The spin label 1-oxyl-2,2,5,5-tetramethylpyrroline-3-carboxylic acid (4) was attached through esterification of the terminal phenolic OH groups of the scaffold.

Journal Article↗
PubMed2000

Dead-time free measurement of dipole-dipole interactions between electron spins.

A four-pulse version of the pulse double electron-electron resonance (DEER) experiment is presented, which is designed for the determination of interradical distances on a nanoscopic length-scale. With the new pulse sequence electron-electron couplings can be studied without dead-time artifacts, so that even broad distributions of electron-electron distances can be characterized. A version of the experiment that uses a pulse train in the detection period exhibits improved signal-to-noise ratio. Tests on two nitroxide biradicals with known length indicate that the accessible range of distances extends from about 1.5 to 8 nm. The four-pulse DEER spectra of an ionic spin probe in an ionomer exhibit features due to probe molecules situated both on the same and on different ion clusters. The former feature provides information on the cluster size and is inaccessible with previous methods.

Electron Spin Resonance Spectroscopy↗
PubMed2000

The limitation of primary excision of cicatricial alopecia: a report of 63 patients.

This 11-year retrospective study (1985-1996) of 63 patients demonstrates that cicatricial alopecia is almost always distressing for the patient and is considered as a social handicap, which makes repair a necessity. Two major therapeutic methods for remedying this condition were used in the study: suture excision and tissue expansion. The optimal use and limitations of each method are defined on the basis of treatment quality, as evaluated by the patient and the surgeon. Suture excision often ends with disappointing results for the surgeon as well as the patient and seems limited to alopecias no greater than 10 mm in width. Tissue expansion is considered generally satisfactory, but has the problem of scar enlargement, which reduces the quality of the result.

Adolescent↗