PubMed Health⌕ Search

Biomedical subjects

M Relander

Publications and source records attributed to M Relander.

13 recordsLinked to original sources
PubMed1997

Microvascular free tissue transfers after preoperative irradiation in head and neck reconstructions.

Surgical reconstruction of large head and neck tumors involves great problems. Preoperative irradiation increases the risk of postoperative complications. The use of microvascular free flaps has definitive advantages over conventional reconstruction techniques and permits immediate preoperative high-dose radiation therapy. Eighty-eight patients, 55 (62%) men and 33 (38%) women, with head and neck tumors underwent microvascular reconstruction at the Turku University Central Hospital in 1985-1995; 77 of them were irradiated before surgery. All irradiated patients underwent primary reconstruction. The preoperative radiation dose was 50-65 Gy. The free tissue transfer was successful in 77 (88%) of the 88 patients. The success rate was 87% in irradiated patients and 91% in nonirradiated patients. Free tissue transfers are suitable for one-stage reconstruction in selected patients such as those receiving high-dose preoperative irradiation. The transfer of microvascular free flaps to the head and neck has become the most common reconstruction method owing to its increasing success rates as well as its excellent esthetic and functional results.

Female↗
PubMed1997

The success rate of free flaps after preoperative irradiation in head and neck reconstruction.

BACKGROUND AND AIMS: The reconstructive treatment of large head and neck tumours involves serious problems. Preoperative irradiation increases the risk of postoperative complications. Microvascular free flaps offer definite advantages over conventional reconstruction techniques and permit immediate preoperative high-dose radiation therapy. MATERIAL AND METHODS: In 1985-1996, at the Turku University Central Hospital, 101 patients, 61 (60%) men and 40 (40%) women (age range 15-79 years, mean 61 years), with head and neck tumours, underwent microvascular reconstructions, and 90 of them were irradiated before surgery. All irradiated patients underwent primary reconstruction immediately after resection. The total irradiation dose was about 60 Gy, usual range 50 to 65 Gy. The patients were operated on 3 to 5 weeks after discontinuation of irradiation therapy. RESULTS: Of the whole material of 101 free flaps, 89 (88%) were transferred successfully. The success rate in irradiated patients was 88% and in nonirradiated patients 91%. Reoperation had to be performed within twelve hours in three cases, with good results. Only two hernias occurred as donor complications (2%). Two of the patients died postoperatively (2%). Partial flap necrosis occurred in five patients and five patients underwent another reconstruction using a new free flap or with conventional reconstruction techniques. CONCLUSIONS: Free flaps are often the only acceptable choice in extensive head and neck primary reconstructions after irradiation. Microvascular free tissue transfers to the head and neck after preoperative irradiation has become the accepted method of reconstruction as a result of increased success rates with superior aesthetic and functional results.

Adolescent↗
PubMed1988

Caudal musculocutaneous trapezius flaps for reconstruction of soft tissue defects.

To date trapezius flaps have been utilized only to a limited extent in reconstructive surgery. We present the experience we have gained of caudal trapezius flaps in the reconstruction of tissue defects on the neck and shoulders. We have operated on a total of 6 patients. The anatomy of the trapezius muscle and its function are presented in brief. The surgical technique is explained and case studies of 3 patients are presented.

Adult↗
PubMed1988

Recurrence of surgically treated pressure sores.

During an 8-year period, 39 patients were referred to our department for surgical treatment of primary pressure sores. They were examined 2-12 years postoperatively in order to demonstrate the incidence of healing or the recurrence rate of pressure sores. Approximately 2/3 of the patients suffered from a neurological disability, inducing impaired sensitivity in the critical skin areas. In our follow-up it was found that 48% of the operated sores recurred--56% occurring in the patients with spinal cord lesions. 48 out of 66 sores healed, but several required more than one operation, and in one patient, as many as four operations had to be performed. The results achieved with musculocutaneous flaps were comparable to those reached by closure with cutaneous flaps. Flaps with intact sensitivity were not used. The time of hospitalization was quite long. As a rule, only one sore was treated at a time. Hence the cost of treatment for these patients is rather high, especially in view of the fact that every second patient will return displaying a new or recurrent pressure sore. It is, therefore most important to inform patients of the continuous risk of a relapse and to analyze his social and psychological environment. Especially, young, neurologically disabled patients need to be made aware of this. A patient treated surgically, whose sores have healed, must stay alert and well in order to avoid recurrence. A psychological study of the patient may be helpful when trying to indicate possible risk groups.

Adolescent↗
PubMed1987

Treatment of the exposed knee prosthesis.

Ten knees with early tissue breakdown after knee arthroplasty resulting in exposed prostheses were treated with different plastic surgical techniques. Six knees were successfully covered: four using a gastrocnemius musculocutaneous flap, one using a fasciocutaneous flap, and one using split-skin grafts. Four knees failed: two using local skin flaps and two using split-skin grafts. A gastrocnemius musculocutaneous flap seems to provide a reliable coverage of the exposed knee joint.

Aged↗
PubMed1982

[Laser surgery].

Explore the source record for details and available documents.

Argon↗
PubMed1972

Controlled trial of treatment for cerebral concussion.

In a study designed to compare two types of treatment of cerebral concussion, 178 patients were allocated to a routine treatment or to an active treatment group; in the latter a good prognosis was emphasized, the patient was mobilized early and given physiotherapy. In the routine treatment group the average time off work was 32 days compared with 18 days in the active treatment group. Physiotherapy seemed to be particularly valuable in old patients and in those with exaggerated fears about their condition. It is suggested that throughout their illness and follow-up, patients with cerebral concussion should be under the care of one doctor, one who is particularly interested in the subject and that more propaganda is needed

Absenteeism↗