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Biomedical subjects

M Scheflan

Publications and source records attributed to M Scheflan.

At least 37 records · Page 2Linked to original sources
PubMed1982

Chest wall reconstruction--management of the difficult chest wound.

Full-thickness chest wall defects after ablative surgery for metastatic cancer, trauma, infection, or irradiation injury have posed major and often impossible dilemmas for reconstruction. At times, resection has had to be abandoned because reconstruction was deemed infeasible. However, recent knowledge of the multicentric blood supply and anatomy of the latissimus dorsi and pectoralis major muscle make it possible to use these muscles and myocutaneous units (even following division of their major blood supply) for reconstruction of the chest wall. The reconstruction of difficult anterolateral chest wall defects is discussed and the options available to the surgeon before and after interruption of the major blood supply to these flaps are presented.

Adult↗
PubMed1982

Surgical methods for managing ischial pressure wounds.

Several surgical modalities are available for closing ischial pressure wounds, but while they all aim for a permanently closed and well-padded ischial area, the manner in which this objective is achieved is different for each operation. Each technique has its unique design, transposes variable amounts and quality of soft tissue, and creates different scars and donor defects. These factors, in return, influence to a considerable extent the durability of each operation and, more important, create scars that dictate the nature of the secondary surgery in the all too common event of recurrent ulceration. No tissue is immune to pressure, and therefore there is no one best operation for closing pressure ulcers. This article critically reviews and updates contemporary surgical management and presents an orderly approach to selecting an operation for closing ischial pressure ulcers.

Adult↗
PubMed1982

Breast reconstruction with a transverse abdominal island flap.

A rectus abdominis musculocutaneous island flap for breast reconstruction following mastectomy is presented. The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy. Cadaver dissections are shown, demonstrating the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap. The surgical technique is demonstrated and representative patients are shown.

Abdominal Muscles↗
PubMed1982

Clinical trials of amniotic membranes in burn wound care.

Four test conditions of increasing complexity were used to evaluate the clinical efficacy of amniotic membranes as biologic dressings on donor sites and burn wounds in children. These were the clean-skin donor-site wound, the uncontaminated shallow partial-thickness burn wound, the bed of freshly excised full-thickness wounds, and the granulating surface of colonized burn wounds. The rate of epithelialization under amniotic membranes was the same as that under 5% scarlet red ointment or 0.5% silver nitrate solution dressings. Preservation of a healthy excised wound bed and maintenance of a low bacterial count in contaminated wounds paralleled the experience with human allograft dressings despite technical difficulties and the absence of vascularization of amniotic membrane and its fragile structure. Tentative conclusions are drawn as to the mechanisms by which biologic dressings exert their beneficial effects.

Bandages↗
PubMed1981

Surgical management of heel ulcers--a comprehensive approach.

Reconstruction of the ankle, heel, and foot remains a challenging, often frustrating problem for surgeon and patient alike. Little local soft tissue is available for the reconstruction, and often the underlying disorder precludes use of some procedures. The ankle and the heel are vital musculoskeletal structures, responsible for shock absorption, weight-bearing, and locomotion, and their dysfunction inflicts discomfort and disability on the individual that commonly lasts many months or even over a year. Soft tissue defects on the weight-bearing versus the nonweight-bearing surfaces present two quite different problems. Many surgical modalities, beginning with a skin graft and ending with microvascular transplantation of sensile tissues, are now available to the reconstructive surgeon for resurfacing the sole of the foot. We present a classification of heel ulcers based on their etiology, location, size, and the status of the peripheral circulation; offer new operative modalities and update the operations already available; and suggest an orderly approach to selecting an operation for reconstructing the foot.

Adolescent↗
PubMed1981

The tensor fascia lata: variations on a theme.

Using more of the true musculocutaneous (or proximal) portion of the tensor fascia lata enables the surgeon to augment its bulk, include bone in the flap, close the donor site primarily, and use the flap even if the distal fascial compartment has been damaged. Alternative designs, inclusion of bone in the flap, and tetracycline bone labeling are discussed.

Fascia Lata↗
PubMed1980

The latissimus dorsi musculocutaneous flap: a one-stage breast reconstruction.

As an alternative to multistaged tube pedicle flap breast reconstruction, we present a reliable, one-stage method of breast reconstruction using the latissimus dorsi muscle and musculocutaneous flap. Based on our experience with 200 falps over the last three years, we believe that the latissimus dorsi flap is a safe and effective operation for supplying skin and muscle tissue for breast reconstruction.

Breast↗
PubMed1980

Biliary secretion of methadone and methadone metabolites in man.

A method for the simultaneous quantitative analysis of human bile for methadone, and two of its metabolites: pyrrolidine, the major metabolite formed by N-demethylation, and pyrroline, formed by a second N-demethylation, using gas liquid chromatography and both radiolabeled methadone and pyrrolidine as standards for determinations of recovery has been developed. This method has been applied to the quantitative analysis of methadone and its metabolites in bile collected over three days from T-tube drainage in a methadone-maintained patient who had undergone cholecystectomy and common bile duct exploration but who had no liver disease. The concentrations and total amounts of the pyrrolidine metabolite far exceeded those of methadone and of the pyrroline metabolite. The amounts of unchanged methadone found in bile (as in previous studies of feces) were found to be very low. Therefore, at least in this patient, a significant enterohepatic circulation of unchanged methadone is unlikely.

Bile↗
PubMed1977

Pancreaticoduodenal artery aneurysm simulating carcinoma of the head of the pancreas.

Aneurysms of the pancreaticoduodenal arcades, although uncommon, may rupture and produce symptoms similar to those of pancreatic carcinoma. We describe one patient with a ruptured interior pancreaticoduodenal artery aneurysm and a large hematoma in the pancreatic head. He had a three-week history of painless jaundice. Angiography was essential in establishing the diagnosis and defining a vascular road map preoperatively. The surgical management involved resection of the aneurysm and vascular reconstruction.

Aneurysm↗