PubMed HealthSearch

Biomedical subjects

M T Edgerton

Publications and source records attributed to M T Edgerton.

At least 19 recordsLinked to original sources

Activity of antibiotics in contaminated wounds containing clay soil.

Most traumatic wounds are contaminated to some degree by soil and run a high risk of infection. The presence of soil in wounds interferes with natural tissue defenses, which include phagocytosis and serum bactericidal capacity. The experimental studies reported herein clearly demonstrate that soil also limits the antibacterial effects of specific antibiotics. This inactivation appears to be the result of a chemical reaction between the charged antibiotics and the soil particles.

Animals

Physician and patient acceptance of emergency nurse practitioners.

Patient and physician attitudes toward emergency nurse practitioners (ENP) were surveyed in our emergency medical service. The responses to the questionnaires indicated a high degree of satisfaction with the ENP similar to that reported in a survey of patient reaction to physician assistants (PA) in the emergency department. In our emergency medical service, physicians expressed a concern over the practitioner's care of the emergent patient. Their confidence in the practitioner's clinical judgment was greater in their care of nonurgent and urgent patients.

Attitude

Extinguishing the flaming burn victim.

The multipurpose dry chemical fire extinguishers are unusually efficient in extinguishing many classes of fire: A) ordinary combustible; B) flammable liquids and C) electrical equipment. This exemplary performance of multipurpose extinguishers is associated with minimal toxic effects to humans. Following contact of soft tissue with the multipurpose dry chemical, the tissue exhibits a remarkable ability to resist infection and a normal capacity to heal following injury. This negligible toxicity of the multipurpose dry chemicals makes them safe for extinguishing the flaming clothes of human burn victims.

Animals

Periosteal pennant lateral canthoplasty.

A periosteal pennant method of primary lateral canthoplasty is described, and it effectively maintains surgical correction of the axis of the palpebral fissure and the position of the lateral canthus. In using it more than 50 times, we have not had to do a secondary correction.

Adolescent

Male transsexualism--a review of genital surgical reconstruction.

Transsexualism is a poorly understood, uncommon, and controversial entity of recent interest to the lay public and medical profession. Important features of the condition are discussed, surgical procedures for genital conversion in male transsexuals are compared, and our experience at the University of Virginia where 53 patients have been treated surgically is presented. All patients have made satisfactory postoperative psychosocial adjustment despite a surgical complication rate approaching 50 per cent. It is concluded that alternative (better) surgical procedures for male transsexuals should be explored.

Castration

Debridement: an essential component of traumatic wound care.

The harmful influences of devitalized tissue on wound defenses are documented and the importance of wound debridement in the care of the traumatic wound is stressed. All devitalized soft tissues damaged the host's defenses and encouraged the development of infection. The capacity of divitalized muscle, fat, and skin to enhance infection was comparable. The infection-potentiating effect of skin was enhanced by exposing it to a dry thermal injury. The mechanisms by which devitalized soft tissue enhanced infection are several. The devitalized soft tissue acts as a culture medium promoting bacterial growth. In addition, the devitalized tissue inhibits leukocyte phagocytosis of bacteria and subsequent kill. Finally, the anaerobic environment within the devitalized tissue may also limit leukocyte function.

Debridement

Platysma myocutaneous flap for intraoral reconstruction.

Fourteen patients were treated for intraoral epidermoid carcinoma with a single stage reconstructive technic employing a myocutaneous flap based upon the platysma muscle. This flap carries on its distal tip a portion of isolated cervical skin to be used for intraoral replacement of the resected tissue. The flap has proved to be highly reliable and has significant benefits over many other technics commonly employed for head and neck reconstruction.

Carcinoma, Squamous Cell

Mechanisms by which proteolytic enzymes prolong the golden period of antibiotic action.

These experimental studies provide an explanation for the therapeutic value of proteolytic enzymes as adjuncts to antibiotic treatment of contaminated wounds. After wounding, a fibrinous coagulum develops on the wound surface. This coagulum surrounds the bacteria and protects them from contact with sustemically or topically administered antibiotics. Treatment of the wound surface with proteolytic enzymes disrupts the coagulum and exposes the bacteria to the action of the antibiotic. The topical use of enzymes is also associated with significant increases in the concentration of antibiotic at the wound and thus a decrease in the rate of infection.

Administration, Topical

Evaluation of vocal pitch in male transsexuals.

A 49-year-old male-to-female transsexual was administered voice therapy following surgery. Tape recordings were made of her speech prior to and each week during therapy. Selected sentences from these reocrdings were analyzed. Results indicate that changes in both fundamental frequency and perceptual judgments of femininity were statistically significant and supportive to the client. The voice of the client was still discernible from that of a female speaker, although less so than before therapy. It is suggested that a composite treatment program combined with laryngeal modification through surgical intervention may be necessary.

Evaluation Studies as Topic

Vascular and lymphatic tumors in infancy, childhood and adulthood: challenge of diagnosis and treatment.

The essential features of the major benign and malignant vascular tumors affecting infants, children and adults have been presented. Major emphasis has been placed upon the classification and treatment of hemangiomas, although malignant vascular tumors are discussed, and extensive and selected references are cited. The classification system of hemangiomas presented in this monograph is based upon the clinical prognosis of the angioma. The principles of treatment for hemangiomas based upon our clinical classification are discussed and may be summarized as follows: 1. The diagnostic features and prognosis vary with the variety of the angioma. 2. Spontaneous regression occurs only with juvenile hemangiomas, and the major involution occurs before age 5. 3. Patients with rapidly growing capillary cavernous hemangiomas should be treated with steroids. 4. Treatment modalities that increase scarring of the surface epithelium are contraindicated. 5. Intradermal and cirsoid angiomas do not spontaneously regress. 6. Congenital A-V fistulas require aggressive surgery. 7. The ultimate deformity resulting from angiomas may be greatly reduced by plastic surgical techniques. 8. Radiation therapy is never indicated for the treatment of hemangiomas. 9. The psychologic impact of the congenital deformity on patients is generally more detrimental than comparable postsurgical or traumatic deformities.

Adult

Airless paint gun injuries: an update.

The airless paint gun delivers paint at pressures approximating 3,000 psi. Paint accidently injected into the skin under this pressure causes a devastating injury which is a result of the paint material, the level of bacterial contamination, and the pressure at which the paint is delivered. The time interval between injury and treatment seems a critical determinant of outcome. Decompression of the closed vascular compartments of the hand must be begun immediately to release the underlying tissue distended by the injected paint. Judicious wound debridement must be performed. Immediate antibiotic treatment is indicated in all patients. Studies seem to indicate that steroids limit the severity of inflammatory response. A regimen of hydrocortisone sodium succinate, 100 mg IV, administered immediately before surgery should be followed by a seven-day tapering course of oral prednisone starting with 40 mg on the first postoperative day. Recent safety measures and consumer warnings through the Consumer Product Safety Commission may reduce the number of airless paint gun injuries.

Adrenal Cortex Hormones

Modification of the American Burn Association injury severity grading system.

This study evaluated the regional burn health care system of the Commonwealth of Virginia using the criteria for optimal care of the burn patient designated by the American Burn Association. The data base for this evaluation was hospital records of seven hospitals in Virginia. The major shortcoming of the designated criteria was the grading system for the severity of burn injury. Using the criteria designated by the American Burn Association, a large number of minor burn injuries were judged erroneously to be major burn injuries. A modification of the American Burn Association's injury severity grading system is proposed which more precisely identifies the minor burn injury.

Aged

Results of surgical lengthening of the short nose in the bilateral cleft lip patient.

Some children with bilateral cleft lips do not grow a long enough nose and require surgical lengthening of the nose. We review our 12-year experience with a one-stage slide operation to achieve this. Seven males and 5 females had this operation at ages 7 through 13 years, and we have followed them from 6 months to 12 years. The results, and the subsequent growth effects are described. In general, good long-term improvement has been achieved and the external scars have not proved to be a major drawback. Subsequent procedures upon the columella, alae, and upper lip are often required to establish an unobtrusive nasal appearance.

Adolescent

Immediate correction of sagittal synostosis.

A technique for correction of sagittal synostosis with achievement of an immediately pleasing cosmetic result is presented. Even with replacement of bone and no attempt to inhibit bone union, premature reclosure does not occur. Moss' theory of dural tensions is discussed to explain the effect.

Humans