Biomedical subjects
Publications and source records attributed to O N Mehrotra.
This is a review of six patients presenting with severe injuries of the dorsum of the hand following motor vehicle accidents. In each case the injury was sustained by the hand being trapped between the road and the overturning vehicle. The injured hands were either outside the window or passed through the open window at the time of the accident. These injuries were all sustained during the summer months.
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Contour defects resulting from trauma, from the excision of a neoplasm, or present at birth, may be restored in a number of ways, and the material used may be autogenous, homogenous, heterogenous, or synthetic in nature. The use of Silastic implants is currently fashionable, but despite the manufacturer's claims, there is no foreign material which the body will accept permanently as its own. Implants are easy to procure and to shape, and their use can sometimes simplify a surgical procedure, but there is no doubt that where autogenous material is available, it will almost always give the best and most permanent result. This paper illustrates the versatility of simple de-epithelialization and over-flapping procedures in restoring contour defects, and is also a plea for the use of living tissue where it is readily available.
Improvement in the function and appearance of hand brought about by using tissue from a damaged index finger is presented. The damaged index finger could have been retained as a stiff digit or thrown away in the bucket.
Management of compression injuries of the hand. Primary treatment of extreme conversatism is recommended. Repair by local tissues is superior in every way as regards function, sensation and appearance of the hand. Where local tissues cannot be used free skin grafting and distant flaps should be considered.
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A method is presented for the repair of full-thickness defects of the eyelid. The lining and tarsal plate are replaced by a free chondromucosal graft from the nasal septum, in which the cartilage is thinned and perforated. Cover is provided by a compound, bipedicled flap of skin and muscle from the opposite lid.
Reports of three cases of large oral fistula following tumour excision are presented. The repairs utilized deltopectoral, forehead, and scalp flaps. Technical points discussed include the de-epithelialization of folded flaps, the preservation of vermilion, the placement of immediate fascial slings and the use of island flaps.
A unique opportunity to reconstruct a deformed hand by designing two neurovascular island flaps from a damaged index finger has been presented. One flap, a composite carrying the index tip, was used basically as in pollicization, while the second flap was used to reconstruct the web space. An excellent functional result was achieved.
Problems relating to the management of traumatic skin loss of the lower extremity and methods of replacement are discussed with emphasis on several new methods namely, muscle flaps. foot flaps carried on its own blood vessels are nerve as an island flap and free microvascular flaps. Cases treated by these methods are illustrated.