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Biomedical subjects

P C Cavadas

Publications and source records attributed to P C Cavadas.

At least 19 recordsLinked to original sources
PubMed2001

Posterior interosseous free flap with extended pedicle for hand reconstruction.

The anatomy of the posterior interosseous vessels makes them suitable as a donor area of free flap. The skin island can be designed on the perforating vessels of the distal third of the forearm, up to the dorsal wrist crease, to increase the pedicle length (7 to 9 cm). A series of nine flaps transferred to reconstruct hand defects is presented. All flaps were designed over the dorsal distal forearm, and dimensions permitted direct closure of the donor site (up to 4 to 5 cm wide). Apart from a linear scar, donor morbidity was negligible. All transfers were successful. Although its dissection is somewhat tedious, the anatomy of the vascular pedicle is suitable for microanastomosis and the skin island is thin, although hairy. The posterior interosseous free flap with extended pedicle may be a good choice when limited amounts of thin skin and a long vascular pedicle are needed.

Adolescent↗
PubMed2001

Sagittal synostosis: results of surgical treatment in 210 patients.

From 1977 to 1996, 210 patients suffering from scaphocephaly, have been operated on in our institutions. The surgical technique depended on the patients age. Single wide sagittal synostectomy was performed in 155 babies aged less than 3 months, obtaining good cosmetic results. Patients older than 3 months needed more complex and aggressive procedures to achieve similar results. The conclusions is that sagittal suturectomy is the proper treatment in younger patients under 3 months of age, and that a greater effort must be made to diagnose and treat these patients early.

Anthropometry↗
PubMed2001

The medial sural artery perforator free flap.

The medial sural artery supplies the medial gastrocnemius muscle and sends perforating branches to the skin. The possible use of these musculocutaneous perforators as the source of a perforator-based free flap was investigated in cadavers. Ten legs were dissected, and the topography of significant perforating musculocutaneous vessels on both the medial and the lateral gastrocnemius muscles was recorded. A mean of 2.2 perforators (range, 1 to 4) was noted over the medial gastrocnemius muscle, whereas in only 20 percent of the specimens was a perforator of moderate size noted over the lateral gastrocnemius muscle. The perforating vessels from the medial sural artery clustered about 9 to 18 cm from the popliteal crease. When two perforators were present (the most frequent case), the perforators were located at a mean of 11.8 cm (range, 8.5 to 15 cm) and 17 cm (range, 15 to 19 cm) from the popliteal crease. A series of six successful clinical cases is reported, including five free flaps and one pedicled flap for ipsilateral lower-leg and foot reconstruction. The dissection is somewhat tedious, but the vascular pedicle can be considerably long and of suitable caliber. Donor-site morbidity was minimal because the muscle was not included in the flap. Although the present series is short, it seems that the medial sural artery perforator flap can be a useful flap for free and pedicled transfer in lower-limb reconstruction.

Adolescent↗
PubMed1998

Multiple vein grafts for microarterial repair: an experimental study.

The influence of multiple suture lines along a vein graft for arterial repair was evaluated in a microsurgical model. Forty-five rats were divided into three groups. The femoral artery was repaired using one vein graft in group I, two sequential vein grafts in group II, and three grafts in group III. Patency rates were evaluated at 48 h and 10 days, and found to be 100% in all three groups. In the present study, patency was not affected by the number of suture lines. These results suggest that the use of multiple vein grafts for microarterial repair may be safe in difficult cases.

Animals↗
PubMed1998

Tracheal reconstruction using a free jejunal flap with cartilage skeleton: experimental study.

An experimental study was undertaken to evaluate the behavior of an autologous microvascularjejunal transfer with a cartilage skeleton for major tracheal reconstruction in the goat model. A 15-cm segment of the cervical trachea was replaced by a free microvascularjejunal transfer with costal cartilage skeleton as a single-stage procedure. The flap was stented for 4 weeks with an endotracheal T-tube. Bronchoscopy was done to the survivors at 6 months. The perioperative mortality rate was 40 percent, with 30 percent of the animals surviving the 30-week follow-up period. Bronchoscopy showed a smooth and appropriate lumen. Histology showed hyaline cartilage integrated within the jejunal wall and normal jejunal mucosa. The reconstruction of a large circumferential tracheal defect with a free jejunal transfer with cartilaginous skeleton remained stable, without undue mucous secretion, and the surviving animals remained asymptomatic for the follow-up.

Animals↗
PubMed1997

Reversed saphenous neurocutaneous island flap: clinical experience.

The description of blood supply to the skin through the superficial perineural vascular network has led to the concept of neurocutaneous flaps. Based on preexisting anatomic studies, the clinical use of large reversed-flow neurocutaneous saphenous island flaps is described. This flap is based on the arterial axis associated with the saphenous nerve and the greater saphenous vein in the lower leg. The donor area can be closed by soleus muscle advancement over the tibia and skin grafting. Five successful cases are reported with a low complication rate.

Adult↗
PubMed1996

In vivo microarterial freezing: experimental study.

In vivo freezing of microarteries with liquid nitrogen is known to relieve spasm without inducing thrombosis. In the present study the patency rates of microanastomoses in pre- and postfrozen vessels were investigated in the rat model. Freezing of the femoral artery was done with ethyl chloride. The artery was frozen before the anastomosis was performed on the left side (prefrozen), and after on the right side (postfrozen); patency rates were recorded at 2, 10, and 30 days. Patency rates were 100% in prefrozen vessels and 100% in postfrozen ones at all three time intervals. Histologic examination showed depopulation of all vessel walls with loss of the intima layer and fragmentation of the inner elastic lamina. Progressive cellular repopulation and regeneration of the endothelium occurred later, with no differences between pre- and postfrozen arteries. It is concluded that freezing of vessels with ethyl chloride reverts arterial spasm without inducing thrombosis and that frozen arteries can be repaired by microsurgical anastomosis with patency rates comparable to those of virgin arteries.

Anastomosis, Surgical↗
PubMed1996

In vivo microvascular freezing in veins: experimental study.

In vivo freezing of microarteries is known to relieve spasm without inducing thrombosis. In the present study the process of vascular freezing was investigated in veins using ethyl chloride in the rat model. Two separate experiments were performed. In experiment 1 the epigastric and femoral veins were frozen, and the immediate change in diameter was recorded. Patency rates were evaluated and specimens harvested at 2, 10, and 30 days. In experiment 2 the epigastric and femoral veins were frozen, divided, anastomosed, and examined for patency at 72 hours. Patency in frozen epigastric and femoral veins was 100%. Pathological findings were loss of intima and part of the media layers, and cellular depopulation of the media layer, with progressive regeneration. Increase in vein diameter was statistically significant. In experiment 2, patency rates were 5% at 72 hours for epigastric veins and 100% for the femoral vein. Microthrombi adherent to the wall were demonstrated in all specimens. In conclusion, the freezing of microveins relieves spasm without inducing thrombosis; the frozen veins can be reliably divided and anastomosed in the femoral vein but not in the epigastric vein, the difference being most likely due to the different diameter and flow.

Anastomosis, Surgical↗