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Biomedical subjects

R F Edlich

Publications and source records attributed to R F Edlich.

At least 91 records · Page 5Linked to original sources

Mechanical performance of a work hardened pointed surgical wire.

The design and material properties of a surgical wire have been enhanced to improve its performance in surgery. One blunt end of the wire has been honed to a point to decrease the axial compressive force required to penetrate tissue. In addition, its sharp end has been work hardened to increase its yield strength. The mechanical performance of this wire has been characterized by a series of in vitro experiments and a clinical trial.

Bone Wires

Pseudofolliculitis barbae with keloids.

Pseudofolliculitis barbae is a common cutaneous infection occurring in the bearded area of the face of black men. The infection is caused by ingrown hairs that produce an inflammatory foreign body reaction characterized by papules and pustules at the point of hair penetration that may result in permanent scarring, usually in grooved patterns, and occasionally in keloids. The purpose of this article is to describe the successful treatment of a patient with pseudofolliculitis with keloids that was based on the pathophysiology of the disease and the biology of wound repair.

Adult

Pig's foot holder for wound-repair training.

A special pig's foot holder has been developed for wound-repair teaching sessions. It has been designed to stabilize the pig's foot without obstructing the physician's view of the wound.

Ambulatory Care

Epidemiology, pathology, and treatment of axillary hidradenitis suppurativa.

The epidemiology, pathology, and management of axillary hidradenitis suppurativa were examined in 11 patients with this disease. On the basis of this study, the following predisposing factors were incriminated in the epidemiology of the disease: predilection of the disease for women, obesity, hair removal by a safety razor, antiperspirants and deodorants, and local pyogenic infections distant from the axilla. Because antiperspirants do not effect transepidermal water loss of axillary skin, their potential deleterious effects are probably related to their chemical irritant effects on cut, nicked, or irritated axillary skin. Treatment of this disease will vary according to its severity. Incision and drainage are usually needed to treat the localized disease. Specific measures must also be instituted to prevent progression of the disease (eg, weight reduction, avoidance of safety razor and antiperspirants and deodorants, and control of localized pyogenic infections distant from the axilla). Management of the chronic phase of the disease is primarily excision of infected axillary skin.

Adult

Novafil. A dynamic suture for wound closure.

Abdominal wound dehiscence was quantitatively studied in a rat model. Polybutester suture is a new monofilament nonabsorbable suture that has unique stress-strain properties that are potentially beneficial for abdominal wound closure. The abdominal volume at the moment of wound dehiscence was correlated with the extensibility of the suture material used for closure. Interrupted sutures of polybutester cut through the tissues at a mean abdominal volume of 212 +/- 3 ml. This volume was significantly (p less than or equal to 0.005) greater than the mean volumes reached with nylon (197 +/- 3 ml) or polyglycolic acid (187 +/- 4 ml). Closure of abdomens with continuous polybutester suture resulted in a mean rupture volume of 218 +/- 3 ml, which was significantly (p less than or equal to 0.005) greater than that achieved with the same suture employed as simple interrupted sutures (212 +/- 4 ml). The influence of width of tissue bite, suture size, and needle configuration was also evaluated.

Abdominal Muscles

Emergency department management of puncture wounds and needlestick exposure.

Puncture wounds are common and challenging problems facing the physician. In general, puncture wounds can be classified into two distinct types. In one type, a child usually sustains a puncture wound of the foot. The other type of puncture wounds occur among hospital employees. These seemingly innocuous injuries may have serious sequelae that can be averted by prompt appropriate care of the wound. The fundamental trends of treatment of puncture wounds include cleansing the wound, débridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis.

Adolescent

Tetanus.

Tetanus is produced by the action of the potent neurotoxin, tetanospasmin, which is elaborated during the growth of Clostridium tetani. The objectives of management of tetanus are to provide supportive care until the tetanospasmin that is fixed in tissue has been metabolized, to neutralize circulating toxin, and to remove the source of tetanospasmin. This disease, which is frequently fatal, is prevented by immunization.

Bacterial Toxins

Antimicrobial treatment of minor soft tissue lacerations: a critical review.

This article is a collective review of all the prospective clinical studies that assessed the therapeutic value of antibiotics in minor soft tissue lacerations. This review critically evaluates each study that tests the hypothesis that antibiotic treatment reduces the incidence of infection. Even though the design of each of the studies was scientifically inadequate, important factors were identified that influenced the incidence of infection. On the basis of this collective review as well as other studies, indications for antibiotic therapy of minor soft tissue lacerations have been identified. Future clinical studies must be designed to test more precisely the validity of these recommendations.

Adult

Toxic epidermal necrolysis.

Toxic epidermal necrolysis (TEN) is a symptom complex characterized by a devastating skin disorder, erosive involvement of two or more mucous membranes, and severe constitutional symptoms. The disorder shares features with erythema multiforme and is thought to be an expression of the syndrome. Although a wide range of etiologic factors have been incriminated in TEN, only a few cases have provided convincing evidence of a direct causal link. Most cases of TEN have been associated with drug administration.

Adolescent

Emergency department management of mammalian bites.

Mammalian bites have reached epidemic proportions with more than one half million people being bitten by an animal or another person. Although the bite wound may initially appear to be innocuous, it may lead to severe complication that can be prevented by a timely and comprehensive treatment program that is outlined in this report. Our approach to these challenging injuries includes a complete evaluation of the injury, planned surgical intervention, antimicrobial therapy, immunoprophylaxis, and appropriate postoperative care.

Animal Population Groups

Quality assessment of tetanus prophylaxis in the wounded patient.

New guidelines on tetanus prophylaxis in wound management have been prepared by the American College of Surgeons and are available in a poster format or in bulletins. The purpose of this study was to determine the impact of these educational brochures on tetanus prophylaxis in a hospital setting. The results of this study indicate that these informational brochures and posters had insignificant impact on the quality of prophylaxis against tetanus in our hospital. Innovative programs of information exchange and quality assurance are urgently needed to improve the delivery of health care.

Diphtheria Toxoid

Heat welding for surgical sutures.

The purpose of this experimental study was to test the potential value of heat welding to cut the ends of knotted surgical sutures. This heat process resulted in knot security in a coated polyglactin suture with fewer throws than those needed for the same suture with knotted ends cut by scissors. Results of mechanical performance testing of the knotted sutures cut either by scissors or welding did not differ significantly. With refinements in the technical design of the heat source, suture welding may have important applications in surgery.

Hot Temperature

The arcuate skin staple: its influence on pain of staple penetration and removal.

The purpose of this study was to measure the degree of pain elicited by either staple implantation and by removal in human subjects. Included in the study were conventional rectangular staples and the new arcuate staples. The pain associated with staple implantation was significantly greater than that associated with staple removal. The configuration of the staple did not influence the magnitude of pain associated with either staple implantation or staple removal.

Equipment Design

Excision of multiple epidermal facial cysts in Gardner's syndrome.

A rhytidectomy incision is recommended to excise multiple facial epidermal cysts in patients with Gardner's syndrome. The advantage of this approach is that it permits excision of excess skin over the cyst with esthetically pleasing hidden scars. The alternative to this procedure, a separate incision over each cyst, results in disfiguring and conspicuous scars.

Adult

Evaluation of surgical tapes for wound closure.

The performance of four wound closure tapes was evaluated by a series of standardized tests. The tapes examined in this study were a nonwoven microporous tape, a nonwoven microporous reinforced tape, a gauze tape, and a polyurethane tape. The performance of these tapes was assessed by measuring their breaking strength, degree of elongation under loading, adhesion to skin, air and water vapor transmission, and bacterial growth under the tape. On the basis of these in vitro and in vivo studies, the nonwoven microporous tape is recommended for skin closure. This tape has a nonwoven microporous structure with an adhesive that aggressively adheres to the underlying skin. It is strong enough to resist breakage during clinical use and elongates sufficiently to prevent blister formation. Its microporous structure permits rapid air transmission in vitro and results in an environment that is antithetical to bacterial growth.

Air

Clavicular fractures and acromioclavicular joint dislocations in lacrosse: preventable injuries.

Clavicular fractures and acromioclavicular joint dislocations occur frequently in high school lacrosse players. This injury is restricted to attackmen who are struck in the clavicular region by the stick of the defensemen. The conventional foam shoulder pads with or without flexible plastic inserts worn by the attackmen did not protect them from this injury. On the basis of this clinical experience, a new protective shoulder pad containing high-density polyethylene over the clavicle and acromioclavicular joint has been designed and manufactured to prevent these injuries. Our initial experience with this new shoulder pad indicates that it will protect lacrosse players from clavicular fractures and acromioclavicular joint dislocations.

Acromioclavicular Joint

Prosthetic valve endocarditis developing after an infected scalp laceration.

This case report describes a 21-year-old man who developed prosthetic valve endocarditis (PVE) from an infected scalp laceration. Despite intravenous antibiotic therapy, the infectious process could not be controlled and the patient required replacement of the aortic valve. Our patient is the fourth case of late PVE occurring after a subcutaneous infection. In each case, antibiotic prophylaxis of infective endocarditis was not practiced. Current antibiotic regimens for prophylaxis of PVE are reviewed.

Adult