Interplast program in Peshawar, Pakistan.
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Biomedical subjects
Publications and source records attributed to R J Zeeman.
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Traumatic, subcutaneous ruptures of flexor tendons in the hand are infrequent findings in clinical practice. They usually occur at the bony insertion or at the musculotendinous junction. Intratendinous ruptures are reported almost only in association with underlying pathologic conditions. We report a case of subcutaneous rupture through the healthy substance of the profundus flexor tendon of the small finger in the palm of the hand, which was associated with a complete tendinous fusion between the deep flexor of the ring and small finger up to the lumbrical insertion.
In 18 patients with 25 chronic stasis ulcers and in 15 patients with 22 chronic leg ulcers of different aetiology, and in 7 patients with a variety of skin defects the effect of cryopreserved cultured allografts (CPA) on wound healing was investigated. The ulcers were grafted weekly or every other week on an outpatient basis until healing occurred. In 78% of the patients with stasis ulcers (84% of the ulcers) there was complete healing with a mean healing time of 31 days and a mean healing rate of 4.9 cm2 per week. The mean healing time of arterial and rheumatoid ulcers was 68 days and 56 days, respectively, while donor sites and erosive skin lesions all healed within 5 days. Five ulcers (9%), including one stasis ulcer, in 5 patients showed no change. We conclude that CPA is an easily applicable and effective biological product that profoundly stimulates the host epithelialisation, reduces the pain and is specifically effective in accelerating the healing of chronic stasis ulcers and donor sites.
Twenty-seven consecutive fasciocutaneous flaps comprising skin, fat, and deep fascia have been successfully used to close a variety of defects on the lower leg and trunk. The advantages of these flaps are enumerated, and the blood supply of the deep fascia and its relationship to the tissues deep and superficial to it are described.
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A 57-year-old female patient presented with a tenosynovitis due to Mycobacterium avium-intracellulare (MAI). A relapse occurred following surgical treatment, after which she was successfully treated with ansamycin and ethambutol. Previously reported cases of tenosynovitis due to MAI are reviewed and the treatment modalities are discussed.