Biomedical subjects

R Kuzbari

Publications and source records attributed to R Kuzbari.

26 records · Page 2Linked to original sources

PubMed1995

Long term results of inflatable mammary implants.

In this retrospective study, the long term results of 167 inflatable mammary implants in 77 patients who underwent either breast reconstruction or augmentation between 1972 and 1990 were evaluated. All inflatable implants were manufactured by Heyer-Schulte/Mentor company, and were equipped with a posterior leaf valve (style 1800). The mean follow-up was 9 years (SD = 4.3). Complete deflation was found in 23.9% of the implants (22.2% deflation rate from 1972 to 1984 and 25.5% from 1985 to 1992). The incidence of this complication was significantly higher in patients who underwent previous open (p = 0.012) or closed (p = 0.038) capsulotomy. Severe contracture of the implant fibrous capsule (BAC 3 and 4) was found in 37.6% of the patients. Its incidence increased significantly when the postoperative blood loss (assessed by the volume of blood collected by suction drainage) exceeded 250 cc (p = 0.025). Neither the site of the implant (submuscular/subglandular) nor the indication for surgery (reconstruction/augmentation) influenced the rate of severe capsular contracture significantly in this retrospective study.

Adolescent↗

PubMed1995

The extended gracilis muscle flap for reconstruction of the lower leg.

The width of the gracilis muscle was measured before and after removal of the epimysium in 10 fresh cadavers. The average extent of muscle widening achieved by epimysium removal was over 100% (mean 112.6%; standard deviation 11.9%). This extended muscle flap enabled us to cover successfully even large soft tissue defects measuring up to 300 cm2. In 27 consecutive patients, soft tissue defects of the lower leg with exposed bone have been repaired by free tissue transfer of a gracilis muscle flap, covered with split skin grafts. The advantages of the gracilis muscle flap were the low donor site morbidity with almost no recognisable functional loss, the easy surgical access, the thin and flat shape of the muscle, and its adequate size after excision of the epimysium. Reconstruction with a gracilis muscle flap resulted in an inconspicuous, stable, and flat contour of the lower leg. The entire length of the vascular pedicle of the gracilis muscle was easily harvested in our patients by routinely dissecting the pedicle on both sides of the adductor longus muscle.

Adolescent↗

PubMed1995

Donor-site morbidity of the gracilis flap.

To determine whether there is a specific donor-site morbidity inherent in the elevation of the gracilis flap, we retrospectively examined 42 patients who underwent elevation of their gracilis muscles. We found, on dynamometric measurement, that the adduction strength of the hip joint was decreased by 11 percent when the gracilis muscle was elevated. This decrease in strength was not noticed by the patients. We also found an area of hypesthesia corresponding to the cutaneous territory of the obturator nerve in 40.5 percent of the patients. In addition, many patients were dissatisfied with the aesthetic appearance of the donor site, and a contour deformity of the thigh was present when a myocutaneous flap was elevated. Therefore, we conclude that the gracilis flap has a low but definite rate of donor-site morbidity. The advantages of the flap outweigh by far, however, the sequelae at the donor site.

Adult↗

PubMed1995

[Functional and esthetic assessment of donor site defects following transfer of the gracilis muscle].

In order to determine donor-site morbidity after elevation of the gracilis flap, 53 patients from four different departments were examined. The patients filled out a questionnaire about their complaints. 36 patients underwent dynamometric measurements. The adduction strength of the hip-joint was decreased by 11% after elevation of the gracilis muscle. This decrease in strength was not noticed by the patients. 53% of the patients complained about hypesthesia or dysesthesia corresponding to the cutaneous territory of the obturator nerve. The contour of the thigh was adversely affected after elevation of a musculocutaneous flap. The gracilis flap has a low but definite donor-site morbidity, especially concerning the esthetic aspect.

Adult↗

PubMed1994

[Local complications after poisonous snake bite].

The case of a zoo keeper who was bitten on the left finger by a venomous snake (Vipera xanthina) is reported. The administration of antivenom prevented the development of systemic poisoning but had no effect on the extent of the local complications. A compartment syndrome with a concomitant severe reaction at the bite site required fasciotomy of the upper and lower arm. The extensor tendon of the involved finger ruptured spontaneously, many weeks after wound healing was completed. Therefore, delayed local complications following snake bites may occur, even if signs of systemic poisoning are missing.

Accidents, Occupational↗

PubMed1993

[Minimizing scar expansion using the B technique in form correction of the breast].

For the last two years, the B-technique has been used in mammaplasty to minimise the extent of scars, if the expected resection weight is 700 g or less. 33 patients were operated by means of this technique. Scar formation and areola sensation were examined and compared with 188 patients operated by the techniques of McKissock, Strömbeck or Pitanguy. 19 of those patients and 3 patients, who had been operated on by the B-technique, developed hypertrophic scars. The widths of the scars was significantly smaller after operation by the B-technique, than by other techniques. After operation by the B-technique, the areola sensation was unchanged in 67% compared to 46% after operation by above mentioned and other techniques. In cases, where the expected resection weight does not exceed 700 g, the B-technique is superior to other techniques, because the medial scars can be avoided.

Adolescent↗

PubMed1993

Surgical treatment of developmental asymmetry of the breast. Long term results.

To evaluate our operative techniques for the treatment of breast asymmetry, 30 patients were interviewed and examined three to 16 years after correction of developmental asymmetry. Breast symmetry was assessed by linear measurements and by subjective evaluation. The most satisfactory long term results were found in the patients who had undergone bilateral reduction mammaplasty or unilateral reduction mammaplasty combined with a contralateral mastopexy. In some cases longer lasting symmetry could be achieved by operating on both breasts using similar techniques. Long term results were not significantly better in those patients who had been operated after reaching the age of 18 years, compared with those of patients operated on at the age of 17 years or younger. To avoid psychological consequences therefore it is not always justifiable to delay operation until the breasts have matured.

Adolescent↗

PubMed1992

Age-associated changes of the triangular fibrocartilage of the wrist: evaluation of the diagnostic performance of MR imaging.

To define the appearance of degenerative changes of the triangular fibrocartilage (TFC) of the wrist on magnetic resonance (MR) images, the TFCs in one wrist of each of 30 healthy subjects in three age groups (20-35, 36-50, and greater than 50 years) and six TFCs from fresh cadavers were examined by means of coronal T1-weighted spin-echo sequences. Histologic findings were compared with findings on MR images in the cadaveric TFCs. It was proved that patches or lines of signal hyperintensity within the cadaveric TFCs were caused by degenerative changes and tears. Similar changes of the TFCs on MR images of the healthy subjects may have been caused by degeneration. In the healthy subjects, degenerative changes of the TFC, usually well defined on MR images, occurred at a very early age. The TFC appears to undergo stages of degeneration comparable to those of the menisci of the knee, but differentiation between traumatic and degenerative tears may be difficult.

Adult↗