Biomedical subjects
R L Thatte
Publications and source records attributed to R L Thatte.
Saucerization and skin cover for osteomyelitis: back to square one?
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Sandpaper mounted on a safety razor: a simple device for dermabrasion.
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V-Y advancement flap out of an existing flap.
A case is reported in which a large V-Y flap was fashioned out of a flap already present over the dorsum of the hand, to cover a defect created adjacent to it. The V-Y advancement appeared more effective to fill the defect than the traditional method of mobilisation of a part of the flap achieved by dissecting it from its base.
A radical approach in the treatment of the deviated nose.
Surgical attempts to straighten a deviated nose do not always produce a satisfactory result, partly due to the surgeon's inability to straighten the anterior part of the nasal septum or to maintain it in a correct position postoperatively. In a radical departure from accepted norms we have, in eight cases, excised the deviated part of the anterior nasal septum and replaced it with a bone graft. The background and the need for this procedure are explained, followed by a case report in some detail. Details of the eight cases are given in a table and representative cases are presented with illustrations and comments regarding the problems encountered with the present method.
Two flag flaps based on the supratrochlear vessels for nasal reconstruction.
A short forehead or a low hairline sometimes precludes the use of a median forehead flap for reconstruction of defects of the lower nose when both lining and cover are needed. Two flag flaps based on the supratrochlear vessels were used in a patient with a full-thickness alar defect and a narrow, short forehead.
The saphenous venous flap.
Eight cases, in which a new single-pedicled venous flap, based on the long saphenous vein, was used to close defects around the knee, are presented with the details of indications, size and survival. Of the eight cases, seven achieved their aim; five flaps survived completely, two had partial distal loss and one died completely. This clinical work is further confirmation that fasciocutaneous island flaps of fairly large dimensions, with a single cephalad vein, survive and can be used to cover defects in their adjacent areas.
Static and dynamic computerised radioactive tracer studies, vital dye staining and theoretical mathematical calculations to ascertain the mode of survival of single cephalad channel venous island flaps.
Experiments were performed to ascertain the perfusion and drainage of single cephalad channel saphenous venous flaps in dogs. In the first experiment a standard saphenous flap and a single cephalad channel saphenous venous island flap were dissected on contralateral thighs of dogs. A radioactive tracer, 99mTc, was injected into a foreleg vein and its appearance in both flaps was monitored with the use of a static and dynamic scanner. After this experiment, Evans blue, a vital dye, was injected into the foreleg vein of the dog. Five minutes later both flaps were excised and the dye in the flaps was assayed quantitatively. In the third experiment radioactive tracer was injected into the single cephalad channel venous flap subcutaneously and its decay in the flap as well as its uptake in the rest of the body were measured dynamically. The experiments show that the single cephalad channel venous island flap is perfused by and drains through its single cephalad vein. A mathematical model to justify the above conclusion was worked out independently, based on standard values involved in mammalian circulatory mechanisms as in dog and man.
An unusual case of congenital chest wall deformity with polymastia and absence of part of the lung.
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Cephalic venous flap: a series of 8 cases and a preliminary report on the use of 99mTc labelled RBCs to study the saphenous venous flap in dogs.
From December 1985 to December 1987 a total of eight fasciocutaneous island flaps with only a proximal venous pedicle were performed. Seven of these eight survived completely. The standard flap design and operative technique are given. The results are presented in a tabulated form. One case is presented with illustrations. A preliminary report on the appearance of 99mTc tagged RBCs and Evans blue in a proximal venous saphenous island flap in the dog is included. Comments on the survival of these flaps and the solitary case where the flap necrosed completely are added.
An interesting case of aglossia-adactyly syndrome.
A case of aglossia-adactyly syndrome with a sagittal band between the floor of the mouth and the palate is reported. The literature concerning this case is briefly reviewed. This case is being presented for its extreme rarity.
A manoeuvre to locate the distal urethral opening at the tip of the glans in the final stage of Cecil-Culp urethroplasty.
One of the drawbacks of Cecil-Culp urethroplasty for hypospadias is its failure to place the distal urethral meatus at the tip of the glans when the scrotal flap is detached. This paper describes a manoeuvre to overcome this drawback with the help of a small flap from the median raphe of the scrotum at the third and final stage of Cecil-Culp urethroplasty. Relevant illustrations from a case and line drawings are included to describe the procedure. A small note is appended as a comment.
Deepithelialized turnover flaps.
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A study of the saphenous venous island flap in the dog without arterial inflow using a non-biological conduit across a part of the length of the vein.
This paper includes material which is a follow-up on the work of Se Min Baek et al. (1985) who demonstrated that in dogs a saphenous flap could survive without arterial inflow. Here we have repeated part of their work and confirmed it. In addition, this paper shows that in dogs a saphenous venous flap with only the cephalad venous channel intact can survive even if the vein is cut and replaced by a non-biological conduit (a polyethylene tube). A total of 13 dogs and 19 flaps were studied. The possible reasons for the survival of these flaps are discussed.
Cephalic venous flap.
A case is reported in which an island fasciocutaneous flap from the radial side of the forearm, with only the cephalic vein connecting it to the rest of the body (Fig. 1) was successfully transposed to cover part of a defect on the ulnar side of the elbow. An earlier case in which such a venous flap was raised but not used for cover is also detailed. A brief discussion speculating on the way this flap survived without any arterial inflow and only proximal venous drainage is included.
The anatomical basis of the SEPA flap.
The superficial external pudendal artery (SEPA) flap was described by Dias in 1984. This paper describes the anatomical foundation of the flap, based on dissections of 12 cadavers and clinical findings in patients undergoing surgery in the groin and lower abdomen. The artery was found to be adequate in calibre and length to sustain a skin flap, on either side of the midline, extending from the symphysis pubis to the umbilicus.
The uses of the SEPA flap in the repair of defects in the hands and fingers.
A series of 30 cases is presented in which the SEPA flap was used to provide skin cover for injuries and defects in the hand and fingers. Our experience with both unilateral and bilateral SEPA flaps confirms their reliability, convenience and versatility. The SEPA flap design can be used in conjunction with other flaps and in itself contributes to a more rational use of the skin of the lower abdomen in reconstructive surgery.
A combination of unusual abnormalities of the lachrymal apparatus and nostrils in a case of bilateral cleft with choanal atresia.
An unusual congenital anomaly of a bilateral complete cleft of the primary palate, a complete cleft of the left secondary palate with abnormal nostrils without external openings and right choanal atresia is presented. The child also has a lachrymal fistula below the right lower eyelid and a coloboma of the same eyelid medially. Neither lachrymal system drained into the nose.