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Biomedical subjects

R Riefkohl

Publications and source records attributed to R Riefkohl.

At least 19 recordsLinked to original sources
PubMed1989

Preoperative positioning of the protruding premaxilla in the bilateral cleft lip patient.

The rationale and technique for preoperative retraction of a protrusive premaxilla in the bilateral complete cleft lip and palate patient are presented. Two types of pinned intraoral appliances are presented that can expand the palatal shelves while retracting the premaxillary segment. Findings from lateral cephalometric x-ray studies of eight appliance patients and six control patients with bilateral clefts but no appliance treatment are presented at age 15. The data indicate that the cephalometric values at age 15 are within the normal range for most patients. Incisor angulation was quite varied among the subjects.

Adolescent↗
PubMed1988

Mammary implants, diving, and altitude exposure.

Mammary implants were exposed to various simulated dive profiles followed by altitude exposures to stimulate aircraft travel and then were observed for bubble formation and volume changes. Minimal volume changes occurred after each dive. Numerous bubbles formed, however, reaching their maximum size in 3 hours. By comparison, when implants were exposed to high altitude following a dive exposure, significant volume changes occurred. This in vitro study showed that bubble formation and volume expansion occur after exposing implants to diving and altitude, but the circumstances required to produce these changes in vivo are extremely unlikely to occur normally.

Altitude↗
PubMed1987

Evaluation of transcutaneous oxygen tension monitoring during cosmetic surgery.

Transcutaneous oxygen monitoring during rhytidectomy surgery under local anesthesia was evaluated in 18 patients. Blood gas analysis of samples of arterial blood obtained from the superficial temporal arteries during rhytidectomy was compared with transcutaneous PO2 values. Simple linear regression analysis indicated that the transcutaneous PO2 correlates strongly with arterial PO2. Transcutaneous PO2 monitoring could be a reliable, inexpensive, and continuous method of assessing gradual or sudden changes in arterial PO2, provided the sensor is fastidiously maintained and properly applied, elements which are critical to relying on this particular device. However, this instrument has no advantages over the digital pulse oximeter.

Anesthesia, Local↗
PubMed1987

The orticochea pharyngoplasty and primary palatoplasty: an evaluation.

A primary Orticochea pharyngoplasty with a primary palatoplasty was studied in 15 children with cleft palates. Although all children demonstrated velopharyngeal competence, radiographic, endoscopic, and oral examinations suggested that 54% of the children studied would not have needed a pharyngoplasty. In addition, 27% of the children demonstrated aberrant speech patterns associated with velopharyngeal incompetence. Emphasis is placed on the difficulty in identifying which cleft palate patients will have residual velopharyngeal incompetence and the need for continued study and development of techniques for more accurate prediction of which patients would benefit from a primary pharyngoplasty.

Child, Preschool↗
PubMed1986

Use of the rectus abdominis muscle flap in urological reconstructive procedures.

The rectus abdominis muscle flap has been used successfully in 4 reconstructive procedures complicated by tissue loss or urinary fistula. This simple procedure is advocated as an alternative to the use of omentum when prior abdominal surgery precludes omental mobilization. No adverse functional nor cosmetic result to the abdominal wall resulted.

Abdominal Muscles↗
PubMed1986

Chain saw injuries to the face.

Chain saws may produce devastating facial injuries when the blade kicks back after striking a hard object. A review of experience with 12 male patients indicates that in addition to extensive ragged lacerations of skin and soft tissues, bone and teeth are frequently fractured. Eye injuries are rare, but the eyelids may be extensively damaged. Management includes debridement and exploration of the wounds, repair of soft tissues, removal of fractured roots, and application of arch bars if the jaw is fractured.

Facial Bones↗
PubMed1986

An aesthetic approach for nasal tumors.

An elongated columella flap has been found to give excellent exposure to the nasal dorsum, allowing satisfactory removal of soft tissue nasal masses such as dermoid cysts or hemangiomas. This approach provides a more acceptable scar than the standard vertical dorsal nasal incision.

Child, Preschool↗
PubMed1986

A practical method for oxygen administration during cosmetic facial surgery.

An effective and practical method of oxygen administration during cosmetic facial surgery under local anesthesia is described. A large volume of oxygen is delivered directly to the nasopharynx, and partial upper airway obstruction caused by the tongue falling into the pharynx is resolved, yet the apparatus does not interfere with execution of the operation.

Catheterization↗
PubMed1986

Association between cutaneous occlusive vascular disease, cigarette smoking, and skin slough after rhytidectomy.

This prospective study attempted to determine if nonreversible occlusive vascular changes in the skin contribute to skin slough after rhytidectomy. The dermal microvasculature from 83 consecutive rhytidectomies was evaluated for intimal proliferation and/or hyalin sclerosis. Occlusive vascular disease increased progressively with age in all patients, but smokers and ex-smokers had significantly greater involvement than nonsmokers at any given age (p = 0.03). Severe occlusive vascular disease and skin slough were associated (p = 0.02), and there was a strong trend toward an association between active smoking and skin slough (p = 0.06). Among smokers, there was a significant relationship between skin slough and failure to abstain from smoking postoperatively (p = 0.006). We conclude that with aging, nonreversible occlusive changes develop in the dermal microvasculature. These changes appear to be accelerated by cigarette smoking. Our data, however, show that these nonreversible occlusive vascular changes by themselves do not completely account for the occurrence of skin slough after rhytidectomy.

Adult↗
PubMed1986

Skin coverage in occupational hand injuries.

Intact skin is vital after occupational hand injuries. The best bone, tendon, and neurovascular repairs are meaningless without suitable skin coverage to protect them. This article presents various methods of providing skin coverage in the hand after occupational injuries and follows the same thought process that surgeons should use in selecting the most appropriate method of repair.

Dermatologic Surgical Procedures↗
PubMed1985

Efficacy of povidone-iodine in pre-operative skin preparation.

Cultures were obtained of the microbial flora from the skin of the operation site pre-operatively and following preparation of the surgical field with povidone-iodine (PVP-I). Preliminary results indicate that PVP-I is a reasonable and effective antibacterial agent when used to prepare skin for surgical operations.

Adolescent↗
PubMed1985

A flap for moderate-sized oral defects.

The use of a cervical musculocutaneous flap is described which is easily transferable to the oral cavity to cover an osseous and soft tissue operative defect, eliminating the need for a more distant and extensive musculocutaneous flap.

Aged↗
PubMed1985

Cherubism.

Cherubism is a rare, hereditary fibroosseous lesion of the jaws that is thought to undergo spontaneous involution after puberty. Treatment is unnecessary unless functional or emotional disturbances develop. This article describes the 21-year follow-up of a patient with cherubism and briefly reviews the pertinent literature.

Adolescent↗
PubMed1985

To share or not to share.

We describe our extensive experience in nipple reconstruction on breasts formed by subpectoral implants, latissimus dorsi musculocutaneous flaps, or rectus abdominis musculocutaneous flaps.

Breast↗
PubMed1985

The nasolabial fold lift.

A modification of the standard superficial musculoaponeurotic system incision is described which results in a more direct lifting and flattening of the nasolabial fold during a face and neck lift. The technique has been applied in 43 patients without complications and with satisfactory results.

Consumer Behavior↗
PubMed1985

A rationale for the treatment of difficult basal cell and squamous cell carcinomas of the skin.

During a 56-month period, 1,348 patients with either basal cell or squamous cell carcinoma of the skin underwent microscopically controlled excision (Mohs' fresh-tissue technique) by a dermatologic surgeon. Of these 1,348 patients, 394 required various types of wound reconstruction by a plastic surgeon. The average dimensions of these wounds were 5 X 3.5 cm, with a range of 1.5 to 20.0 cm in diameter. There were postoperative complications in 13.9% of the 394 patients. The recurrence rate in these 394 patients, to date, for basal cell carcinoma is 5.2% and for squamous cell carcinoma, 11.9%. The advantages of this treatment arrangement include maximum conservation of normal tissue with provision of more reliable complete tumor excision, optimum time utilization by both dermatologic and plastic surgeons, separation of the responsibility for tumor ablation from that for wound reconstruction, and, in many instances, economic savings. We recommend this method of management for difficult, high-risk basal cell or squamous cell carcinomas.

Adult↗
PubMed1985

Lack of adverse effect of silicone implant on sarcoidosis of the breast.

Involvement of the breast by sarcoidosis is extremely rare, with only 11 case reports in the literature. The potential adverse interaction between silicone prostheses and this disease process poses an unusual clinical dilemma. However, two patients with sarcoidosis of the breast had silicone breast implants placed without exacerbation of their disease nor unusual periprosthetic complications. We conclude that sarcoidosis of the breast does not appear to be a contraindication to placement of silicone implants.

Adult↗