Biomedical subjects

R Saltz

Publications and source records attributed to R Saltz.

11 recordsLinked to original sources

PubMed1992

Mechanical properties of fibrin adhesives for blood vessel anastomosis.

Various methods have been used for anastomosing, or attaching, two ends of a severed blood vessel together. The most common method, suturing, is tedious, can be time-consuming, and requires special training in microvascular surgery. Other methods, such as mechanical devices and lasers, have some problems as well. The use of fibrin adhesives for blood vessel anastomosis might eliminate some of the current problems by allowing a quicker, simpler, and more reliable method of attachment. Although mechanical studies have been conducted to determine fibrin glue properties in shear, tensile, and burst tests; most of these studies have used skin or intestinal tissue. Therefore, to evaluate the feasibility of using fibrin glue as an adhesive for blood vessel anastomosis, the mechanical properties of blood vessels joined with fibrin glue were examined using tensile and burst tests. High and low fibrinogen concentrations were tested after 5- or 45-min time periods. In addition, three clinical methods of attachment were compared: end-to-end anastomosis, vessel overlapping, and suturing. In this study, because the adhesive strength was not found to increase significantly after 5 min, setting times for fibrin glue may be short enough to make it a clinical option when compared to suturing. In addition, the higher fibrinogen concentration did not result in a significantly higher adhesive strength, indicating that the lower concentration fibrin adhesives may be of comparable strength to the higher concentrations for clinical applications.

Anastomosis, Surgical↗

PubMed1992

Fibrin glue.

Explore the source record for details and available documents.

Adhesiveness↗

PubMed1991

Muscle and musculocutaneous flaps of the foot.

This article describes the most common options available for reconstruction of the foot. The foot is considered a group of different regions, and it is helpful to classify it into four different anatomic and functional areas. The planning and final outcome of the reconstruction are based on the type of flap available for a specific defect in one of these four territories.

Foot↗

PubMed1991

Experimental and clinical applications of fibrin glue.

A 2-year experience with laboratory and clinical applications of fibrin glue is presented. An autologous technique, which eliminates the danger of multidonor preparations, has been developed in our blood bank. While one can obtain different fibrinogen concentrations from the same amount of a patient's blood, in vitro mechanical testing demonstrated that at higher fibrinogen concentrations there is an increase in shear adhesive strength. Evaluation of skin-graft take in 16 Sprague-Dawley rats did not demonstrate significant differences in healing when adhesive use was compared with suture technique. In a clinical study, four different groups of patients (facial burns, hand burns, difficult graft sites, and miscellaneous surgical applications) benefited from autologous or single-donor fibrin glue for a total of 82 cases. There are several distinct advantages to the use of fibrin adhesive: The autologous technique eliminates the risk of transmissible viral diseases (AIDS, hepatitis); it can be used as a sealant in the treatment of seromas, dural leaks, and lymphoceles; and it improves hemostasis and early graft adherence. Face and hands are resurfaced with sheet grafts in a single procedure, obtaining a better aesthetic result with complete graft take and immediate start of physical therapy. Neither sutures nor pressure dressings are required. The minimal postoperative care associated with early return to normal activities seems to increase the satisfaction of patients and nurse personnel.

Adolescent↗

PubMed1988

Sapphire ring constriction syndrome.

An uncommon case of a partially embedded ring under the skin is presented. A technique for removal is described. All previously reported cases as well as ours occurred in mentally handicapped individuals.

Adult↗

PubMed1988

Diagnostic peritoneal lavage for blunt abdominal trauma: an unusual result.

We have reported the unusual finding of a grossly bile-stained peritoneal lavage 24 hours after blunt abdominal trauma, associated with neither enteric, hepatic, nor biliary tract injury at laparotomy. Intraoperative transcholecystic cholangiography is recommended in such a situation to rule out biliary tract injury.

Abdominal Injuries↗

PubMed1987

The role of splenorrhaphy in splenic trauma.

Eighty-five cases of splenic trauma that were treated surgically from 1981 to 1983 were reviewed to define the exact role of splenorrhaphy. There were 73 male and 12 female patients with a mean age of 34 years. The mechanism of injury was blunt trauma in 51 and penetrating trauma in 34. The incidence of associated intraabdominal injury was 31 per cent and 79 per cent in blunt and penetrating trauma, respectively. Splenectomy was performed in 43 (51%) and splenorrhaphy in 42 (49%). Splenorrhaphy was performed in 19 (37%) who had blunt trauma and 23 (67%) who had penetrating trauma (P less than 0.01). Overall six patients died, three in the splenorrhaphy group (7.1%). Only one patient who had splenorrhaphy required reoperation for splenic hemorrhage. The authors conclude that about 50 per cent of all injured spleens in the patient population studied can be salvaged during laparotomy for splenic trauma, the splenic salvage rate is higher in penetrating trauma, and splenorrhaphy is a safe operation.

Adolescent↗

PubMed1976

A seven-year follow-up of intelligence test scores of foster grandparents.

After 7 years, a group of originally nonemployed poverty-level older people (over 60) who had been employed as foster grandparents were retested with the WAIS. Four WAIS subtests - Vocabulary Similarities, Digit Span, and Block Design - were employed. Of the original group of 39, complete data were available for 28; 18 of these were still working on the project, and the other 10 had dropped out. Dropouts as a group tested lower originally and also showed more deterioration in functional health ratings over time. For the total group of 32 foster grandparents, three subtest scores showed stability over the 7 years. Only Digit Span showed a statistically significant drop. Neither age nor the initial level of health or WAIS scores was related to test-score changes over time.

Aged↗

PubMedDate not supplied

"Supercharging" the rectus abdominis muscle to provide a single flap for cover of large mediastinal wound defects.

Mediastinitis continues to be a devastating complication of open heart surgery. Supercharging the rectus abdominis muscle through revascularisation of the deep inferior epigastric vessels in the neck adds another safety factor in the management of these difficult problems. Large mediastinal wound defects that would usually require more than one muscle for cover can be covered adequately with this technique. Viability of the entire rectus abdominis is assured and permits use in its entirety. Details of the technique are presented as well as a review of the reconstructive options for mediastinal wound infections.

Humans↗

PubMedDate not supplied

A new alternative in burn reconstruction: the muscle vascularized pedicle flap.

A technique is presented that revascularizes a portion of skin and subcutaneous tissue by the implantation of a vascular pedicle surrounded by a small amount of muscle. The muscle vascularized pedicle flap technique allows one to select a skin territory and convert it into a free flap donor site as long as it is within the arc of rotation of a major vascular pedicle. The vascular pedicle and small portion of muscle is simply sutured to a sequentially delayed skin flap. After approximately two or three weeks the newly revascularized skin and subcutaneous tissue is transferred as a conventional free flap. The main advantage is that of freeing the reconstructive surgeon from the anatomical landmarks of the conventional free flap areas. In addition, one can fashion a very thin flap to fit the defect exactly. Illustrative cases are presented.

Adolescent↗

PubMedDate not supplied

Application of autologous fibrin glue in burn wounds.

Biological adhesive fixation of skin grafts has been performed successfully on patients with facial burns and burns at difficult sites by using autologous human fibrin adhesive, which eliminates the danger of multidonor pool preparations. There are several distinct advantages to the use of fibrin glue: There is no danger of multidonor pool preparations. Wounds do not require any sutures or pressure dressings in the immediate postoperative period. Grafts demonstrate excellent take with minimal postoperative care. The patients can maintain normal ambulation. Fibrin glue seems to be an important factor in the application of skin grafts to burned areas in these two groups of patients.

Burns↗