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Biomedical subjects

Richard W Griffiths

Publications and source records attributed to Richard W Griffiths.

4 recordsLinked to original sources
PubMed2006

Anthropometric measurements and their value in predicting complications following reduction mammaplasty and abdominoplasty.

Body mass index (BMI) is the traditional way of assessing patients for body contouring surgery and has been shown to have a predictive value for surgical complications. In recent years, there have been discussions about accuracy of BMI as an indicator of obesity, and other obesity indices have been developed. This study aimed to measure and compare different anthropometric variables and examine their association with surgical morbidity. Prospective measurements of height, weight, waist, and percentage body fat were obtained preoperatively in 60 patients undergoing body contouring surgery. Demographics, patient characteristics, operative details, and postoperative complications were recorded. Statistical analysis was performed using chi, ANOVA, or Spearman rank correlations as appropriate. We found that BMI, percentage of body fat, weight, height-to-weight ratio, and waist circumference all correlate well as indicators of obesity and showed similar trends in their association with surgical complications.

Abdominal Wall↗
PubMed2004

Keratoacanthoma observed.

Conventional advice for managing suspected keratoacanthoma is total excision because of concern that the lesion may be a squamous cell carcinoma and histological differentiation of the two lesions is difficult. Only isolated cases have been published where lesions have been observed, with photographic documentation, to spontaneous resolution. Over 11 years (1992-2002) the author made a primary clinical diagnosis of solitary keratoacanthoma in 19 patients based upon the history and lesion appearance. Two thigh skin graft donor site lesions, and one on the nose and one on the lower lip were excised when there was concern about their growth pattern. A fifth patient was not content to be observed and had the lesion curetted by an oncologist. The remaining 14 patients had observed lesions photographed sequentially until resolution. The commonest single site affected was the hand (five cases). The mean age was 65 years (42-86 years). The mean duration of the lesion at presentation was 9 weeks (4-28 weeks), and the mean time to resolution from appearance was 27 weeks (12-64 weeks). Mean follow-up after resolution was 3 years 5 months (range 9 months-8 years). No recurrences occurred. No scar revisions were necessary. Claims that resolved keratoacanthomas leave poor quality scars that may need surgical revision, were not confirmed in this illustrated series which is the largest published to date. The principles of observational management are outlined and the natural history of the condition and patterns of spontaneous resolution described.

Adult↗
PubMed2003

Where to draw the line: the error in marking surgical excision margins defined.

We studied the accuracy of marking surgical margins for excision surrounding skin lesions, to assess if the percentage error would differ for varying increments in margin measurements. In designing an experiment to test this hypothesis, surgeons of differing experience (n=19) marked excision margins of 2, 5 and 10 mm around a standard circular lesion drawn on paper. Use of surgical markers, rulers and loupe magnification were all permitted, with five attempts for each margin. The percentage error found was 35, 14 and 4% for the 2, 5 and 10 mm margins, respectively (regardless of the grade of surgeon). Repetition of the experiment on volunteer skin demonstrated a percentage error of 45, 16 and 8% for 2, 5 and 10 mm margins (significantly greater than the corresponding errors on paper, p<0.001 in all cases). These findings indicate that for these surgically marked margins, the term "accurate excision margins" may be inaccurate to a significant degree. This study has defined the errors inherent in the marking of surgical margins, and these should be taken into account when assessing studies that report margins around tumours. Specifically, comparisons between surgical and histological margins would aid assessment of reports detailing surgical margins dawn around skin tumours.

Clinical Competence↗