Biomedical subjects
Publications and source records attributed to S B Standiford.
We present four patients who developed posthemipelvectomy hernias. Identified etiologic factors include infection at the time of hemipelvectomy, radiation therapy, and excessive weight gain. Two patients were reconstructed using local tissues, and two required prosthetic materials. There were no hernia recurrences, although two patients died of recurrent cancer.
Inflammatory pseudotumors (plasma cell granulomas) are localized lesions consisting of a fibrous stroma, chronic inflammatory infiltrate with a predominance of plasma cells, and an absence of anaplasia, which can mimic malignant disease by their gross appearance. Reported in many sites, they are most frequently described in the lung. Twelve cases involving the liver and biliary tract have previously been reported. Here, a 77-year-old man who presented with fever and malaise was found to have a lesion in the left lobe of the liver, which, on exploration, was found to be an inflammatory pseudotumor. This patient, and each of those previously reported, has recovered uneventfully. Because of the benign course of this lesion, hepatectomy should be considered only in those instances in which the mass effect of the lesion is producing symptoms or in those cases in which a firm histologic diagnosis cannot be made preoperatively or by frozen section intraoperatively.
Explore the source record for details and available documents.
A case is reported of metastatic basal cell carcinoma presenting with multiple neurologic deficits 20 months after excision of the primary lesion with good local control. Many features associated with the development of metastasis from basal cell carcinoma were not present in this case.
The ideal wound-support material would reinforce a wound early in the healing process when intrinsic wound strength is the weakest, yet disappear over time, preventing many of the untoward late effects seen with currently utilized nonabsorbable materials. This study was designed to evaluate the effectiveness of a newly designed absorbable material, polyglycolic acid mesh (Dexon), as a buttress for abdominal wounds closed under moderate tension. Young male rats (n = 211) were divided into three experimental groups. Animals in groups 1 (n = 96) and 2 (n = 95) had a 1.2 cm2 midline abdominal wall defect created and closely primarily. Animals in group 2 had a 2 X 5 cm piece of polyglycolic acid mesh sutured to the anterior abdominal wall overlying the closed abdominal defect. Animals in group 3 (n = 20) were unoperated controls. The animals in groups 1 and 2 were killed 1, 2, 3, 4, and 5 weeks after surgery. The entire anterior abdominal wall was removed and placed upon a bursting strength testing device. Bursting strength determinations of the supported and unsupported abdominal closures revealed that the strength of the wounds reinforced with polyglycolic acid mesh was significantly greater than unsupported wounds at 1, 2, and 3 weeks after surgery. Wounds supported with mesh had bursting strengths similar to unoperated abdomens by the first postoperative week. This study demonstrates that abdominal wall defects in rats closed primarily develop increased wound strength when the closure is supported by absorbable polyglycolic acid mesh. The use of an absorbable material may alleviate potential late complications associated with implantation of nonabsorbable materials. The clinical application of such a material remains to be determined.