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Biomedical subjects

S Sion

Publications and source records attributed to S Sion.

4 recordsLinked to original sources

[Cornea donation: improving hospital coordination].

PURPOSE: To evaluate the impact of procedures developed to increase cornea donation in a general hospital. Comparative study before and after intervention. Since february 2002 all cases of intra-hospital death were considered by the hospital coordinator. A written selection protocol for potential donors was adopted and telephone interviews to obtain family consent were conducted using a standardized procedure. METHODS: The number of deaths in the institution, deaths considered by the hospital coordinator, clinical contraindications to harvesting, potential donors, face-to-face interview and telephone contact with families, the donation acceptance rate during telephone and face-to-face interviews, and the number of donors and corneas actually collected were recorded before and after intervention. The data were analyzed during two consecutive periods: Period 1, february 2001 to january 2002 (before protocol), and period 2, february 2002 to january 2003 (after protocol). RESULTS: The number of deaths in the institution was similar for the two periods. The increase in deaths considered by the hospital coordinator and the decrease in contraindications resulted from increasing the pool of potential donors from 188 to 401 (p < 0.001). The number of telephone interviews increased from 33 to 274. The rate of family consent given during face-to-face interviews was similar, 61% versus 72% (p = 0.1), but acceptance during telephone interviews increased from 15% to 60% (p < 0.001) and 138 corneas were collected in period 1 and 443 in period 2. The rate of cornea donors increased from 6% to 20% of the hospital's deaths. CONCLUSION: The consideration of all hospital deaths, the use of a written protocol of contraindications for cornea donation and the wide use of telephone interviews to obtain family consent led to a dramatic increase in cornea donation.

Cornea↗

[Repeated total knee arthroplasty].

The causes of failure of total knee arthroplasty are now better known and usually avoidable, being due to the surgical technique. Choosing a prosthesis with minimal constraint is of paramount importance. Exact technique for perfect placement of the implant, realignment of the limb and correction of asymmetrical bone lesions are stringent prerequisites. As for deep sepsis, which is still the most severe of post-arthroplasty complications, it can now be treated with success in nine out of ten knees, whilst preserving a functional knee prosthesis. The knee prosthesis placement technique is very demanding in most cases, but the excellent results obtained seem to be more durable than those of total hip replacement.

Humans↗

[Surgical reduction of the external ligament for chronic instability of the tibio-tarsal joint. Apropos of 58 reviewed cases].

Between 1975 and 1986, 75 cases of surgical tightening of the lateral ligament have been performed for chronic instability of the ankle. 58 of them have been reviewed with a mean delay of 36 months (extremes of 6 months to 6 years). Surgery corrected completely the instability four out of five times. In six patients there still remained more or less incapacitating pain. Talo-navicular movements were constantly preserved, as well as that of the sub-talar joint, except in six cases where it was slightly diminished. The results have been excellent in 18 cases; very good in 18 cases; good in 6 cases; mild in 8 cases and poor in 4 cases. Furthermore, four patients who originally had an excellent or very good results have subsequently presented with a recurrence of joint laxity and instability following a new severe ankle sprain. X-ray results were less satisfactory as the joint laxity was only partially controlled (average tilt of 7 degrees). But all joint laxities except one have been improved by this type of surgery. After failure of proprioceptive rehabilitation which must be performed systematically, surgical tightening of the lateral ligament can be proposed, and should be preferred to peroneus brevis ligamentoplasties, which are more traumatic and less physiological.

Adolescent↗