PubMed Health⌕ Search

Biomedical subjects

T J Krizek

Publications and source records attributed to T J Krizek.

At least 37 records · Page 2Linked to original sources
PubMed1985

The use of prophylactic antibacterials in plastic surgery: a 1980s update.

A questionnaire designed to determine the pattern of usage of prophylactic antibacterials, similar to one used a decade ago, was distributed to plastic surgeons, of whom 1718 responded. The pattern of antibacterial use in 8 major categories and 55 separate operations and circumstances was reviewed. The timing and the influence of various modifying factors was evaluated. The data present the pattern of antibacterial use by plastic surgeons at this point and time, that is, what is "usual and customary".

Anti-Bacterial Agents↗
PubMed1983

Experience with the transverse lower rectus abdominis operation for breast reconstruction.

Our initial experience with the lower rectus abdominis procedure for breast reconstruction in 19 patients is presented. Anatomic considerations, surgical technique, and results are reviewed. Errors in flap design and execution resulted in a disproportionately high complication rate, which improved following certain technical refinements. The lower rectus flap has proved to be an alternative to conventional techniques of breast reconstruction. As more experience is gained with this flap, its particular role in the reconstructive armamentarium will be more clearly defined.

Adult↗
PubMed1982

Autogenous vein graft as a conduit for nerve regeneration.

This study was performed to determine whether vein grafts might serve as a conduit for nerve regeneration. A 1 cm segment of sciatic nerve was removed bilaterally in 12 Sprague-Dawley rats. On one side the gap was not repaired, and on the other side a segment of femoral vein was used to bridge the nerve gap. Nerve conduction studies and necropsies were performed at intervals. Reconstitution of nerve trunk continuity and healing of plantar ulcers occurred only in the vein-grafted side. Histologic examination revealed orderly growth of nerve fibers within the lumen of the vein grafts as early as 1 month after repair. Most regenerating nerve fibers passed through the proximal junction in an orderly pattern and reached the distal stumps within 2 months after repair. Results of nerve conduction study at 4 months after operation demonstrated restoration of conduction through the vein-grafted sciatic nerves with muscle reinnervation. Nearly normal muscle fibers in the gastrocnemius on the repaired side were confirmed at necropsy. This study demonstrated that autogenous vein grafts can serve as a conduit for nerve regeneration in rodents.

Animals↗
PubMed1980

The physician's assistant as resident on surgical service. An example of creative problem solving in surgical manpower.

A residency program for physician assistants (PAs) on a surgical service was undertaken to develop health professionals who could serve in a capacity similar to that of junior surgical residents helping to deliver preoperative and postoperative care under the supervision of surgeons and assisting in operations. As the number of approved surgical residencies and the number of individuals available for residency has decreased, a manpower void is occurring in some institutions in providing in-house services to surgical patients. The use of medical or family practice residents or full-time in-house surgeons is not totally satisfactory. A PA with special training in surgical case management and operative assisting meets many needs previously provided by surgical residents. The surgical PA is, indeed, a surgeon extender and seems, from our three-year experience, to be a good solution to this problem of surgical care in community hospitals. This program also provides an educational mission for the institution and the surgical staff.

Connecticut↗
PubMed1980

The scalp flap only onlay: a method for managing large dural defects.

The standard approach to loss of substantial amounts of calvarium and dura is replacement of the dura with pathches, usually of biologic material such as fascia. We question the need for such patches and offer experimental and clinical evidence to support a different approach. Treatment of large calvarium and dural defects in 20 rats divided in two groups showed no difference in dural regeneration between animals repaired with patches and those repaired with the scalp flap only onlay on the brain. An illustrative clinical case confirms the observations. The scalp flap only onlay repair of cranial defects involving the dura provides a reasonable means for reconstruction. (1) In experimental animals there appeared to be no histologic difference between dura repaired by autogenous patch and that repaired by the scalp flap only onlay. (2) Clinically, well-nourished galea effects an ideal onlay repair of the dura. Secondary reconstruction of the bony calvarium can be performed utilizing a modified crane technique. (3) The procedure is simple in design, requires no donor sites, and certainly has application in cases other than trauma.

Animals↗
PubMed1979

Difficult wounds: radiation wounds.

In an era of modern radiotherapy, problems associated with the indiscriminate treatment of benign disease have largely disappeared. Skin sparing effects of super voltage radiation equipment make the problems previously seen with orthovoltage equipment less frequent. Vigilance on the part of the workers in the field, in general, protects from the disasters that befell Thomas Edison's laboratory assistant. Despite these modern advances, the reconstructive surgeon often faces problems of managing acute local radiation injury from accident following planned therapeutic radiation or the ulcerations and breakdowns seen months or years after radiation therapy. The single most serious hazard to surgery in radiated tissue is the lodgment of bacteria in this tissue rendered avascular by the radiation and secondary necrosis from the infection itself. The principles of management are no different from those used for other chronic granulating wounds: local wound care, appropriate topical antibacterial therapy, systemic antibiotics during the perioperative period and, most importantly, adequate soft tissue coverage.

Acute Disease↗
PubMed1978

Wound contraction and fibrocontractive disorders.

A most important contribution to the understanding of wound healing has been the identification of the myofibroblast. These cells contract like smooth muscle cells and have been identified in a variety of chronic and open wounds. The myofibroblasts have been reported as the causative factor resulting in the wound contraction. This report demonstrates the presence of the myofibroblasts in breast capsule contraction, as well as in Peyronie's disease. The presence of the myofibroblast in Peyronie's disease and Dupuytren's contracture suggests that the myofibroblast may be the causal factor behind the association of these two disorders. The evidence suggests that a spectrum of fibrocontractive disorders exists that has the myofibroblast as the common denominator. Some evidence is presented that permits the speculation that the myofibroblast may be a transformation of the local fibroblast to a smooth muscle cell in response to forces applied to the tissue.

Animals↗
PubMed1978

George David Pollock and the development of skin grafting.

George David Pollock, F.R.C.S., convinced the world of the efficacy of skin autografting and homografting. Previous studies on the priority of skin grafting are reviewed. The life of Pollock, including a glimpse of the surgical world of the Victorian era is described. A detailed analysis of the roles and relationships of Pollock, Reverdin, and Gosselin is given.

England↗
PubMed1978

A simplified technique for correction of the cleft lip nasal deformity.

The cleft lip nasal deformity is a result of imbalance of the structures caused by a collapsed alar cartilage, a widened nostril floor, and a lowered nasal orifice. This deformity can be corrected most readily by repositioning and supporting the collapsed alar cartilage of the cleft side. A technique has been developed to achieve this by releasing the ala from the nasolabial fold, elevating and supporting the alar cartilage, and repositioning the alar rim on its new deepithelialized base. One- to two-year follow-up of seven patients who underwent such repair has demonstrated satisfactory correction of the deformity.

Cleft Lip↗
PubMed1978

Sutures and suturing--current concepts.

Currently available suture materials can be classified as nonabsorbable and absorbable types. Too often the surgeon selects the material on the basis of handling properties alone. The "perfect" suture material does not exist. Physical properties such as tensile strength, reactivity, size, and absorbability must be considered in light of current knowledge of wound healing. Placement of sutures is obviously as important as selection of material.

Biocompatible Materials↗
PubMed1977

Identification of squamous cell carcinoma of the head and neck by tissue culture and immunological testing.

We outline the techniques used to successfully grow squamous cell carcinoma in tissue culture, and to test the cellular immunity of the patient by lymphocyte cytotoxicity studies. Lymphocytes cultured with malignant squamous cells killed from 40 to 60 percent of the tumor cells during 48 hours of incubation. These same lymphocytes did not show any killing potential against cultured melanoma cells or against cultured fibroblasts. This demonstrates an immune response that is tumor-antigen specific. There was no evidence of any serum-blocking factor, because the killing potential of these lymphocytes was not significantly altered by the addition of the patients' sera. The implications and potential for early diagnosis made possible by these techniques are discussed.

Adult↗
PubMed1977

Ring avulsion injury.

Dependent upon the age, the occupation, and the requisites of an individual patient, the less important ulnar fingers may be of great value; in these the philosophy of discriminate preservation should be given considerable weight in the choice of treatment. Revascularization of fingers injured by a ring avulsion, and restoration of tactile gnosis with esthetic coverage make salvage of the valued ulnar fingers feasible. Three illustrative cases are described.

Adolescent↗
PubMed1976

In defense of the open wound.

In a case of bilateral five-finger Dupuytren contracture, one hand was treated by open excision of the contracutred fascia and shortened skin with application of skin graft. The opposite hand was treated by the "open-palm" technique for comparison. There was no observable difference in the ranges of motion at the end of the two months following surgery. The open-palm technique continues to be simple alternative for the advanced cases requiring extensive excision of the palmar fascia leaving wide gaps in the palmar skin.

Dupuytren Contracture↗
PubMed1976

The undelayed Mütter flap in head and neck reconstruction.

Twenty-one mastoid-occiput-based shoulder flaps have been used to reconstruct patients with head and neck cancer. When the tip of the flap does not extend beyond the midclavicle, this flap can safely be elevated and transferred into its final position without delay procedures. Not requiring secondary sectioning and implantation, the Mütter flap can successfully be used to reconstruct multiple defects within its arch. Its utility thus rivals the more commonly used medially based deltopectoral flap and forehead flap.

Head and Neck Neoplasms↗