Biomedical subjects
Publications and source records attributed to T Mathivanan.
We report a rare case of absence of the flexor pollicis longus in a hypoplastic right thumb, without hypoplasia of the thenar muscles in an 11-year-old girl, who was treated by transfer of flexor digitorum superficialis of the ring finger to the thumb to achieve active flexion at the interphalangeal joint of the thumb.
Acute and chronic burns leave behind a full-thickness defect that always requires a flap cover. Such defects are common in electrical burn injuries of the limbs. This paper deals with 35 patients with full-thickness defects following burns in whom deepithelialized turnover dermis flaps and deepithelialized turnover flaps with deep fascia have been used. This flap is an extension of Hynes's reversed dermis graft and Smahel's deepithelialized turnover flap where there is a larger area of blood supply on the deeper aspect of the dermis. If a good hinge is provided for safe blood supply, such a flap settles well in the defect, and cumbersome multistaged procedures can be avoided. If there is less fatty tissue in the area of flap used, then reversed dermis flaps are ideal because split-skin graft take is good. When there is a lot of fatty tissue on the undersurface of dermis, the fascia is also included to make it a reversed fasciocutaneous flap to augment the blood supply and for better split-skin graft survival. Advantages of the procedure and complications are elaborated.
The incidence of velopharyngeal incompetence (VPI) following cleft palate surgery is fairly high in our country. We have attempted to analyse the aetiology and then selected 50 cases of VPI from our group of operated cleft palates. These patients were then evaluated using cephalometry, speech rating, pressure studies and nasendoscopy. We identified 13 patients in whom there was incompetence due to failure of movement of the walls responsible for proper closure of the velopharyngeal port. In these patients we performed circumferential sling pharyngoplasty using denervated palmaris longus; since this procedure narrowed the port circumferentially. We re-evaluated these patients and the results have been gratifying. Speech rating improved and E.M.G. tracings after 6 months showed evidence of reinnervation of the Palmaris Longus.
Infection is the most important problem in the treatment of burns in a developing country. A burn compromises a major body protective mechanism, namely the skin. Hence, the susceptibility to local infection increases at these sites. The incidence of burn wound sepsis is very high in south India as the socio-economic conditions and the standard of personal hygiene are poor and the hot moist climatic conditions encourage bacterial growth. These three factors are rarely present in the temperate zone countries of Europe and North America. This study was undertaken to identify more clearly the factors that are responsible for the higher incidence of burn wound infection and to formulate methods of treatment which are appropriate for our patient population living in a tropical country.