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Biomedical subjects

V M Grishkevich

Publications and source records attributed to V M Grishkevich.

At least 19 recordsLinked to original sources
PubMed1996

Surgical treatment of postburn boutonniere deformity.

A new method of surgical treatment of postburn boutonniere deformity was used in 124 fingers of 66 patients. This method includes reconstruction of the lateral band's position of an extensor apparatus and anatomic continuity of a central band. Before tendon plasty, passive movements in a proximal interphalangeal joint are restored and contracture of others joints is released. If the soft tissue of the digital back is affected, tendon grafts are covered with a groin pedicled flap. With this method we could restore active movements in the proximal interphalangeal joint in 89.2 percent of the patients and avoid fusion or amputation. The failures were connected with serious intrajoint changes.

Burns↗
PubMed1996

[Restoration of the burn-damaged face with a split-thickness skin-fatty tissue flap from the neck].

The article deals with experience in the treatment of 94 patients with a split-thickness cellulocutaneous flap taken from the neck. It has been established that the skin on the neck has an axial blood supply which allows it to be mobilized extensively without including the platysma of the neck and chest wall and transfer it to the face, avoiding necrosis. Four main types of cicatricial damage to the face are distinguished, which determine the peculiarities of transfer of the mobilized skin. Maintenance of the platysma in situ and vacuum drainage of the space under flap retain the contours of the neck and face. In total affection of the face the tissues must be mobilized again in 6 to 12 months and moved so to restore the skin to the orbits. The skin of the neck, when transferred to the face, maintains its natural properties and is best plastic material. The method is indicated in all cases in which the skin of the neck and anterior surface of the chest is not damaged.

Burns↗
PubMed1995

[Surgical treatment of severe postburn flexion contractures of the hand].

The authors discuss the surgical tactics in multiple burn contractures of the palmar surface of the hand from experience in the treatment of 45 patients. The operation is conducted in one stage, with the manipulations performed in a definite order, which makes it much easier. The operation consists in correction of adduction of the thumb and the region of flexion contractures of the metacarpophalangeal articulations, palmar syndactyly, flexion contractures of the fingers, and contractions of the palm. Plastics with trapeziform grafts in combination of the palm. Plastics with trapeziform grafts in combination with free skin grafting makes it possible to correct all contractures in one stage and restore the function of the hand.

Burns↗
PubMed1995

[Restoration of shape, position and skin of burn-damaged breasts].

Experience in the treatment of 24 females with restoration of 29 breasts which had been damaged by burns is discussed. In 16 of them the breast lay flat under scars. An effective method for restoring the shape and position of the breast in suggested. It consists in radical excision of the scars covering the glandular tissue, application of multilayer subcapsular circular retention sutures for 3 months, and restoration of the skin over the breast with a split-skin graft or healthy skin taken from an adjacent area and stretched with an extender. Good cosmetic results were obtained in all cases, stable restoration of the shape, position, and skin over the breasts distorted by scars was achieved.

Adolescent↗
PubMed1993

[Prevention of complications in reconstructive surgery of burn injuries].

On the basis of treatment of more than 5,000 patients with postburn cicatricial contractures of the joints, deformities and defects of the soft tissues the authors studied the complications and their causes. Suppuration of the operative wounds, necrosis of grafts and the edges of the wound, and hematomas are the main complications. The character of the complications and their sequelae are connected directly with the specific features of the surgical intervention and type of plastics (free, flap, microsurgical, dermatotensia), as well as with the anatomical features of the tissues and vessels damaged by the burn, which reduce the resistance to infection and facilitate the appearance of circulatory disorders. Preventive measures are suggested which excluded purulent complications and reduced tissue necrosis to minimum. Therapeutic measures reducing sharply the sequelae of the complications are discussed. Preeminence of preventive measures over therapeutic measures is emphasized. Their timely application helps in attaining good outcomes of restorative and reconstructive operations in patients who had suffered from burns.

Burns↗
PubMed1993

[Treatment of chronic non-healing donor sites: transplantation of cultured human fibroblasts].

The authors discuss the first results of the use of cultivated human allofibroblasts in the treatment of persisting wounds of the donor areas in 13 patients with deep burns and cicatricial deformities caused by the burns. Transplantation of cell cultures led to complete epithelialization of the wounds in 6-10 days. Complication, suppuration of the grafted material, was recorded in one case. Reaction of graft rejection was not encountered. The authors believe that the effect of the transplantation is due to stimulation of the epithelialization processes by the cultivated fibroblasts.

Burns↗
PubMed1992

[Tendoplasty of the fingers and the restoration of the skin-fatty layer of the dorsal surface of the hand in boutonnière contracture].

In the period from 1983 to 1990 operations were conducted on 63 patients with postburn boutonnière contracture of 116 fingers. In 19 patients (42 fingers) tendoplasty of the extension apparatus of the fingers was carried out with simultaneous restoration of the dermatoadipose layer on the dorsal surface of the hand with an inguinal or dermatoadipose graft. In 39 patients the tendon of the extensor digitorum muscle was injured over several proximal interphalangeal articulations. A new method for treating boutonnière contracture is suggested. It is based on restoration of the continuity of the central fasciculus and the normal position of the lateral fasciculi with a single tendon autograft. The suggested method produced good results in 90% of cases, i.e. in all cases in which a sufficient volume of passive movements at the proximal interphalangeal articulation was restored in the preoperative period.

Adipose Tissue↗
PubMed1991

[The surgical treatment of postburn cicatricial contractures of the knee joint extensors].

In the recent 3 years operations were carried out in 8 patients with postburn extension contractures of the knee joints, which accounted for 12.9% of all cicatricial contractures of this joint. The anatomical essence of the contracture was ascertained. A method of surgical treatment was developed, which consisted in restoration of the cutaneoadipose layer in the region of the knee with a cutaneofascial graft taken from the contralateral leg and subsequent excision of the scars on the thigh, by freeing of the muscles extending the joint, and restoration of the skin surface with a split nonperforated autodermal graft. The operation restores knee joint movement and removes trophic ulcers of pathological postburn scars.

Adult↗
PubMed1990

[Cutaneo-fascial flaps in restorative and reconstructive surgery of burns].

On the basis of experience with the treatment of more than 1,500 patients with post-burn defects, deformities, and trophic ulcers, the authors distinguished types of affection in which the traditional methods are ineffective. These 133 patients were subjected to plasty with ++cutaneo-fascial grafts; the zones of donor areas from which the grafts are taken are determined. Plasty with ++cutaneo-fascial grafts is indicated in defects of the face, deformity of the neck, total adduction contracture of the arm, defect of the breast, and affections of the hand, leg, and foot. Concrete grafts and the site from which they are taken for restoration of certain regions of the body are suggested. ++Cutaneo-fascial grafts make it possible to restore the shape, function, and the skin of the involved region.

Burns↗
PubMed1990

[Surgical treatment of extensive and deep defects of crural soft tissues using the gastrocnemius muscle and skin flaps].

The article discusses a method for surgical treatment of extensive and deep defects in the soft tissues of the leg by plasty with a gastrocnemius musculocutaneous graft taken from the contralateral limb. The operation was conducted in two stages. It is emphasized that if all the described technical details are followed, the postoperative period will be uncomplicated and the outcome of the operation will be good.

Body Surface Area↗
PubMed1990

[Use of cutaneo-fascial flaps in reconstructive surgery of the lower extremities].

Defects in the soft tissues of the lower extremities after burns and traumas in 10 patients were managed by plastic surgery using ++cutaneo-fascial grafts formed from the leg of the same or contralateral side. The operation was performed in two or three stages. ++Cutaneo-fascial grafts formed on the posteromedial or posterolateral surface of the leg may have a width:length ratio of 1:3. In cross plastics the proximal one third of the graft is folded like a tube. Inclusion of the vena saphena magna in the graft and measures aimed at prevention of separation of the fascia from the layer of fat increase the viability of the graft. Secondary deformity is significantly reduced by modelling the edges of the donor wound and closing it with an unperforated graft of split skin.

Adult↗
PubMed1990

[Treatment of cicatricial alopecia by the method of tissue expansion].

The tissue extension method was applied in 13 patients with cicatricial alopecia of the scalp. Eighteen Soviet-made tissue expanders were used. Clinical experience showed that the sequelae of burns of the scalp attended by alopecia should be treated by tissue extension. The growth of hair can be restored on up to half of the scalp surface by expansion of the local tissues by their direct transfer and by additional formation of grafts for contour plastics. Plastics by expanded tissues is indicated for closure of naked bones of the vault of the skull.

Alopecia↗
PubMed1990

[Removal of postburn scar deformations of the lower third of the face].

The authors treated 324 patients with postburn scar deformations of the lower third of the face. It was established that the postburn deformation of a face should be eliminated after conservative treatment and "scar maturation" in one step, removing the scars along the intermediate layer without damaging the subcutis. When performing this, it is necessary to restore the filtrum, mental fossa and commissures of the mouth slit with the trapeziform flaps. The best plastic material is the intact skin of the submaxillary region and neck, the deltopectoral and brachiopectoral fasciocutaneous flaps can be used. It is necessary to perform strictly a number of technical manoeuvres at all the stages of operation.

Burns↗
PubMed1989

[Correction of extensive defects in soft tissues].

It was established on the basis of treatment of 7 patients that in approximately half of the patients with post-burn defects and deformities of tissues, for whom the method of tissue stretching is indicated, the use of two and more tissue-stretching instruments is expedient. This makes it possible to prepare a large skin area, use its uninjured parts, and attain the best results of plastic operations. In transposition of dermal-fat and dermal-fascia grafts the use of certain described technical manipulations is needed, they make rational utilization of plastic material easier.

Burns↗