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Biomedical subjects

W C Lineaweaver

Publications and source records attributed to W C Lineaweaver.

At least 127 records · Page 7Linked to original sources
PubMed1989

Multiple microvascular transplants: a preliminary report of simultaneous versus sequential reconstruction.

We review a 10-year experience with multiple microvascular transplants (MMTs) performed on 94 patients undergoing reconstruction of complex extremity and head and neck wounds. One hundred ninety-eight flaps were performed with an overall success rate of 95%. Patients were classified into two groups: Group I comprised 38 patients who received simultaneous MMTs (76 total flaps); two flaps were transplanted in the initial operative procedure. Group II consisted of 56 patients undergoing reconstruction with sequentially transplanted MMTs (122 total flaps). The success rates of the two groups were not statistically different (97% vs. 93.4%). Complications were similar in both groups, although sequential reconstruction of lower extremity wounds had a higher frequency of complications and flap failures than the simultaneous method. Patients receiving simultaneous MMTs required more emergent reexplorations, but salvage rates were high (87.5%), particularly in upper extremity reconstructions. We suggest that simultaneous MMTs are a reliable, cost-effective method of reconstructing complex injuries. They reduce patient morbidity by eliminating second hospitalizations and reoperations without increased complications or flap failure.

Adolescent↗
PubMed1989

Subtransversalis passage of a rectus abdominis island flap for treatment of osteomyelitis of the posterior superior iliac spine.

An osteomyelitic defect of the posterior superior iliac spine was filled with a rectus abdominis island pedicle flap passed beneath the transversalis fascia and through the preperitoneal and retroperitoneal spaces. This maneuver extends the arc of rotation of this flap to the posterior rim of the pelvis and increases the potential uses of the flap in the reconstruction of complex pelvic wounds.

Abdominal Muscles↗
PubMed1989

Reconstruction of the upper extremity with multiple microvascular transplants: analysis of method, cost, and complications.

During an 8-year period, 131 multiple microvascular transplants were performed on 62 patients for upper extremity reconstruction of complex wounds. Patients were classified into two groups: In group I 35 patients received paired simultaneous transplantation of 70 flaps performed in 35 operations. Group II consisted of 27 patients who underwent reconstruction with 61 sequentially transferred flaps; each procedure consisted of a single transplant. No statistical differences in flap failure or complications were seen between groups, except that group I required emergency reexploration more frequently. Patients receiving sequential reconstruction required rehospitalization, leading to significantly elevated costs. In our experience, simultaneous multiple microvascular transplants, particularly in patients admitted with acute injuries, result in reduction of costs, total number of procedures, and duration of hospitalization without increased complications.

Adolescent↗
PubMed1988

Pilomatrix carcinoma.

Pilomatrixomas are uncommon tumors of hair matrix origin. They are characteristically benign, calcifying lesions. Eleven cases of aggressively invasive pilomatrixomas have been reported, and this variant has been termed pilomatrix carcinoma. This report presents the first known case of a cervical pilomatrix carcinoma. Modified radical neck dissection was necessary for tumor extirpation. Pilomatrix carcinoma behaves similarly to an aggressive basal cell carcinoma. These lesions require definitive, anatomic resection, careful histological examination of margins, and systematic follow-up examinations.

Adult↗
PubMed1988

Cefotaxime-sensitive Aeromonas hydrophila infection in a revascularized foot.

Three days following revascularization of a foot injured in a boating accident, Aeromonas hydrophila cellulitis developed in the victim's foot and leg. The infection resolved with debridement and 10 days of cefotaxime therapy. A. hydrophila infection has not previously been reported in a revascularized extremity. Clinical response of an A. hydrophila cellulitis to cefotaxime is likewise undescribed. Our findings of a cefotaxime-sensitive Aeromonas infection and its successful treatment suggests that the organism should undergo further evaluation of cefotaxime sensitivity and that cefotaxime and other third-generation cephalosporins may have a role as broad-spectrum antibiotic agents in fresh-water trauma.

Adult↗
PubMed1988

Hematoma in a latissimus dorsi donor site 21 months after surgery.

Following strenuous upper extremity exertion, a 40-year-old man experienced pain and swelling in a latissimus dorsi donor site 21 months following harvest and microsurgical transfer of the muscle. Examination and aspiration proved the mass to be a hematoma, and 595 cc of blood were evacuated with resolution of swelling. Late hematoma in a latissimus dorsi donor site must be distinguished from ventral hernia and can be managed by aspiration.

Adult↗
PubMed1988

Massive doses of midazolam infusion for delirium tremens without respiratory depression.

After undergoing replantation and revascularization surgery for a complex hand injury, a 25-yr-old male developed florid delirium tremens. Over a 5-day period, he received 2850 mg of midazolam as a constant infusion of varying rates. The midazolam controlled his severe agitation without respiratory depression and the hand reconstruction survived undamaged.

Adult↗
PubMed1987

Internal pudendal pseudoaneurysm complicating an ischial pressure sore.

A 23-year-old paraplegic patient experienced two episodes of substantial hemorrhage from an ischial pressure sore. Computed tomography showed that the wound extended into the pelvis and retroperitoneum, and arteriography demonstrated a pseudoaneurysm of the internal pudendal artery. The artery was selectively embolized, permitting debridement and flap coverage uncomplicated by bleeding. Bleeding from a pelvic extension of a pressure sore can be a catastrophic combination of distorted anatomy and relatively inaccessible vessels. As in hemorrhagic complications of pelvic trauma, tumors, and radiation, arteriography and transcatheter embolization can localize and control the source of bleeding.

Adult↗
PubMed1987

Low residue nutritional supplementation as an adjunct to mechanical preparation for surgical treatment of the colon.

The mechanical and nutritional efficacy of a low residue nutritionally complete liquid diet was evaluated as an adjunct for colonic preparation in patients undergoing large intestinal operations. The complete liquid diet was identical to more traditional clear liquid diets in terms of cleanliness of the intestine and general profile of bacterial flora. This complete diet was well accepted by patients and was superior in its provision of energy, protein, vitamins, minerals and nitrogen. The use of this low residue supplemental diet was associated with a statistically earlier return of intestinal function and a trend toward shorter length of hospitalization. The results of this study indicate that low residue nutritionally complete liquid diets not only offer comparable mechanical cleanliness but also outstanding nutritional advantages not obtained with traditional preparatory diets.

Adult↗
PubMed1986

Complications of free flap transfers.

Review of 72 cases of free flap transfer showed that flap failure was associated with thrombocytosis and open wounds and that complications were associated with open wounds. Specific biologic variables, therefore, may underlie flap failure and complications, and investigation of these variables could lead to reduced morbidity.

Adult↗
PubMed1985

Pancreatic cancer: unreliability of frozen section in diagnosis.

Thirty-two patients with a resectable mass in the head of the pancreas had pancreaticoduodenectomy for suspected or proven cancer. Twenty-eight proved to have cancer (15 periampullary and 13 pancreatic), and four had pancreatitis. The five-year survival for periampullary and pancreatic cancer was 25% and 0%, respectively. The operative mortality was 19%. There were no false-positive frozen section diagnoses. Seventy-five percent with negative frozen section proved to have cancer, of which 17% were five-year survivors. Surgical judgment based on clinical findings may be more reliable than a negative frozen section in the diagnosis of suspected malignancy. Pancreaticoduodenectomy can be done on the basis of clinical judgment when no tumor is seen on frozen section of a mass in the head of the pancreas.

Adult↗
PubMed1984

Squamous carcinoma arising in a pilonidal sinus.

A patient with squamous cell carcinoma arising from an extensive pilonidal sinus was treated with wide local excision, resulting in an apparent cure over a 1-year follow-up period. Review of the literature revealed 32 previously reported cases of this entity. Forty-four percent of these patients developed recurrences or metastases, and 22% died of their disease. The largest historical treatment group with at least 1-year follow-up (19 patients with localized disease) underwent wide excision. Forty-two percent of these patients recurred or developed metastases. Ultimately, 89.5% of these patients were reported cured, but only five survivors were followed for as long as 5 years. Historical experience appears to identify pilonidal tract squamous carcinoma as an aggressive tumor. The reported success of wide local excision is based on a small number of patients followed for short periods of time. Continued experience with this disease should be reported to verify the adequacy of local excision or identify the need for adjunctive therapy.

Adult↗
PubMed1982

Computed tomographic diagnosis of acute aortoiliac catastrophes.

Whole-body computed tomography (CT) was used as an initial examination in stable patients whose symptoms were suggestive of aortoiliac emergencies. In three cases, CT provided highly specific diagnoses in three different aortoiliac complications. Computed tomography proved to be a fast and reliable diagnostic tool in emergency settings.

Aged↗