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Biomedical subjects

Willy Serlo

Publications and source records attributed to Willy Serlo.

6 recordsLinked to original sources
PubMed2004

Congenital diaphragmatic hernia: a survey of practice in Scandinavia.

There is no consensus on the treatment of congenital diaphragmatic hernia (CDH), and practice seems to vary between centres. The main purpose of the present study was to survey current practice in Scandinavia. Thirteen paediatric surgical centres serving a population of about 22 million were invited, and all participated. One questionnaire was completed at each centre. The questionnaire evaluated management following prenatal diagnosis, intensive care strategies, operative treatment, and long-term follow-up. Survival data (1995-1998) were available from 12 of 13 centres. Following prenatal diagnosis of CDH, vaginal delivery and maternal steroids were used at eight and six centres, respectively. All centres used high-frequency oscillation ventilation (HFOV), nitric oxide (NO), and surfactant comparatively often. Five centres had extracorporeal membrane oxygenation (ECMO) facilities, and four centres transferred ECMO candidates. The majority of centres (7/9) always tried HFOV before ECMO was instituted. Surgery was performed when the neonate was clinically stable (11/13) and when no signs of pulmonary hypertension were detected by echo-Doppler (6/13). The repair was performed by laparotomy at all centres and most commonly with nonabsorbable sutures (8/13). Thoracic drain was used routinely at seven centres. Long-term follow-up at a paediatric surgical centre was uncommon (3/13). Only three centres treated more than five CDH patients per year. Comparing survival in centres treating more than five with those treating five or fewer CDH patients per year, there was a tendency towards better survival in the higher-volume centres (72.4%) than in the centres with lower volume (58.7%), p =0.065.

Cross-Sectional Studies↗
PubMed2004

Successful use of biosorb osteofixation devices in 165 cranial and maxillofacial cases: a multicenter report.

Bioabsorbable osteofixation devices were developed to avoid problems associated with metals. Bioabsorbable devices are mostly made of the polymers polylactide, polyglycolide, and their copolymers [polyglycolide-co-polylactide and P(L/DL)LA]. Using the technique of self-reinforcement of bioabsorbable materials, it is possible to manufacture osteofixation devices with ultra high strength. Self-reinforced polyglycolide-co-polylactide 80/20 was selected to make devices (Biosorb PDX) for this study because of its favorable degradation characteristics. The aim of this study was to evaluate the efficacy of using self-reinforced polyglycolide-co-polylactide 80/20 (Biosorb) plates and screws in the fixation of osteotomies in craniomaxillofacial surgery. In a prospective study, 165 patients (161 children and 4 adults) were operated on in four European Union centers (Paris, Innsbruck, London, and Oulu) from May 1, 1998 to January 31, 2002. Indications included correction of dyssynostotic deformities (n = 159), reconstruction of bone defects after trauma (n = 2), tumor removal (n= 2), and treatment of encephalocele (n = 2). Plates used were 0.8, 1, or 1.2 mm thick, and screws had an outer (thread) diameter of 1.5 or 2 mm and a length of 4, 6, or 8 mm. Tacks had an outer diameter of 1.5 or 2 mm and a length of 4 or 6 mm. During surgery, the devices were easy to handle and apply and provided stable fixation apart from 2 cases. Postoperative complications occurred in 12 cases (7.3%), comprising infection (n = 6), bone resorption (n = 4), diabetes insipidus (n = 1), delayed skin wound healing/skin slough (n = 2), and liquorrhea (n = 1). Accordingly, self-reinforced polyglycolide-co-polylactide 80/20 (Biosorb) plates and screws can be used safely and with a favorable outcome in corrective cranioplasties, especially in infants and young children.

Absorbable Implants↗
PubMed2003

A new technique for correction of trigonocephaly using bioabsorbable osteofixation tacks and plates and a novel tack-shooter.

We report on the feasibility of applying bioabsorbable tacks using a new tack-shooter to fix bioabsorbable plates applied endocranially for the correction of three cases of trigonocephaly. Tacks do not require tapping or tightening because they are applied using a tack-shooter directly into drill holes in the bone. Hence, the technique saves valuable operative time. A 1.5- to 2.0-cm broad supraorbital bar (bandeau) was raised and reshaped. The corrected shape was maintained using a Biosorb plate (Bionx Implants Ltd, Tampere, Finland), and tacks were applied on the endocranial side of the bar. The plate extended a few centimeters laterally beyond the edge of the supraorbital bar, and it was fixed with Biosorb miniscrews and/or tacks affixed to the temporal bones. Other molded bone pieces were fixed using Biosorb plates, screws, and/or tacks. The technique of using tacks was easy, and it provided secure osteofixation. Cosmetic results were excellent, and no complications were encountered except for palpability of plate edges on the right side of the skull in one case.

Absorbable Implants↗
PubMed2003

Treatment of hydrocephalus determined by the European Orbis Sigma Valve II survey: a multicenter prospective 5-year shunt survival study in children and adults in whom a flow-regulating shunt was used.

OBJECT: The goal of this study was to evaluate the long-term results of a flow-regulating shunt (Orbis Sigma Valve [OSV] II Smart Valve System; Integra NeuroSciences, Sophia Antipolis, France) in the treatment of hydrocephalus, whether it was a first insertion procedure or surgical revision of another type of shunt, in everyday clinical practice in a multicenter prospective study. METHODS: Patients of any age who had hydrocephalus underwent implantation of an OSV II system. The primary end point of the study was defined as any shunt-related surgery. The secondary end point was a mechanical complication (shunt obstruction, overdrainage, catheter misplacement, migration, or disconnection) or infection. The overall 5-year shunt survival rates and survival as it applied to different patient subgroups were assessed. Five hundred fifty-seven patients (48% of whom were adults and 52% of whom were children) were selected for OSV II shunt implantation; 196 patients reached the primary end point. Shunt obstruction occurred in 75 patients (13.5%), overdrainage in 10 patients (1.8%), and infection in 46 patients (8.2%). The probability of having experienced a shunt failure-free interval at 1 year was 71% and at 2 years it was 67%; thereafter the probability remained quite stable in following years (62% at the 5-year follow-up examination). No difference in shunt survival was observed between the overall pediatric (< or = 16 years of age) and adult populations. In the pediatric age group, however, there was a significantly lower rate of shunt survival in children younger than 6 months of age (55% at the 5-year follow-up examination). CONCLUSIONS: In this prospective study the authors demonstrate the effectiveness of flow regulation in the treatment of hydrocephalus both in children and in adults. Flow-regulating shunts limit the incidence of overdrainage and shunt-related complications. The overall 5-year shunt survival rate (62%) compares favorably with rates cited in other recently published series.

Adolescent↗
PubMed2002

A new technique for cranial bone osteofixation: use of bioabsorbable tacks and plates to fix parietal bone split grafts used for reconstruction of a posttraumatic frontal bone defect.

Recent advances in bioabsorbable devices have introduced tacks that do not require tapping. This may help to reduce operative time and, consequently, costs. The goal of this study was to demonstrate the feasibility of a new method of cranial bone osteofixation using novel bioabsorbable tacks and plates instead of screws. A 36-year-old man presented for elective cranioplasty to reconstruct a large frontal cranial bone defect that followed a decompression operation performed because of a head injury sustained 6 months previously. Cranioplasty was performed using split parietal bone grafts to reconstruct the defect. Bone grafts were fixed together and to the skull using self-reinforced (SR) poly(L/DL)lactide [SR-poly(L/DL)lactide] (70/30) (Biosorb FX) plates (n = 10) and tacks (n = 98). The plates were 0.6 mm thick, 102 mm long, and 12 mm wide. The tacks had a maximum thread diameter of 2 mm and a length of 6 mm. The tacks used did not require any tapping procedure, and they were applied using a special applicator gun. Stable and secure fixation was obtained during surgery. The postoperative period was uneventful, except for delayed epithelialization of a small area (1 x 0.5 cm) over the frontal skin that healed later. One year after surgery, the cosmetic result was excellent, and no complications were detected. Stabilization of large cranial bone pieces can be achieved using bioabsorbable SR-poly(L/DL)lactide plates and tacks, with excellent cosmetic results. The method is thought to be reliable and may help to reduce operative time.

Absorbable Implants↗