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Biomedical subjects

Y Godwin

Publications and source records attributed to Y Godwin.

15 recordsLinked to original sources
PubMed2001

Extra-abdominal desmoid tumour of the breast: review of the primary management and the implications for breast reconstruction.

This case report illustrates the presentation and management of an extra-abdominal desmoid tumour of the breast. A review of the literature describing the aetiology, pathology and risk of recurrence was undertaken to determine how current understanding of this rare tumour may affect the management of patients, should they require breast reconstruction after radical excision of the primary tumour. The natural progression of the disease is variable and there are no markers predictive of recurrence or regression. Primary lesions should be assessed with respect to their anatomical site of origin (i.e. whether they arise within the breast or invade the breast from the underlying musculo-aponeurotic tissue) and the extent of local invasion. Radical excision of the tumour with clear histological margins decreases the likelihood of recurrence. Tumours arising from the musculo-aponeurotic system have increased risks of recurrence and of developing multifocal primary tumours in specific anatomical territories. Local recurrences should be assessed for extent and anatomical distribution, and radical excision performed as for a primary tumour. Radiotherapy can be used as an alternative treatment if radical excision of a primary or recurrent tumour would cause severe functional loss or mutilation. Radiotherapy can be used for positive histological margins following tumour excision. There is a higher risk of recurrence in the first 3 years after primary excision, and breast reconstruction may be best delayed for this period. Surgical trauma has been implicated in the aetiology of recurrence and the patient should be informed of this prior to breast reconstruction.

Breast Neoplasms↗
PubMed2000

Do they listen? A review of information retained by patients following consent for reduction mammoplasty.

For valid informed consent the nature, purpose and material risks of the proposed procedure must be discussed. This study aims to clarify how much of this information is retained by the competent patient who gives written consent for reduction mammoplasty. A total of 38 patients were taken through specific and general factors relating to reduction mammoplasty by their surgeon at the time of obtaining consent. Six days following surgery they were asked how many facts they had retained. They were also asked to grade their surgeon on his/her ability at obtaining an informed consent and to suggest anything they felt would make consent clearer. The overall recall of facts by the patients was poor. The average number of retained facts was three out of twelve mentioned. Despite poor recall, 97% of the patients felt that the procedure of obtaining consent was adequate. 63% of patients gave the procedure for obtaining consent maximal score suggesting they were entirely satisfied. 74% would have liked some visual back-up at the time of giving their consent such as a photograph. Consent is a two-way process with clear information from the doctor and the understanding of that information by the patient. Despite poor retention of this information, patients in this study felt they had received clear information allowing written consent.

Audiovisual Aids↗
PubMed2000

The farmer's wife and the salmon fork: a near miss for the median nerve.

This case history illustrates how a farmer's wife accidentally impaled her forearm on a salmon fork with barbs. Despite the fact that the barbs were not obvious to the rescuing firemen, they had the good sense to transfer the patient with the fork in situ and well supported to prevent traction injury. Any effort to remove the fork at the time of injury would have resulted in complete division of the median nerve.

Female↗
PubMed1999

Reconstruction of a large defect of the ear using a composite graft following a human bite injury.

Human bites to the ear are not an uncommon injury as a consequence of brawls or even contact sports like rugby. Untreated, the cosmetic outcome of such injury is unsightly. This case history documents how a patient, who had two-thirds of his external ear bitten off, was treated successfully by replacing the part as a composite graft. The segment replanted was minimally trimmed but inset to allow maximal soft tissue apposition at the skin edges. An episode of postoperative venous congestion was treated with leeches. Patience was exercised rather than early debridement of any struggling tissue. All these factors helped the final result, which was 100% take of the replanted segment. Six months from the time of injury, the grafted segment has maintained its shape without cartilage resorption.

Adult↗
PubMed1998

A cheap, disposable external fixator for comminuted phalangeal fractures.

Reduction of a severely comminuted fracture of a long bone in the hand can be difficult to hold. An external fixator can be the best method of maintaining satisfactory reduction in such fractures. A small, disposable external fixator is described, made from a syringe barrel and K-wires. It allows accurate reduction with minimal soft tissue trauma and is easy to construct and apply. It allows early mobilization of the digit and is inexpensive.

Bone Wires↗
PubMed1998

Major burns in Cape Town: a modified burns score for patient triage.

Major burns equal to, or greater than, 30 per cent total body surface area (TBSA) constitute 23 per cent of the admissions to the adult burns unit in Cape Town. A retrospective review over a 28-month period identified 87 cases of major burns. This paper summarizes the epidemiology and mortality amongst this patient group over this period. Demand for treatment can exceed bed availability in the unit. The difficult issue, this raises, of patient triage in relation to the relatively limited resources is addressed and a simple modified burns score proposed for this unit. The effect this score would have in optimizing the use of our resources is demonstrated.

Adolescent↗
PubMed1998

Egg on your face.

Explore the source record for details and available documents.

Accidents, Home↗
PubMed1998

A comparison of the patient and surgeon opinion on the long-term aesthetic outcome of reduction mammaplasty.

The aim of this study was to assess the difference in opinion between patients and surgeons regarding the aesthetic outcome of reduction mammaplasty. A total of 34 women, who were more than 1 year post surgery, attended an outpatient clinic to assess their opinion of the aesthetic outcome of their breast reduction. A questionnaire was used to standardise their responses. Photographic slides were taken to record the frontal, left oblique and recumbent view of their torso. These slides were assessed by four consultant plastic surgeons who completed the same questionnaire, and were blinded as to the surgeon and patient. The majority of patients rated the aesthetic outcomes of their surgery significantly higher than the consultants. Scarring was the most frequent cause of dissatisfaction for both surgeons and patients. The consultants considered the scarring following Lejour reduction to be significantly better than that following the inferior mound reduction. The nipple was considered to be too high on the breast by 12% of women but they did not request correction of this. However, consultants thought this was a problem in 27% of cases. The aesthetic outcome of reduction mammaplasty was acceptable to the patients although surgical assessment indicates that there is scope for improvement. The main area of aesthetic dissatisfaction remains the postoperative scarring.

Adult↗
PubMed1998

The burnt male--intentional assault on the male by his partner.

There are few studies which address the burnt male patient who has been intentionally assaulted by his partner. Thirty such patients were admitted to the Somerset Hospital Burns Unit between January 1993 and May 1995. The average age was 37 years and the mean total burn surface area was 19.6% (range 2-55%). A variety of agents had been used to inflict the burn, but throwing hot fluid at the victim was the most common. The head, neck and chest were the most common areas burnt. Five patients developed respiratory burns and 2 required ventilatory support. Three patients died: 1 of respiratory failure and 1 of septicaemia, while 1 committed suicide. The burnt and battered male patient is a real clinical entity which is becoming more common. Treatment should investigate psychosocial factors in addition to ensuring healing of the burn wound.

Adult↗
PubMed1997

Shack fires: a consequence of urban migration.

Shack fire burns are the second most common reason for admission of patients to the burns unit in Cape Town. A retrospective analysis of 99 patients between January 1993 and June 1995 was undertaken to investigate the demographics and mortality associated with shack fire burns. There were 58 males and 41 females with an average age of 34 years (range 13-17 years). The average total burn surface area (TBSA) was 31 per cent (range 3-98 per cent) and in 67 of these patients a full-thickness component to the burn was noted. The upper limbs and head and neck were the most commonly burnt areas. Inhalation injury affected 61 patients, 18 of whom required admission to an intensive care unit for assisted ventilation due to respiratory failure. Thirty nine patients (39.4 per cent) died. Shack burns are a specific entity associated with significant morbidity and a high mortality. The injuries had a major impact on the victim's life and prevention is the best form of treatment.

Adolescent↗