ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts.A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Previous reports have stressed the importance of the nutrient blood supply in rib grafts transferred by microvascular anastomoses. In the present experimental study, we have demonstrated that a rib graft transferred by microvascular anastomoses based on periosteal vessels can survive; vascular clearing studies demonstrated that the vascularity of these grafts extends not only into the cortex but the medulla as well. The relative facility of harvesting these grafts (compared with those based on nutrient vessels) should make them the favored choice. Technetium bone scintigraphy proved accurate in the assessment of both vascular pattern and microanastomotic patency. Tetracycline labeling did not correlate well with the patency of a rib graft's pedicle blood supply.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

To better understand skin flap research, three pivotal papers of the last decade are reviewed. The validity of Milton's questioning the accepted length to width ratio is confirmed, whereas the shunt theory of skin flap failure is rejected, and the value of isoxsuprine treatment for preventing flap failure is debated. Current trends in three other areas of skin flap research are highlighted—skin flap metabolism, skin flap monitoring, and the use of musculocutaneous flaps for contaminated wounds.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A study of bacterial quantitation in burn wounds was undertaken to compare a new absorbent paper disc technique with the standard burn wound biopsy technique. In the first part of the study 228 paired samples were used to compare the two methods; a high correlation coefficient was found with the four most commonly encountered bacteria, and both methods showed a high specificity and sensitivity for each of the organisms. In the second portion of the study, the discs were compared with burn wound biopsies that had been divided into their superficial and deep segments. Thirty paired samples were studied and again the correlation was high, indicating that the disc technique also measured the organisms found in the deeper tissue levels.The absorbent disc technique is simple, convenient, noninvasive, inexpensive, and yields reproducible results. These findings indicate that burn wound biopsies may no longer be required for infection monitoring in the burn patient.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

The immediate onset of hypermetabolism after a major burn dictates that nitrogen and calories be supplied as early as possible to such patients to prevent the well-documented catabolic state. However, intravenous hyperalimentation is not always possible, and enteral feeding is not usually attempted in the early resuscitative period.Twelve patients with major burns (40% to 70%) were fed nasoduodenally in the early postburn period with a new solution (3.5% Aminosyn, 25% Polycose, and appropriate additions of electrolytes and vitamins). All patients reached positive nitrogen balance in 9.8 ± 2.3 days, tolerated the feeding extremely well, and had no distention or diarrhea. Metabolic assessment showed remarkable stability. The characteristic signs of hypermetabolism, such as hyperglycemia and hypoinsulinemia or hyperinsulinemia, were absent. Furthermore, there was no persistent neutrophilia or leukocytosis and there was a significant (p<.01) decrease in the percentage of juvenile neutrophils and a significant (p<0.001) increase in absolute lymphocytes between days 0 and 14 of the study.These data indicate that early enteral feeding of Polycose-Aminosyn is safe and well tolerated, and that the small intestine absorbs nutrients readily in the early postburn period, leading to positive nitrogen balance, preventing loss of serum protein, assisting in the maintenance of normal carbohydrate metabolism, and restoring granulocytes and lymphocytes to normal ratios.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

A new anastomotic device is demonstrated that is suitable in microvascular surgery for repairing severed blood vessels and inserting vein grafts. Initial pilot studies indicate a 100% patency rate for vessel anastomosis, and a one-year study produced a 96% success rate. However, histological examination revealed notable vessel deterioration with a rigid device. Therefore, an absorbable anastomotic coupler was developed that demonstrates a high patency rate (92%) in both arteries and veins, with substantial absorption of the device by 70 days. Healing at the anastomotic site was qualitatively similar to that obtained with a sutured anastomosis; there was endothelialization by 14 days and absorption of the device by 70 days.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Experiments in primates suggest that the skin senses are served by distinct classes of sensory receptors that relay their messages to the cortex on separate and parallel paths. When a peripheral nerve is transected and repaired, each sensory receptor that becomes reinnervated is innervated by a member of the class of axons that originally served that receptor. This specificity of reconnection allows the appropriate classes of sensations to be transmitted again from the skin to the cortex. However, sensory experiences are not completely normal because the regenerated axons have lost their previous spatial relationships and convey a spatially disordered message. Recent experiments suggest that the maps in the somatosensory cortex can respond to alterations of the somatosensory input in a manner that may compensate for some of the deficits produced by nerve injuries. There are, however, severe constraints on this reorganization, including restrictions to a cytoarchitectonic area, restrictions by certain boundaries within the somatotopic maps, and a requirement that a minimal topological order exist in the regenerated peripheral nerve.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID

摘要:

Two experimental models for tissue transplantation between unrelated individuals of a primate species have been designed to study survival and reinnervation. The first is a neurovascular free flap consisting of the entire soft tissue coverage of the index finger. The second is an entire hand transplant through the distal forearm. Ongoing studies show that cyclosporin A at high doses, in combination with a tapering regimen of steroids to a low maintenance level, permits prolonged survival of both transplant models. Careful biochemical, hematological, and cyclosporin A serum trough level monitoring permits use of this drug at very high dosages in primates. Continuing experiments should yield detailed neurophysiological data on the reinnervation of these transplants over the next 6 to 18 months.

ISSN:0148-7043    

出版商:OVID    

年代:1984

数据来源: OVID