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Biomedical subjects

A Danino

Publications and source records attributed to A Danino.

28 records · Page 2Linked to original sources
PubMed2002

[Cup and cone arthrodesis of the thumb in palliative surgery for tetraplegia. Retrospective study of 57 cases].

INTRODUCTION: The cup and cone technique, first described by Carrol and Hill is very simple. It affords excellent contact between bones, and allows all possible adjustments of the arthrodesis in three planes before its final fixation. MATERIAL AND METHODS: Fifty seven cup and cone arthrodesis of the thumb were performed in 41 adult tetraplegic patients. Level of arthrodesis was i.p. in 28 cases, TM in 25 cases and MP in 4 cases. Distribution in Giens classification was 3 group 1, 14 group 2, 9 group 3, 23 group 5, 2 group 6, 1 group 7, 2 group 10. Mean follow-up was 51 months. Three criteria were retrospectively studied: the clinical strength of arthrodesis, its position, and the potential existence of complications. RESULTS: Clinical fusion was obtained in 8 week in all cases, without any infection. No delayed union was observed. In only one case, a surgical revision was required, due to initial bad setting of TM arthrodesis and an intermetacarpal arthrodesis was performed with a bony graft. In all other cases, position of arthrodesis was correct. In a few cases, only minor or non specific drawbacks were observed: TM arthrodesis were sometimes painful during the first 6 months postoperatively; transient dystrophy of the thumb nail occurred two times in i.p. arthrodesis; the worst drawback was the shortening of the thumb, which impaired the key-grip in cases where the thumb was preoperatively short. DISCUSSION: In tetraplegic patients, stabilization of the thumb can be obtained either by split distal FPL tenodesis or by an arthrodesis at TM, MP or i.p. level of the thumb. When the provided thumb length is adequate arthrodesis is preferred. The cup and cone technique is very simple and effective. It is fit particularly in tertraplegic patients, whatever the level of the thumb arthrodesis.

Adult↗
PubMed2002

Endoscopic harvest of the medial gastrocnemius muscle flap: a cadaveric study.

The aim of our study was to prove that endoscopic-assisted harvest of the medial gastrocnemius muscle is as effective as the conventional technique. We performed endoscopic dissection on 10 fresh human cadavers, and found that the medial gastrocnemius muscle was easily harvested through a minor donor-site incision, because of its topography and constant dominant proximal vascular pedicle. The operative technique is described.

Cadaver↗
PubMed2001

[A scanning electron microscopy study of the surface of porous-textured breast implants and their capsules. Description of the "velcro" effect of porous-textured breast prostheses].

The efficacy of breast prosthesis texturing in the prevention of capsular contracture has been established for about 20 years. This successful procedure has led to the development and marketing of a number of different models. In the present study, four porous-textured breast prostheses have been examined: the Arion monoblock implant, the CUI (McGahn), the Biocell (Mcgahn), and the Sebbin LS21. Scanning electron microscopic (SEM) investigation of the implant surfaces of the different prostheses was carried out on new samples received from the manufacturers. During a prospective study on eight patients, capsule samples corresponding to the four above-mentioned prostheses were taken to determine whether a secondary intervention was necessary for correction of asymmetry or malpositioning. These samples were analyzed by SEM to investigate whether there could be a correlation between prosthesis texturing and the aspect of the corresponding capsules. Significant ultrastructural differences were found between the various prostheses examined: the results showed that only the CUI and Biocell prostheses presented a mirror image of the capsule texturing, with a correspondence between the depressions on the prosthesis and the contacts on the capsule. This finding seems to be linked to the existence of a critical size for the pores that constitute the implant surface. This observation led to the hypothesis of an adhesive "velcro" effect between the prosthesis and its capsule. Although the latter may not be directly linked to the prevention of capsular contracture it can, however, have a major effect on implant stabilization in cases of primary breast reconstruction and in possible secondary adjustments of asymmetry and malpositioning.

Adult↗
PubMed2001

[Use of the lateral tongue flap for closure of cleft palate. Retrospective study of seven cases].

Due to its central position, mobility and good blood supply, the tongue is a most suitable donor site for the closure of cleft palate fistulae. The aim of this retrospective study was to reassess the efficacy of the lateral tongue flap technique, first reported in 1884 and in use up to the 1970s, after which it was replaced by more sophisticated methods for the reconstruction of buccal and labial defects, which however could be deleterious to the patient. The results of the present study demonstrate the reliability and technical simplicity of the lateral tongue technique. The procedure took place in two stages, after which the patient was fed for five postoperative days by nasogastric tube, thereby facilitating the healing process via non-interference with scar tissue. Out of the seven patients who received treatment, six successful closures were noted, and only one partial failure was observed, in all cases without any functional sequelae involving the tongue.

Adolescent↗
PubMed2000

[Microtia: a new chronology for the total external ear reconstruction. A retrospective study of eight cases].

After 14 months of personal training with Professor Ichinose's team in Chiba (Japan), the author reports a new chronology of the total external ear reconstruction for microtia. This approach, proposed by Dr Yoshimoto, subtracts in time spent on creating the cartilaginous framework from the total general anesthesia time. The principles of this technique and its chronology are described. The results of eight patients operated according to this method between February 1994 and October 1999 are analyzed and compared to the 35 previous reconstructions performed by this team. The advantage of this chronology has been established: this method allows a considerable reduction of the general anesthesia time, a rationalization of the cost of these reconstructions, an increased comfort for the patients and an easier learning process for young plastic surgeons.

Cartilage↗
PubMed1999

[Position of venous outflow: a crucial aspect in flaps with 2 opposed pedicles. Application to the cutaneous delay phenomenon. Experimental study with rats].

In the present study, the authors decided to focus on the effect of the venous outflow location in the survival of a flap with a choke vessels barrier by means of a rat bipedicled ventral island flap. In a first experiment, the extent of flap necrosis was examined in three experimental groups: group 1, alternate vein and artery ligation (n = 5); group 2, unilateral artery ligation (n = 5); group 3, unilateral pedicle ligation (n = 5). Less than 10% necrosis occurred in group 1; 28% in group 2 and 33% in group 3. In a second experiment we applied the first results to the delay phenomenon. 10 rats were divided into 2 groups: group 4, primary ligation of a complete pedicle on one side; group 5, primary alternate vein and artery ligation and the flaps were raised 21 days later. We observed 20% necrosis in group 4 and only 4% in group 5. The data of the first experiment indicate that a vein remaining near the artery can be a dramatic obstacle to the efficiency of choke vessels. The second experimental study shows the superiority of primary selective ligation in the delay phenomenon.

Animals↗
PubMed1998

External-internal oblique reverse blood supply musculocutaneous flap for chest wall reconstruction.

A defect resulting from resection of advanced breast tumor can be quite large, posing a difficult reconstructive challenge. A significant number of such patients are found to have local recurrences after receiving beam radiation therapy and chemotherapy. The external oblique musculocutaneous flap is now considered a reliable option, with segmental blood supply from the posterior intercostal arteries. We report a 57-year-old man with local recurrence of breast tumor after external beam therapy. We faced a difficult challenge in performing reconstruction because of (1) several previous operations that used most of the usual options and (2) the absence of recipient vessels for microsurgery. We performed an external-internal oblique musculocutaneous flap with a reverse blood supply from the lateral branches of the inferior epigastric artery. Our use of a reverse-flow external-internal oblique flap supports the concept of rotating the muscles as a unit to encourage viability of the denervated and relatively devascularized component.

Arteries↗
PubMedDate not supplied

[Reconstruction strategy in chest wall defect relating to the localization of the lost substances: retrospective study of 18 patients].

OBJECTIVE: To evaluate an original algorithm in function of the chest wall defect localization after large surgery for cancer including more than 3 ribs. PATIENTS AND METHODS: Our retrospective study on 18 patients (10 women, 8 men), operated by the senior author, showed 8 pathological tumor localization in the central chest region, 7 in the lateral region and 3 borderline localizations. For central localizations, when the sternum was resected, the reconstruction was realized with a Gore-tex mesh in depth, metal hooks (staples) and Marlex mesh under the musculocutaneous superficial coverage flap. Lateral localizations was done by a Gore-tex mesh covered by the musculocutaneous flap; the borderline localizations were covered by a Marlex mesh and superficial musculocutaneous flap. The superficial coverage flaps were performed by latissimus dorsi flaps in 16 cases and transversus rectus abdominis flap in 2 cases. RESULTS: All the patients were extubated and breathed spontaneously in the postoperative period. Two deaths and one infection were to regret at distance. No flap was lost. CONCLUSION: The algorithm of reconstruction according to the location of the defect allows a simplification of the indications.

Adolescent↗