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Biomedical subjects

A De Mey

Publications and source records attributed to A De Mey.

At least 37 records · Page 2Linked to original sources
PubMed1991

Late results and current indications of latissimus dorsi breast reconstructions.

One hundred and fifty latissimus dorsi flaps were used in 145 patients out of a series of 483 breast reconstructions performed from 1977 to 1988. There were few immediate complications and a durable, good cosmetic result was obtained in two-thirds of the 103 cases reviewed after at least one year. The main reasons for dissatisfaction with long-term results were capsular contracture (grades III and IV) and upper displacement of the implant. The rate of these late complications was 30%, the same as found in the simpler subpectoral reconstruction. However, prostheses with a thick outer envelope induced only 10% of severe capsular contracture. Reconstructions with autologous tissue are currently replacing latissimus dorsi flap reconstructions unless local or general conditions contraindicate such major surgery or when the patient lacks motivation.

Back↗
PubMed1990

Treatment of palatal fistula by expansion.

Treatment of a large anterior fistula of the hard palate remains a problem. A new approach is presented by expansion of the palatal mucosa by custom-made implants, allowing closure in two layers without tension or extensive undermining.

Child↗
PubMed1989

Anatomy of the orbicularis oris muscle in cleft lip.

The anatomy of the orbicularis oris muscle was studied using histological sections of 18 operative specimens of unilateral cleft lip (14 incomplete and 4 complete). In incomplete clefts the intrinsic part of the orbicularis, located in the vermilion, is simply interrupted without distortion. The extrinsic part, lying higher in the lip, crosses the cleft but is distorted vertically according to the degree of the nasal deformity. In complete clefts the intrinsic bundle ends in the submucosa of the vermilion as in incomplete clefts. The extrinsic bundle is deviated towards the ala nasi on the lateral side. On the medial side, the fibres are rarer and more horizontal. Conclusions are drawn regarding reorientation of the muscle fibres during cheiloplasty.

Cleft Lip↗
PubMed1989

Pterygium colli: surgical treatment.

The authors report three cases of pterygium colli. Two of them presented as part of Turner's syndrome and were treated following a personal technique. The third, which was probably due to jugular lymphatic obstruction, was treated according to the butterfly excision technique of Shearin.

Adolescent↗
PubMed1989

[Value of POR 8 in the treatment of burns].

Excision and skin grafting is the best treatment for burn wounds. In order to avoid excessive bleeding during the operation, sub-eschar infiltration with POR 8 (para ornithine 8 - vasopressin) has been performed in 115 patients between 1979 and 1984. The results being encouraging, infiltration was later also performed under the donor site. Bleeding was reduced enough by this technique to allow one stage excision and grafting of surfaces up to 20% of the body surface. No general or local complication of POR 8 infiltrations has been observed except a slight increase of blood pressure without clinical consequence.

Adolescent↗
PubMed1986

Conservative treatment of 725 burned children hospitalized in 10 years.

Seven hundred and twenty-five children were hospitalized in the paediatric burn unit of Brugmann University Hospital during the past 10 years. The majority of the patients were under 5 years of age and presented with scalds on less than 10 per cent of the body surface area. As burn depth was difficult to assess on admission, a conservative form of treatment was performed including a daily bath containing chlorhexidine and silver sulphadiazine dressings. Contamination of the wounds was observed in 80 per cent of the larger than 20 per cent surface burns but only 18 cases (2.4 per cent) of the series needed administration of systemic antibiotics for repeated contamination. No lethal septicaemia was observed. Mean inpatient time ranged between 16 days for ungrafted patients to 69 days for over 20 per cent surface grafted patients. The lower iatrogenic risks (anaesthesia and donor site morbidity) seemed important enough to justify conservative treatment in children despite a slightly longer hospitalization time.

Administration, Topical↗
PubMed1985

Use of POR-8 in the management of burned children.

In the paediatric burn unit of Brugmann University Hospital, children are treated conservatively for three weeks before excision and grafting. In order to avoid excessive bleeding during tangential excision of the granulating tissue, sub-eschar infiltration with Para-Ornithin-8-Vasopressin (POR 8), a synthetic neurohypophyseal-like hormone, has been performed since 1979 on 145 children. Bleeding is reduced dramatically by this technique. Therefore, since 1984, infiltration of the donor site with POR 8 was also performed in 25 children. Excision and grafting of areas up to 20% of total body surface are possible in one operation with a graft take rate of 95 to 100%. We didn't record any variation in heart rate. A 5 to 10% increase of arterial blood pressure occurred in all children. No general or local complications have been observed. We believe this technique to be of great help in the operative treatment of burns in children.

Adolescent↗
PubMed1983

Experience with 33 epigastric rectus flaps in breast reconstruction.

The contralateral epigastric rectus flap (ERF) is a myocutaneous island flap, including epigastric skin, and the upper part of the rectus abdominis muscle with the superior epigastric artery. It measures at least 20 X 8 cm. In breast reconstruction, the ERF is transferred from the normal side to the mastectomized side on its vascular pedicle. The donor site is hidden in the submammary fold. The ERF has many advantages over the latissimus flap (larger amount of skin, skin comparable to breast skin, that can be taken without position change during surgery, no muscle dysfunction, no donor site in the back, upper abdominal lift with major addition of homolateral epigastric skin to the reconstruction), but is not so suitable in patients with thin or irradiated skin. Compared to the lower rectus flap, it is a less extensive procedure with no abdominal scar, but it brings less adipose tissue to the reconstructed breast.

Abdominal Muscles↗
PubMed1982

Primary lengthening of the columella in bilateral clefts of the lip.

Children with bilateral complete cleft lip and palate were treated by a two stage repair of the lip and nasal floor, including a small prolabial flap to lengthen the columella according to the technique of Skoog. Seventeen of these children, now at least 2 years of age were reviewed. In no case was normal length of the columella obtained, six children had obvious scars, in five the flap bulged at the base of the columella, and in four there was a displacement of the flap toward the lip. Three cases have already required a secondary forked flap. We concluded that the results of this procedure are inconsistent and od not justify the additional scarring.

Child↗
PubMedDate not supplied

Atypical cause of forearm skin ulceration in a leukaemic child: mucormycosis. A case report.

Primary cutaneous mucormycosis is an uncommon, deep and aggressive fungal infection occurring mainly in immunosuppressed or diabetic patients. Rapid diagnosis and therapy are necessary to prevent a fatal outcome. An eight-year-old leukaemic child presented with a dark necrotic ulcer on the volar-ulnar aspect of the left forehand. The lesion had developed over seven days, beginning as a vasculo-haemorrhagic erythematous plaque. There was no known history of trauma to the area, but skin necrosis from external compression caused by an intravenous line could not be completely ruled out. The lesion rapidly progressed to a 5 x 8 cm painful necrotic ulcer with an erythematous border. Treatment with ichthyol dressing and intra-venous antibiotherapy failed to improve the condition. Wide debridement was performed and specimens were sent for microbiology and pathology examinations. Microscopic examination demonstrated broad, irregularly walled, non-septate fungal hyphae that were consistent with Mucor. Amphotericin B was administrated intravenously (1 mg/kg/day) and hydrogel and hydrophile adhesive polyurethane foam dressings were applied. After 12 days, the soft tissue defect was covered with a split-thickness skin graft, harvested from the lateral aspect of the thigh. Diagnosis of this infection is based on complete histopathological and microbiological studies. Awareness, and a high index of suspicion are required because of the potential fulminant and fatal course.

Amphotericin B↗