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Biomedical subjects

A G Perks

Publications and source records attributed to A G Perks.

12 recordsLinked to original sources
PubMed2001

Airway fire during tracheostomy: prevention strategies for surgeons and anaesthetists.

Airway fires are an uncommon but real and devastating complication of tracheostomy. One such fire in a 31-year-old man is described. Surgical fires are discussed, and 15 reported cases of tracheostomy fire are reviewed. A tracheostomy protocol, adopted by our department and designed to avoid this life-threatening complication, is described. Surgeons and anaesthetists involved in tracheostomy must understand the fire hazard and how to avoid it.

Adult↗
PubMed2000

In search of evidence-based plastic surgery: the problems faced by the specialty.

Recently, there has been significant interest both from government and medical practitioners in the discipline of evidence-based medicine. In this article we discuss the problems faced by the plastic surgeon when trying to ensure that practice is evidence-based and highlight some of the reasons behind these difficulties. With the rapid growth of the Internet we also outline its use to access high quality information for the plastic surgeon.

Benchmarking↗
PubMed1997

Solitary median maxillary central incisor, short stature, choanal atresia/midnasal stenosis (SMMCI) syndrome.

This article describes a series of 21 consecutive cases, each involving a solitary median maxillary central incisor; the patients were seen in the Department of Dentistry or the Victorian Clinical Genetics Unit, Murdoch Institute, at the Royal Children's Hospital, Melbourne, from 1966 to 1997. The spectrum of anomalies and associated features present in these cases--solitary median maxillary central incisor, choanal atresia, and holoprosencephaly--is described, and the literature related to the features, including genetic studies in these conditions, is reviewed. We relate our findings in these cases to current knowledge of developmental embryology. It is hoped that the findings, together with our interpretation of them, will help to clarify understanding of solitary median maxillary central incisor syndrome. This syndrome was previously considered a simple midline defect of the dental lamina, but it is now recognized as a possible predictor of holoprosencephalies of varying degrees in the proband, in members of the proband's family, and in the family's descendants.

Body Height↗
PubMed1996

Ferguson-Smith syndrome: the importance of long term follow-up.

A case is presented which highlights the importance of long term follow-up and early intervention in this unusual dermatosis. A 39-year-old man presented with an extensive tumour of his left ear and scalp. Surgery was not feasible. The progressive nature of the lesion eventually killed the patient.

Adult↗
PubMed1995

Severe upper limb injuries in four passengers of a 'People Carrier'; the contribution of design faults.

Four passengers of a 'People Carrier' in a single vehicle motor accident sustained severe left upper limb trauma, when the vehicle rolled onto the near side. These injuries were directly attributable to the large glass interface between patient and road. The glass windows shattered on contact, providing no protection and in effect created a secondary injury mechanism. We advocate both the use of laminated side windows and mandatory testing of 'roll-over' characteristics for these 'People Carriers' to reduce the incidence of such injuries.

Accidents, Traffic↗
PubMed1994

Facilitation of peripheral intravenous access: an evaluation of two methods to augment venous filling.

STUDY OBJECTIVE: To evaluate two methods of augmenting venous filling as potential aids to i.v. cannulation. DESIGN: Comparative study of cross-sectional areas of preselected antecubital fossa veins. SETTING: Vascular laboratory of a British university teaching hospital. PARTICIPANTS: Thirty healthy, normotensive, adult volunteers. INTERVENTIONS: Vessel cross-sectional areas measured noninvasively using a color flow duplex ultrasound scanner. Measurements were taken at rest, after application of a venous tourniquet, with tourniquet and Esmarch bandage, and with tourniquet and Rhys-Davies exsanguinator. RESULTS: Mean (+/- SD) cross-sectional area at rest was 0.18 +/- 0.094 cm2 and after tourniquet was 0.28 +/- 0.14 cm2. Application of an Esmarch bandage produced an increase to 0.33 +/- 0.14 cm2, and Rhys-Davies exsanguinator produced an increase to 0.32 +/- 0.15 cm2 (P < .0001 for all comparisons except Rhys-Davies exsanguinator versus Esmarch bandage). CONCLUSION: Application of either the Esmarch bandage or the Rhys-Davies exsanguinator caused significant filling of antecubital fossa veins in excess of that produced by a venous tourniquet alone in normovolemic, normotensive volunteers.

Adult↗
PubMed1993

A cheap and efficacious intraoperative tissue expander.

The application of a mass produced antral balloon catheter for intraoperative tissue expansion in the head and neck is described. This balloon catheter has the advantage of being cheap and readily available.

Catheterization↗
PubMed1991

Finger injuries to children involving exercise bicycles.

OBJECTIVE: A previously unreported source of injuries to children, the exercise bicycle, is identified and the associated injuries and their treatment are described. DESIGN: A retrospective review of clinical records and the records of the Victorian Injury Surveillance System. SETTING: The Plastic Surgery Unit of the Royal Children's Hospital, Parkville, Victoria. PATIENTS: Seventeen children with finger injuries from exercise bicycles presented to the Emergency Department of the hospital and one presented to one of us (K L M) at his private practice. Sixteen of the 18 children were under five years of age; 10 were less than two years of age. Five times as many boys as girls were injured. INTERVENTIONS: Fourteen children required surgical treatment of their injuries. RESULTS: Four children had superficial injuries not in need of surgical repair. Eleven children had single digit injuries--five had injuries that were repaired by suture; five had complete avulsion of the tip of the digit that required flap graft repair; and one child underwent amputation of the index finger. Three boys had multiple digit injuries, each one requiring the amputation of a digit and repair of other digits. Two of these boys underwent replantation of a digit; only one replantation was successful. CONCLUSIONS: The most dangerous parts of the exercise bike were the wheel, the chain and the sprocketwheel. Design modifications and education of parents about the risks for children playing near exercise bikes are warranted.

Accidents, Home↗
PubMed1990

Tissue expansion in the lower limbs of children and young adults.

We report the successful use of tissue expansion in the lower limbs of five children and one young adult. It was possible to replace dense adherent skin grafts by expanded skin and subcutaneous tissue. Such expansion needs to be undertaken slowly, but expanded tissue matches the normal local tissue and has normal sensation. These qualities were particularly important in three amputations which were revised.

Adolescent↗