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Biomedical subjects

B M O'Brien

Publications and source records attributed to B M O'Brien.

At least 127 records · Page 7Linked to original sources
PubMed1982

Free microneurovascular muscle transfer in limbs to provide motor power.

The experience gained in a series of 7 free microneurovascular muscle transfers to the limbs over a seven-year period has led us to conclude that: free gracilis microneurovascular flaps can be safely transferred and can aid restoration of movement following severe injuries of the limbs, including post-replantation cases; inclusion of a cutaneous island with the muscle is safe, improves cover, and simplifies closure following muscle transfer; tendon adhesions and joint stiffness are the greatest obstacles to transferred muscle function, and early passive extension is recommended; additional procedures are usually required after muscle transfer, to improve the level of function; and additional experimental work is required to determine methods of establishing the correct resting tension in transferred muscles.

Adolescent↗
PubMed1982

Digital reconstruction in the mutilated hand.

Salvage and reconstruction of the mutilated degloved hand or digit pose a problem because of the deficiency of local innervated pulp tissue. Free neurovascular flaps from the first web space of the foot supply a large area of well-padded innervated glabrous skin to resurface such defects. In thumb reconstruction free flaps, which may include the toenail, have many advantages over the conventional ring-finger island flap. Finger and whole-toe transfers are innervated reconstruction par excellence and these, in combination with innervated free flaps, offer a large armamentarium for reconstruction. The quality of sensation, however, is poorer than normal in these transfers and they are therefore limited to circumstances in which their use is not substituted by adjacent normal units.

Finger Injuries↗
PubMed1982

An experimental study of the sleeve technique in microarterial anastomoses.

The patency rate of the technique of sleeve anastomosis was assessed in a series of femoral arterial repairs in the rabbit. It was found that the patency rate was significantly less than that achieved by the conventional end-to-end anastomosis. The minor advantage of speed of execution of the repair and the suppressed advantage of less luminal surface disruption and intraluminal suture exposure did not outweigh the overall lower patency rate as ascertained by direct exploration at varying times. These findings suggest that this type of sleeve anastomosis may not be of benefit in clinical situations.

Animals↗
PubMed1982

The versatile latissimus dorsi myocutaneous flap in breast and other reconstruction.

In this series of 35 clinical cases, the versatility of the latissimus dorsal flap is demonstrated. Whilst its width is limited to approximately 10 cm to gain primary closure, its length extends from the axilla almost to the iliac crest. If a larger area of soft tissue cover is required, muscle only may be used covered with a split skin graft. Its safe rapid dissection, reliable blood supply and wide arc of rotation makes it suitable for many of the reconstructive needs in the trunk, head and neck. Its large vascular pedicle makes it particularly suitable for free flap transfer. The commonest indication for use of the flap has been reconstruction of the breast following radical surgery. The secondary morbidity at the donor site is negligible.

Adolescent↗
PubMed1981

Effect of lymphangiography on lymphedema.

Lymphangiography, using oily radiopaque Lipiodol Ultra Fluid has been shown to increase lymphedema in one-third of the patients with obstructive lymphedema and to cause lymphatic obliteration (demonstrated histologically). No effective element has been observed, although subclinical infection could not be ruled out. Allergy is another possible contributor, but the evidence from this series suggests that Lipiodol may act as a direct irritant when it is not rapidly cleared, as in the case of obstructive lymphedema, and proceed to obliteration of the residual lymphatics. On the basis of these findings, elective routine preoperative lymphangiography for lymphedema is considered strongly inadvisable.

Female↗
PubMed1981

[Free microvascular epiphyseal transplantation: experimental study on the dog].

13 mongrel puppies underwent at the age of 3-5 months epiphyseal transplantations of the distal part of the ulna. Some of these transplantants were immediately revascularized by microsurgical anastomosis, others were left without anastomosis. Growth was followed by X-rays over a period of 6 months. Non-revascularized transplants showed minimal growth and were partially absorbed whereas revascularized transplants showed continuing growth, achieving 2/3 of normal growth of the control legs.

Animals↗
PubMed1980

Free microvascular epiphyseal transplantation: an experimental study in dogs.

Orthopic and heterotopic microvascular epiphyseal transplants based on periosteal blood supply were performed in 2 experiments. Heterotopic transplants averaged 69 per cent of growth of non-operated control bones. Orthopic transplants achieved a better result but the number of dogs available for evaluation was too small to be conclusive. The question is raised whether additional blood supply to the epiphyseal side of the transplant could improve the results.

Animals↗
PubMed1980

Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy.

Cross-facial nerve grafts followed in 4 to 12 months by microneurovascular free gracilis transplantation can produce adequate reconstruction in the lower two-thirds of a paralysed face. The mixed sensory and motor deep peroneal nerve and the small muscle bulk of the extensor digitorum brevis limit its usefulness in facial palsy. The gracilis has proved to be a much superior muscle. A feasible method for total reamination of unilateral facial palsy is presented.

Adolescent↗
PubMed1980

Perichondrial microvascular free transfer: an experimental study in rabbits.

Vascularised and non-vascularised perichondrial grafts from the rabbit's ears were transplanted to the lower abdominal wall and their cartilage formation compared. Similar results were found in both groups. Presence of blood and spontaneous revascularisation of non-vascularised grafts as well as self limitation of cartilage formation in immediately revascularised grafts seem to be the reason for these results.

Animals↗
PubMed1980

The effects of cooling on experimental free flap survival.

Cooling to 6-7 degrees significantly increases ischaemic tissue survival to 48 and, probably, 72 hours. Inflammatory changes develop in direct proportion to the duration of the cold ischaemia time. The skin and vessels within the flap appear to be minimally affected by cold ischaemia while fat and muscle demonstrate significant necrosis, inflammation and ultimate fibrosis. Very little, if any, muscle survives the ischaemic insult studied in this model.

Animals↗
PubMed1980

Segmental microvenous graft to artery.

One hundred and five microvenous grafts were carried out during three periods of time. Forty-five were performed in 1971, 25 were performed in 1975 and 35 were performed in 1979. The rabbits weighed 2 to 2.5 kg and a standard technique was followed by inserting a 1 cm vein graft after creating a defect of 0.5 cm in the femoral artery, taking the graft from the femoral vein on the same side. Exploration was carried out from 1 to 21 weeks at weekly intervals. The patency rate in Series I (1971) was 71 per cent, whereas the patency rate in Series II (1975) was 96 per cent and in Series III (1979) was 100 per cent. The scanning electron microscope showed that in the short term there was no narrowing of the lumen, nor any microaneurysm formation as reported previously by Buchler and Buncke (1979).

Animals↗
PubMed1980

Results of the use of autotransplantation of the intraabdominal testis using microsurgical vascular anastomosis.

This study indicates that where facilities are available, the use of autotransplantation of the intraabdominal testis with microsurgical anastomosis to vessels of the groin is an acceptable, and possibly the best, alternative to orchidectomy for the intraabdominal testis. It is certainly justifiable in the case of the bilateral intraabdominal testis but in the case of the unilateral intraabdominal testis with a normally descended and apparently normal testis in the opposite hemiscrotum, the incresed incidence of neoplasia in intraabdominal testes should be taken into account in the decision on the method of treatment.

Adolescent↗
PubMed1980

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.

Thumb reconstruction requires accurate functional and esthetic approximation to the original. Accepted methods generally have some deficiencies, particularly in appearance, and frequently the secondary morbidity is unacceptable. A method of thumb reconstruction with the use of an iliac crest bone graft and a free neurovascular "wrap-around" flap from the big toe is described that combines the attributes of previous methods without their secondary morbidity.

Adult↗