Biomedical subjects
Publications and source records attributed to B V Stromberg.
Review of 68 consecutive patients seen between 1966 and 1976 with low-velocity gunshot wounds of the neck is reported. Treatment and results are compared. Comparison of preoperative evaluation and operative findings shows that the initial evaluation may miss serious injuries. Associated severe injuries are common. Morbidity following exploration is low. Exploration of all low-velocity gunshot wounds to the neck is recommended.
Two cases of cystosarcoma phylloides in the adolescent female are presented and the literature reviewed. This lesion is usually benign. Even when malignant, simple excision has been curative in 2 or 3 cases. Therapy recommended is local excision with a small margin of normal tissue.
Of 41 consecutive patients with low-velocity gunshot wounds to the hand, 28 were treated by superficial debridement of wound edges and 13 were treated by meticulous debridement and exploration under operating room conditions. All patients received antibiotics. All wounds were closed primarily. Some had small drains for 24 to 48 hours. There were no complications of exploration. Of the 28 patients whose wounds were not explored, 16 had complications or residual deficits that required exploration. Hospital stay of the two groups was similar. Surgical exploration of low-velocity gunshot wounds to the hand is recommended.
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A 30-year experience with 31 cases of squamous cell carcinoma arising in scars is reviewed. Mean age of the patients was 58 years. Average time from injury to diagnosis was 23 years. The male to female ratio was 4:1. Tumors were well differentiated in 23 cases and poorly differentiated in eight cases. Three-year survival rate was 94% for patients with well-differentiated lesions, but only 38% for those with poorly differentiated ones which were more likely to metastasize. Implications of these findings are discussed in relation to therapy.
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To determine ideal treatment, 58 patients with cystic hygroma of the neck were studied. Approximately equal distribution of the lesion among sexes and sides of the neck was noted, but frequency was less than expected among blacks. Complete excision, the treatment of choice, gave an 81% cure rate. Partial excision was curative in only 12% of cases, but it decreased the tumor mass enough to eliminate the need for further treatment in 62% of cases. Aspiration of the cysts may be of value in diagnosis and management of acute respiratory problems but not for definitive therapy. Sclerosing agents and radiation therapy was not effective treatment of cystic hygromas. Of the clinical recurrences, 76% occurred within a year after therapy.
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To study new collagen formation in the healing of anastomoses in the right colon, five male Sprague-Dawley rats had single-layer colonic anastomosis performed. Five additional rats had suture of the colon with interrupted sutures without transection of the colon. Ten animals served as controls. One week after surgery, animals were given 3H-proline repeatedly to label new collagen formation during the second and third weeks. Animals were sacrificed three weeks after suturing or anastomosis. Two- or 10-mm segments were precisely excised on either side of the suturing or anastomoses. Total collagen and its total radioactivity were measured per segment. Collagen hydroxyproline and its radioactivity increased (100 per cent) only within 1 cm of the anastomosis or suture alone. No local or distant decrease in collagen was observed. Collagen formation in colonic wounds appears to be a local process.
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