[The anterior tibial muscle as a distal pedicled osteomuscular transposition flap].
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Biomedical subjects
Publications and source records attributed to C Papp.
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Composite intercostal muscle flaps were experimentally used to repair major intrathoracic tracheal defects in the mongrel dog. These composite flaps provided an adequate tracheal lumen with both sufficient mobility and structural stability. Stenosis of the reconstructed trachea was an uncommon finding, but the incidence of early postoperative mortality was high.
Intercostal muscle flaps were successfully used to repair 3 cm defects of the ventricular myocardium in the mongrel dog. Early and late healing of all flaps was uncomplicated and there were no late complications related to aneurysmal formation or electrical abnormalities of the heart. The existing blood supply of the heart was unaffected. The intercostal muscle is suggested as an alternative muscle flap for use in myocardial wall reconstruction.
The examination of the coverage of vascular defects with intercostal muscles showed during an observation period of 7 weeks the development of cartilage tissue with thick elastic fiber nettings running between the chondroma.
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Large defects of soft tissue and bone in the lower extremity are still a great surgical problem with regard to morbidity and preservation of the leg. Conventional operative procedures such as cross leg or pedical flap are frequently not sufficient to guarantee successful treatment. Local muscle flap, myocutaneous flap and free-tissue transfer with microvascular anastomoses are excellent surgical supplements for better and quicker treatment, as they can generally be performed in one operative step. Strict indication and a specially trained operating team are essential for successful treatment in these more risky procedures. The new techniques and applications are demonstrated on various cases.
From the first to the fourth year after replantation 12 patients were examined with a venous occlusion plethysmograph. The blood flow in the replanted digit was measured at 15 degrees C and 32 degrees C and compared with the blood flow of the corresponding healthy finger. The blood flow was found to increase during the first year and decrease thereafter. The possible causes for this change in the blood flow are discussed.
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In 58 patients with extensive deep dermal burns the consequences of intubation, tracheotomy and central venous catheter in respect to pneumonia and bacteriaemia were studied. The sputum of tracheotomized patients showed twice as many pathogenic bacteria as the sputum of patients with prolonged intubation. From 93 subclavian catheters under bacteriological control 16 (17%) showed pathogenic bacteria on the tip. An identity between the bacille found in the blood stream and on the catheter tip was only found in 21%. From this study it seems conclusively that prolonged intubation is generally preverable to tracheostomy in severely burned patients and that the venous catheter can not be the most frequent cause of bacteriaemia.
Results are reported of 107 patients, which had been operated upon from 1969-1975 at the Innsbruck University Department of Surgery, because of anorectal fistulas. The standard procedure was splitting of the fistula and ample excision of the walls of the fistula down to the skin. This procedure yielded satisfactory results in 74% of all cases. Fistulas penetrating the musculus levator ani were excised below this muscle respectively extracted, whereas the part of the fistula duct reaching above this muscle was left and scratched out cautiously.
We suggest to differentiate between the real spontaneous perforation of the gallbladder and the inflammatory rupture and contrast both with the traumatic form. In one case treated by us we suceeded in finding the cause of the perforation to be an antatomical deficiency. Sterile cholascos should be distinguished from severe bile peritonitis.
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Gastrostomy has the same field of application as the feeding tube which is introduced either orally or nasally. With careful nursing and surgical technique, only few and slight disturbances are to be expected. This method, however, ist not suited for routine application by the premature baby because of its possible septic complications.
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