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Biomedical subjects

C R Rayner

Publications and source records attributed to C R Rayner.

At least 19 recordsLinked to original sources
PubMed1992

Teaching plastic surgery to medical students.

A plastic surgery syllabus for third-year medical students is described. It is intended for a teaching programme in which plastic surgery is integrated into the surgical teaching on the same basis as the other surgical specialties. The syllabus was designed to concentrate on aspects of plastic surgery relevant to the needs of undergraduates. An audit of the teaching showed that the students were readily interested and considered the teaching to be relevant to their examinations and to their future as doctors. A survey of all plastic surgery centres in the British Isles showed that similar teaching was being undertaken in 11 centres out of 51.

Clinical Competence↗
PubMed1991

Survival assessment of cultured epidermal allografts applied onto partial-thickness burn wounds.

Cultured epidermal allografts (C.E.A.) were applied to 6 partial thickness burns. Biopsies were obtained at intervals between 8-100 days after grafting. In the second week clinical re-epithelialisation of the allografted sites was confirmed histologically. Blood group- and sex-mismatch studies showed that the allografted cells were not present between 8-100 days post-grafting, suggesting that the newly formed epithelium was of host origin.

Adult↗
PubMed1991

The differentiation and proliferation of newly formed epidermis on wounds treated with cultured epithelial allografts.

Fifteen patients, eight with burn or scald wounds and seven with split-thickness donor sites, were treated with cultured epithelial allografts. Skin was obtained from HIV-negative donors undergoing circumcision and sheets of epithelium were cultured using the 3T3 feeder method. Multiple post-operative biopsies were performed at various time intervals and stained with a panel of monoclonal antibodies against cytokeratins, involucrin, transferrin receptor and epidermal growth factor receptor. Fresh cultured epithelial sheets, normal skin, standard treated donor sites and burns treated with autografts were also studied. Cytokeratin-10 expression was not observed at treated sites until 4 weeks post-grafting, when normal suprabasal levels were observed. Cytokeratins 13 and 16, usually observed in highly proliferative states such as psoriasis, were observed in epithelial-treated sites for up to 6 months. Other proliferation markers such as Ki67 and transferrin receptor were only expressed 2-3 weeks post-operatively. Involucrin, a marker of keratinocyte terminal differentiation, was expressed throughout newly formed epidermis until 15 weeks, when the normal pattern of granular expression was observed. These results indicate that although the cultured 'allograft' does not survive, it may modulate the proliferation and differentiation of spontaneously regenerating epithelium.

Adult↗
PubMed1990

Extensor tendon repair: an animal model which allows immediate post-operative mobilisation.

In adult rabbits, an experimentally transected digital extensor tendon was repaired. The technique employed a tongue, created from the proximal tendon, folded over to bridge the transection and reattached distally. Animals were allowed immediate post-operative mobilisation. Tendon material, 14-120 days post-operatively, was examined ultrastructurally in control and experimental animals from four different zones within the repaired tendon. The operation was well tolerated and adhesion free. Associated with the repair, two types of collagen fibril populations were observed. Firstly, in areas where tendon tissue had been removed, there was a population of fibrils with a narrow range of diameters. Secondly, in areas where tendon tissue was subjected to an increased level of stress per unit cross-sectional area, a population of fibrils with a range of diameters similar to that of controls but with a marked increase in the percentage of small diameter fibrils. The relevance of these observations to human tendon repair is discussed.

Animals↗
PubMed1987

A new method of resurfacing the lip.

The whole lip can be resurfaced with sensate musculo-mucosal flaps taken from the cheeks. These flaps can be combined with major resection of the whole lip curtain. The return of sensation is of particular benefit to elderly patients who make up the greatest number of patients in the series.

Humans↗
PubMed1987

The treatment of deep dermal burns by abrasion.

Deep dermal burns usually heal by a combination of epithelialisation and granulation tissue formation, and may form hypertrophic scars. Sometimes, however, they heal spontaneously and early with no hypertrophy. Early tangential excision and grafting is practised by many surgeons for these burn wounds, but, because of the problems of diagnosis and therefore the risks of unnecessary surgery, we have practised a policy of abrasion of burn wounds unhealed at two weeks after injury. The wounds were over-grafted or not depending on the appearance of the remaining dermis. Healing was generally rapid. Long term results show good scar formation with few problems from scar hypertrophy or contracture.

Burns↗
PubMed1984

Oral mucosal flaps in midfacial reconstruction.

Experience in the use of oral mucosal flaps in 18 patients shows that their viability is good if drying is prevented and the blood supply enhanced either by muscle inclusion in the pedicle or by insertion into a vascular bed. A number of potential uses remain to be evaluated.

Face↗
PubMed1984

Lateral calcaneal artery island flaps.

A robust, arterially based, innervated island flap of thin skin has been successfully used in nine patients to repair defects around the ankle and heel. Based on the lateral calcaneal artery, the flap gives excellent, well-bedded cover in a short operation with insignificant donor site problems.

Aged↗
PubMed1984

Neonatal upper limb ischaemia. The case for conservative management.

General supportive measures, the ability to avoid infection, the natural tendency to improvement and the feasibility of major reconstructive procedures later suggest that neonatal limb ischaemia should be managed conservatively at first, despite an alarming appearance. The number of infants at risk, especially due to prematurity and effective resuscitation, is theoretically increasing.

Arm↗
PubMed1984

The technique of late dermabrasion for deep dermal burns. Implications for planning treatment.

Deep dermal burns can be induced to epithelialize rapidly, and, therefore, heal by abrasion at about day 14 after injury. Hypertrophic scarring does not occur after such healing. If necessary, meshed skin graft can be applied at operation. Reduced blood loss, safe graft-take, smaller donor areas and avoidance of unnecessary surgery are all advantages of the method and make it a feasible alternative to early tangential excision and grafting.

Burns↗
PubMed1983

A hypothesis of the healing of deep dermal burns and the significance for treatment.

Deep dermal burns heal by a combination of new connective tissue formation (granulation) and epithelialization. In deep dermal wounds, which are unhealed after 14 days of conservative treatment, epithelialization can be enhanced by abrasion either alone or combined with provision of a skin graft. Some 42 burn wounds in 25 patients treated by this method have healed quickly and with good results. This method represents a move away from the current trend of early tangential excision and grafting of burn wounds and raises the possibility of developing a regime with the advantages but not the disadvantages of early tangential excision and grafting.

Burns↗
PubMed1983

Breast implants.

Explore the source record for details and available documents.

Breast↗
PubMed1981

The results of node resection for clinically enlarged lymph nodes in malignant melanoma.

Patients with malignant melanoma who require a block dissection for clinically enlarged lymph nodes have a relatively good prognosis if only one node is involved histologically and the primary is on the lower limb. Sixty per cent of these patients with single nodes show a 10 year disease-free survival rate, compared with 9% for those with multiple node involvement. The local recurrence rate at the resection site of hyperplastic nodes was 26% but fell to 10% when only a single node was involved. The disease-free interval and the survival time are a useful measure of the effectiveness of node resection.

Axilla↗