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Biomedical subjects

C V Bowen

Publications and source records attributed to C V Bowen.

At least 37 records · Page 2Linked to original sources
PubMed1994

Donor site deficit of the osteocutaneous radial forearm flap.

A functional evaluation was made of osteocutaneous radial forearm flap donor upper extremities at a mean 19.4 months postoperatively. Donor deficits were evaluated as follows: (1) skin: subjective appearance and durability; (2) skeleton: range of motion of adjacent joints; (3) vessels: cold intolerance, digital temperature, digital--brachial index; (4) muscle: key pinch; (5) nerve: two-point discrimination of dorsal first web space. Ten consecutive patients with a mean donor site area of 51.5 cm2 and mean length of harvested radius of 10.9 cm were studied. Incomplete skin graft take at the donor site (7 of 10 patients) and appearance of fair or poor (6 of 10 patients) were frequent cutaneous complications. Wrist range of motion was decreased with pronation (90%), flexion (90%), and extension (89%). Mean digital temperature, comparing extremities that did (operated) and did not (nonoperated) undergo surgery, or comparing the radial artery-supplied fingers to the ulnar artery-supplied fingers within the same operated hand showed no effect from the lost radial artery. Mean digital-brachial index was 1.24 for the nonoperated and 1.15 for the operated extremity. Key pinch on the operated side was a mean of 74% of the nonoperated side. Although raising the flap creates multiple tissue deficits, each with the potential to alter upper extremity function, detailed functional evaluation failed to demonstrate significant alteration in upper extremity function after flap harvest.

Forearm↗
PubMed1994

Pregnancy-induced carpal tunnel syndrome requiring surgical release longer than 2 years after delivery.

OBJECTIVE: To determine the percentage of patients in whom carpal tunnel syndrome was induced by pregnancy, the presence of any risk factors causing persistent symptoms after delivery, and the outcome of surgical decompression in these patients. METHODS: We reviewed retrospectively the records of 100 consecutive women treated by carpal tunnel release in our unit from 1988-1991. RESULTS: Seven patients had the onset of hand symptoms during pregnancy. One patient was diabetic and worked as a machine operator, but none of the others had predisposing factors that could have led to persistent postpartum symptoms. The hand symptoms persisting after delivery initially required conservative treatment only. However, 2-16 years later, symptoms became severe enough to warrant surgical release of the carpal tunnel. All patients had resolution of symptoms after surgery. CONCLUSION: Some patients with mild residual hand symptoms due to carpal tunnel syndrome may initially respond to conservative treatment, but 2-16 years later, symptoms may become severe enough to warrant surgical release. We recommend long-term follow-up of patients with residual postpartum hand symptoms.

Adult↗
PubMed1994

Extremity arteriovenous malformations: review of a series.

OBJECTIVE: To examine the diagnosis and treatment of arteriovenous malformations in adults, because of the tendency of the condition to recur. DESIGN: Chart and literature review. SETTING: Three tertiary-care hospitals. PATIENTS: Twelve adults with diffuse arteriovenous malformations of the extremities. INTERVENTIONS: Surgery of embolotherapy. MAIN OUTCOME MEASURE: Recurrence. RESULTS: Of the 12 cases reviewed, the arteriovenous malformations recurred in 8 patients; 2 of these were well, 6 months and 2 years after a second or third treatment. Two others were well, 2 months and 5 years after surgery or embolotherapy. One pregnant woman, whose case is described in detail, received no treatment, and her arteriovenous malformation diminished in size after her child was born. The outcome in the last patient is unknown. CONCLUSION: Diffuse arteriovenous malformations recur after ablative treatment.

Adolescent↗
PubMed1992

Skeletal fixation in the rabbit knee transplantation model.

The immature rabbit knee model for epiphyseal plate transplantations has been used by a number of investigators. Rigid fixation of the femoral osteosynthesis has been difficult to achieve reliably. This paper describes a new technique for obtaining consistent and satisfactory skeletal fixation in this model. The tibia was internally fixed with an ASIF/AO four-hole minifragment plate. The femur was fixed with a 2.4 mm Steinman pin supplemented with two 26 gauge stainless steel interosseous wire loops placed at right angles to each other.

Animals↗
PubMed1992

Microsurgical free flap transfer in sickle cell disease.

A patient with sickle cell anemia and recurrent ankle ulceration is presented. Multiple previous skin grafts did not resolve the painful ulcers. A radial forearm free flap was attempted. Despite preoperative transfusions to reduce her hemoglobin S levels, postoperative thrombosis occurred. The true risk of free flap failure in sickle cell anemia is unknown and there is still debate about the exact nature of the hypercoagulable state that exists in this disease. We recommend, however, that consideration is given to the use of prophylactic anticoagulation in patients undergoing complex procedures or in whom other risk factors have been identified.

Adult↗
PubMed1991

Experimental and clinical free cutaneous transfers in the dog.

Various reconstructive techniques have been applied to the management of difficult wounds in the dog. Wounds in the distal extremities and on the face are hard to manage by conventional methods. A free cutaneous flap, based on the superficial cervical vessels, was developed and used in a series of experimental and clinical cases. Six of eight experimental orthotopic transfers survived. The two failures were thought to be related to technical error. The seven flaps, used in clinical cases, all survived and successfully resolved the dogs' clinical problems.

Animals↗
PubMed1991

Free tissue transfer of digital food pads for reconstruction of the distal limb in the dog.

Reconstructive procedures used in salvaging distal limb injuries in the dog are reviewed. Techniques employed to resurface the distal weight-bearing surface include local reconstruction using pedicle flap transposition of foot pads. The development of a previously described free microneurovascular digital foot pad flap is reviewed; the experimental results and potential for clinical use of the free flap are discussed.

Animals↗
PubMed1991

Axial pattern skin flaps in cats.

The major direct cutaneous vessels identified in the cat include the omocervical, thoracodorsal, deep circumflex iliac, and caudal superficial epigastric arteries. Axial pattern skin flaps based on the thoracodorsal and caudal superficial epigastric arteries have been developed in cats. Rotation of these flaps as islands allows skin coverage to the carpus and metatarsus, respectively. The thoracodorsal and caudal superficial epigastric flaps provide a practical, one-step option in the reconstruction of large skin defects involving the distal extremities of cats.

Animals↗
PubMed1991

Experimental cutaneous free flap transfers in the horse.

Equine limb wounds often heal slowly by epithelialization, and large scars are a frequent end result. In some ways, they resemble the wound associated with human tibial injuries. The literature indicates that previous investigators have failed to transfer free skin flaps successfully in the horse. In this paper, we review our experimental work with the deep circumflex iliac flap in the horse. Dissections of 20 cadavers confirmed the anatomical consistency of the flap. Four flaps survived well when elevated as island flaps, but five orthotopic and nine heterotopic free flap transfers all failed. The cause of failure is still unknown, but our experiments suggested that the horse must be highly susceptible to ischemic reperfusion injury.

Animals↗
PubMed1991

Microsurgical free bone transfer in the dog.

Bone grafts have been used extensively for the reconstruction of skeletal injury in dogs. Cancellous and corticocancellous chip autografts are used for their osteoinductive and osteoconductive properties. Fresh, fresh-frozen, freeze-dried, and ethylene oxide-sterilized cortical allografts have been recommended for the reconstruction of segmental cortical defects. Donor sites for microsurgical bone transfer have been identified experimentally in the dog, but these remain to be used clinically. This paper reviews the anatomy and structural characteristics of donor sites for microsurgical bone transfer. Potential clinical indications for microsurgical bone transfer in the dog are described.

Animals↗
PubMed1991

Rotating shaft avulsion amputations of the thumb.

In a three-year period twenty-nine patients were treated for rotating shaft avulsion amputations of the thumb. Twenty-three thumbs were considered suitable for replantation. A staged approach, consisting of primary replantation and secondary nerve grafting and tendon reconstruction, was used because of concern that survival rates would be low. Survival was achieved in nineteen of twenty-three replantations. At mean follow-up of 20.5 months grip strength was 94.6% of the unaffected side and key pinch was 77.1%. Five patients achieved a two-point discrimination less than five millimeters. Success was better anticipated and now a full reconstruction is carried out in a single-stage procedure.

Accidents, Occupational↗
PubMed1990

Identification of a free skin flap from the region vascularized by the deep circumflex iliac artery of horses.

Areas of skin vascularized by large axial vessels potentially suitable for microvascular anastomosis were investigated in 10 horse cadavers. Eleven such areas were dissected, and the skin over the flank region vascularized by the deep circumflex iliac artery was most suitable. The anatomy of this area was further defined, using angiography and latex injection studies on 10 cadavers.

Animals↗
PubMed1988

Attritional flexor tendon ruptures by an old lunate dislocation.

A 76-year-old man sustained attritional disruption of the extrinsic flexor tendons to the ulnar two fingers over 40 years after an untreated palmar lunate dislocation. Spontaneous flexor tendon rupture is rare without wrist joint pathology, even in the absence of chronic pain or median nerve compression.

Aged↗
PubMed1988

Experimental microvascular growth plate transfers. Part I--Investigation of vascularity.

A model was developed in the dog to allow both the metaphysis and epiphysis of the distal ulnar growth plate to be microsurgically revascularised from the pedicle of the anterior interosseous vessels. With both circulations revascularised, grafts retained their structural integrity and growth continued at rates only slightly less than normal (mean 85%). If either or both circulations were not revascularised, growth rates were lower and were associated with skeletal collapse in the ischaemic bone segment.

Animals↗
PubMed1988

Experimental microvascular growth plate transfers. Part 2--Investigation of feasibility.

We investigated the feasibility in the dog of using transfers of the distal ulna into the radius either as growth plate replacements or as accessory growth plates in the diaphysis. Preliminary work determined the most satisfactory method of skeletal fixation. The experimental study showed that transfers used as growth plate replacements grew at almost normal rates, uniting with the recipient bone in a mean of 7.1 weeks. Transfers into the diaphysis initially nearly doubled the growth rate of the radius, although in the long-term results were unsatisfactory, because of fracture of the graft after a mean period of 8.2 weeks.

Animals↗