Biomedical subjects

D P Orgill

Publications and source records attributed to D P Orgill.

42 records · Page 3Linked to original sources

PubMedDate not supplied

The use of free tissue transfer in burn reconstruction.

Patients that sustain extensive burns commonly present the reconstructive surgeon with problems caused by exposed tendons, scar contractures, and loss of digits. Frequently there is inadequate local tissue available to solve these reconstructive problems. To solve these complex postburn defects, we have used free tissue transfer in addition to more traditional therapy. From 1987 thru 1994, we have used free tissue transfer as an adjunct to our reconstructive armamentarium in 35 patients who have undergone a total of 45 free tissue transfers for the correction of postburn deformities. There have been two failures (96% flap survival). There were 27 males and 9 females. Twelve free flaps were performed during the initial hospitalization, and 33 were performed during subsequent hospitalizations. Sites of reconstruction included the hand (n = 17), neck (n = 12), face (n = 8), leg (n = 4), penis (n = 2), arm and axilla, 1 each. Flap origin included anterolateral thigh (n = 16), parascapular (n = 10), digital transfer (n = 4), rectus abdominus (n = 3), radial forearm (n = 3), groin, fibula, and foot, two each. Nine flaps underwent prefabrication or prelamination before transfer. In summary, free tissue transfer is a valuable tool in burn reconstruction and it can be used safely and effectively with minimal morbidity to the patient.

Adult↗

PubMedDate not supplied

A finite-element model predicts thermal damage in cutaneous contact burns.

Thermal injury results from exposure of skin elements to an externally applied heat source. Finite-element analysis of heat transfer in cutaneous burns allows for an accurate prediction of tissue time-temperature relationships throughout the exposed tissue. A two-dimensional, axisymmetric, finite-element model of a contact burn was constructed, and damage integrals were calculated by applying the Arrhenius equation to the time-temperature profiles at each point. The epidermis, dermis, and subcutaneous fat were modeled as uniform elements with distinct thermal properties. Heated aluminum blocks were applied to Yorkshire pigs for 10 to 80 seconds to produce contact burns. Wound biopsies taken at 1, 24, and 48 hours were examined histologically and measured for the depth of burn. A significant deepening of the gelatinized tissue was observed in tissue taken from 1 hour to 24 hours. The finite-element prediction of cutaneous contact burn damage correlated well with histologic observations in this porcine model.

Animals↗

PubMedDate not supplied

Sprayed keratinocyte suspensions accelerate epidermal coverage in a porcine microwound model.

Keratinocyte suspensions can potentially treat a variety of epidermal defects, but the mechanism of action has not been fully determined. We developed a porcine model to study the effect of sprayed cell suspensions delivered on small wounds within a meshed autograft. Paired full-thickness surgically excised wounds were covered with a fully expanded 3:1 meshed split-thickness autograft. A keratinocyte cell suspension was sprayed onto half of the wounds at a seeding density of 2.8 x 10(3) cells/cm2; the remaining wounds were sprayed with cell culture medium alone. Histologic analysis at days 5 and 8 showed an increase in average epidermal thickness, confluence, keratin cysts, and blood vessels in the keratinocyte cell suspension group compared with the cell culture medium control group. Wounds sprayed with the cell suspension showed faster and better quality of epithelialization than wounds sprayed with cell culture medium alone.

Animals↗

PubMedDate not supplied

Melanocyte repopulation in full-thickness wounds using a cell spray apparatus.

Melanocyte restoration is critical in reconstituting skin color. We developed a spotted (piebald) pig wound model to study methods of restoring melanocytes to the epidermis. Paired, full-thickness, porcine wounds were covered with nonpigmented, fully expanded, 3:1 meshed, split-thickness skin grafts and were sprayed with an epidermal cell suspension. The suspensions were highly pigmented skin (HPS) cell isolates for half of the wounds (n = 16) and nonpigmented skin (NPS) cell isolates for the remaining wounds (n = 16). Histologic sections showed 6.0 +/- 3.0 and 15 +/- 4.0 pigmented melanocytes per high-power field on days 8 and 20 in HPS-treated wounds and no pigmented melanocytes in NPS-treated wounds. Melanin pigment was dispersed in all layers of the epithelium for the HPS group on day 20 compared with a lack of melanin pigment observed in the NPS group. Cell spraying may provide a clinical method to restore color to skin; further work is needed to control the expression of melanin.

Administration, Cutaneous↗

PubMedDate not supplied

A review of computer-aided body surface area determination: SAGE II and EPRI's 3D Burn Vision.

Estimates of percent body surface area (%BSA) burns correlate well with fluid needs, nutritional requirements, and prognosis. Most burn centers rely on the Lund Browder chart and "rule of nines," to calculate the %BSA. Computer-based methods may improve precision and data analysis. We studied two new methods of determining %BSA: a two-dimensional Web-based program (Sage II) and a three-dimensional computer-aided design program (EPRI 3D Burn Vision). Members of our burn team found the Sage II program easy to use and found many of the features useful for patient care. The EPRI program has the advantage of 3D images and different body morphologies but required training to use. Computer-aided methods offer the potential for improved precision and data analysis of %BSA measurements.

Adult↗

PubMedDate not supplied

The development of an educational web site for burn care: burnsurgery.org.

Advances in burn care are well documented in the literature but often do not reach health care professionals who treat burn patients. The World Wide Web provides instant access to a wide variety of information globally. We describe the development of www.burnsurgery.org, a nonprofit Web site dedicated to the education of burn care professionals. Internet-based medical education is becoming a dominant method of information transfer and we believe that it will help to standardize and improve burn care throughout the world.

Burns↗