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Biomedical subjects

D T Gault

Publications and source records attributed to D T Gault.

At least 19 recordsLinked to original sources
PubMed1992

Intracranial pressure and intracranial volume in children with craniosynostosis.

Intracranial volume and intracranial pressure have been measured in 66 children with craniosynostosis, 48 boys and 18 girls. The premature fusion of skull sutures is assumed to restrict skull growth and predispose to elevated intracranial pressure. Thirteen children (20 percent) had raised intracranial pressure and demonstrated a significant restriction of skull growth. In this series, volume measurement alone, however, did not serve as a reliable predictor that the intracranial pressure was raised.

Adolescent↗
PubMed1991

Pain and forehead expansion.

Tissue expansion of the forehead by intermittent bolus injection in three patients was noted to be extremely painful. This stimulated a prospective study in four patients whose discomfort was found to be related to a sharp rise in intraluminal pressure after bolus inflation. Tolerable infusion volumes were small (mean 6.25 cc) and associated with high pain scores (mean 7/10). Adequate expansion was protracted (mean 45 1/2 days) and was limited by pain. To eliminate the sharp rises in pressure associated with expansion by bolus injection, a syringe pump was used in two further inpatients. Adequate expansion was both quicker (mean 8.5 days) and less painful (mean pain score 2.6/10).

Aged↗
PubMed1990

Perineal, vulval and vaginoperineal reconstruction using the rectus abdominis myocutaneous flap.

Poor perineal healing is a major complication of total or partial pelvic exenteration especially when the pelvis and perineum have previously been irradiated. Perineal, vulval or vaginoperineal reconstruction was performed in five women using the inferiorly based rectus abdominis myocutaneous flap. Primary perineal wound healing occurred in all patients and no flap-related complications developed. Primary healing of abdominal wall wounds occurred in all patients without incisional hernia. Three of the patients had an anterior or total pelvic exenteration with continent urinary diversion by the Mitrofanoff technique. Two of the patients had complete vaginal reconstruction and one patient had after-loading catheters inserted for postoperative interstitial irradiation. The patients were in hospital for 42, 28, 21, 17 and 15 days respectively. The longest stays were associated with training for self-catheterization of the continent urinary diversion. Median follow-up was 9 months. One patient developed two perineal recurrences at 16 months which were resected, and she remains disease-free 6 months later.

Abdominal Muscles↗
PubMed1990

Infected sternotomy wounds.

Three babies who developed infection in their median sternotomy wounds are reported. In one child, a retrosternal abscess was drained and in the other two cases, the wounds dehisced. The wound cavities were filled with a rectus abdominis myocutaneous island flap and in each case, the wounds healed primarily. Early flap repair resolved the infection, shortened the hospital stay and provided protection to the exposed mediastinum.

Abdominal Muscles↗
PubMed1990

Intracranial volume in children with craniosynostosis.

The intracranial volume of 104 children with craniosynostosis was measured. Premature fusion of skull sutures is thought to deny the growing brain room to expand, but contrary to traditional teaching the intracranial volume of such children is often within normal limits.

Cephalometry↗
PubMed1989

Glove perforation during plastic surgery.

Intraoperative perforation of surgical gloves is common. Nine hundred and forty surgical gloves were tested after 100 consecutive plastic surgical operations, each involving a surgeon, a variable number of assistants and a scrub nurse. In the first 52 operations, single gloves were used and 21.5% of the staff were found to have a perforated glove. In the second 48 operations, double gloves were used by all members of the surgical team and the number with perforations (of both inner and outer gloves) was reduced to 9%. Most perforations occurred on the dorsum of the hand and fingers and on the thumb tip, especially in the non-dominant hand. The risk of acquiring AIDS due to glove perforation is low but the consequences of such an event could be lethal.

Acquired Immunodeficiency Syndrome↗
PubMed1988

The role of cross-finger flaps in the primary management of untidy flexor tendon injuries.

This is a report of five patients who sustained untidy division of flexor tendons in zones 1 and 2, associated with overlying soft tissue loss. Contrary to traditional teaching, the tendon injuries were repaired primarily, and the tissue loss was made good with a cross-finger flap. At final evaluation, three cases were assigned excellent grades and two cases fair grades by Kleinert criteria. This unexpectedly favourable outcome may be due to a quality of the inner surface of the cross-finger flap and/or to staggering of the skin and tendon suture lines.

Adolescent↗
PubMed1988

A prosthesis to camouflage indented scars.

Traditional silicone prostheses have been found to be inflexible, heavy, and of poor color match when used on the limbs. Ten patients distressed by contour deformities on their limbs after the wide excision of malignancies or following trauma were fitted with a light-weight prosthesis whose special features include a flexible foam backing, an outer tinted skin, and finely feathered edges that draw the eye away from the margins of the defect. The prosthesis sticks dependably to the skin and is particularly effective when worn under stockings or tights. When reviewed, all patients were continuing to use the device. It is a useful alternative to surgical reconstruction in such patients.

Adult↗
PubMed1987

Loop mattress suture.

Explore the source record for details and available documents.

Dermatologic Surgical Procedures↗
PubMed1987

Reduction of grip strength, finger flexion pressure, finger pinch pressure and key pinch following flexor tendon repair.

67 patients with 176 repaired flexor tendons have been reviewed after a mean follow-up interval of 26.4 months. After repair, mean grip strength was 74.5%, mean finger flexion pressure 76.8% and mean finger pinch pressure 74.7% of that of the opposite uninjured hand or digit. For 16 patients with repaired flexor pollicis longus tendons, mean key pinch was 78.7%. Grip strength was reduced after injury to tendons alone, but was especially reduced when there was concomitant damage to the median or ulnar nerves.

Adolescent↗
PubMed1987

A review of repaired flexor tendons.

67 patients with 176 repaired flexor tendons have been reviewed after a mean interval of 26.4 months. 160 tendons to 100 fingers, and 16 flexor pollicis longus tendons were repaired. When evaluated by Buck-Gramcko criteria, the functional results in 92% of the fingers and 69% of the thumbs were graded as excellent or good. Patients with partially divided tendons fared no better than those whose tendons were completely divided. The results of repair in the little finger were less satisfactory than in other fingers.

Adolescent↗
PubMed1987

Burns from buried electric cables.

Twenty-six patients who sustained significant burn injuries as a result of striking underground electric cables are reviewed. This study sets out to highlight why such injuries occur and to recommend preventive measures to those digging in the London area. There were three deaths in this series.

Accidents, Occupational↗
PubMed1987

Serum cholinesterase levels after thermal injury. Is treatment required?

Changes in serum cholinesterase (also known as pseudo- or non-specific cholinesterase) activity have been measured in 20 patients after thermal injury. In 19 patients a marked fall was noted at around day 5 post-burn, and recovery to normal levels was variable and in some cases prolonged. A variety of symptoms, for example, dyspnoea and confusion, have been attributed to lowered serum cholinesterase activity and some workers have gone so far as to advocate blood transfusion to treat such a condition (Price et., 1970; Frohlich, 1977). In this study we found 13 patients (65 per cent) with such symptoms coexisting with a low serum cholinesterase activity. However, we do not believe these symptoms were directly attributable to the low enzyme activity for the following reasons: In only three of the 13 patients were symptoms observed at times when the lowest cholinesterase activity was recorded. A conventional explanation for these symptoms was available, except in three cases with abdominal distension. In six cases no symptoms were observed despite very low cholinesterase levels.

Acetylcholinesterase↗