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Biomedical subjects

E C Smoot

Publications and source records attributed to E C Smoot.

At least 19 recordsLinked to original sources
PubMed1992

Assessment of flap perfusion in a porcine model with a heated laser Doppler probe.

Skin and musculocutaneous flaps in a pig model were studied for their response to heating of the laser Doppler probe, both in the perfused state and in conditions of vascular occlusion. Even though heating the probe resulted in an elevation of perfusion of the flaps with no occlusions, it also increased the apparent perfusion of flaps that were occluded. The ability of flows to a augment with heating, therefore, could not be perfectly correlated with impeded vascular flow. The addition of a heated perfusion reading for assessment of vascular occlusion did not improve the accuracy of the laser Doppler for monitoring of capillary-bed perfusion to detect vascular occlusion.

Animals↗
PubMed1992

The effect of hyperbaric oxygen on reperfusion of ischemic axial skin flaps: a laser Doppler analysis.

This study evaluates the microvascular reperfusion of ischemic skin flaps with and without acute hyperbaric oxygen (HBO) treatment. Thirty-two axial pattern epigastric skin flaps (3 x 6 cm) in male Wistar rats were subjected to 8 hours of global ischemia by pedicle clamp occlusion. The rats were divided into the following control and two experimental groups: Control (n = 12) with ischemia, no HBO; Group 1 (n = 11) with HBO treatment (three 1.75-hour dives, 2.5 absolute atm, 100% O2) during ischemia; and Group 2 (n = 9) with HBO treatment (two 1.75-hour dives) immediately after ischemia. Laser Doppler flows were recorded in two distal standardized flap locations at 0.5, 2, 4, and 18 hours after reperfusion in control rats and Group 1 rats and at 18 hours only in Group 2 rats, using a Med-Pacific 6000 laser Doppler unit. Mean distal flap laser Doppler flows (mV) were Control: 0.5 hours = 23.2 +/- 11.9, 2 hours = 52.8 +/- 27.3, 4 hours = 53.6 +/- 32.1, 18 hours = 40.2 +/- 36.2; Group 1: 0.5 hours = 71.8 +/- 30.9 (p less than 0.05 vs. control), 2 hours = 74.3 +/- 27.3, 4 hours = 67.4 +/- 20.6, 18 hours = 79.1 +/- 40.3 (p less than 0.05 vs. control); and Group 2: 18 hours = 90.3 +/- 47.9 (p less than 0.05 vs. control). It is concluded that acute HBO treatment of ischemic rat skin flaps improves distal microvascular perfusion as measured by laser Doppler flowmetry. This effect is observed for HBO treatment given either during or immediately after prolonged global ischemia.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1992

Operating safely in an underdeveloped country.

The visiting surgical team doing cleft lip and cleft palate repair in an underdeveloped country may find long hours and adverse conditions. Some of the trips are undertaken for resident education. It is the responsibility of the expedition leader to implement safety precautions for protection of both the patients and the volunteers in the operative party as suggested in this article. Equipment maintenance and modified sterilization techniques are also described.

Airway Obstruction↗
PubMed1991

Fingernail deformities secondary to ganglions of the distal interphalangeal joint (mucous cysts).

Twenty-six nail deformities secondary to ganglions of the distal interphalangeal joint were retrospectively reviewed to assess the important aspects of their management. The patients' ages ranged from 41 to 79 years. The long and index fingers were most commonly involved. A depression or groove was present in 23 of 26 digits reviewed. Two had gross disruption of the nail. Fifty-eight percent of the cysts had spontaneously drained or had been drained by the patient or a physician preoperatively. Degenerative arthritic changes were seen in 87 percent of those with x-rays or a radiology report available. Most underwent surgical removal of the cyst and debridement of associated osteophytes of the distal interphalangeal joint. The cyst was located above the germinal matrix in all but two digits. Osteophytes were found in all 20 digits in which the joint was explored. No recurrences were seen in those available for postoperative follow-up (22 of 25). Normal nail growth was found in 14 of 22, although follow-up was short in one. All eight postoperative nail deformities were quite mild and of little concern to the patient. There was no correlation between preoperative cyst drainage and aesthetic postoperative nail growth. Nail removal at the time of surgery appeared to be unnecessary unless the nail was grossly disrupted.

Adult↗
PubMed1991

In vitro toxicity testing for antibacterials against human keratinocytes.

The use of cultured human keratinocytes in an in vitro comparison of topical antibacterial toxicity for epithelial cells was examined. The complement of three assessments allows testing of epithelial migration, growth, and survival. The three assessments included (1) flow cytometry for determination of cell survival, (2) a comparison of confluent cell culture growth after antibacterial exposures, and (3) an evaluation of cell migration using a technique of dermal explants to study radial migration. A comparative ranking of the toxicities of the various topical antibacterials was determined with the three assessments. This has confirmed anecdotal reports that many of the topical antibacterials are cell-toxic and may inhibit wound healing. This information can be directly extrapolated to the clinical setting, unlike many of the animal data for wound healing that currently exist.

Anti-Bacterial Agents↗
PubMed1990

Leech therapy and bleeding wound techniques to relieve venous congestion.

Temporary restoration of capillary skin blood flow can be established by using leeches or by the creation of a dermal wound and the promotion of continued bleeding from the wound site in a flap with venous occlusion. An increasing restoration of capillary flow occurred with initial application of the leech and tended to exceed other techniques of restoring flow. However, all techniques of exsanguination, including leech therapy, restored very low perfusion over a two-hour course of therapy for a volume of tissue simulating a distal finger replant. The temporary increase in flap perfusion with a single leech application was greatest during the feeding activity of the leech and tapered off after the leech was satiated, to approximate flows achieved with local heparin injection and a punch wound.

Animals↗
PubMed1989

The effect of acute hyperbaric oxygen therapy on axial pattern skin flap survival when administered during and after total ischemia.

The effect of hyperbaric oxygen (HBO) on axial pattern skin flap survival in male Wistar rats, when administered during and immediately following prolonged total flap ischemia, was evaluated. Eighty-one 3 x 6 cm rectangular epigastric skin flaps were elevated, and the inferior epigastric pedicle of each flap occluded for 8 hr. The animals were divided into a control and three other experimental groups: Control (n = 27) -8 hr flap ischemia, no HBO; Group (n = 21) - HBO therapy (100 percent O2--three 1.75 hr dives at 2.5 atm) during ischemia; Group 2 (n = 21) - HBO therapy (two 1.75 hr dives) following ischemia; Group 3 (n = 12) - HBO treatment during ischemia but with the flap contained in a metal-coated Mylar bag to prevent oxygen diffusion. The percentage of flap necrosis was calculated on postoperative day 6. Mean flap necrosis for controls was 28 percent (+/- 21 S.D.), while HBO treatment during ischemia or during reperfusion significantly reduced this necrosis to 9 percent (+/- 11) and 12 percent (+/- 14), respectively (p less than 0.01). The percentage of necrosis for Group 3, with the local with the local effect of HBO on the flap blocked by the diffusion barrier, was 5 percent (+/- 7), also significantly better than the controls (p less than 0.0005) but no different from the other two experimental groups. HBO treatment increases the percentage of axial pattern skin flap survival when administered during or immediately following total flap ischemia. The improved flap survival appears to be a systemic and not a local effect.

Animals↗
PubMed1989

Mauling by pit bull terriers: case report.

A child with extensive soft-tissue defects following an attack by four pit bull terriers is presented. Some future procedures are required and she will have a permanent gait disability. The multidisciplinary management of this patient is described. The escalating problem of dog attacks in the United States is discussed. It is hoped that increased physician and public awareness will expedite the enactment and enforcement of effective vicious-dog legislation.

Animals↗
PubMed1988

Method for elevating the pediatric hand.

We have described a technique for elevating the injured pediatric hand for the patient who is nursed in a crib. This system allows full movement of the patient throughout the length of the crib with little danger for the potential of shoulder dislocation.

Hand↗
PubMed1988

The craniofacial team and the Navajo patient.

The craniofacial team at the University of New Mexico Medical Center in Albuquerque, New Mexico has treated a large population of Navajo Indians. Team awareness of the Navajo concept of health as man in balance with his environment has resulted in more expedient treatment of the Navajo children. An understanding of Navajo concerns with ghosts, skinwalkers, and rules for orderly living has allowed team members to integrate the family and the Navajo medicine man in caring for the children with craniofacial disease. Special concerns for informed surgical consent and genetic counseling of the Navajo are reviewed. Respect for the traditional Navajo healing ceremonies and special handling of disposed body parts in surgery are required of the health professionals caring for these people.

Child↗
PubMed1987

Recognizing the temporomandibular joint ganglion.

A case report of a cystic preauricular mass that changed in size and position with jaw movement is presented. This tumor proved to be a ganglion of the temporomandibular joint (TM) cyst, which is relatively rare. When a preauricular mass retrudes into the masseter muscle in jaw opening, pathological conditions associated with the TMJ should be considered. Ganglion cysts of the TMJ are a benign pathological entity which can mimic parotid tumors. Temporomandibular joint radiography and perhaps ultrasonography of the region are useful in the preoperative evaluation of preauricular masses. The TMJ ganglion cyst can be successfully treated by direct excision and repair of the joint capsule. This approach avoids the potential morbidity of a superficial parotidectomy.

Female↗
PubMed1986

The sit-up position for breast reconstruction.

For breast reconstruction, we have found that breast symmetry can be created optimally when the patient is brought to a totally upright position with the trunk vertical and perpendicular to the floor. The size of the opposite breast can better be appreciated. Nipple and areola position can be determined accurately even with the patient asleep if she is brought to the upright position. The safety of the upright positioning is documented in our series but depends on planning with the anesthesiologist preoperatively and allowing time to move the patient cautiously. An anesthesia technique for intraoperative vertical positioning is reported.

Adult↗