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Biomedical subjects

F G Wolfort

Publications and source records attributed to F G Wolfort.

At least 19 recordsLinked to original sources
PubMed1999

Retrobulbar hematoma and blepharoplasty.

Retrobulbar hematoma leading to visual impairment is a rare but serious complication associated with elective blepharoplasty. A review of the literature addressing etiology, prevention, and management is presented. Removal of anterior orbital fat associated with traction and rupture of vessels within posterior orbital fat is currently most strongly supported as the cause of retrobulbar hematoma after blepharoplasty. Optic nerve ischemia is identified as the likely cause of visual impairment. Specific recommendations for avoidance and management of acute retrobulbar hematoma are offered. Recent background animal and human research is summarized.

Animals↗
PubMed1999

Suction-assisted lipectomy for lipodystrophy syndromes attributed to HIV-protease inhibitor use.

The addition of HIV-protease inhibitors to the arsenal of therapies for the treatment of HIV infection has resulted in significant suppression of viral load such that HIV-positive individuals experience reduced morbidity and extended life expectancy. Recently, a number of syndromes have been described involving abnormal fat distribution that may be associated with prolonged HIV-protease inhibitor therapy. These syndromes include hypertrophy of the cervicodorsal fat pad ("buffalo hump"); a tendency toward increased central adiposity ("protease paunch"); adiposity in the submental, mandibular, and lateral cheek regions of the face; and hypertrophy of adipose tissue in the breast in women. A peripheral lipodystrophy, or fat-wasting, in the extremities and face (particularly the malar and nasolabial fold regions) has also been observed. As these patients live longer and healthier lives, many are beginning to seek surgical correction of the disfigurements. In this regard, we present a review of the literature regarding these recently described syndromes to familiarize plastic and reconstructive surgeons with the unique deformities encountered in this ever-increasing patient population. We also present our results with suction-assisted lipectomy for treatment of these deformities. Physical findings, pathogenesis, and surgical management are discussed.

Adult↗
PubMed1998

Plantar verrucous carcinoma following transmetatarsal amputation and renal transplantation.

Verrucous carcinoma is a rare, low-grade, well-differentiated squamous cell carcinoma that may occur anywhere on the skin. It is slow growing, enlarges relentlessly, and invades locally. Most cutaneous verrucous carcinomas are found on the plantar surface of the foot, and share many gross and histological characteristics common to the ubiquitous verruca vulgaris. It is not uncommon for verrucous carcinoma of the sole to be mistaken for the more common verruca plantaris. The case of a 53-year-old white male with plantar verrucous carcinoma following cadaveric renal transplantation, right popliteal-tibial bypass, and a right transmetatarsal amputation is presented. Treatment included reamputation followed by reconstruction with a free radial forearm fasciocutaneous flap. Verrucous carcinoma is a slow-growing but relentlessly invading tumor that is easily misdiagnosed. The extent of early resection is often inadequate. We must be aware that certain persistent "warts" may represent a form of cancer that is treated differently from common verrucae or other squamous carcinomas.

Amputation, Surgical↗
PubMed1997

Nuances of aesthetic blepharoplasty.

The orbits and surrounding tissues form the emotional and expressive center of the human face. Eye contact forms a large part of human interaction and, unfortunately, it is often this region that first surrenders to the aging process. A successful blepharoplasty depends on the careful evaluation of a patient's eyes, correct assessment of the cosmetic problems, and the surgical dexterity to repair such defects adequately. Consistent success may be achieved only with mastery of aesthetic consideration of the eyes, which aid in the diagnosis of the deformity of asymmetry. From that, the appropriate surgical intervention may ensue. This discussion will review the anatomy related to different orbital expressions, delineate the effects of aging, and briefly touch on techniques in our surgical armamentarium to correct and improve eyes through blepharoplasty.

Adult↗
PubMed1996

Alcohol and preoperative management.

The French paradox is a recently coined term used to describe the lower incidence of heart disease in the French as compared with Americans in the face of increased cholesterol intake, higher serum cholesterol levels, and elevated blood pressures. The principal lifestyle factor explaining this paradox is alcohol intake. Research has shown that alcohol in general and wine in particular have myriad effects on the cardiovascular system--raising high-density lipoprotein levels, increasing antioxidant capabilities, and prolonging platelet aggregation. The most impressive benefits of alcohol appear to be platelet-related. Research has demonstrated an undeniable effect of alcohol on platelet function and bleeding characteristics. This information has been used recently to modify risk factors for heart disease; however, these data have a role in the preoperative management of surgical patients. In order to decrease the incidence and severity of intraoperative and postoperative bleeding, patients should be advised to abstain from alcohol and particularly red wine before surgery. In addition, alcohol has been found to have a synergistic effect with aspirin on bleeding times. These two substances, both individually and in combination, should be avoided preoperatively.

Animals↗
PubMed1996

Reconstruction following resection of malignancies of the upper extremity.

A multidisciplinary approach using advances in diagnosis, staging, adjuvant therapy, surgical resection, and especially reconstruction has made limb salvage a viable option in the treatment of most upper extremity malignancies. Although adequate surgical resection never should be compromised by reconstructive considerations, the reconstructive surgeon's input into preoperative planning may be crucial to the best possible functional and aesthetic outcome. Emphasis should be placed on a thorough evaluation by all members of the treatment team so that the best possible result is not compromised. A broad spectrum of techniques currently available for both salvage and restoration of function includes local soft-tissue flaps, regional pedicled and vascular island flaps, free tissue transfers, bone autografts and allografts (Fig. 17), endoprostheses, skin expansion, skeletal lengthening techniques, tendon transfers, and nerve and arterial grafts. This article reviews both new and well-established reconstructive options after resection of upper extremity malignancies in children and adults and provides illustrative case examples.

Amputation, Surgical↗
PubMed1995

Ptosis after blepharoplasty.

Ptosis is a complication that can arise after blepharoplasty resulting in lid asymmetry. It should be recognized early and intervention directed at its underlying anatomical cause. Ptosis can be secondary to lid edema, hematoma, septal levator adhesions, septal suturing, supratarsal fixation, and levator complex injury. Injury to the levator complex can be rarefaction, dehiscence, or disinsertion. Evaluation of this condition involves assessment of the degree of ptosis and the amount of levator function. Severe ptosis with poor levator function requires reexploration and repair of the levator mechanism. Mild or moderate ptosis may resolve spontaneously and can be managed expectantly. Chronic cases (longer than 3 months) may need exploration, and the procedure used is guided by the amount of levator function present.

Blepharoptosis↗
PubMed1995

Toxic shock syndrome as a complication of breast prostheses.

A case of a 21-year-old woman who developed toxic shock syndrome 6 days after augmentation mammaplasty with saline breast implants is reported. The infecting organism was S. aureus that was toxic shock syndrome exotoxin 1-negative and staphylococcal endotoxin B-positive. The causes and etiology of this rare postoperative complication are discussed.

Adult↗
PubMed1990

Chondrolaryngoplasty for appearance.

Prominent thyroid cartilage (pomus Adamus) is frequently a constant embarrassment to the male transsexual as well as to the asthenic male. The demand for reduction and contouring of the pomus Adamus continues to increase in our societies today. Since our first presentation of this procedure, we have been able to follow 31 patients over a 17-year period. We present a review of our technique of chondrolaryngoplasty, with anatomic details and a follow-up of 31 patients ranging from 4 months to 17 years. The results are effective and satisfying, with few complications. Those which do occur tend to be transient, with the most frequent being a temporary mild voice weakness. We believe this operation has a place among the techniques of plastic surgeons.

Adolescent↗
PubMed1989

Torticollis.

Torticollis can be an isolated deformity or a sign of other neuromuscular disease. Underlying central nervous system or infectious disorders need to be considered and treated. In most patients, an improvement in the aesthetic disability is the primary objective. In general, an operation is indicated for the classical "congenital" muscular torticollis that does not respond to physiotherapy and forceful stretching of the restricting neck band. The mass or "tumor" of "congenital" torticollis requires no specific treatment. Operation may be delayed until age 1, but should probably be completed prior to school age. Reversal of craniofacial asymmetry is best achieved at an early age when there is maximum growth potential. Principles of surgery are (1) identification and release of all restricting bands involving the sternocleidomastoid muscle and other neck structures, (2) moving of the head and neck through a full range of motion prior to the completion of the procedure, and (3) resumption of physical therapy within 2 weeks of operation to prevent recurrent scar contracture. Various operations have been recommended, the most popular and reliable being inferior open tenotomy of the sternal and clavicular heads of the sternocleidomastoid muscle. Incisions should be placed low in the neck along skin lines and not over the clavicle in order to avoid hypertrophic scarring. Other procedures discussed are superior open sternocleidomastoid tenotomy (mastoid release), muscle lengthening procedures, and sternocleidomastoid excision. Only modest results should be anticipated in older children or adults with long-standing disease or advanced craniofacial asymmetry.

Humans↗
PubMed1988

Multiple familial angiolipomatosis: treatment of liposuction.

Lipomas constitute the most common soft-tissue tumors [11] and may occur sporadically or as one of several inherited disorders. Benign fatty tumors can be classified into three major categories: solitary lipomas, familial multiple lipomatosis, and congenital diffuse lipomatosis [4]. The latter has also been referred to as multiple symmetric lipomatosis, Madelung's disease, or Launois-Bensaude syndrome. Within the categories a more vascular varient of the lipoma, the angiolipoma, has been described separately by some authors, but in many reports it is not distinguished from a lipoma. Liposuction has been used for the treatment of solitary lipomas, but to our knowledge liposuction has not previously been reported for excision of angiolipomas or in familial cases involving multiple lipomas as described here.

Adipose Tissue↗
PubMed1987

Resection of tumors in irradiated fields with subsequent immediate reconstruction.

With increased use of primary radiation therapy for treatment of cancer and adjuvant radiation therapy after surgical removal of a bulk tumor, recurrence in these fields has posed significant new and increasingly technical and biologic problems. We report our experience with ten such cases in which difficult wounds were reconstructed immediately after major regional resections of advanced or recurrent tumors in fields of previous irradiation. All of these patients could undergo extirpation of their recurrent tumors in irradiated fields because of improved techniques in reconstructive flap surgery allowing large amounts of well-vascularized tissue to be transferred, sometimes over a significant distance. Follow-up of these patients has ranged from three to 18 months (median, nine months). Primary healing, decreased deformity, reduced morbidity, and prolonged disease-free intervals have been achieved with the combination of extirpative and reconstructive techniques.

Abdominal Neoplasms↗
PubMed1984

Multiple chondrosarcomas of the hand.

An unusual case of multiple chondrosarcomas of the hand arising from multiple enchondromas is presented. Chondrosarcoma is an unusual tumor of the hand that requires careful clinical, radiological, and pathological examination for accurate diagnosis. These tumors can usually be managed successfully by wide local excision or ray amputation. However, long follow-up is indicated.

Adult↗