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Biomedical subjects

H Tritsch

Publications and source records attributed to H Tritsch.

At least 19 recordsLinked to original sources

Malignant melanoma and lymph nodes.

A total of 226 cases of malignant melanoma of the skin (MM), clinical stage I disease, located on the leg (87), arm (36), or trunk (103), were treated with elective regional node dissection (ERND). The axillary lymph nodes were dissected by a T-shaped skin incision line, whereas the inguinal nodes were removed with the help of a spindle-shaped skin excision. Both techniques, without mortality, offered the precondition for extirpation of the lymph nodes en bloc and guaranteed well-healing wounds.

Axilla

[Histology of dermabrasion in giant nevi].

Three female infants suffering from nevocytic giant nevi (GNi) of lumbosacral location were treated by means of high-r.p.m. dermabrasion. In the follow-up period up to 26 months, the GNi completely healed, and there were no recurrences. Before and immediately following dermabrasion as well as after complete healing without any irritation, we took biopsies from the affected areas for histological examination. By way of dermabrasion, we removed the pigmented nevus cell-tissue with its focal arrangement in the upper corium. In the depth of the dermis, however, reaching down to the subcutaneous tissue, there were widespread nevus cells left together with single hair follicles and sweat glands. In the course of healing, we observed the formation of a scar camouflaging the remaining nevus, but sharply demarcated from it, and showing no junctional activity. The clinical healing of the three nevocytic GNi went without junctional activity which usually indicates possible cancerization as mode of development associated with these malformations in the dermo-epidermal border line. Thus dermabrasion might reduce the risk for melanoma. There is still left some risk coming from the remaining nevus cell formations in the depth of the dermis or the proliferating cutaneous appendages that may induce junctional activity.

Cicatrix

[Indications for surgical treatment of varicose veins].

Surgical treatment of varicose veins is always indicated when changes in the vessel walls are combined with insufficient flow of the superficial venous system. Other indications can arise as a result of prospective appraisal of the findings and cosmetic esthetic concerns. There are a number of surgical methods for the treatment of varicose veins, the selection of which depends on the special findings. These methods include crossectomy, stripping of the saphenous veins, phlebectomy and venous incision. A combination of several methods can even be used, especially when there are certain anatomical and pathological facts. Before a decision on the operative method can be made, many details have to be taken into consideration, ranging from the diagnostic and prospective appraisal to knowledge of several methods and the technics involved.

Humans

[Double flap method in the frontal and temporal area to cover larger defects left by surgery].

Regional flaps are often necessary to cover defects left after operations in the forehead and temple area, since the skin of the scalp does not stretch well and because of the likelihood of dislocation of the eyebrow. We find the double advancement-flap technique using curving incisions of great use in this area. These curved flaps margins follow the wrinkles of the forehead and the relaxed skin tension lines. This contributes to easy healing and inconspicous scars. At the same time undersired facial asymmetry or disturbance of expression can be avoided.

Facial Asymmetry

[Subungual malignant lentigo with longitudinal nail pigmentation--diagnosis and surgical treatment].

A subungual Lentigo maligna was found to be the cause of a longitudinal melanotic stripe in the thumbnail of a 45-year old male. Because of the possibility of a malignant process, a histological diagnosis must be made in all cases of pigmented nail stripes. The best procedure is complete excision of the lesion in a bloodless field, followed immediately by frozen section analysis. According to the result either a larger operation is made during the same session or the wound closed. This procedure enables a specific therapy of pigmented subungual lesions, and contributes to the early recognition and prophylaxis of subungual malignant melanomas.

Amputation, Surgical

[Malignant melanoma in husband and wife (author's transl)].

There have been three previous reports of malignant melanoma of the skin in husband and wife. The authors add an observation of their own and compare it with the previously reported ones. In their own case, the couple had been married for 27 years. The husband's tumour was noted eight years before that of his wife. The tumours were histologically very similar. None had HL-A-5 antigen.

Female

[Skin incisions in inguinal lymph-node excision].

Wound complications in the postoperative period of the inguinal lymph node dissection are frequent events. The main factor in wound complications is due to dissection of the vascular architecture. In most of the cases the impaired wound healing occurs distal to Poupart's ligament. Suggestion for its prevention is the use of an oblique, subinquinal, wide spindle-S-shaped skin excision crossing over Scarpa's triangle with an extension to the anterior superior iliac spine from its lateral and a vertical prolongation onto the thigh from its medial end. The wide spindle-S-shaped excision minimizes the later devascularisation of skin flaps. The anatomic outline of the inguinal lymphatic basin to be removed can easily be reached by the extend of these two incision lines. Besides an undisturbed healing the technique offers two further possibilities. If malignant skin tumors are in anatomical positions which lend themselves to incontinuity dissection, removing primary tumor, intervening lymphatics and regional lymph nodes en bloc can be combined with the incision lines. Furthermore the excised groin skin can be used for a free flap to cover the excision wound of the primary tumor. The method is described in ten cases.

Adult

[Square plastic using lower abdominal full skin].

The advantages of full thickness free skin grafting (Wolfe graft) from the hypogastricum are described in ten cases. The method is suitable for covering fresh skin defects--dermis and subcutaneous tissue--which results in dermato-tumorsurgery in extremities and skull region. The hypogastricum was taken as donor area because the wound edges can be closed in order to produce the least conspicuous scar. Large free skin grafts can be taken. The dermis is thin and promotes a good wound healing. For the take of the Wolfe graft the carfull removing of all visible fat on its under-surface is essential. The tendency of the graft to take is judged by morphological criteria and subdivided in five degrees. Most important for the final form of the skin graft is the local treatment.

Abdomen

[Double-lobed rotation pedicle flap].

This is a report on the bilobed rotation pedicle flap, a special type of pedicled flap transfer. The method is suitable for reconstruction of roundish skin defects, dermis and subcutaneous tissue with diameters from 8--15 cm, especially in dermato-tumorsurgery in trunk and thigh regions. The regional flap consists of two tongue-shaped donor lobes separated by the wound. The conventional form of the bilobed flap has an angle of 180 degrees between the bases of the lobes. By shifting the tissue at the surrounding of the defect, the procedure has the distinct advantage of camouflaging the donor sites. In addition it reduces the size of the wound. With the final transposition of the relatively small lobes large defects can be closed without the use of additional skin grafts. The method, here described in ten cases, is a simple way to resurface and reconstruct the wound with good functional and cosmetic result.

Adult

[Development in the immunotherapy of malignant melanoma].

Recent progress in the investigation of malignant melanoma has encouraged the possibilities of using immunological methods in the treatment of cancer. Under investigation are especially attempts to influence both the humoral and cellular immunity with cytotoxic effect on tumor cells. In perspective of these studies schedules for greater effectiveness of immunotherapy by combination of active, passive, eliminative or adoptive methods are conceivable. They provide a rational basis particulary because essential questions of alternation between the immune reactions are not yet understood.

Adjuvants, Immunologic

[Basaliomas].

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Basal Cell Carcinoma