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Biomedical subjects

I Fogdestam

Publications and source records attributed to I Fogdestam.

At least 37 records · Page 2Linked to original sources
PubMed1983

Microsurgical end-to-end and end-to-side epididymovasostomy to correct occlusive azoospermia.

Reconstruction of the duct system using microsurgical technique represents an anatomically more attractive approach to correction of occlusive azoospermia than the conventional sperm fistula operations. The microsurgical technique of Silber entails transection of the entire epididymis in progressively more cranial planes. After microsurgical dissections of testicle specimens, we developed a different technique: dissection of a single loop of the ductus epididymis and connection to the ductus deferens, performed either as a two-layer end-to-end or as an end-to-side anastomosis. To reveal patency of each single anastomosis, the operations were performed unilaterally. Twenty-eight men were operated upon. They were referred from urology departments after standard investigations including repeated sperm tests. In 7 patients (25%) the prerequisites for an anastomosis were not present. Twelve patients were primarily operated upon with the end-to-end technique. Six of them have produced sperms in their specimens. Nine patients were operated upon with the end-to-side anastomosis. So far, five of these have presented positive sperm tests but the follow-up period is relatively short in this part of the series. During the investigation, it became evident that both the identification of sperms or fragments in the epididymal fluid and an adequate flow are prerequisites for successful surgery.

Epididymis↗
PubMed1983

Distally based fasciocutaneous flap from the sural region. A preliminary report.

Based on the principle of skin vascularization through perforating branches along intermuscular septa, a new distally based fasciocutaneous flap from the sural region is presented. Its use in reconstruction of defects in the middle and lower third of the leg is demonstrated by the clinical application in our sample of 3 cases. The limits of the extent and the exact basis of its vascularity have to be determined by further investigations.

Achilles Tendon↗
PubMed1982

Experiences with free flap surgery.

During three years of reconstructive microvascular surgery 24 free flap cases have been performed. The success rate was 79% (19 cases). Starting with aesthetically indicated small flaps we have during the last year treated only functionally required cases. The trend has been towards flaps with long vascular pedicles and compound flaps, especially those including bone. When the cases are properly selected, the microvascular technique is able to save a lot of human suffering and large sums of money for society.

Adult↗
PubMed1981

Delayed primary closure. Tissue gas tensions in healing rat skin incisions.

In a previous biomechanical study the healing of delayed primary closure (DPC) wounds was investigated. With delay intervals of 3-6 days DPC wounds were shown to develop much higher late term mechanical strength than control primary closure (PC) wounds. In the present work measurements of wound tissue gas tensions were performed with implanted silicone tonometer tubes. Higher pO2 values were found in DPC wounds than in control PC wounds from the 6th to 15th postoperative day. No difference in pCO2 was found between the two types of wounds. The results are in accordance with the biomechanical results and give evidence of a higher local oxygen supply in DPC wounds.

Animals↗
PubMed1981

Delayed primary closure. Blood-flow in healing rat skin incisions.

In an earlier study delayed primary closure (DPC) wounds were shown to develop higher biomechanical strength than primary closure (PC) wounds. In order to elucidate the underlying mechanism, local clearance of 133Xenon and thermography studies were undertaken. A paired comparison design with deposits of 133Xenon injected in the wound margins 3 and 4 days postoperatively, and directly into the wound tissue 10, 20 and 60 days postoperatively was used. Very pronounced differences, with higher blood-flows for DPC wounds, were found in the early measurements. In the later measurements there were significant but less obvious differences. With thermography no differences could be detected. It is concluded that DPC wound have a higher blood-flow, especially in the initial wound healing phase. This supports the hypothesis that an increased blood-flowing during early wound healing is beneficial for the development of mechanical strength in the maturing normal scar.

Animals↗
PubMed1981

A biomechanical study of healing rat skin incisions after delayed primary closure.

The biomechanical strength of delayed primary closure wounds was assessed by in vitro determination of their relative failure energy. This is the most accurate measure of the wound's ability to resist rupturing forces. Primary closure wounds were used as controls, and measurements were always made at equal intervals after wounding--ten, 20 and 60 days. There was no differences in energy values for three, four and five day delayed wounds tested ten days postoperatively. For six day delayed wounds, however, the energy values were lower than for control wounds after ten days. Twenty days postoperatively, this difference had disappeared. The three day delayed primary closure wounds had now developed significantly higher energy values than the control wounds. When tested 60 days postoperatively, the energy values for both three and six day delayed primary closure wounds were almost double those of the control wounds. It was concluded that, in short term healing--ten days, delayed primary closure with moderate delay intervals of three to five days had no biomechanically adverse effects. In long term healing--60 days, delayed primary closure wounds showed a pronounced increase of wound strength compared with primary closure wounds. Extrapolated to the clinical situation, there would, thus, be no reason from a biomechanical point of view to hesitate to use the delayed primary closure procedure whenever primary closure is not clearly indicated.

Aging↗
PubMed1981

A case of forearm amputation with additional multilevel partial amputations.

A right-handed 4 1/2-year old boy had a sharp amputation 3 cm proximal to his left wrist joint in a hay-cutting machine accident. In addition, he sustained 5 incisions on the anterior and ulnar aspects of the same forearm, the proximal and deepest including radius, ulna and the deep branch of the radial nerve. In a 19 1/2 hours operation, his left hand was replanted and the mainly cold anoxaemia time was 16 hours. Despite several reoperations, the hand could not be saved but the proximal portion of the amputated part did survive. On the 21st day the hand was reamputated at the radiocarpal joint level and the stump closed with viable skin from the proximal 2/3 of the dorsum of the hand. On a 1 year follow-up, the length growth was found to be close to normal. A myoelectric prosthesis is functioning well not only from impulses in the reinnervated extensor muscles but also from the flexor muscles which have been denervated and anatomically divided at least at two levels. Partial replantation success and perfect revascularization and reinnervation in the forearm was gained, thanks to extensive surgery. These results in an extremely complicated injury like this do show that every surgical effort should be made in pediatric extremity trauma.

Amputation, Traumatic↗
PubMed1980

Microvascular osteocutaneous groin flap in the treatment of an ununited tibial fracture with chronic osteitis. A case report.

A 37-year-old man with an ununited tibial fracture combined with a significant skin defect underwent a microvascular transfer of an island osteocutaneous flap of groin skin and iliac crest bone. The bone component of the flap was shown to be a living transplant by the observation of brisk cancellous bone bleeding when the flap was isolated on its vascular stalk; by rapid fracture healing (weight-bearing 15 weeks postoperatively); and sequential bone scan investigations. Various aspects of the flap blood supply, particularly to bone, are discussed, and reference is made to the use of a more suitable vessel system.

Adult↗
PubMed1979

The sleeve anastomosis in clinical microsurgery. Case report.

Clinical use of the microvascular sleeve anastomosis in 6 elective free tissue transfers is reported. Arterial and venous anastomoses were performed. It was found that with the exception of the distal anastomosis of a vein graft to artery the sleeve anastomosis was simple and efficient. It was concluded that when the vessels to be anastomosed have suitable length and diameter the sleeve anastomosis may well be used. By its use time and effort can be saved, especially in cases requiring multiple anastomoses.

Adult↗
PubMed1979

The influence of cortisol on wound healing of the skin and distant connective tissue response.

The effect of moderate dosage cortisol treatment on healing wounds and on the response in skin distant to the wounds was investigated. The stress-strain characteristics of a skin wound and intact skin specimens were examined. Also, skin thickness, water content and collagen content were measured. Cortisol treatment resulted in reduced extensibility and increased stiffness for ten day wounds, but unchanged failure energies; for 20 day wounds, failure energies were reduced, indicating reduced ability to withstand rupturing forces. Thus, the mechanical properties of healing wounds under moderate dosage, long term corticosteroid treatment were found to be slightly impaired. A systemic effect of wounding at day 10 resulted in decreased stiffness and increased collagen content of the skin distant to the wound.

Animals↗
PubMed1977

A biomechanical study of healing of skin incisions in rats during pregnancy.

Wound healing during both pregnancy and the postpartum phase results in stiffer, but not stronger, wounds. The probable mechanism is a hormonally mediated enhancement of fiber maturation. This mechanism, however, remains to be verified by a more direct study of the molecular stability of the collagen fibers. This study was undertaken to analyze the influence of pregnancy on reparative processes in extragenital connective tissue by using skin wound healing as an experimental model. Wounds were induced on gestational days 1 and 20, respectively, and analyzed biomechanically ten or 20 days later. Twenty day old wounds in rats in the pregnant and postpartal groups were found to be stiffer and required less energy to be ruptured than did those produced in nonpregnant rats, whereas ten day old wounds in pregnant rats were not found to differ in strength and stiffness from those in nonpregnant rats. The findings are compared with other studies on changes in reproductive hormone levels, and a mechanism for the biomechanical differences found is suggested.

Animals↗
PubMed1976

Surgical treatment of hyperhidrosis axillae.

58 patients have been operated on for axillary hyperhidrosis by excision of the skin and subcutaneous tissue. The hyperhidrotic area was determined by application of a crêpe paper in the axilla. Either 60% or 90% of the hyperhidrotic area was excised, using a bat-like pattern. Only after excision of 90% of the hyperhidrotic area acceptable results were achieved. In a series of 22 patients with 90% excision bilaterally 18 had excellent results, three were good, and one was poor. The entire series was without complication. The advantage of this technique is its simplicity, freedom from complication, performance on an out-patient basis, and short convalescent time.

Adolescent↗