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Biomedical subjects

J B Lynch

Publications and source records attributed to J B Lynch.

At least 55 records · Page 3Linked to original sources
PubMed1979

Use of the free dorsalis pedis flap in head and neck repairs.

Many defects of the head and neck can be readily repaired with a free dorsalis pedis flap, and we report success with these flaps in 9 of 12 cases. A precise knowledge of the anatomy of the arterial supply of the flap is necessary. Preoperative arteriography is recommended if the dorsalis pedis artery is not easily palpable, or if an anomalous distribution of the artery along the dorsum of the foot is sus pected. However, the transfer of the flap should be delayed for two weeks after preoperative arteriography is performed. The one-stage soft tissue reconstruction with a free dorsalis pedis flap has been associated with minimal morbidity and good acceptance by patients. A delay procedure for the flap seems to enhance the chances of complete survival which is so necessary in the repair of intraoral and pharyngeal defects. Careful attention to details and close monitoring of the flap will minimize morbidity. In case of an early failure of a flap, a secondary reconstruction by a different flap can be done in the first 48 to 72 hours. Early postoperative radiotherapy has been well tolerated over these free flaps.

Aged↗
PubMed1979

Classification of oblique facial clefts with microphthalmia.

We believe the Tessier classification system facilitates the description of complicated facial clefts, and we describe its use in 4 cases--all of whom had variations of a Tessier-3 cleft. Microphthalmia is associated with the Tessier-3 cleft. Computerized axial tomography may be helpful in differentiating an extreme microphthalmia from a true anophthalmia, and in detecting bony clefts not seen on roentgenographic studies. Facial tomograms show that abnormalities of the medial wall of the orbit in the Tessier-3 cleft vary from actual clefts to widening of the ethmoid. In our experience (with 4 patients) mental retardation does not necessarily occur in patients with the Tessier-3 cleft and extreme microphthalmia. Abnormalities of the nasolacrimal apparatus may be the most constant finding in patients with the Tessier-3 cleft. Children with the Tessier-3 cleft should be identified early for purposes of determining the proper treatment and valid genetic counseling.

Anophthalmos↗
PubMed1979

Effects of topical applications of epidermal growth factor on wound healing. Experimental study on rabbit ears.

In wounds in rabbit ears, the application every 12 hours of an ointment containing epidermal growth factor appears to produce faster and better healing. The resulting epithelium is thicker and more cellular than in the untreated ear wounds, and more fibroblasts appeared sooner during the healing process. Less wound contracture occurred in the EFG-treated wounds, and wound maturation occurred earlier. The healed wounds that had been treated with EGF more closely resembled the surrounding normal tissue, producing less local deformity than in the controls. It is too early to know whether this will have clinical application, but other experiments are under way to further investigate the effects of EGF on wound healing.

Animals↗
PubMed1979

Five-year history of the American Society of Plastic and Reconstructive Surgeons, 1974--1978.

This report was intended to summarize the significant happenings in the American Society of Plastic and Reconstructive Surgeons, and its affiliates, from the end of the annual meeting in 1973 to the end of the 1978 annual meeting. It was decided to not include our sister organizations--the American Association of Plastic Surgeons, the American Society for Aesthetic Plastic Surgery, the American Society of Maxillofacial Surgeons--because their historians publish periodic reports about their activities. I am sure that the future reports of historians will record with pride the continued growth and development of plastic surgery, because the future of our specialty has never seemed brighter.

Humans↗
PubMed1978

Breast reconstruction following mastectomy for cancer.

Breast reconstruction following mastectomy for cancer is a feasible procedure. The selection of the proper type of mastectomy should be the decision of the cancer surgeon. However, with the advent of modified mastectomies, the use of fewer primary skin grafts, and the preservation of all or part of the pectoralis major muscle, breast reconstruction has become more satisfactory. Since many women adjust poorly to mastectomy, the chance for reconstruction offers hope for a fuller life. Reconstruction of the postmastectomy cancer patient can be accomplished in three basic steps: 1) An adequate breast mound can be constructed with a prosthesis. A flap may be used if the skin cover is inadequate. 2) The size and shape of the remaining breast can be adjusted to obtain symmetry. 3) The nipple-areola complex can be reconstructed if the patient desires. Correction of the infraclavicular and axillary defects may be required. The techniques employed in 14 patients are presented.

Adult↗
PubMed1978

Adriamycin extravasation.

Adriamycin extravasation creates a severe tissue necrosis which is unusual, because it may not appear until several weeks later, and may continue to worsen for several months. As soon as the progressive nature of the tissue necrosis is established, we recommend that an early wide excision be performed in an attempt to remove the necrotic area and the surrounding tissues containing the extravasated drugs--before it has had an opportunity to diffuse even further. Adequate debridement requires removal of any adjacent tissue that is indurated, reddened, edematous, or pale. Skin grafts take poorly if there are small amounts of Adriamycin left in the tissue of the recipient site. Synergistic effects with radiotherapy, and continued systemic Adriamycin therapy, can aggravate or recall necrosis. The administration of more dilute solutions of Adriamycin may decrease the hazard of extravasation necrosis.

Doxorubicin↗
PubMed1978

Fibrinolytic activator activity in human neoplasms.

The results of this study suggest that many malignant tumors contain low levels of fibrinolytic activator activity. Evidence is presented to suggest that this low activity may be due to the presence of an inhibitor of fibrinolysis. The presence or absence of measurable fibrinolytic activator activity, and/or inhibitor in neoplastic growths may enable one to predict the probability of viable metastases to a distant site.

Anticoagulants↗
PubMed1978

Loss of silicone implants after subcutaneous mastectomy and reconstruction.

We studied 89 patients who had immediate or delayed placement of implants after subcutaneous mastectomies. The complications of infection, necrosis of the skin or areola, and extrusion of the prosthesis occurred in 28 percent of these patients, and the incidence was the same after immediate or delayed placement. Only one of the 45 patients who received prophylactic antibodies preoperatively developed an infection after insertion of the prosthesis. The late complications in some of these patients indicate the need for long-term follow-up.

Adult↗
PubMed1977

Management of facial fractures.

Maxillofacial fractures are usually diagnosed easily by history, clinical findings, and standard roentgenograms. Emergency treatment centers around airway management; the conscious patient should be allowed to clear his own airway whenever possible. Treatment of lower and upper jaw fractures focuses on reducing the fragments so that dental occlusion is normal. Other midface fracture reductions require additional exact orbital rim alignment. Immobilization of fractures can require various combinations of intermaxillary fixation, interosseous wiring, suspensory wires from intraoral arch bars, transfacial Kirschner wires, occasional maxillary antral packs, and rare external fixation with headframes or external pins. Patients who may be comatose or seriously ill for several weeks should have a simple and safe compromise reduction and K-wire fixation done at the bedside. Management of blow-out fractures of the orbit and frontal sinus fractures is somewhat controversial. Naso-orbital central factial fractures are especially difficult to maintain in proper reduction. Listed are possible late postoperative complications after treatment of facial fractures.

Airway Obstruction↗
PubMed1977

Esthesioneuroblastoma. Case report.

We present a case of esthesioneuroblastoma, and we emphasize the importance of considering this tumor in the differential diagnosis of primary intranasal carcinomas. Although the tumor is uncommon, we feel that many cases have been misdiagnosed histologically. The typical history in these patients is one of intermittent recurring epistaxis or nasal destruction and frequently, at the time of the initial examination, the tumor has reached a considerable size with evidence of local invasion.

Diagnosis, Differential↗
PubMed1976

Observations on the myth of "informed consent".

A series of 100 patients in a general plastic surgery population were interviewed by standard format to determine their retention rate of preoperative information given to them. An overall recall, or retention rate, of 35 percent was found.

Educational Status↗