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Biomedical subjects

J Bardot

Publications and source records attributed to J Bardot.

At least 37 records · Page 2Linked to original sources
PubMed1999

[Use of skin expansion in resurfacing defective amputation stumps of the lower limbs. 6 case reports].

Better procedures and materials have enabled us to improve the results of skin expansion under knee level and extend its indications. We have used such procedures to cover defective amputation stumps in the lower extremity. When the local conditions are suitable, skin expansion permits the use of healthy skin from the lateral sides of the stump to provide coverage for the ulcerated areas, thus fulfilling the main goals which are to keep the bone shaft as long as possible and cover the stump with sensitive skin, so that a prosthesis can be fitted. In two cases, we also performed skin expansion at a distance to reduce the residual scar at the donor site (expanded flap from the other leg, expanded full-thickness skin graft) when the amount of healthy skin available around the stump was insufficient; the functional results were satisfactory. Skin expansion has become a choice strategy for this type of indication, but it must be performed perfectly to avoid complications or failures (our two first cases). It is important to take precautions at various stages of the operation which must be carefully staged.

Accidents, Traffic↗
PubMed1999

[Extensive rhinectomy. Apropos of 7 cases].

We report our experience in reconstructive surgery after total rhinectomy. Reconstructive surgery is performed after large excision and negative marginal biopsy results. The three layers of the nose (mucosal, osteocartilagineous and cutaneous) are restored by mucosal and cutaneous flaps and osteocartilaginous grafts. Carcinologic and cosmetic results are satisfactory but functional results may yet be improved.

Adult↗
PubMed1998

Early curettage of giant congenital naevi in children.

Early curettage of giant congenital naevi in new-born infants, if performed during the first few weeks after birth, can have a substantial effect on the pigmentation of the lesions, reducing the number of pigmented cells and leaving only moderate scars. We describe our experience in a series of nine congenital naevi treated by curettage between the first and seventh week after birth. Histological changes that occur in the naevus during the first few days after birth mean that early treatment is needed to obtain a cosmetic improvement. Curettage as an early treatment for giant congenital naevi in new-born infants provides cosmetic improvement and might decrease the risk of malignancy; however, the lesions are not cured. Naevus cells persist in the deep dermal layers and may come to the surface, such that close monitoring is needed long after curettage. The cosmetic improvement is likely to benefit the child's psychological development.

Back↗
PubMed1998

[Malignant melanoma in children. Apropos of 6 cases].

Six cases of malignant melanoma were observed in children aged 5-14 years, over a 14-year period: both sexes were equally affected. In three cases, the melanoma was a primary tumor, which indicates that this diagnosis should always be born in mind in children and any suspicious lesion should be biopsied and removed. Three cases had a family history: dysplastic naevus in two cases and malignant melanoma in one case, which confirms the increased risk in some families. Histologically, nodular forms were more frequent than those which spread superficially and the tumors were quite thick when diagnosed (mean thickness: 3.9 mm). Treatment includes wide excision and coverage with skin grafts associated with immuno or chemotherapy in some cases. Mean follow-up was 38 months and no death occurred during this period.

Adolescent↗
PubMed1998

[What's new in upper limb skin expansion?].

The indications for skin expansion of the upper limb are now well defined. Based on a series of 56 cases, the authors confirm that a rigorous technique and good management of complications can minimize failures of the method. Technical progress and new biomaterials certainly allow further reduction of these complications and possibly the development of new indications.

Adolescent↗
PubMed1997

Infantile digital fibroma--report on eleven cases.

Infantile digital fibroma is a benign lesion, but it is sometimes a locally aggressive proliferative lesion. After having examined the literature, we analysed 11 cases of infantile digital fibroma among children between 1 to 16 years, with a long-term follow-up (14 years). We had 4 recurrences. Treatment was surgical. The histological diagnosis has required special stains to put in evidence the typical cytoplasmic eosinophil elements. Surgery usually involved excision and grafting. We also discuss therapeutic measures.

Adolescent↗
PubMed1996

[Skin expansion. Material and technique].

Skin expansion material has progressed and now covers all needs in plastic and reconstructive surgery. Breast reconstruction occupies a special place among expansion techniques and requires specific material. The skin expansion technique was approved by French Social Security in 1995 and is now covered in both the public and private sectors. The skin expansion protocol is rigorous with no room for improvisation. It is only in this way that the quality of the result justifies the use of this technique.

Dermatologic Surgical Procedures↗
PubMed1996

[Skin expansion on the extremities].

The indications for skin expansion in the limbs are now well defined. This technique is particularly irreplaceable below the knee, and allows the resection of very large lesions despite a minimal skin capital. More than in other sites, it is a difficult technique which requires rigour and a sound basis in reconstructive surgery. The operative plan must include precise assessment of the tissue gain with selection of prostheses adapted to local conditions. The techniques of insertion, filling and resection must be irreproachable. The functional and aesthetic indications are numerous and the technique often provides a minimal residual scar.

Dermatologic Surgical Procedures↗
PubMed1996

[Management of complications of expansion].

Although the complication rate during skin expansion has decreased, they can still occur. The authors describe the various possible complications. Complications during insertion of the expander include skin effraction, infection, pain and filling difficulties. During the filling phase, they consist of infection, leaks, cutaneous ischaemia, ulcerations underneath folds of the prosthesis, valves or tubing. Insufficient filling and impairment of the arterial or venous blood supply of the flap can occur during the final operation. Long-term complications essentially consist of persistent oedema, filling of the reconstructed contours, widening of scars, loss of sensitivity and occasionally bone deformities induced by compression. The prevention of these complications is based on an irreproachable technique and regular follow-up.

Humans↗
PubMed1995

Advantages of early burn excision and grafting in the treatment of burn injuries of the anterior cervical region.

Excision and grafting in deep partial and full skin thickness burns of the anterior cervical region in a series of 40 patients treated between 1982 and 1992 is reported. The advantages of surgical management of deep burns in this region in a single staged operation have proved its efficacy compared to the severe sequelae which appear when the standard conservation treatment is used. A comparative study of two groups of patients treated either by early excision and grafting (n = 19/40), or by delayed excision and grafting (n = 21/40) demonstrated the advantages of elective early excision and grafting with respect to: length of hospital care, complications and their severity, and surgical repair.

Adult↗
PubMed1995

Effects of strabismus surgery on refraction in children.

We assessed 115 eyes of 59 children with esotropia 2-3 months postoperatively to evaluate the effects of strabismus surgery on refraction. Three variables were measured: spherical equivalent, and cylinder power and axis. The mean changes in spherical equivalent were non-significant. The axis of postoperative astigmatism moved towards 'with-the-rule', thus improving refraction. The amount of recession and the consequent changes in cylinder power were inversely related. The results showed a significant change in cylinder axis after recession of the inferior oblique. Recession-tucking procedures led to the largest changes in cylinder power.

Astigmatism↗
PubMed1995

[Reduction mammaplasty with free nipple. Apropos of 5 cases].

Thorek's technique for reduction mammaplasty with free nipple graft, described in 1922, has progressively been superseded by procedures using a dermo-glandular pedicle. Following a description of the surgical procedure used, we present a series of 50 patients operated with an average follow-up of 14.6 months; the outcome of the nipple graft was particularly studied. It appeared that the faults which are usually seen with this technique (loss of pigmentation, loss of sensitivity and contractility of the nipple and areola) were only observed in a minority of cases and were never considered to be unsatisfactory for the patients. Thorek's technique also presents advantages: short surgical procedure, simplicity of the glandular resection, minimising the risk of cytosteatonecrosis. This seems to us to be a preferential procedure for the treatment of major hypertrophy in patients presenting vascular risk factors of with a history of tumour.

Adolescent↗
PubMed1995

[Accidents of chemotherapy involving the upper limb].

Subcutaneous extravation of antimitotic agents in the upper limb is a rare complication of chemotherapy. The functional integrity of the limb can be compromised due to severe skin damage. Extensive soft tissue necrosis is difficult to manage and cannot always be repaired without sequellae. Based on an analysis of a series of patients and a review of the literature, we report the main pathophysiological features and clinical signs of such accidents as well as the still debated therapeutic management. Two points are essential: the emergency situation created by these accidents requiring adequate and rapid treatment despite the apparently benign appearance of the extravation and imperative prevention which is the main therapeutic tool.

Antineoplastic Agents↗
PubMed1994

[Cutaneous cicatrix: natural course, anomalies and prevention].

Improving scar quality has become a major concern for surgeons. Although good skin suturing is of primordial important, the healing process varies greatly from one patient to another and the risk of hypertrophic or keloid scar evolution is currently unpredictable. Local massage and above all post-operative compression using compressive garments and sheets of silicon are an efficient methods of counteracting the proliferative phase which occurs during the first few months. In severe cases, particularly in burn patients, high-pressure springwater hydrotherapy to reduce scar contracture has proved to be effective. The current trend is to decrease the risk of bad scars in the immediate post-traumatic, post-operative stage in order to obtain the best possible scar initially and thus avoid revision surgery.

Adult↗
PubMed1994

Ocular findings in trigonocephaly.

BACKGROUND: Trigonocephaly, caused by premature closure of the metopic suture, is a rare form of craniosynostosis. The aim of this study was to assess the visual outcome in children operated on for trigonocephaly. METHODS: We present eight cases of children with trigonocephaly surgically corrected by the same craniofacial technique. CT with 3D reconstruction was performed in all cases. Genitori defined three types of trigonocephaly according to the severity of the deformity of the skull base only types II and III were included in this study directed at evaluation of the ocular disorder. A complete eye examination was performed on all children by the same observer, with a follow-up of 2-6 years. RESULTS: 3D-CT reconstruction of the skull base showed that the frontozygomatic region was affected by the deformation. Ocular examination showed considerable astigmatism in most children with late operation. A low degree of strabismus was observed in most children. CONCLUSION: This study demonstrated that reconstructive surgery should be performed by the age of 6 months, given the immaturity of the visual system up to that time. Close cooperation between neurosurgeons, pediatricians and ophthalmologists is of paramount importance in order to prevent this bone deformation exerting an adverse effect on visual development. The ophthalmologist must possess a basic understanding of the various craniosynostoses.

Astigmatism↗
PubMed1994

[Coverage of arterial repair of the upper limb. Choice of a technique apropos of 24 cases].

Twenty-four cases of complex trauma of the upper limb, with soft tissue damage including at least loss of part of an artery and the overlying skin, were recorded and treated in the Hand Emergency Unit at the Timone Hospital in Marseilles. These cases were dealt with globally in a single staged operation with careful wound care, bone stabilisation when this was deemed necessary, arterial shunt and repair of the soft tissues. To cover the exposed arterial shunt, the choice of coverage technique depends on the site of the lesion, on the extent of soft tissue damage, and also on the reliability of the flap and its residual scar. The authors analyse their series and present their indications.

Arm Injuries↗
PubMed1994

[Mandibular reconstruction using an iliac crest free flap vascularized by the deep circumflex iliac vessels. A clinical study apropos of 30 cases].

Thirty cases of mandibular defects were reconstructed with a free iliac flap vascularised by the deep circumflex iliac vessels. Twenty five of these cases involved soft tissue damage with a defect of the mandible. The surgical procedure described by I. Taylor was used. Three anatomical variations of the pedicle were found. The features of the iliac bone are particularly suitable for mandibular reconstruction. The natural shape of the iliac bone does not require complex osteotomies and its healing capacity allows simple osteosynthesis. The thickness of the muscular pedicle, and thus the flap, is determined by the position of the lower edge of the skin components with respect to the iliac crest. This type of flap currently remains very useful in reconstruction of major mandibular and adjacent soft tissue destruction because of the very low incidence of failure (2 cases) and complications.

Adolescent↗