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J Baudet

Publications and source records attributed to J Baudet.

At least 37 records · Page 2Linked to original sources
PubMed2001

[Microsurgery and esthetic considerations. Two cases of heel reconstruction].

With two case reports of heel reconstruction on female patients the authors report the advantages and drawbacks of the two main types of reconstruction: free or regional flaps. Regional flaps are technically easy and reliable but their aesthetic after-effects on the donor site may be disabling, specially on the leg of a female patient. Microsurgery is technically more difficult and presents more complications specially on the lower limb. However, in certain conditions, and with the appropriate choice of donor site, free flaps authorize good quality reconstructions with minimal aesthetic after-effects.

Accidents, Occupational↗
PubMed2001

[Terminal-lateral nerve anastomoses. Preliminary clinical report of two cases].

Nerve regeneration is based on three phenomenons of critical importance: neurotropism, nerve guidance and neurotrophis. These principles allow understanding the mechanisms of nerve suture and grafting, but also the newly described end-to-side nerve anastomoses. In this procedure, the distal stump of a severed nerve is anastomosed on the lateral side of an intact nerve, with or without removal of the perineurium. Authors report their beginning experience with this procedure (ten cases) and discuss the early results. End-to-side anastomosis seems to be a useful and reliable technique for clinical nerve repair. Even if nerve grafting remains the gold standard to bridge nerve defects, one has nothing to loose if a few minutes, anastomosing the severed nerve on the lateral side of an intact nerve, rather than doing nothing.

Adolescent↗
PubMed2001

[Vascularized bone pedicle grafts of the hand and wrist: literature review and new donor sites].

Some situations in hand surgery require vascularized bone grafts. Good mechanical strength and decreased time for bone healing may explain their use. Although many donor sites have been described, the authors were interested by donor sites with a blood supply provided by an accessory vessel not disturbing the perfusion of the hand. Literature review of the different donor sites demonstrate (a) Three sites at the dorsal aspect of the distal epiphysis and one at the dorsal distal ulna. Only the radialmost site has been regularly used for surgical application. (b) At the palmar aspect of the radial epiphysis, the pronator quadratus vascularised bone graft may be elevated in an antero or retrograde way. (c) Among the carpal bones, the pisiform and part of the capitate has been used as pedickled bone graft. (d) Metacarpals may also be a donor site. Description of sites at the proximal and distal part of the second metacarpal has been used for surgical applications. The authors describe a new site at the first metacarpal at the radiodorsal or uino-dorsal aspect which may be used as a composite bone-skin graft. A clinical application is presented. Clinical use of these pedicles graft is discussed and apply mainly for scaphoid nonunion and some case of Kienbock's disease. Distal stump reconstruction is possible with the new flap.

Bone Transplantation↗
PubMed2001

Limits and indications of the dorsal transposition flap: critical evaluation of 15 cases.

The dorsal transposition flap was used in 15 cases of distal fingertip amputation. The amputations were either oblique ulnar, oblique radial, oblique palmar, or transverse. Two flaps developed partial necrosis. Flat nail growth always occurred, but the nail was considered short in 4 cases due to a proximal amputation through the nail bed. The mean 2-point discrimination test result was 8 mm. Distal interphalangeal joint range of motion was normal in 5 cases. Four cases lacked 10 degrees from full extension, 9 cases lacked up to 20 degrees from full flexion, and 1 case lacked 35 degrees. Even if this procedure is simple, reliable, and fast, due to its limited size and arc of rotation, as well as its poor sensibility, this flap may only be indicated for oblique ulnar fingertip amputations.

Adolescent↗
PubMed2001

Treatment of facial haemangiomas: the present status of surgery.

Although conservative management is usually proposed for haemangiomas occurring in infancy, the presence of these tumours on the face may result in severe complications and provide an indication for treatment. In this paper, we report 35 patients who underwent surgical treatment for facial haemangiomas. The series consists of 23 females and 12 males, ranging in age from 2.5 months to 35 years. In six patients early surgery, before the age of 2 years, was performed because of severe complications, including visual occlusion, repeated bleeding and distortion of adjacent structures. In 16 children surgical resection of haemangiomas was carried out between 2 and 5 years of age, before complete involution. In 13 patients persisting haemangiomas were surgically treated at an older age. The operative technique depended on the location and size of the lesion, and focused on resection of the tumour and reconstruction of the adjacent structures when necessary. The postoperative outcomes were very satisfactory. Early surgery is mandatory in the management of large periocular haemangiomas, to prevent secondary amblyopia, and proliferative labial tumours, which are prone to bleeding and cause difficulty while eating. Early surgical treatment is also recommended for nasal-tip haemangiomas, which regress very slowly and may result in severe distortion of the cartilaginous framework. In conclusion, facial haemangiomas causing functional disturbance or serious psychological distress deserve surgical excision before the age of expected spontaneous regression; surgery can provide active treatment with excellent results and minimal morbidity.

Adolescent↗
PubMed2001

Vascular blood supply of the dorsal side of the thumb, first web and index finger: anatomical study.

Twenty-nine hands were dissected in order to define the dorsal blood supply of the thumb, the first web and the index finger. The main objective was to determine if it is possible to create a local osteocutaneous flap to cover partial and complex tissue defects in the distal part of the thumb. We found that the thumb metacarpal could be used as a donor site in these situations, with either a radiodorsal pedicle or an ulnadorsal pedicle.

Arteries↗
PubMed2001

Dorso-ulnar osteocutaneous reverse flow flap of the thumb.

Three cases of distal thumb reconstruction with a reverse pedicled osteocutaneous flap taken from the dorso-ulnar aspect of the first metacarpal are presented. Even though the indications are rare, this flap is useful for the reconstruction of distal osteocutaneous defects of the thumb where more complex procedures are not feasible or considered as excessive.

Adult↗
PubMed2001

Ten years of experience with the submental flap.

This article describes the authors' experience with the submental flap over the past 10 years. A brief review of the key points and some refinements in the operative technique are discussed. The results concern 31 patients with a mean age of 57 years. All flaps were pedicled except two. One case of composite flap with bone was used. The mean size of the flap was 11.8 x 5.5 cm, and the mean postoperative stay was 11.1 days. Complications encountered were one case of temporary palsy of the marginal mandibular branch of the facial nerve, one hematoma at the recipient site, and two cases of partial flap loss. Color and texture match were good. The authors believe this flap to have great clinical potential and to be a worthwhile addition to the existing surgical armamentarium.

Adult↗
PubMed2001

Internal use of n-butyl 2-cyanoacrylate (Indermil) for wound closure: an experimental study.

n-Butyl 2-cyanoacrylate glue (Indermil) was used for the closure of dorsal wounds on rabbits. A 4-cm-long and 1-cm-wide laceration was created bilaterally on the back of 15 rabbits. One side was closed with absorbable 2-0 subcutaneous sutures and fast absorbable 3-0 skin sutures, whereas the other side was closed with cyanoacrylate glue applied on both deep and superficial tissues. A partial wound dehiscence occurred on the glue side in one animal at 2 weeks. The animal was killed at this time and considered a bad result in the glue group. In all other animals, no seroma, partial dehiscence, or wound infection occurred. Histopathologic analysis revealed that Indermil induced edema and a mild acute inflammatory reaction and resorbed almost completely within 2 months when applied to well-vascularized tissues. The application of glue on the cutaneous wound edges is a fast and easy procedure that does not seem to delay or inhibit the healing process or its quality.

Animals↗
PubMed2001

The submental flap: its uses as a pedicled or free flap for facial reconstruction.

The submental flap is an alternative to microsurgical flaps for facial and intraoral defects. The submental flap is simple and can be raised rapidly. It produces good color, texture, and contour match without a conspicuous site. Its versatility and its rotational arc explains its large application in facial surgery. The pedicle is reliable when the flap is not used with a reverse flow. The surgeon must know the possible presence of valves in the venous system of the face and plan to perform a venous microsurgical anastomosis if venous congestion jeopardizes the flap's survival. The location of the flap in a lymph node area restricts its uses for traumatic cases, and for benign and malignant tumors, to reduce the potential of cancer spreading to the lymph nodes (e.g., basal cell carcinoma).

Aged↗
PubMed2000

Soleus-fibula free transfer in lower limb reconstruction.

Free-fibula transfer has been widely used since 1975. Many modifications have been described; one of them, association of the lateral part of the soleus muscle to the fibula, is reported here through a 14-case series. This composite flap is intended for extensive defects of the lower limbs involving bone and soft tissues. The flap is considered by the authors to be reliable, with a constant vascularization. A 20-cm length offibula may be harvested associated either with the lateral part of the soleus muscle or with the whole muscle. Moreover, the soleus muscle represents a vascular security inasmuch as it preserves both medullar and periosteal bone supply. Fourteen cases have been performed by the authors since 1978 and could be reviewed with a minimum 2-year follow-up. Average length of bone defect was 12 cm, and average length offibula harvested was 18.6 cm. Soft-tissue defect was always associated and ranged from 8 x 4 cm to 20 x 30 cm. The fibula was harvested with the lateral part of the soleus muscle in 10 cases and with the whole soleus muscle in 4 cases. One total treatment failure was reported and was related to intimal degenerative lesions on veins used for arteriovenous bypass. In other patients, mean time for bone healing was 11 months. Patients could walk again, on average, 17 months after reconstruction. Sequelae at the donor site were minimal.

Adolescent↗
PubMed2000

[The modiolus. Comparative anatomy, embryological and physiological review, surgical importance].

Monkeys, imitators of man's gesture never shared smile with him and their facial expressions only result in grimaces. Study of animal anatomy may explain why subtle expressions of the lips are a more man's special gift than laughter. These fine movements are related to a subcutaneous muscular structure termed modiolus, which is the meeting point of muscles involved in the motion of mouth and comparative anatomy shows this structure to be better defined in Man than in other primates. Embryologically, muscles that form the modiolus derive from a cellular concentration in the region of the second branchial arch. It is then logical to see these muscles converge to the corner of the mouth to form the modiolus, as they emerge from a common area. Functioning of the modiolus is complex, as its position may change many times in a minute to allow the orbicularis oris muscle to take any position and do any movement as if it was inserted on bone. With its complex physiology, the modiolus is of critical importance in the subtle expressions of the lips and must be preserved or reconstructed when performing repair of full-thickness tissue defects of lips.

Animals↗
PubMed2000

[Autologous bone grafts. Anatomo-physiology, technique and actual location for bone reconstructions].

The authors discuss the indications for conventional nonvascularized bone grafts, of which the scope of utilisation has been considerably reduced since the advent of vascularized bone grafts. The objective of this study is to highlight the essential knowledge regarding the biology and biomechanics of the incorporation of bone grafts. The principal donor sites are examined with respect to the operative techniques and the advantages and disadvantages. The authors then derive the principal indications for conventional bone grafting and illustrate them with examples selected for limb reconstruction.

Bone Transplantation↗
PubMed2000

[The iliac crest. Perspective on a donor site of exceptional free flaps, 20 years after its initial description].

The iliac crest represents the principle 'reservoir' for the cortico-spongy bone. After having been used for a long time in the form of a conventional graft, it has been the object, in the last 20 years, of increasingly sophisticated transfers, making it possible to extract it in vascularized form. The authors present the anatomical bases of these transfers, which can be conceived on four different vascular axes: the superficial circumflex iliac axis, which was the first used, the deep circumflex iliac axis, the superior gluteal axis, and the lateral femoral circumflex axis. After having presented the various techniques of extraction of the anterior and posterior crests, the authors attempted to delineate the indications of each variant in the reconstruction of the members and the cervico-facial sphere. A comparison with the fibula flap will be finally carried out in order to parallel the advantage and respective disadvantages of these two transfers.

Bone Transplantation↗
PubMed2000

[The scapula: a preferred donor site for a free flaps or pedicles transfer].

The authors present all the possibilities that the scapula can offer as a donor site for bone. After having reviewed the potential for acromial transfer on a pedicled trapezial flap, they summarise the anatomical basis for the transfer of the lateral border. There are two systems of vascular supply, one based on the circumflex scapular vessels described by Téot and the other based on the vessels of the angle of the scapula described by Deraemacker. This dual blood supply forms a very rich anastomosis with a predominant periosteal supply that allows for multiple osteotomies to be made. The technique of harvesting and the indications are highlighted as well as an iconography, which presents the principle forms of reconstruction that have been described until today. The authors support the use of the pedicled transfer of the lateral border, which is poorly known and above all poorly used. Their experience in five consecutive clinical cases demonstrates all the potential of this technique for humeral reconstruction. As a microsurgical transfer, however, the principal advantage of using the inferior scapular axis is offset by a few drawbacks, the principal one being the difficulty of dissection. Its main indication as a free flap is in the maxillofacial surgery where it allows very precise reconstructions of the mandible, the palate or the maxillozygomatic region.

Bone Transplantation↗
PubMed2000

[The technique and location of secondary donor sites of vascularized bone grafts in the therapeutic arsenal of the plastic surgeon].

Most of the donor sites for conventional bone grafts can also provide vascularised bone grafts. Increased progress in vascular research has enabled the harvesting of grafts that are increasingly reliable and versatile. This work does not give emphasis to classic vascularised bone transfers like the iliac crest, the fibula or the lateral border of the scapula but highlights 'secondary' sites which are often underutilized. Several donor areas are studied; the upper limb including the clavicle, the lower limb, the thorax and the cranium. The hands and toes, which constitute a specific entity, are excluded. In each chapter the authors have emphasised the fundamental points relating to the anatomy, the technique of harvesting and the indications.

Bone Transplantation↗