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Biomedical subjects

J W May

Publications and source records attributed to J W May.

At least 127 records · Page 7Linked to original sources
PubMed1982

Microvascular transfer of free tissue for closure of bone wounds of the distal lower extremity.

Extensive compound fractures of the distal lower extremity may result in chronic infection of the deep tissues and bone if primary healing does not occur. Treatment may require several operations and prolonged hospitalization. In an attempt to improve the management of such problems, 18 patients who had chronic bone-exposure wounds and four patients who had extensive compound fracture wounds of the distal lower extremity were treated with radical debridement, intravenous antibiotics, and microvascular transfer of vascularized tissues for immediate wound closure. All wounds healed, and there was no evidence of recurrent infection during a mean follow-up period of 19.3 months in the patients with chronic wounds and 16.3 months in those with acute wounds. In selected patients this free-tissue-transfer method of wound closure appears to have considerable advantages over conventional methods of management.

Adolescent↗
PubMed1982

Digital replantation distal to the proximal interphalangeal joint.

Microvascular replantation of digits distal to the proximal interphalangeal joint were reviewed in 24 digits in 18 patients. Of the 24 digits studied, five were seen in patients who had a single digit amputated and replanted, 10 were seen in patients who had multiple distal digital amputations and replantations, and eight were seen in patients who had other proximal digital replantations or other associated hand injuries in addition to the distal replantations. Survival rate in this study was 96%, and the mean active range of motion at the proximal interphalangeal joint was 95 degrees with 8.9 degrees active motion at the distal interphalangeal joint. Two-point discrimination averaged 11 mm, and all patients had some cold intolerance. The nine students in this study required a mean 1.7 months to return to school; nine patients were workers and required a mean of 5.1 months to return to work. Acceptance for the procedures was overwhelmingly good. Replantation of an amputated digit distal to the proximal interphalangeal joint in selected cases can be a worthwhile procedure.

Adolescent↗
PubMed1982

Teres major--latissimus dorsi skin-muscle flap for chest-wall reconstruction.

The complete survival of a teres major--latissimus dorsi skin-muscle flap for chest reconstruction is reported in a patient in whom the primary neurovascular pedicle of the latissimus muscle had previously been sacrificed. At operation, collateral vessels of 1-mm proportions were noted to have developed between the innervated teres major and denervated latissimus dorsi muscle. In this case, the teres major muscle rotated with the latissimus muscle to affect reconstruction of a full-thickness anterior chest resection. This report suggests the possibility of a denervated, relatively devascularized muscle obtaining additional blood supply from adjacent innervated vascularized muscles and supports the concept of rotating the muscles as a unit to encourage viability of the denervated component.

Breast Neoplasms↗
PubMed1982

Growth-plate behavior in whole joint replantation in the rabbit.

We studied the behavior of the distal femoral and proximal tibial physes after whole knee-joint replantation in skeletally immature New Zealand White Rabbits. We developed an operative model in which a rabbit's knee was isolated on a vascular pedicle and was then replanted using microvascular technique. In a short-term study (three weeks or less) of ten rabbits, the patency of the vascular repairs and the resumption of metabolic activity of the cells in the growth plates were assessed. A long-term study (ninety days) of eight rabbits was designed to monitor growth after replantation. The results indicated that in rabbits, the femoral and tibial growth plates could be removed and returned to place during whole-joint replantation. If the blood supply was successfully re-established, metabolic function of the cells in the physes remained normal during the early postoperative period, and at ninety days (near the time of skeletal maturity) bone growth in the limb that was operated on was about equal to that of the opposite limb which was not operated on.

Angiography↗
PubMed1982

Thermal-energy dissipation: a laboratory study to assess patency in blood vessels.

Surgeons involved in the repair of small blood vessels could benefit from a postoperative monitoring system that would allow vessel-patency determination. These experiments have confirmed that thermal-energy dissipation, measured electrically by direct vascular thermocouple application, is a sensitive and accurate indicator of regional arterial perfusion. Occlusion of arteries 1 to 2 mm in diameter produced a significant temperature decrease in direct artery measurements in the rat and island-flap artery assessments in rats and rabbits. Early recognition of vessel occlusion could allow for rapid intervention and increase the likelihood of tissue salvage. While this technology need not replace existing methodology, it does alleviate many of the problems seen with other vessel- and tissue-monitoring methods and thus may deserve further investigation.

Animals↗
PubMed1981

Latissimus dorsi free muscle flap in lower-extremity reconstruction.

The free latissimus dorsi skin-muscle flap has gained wide popularity to solve a variety of difficult reconstructive surgical problems. However, the donor site of this skin-muscle flap leaves a conspicuous scar and indentation, and frequently in the recipient site the skin-muscle flap leaves a conspicuous scar and indentation, and frequently in the recipient site the skin-muscle flap requires staged defatting procedures. This case demonstrates the use of the latissimus dorsi muscle flap for lower-extremity reconstruction, where a new blood supply and soft-tissue coverage are required to solve a chronically infected, open ankle joint. By taking the latissimus muscle only through a short, axillary incision, much of the donor-site deformity is minimized, and after transfer, the muscle can be molded and shaped to fit the recipient site with split-thickness skin graft coverage. This combination of free muscle flap transfer and skin graft would appear to provide a flexible, contoured, well-vascularized muscle with a relatively inconspicuous incision and skin-graft donor site.

Adult↗
PubMed1981

Effects of age on color preference for black and white by infants and young children.

The purpose of this study was to determine whether age influenced preference for the colors black and white by infants and young children. The investigator administered a color-preference test to 160 subjects who attended day-care centers and who ranged in age from 6 mo. to 4.5 yr. There were equal numbers of males and females and equal numbers of Afro- and Euro-American subjects. Ages of the subjects were controlled so there were 20 subjects in each 6-mo. age interval. Data were obtained from a 12-term test in which pairs of toys were presented to each subject. The toys were identical except that one was black and the other was white. The toy the subject selected was considered the subject's preference and the color of that toy was recorded. Results of a chi-squared test and of an analysis of variance indicated that, as a group, age affected color preference. A pro-black bias was found for the younger children. The findings suggest that color preference of infants and young children is not the same as for older children and adults.

Child Development↗
PubMed1981

The latissimus dorsi muscle: a fresh cadaver study of the primary neurovascular pedicle.

The primary neurovascular pedicle of the latissimus dorsi muscle was studied in 50 fresh cadaver dissections and pertinent dimensions and anatomic relations was recorded. Some findings applicable to clinical reconstructive surgery are: 1. Vascular pedicle of 11 cm mean length (subscapular-thoracodorsal artery and vein). 2. Consistent T-shaped relationship among subscapular artery, thoracodorsal artery, circumflex scapular artery, and serratus arterial branch(es). 3. Large serratus anterior branch(es) from the thoracodorsal artery (1.1 mm mean diameter). 4. Consistent posterior location of neurovascular hilus at muscle junction. 5. Bifurcation of neurovascular structures at the hilus into superior and lateral intramuscular bundles (86 percent of dissections), making various surgical options with the latissimus dorsi skin-muscle flap possible. 6. Lengthy thoracodorsal nerve (12.3 cm mean length). 7. Low incidence of atherosclerosis in the subscapular artery (8 percent) and no significant atherosclerosis seen in the thoracodorsal artery.

Back↗
PubMed1981

Toe-to-hand free tissue transfer for thumb construction with multiple digit aplasia.

Successful one-stage toe-to-hand free tissue transfers were performed for bilateral aplasia of the radial digits of both hands in a 9-year-old boy with associated congenital bilateral cleft foot deformity. The results indicate that toe-to-hand free tissue transfer can successfully create a functional, movable, sensate, radial, prehensile digit in hands that are markedly deficient in local reconstructive tissues.

Abnormalities, Multiple↗