Congenital absence of the hand.
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Hand Deformities, Congenital↗
Biomedical subjects
L A Chait
Publications and source records attributed to L A Chait.
An anti-drooling operation in cerebral palsy.
Persistent drooling in cases of cerebral palsy can be successfully controlled by a combination of bilateral parotid duct translocation and bilateral submandibular gland excision. Ten children are described who underwent this operation with satisfactory results. Apart from mile transient postoperative swelling of the cheek, there have been no postoperative complications. The importance of bilateral submandibular gland excision is stressed and the operative details are described. These include elevating a flap of buccal mucosa distally from the orifice of the parotid duct and then burying this strip beneath the buccal mucosa posteriorly to emerge in the pharynx just above the tonsillar fossa. The edges are then sutured to the mucosa of the pharynx. In time the parotid secretions pass into the pharynx via the newly created tube of mucous membrane. The technique is simple and the end result is satisfactory.
Cerebral Palsy↗
A method of treating the exposed cardiac pacemaker.
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Aged↗
The no-reflow phenomenon in experimental free flaps.
The no-reflow phenomenon was studied following reconstitution of blood flow by microvascular anastomosis in an ischemic and denervated free epigastric flap in the rabbit. Microscopic, histological, angiographic, and hematological studies demonstrated the progressive nature of this obstruction to the peripheral blood flow after increasing periods of ischemia. This obstruction reached a point of irreversibility after 12 hours of ischemia, leading to ultimate death of these flaps. These results are consistent with the hypothesis that an ischemia-induced no-reflow phenomenon is caused by cellular swelling, intravascular aggregation, and the leakage of intravascular fluid into the interstitial space. Similarities between these experimental findings and human observations are made. The clinical importance of early diagnosis and treatment of ischemic tissues is emphasized.
Animals↗
The effects of the perfusion of various solutions on the no-reflow phenomenon in experimental free flaps.
The effects of solution perfusion in the free epigastric flap of the rabbit, after normothermic ischemic periods of 8 hours or 12 hours, have been examined by operative microscopic and histological methods. A smaller group of animals was also studied in which the perfusion was done before the ischemic insult. An ischemia-related obstruction to the peripheral blood flow occurred in the absence of stagnant ischemic blood in this model. Although the 3 perfusion fluids studied were shown to penetrate to all levels of a flap after such an ischemic period, none of them had a beneficial effect on skin survival. However, the solution containing mannitol did have a protective effect on fat survival. Analogies between these experimental findings and the clinical situation are made, and the importance of the early diagnosis and treatment of ischemia in a flap is emphasized.
Abdominal Muscles↗
Hallux-to-thumb transfer by microvascular anastomosis.
The replacement of a missing thumb with a big toe transferred as a free vascularized composite graft is described. The anatomical basis relating to this transfer is described and the methods and the advantages and disadvantages of this as alternative thumb reconstruction are discussed. To the best of our knowledge, this procedure is the first of its kind to be undertaken in South Africa.
Adolescent↗
Free neurovascular flap from the first web of the foot in hand reconstruction.
To identify an anatomically reliable and functionally acceptable neurovascular free flap for use in hand reconstruction, 50 fresh cadaver feet were dissected under the operating microscope, with particular attention paid to the anatomy of the first web area. A distal communicating artery was seen in 100% of dissections, allowing either dorsal or plantar donor artery inflow to nourish the entire flap area. Because of the ease of dissection, the first dorsal metatarsal or dorsalis pedis is suggested as the donor artery, and a dorsal branch of the greater saphenous venous system is suggested as the donor vein. The deep peroneal nerve was seen to consistently innervate the first web and, along with the plantar digital nerves, is suggested as an anatomically identifiable donor nerve. Either part of the foot first web may be used alone or together as a free flap. When indicated further dorsal skin may be incorporated into the web flap to expand its application. Two-point discrimination studies of the lateral plantar surface of the great toe in 50 normal individuals showed an average of 11.2 mm. This was significantly better as a potential donor flap than the medial dorsum of the foot where the average was 32 mm. A single case demonstrating the application of this flap in hand reconstruction is presented.
Adolescent↗
Preventing the high-riding nipple after McKissock breast reductions.
We reviewed 50 patients who had reduction mamaplasties done by us using the McKissock vertical pedicle technique. The results were satisfactory, except for the high-riding nipple which developed. We describe a minor modification which seems to prevent this complication.
Breast↗
Skin cover in extensive hand injuries.
The concept of 'axial-based' flaps has revolutionised the replacement of full-thickness defects of the skin and subcutaneous tissue of the hand. The groin flap provides extensive skin replacement, and has the advantage of allowing considerable mobility of the hand, elbow and should during the period of attachment.
Abdomen↗
Ulceration caused by cytotoxic drugs.
Five cases of severe ulceration of the dorsum of the hand and forearm, caused by the large extravasation of a cytotoxic agent, administered for haematological disorders, are presented.
Adult↗
The treatment of contact burns of the palm in children.
A combination of early tangenital excision and skin grafting, with early continuous splinting in an acrylic sandwich-splint, is described as a method of management of contact burns of the palm in children.
Acrylic Resins↗
The treatment of burns by early tangential excision and skin grafting.
The principles, aims and detailed techniques of tangential excision and skin grafting of burns are described. The results and advantages of the method in 28 burned patients are discussed.
Adolescent↗
Dogbite injuries in children.
An analysis of 50 children suffering from severe dogbites showed that the face was the anatomical site of predilection (75%(, and that the breed of dog most commonly involved was the Alsatian (German Shepherd). Primary debridement and suture under general anaesthesia is the treatment of choice. Ampicillin has been shown to be the antibiotic giving the widest over-all prophylactic chemotherapeutic cover.
Adolescent↗