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Biomedical subjects

M D Brough

Publications and source records attributed to M D Brough.

15 recordsLinked to original sources
PubMed1991

The King's Cross fire. Part 1: The physical injuries.

Fire broke out at the end of the evening rush-hour at King's Cross Underground Station, London on the 18 November 1987. Fifty-eight people were killed or injured by the flash-over in the main ticket concourse at the top of the escalator, beneath which the fire began. Twenty-eight survivors were treated for thermal injuries of a broad spectrum of severity but with a similar pattern. The sequence of events in the initial response, the distribution of patients and the pattern of injuries with details of their management over 2 years are described. The psychological effects of the disaster on the patients involved are detailed in Part 2, the accompanying article (D. Sturgeon, R. Rosser and P. Shoenberg (1991) Burns 17, (1), 10-13).

Adult↗
PubMed1991

Mastoid obliteration with the temporoparietal fascia flap.

Obliteration of persistently discharging open mastoid cavities is one surgical option to achieve a dry ear. All the currently described techniques involve the use of random pattern local tissue flaps or free grafts. Ten patients have undergone obliteration procedures using the vascularized temporoparietal fascia flap. This resulted in rapid epithelialization by six weeks in seven out of 10 cases. The remaining three patients have persistent non healed areas over the medial attic wall, but are not troubled by otorrhoea. The indications, technique and complications of mastoid obliteration by this axial pattern flap are described.

Adolescent↗
PubMed1990

Comparison of laser-assisted and conventionally sutured microvascular anastomoses by bursting pressure: a reanalysis and further studies.

Methods of testing the strength of microvascular anastomoses are reviewed historically, in the light of recent applications to laser-assisted microvascular anastomosis techniques. The results of two experiments using hydrostatic distension to bursting point to determine the strengths of laser-assisted and conventionally sutured anastomoses of rat arteries and veins are presented. Considerable variation of the bursting pressures was found at any given time after anastomosis, and by the third postoperative day, the sutured vessels showed a significant fall in strength to their weakest level, with not as great a fall in the laser group. The sutured vessels were stronger than were the laser-anastomosed vessels, except at 3 days and after 6 weeks, when there were no significant differences between the two types of anastomosis. Aneurysmal vessels did not always burst at lower pressures than did nonaneurysmal vessels of comparable age.

Anastomosis, Surgical↗
PubMed1990

Mandibular reconstruction using vascularised fibula.

The osteocutaneous fibula flap has been used to reconstruct large segments of mandible in cases following ablation for cancer or radionecrosis. The bone can be cut to the appropriate shape and the fasciocutaneous flap may be used simultaneously to provide oral cavity lining or skin cover. The technique is described and its successful use in seven patients is reported with details of the complications encountered.

Adult↗
PubMed1990

Donor site morbidity following osteocutaneous free fibula transfer.

Nine patients who had undergone free fibula transfer were reviewed to determine the incidence of donor site complications. Problems identified included distal oedema, cold intolerance, sensory loss and weakness. However, the functional deficit was not great and most patients were not troubled by their symptoms. More serious potential complications from raising this flap are considered.

Adult↗
PubMed1989

Fluid requirements of patients with burns and inhalation injuries in an intensive care unit.

We have studied 9 patients with burns (20%-75%) who had inhalation injuries and compared their actual fluid requirements with their requirements calculated from the Muir and Barclay formula. All patients were resuscitated with plasma protein fraction at a rate sufficient to keep their physiological variables within the following range: heart rate less than 120/min, central venous pressure 8-12 cm H2O, urine output greater than 30-50 ml/h, systolic blood pressure greater than 90 mm Hg and diastolic blood pressure greater than 60 mm Hg. The amount of plasma protein fraction needed was 4.38 +/- 1.26 ml/kg/% burn in the first 24 h and 2.15 +/- 0.97 ml/kg/% burn in the second 24 h. This is an increase of 75% and 110% respectively above values predicted from the formula. We suggest that the observed difference is due to a combination of the presence of an inhalation injury which increases fluid requirements by approximately 30% in the first 24 h and the use of plasma protein fraction rather than the dried plasma used in the original Muir and Barclay formula.

Adult↗
PubMed1988

Laser assisted microvascular anastomosis of arteries and veins: laser tissue welding.

Using a milliwatt CO2 laser, a series of 160 arteries and 105 veins have been anastomosed in Wistar rats. Three stay sutures and a laser tissue welding technique were used. These were compared with a series of conventionally sutured vessels in terms of patency, speed and ease of procedure, and aneurysm formation. Patency rates of successful first time anastomoses are comparable with conventional suturing methods but the aneurysm rate is higher. Laser assisted anastomosis is faster to learn and perform than conventional suturing, but microsurgical skills are still needed. Despite the large number of variables the laser assisted technique has a high success rate, and work to minimise variables and optimise the laser parameters may improve these results.

Anastomosis, Surgical↗
PubMed1987

Reconstruction of the middle third of mandible.

The radial forearm flap is established as a suitable method of providing bone with soft tissue lining or skin cover in reconstruction of the mandible. A simple and effective method of modelling the radius to provide the appropriate contour to the anterior arch of the mandible is described.

Humans↗
PubMed1986

Scalp expansion flaps.

A mean 5 year review of 20 patients who had surgery for localised alopecia of the scalp is presented. The technique of using scalp expansion flaps is described and evaluated: it is associated with a low morbidity and high patient satisfaction rate; it provides an excellent one-stage procedure for intermediate size defects and, in the frontal area, for larger defects. Particular emphasis is laid on making incision lines at right angles to the direction of hair growth in order to cover stretched scars, and in performing Z-plasties when closing small scalp defects. Finally, a rationale for the treatment of localised areas of baldness according to their size is put forward.

Adolescent↗
PubMed1977

Dermatitis artefacta.

An unusual case of dermatitis artefacta is presented. The patient lost the whole of the index finger of his dominant hand before the diagnosis was established. The motive was financial gain. The literature on self-inflicted disease is reviewed.

Adult↗
PubMedDate not supplied

Basaloid squamous carcinoma of the buccal cavity.

Basaloid-squamous carcinoma was first recognized as a separate pathologic entity in 1986. It has been described in the hypopharynx, larynx, base of tongue, and nasal cavity. We report the first case of this rare tumor occurring in the buccal cavity and review the atypical squamous cell carcinomas that occurred in these sites.

Aged↗