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Biomedical subjects

M R Wexler

Publications and source records attributed to M R Wexler.

At least 19 recordsLinked to original sources
PubMed1992

[A decade of experience in craniofacial surgery].

Our craniofacial surgery team includes experts from the following fields: plastic surgery, neurosurgery, ophthalmology, genetics, neurology, orthodontics, pedodontics, facial rehabilitation, psychiatry, social work, anesthesiology and intensive care. Craniofacial surgery became to a large extent pediatric surgery, following evidence that careful, early surgery does not impair growth and that development following surgery is almost normal. The malformations that were repaired included those of the Crouzon and Apert syndromes, requiring frontal remodelling and advancement of the middle third of the facial skeleton; hypertelorism in which orbits were moved to the midline; large craniofacial clefts in which the hemiface from either side was moved to the midline; and different types of craniostenosis in which frontal advancement and remodelling with reconstruction of the vault was performed. The series consisted of 78 patients who presented between 1979-1989. 3 illustrative cases are described.

Craniofacial Dysostosis↗
PubMed1992

Phosphorous pentachloride chemical burn--a slowly healing injury.

A 51-year-old chemical engineer sustained phosphorous pentachloride partial skin thickness burns over 20 per cent of his body surface area. Although macroscopically and microscopically the wound seemed to be superficial, the course of clinical healing of this injury was very slow and painful. Retrospectively this burn should have been treated by early excision and grafting.

Accidents, Occupational↗
PubMed1992

Structural and functional evaluation of modifications in the composite skin graft: cryopreserved dermis and cultured keratinocytes.

Structural and functional aspects of modifications in the composite skin graft consisting of cultured keratinocytes and cryopreserved dermis were determined. Cryopreserved human cadaveric dermis separated from skin by short and mild trypsinization was compared with dermis obtained by prolonged incubation in medium and with fresh dermis obtained by the same methods. All types of dermis were shown to retain normal ultrastructure and topographic organization, as detected by scanning and transmission electron microscope and immunofluorescence analysis. However, in fresh skin, the layers were more firmly attached, mechanical separation was more difficult, and residual epidermis often remained attached to the dermis. Keratinocytes attached better, began replication earlier, and generally reached higher cell numbers when cultured on trypsinized dermis than on medium-treated dermis. The performance of several modifications in the reconstitution and grafting procedures of the composite skin graft after transplantation to athymic mice was examined. Cultured epidermis combined onto trypsinized or medium-treated whole and meshed dermis, dermis pregrafted and allowed to take before transplanting epidermis on top, and keratinocytes grown into multiple epithelia on top of trypsinized meshed or whole dermis prior to grafting. The best grafting results were obtained with an "instant" reconstituted skin model: multiple epithelia grown in vitro combined immediately before grafting onto meshed trypsinized dermis. The transplantation results of this modification were significantly better than those of all the other modifications, including initial growth of keratinocytes into multiple epithelia on top of trypsinized dermis prior to grafting.

Animals↗
PubMed1991

Use of buried skin implants after recurrent failure of conventional skin grafting in a massive burn: the renewal of an old technique.

The technique of burying small pieces of skin under old granulation tissue after recurrent failure of conventional skin grafting is described in a patient with 95 per cent full skin thickness burns. This method of treatment, which was described in the past and neglected, is of value for massive burns or grafting in difficult areas. The technique is described again and the relevant literature reviewed.

Adolescent↗
PubMed1991

Silver sulphadiazine-induced haemolytic anaemia in a glucose-6-phosphate dehydrogenase-deficient burn patient.

A 20-year-old soldier sustained 35 per cent body surface area burns by open flames. He was treated with topical application of 1 per cent silver sulphadiazine (SSD) twice daily. Four days postburn he developed acute haemolytic anaemia. Withdrawal of SSD was followed by complete recovery. A glucose-6-phosphate dehydrogenase (G6PD) deficiency was proven by pathological Motulski tests. Although the hazards of SSD are well indicated by the manufacturers, there appear to be no written reports of haemolysis induced by this drug in G6PD-deficient patients.

Acute Disease↗
PubMed1991

Giant melanoma of the inner thigh: a homeopathic life-threatening negligence.

The strange case of a 37-year-old modern, Western woman who presented with a giant black mass on her inner right thigh is presented. She was treated 10 months before this present admission by an excision of a nodular melanoma, and she was treated, thereafter, by a homeopathic practitioner until she came late to follow-up. The woman is discussed with special attention to the fact that alternative medicine does not always constitute good advice, and the relevant literature is reviewed.

Adult↗
PubMed1991

Congenital dysplasia of the heel fat pad: a case report of a previously undescribed entity.

We describe a 13-year-old girl who was born with a congenital anomaly of her left heel fat pad. We call this anomaly congenital dysplasia of the heel pad, due to under development of all elements of the heel fat pad. In the case presented the vertical fibrous septa were missing and the amount of fat and its distribution were abnormal. As a result, the abnormal biomechanical shock absorber mechanism caused a painful callosity formation. A surgical procedure aiming to produce adhesions between the fat pad and the calcaneous in order to decrease the shear of the heel pad was only partially successful. Different types of orthotic devices did not resolve the clinical problem of the painful heel. Such a congenital anomaly has never been described in the English literature, and we coined the term congenital dysplasia for the previously undescribed entity.

Adipose Tissue↗
PubMed1990

Deep partial skin thickness burns: a reproducible animal model to study burn wound healing.

A reproducible deep partial skin thickness burn model using guinea-pigs to study the healing process of this injury is described. Round aluminium templates heated to 75 degrees C and applied for 5 s to the moistened, clipped and depilated dorsal skin produced the desired depth of injury. This model is applicable for the study of the three main components of the burn wound healing process: epithelialization, contraction and scar formation. It is recommended that the India ink injection technique be used to confirm the depth of the burn wound.

Animals↗