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Biomedical subjects

M R Wexler

Publications and source records attributed to M R Wexler.

At least 37 records · Page 2Linked to original sources
PubMed1994

Terrorist bombing with a 'Molotov cocktail' inside travelling cars: an old weapon for a new burn syndrome?

The 'Molotov cocktail' terrorist weapon which is thrown into a travelling car has given a new type of injury to people who sustain massive smoke inhalation together with disfiguring burns of face, thighs, hands and chest, and post-traumatic psychological disorder. The combination of petrol ignition with the synthetic fumes inside the care is a unique occurrence with a high morbidity and mortality which is difficult to treat and to manage. We propose to show that the combination of all the above components can be defined as the 'Molotov cocktail' burn syndrome.

Adolescent↗
PubMed1994

Cyclosporin A treatment failed to extend skin allograft survival in two burn patients.

Prolongation of skin allograft survival by immunosuppression of burn casualties has been reported sporadically during the past two decades. Recently cyclosporin A (CycA) has been used effectively for such an indication. We report here two paediatric patients with extensive burns (85-95 per cent BSA) treated with fresh, family-related skin allografts that were rejected during CycA treatment after 14-18 days. One of these children survived while the other died with candida sepsis.

Burns↗
PubMed1994

The inframammary midline triangle in reduction mammaplasty: the renewal of an old idea.

The junction between the inframammary and vertical suture lines after reduction mammaplasty is a weak point well known to plastic surgeons. This junction is prone to either necrosis or disruption, or both, in some cases. A small triangle of skin left in that location may prevent this problem. This is done routinely in all the cases of McKissock reduction mammaplasty, but it could be employed in any other techniques as well. The cosmetic appearance is good. The method, which is not new and has been used in the past, has been found very helpful and is described here along with its advantages.

Breast↗
PubMed1993

The cost of an extensive burn survival.

A 17-year-old male sustained 95 per cent body surface area burns (87 per cent full thickness skin loss). He was hospitalized in the Department of Plastic Surgery that also treats burns. After 232 days he was discharged home when he was functionally independent. He had 16 surgical procedures for excision of burn eschar and skin grafting; received a total of 128 units of blood; 899 units of fresh frozen plasma and had enteral hyperalimentation for 175 days. About 1000 physician-hours, 3000 nurse-hours, 1000 physiotherapy and occupational therapy-hours and about 250 dietician-hours were needed for his treatment. More than 1850 laboratory tests and 120 X-rays were performed, and more than 600 kg of ointment and creams were used, as well as half a ton of topical antimicrobial solutions. Ten different antibiotics were used for a total of 85 treatment days. Some 8500 m of dressing were applied with more than 6000 pieces of petroleum jelly gauze dressing. Hospitalization costs were found to be US$141,750, only 37.5 per cent of which were salaries. An analysis of these costs is given.

Adolescent↗
PubMed1993

The use of sandpaper in chemical peeling combined with dermabrasion of the face.

The combined use of chemical peel and dermabrasion of the face was widely accepted since the first reports of DuPont and Horton. We present a refinement of this combined method by introducing the use of a simple diathermy head cleaner (Surgikos, Inc) as a safer method of face abrasion. This disposable device, available at every surgical theater allows a better control of the abrasive tool, permits a more accurate depth of the abrasion, and reduces the incidence of unexpected complications in this combined technique.

Chemexfoliation↗
PubMed1993

Case study: full thickness chemical burn of the abdomen and chest.

An 81 year old patient, suffering from Alzheimer's disease sustained a full thickness HCI Acid burn of her abdomen and chest wall due to leakage of gastric content from her gastrostomy feeding tube. The controversial management of such a patient is discussed and early surgical treatment is recommended.

Abdominal Injuries↗
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↗