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Biomedical subjects

M Spira

Publications and source records attributed to M Spira.

At least 91 records · Page 5Linked to original sources
PubMed1983

Tissue pH monitoring in microsurgery: a preliminary evaluation of continuous tissue pH monitoring as an indicator of perfusion disturbances in microvascular free flaps.

In an experiment using a continuous tissue pH monitoring system, selective occlusion of the vessels supplying lower abdominal island flaps in Sprague-Dawley rats resulted in predictable tissue pH changes. Arterial occlusion resulted in a rapid fall in pH. In all three experimental groups, the steepest rate of pH drop occurred during the first 30 minutes postocclusion. In a series of 9 patients who underwent microvascular free flap surgery the continuous pH monitor was employed postoperatively. Tissue pH was (and remained) normal in well-perfused free flaps. Tissue pH fell almost immediately with anastomotic failures. These findings demonstrate that pH measurement offers the microvascular surgeon a new, simple, and reliable approach to perfusion assessment in free flaps. Perhaps improved survival rates will result from earlier anastomotic exploration in compromised free flaps that exhibit falling pH values.

Adult↗
PubMed1983

A modified gluteus maximus musculocutaneous free flap based on the inferior gluteal vessels.

A single case is reported of a large posterior calf defect, involving skin, subcutaneous tissue, and underlying muscle, in which contour is restored employing an inferior half of the gluteus maximus musculature and overlying skin as a free flap. In this patient a bulk of tissue was moved using microvascular surgical techniques while maintaining minimal donor site deformity.

Buttocks↗
PubMed1983

The perioperative management of the patient with pressure sores.

The occurrence of pressure sores is a major obstacle to the long-term rehabilitation of the spinal cord--injured patient. To achieve the best functional result with the most efficient use of resources, a comprehensive treatment plan is needed. In our twenty-five-year experience we have evolved guidelines for the perioperative management of the spinal cord-injured patient with pressure sores. Through a team approach such as that used at TIRR, the spinal cord-injured patient with a decubitus ulcer can be treated and rehabilitated. Our aim is to decrease morbidity, achieve better functional outcome, and efficiently utilize public and private resources to rehabilitate such patients.

Anti-Bacterial Agents↗
PubMed1983

Electric current arterial injury: a laboratory model.

A laboratory model capable of creating reproducible, nonlethal, fourth-degree type electrical extremity burns in rats was developed. Fifty-seven rats were studied immediately after burn to 90 days after burn with microdissections, light microscopy, microangiography, and flow studies. Progressive necrosis was not observed. Minimal major vessel arterial injury was demonstrated. This significant finding supports the concept of early debridement and reconstruction to include possible free tissue transfer.

Animals↗
PubMed1983

V-Y advancement of a subcutaneous pedicle in vermilion lip reconstruction.

We present three patients with lip cancer in whom the classic wedge excision would have resulted in an inordinate loss of tissue and possible compromise in shape and function. Without sacrificing the primary principle of adequately removing the cancer, the authors were able to excise the lesion and reconstruct the defect by means of a subcutaneous pedicle that might otherwise have been discarded with the usual wedge resection. There is a slight tendency for the healed skin flap to exhibit trapdoor scarring; however, in the older age group, in whom this technique has its greatest applicability, this has not been a permanent problem. This one-stage method of closing lip defects using subcutaneous pedicle flaps has the additional advantages of easy execution and minimal morbidity.

Basal Cell Carcinoma↗
PubMed1983

Dimethyl sulfoxide alteration of collagen.

In vitro incubation of human scar in our laboratory with 99% DMSO demonstrated, by electron microscopy, the disruption of the collagen fibers. This may prove to be a useful preparatory step for selective enzymatic assault upon exuberant or undesirable scar tissue in the clinical setting. Further study of this concept is planned.

Collagen↗
PubMed1982

Direct microvascular monitoring with implantable ultrasonic Doppler probes.

A method for constructing high-frequency pulsed Doppler ultrasonic microprobes is described. Such probes were constructed and implanted on the femoral arteries of 14 rats. All of the probes gave excellent signals during the early postoperative period and all probes were found to be functional when retrieved one month after implantation. We feel that high-frequency pulsed Doppler microprobes have important advantages for microvascular monitoring.

Animals↗
PubMed1982

Application of the latissimus dorsi muscle to the heart.

A technique was investigated for possible application in the treatment of myocardial ischemia and for repair of ventricular aneurysms. Six dogs underwent operations to transpose the latissimus dorsi muscle onto the surface of a tangentially excised area of myocardium. Three dogs were reexplored at 4 months, and 1 was reexplored at 11/2 years. A firm union of latissimus dorsi to myocardium was demonstrated macroscopically, and there was microangiographic evidence of neovascularization. The latissimus dorsi muscle flap provides considerable bulk, leaves a minimal donor site defect, has the potential for neovascularization, may provide mechanical cardiac assistance, and is simple to transfer. Further investigation is indicated.

Animals↗
PubMed1981

The new Davol dermatome.

The Davol dermatome, which was introduced in 1965, had several shortcomings in clinical application. In order to increase the efficiency of this machine, changes in the motor and drive linkages of the power handle have been made. In the clinical use of the new dermatome, ;we have found significant improvement in its application. The stalling characteristics of the dermatome have been improved and more satisfactory grafts are now obtainable. This article presents some of the technical data involved in the new drive linkage and motor complex.

Dermatologic Surgical Procedures↗
PubMed1981

Utilization of a composite island flap employing omentum in organ reconstruction: an experimental investigation.

New methods for the reconstruction of the ear, nose, and breast using omentum to vascularize appropriate tissue composites of skin, bone, and cartilage are described. The initial investigation demonstrated that it is possible to obtain an island composite flap with omentum-costal cartilage-skin flap and preserve cartilage viability inside the omentum. The ear and nose were reconstructed in two stages. In the first stage, the appropriately carved cartilage and/or bony framework was covered with omentum and a skin graft, leaving the tissue composite buried subcutaneously. In the second stage, the newly reconstructed organ was exteriorized and diagnostic studies were done. The breast reconstruction was undertaken in two stages, first creating an omental island skin flap and subsequently either implanting a standard prosthesis under the flap or transferring the entire composite superiorly to better simulate the clinical reconstruction wherein the lower abdominal skin with omentum would be moved to the anterior chest. In each reconstruction a variety of diagnostic studies, including intravenous fluorescein dye, radioactive isotope uptake, and microangiography, were performed.

Animals↗