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Biomedical subjects

P Micheau

Publications and source records attributed to P Micheau.

At least 37 records · Page 2Linked to original sources
PubMed1997

[Clinico-immunological study of 16 cases of benzoate intolerance in children].

The authors report a sery of 16 cases of intolerance to the benzoates in children. Sixteen children (9 boys and 7 girls) were directed to the Hospital of Tarbes from June 1995 to July 1995, for recurring urticaria (7/16) combined with asthma (1/16), atopic eczema (2/16), dermorespiratory syndrome (2/16) and asthma (1/16). All were subject to an immunological examination comprising alimentation inquiry, prick test, IgE determination, RAST, oral provocation test to benzoates, which establishes the diagnosis, whose confirmation is certified by the benefit of the food eviction. To conclusion, the authors underline several points: the presumable underestimation of the intolerance, the often mentioned atopic familial context, the observed pathology (urticaria, asthma, eczema), the importance of the provocation test. Finally, besides food such as grey shrimps, sodas and antibiotic syrups, one finds benzoates in the antiallergic syrups initially prescribed as a preventive measure.

Asthma↗
PubMed1997

[Imaging of abdominal wall eventration: role and value of x-ray computed tomography].

The role of imaging in preoperative investigation of incisional hernia was studied in a series of 332 operated patients. CT scan (220 patients) remains the reference investigation. Magnetic resonance imaging (8 patients) does not provide any supplementary information at the present time. The classical features of median and lateral incisional hernia are described and the importance of evaluation of the elasticity and strength of the abdominal wall is stressed. In the authors' experience, this evaluation has implications for pre- and intraoperative strategy.

Abdominal Muscles↗
PubMed1995

[Large eventrations: deep extensive cleavage of the abdominal wall and prosthetic repair].

The objective for surgical repair of major defects of the abdominal wall is an anatomical reconstruction and reinforcement with a support prosthesis. Wall reconstruction should be obtained without tension. This requires deep extensive cleavage so the deep musculo-aponevrosis can be advanced approximately 10 cm. This manoeuvre is anatomic and preserves vascularization and innervation. A prosthesis covers the orificies and reinforces the anatomic construction. In peripheral defects, cleavage is necessary for closure. The prosthesis is anchored on deep solid structures (ribs, iliac crests) guaranteeing solidity. In a series of 252 operated patients, abdominal wall solidity was achieved in 91% of the cases with a mean follow-up of 2 to 13 years. Mortality was 1.2% and morbidity 8%, emphasizing the importance of rigorous indications. Intensive preparation including the Goni Moreno pneumoperitoneum is required for surgery in all major abdominal wall defects.

Abdominal Muscles↗
PubMed1995

[The greater omentum. Its role in reconstructive plastic surgery].

The greater omentum, an original visceral flap, offers great possibilities of repair of complex defects. First proposed in the 1960s following the work by Kiricuta, rejuvenated following a better understanding of its physiology as a result of recent research, the value of the omentum resides in its specific properties of defence, detersion, and revascularization. During laparotomy, the only way of determining the extent of this organ (an average of 400 cm2) and defining its blood supply, the surgeon may decide to perform a flap on the left or right gastro-omental pedicle. The right pedicle is dominant with an artery and a vein which have a mean calibre of 2 millimeters. After colo-omental detachment and release of the greater curvature, the omentum pedicle flap reaches the entire anterior surface of the trunk, the proximal part of the limbs, and the base of the neck. It can be used as a free graft, or may be revascularised by microsurgery. It can be transferred to any site, especially to the proximal part of the lower limb. An immediate or secondary split-skin graft ensures cover of the organ. The indications for omentoplasty are eclectic, but restricted in relation to the initial proposals: it should no longer be used to reconstruct a relief nor to dry up bony suppuration, or to drain lymphoedema. The situations in which omentum still remains indicated, or even irreplaceable, are those in which a free or local flap is impossible, insufficient, or uncertain: poorly defined, deep, torpid, infected defects and cases of radiation necrosis, pharyngostomy, thoracic empyema (especially those maintained by a bronchial fistula). In cancers of the oropharynx, the addition of a conjoint potion of the stomach allows reconstruction of gastrointestinal continuity. In traumatology, an omental free flap can save a leg or a foot, with bony disruption and major soft tissue destruction. The only limitation to the use of the greater omentum is the laparotomy, which cannot always be performed in patients with respiratory failure or following multiple abdominal operations. Apart from this reservation, the omentum remains an "extreme" flap for "extreme" situations.

Humans↗
PubMed1994

[Launois Bensaude disease. Focus apropos of 16 cases].

After a review of the clinical, pathological and aetiological features, the authors describe the various surgical techniques used (conventional surgery or liposuction) to restore a normal social life to these patients, deformed by their disease. They confirm the predominant role of conventional surgery and define the limited indications in which liposuction can be used. Based on a review of 16 cases, the surgeon must make sure that the patient has ceased his or her alcohol abuse before performing this difficult treatment associated with a number of complications.

Alcoholism↗
PubMed1993

[Esthetic reconstruction of the face in burnt patients].

All reconstruction should be aesthetic but in burned patient, everything combines to make a cosmetically satisfactory result more difficult to achieve. However the burns patients, deformed and disfigured has to confront the gaze of others in daily life. Three points are discussed by authors: skin quality can be improved or replaced by a full thickness pressure graft; surgical modification of the underlying structures; repair of peri-orificial areas and free edges.

Adult↗
PubMed1982

[Inguinal island flap for covering trochanteric bedsores].

Trochanteric bedsores are a serious condition because of the danger of osteoarthritis of the coxofemoral joint, which is a source of septicemia, and also because of the difficulty of covering them with skin owing to the mobility of the bone and the absence of skin laxity in the area. The authors suggest a new technique of closure after local preparation providing a clean "surgical" defect. They use a groin island flap raised in the Japanese "retrograde" manner (i.e. laterally to medially). This technique is of course the fruit of the authors' experience of the microsurgery. The distal portion of the flap is drawn, corresponding to the size of the defect (round shape). The proximal portion contains the vessels surrounded by subcutaneous and protected by a de-epithelialized triangle of skin with a distal base. The flap is passed through a subcutaneous tunnel between the femoral trigone and the trochanteric area to be covered. The donor site is closed by approximation of the edges after they have been undermined. The authors discuss the others possible surgical managements: 1) local flaps (transposition flap, Z plasties, are unsuitable; 2) the double S-rotation flap had the drawback of creating a large undermined area and leaving a scar on the trochanteric region; 3) simple GER-type muscle flaps are not advisable because the transposed muscle always indergoes a fibrous involution so that the graft provides insufficient protection; 4) myocutaneous flaps, and especially fascia lata myocutaneous flap, offer better indication, because of muscle only acts as a vascular pedicle for the skin flap. The only drawback is the relative defect resulting from raising the flap. The authors conclude that the groin island flap offers the following advantages; a skin material which is more than efficient; ideal vascularization; perfect corverage without undue tension of the trochanteric surface; an interesting training for the plastic surgeon performing microsurgical reconstruction.

Groin↗
PubMed1981

[Revascularization using the greater omentum. Results of an experimental study in dogs. Clinical perspectives (author's transl)].

An experimental study was conducted in dogs to study the increase an vascular supply to an ischemic zone after transplantation of the greater omentum. The study design, applied in eleven dogs, is described, and the various technical details emphasized : staged vascular ligature of one paw, preparation of the omentum, and transplantation using microsurgical procedures. The circulatory deficiency, evaluated by comparison with the healthy or similarly ligatured opposite paw, is well-compensated by the omental transplant, and a new circulation is established. This is apparent on pathological examinations and arteriography. Isotopic angiography, by means of labelled erythrocytes, supplies proof that a vascular pool is effectively derived from the transplanted organ and that it reaches the distal region of the ischemic limb. The increase in blood supply obtained suggests the possibility of new clinical indications. Apart from omentoplasty, already widely used in plastic surgery, the omentum could perhaps also be effective in certain areas of cardiovascular surgery, especially in some cases of arteritis where the distal vascular bed is greatly reduced. Further experimental studies, such as these described, are necessary before using this technique in humans.

Animals↗
PubMed1978

[LLL plasty in reparative surgery of the face (author's transl)].

The problem of the repair of loss of cutaneous substance from the face is extensively studied in works on plastic surgery. The so-called LLL lozenge plasty of Dufourmentet no longer has the place of which it is worthy, when it is not ignored altogether. The authors here stress the advantages: simplicity, minimal separation of the skin from underlying structures, ease of application using local anaesthetic, minimal scarring, aesthetic quality. The limitations of this autoplasty are also described, in particular with regard to the extent of the repair and the problem of malignancy.

Cicatrix↗