Biomedical subjects
Publications and source records attributed to P Soyka.
So far only few cases of familial occurrence of popliteal artery entrapment have been reported. Such a case involving two brothers and one sister is described. Both the male subjects presented with additional patellar dysplasia and had to undergo surgical therapy. In the case of their sister a conservative treatment was sufficient.
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This retrospective study concerns 8 patients, who had successful vascular reconstruction for ischaemia of a lower extremity but nevertheless needed lower or upper leg amputation. The analysis shows that in four patients (one of them diabetic) misjudgement was the cause of failure. The other four patients all had diabetic angiopathy. No misjudgement or wrong decision was found in the analysis of their case. Here the failure is interpreted as the fatal destiny of a seriously damaged microangiopathic extremity.
Infection or breakdown of a wound in the groin is a dreaded complication in vascular surgery. On 8 patients with such impending or declared wound complications, a distally pedicaled sartorius muscle-flap was performed immediately after wound debridement, to cover the autologeous or alloplastic vascular graft. In all but one case the groin healed promptly. In 6 cases the vascular repair remained patent.
An additional aiming-device to the original Hielekes intramedullar locking nail system is presented and described. It simplifies greatly the difficult performance of distal locking of a tibial nail. The principle is a firm connection between the intramedullar nail and the aiming-device as well as between the aiming-device and the tibia.
Analysis of causes of death in 54 patients in the Zürich Burn Center has shown that pneumonia and septicemia occur secondary to pulmonary edema. Pulmonary infection and septicemia were the main causes of death in our cases. Pathophysiologically, a timetable of danger phases can be established: a) 1st day: death from unknown cause (organ edemas); b) 2nd to 6th day: pneumonia and pulmonary edema in combinations of varying degrees; c) after the 6th day: death from pneumonia and septicemia. Wound infection alone seldom causes septic death. From this it is concluded that the badly burned patient should not be overhydrated in the initial phase of therapy. Kidneys can be subjected to more strain than was previously supposed.
Creams containing corticosteroids are not efficient in the treatment of scar hypertrophy. In 23 patients Betamethason as a cristal suspension was injected into 32 hypertrophic scars by means of a jet-injector. The preparation has proven to reduce bulk and tension in mature scars, but had no effect on fresh and active scar formation, nor in preoperative prevention. The jet-injector is of advantage.
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