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Biomedical subjects

P W Black

Publications and source records attributed to P W Black.

14 recordsLinked to original sources
PubMed1997

Radical hysterectomy: current management guidelines.

Over the past 11 years (January 1985 through December 1996) the senior authors (B.F.H. and H.B.K.) have performed 205 radical hysterectomies. The most notable trend observed was a marked decrease in length of stay from 12.8 days to 3.5 days. Contributing factors include use of the Maylard incision, placement of suprapubic Foley catheters, discontinuation of drains, early oral feeding, admission to the hospital on the day of surgery, and initiation of a critical care pathway. All criteria for short-stay radical hysterectomy were established by 1994. With continued modification of surgical technique and use of the critical care pathway, short stay has become our standard of care for radical hysterectomy. Complications are minimal, with neither long-term morbidity nor mortality associated with the short stay. In addition, significant cost savings occur, which benefits the patient, hospital, and the health care system.

Adult↗
PubMed1991

Rhinoplasty.

The nose is one of a person's most noticeable features, a feature with which he or she personally identifies and by which he or she may be known and recognized by others. When there is a facial disharmony by virtue of this important feature being relatively unflattering, disproportionate, disfiguring, or dysfunctional, then surgical change can make an important contribution physically, functionally, psychologically, and socially. Rhinoplasty involves a considerable normal concern on the part of the patient and presents a very significant professional challenge to the surgeon. Both the patient and the surgeon are likely to receive a great deal of personal satisfaction from surgery well done.

Esthetics↗
PubMed1985

Bilateral cleft lip.

Directing the course of care for a patient with bilateral cleft lip problems is a great responsibility and challenge for the surgeon, and it requires full commitment, effort, and talent. The goal is to enable the patient to develop anatomically, functionally, and psychologically as normally as possible and to achieve and succeed in life according to natural abilities, unimpeded by the congenital deformity complex. An individualized and organized effort must continue until the child is grown. One important aspect of this effort is the technical cleft lip repair. No matter how well done, perfection is always a step away. Open minds and energetic young students should be reluctant to accept the "status quo"; they should be encouraged to accept this challenge and make contributions. Although many other "big, new" operations may be very dramatic, none will be more satisfying to the surgeon than the well-performed bilateral cleft lip repair. The surgeon must remember that the day of cleft lip repair is one of the single most important days of a person's life. The result will have meaning from that moment on!

Child, Preschool↗
PubMed1984

Bilateral cleft lip and palate: presurgical treatment.

Patients with bilateral cleft lip and cleft palate problems may present with severe tissue disparities. A good surgical repair without tension may be difficult to achieve. With proper presurgical orthodontic management the tissues can be brought into good relationships, permitting a one-stage surgical repair under optimal conditions. An appliance can be used to secure the lateral arches in proper position. Then external gradual traction can reposition the lateral arch and central arch segment relationships, establishing a more normal arch. After lip repair the "artificial palate" denture is worn until palate repair. The common types of situations encountered are categorized and illustrated with case reports. Not only is this approach more advantageous surgically, but it also helps feeding, provides and maintains good early arch form, and theoretically could contribute to speech. It avoids lip adhesions and can be accomplished within the time that is usually allowed before lip repair.

Cleft Lip↗
PubMed1984

Bilateral cleft lip repair: "putting it all together".

The surgical repair of the bilateral cleft lip should take into consideration restoration of normal anatomy throughout the lip. If it is well done, it contributes to both form and function. A composite technique is presented here, with additions taking advantage of all tissues and based on this principle. Preoperative orthodontic preparation is used to achieve more satisfactory spatial relationships when appropriate and to permit a one-stage repair without lip adhesions. The technical aspects are clearly outlined and supported by case presentations. The technique saves all tissue; avoids tightness; provides good muscular function; constructs a labial sulcus providing for proper movement of the lip; provides good nasal sills and floors; is adaptable to complete or incomplete clefts; can be easily revised or used for secondary revisions in other cases, and so on.

Cleft Lip↗
PubMed1984

Cleft lip type nasal deformity: definitive repair.

The problem of the cleft lip nasal deformity is one of understanding the specific anatomical defect and providing proper correction. Each may depend on good exposure. This article is not intended to review the literature, but rather to make a statement in this regard. An approach is taken which outlines the nature of the typical deformity and a method of definitive correction with the aid of a midface avulsion flap for total exposure. Cases are presented for illustration. This technique can be used with other associated corrective maneuvers simultaneously as appropriate (such as repair of fistulae, septal corrections, floor changes, and so on). The exposure principle can be adapted to many difficult midface or nasal surgical needs.

Adolescent↗
PubMed1982

Breast reconstruction with a transverse abdominal island flap.

A rectus abdominis musculocutaneous island flap for breast reconstruction following mastectomy is presented. The vascular anatomy of the abdominal wall has been clinically studied in patients undergoing abdominal lipectomy. Cadaver dissections are shown, demonstrating the anatomy, arc of rotation, and design alternatives of the rectus abdominis flap. The surgical technique is demonstrated and representative patients are shown.

Abdominal Muscles↗