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Biomedical subjects

R F Edlich

Publications and source records attributed to R F Edlich.

At least 253 records · Page 14Linked to original sources
PubMed1979

Side-effects of topical proteolytic enzyme treatment.

The results of this study indicate that short term treatment of wounds with topical enzymes appears to be safe and is accompanied by no clinically significant side-effects. Topical wound treatment with this enzyme did not interfere either with healing of experimental wounds or the activity of the antibiotics. Wounds subjected to this enzyme treatment exhibited a normal capacity to resist infection, even though this enzyme interferred with leukocyte phagocytosis in vitro. The potential benefits of this treatment in experimental wounds as an adjunct to antibiotics considerably outweigh its damaging effects. Its clinical use in patients must await the results of carefully controlled clinical trials in which the efficacy of this treatment is evaluated.

Administration, Topical↗
PubMed1978

Male transsexualism--a review of genital surgical reconstruction.

Transsexualism is a poorly understood, uncommon, and controversial entity of recent interest to the lay public and medical profession. Important features of the condition are discussed, surgical procedures for genital conversion in male transsexuals are compared, and our experience at the University of Virginia where 53 patients have been treated surgically is presented. All patients have made satisfactory postoperative psychosocial adjustment despite a surgical complication rate approaching 50 per cent. It is concluded that alternative (better) surgical procedures for male transsexuals should be explored.

Castration↗
PubMed1978

Debridement: an essential component of traumatic wound care.

The harmful influences of devitalized tissue on wound defenses are documented and the importance of wound debridement in the care of the traumatic wound is stressed. All devitalized soft tissues damaged the host's defenses and encouraged the development of infection. The capacity of divitalized muscle, fat, and skin to enhance infection was comparable. The infection-potentiating effect of skin was enhanced by exposing it to a dry thermal injury. The mechanisms by which devitalized soft tissue enhanced infection are several. The devitalized soft tissue acts as a culture medium promoting bacterial growth. In addition, the devitalized tissue inhibits leukocyte phagocytosis of bacteria and subsequent kill. Finally, the anaerobic environment within the devitalized tissue may also limit leukocyte function.

Debridement↗
PubMed1978

Mechanisms by which proteolytic enzymes prolong the golden period of antibiotic action.

These experimental studies provide an explanation for the therapeutic value of proteolytic enzymes as adjuncts to antibiotic treatment of contaminated wounds. After wounding, a fibrinous coagulum develops on the wound surface. This coagulum surrounds the bacteria and protects them from contact with sustemically or topically administered antibiotics. Treatment of the wound surface with proteolytic enzymes disrupts the coagulum and exposes the bacteria to the action of the antibiotic. The topical use of enzymes is also associated with significant increases in the concentration of antibiotic at the wound and thus a decrease in the rate of infection.

Administration, Topical↗
PubMed1978

Airless paint gun injuries: an update.

The airless paint gun delivers paint at pressures approximating 3,000 psi. Paint accidently injected into the skin under this pressure causes a devastating injury which is a result of the paint material, the level of bacterial contamination, and the pressure at which the paint is delivered. The time interval between injury and treatment seems a critical determinant of outcome. Decompression of the closed vascular compartments of the hand must be begun immediately to release the underlying tissue distended by the injected paint. Judicious wound debridement must be performed. Immediate antibiotic treatment is indicated in all patients. Studies seem to indicate that steroids limit the severity of inflammatory response. A regimen of hydrocortisone sodium succinate, 100 mg IV, administered immediately before surgery should be followed by a seven-day tapering course of oral prednisone starting with 40 mg on the first postoperative day. Recent safety measures and consumer warnings through the Consumer Product Safety Commission may reduce the number of airless paint gun injuries.

Adrenal Cortex Hormones↗
PubMed1978

Modification of the American Burn Association injury severity grading system.

This study evaluated the regional burn health care system of the Commonwealth of Virginia using the criteria for optimal care of the burn patient designated by the American Burn Association. The data base for this evaluation was hospital records of seven hospitals in Virginia. The major shortcoming of the designated criteria was the grading system for the severity of burn injury. Using the criteria designated by the American Burn Association, a large number of minor burn injuries were judged erroneously to be major burn injuries. A modification of the American Burn Association's injury severity grading system is proposed which more precisely identifies the minor burn injury.

Aged↗
PubMed1978

Immediate insertion of silicone rubber rods in fingers with cut flexor tendons.

In 7 patients with cut flexor tendons of the hand, we did an immediate quantitative bacterial analysis of the wounds. These showed fewer than 10(5) bacteria per gram of tissue, so we inserted silicone rubber rods in 10 of these fingers. All healed without infection, and this shortened the reconstruction. In retrospect, we believe it best not to insert the rods primarily in crush injuries. However, this seems to be a safe, worthwhile measure for those patients with sharp injuries of the tendons.

Finger Injuries↗
PubMed1978

Emergency Department treatment, triage and transfer protocols for the burn patient.

Emergency department treatment, triage and transfer protocols for patients with major thermal injury have been devised by the three burn centers in Virginia. A burn nurse educator has presented these guidelines to the emergency departments of Virginia. The development of these protocols has considerably improved the immediate care of the victims of thermal injury who are transferred to the burn centers in the Commonwealth of Virginia.

Adolescent↗
PubMed1977

Nonoperative management of fingertip pulp amputation by occlusive dressings.

Nonoperative management of fingertip pulp amputations has been employed in eighteen adults. After wound cleansing and debridement, the wound was covered by an occlusive dressing. Healing of the amputated fingertip occurred within four weeks. The healed fingertip had an excellent sensory perception, normal range of motion and an acceptable cosmetic appearance. This satisfactory outcome was realized with less than ten days lost from work.

Aluminum↗
PubMed1977

Influence of subcuticular sutures on scar formation.

The purpose of this study was to determine the influence of nonabsorbable and absorbable subcuticular sutures on the width of scars of the human skin. This study included seventeen patients undergoing partial laminectomy for radiculopathy secondary to herniated nucleus pulposis. The scar of each patient served as its only control with its superior and inferior portions being subjected to different closure technics. The most important determinant of scar width was the patient himself. The width of the scar varied from an almost imperceptible scar in one patient to a very wide scar in another. An additional determinant of scar width was the location of the scar. The width of the inferior half of the scar was wider than the width of the superior half of the scar. Subcuticular closure of the laminectomy scar did not alter the magnitude of scar formation.

Cicatrix↗
PubMed1977

A rapid technic for quantitating wound bacterial count.

An improved technic has been developed to predict rapidly the critical number of bacteria in tissues. This technic gave reliable and accurate measurements for wounds containing more than 2 X 10(5) organisms per gram of tissue. It is fortuitous that 10(6) bacteria is the critical number of bacteria that will induced clinical infection in experimental animals and humans. The rapid slide technic is now being utilized routinely in our medical center to determine graft bed receptiveness, predict the safety of wound closure, and monitor the course of burns.

Animals↗
PubMed1977

Emergency nurse practitioner: an answer to an emergency care crisis in rural hospitals.

During the last three years, a nine-month training program at the University of Virginia was designed and implemented to prepare the nurse to assume an expanded role in the emergency department. The course provides the student with sufficient knowledge and skill to diagnose and treat patients in the emergency department setting while under the supervision of a physician. Graduates of the program are certified by the State of Virginia as "emergency nurse practitioners". Qualified candidates who had identified a physician preceptor or were from an area with embryonic emergency medical systems were given priority in the selection process. The training program was divided into three-month modules which dealt first with teaching interview techniques and physical assessment skills, then clinical experiences in rural and urban emergency departments, and finally a preceptorship in the community hospital where the nurses work with the physician preceptors.

Curriculum↗
PubMed1977

Self-instructional emergency medicine program for medical students.

A self-instructional program in emergency medicine has been developed for freshmen medical students at the University of Virginia School of Medicine. The cognitive objective of the course is to give the student the minimum level of knowledge to diagnose emergency medical conditions. Performance of the appropriate practical treatment is the course's psychomotor objective. Evaluation of the student's grasp of the program's cognitive and psychomotor objectives is accomplished by the written and practical examination for certification of emergency medical technicians and practical tests in basic life-support. Self-instructional guides, algorithms, videotapes and reading materials are the educational resources for the course. As a result of successful completion of the training program, the student is certified as an emergency medical technician in the Commonwealth of Virginia.

Audiovisual Aids↗