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Biomedical subjects

R F Edlich

Publications and source records attributed to R F Edlich.

At least 109 records · Page 6Linked to original sources
PubMed1994

Non-insulin-dependent diabetes mellitus: diagnostic and therapeutic challenges in the severely burned patient--a case report.

The purpose of this paper is to describe the management of a previously undiagnosed non-insulin-dependent diabetic patient with a severe burn injury. The hyperglycaemia and glucose intolerance following burn injury was complicated by the hyperglycaemia of diabetes mellitus. Intravenous insulin infusion monitored by hourly glucose levels was required to manage this hyperglycaemia. During day 11 postburn injury, this patient required 2104 units of insulin to control his hyperglycaemia. Aggressive detection and management of infections complemented by early debridement and coverage of the burn wound were other important considerations in the management of this patient. The diagnosis of non-insulin-dependent diabetes mellitus (NIDDM) was made after the patient recovered from his burn injury. His rehabilitation programme has included primary prevention strategies for NIDDM that focus on health-improving behaviours such as improved diet, exercise, and weight control.

Adult↗
PubMed1994

Diagnosis, complications, and treatment of dentoskeletal malocclusion.

The frequency of correctable malocclusion makes it imperative that the condition be diagnosed and referred for appropriate treatment. A complete dentofacial examination, which assesses facial symmetry and the dentition in the transverse, sagittal, and centric relations, is appropriate. Early diagnosis is imperative because malocclusion leads to long-term complications such as temporomandibular joint (TMJ) dysfunctions, perodontal disease, obstructive sleep apnea, psychological disorders, and articulation errors. A combination of orthodontic treatment and orthognathic surgery will correct the dentoskeletal malocclusion and prevent any long-term complications. The purpose of this case report is to describe a patient with severe dentoskeletal malocclusion who benefitted from appropriate orthodontic treatment and orthognathic surgery.

Adult↗
PubMed1994

The use of recombinant human erythropoietin and cultured epithelial autografts in a Jehovah's Witness with a major thermal injury.

Haemostatic debridement, recombinant-human erythropoietin and cultured epithelial autografts have been used successfully in a Jehovah's Witness with a major burn injury. Tourniquet ischaemia complemented by a topical haemostatic agent minimized excisional blood loss, while recombinant-human erythropoietin accelerated erythropoiesis, thereby correcting postburn anaemia. Cultured epithelial autografts provided coverage of the granulating wounds without creating donor sites.

Adult↗
PubMed1994

Some biomechanical considerations in microsutures.

The purpose of this study was to measure the biomechanical performance for commercially available microsutures, nylon polypropylene, polyester, and polyglactin 910. The biomechanical performance was determined by reproducible, biomechanical parameters that included stiffness, elasticity, resistance to creep, secure knot construction, and knot breaking strength. On the basis of these comprehensive studies, the handling characteristics of the nylon microsutures were judged to be superior over the other microsutures. Knot security was achieved with a three-throw square (1 = 1 = 1) knot that allowed a preview of the ultimate apposition of the divided tissue. In addition, nylon microsutures were more supple than the other microsutures. The breaking strength of the knotted nylon microsutures was comparable with those of the knotted polyglactin 910 and polyester microsutures, and significantly greater than that of the knotted polypropylene sutures. Its resistance to creep was significantly greater than that of the polypropylene microsutures but less than those of polyglactin 910 and polyester microsutures.

Biomechanical Phenomena↗
PubMed1994

A new device for securing meshed split-thickness skin grafts.

This report describes the design, operation, and biomechanical performance of the Auto Suture Multifire Graftac-S disposable surgical staplers and absorbable tacks. The performance of this reloadable stapler has been compared to that of the Auto Suture Multifire Premium disposable skin stapler. The Premium stapler forms stainless steel staples to close the wound. The Graftac-S ejects absorbable tacks into the graft from a cartridge, which can be reloaded during a single operation. In two clinical trials of 10 patients each, the Graftac-S delivered absorbable tacks which were biocompatible and successfully secured the graft to the wound. The most obvious advantage of this device is that it obviates the need to remove the staples from the wound later. By the tenth postoperative day, about 90% of the tacks had extruded spontaneously, thereby reducing the amount of postoperative care required; discomfort to the patient during removal of the stainless steel staples is eliminated.

Biocompatible Materials↗
PubMed1994

Biomechanics of surgical glove expansion.

The purpose of this study was to correlate the latex gloves' susceptibility to hydration to its development of glove expansion or irreversible elongation of the latex glove. During hydration, the Micro-Touch glove exhibited significantly more creep strain than did the Biogel gloves. Similarly, the Micro-Touch glove exhibited glove growth, while the Biogel glove maintained a uniform fit during hydration.

Biomechanical Phenomena↗
PubMed1994

Modern concepts of packaging surgical needles and suture.

A new, innovative packaging system for surgical needles and sutures has been developed that meets the special needs of surgical technologists. This packaging system consists of an overwrap, or breather pouch, as well as an innerwrap containing the suture swaged to a surgical needle. The flaps of the overwrap are offset and serrated to facilitate the opening and sterile transfer of the inner packet to the sterile field. The inner packet contains either a plastic labyrinth, or craft board that maintains the suture as straight as possible until knot construction. The needle swaged to a suture is 'parked' in foam to protect its sharp cutting edges and point.

Drug Packaging↗
PubMed1993

Biomechanical performance of new vascular sutures and needles for use in polytetrafluoroethylene grafts.

Two new cardiovascular monofilament sutures attached to taper point needles have been developed for use in expanded polytetrafluoroethylene (PTFE) grafts. One monofilament suture made of PTFE has a microporous structure that allows it to be channel swaged to a needle that closely approximates its suture diameter. The other suture is a monofilament polypropylene suture that has been extruded to produce a tapered swage end, which was significantly smaller than that of the remainder of the suture in order to be channel swaged to smaller diameter needles. On the basis of comprehensive biomechanical performances, the performance of the new needle suture products with needle/suture diameter ratios approaching 1:1 was superior to needle suture products with 2:1 needle/suture diameter ratios for use in PTFE vascular grafts, regardless of the suture material.

Blood Vessel Prosthesis↗
PubMed1993

A synthetic membrane for testing needle penetration.

Needle performance is primarily judged by its penetration through tissue. For detailed studies of needle performance, tissue is too heterogeneous and unstable and difficult to obtain. A homogeneous, stable, and readily available polyurethane substrate has been evaluated as a suitable alternative to biological tissue for evaluation of needle penetration. The needle penetration profiles through the synthetic substrate correlated very well with those through natural tissue. In addition, the synthetic substrate was sensitive enough to easily detect a 20% increase in the force necessary to penetrate natural tissue. This polyurethane substrate offers a valid alternative to biological tissue for the testing of needle penetration performance.

Animals↗
PubMed1993

Influence of surgeon's tying technique on knot security.

The purpose of this study was to determine the influence of the surgeon's tying technique on knot security using 0 and 2-0 monofilament and multifilament nylon sutures. Using an Instron Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. Using the portable tensiometer, their knot tying techniques were judged to be superior to those used by surgeons. The surgeon's faulty technique can easily be corrected by didactic information and psychomotor skill training.

Clinical Competence↗
PubMed1993

A portable tensiometer for assessing surgeon's knot tying technique.

The purpose of this study was to determine the influence of surgeon's tying technique on knot security using O and 2-O monofilament and multifilament nylon sutures. By use of an Instron Tensile Tester and a portable tensiometer, knot security was achieved with these sutures using four-throw square knots (1 = 1 = 1 = 1). After didactic and psychomotor skill training, medical students were taught to construct the four-throw square knot using either a two-hand tie or an instrument tie. By use of the portable tensiometer, their knot tying techniques were judged to be superior to those used by a cohort of obstetricians and gynecologists. The surgeon's faulty technique can easily be corrected by didactic information and psychomotor skill training.

Suture Techniques↗
PubMed1993

New advances in automatic disposable rotating cartridge skin staplers.

This report describes the design, operation, and mechanical performance of Auto Suture Multifire Premium disposable skin staplers and staples in a biomechanical laboratory investigation and a clinical evaluation. The performance of this reloadable stapler has been compared with that of a new disposable skin stapler with a rotating cartridge, the Proximate RH stapler. The latter exemplifies a disposable skin stapler whose cartridge cannot be reloaded. The Auto Suture Multifire Premium disposable skin stapler has been designed so that its cartridge can be reloaded during a single surgical procedure. The most obvious advantage of this new device is that it substantially reduces the cost of skin stapling during surgery. Another unique benefit of this stapler is that it can accommodate either regular or wide staples, allowing the surgeon to use both size of staples without discarding the stapler. On the basis of this investigation, the Auto Suture Multifire Premium disposable skin stapler is recommended for skin incision and graft closure, since it provides maximal visualization of the wound as well as the staple during its formation. It delivers the staple into the skin or skin graft so that the topspan of the staple is above the skin or wound surface. In addition, the Auto Suture Multifire Premium disposable skin stapler has a prepositioning (precocking mechanism) that is controlled by the surgeon with minimal force, a mechanism which allows the stapler to hold its staple securely, even when its pointed legs extend beyond the delivery end of the stapler. The force required to form its staples is so low that the surgeon can staple repetitively without fatigue.(ABSTRACT TRUNCATED AT 250 WORDS)

Disposable Equipment↗
PubMed1993

Electrical burn injuries of workers using portable aluminium ladders near overhead power lines.

The use of aluminium ladders around high voltage power lines has resulted in a significant number of electrical injuries and electrocutions. Workers often misjudge wire distances or lose control of fully extended ladders, thereby exposing themselves to electrocution hazard. High-voltage electrical burns of two workers using an aluminium ladder that contacted a high voltage power line are reported. The circumstances surrounding the injury, the clinical management of the case, and the methods of prevention are presented and discussed.

Accidents, Occupational↗
PubMed1993

Salvage of a patient with burn inhalation injury and pancreatitis.

A multidisciplinary approach by the staffs of the Emergency Department and the Regional Burn Center saved the life of a burn patient with an inhalation injury and pancreatitis. This successful treatment is attributed to ventilatory management using fibreoptic bronchoscopy in the Emergency Department, followed by burn eschar excision with coverage by cultured skin and non-operative management of an enlarging pseudocyst by percutaneous transgastric drainage.

Adult↗
PubMed1993

Past, present, and future for surgical needles and needle holders.

During the last two decades, major advances in surgical needle and needle holder technology have markedly improved surgical wound repair. These advances include quantitative tests for surgical needle and needle holders performance, high nickel maraging stainless steels, compound curved needles, needle sharpening methods, laser-drilled holes for swages, needle:suture ratios of 1:1, and the atraumatic needle holder.

Animals↗
PubMed1992

Biomechanical performance of ophthalmic surgical needles.

The mechanical performance of ophthalmic surgical needles is studied. Standard biomechanical tests, devised to evaluate the performance of ophthalmic surgical needles, are presented. Four comparable groups of ophthalmic surgical needles were selected from two different manufacturers for these biomechanical studies. The results of this testing demonstrate that needle point geometry and needle composition are important determinants of needle performance. When comparable size needles were evaluated, the biomechanical performance of the recently introduced CS160-6 ophthalmic needle (Ethicon, Inc) was superior to the AU-5, CU-5, and SU-5 needles (Alcon, Inc). Whereas the development of these biomechanical tests has allowed the evaluation of these ophthalmic needles, these same tests can be used to assess the performance of other new ophthalmic surgical needles.

Alloys↗