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Biomedical subjects

R F Morgan

Publications and source records attributed to R F Morgan.

At least 91 records · Page 5Linked to original sources
PubMed1986

Surgical management of vascular malformations of the head and neck.

The evaluation and treatment of non-involuting hemangiomas with arteriovenous components and arteriovenous malformations of the head and neck remain difficult. Surgical excision is still the most important and effective method of controlling these lesions. Radiotherapy should never be used. It is ineffective, dangerous, and often complicates any later operation that may be required. Evaluation of vascular malformations with computerized tomography, arteriography, magnetic nuclear imaging, and Doppler mapping will aid diagnosis. Adjunctive hypotensive anesthesia, intraoperative embolization with Gelfoam, and temporary peripheral suture ligations have made the surgical task more manageable. The integration of reconstructive techniques into the surgical program is essential if optimum results are to be obtained. Incisions must be planned so that future flap patterns are preserved. Axial vessels may be needed later. Fascial slings, muscle transfers, nerve grafts, and tissue expansion of adjacent normal tissue may be needed to maintain and restore function and features. Above all, the treatment of each patient requires individual planning. The most common errors in the treatment of vascular hemangiomas result from missed diagnoses and faint-heartedness in tackling the surgical removal of such highly vascular tumors. Many patients go for years without finding a surgeon who will help them. We believe that aggressive surgical treatment offers much to many of these patients.

Adolescent↗
PubMed1986

Mechanical performance of a work hardened pointed surgical wire.

The design and material properties of a surgical wire have been enhanced to improve its performance in surgery. One blunt end of the wire has been honed to a point to decrease the axial compressive force required to penetrate tissue. In addition, its sharp end has been work hardened to increase its yield strength. The mechanical performance of this wire has been characterized by a series of in vitro experiments and a clinical trial.

Bone Wires↗
PubMed1986

Pseudofolliculitis barbae with keloids.

Pseudofolliculitis barbae is a common cutaneous infection occurring in the bearded area of the face of black men. The infection is caused by ingrown hairs that produce an inflammatory foreign body reaction characterized by papules and pustules at the point of hair penetration that may result in permanent scarring, usually in grooved patterns, and occasionally in keloids. The purpose of this article is to describe the successful treatment of a patient with pseudofolliculitis with keloids that was based on the pathophysiology of the disease and the biology of wound repair.

Adult↗
PubMed1986

Pig's foot holder for wound-repair training.

A special pig's foot holder has been developed for wound-repair teaching sessions. It has been designed to stabilize the pig's foot without obstructing the physician's view of the wound.

Ambulatory Care↗
PubMed1986

Tracheal reconstruction with autogenous jejunal microsurgical transfer.

Tracheal defects due to stricture formation, tracheomalacia, and neoplasms can present difficult reconstructive problems. Tracheal defects were surgically created in 6 dogs and primarily reconstructed with microsurgical free tissue transfer of autogenous jejunal segments. Primary healing was accomplished in all dogs without severe air leakage or infection. Bronchoscopy demonstrated no substantial secretions or tracheal narrowing. Gross pathological examination of the trachea revealed no evidence of tracheal disruption or infection. Direct measurements revealed no major tracheal narrowing. Microscopic examination demonstrated normal jejunal mucosa with a minimal amount of inflammatory change at the margins of the reconstruction at 6 weeks. Microvascular free tissue transfer of jejunal segments to correct cervical tracheal defects can readily be accomplished with excellent healing and maintenance of the tracheal lumen in dogs.

Animals↗
PubMed1986

Thermal changes in a rabbit ear model after sympathectomy.

The long-term cutaneous thermal changes and the degree of sympathetic reinnervation of the vessels after a distal sympathectomy in an experimental model are reported. Under general anesthesia, a distal sympathectomy was performed at the proximal portion of the central artery of a rabbit ear. The contralateral ear served as a control. A dual-channel digital thermometer was used to record periodic cutaneous temperatures in identical positions on the distal third of the ears. Sympathetic reinnervation was assessed with catecholamine histofluorescence in the dead animals. A mean difference in temperature of 1.2 degrees C (P less than 0.01) was recorded 12 months after surgery. All of the sympathectomized ears maintained higher temperatures than their contralateral controls. Arterial sympathetic reinnervation 3 months after surgery was sparse and inconsistent. No increased reinnervation was noted at 12 months.

Animals↗
PubMed1986

An algorithm for the management of ligamentous injuries of the knee associated with common peroneal nerve palsy.

Peroneal nerve palsy is the result of traction of the nerve at the fibular head and can be seen after varus injuries of the knee. The complication is uncommon and spontaneous, useful recovery is unusual. The treatment of either the ligamentous injury or the nerve injury alone is uncomplicated. However, when these injuries are seen in combination, management is more complicated. The clinical and laboratory findings of the nerve palsy in such a situation are reviewed. In addition, an algorithm has been constructed that is useful in determining the appropriate diagnostic and therapeutic steps in managing combined injuries.

Humans↗
PubMed1986

Emergency department management of puncture wounds and needlestick exposure.

Puncture wounds are common and challenging problems facing the physician. In general, puncture wounds can be classified into two distinct types. In one type, a child usually sustains a puncture wound of the foot. The other type of puncture wounds occur among hospital employees. These seemingly innocuous injuries may have serious sequelae that can be averted by prompt appropriate care of the wound. The fundamental trends of treatment of puncture wounds include cleansing the wound, débridement of any necrotic or devitalized tissue, and appropriate immunoprophylaxis.

Adolescent↗
PubMed1986

External cranioplasty: historical perspectives.

Selective external cranial vault remodeling has been practiced since antiquity. The variations, methods, and desired results of external cranioplasty are as pervasive as the practice is old.

Aged↗
PubMed1986

Tetanus.

Tetanus is produced by the action of the potent neurotoxin, tetanospasmin, which is elaborated during the growth of Clostridium tetani. The objectives of management of tetanus are to provide supportive care until the tetanospasmin that is fixed in tissue has been metabolized, to neutralize circulating toxin, and to remove the source of tetanospasmin. This disease, which is frequently fatal, is prevented by immunization.

Bacterial Toxins↗
PubMed1986

Antimicrobial treatment of minor soft tissue lacerations: a critical review.

This article is a collective review of all the prospective clinical studies that assessed the therapeutic value of antibiotics in minor soft tissue lacerations. This review critically evaluates each study that tests the hypothesis that antibiotic treatment reduces the incidence of infection. Even though the design of each of the studies was scientifically inadequate, important factors were identified that influenced the incidence of infection. On the basis of this collective review as well as other studies, indications for antibiotic therapy of minor soft tissue lacerations have been identified. Future clinical studies must be designed to test more precisely the validity of these recommendations.

Adult↗
PubMed1986

Emergency department management of mammalian bites.

Mammalian bites have reached epidemic proportions with more than one half million people being bitten by an animal or another person. Although the bite wound may initially appear to be innocuous, it may lead to severe complication that can be prevented by a timely and comprehensive treatment program that is outlined in this report. Our approach to these challenging injuries includes a complete evaluation of the injury, planned surgical intervention, antimicrobial therapy, immunoprophylaxis, and appropriate postoperative care.

Animal Population Groups↗
PubMed1985

A digit replantation model.

A simple, inexpensive, reproducible, and reliable model for digital replantation is described utilizing the rabbit ear. When compared to the human digit, it provides benefits over previous models. It is of similar tissue type and characteristics. The vessels closely approximate the digit in size and number. Results are easily quantified and the opportunity for a paired control in the same animal exists. Therefore, experimental design and statistical calculations may be simplified. The model can function for either replantation or revascularization with only slight changes in its preparation. Survival rates have been over 90%. In addition, the model provides an excellent forum for the development of technical expertise in the aspiring microvascular surgeon.

Animals↗
PubMed1985

Innovations in skin suture removal.

A cutting forceps and suture removal scissors have been specially designed for removal of percutaneous sutures. Our clinical experience with these instruments indicate that they facilitate removal of percutaneous sutures in the surgical patient.

Dermatologic Surgical Procedures↗
PubMed1985

Acute phalangeal fractures due to undiagnosed sarcoidosis.

Skeletal involvement, although common late in the course of sarcoidosis, is rarely an early manifestation. We report a case of acute bilateral phalangeal fractures that led to the diagnosis of sarcoidosis in an individual who otherwise had no symptoms.

Adult↗
PubMed1985

Tissue expansion in reconstructive hand surgery: case report.

A 22-year-old musician requested the correction of his digital syndactyly deformity without the use of skin grafts. Failure of the original correction to heal primarily resulted in the formation of dense scar tissue. A small, custom-designed tissue expander was inserted within the web space and was slowly expanded. The additional expanded tissue permitted reconstruction of the web space and the sides of the fingers without the use of skin grafts.

Adult↗
PubMed1985

Facial injuries associated with cervical fractures: recognition, patterns, and management.

Publications in both the orthopedic and maxillofacial literature have noted the association of cervical spine and facial injuries. However, because the incidence of spinal injury is low, we found no study which documented the relationship between maxillofacial and cervical spine injuries. The present study reviewed 982 cervical spine injuries in two major trauma centers, finding a 19.3% incidence of facial injury. Fourteen per cent of patients had soft-tissue injuries and 8.6%, facial fractures. Important relationships were noted between fractures of the mandible and upper cervical spine, and soft-tissue injuries of the upper face and fractures of the lower cervical spine. Methods of care adapted to the combined injuries are described. The study concludes that examination of the face for soft-tissue and bony injuries may give important clues on the direction and intensity of the force injuring the cervical spine.

Adolescent↗