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Biomedical subjects

R F Morgan

Publications and source records attributed to R F Morgan.

At least 109 records · Page 6Linked to original sources
PubMed1985

Lawnmower injuries in children: lower extremity reconstruction.

Power lawnmower accidents are one of the most frequent causes of mutilating injuries in pediatric patients. Guidelines for the optimal surgical management of children differ from adult patients by several key anatomic, physiologic, and rehabilitative features. Small blood vessels in children less than 2 years old may prohibit microvascular surgery. Older children with larger vessels are often better candidates for microvascular flaps than their adult counterparts. Pediatric patients also resist recurrent ulceration of foot skin grafts, tolerate prolonged immobilization, and are rehabilitated more readily than adults. In considering these facts, we outlined an algorithm for surgical reconstruction. Split-thickness skin grafts are generally the first choice for coverage. The medial gastrocnemius is the workhorse of the knee and upper third leg. The soleus provides coverage for the middle third leg; microvascular flaps are used for large lower third leg defects. Crossleg fasciocutaneous flaps are good alternatives when microsurgery is not feasible. When possible, the weight-bearing surface of the foot should be covered with local vascularized sensate flaps; larger defects may require free flaps, crossleg, or gluteal-thigh flaps. Excellent functional rehabilitation has been achieved in our young patients through the combined efforts of the trauma service, plastic and orthopedic surgery, and physical and occupational therapy services.

Accidents↗
PubMed1985

Clinical syndromes caused by staphylococcal epidermolytic toxin.

Coagulase-positive staphylococci of phage group II produce an epidermolytic toxin that results in a spectrum of diseases that include localized bullous impetigo, generalized scarlatiniform syndrome without exfoliation, and staphylococcal scalded-skin syndrome (SSSS). The mechanism of action of the toxin occurs at the level of the lower stratum granulosum, resulting in intraepidermal cleavage. Generalized exfoliative dermatitis, or SSSS, is one of the most severe infections characterized by generalized epidermolysis with desquamation. Generalized scarlatiniform syndrome is an erythematous rash without exfoliation. A localized infection that results in a bulla larger than 5 mm in diameter is bullous impetigo.

Bacterial Toxins↗
PubMed1985

Entrapment neuropathies of the upper extremity.

Entrapment neuropathies occur in a number of different but predictable locations in the upper extremity. These neuropathies can produce a spectrum of sensory and motor deficits in the hand and upper extremity. A careful clinical examination in conjunction with electromyography and nerve conduction velocity studies can usually delineate peripheral nerve dysfunction. Prognosis depends on the degree of nerve injury, which is related to both the cause and the duration of the entrapment.

Carpal Tunnel Syndrome↗
PubMed1985

Lightning injuries.

Lightning causes more deaths than any other weather phenomenon. It is an electrical current that will choose the shortest paths between the contact points of the human body and may involve vital structures in its pathway. Almost every organ system can be injured by the electrical current of lightning. A broad spectrum of complications resulting from damage to the various organ systems has been reported. The sequelae peculiar to this specific type injury will dictate the choice of therapy.

Bone and Bones↗
PubMed1985

Electric burns of the oral cavity.

Low-voltage electric burns are the leading cause of electric burn injury in childhood and can result in an injury to the oral cavity that can heal with a noticeable deformity. The mechanisms of burn injuries to the oral cavity are either due to the electric arc or current or both. Electric burns of the oral cavity can involve the lip, tongue, mucous membranes, and underlying bone. Therapy for these injuries should include management of systemic sequelae and treatment of the local burn injury. Our therapeutic approach to this injury is dictated by the pathophysiology of the electric burn of the oral cavity.

Burns, Electric↗
PubMed1985

A comparative analysis of the clinical, sialographic, and pathologic findings in parotid disease.

In review of the clinical and sialographic ability to predict parotid pathology, it was found that the clinical exam was consistently more accurate. Sialographic findings and histopathology were compared in 119 patients who underwent 120 sialograms and subsequent parotidectomies. Sialography alone was able to diagnose a malignant tumor in only 8 per cent (1/13) of the cases. The sialogram proved most helpful for the clinician in the management of patients when the diagnosis was calculus, obstruction, or sialectasia. On the other hand, mass lesions in or adjacent to the parotid, diffuse enlargement of the gland, or conditions such as masseter muscle hypertrophy are probably better evaluated with newer CT techniques in conjunction with sialography or without sialography.

Adolescent↗
PubMed1984

The trapezius musculocutaneous flap in head and neck reconstruction: potential pitfalls.

Defects resulting from bulky tumor resection of the head and neck region represent a reconstructive challenge. The trapezius musculocutaneous paddle flap based on the transverse cervical vessels is a useful tool for the reconstructive surgeon. Failure to recognize the variable anatomy is discussed in relation to other musculocutaneous flaps used for the purpose of head and neck reconstruction. The trapezius muscle has a variably located vasculature and diverse nomenclature. The knowledge of the variance of its anatomical vasculature is essential in the successful use of the trapezius musculocutaneous flap.

Arteries↗
PubMed1984

Galeal-pericranial flaps in head and neck reconstruction. Anatomy and application.

Head and neck deformities of congenital, traumatic, or neoplastic cause often require reconstruction. At the University of Virginia over the past 14 years, we have used galeal, temporalis fascial, and pericranial flaps to correct these defects in more than 150 patients. Dissection of these flaps on both cadavers and reconstructive patients had demonstrated new anatomic findings different from those reported in standard textbooks. The galea is the most superficial layer of fascia. The pericranium is the next tissue layer. It is continuous above and separate from the temporalis muscle fascia. We may, therefore, consider three separate fascial layers for reconstruction. A rich vascular plexus arises from branches of the external and internal carotid arteries. Blood flow is axial to the galea and temporalis fascia. Pericranium has a dual supply from peripheral axial vessels and from perforating vessels from the overlying galea. Galeal, temporalis fascial, and pericranial flaps are reliable, thin, and supple and have a good arc of rotation and minimal donor site morbidity. They may be used to cover bone, cartilage, or implants, may be folded for bulk, may be used to carry blood to poorly vascularized recipient sites, or may be used to nourish bone, cartilage, skin, and mucosal grafts. Their versatility permits a wide variety of potential applications in head and neck surgery.

Adult↗
PubMed1984

Bacteriologic evaluation of electric clippers for surgical hair removal.

Clipper blade assemblies for electric clippers used repeatedly without sterilization demonstrated high levels of bacterial contaminations that are potential sources of infection. A technique of sterilization of the clipper blade has been reported that eliminates the exogenous bacterial contamination.

Adolescent↗
PubMed1984

Rodeo roping thumb injuries.

Three men with thumb injuries sustained during rodeo roping competition have been treated recently. Two of the thumbs were amputated, and the third was partially avulsed. The mechanism of injury was identical in all three cases. The thumbs were entwined between the rope and saddle horn while reducing the slack in the rope and then subjected to shearing and crushing forces as tension was placed on the rope. These injuries emphasize the importance of keeping the thumb upward and clear of the rope to avoid entrapment between the rope and saddle horn.

Adult↗
PubMed1984

Quantitation of skin-flap survival: a computer-based method.

We have proposed a standard scheme for presenting data on experimental skin flap survival in pharmacologic studies that will aid in comparing results. In addition, we have presented a method using desktop computer accessories for accurately measuring the area of any flap.

Animals↗
PubMed1984

Subepineural pacinian corpuscle: a cause of digital pain.

A patient is presented who had chronic digital pain as a result of an abnormally located subepineural pacinian corpuscle. The patient had complete relief of her symptoms and return of normal digital function following removal of the pacinian corpuscle. A review of the literature concerning this entity revealed very few reported cases. However, these cases shared many of the same symptoms, as well as both physical and operative findings. It is suggested that patients suffering from digital pain of unknown etiology with a previous history of direct or indirect trauma may benefit from a localized operative exploration of the digit to remove an abnormally located pacinian corpuscle affecting the digital nerve.

Adolescent↗
PubMed1984

Pica.

Explore the source record for details and available documents.

Adolescent↗
PubMed1984

Use of the Satinsky clamp for excision of anterior tongue lesions.

The use of Satinsky atraumatic vascular clamps in the resection of lesions of the tongue is described. This technique provides for extirpation of tongue lesions in a hemostatically controlled, dry operative field. The application of these clamps does not appear to alter significantly the histopathologic findings at the resected tumor margins, as is found with extensive dissection using electrocautery. In addition, the clamps provide excellent control of the unresected tongue to allow optimal exposure while reapproximating the wound edges.

Constriction↗
PubMed1983

Value of contralateral supraomohyoid neck dissections.

This study was carried out to determine the merit of contralateral supraomohyoid neck dissection in the clinically negative neck. When performed in conjunction with a standard radical neck dissection on the ipsilateral side, a yield of 2.8 percent pathologically positive nodes (5 of 177) was obtained in the contralateral neck. Little difference was noted in the yield of midline lesions versus unilateral lesions which approached the midline (3 and 2.6 percent, respectively). Similarly, the yield with preoperative radiation was close to that of the nonradiated group (3 and 2.7 percent, respectively). Additionally, in 1.7 percent of patients (3 of 177) with both clinically and pathologically negative nodes, metastases later developed in the contralateral neck, which indicates that the dissection is not necessarily effective in preventing future disease. The contralateral supraomohyoid neck dissection in the treatment of malignancies of the oral cavity, pharynx, and larynx does not appear to be of significant therapeutic value.

Head and Neck Neoplasms↗
PubMed1983

Early ambulation after skin grafting of depressed wounds of the leg.

Silicone molds can be fitted precisely to skin grafted, depressed surgical defects of the leg and can be secured in place with a tight-fitting elastic support. The gravitational effect and resultant edema under the skin graft can be reduced. Earlier ambulation and better results than have been reported in the past can be obtained.

Aged↗