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Biomedical subjects

R Kalus

Publications and source records attributed to R Kalus.

7 recordsLinked to original sources

Preventable inpatient time: adequacy of electronic patient information systems.

OBJECTIVES: This study assessed hospital electronic patient information systems (EPIS) for inclusion of variables associated with avoidable and extended hospitalization (preventable inpatient time). METHODS: We searched MEDLINE and HealthSTAR databases to identify predictors of preventable inpatient time. We then audited the admissions process and the handwritten medical record at 1 hospital, and the EPIS at all hospitals, affiliated with the Yale University School of Medicine for inclusion of the predictors. RESULTS: Whereas the written medical record included all 58 predictors, the EPIS of the 10 hospitals surveyed included an average of only 38% of the predictors. CONCLUSIONS: The conventional approach to information gathering during hospital admission is highly inefficient. Revising EPIS to include predictors of preventable inpatient time could enhance efficiency and quality, while reducing costs, of hospital care.

Connecticut↗

Aesthetic considerations in facial reconstructive surgery: the V-Y flap revisited.

The subcutaneous pedicled V-Y advancement flap (also known as the "kite flap" of Dufourmentel) has been described by many authors. Its versatility in reconstructive surgery is well known, both in facial reconstructive surgery as well as surgery of the trunk and extremities. Its advantages in achieving aesthetic reconstruction in specific facial regions have been less well emphasized in the literature. The flap can be designed within natural facial creases and heals inconspicuously because of its widely based subcutaneous or muscle pedicle which incorporates venous and lymphatic drainage over most of its length. The undesirable "biscuiting" or flap edema frequently observed with other conventional transposition flaps is avoided. We have found the V-Y flap particularly useful in reconstructing the lower eyelid/medial canthus, supra-alar, and nasolabial regions. Our experience with over 40 such flaps is described, and technical considerations in designing and elevating the flap are discussed.

Face↗

Posterior hindfoot reconstruction.

From August 1983 through December 1988, 25 patients with complex wounds involving the posterior hindfoot underwent reconstruction of that region. The present study reviews the use of microsurgical free-tissue reconstruction in this complex anatomic area. A questionnaire was sent to all patients; 60 percent responded, with a mean postoperative period of 2.1 years. Our experience shows that complex wounds involving soft tissue, bone, tendon, and nerve may be successfully reconstructed by the judicious use of free-tissue transfer combined with standard adjunctive techniques. When flap donor tissue is carefully selected, a one-stage reconstruction without the need for contour revision should be possible. Patient satisfaction has been excellent and solidly healed wounds have been maintained.

Adolescent↗

Steatocystoma multiplex: a case report.

A severe case is reported of a rare skin disorder characterized by multiple intracutaneous cystic lesions; the condition is difficult to manage and impossible to cure. The complicating cystic infections that accompany the condition are treated acutely using sound surgical principles, yet long-term management remains a difficult and unsolved problem. Some of the approaches to treatment are discussed. Surgical cures are usually precluded by the extensive nature of the disease. Perhaps most disheartening is the devastating social and psychological damage resulting from the progressive facial and bodily disfigurement, for which there is at present no satisfactory treatment.

Epidermal Cyst↗