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Biomedical subjects

R Riefkohl

Publications and source records attributed to R Riefkohl.

At least 37 records · Page 2Linked to original sources
PubMed1985

Long-term clinical outcome of immediate reconstruction after mastectomy.

Immediate reconstruction of a breast removed for treatment of carcinoma can be accomplished without altering the cancer-ablative surgical procedure. The theoretical possibility that reconstruction might compromise the cure rate has tempered enthusiasm for this approach. To test this issue, the relapse-free survival of 101 patients who underwent breast reconstruction in the immediate postmastectomy period was compared with that of 377 patients with breast cancer who underwent mastectomy without immediate reconstruction. This comparison was accomplished using multivariable statistical techniques to correct for baseline inequalities between the patient groups. After adjustment for the relevant prognostic factors, no significant difference remained between the two groups. We conclude that immediate reconstruction has no discernible adverse influence on the natural history of surgically treated breast carcinoma.

Adult↗
PubMed1984

The effectiveness of benzodiazepines and narcotics in outpatient surgery.

In a prospective study of 211 outpatients undergoing cosmetic surgical procedures under local anesthesia supplemented with intravenous diazepam and morphine, patient pain response to the local anesthetic infiltration was graded and the recall of the operative experience was assessed. One hundred and fifty-five patients (73%) had either no pain response or a mild response, 41 (19%) had a moderate response, and 15 (7%) had a severe response. One hundred and eighty-seven patients (88%) had total amnesia for the local anesthetic infiltration and the operative procedure, and 183 (87%) could not recall pain, but had recall of events during surgery. There were no untoward drug reactions nor episodes of cardiorespiratory depression. We conclude that intravenous diazepam with or without intravenous morphine following triazolam, morphine, and premethazine premedication is a safe and effective regimen for outpatient surgery.

Ambulatory Surgical Procedures↗
PubMed1984

Experience with triazolam as a preoperative sedative for outpatient surgery under local anesthesia.

Triazolam, a new benzodiazepine hypnotic agent with an ultra-short duration of action, was given preoperatively to 251 outpatients who underwent plastic surgical procedures under local anesthesia. Satisfactory sedation was obtained in 96% of the patients, all of whom received intravenous diazepam primarily for its amnesic action. There were no untoward results attributed to triazolam and no residual effects postoperatively. Triazolam may be preferable over other benzodiazepine sedative-hypnotic agents used for outpatient surgery because of its rapid onset and short half-life.

Ambulatory Surgical Procedures↗
PubMed1984

Masseter muscle hypertrophy.

Benign hypertrophy of the masseter muscle is an uncommon entity important in the differential diagnosis of head and neck masses, particularly a unilateral mass located in the cheek. Ten cases of benign masseteric hypertrophy are reviewed, current surgical treatment is described, and the pertinent literature is summarized.

Adolescent↗
PubMed1984

Metastatic basal cell carcinoma.

Basal cell carcinoma rarely metastasizes. There are over 130 reported cases, 70% of which involve lymph nodes. In many cases a large, chronic, neglected or inadequately treated basal cell carcinoma preceded the metastasis. We report a case in which a basal cell carcinoma of the cheek metastasized to cervical lymph nodes.

Adult↗
PubMed1984

Postoperative alopecia in a woman after a lengthy plastic surgical procedure.

Pressure-induced alopecia was reported in the past. We observed postoperative alopecia (presumably pressure-induced) after a plastic surgical procedure of a long duration. Shortly after the operation, the patient noted swelling and exudation of the scalp near the vertex. The symptoms abated in the course of a week. The hair loss occurred quite rapidly (within 48 hours) in the area of the previous symptoms on the sixth postoperative day. Irregular regrowth of short hairs was first noted after 6 weeks. The patient's last examination 10 weeks after the operation revealed a 4 x 4 cm area of baldness with few scattered hairs 5 to 6 mm in length. The cause is considered to be pressure-induced ischemia based on the following: preceding period of deep unconsciousness (the operation) and natural history of the disease.

Adult↗
PubMed1984

A rationale for modifying the site of insertion of the orticochea pharyngoplasty.

A modification of the insertion level of Orticochea flaps is proposed. The purpose of the modification is to place the pharyngoplasty at a higher site, in the area of attempted velopharyngeal contact. The site of velopharyngeal contact can be identified using lateral radiographic techniques. A success rate of 93 percent was achieved in improved oral-nasal resonance balance when the pharyngoplasty was placed at a site in the nasopharynx.

Adolescent↗
PubMed1983

Rhinophyma: a thirty-five-year experience.

We have treated rhinophyma by a variety of methods during the past 35 years. We describe our current management, which has given the most satisfactory results and fewest problems.

Humans↗
PubMed1983

Complications of the forehead-brow lift.

The actual and possible sequelae and complications associated with a series of forehead-brow lifts are reviewed. Based on a review of the records of 61 patients who underwent the procedure, we recommend that the forehead-brow lift be primarily intended to correct soft tissue ptosis of the upper face. Because of the significant number of patients who required a revision upper blepharoplasty, this procedure either should not be combined with a brow lift, or the patient should be warned of the probable necessity of a later revision upper blepharoplasty.

Eyebrows↗
PubMed1982

The forehead-brow lift.

The forehead-brow lift, though generally thought to achieve very little and for only a brief time, corrects ptosis of the eyebrows, redundancy of the upper eyelids, and skin wrinkles on the forehead, nasoglabellar, and lateral canthal regions. Other aesthetic improvements include restoration of the contour of the root of the nose and elevation of the nasal tip. However, careful attention to complete release of the frontalis-galea unit from the underlying orbital rims and zygomatic arches is essential for long-term success. A forehead-brow lift technique is described and the results and complications in 34 patients reviewed.

Face↗
PubMed1981

A silent but lethal injury associated with facial trauma.

Without a careful evaluation of all patients with major facial injuries and a thorough search for possible associated injuries, traumatic transection of the aorta may be easily missed, if the patient survives the first 24 hours after injury. Any patient subjected to sudden deceleration injury, particularly following automobile or motorcycle accidents, should be evaluated carefully for traumatic aortic rupture. Patients with associated chest trauma should have chest x-rays in the emergency room, and repeat chest films several hours later should be obtained to identify subsequent development of a widening mediastinum. Proper management of possible aortic transection should include arteriograms when appropriate and prompt surgical intervention when indicated. All patients with major injuries should be thoroughly evaluated by a trauma team so that associated injuries may be quickly recognized and treated.

Accidents, Traffic↗
PubMed1980

Use of skin staples in plastic surgery.

Skin closure with stainless steel staples can be done economically, simply, quickly, and accurately. Stapling is indicated in a wide range of surgical procedures. Scarring is minimal and patient acceptance is excellent.

Dermatologic Surgical Procedures↗