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Biomedical subjects

S Krupp

Publications and source records attributed to S Krupp.

At least 19 recordsLinked to original sources
PubMed1994

Mid-term results with cultured epidermal autografts, allogenic skin transplants and cyclosporin A medication.

Transplantation of allogenic split thickness skin grafts (STSG) and immunosuppression with cyclosporin A enable early and definitive skin replacement of extensive, deep partial and full thickness burns. Covering burn defects with definitely engrafted, allogenic dermis and cultivated epithelial autografts (CEA) permits the subsequent withdrawal of cyclosporin A medication. Light-microscopy examination of biopsies, taken 12 and 24 months postgrafting, and electron microscopy of biopsies taken 12 months postgrafting, demonstrates a re-established, but somewhat reduced anchoring of the CEA as compared with a normal epidermal-dermal junction. Clinical inspection, 20 months postgrafting, confirms the histological observations that epifascial transplantation is qualitatively inferior to placing the allogenic STSG on the subcutaneous tissue. In the first situation, the dermis is inelastic and collagen deposition is excessive, whereas in the second case collagen deposition is comparatively reduced and the dermis shows clinically some elasticity.

Adult↗
PubMed1992

Cutaneous copper and zinc losses in burns.

To measure the exudative cutaneous copper (Cu) and zinc (Zn) losses in burns, 10 patients, aged 36 +/- 9 years (mean +/- s.d.) with burns covering 33 +/- 10 per cent of the total body surface area, were studied from the first postburn day (D1) until D7. All intakes and losses were analysed for Cu, Zn and nitrogen (N) content. Cutaneous losses were extracted from textiles surrounding the patients. Urinary excretions were 0.12 +/- 0.06mg/24h for Cu, 0.9 +/- 0.6mg/24h for Zn, and 14.1 +/- 4.4g/24h for N. Mean daily exudative losses through wound seepage from D1 to D7 were 4.7 +/- 2.1mg/24h for Cu, 27.1 +/- 14.4mg/24h for Zn, and 8.7 +/- 3.8g/24h for N. The cumulated mean losses over 7 days were 37mg for Cu, and 212mg for Zn, representing respectively 20-40 per cent and 5-10 per cent of normal body content. Serum Cu and Zn levels were strongly depressed. The urinary Cu/N ratios correlated with clinical improvement. We conclude that the exudative Cu and Zn losses during the first week postburn contribute significantly to the increased nutrient requirements in burns.

Adult↗
PubMed1992

The neurosensory musculocutaneous tensor fasciae latae flap: long term results.

In 1971 we started covering pressure sores and unstable scars with transposition-rotation-muscle and musculocutaneous flaps. In 1980 we published the first results with 6 neurosensory musculocutaneous tensor fasciae latae flaps. Until April 1989, 31 tensor fasciae latae flaps (TFL) were used, and we review a consecutive series of 19 neurosensory TFL-flaps. Questions such as whether to delay the procedure; early and late complications; evolution of the sensation; and indications are outlined under the aspects of long term follow up studies. The conclusion is that if the neurological pattern permits a neurosensory flap, such flaps should be done because no local recurrence occurred. In extended neurosensory TFL-flaps sensation of the filling status of the rectum is improved, and sitting control and perception of the 'body scheme' are also improved.

Follow-Up Studies↗
PubMed1992

Current concepts in pediatric burn care: management of burn wounds with cultured epidermal autografts.

Our experience with CEA is based on 21 patients operated on from 1986 to 1991. The areas covered with CEA measured 500 cm2 to 3160 cm2. At one setting no more than 40 sheets of 40 cm2 CEA have been transplanted. The take of CEA is over 75% when applied to dermis. The same holds true when covering "deepithelialised" skin homografts on immunosuppressed patients. Scar formation has not been a problem, and the overall results have been good.

Adolescent↗
PubMed1991

The sensory tensor fasciae latae flap: a 9-year follow-up.

From January 1979 to April 1989, 19 neurosensory tensor fasciae latae flaps were used to cover ischial pressure sores in paraplegic patients. This flap provides protective sensation and improves the sensory control of the filling status of the rectum and the sitting control in a wheelchair. Patients were reexamined between 12 and 110 months; no recurrence or new pressure sores were seen. Indications, early and late complications, and evolution of the sensation are discussed.

Adolescent↗
PubMed1991

Otoplasty without a conformer dressing.

Since 1969, all our constructive, reconstructive, and aesthetic otoplasties have been managed without a conformer dressing. U-sutures, loosely tied over coated cotton rolls up until 1975, when thin and elastic silicone tubes began to be used, maintain the tissues in their new position. Experience and results of 193 ear operations are reported.

Ear Cartilage↗
PubMed1991

[Cutaneous reconstruction of external genital organs: an older method still in current use].

The authors present four patients with cutaneous defects of the genital organs, one with a degloving injury to the penis, one with Fournier's gangrene, one with massive lymphoedema and one with a full thickness burn. In those four cases, a stable coverage was obtained through skin grafts, maintained by an external splint. The use of this older method gave an excellent esthetic and functional result.

Adult↗
PubMed1991

[Thoracic fascio-cutaneous flap].

Fascio-cutaneous flaps (LFC) of the thoracic wall are of rather historical interest with the exception of axillary and lateral thoraco-dorsal LFC. The reason has been the development of muscular, musculo-cutaneous and microvascular flaps which provide larger surfaces for defect cover, greater arc of rotation or none at all as well as superior vascularisation. The axillary LFC is used to correct axillary contractures after burns or to cover skin defects following radical excision for hidradenitis suppurativa. The lateral thoraco-dorsal LFC permits immediate reconstruction of an amputated breast with a minimum of time and blood loss and an unsurpassed fiability. Furthermore it allows postoperative X-ray treatment if necessary as well as uninhibited control of loco-regional metastases.

Breast Neoplasms↗
PubMed1990

Mastopexy: modification of periwinkle shell operation. Ten years of experience.

Degrees I and II ptosis and atrophy of the female breast can definitively be corrected by the modified periwinkle shell operation. More problematic are the long-term results after correction of a degree III condition, especially when silastic prostheses for augmentation have been used. The long-term results can be optimized by a combination of dermal and glandular mastopexy and mammary implants.

Adult↗
PubMed1990

Effects of beta-blockade on energy metabolism following burns.

The purpose of this study was to compare the effects of propranolol administered either by i.v. infusion or by prolonged oral administration (4 days) during the first 3 weeks following burns. The resting metabolic rate (RMR) of 10 non-infected fasting burned patients (TBSA: 28 per cent, range 18-37 per cent) was determined four times consecutively by indirect calorimetry (open circuit hood system) following: (1) i.v. physiological saline; (2) i.v. propranolol infusion (2 micrograms/kg/min following a bolus of 80 micrograms/kg); (3) oral propranolol (40 mg q.i.d. during 4 +/- 1 days); and (4) in control patients. All patients showed large increases in both RMR (144 +/- 2 per cent of reference values) and in urinary catecholamine excretion (three to four times as compared to control values). The infusion of propranolol induced a significant decrease in RMR to 135 +/- 2 per cent and oral propranolol to 129 +/- 3 per cent of reference values. A decrease in lipid oxidation but no change in carbohydrate and protein oxidation were observed during propranolol administration. It is concluded that the decrease in RMR induced by propranolol was not influenced by the route of administration. The magnitude of the decrease in energy expenditure suggests that beta-adrenergic hyperactivity represents only one of the mediators of the hypermetabolic response to burn injury.

Administration, Oral↗
PubMed1990

Management of cleft lip and nose defects: one or more operations?

Forty-seven patients with cleft lips and noses were operated on between 1981 and 1986 and the subsequent defects were evaluated at least two years after corrective operations. Of thirty-four unilateral deformities, 19 patients had only one operation, with satisfactory results in 16 patients and poor results in a further three. Ten patients had two operations, and an additional five patients had three and more. Of 10 patients with bilateral defects, four had two operations, and four had at least three. In addition, three children who were operated on between the ages of 8 and 10 showed normal growth of all the affected structures despite extensive mobilisation of the soft tissues.

Adolescent↗
PubMed1989

[Supplemented local anesthesia in plastic surgery].

A study of 34 reconstructive or aesthetic operations done with supplemented local anaesthesia (local anaesthesia associated with a premedication of methadone, midazolam and droperidol) is presented. Results of this anaesthesia were good in 88% as judged by the surgeon. The immediate post-operative impression was indifferent to pleasant in 85% of the patients. A few months later on, 72% of this cohort of patients would accept a new operation with the same kind of anaesthesia. Although these results are good, ways of improving the results are discussed.

Adolescent↗
PubMed1988

Tissue expansion in children.

Tissue expansion is a useful tool in reconstructive surgery. It permits the correction of large skin lesions by expanded cutaneous or fascio-cutaneous flaps, well vascularised and matching in colour, texture and thickness. We report our results in 12 children. There was a relatively high complication rate.

Burns↗