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S Monstrey

Publications and source records attributed to S Monstrey.

28 records · Page 2Linked to original sources
PubMed1996

Revascularisation by ingrowth of a free flap: fact or fiction?

Revascularisation of a critically ischaemic extremity by means of a free flap occurs through the development of vascular connections at the free flap-surrounding tissue interface. Three clinical cases are presented showing that in the particular situation of free tissue reconstruction of an ischaemic limb, vascular connections develop which are able at least partially to supply the free flap after occlusion of its arterial pedicle. One other case demonstrates similar vascular connections by angiography.

Aged↗
PubMed1996

Free flap coverage of a gangrenous forefoot in a patient with Buerger's disease: a case report.

A patient with Buerger's disease is described in whom reconstruction of a gangrenous forefoot with a free flap has been successfully performed. In order to limit the amputation level, a more aggressive approach toward reconstruction in young patients seems appropriate. To our knowledge, this is the first described case of free flap reconstruction of a gangrenous defect in a Buerger patient.

Adult↗
PubMed1996

The use of cryopreserved microvenous allografts in the venous system without immunosuppression: an experimental study.

Autogenous vein grafts are currently the number one choice in microsurgical practice for managing vessel length discrepancies. A significant percentage of these grafts is used in the venous system. Allografts may serve as a viable alternative source of vein grafts. Few studies in the past have described the use of cryopreserved vein grafts (1 mm in diameter) in the venous system. In the present study, we cryopreserved the femoral veins of rats and transplanted these across rat species (ACI to Lewis) as interpositional vein grafts into a defect in the femoral vein. Short-term patencies (21 days), expressions of systemic antigenicity, histology, and scanning electron microscopic studies were performed. We obtained 100% patencies with fresh control veins and cryopreserved veins at 21 days.

Animals↗
PubMed1996

Reliability of the fibular osteocutaneous flap for mandibular reconstruction: anatomical and surgical confirmation.

There is ongoing controversy regarding the reliability of the skin island associated with the fibular osteocutaneous flap for mandibular reconstruction. Anatomical dissections and a clinical series of mandibular reconstructions using the fibular osteocutaneous flap have demonstrated unequivocally that a skin flap can be reliably harvested with the fibula based purely on the septal perforators, without needing to incorporate portions of the soleus or flexor hallucis longus muscles or to perform any intramuscular dissection or anastomosis of the muscle perforators. However, the skin island should be designed more distally over the distal third of the lower leg at the junction of the middle and distal thirds of the fibula. A fibular osteocutaneous flap was designed over the distal third of the fibula in 60 fresh cadavers, and each flap was completely isolated on the septum and all muscle perforators were ligated before dye injection. A major perforator through the soleus muscle or flexor hallucis muscle was identified in 41 of 60 dissections (67 percent) and discrete septal perforators were identified under loupe magnification in 45 dissections (75 percent). All 60 flaps demonstrated 100 percent reliable perfusion of the skin island after injection of the proximal peroneal artery with methylene blue or red latex. This anatomical study was corroborated with 100 percent survival of 34 fibular osteocutaneous flaps for mandibular reconstruction with the skin island designed over the distal third of the lower leg and based only on septal perforators without incorporating the soleus or flexor hallucis muscles. Reliability of this fibular osteocutaneous flap for mandibular reconstruction is attributed to (1) design of the skin island more distally over the distal third of the lower leg, (2) preoperative precision Doppler mapping of the perforators, and (3) design of the closing wedge osteotomies of the fibula to protect the septocutaneous perforators transversing through the posterior periosteum of the fibula.

Cadaver↗
PubMed1993

The use of cryopreserved venous allografts in microvascular surgery without immunosuppression: an experimental study.

Excellent patency rates are currently established in the use of autogenous veins as interposition vein grafts in microsurgical practice. Allografts may be a viable alternative source of vein grafts. Recent advances in cryobiology have enabled the controlled freezing of tissues with preservation of vital cellular elements. Although several reports have shown the successful use of cryopreserved large-vessel allografts, few have addressed cryopreservation of microvessels (1 to 2 mm in diameter). In this study, the authors have successfully cryopreserved femoral veins in a rat model and transplanted them as interposition vein grafts into arterial defects across major histocompatibility barriers (ACI to Lewis). Short-term patencies (21 days) were determined, and histologic and scanning electron microscopic analysis were performed. Patency of 100 percent was achieved in both fresh control veins and in cryopreserved veins at 21 days.

Animals↗
PubMedDate not supplied

Surgical therapy in transsexual patients: a multi-disciplinary approach.

A transsexual patient has the constant and persistent conviction that he or she belongs to the opposite sex, thus creating a deeply seated gender identity conflict. With psychotherapy being unsuccessful, it has been proven that in carefully selected patients, gender reassignment or adjusting the body to the mind (both with hormones and surgery) is the best way to normalize their lives. Optimal treatment of these patients requires the multidisciplinary approach of a gender team with the input of several specialties. Such a team consists of a nucleus of physicians who sees the patient more frequently: the psychiatrist, the endocrinologist, the plastic surgeon, the gynecologist and the urologist and a more peripheral group that sees the patients more incidentally: the psychologist, the otorhinolaryngologist, the dermatologist, the speech therapist, the lawyer, the nurse and the social worker. Between 1987 and 1999, a total of 71 male-to-female (MTF) and 54 female-to-male transsexuals have undergone gender confirming surgery in our hospital. This article gives a review and an update on the different surgical procedures as well as on the outcome in our patient population. The results in this series of patients clearly demonstrate that a close cooperation of the different surgical specialties, within our multidisciplinary gender team, is the key to success in treating transsexual patients.

Female↗
PubMedDate not supplied

The management of parotid tumors; a ten-year experience.

In a retrospective study 101 patients who underwent surgery for a parotid mass were evaluated. The different diagnostic modalities (sialography, ultrasound, needle biopsy and frozen section) are described and discussed. Eighty-one tumors proved to be benign, of which 56 patients had a pleiomorphic adenoma, ten of them had a recurrent pleiomorphic adenoma, all after an enucleation, which again proved to be an inadequate operation for a parotid mass. The 20 malignant parotid tumors had a poor clinical outcome. Of the 18 patients with a malignant primary parotid tumor three showed a local recurrence and five metastatic disease within five years. The morbidity of parotid surgery is mainly due to post-operative facial nerve weakness (30%), which is mostly reversible, and the Frey syndrome (10%).

Adenoma↗
PubMedDate not supplied

Pressure sores.

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Hot Temperature↗