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Biomedical subjects

S P Kay

Publications and source records attributed to S P Kay.

44 records · Page 3Linked to original sources
PubMed1987

Nutritional status and wound healing in lower extremity amputations.

This prospective study examines the importance of nutritional status in 41 consecutive patients with lower extremity amputations proximal to the Symes level. The nutritional status of the patients was assessed by evaluating serum albumin levels and total lymphocyte counts, proven indices of nutritional status. Fifteen of 16 patients with normal nutritional parameters healed their amputations uneventfully, whereas 11 of 25 malnourished patients suffered either local or systemic postoperative complications. The difference in the complication rate between the nourished and malnourished groups is statistically significant (p less than 0.05). Malnutrition adversely affects the prognosis for healing lower extremity amputations, but it seems to be less detrimental to wound healing in the more proximal amputations, where blood flow is superior. Based on these findings, it is recommended that patients being admitted for lower extremity amputation should be screened at the time of admission, and those with laboratory parameters indicative of malnutrition should have elective surgery postponed until their malnourished state is corrected. Patients requiring urgent surgical treatment should probably receive supplemental nourishment in the perioperative period.

Adult↗
PubMed1986

Brachial plexus palsy secondary to clavicular nonunion. Case report and literature survey.

Compression neurapraxias of the brachial plexus secondary to nonunion of the clavicle are extremely rare. These palsies routinely affect the medial cord, producing primarily ulnar nerve symptoms. The nonunions that cause them are almost exclusively hypertrophic and are usually in the middle third of the clavicle. These palsies result from the entrapment of the medial cord of the brachial plexus within the costoclavicular space of Berkheiser. Onset of symptoms is highly variable. Treatment recommendations are divided between partial clavicular excision and open reduction with internal fixation. Because this lesion requires operative intervention, it must be carefully distinguished from traction palsy of the plexus for which it is easily mistaken. This distinction requires a meticulous neurologic examination during the initial evaluation of the patient with an acute calvicular fracture.

Brachial Plexus↗
PubMedDate not supplied

Microvascular surgery in children.

43 microvascular procedures were performed in 38 children, (age limit 15 years) over a three year period. The average age was 5.4 years. The majority of the procedures were elective (63%), the remainder urgent or emergency. The overall vascular success rate was 93%, confirming previous reports. Three failures were observed, 2 of these being thumb avulsion injuries, the third a free-flap. Two patients underwent re-exploration of the anastomosis with successful outcomes. Vessel size was not a problem and generally exceeded 0.8 mm external diameter. The total time under anaesthetic averaged 5.5 hours, and post-operative recovery included monitoring and pain control on a High Dependency Unit. The average hospital stay was 10 days. The indications for surgery differ from those in adults, management is more complex, and includes the physical and psychosocial care of the child and parents. Despite raising certain anxieties in the past, microvascular surgery in children is safe, reliable and carries a high success rate.

Adolescent↗