Search PubMed⌕ Search

Biomedical subjects

W A Morrison

Publications and source records attributed to W A Morrison.

At least 145 records · Page 8Linked to original sources
PubMed1983

Comparison of vascular hemodynamics in experimental models of microvascular anastomoses.

Blood flow was measured in the canine saphenous artery using electromagnetic flowmetry. Significant increase in blood flow was noted after occlusion of the distal femoral artery. However, after raising a saphenous island flap there was no significant change in the blood flow before and after distal femoral artery occlusion. The flap peripheral resistance and blood flow were compared after end-to-end and end-to-side anastomosis and no statistical difference was noted.

Animals↗
PubMed1983

The instep of the foot as a fasciocutaneous island and as a free flap for heel defects.

The instep flap needs neither muscle nor a transposition base for survival or innervation. It can be transposed as an island fasciocutaneous flap either on the medial or lateral plantar neurovascular bundles or both, and it can be transferred also as a free flap from the opposite foot. Four cases demonstrating the use of the flap as an island and free flap are presented with follow-up ranging from 1 to 2 years. The absence of muscle in the flap provides greater stability of the heel reconstruction and results in a lesser secondary defect. Sensation in the flaps is diminished but adequate for long-term function, but hyperkeratotic reaction remains an unpredictable problem. The ability to transfer the flap as a free transfer widens the scope of the flap to reconstruct both heel and forefoot defects where local instep tissue or vascularity are inadequate for local reconstruction. The secondary defect, particularly when no muscle is included in the flap, has been minimal.

Adolescent↗
PubMed1983

Microsurgical repair of the fallopian tubes.

The microsurgical techniques used and the results achieved in a series of 27 patients submitted for fallopian tube repair are presented, the majority following elective sterilization.

Adult↗
PubMed1982

The scapular free flap.

A purely cutaneous free flap overlying the infraspinous region of the scapula has been used successfully in three cases. It is of intermediate thickness, predominantly hairless and is based on the cutaneous branch of the circumflex scapular artery. Te dissection of the flap is easy, quick and safe, resulting in a minimal pedicle length of 3 cm but this can be lengthened significantly by the inclusion of the more proximal vessels. The vessel diameter and its distribution make revascularization predictable. In this vessels. The vessel diameter and its distribution make revascularization predictable. In this series, the longest flap used was 24 cm and the widest was 12 cm, the width being limited by the ability to achieve primary closure. The only donor site disability is related to a tight linear transverse scar. These is no functional limitation nor distortion of the axillary contours. This contrasts with the thicker and widely used latissimus dorsi free flap. The scapular flap should replace the latissimus dorsi flap where the size of the defect to be covered is within the critical dimensions of this flap. The scapular flap can be combined with the latissimus dorsi flap for larger areas of skin cover, or the two flaps can be separated still based on their common vascular pedicle to cover two areas with diverging axes.

Adult↗
PubMed1982

Free microneurovascular muscle transfer in limbs to provide motor power.

The experience gained in a series of 7 free microneurovascular muscle transfers to the limbs over a seven-year period has led us to conclude that: free gracilis microneurovascular flaps can be safely transferred and can aid restoration of movement following severe injuries of the limbs, including post-replantation cases; inclusion of a cutaneous island with the muscle is safe, improves cover, and simplifies closure following muscle transfer; tendon adhesions and joint stiffness are the greatest obstacles to transferred muscle function, and early passive extension is recommended; additional procedures are usually required after muscle transfer, to improve the level of function; and additional experimental work is required to determine methods of establishing the correct resting tension in transferred muscles.

Adolescent↗
PubMed1982

Digital reconstruction in the mutilated hand.

Salvage and reconstruction of the mutilated degloved hand or digit pose a problem because of the deficiency of local innervated pulp tissue. Free neurovascular flaps from the first web space of the foot supply a large area of well-padded innervated glabrous skin to resurface such defects. In thumb reconstruction free flaps, which may include the toenail, have many advantages over the conventional ring-finger island flap. Finger and whole-toe transfers are innervated reconstruction par excellence and these, in combination with innervated free flaps, offer a large armamentarium for reconstruction. The quality of sensation, however, is poorer than normal in these transfers and they are therefore limited to circumstances in which their use is not substituted by adjacent normal units.

Finger Injuries↗
PubMed1982

The versatile latissimus dorsi myocutaneous flap in breast and other reconstruction.

In this series of 35 clinical cases, the versatility of the latissimus dorsal flap is demonstrated. Whilst its width is limited to approximately 10 cm to gain primary closure, its length extends from the axilla almost to the iliac crest. If a larger area of soft tissue cover is required, muscle only may be used covered with a split skin graft. Its safe rapid dissection, reliable blood supply and wide arc of rotation makes it suitable for many of the reconstructive needs in the trunk, head and neck. Its large vascular pedicle makes it particularly suitable for free flap transfer. The commonest indication for use of the flap has been reconstruction of the breast following radical surgery. The secondary morbidity at the donor site is negligible.

Adolescent↗
PubMed1981

Effect of lymphangiography on lymphedema.

Lymphangiography, using oily radiopaque Lipiodol Ultra Fluid has been shown to increase lymphedema in one-third of the patients with obstructive lymphedema and to cause lymphatic obliteration (demonstrated histologically). No effective element has been observed, although subclinical infection could not be ruled out. Allergy is another possible contributor, but the evidence from this series suggests that Lipiodol may act as a direct irritant when it is not rapidly cleared, as in the case of obstructive lymphedema, and proceed to obliteration of the residual lymphatics. On the basis of these findings, elective routine preoperative lymphangiography for lymphedema is considered strongly inadvisable.

Female↗
PubMed1980

Cross-facial nerve grafts and microneurovascular free muscle transfer for long established facial palsy.

Cross-facial nerve grafts followed in 4 to 12 months by microneurovascular free gracilis transplantation can produce adequate reconstruction in the lower two-thirds of a paralysed face. The mixed sensory and motor deep peroneal nerve and the small muscle bulk of the extensor digitorum brevis limit its usefulness in facial palsy. The gracilis has proved to be a much superior muscle. A feasible method for total reamination of unilateral facial palsy is presented.

Adolescent↗
PubMed1980

Vascularised tube pedicle: a case report.

The conventional 4-stage migration of a tube pedicle extending over a period of several months can be reduced to a 2-stage procedure taking 4 weeks. By using the groin flap and revascularising its medial end by anastomsis to wrist vessels, the flap can be applied to its intended site in one stage. Four weeks later it is detached and insert. This method of transfer could sound the death knell of the tube pedicle as conventionally conceived if economics and patient comfort are to be considered.

Adolescent↗
PubMed1980

Microvascular segmental thumb reconstruction: a case report.

The great toe provides an ideal source of tissue for both functional and aesthetic reconstruction of segmental defects in the thumb and can be used without mutilation of the foot. A successful case is presented of a I-stage primary reconstruction of a segmental defect of the thumb using a composite free flap transfer from the great toe containing pulp, tissue, nail and bone, with neurovascular anastomosis. The donor defect on the great toe was repaired at the same time.

Adult↗
PubMed1980

Replantation and revascularisation surgery in children.

Salvage of any amputated, or devascularised, digit or extremity in a child should be seriously considered and carefully planned. Bone shortening should be minimised. Replanted and revascularised digits and extremities do grow and often demonstrate minimal retardation when well revascularised and minimally traumatised. Even in more extensive injuries progressive growth is observed. Replanting of single digits is worth while in children. Vein grafting should be seriously considered when replanting any avulsed digit. The return of excellent sensation and good function in amputated parts in children makes these procedures rewarding and beneficial.

Adolescent↗
PubMed1980

Thumb reconstruction with a free neurovascular wrap-around flap from the big toe.

Thumb reconstruction requires accurate functional and esthetic approximation to the original. Accepted methods generally have some deficiencies, particularly in appearance, and frequently the secondary morbidity is unacceptable. A method of thumb reconstruction with the use of an iliac crest bone graft and a free neurovascular "wrap-around" flap from the big toe is described that combines the attributes of previous methods without their secondary morbidity.

Adult↗
PubMed1980

The surgical repair of amputations of the thumb.

Twenty-four thumb mutilations have been repaired by using either whole toe transfers or portions of the big toe for reconstruction. The hallux has many of the properties uniquely suitable for thumb reconstruction. Its total sacrifice, however, leaves a significant defect in the foot, and it is usually too big to look convincing as a thumb. Essential portions of it can be transferred without undue deformity in the foot, and these, in combination with an iliac crest bone graft, can be modelled into a most aesthetic and functional thumb.

Amputation, Traumatic↗