bluuebunny/crossref_metadata_2025_split huggingface dataset:
The medical leech: An old treatment revisited
Authors: Wells Mark D. , Manktelow Ralph T. , Brian Boyd J. , Bowen Vaughan 
Published: March 2007

AbstractThe treatment modality of choice for venous insufficiency after free tissue transfer or replantation remains surgical repair. When this is not technically possible, the use of medical leeches is a useful adjunct to treatment. This paper reviews the history of the use of leeches in medicine, the anatomy and physiology of Hirudo medicinalis, the techniques of leech therapy, and the complications and contraindications. © 1993 Wiley‐Liss Inc.
Complications in head and neck microsurgery
Authors: Al Qattan Mohammad M. , Brian Boyd J. 
Published: March 2007

AbstractMicrovascular surgery plays a vital role in head and neck reconstruction. This paper deals with the complications arising from this form of surgery. They can be classified as general complications, anastomotic problems, and specific problems related to particular donor and recipient sites. © 1993 Wiley‐Liss Inc.
Complications and unsatisfactory results in the microsurgical reconstruction of lower extremities
Authors: Bowen Vaughan , Manktelow Ralph T. 
Published: March 2007

AbstractComplications and unsatisfactory results in the microsurgical reconstruction of lower extremities were reviewed in a chronological sequence. Perioperative complications were grouped into the following categories: improper patient or donor tissue selection, unsatisfactory choice of recipient site vessels, inadequate exposure of recipient site vessels, improper „insetting”︁ of the free tissue transfer, extralumenal obstruction, and miscellaneous adverse factors. Vascular changes in the limb as a result of free tissue transfer are discussed. Discussion of late postoperative problems includes the long‐term results of soft tissue and skeletal reconstruction. © 1993 Wiley‐Liss Inc.
Experimental microsurgical vein grafts: Quantitative temporal analysis of progressive media fibroplasia
Authors: McDonald James P. , Shaffer John W. , Carter John R. , Field Greg 
Published: March 2007

AbstractThe sequential histopathologic changes in microvenous grafts placed in a microarterial system were studied. In 48 Sprague Dawley rats, a 1 cm segment of epigastric vein was interposed into a defect created in the femoral artery. Grafts were explored at 1, 2, 4, and 12 weeks. After an initial smooth muscle hyperplasia, a progressive fibroplasia of the media was observed. Only small focal areas of intimal hyperplasia were seen. The width of the media was measured with an eyepiece micrometer. A statistically significant (P < 0.01) increase in width from 17 μm at 1 week to 462 μm at 12 weeks was noted. Although this process has been described before, this is the first quantitative assessment. © 1993 Wiley‐Liss Inc.
Colon transplantation: A new microvascular technique
Authors: Plapler Hélio , Cohen Zane 
Published: March 2007

AbstractThis paper describes a new transplantation technique, using the colon instead of the small bowel for intestinal transplantation. With microsurgical techniques, aljogeneic colon transplantation was carried out in rats in a hetero‐topic fashion. The vascular pedicle containing the aortic cuff and the portal vein was anastomosed to the aorta and the inferior vena cava of the host, respectively. The technique has proven reliable and reproducible, and our preliminary results suggest that the colon produces a milder rejection response than transplantation of the small bowel. © 1993 Wiley‐Liss Inc.
Replantation of a multiple digit and circular palm amputation: A case report
Authors: Cai Jinfang , Cao Xuecheng , Pan Jiqing , Hu Jianguo 
Published: March 2007

AbstractA case of successful replantation of multiple digits and circular palm amputation caused by an industrial punch force is reported. The two‐level amputation was reconstructed by first replanting the severed fingers to the palmar segment and then connecting the palm segment to the hand stump. An arterial crisis was treated with urokinase, and postoperative functional recovery is described. © 1993 Wiley‐Liss Inc.
Percentage of nerve injuries in which primary repair can be achieved by end‐to‐end approximation: Review of 2,181 nerve lesions
Authors: de Medinaceli Luis , Prayon Marina , Merle Michel 
Published: March 2007

AbstractPrimary nerve repair yields better results than secondary reconstruction but is not always possible. We reviewed a series of 2,181 fresh nerve injuries of the upper limb. One nerve only was injured in 41% of the patients; two or more in 59%. One thousand four hundred eighty‐two injuries (68%) were located in the digits. The injured limb segment was lost or beyond repair in 387 cases (18% of all cases). In the 1,794 remaining injuries, primary treatment was accomplished by end‐to‐end suture 1,568 times (87%) and by graft 33 times (>2%) and was impossible in 193 cases (11%). © 1993 Wiley‐Liss Inc.
Congenital pseudarthrosis of the forearm: Treatment of six cases with vascularized fibular graft and a review of the literature
Authors: Mathoulin Christophe , Gilbert Alain , Azze Ronaldo Gorge 
Published: March 2007

AbstractSix cases of pseudarthrosis of the forearm are reported. One involved only the radius, one the ulna alone, and four both forearm bones. There was associated neurofibromatosis in five cases. All the cases were treated by wide resection and free vascularized fibular graft. In two cases, a single‐bone forearm was created. In all cases, good results were achieved, with moderate forearm shortening. The literature suggests electrical stimulation, corticoperiosteal graft, osteotomy of the involved bone, and free vascularized bone grafting as treatment alternatives. Vascularized free bone grafting appears to be more successful than other treatments. The use of microsurgical sutures permits this treatment in young patients. © 1993 Wiley‐Liss Inc.
Wound closure at the trunk by micro vascular free flap transfer
Authors: Piza Hildegunde , Rath Thomas , Hausmaniger Claudia , Leopold Walzer R. 
Published: March 2007

AbstractDefects of the thoracic or abdominal wall can be congenital or caused by trauma or tumour resection. There may be other problems, such as infection and irradiation effects. In most cases those defects can be closed by local cutaneous and fasciocutaneous or by muscle and myocutaneous flaps. In some rare instances, the use of pedicled flaps may be limited. The size of the defect, the impossibility of closing the donor site, an impaired blood supply, or poor quality of local tissues represent such limitations. In these cases microvascular flap transfer has enlarged our choice of alternative methods. Advantages of this method are the one‐stage procedure and the wound coverage by well‐vascularized tissue. This is especially beneficial in areas of infected or irradiated tissue. On the other hand microvascular flap transfer requires high technical skill and extensive perioperative and postoperative care. © 1993 Wiley‐Liss Inc.
Histological evaluation of free revascularized iliac crest bone after transplantation for mandibular reconstruction
Authors: Leimbruckner Bernhard D. , Dielert Eckhard , Stock Wolfgang 
Published: March 2007

AbstractDiffering views on the nutritional status of revascularized bone in animal studies and in human transfer have been expressed. Normal viability is reported as well as single cell necrosis and devitalized areas and, finally, necrosis of the complete graft. From 19 patients with revascularized bone transfer into injured recipient tissues, we obtained 32 drill biopsies out of the centre of the graft and near the mandibular stump during the removal of the osteosynthesis plates. The histological preparations were examined for bone viability. In 58% of all patients, there occurred partial necroses in the grafted bone and in 26% single cell necroses; 16% of the transplants maintained normal viability. The areas with disturbed nutrition were found more frequently in peripheral areas than in central regions of the graft (p < 0.05, x2 test). The overall graft failure rate was 6.8%. The results of this clinical study are discussed with particular reference to the technical procedure, the recipient tissue quality, and the design of the graft. The indication for using revascularized bone transfer in difficult local conditions of the recipient tissues has been confinned. The viability of the grafts cannot always be maintained entirely. The particular risk to the viability of the graft in the peripheral regions requires careful technical procedures. © 1993 Wiley‐Liss Inc.
Microsurgery in gaining paediatric vascular access for haemodialysis
Authors: Sanabia Juan , Polo José R. , Morales Maria D. , Canals Maria J. , Polo Jorge , Serantes Angela 
Published: March 2007

AbstractOne hundred and one surgical procedures performed in children for construction and maintenance of vascular accesses for haemodialysis were retrospectively analyzed. There were 86 operations performed to create a new fistula in patients without vascular access or with nonrecoverable failed angioaccess. Fifteen surgical procedures were performed to treat fistula complications. The new fistulas were radiocephalic n = 60 (70%), ulnar‐basilic n = 5 (5.8%), antecubital n = 9 (10.3%), and PTFE grafts n = 12 (14%). Microsurgical techniques were used in all cases, including PTFE graft fistulas. A microscope was used in 56 cases (55.4%) and magnifying loupes (× 2.5 magnification) in the rest of the operations. Early‐failure rate for radiocephalic fistulas was 10%. Cumulative patency rates in radiocephalic fistulas were 79%, 75%, and 70% at 1, 2, and 5 years, respectively. No statistical differences were found from the cumulative patency curve of 730 radial‐cephalic fistulas performed in adults during the same period of time. Radiocephalic fistulas can be constructed in most paediatric cases using microsurgical technique. Elbow fistulas can be the second‐choice vascular access, and PTFE grafts can be reserved for children with exhaustion of autologous veins. Brachial‐jugular PTFE grafts can be used in cases of subclavian vein stenosis. © 1993 Wiley‐Liss Inc.
Dextran's antithrombotic properties in small arteries are not altered by low‐molecular‐weight heparin or the fibrinolytic inhibitor tranexamic acid: An experimental study
Authors: Zhang Baimeng , Wieslander Jan B. 
Published: March 2007

AbstractIn two separate blind, randomized studies, 48 rabbits were divided into five groups. Three treated groups received dextran 70 (0.51 g/kg) as a single injection, dextran 70 combined with low molecular‐weight heparin (LMWH) (560 IU/kg as anti‐FXa and 140 IU/kg as APTT in 3 hr), and dextran 70 plus tranexamic acid (14 mg/kg) following severe arterial trauma (arteriotomylintimectomy). Two control groups received the same amount of saline. The bleeding times from the arteriotomy were recorded, and patency rates and the weight of thrombotic materials were registered 2 hr after reperfusion of the trauma region. The bleeding times in three treated groups, all including dextran, were significantly prolonged compared to the control groups (P < 0.05 or 0.01). The patency rates of treated groups, which were 100% (1 8/18 vessels patent) in the dextran‐treated group, 90% (18/20 vessels patent) in the dextran + LMWH group and 95% 19/20 vessels patent) in dextran + tranexamic acid group, were significantly higher than those of their control groups (55‐67% patent vessels) (p < 0.05 or 0.01). The mean weights of thrombotic materials were significantly reduced in the treated groups compared to the corresponding control groups (p < 0.01). In conclusion, dextran 70 in an ordinary dose exerted such a profound antithrombotic effect (100% patency) in small traumatized arteries that the addiiion of a high dose of LMWH could not further improve patency rates or decrease thrombotic materials but did not prolong vessel bleeding times compared to the single dextran treatment. The addition to dextran 70 treatment of a clinical dose of the antifibrinolytic agent tranexamic acid did not disturb the good antithrombotic effect, suggesting that fibrinolysis enhancement is a less important characteristic of the dextran antithrombotic effect in small traumatized arteries. © 1993 Wiley‐Liss Inc.
Nerve reconstruction with glycerol‐preserved allogenic grafts in the rat
Authors: Wolff K.‐D. , Walter G. , Zimmer C. 
Published: March 2007

AbstractA variety of materials have been evaluated as potential nerve grafts. To date, none has been shown to be consistently equal with regard to functional outcome when compared to standard autogenous nerve grafts. In this study, nerves stored in glycerol were evaluated for their peripheral nerve regenerative capacity. Femoral nerves were harvested from Fischer rats and stored for a minimum of 100 days in 98% glycerol at 4°C. They were grafted into femoral nerve gaps of Lewis rats. After 3 months, histologic, electrophysiologic, and morphometric (axon diameter) analyses revealed less regenerative response than nerve gaps grafted with fresh, syngeneic controls. The differences disappeared by 6 months, although neither graft technique achieved recovery comparable to unoperated nerves. Immunohistochemical evaluation demonstrated a modest immune response at 3 months, which subsided by 6 months. These findings are encouraging for the development of glycerol‐preserved nerve graft banking. © 1993 Wiley‐Liss Inc.
Comparison of 10‐0 polypropylene and 10‐0 nylon sutures in rat arterial anastomosis
Authors: Chen Long‐En , Seaber Anthony V. , Urbaniak James R. 
Published: March 2007

AbstractThe selection of suture materials is an important factor in further improving the results of microsurgical operations. In this study, two kinds of nonabsorbable suture materials, 10‐0 polypropylene and 10‐0 nylon monofilament, were compared in end‐to‐end anastomosis of 66 femoral arteries of adult rats. Both suture types were of identical size (70 μm needle/28 μm suture) and each artery received eight sutures. The vessels were harvested at various intervals from 2 hr to 180 days postoperatively and were evaluated by pathology, radiology, and tensile strength test. The results show that both sutures are capable of achieving excellent long‐term patency (100%) of anastomosed sites. Polypropylene suture was equivalent to nylon in mechanical integrity of the anastomosis sites but was superior in handling, knotting, and biocompatibility. These physical and biological properties of polypropylene sutures may offer the benefits of diminished early and late complications at anastomosis sites and reduced operation time. Enhancement of contrast against surrounding tissue may make polypropylene a superior alternative to nylon sutures for microsurgical use. © 1993 Wiley‐Liss Inc.
Flexible technique for multiple organ procurement in rats: A training and research tool in transplantation
Authors: D'silva Milbhor , Pirenne Jacques , Bonnet Pierre , Honore Pierre , Meurisse Michel , Lee Sun , Jacquet Nicolas 
Published: March 2007

AbstractMultiple organ procurement techniques are increasingly popular in many transplant centers. This paper describes a technique for multiorgan unit(s) explantation in rats. The procedure involves in situ preliminary dissection, cold perfusion of the thoracic and abdominal organ units as separate procedures, explantation, and finally the ex situ isolation of various organ units as single and/or multiple organ combination units. The procedure is feasible, allows for flexibility in the separation of combination organ units, and is reproducible. The exercise is provided as a training and research tool for clinical and research transplant surgeons. The technique is also presented as an animal model for clinical organ sharing. © 1993 Wiley‐Liss Inc.
Free vascularized fibula in traumatic long bone defects and in limb salvaging following tumor resection: Comparative study
Authors: Malizos Konstantinos N. , Nunley James A. , Goldner Richard D. , Urbaniak James R. , Harrelson John M. 
Published: March 2007

AbstractIn this retrospective analysis, we present our experience with two groups of patients who had long bone defects secondary to trauma or tumor resection and who were treated with a free vascularized fibular graft for skeletal reconstruction. Both groups were comparable in number and average age of patients, length of bone defect, and mean follow‐up (average 3 years both groups). The number of surgical procedures prior to microvascular grafting was significantly higher for the traumatic defects. Primary bone union in a mean period of 6 months occurred at a higher rate in the tumor patients; the trauma patients had a significantly higher nonunion rate, which required multiple additional surgical procedures. The latter did not, significantly, improve the rate of success in the trauma group. Residual limb shortening was present in one‐half of the patients with traumatic defects. On the basis of this review, it appears that the scarred and relatively avascular soft tissues surrounding the long bone defects secondary to trauma affect the course and the final outcome of the microvascular fibular grafting. A similar procedure applied for limb salvaging after tumor resection is better. © 1993 Wiley‐Liss Inc.
Five year digital replantation series from the frigid zone of China
Authors: Zhang Wen‐De , Zhou Guang‐Hen , Zhao Hu‐Rui , Wei Zhou , Mu Yu‐Ke 
Published: March 2007

AbstractA series of 208 digital replantations from the frigid zone within the People's Republic of China is presented. The extremely cold climate (often −20M‐0C to −30M‐0C) presents the problem of warming exposed amputated digits prior to replantation without causing further damage. An overall replantation survival rate of 94% is reported, and this includes 45 cases of multiple digit amputation. Longer periods of ischemia seem to be tolerated under these unusually frigid conditions. Problems encountered within the series and suggestions for successful outcomes are discussed. © 1993 Wiley‐Liss Inc.
Clinical and experimental studies of cigarette smoking in microvascular tissue transfers
Authors: Gu Yu‐Dong , Zhang Gao‐Meng , Zhang Li‐Yin , Li Gi‐Feng , Jiang Ji‐Fu 
Published: March 2007

AbstractCirculatory crisis, attributed to cigarette smoking, in three microvascular cases (two toe transfers, one musculocutaneous flap) is reported. After anticoagulation and antispasm treatment only one transfer survived. Coordinated experimental studies in the rat demonstrated that cigarette smoking delayed anastomotic healing. Five days after anastomoses were performed, endothelial cells completely covered the sutures in the experimental smoking group in only 16–19% of sutures, while the control group had a 75% coverage rate. Mechanisms and characteristics of circulatory crisis caused by cigarette smoking are discussed. © 1993 Wiley‐Liss Inc.
Group fascicular vein grafts with interposition of nerve slices for long ulnar nerve defects: Report of three cases
Authors: Tang Jin‐Bo 
Published: March 2007

AbstractGroup fascicular vein grafts with interposition of nerve slices were designed for reconstruction of three ulnar nerves with defects of 2.5–4.5 cm. The veins were taken from superficial veins in the forearm and reversed to bridge the fascicles in both stumps. Normal nerve slices were sectioned from fascicles in the proximal stump and inserted inside the corresponding vein conduits. Postoperatively, the Tinel's sign was detected across the vein conduits, and electromyography showed reinnervation of intrinsic muscles of the hands. Follow‐up for more than 2 years revealed motor recovery to M4 and sensory recovery to S3–S4 in these three cases. This technique may be a promising alternative to group fascicular nerve grafting for long defects in peripheral nerve trunks. © 1993 Wiley‐Liss Inc.
Retransplantation of the liver in the rat
Authors: Delriviere Luc , Kamada Naoshi , Goto Shigeru , Kobayashi Eiji 
Published: March 2007

AbstractA successful technique of liver retransplantation in the rat is described. Heterotopic nonauxiliary liver engraftment of a whole liver using cuffed anastomoses is the primary transplant procedure. The graft is implanted in the right hypochondrium and is revascularized by a portal end‐to‐end anastomosis. Venous drainage is via an end‐to‐side anastomosis between the donor infrahepatic vena cava and recipient right renal vein. The graft suprahepatic vena cava is ligated. Biliary drainage is achieved by a double stent anastomosis of the biliary ducts. Total parenchymectomy of the recipient's liver is completed leaving intact the intrahepatic and suprahepatic vena cava. Retransplantation in the orthotopic position can thus be attempted, after removal of the first graft, by cuffed anastomoses between the donor and recipient portal veins, infrahepatic vena cava and a double stent anastomosis of the common bile ducts. Anastomosis between the donor and recipient suprahepatic vena cava is completed with a 7/0 Prolene running suture. In the first group of operations (n = 6), a three week survival rate of 50% after retransplantation was obtained. Using the technical lessons of these preliminary cases, 80% of the second group of operations (n = 5), were successful in the long term. Utilization of this new technique may allow further investigations in different fields of research dealing with liver surgery and transplantation. © 1993 Wiley‐Liss Inc.
A modified technique of micro‐arteriography utilizing dental x‐ray equipment
Authors: Zhang Ling , Wu Feng C. , Moskovitz Martin , Siebert John 
Published: March 2007

AbstractWe report on the use of dental x‐ray equipment for micro‐arteriography in 18 rat arterial anastomoses. Our experience has shown that an exposure of 70 kV, at 7mA, for 0.17 seconds, gives excellent results. This is an easy and useful technique for evaluating the patency and stenosis of microvascular anastomoses. © 1993 Wiley‐Liss Inc.
Microsurgical neurolysis: Its anatomical and physiological basis and its classification
Authors: Millesi H. , Rath Th. , Reihsner R. , Zoch G. 
Published: March 2007

AbstractNeurolysis is a procedure which has to be performed if the gliding apparatus of a peripheral nerve does not function, and consequently, adhesions and fibrosis develop. The gliding tissue has to provide the ability for the nerve to adapt to the different position of the extremity by longitudinal passive movement. The paraneurium provides movements between the nerve and the surrounding tissue; the interfascicular epineurium provides the possibility of the movement within the nerve. Internal neurolysis is defined as surgery within the nerve if the epifascicular epineurium is completely transected. A classification of different degrees of fibrosis is given with special reference to the procedure which has to be done in each case. Neurolysis is a step‐wise procedure with the aim to decompress the fascicles and which is immediately stopped if this aim is achieved. In very severe cases, if the gliding tissue does not regenerate, a gliding tissue flap to envelope the nerve may solve the problem. © 1993 Wiley‐Liss Inc.
Arteriovenous fistula with a saphenous long loop
Authors: Silveira Luis F. , Patricio Joao A. 
Published: March 2007

AbstractAfter radiation, chronic infection or previous operations recipient vessels for free tissue transfer become difficult to find. It may be necessary to locate vessels remote from the area of reconstruction and to construct long venous grafts. Long venous grafts can be compressed in the tissue tunnels that may be required. In this series of patients, an arteriovenous fistula was created with a long saphenous loop 10 to 21 days prior to tissue transfer. The saphenous loops were placed close to the area for reconstruction and when divided at the time of transplantation, provided one artery and one vein. In this series of 12 cases, adequate vascularization was achieved in 10 cases. In the other 2 cases, we believe that maturation of the fistula may have been necessary before proper function. The other advantages of the technique are: the procedure can be carried out under local anaesthesia, ease of positioning of the patient on the operating table, and a reduction in the time taken to perform the tissue transfer. © 1993 Wiley‐Liss Inc.