Subject(s)
Geriatric Psychiatry , Aged , Community Mental Health Services/organization & administration , Continuity of Patient Care , Delivery of Health Care, Integrated , Geriatric Assessment , Geriatric Psychiatry/organization & administration , Health Care Reform , Health Services for the Aged/organization & administration , Humans , Models, Organizational , Patient Readmission , Regional Medical Programs , SwedenABSTRACT
The details of two consecutive groups of cleft palate patients treated with one- or two-stage palate repair are presented. The total number of patients is 237, with 128 operated in one stage, and 109 operated in two stages. In the two-stage group, the frequency of 'unintended' palatal fistulas decreased by 80%, and the use of blood transfusions was greatly reduced, but total operation time and hospital stay were longer. The results in terms of speech quality, facial growth and dental occlusion, will be reported on separately.
Subject(s)
Cleft Palate/surgery , Child , Child, Preschool , Female , Humans , Infant , Male , Methods , Postoperative Complications , ReoperationABSTRACT
The effects of delayed periosteoplasty were studied longitudinally from 5 to 17 years of age in 35 consecutive cases (24 boys and 11 girls) with clefts involving the maxillary alveolar process. The mean age at operation was 6.4 years. In patients younger than 7 years of age at the time of delayed periosteoplasty, good bone formation developed in 80%, compared with 47% after infant periosteoplasty. After delayed periosteoplasty the formation of new bone continued an average of 5 years postoperatively. The frequency of anterior crossbite was lower than that reported for other Scandinavian cleft lip and palate materials of the same age and type of cleft. Cephalometric analysis indicated that growth of the facial skeleton of the patients in the present material was well within the limits reported for the above-mentioned Scandinavian materials subjected neither to periosteoplasty nor to bone-grafting. The results indicate that delayed periosteoplasty might be a superior method in the reconstruction of the alveolar cleft in young individuals.
Subject(s)
Alveoloplasty/methods , Cleft Palate/surgery , Periosteum/surgery , Adolescent , Age Factors , Alveolar Process/physiology , Cephalometry , Child , Child, Preschool , Dental Occlusion , Evaluation Studies as Topic , Female , Humans , Longitudinal Studies , Male , Maxillofacial DevelopmentABSTRACT
The fasciocutaneous flap is very useful in the repair of soft tissue defects on the lower leg. It is easy to design and construct large flaps that are safe because of the good circulation. The operating time is short for an experienced surgeon and no extra equipment is needed. It is perfectly possible to carry out surgery on the underlying bones at the same time. The postoperative treatment is simple for both the patient and the staff. The surgical technique is described and the results of 23 flaps are critically reviewed.
Subject(s)
Leg/surgery , Surgical Flaps , Adolescent , Adult , Aged , Female , Fractures, Bone/surgery , Humans , Leg Injuries/surgery , Leg Ulcer/surgery , Male , Methods , Middle AgedABSTRACT
Cooperation between orthopaedic and plastic surgeons is an important factor in the treatment of open fractures. In this article a report is made on a retrospective study of a 5-year series of open fractures of the shaft of the tibia treated at the University Hospital in Uppsala between 1972 and 1976. The study proves that the change to external fixation of these fractures and 'open' treatment of the wounds has meant that to a large extent the previous use of pedicle flaps to cover skin defects has been replaced by split skin grafts. The results in the reported series were good, with adequate function in most cases. The final results may, however, be less good than they appeared at this early review time.
Subject(s)
Fractures, Open/surgery , Tibial Fractures/surgery , Adolescent , Adult , Aged , Female , Fracture Fixation , Fracture Fixation, Internal , Humans , Male , Middle Aged , Skin Transplantation , Transplantation, Autologous , Wound Healing , Wound Infection/therapySubject(s)
Breast/surgery , Prostheses and Implants/psychology , Surgery, Plastic/psychology , Adolescent , Adult , Attitude , Divorce , Female , Follow-Up Studies , Humans , Marriage , Mental Disorders/complications , Middle Aged , Prostheses and Implants/adverse effects , Surgery, Plastic/methods , SwedenABSTRACT
In patients with clefts of the secondary palate, the effect of surgical reconstruction was studied from the time of the palate repair, at the age of 18-24 months, to the age of 5 years. The material comprised 99 children (37 boys and 62 girls). The material was grouped according to the antero-posterior size of the cleft. The changes of the maxillary dimensions were studied on the casts by linear measurements. The occlusion was analysed by descriptive and numerical methods. In the deciduous dentition the smallest intercanine and intermolar dimensions were recorded in patients with large palatal clefts. A the age of 5, the frequency of anterior crossbite was 38% in patients with large palatal clefts, compared with 19--21% in patients with smaller clefts. In boys with cleft palates, the frequency of anterior crossbite was 13% higher than in girls, in spite of the fact that in the material the incidence of large palatal clefts was lower in boys than in girls. In cases of large clefts of the secondary palate, the incidence of anterior crossbite was 12.5 times higher than in a material of non-cleft patients of the same age.
Subject(s)
Cleft Palate/surgery , Dental Arch , Malocclusion , Tooth, Deciduous , Anthropometry , Child, Preschool , Dentition , Female , Follow-Up Studies , Humans , Infant , Male , Sex FactorsABSTRACT
Astra 2337 ketocaine-soaked pads applied to the skin surface produced analgesia adequate for split skin graft cutting 85 out of 86 patients. In 86 per cent, the analgesia was completely satisfactory; a few had some discomfort or pain but all could tolerate this. Application for 1 hour is time enough, but the effect lasts for at least 8 hours and probably longer. Apart from occasional redness and oedema of the skin, no adverse effects wer noted and the blood levels of absorbed ketocaine were far below the toxic level. This simple effective technique is of great value, particularly in such cases as burns who require multiple grafting operations and in whom repeated general anaesthetics can have such adverse effect.
Subject(s)
Anesthesia, Local/methods , Butyrophenones , Dermatologic Surgical Procedures , Butyrophenones/blood , Humans , Male , Propylamines/blood , Skin Transplantation , Time FactorsSubject(s)
Burns/therapy , Adolescent , Adult , Basal Metabolism , Burns/metabolism , Female , Humans , Male , Methods , Middle Aged , Oxygen ConsumptionABSTRACT
In this investigation sterile collagen film has been used as a dressing for 55 donor areas. The two aims of our study were to find out whether this film could be used as a dressing and whether the film which was applied at the time of surgery could be used as the only dressing before complete healing was achieved. The results were good in 56% of the cases and fair in 20%. It was noted that local pre-treatment with epinephrine gave better results. If only small or medium sized donor areas were included the results were even better. This is probably because the film in larger donor areas could slip away leaving the donor site more or less exposed. The results are encouraging in two important aspects: The donor sites were not painful and the nursing staff could reduce or eliminate time-consuming work with frequent dressings.
