Research Articles (Plastic and Reconstructive Surgery)
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- ItemAnaesthesia for microsurgery(Health and Medical Publishing Group -- HMPG, 1985-04) Jakubowski, M.; Lamont, A.; Murray, W. B.; De Wit, S. L.The data from a retrospective study of 32 anaesthetics administered for free-flap tissue operations are analysed. We suggest balanced analgesic-dominated general anaesthesia, supported wherever possible by continuous regional block. Special attention is paid to full control over the cardiovascular system and the haemodynamics, including the microcirculation and optimal rheological properties of the blood, as well as metabolic ability. Our results suggest that factors such as adequate infusion therapy guided by central venous pressure and urinary output and strict body temperature control, supplementary use of regional blocks and peri-operative use of dextran 40 (Rheomacrodex) can contribute significantly towards the overall success of free-flap surgery.
- ItemBreast reconstruction during the COVID-19 pandemic in resource-limited settings(GMS, 2021) Al-Benna, Sammy; Gohritz, AndreasThe coronavirus disease 2019 (COVID-19) is a novel, rapidly changing pandemic. It has affected specialized medical services in unprecedented ways. Surgical decision making, always the most important aspect of care has taken on an added layer of complexity in the face of the COVID-19 pandemic. Therefore, recommendations for breast reconstruction during COVID-19 remain challenging and unclear. This article reviews the impact of the COVID-19 pandemic and suggests potential approaches that could be considered in the absence of validated strategies in breast reconstruction.
- ItemConsiderations for breast reconstructive surgery in South Africa during the COVID-19 pandemic(Medpharm, 2020-09) Al-Benna, S.; Gohritz, A.ENGLISH ABSTRACT: The coronavirus disease 2019 (COVID-19) pandemic has added a layer of complexity to surgical decision making particularly for complex reconstructive oncological surgery. In the absence of data on which to base validated strategies for breast reconstruction in the South African context, this article discusses the current trends in management and potential approaches which could be employed
- ItemFree flap transfer with microvascular anastomosis(HMPG, 1976-11) Visse, J. H.; Adendorff, D. J.; Malherbe, W. D. F.The development of the flap transfer technique in plastic and reconstructive surgery has evolved to the stage where free transplantation of a full thickness skin flap, by means of microvascular anastomosis, has become possible. For the first time in South Africa, a case is documented where such a free graft was used successfully to reconstruct a severe burn contracture of the neck. Experience with this and subsequent cases has taught valuable lessons about the procedure.
- ItemGeneralized surgical emphysema as an early complication of facial fracture : a case report(HMPG, 1977-05) Adendorff, D.; Malherbe, W. D. F.; Grotepass, F.A case of multiple facial fractures complicated by subcutaneous emphysema, pneumomediastinum and pneumoretroperitoneum, in the absence of intra-abdominal, neck or chest injuries, is described.
- ItemImpact of COVID-19 on surgical registrars' education and training(Medpharm Publications, 2020) Al-Benna, S.The coronavirus disease 2019 (COVID-19) pandemic has affected all aspects of medical practice in unprecedented ways. It has already produced significant changes within most hospitals, including, cancellation of elective procedures, decreased volume of acute care surgery, and cancellation of lectures and educational conferences to adhere to social distancing recommendations. This article focuses on the effects of the COVID-19 pandemic on surgical registrars, their education and training and proposes ideas on how to get through this major disruption.
- ItemImproving the longevity and results of mastopexy and breast reduction procedures : reconstructing an internal breast support system with biocompatible mesh to replace the supporting function of the ligamentous suspension(Springer Open, 2011-10) Van Deventer, Petrus V.; Graewe, Frank R.; Wuringer, ElisabethThe reasons for recurrent ptosis in mastopexy and breast reduction procedures are twofold. First, available surgical techniques do not reconstruct the normal breast anatomy responsible for maintaining breast shape. Second, in many instances the techniques rely on atrophied tissue to provide long-term support. The discovery in 1997 of the ligamentous suspension (the supporting system of the breast) gave rise to the concept that reconstruction of this anatomical structure was needed to ensure a sustained postoperative result. Applying the latest knowledge regarding the structural and vascular anatomy of the breast in the surgical technique and utilizing material other than atrophied breast tissue enabled us to prevent the recurrence of breast ptosis. Methods A surgical technique was developed to replace the supportive function of a failed ligamentous suspension in 112 patients with ptotic breasts. This was done by reconstructing an internal breast-supporting system (IBSS) with biocompatible mesh. Results Satisfactory breast shape, nipple projection, and upper breast fullness was obtained with this technique in mastopexy patients with moderate-sized ptotic breasts. In patients with larger breasts good results were obtained with a simultaneous breast reduction. The longest follow-up is 6 years 3 months. Conclusions With this technique recurrent breast ptosis can be prevented in mastopexy and breast reduction procedures. The results are such that it eliminates the need for silicone prostheses to obtain satisfactory upper-breast fullness. The surgical technique is especially indicated in patients with skin of poor quality or patients with high expectations.
- ItemThe incidence of cleft lip and palate in the Western Cape(Health and Medical Publishing Group (HMPG), 1985-10) Morrison, G.; Cronje, A. S.; Van Vuuren, I.; Op't Hof, J.The incidence of cleft lip and palate in the Western Cape was studied using data from two cleft palate centres and from all plastic surgeons in practice in the area. A high incidence was found among coloureds, while the incidences among whites and blacks were similar to figures reported from other countries.
- ItemInjuries to the skin of the male external genitalia in Southern Africa(Health and Medical Publishing Group (HMPG), 1975) Malherbe, W. D. F.The more common injuries to the skin of the male external genital organs are described; some of these mutilations are unique to the African continent. The extent of trauma ranges from small penile skin defects after circumcision to complete avulsion of the skin of the penis and scrotum. The techniques of reconstruction are described.
- ItemMycotic aneurysm of the radial artery of the hand : a case report(Health and Medical Publishing Group -- HMPG, 1983-03) De Greef, A.Aneurysms of the hand (including the wrist region) are reviewed; a case is reported, and the relevant surgical anatomy is discussed.
- ItemRepair of a cosmetic defect of the lower leg with a myocutaneous free flap(Health & Medical Publishing Group, 1982) Lamont, A.; Malherbe, W. D. F.; Middelhoven, J.The use of free-tissue transfers by modern techniques of microvascular surgery is not new, and the many possibilities in reconstructive surgery are well documented. A case in which a disfiguring cosmetic defect of the lower leg was repaired in one stage with a latissimus dorsi myocutaneous free flap is described.
- ItemTissue expansion in reconstructive surgery : a case report(Health & Medical Publishing Group, 1986-05) De Greef, A.A case is reported in which serial expansion was used to create scalp and forehead flaps of superior quality skin and subcutaneous tissue to cover a central forehead defect. The background and principles governing this surgery are discussed.