42 results on '"Barbara Jemec"'
Search Results
2. How can visits from international plastic surgery teams cater for the demands and needs of partners in low and middle income settings?
- Author
-
Jenny Reid, Faith Muchemwa, Huyen Tran, Tanveer Ahmed, Bishal Karki, Kiran Nakarmi, Moazzam Tarar, Naheed Chaudhry, Ali Adil, Rafia Ijaz, Yasir Iqbal, Yong-June Kim, Sarah Tucker, Muhammad Riaz, Wee Lam, and Barbara Jemec
- Subjects
Surgery - Published
- 2022
- Full Text
- View/download PDF
3. The governance of overseas surgical collaborations – BFIRST/BSSH
- Author
-
Jefferson M. Jones, Barbara Jemec, Wee L. Lam, R. Nicholas, R. Eckersley, M. Fell, B. Sommerlad, R. Bhopal, S.P. Hodgson, N. Nyamulani, M. Riaz, M.R. Karim Khan, and Kapila Mendis
- Subjects
Clinical governance ,medicine.medical_specialty ,Local practice ,business.industry ,Corporate governance ,media_common.quotation_subject ,education ,Patient care ,Surgery ,Upper limb surgery ,03 medical and health sciences ,0302 clinical medicine ,Nursing ,030220 oncology & carcinogenesis ,Medicine ,Quality (business) ,030212 general & internal medicine ,business ,media_common - Abstract
Summary Clinical governance is the structured approach to maintaining and improving the quality of patient care and is a vital part of global surgery. BFIRST and BSSH closely collaborate with local doctors on a number of overseas projects, seeking to strengthen and develop local knowledge and skills, aiming for an independent local practice in reconstructive and upper limb surgery. Thoughts on essential requirements, improvements and pitfalls in the ethical approach to global collaboratives are presented.
- Published
- 2021
- Full Text
- View/download PDF
4. Managing Hand Trauma during the COVID-19 pandemic using a One-Stop Clinic
- Author
-
Nikki Burr, Amir H. Sadr, Miss Barbara Jemec, Dariush Nikkhah, and Miss S Gardiner
- Subjects
medicine.medical_specialty ,2019-20 coronavirus outbreak ,Outpatient Clinics, Hospital ,Coronavirus disease 2019 (COVID-19) ,Pneumonia, Viral ,MEDLINE ,Article ,Health Services Accessibility ,Perioperative Care ,Correspondence and Communications ,Betacoronavirus ,London ,Pandemic ,medicine ,Humans ,Outpatient clinic ,Orthopedic Procedures ,Pandemics ,Infection Control ,biology ,SARS-CoV-2 ,business.industry ,COVID-19 ,Hand Injuries ,Plastic Surgery Procedures ,medicine.disease ,biology.organism_classification ,Surgery ,Pneumonia ,Models, Organizational ,Emergency medicine ,Triage ,Coronavirus Infections ,business ,Anesthesia, Local - Published
- 2020
- Full Text
- View/download PDF
5. Fractures and Dislocations in the Hand
- Author
-
Barbara Jemec and Nicola Burr
- Subjects
medicine.medical_specialty ,Rehabilitation ,Conservative management ,business.industry ,medicine.medical_treatment ,Physical therapy ,Medicine ,Hand therapy ,book.journal ,Dislocation ,business ,book ,Surgery - Abstract
This chapter offers a comprehensive overview of the management of pediatric and adult fractures, open and closed. Potential complications and operative options are discussed, if conservative management is not an option, alongside hand therapy rehabilitation.
- Published
- 2022
- Full Text
- View/download PDF
6. List of Contributors
- Author
-
Jonathan Adamthwaite, Nidal Farhan AL Deek, Hanan Alhusainan, Robert J. Allen, Rebecca Ayers, Gurdip Azad, Alain J. Azzi, Alex Barnacle, Scott P. Bartlett, Irina Belinsky, Oded Ben-Amotz, Nathaniel A. Blecher, Kirsty Boyd, Karl C. Bruckman, Donald W. Buck, Neil W. Bulstrode, Nicola Burr, Daniel P. Butler, Marc A. Cohen, Sydney R. Coleman, Ryan Constantine, Michelle Coriddi, Sabrina Cugno, David J. David, Kristen M. Davidge, Joseph Dayan, Ilse Degreef, David J. Dunaway, Francesco M. Egro, Ebby Elahi, Dino Elyassnia, Kathryn Evans, Rostam D. Farhadieh, Michael W. Findlay, Françoise Firmin, David M. Fisher, Stephen Flood, Antonio J. Forte, Adam C. Gascoigne, Mirko S. Gilardino, Aina V.H. Greig, Adriaan O. Grobbelaar, Geoffrey C. Gurtner, Lucinda Gunn, Bahman Guyuron, Elizabeth J. Hall-Findlay, Matthew M. Hanasono, John Harper, Kareem Hassan, Michael A. Henderson, Geoffrey E. Hespe, Tobias Heuft, Stefan O.P. Hofer, Steven E.R. Hovius, Benjamin H.L. Howes, Yun-Huan (Barry) Hsieh, Navid Jallali, Barbara Jemec, Nikita Joji, Mazyar Kanani, Raghu P. Kataru, Julia L. Kerolus, Veronica Kinsler, Emily M. Krauss, Jonathan I. Leckenby, Gordon K. Lee, Ben Levi, L. Scott Levin, Se Hwang Liew, Charles Y.Y. Loh, Susan E. Mackinnon, Timothy J. Marten, David W. Mathes, Gregory McCarten, Alan A. McNab, Babak J. Mehrara, Bryan Mendelson, Shaun D. Mendenhall, Alexander F. Mericli, Ximena Mimica, Edwin Morrison, Wayne A.J. Morrison, Andrew Morritt, Afshin Mosahebi, Peter M. Murray, Imran Mushtaq, Nagarajan Muthialu, Simon Myers, Paul S. Nassif, Tim H.J. Nijhuis, Dariush Nikkhah, Niri S. Niranjan, Shelley S. Noland, Chris Nutting, Adeyemi A. Ogunleye, Anne C. O’Neill, Robert Pearl, Grace Lee Peng, Olivia M. Perotti, Mark Pickford, Hollie A. Power, Krishna Rao, Aline Rau, Patrick L. Reavey, Dirk F. Richter, Abigail M. Rodriguez, Carlo Riccardo Rossi, J. Peter Rubin, Michel Saint-Cyr, Donald Sammut, Marlene See, Maria Z. Siemionow, Bran Sivakumar, Oliver J. Smith, Paul Smith, Antonio Sommariva, Brian C. Sommerlad, Catherine Soufan, Derek M. Steinbacher, Ajay R. Sud, Justine Victoria Sullivan, Marc C. Swan, Jin Bo Tang, Ali Totonchi, William A. Townley, Lara S. van de Lande, Renata V. Weber, Fu-Chan Wei, Paul M.N. Werker, Jason Wink, Simon Withey, Chin Ho Wong, Stacy Wong, Yasamin Ziabari, Susan Zoltan, and Fatih Zor
- Published
- 2022
- Full Text
- View/download PDF
7. Distal interphalangeal joint arthrodesis using the ADS memory staple – the London experience
- Author
-
Arvind Mohan, Andreas Fox, Barbara Jemec, and Anna Allan
- Subjects
arthrodesis ,medicine.medical_specialty ,ADS ,business.industry ,Osteomyelitis ,Arthrodesis ,medicine.medical_treatment ,Osteoarthritis ,610 Medical sciences ,Medicine ,Thumb ,medicine.disease ,Surgery ,law.invention ,Intramedullary rod ,Psoriatic arthritis ,Plastic surgery ,trauma ,Patient satisfaction ,medicine.anatomical_structure ,arthritis ,ddc: 610 ,law ,medicine ,business - Abstract
Aims: The ADS memory staple is the first intramedullary shape device in use for distal interphalangeal joint arthrodesis. We describe our experience of the device used in two hand units Methods: An analysis of 17 consecutive patients undergoing single digit DIPJ arthrodesis using the device between[for full text, please go to the a.m. URL], 14th Triennial Congress of the International Federation of Societies for Surgery of the Hand (IFSSH), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT), 11th Triennial Congress of the International Federation of Societies for Hand Therapy (IFSHT)
- Published
- 2020
- Full Text
- View/download PDF
8. Global Surgery Fellowships-An Investigation of Opportunities, Outcomes, and Applicants
- Author
-
Eliza J. Davison, Barbara Jemec, and Satyendra K. Singh
- Subjects
medicine.medical_specialty ,Quality management ,business.industry ,Public health ,Professional development ,Commission ,030230 surgery ,Quarter (United States coin) ,Popularity ,Surgery ,03 medical and health sciences ,Critical appraisal ,0302 clinical medicine ,030220 oncology & carcinogenesis ,Medicine ,Duration (project management) ,business - Abstract
Following the Lancet Commission on Global Surgery in 2015, the Global Surgery Fellowships have risen in popularity, advertised as formalized opportunities for surgical trainees who have an interest in international surgical care. There is currently no up-to-date review of all fellowships available and an urgently needed overview of these opportunities is presented, including critical appraisal of their accessibility, funding, and outcomes. Detailed searches were conducted on the web engine Google, using the term “global surgery fellowship” and iterations. From the 547 resulting links, after applying exclusion criteria, 69 relevant fellowships were included in analysis. The majority of fellowships based in the United States (55%) and arranged by non-governmental organizations (NGOs) or universities (>70%). Also, 60% of fellowships had a duration of 1 year or longer. Only a quarter of the fellowships was open solely to trainees from low- or middle-income countries (LMIC), with over 80% of these being full funded. But 40% of the fellowships were advertised as open to trainees from any country, though only one-third of these provided full funding. Key themes across the fellowships’ outcomes included “Professional Development,” “Research,” and “LMIC Quality Improvement.” Almost all of the fellowships (95%) stated international travel opportunities. Twelve of the fellowships offered higher degrees, with the most common being a Masters of Public Health. The global distribution of fellowships and reduced funding opportunities for trainees from LMIC limit accessibility of the Global Surgery Fellowships. It is, however, still promising that most of key themes and high rates of international work are in line with The Lancet Commission’s recommendations. This overview of the Global Surgery Fellowships highlights the need for collaboration between institutions and has illustrated points for consideration when introducing new and the value of established fellowships.
- Published
- 2021
9. Non-melanoma skin cancer and premalignant conditions
- Author
-
Barbara Jemec and Gregor B.E. Jemec
- Subjects
integumentary system ,business.industry ,medicine ,Cancer research ,Skin cancer ,medicine.disease ,business ,Non melanoma - Abstract
This chapter describes the diagnosis, non-surgical treatment, and surgical treatment of non-melanoma skin cancers, such as basal cell carcinoma, squamous cell carcinoma, Merkel cell carcinoma, and others.
- Published
- 2021
- Full Text
- View/download PDF
10. Soft tissue infections of the hand and upper limb
- Author
-
Barbara Jemec and Sophie Collier
- Subjects
body regions ,medicine.anatomical_structure ,business.industry ,Soft tissue ,Medicine ,Upper limb ,Anatomy ,business - Abstract
This chapter offers a comprehensive overview of the management of soft tissue infections of the upper limb, including operative control, antibiotic prophylaxis, and treatment in acute, chronic, and atypical cases.
- Published
- 2021
- Full Text
- View/download PDF
11. Communication: A Safe Skin Cancer Surgery set-up during the COVID-19 crisis
- Author
-
T.R. Friebel, Barbara Jemec, and S. Rinkoff
- Subjects
Male ,Local anaesthesia ,medicine.medical_specialty ,2019-20 coronavirus outbreak ,Skin Neoplasms ,Coronavirus disease 2019 (COVID-19) ,Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) ,MEDLINE ,medicine.disease_cause ,Correspondence and Communications ,Occupational Exposure ,medicine ,Humans ,Coronavirus ,Infection Control ,SARS-CoV-2 ,business.industry ,Nosocomial transmission rate ,COVID-19 ,Middle Aged ,Plastic Surgery Procedures ,medicine.disease ,United Kingdom ,Surgery ,Outcome and Process Assessment, Health Care ,Carcinoma, Basal Cell ,Carcinoma, Squamous Cell ,Female ,Skin cancer ,business ,Delivery of Health Care ,Skin cancer surgery - Published
- 2020
12. Is radiation therapy as a primary treatment modality for squamous cell carcinoma of the hand the best choice? Case series and review of the literature
- Author
-
Christopher F, Brewer, Christopher J, Deutsch, and Barbara, Jemec
- Subjects
Adult ,Aged, 80 and over ,Male ,Skin Neoplasms ,Radiotherapy ,Brachytherapy ,Middle Aged ,Hand ,Carcinoma, Squamous Cell ,Humans ,Female ,Neoplasm Recurrence, Local ,Radiation Injuries ,Aged - Abstract
Squamous cell carcinoma (SCC) is the most common malignancy of the upper limb, and can pose a significant therapeutic challenge. Early treatment needs to be radical whilst maintaining function.We describe two cases of upper limb squamous cell carcinoma treated with radiotherapy, review the literature on radiotherapy as a primary treatment modality, and discuss the specific difficulties treating SCC in the hand.Radiation therapy was inadequate in tumor clearance in both cases, with recurrence both extensive and distal to the initial focus. Moreover, both patients developed progressive functional loss related to pain, swelling, and stiffness.The evidence basis for radiation therapy as a primary modality is limited, although clearance rates are comparable to surgery. Both radiotherapy and surgery can be utilized to treat SCC. However, we make the case for the hand being especially susceptible to the unwanted side effects of radiotherapy.
- Published
- 2020
13. Experience of nail bed injuries at a tertiary hand trauma unit: a 12-month review and cost analysis
- Author
-
Colin T Brewster, Barbara Jemec, Lara Yildirimer, Zeynep Unluer, Hina Aziz, and Anna De Leo
- Subjects
Adult ,Male ,medicine.medical_specialty ,Injury control ,Adolescent ,Office Visits ,Poison control ,Occupational safety and health ,Tertiary Care Centers ,03 medical and health sciences ,Fractures, Bone ,Young Adult ,0302 clinical medicine ,Age Distribution ,Injury prevention ,Finger Injuries ,Retrospective analysis ,Medicine ,Humans ,030212 general & internal medicine ,Child ,Aged ,Retrospective Studies ,Aged, 80 and over ,business.industry ,General surgery ,Infant, Newborn ,Infant ,030208 emergency & critical care medicine ,Middle Aged ,United Kingdom ,Cost savings ,medicine.anatomical_structure ,Nails ,Child, Preschool ,Cost analysis ,Nail (anatomy) ,Costs and Cost Analysis ,Surgery ,Female ,business - Abstract
The aim of this study was to analyse the management of nail bed injuries from a clinical and economic perspective. We carried out a retrospective analysis of nail bed injuries treated operatively at a tertiary Plastic Surgery Hand Trauma Unit during 2016. The National Schedule of Reference Costs (2015–2016) was used to estimate the costs of treating 630 patients. The most common mechanism was a crush injury in a door (33%). Fifty-five per cent of patients had an associated tuft fracture. The minimum cost per annum for patients treated for nail bed injuries in our unit was calculated to be £511,560 (€573,362; US$666,664). Many nail bed injuries are preventable and because they present a very high financial burden on the National Health Service, targeted prevention strategies should be considered. Level of evidence: IV
- Published
- 2019
14. External circumferential glove reduction (ECGR) of phalangeal hand fractures to aid percutaneous stabilization
- Author
-
Anadkat M, Miranda Bh, Barbara Jemec, and Ruston J
- Subjects
Adult ,Male ,medicine.medical_specialty ,Percutaneous ,Adolescent ,medicine.medical_treatment ,030230 surgery ,Finger Phalanges ,Fractures, Bone ,Young Adult ,03 medical and health sciences ,0302 clinical medicine ,Humans ,Medicine ,Gloves, Surgical ,Physical Therapy Modalities ,Reduction (orthopedic surgery) ,Aged ,Aged, 80 and over ,business.industry ,Middle Aged ,Closed Fracture Reduction ,Surgery ,030220 oncology & carcinogenesis ,Female ,business ,Bone Wires - Published
- 2015
- Full Text
- View/download PDF
15. PBNR
- Author
-
Logendra Murugesan, Barbara Jemec, Adriaan O. Grobbelaar, and Benjamin H Miranda
- Subjects
Male ,medicine.medical_specialty ,Percutaneous ,Joint stability ,Hand therapy ,Fixation (surgical) ,Blunt ,Mallet finger ,Finger Injuries ,Deformity ,medicine ,Humans ,Minimally Invasive Surgical Procedures ,Orthopedics and Sports Medicine ,Prospective Studies ,book ,Mallet ,business.industry ,medicine.disease ,Surgery ,Radiography ,Needles ,Manipulation, Orthopedic ,book.journal ,Female ,Radiology ,medicine.symptom ,business - Abstract
Mallet finger injuries are common; treatment goals include achieving joint stability, preventing extensor lag, and subsequent swan-neck deformity. We describe a simple technique for improving intraoperative bony mallet reduction, which may avoid the requirement for closed Ishiguro extension blocking wires or open fixation, and present a prospective case series (n=12). Intraoperative percutaneous blunt needle reduction (PBNR) is achieved under image intensifier guidance. Using artery forceps, a blunt fill needle tip is manipulated onto the proximal avulsed fragment; this is then guided into a reduced position and maintained using a well-formed Zimmer splint across the distal interphalangeal joint in 15- to 30-degree extension. There were 5 injuries involving >1/3 of the articular surface (Doyle's classification IVb) and 7 injuries involving >1/2 of the articular surface (Doyle's classification IVc). Mean hand therapy follow-up was 10.6±1.0 weeks, extensor lag was 4.6±1.7 degrees, and all patients achieved full functional recovery with return to normal daily activity. No complications were reported. Closed techniques, for example, Ishiguro extension blocking wires, may reduce the risks associated with open reduction, but do not avoid further articular surface damage. PBNR offers the surgeon a useful adjunct to the treatment options for bony mallet injuries, without excluding progression to surgical fixation if required. PBNR represents a less-invasive management option for bony mallet injures where surgical fixation may also be indicated.
- Published
- 2015
- Full Text
- View/download PDF
16. Experience of an Orthoplastic Limb Salvage Team after the Haiti Earthquake: Analysis of Caseload and Early Outcomes
- Author
-
Barbara Jemec, Waseem Saeed, Richard Buxton, Sahan Rannan-Eliya, A. James P. Clover, Shehan Hettiaratchy, and Sanjib Majumder
- Subjects
Adult ,medicine.medical_specialty ,Limb salvage ,medicine.medical_treatment ,Salvage treatment ,Earthquake disaster ,Amputation, Surgical ,Postoperative Complications ,Anesthesiology ,Perioperative Nursing ,Earthquakes ,medicine ,Retrospective analysis ,Humans ,Surgery, Plastic ,Child ,West indies ,Patient Care Team ,Arm Injuries ,Leg ,business.industry ,Limb Salvage ,Haiti ,Surgery ,Orthopedics ,Treatment Outcome ,Amputation ,business - Abstract
Background: After the devastating earthquake in Haiti on January 12, 2010, a British orthoplastic limb salvage team was mobilized. The team operated in a suburb of Port-au-Prince from January 20, 2010. This analysis gives an overview of the caseload and early outcomes. Methods: A retrospective analysis of operative data from the log book was performed from the opening of the facility on January 20, 2010, until March 12, 2010. Results: In total, 348 operations were carried out on 158 patients, at an average of 47 cases per week. Seventy-three percent of the cases were soft-tissue cases and 25 percent were bony or combined soft-tissue and bony cases. The majority of bony procedures (n = 26; 16 percent) and flap procedures (n = 16; 10 percent) took place in the early weeks (weeks 1 through 4). Combined orthoplastic cases accounted for 37 percent of cases (16 of 44) in week 2 but only 7 percent (three of 43) in week 7. General anesthetic cases accounted for 89 percent of cases (39 of 44) in week 2 but only 40 percent (17 of 43) in week 7. Only six patients (4 percent) underwent amputation, but 36 operations (10 percent) dealt with the sequelae of amputation. Sixteen patients (10 percent) suffered complications, including two amputations for failed limb salvage. Conclusions: This article reports the outcomes of a limb salvage team in the acute response after an earthquake disaster with a favorable amputation rate and highlights the potential benefit of mobilizing this type of team. Detailing the changing caseload over time will allow for more efficient planning in case of a similar future disaster.
- Published
- 2011
- Full Text
- View/download PDF
17. The Complications of Dupuytren’s Contracture Surgery
- Author
-
P. J. Smith, Barbara Jemec, and Neil W. Bulstrode
- Subjects
Adult ,medicine.medical_specialty ,Heart disease ,Postoperative Complications ,Hematoma ,medicine ,Humans ,Orthopedic Procedures ,Orthopedics and Sports Medicine ,Myocardial infarction ,Dupuytren's contracture ,Carpal tunnel syndrome ,Aged ,Aged, 80 and over ,Urinary retention ,business.industry ,Middle Aged ,Hand ,medicine.disease ,Surgery ,Dupuytren Contracture ,Contracture ,medicine.symptom ,Complication ,business - Abstract
Purpose To determine the complication rate of a modified Skoog's technique in the surgical treatment of Dupuytren's contracture. Methods A retrospective analysis was performed on 253 patients who had surgery by 1 surgeon using 1 technique with a mean follow-up period of 3.6 years. We studied the complication rate of the modified Skoog's procedure, relating it to a grading system for disease severity. A separate prospective long-term study was performed with an unselected cohort in which disease recurrence producing contracture was investigated prospectively in a group of 75 patients. Results Complications occurred in 46 patients. Thirty-five patients had 1 complication and 11 patients had more than 1 complication. Intraoperative complications included 6 patients with nerve injury and 1 patient with an arterial injury. Early postoperative complications before wound healing included 5 patients with digital hematoma, 24 patients with wound infection, 6 patients with sympathetic dystrophy, and 6 patients with skin slough. Late postoperative complications included 3 patients with scar contraction and 2 patients with carpal tunnel syndrome. There were 3 non–hand-related complications: 1 urinary retention, 1 left ventricular failure, and 1 myocardial infarction. Recurrence of Dupuytren's disease occurred in 23 of 75 patients after a mean follow-up period of 9.4 years. Conclusions The complication rate increased with the severity of disease particularly if the proximal interphalangeal joint contracture was 60° or more. There was no difference in the complication rate for patients who had surgery for primary or recurrent disease.
- Published
- 2005
- Full Text
- View/download PDF
18. A Prospective Randomised Clinical Trial of the Intra-Operative Use of 5-Fluorouracil on the Outcome of Dupuytren’s Disease
- Author
-
Neil W. Bulstrode, Adriaan O. Grobbelaar, Duncan A. McGrouther, Barbara Jemec, Marcus A. Bisson, and Anna L Pratt
- Subjects
Male ,medicine.medical_specialty ,Antimetabolites ,030230 surgery ,Placebo ,law.invention ,Intraoperative Period ,03 medical and health sciences ,0302 clinical medicine ,Double-Blind Method ,Randomized controlled trial ,law ,Internal medicine ,Secondary Prevention ,medicine ,Humans ,Prospective Studies ,Prospective cohort study ,030222 orthopedics ,Transplantation ,business.industry ,Middle Aged ,Rheumatology ,Surgery ,Dupuytren Contracture ,Clinical trial ,Treatment Outcome ,Fluorouracil ,Orthopedic surgery ,Contracture ,medicine.symptom ,business ,medicine.drug - Abstract
5-Fluorouracil reduces proliferation rates of fibroblasts, myofibroblast differentiation and contractility of ocular fibroblasts in vitro. This double-blind randomized clinical trial assesses whether intra-operative topical treatment with 5-fluorouracil reduces the recurrence rate after limited excision of Dupuytren’s tissue. Patients with two-digit disease were randomized to having 5-fluorouracil (25 mg/ml) treatment for 5 minutes on one digit and placebo on the other. Fifteen patients were enrolled with 18 months follow-up. There were no peri-operative complications. Wound healing was not delayed and there was no deterioration in the flexion deformity of the 5-fluorouracil treated digits. Patients were subsequently assessed by joint angle measurement at 3, 6, 12 and 18 months. There was no significant difference between control and 5-fluorouracil treated digits.
- Published
- 2004
- Full Text
- View/download PDF
19. The outcomes of digital tip amputation replacement as a composite graft in a paediatric population
- Author
-
D. P. Butler, J. Ruston, L. Murugesan, A. C. Woollard, and Barbara Jemec
- Subjects
Graft Rejection ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,030230 surgery ,03 medical and health sciences ,0302 clinical medicine ,Amputation, Traumatic ,Surveys and Questionnaires ,Finger Injuries ,Deformity ,medicine ,Humans ,Child ,Retrospective Studies ,030222 orthopedics ,Retrospective review ,business.industry ,Graft Survival ,Infant ,Surgery ,Treatment Outcome ,Amputation ,Child, Preschool ,Replantation ,Female ,Composite graft ,medicine.symptom ,business ,Paediatric population - Abstract
Limited studies exist on the outcome of replacing an amputated fingertip as a composite graft. We report the outcomes and predictors for composite graft survival along with the long-term morbidity. A retrospective review of all patients 4. Of the patients, 17% developed post-operative complications; 48% of patients reported a hook-nail deformity and 17% reported cold intolerance. Only 5% of patients reported any functional difficulties long term. The rate of complete composite graft survival in a paediatric population is low, although the long-term function of these patients is good. Level of evidence: 3
- Published
- 2015
20. The extent of soft tissue and musculoskeletal injuries after earthquakes; describing a role for reconstructive surgeons in an emergency response
- Author
-
Anthony D. Redmond, A.J.P. Clover, and Barbara Jemec
- Subjects
medicine.medical_specialty ,Soft Tissue Injuries ,medicine.medical_treatment ,Poison control ,Occupational safety and health ,Amputation, Surgical ,Disasters ,Fractures, Bone ,Fractures, Open ,Injury prevention ,medicine ,Earthquakes ,Humans ,Surgery, Plastic ,Intensive care medicine ,Physician's Role ,Musculoskeletal System ,business.industry ,Human factors and ergonomics ,Soft tissue ,Vascular surgery ,Plastic Surgery Procedures ,medicine.disease ,Limb Salvage ,Amputation ,Musculoskeletal injury ,Surgery ,Medical emergency ,business - Abstract
Earthquakes are the leading cause of natural disaster-related mortality and morbidity. Soft tissue and musculoskeletal injuries are the predominant type of injury seen after these events and a major reason for admission to hospital. Open fractures are relatively common; however, they are resource-intense to manage. Appropriate management is important in minimising amputation rates and preserving function. This review describes the pattern of musculoskeletal and soft-tissue injuries seen after earthquakes and explores the manpower and resource implications involved in their management.A Medline search was performed, including terms "injury pattern" and "earthquake," "epidemiology injuries" and "earthquakes," "plastic surgery," "reconstructive surgery," "limb salvage" and "earthquake." Papers published between December 1992 and December 2012 were included, with no initial language restriction.Limb injuries are the commonest injuries seen accounting for 60 % of all injuries, with fractures in more than 50 % of those admitted to hospital, with between 8 and 13 % of these fractures open. After the first few days and once the immediate lifesaving phase is over, the management of these musculoskeletal and soft-tissue injuries are the commonest procedures required.Due to the predominance of soft-tissue and musculoskeletal injuries, plastic surgeons as specialists in soft-tissue reconstruction should be mobilised in the early stages of a disaster response as part of a multidisciplinary team with a focus on limb salvage.
- Published
- 2014
21. The Merkel cell carcinoma: survival and oncogene markers
- Author
-
Adriaan O. Grobbelaar, Barbara Jemec, Jagdeep S. Chana, and R. Grover
- Subjects
Adjuvant radiotherapy ,Skin Neoplasms ,Mitotic index ,medicine.diagnostic_test ,Oncogene ,Merkel cell carcinoma ,business.industry ,Melanoma ,medicine.medical_treatment ,Dermatology ,medicine.disease ,Flow cytometry ,Carcinoma, Merkel Cell ,Proto-Oncogene Proteins c-myc ,Radiation therapy ,Infectious Diseases ,Biomarkers, Tumor ,Mitotic Index ,medicine ,Cancer research ,Humans ,Immunohistochemistry ,business ,Aged - Abstract
Background Merkel cell carcinoma (MCC) is a rare and malignant tumour. Survival data and prognostic factors are scarce. Aim To investigate the usefulness of biological markers to predict the prognosis for these aggressive tumours. Methods C-myc oncoprotein and proliferation was analysed in specimens from 13 patients with MCC, treated between 1983 and 1997. The average age at presentation was 68.3 years. Overall follow-up ranged from 14 to 158 months, with a mean of 68.2 months. Specimens were analysed by immunohistochemistry for proliferation (mib-1) and flow cytometry for oncogene activity (c-myc). Results The median positivity was 52% for the c-myc oncogene and 50% for proliferation, but these did not correlate to survival as analysed by the Kaplan–Meier method. Other parameters such as median age at presentation, sex, site of tumour and adjuvant radiotherapy were also analysed, but none were found to be significant. Conclusions This study showed that neither c-myc oncogene activity or mitotic index in MCC can be related to patient survival.
- Published
- 2000
- Full Text
- View/download PDF
22. The effect of 5-fluorouracil on Dupuytren fibroblast proliferation and differentiation
- Author
-
Duncan A. McGrouther, Roy Sanders, Barbara Jemec, P. J. Smith, C. Linge, and Adriaan O. Grobbelaar
- Subjects
Male ,Pathology ,medicine.medical_specialty ,Cell division ,Antimetabolites ,Cellular differentiation ,medicine.medical_treatment ,Drug Evaluation, Preclinical ,Cell Count ,Myofibrils ,Recurrence ,medicine ,Humans ,Orthopedics and Sports Medicine ,Fibroblast ,Cells, Cultured ,Aged ,Chemotherapy ,business.industry ,Cell Differentiation ,General Medicine ,Fascia ,Fibroblasts ,Middle Aged ,musculoskeletal system ,Dupuytren Contracture ,body regions ,medicine.anatomical_structure ,Chemotherapy, Adjuvant ,Cell culture ,Case-Control Studies ,Female ,Surgery ,Fluorouracil ,Contracture ,medicine.symptom ,business ,Myofibroblast ,Cell Division - Abstract
INTRODUCTION: Dupuytren's disease is a proliferative disease with contractile properties, prone to recur after surgery. Intra-operatively applied 5-fluorouracil has been used to avoid scar problems in the eye after glaucoma filtration surgery and was therefore investigated as a means to inhibit proliferation and myofibroblast differentiation in Dupuytren fibroblasts in vitro. METHOD: Primary cell lines were obtained by explants from Dupuytren's tissue (n = 6), non-diseased palmar fascia from patients with Dupuytren's disease (n = 3) and carpal ligament from patients undergoing carpal tunnel release (n = 3). The effect of 5-fluorouracil on proliferation was assessed by cell counting. Myofibroblast differentiation, an intergral part of Dupuytren's contracture, was investigated by staining for alpha smooth muscle actin, a marker for contractile cells, using immunohisto-chemical methods. RESULTS: A single exposure to 5-fluorouracil caused a sustained inhibition of proliferation in Dupuytren's and non-diseased fascia cultures, whilst the effect on carpal ligament cultures was transient. Untreated Dupuytren's fibroblasts exhibited the highest myofibroblast differentiation, whilst differentiation in non-diseased fascia cultures was shown to be proportional to cell density and virtually non-existent in carpal ligament cultures. After 5-fluorouracil exposure, the differentiation was significantly reduced in Dupuytren's fibroblasts cultures, reduced at high cell densities in non-diseased fascia and unchanged in carpal ligament cell cultures. DISCUSSION: 5-fluorouracil inhibits both proliferation and myofibroblast differentiation in Dupuytren's cell cultures and may have a potential use as an adjuvant treatment to Dupuytren surgery in order to reduce the rate of recurrence and contracture.
- Published
- 2000
- Full Text
- View/download PDF
23. Is Dupuytren’s Disease Caused by an Imbalance between Proliferation and Cell Death?
- Author
-
Duncan A. McGrouther, Barbara Jemec, P. J. Smith, Adriaan O. Grobbelaar, Roy Sanders, and George S. Wilson
- Subjects
Male ,0301 basic medicine ,Cytoplasm ,Pathology ,Fibrosarcoma ,Genes, myc ,Gene Expression ,Pathogenesis ,Retinaculum ,Recurrence ,Reference Values ,Fascia ,Aged, 80 and over ,Cell Death ,medicine.diagnostic_test ,Biopsy, Needle ,Middle Aged ,musculoskeletal system ,Immunohistochemistry ,Dupuytren Contracture ,medicine.anatomical_structure ,Female ,medicine.symptom ,Cell Division ,Adult ,medicine.medical_specialty ,Sensitivity and Specificity ,Statistics, Nonparametric ,Diagnosis, Differential ,03 medical and health sciences ,Biopsy ,medicine ,Humans ,Dupuytren's contracture ,neoplasms ,Aged ,Transplantation ,030102 biochemistry & molecular biology ,Oncogene ,business.industry ,Fibroblasts ,medicine.disease ,Genes, bcl-2 ,body regions ,030104 developmental biology ,Surgery ,Contracture ,business - Abstract
Dupuytren’s contracture shares certain properties with malignant tumours, characterized by proliferation and lack of apoptosis, which may be induced by the c- myc oncogene. Because of these similarities, the relationship between the c- myc oncogene expression, bcl-2 oncogene (antiapoptotic gene) and proliferation was investigated in Dupuytren’s disease. Proliferation was assessed by immunohistochemical staining of the mib-1 antibody. Results were compared with those from fibrosarcoma specimens, representing a related malignant tumour. Non-diseased fascia from Dupuytren patients and flexor retinaculum from patients undergoing carpal tunnel release without Dupuytren’s disease were used as controls. Expression of c- myc was elevated in primary Dupuytren’s disease and fibrosarcoma specimens, whilst recurrent Dupuytren’s disease, non-diseased Dupuytren fascia and flexor retinaculum exhibited significantly lower levels. Neither bcl-2 nor mib-1 were detected in Dupuytren’s disease, non-diseased fascia or flexor retinaculum, in contrast to fibrosarcoma. The imbalance between proliferation and apoptosis, producing malignant growth was thus confirmed for fibrosarcoma, but not for Dupuytren’s disease.
- Published
- 1999
- Full Text
- View/download PDF
24. Fractures and dislocations
- Author
-
Barbara Jemec
- Published
- 2014
- Full Text
- View/download PDF
25. A simple technique using the mini C-arm to guide depth gauge placement
- Author
-
Barbara Jemec, Benjamin H Miranda, and D.P. Butler
- Subjects
medicine.medical_specialty ,Equipment Safety ,business.industry ,Bone Screws ,Hand Injuries ,Equipment Design ,Gauge (firearms) ,Sensitivity and Specificity ,Mini c arm ,Surgery ,Fracture Fixation, Internal ,Fractures, Bone ,Surgery, Computer-Assisted ,Simple (abstract algebra) ,Fluoroscopy ,medicine ,Calculus ,Humans ,business - Published
- 2013
26. A difficult case: omental transposition flap reconstruction of a large radionecrotic axillary ulcer in a patient with extensive previous abdominal surgery
- Author
-
Barbara Jemec, Christoph E. A. Hartmann, Loretta W.L. Ko, and Lucion Ion
- Subjects
medicine.medical_specialty ,Breast surgery ,medicine.medical_treatment ,Mammaplasty ,Rectus Abdominis ,Breast Neoplasms ,Risk Assessment ,Severity of Illness Index ,Surgical Flaps ,Breast cancer ,Skin Ulcer ,medicine ,Humans ,Neoplasm Invasiveness ,Radiation Injuries ,Mastectomy ,Neoplasm Staging ,Wound Healing ,business.industry ,Carcinoma, Ductal, Breast ,Middle Aged ,medicine.disease ,Surgery ,Obesity, Morbid ,Radiation therapy ,Axilla ,medicine.anatomical_structure ,Treatment Outcome ,Female ,Radiotherapy, Adjuvant ,Radiodermatitis ,Breast reconstruction ,business ,Omentum ,Abdominal surgery - Abstract
Radionecrotic ulcers due to breast cancer treatment is a highly morbid and disabling condition, causing pain, malodour, need for frequent dressings, reduced range of shoulder movements and an unacceptable cosmetic appearance. In patients with radiotherapy to the chest and/or axilla and general poor health the usual reconstructive options may not be suitable due to regional tissue damage and inappropriate long anaesthetic time, respectively. Described procedures include the pedicled latisimus dorsi flap, transverse rectus abdominal flap (TRAM) and omental transposition flap, as well as free tissue transfer (e.g. free TRAM, DIEP). We report a case of a morbidly obese female patient presenting with a large radionecrotic ulcer in her left axilla, following mastectomy, axillary clearance and local radiotherapy to left chest and axilla for breast cancer. She underwent reconstruction using an omental transposition flap, despite previous abdominal surgery.
- Published
- 2012
27. To Cut or Not, That Is the Question
- Author
-
Barbara Jemec and Gregor B.E. Jemec
- Subjects
Incisional biopsy ,medicine.medical_specialty ,business.industry ,Medicine ,Field cancerization ,business ,Keloid scarring ,Dermatology - Published
- 2010
- Full Text
- View/download PDF
28. The abnormal nucleus as a cause of congenital facial palsy
- Author
-
Barbara Jemec, Douglas H. Harrison, and Adriaan O. Grobbelaar
- Subjects
Adult ,Male ,medicine.medical_specialty ,Adolescent ,Facial Paralysis ,complex mixtures ,medicine ,Humans ,Cranial nerve disease ,Child ,Aged ,Palsy ,medicine.diagnostic_test ,business.industry ,Brain ,Magnetic resonance imaging ,Aplasia ,Middle Aged ,bacterial infections and mycoses ,medicine.disease ,Magnetic Resonance Imaging ,Facial nerve ,Facial paralysis ,Surgery ,Facial Nerve ,Child, Preschool ,Pediatrics, Perinatology and Child Health ,General and Specialist Paediatrics ,Etiology ,Female ,Radiology ,Abnormality ,medicine.symptom ,business - Abstract
BACKGROUND—Congenital facial palsy (CFP) is clinically defined as facial palsy present at birth. It is associated with considerable disfigurement and causes functional and emotional problems for the affected child. The aetiology of the majority of cases however, remains elusive. AIMS—To investigate the role of a neuroanatomical abnormality as a cause of unilateral CFP. METHODS—Magnetic resonance imaging (MRI) scans were performed on 21 patients with unilateral CFP. Fifteen patients had unilateral CFP only; six suffered from syndromes which can include unilateral CFP. RESULTS—Of the 15 patients with unilateral CFP only, four (27%) had an abnormal nucleus or an abnormal weighting of this area on the MRI scan, compared to one (17%) of the remaining six patients. CONCLUSION—Developmental abnormalities of the facial nucleus itself constitute an important, and previously ignored, cause of monosymptomatic unilateral CFP.
- Published
- 2000
- Full Text
- View/download PDF
29. Surgical treatment of periocular hemangiomas: a single-center experience
- Author
-
Ken K. Nischal, Barbara Jemec, Vernon S. Y. Geh, Jenny L. C. Geh, David Dunaway, Alki Liasis, and John I. Harper
- Subjects
Male ,medicine.medical_specialty ,Single Center ,Eyelid Neoplasms ,Hemangioma ,Angioma ,medicine ,Humans ,Retrospective Studies ,medicine.diagnostic_test ,Vascular disease ,business.industry ,Capillary hemangioma ,Infant ,Magnetic resonance imaging ,Retrospective cohort study ,Eyelid Neoplasm ,medicine.disease ,eye diseases ,Surgery ,body regions ,Child, Preschool ,Female ,sense organs ,business - Abstract
BACKGROUND: At Great Ormond Street Hospital for Children, patients with periocular hemangiomas are assessed in a multidisciplinary team setting using a protocol developed in 1999. As part of this protocol, surgery is indicated for lesions that continue to cause amblyopia despite treatment with systemic or intralesional steroids or both. Surgery is performed by one of the authors (D.D.). This experience is described. METHODS: A retrospective notes review was undertaken of surgically excised periocular hemangiomas. RESULTS: Eighteen consecutive cases (15 girls and three boys) were identified as having surgical treatment over a 5-year period. The mean age at the time of surgery was 22 months (range, 5 months to 3 years). All but one of the patients had amblyopia or a threat to normal visual development. The follow-up ranged from 1 month to 4 years. Three were lower lid lesions and 15 were upper lid lesions. When there was a threat to normal visual development, preoperative imaging by ultrasound, magnetic resonance imaging, or contrast computed tomography was performed. No rebound growth or deterioration in visual development occurred in this group of patients. CONCLUSIONS: There is limited experience in the literature of excisional surgery for the treatment of periocular hemangiomas. The authors present a series of 18 patients who have been treated at Great Ormond Street Hospital for Children after either failed medical therapies or after patient request. With the appropriate indications and surgical principles, periocular hemangiomas in children can be safely and effectively excised.
- Published
- 2007
30. Measurement of skin mechanics
- Author
-
Monika Gniadecka, Gregor B.E. Jemec, and Barbara Jemec
- Subjects
Suction ,integumentary system ,Skin mechanics ,business.industry ,Coefficient of variation ,Dermatology ,Anatomy ,Distension ,Intra individual ,medicine.anatomical_structure ,Variation (linguistics) ,Forearm ,Healthy volunteers ,medicine ,business ,Biomedical engineering - Abstract
Background/aims: Skin mechanics may be affected by a number of dermatological and systemic conditions, and reliable quantification of skin distension may therefore be of considerable interest. This study was undertaken in order to assess the intra-and inter-individual variation of measurements of skin distensibil-ity when using Dermaflex A. Methods: Dermaflex is a suction device that measures the deformation of the skin surface within a 10- mm cup following application of given suction. Three levels of suction were studied on the flexural side of the forearm in 19 healthy volunteers. Results: Increasing levels of suction produced significantly increasing skin distension (P
- Published
- 1996
- Full Text
- View/download PDF
31. Acne: treatment of scars
- Author
-
Barbara Jemec and Gregor B.E. Jemec
- Subjects
medicine.medical_specialty ,Cicatrix, Hypertrophic ,business.industry ,Common disease ,Scars ,Dermatology ,Disease ,Acne treatment ,medicine.disease ,Disfigurement ,Surgery ,Cicatrix ,Keloid ,Acne Vulgaris ,medicine ,Effective treatment ,Humans ,medicine.symptom ,business ,Acne - Abstract
Acne is a common disease affecting a significant proportion of the population.(1-3) It causes considerable morbidity through soreness, disfigurement, and social handicap due to inflammatory lesions.(4,5) Modern therapy ensures that a considerable proportion of all patients can be offered effective treatment of their disease, but the morbidity is not restricted solely to the inflammatory lesions of acne.(6,7) Despite appropriate and effective primary prevention of scarring, scarring occurs in some degree in 95% of all patients irrespective of the severity of inflammatory acne (although severe acne causes more scarring than the milder forms). The scarring causes long-term morbidity that requires specific therapy.(7)
- Published
- 2004
32. [Dupuytren's contracture]
- Author
-
Barbara, Jemec
- Subjects
Dupuytren Contracture ,Humans - Abstract
Dupuytren's contracture is a common disease affecting the palmar fascia. It is mostly found in the elderly population, although more aggressive cases are not uncommon in the younger population. After a historic and epidemiological review, the clinical picture, histology and pathogenesis, the surgical treatment, and the latest therapeutic options are presented.
- Published
- 2003
33. Two case reports of vinorelbine extravasation: management and review of the literature
- Author
-
David Gault, Silvia Cicchetti, and Barbara Jemec
- Subjects
Oncology ,Cancer Research ,medicine.medical_specialty ,Vinca ,medicine.drug_class ,Hyaluronoglucosaminidase ,Sodium Chloride ,Vinorelbine ,Vinblastine ,030218 nuclear medicine & medical imaging ,Vinca alkaloid ,03 medical and health sciences ,0302 clinical medicine ,Vinorelbine Tartrate ,Internal medicine ,medicine ,Humans ,Local anesthesia ,Lung cancer ,biology ,business.industry ,Hand Injuries ,General Medicine ,Middle Aged ,biology.organism_classification ,medicine.disease ,Antineoplastic Agents, Phytogenic ,Extravasation ,Surgery ,Lymphoma ,Treatment Outcome ,030220 oncology & carcinogenesis ,Female ,business ,medicine.drug ,Anesthesia, Local ,Extravasation of Diagnostic and Therapeutic Materials - Abstract
Vinorelbine tartrate (Navelbine, Burroughs Wellcome Company, Research Triangle Park, NC, USA) is a semisynthetic vinca alkaloid approved in many countries for the first-line treatment of patients with advanced non-small-cell lung cancer. It is also used in the treatment of advanced breast and ovarian cancers and lymphoma. Like other vinca alkaloids, Navelbine can cause skin necrosis as a consequence of inadvertent extravasation in surrounding tissues during intravenous administration. In such cases, early treatment is strongly advocated. There is no documented case of vinorelbine extravasation in the literature. The authors herein report two cases successfully treated with hyaluronidase injections plus saline flushout under local anesthesia.
- Published
- 2000
34. A facial low-flow venous malformation treated with fibrin glue
- Author
-
Barbara Jemec and Roy Sanders
- Subjects
medicine.medical_specialty ,medicine.medical_treatment ,Fibrin Tissue Adhesive ,complex mixtures ,Fibrin ,Veins ,Sclerotherapy ,otorhinolaryngologic diseases ,medicine ,Humans ,Fibrin glue ,Child ,medicine.diagnostic_test ,biology ,business.industry ,Vascular disease ,technology, industry, and agriculture ,Arteriovenous malformation ,Phlebography ,medicine.disease ,Magnetic Resonance Imaging ,Surgery ,surgical procedures, operative ,Otorhinolaryngology ,Face ,Angiography ,biology.protein ,Female ,Tissue Adhesives ,Venous malformation ,business - Abstract
A young girl with recurrent swelling of a facial low-flow venous malformation was treated successfully by injection of fibrin glue.
- Published
- 2000
35. Massive Localized Lymphoedema
- Author
-
Barbara Jemec, Wayne Sturley, and Jonathan Hutt
- Subjects
medicine.medical_specialty ,Morbidly obese ,Severity of Illness Index ,Postoperative Complications ,hemic and lymphatic diseases ,Humans ,Medicine ,Lymphedema ,integumentary system ,business.industry ,Biopsy, Needle ,Middle Aged ,Immunohistochemistry ,Magnetic Resonance Imaging ,Abscess ,Anti-Bacterial Agents ,Obesity, Morbid ,Surgery ,body regions ,Treatment Outcome ,Diabetes Mellitus, Type 2 ,Thigh ,Drainage ,Female ,business ,Follow-Up Studies - Abstract
A case report of massive localized lymphoedema in a morbidly obese 50-year-old woman and review of the literature.
- Published
- 2009
- Full Text
- View/download PDF
36. A functional variant of lower lip reconstruction
- Author
-
Barbara Jemec and Roy Sanders
- Subjects
Male ,medicine.medical_specialty ,Lower lip ,Skin flap ,Surgical Flaps ,Dogs ,Tongue ,Medicine ,Animals ,Humans ,Bites and Stings ,Vermilion ,integumentary system ,business.industry ,Orbicularis oris muscle ,Anatomy ,Middle Aged ,Plastic Surgery Procedures ,Lip ,stomatognathic diseases ,Plastic surgery ,medicine.anatomical_structure ,Otorhinolaryngology ,Surgery ,business ,Follow-Up Studies - Abstract
A functional variant of lower lip reconstruction is reported, in which a nasolabial skin flap was combined with upward transposition of the inferior part of the orbicularis oris muscle in a 'bucket-handle' fashion. The tongue was split to provide both an intraoral lining to the lip and a new vermilion.
- Published
- 1999
37. Abdominoplasty: a case report
- Author
-
Naguib El-Muttardi, Catherine E. Rennie, and Barbara Jemec
- Subjects
medicine.medical_specialty ,Abdominoplasty ,business.industry ,medicine.medical_treatment ,medicine ,Surgery ,business - Published
- 2008
- Full Text
- View/download PDF
38. Soft-tissue thumb reconstruction
- Author
-
Adriaan O. Grobbelaar, Barbara Jemec, and Douglas H. Harrison
- Subjects
medicine.medical_specialty ,business.industry ,Soft Tissue Infections ,Soft tissue ,General Medicine ,Anatomy ,Thumb ,Middle Aged ,Plastic Surgery Procedures ,Abscess ,Surgery ,medicine.anatomical_structure ,Streptococcal Infections ,medicine ,Humans ,Female ,business ,STREPTOCOCCAL INFECTIONS ,Thumb reconstruction ,Research Article - Published
- 1998
39. Differences in outcome for patients referred to dermatology or plastic surgery with suspected skin cancer
- Author
-
Shantini Rice, Barbara Jemec, Nicola Bystrzonowski, Victoria Swale, Matthew D Gardiner, and Justine Kluk
- Subjects
Plastic surgery ,medicine.medical_specialty ,business.industry ,Suspected skin cancer ,Medicine ,Surgery ,General Medicine ,business ,Dermatology - Published
- 2013
- Full Text
- View/download PDF
40. The microsurgical instrument tray – a tremor-free assistant for stabilising amputated parts in replant surgery
- Author
-
Adam Blackburn and Barbara Jemec
- Subjects
Involuntary movement ,Microsurgery ,medicine.medical_specialty ,business.industry ,medicine.medical_treatment ,Equipment Design ,Amputation, Surgical ,Surgery ,Amputation ,Replantation ,Instrument tray ,medicine ,Humans ,Instrumentation (computer programming) ,business ,Equipment and Supplies, Hospital - Published
- 2007
- Full Text
- View/download PDF
41. The effect of superficial hydration on the mechanical properties of human skin in vivo: Implications for plastic surgery
- Author
-
Barbara Jemec, Jørgen Serup, Gregor B.E. Jemec, and Borut I. E. Jemec
- Subjects
Adult ,Male ,medicine.medical_specialty ,medicine.medical_treatment ,Dermatologic Surgical Procedures ,Human skin ,Skin hydration ,In vivo ,Skin Physiological Phenomena ,medicine ,Humans ,Surgery, Plastic ,Practical implications ,Aged ,Aged, 80 and over ,business.industry ,Biomechanics ,Water ,Anatomy ,Middle Aged ,Elasticity ,Biomechanical Phenomena ,Plastic surgery ,Surgery ,Female ,business ,Tissue expansion - Abstract
The influence of topically applied tap water on the mechanical properties of human skin was studied in vivo by applying tap water to the ventral aspect of the forearms of 18 healthy volunteers for 10 or 20 minutes and then measuring distensibility, elastic retraction, and hysteresis. Significant increases in distensibility, resilient distensibility, and hysteresis were noted after 20 minutes of soaking. Most of these findings were already apparent after 10 minutes. This study shows that the epidermis plays a significant role in determining the mechanical properties of human skin. Possible practical implications of superficial skin hydration for plastic surgery such as tissue expansion and larger excisions are briefly discussed.
42. 'There are strict rules, surgery must be clinically necessary'.
- Author
-
Barbara Jemec
- Abstract
TO be operated on purely for cosmetic reasons you have to be enormously affected. [ABSTRACT FROM PUBLISHER]
- Published
- 2009
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.