ORCID Profile
0000-0001-5360-8894
Current Organisation
Royal College of Surgeons of England
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Publisher: Elsevier BV
Date: 10-1983
DOI: 10.1016/0007-1226(83)90137-6
Abstract: This paper describes the use of the "crane principle" to vascularise a free lipo-dermal graft in the correction of a complicated post-burn contour defect of the forehead.
Publisher: Elsevier BV
Date: 07-1990
DOI: 10.1016/0007-1226(90)90003-I
Abstract: The osteocutaneous fibula flap has been used to reconstruct large segments of mandible in cases following ablation for cancer or radionecrosis. The bone can be cut to the appropriate shape and the fasciocutaneous flap may be used simultaneously to provide oral cavity lining or skin cover. The technique is described and its successful use in seven patients is reported with details of the complications encountered.
Publisher: Elsevier BV
Date: 11-2005
DOI: 10.1016/J.JHSA.2005.06.015
Abstract: Kaplan's accessory branch is an aberrant branch of the dorsal cutaneous branch of the ulnar nerve that arises proximal to the styloid process of the ulna and courses ulnar to the pisiform. Variations of this anomaly have been described as having an end point of connection to the sensory branch of the ulnar nerve, to the motor branch of the ulnar nerve (rare), to the digital nerve at the level of the midhypothenar eminence, or to the proximal interphalangeal joint of the small finger or as running as an independent branch to the volar aspect of the small finger. We report a variant of Kaplan's accessory branch that coursed through the insertion of the flexor carpi ulnaris, a groove on the ulnar aspect of the pisiform, and connected to the ulnar nerve trunk proximal to its bifurcation into its motor and sensory branch. Based on the findings of the case presented and a review of the literature we offer a classification system for this anomaly.
Publisher: SAGE Publications
Date: 06-1991
DOI: 10.1016/0266-7681(91)90066-W
Abstract: Two cross-arm dermis flaps were successfully used to cover distal dorsal defects on the finger where tendon reconstruction was needed. Division after five days allowed early mobilisation.
Publisher: SAGE Publications
Date: 03-1923
DOI: 10.1016/S0266-7681(97)80282-3
Abstract: This study records the subjective opinion of 30 patients who sustained a distal utation of a single finger beyond the FDS tendon insertion which was treated by replantation, successfully or unsuccessfully, or by terminalization. All other patients who underwent replantation or terminalization of a single distal finger utation but also had other injuries of the hand or fingers were excluded. Eleven patients had successful replantation, nine in whom replantation was not possible or was not successful had subsequent terminalization and ten had primary terminalization without attempting replantation. Only seven of the patients undergoing terminalization had further shortening of bone, the remainder being treated with homodigital neurovascular advancement flaps. Replantation was favoured by patients for sensory and motor functional reasons as well as for cosmetic reasons. Cold intolerance was less common in the successfully replanted fingers.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 2005
Publisher: Elsevier BV
Date: 07-1985
DOI: 10.1016/0007-1226(85)90260-7
Abstract: Only two cases of malignant melanoma in childhood have previously been reported in this Journal (Olbourne and Harrison, 1974 Keall et al., 1981). The report describing 31 cases in the Manchester area (Pratt et al., 1981) indicates that this condition may be more common in this country than previously supposed. A case of malignant melanoma arising in a mole in a 23 month male child is reported. A review of the literature shows that there are no survival figures for cases without metastasis but at present there is no reason to suspect that the disease is any less aggressive than in adults. It cannot be stressed too often that any mole with rapid growth, ulceration, bleeding with minimal trauma and change in colour should be biopsied urgently irrespective of the age of the patient.
Publisher: Springer Science and Business Media LLC
Date: 12-1986
DOI: 10.1007/BF02032422
Publisher: Elsevier BV
Date: 03-2001
Publisher: Springer Science and Business Media LLC
Date: 20-08-2009
Publisher: Springer Science and Business Media LLC
Date: 09-1990
DOI: 10.1007/BF02032655
Publisher: Wiley
Date: 09-05-2023
DOI: 10.1111/ANS.18515
Publisher: Cambridge University Press (CUP)
Date: 03-1988
DOI: 10.1017/S0022215100104736
Abstract: Tracheostomal stenosis following laryngectomy can prevent satisfactor rehabilitation of a patient, and may be difficult to correct. A reconstructive technique using a flap within a deltopectoral flap to treat this condition is described.
Publisher: Elsevier BV
Date: 1980
DOI: 10.1016/0007-0971(80)90032-7
Abstract: In a patient with widespread endobronchial amyloidosis, the amyloid deposits resulted in severe disability over a ten-year period from obstruction of large airways and from recurrent chest infections and atelectasis. Repeated excision of small quantities of amyloid material during rigid bronchoscopy under general anaesthetic have resulted in symptomatic relief and measurable improvement of aiways obstruction.
Publisher: Springer Science and Business Media LLC
Date: 09-2003
Publisher: Elsevier BV
Date: 07-1988
DOI: 10.1016/0007-1226(88)90078-1
Abstract: Using a milliwatt CO2 laser, a series of 160 arteries and 105 veins have been anastomosed in Wistar rats. Three stay sutures and a laser tissue welding technique were used. These were compared with a series of conventionally sutured vessels in terms of patency, speed and ease of procedure, and aneurysm formation. Patency rates of successful first time anastomoses are comparable with conventional suturing methods but the aneurysm rate is higher. Laser assisted anastomosis is faster to learn and perform than conventional suturing, but microsurgical skills are still needed. Despite the large number of variables the laser assisted technique has a high success rate, and work to minimise variables and optimise the laser parameters may improve these results.
Publisher: Springer Science and Business Media LLC
Date: 07-1994
DOI: 10.1007/BF00188569
Publisher: Wiley
Date: 1990
Abstract: Methods of testing the strength of microvascular anastomoses are reviewed historically, in the light of recent applications to laser-assisted microvascular anastomosis techniques. The results of two experiments using hydrostatic distension to bursting point to determine the strengths of laser-assisted and conventionally sutured anastomoses of rat arteries and veins are presented. Considerable variation of the bursting pressures was found at any given time after anastomosis, and by the third postoperative day, the sutured vessels showed a significant fall in strength to their weakest level, with not as great a fall in the laser group. The sutured vessels were stronger than were the laser-anastomosed vessels, except at 3 days and after 6 weeks, when there were no significant differences between the two types of anastomosis. Aneurysmal vessels did not always burst at lower pressures than did nonaneurysmal vessels of comparable age.
Publisher: BMJ
Date: 06-09-1997
Publisher: BMJ
Date: 02-2020
DOI: 10.1136/BMJOPEN-2019-032351
Abstract: This study investigates perceived barriers towards the implementation of multiprofessional team briefings (MPTB) in operating theatres, as well as ways to overcome these perceived barriers. Previous research shows that MPTB can enhance teamwork and communication, but are underused in operating theatres. By adopting a multilevel systems perspective, this study examines perceived barriers and solutions for MPTB implementation. Participants completed open-ended survey questions. Responses were coded via qualitative content analysis. The analysis focused on themes in the responses and the systems level at which each barrier and solution operates. Four tertiary hospitals in Australia. 103 operating theatre staff, including nurses, surgeons, anaesthetists, technicians and administrators. Participants identified barriers and solutions at the organisational (15.81% of barriers 74.10% of solutions), work group (61.39% of barriers 25.09% of solutions) and in idual level (22.33% of barriers 0% of solutions). Of all the perceived barriers to MPTB occurrence, a key one is getting everyone into the room at the same time . Matching of perceived barriers and solutions shows that higher systems-level solutions can address lower level barriers, thereby showing the relevance of implementing such wider reaching solutions to MPTB occurrence (including work practices at occupational level and above) as well as addressing more local issues. Successful MPTB implementation requires changes at various systems levels. Practitioners can strategically prepare and plan for systems-based strategies to overcome barriers to MPTB implementation. Future research can build on this study’s findings by directly examining higher systems-level barriers and solutions via detailed case analyses.
Publisher: SAGE Publications
Date: 10-1994
DOI: 10.1016/0266-7681(94)90126-0
Abstract: A series of 233 patients with complete isions of flexor tendons in zones 1 and 2 underwent operation following emergency admission over a period of 3.5 years. These included 203 patients with 317 ided tendons in 224 fingers injuries in zones 1 and 2 and 30 patients with 30 complete isions of the flexor pollicis longus tendon in zones 1 and 2. All of these patients were mobilized post-operatively in a controlled active motion regimen. 13 (5.8%) fingers and five (16.6%) thumbs suffered tendon rupture during the post-operative period. Patients treated during the last year of the study were followed prospectively for a minimum period of 3 months ten of the 16 (62.5%) fingers with zone 1 repairs, 50 of the 63 (79.4%) fingers with zone 2 repairs, all three (100%) FPL isions in zone 1 and three of four (75%) FPL isions in zone 2 had good and excellent results on assessment by the original Strickland criteria (Strickland and Glogovac, 1980). These results confirm the safety of this regimen as an alternative to other regimens of post-operative flexor tendon repair mobilization in zone 1 and 2 finger injuries. However, in the unmodified form used in this series, this regimen has too high a rupture rate for FPL mobilization.
Location: United Kingdom of Great Britain and Northern Ireland
Location: United Kingdom of Great Britain and Northern Ireland
No related grants have been discovered for Adrian Frederick Stewart Flemming.