ORCID Profile
0000-0002-8294-0818
Current Organisations
University of Adelaide
,
University of Melbourne
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Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 04-08-2022
Publisher: Wiley
Date: 03-03-2023
DOI: 10.1111/ANS.18362
Abstract: Surgical fixation of scaphoid fractures may result in unrecognized screw protrusion and subsequent cartilage damage to the adjacent joints. The purpose of this study was to use a three‐dimensional (3D) scaphoid model to determine the wrist and forearm positioning that will allow intra‐operative fluoroscopic visualization of screw protrusions. Two 3D scaphoid models, with the wrist in neutral and 20° ulnar deviated, were reconstructed from a cadaveric wrist using the Mimics software. The scaphoid models were ided into three segments and further ided into four quadrants in each of the three segments along the scaphoid axes. Two virtual screws, with a 2 and 1 mm groove from the distal border, were placed so that the screws protrude from each quadrant. The wrist models were rotated along the long axis of the forearm and the angles at which the screw protrusions were visualized were recorded. One‐millimetre screw protrusions were visualized at a narrower range of forearm rotation angles compared to 2 mm screw protrusions. One‐millimetre screw protrusions in the middle dorsal ulnar quadrant could not be detected. Visualization of the screw protrusion in each quadrant varied with forearm and wrist positioning. In this model, all screw protrusions, except 1 mm protrusions in the middle dorsal ulnar quadrant, were visualized with the forearm in pronation, supination or in the mid‐pronation position and with the wrist in neutral or 20° ulnar deviated.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Springer Science and Business Media LLC
Date: 18-06-2020
DOI: 10.1245/S10434-020-08720-2
Abstract: Extremity lymphedema can occur bilaterally with different severities on each side. The aim of this study is to investigate the treatment outcomes of such patients with bilateral extremity lymphedema of different severities. Between 2013 and 2017, patients with bilateral extremity lymphedema of different severities according to the Taiwan Lymphoscintigraphy Staging (TLS) system were retrospectively reviewed. Ipsilateral vascularized lymph node transplantation (VLNT) was indicated in TLS total obstruction and contralateral lymphovenous anastomosis (LVA) in TLS partial obstruction with patent lymphatic vessels on indocyanine green lymphography. Outcomes were assessed using circumference improvement, frequency of cellulitis, and lymphedema-specific quality of life (LYMQoL) questionnaires. A total of 10 patients with bilateral extremity lymphedema with median age of 63 (range 12–75) years were included. The median symptom duration of the lymphedematous limb was 60 (range 36–168) months and 12 (range 1–60) months in the VLNT and LVA group, respectively ( p 0.05). At average follow-up of 37.5 (range 14–58) months, the average limb circumference improvement was 2.4 (range − 3.3 to 7.8) cm in the VLNT group and 2.3 (range 0.3–7) cm in the LVA group ( p = 1). The median episodes of cellulitis decreased significantly from 4 to 0.5 and 1 to 0 times/year in the VLNT and LVA group, respectively ( p = 0.02, p = 0.06). The overall LYMQoL score improved from 4.5 preoperatively to 7.5 postoperatively ( p 0.01). Limb-specific VLNT and LVA selected by TLS effectively treated bilateral extremity lymphedema with different severities.
Publisher: Wiley
Date: 25-09-2019
DOI: 10.1002/JSO.25707
Abstract: Vascularized lymph node transfer (VLNT) is an effective surgery for extremity lymphedema. This study evaluated a lymphatic drainage device (LDD) for the drainage of accumulated fluid into the venous system. Micropore filtering membranes with pore sizes of 5, 0.65, and 0.22 μm polyvinylidene difluoride, and 0.8 μm Nylon Net Filter were evaluated to determine the in vitro efficiency of drainage flow of an LDD. The two superior membranes were further used for the evaluation of the inflow and outflow of the LDD in vivo using 5% albumin. At 5 minutes, the volumes drained with 5, 0.65, and 0.22 μm polyvinylidene difluoride and 0.8 μm nylon membranes were 15.2, 2.77, 2.37, and 0.59 mL, respectively ( P .01). At 10 minutes, the collected volumes of 5 and 0.65 μm polyvinylidene difluoride were 1788 and 1051 μL ( P = .3). The indocyanine green fluorescence was detected at 50 seconds for the 5 μm polyvinylidene difluoride membrane but not for the 0.65 μm membrane. The study successfully demonstrated the proof‐of‐concept of the LDD prototype that mimicked VLNT with drainage of 5% albumin into the venous system in a rat model.
Publisher: Wiley
Date: 06-04-2018
DOI: 10.1002/MICR.30325
Abstract: The survival of engineered cardiac muscle 'grafts' to the epicardium is limited by vascularization post-transplantation in rat models. In this article, we describe the methodology of a novel rat model that allows for the transplantation of an engineered cardiac muscle flap (ECMF) onto the epicardium. A total of 40 rats were used. Twenty-four neonatal rats were used to harvest cardiomyocytes. At week 1, ECMF were generated by seeding cardiomyocytes into the arteriovenous loop (AVL) tissue engineering chamber implanted into the right groin of adult rats (n = 8). At week 6, the ECMF were harvested based on a pedicle along the femoral-iliac-abdominal vessel and anastomosed to the neck vessels of the recipient syngeneic adult rats (n = 8). The flaps were delivered into the thoracic cavity and onto the epicardium. The transplanted flaps were harvested at week 10. Survival of the flaps was assessed by the patency of anastomoses and viability of the cardiomyocytes through histological analysis (hematoxylin and eosin [H&E], desmin, and von Willebrand factor [vWF] immunostaining). Six out of 8 rats survived the transplantation procedure. These remaining 6 recipient rats survived until harvest time point at 4 weeks post-transplantation. The mean area of the flap was 46.7mm This is a technically feasible model that will be useful for future assessment of different cardiac stem cell implants and their functional significance in rat heart models.
Publisher: Wiley
Date: 08-04-2020
DOI: 10.1002/MICR.30456
Abstract: Reconstruction of defects measuring approximately two-thirds of the lower lip width is traditionally reconstructed utilizing loco-regional flap utilizing lip and cheek tissues. This often results in microstomia and unsatisfactory aesthetic outcome. This may hinder the psychosocial aspect of a recovering cancer survivor. Here we describe a single-stage reconstruction in a 79-year-old male patient who received lower lip resection for squamous cell carcinoma. The reconstruction was accomplished using a facial artery musculomucosal flap together with a free radial forearm flap for vermilion and soft tissue defect reconstruction after lip tumor resection with uneventful postoperative course. The patient remains disease-free after 2-year follow-up and does not require revision surgeries for functional or aesthetic reason. This approach may be considered a good option for reconstruction of missing lip and soft tissue simultaneously when the facial vessels are well-preserved during neck dissection. Aesthetically pleasing and functionally satisfactory outcomes may be produced.
Publisher: Mary Ann Liebert Inc
Date: 10-2012
Publisher: Elsevier BV
Date: 12-2019
DOI: 10.1016/J.BJPS.2019.08.006
Abstract: Pedicled medial sural artery perforator (MSAP) flap has been described primarily for the coverage of knee and proximal-third leg defects. The technique for reaching the middle third and its use as a retrograde-flow flap were never demonstrated with clarity. This retrospective case-series aimed to report the author's experience in these regards. Details of all patients who underwent pedicled MSAP flap for lower limb reconstruction over a 7-year period were collected. Surgical outcomes were examined retrospectively. For defects in the anterior middle third of the leg, the "pedicled propeller flap" design was utilized. To determine more distal defects beyond the reach of the anterograde-flow MSAP flap, retrograde-flow pedicled MSAP flaps were used. Eleven anterograde-flow pedicled MSAP flaps were used for defects ranging from the knee to the middle third of the leg. The etiologies of defects included trauma, chronic ulcer, and skin malignancy. All 11 anterograde pedicled MSAP flaps survived and achieved good outcomes. The mean pedicle length was 11.3 cm (range 7-18 cm), and the mean arc length after double pivoting (n = 4) was 29 cm (range 22-36 cm). Of three retrograde-flow pedicled MSAP flaps, two achieved the goal of wound coverage and one suffered complete flap loss. The "pedicled propeller flap" design extends the reach of the anterograde-flow pedicled MSAP flap as far as the middle-third anterior leg defects. Our preliminary experience with retrograde-flow MSAP flap has mixed results. Further studies are required to examine its reliability.
Publisher: Wiley
Date: 13-12-2022
DOI: 10.1002/MICR.30992
Abstract: Donor nerve options for lower lip reanimation are limited in patients undergoing oncological resection of the facial nerve. The ansa cervicalis nerve (ACN) is an advantageously situated donor with great potential but has not been examined in detail. In the current study, the anatomical technical feasibility of selective ACN to marginal mandibular nerve (MMN) transfer for restoration of lower lip tone and symmetry was explored. A clinical case is presented. Dissections were conducted in 21 hemifaces in non‐embalmed human cadavers. The maximal harvestable length of ACN was measured and transfer to MMN was simulated. A 28‐year‐old male underwent ACN‐MMN transfer after parotidectomy (carcinoma) and was evaluated 12 months post‐operatively (modified Terzis' Lower Lip Grading Scale [25 observers] and photogrammetry). The harvestable length of ACN was 100 ± 12 mm. A clinically significant anatomical variant (“short ansa”) was present in 33% of cases (length: 37 ± 12 mm). Tensionless coaptation was possible in all cases only when using a modification of the surgical technique in “short ansa” cases (using an infrahyoid muscle nerve branch as an extension). The post‐operative course of the clinical case was uneventful without complications, with improvement in tone, symmetry, and function at the lower lip at 12‐month post‐operative follow‐up. Selective ACN‐MMN nerve transfer is anatomically feasible in facial paralysis following oncological ablative procedures. It allows direct nerve coaptation without significant donor site morbidity. The clinical case showed good outcomes 12 months post‐operatively. A strategy when encountering the “short ansa” anatomical variant in clinical cases is proposed.
Publisher: Elsevier BV
Date: 05-2021
Publisher: Wiley
Date: 18-10-2017
DOI: 10.1002/CCR3.1223
Publisher: Wiley
Date: 16-08-2010
DOI: 10.1111/J.1445-2197.2010.05435.X
Abstract: In heart failure, post-myocardial infarction and some congenital cardiac anomalies, organ transplantation is the only effective cure. Shortage of organ donors and complications of orthotopic heart transplant remain major challenges to the modern field of transplantation. Tissue engineering using cell-based strategies presents itself as a new way of generating functional myocardium. Engineering functional myocardium de novo requires an abundant source of cells that can form cardiomyocytes. These cells may be used with biocompatible scaffold materials to generate a contractile myocardium. Lastly, to sustain the high metabolism of the construct, a functional vasculature needs to be developed with the forming cardiac tissue. This review provides an update on the progress of stem cell research in the context of cardiac tissue development, types of biomaterials used in cardiac tissue engineering (CTE) and currently employed strategies for vascularization in CTE. In addition, a brief overview of strategies utilized in CTE is provided.
Publisher: Wiley
Date: 05-2007
DOI: 10.1111/J.1445-2197.2007.04060.X
Abstract: The purpose of the study was to illustrate the increasing trend in the number of adult burns patients admitted to the Royal Adelaide Hospital and attempt to explain it and to describe the burn patients admitted to the Royal Adelaide Hospital in terms of age, sex, origin, cause and burn size, particularly since the increasing trend began, in an effort to identify a particular group or burn cause, which may make up a large proportion of the increasing numbers. A retrospective review of 1548 acute burn-injured patients using information from the burns unit database between 1996 and 2004 was carried out. Of 1841 total admissions, 1548 were admitted for acute burn injury. There has been an increase in the number of admissions since 2001 amounting to approximately 20% per annum. The cumulative rise in total admissions 2000-2004 is 107% where the increase in acute burn admission in the same period is 82%. There appears to be no difference whether the patient is from a rural or a metropolitan area. Burns of <10% total body surface area constitute most of the increase and are mainly flame and scald injuries. Chemical and contact burns are proportionately increasing. The increase in acute admissions is mainly due to the increasing presentation of smaller burns to the unit. The statewide rural burn education programme and media exposure following the 2002 Bali bombings may have contributed to the increase in acute admissions.
No related grants have been discovered for Richard Tee.