Experimental use of intercostal muscle flaps for repair of induced cardiac defects

Intercostal muscle flaps were successfully used to repair 3 cm defects of the ventricular myocardium in the mongrel dog. Early and late healing of all flaps was uncomplicated and there were no late complications related to aneurysmal formation or electrical abnormalities of the heart. The existing blood supply of the heart was unaffected. The intercostal muscle is suggested as an alternative muscle flap for use in myocardial wall reconstruction.

Experimental reconstruction of the trachea with autogenous materials

Composite intercostal muscle flaps were experimentally used to repair major intrathoracic tracheal defects in the mongrel dog. These composite flaps provided an adequate tracheal lumen with both sufficient mobility and structural stability. Stenosis of the reconstructed trachea was an uncommon finding, but the incidence of early postoperative mortality was high.

[Current reconstructive measures for the covering of defects in the extremities]

Large defects of soft tissue and bone in the lower extremity are still a great surgical problem with regard to morbidity and preservation of the leg. Conventional operative procedures such as cross leg or pedical flap are frequently not sufficient to guarantee successful treatment. Local muscle flap, myocutaneous flap and free-tissue transfer with microvascular anastomoses are excellent surgical supplements for better and quicker treatment, as they can generally be performed in one operative step. Strict indication and a specially trained operating team are essential for successful treatment in these more risky procedures. The new techniques and applications are demonstrated on various cases.

[The effect of intubation, tracheotomy and central venous catheter on pneumonia and sepsis in burn patients]

In 58 patients with extensive deep dermal burns the consequences of intubation, tracheotomy and central venous catheter in respect to pneumonia and bacteriaemia were studied. The sputum of tracheotomized patients showed twice as many pathogenic bacteria as the sputum of patients with prolonged intubation. From 93 subclavian catheters under bacteriological control 16 (17%) showed pathogenic bacteria on the tip. An identity between the bacille found in the blood stream and on the catheter tip was only found in 21%. From this study it seems conclusively that prolonged intubation is generally preverable to tracheostomy in severely burned patients and that the venous catheter can not be the most frequent cause of bacteriaemia.