[Case report of successful therapy of necrotizing fasciitis using a device of vacuum assisted closure]. / Fallbeschreibung: Erfolgreiche Therapie einer nekrotisierenden Fasziitis li. Bein mit V.A.C.-System.

Successful wound management is reported in a case of extended and life threatening necrotizing fasciitis of the leg of a poly-morbid older woman by use of standards of septic surgery (sufficient excision of necrotic tissue, use of bacteria adapted antibiotics, programmed wound revisions) and use of an industrial supplied device of vacuum assisted closure (V.A.C.).

[MRT in clinically unclear posttraumatic knee joint lesions]. / MRT bei klinisch unklaren posttraumatischen Kniegelenksläsionen.

An MRI examination was performed on 31 patients with clinically questionable posttraumatic knee joint lesions. A broad range of intra- und extraarticular pathological changes was found. The correlation of MRI with arthroscopy and surgery showed a correct MRI diagnosis in 78% of the meniscal lesions (n = 18) and in 89% of the anterior cruciate ligament ruptures (n = 9). An analysis of false positive and false negative MRI diagnoses was made. MRI offers the opportunity for noninvasive complex assessment of knee joint structures and is of particular value in the diagnosis of posttraumatic knee joint lesions.

[The gamma nail. Indications, technique and early results]. / Der Gammanagel. Indikation, Technik und Frühergebnisse.

It is reported about indication, technique and the first results of 40 osteosynthesis carried out in proximal femur fractures with the help of a gamma nail. The indication of the gamma nail ranges from the lateral fracture of the femoral neck to subtrochanteric fractures of the femur. According to existing experiences the following conclusions could be drawn: The technique of this modern interlocking nailing is to be learned in a short time period. The instruments are practically compiled and in case of a suitable use the handling is free of complications. It could be used in all stable and instable pertrochanteric fractures. The possibility of an immediate postoperative load of the fracture is one of the essential advantages of this method.

[Pancreas transplantation with exocrine bypass to the gallbladder as receiver. Experimental results and the first clinical case]. / Transplantation pancréatique avec dérivation exocrine dans la vésicule biliaire du receveur. Résultats expérimentaux et premier cas clinique.

A new procedure for intraperitoneal pancreas transplantation, donor-pancreatoduodenectomy/receiver-cholecystectomy, is described. The pancreas, with a segment of the duodenum, is placed dorsally in the peritoneal cavity. The portal vein is anastomosed to the sub-hepatic caval vein and the long aortic segment of the graft is anastomosed with the receiver's aorta. Pancreas exocrine excretion is deviated to the receiver's gallbladder via a duodenobladder bypass.

[Tibial shaft fracture. Forms of therapy and their complications]. / Die Unterschenkelschaftfraktur. Therapieformen und deren Komplikationen.

The rate of complications in treatment of lower leg fractures has continued to be high, which calls for critical appraisal of possible therapeutic approaches. The effectiveness of both conservative and surgical treatment has been shown by a prospective study which covers a period from 1984 to 1988. An analysis of 166 cases proved helpful in providing guidelines for therapy of closed and open lower leg fractures. Conditions and prerequisites are expounded for the use of various surgical techniques, and hints are given on how to reduce complications.

[Diagnosis of rejection after pancreatic transplantation in the minipig model]. / Rejektionsdiagnostik nach Pankreastransplantation am Minischweinmodell.

An allogenic transplantation of the total-pancreas with duodenum was carried out in the minipig model. The oral duodenum was closed blindly and the aboral part was led out as a stoma. The portal vein of the transplant was anastomosed end-to-side in the inferior vena cava and the celiac artery of the transplant in the distal aorta. Investigations for early diagnosis of rejection were carried out in this model parallelly respectively one by one. CT/MRT, selective angiography, laboratory chemical parameters were unsuitable for early detection. The pancreatic succus cytology and nuclear medical investigations show reproducible changes caused by rejection before the blood-sugar level was increased.

[Pancreatoduodenal transplantation with and without the spleen in an animal experiment]. / Pankreatoduodenale Transplantation mit und ohne Milz im Tierexperiment.

It is a report on the heterotop transplantation of the pancreas with duodenum with or without spleen to diabetic mini-pigs. 7 days after a total resection of the pancreas the truncus coeliacus of the transplant is anastomosed end-to-side with the distal aorta. The same is done with the vena cava inferior. After having closed the duodenum orally the pancreatic juice is drained through on anus praeter. The immunosuppression is reached by giving Cyclosporin A and prednisolone after having analyzed the blood picture. The postoperative laboratory tests as well as affection tests including selective angiographic and nuclear medical in vivo controls show the efficiency of this transplantation variant to control a diabetic metabolic level for several weeks without an external insulin supply. The transplantation model described is technically uncomplicated and it is the basis for further studies.

[Peripheral venous pressure in acute and chronic femoral-pelvic vein occlusion--an experimental study]. / Der periphere Venendruck beim akuten und chronischen Bein-Beckenvenenverschluss--eine experimentelle Studie.

The behaviour of the peripheral venous pressure was checked after starvation of the venous main vessel of the pelvic limb in 34 mongrel dogs in long-term course about 40 weeks. The influence of recanalisation processes on the pressure development was excluded by the ligature model. The pressure measurements took place continuously statically and dynamically in horizontal and in oblique posture. They produced a changed pressure characteristic with a chronically increased resting pressure and a decreased drop in pressure with load. The insufficient transport capacity of the spontaneously originated collateral circulation could be pointed out.

[Surgery of leg and pelvic venous thrombosis]. / Die chirurgische Therapie der Bein- und Beckenvenenthrombose. Operative Möglichkeiten und Ergebnisse.

33 patients suffering from crural-pelvic venous thrombosis and having been treated surgically were now followed-up. The late results obtained were satisfactory.