DOCSLIB.ORG

Dr. JFS Esserand His Influence on the Development of Plastic And

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text

Load more

DR. J.F.S. ESSERAND HlS INFLUENCE ON THE DEVELOPMENT OF PLASTIC AND RECONSTRUCTIYE SURGERY Madrid, 1935 Dr. J.F.S. Esserand his influence on the development of plastic and reconstructive surgery Dr. J.F.S. Esseren zijn invloed op de ontwikkeling der plastische en reconstructieve chirurgie PROEFSCHRIFT TER VERKRIJGING VAN DE GRAAD VAN DOCTOR IN DE GENEESKUNDE AAN DE ERASMUSUNIVERSITEIT ROTTERDAM OP GEZAG VAN DE RECTOR MAGNIFICUS PROF. DR. J. SPERNA WEILAND EN VOLGENS BESLUITVAN HET COLLEGE VAN DE KANEN. DE OPENBARE VERDEDIGING ZAL PLAATSVINDEN OP WOENSDAG 9 NOVEMBER I983 TE 14.00 UUR DOOR BAREND HAESEKER geboren te Amerongen PROMOTOREN: PROF. DR. J.C. VAN DER MEULE"' PROF. DR. D. DE MOUUN Contents Preface VII PART ONE: A biography of Johannes Fredericus Samuel Esser ( 1877-1946) Introduetion 5 Early chiidhood and schoollife of Jan Esser. 8 Involvement in the development of chess in Holland I 0 Medica! studies: Leiden and Utrecht (1896-1903) 12 Medica! career. 15 Short historica! review of plastic surgery . 21 Esser's training in general surgery 28 Plastic and reconstructive ·surgery in Paris 31 Plastic surgery in Rotterdam . 35 World War I (1914-1918). 37 War surgery in Brünn 40 Vienna . 46 Budapest 53 Berlin (1917-1925) 60 Revolutionary movements in Russia and Germany 66 Plastic surgery in the First World War on the Allied side 74 Esser's plan for an international centre of plastic and reconstructive surgery 77 France 79 Soulh-America 82 Monaco. 85 Italy . 88 Crusade through Europe 96 Institut Esser de Chirurgie Structive 99 Greece (1937) 104 Sojourn in the United Statesof America . 111 Notes. 114 V PART TWO: Specific techniques and principles of plastic and raonstructive surgery. The contributions of Dr. J. F. S. Esser. General observations by Esser on wound repair related to facial injuries in World War I 119 The Esser-inlay 123 Surgical technique of the split skin graft inlay technique. 125 Biologica! or artery Oaps and island Oaps 128 Principles and technique of the biologica! Oap 132 Rotatien of the cheek 141 Specific prob!ems of the amputee 145 Esser's description and ideas of the technique of the cross-leg Oap 147 Cineplastic operations 148 Toe-to-hand transfers 149 Pedicled breast Oap . 154 The treatment of burns and frostbite 157 Fire and Oame burns 158 Radialion burns 159 Electrical burns 160 Chemica! burns 161 Frostbite 162 Plastic surgery applied to ophthalmology. 163 PART THREE: The injluence of Esser's most fundamental techniques on modern plas­ tic and reconstructive surgery. Introduetion 169 Impact on modern plastic surgery 169 Oral surgery and the Esser-inlay. 171 The arrerial Oap . 172 The rotatien Oap of the cheek in eyelid repairs . 176 The bilobed Oap 176 SuM~YIARY AND Cor-:cLusioNs 181 SAMENVATTING EN CONCLUSIES 184 ZUSAMMENFASSUNG UND SCHLUSSFOLGERUNGEN . 188 RÉSUMÉ ET CONCLUSIONS 191 ACKNOWLEDGEMENTS 194 BIBLIOGRAPHY OF DR. J. F. S. ESSER 197 RIFERENCES. 203 1::-.JDEX OF NAMES 221 CuRRICULUM VITAE AucTORIS 224 VI Preface Jan F.S. Esser (1877-1946) was a remarkable and gifled Dutch surgeon whose contributions to plastic and reconstructive surgery, made long befare this specialty was recognised as a branch of surgery, are part of our surgical heritage. His interest in the bloodsupply of skin flaps was the !are-runner of the clinical and anatomical research that lead to the defînîtion of the axial­ pattern flap, the island flap, and later the work on myocutaneous flaps. Esser was one of the first physicians in Holland to have studied bath denlistry and medicine, a unique and fortunate combination that lead him to in vent the skin graft inlay technique: an operation that is still named alter him. His dexterity and love lor manual craftmanship is reflected in his beautiful leatherbound collection of atlases of war injuries, made by the old master baak-binders in Antwerp. He was an eminent chess player and at one time chess champion of Holland. He was also dedicated to the arts and a very shrewd busînessman. He was a tireless and energetic worker, but at the sa me time a rugged individualist, and at times hopelessly unrealistic. His suspicious attitude. hotheadedness, and ocassional stinginess were among bis other weaknesses. In the international literature on plastic surgery he is quoted as being one of the pioneers and in ventors of reconstructive surgery, of the sa me stature as Joseph and Lexerin Germany, Gillies and Kilner in Great-Britain, Morestin in France, Burian in Czechoslovakia and Staige Davis in the United Statesof America. Yet in bis native country, Holland, he was barely noticed. He travelled all over the world with the aim of spreading, on the basis of his personal experience, the possibilities of plastic and "structive" surgery. especially in Europe and both Americas. lor the surgical treatment. rehabili­ tation and return to society of the mutîlated war victims who were regarded as outcasts of societv in those days. (Aufricht, 1946b). The development of the Esser-inlay. publisbed in both the German and American surgical journals, marked the beginning of an era in plastic surgery and was used extensively tbraughout the First and Second World War. His discovery of the "biologica!" arterial flap, used then as a pedicled flap and more recently as a free flap has revolutionized reconstructive surgery. Another of his innovations, the bilobed flap, it still used extensively lor the reconstruction of certain facial and nasal defects. Esser did not invent surgical instruments, but restated and defined surgical principles instead. VII In the succeeding pages the writer bas attempted to find the answer to the following questions: 1. Who was the Dutchman Jan Esser, and why and how did he become a renowned plastic surgeono 2. What bas been the influence of bis publisbed work on modern plastic surgery? 3. What is the explanation of his relative obscurity in his native country Holland0 4. What part did Esser play in the development of plastic surgery in Europe. between 1910 and 1940° VIII PART ONE A BIOGRAPHY OF JOHANNES FREDERICUS SAMUEL ESSER (1877-1946) ... Plastic surgery was known til! recently as the Cin­ derella among the bratherbood of surgical specialities. It was considered undignified for any wellqualified man to be a plastic surgeon. How \\Tong was thîs vie\\' was demonstrated by bath world \vars. The more civilisation progressed and the more powertul the weapons of war became the more bideaus the injuries. Only then people realised that plastic surgery means more than beauty treatment. It was nat enough to save the life of a burnt airman or the disfigured ar maimed soldier of a tank unit. It was necessary to make him normal in appearance as well, and bere plastic surgery came into its own .. George BankalL 1947 Introduetion to Part One An incomplete and rough draf! of the autobiography of Dr. J.F.S. Esser bas been used as a guideline for this biography. These memairs were cammeneed on September 28, 1941 in Chicago, when Esser was temporarily bedridden, due to a !all from a ladder. This unhappy even! gave him the opportunity to dielate bis life-story to two of bis ex-patients Robert Hart and David Tucker, who assisted in typing the manuscript. Since at that time he was without notes or photographs. Esser had to rely on bis memory. The life story was written in great detail, butsome mistakes in dates and spelling of narnes did occur. The typewritten pages also contained many iterations and moreover were incomplete. The autobiography stops abruptly in 1928. Many original documents and letters, coming from the family archives have been studied, and helped to correct the mistakes and ambiguities in the original draft. Information of a doubtful nature that proved difficult to substantiate from further studies of documents, municipal and war archives, institutes of medica! history and University libraries. bas been omitted. Discussions and correspondence with Esser's rclatives, acquaintances, sec­ retaries, and colleagues interested in the history of plastic surgery. have clarified and confirmed many events. Visits to the Dutch towns and villages, like Amsterdam, Rotterdam, Pols­ broek, Utrecht and Leiden, and to Paris and Faye-la-Vineuse in France, proved to be invaluable to understand specific local situations. 3 Abridged genealogical table of Dr. J.F.S. Esser N1artinus Henricus Esser x Voske Elisabeth Hendriks 19-02-1809 (Amsterdam) 01-04-1800 (The Hague) 04-06-1891 (Leiden) 29-06-1886 (Leiden) 1. Martirrus Henricus Volgueres Esser 18-10-1840 (Leiden) 12-03-1864 (Leiden) 2. Johannes Fredericus Esser x Jannetje Boekee 30-01-1843 (Leiden) 01-05-1843 (Rijnsburg) 18-01-1891 (Leiden) 3. Agatha Elisabeth Esser 14-12-1845 (Leiden) 16-02-1849 (Leiden) 1. Elisabeth Henriette Esser 17-07-1876 (Leiden) 05-03-1952 (Katwijk) 2. Johannes Fredericus Samuel Esser 13-10-1877 (Leiden) 03-08-1946 (Chicago) 4 Introduetion The second French Revolution starled in Paris on July 27, 1830, one day alter the proclamation of a new act announcing the abolition of parliament, the end of freedom of the press and a reduction in the electorale. The French King Charles X (1757-1836) left lor Great-Britain and was replaced by the Duke of Orléans, Louis-Philippe ( 1773-1850). nicknamed the ''Citizen King ... The revolution had an effect on the neighbouring countries and the first signs were seen in the Kingdom of the Netherlands a few weeks later. Belgium was then still a part of the Kingdom of the Netherlands. The Belgian part of the population was mainly Catbalie and the Dutch Provinces Protestant. William (Willem) I (1772-1843) King of the Uniled Provinces si nee 1813. was Dutch and Protestant, but he recognised religious liberty. The official language was Dutch.
Recommended publications
  • A Comprehensive Curriculum of the History of Regional Anesthesia

    A Comprehensive Curriculum of the History of Regional Anesthesia

    University of Massachusetts Medical School eScholarship@UMMS Anesthesiology and Perioperative Medicine Publications Anesthesiology and Perioperative Medicine 2019-09-18 A Comprehensive Curriculum of The History of Regional Anesthesia Gustavo Angaramo University of Massachusetts Medical School Et al. Let us know how access to this document benefits ou.y Follow this and additional works at: https://escholarship.umassmed.edu/anesthesiology_pubs Part of the Anesthesia and Analgesia Commons, Anesthesiology Commons, History of Science, Technology, and Medicine Commons, and the Medical Education Commons Repository Citation Angaramo G, Savage J, Arcella D, Desai MS. (2019). A Comprehensive Curriculum of The History of Regional Anesthesia. Anesthesiology and Perioperative Medicine Publications. Retrieved from https://escholarship.umassmed.edu/anesthesiology_pubs/193 Creative Commons License This work is licensed under a Creative Commons Attribution 4.0 License. This material is brought to you by eScholarship@UMMS. It has been accepted for inclusion in Anesthesiology and Perioperative Medicine Publications by an authorized administrator of eScholarship@UMMS. For more information, please contact [email protected]. Journal of Clinical Anesthesia and Pain Medicine Research Article A Comprehensive Curriculum of The History of Regional Anesthesia This article was published in the following Scient Open Access Journal: Journal of Clinical Anesthesia and Pain Medicine Received August 30, 2019; Accepted September 12, 2019; Published September 18, 2019 1 Gustavo Angaramo , James Savage, Abstract David Arcella and Manisha S. Desai1* Department of Anesthesiology and Perioperative The study of the past with regards to medical history has been an underemphasized Medicine, University of Massachusetts Medical component of the medical school curriculum for several reasons. School, Worcester, Massachusetts.
  • Homenagem a August Karl Gustav Bier Por Ocasião Dos 100 Anos Da

    Homenagem a August Karl Gustav Bier Por Ocasião Dos 100 Anos Da

    Rev Bras Anestesiol ARTIGO DIVERSO 2008; 58: 4: 409-424 MISCELLANEOUS Homenagem a August Karl Gustav Bier por Ocasião dos 100 Anos da Anestesia Regional Intravenosa e dos 110 Anos da Raquianestesia* Eulogy to August Karl Gustav Bier on the 100th Anniversary of Intravenous Regional Block and the 110th Anniversary of the Spinal Block Almiro dos Reis Jr, TSA1 RESUMO Unitermos: ANESTESIA, Regional: subaracnóidea, venosa; Reis Jr. A — Homenagem a August Karl Gustav Bier por Ocasião dos ANESTESIOLOGIA: história. 100 Anos da Anestesia Regional Intravenosa e dos 110 Anos da Raquianestesia SUMMARY JUSTIFICATIVA E OBJETIVOS: August Karl Gustav Bier foi o in- Reis Jr A — Eulogy to August Karl Gustav Bier on the 100th Anni- trodutor de duas importantes técnicas de anestesia regional: a versary of Intravenous Regional Block and the 110th Anniversary of anestesia regional intravenosa e a anestesia subaracnóidea, Spinal Block. ambas até hoje amplamente empregadas. Completando neste ano de 2008 a primeira delas 100 anos e a segunda 110 anos de exis- BACKGROUND AND OBJECTIVES: August Karl Gustav Bier in- tência, seria mais do que justo prestarmos uma homenagem ao no- troduced two important techniques in regional block: intravenous tável médico que as criou. regional block and subarachnoid block, widely used nowadays. Since the first one celebrates its 100th anniversary and the second CONTEÚDO: O texto relata os dados familiares, estudantis inici- its 110th anniversary, it is only fair that we pay homage to this ex- ais, do curso acadêmico e da residência médica, as atividades pro- traordinary physician who created them. fissionais e universitárias, a personalidade, a aposentadoria e o falecimento de A.
  • Jones Robert W

    Jones Robert W

    ‘Lain Beside Gold’ Narrative, Metaphor, and Energy in Freud and Conan Doyle Robert W. Jones PhD Candidate Aberystwyth University Contents Chapter 1 Introduction and Methodology ............................................................................. 3 1.1 Overview .......................................................................................................................... 3 1.2 Secondary Material: Literature Review ........................................................................... 8 1.2.1 Critiques of Freud’s Narrativity ................................................................................ 8 1.2.2 Other Critiques ........................................................................................................ 11 1.2.3 Royle and the Uncanny Text ................................................................................... 14 1.2.4 Holland and the Practical Text ................................................................................ 17 1.3 Approaches ..................................................................................................................... 20 1.3.1 Metaphor .................................................................................................................. 23 1.3.2 The Text World ....................................................................................................... 30 1.3.3 Text as Performative Space ..................................................................................... 36 Chapter 2 Freud, Narrative, and the
  • Femoral Nerve Blocks

    Femoral Nerve Blocks

    Femoral Nerve Blocks Julie Ronnebaum, DPT, GCS, CEEAA Objectives 1. Become familiar with the evolution of peripheral nerve blocks. 2. Describe the advantages and disadvantages of femoral nerve blocks 3. Identify up-to-date information on the use of femoral nerve block. 4. Recognize future implications. History of Anesthesia The use of anesthetics began over 160 years ago. General Anesthesia In 1845, Horace Wells used nitrous oxide gas during a tooth extraction 1st- public introduction of general anesthesia October 16, 1846. Known as “Ether Day” ( William Morton) In front of audience at Massachusetts General Hospital First reported deat h in 1847 due to the ether Other complications Inttouctoroduction to eteteher was ppoogerolonged Vomiting for hours to days after surgery Schatsky, 1995, Hardy, 2001 History of Anesthesia In 1874, morphine introduced as a pain killer. In 1884, August Freund discovers cy clopropane for surgery Problem is it is very flammable In 1898, heroin was introduced for the addiction to morphine In 1923 Arno Luckhardt administered ethylene oxygen for an anesthetic History of Anesthesia Society History of Anesthesia Alternatives to general anesthesia In the 1800’s Cocaine used by the Incas and Conquistadors 1845, Sir Francis Rynd applied a morphine solution directly to the nerve to relieve intractable neuralgg(ia. ( first recorded nerve block) Delivered it by gravity into a cannula In 1855, Alexander Wood is a glass syringe to deliver the medication for a nerve block. ( also known as regg)ional anesthesia) In 1868 a Peruvian surgeon discovered that if you inject cocaine into the skin it numbed it. In 1884, Karl Koller discovered cocaine could be used to anesthetized the eye of a frog.
  • Comparision of Dexmedetomidine and Fentanyl As Adjuvants to 0.5% Hyperbaric Bupivacaine in Spinal Anesthesia in Elective Lower Abdominal Surgeries

    Comparision of Dexmedetomidine and Fentanyl As Adjuvants to 0.5% Hyperbaric Bupivacaine in Spinal Anesthesia in Elective Lower Abdominal Surgeries

    Indian Journal of Clinical Anaesthesia 2021;8(2):257–264 Content available at: https://www.ipinnovative.com/open-access-journals Indian Journal of Clinical Anaesthesia Journal homepage: www.ijca.in Original Research Article Comparision of dexmedetomidine and fentanyl as adjuvants to 0.5% hyperbaric bupivacaine in spinal anesthesia in elective lower abdominal surgeries V Sai Divya1, Rajola Raghu1, P Indira1,*, Sadhana Roy1 1Dept. of Anaesthesiology, Osmania Medical College and Hospital, Hyderabad, Telangana, India ARTICLEINFO ABSTRACT Article history: Spinal anesthesia has become most commonly used and choice of anaesthesia for surgeries on lower half of Received 03-01-2021 body after first planned spinal anaesthesia for surgery in man was administered by August Bier (1861–1949) Accepted 27-01-2021 on 16 August 1898, in Kiel(1), Germany. Coadministration of adjuvant drugs improve the quality and Available online 01-06-2021 duration of anesthesia and analgesia and patient safety. Aim of Study: To compare effects of Dexmedetomidine and Fentanyl as adjuvants to 3ml of 0.5% heavy bupivacaine injected intrathecally, in lower abdominal surgeries. Keywords: Design of the Study: Prospective randomized comparative study. Bupivacaine Materials and Methods: The study was approved by ethics committee and was conducted in 100 randomly Dexmedetomidine hydrochloride selected patients posted for elective lower abdominal surgeries in the age group 18-60yrs belonging to both Fentanyl citrate sex. Patients were divided into two groups- Group D (n=50) - received 5µg Dexmedetomidine+3ml 0.5% Spinal anesthesia heavy bupivacaine, Group F(n=50)-received 25µg Fentanyl +3ml 0.5% heavy bupivacaine, intrathecally respectively. Observations and Results: In group D patients onset of sensory block was significantly faster 2.620.56 mins (p<0.001) with better haemodynamic stability, intraoperative sedation, less incidence of side effects and analgesic sparing effect in post operative period when compared to group F.
  • Lebensstationen Prof. Dr. August Bier

    Lebensstationen Prof. Dr. August Bier

    Vor 150 Jahren in Helsen geboren Prof. Dr. August Bier © Bildfolge und Basistext des Vortrags von Dr. Peter Witzel vom 6. Oktober 2011 Lebensstationen Prof. Dr. August Bier Heute möchte ich mit Ihnen das Album des Lebens von August Bier durchblättern, des weltberühmten Chirurgen, des tiefsinnigen Philosophen und des erfolgreichen Forstwirts. Sein Lebensfaden zieht sich vom Kaiserreich über die Weimarer Republik, über das Dritte Reich bis zum ersten Deutschen Arbeiter- und Bauernstaat. Seine Lebensstationen nachzuzeichnen, bedeutet eine höchst interessante Zeitreise. In diesem Jahr wird sein 150ter Geburtstag in Sauen, in Berlin, in Helsen und Bad Arolsen und in Korbach festlich begangen. Ich möchte nicht die Lebensleistungen des berühmten Geheimrats Prof. Dr. August Bier analysieren und bewerten. Das mögen Berufenere tun und haben es schon vielfach getan. Ich möchte einfach mit Ihnen noch einmal seinen Lebensweg nachschreiten. Die Federzeichnung zeigt einen Blick von der Luisenhöhe auf die fürstliche Residenzstadt Arolsen im Jahre 1894. Am 1. Mai 1880 hatte Kaiser Wilhelm I. den Abschnitt der Bahnlinie von Warburg bis Arolsen feierlich eingeweiht. Die Fortführung der Strecke bis Korbach erforderte nochmals 13 Jahre. Der Bahnhof im Vordergrund befindet sich auf dem Boden der Gemeinde Helsen. Die gerade Achse der Hauptstraße führt bis ins Herz der Stadt zum Kirchplatz. Es gibt keine markanten Gebäudesilhouetten, die die vielen Baumwipfel auch in der Stadt überragten. Zu Recht trägt sie den Namen „Arolsen die Stadt im Walde.” In Arolsen und in Helsen wurden zwei Männer geboren, die beide große Chirurgen wurden und in über drei Jahrzehnten enger beruflicher Zusammenarbeit die Medizin des 19. Und 20. Jahrhunderts an vorderster Stelle nachhaltig mitgestalteten: August Bier und Rudolf Klapp.
  • Effectiveness and Safety of Autologous Fat Transfer in Various Treatment Protocols

    Effectiveness and Safety of Autologous Fat Transfer in Various Treatment Protocols

    Effectiveness and Safety of Autologous Fat Transfer in Various Treatment Protocols Citation for published version (APA): Groen, J-W. (2018). Effectiveness and Safety of Autologous Fat Transfer in Various Treatment Protocols. Datawyse / Universitaire Pers Maastricht. https://doi.org/10.26481/dis.20180412jg Document status and date: Published: 01/01/2018 DOI: 10.26481/dis.20180412jg Document Version: Publisher's PDF, also known as Version of record Please check the document version of this publication: • A submitted manuscript is the version of the article upon submission and before peer-review. There can be important differences between the submitted version and the official published version of record. People interested in the research are advised to contact the author for the final version of the publication, or visit the DOI to the publisher's website. • The final author version and the galley proof are versions of the publication after peer review. • The final published version features the final layout of the paper including the volume, issue and page numbers. Link to publication General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights. • Users may download and print one copy of any publication from the public portal for the purpose of private study or research. • You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal.
  • History of Pediatric Regional Anesthesia T.C.K

    History of Pediatric Regional Anesthesia T.C.K

    Pediatric Anesthesia ISSN 1155-5645 REVIEW ARTICLE History of pediatric regional anesthesia T.C.K. Brown Formerly, Department of Anaesthesia, Royal Childrens Hospital, Melbourne, Vic., Australia Keywords Summary spinal; caudal; epidural; children The history of local and regional anesthesia began with the discovery of Correspondence the local anesthetic properties of cocaine in 1884. Shortly afterwards nerve T.C.K. Brown, blocks were being attempted for surgical anesthesia. Bier introduced spinal 13 Alfred St., Kew, Vic. 3101, Australia anesthesia in 1898, two of his first six patients being children. Spinal Email: [email protected] anesthesia became more widely used with the advent of better local anes- thetics, stovaine and procaine in 1904–1905. Caudals and epidurals came Section Editor: Per-Arne Lonnqvist into use in children much later. In the early years these blocks were per- Accepted 16 May 2011 formed by surgeons but as other doctors began to give anaesthetics the spe- cialty of anesthesia evolved and these practitioners gradually took over this doi:10.1111/j.1460-9592.2011.03636.x role. Specific reports of their use in children have increased as pediatric anesthesia has developed. Spinals and other local techniques had periods of greater and lesser use and have not been universally employed. Initial loss of popularity seemed to relate to improvements in general anaesthesia. The advent of lignocaine (1943) and longer acting bupivacaine (1963) and increasing concern about postoperative analgesia in the 1970–1980s, contributed to the increased use of blocks. The history of pediatric regional anesthesia followed its France and a 1000 from Bier’s clinic in Germany in introduction in adults, which occurred after the discov- 1907, representing a huge increase in 3 years.
  • Sudden Cardiac Arrest Under Spinal Anesthesia in a Mission Hospital: a Case Report and Review of the Literature Bamidele Johnson Alegbeleye

    Sudden Cardiac Arrest Under Spinal Anesthesia in a Mission Hospital: a Case Report and Review of the Literature Bamidele Johnson Alegbeleye

    Alegbeleye Journal of Medical Case Reports (2018) 12:144 https://doi.org/10.1186/s13256-018-1648-5 CASEREPORT Open Access Sudden cardiac arrest under spinal anesthesia in a mission hospital: a case report and review of the literature Bamidele Johnson Alegbeleye Abstract Background: Sudden cardiac arrest following spinal anesthesia is relatively uncommon and a matter of grave concern for any anesthesiologist as well as clinicians in general. There have been, however, several reports of such cases in the literature. Careful patient selection, appropriate dosing of the local anesthetic, volume loading, close monitoring, and prompt intervention at the first sign of cardiovascular instability should improve outcomes. The rarity of occurrence and clinical curiosity of this entity suggest reporting of this unusual and possibly avoidable clinical event. Case presentation: We report the occurrence of unanticipated delayed cardiac arrest following spinal anesthesia in a 25-year-old Cameroonian man. Incidentally, the index patient was successfully resuscitated with timely and appropriate cardiopulmonary resuscitative measures. He went ahead to have emergency open appendectomy with good post-operative outcome and recovery. Conclusions: The management of such cardiac arrest under spinal anesthesia is very challenging in resource- limited settings such as ours. Anesthetists and clinicians need to be well informed of this grave complication. A good understanding of the physiologic changes caused by spinal anesthesia and its complications, adequate patient selection, respecting the contraindications of the procedure, adequate monitoring, and constant vigilance are of paramount importance to the eventual outcome. Keywords: Anesthesia-spinal, Cardiac arrest, Intraoperative complications, Resuscitation Background and prompt intervention in the management of sud- Ever since August Bier administered the first clinical den cardiac arrest under spinal anesthesia in a low- spinal anesthesia more than a century ago, it has become resource setting.
  • A Genital Problem: Infections Caused by Self-Inflicted Penile Augmentations

    A Genital Problem: Infections Caused by Self-Inflicted Penile Augmentations

    Research Article Clinics in Surgery Published: 27 May, 2021 A Genital Problem: Infections Caused by Self-Inflicted Penile Augmentations Olivia Aschacher*, Christine Radtke and Wolfgang Happak Department of Plastic and Reconstructive Surgery, Medical University of Vienna, Austria Abstract Introduction: Social pressure and dissatisfaction leads to dubious penile augmentation with paraffin, Vaseline, silicone and other foreign materials. Unhygienic conditions cease in painful infections and long-lasting medical treatment. Aim: Aim of this study was to identify the epidemiology and morbidity throughout the Austrian population and to present the cases treated at our department. Methods: The incidence was evaluated from 2001 till 2019 of the Austrian provinces by the Austrian Registry and distributed by age for these years. A retrospective analysis of patients treated at our department was performed to detect penile infections caused by foreign materials. Results: From 2001 till 2019 an overall of 502 male patients were discharged in Austria with a mean value of 27. The incidence rate by age rises from the age group 20 to 29 (n=42) and reaches a peak in the age group 60 to 69 (n=92) and then flattens out again continuously. Three men aged between 20 and 34 years old were presented at our department in 2014. All presented deformed, painful, swollen symptoms of the penis. The overlaying skin was intact and no perforation of the deep fascia was detected. Conclusion: Self-experimental penile augmentation persists to be a consistent trend in Austria. We observed the formation of granulomas and local abscesses which, if expanded, can lead to disseminating lymphogranulomas and a rupture of the erectile tissue, which can result in life- OPEN ACCESS threatening conditions.
  • Volume 6, Number 2 (May – August 2012)

    Volume 6, Number 2 (May – August 2012)

    VolumeVolume 65 •• Number 32 OcialOfficial Newsletter ofof thethe International International Society Society of of Aesthetic Aesthetic Plastic Plastic Surgery Surgery JOIN US IN GENEVA IN SEPTEMBER he 21st Congress of ISAPS will have Tthe largest faculty in our 42-year history, and activities surrounding this biennial event will span an entire week. Registration numbers already exceed our expectations with plastic surgeons coming from 76 countries – the largest delegation from Switzerland, as might be expected. Our hosts in Geneva have planned unique social events with a definite Swiss flavor, and day tours have been organized to show our guests the beautiful mountain villages, chocolate factories, and the surrounding area. Geneva is a truly international city, as befits our truly international organization. continued on page 32 May – August 2012 www.isaps.org president’s message Board of directors PRESIDENT Jan poëll, md – switzerland Jan Poëll, MD St. Gallen, Switzerland ISAPS President [email protected] PRESIDENT-ELECT Carlos Uebel, MD, PhD Dear Friends and Colleagues, Porto Alegre, RS, Brazil [email protected] ime passes fast and soon my two years as President of this noble society will be over. FIRST VICE PRESIDENT Susumu Takayanagi, MD It’s been an interesting time that I wouldn’t have wanted to miss. It will end with Osaka, Japan Tan unforgettable biennial Congress in Geneva in September. I had a lot of work, [email protected] but interesting such that I recommend to every young colleague to try to become involved SECOND VICE PRESIDENT Renato Saltz, MD in the management of our society either through a committee or as a National Secretary.
  • Corning and Cocaine: the Advent of Spinal Anaesthesia

    Corning and Cocaine: the Advent of Spinal Anaesthesia

    Grand Rounds Vol 9 pages L1–L4 Speciality: Landmark Case report Article Type: Case Report DOI: 10.1102/1470-5206.2009.L001 ß 2009 e-MED Ltd Corning and cocaine: the advent of spinal anaesthesia Alex Looseley Derby City General Hospital, Derby NHS Foundation Trust, Derby, UK Corresponding address: Dr Alex Looseley, Derby City General Hospital, Uttoxeter Road, Derby, DE22 3NE, UK. E-mail: [email protected] Date accepted for publication 17 June 2009 Abstract The inception of spinal anaesthesia can be traced to James Leonard Corning, a New York neurologist who inadvertently administered cocaine spinal anaesthesia in 1885. In 1898 August Karl Gustav Bier, a German surgeon, pioneered the successful use of operative spinal anaesthesia in lower limb surgery. Early spinal anaesthesia was fraught with complications but through advances in aseptic technique, anaesthetic agents and equipment, the seminal work of Corning and Bier has evolved into a widely established anaesthetic modality. Keywords Spinal anaesthetic; Leonard Corning; August Bier; history; development. Early history The very first spinal anaesthetic was delivered by accident. Its inception can be traced to the late 19th century and the work of a New York neurologist James Leonard Corning (1855–1923)[1]. Corning was born in Connecticut but received his medical education in Germany, graduating from the University of Wu¨rzburg in 1878. His earlier research was conducted using hydrochlorate of cocaine – the only available local anaesthetic agent at the time – first on the peripheral nervous system and later the central nervous system. He observed that subcutaneous injection of cocaine was associated with both vasoconstriction and local anaesthesia.