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44 results on '"Follmar, Keith"'

8. The Therapeutic Efficacy of Botulinum Toxin in Treating Scleroderma-Associated Raynaud's Phenomenon: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial Assessing

Author

Bello, Ricardo J., Cooney, Carisa M., Melamed, Eitan, Follmar, Keith, Yenokyan, Gayane, Leatherman, Gwendolyn, Shah, Ami A., Wigley, Fredrick M., Hummers, Laura K., and Lifchez, Scott D.

Subjects
Adult, Male, Raynaud Disease, Middle Aged, Hand, Article, Young Adult, Treatment Outcome, Double-Blind Method, Neuromuscular Agents, Scleroderma, Limited, Scleroderma, Diffuse, Laser-Doppler Flowmetry, Humans, Female, Patient Reported Outcome Measures, Botulinum Toxins, Type A, Aged, Pain Measurement
Abstract

To assess the therapeutic efficacy of local injections of botulinum toxin type A (Btx-A) in improving blood flow to the hands of patients with Raynaud's phenomenon (RP) secondary to scleroderma.In this randomized, double-blind, placebo-controlled clinical trial, patients with scleroderma-associated RP received Btx-A (50 units in 2.5 ml sterile saline) in one randomly selected hand and sterile saline (2.5 ml) in the opposite hand. Follow-up at 1 and 4 months postinjection included laser Doppler imaging of hands, patient-reported outcomes, and physical examination. We compared outcomes using paired t-tests and population-average generalized models with generalized estimating equations.Of 40 patients enrolled, 25 had limited scleroderma and 15 had diffuse scleroderma. From baseline to 1-month follow-up, there was a greater reduction in average blood flow in Btx-A-treated hands compared to placebo-treated hands. The model estimated that this difference was statistically significant (average difference -30.08 flux units [95% confidence interval -56.19, -3.98], P for interaction = 0.024). This difference was mainly influenced by patients with longstanding RP and diffuse scleroderma. Change in blood flow at 4-month follow-up was not significantly different between groups. Clinical measures (QuickDASH, McCabe Cold Sensitivity Score, pain on a visual analog scale, and Raynaud's Condition Score) improved slightly for Btx-A-treated hands.Our laboratory-based laser Doppler imaging flow data do not support using Btx-A to treat RP in all scleroderma patients. The secondary clinical outcomes suggest some positive effect, but its clinical meaningfulness is questionable. The role of Btx-A in treating RP should be further studied with more homogeneous patient populations and in unique clinical situations such as acute digital ischemia.

Published
2017

9. The Therapeutic Efficacy of Botulinum Toxin in Treating Scleroderma-Associated Raynaud's Phenomenon: A Randomized, Double-Blind, Placebo-Controlled Clinical Trial

Author

Bello, Ricardo J., primary, Cooney, Carisa M., additional, Melamed, Eitan, additional, Follmar, Keith, additional, Yenokyan, Gayane, additional, Leatherman, Gwendolyn, additional, Shah, Ami A., additional, Wigley, Fredrick M., additional, Hummers, Laura K., additional, and Lifchez, Scott D., additional

Published
2017
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12. Rheumatoid Arthritis

Author

Follmar, Keith E., Broyles, Justin M., and Shores, Jaimie T.

Subjects
Interesting Case Series
Published
2013

13. Palmar Contracture

Author

Follmar, Keith E. and Lifchez, Scott D.

Subjects
Interesting Case Series
Published
2013

21. A Treatment Strategy for Postburn Neck Reconstruction

Author

Xin Zhang, Yi, primary, Wang, Danru, additional, Follmar, Keith E., additional, Yang, Jun, additional, Siang Ong, Yee, additional, Messmer, Caroline, additional, Coan, Brian, additional, Erdmann, Detlev, additional, Qian, Yunliang, additional, and Levin, L. Scott, additional

Published
2010
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23. The Helical Arcade

Author

Erdmann, Detlev, primary, Bruno, Anthony D., additional, Follmar, Keith E., additional, Stokes, Tracey H., additional, Gonyon, Dennis L., additional, and Marcus, Jeffrey R., additional

Published
2009
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34. The Distally Based Sural Flap

Author

Follmar, Keith E., primary, Baccarani, Alessio, additional, Baumeister, Steffen P., additional, Levin, L Scott, additional, and Erdmann, Detlev, additional

Published
2007
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43. A treatment strategy for postburn neck reconstruction: emphasizing the functional and aesthetic importance of the cervicomental angle.

Author

Zhang YX, Wang D, Follmar KE, Yang J, Ong YS, Messmer C, Coan B, Erdmann D, Qian Y, and Levin LS

Subjects
Adolescent, Adult, Child, Cicatrix etiology, Contracture etiology, Female, Humans, Male, Middle Aged, Neck anatomy & histology, Neck Muscles surgery, Recurrence, Skin Transplantation, Surgical Flaps, Young Adult, Burns complications, Cicatrix surgery, Contracture surgery, Neck surgery, Neck Injuries complications, Plastic Surgery Procedures methods
Abstract

The authors describe an algorithm for reconstruction of both the soft tissue and skeletal components of severe postburn neck deformities. The critical functional and aesthetic importance of the cervicomental angle is emphasized. The neck is subdivided into 3 anatomic subunits: (1) lower lip/chin subunit, (2) submental subunit, and (3) anterior neck subunit. After release of contractures, platysmaplasty is performed to prevent recurrence and to deepen the cervicomental angle. In cases where chin retrusion is present, sliding genioplasty is performed. The 3 subunits are resurfaced individually by skin grafts and free flaps. The combined scapular and parascapular bilobed free flap is an ideal flap for cases involving 2 subunits. Fifty patients with severe postburns neck contractures were treated. After excision and release of scar, 47 (94%) patients underwent platysmaplasty, and 12 (24%) patients underwent sliding genioplasty. Defects were covered with skin grafts alone in 20 (40%) patients, with free flaps only in 22 (44%) patients, and with a combination of skin grafts and free flaps in 8 (16%) patients.

Published
2010
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44. The helical arcade: anatomic basis for survival in near-total ear avulsion.

Author

Erdmann D, Bruno AD, Follmar KE, Stokes TH, Gonyon DL, and Marcus JR

Subjects
Amputation, Traumatic surgery, Cadaver, Carotid Artery, Common anatomy & histology, Child, Preschool, Dissection, Ear Canal surgery, Ear, External injuries, Female, Follow-Up Studies, Humans, Lacerations pathology, Lacerations surgery, Male, Middle Aged, Replantation, Skin Transplantation methods, Temporal Arteries anatomy & histology, Tissue Survival, Young Adult, Amputation, Traumatic pathology, Ear, External blood supply
Abstract

Survival of the ear based on a single vascular pedicle has been previously documented. The anatomic basis for this survival remains incompletely described. In the 3 clinical cases of inferior-to-superior near-total ear avulsion presented herein, the authors have observed that the ear can survive based on a narrow pedicle along the helical root. In an anatomic study to further investigate the relevant vascular anatomy, the common carotid artery system of 6 fresh human cadaver specimens was injected with latex. The superficial temporal artery and its branches located at the helical root were examined. This anatomic study showed that the upper auricular branch of the superficial temporal artery continues into the ear as the helical artery supplies an arterial arcade, which we have termed the helical arcade. This arcade seems to allow for communication between the anterior and posterior arterial systems of the ear and allows the helical artery to provide sufficient arterial supply to the entire ear.

Published
2009
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