B Loos

Friedrich-Alexander Universität Erlangen-Nürnberg, Erlangen, Bavaria, Germany

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Publications (19)29.64 Total impact

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    ABSTRACT: This case report describes a very rare and highly malignant type of lymphoma, which presents as a mucous cyst on the finger. The cyst was excised and the specimen pathohistologically analyzed. The analysis revealed the presence of a Natural-Killer cell neoplasm. This case illustrates and stresses the importance of a pathohistological examination when doubts arise about the initial diagnosis of a benign tumorous lesion.
    Archives of Orthopaedic and Trauma Surgery 12/2009; 129(12):1613-6. DOI:10.1007/s00402-008-0794-4 · 1.60 Impact Factor
  • Bernd Loos · Raymund E Horch ·

    Plastic and Reconstructive Surgery 08/2008; 122(2):99e-100e. DOI:10.1097/PRS.0b013e31817d653b · 2.99 Impact Factor
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    ABSTRACT: Dupuytren's disease belongs to the group of so called fibromatoses and is considered to be a non infectious disease. Since first degree Dupuytren's disease is generally not operated upon, we want to report the unexpected finding of phlegmonous-abscessing infection in nodules in Dupuytren's disease in a 61 year old patient, who was treated surgically because of complaining painful symptoms in first degree nodules in his palm without clinically visible signs of infection.
    Archives of Orthopaedic and Trauma Surgery 04/2008; 129(4):445-8. DOI:10.1007/s00402-008-0589-7 · 1.60 Impact Factor
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    ABSTRACT: Dynamic external fixation systems are considered as optimal devices for treatment of fracture dislocations of the proximal interphalangeal joint (PiP). The pins and rubbers traction system (PRTS) is cheap, easy to assemble and comfortable and allows early mobilization of the affected digit. We investigated the influence of different wire positions and rubber strength and provided a follow-up of five consecutively treated patients. Sixteen cadaver fingers (dig 2-5) were included into the biomechanical study. Forces for flexion of the PiP joint (30 degrees, 60 degrees, and 90 degrees) were measured by pulling the flexor digitorum profundus tendon; width of the PiP joint was assessed radiologically. Measurements were obtained prior and after assembly of PRTS and were repeated with three different types of rubbers and two different positions of the retention wire (distal and proximal). The clinical part of the study included five patients (21-72 years) who were treated using the PRTS. Mean follow-up was 272 days. The PRTS increased flexion force of the PiP joint. Proximal position of the retention wire increased forces for 30 degrees flexion. Different rubber strengths did neither increase PiP width nor influence flexion forces. In the clinical part of the study total range of motion was 74 degrees and DASH score was 10.1. Pinch grip of the affected digit was 72% of the unaffected side. The PRTS allows for efficient treatment of intraarticular fractures with PiP involvement. Although standardized positioning of the wires is important, proximal position of the retraction only increased forces for 30 degrees flexion.
    Archives of Orthopaedic and Trauma Surgery 01/2008; 129(1):29-37. DOI:10.1007/s00402-007-0526-1 · 1.60 Impact Factor
  • B Loos · J Kopp · W Hohenberger · R.E. Horch ·
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    ABSTRACT: The aim of this study was to salvage or to integrate exposed alloplastic meshes in post malignancy irradiated chronic wounds by using topical negative pressure (TNP) therapy together with staged debridement. Three patients with secondarily exposed alloplastic meshes in irradiated non-healing wounds were treated by serial debridement and repeated topical negative pressure therapy until clean and vital wounds were achieved, followed by ultimate plastic coverage by a myocutaneous flap or split-thickness skin graft. The range of the follow-up period was from 18 to 36 months. After staged serial debridement and repeated vacuum treatment periods wounds were preconditioned in an acceptable fashion for ultimate plastic coverage. After the treatment with a myocutaneous flap or split-thickness skin graft all three patients achieved long-term stable wounds with no alloplastic mesh complication within the follow-up period. Computer-controlled TNP therapy (vacuum-assisted closure therapy) together with staged debridement can help to induce granulation tissue formation in irradiated wounds and allows integration of alloplastic materials into regenerating wounds after ablative oncologic surgery.
    European Journal of Surgical Oncology 10/2007; 33(7):920-5. DOI:10.1016/j.ejso.2006.12.018 · 3.01 Impact Factor

  • Journal of the European Academy of Dermatology and Venereology 03/2007; 21(2):252-4. DOI:10.1111/j.1468-3083.2006.01827.x · 2.83 Impact Factor
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    Bernd Loos · Valerij Puschkin · Raymund E Horch ·
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    ABSTRACT: Dupuytren's disease (DD) is a hand disorder mainly among the northern population. In contrast it is rare in the mediterranean population. Therefore typical habits and dietetic influences have been discussed as well as genetic predisposition. Still, since the first description by Dupuytren in 1834 only little is known about the etiology and pathogenesis of this disease. Some hints were found for a higher prevalence among people with diabetes, alcohol abuse or smoking. Also, intensive manual work or hand injuries have been discussed to have an influence on DD. To our knowledge this is the largest retrospectively evaluated series of symptomatic patients published to date. The study includes patients from the last 50 years. It was performed to show possible correlations between DD and typical risk factors such as diabetes, alcohol consumption, and smoking. We retrospectively analysed all patient records with DD documented between 1956 and 2006 in the Surgical University Hospital in Erlangen. Data acquisition was conducted by reviewing the medical records from 1956 to 2006 including data from all patients who were surgically treated because of DD. We reviewed 2579 male and 340 female surgically treated patients with DD. More than 80% of the patients were between 40 and 70 years old. In 28.9% only the right hand was effected by DD, in 25.3% only the left hand and in 45.8% both hands. In 10.3% of all Patients suffered from Diabetes mellitus. Statistical analysis revealed no significant correlation between diabetes, alcoholism or smoking on the degree of DD in our patients. Most data are consistent with previously published results from smaller, comparable retrospective studies with regard to right- or left handedness. We could not confirm a statistically significant correlation of DD with diabetes mellitus, severe alcohol consumption, heavy smoking or epilepsy and the stage of the disease as described in other studies. However, in the whole cohort of our operated patients during the last 50 years the prevalence of the above mentioned risk factors is slightly higher than in the normal population.
    BMC Musculoskeletal Disorders 02/2007; 8(60):60. DOI:10.1186/1471-2474-8-60 · 1.72 Impact Factor
  • Bernd Loos · Raymund E Horch ·

    Plastic and Reconstructive Surgery 07/2006; 117(7):129e-132e. DOI:10.1097/01.prs.0000218179.86916.ff · 2.99 Impact Factor
  • B Loos · J Kopp · U Kneser · M Weyand · R E Horch ·
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    ABSTRACT: Since its introduction in 1997 the vacuum assisted closure therapy has gained widespread and is for its indications international accepted. It is also well established in the treatment of sternal infections a dreaded complication after median sternotomy in cardiac surgery. The well known positive effects of the vacuum therapy act as a dignified cleaning procedure between debridement and plastic coverage or as a temporarily closure method if the first debridement was properly not sufficient. Between January 2003 and December 2005 twenty eight patients with advanced sternal infection after median sternotomy were treated by radical debridement, vacuum assisted closure therapy and definitive plastic coverage by muscle flaps. In this article three patients are exemplarily introduced. In all patients a sufficient plastic coverage was achieved after radical debridement an vacuum assisted closure therapy. The patients received a pedicaled muscle flap. Stable wound condition with no signs of a recurrent sternal infection were observed in all patients. Vacuum assisted closure therapy acts as a link between radical Debridement and definitive plastic coverage in prolonged sternal infection after median sternotomy. Before the invention of V.A.C.(R) dressing changes were obliged every day in patients with deep sternal infection. The V.A.C.(R) therapy reduces the frequency of this painful dressing changes significantly and on this behalf makes life more comfortable for this mostly multi-morbid patients.
    Zentralblatt für Chirurgie 05/2006; 131 Suppl 1:S124-8. · 1.05 Impact Factor
  • A Grimm · B Loos · R E Horch ·
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    ABSTRACT: Extensively undermined wound cavities represent a common surgical problem. By a modified vacuum therapy the healing of such wounds can be accelerated. Based on our experience in selected cases with wound healing disorders or extremely undermined wounds following degloving injuries or abscess formations the application of topical negative pressure therapy to fix wound margins to the wound ground while at the same time allowing exudates emission with additional drainages is described. In 5 patients we were able to demonstrate the efficacy of vacuum dressing system described here with successful and lasting adaptation of the wound margins to the defect. All wounds were brought to permanent healing. Extensive tissue degloving and wound healing disorders after excessive tissue mobilization during plastic surgical defect coverage can be treated successfully with topical negative pressure therapy (TNP). Whereas longterm complete conventional polyurethane foam lining of wound cavities is an effective method and may be necessary in special situations, the application of TNP can lead to a firm adhesion of wound margins in extensive subcutaneous or epi-fascial wounds to the undersurface. To avoid exudate formation in the adjoining tissue TNP can be effectively optimized by the placement of drainage tubes into the surrounding tissue.
    Zentralblatt für Chirurgie 05/2006; 131 Suppl 1:S19-23. · 1.05 Impact Factor
  • J Kopp · A D Bach · U Kneser · B Loos · R E Horch ·
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    ABSTRACT: Arterialized venous flaps are normally raised from the anterior and distal third of the forearm by integration of a venous pathway. Basically, they are composed of skin, subcutaneous tissue, and subdermal venous plexus. Following transposition to the recipient site one vein is linked to a nourishing artery while the other veins are connected to one or more regional veins. The atypical blood perfusion and the delayed opening of intervenous shunts may result in edema, epidermolysis, or even some degree of skin necrosis that disappear during subsequent treatment. We report the salvage of an atypically raised oversized arterialized venous flap for total soft tissue reconstruction in a complete avulsion of a thumb. By applying V.A.C. therapy atypical perfusion and early intervenous shunt formation was treated successfully, resulting in stable healing and survival of the flap.
    Zentralblatt für Chirurgie 05/2006; 131 Suppl 1:S3-6. · 1.05 Impact Factor
  • J. Kopp · A. Bach · U. Kneser · B. Loos · R. Horch ·

    Zentralblatt für Chirurgie 04/2006; 131:3-6. DOI:10.1055/s-2006-921488 · 1.05 Impact Factor
  • A. Grimm · B. Loos · R. Horch ·

    Zentralblatt für Chirurgie 04/2006; 131:19-23. DOI:10.1055/s-2006-921426 · 1.05 Impact Factor
  • B. Loos · J. Kopp · U. Kneser · M. Weyand · R. Horch ·

    Zentralblatt für Chirurgie 04/2006; 131(S 1):124-128. DOI:10.1055/s-2006-921425 · 1.05 Impact Factor
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    ABSTRACT: The relationship between clinical course and changes of laboratory findings in patients with high-voltage electrical burns with regard to creatinine kinase activity was analyzed in order to determine the value of this prognostic parameter with regard to patients survival and risk of limb amputation. In a retrospective study 42 patients with electrical burns were reviewed. CK serum levels were determined every day during the first 10 days following submission. Analysis of data revealed a relation between strongly elevated CK levels and patients risk of limb amputation and mortality. Although further research is necessary, there is strong evidence that the amount of burned body surface area does not directly correlate with the true extent of tissue damage caused by high tension injuries. Our data suggest that the degree of muscle tissue violation corresponds with the initial excess of creatinine kinase levels in blood serum. This may be an additional factor to support the decision for early surgical decompression of electrically burned extremities and aggressive surgical management of the high-voltage burn victim. Furthermore, it may provide a prognostic parameter for the clinical outcome of these patients.
    Burns 12/2004; 30(7):680-3. DOI:10.1016/j.burns.2004.05.008 · 1.88 Impact Factor
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    ABSTRACT: Peripheral arteriovenous (AV) malformations may present with a plethora of clinical symptoms such as paradoxical emboli, severe hypertension, nerve palsies or pain syndromes. Hemodynamically compromising lesions of the limbs are rare and involve high-flow AV fistulae with marked arteriovenous shunting. A female patient with a high-flow arteriovenous malformation of the left upper-extremity is presented. Preoperative assessment by magnetic resonance imaging and magnetic resonance angiography together with a color duplex investigation revealed a hemodynamically compromising arteriovenous fistula (shunt volume 30%) involving the entire left forearm and hand. The lesion was managed operatively with a combination of selective ligation and sclerosing of the feeding artery. There was marked clinical improvement postoperatively. Magnetic resonance angiography confirmed a drastic decrease in the number and size of the arteriovenous fistulae. The shunt ratio was diminished to 10%. Although surgical treatment of arteriovenous fistulae is known to have high complication and recurrence rates, thorough preoperative planning and intraoperative monitoring, can supply the prerequisites for a favorable outcome in severe symptomatic cases.
    European Journal of Plastic Surgery 07/2004; 27(4):204-209. DOI:10.1007/s00238-004-0654-6
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    ABSTRACT: Arterialized venous soft tissue flaps are defined as tissue portions usually harvested from the anterior and distal third of the forearm over a venous pathway to be transplanted to another recipient area. Basically, they are composed of skin, subcutaneous tissue, and subdermal venous plexus. At the recipient site flaps are perfused by a nourishing artery while the other veins are connected to one or more regional veins. The retrograde blood perfusion often results in edema, temporary epidermolysis, or even some degree of skin necrosis that disappear during subsequent treatment. To circumvent these drawbacks grafting of arterialized flaps was combined with local application of vacuum to overcome the venous initial stasis, resulting in improved healing and survival of these flaps.
    Zentralblatt für Chirurgie 06/2004; 129 Suppl 1(1):S82-4. DOI:10.1055/s-2004-822617 · 1.05 Impact Factor
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    ABSTRACT: Modern multimodal concepts of complex reconstructions and advanced wound management enlarge strategies for surgical oncological therapies. One of the mainstays of classical surgical therapy in case of exposed alloplastic materials in irradiated wounds was to remove the foreign body due to the risk of infection. This loss of integrity and function of the contaminated host bed was to allow wound healing and closure. We report the management of a 56-year-old female patient who developed a lyomyosarcoma at her left shoulder girdle 8 years after radiation of the left thorax because of breast cancer. After radical tumor resection and exarticulation of her left arm in the shoulder joint a necrosis of the soft tissue envelope developed, leading to an exposed alloplastic mesh. Staged debridement and continuous application of negative pressure was performed three times. Ultimate plastic coverage was performed by means of a pectoralis myocutaneous island flap from the other breast. After staged debridement and repeated vacuum application excellent wound cleaning, neovascularisation, wound contraction and formation of granulation tissue within the previously irradiated tissue zone was observed. Until fourteen months postoperative wound coverage remained stable and no signs of infection were observed. By means of negative pressure therapy even in radiated wounds excellent wound cleaning and sufficient formation of granulation tissue can be achieved. In some cases negative pressure therapy together with staged debridement allows reintegration of exposed and therefore potentially contaminated alloplastic meshes into new formed granulation tissue in radiated wounds respectively radiation ulcers. Thus leading to the possibility of ultimate plastic coverage.
    Zentralblatt für Chirurgie 06/2004; 129 Suppl 1(1):S133-6. DOI:10.1055/s-2004-822642 · 1.05 Impact Factor
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    ABSTRACT: In 1920 Braun described a technique of skin grafting particularly designed for areas where shearing forces, high pressure and extensive secretion cause repetitive loss of conventionally transplanted skin. During the last 10 years we successfully used this technique when impaired wound healing was encountered due to various reasons. Clinical examples of application and results are presented. By combining this technique with vacuum therapy, formation of granulation tissue can be accelerated, thereby resulting in successful transplantation of problematic and therapy resistant wounds.
    Zentralblatt für Chirurgie 06/2004; 129 Suppl 1:S129-32. DOI:10.1055/s-2004-822649 · 1.05 Impact Factor