M Russ

Universität Ulm, Ulm, Baden-Wuerttemberg, Germany

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Publications (11)6.6 Total impact

  • [Show abstract] [Hide abstract]
    ABSTRACT: Between 1 October 1996 and 31 December 1998 123 patients (74 men, 43 women) suffering from acute (n = 17) and chronic (n = 21) infections and chronic wounds (n = 85) were treated with sterile maggots (Lucilia sericata). In most patients the indication for the use of maggots was a failure to respond to standard therapy. Healing occurred in all patients with acute infections, and chronic infections showed excellent short-term results. In chronic wounds disturbances of healing in diabetics responded best to maggot therapy, the etiologically inhomogeneous group of leg ulcers asked for a polypragmatic approach, and the worst results were seen in chronic arterial occlusive disease (stage 4). Our limited experience with "biosurgery", biased selection of patients, and lack of late results reduce the significance of our data; nevertheless, sterile maggots seem to be an astonishingly workable tool for solving problems in surgical wound treatment.
    Der Chirurg 12/1999; 70(11):1340-6. · 0.52 Impact Factor
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    ABSTRACT: Vom 1.10.96 bis zum 31.12.98 wurden 123 Patienten (74 Männer, 43 Frauen) mit akuten (n = 17) und chronischen (n = 21) Infektionen sowie chronischen Wunden (n = 85) mit sterilen Fliegenlarven (Lucilia sericata) zunächst ausschließlich stationär, später auch ambulant behandelt. Es handelte sich vorwiegend um bislang therapieresistente Wunden. Die akuten Infekte kamen alle zur Ausheilung, bei den chronischen Infektionen zeigten sich überzeugende Anfangserfolge. Bei den chronischen Wunden erbrachten die diabetischen Wundheilungsstörungen die besten Ergebnisse, bei den ätiologisch heterogenen Ulcera cruris führte ein eher polypragmatischer Therapieansatz zum Erfolg. Die arterielle Verschlußkrankheit (AVK) im Stadium 4 zeigte die meisten Therapieversager. Begrenzte Erfahrung mit der „Biochirurgie“ verbunden mit hochgradiger Patientenselektion und kurzer Nachbeobachtungsdauer relativieren unsere Behandlungsergebnisse; dennoch ist die Therapie mit sterilen Fliegenlarven ein neuer Hoffnungsträger für Problemlösungen im Gesamtkonzept der chirurgischen Wundbehandlung. Between 1 October 1996 and 31 December 1998 123 patients (74 men, 43 women) suffering from acute (n = 17) and chronic (n = 21) infections and chronic wounds (n = 85) were treated with sterile maggots (Lucilia sericata). In most patients the indication for the use of maggots was a failure to respond to standard therapy. Healing occurred in all patients with acute infections, and chronic infections showed excellent short-term results. In chronic wounds disturbances of healing in diabetics responded best to maggot therapy, the etiologically inhomogeneous group of leg ulcers asked for a polypragmatic approach, and the worst results were seen in chronic arterial occlusive disease (stage 4). Our limited experience with “biosurgery”, biased selection of patients, and lack of late results reduce the significance of our data; nevertheless, sterile maggots seem to be an astonishingly workable tool for solving problems in surgical wound treatment.
    Der Chirurg 10/1999; 70(11):1340-1346. · 0.52 Impact Factor
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    ABSTRACT: The BMW-concept (Biosurgical-Mechanical-Wound treatment) is a effective supplement of already existing options of wound treatment. Based on the established principles of septic surgery vacuum sealing, instillation vacuum sealing and the application of sterile maggots optimize the treatment of diabetic foot ulcers, reduce time of treatment and offers a high comfort to the patient.
    Zentralblatt für Chirurgie 02/1999; 124 Suppl 1:69-72. · 0.69 Impact Factor
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    ABSTRACT: Between 1.4.96 and 1.3.97 27 patients with acute infections of bone and soft tissues (n = 13), chronic osteomyelitis (n = 8), and chronic wounds (n = 6) were treated by using Instillation-Vacuum-Sealing. Polyvinylalcohol sponges with drainage tubes were used to cover the internal or external wound surfaces which resulted from surgical debridement. Having hermetically covered the wound with a transparent film dressing a vacuum source generated a partial vacuum in the sponge which was modified according to the type of wound between 20 and 80 kPa. Several times daily, the vacuum line was blocked and, in an alternating fashion, antiseptic or antibiotic solution instilled for 30 minutes. Then, the vacuum was reestablished and the fluids drained from the wound. Seven days later, intermittent drug instillation was stopped and there was either immediate or delayed wound closure by secondary suturing (n = 22), skin grafting (n = 3) or spontaneous epithelialization (n = 2). During a follow-up from the beginning of the instillation treatment of 4.2 (3-14) months there was one recurrency of infection in a patient with chronic osteomyelitis.
    Der Unfallchirurg 09/1998; 101(8):649-54. · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Between 1.4.96 and 1.3.97 27 patients with acute infections of bone and soft tissues (n = 13), chronic osteomyelitis (n = 8), and chronic wounds (n = 6) were treated by using Instillation-Vacuum-Sealing. Polyvinylalcohol sponges with drainage tubes were used to cover the internal or external wound surfaces which resulted from surgical debridement. Having hermetically covered the wound with a transparent film dressing a vacuum source generated a partial vacuum in the sponge which was modified according to the type of wound between 20 and 80 kPa. Several times daily, the vacuum line was blocked and, in an alternating fashion, antiseptic or antibiotic solution instilled for 30 minutes. Then, the vacuum was reestablished and the fluids drained from the wound. Seven days later, intermittent drug instillation was stopped and there was either immediate or delayed wound closure by secondary suturing (n = 22), skin grafting (n = 3) or spontaneous epithelialization (n = 2). During a follow-up from the beginning of the instillation treatment of 4,2 (3–14) months there was one recurrency of infection in a patient with chronic osteomyelitis. Vom 1.4.96 bis zum 1.3.97 wurden 27 Patienten wegen akuten Knochen- oder Weichteilinfektionen (n = 13), chronischen Osteitiden (n = 8) und chronischen Weichteilwunden (n = 6) behandelt. Mit Drainagen versehene Schwämme aus Polyvinylalkohol (Vacuseal, Polymedics) bedeckten möglichst vollständig die chirurgisch revidierte Wundoberfläche. Nach hermetischem Abdichten der Wunde mit einer transparenten Verbandsfolie (Opsite, Smith & Nephew) erzeugte eine Vakuumquelle (Pumpe, Vakuumflasche oder Wandabsaugung) über die Drainagen einen Unterdruck. Dieser lag in Abhängigkeit vom Wundtyp zwischen 20 und 80 kPa und wurde vom Schwamm großflächig auf die Wundoberfläche übertragen. Mehrfach täglich wurde die Vakuumpumpe abgestellt, abwechselnd Lavasept oder Nebacetin-Lösung in das Versiegelungssystem instilliert und nach 30minütiger Einwirkdauer durch Freigabe des Vakuums wieder vollständig abgesaugt. Nach 7 Tagen endete die intermittierende Instillationsbehandlung des Infekts und es erfolgte entweder sofort oder nach weiterer Wundkonditionierung verzögert der definitive Wundverschluß durch Sekundärnaht (n = 22), Hauttransplantation (n = 3) oder spontane Epithelisation (n = 2). Während eines Nachbeobachtungszeitraums von 4,2 (3–14) Monaten nach Beginn der Instillationsbehandlung trat bislang nur ein Infektrezidiv bei chronischer Osteitis auf.
    Der Unfallchirurg 07/1998; 101(8):649-654. · 0.64 Impact Factor
  • W Fleischmann, M K Russ, D Moch
    Der Chirurg 02/1998; 69(2):W222-32. · 0.52 Impact Factor
  • W. Fleischmann, M.K. Russ, D. Moch
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    ABSTRACT: Die morphologischen, biochemischen und immunologischen Abläufe sowie die Pathophysiologie der Wundheilung gewinnen zunehmend an klinischer Bedeutung. Die Behandlung von akut und chronisch infizierten Wunden wird durch Antibiotikaresistenzen der Bakterien immer problematischer. Mit dem Durchschnittsalter der Bevölkerung steigt unaufhaltsam auch die Inzidenz chronischer Wundheilungsstörungen. Eine wirksame Wundbehandlung ist somit gerade in einer Zeit knapper finanzieller Resourcen von besonderer medizinischer und ökonomischer Bedeutung.
    Der Chirurg 01/1998; 69(2):222-232. · 0.52 Impact Factor
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    ABSTRACT: Between 1 January 1992 and 31 July 1995, 313 patients with acute and chronic infections were treated by vacuum sealing (VS). The average duration of VS treatment was 16.7 days, and there was an average of 3.1 changes in the VS system. In acute infections (n = 203) the wounds were closed by secondary suturing (65.5%), spontaneous epithelialization (17.2%), skin grafting (12.3%) and flap transfer (2%). Six patients died (3%). Infection recurred in 3.9% and was cured by another VS treatment. Unstable scar formations (1%) were treated by free flap transfers. When compared with standard open-wound treatment, the low-cost VS technique offers great advantages with regard to hospital hygiene, patient comfort and therapeutic results.
    Der Unfallchirurg 05/1997; 100(4):301-4. · 0.64 Impact Factor
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    ABSTRACT: Vom 01.01.1992 bis zum 31.07.1995 wurden 313 Patienten mit akuten und chronischen Infektionen durch Vakuumversiegelung (VVS) behandelt. Die durchschnittliche Dauer der Versiegelungen betrug 16,7 Tage, und es erfolgten im Mittel 3,1 Wechsel des Versiegelungssystems. Der Abschluß der Behandlung bestand bei akuten Infekten (n = 203) aus Sekundärnaht (65,5%), spontaner Epithelisierung (17,2%), Hauttransplantationen (12,3%) und Lappenplastiken (2%); 6 Patienten starben (3%). Bei 3,9% traten Infektrezidive auf, die durch VVS ausbehandelt wurden. Instabile Narbenbildungen (1%) wurden durch freie mikrovaskuläre Lappen beseitigt. Die kostengünstige VVS bietet gegenüber der offenen Wundbehandlung Vorteile im Hinblick auf Krankenhaushygiene, Patientenkomfort und Behandlungsergebnis. Between 1 January 1992 and 31 July 1995, 313 patients with acute and chronic infections were treated by vacuum sealing (VS). The average duration of VS treatment was 16.7 days, and there was an average of 3.1 changes in the VS system. In acute infections (n = 203) the wounds were closed by secondary suturing (65.5%), spontaneous epithelialization (17.2%), skin grafting (12.3%) and flap transfer (2%). Six patients died (3%). Infection recurred in 3.9% and was cured by another VS treatment. Unstable scar formations (1%) were treated by free flap transfers. When compared with standard open-wound treatment, the low-cost VS technique offers great advantages with regard to hospital hygiene, patient comfort and therapeutic results.
    Der Unfallchirurg 01/1997; 100(4):301-304. · 0.64 Impact Factor
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    ABSTRACT: Between 1.6.1995 and 31.12.1995, 17 trauma defect wounds were closed by suturing in 12 patients with a median of age of 35 (11-65) years, a new type of instrument for skin stretching being used in combination with a vacuum sealing procedure. According to clinical experience, closure of the skin defect would have required skin grafting in all patients. After secondary suturing 15 wounds healed without problems, while in the case of 1 wound there was a small skin defect, which healed spontaneously. In another sutured wound a partial dehiscence occurred over the medial malleolus on the 10th postoperative day; this also healed spontaneously without further surgical measures. There were no wound infections or necroses of the wound edges. This procedure is recommended for the closure of defect wounds, as it reduces the risk of wound infections, shortens the period of treatment and avoids cosmetically and functionally inadequate skin grafts.
    Der Unfallchirurg 01/1997; 99(12):970-4. · 0.64 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: Between 1.6.1995 and 31.12.1995, 17 trauma defect wounds were closed by suturing in 12 patients with a median of age of 35 (11 – 65) years, a new type of instrument for skin stretching being used in combination with a vacuum sealing procedure. According to clinical experience, closure of the skin defect would have required skin grafting in all patients. After secondary suturing 15 wounds healed without problems, while in the case of 1 wound there was a small skin defect, which healed spontaneously. In another sutured wound a partial dehiscence occurred over the medial malleolus on the 10th postoperative day; this also healed spontaneously without further surgical measures. There were no wound infections or necroses of the wound edges. This procedure is recommended for the closure of defect wounds, as it reduces the risk of wound infections, shortens the period of treatment and avoids cosmetically and functionally inadequate skin grafts.
    Der Unfallchirurg 11/1996; 99(12):970-974. · 0.64 Impact Factor

Publication Stats

186 Citations
6.60 Total Impact Points

Institutions

  • 1996–1997
    • Universität Ulm
      • Clinic of Trauma, Hand, Plastic and Reconstructive Surgery
      Ulm, Baden-Wuerttemberg, Germany