Gerald L Sparkes's research while affiliated with Dalhousie University and other places

Publications (6)

Article
The objective of zygoma fracture repair is to restore preinjury function and appearance. The optimal surgical technique represents a balance between accurate fracture reduction and soft-tissue morbidity. Fifty patients were eligible for review after treatment for isolated simple zygoma fractures using a combination of Gillies elevation and percutan...
Article
The elective use of low-dose epinephrine in hand surgery has allowed for the performance of simple operative procedures with tourniquet-free pure local anesthesia (the wide-awake approach). The absence of general anesthesia or sedation has, in turn, allowed for the observation of how quickly the sensorimotor cortex adapts following procedures such...
Article
To examine prospectively the incidence of digital infarction and phentolamine rescue in a large series of patients in whom local anesthesia with adrenaline was injected electively into the hand and fingers. There continues to be a commonly held belief that epinephrine injection is contraindicated in the finger despite a lack of valid evidence to su...
Article
Although clinical observation is the gold standard, the ideal free flap monitoring device has not been identified. The purpose of the present study was to review the first 14 months of experience using an implantable 20-MHz ultrasonic Doppler probe to monitor the microvascular anastamoses of free tissue transfers. Twenty-five flaps in 23 patients,...
Article
Reported beneficial effects of presurgical maxillary orthopedics in cleft lip include reduction of the cleft width, alignment of the maxillary segments, elevation of the alar base on the cleft side, diminished need for alveolar bone grafting and lip closure without tension. Possible adverse effects of presurgical maxillary orthopedics include tooth...
Article
Three cases of the successful salvage of ring finger degloving injuries using medicinal leeches are described. In each case, good arterial inflow was present in the avulsed soft tissue, but venous insufficiency would have prevented viability. If venous microvascular repair failed, venous return could be temporarily provided by leeches, applied to t...

Citations

... The FPS device can be wrapped around natural blood vessels or synthetic grafts at the time of surgery and remain implanted without constriction if the material is more flexible than the host vessel or graft [18]. The silicone-based cuffs of temporary Doppler flow probes, for example, remain permanently wrapped around blood vessels even after the monitoring leads are removed [19]. Use of these invasive devices is justified by the surgical environment in which vascular repairs and graft implantations are performed. ...
... Increasing evidence has supported the switch from general anesthesia to wide-awake flexor tendon repair. [16][17][18] This WALANT (wide-awake, local anesthesia, no tourniquet) technique utilizes locally injected lidocaine and epinephrine for anesthesia and hemostasis without using a tourniquet. This allows patients to actively move the tendon while the surgeon examines and makes final adjustments before the skin is ultimately closed. ...
... 34 Retraining donor motor units after tendon transfers, before the advent of WALANT, was considered a lengthy rehabilitation process. 37 Bezuhly et al. and other investigators have found that the cognitive activation of the donor unit is immediate when appropriate synergistic muscles are used. 34,37,38 In addition, under wide-awake conditions, the muscle tension, repair strength and excursion can immediately be assessed and altered if necessary, and the patients can witness the effect of the tendon transfer immediately. ...
... Bezuhly M et al., have shown in their study that Gillies elevation combined with percutaneous Kirschner wire fixation provides facial contour restoration that is not significantly different from that of open reduction and internal fixation, with less soft-tissue morbidity. The technique is safe, easy to learn, and easy to perform, and should be considered in cases of isolated simple zygoma fractures [32]. In most countries, traffic accidents are the leading cause of orbital fractures [33]. ...