norman waterhouse - Academia.edu (original) (raw)

Papers by norman waterhouse

Research paper thumbnail of Student views on continuous assessment at Birmingham University Medical School

BMJ, 1975

Student opinion on the system of continuous assessment used at Birmingham Medical School was samp... more Student opinion on the system of continuous assessment used at Birmingham Medical School was sampled by distributing questionnaires to 621 students in the first four years of the course; 482 questionnaires (78°o) were returned. Many comments and criticisms of the system were received but the vast majority of students (92/O) said they preferred the present style of assessment to conventional final examinations. These criticisms are discussed and recommendations are made to improve the existing scheme.

Research paper thumbnail of Prediction of postoperative urinary tract infection in men undergoing cardiac surgery by preoperative measurement of urine flow

Research paper thumbnail of The transpelvic rectus abdominis flap: its use in the reconstruction of extensive perineal defects

Annals of the Royal College of Surgeons of England, 1995

We present our experience of rectus abdominis flaps tunnelled transpelvically in 12 patients (mea... more We present our experience of rectus abdominis flaps tunnelled transpelvically in 12 patients (mean age 48.4 years, range 19-72 years) with a diverse range of surgical pathologies, the largest reported series to date. Satisfactory obturation of the pelvic cavity and control of radionecrotic tissue sepsis was achieved. Average duration of hospital stay was 17.6 days with a mean follow-up of 18.7 months. The rectus abdominis flap provides a significant volume of well-vascularised tissue, ideally suited for reconstruction of extensive perineal defects after tumour ablative surgery. When tunnelled transpelvically, the flap is unique in its ability to obturate the pelvic inlet, eliminating the distressing complication of perineal bowel herniation and allowing for perineal radiotherapy.

Research paper thumbnail of Department of Health withdraws variant CJD transmission recommendations for single-use instruments

British Journal of Plastic Surgery, 2002

Research paper thumbnail of A Novel Application of the Haemostatic Net in Aesthetic Breast Surgery: A Preliminary Report

Aesthetic Surgery Journal, 2022

Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast s... more Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast surgery, particularly with poor quality skin, when downsizing implants and in cases where patients will not accept additional mastopexy scars. Most techniques described in these cases rely on internal suturing and capsulorrhaphy, which can lack precision in tailoring the skin over the internal pocket. Objectives The authors present their experience using the haemostatic net to help address a range of challenging breast cases in their practices. Methods A multi-centre retrospective analysis of patients undergoing aesthetic and reconstructive breast surgery between 2019 and 2021 was conducted. A database was established to record patient demographics, indications for surgery, surgical technique and complications. Following capsulorrhaphy, the haemostatic net was applied in as many rows as required with monofilament sutures and removed 3-7 days post-operatively. Results Twenty-four women (23...

Research paper thumbnail of Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic

Aesthetic Surgery Journal

Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, inc... more Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. We carried out a national, prospective data collection of the first aesthetic plastic surgery procedures carried out during the COVID-19 pandemic in the United Kingdom. Objectives Our aim was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic. Methods Over a 6-week period from June 15 th-August 2 nd, 2020, data was collected using a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for the audit period of 14 days post-surgery. Results Our results demonstrated that none of the 371 patients audited whom underwent aesthetic surgical procedures developed any symptoms of COVID-19-related illness and none required treatment for any subsequent respiratory illness. Conclusions We f...

Research paper thumbnail of Periorbital, lower face, and neck

Oxford Textbook of Plastic and Reconstructive Surgery

Facial ageing occurs as a consequence of multifactorial changes in both the external skin and und... more Facial ageing occurs as a consequence of multifactorial changes in both the external skin and underlying tissues. The ageing process may vary dramatically between individual patients and is thus influenced by genetic factors. When assessing the ageing face it is important to consider the skeletal architecture, the soft tissue layers including the anterior fat pads, the osseocutaneous ligament anchors, and finally the overlying skin. Assessment of the external skin incorporates factors such as dermal thinning, solar damage, lifestyle effects such as smoking, and Fitzpatrick skin type. Surgical correction of facial ageing attempts to reverse both gravitational change of soft tissues and also to restore volume loss. There are a variety of methods used to divide the face into regions, but for the purpose of this chapter, the surgical management of facial ageing will be separated into three anatomical areas: (1) upper face, including the upper eyelids, eyebrows, and forehead; (2) midface...

Research paper thumbnail of Preliminary Report of a National Audit of Aesthetic Surgery Practice in the United Kingdom During the COVID-19 Pandemic

Aesthetic Surgery Journal

Research paper thumbnail of Regenerative Medicine, Stem Cell Therapies, and Platelet-Rich Plasma: Where Is the Evidence?

Aesthetic Surgery Journal

Research paper thumbnail of A review of five years experience of digital replantation

Plastic and Reconstructive Surgery

A five year experience of digital replantalion is reviewed. The crude survival rate of50%/o is lo... more A five year experience of digital replantalion is reviewed. The crude survival rate of50%/o is lower lhan thal reported in olher comparable

Research paper thumbnail of The clavicular head of the pectoralis major musculocutaneous free flap

Plast Reconstr Surg, 1987

A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap i... more A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap is comprised of the clavicular head of pectoralis major muscle with overlying skin. It is also possible to harvest vascularised clavicular bone with the flap. The vascular anatomy is reviewed and the technique of raising the flap described. Its clinical application is illustrated with five cases. Four of these were intra-oral reconstructions and the fifth a composite osteo-musculocutaneous flap to a lower limb following trauma.

Research paper thumbnail of Nasal tip necrosis : an unusual presentation of rheumatoid vasculitis

Clinical Rheumatology, Feb 23, 2007

Research paper thumbnail of Les complications des liftings

Ann Chir Plast Esthet, 2004

Research paper thumbnail of Use of Platelet Preparations in Facial Rejuvenation and Wound Healing Remains Unproven

Aesthetic Plastic Surgery, 2016

There is growing interest in the use of platelet derivatives in facial aesthetic surgery and woun... more There is growing interest in the use of platelet derivatives in facial aesthetic surgery and wound healing. Sclafani et al. have concluded from their review of the literature that the vast majority of studies show a significant and measurable effect on facial aesthetic outcomes with the use of these platelet preparations. We suggest that an alternative review of the same literature may well have produced a different set of conclusions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Research paper thumbnail of One Stage Thumb Reconstruction Using a Previously Injured Little Finger from the Contralateral Hand

J Hand Surg Brit Eur Vol, 1985

Research paper thumbnail of Comparison of a modified minimally invasive with an open technique following harvesting of cancellous iliac bone

European Journal of Plastic Surgery, 2005

The open technique for obtaining cancellous iliac bone is often used for the repair of the cleft ... more The open technique for obtaining cancellous iliac bone is often used for the repair of the cleft defects of the alveolus. However, recently a number of authors have stated that the morbidity and long-term cosmesis are unacceptable. The results of a long-term retrospective study of the donor sites in 47 patients who underwent the open technique are discussed. No major long term morbidity was found but a number of minor, troublesome symptoms were revealed in 36% including, itching, discomfort, hypertrophic scars and anaesthesia. The scar was considered unacceptable with a mean of 60 mm length and 4 mm wide. A minimally invasive technique is described that produces an adequate volume of milled bone, between 1.5 mls and 4 mls, (equivalent to 3-8 mls of unmilled bone). Discomfort was minimal postoperatively, and both gait and scar showed a highly favourable outcome. This unit is no longer employing the open technique for cancellous iliac bone removal.

Research paper thumbnail of Facial Plastic Surgery Clinics of North America: Multicultural Aesthetics in Facial Plastic Surgery

Aesthetic Surgery Journal, 2015

Research paper thumbnail of Statistical Review of 1078 Consecutive Facelifts: Lessons for the Prevention of Hematoma

Seminars in Plastic Surgery, 2002

Research paper thumbnail of Reconstruction after radical hemimaxillectomy using a free multidimensional latissimus dorsi myocutaneous flap

European Journal of Plastic Surgery, 1986

A series of safe, simple and single-staged reconstructions following radical resection of maxilla... more A series of safe, simple and single-staged reconstructions following radical resection of maxillary antral carcinomas with soft tissue involvement is presented. These reconstructions were performed using free triple-folded latissimus dorsi myocutaneous flaps revascularised via the facial vessels. This technique can be safely used in irradiated patients and, when indicated, allows for the administration of early postoperative radiotherapy, thus improving the potential cure rate. Advantages and disadvantages of the technique are discussed.

Research paper thumbnail of Versatility of diced cartilage-fascia grafts in dorsal nasal augmentation

Plastic and reconstructive surgery, 2007

Augmentation of the nasal dorsum using autologous cartilage remains an exacting task in rhinoplas... more Augmentation of the nasal dorsum using autologous cartilage remains an exacting task in rhinoplasty. Precise, long-term control over graft contour and alignment can be difficult to achieve. In an attempt to alleviate these problems, the use of diced cartilage wrapped in a supportive sleeve has recently seen a resurgence of interest. The Turkish delight technique uses Surgicel as the sleeve material, whereas Daniel and Calvert have proposed autologous fascia. The objective of this study was to assess the efficacy and reliability of diced cartilage-fascia grafts in the treatment of dorsal nasal volume deficiencies. Over a 2-year period, 20 adult patients underwent nasal augmentation using diced cartilage-fascia grafts. The indications for dorsal grafting were congenital saddling, racial refinement, or iatrogenic or posttraumatic deformities. Apart from one infection, all of the hybrid grafts retained their original volume and had not undergone resorption by a mean time of 16 months po...

Research paper thumbnail of Student views on continuous assessment at Birmingham University Medical School

BMJ, 1975

Student opinion on the system of continuous assessment used at Birmingham Medical School was samp... more Student opinion on the system of continuous assessment used at Birmingham Medical School was sampled by distributing questionnaires to 621 students in the first four years of the course; 482 questionnaires (78°o) were returned. Many comments and criticisms of the system were received but the vast majority of students (92/O) said they preferred the present style of assessment to conventional final examinations. These criticisms are discussed and recommendations are made to improve the existing scheme.

Research paper thumbnail of Prediction of postoperative urinary tract infection in men undergoing cardiac surgery by preoperative measurement of urine flow

Research paper thumbnail of The transpelvic rectus abdominis flap: its use in the reconstruction of extensive perineal defects

Annals of the Royal College of Surgeons of England, 1995

We present our experience of rectus abdominis flaps tunnelled transpelvically in 12 patients (mea... more We present our experience of rectus abdominis flaps tunnelled transpelvically in 12 patients (mean age 48.4 years, range 19-72 years) with a diverse range of surgical pathologies, the largest reported series to date. Satisfactory obturation of the pelvic cavity and control of radionecrotic tissue sepsis was achieved. Average duration of hospital stay was 17.6 days with a mean follow-up of 18.7 months. The rectus abdominis flap provides a significant volume of well-vascularised tissue, ideally suited for reconstruction of extensive perineal defects after tumour ablative surgery. When tunnelled transpelvically, the flap is unique in its ability to obturate the pelvic inlet, eliminating the distressing complication of perineal bowel herniation and allowing for perineal radiotherapy.

Research paper thumbnail of Department of Health withdraws variant CJD transmission recommendations for single-use instruments

British Journal of Plastic Surgery, 2002

Research paper thumbnail of A Novel Application of the Haemostatic Net in Aesthetic Breast Surgery: A Preliminary Report

Aesthetic Surgery Journal, 2022

Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast s... more Background Obtaining optimum breast aesthetics can be challenging in secondary aesthetic breast surgery, particularly with poor quality skin, when downsizing implants and in cases where patients will not accept additional mastopexy scars. Most techniques described in these cases rely on internal suturing and capsulorrhaphy, which can lack precision in tailoring the skin over the internal pocket. Objectives The authors present their experience using the haemostatic net to help address a range of challenging breast cases in their practices. Methods A multi-centre retrospective analysis of patients undergoing aesthetic and reconstructive breast surgery between 2019 and 2021 was conducted. A database was established to record patient demographics, indications for surgery, surgical technique and complications. Following capsulorrhaphy, the haemostatic net was applied in as many rows as required with monofilament sutures and removed 3-7 days post-operatively. Results Twenty-four women (23...

Research paper thumbnail of Aesthetic Surgery Practice Resumption in the United Kingdom During the COVID-19 Pandemic

Aesthetic Surgery Journal

Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, inc... more Background The global COVID-19 pandemic has significantly impacted all aspects of healthcare, including the delivery of elective aesthetic surgery practice. We carried out a national, prospective data collection of the first aesthetic plastic surgery procedures carried out during the COVID-19 pandemic in the United Kingdom. Objectives Our aim was to explore the challenges aesthetic practice is facing and to identify if any problems or complications arose from carrying out aesthetic procedures during the COVID-19 pandemic. Methods Over a 6-week period from June 15 th-August 2 nd, 2020, data was collected using a proforma for aesthetic plastic surgery cases. All patients had outcomes recorded for the audit period of 14 days post-surgery. Results Our results demonstrated that none of the 371 patients audited whom underwent aesthetic surgical procedures developed any symptoms of COVID-19-related illness and none required treatment for any subsequent respiratory illness. Conclusions We f...

Research paper thumbnail of Periorbital, lower face, and neck

Oxford Textbook of Plastic and Reconstructive Surgery

Facial ageing occurs as a consequence of multifactorial changes in both the external skin and und... more Facial ageing occurs as a consequence of multifactorial changes in both the external skin and underlying tissues. The ageing process may vary dramatically between individual patients and is thus influenced by genetic factors. When assessing the ageing face it is important to consider the skeletal architecture, the soft tissue layers including the anterior fat pads, the osseocutaneous ligament anchors, and finally the overlying skin. Assessment of the external skin incorporates factors such as dermal thinning, solar damage, lifestyle effects such as smoking, and Fitzpatrick skin type. Surgical correction of facial ageing attempts to reverse both gravitational change of soft tissues and also to restore volume loss. There are a variety of methods used to divide the face into regions, but for the purpose of this chapter, the surgical management of facial ageing will be separated into three anatomical areas: (1) upper face, including the upper eyelids, eyebrows, and forehead; (2) midface...

Research paper thumbnail of Preliminary Report of a National Audit of Aesthetic Surgery Practice in the United Kingdom During the COVID-19 Pandemic

Aesthetic Surgery Journal

Research paper thumbnail of Regenerative Medicine, Stem Cell Therapies, and Platelet-Rich Plasma: Where Is the Evidence?

Aesthetic Surgery Journal

Research paper thumbnail of A review of five years experience of digital replantation

Plastic and Reconstructive Surgery

A five year experience of digital replantalion is reviewed. The crude survival rate of50%/o is lo... more A five year experience of digital replantalion is reviewed. The crude survival rate of50%/o is lower lhan thal reported in olher comparable

Research paper thumbnail of The clavicular head of the pectoralis major musculocutaneous free flap

Plast Reconstr Surg, 1987

A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap i... more A new free flap is described based on the deltoid vessels of the acromiothoracic axis. The flap is comprised of the clavicular head of pectoralis major muscle with overlying skin. It is also possible to harvest vascularised clavicular bone with the flap. The vascular anatomy is reviewed and the technique of raising the flap described. Its clinical application is illustrated with five cases. Four of these were intra-oral reconstructions and the fifth a composite osteo-musculocutaneous flap to a lower limb following trauma.

Research paper thumbnail of Nasal tip necrosis : an unusual presentation of rheumatoid vasculitis

Clinical Rheumatology, Feb 23, 2007

Research paper thumbnail of Les complications des liftings

Ann Chir Plast Esthet, 2004

Research paper thumbnail of Use of Platelet Preparations in Facial Rejuvenation and Wound Healing Remains Unproven

Aesthetic Plastic Surgery, 2016

There is growing interest in the use of platelet derivatives in facial aesthetic surgery and woun... more There is growing interest in the use of platelet derivatives in facial aesthetic surgery and wound healing. Sclafani et al. have concluded from their review of the literature that the vast majority of studies show a significant and measurable effect on facial aesthetic outcomes with the use of these platelet preparations. We suggest that an alternative review of the same literature may well have produced a different set of conclusions. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Research paper thumbnail of One Stage Thumb Reconstruction Using a Previously Injured Little Finger from the Contralateral Hand

J Hand Surg Brit Eur Vol, 1985

Research paper thumbnail of Comparison of a modified minimally invasive with an open technique following harvesting of cancellous iliac bone

European Journal of Plastic Surgery, 2005

The open technique for obtaining cancellous iliac bone is often used for the repair of the cleft ... more The open technique for obtaining cancellous iliac bone is often used for the repair of the cleft defects of the alveolus. However, recently a number of authors have stated that the morbidity and long-term cosmesis are unacceptable. The results of a long-term retrospective study of the donor sites in 47 patients who underwent the open technique are discussed. No major long term morbidity was found but a number of minor, troublesome symptoms were revealed in 36% including, itching, discomfort, hypertrophic scars and anaesthesia. The scar was considered unacceptable with a mean of 60 mm length and 4 mm wide. A minimally invasive technique is described that produces an adequate volume of milled bone, between 1.5 mls and 4 mls, (equivalent to 3-8 mls of unmilled bone). Discomfort was minimal postoperatively, and both gait and scar showed a highly favourable outcome. This unit is no longer employing the open technique for cancellous iliac bone removal.

Research paper thumbnail of Facial Plastic Surgery Clinics of North America: Multicultural Aesthetics in Facial Plastic Surgery

Aesthetic Surgery Journal, 2015

Research paper thumbnail of Statistical Review of 1078 Consecutive Facelifts: Lessons for the Prevention of Hematoma

Seminars in Plastic Surgery, 2002

Research paper thumbnail of Reconstruction after radical hemimaxillectomy using a free multidimensional latissimus dorsi myocutaneous flap

European Journal of Plastic Surgery, 1986

A series of safe, simple and single-staged reconstructions following radical resection of maxilla... more A series of safe, simple and single-staged reconstructions following radical resection of maxillary antral carcinomas with soft tissue involvement is presented. These reconstructions were performed using free triple-folded latissimus dorsi myocutaneous flaps revascularised via the facial vessels. This technique can be safely used in irradiated patients and, when indicated, allows for the administration of early postoperative radiotherapy, thus improving the potential cure rate. Advantages and disadvantages of the technique are discussed.

Research paper thumbnail of Versatility of diced cartilage-fascia grafts in dorsal nasal augmentation

Plastic and reconstructive surgery, 2007

Augmentation of the nasal dorsum using autologous cartilage remains an exacting task in rhinoplas... more Augmentation of the nasal dorsum using autologous cartilage remains an exacting task in rhinoplasty. Precise, long-term control over graft contour and alignment can be difficult to achieve. In an attempt to alleviate these problems, the use of diced cartilage wrapped in a supportive sleeve has recently seen a resurgence of interest. The Turkish delight technique uses Surgicel as the sleeve material, whereas Daniel and Calvert have proposed autologous fascia. The objective of this study was to assess the efficacy and reliability of diced cartilage-fascia grafts in the treatment of dorsal nasal volume deficiencies. Over a 2-year period, 20 adult patients underwent nasal augmentation using diced cartilage-fascia grafts. The indications for dorsal grafting were congenital saddling, racial refinement, or iatrogenic or posttraumatic deformities. Apart from one infection, all of the hybrid grafts retained their original volume and had not undergone resorption by a mean time of 16 months po...