Keith Poskitt
Charing Cross Hospital
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Featured researches published by Keith Poskitt.
BMJ | 1987
Keith Poskitt; A H James; E R V Lloyd-Davies; J Walton; Charles McCollum
Chronic venous ulcers are common, and even with effective compression or elevation large ulcers may take months to heal. Pinch skin grafting may allow healing from epithelial islands throughout the surface area of the ulcer, and a prospective randomised trial was therefore conducted comparing this treatment with porcine dermis dressings. Most patients were treated as outpatients, 25 ulcers being randomised to treatment with pinch skin grafts and 28 to treatment with porcine dermis. Though the groups were well matched, the mean healing rate in the first week was 15 cm2 for pinch skin grafts compared with 3.5 cm2 with porcine dermis (p less than 0.02). By life table analysis 64% of ulcers treated by pinch grafts were healed at six weeks and 74% by 12 weeks compared with 29% and 46% of ulcers, respectively, treated with porcine dermis dressings (chi2 = 4.1; p less than 0.05). All ulcers that failed to heal within 12 weeks included an area posterior to the medial malleolus, where local compression may have been inadequate. Pinch skin grafting improves the rate of healing in large venous ulcers and is a simple technique that may be performed as an outpatient procedure under local anaesthesia.
Angiology | 1987
Keith Poskitt; Mark N. Payne; I. F. Lane; C. N. McCollum
Multiple pulmonary emboli are recognized to be the cause of progressive pulmonary failure. In these patients, the source of emboli may be difficult to detect, even by venography. The authors describe the use of autologous Indium 111-labeled platelets to locate the origin in a patient with progressing right heart failure.
Vascular Surgery | 1985
I. F. Lane; Keith Poskitt; M Sinclair; C. N. McCollum
Thrombus formation within arterial aneurysms may lead to embolisation and distal ischaemia. We have investigated the use of 111-indium labelled plate lets in the diagnosis of atherosclerotic and false aneurysms. Autologous platelets labelled with 111-indium oxine were injected into patients with eleven proven aneurysms (8 atherosclerotic, 3 false) . Gamma camera imaging performed be tween 24 and 72 hours later was positive for 10 of the aneurysms. In every case there was increased uptake of label over the aneurysm when compared to undis eased blood vessels (p < 0.05). Most aneurysms could be demonstrated within 24 hours of labelling platelets. 111-indium labelled platelets may prove useful in identifying the source of peripheral arterial emboli.
Archive | 1986
Keith Poskitt; Edward Lloyd-Davies; Alan James; C. N. McCollum
Skin grafting is commonly used in the treatment of burns, venous and ischaemic ulceration and post-operative wound defects. Most skin grafting can adequately be performed with the use of free skin grafts which can be broadly categorised into whole and split skin grafts. The use of pinch skin grafts (Fig 1) which are in effect whole skin grafts centrally and split skin grafts peripherally are more1,2 frequently being used for the treatment of venous ulceration . It is well described that the donor sites from which skin grafts are obtained are the source of more discomfort than the recipient site. This discomfort is caused by exposure of the dermal nerve endings and is diminished more rapidly it epithelialisation occurs readily. The presence of infection delays healing and can in addition cause increased discomfort. Donor site discomfort may also vary depending on the site from which the skin graft is obtained. In pinch skin grafting the donor sites more commonly used are the anterolateral and anteromedial aspect of the thigh.
Archive | 1986
I. F. Lane; Joseph Irwin; Keith Poskitt; C. N. McCollum
Platelet inhibitory therapy has applications in vascular surgery and in patients who have coronary and cerebral vascular disease1. Screening of new products to assess their ethicacy involves measurement of platelet aggregation responses to standard aggregants2 the use of artificial circuits3 and clinical trials, which are time consuming and expensive. The frequent side-effects found with the standard platelet inhibitory therapy of aspirin combined with dipyridamole4 has led for a search for new compounds. We have developed an in vivo canine model which is used to identify effective compounds on the basis of the rate of platelet accumulation and subsequent thrombosis on artificial arterial prostheses. We describe this model and its use to evaluate a new reversible cyclo-oxygenase inhibitor, indobufen (Farmitalia Carlo Erba).
Archive | 1986
Carol Miller; Keith Poskitt; I. F. Lane
Infection of surgical wounds leads to delaying healing, incisional herniation and occasionally to fatal septic complications. Contamination by micro-organisms at the time of surgery is prevented by an aseptic operating environment. Postoperatively, wounds are dressed to reduce entry of bacteria such as Staphyloccoci aureus and Eschericia coli which occur naturally as skin commensals.
Archive | 1986
I. F. Lane; Marion Sinclair; Keith Poskitt; C. N. McCollum
Human prosthetic vascular grafts do not sustain a growth of endothelium on the luminal surface and remain thrombogenic indefinitely1. Whilst large diameter aortic grafts develop a thin layer of platelet thrombus as pseudointima, smaller prostheses such as those in the femoro-popliteal position have a thrombosis and occlusion rate approaching 60% at 1 year after implantation2. Platelet inhibitory therapy is established in the prevention of thrombosis but the combination of aspirin plus dipyridamole produces frequent gastro-intestinal side effects. This has been shown in the recent Persantin Aspirin Re-infarction Study3 where 25% of patients had to discontinue aspirin therapy. Thromboxane A2 (TXA2) which is a product of aracidonic acid metabolism, is a powerful stimulator of platelet aggregation4. It is produced by enzymes including cyclo-oxygenase and thromboxane synthetase in platelets and the natural biological opponent of TXA2 is prostocyclin (PGI2).
British Journal of Surgery | 1986
I. F. Lane; J. T. C. Irwin; S. A. Jennings; Keith Poskitt; A. C. Meek; C. N. McCollum
British Journal of Surgery | 1988
Keith Poskitt; J. T. C. Irwin; I. F. Lane; S. Karacagil; C. N. McCollum
Critical Care Medicine | 1987
Cm Backhouse; Keith Poskitt; Sadi Karacagil; C. N. McCollum