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https://www.readbyqxmd.com/read/27909643/source-control-and-graft-preservation-using-negative-pressure-wound-therapy-with-antibiotic-instillation-a-case-report
#1
Victoria Gilbert, Timothy Kelly, Robert Grossi
Negative pressure wound therapy (NPWT) is widely used to treat many types of complex wounds, and the advent of the instillation and dwell time (NPWTi-d) technique has enhanced this system with the addition of automated treatment with topical solutions. In the field of vascular surgery, NPWT is utilized to help close wounds over underlying grafts; however keeping these wounds free of infection and avoiding large reoperation when infection occurs remains a challenge. In this case report we present a patient who required acute intervention for limb ischemia, with a large wound created in the groin for anastomosis of a prosthetic graft bypass...
October 31, 2016: Curēus
https://www.readbyqxmd.com/read/27909641/a-case-series-of-complex-recalcitrant-wounds-treated-with-epidermal-grafts-harvested-from-an-automated-device
#2
Stephen S Cai, Arvind U Gowda, Karan Chopra, Rachel Waldman, Ronald P Silverman, Yvonne M Rasko
INTRODUCTION: Epidermal grafting has several advantages over full-thickness or split-thickness grafts in the treatment of complex non-healing wounds. These include the low risk of donor site complications, minimal patient discomfort, and abstention from the operating room. Traditionally, the lack of reliable epidermal harvesting techniques has limited its clinical utilization. The development of an automated suction blister epidermal graft (SBEG) harvesting device may facilitate clinical utilization of this technique...
October 30, 2016: Curēus
https://www.readbyqxmd.com/read/27909303/conditional-knockout-of-n-wasp-in-mouse-fibroblast-caused-keratinocyte-hyper-proliferation-and-enhanced-wound-closure
#3
Neeraj Jain, Pazhanichamy Kalailingam, Kai Wei Tan, Hui Bing Tan, Ming Keat Sng, Jeremy Soon Kiat Chan, Nguan Soon Tan, Thirumaran Thanabalu
Neural-Wiskott Aldrich Syndrome Protein (N-WASP) is expressed ubiquitously, regulates actin polymerization and is essential during mouse development. We have previously shown that N-WASP is critical for cell-ECM adhesion in fibroblasts. To characterize the role of N-WASP in fibroblast for skin development, we generated a conditional knockout mouse model in which fibroblast N-WASP was ablated using the Cre recombinase driven by Fibroblast Specific Protein promoter (Fsp-Cre). N-WASP(FKO) (N-WASP(fl/fl); Fsp-cre) were born following Mendelian genetics, survived without any visible abnormalities for more than 1 year and were sexually reproductive, suggesting that expression of N-WASP in fibroblast is not critical for survival under laboratory conditions...
December 2, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27904691/implantation-of-placenta-derived-mesenchymal-stem-cells-accelerates-murine-dermal-wound-closure-through-immunomodulation
#4
Haifeng Wang, Lianyu Chen, Yang Liu, Bangzhen Luo, Nanzi Xie, Tao Tan, Lige Song, Pei Erli, Ming Luo
BACKGROUND: Diabetic foot ulcer (DFU) is a major complication of diabetes mellitus. Although previous studies have established that inflammation, ischemia and neuropathy contribute to the development of DFU, it is still an unmet medical need due to lack knowledge of cellular and molecular mechanisms associated with DFU. In the present study, we tested our hypothesis that subcutaneous application of human placental mesenchymal stem cells (PMSCs) can accelerate diabetic dermal wound healing by modulating immunoresponse...
2016: American Journal of Translational Research
https://www.readbyqxmd.com/read/27902170/the-effects-of-general-and-spinal-anesthesia-on-systemic-inflammatory-response-in-patients-undergoing-total-knee-arthroplasty
#5
Mehmet Eroğlu, Serdar Kokulu, Halit Buğra Koca, Mehmet Ersegün Demirboğan, Elif Doğan Baki, Özal Özcan
OBJECTIVES: This study aims to compare the systemic inflammatory responses (SIRs) developing after total knee arthroplasty (TKA) performed under general or spinal anesthesia. PATIENTS AND METHODS: This prospective study included 40 patients (8 males, 32 females; mean age 67.15±9.27 years; range 51 to 89 years) who underwent TKA in our clinic between February 2014 and July 2014. Patients were grouped to receive general (group 1, n=20) or spinal anesthesia (group 2, n=20)...
December 2016: Eklem Hastalıkları Ve Cerrahisi, Joint Diseases & related Surgery
https://www.readbyqxmd.com/read/27901383/security-and-biomechanical-strength-of-three-end-pass-configurations-for-the-terminal-end-of-intradermal-closures-performed-with-unidirectional-barbed-suture-material-in-dogs
#6
Penny J Regier, Daniel D Smeak, Kirk C McGilvray
OBJECTIVE To compare security of continuous intradermal suture lines closed by use of barbed suture with 3 end-pass configurations or without an end-pass configuration. SAMPLE 40 full-thickness, 4-cm-long, parasagittal wounds in canine cadavers. PROCEDURES Each continuous intradermal closure was terminated with 1 of 3 end-pass techniques or without an end-pass configuration (control group). A servohydraulic machine applied tensile load perpendicular to the long axis of the suture line. A load-displacement curve was generated for each sample; maximum load, displacement, stiffness, mode of construct failure, and load at first suture slippage at termination (ie, terminal end of the suture line) were recorded...
December 2016: American Journal of Veterinary Research
https://www.readbyqxmd.com/read/27901277/negative-pressure-wound-therapy-for-prevention-and-treatment-of-surgical-site-infections-after-vascular-surgery
#7
REVIEW
S Acosta, M Björck, A Wanhainen
BACKGROUND: Indications for negative-pressure wound therapy (NPWT) in vascular surgical patients are expanding. The aim of this review was to outline the evidence for NPWT on open and closed wounds. METHODS: A PubMed, EMBASE and Cochrane Library search from 2007 to June 2016 was performed combining the medical subject headings terms 'wound infection', 'abdominal aortic aneurysm (AAA)', 'fasciotomy', 'vascular surgery' and 'NPWT' or 'VAC'. RESULTS: NPWT of open infected groin wounds was associated with shorter duration of wound healing by 47 days, and was more cost-effective than alginate dressings in one RCT...
November 30, 2016: British Journal of Surgery
https://www.readbyqxmd.com/read/27900992/improved-intermittent-clamped-drainage-in-lower-lumbar-internal-fixation-a-randomized-prospective-study
#8
Qing-Ying Hao, Chu-Yin Liu, Chan-Juan Fu, Xiao-Hua Zhang, Ming-Sheng Tan
BACKGROUND: Continuous negative pressure drainage (CNPD) is widely used after lower lumbar internal fixation; however, it may cause tremendous blood loss and lead to postoperative hemorrhagic anemia. The present study explored the efficacy and safety of improved intermittent-clamped drainage (ICD) for lower lumbar internal fixation. METHODS: This was a prospective study that included 156 patients with decompression of the spinal canal and internal fixation for the first time from January 2012 to December 2014...
2016: Chinese Medical Journal
https://www.readbyqxmd.com/read/27900338/the-bridge-enhanced-anterior-cruciate-ligament-repair-bear-procedure-an-early-feasibility-cohort-study
#9
Martha M Murray, Brett M Flutie, Leslie A Kalish, Kirsten Ecklund, Braden C Fleming, Benedikt L Proffen, Lyle J Micheli
BACKGROUND: This study assessed the safety of the newly developed bridge-enhanced anterior cruciate ligament (ACL) repair (BEAR), which involves suture repair of the ligament combined with a bioactive scaffold to bridge the gap between the torn ligament ends. As the intra-articular environment is complex in its response to implanted materials, this study was designed to determine whether there would be a significant rate of adverse reaction to the implanted scaffold. HYPOTHESIS: The primary hypothesis was that the implanted scaffold would not result in a deep joint infection (arthrocentesis with positive culture) or significant inflammation (clinical symptoms justifying arthrocentesis but negative culture)...
November 2016: Orthopaedic Journal of Sports Medicine
https://www.readbyqxmd.com/read/27900320/the-golden-spiral-flap-a-new-flap-design-that-allows-for-closure-of-larger-wounds-under-reduced-tension-how-studying-nature-s-own-design-led-to-the-development-of-a-new-surgical-technique
#10
Sharad P Paul
This paper details the study of biodynamic excisional skin tension lines on the scalp and the development of a new flap technique for closure of scalp wounds. Recently, a study by this author, on pigskin, replicated whorls by placing tissue under rapid stretch using saline tissue expanders, by recreating rapid dermo-epidermal shear of skin - thereby concluding that the golden spiral pattern is nature's own pattern for rapid expansion. Given the relationship between tissue expansion and stretch has been shown to cause deformation gradients that have both elastic and growth factors, the author set out to test the hypothesis that a golden spiral pattern therefore would be more efficient at closing wounds under less tension when compared with standard semicircular rotational flap patterns...
2016: Frontiers in Surgery
https://www.readbyqxmd.com/read/27899142/vancomycin-microspheres-reduce-postoperative-spine-infection-in-an-in-vivo-rabbit-model
#11
Gang Liu, Si Chen, Jun Fang, Baoshan Xu, Shuang Li, Yonghong Hao, Naif A Al-Dhabi, Shucai Deng, Veeramuthu Duraipandiyan
BACKGROUND: Surgical site infections are common and devastating complications after implants related surgeries. Staphylococcus aureus contamination is a leading cause of surgical site infections. This study aims at assessing the effect of vancomycin microspheres on reducing Staphylococcus aureus infection in an in vivo rabbit model. METHODS: Sixty surgical sites of 20 New Zealand White rabbits underwent spinal implant were randomly divided to three groups: the control group, the vancomycin group and vancomycin microspheres group...
November 29, 2016: BMC Pharmacology & Toxicology
https://www.readbyqxmd.com/read/27898352/management-of-the-open-abdomen-using-negative-pressure-wound-therapy-with-instillation-in-severe-abdominal-sepsis-a-review-of-48-cases-in-hospital-mexico-costa-rica
#12
Pablo Sibaja, Alfredo Sanchez, Guillermo Villegas, Alvaro Apestegui, Esteban Mora
INTRODUCTION: Despite the numerous advances in recent years, severe abdominal sepsis (with associated organ failure associated with infection) remains a serious, life-threatening condition with a high mortality rate. OA is a viable alternative to the previously used scheduled repeat laparotomy or continuous peritoneal lavage. The use of Negative Pressure Wound Therapy (NPWT) has been described as a successful method of management of the open abdomen. Adding instillation of saline solution to NPWT in a programmed and controlled manner, could offer the clinician an additional tool for the management of complex septic abdomen...
November 17, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27896188/foot-syndactyly-a-clinical-and-demographic-analysis
#13
Jong Ho Kim, Byung Jun Kim, Sung Tack Kwon
BACKGROUND: Syndactyly of the foot is the second most common congenital foot anomaly. In East Asia, however, no large case study has been reported regarding the clinical features of isolated foot syndactyly. In this study, we report a review of 118 patients during the last 25 years. METHODS: We conducted a chart review of patients who underwent surgical correction for foot syndactyly between January 1990 and December 2014. Operations were performed with a dorsal triangular flap and a full-thickness skin graft...
November 2016: Archives of Plastic Surgery
https://www.readbyqxmd.com/read/27895539/practical-considerations-in-pediatric-surgery
#14
REVIEW
Matthew R Louis, Jesse D Meaike, Edward Chamata, Larry H Hollier
The care of pediatric patients requires special considerations that are often not addressed in the literature. Relatively straightforward tasks such as clinical evaluation, antibiotic use, splinting, wound closure, and care of simple burns become complicated in the pediatric population for several reasons. The authors seek to demystify some of these topics using the senior author's years of clinical experience treating pediatric patients by giving practical advice and general considerations when treating children...
November 2016: Seminars in Plastic Surgery
https://www.readbyqxmd.com/read/27895083/locking-plate-external-fixation-and-negative-pressure-wound-therapy-for-treatment-of-a-primary-infection-in-a-closed-clavicle-fracture
#15
Robert M Kenyon, David I Morrissey, Diarmuid C Molony, John Francis Quinlan
Infection in a clavicle fracture is uncommon, but remains a challenging problem. A paucity of soft tissue coverage often combined with significant displacement and interfragmentary movement add complexity to an already difficult situation for effective infection treatment. External fixation in principle offers a means of achieving fracture stability, while the infection is being eradicated. We present the case of a closed clavicle fracture, initially treated conservatively, that presented 5 weeks later with infection...
November 28, 2016: BMJ Case Reports
https://www.readbyqxmd.com/read/27893570/nonoperative-treatment-of-a-tracheocutaneous-fistula-in-a-burn-patient
#16
Katherine Marie Huber, Alicia Rose Billington, Loryn J Taylor, Kimberly Brown Maynell, C Wayne Cruse
Tracheocutaneous fistula (TCF) is a complication occurring after decannulation of a long-term tracheostomy and can lead to significant morbidity. We describe a case of a TCF in a burn patient treated without surgery. No previous cases have been described. A 65-year-old woman presented with symptomatic hypertrophic burn scar contractures of the anterior neck 6 months after undergoing excision and grafting of full-thickness burns to the neck and chest. She had a history of tracheostomy placement at the time of burn...
November 18, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27893512/flap-designs-for-flap-advancement-during-implant-therapy-a-systematic-review
#17
Alexandra B Plonka, Rachel A Sheridan, Hom-Lay Wang
PURPOSE: Guided bone regeneration (GBR) procedures allow ridge augmentation before or at time of implant placement. GBR outcomes rely on primary passive tension-free wound closure, which may be achieved by a variety of flap designs and surgical procedures. A comprehensive literature review of flap design and management is provided, including material types, incision design, reflection, releasing, and suturing techniques. MATERIALS AND METHODS: Two reviewers completed a literature search using the PubMed database and a manual search of relevant journals...
November 23, 2016: Implant Dentistry
https://www.readbyqxmd.com/read/27888895/treating-scars-in-the-auricle-region
#18
REVIEW
Deborah Watson, Bharat Panuganti
This article provides a review of the surgical and nonsurgical options available to manage a variety of auricular scars. The basics of wound healing are discussed in addition to the etiology of keloids and the cauliflower ear. Many auricular scars can be revised with scar excision techniques, but separate discussions for the treatment of keloids and the cauliflower ear are provided. The management plan for auricular scarring requires appropriate patient counseling regarding the risk of recurrence in keloids, regrowth of scar tissue in cauliflower ears, scar hypertrophy at the line of closure, widening of the scar, and persisting ear contour deformities...
February 2017: Facial Plastic Surgery Clinics of North America
https://www.readbyqxmd.com/read/27886972/the-resident-run-minor-surgery-clinic-a-pilot-study-to-safely-increase-operative-autonomy
#19
REVIEW
Brandon M Wojcik, Zhi Ven Fong, Madhukar S Patel, David C Chang, Emil Petrusa, John T Mullen, Roy Phitayakorn
OBJECTIVE: General surgery training has evolved to align with changes in work hour restrictions, supervision regulations, and reimbursement practices. This has culminated in a lack of operative autonomy, leaving residents feeling inadequately prepared to perform surgery independently when beginning fellowship or practice. A resident-run minor surgery clinic increases junior resident autonomy, but its effects on patient outcomes have not been formally established. This pilot study evaluated the safety of implementing a resident-run minor surgery clinic within a university-based general surgery training program...
November 2016: Journal of Surgical Education
https://www.readbyqxmd.com/read/27884340/use-of-an-experimental-model-to-evaluate-infection-resistance-of-meshes-in-abdominal-wall-surgery
#20
Ramón Pérez-Tanoira, C Lévano-Linares, Á Celdrán-Uriarte, M C Isea-Peña, M Sánchez De Molina, C García-Vasquez, J Esteban-Moreno
BACKGROUND: Staphylococcal species are the most common organisms causing prosthetic mesh infections, however, infections due to rapidly growing mycobacteria are increasing. This study evaluates the resistance of biomaterial for abdominal wall prostheses against the development of postoperative infection in a rat model. MATERIAL AND METHODS: In 75 rats, we intramuscularly implanted three different types of prostheses: (1) low-density polypropylene monofilament mesh (PMM), (2) high-density PMM, and (3) a composite prosthesis composed of low-density PMM and a nonporous hydrophilic film...
December 2016: Journal of Surgical Research
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