Deep Sternal Wound Infection (DSWI) and Mediastinitis After Cardiac Surgery: Current Approaches and Future Trends in Prevention and Management.
Deep Sternal Wound Infection (DSWI) and Mediastinitis After Cardiac Surgery: Current Approaches and Future Trends in Prevention and Management. Surg Technol Int. 2020 Mar 26;36: Authors: Chello C, Lusini M, Nenna A, Nappi F, Spadaccio C, Satriano UM, Cardetta F, Mastroianni C, Chello M Abstract Median sternotomy is the most common access for cardiac surgery. Deep surgical wound infection (DSWI) and mediastinitis after median sternotomy remain significant clinical problems after cardiac surgery in terms of mortality, morbidity and healthcare-associated costs. Despite recent advances in medical management and consensus papers, their incidence ranges from 1% to 5%, and the associated mortality ranges from 20% to 50%. Recent studies in this field are providing excellent outcomes with promising results for the near future. The choice of sternal closure technique plays a crucial role in the prevention of DSWI and mediastinitis and should be tailored to the patient's characteristics, as clinical judgement and experience play a pivotal role. Early aggressive surgical debridement, vacuum-assisted closure (VAC) therapy, muscle flap and newer technologies are revolutionizing the paradigm of treatment of DSWI. Also, recent advances in tissue engineering have been refining potential approaches to tissue regeneration or substitution for enhanced wound repair. This editorial aims to briefly summarize the current and future techniques in DSWI prevention and treatment aft...
Publication date: Available online 2 June 2020Source: Life SciencesAuthor(s): Xiaofang Fan, Xiaoqiong Shan, Shan Jiang, Sixian Wang, Fukun Zhang, Qiuyun Tian, Danyang Chen, Jianshe Ma, Feng Xue, Sunzhong Mao, Junming Fan, Yongyu Wang, Yongsheng Gong
We report a case of a 65-year old Caucasian man with a slow and painful recovery after arthroscopic shoulder surgery encompassing rotator cuff repair, biceps tenotomy and acromioplasty, with recurrence of impingement symptoms unresponsive to conservative therapy (physiotherapy and one sub- acromial injection). He developed a severe heterotopic ossification at the acromial insertion of the deltoid and in the coraco-acromial ligament. This was successfully treated by arthroscopic excision of the lesion and postoperative prophylactic therapy with nonsteroidal anti-inflammatory drugs. PMID: 32490788 [PubMed - in process]
Publication date: Available online 5 June 2020Source: American Journal of Orthodontics and Dentofacial OrthopedicsAuthor(s): Tiancheng Li, Zeyuan Zhou, Han Wang, Chunxiao Lv, Cheng Zhang, Guiyu Tao, Xiaobing Li, Shujuan Zou, Peipei Duan
CONCLUSIONS: it is very important to establish an early diagnosis for patients with Boerhaave's syndrome. Early ( 24 h) primary repair, even for those reinforced with vascular muscle flaps. Furthermore, repair reinforcement with different muscle flaps appears to render similar results for patients with delayed diagnosis. PMID: 32496118 [PubMed - as supplied by publisher]
Abstract PURPOSE: To evaluate the in vivo response of photobiomodulation therapy associated with norbixin-based poly(hydroxybutyrate) membrane (PHB) in tenotomized calcaneal tendon. METHODS: Thirty rats were randomly allocated to six groups (n=5 each): LED groups (L1, L2 and L3) and membrane + LED groups (ML1, ML2 and ML3). The right calcaneal tendons of all animals were sectioned transversely and were irradiated with LED daily, one hour after surgery every 24 hours, until the day of euthanasia. At the end of the experiments the tendons were removed for histological analysis. RESULTS: The histological an...
Conclusion: In this study, an elevated NLR and those with bowel obstruction are associated with an increased risk of bowel resection among patients with IGH. Based on our findings, surgeons should prioritize prompt emergency surgical repair for patients who present with elevated NLR and bowel obstruction concurrent with IGH.
Publication date: Available online 3 June 2020Source: Arthroscopy TechniquesAuthor(s): Joshua W. Sy, Zackary A. Johnson, Kyong S. Min
Publication date: Available online 4 June 2020Source: Journal of Cranio-Maxillofacial SurgeryAuthor(s): Chang Ryul Yi, Tea Min Oh, Woo Shik Jeong, Jong-Woo Choi, Tae Suk Oh
CONCLUSION: ABS application results in a clean wound healing that is as strong as primary repair. However, additional studies are required to evaluate the late results of increased fibroblastic activity in the early period of ABS application alone. PMID: 32490638 [PubMed - as supplied by publisher]
AbstractObjectivesThe hypothesis of the proposed intervention is that Granulocyte-macrophage colony-stimulating factor (GM-CSF) has profound effects on antiviral immunity, and can provide the stimulus to restore immune homeostasis in the lung with acute lung injury post COVID-19, and can promote lung repair mechanisms, that lead to a 25% improvement in lung oxygenation parameters. Sargramostim is a man-made form of the naturally-occurring protein GM-CSF.Trial designA phase 4 academic, prospective, 2 arm (1:1 ratio), randomized, open-label, controlled trial.ParticipantsPatients aged 18-80 years admitted to specialized COVID...