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Sample records for conventional skin grafts

  1. Delayed skin grafting.

    PubMed

    Ceilley, R I; Bumsted, R M; Panje, W R

    1983-04-01

    The use of skin grafts on granulating wounds is an established practice. Delaying the application of a full- or split-thickness skin graft may be an advantageous alternative method of surgical reconstruction in selected cases. Partial healing by secondary intention is useful for filling in deeper defects and usually produces a wound that is much smaller and of more normal contour than the original defect. Contraction of the graft bed is markedly influenced by location, tissue laxity, surface tension lines, motion, and wound geometry. Proper wound care, correct surgical preparation of the defect, and timing of the graft procedure are all important considerations in maximizing the overall result. Through-and-through defects and wounds produced over areas with little underlying support (eyelids and lip) often need flap reconstruction or immediate grafting to prevent undesirable functional and cosmetic results. By combining delayed healing and conventional reconstructive techniques, major tissue loss can often be restored while minimizing patient morbidity.

  2. Skin graft

    MedlinePlus

    ... caused a large amount of skin loss Burns Cosmetic reasons or reconstructive surgeries where there has been ... Smoking increases your chance of problems such as slow healing. Ask your doctor or nurse for help ...

  3. Novel expansion techniques for skin grafts.

    PubMed

    Kadam, Dinesh

    2016-01-01

    The quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal-epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials. PMID:27274117

  4. Novel expansion techniques for skin grafts

    PubMed Central

    Kadam, Dinesh

    2016-01-01

    The quest for skin expansion is not restricted to cover a large area alone, but to produce acceptable uniform surfaces, robust engraftment to withstand mechanical shear and infection, with a minimal donor morbidity. Ease of the technique, shorter healing period and reproducible results are essential parameters to adopt novel techniques. Significant advances seen in four fronts of autologous grafting are: (1) Dermal–epidermal graft expansion techniques, (2) epidermal graft harvests technique, (3) melanocyte-rich basal cell therapy for vitiligo and (4) robust and faster autologous cell cultures. Meek's original concept that the sum of perimeter of smaller grafts is larger than the harvested graft, and smaller the graft size, the greater is the potential for regeneration is witnessed in newer modification. Further, as graft size becomes smaller or minced, these micrografts can survive on the wound bed exudate irrespective of their dermal orientation. Expansion produced by 4 mm × 4 mm sized Meek micrografts is 10-folds, similarly 0.8 mm × 0.8 mm size micrografts produce 100-fold expansion, which becomes 700-fold with pixel grafts of 0.3 mm × 0.3 mm size. Fractional skin harvest is another new technique with 700 μ size full thickness graft. These provide instant autologous non-cultured graft to cover extensive areas with similar quality of engraftment surface as split skin grafts. Newer tools for epidermal blister graft harvest quickly, with uniform size to produce 7-fold expansions with reproducible results. In addition, donor area heals faster with minimal scar. Melanocyte-rich cell suspension is utilised in vitiligo surgery tapping the potential of hair root melanocytes. Further advances in the cell culture to reduce the cultivation time and provide stronger epidermal sheets with dermal carrier are seen in trials. PMID:27274117

  5. Application of N-Butyl Cyanoacrylate to Split-Thickness Skin Grafts in Rats: An Experimental Study.

    PubMed

    Görgülü, Tahsin; Olgun, Abdulkerim; Torun, Merve; Kargi, Eksal

    2015-09-01

    Skin grafts are a standard option for closing skin defects that cannot be closed primarily. A split -thickness skin graft entirely transfers the epidermis and a part of the dermal layer to the wound site. Using conventional techniques, the skin graft is fixed to the wound using sutures and kept closed for 3 to 7 days with a pressed bolster dressing. Continued care includes applying routine graft dressings after the bolster dressing has been removed. The use of fibrin glue and cyanoacrylate derivatives-which shortens the duration of surgery and improves graft fixation to the recipient bed-has become widespread. However, applying fibrin glue during skin graft surgery is limited because there are considerable disadvantages in terms of preparation and cost. Many studies have been conducted on the use of cyanoacrylate derivatives during skin grafting; however, few reports have investigated the effects of cyanoacrylate derivatives on skin graft survival and related histopathologic changes.In this study, the authors used n-butyl cyanoacrylate to prepare split-thickness skin grafts that were subsequently applied to Wistar albino rats, and the authors evaluated the results both histopathologically and macroscopically. The authors also statistically analyzed the effects of graft fixation according to surgical duration. The findings of authors suggest that n-butyl cyanoacrylate can be safely applied during split-thickness skin graft surgery because it significantly reduces surgical duration, demonstrates substantial advantages in terms of graft fixation and monitoring, and, most importantly, demonstrates no notable disadvantages in comparison with conventional methods.

  6. Evolution of instruments for harvest of the skin grafts

    PubMed Central

    Ameer, Faisal; Singh, Arun Kumar; Kumar, Sandeep

    2013-01-01

    Background: The harvest of autologous skin graft is considered to be a fundamental skill of the plastic surgeon. The objective of this article is to provide an interesting account of the development of skin grafting instruments as we use them today in various plastic surgical procedures. Materials and Methods: The authors present the chronological evolution and modifications of the skin grafting knife, including those contributions not often cited in the literature, using articles sourced from MEDLINE, ancient manuscripts, original quotes, techniques and illustrations. Results: This article traces the evolution of instrumentation for harvest of skin grafts from free hand techniques to precise modern automated methods. Conclusions: Although skin grafting is one of the basic techniques used in reconstructive surgery yet harvest of a uniform graft of desired thickness poses a challenge. This article is dedicated to innovators who have devoted their lives and work to the advancement of the field of plastic surgery. PMID:23960303

  7. A comparison between the HeRO graft and conventional arteriovenous grafts in hemodialysis patients.

    PubMed

    Nassar, George M; Glickman, Marc H; McLafferty, Robert B; Croston, J Kevin; Zarge, Joseph I; Katzman, Howard E; Peden, Eric K; Lawson, Jeffrey H; Martinez, Jeffrey M; Thackeray, Lisa

    2014-01-01

    Venous stenosis and occlusion are a major cause of vascular access dysfunction and failure. The HeRO Graft bypasses occlusion and traverses stenosis with outflow directly into the central venous circulation. A randomized, multicenter study was conducted to evaluate the efficacy and safety of the HeRO Graft relative to conventional AV grafts. The design was to enroll 143 patients in a 2:1 randomization ratio between HeRO and conventional AV control groups. Data on 72 subjects (52 HeRO Graft and 20 AV graft controls) were obtained. The HeRO Graft and control cohorts were comparable in baseline characteristics. Adequacy of dialysis, bacteremia rates, and adverse events were consistent between groups. Twelve month Kaplan-Meier estimates for primary and secondary patency rates were 34.8% and 67.6% in the HeRO Graft cohort, and 30.6% and 58.4% in the control cohort. There was no statistical difference in terms of patency between groups. The rates of intervention were 2.2/year for HeRO Graft and 1.6/year for the control (p = 0.100). Median days to loss of secondary patency was 238 for HeRO Graft versus 102 for the control (p = 0.032). The HeRO Graft appears to provide similar patency, adequacy of dialysis, and bacteremia rates to those of conventional AV grafts.

  8. Feasibility of the Use of RapiGraft and Skin Grafting in Reconstructive Surgery

    PubMed Central

    Cho, In Gook; Kwon, Joon Hyun; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae

    2016-01-01

    Background Skin grafting is a relatively simple and thus widely used procedure. However, the elastic and structural quality of grafted skin is poor. Recently, various dermal substitutes have been developed to overcome this disadvantage of split-thickness skin grafts. The present study aims to determine the feasibility of RapiGraft as a new dermal substitute. Methods This prospective study included 20 patients with partial- or full-thickness skin defects; the patients were enrolled between January 2013 and March 2014. After skin defect debridement, the wound was divided into two parts by an imaginary line. Split-thickness skin grafting alone was performed on one side (group A), and RapiGraft and split-thickness skin grafting were used on the other side (group B). All patients were evaluated using photographs and self-questionnaires. The Manchester scar scale (MSS), a chromameter, and a durometer were used for the scar evaluation. The average follow-up period was 6 months. Results The skin graft take rates were 93% in group A and 89% in group B, a non-significant difference (P=0.082). Statistically, group B had significantly lower MSS, vascularity, and pigmentation results than group A (P<0.05 for all). However, the groups did not differ significantly in pliability (P=0.155). Conclusions The present study indicates that a simultaneous application of RapiGraft and a split-thickness skin graft is safe and yields improved results. Therefore, we conclude that the use of RapiGraft along with skin grafting will be beneficial for patients requiring reconstructive surgery. PMID:27689048

  9. Feasibility of the Use of RapiGraft and Skin Grafting in Reconstructive Surgery

    PubMed Central

    Cho, In Gook; Kwon, Joon Hyun; Lee, Jeong Woo; Choi, Kang Young; Chung, Ho Yun; Cho, Byung Chae

    2016-01-01

    Background Skin grafting is a relatively simple and thus widely used procedure. However, the elastic and structural quality of grafted skin is poor. Recently, various dermal substitutes have been developed to overcome this disadvantage of split-thickness skin grafts. The present study aims to determine the feasibility of RapiGraft as a new dermal substitute. Methods This prospective study included 20 patients with partial- or full-thickness skin defects; the patients were enrolled between January 2013 and March 2014. After skin defect debridement, the wound was divided into two parts by an imaginary line. Split-thickness skin grafting alone was performed on one side (group A), and RapiGraft and split-thickness skin grafting were used on the other side (group B). All patients were evaluated using photographs and self-questionnaires. The Manchester scar scale (MSS), a chromameter, and a durometer were used for the scar evaluation. The average follow-up period was 6 months. Results The skin graft take rates were 93% in group A and 89% in group B, a non-significant difference (P=0.082). Statistically, group B had significantly lower MSS, vascularity, and pigmentation results than group A (P<0.05 for all). However, the groups did not differ significantly in pliability (P=0.155). Conclusions The present study indicates that a simultaneous application of RapiGraft and a split-thickness skin graft is safe and yields improved results. Therefore, we conclude that the use of RapiGraft along with skin grafting will be beneficial for patients requiring reconstructive surgery.

  10. Full-Thickness Skin Grafting in Nasal Reconstruction

    PubMed Central

    Weathers, William M.; Bhadkamkar, Mohin; Wolfswinkel, Erik M.; Thornton, James F.

    2013-01-01

    Skin grafting in nasal reconstruction, long used by dermatologists, can provide superior results and can well be the “go to” procedure for nasal reconstruction. The upper two-thirds of the nose is composed of both flattened, featureless and often thin skin that is well recreated with defect-only full-thickness grafting. Skin grafting for the lower third of the nose has been practiced for years by dermatologists; over the last 4 to 5 years, it has been embraced by plastic surgeons. The patient and donor site selection is critical. Meticulous attention to graft selection, utilization of a no-touch technique during graft harvest and placement of surgical bolsters with through-and-through tacking sutures are essential to ensure 100% graft take and a successful aesthetic result. PMID:24872748

  11. Excellent Aesthetic and Functional Outcome After Fractionated Carbon Dioxide Laser Skin Graft Revision Surgery: Case Report and Review of Laser Skin Graft Revision Techniques.

    PubMed

    Ho, Derek; Jagdeo, Jared

    2015-11-01

    Skin grafts are utilized in dermatology to reconstruct a defect secondary to surgery or trauma of the skin. Common indications for skin grafts include surgical removal of cutaneous malignancies, replacement of tissue after burns or lacerations, and hair transplantation in alopecia. Skin grafts may be cosmetically displeasing, functionally limiting, and significantly impact patient's quality-of-life. There is limited published data regarding skin graft revision to enhance aesthetics and function. Here, we present a case demonstrating excellent aesthetic and functional outcome after fractionated carbon dioxide (CO2) laser skin graft revision surgery and review of the medical literature on laser skin graft revision techniques. PMID:26580878

  12. Skin flaps and grafts - self-care

    MedlinePlus

    ... Free flap - self-care; Skin autografting - self-care; Pressure ulcer skin flap self-care; Burns skin flap self- ... skin infection Surgery for skin cancer Venous ulcers , pressure ulcers , or diabetic ulcers that DO NOT heal After ...

  13. Subcostal Skin Graft Donor Site for Autologous Ear Construction.

    PubMed

    Hassanein, Aladdin H; Greene, Arin K

    2015-06-01

    Autologous ear construction for microtia creates an auricle using a costal cartilage framework. To separate the construct from the mastoid, a skin graft is required to form a retroauricular sulcus. Skin graft donor sites that have been described include the inguinal area (split or full-thickness) or scalp (split-thickness). The purpose of this study is to report a novel skin graft donor site for ear construction. We harvest a full-thickness graft from the subcostal area based on the previous scar from the cartilage harvest. Unlike the inguinal donor site, this method does not place an additional scar on the child. In contrast to the scalp donor site, the technique is simpler and a full-thickness graft minimizes contraction of the retroauricular sulcus. PMID:26080199

  14. Revascularization of autogenous skin grafts placed on irradiated tissue

    SciTech Connect

    Ueda, M.; Torii, S.; Kaneda, T.; Oka, T.

    1982-08-01

    Vascular changes in rat skin after irradiation were examined microangiographically. Revascularization of the skin transplanted during the chronic stage after irradiation was also studied. The results obtained through these examinations revealed higher vascular densities at the acute and the subacute stages, and low values at the chronic stages compared with those of the control. Furthermore, when the skin grafts were transplanted to the irradiated beds in the chronic stage, primary revascularization was scant, and the inhibited capillary proliferation in the recipient sites prevented new vessel penetration. This explains why grafts transplanted to previously irradiated beds fail to survive.

  15. Suction blister skin grafting--a modern application.

    PubMed

    Parbhoo, A V; Simpson, M T

    2014-03-01

    The suction blistering technique produces an ultra-thin skin graft with no morbidity at the donor site. Negative pressure using wall suction in outpatients is used to generate a graft that can be used for reconstruction, and it avoids the need for invasive procedures in patients with coexisting conditions. The harvested tissue has a low metabolic demand and survival is excellent. We used it in a patient when previous reconstructions after excision of skin cancer had failed. Graft survival was more than 95% by surface area and there was no donor site morbidity. We have found it particularly useful for grafting over Integra® dermal regeneration template (Integra LifeSciences Corporation, NJ, USA) to produce healing at difficult sites. Patients tolerate the procedure well and the donor site heals quickly. It is useful where recipient vascularity is poor or where coexisting conditions prevent complex procedures.

  16. Fractional CO2 laser treatment for a skin graft.

    PubMed

    Stephan, Farid E; Habre, Maya B; Helou, Josiane F; Tohme, Roland G; Tomb, Roland R

    2016-01-01

    Skin grafts are widely used in reconstructive and plastic surgery, leaving an inevitable scar appearance on the body, affecting the quality of life of the patients. Fractional ablative lasers have become a leading procedure for the treatment of acne and burn scars. We report a case of a skin graft showing excellent improvement in overall appearance after three sessions of fractional CO2 laser. The undamaged tissue left between the microthermal treatment zones is responsible of collagen formation and reepithelialization. Remodeling and collagen formation are observed even 6 months after a fractional CO2 laser session. PMID:26052811

  17. Bioengineered Self-assembled Skin as an Alternative to Skin Grafts

    PubMed Central

    Climov, Mihail; Medeiros, Erika; Farkash, Evan A.; Qiao, Jizeng; Rousseau, Cecile F.; Dong, Shumin; Zawadzka, Agatha; Racki, Waldemar J.; Al-Musa, Ahmad; Sachs, David H.; Randolph, Mark A.

    2016-01-01

    For patients with extensive burns or donor site scarring, the limited availability of autologous and the inevitable rejection of allogeneic skin drive the need for new alternatives. Existing engineered biologic and synthetic skin analogs serve as temporary coverage until sufficient autologous skin is available. Here we report successful engraftment of a self-assembled bilayered skin construct derived from autologous skin punch biopsies in a porcine model. Dermal fibroblasts were stimulated to produce an extracellular matrix and were then seeded with epidermal progenitor cells to generate an epidermis. Autologous constructs were grafted onto partial- and full-thickness wounds. By gross examination and histology, skin construct vascularization and healing were comparable to autologous skin grafts and were superior to an autologous bilayered living cellular construct fabricated with fibroblasts cast in bovine collagen. This is the first demonstration of spontaneous vascularization and permanent engraftment of a self-assembled bilayered bioengineered skin that could supplement existing methods of reconstruction. PMID:27482479

  18. Bioengineered Self-assembled Skin as an Alternative to Skin Grafts.

    PubMed

    Climov, Mihail; Medeiros, Erika; Farkash, Evan A; Qiao, Jizeng; Rousseau, Cecile F; Dong, Shumin; Zawadzka, Agatha; Racki, Waldemar J; Al-Musa, Ahmad; Sachs, David H; Randolph, Mark A; Huang, Christene A; Bollenbach, Thomas J

    2016-06-01

    For patients with extensive burns or donor site scarring, the limited availability of autologous and the inevitable rejection of allogeneic skin drive the need for new alternatives. Existing engineered biologic and synthetic skin analogs serve as temporary coverage until sufficient autologous skin is available. Here we report successful engraftment of a self-assembled bilayered skin construct derived from autologous skin punch biopsies in a porcine model. Dermal fibroblasts were stimulated to produce an extracellular matrix and were then seeded with epidermal progenitor cells to generate an epidermis. Autologous constructs were grafted onto partial- and full-thickness wounds. By gross examination and histology, skin construct vascularization and healing were comparable to autologous skin grafts and were superior to an autologous bilayered living cellular construct fabricated with fibroblasts cast in bovine collagen. This is the first demonstration of spontaneous vascularization and permanent engraftment of a self-assembled bilayered bioengineered skin that could supplement existing methods of reconstruction. PMID:27482479

  19. The Articulated Alar Rim Graft: Reengineering the Conventional Alar Rim Graft for Improved Contour and Support.

    PubMed

    Ballin, Annelyse C; Kim, Haena; Chance, Elizabeth; Davis, Richard E

    2016-08-01

    Surgical refinement of the wide nasal tip is challenging. Achieving an attractive, slender, and functional tip complex without destabilizing the lower nasal sidewall or deforming the contracture-prone alar rim is a formidable task. Excisional refinement techniques that rely upon incremental weakening of wide lower lateral cartilages (LLC) often destabilize the tip complex and distort tip contour. Initial destabilization of the LLC is usually further exacerbated by "shrink-wrap" contracture, which often leads to progressive cephalic retraction of the alar margin. The result is a misshapen tip complex accentuated by a conspicuous and highly objectionable nostril deformity that is often very difficult to treat. The "articulated" alar rim graft (AARG) is a modification of the conventional rim graft that improves treatment of secondary alar rim deformities, including postsurgical alar retraction (PSAR). Unlike the conventional alar rim graft, the AARG is sutured to the underlying tip complex to provide direct stationary support to the alar margin, thereby enhancing graft efficacy. When used in conjunction with a well-designed septal extension graft (SEG) to stabilize the central tip complex, lateral crural tensioning (LCT) to tighten the lower nasal sidewalls and minimize soft-tissue laxity, and lysis of scar adhesions to unfurl the retracted and scarred nasal lining, the AARG can eliminate PSAR in a majority of patients. The AARG is also highly effective for prophylaxis against alar retraction and in the treatment of most other contour abnormalities involving the alar margin. Moreover, the AARG requires comparatively little graft material, and complications are rare. We present a retrospective series of 47 consecutive patients treated with the triad of AARG, SEG, and LCT for prophylaxis and/or treatment of alar rim deformities. Outcomes were favorable in nearly all patients, and no complications were observed. We conclude the AARG is a simple and effective method for

  20. Utilizing biologic assimilation of bovine fetal collagen in staged skin grafting.

    PubMed

    Neill, James; James, Kenneth; Lineaweaver, William

    2012-05-01

    Seven patients underwent 2-stage skin grafting with bovine fetal collagen (BFC) as an initial wound cover. Split-thickness skin grafts were successfully placed on the wounds after completion of interval management. BFC proved to be a resilient acellular dermal matrix that could proceed to assimilation and skin grafting under a variety of wound conditions. BFC may prove to be a valuable material, as the role of acellular dermal matrices in skin grafting becomes better defined.

  1. A stent for a split-thickness skin graft vestibuloplasty.

    PubMed

    Firtell, D N; Oatis, G W; Curtis, T A; Sugg, W E

    1976-08-01

    Accepting the requirement that there must be intimate contact between a split-thickness skin graft and the underlying periosteum in a vestibuloplasty, a method of forming a stent to meet this.criterion is presented. The procedure uses an overextended impression and a custom-made acrylic resin base. Two methods of modifying the base with a secondary impression to form a stent at the time of the operation are described. PMID:789867

  2. A stent for a split-thickness skin graft vestibuloplasty.

    PubMed

    Firtell, D N; Oatis, G W; Curtis, T A; Sugg, W E

    1976-08-01

    Accepting the requirement that there must be intimate contact between a split-thickness skin graft and the underlying periosteum in a vestibuloplasty, a method of forming a stent to meet this.criterion is presented. The procedure uses an overextended impression and a custom-made acrylic resin base. Two methods of modifying the base with a secondary impression to form a stent at the time of the operation are described.

  3. Comparison of Decontamination Methods for Human Skin Grafts.

    PubMed

    Mann-Salinas, Elizabeth A; Joyner, Denar D; Guymon, Charles H; Ward, Catherine L; Rathbone, Christopher R; Jones, John A; Akers, Kevin S

    2015-01-01

    Skin grafts intended for autologous transplant may be dropped on the operating room floor during handling. The authors examined optimal procedures for decontaminating tissue intended for burn surgery. Porcine skin (5 × 5 cm sections) harvested from expired animals using standard procedures was inoculated with either 10(6) CFU/ml Staphylococcus aureus or Klebsiella pneumoniae. Decontaminating strategies were compared: 10% povidone iodine, 0.04% chlorhexidine, or 50 U/ml bacitracin for injection, and mechanical agitation using normal saline or sterile water; each agent was applied for 60 seconds. Each skin section was blended and plated on agar for bacterial enumeration using the spread plate method. Tissue viability was evaluated in parallel using a cell viability reagent, along with a control (heat at 200 °C for 5 min). Bacterial counts were log transformed; one-way ANOVA with Tukey-Kramer HSD analysis were performed. Concentration of organisms <10(5) CFU/g was considered clinically insignificant colonization. Eight donors provided 21 S. aureus and six K. pneumoniae samples. After exposure, mean organism concentration (CFU/g) was <10(5) for povidone iodine (S. aureus 2.83 × 10(4); K. pneumoniae 1.85 × 10(4)), chlorhexidine (S. aureus 4.52 × 10(4); K. pneumoniae 1.77 × 10(4)), and normal saline (K. pneumoniae 8.76 × 10(4)) treated groups. After log transform, only povidone iodine and chlorhexidine were found to be different from control in both groups. Viability was decreased in the positive control group, but not in treatment groups. Agents routinely used for surgical skin prep (povidone iodine and chlorhexidine), reduced both Gram-positive and Gram-negative contamination in tissue intended for skin grafting procedures. Antiseptic treatments did not impair the cellular viability of porcine skin.

  4. Allogeneic versus xenogeneic immune reaction to bioengineered skin grafts.

    PubMed

    Erdag, Gulsun; Morgan, Jeffrey R

    2004-01-01

    There are conflicting reports on the survival and immune reaction to allografts and xenografts of cultured skin substitutes (CSS). In this study, we investigated the allogeneic and xenogeneic responses to CSS of human keratinocytes and genetically engineered CSS expressing keratinocyte growth factor (KGF) that forms a hyperproliferative epidermis. CSS (control and KGF modified) and neonatal human foreskins were evaluated by immunohistochemistry for the expression of MHC class I and II. To study allograft rejection, grafts were transplanted to human peripheral blood mononuclear cell (huPBMC)-reconstituted SCID mice. To study xenograft rejection, grafts were transplanted to immunocompetent mice. Graft survival and immune reaction were assessed visually and microscopically. After transplantation, control CSS formed a normal differentiated epidermis, whereas KGF CSS formed a hyperproliferative epidermis. Control and KGF CSS expressed class I similar to neonatal foreskin, but did not express class II. In the allograft model, rejection of neonatal foreskins was between 5 and 9 days. In contrast, neither control nor KGF CSS was rejected by huPBMC-SCID mice. Histology showed dense mononuclear cell infiltration in human foreskins, with few, if any, mononuclear cells in control or KGF CSS. In contrast to the allogeneic reaction, CSS (control and KGF) were rejected in the xenograft model, but rejection was delayed (9-21 days) compared with neonatal skin (5-8 days). Humanized SCID mice rejected allografts of human neonatal foreskins, but did not reject control CSS or KGF CSS, even though the KGF CSS formed a hyperproliferative epidermis. Rejection of control and KGF CSS by immunocompetent mice in a xenograft model was comparable and their survival was significantly prolonged compared with neonatal skin. These results demonstrate that control CSS and hyperproliferative KGF CSS are less immunogenic than normal human skin and that sustained hyperproliferation of the epidermis

  5. Clinical Experience and Best Practices Using Epidermal Skin Grafts on Wounds.

    PubMed

    Kirsner, Robert S; Bernstein, Brent; Bhatia, Animesh; Lantis, John; Le, Lam; Lincoln, Katherine; Liu, Paul; Rodgers, Lee; Shaw, Mark; Young, David

    2015-11-01

    Over the years, autologous skin grafting has been used extensively to achieve wound closure, optimize a functional scar, and improve aesthetic outcomes for the patient. Although a vast majority of the literature is on the use of full-thickness and split-thickness skin grafts, epidermal skin grafts (ESGs) have emerged as a viable option in the reconstructive ladder when only the epidermal layer is needed. These grafts are distinct from other types of autologous skin grafts in that they can be harvested without anesthesia and leave minimal or no scarring at the donor site. In order to explore the use of ESGs in the continuum of primary wound closure, a multidisciplinary expert panel convened in October 2014, in Las Vegas, NV, to review the scientific basis and clinical uses of epidermal grafting. This publication provides an overview of epidermal grafting, recommendations for graft application, and potential roles for its use in wound care and closure.

  6. Epidermal skin grafting in vitiligo: a pilot study.

    PubMed

    Janowska, Agata; Dini, Valentina; Panduri, Salvatore; Macchia, Michela; Oranges, Teresa; Romanelli, Marco

    2016-09-01

    Vitiligo is a multifactorial acquired dermatosis characterised by achromic or hypochromic macules and by the absence of functioning melanocytes. Treatment depends on the extent of the affected areas and on disease activity. Surgical techniques have proven to be effective in stable cases but can be time-consuming and, in some cases, aesthetically unsatisfying or painful for the patients. The aim of the study was to assess the clinical safety and effectiveness of a new automatic epidermal skin harvesting device in patients with stable localised vitiligo over a minimum 12-month period. This new system (CELLUTOME™ Epidermal Harvesting System, KCI, an ACELITY Company, San Antonio, TX) is a commercially available epidermal skin harvesting system that can be used without local anaesthesia or other pre-treatments and has been shown to have low rates of donor site morbidity. Epidermal skin grafts can used in patients with acute and hard to heal chronic wounds, burns and stable vitiligo. The use of advanced therapies may improve the quality of life, have cost benefits and accelerate re-pigmentation of patients with vitiligo. In our preliminary study, this system was seen to be a safe and efficacious means of harvesting epidermal micrografts containing melanocytes for use in patients with stable vitiligo unresponsive to standard therapies. PMID:27547963

  7. Traveling waves in the modelling of aerosolised skin grafts

    NASA Astrophysics Data System (ADS)

    Ai, Shangbing

    2008-11-01

    Denman et al. [P.K. Denman, D.L.S. McElwain, J. Norbury, Analysis of travelling waves associated with the modelling of aerosolised skin grafts, Bull. Math. Biol. 69 (2007) 495-523] proposed a novel model on the growth pattern of keratinocyte cell colonies that were sprayed on to a severe burn site to facilitate the healing process. They studied traveling wave solutions of the model by asymptotic analysis and obtained several qualitative properties. In this paper we establish the following result on the traveling waves: there exists a minimal speed c such that the model has a unique biologically meaningful travelling wave solution for each speed c≥c and has no such a solution for any c

  8. Grafting of burns with widely meshed autograft split skin and Langerhans cell-depressed allograft split skin overlay

    SciTech Connect

    Alsbjoern, B.F.S.; Sorensen, B.

    1986-12-01

    Extensively burned patients suffer from lack of sufficient autologous donor skin. Meshing and wide expansion of the obtained split skin has met the requirement to a large degree. However, the wider the expansion, the less chance of a proper take. By covering widely expanded autografts with viable cadaver split skin, the take has been improved. If the epidermal Langerhans cells in the cadaver split skin are depressed by ultraviolet B light and glucocorticosteroids before grafting, a prolonged allograft take can be achieved and the healing of the underlying autografts is ensured for an extended period. Grafting results in 6 patients with extensive burns are reported.

  9. Uninvolved Skin from Psoriatic Patients Develops Signs of Involved Psoriatic Skin after Being Grafted onto Nude Mice

    NASA Astrophysics Data System (ADS)

    Fraki, Jorma E.; Briggaman, Robert A.; Lazarus, Gerald S.

    1982-02-01

    Clinically involved psoriatic epidermis maintains its histological appearance, increased labeling index, and increased level of plasminogen activator after being grafted onto athymic nude mice. Uninvolved psoriatic epidermis develops increases in plasminogen activator activity after being grafted onto athymic nude mice; this is accompanied by an increased labeling index. Thus, psoriatic skin can develop markers of psoriasis independent of the host.

  10. Outpatient or short-stay skin grafting with early ambulation for lower-extremity burns.

    PubMed

    Dean, S; Press, B

    1990-08-01

    Lower-extremity burns and skin grafts to these wounds have traditionally required extended hospitalization. We have used early tangential excision of the burn wounds and application of an Unna boot to fresh skin grafts in an attempt to shorten the hospitalization for such patients. Over a six-month period, 9 patients were treated with Unna boots to fresh skin grafts on the lower extremity. The average hospital stay was 0.9 days (range, 0 to 3 days). Graft take was 85% to 100%; no regrafting was required. Ambulation was begun 24 hours postoperatively. The technique described is a safe, effective, and inexpensive alternative to prolonged immobilization and hospitalization in patients with lower-extremity skin grafts.

  11. The tolerance of skin grafts to postoperative radiation therapy in patients with soft-tissue sarcoma

    SciTech Connect

    Lawrence, W.T.; Zabell, A.; McDonald, H.D. )

    1986-03-01

    During the last ten years at the National Cancer Institute, 11 patients have received 12 courses of postoperative adjuvant radiation therapy to skin grafts used for wound closure after the resection of soft-tissue sarcomas. The intervals between grafting and the initiation of radiation ranged between 3 and 20 weeks, and 4 patients received chemotherapy at the same time as their radiation. Ten of the 12 irradiated grafts remained intact after the completion of therapy. One graft had several small persistently ulcerated areas that required no further surgical treatment, and one graft required a musculocutaneous flap for reconstruction of a persistent large ulcer. Acute radiation effects on the grafted skin sometimes developed at slightly lower doses than usually seen with normal skin, but these acute effects necessitated a break in therapy on only five occasions. Concurrent chemotherapy and a relatively short interval between grafting and the initiation of radiation seemed to contribute to more severe radiation reactions. This experience indicates that postoperative adjuvant radiation therapy can be delivered to skin grafted areas without undue fear of complications, especially if the graft is allowed to heal adequately prior to initiating therapy and if chemotherapy is not given in conjunction with radiation.

  12. Bone scintigraphy in evaluating the viability of composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and free non-revascularized periosteal grafts

    SciTech Connect

    Berggren, A.; Weiland, A.J.; Ostrup, L.T.

    1982-07-01

    Researchers studied the value of bone scintigraphy in the assessment of anastomotic patency and bone-cell viability in free bone grafts revascularized by microvascular anastomoses in twenty-seven dogs. The dogs were divided into three different groups, and scintigraphy was carried out using technetium-labeled methylene diphosphonate in composite bone grafts revascularized by microvascular anastomoses, conventional autogenous bone grafts, and periosteal grafts placed in different recipient beds. The viability of the grafts were evaluated by histological examination and fluorescence microscopy after triple labeling with oxytetracycline on the first postoperative day, alizarin complexone on the fourth postoperative day, and DCAF on the eleventh postoperative day. A positive scintiscan within the first week following surgery indicated patent microvascular anastomoses, and histological study and fluorescence microscopy confirmed that bone throughout the graft was viable. A positive scintiscan one week after surgery or later does not necessarily indicate microvascular patency or bone-cell survival, because new bone formed by creeping substitution on the surface of a dead bone graft can result in this finding.

  13. Delayed skin grafting in facial reconstruction. When to use and how to do.

    PubMed

    Bumsted, R M; Panje, W R; Ceilley, R I

    1983-03-01

    To assess the effectiveness of delayed skin grafting for the reconstruction of facial defects following Mohs excision of cutaneous malignant neoplasms, an analysis was done on 40 patients. All grafts in this series survived. Satisfactory results were obtained in 95% of the patients. Complications were minor and uncommon. Results of this study demonstrate indications for the use of delayed skin grafting to include recurrent or aggressive primary lesions and defects that are large, deep, and favorably located. Advantages of delayed skin grafting are as follows: improved recipient bed vascularity providing high survival of a thicker graft; provision of additional tissue bulk; reduced length of time for healing; less contracture than with granulation healing; and elimination of additional scarring adjacent to the defect. In properly selected patients, this technique offers an additional method of reconstruction of facial defects.

  14. [The use of preputial skin as cutaneous graft after circumcision. Report of 30 clinical cases].

    PubMed

    Chlihi, A; Benbrahim, A; Diouri, M; Terrab, S; Bahechar, N; Boukind, E H

    2002-06-01

    Through a study of 30 clinical cases, collected at the service center of plastic surgery and burns in Averroes University hospital at Casablanca, the authors underline the interest of using preputial skin as full-thickness skin graft for the treatment of burns and their sequelaes in non-circumcised boys, whose age ranged from one to four years. At this age, they are more exposed to domestic accidents. The preputial skin graft gives the advantage of the absence of scare prejudice at the donor site each time the circumcision is possible; and provides a skin of good elastic quality avoiding secondary retraction with a very favorable rate of graft intake. Although the application of this technique for other affections is possible, but remains limited by the hyperpigmentation of the graft. PMID:12148228

  15. Biomarkers to assess graft quality during conventional and machine preservation in liver transplantation.

    PubMed

    Verhoeven, Cornelia J; Farid, Waqar R R; de Jonge, Jeroen; Metselaar, Herold J; Kazemier, Geert; van der Laan, Luc J W

    2014-09-01

    A global rising organ shortage necessitates the use of extended criteria donors (ECD) for liver transplantation (LT). However, poor preservation and extensive ischemic injury of ECD grafts have been recognized as important factors associated with primary non-function, early allograft dysfunction, and biliary complications after LT. In order to prevent for these ischemia-related complications, machine perfusion (MP) has gained interest as a technique to optimize preservation of grafts and to provide the opportunity to assess graft quality by screening for extensive ischemic injury. For this purpose, however, objective surrogate biomarkers are required which can be easily determined at time of graft preservation and the various techniques of MP. This review provides an overview and evaluation of biomarkers that have been investigated for the assessment of graft quality and viability testing during different types of MP. Moreover, studies regarding conventional graft preservation by static cold storage (SCS) were screened to identify biomarkers that correlated with either allograft dysfunction or biliary complications after LT and which could potentially be applied as predictive markers during MP. The pros and cons of the different biomaterials that are available for biomarker research during graft preservation are discussed, accompanied with suggestions for future research. Though many studies are currently still in the experimental setting or of low evidence level due to small cohort sizes, the biomarkers presented in this review provide a useful handle to monitor recovery of ECD grafts during clinical MP in the near future.

  16. The Effect of Adipose-Derived Stem Cells on Full-Thickness Skin Grafts.

    PubMed

    Wang, Juan; Hao, Haojie; Huang, Hong; Chen, Deyun; Han, Yan; Han, Weidong

    2016-01-01

    Background. The purpose of this study was to evaluate the effects of ASCs on full-thickness skin grafts. Specifically, we investigated the anti-inflammatory effects of ASCs that are mediated via regulation of the phenotypes of activated macrophages. Methods. ASCs were isolated, cultured, and injected under full-thickness skin grafts in 15 rats (ASC group). An additional 15 rats served as controls (PBS group). Skin graft survival assessment and vascularization detection were assessed with H&E staining and laser Doppler blood flowmetry (LDF). The effects of ASCs on angiogenesis, anti-inflammation, collagen accumulation-promoting, and antiscarring were assessed. Results. We found that the skin graft survival rate was significantly increased in the ASC group. The neovascularization, collagen deposition, collagen type I to type III ratio, and levels of VEGF and TGF-β3 in the ASC group were markedly higher than those in the PBS group at day 14. Additionally, in the ASC group, the levels of iNOS, IL-1β, and TNF-α were remarkably decreased, whereas the levels of IL-10 and Arg-1 were substantially increased. Conclusions. Our results confirm that ASCs transplantation can effectively improve full-thickness skin graft survival. Additionally, the anti-inflammatory role of ASCs may indirectly contribute to skin graft survival via its effect on macrophage polarization. PMID:27413735

  17. Salvage urethroplasty using skin grafts for previously failed long-segment urethral strictures.

    PubMed

    Sevinc, Cuneyd; Balaban, Muhsin; Ozkaptan, Orkunt; Kutlu, Necmettin; Karadeniz, Tahir

    2016-09-01

    The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate.

  18. The Effect of Adipose-Derived Stem Cells on Full-Thickness Skin Grafts

    PubMed Central

    Hao, Haojie; Huang, Hong; Chen, Deyun; Han, Yan; Han, Weidong

    2016-01-01

    Background. The purpose of this study was to evaluate the effects of ASCs on full-thickness skin grafts. Specifically, we investigated the anti-inflammatory effects of ASCs that are mediated via regulation of the phenotypes of activated macrophages. Methods. ASCs were isolated, cultured, and injected under full-thickness skin grafts in 15 rats (ASC group). An additional 15 rats served as controls (PBS group). Skin graft survival assessment and vascularization detection were assessed with H&E staining and laser Doppler blood flowmetry (LDF). The effects of ASCs on angiogenesis, anti-inflammation, collagen accumulation-promoting, and antiscarring were assessed. Results. We found that the skin graft survival rate was significantly increased in the ASC group. The neovascularization, collagen deposition, collagen type I to type III ratio, and levels of VEGF and TGF-β3 in the ASC group were markedly higher than those in the PBS group at day 14. Additionally, in the ASC group, the levels of iNOS, IL-1β, and TNF-α were remarkably decreased, whereas the levels of IL-10 and Arg-1 were substantially increased. Conclusions. Our results confirm that ASCs transplantation can effectively improve full-thickness skin graft survival. Additionally, the anti-inflammatory role of ASCs may indirectly contribute to skin graft survival via its effect on macrophage polarization. PMID:27413735

  19. Salvage urethroplasty using skin grafts for previously failed long-segment urethral strictures.

    PubMed

    Sevinc, Cuneyd; Balaban, Muhsin; Ozkaptan, Orkunt; Kutlu, Necmettin; Karadeniz, Tahir

    2016-09-01

    The aim of this study was to describe a technique using full-thickness skin grafts (FTSGs) from different parts of the body for salvage urethroplasties and the present outcomes. A total of 24 men underwent urethroplasties for strictures averaging 7.7 cm (range, 5-17 cm) in length, using FTSGs from the inner arm, inner thigh, or abdominal skin. Each of these cases had at least one failed urethroplasty. Twenty-four patients underwent surgery for 26 urethral strictures, with a mean follow-up period of 23.2 (5-44) months and a mean operation time of 140 (115-180) minutes. Reconstruction of the urethra with skin grafting was successful in 18 out of the 26 procedures during the first attempt (69%). A "redo" skin grafting was performed for the eight failed cases, with four successful procedures (50%). Overall, the success rate was 84% (22 out of 26 urethral strictures); however, the failed cases developed abscesses and later, ureterocutaneous fistulas. No hair formation from the skin grafts was seen. Skin grafts provide useful alternative graft sources for previously failed long-segment urethral strictures in which the buccal mucosae are not available or are insufficient for salvage urethroplasties with an acceptable success rate. PMID:27638406

  20. Radiation induced graft copolymerization of methyl methacrylate onto chrome-tanned pig skins

    NASA Astrophysics Data System (ADS)

    Pietrucha, K.; Pȩkala, W.; Kroh, J.

    Graft copolymerization of methyl methacrylate (MMA) onto chrome-tanned pig skins was carried out by the irradiation with 60Co ?-rays. The grafted polymethyl methacrylate (PMMA) chains were isolated by acid hydrolysis of the collagen backbone in order to characterize the graft copolymers. Proof of grafting was obtained through the detection of amino acid endgroups in the isolated grafts by reaction with ninhydrin. The grafting yield of MMA in aqueous emulsion was found to be higher than that for pure MMA and MMA in acetone. The degree of grafting increases with increasing monomer concentration in emulsion and reaches maximum at radiation dose ca 15 kGy. The yield of grafting is very high - ca 90% of monomer converts into copolymer and only 10% is converted into homopolymer. The present paper reports the physical properties of chrome-tanned pig skins after graft polymerization with MMA in emulsion. Modified leathers are more resistant against water absorption and abrasion in comparison with unmodified ones. They have more uniform structure over the whole surface, greater thickness and stiffness. The results reported seem to indicate that MMA may be used in the production of shoe upper and sole leathers. The mechanism of some of the processes occuring during radiation grafting of MMA in water emulsion on tanned leathers has been also suggested and discussed.

  1. Loss of split thickness skin grafts due to non-group A beta-haemolytic streptococci.

    PubMed Central

    Wilson, G. R.; French, G. W.; Sully, L.

    1988-01-01

    Over a 17-month period 77 patients requiring a split skin graft for a burn injury have suffered loss of previously well taken graft due to the growth of a beta-haemolytic streptococcus. Of these only 42 were streptococci of Lancefield group A (Streptococcus pyogenes); 16 were group B, 3 group C and 16 group G. Some strains of groups B, C and G produce cytopathic and spreading factors capable of destroying the new skin graft and regenerating epithelium. We suggest that the non-group A streptococci may be more pathogenic than previously recognised in this particular respect. PMID:3046466

  2. Unique Presentation of Orf Virus Infection in a Thermal-Burn Patient After Receiving an Autologous Skin Graft.

    PubMed

    Hsu, Christopher H; Rokni, Ghasem Rahmatpour; Aghazadeh, Nessa; Brinster, Nooshin; Li, Yu; Muehlenbachs, Atis; Goldsmith, Cynthia S; Zhao, Hui; Petersen, Brett; McCollum, Andrea M; Reynolds, Mary G

    2016-10-15

    We describe a burn patient who developed skin lesions on her skin-graft harvest and skin-graft recipient (burn) sites. Orf virus infection was confirmed by a combination of diagnostic assays, including molecular tests, immunohistochemical analysis, pathologic analysis, and electron microscopy. DNA sequence analysis grouped this orf virus isolate among isolates from India. Although no definitive source of infection was determined from this case, this is the first reported case of orf virus infection in a skin graft harvest. Skin graft recipients with exposures to animals may be at risk for this viral infection. PMID:27456708

  3. THE ROLE OF PASSENGER LEUKOCYTES IN THE ANOMALOUS SURVIVAL OF NEONATAL SKIN GRAFTS IN MICE

    PubMed Central

    Wachtel, Stephen S.; Silvers, Willys K.

    1972-01-01

    The anomalous survival of neonatal C3H skin grafts on CBA mice is correlated with the emigration of passenger leukocytes from the graft vasculature. Thus, newborn homografts whose leukocyte populations are eliminated by X-irradiation or by transient sojourn on an intermediate adult C3H host, do not display prolonged survival. Moreover, the continued presence of the newborn grafts is not requisite to the maintenance of the unresponsive state, an observation consonant with the demonstration that CBA mice bearing long-term neonatal C3H skin grafts are leukocyte chimeras. In contrast, neonatal male C57 skin grafts may persist on C57 females after heavy irradiation of the donor, or after passage on an intermediate adult male host. In addition, tolerance is broken by removal of long-persistant newborn grafts from hitherto unresponsive females, and chimerism is not detectable in female C57 mice tolerant of infant male isografts. Finally, leukocytes of neonatal C3H origin, inoculated subcutaneously into CBA males, may occasionally render these animals unresponsive to subsequent adult C3H skin homografts, whereas those taken from infant C57 males usually sensitize their adult female hosts. Thus, passenger leukocytes are implicated in the extended survival of C3H neonatal homografts on CBA recipients, but not in the persistence of H-Y-incompatible neonatal skin isografts on C57 females. PMID:4551219

  4. Reexamination of the role of Lyt-2-positive T cells in murine skin graft rejection

    SciTech Connect

    LeFrancois, L.; Bevan, M.J.

    1984-01-01

    The authors have investigated which T cell subclass defined by cytolysis with monoclonal anti-Lyt-1.2 and anti-Lyt-2.2 antibodies is required to adoptively transfer the ability to reject skin grafts. B6.Thy-1.1 spleen cells immune to graft antigens were fractionated with antibody plus C' and transferred to adult thymectomized, irradiated, bone marrow-reconstituted (ATXBM) B6.Thy-1.2 hosts that were simultaneously grafted with BALB.B skin. The authors found that when the ATXBM hosts were used 6 wk after irradiation and marrow reconstitution, both Lyt-1-depleted and Lyt-2-depleted immune spleen cells could transfer the ability to promptly reject skin grafts. However, such ATXBM recipients of Lyt-2-depleted cells that had rejected skin grafts were found to contain graft-specific CTL that were largely of host (B6.Thy-1.2) origin. When ATXBM hosts were used for the experiment 1 wk after irradiation and marrow reconstitution, no host-derived graft-specific CTL could be detected. However, graft rejection occurred in recipients of anti-Lyt-1- or anti-Lyt-2 plus C'-treated immune cells and specific CTL were generated from spleen cells of both groups. Thus, in the absence of a host-derived response, adoptively transferred immune Lyt-2+ cells, either resistant to, or that escaped from, antibody plus C' treatment, are able to expand in response to the antigenic stimulus provided by the graft. A more complete elimination of specific T cell subclasses is therefore needed to assess the relative contribution of a particular subset to the graft rejection process.

  5. Flocculation properties of polyacrylamide grafted carboxymethyl guar gum (CMG-g-PAM) synthesised by conventional and microwave assisted method.

    PubMed

    Pal, Sagar; Ghorai, S; Dash, M K; Ghosh, S; Udayabhanu, G

    2011-09-15

    A novel polymeric flocculant based on polyacrylamide grafted carboxymethyl guar gum (CMG-g-PAM) has been synthesised by grafting polyacrylamide chains onto CMG backbone using conventional redox grafting and microwave assisted grafting methods. Under optimum grafting conditions, 82% and 96% grafting efficiencies have been observed in case of conventional and microwave assisted methods respectively. The optimum sample has been characterized using viscometry, spectroscopic analysis, elemental analysis, molecular weight and radius of gyration determination. The flocculation characteristics of grafted and ungrafted polysaccharides have been evaluated in kaolin suspension, municipal sewage wastewater and decolourization efficiency of a dye solution (methylene blue). It is evident from results that CMG-g-PAM synthesised by microwave assisted grafting method is showing best flocculation characteristics. PMID:21802849

  6. Accelerated adhesion of grafted skins by laser-induced stress wave-based gene transfer of hepatocyte growth factor

    NASA Astrophysics Data System (ADS)

    Aizawa, Kazuya; Sato, Shunichi; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Obara, Minoru

    2009-02-01

    In our previous study, we delivered plasmid DNA coding for human hepatocyto growth factor (hHGF) to rat skin grafts based on laser-induced stress wave (LISW), by which production of CD31-positive cells in the grafted skins was found to be enhanced, suggesting improved angiogenesis. In this study, we validated the efficacy of this method to accelerate adhesion of grafted skins; reperfusion and reepithelialization in the grafted skins were examined. As a graft, dorsal skin of a rat was exsected and its subcutaneous fat was removed. Plasmid DNA expression vector for hHGF was injected into the graft; on its back surface a laser target with a transparent sheet for plasma confinement was placed, and irradiated with three nanosecond laser pulses at a laser fluence of 1.2 J/cm2 (532 nm; spot diameter, 3 mm) to generate LISWs. After the application of LISWs, the graft was transplanted onto its donor site. We evaluated blood flow by laser Doppler imaging and analyzed reepithelialization based on immunohistochemistry as a function of postgrafting time. It was found that both reperfusion and reepithelialization were significantly enhanced for the grafts with gene transfection than for normal grafts; reepithelialization was completed within 7 days after transplantation with the transfected grafts. These findings demonstrate that adhesion of grafted skins can be accelerated by delivering HGF gene to the grafts based on LISWs.

  7. Allograft tolerance in pigs after fractionated lymphoid irradiation. I. Skin grafts after partial lateral irradiation and bone marrow cell grafting

    SciTech Connect

    Vaiman, M.; Daburon, F.; Remy, J.; Villiers, P.A.; de Riberolles, C.; Lecompte, Y.; Mahouy, G.; Fradelizi, D.

    1981-05-01

    Experiments with pigs have been performed to establish bone marrow chimerism and skin graft tolerance between SLA genotyped animals. Recipients were conditioned by means of fractionated partial irradiation from lateral cobalt sources (partial lateral irradiation (PLI)). The head, neck, and lungs were protected with lead, the rest of the body being irradiated including the thymus, the majority of lymphoid organs with spleen, and most of the bone marrow sites.

  8. [Post-surgical management of split-thickness skin grafts in oculoplastic surgery].

    PubMed

    Tost, F; Kempin, R

    2015-01-01

    Malignant skin tumours in periocular regions often demand ophthalmo-surgical measures. Split-thickness skin grafts still represent an important treatment alternative when plastic-reconstructive covering through local tissue of the facial area is impossible. Essential technical steps to gain viable split-thickness skin grafts are introduced. Current standards in the after-treatment of split-thickness skin grafts at the receiving location as well as in the after-care of the donor area are presented from interdisciplinary points of view referring to the latest publications. Hydrocolloidal dressings are recommended for the after-treatment of removal areas such as the inside of the forearm since they improve post-surgical management for the ophthalmologist significantly and help in abbreviating healing duration. Pain sensation of the patient as well as the rate of infection are minimal. Throughout the early stages, split-thickness skin grafts at reception areas often demand an intensified local massage treatment with hydrocortisone 2.5 % ophthalmic cream. During the later stages follow-up measures should be stopped neither too soon nor abruptly. Ointments with polysiloxane and silicon dioxide preserve skin suppleness and prevent the occurrence of shrinkage as well as hypertrophic scars. PMID:25611496

  9. Recurrent carcinoma in situ of the vagina following split-thickness skin graft vaginoplasty.

    PubMed

    Gallup, D G; Castle, C A; Stock, R J

    1987-01-01

    A patient who developed squamous cell carcinoma in situ in a split-thickness skin graft neovagina is presented. This is the third reported case in the English literature of a patient previously treated for carcinoma in situ of the vagina who later developed an identical lesion in the graft. Management of this neoplasm is discussed, and follow-up for patients with neovaginas is emphasized. PMID:3539716

  10. Skin graft rejection in mice repopulated with marrow of the skin donor type: a Skn gene in a congenic line

    SciTech Connect

    Harrison, D.E.; Mobraaten, L.E.

    1984-01-01

    Genetically anemic W/Wv mice and lethally irradiated wild-type mice were cured and populated by grafted marrow cells from donor mice of three congenic lines that differed at non-H-2 histocompatibility loci. Tail skin from mice of the same congenic lines was grafted 3-4 weeks later. In two cases, the recipients behaved as expected, no longer rejecting skin syngeneic with the marrow graft that had repopulated them. However, B6-H-24c skin was rejected by WBB6F1-W/Wv mice that were cured with B6-H-24c marrow showing a mean survival time of 9.9 weeks. It was rejected somewhat faster, with a mean survival time of 5.9 weeks, by W/Wv mice cured with marrow from other types of donors. Results were more variable in lethally irradiated WBB6F1-+/+ recipients of B6-H-24c marrow, but they also rejected B6-H-24c skin. Both types of recipients remained chimeras after the skin was rejected, showing more than 90% of the B6-H-24c hemoglobin type. This is the first report of a Skn gene in a congenic line.

  11. Altered glycosylation in donor mice causes rejection of strain-matched skin and heart grafts.

    PubMed

    Gock, H; Murray-Segal, L J; Winterhalter, A C; Aminian, A; Moore, G T C; Brown, S J; d'Apice, A J F; Cowan, P J

    2014-04-01

    Differential protein glycosylation in the donor and recipient can have profound consequences for transplanted organs, as evident in ABO-incompatible transplantation and xenotransplantation. In this study, we investigated the impact of altered fucosylation on graft acceptance by using donor mice overexpressing human α1,2-fucosyltransferase (HTF). Skin and heart grafts from HTF transgenic mice were rapidly rejected by otherwise completely matched recipients (median survival times 16 and 14 days, respectively). HTF skin transplanted onto mice lacking T and B cells induced an natural killer cell-mediated innate rejection crisis that affected 50-95% of the graft at 10-20 days. However, in the absence of adaptive immunity, the residual graft recovered and survived long-term (>100 days). Experiments using "parked" grafts or MHC class II-deficient recipients suggested that indirect rather than direct antigen presentation plays a role in HTF skin graft rejection, although the putative antigen(s) was not identified. We conclude that altered glycosylation patterns on donor tissue can trigger a powerful rejection response comprising both innate and adaptive components. This has potential implications for allotransplantation, in light of increasing recognition of the variability of the human glycome, and for xenotransplantation, where carbohydrate remodeling has been a lynchpin of donor genetic modification.

  12. Quantification of texture match of the skin graft: function and morphology of the stratum corneum.

    PubMed

    Inoue, K; Matsumoto, K

    1986-01-01

    In an attempt to analyze the "texture match" of grafted skin, functional and morphological aspects of the stratum corneum were studied using the Skin Surface Hydrometer (IBS Inc.) and the scanning electron microscope. The results showed that hygroscopicity and water holding capacity of the stratum corneum played a crucial role in making the skin surface soft and smooth. Morphologically there were regional differences in the surface pattern and the mean area of corneocytes, suggesting that these differences affect skin texture. It is suggested that the present functional and morphological studies of the stratum corneum can provide a quantitative measure of the "texture match".

  13. Quantification of texture match of the skin graft: function and morphology of the stratum corneum.

    PubMed

    Inoue, K; Matsumoto, K

    1986-01-01

    In an attempt to analyze the "texture match" of grafted skin, functional and morphological aspects of the stratum corneum were studied using the Skin Surface Hydrometer (IBS Inc.) and the scanning electron microscope. The results showed that hygroscopicity and water holding capacity of the stratum corneum played a crucial role in making the skin surface soft and smooth. Morphologically there were regional differences in the surface pattern and the mean area of corneocytes, suggesting that these differences affect skin texture. It is suggested that the present functional and morphological studies of the stratum corneum can provide a quantitative measure of the "texture match". PMID:3535058

  14. INTRA-ORAL CANCER—The Use of Skin Grafts in the Management of the Condition

    PubMed Central

    Sharp, George S.; Helsper, James T.

    1964-01-01

    Seventy-two patients with 78 intra-oral cancers were treated by surgical excision and repair was carried out with free split-thickness skin grafts. Examination of removed specimens confirmed the precancerous character of the surrounding mucous membranes and emphasized the importance of removing them completely if that is practical. With the free skin graft this wider excision is possible with less impairment of function. It may also prevent the questionable “local recurrence” or second primary adjacent to the scar, and even multiple primaries in the same region of the oral cavity. ImagesFigure 1.Figure 2. PMID:14143665

  15. A Novel Nude Mouse Model of Hypertrophic Scarring Using Scratched Full Thickness Human Skin Grafts

    PubMed Central

    Alrobaiea, Saad M.; Ding, Jie; Ma, Zengshuan; Tredget, Edward E.

    2016-01-01

    Objective: Hypertrophic scar (HTS) is a dermal form of fibroproliferative disorder that develops following deep skin injury. HTS can cause deformities, functional disabilities, and aesthetic disfigurements. The pathophysiology of HTS is not understood due to, in part, the lack of an ideal animal model. We hypothesize that human skin with deep dermal wounds grafted onto athymic nude mice will develop a scar similar to HTS. Our aim is to develop a representative animal model of human HTS. Approach: Thirty-six nude mice were grafted with full thickness human skin with deep dermal scratch wound before or 2 weeks after grafting or without scratch. The scratch on the human skin grafts was made using a specially designed jig that creates a wound >0.6 mm in depth. The xenografts were morphologically analyzed by digital photography. Mice were euthanized at 1, 2, and 3 months postoperatively for histology and immunohistochemistry analysis. Results: The mice developed raised and firm scars in the scratched xenografts with more contraction, increased infiltration of macrophage, and myofibroblasts compared to the xenografts without deep dermal scratch wound. Scar thickness and collagen bundle orientation and morphology resembled HTS. The fibrotic scars in the wounded human skin were morphologically and histologically similar to HTS, and human skin epithelial cells persisted in the remodeling tissues for 1 year postengraftment. Innovation and Conclusions: Deep dermal injury in human skin retains its profibrotic nature after transplantation, affording a novel model for the assessment of therapies for the treatment of human fibroproliferative disorders of the skin. PMID:27366591

  16. Values of a Patient and Observer Scar Assessment Scale to Evaluate the Facial Skin Graft Scar

    PubMed Central

    Chae, Jin Kyung; Kim, Eun Jung; Park, Kun

    2016-01-01

    Background The patient and observer scar assessment scale (POSAS) recently emerged as a promising method, reflecting both observer's and patient's opinions in evaluating scar. This tool was shown to be consistent and reliable in burn scar assessment, but it has not been tested in the setting of skin graft scar in skin cancer patients. Objective To evaluate facial skin graft scar applied to POSAS and to compare with objective scar assessment tools. Methods Twenty three patients, who diagnosed with facial cutaneous malignancy and transplanted skin after Mohs micrographic surgery, were recruited. Observer assessment was performed by three independent rates using the observer component of the POSAS and Vancouver scar scale (VSS). Patient self-assessment was performed using the patient component of the POSAS. To quantify scar color and scar thickness more objectively, spectrophotometer and ultrasonography was applied. Results Inter-observer reliability was substantial with both VSS and the observer component of the POSAS (average measure intraclass coefficient correlation, 0.76 and 0.80, respectively). The observer component consistently showed significant correlations with patients' ratings for the parameters of the POSAS (all p-values<0.05). The correlation between subjective assessment using POSAS and objective assessment using spectrophotometer and ultrasonography showed low relationship. Conclusion In facial skin graft scar assessment in skin cancer patients, the POSAS showed acceptable inter-observer reliability. This tool was more comprehensive and had higher correlation with patient's opinion. PMID:27746642

  17. Evaluation of amniotic fluid as a skin graft storage media compared with RPMI and saline.

    PubMed

    Turhan-Haktanır, Nurten; Dilek, F Hüsniye; Köken, Gülengül; Demir, Yavuz; Yılmaz, Güray

    2011-06-01

    We aimed to assess and compare the histological changes of grafts stored in Roswell Park Memorial Institute-1640 solution (RPMI), amniotic fluid (AF), and saline. Amniotic fluid which has abundant nutrients, proteins, and growth factors, and antimicrobial features may be an easily achievable and cheap alternative for the short term preservation of skin grafts. Discarded surgical skin pieces obtained from 15 trauma patients were divided into three groups as RPMI, AF, and saline. The specimens were evaluated at days 7, 14, 21, and 28 for histological alterations by a 3-point scoring scale. Histological scores in the grafts stored in amniotic fluid and RPMI were found significantly lower than those stored in saline (p<0.01). No significant difference was detected between AF and RPMI stored grafts. AF may be a good alternative for skin graft preservation as demonstrated by histological changes. New studies with multiple AF donators and repeated experiments will be worthwhile. Besides, restrictions of some ethical and legal issues for AF use should be solved. PMID:21269778

  18. Povidone-iodine ointment: no effect of split skin graft healing time.

    PubMed

    Vehmeyer-Heeman, M; Van den Kerckhove, E; Gorissen, K; Boeckx, W

    2005-06-01

    In major burns, local treatment of the split skin graft after a burn injury is important to prevent serious infectious complications. Topical burn wound therapy may improve the bacteriological condition of the wound, which in turn may improve the successful take of a skin graft. Delay of wound healing is an undesired side effect of these topical anti-microbial agents. It is known that povidone-iodine has many clinical advantages. In view of this, the total healing time of the freshly grafted burn wound was studied. In this prospective study, comparable areas of the same patient were treated with povidone-iodine ointment or with simple vaseline gauze. There was no statistical difference in the total wound healing time between the treated and the control group.

  19. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area.

    PubMed

    Jia-Zi, Shi; Xiao, Zhai; Jun-Hui, Li; Chun-Yu, Xue; Hong-da, Bi

    2016-08-01

    Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing.Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at -150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up.All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements.NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus. PMID:27583890

  20. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area

    PubMed Central

    Jia-zi, Shi; Xiao, Zhai; Jun-hui, Li; Chun-yu, Xue; Hong-da, Bi

    2016-01-01

    Abstract Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing. Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at −150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up. All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements. NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus. PMID:27583890

  1. Negative pressure wound therapy combined with skin grafting improves surgical wound healing in the perianal area.

    PubMed

    Jia-Zi, Shi; Xiao, Zhai; Jun-Hui, Li; Chun-Yu, Xue; Hong-da, Bi

    2016-08-01

    Management of large tissue defects resulting from local wide resection of perianal is a clinical challenge for surgeons. The aim of the present study was to investigate the efficacy of negative pressure wound therapy (NPWT) following skin grafting on perianal surgical wound healing.Included in this study were 12 patients with perianal tumors who received skin grafting after perianal tumor resection between December 2012 and December 2014. A self-designed negative pressure drainage device was then applied to maintain a standard negative pressure at -150 mm Hg and removed on day 8 postoperation. The outcome was recorded immediately after NPWT and at 6-month follow-up.All skin grafts survived without infection, hematoma, and necrosis in all 12 patients. No tumor recurrence was detected during 6-month follow-up. Natural folds were observed around the anus. All patients showed normal bowel movements.NPWT following skin grafting was effective for perianal surgical wound healing and infection prevention, thus benefiting anatomical and functional recovery of the anus.

  2. [THE HISTORY OF SKIN GRAFTING, ANCIENT TIMES AND CIVILIZATIONS. THE FIRST MENTIONS].

    PubMed

    Sokolov, V A; Skvortsov, Yu R; Tarasenku, M Yu

    2015-01-01

    The article dials with the history of medicine practiced by the first civilizations. The facts of discovery and analysis of ancient medical treatises by modern researchers are reported. Special emphasis is laid on the achievements of medical practitioners in Ancient Egypt and India that promoted the development of operative treatment including skin grafting. PMID:26168607

  3. [THE HISTORY OF SKIN GRAFTING, ANCIENT TIMES AND CIVILIZATIONS. THE FIRST MENTIONS].

    PubMed

    Sokolov, V A; Skvortsov, Yu R; Tarasenku, M Yu

    2015-01-01

    The article dials with the history of medicine practiced by the first civilizations. The facts of discovery and analysis of ancient medical treatises by modern researchers are reported. Special emphasis is laid on the achievements of medical practitioners in Ancient Egypt and India that promoted the development of operative treatment including skin grafting.

  4. The love surrounding the first skin graft in Taiwan: "British skin" that will stay in Taiwanese hearts.

    PubMed

    Lai, Chung-Sheng; Chen, Austin Deng; Lai, Ya-Wei; Kuo, Shou-Jen

    2012-12-01

    There is a painting that looks like a representation of a simple surgical procedure. However, it holds a warm story of the love surrounding the first skin graft made by Dr. David Landsborough III for a Taiwanese child in 1928. He harvested the donor skin from his wife, Marjorie Landsborough, to save a poor boy. Although the grafted skin could not grow onto the wound, the graft of love was permanently imprinted on Taiwanese People's hearts. The first Taiwanese recipient of MD, PhD degree, Dr. Tsung-Ming Tu invited an artist to recreate and draw the surgical procedure to immortalize the unforgettable love and memory of Dr. Landsborough III. The painting hanging on the hospital wall portrays an important professional role model for every student and health care provider. The life story of this medical missionary in Formosa from 1895 to 1936 contributed greatly to the development of medical care in Taiwan. It is hoped that this story, outlining great love and selflessness, can be glorified and remembered for the world to appreciate for generations to come. PMID:23154327

  5. Accelerated adhesion of grafted skin by laser-induced stress wave-based gene transfer of hepatocyte growth factor

    NASA Astrophysics Data System (ADS)

    Aizawa, Kazuya; Sato, Shunichi; Terakawa, Mitsuhiro; Saitoh, Daizoh; Tsuda, Hitoshi; Ashida, Hiroshi; Obara, Minoru

    2009-11-01

    Gene therapy using wound healing-associated growth factor gene has received much attention as a new strategy for improving the outcome of tissue transplantation. We delivered plasmid DNA coding for human hepatocyte growth factor (hHGF) to rat free skin grafts by the use of laser-induced stress waves (LISWs); autografting was performed with the grafts. Systematic analysis was conducted to evaluate the adhesion properties of the grafted tissue; angiogenesis, cell proliferation, and reepithelialization were assessed by immunohistochemistry, and reperfusion was measured by laser Doppler imaging as a function of time after grafting. Both the level of angiogenesis on day 3 after grafting and the increased ratio of blood flow on day 4 to that on day 3 were significantly higher than those in five control groups: grafting with hHGF gene injection alone, grafting with control plasmid vector injection alone, grafting with LISW application alone, grafting with LISW application after control plasmid vector injection, and normal grafting. Reepithelialization was almost completed on day 7 even at the center of the graft with LISW application after hHGF gene injection, while it was not for the grafts of the five control groups. These findings demonstrate the validity of our LISW-based HGF gene transfection to accelerate the adhesion of grafted skins.

  6. Anterior ischemic optic neuropathy after conventional coronary artery bypass graft surgery

    PubMed Central

    Dorecka, Mariola; Miniewicz-Kurkowska, Joanna; Romaniuk, Dorota; Gajdzik-Gajdecka, Urszula; Wójcik-Niklewska, Bogumiła

    2011-01-01

    Summary Background Perioperative optic neuropathy is a disease which can lead to serious, irreversible damage of vision. This complication could be the result of non-ocular surgery, for example, cardiac or spinal procedures. We present a case of anterior ischemic neuropathy (AION) which occurred following a conventional coronary artery bypass graft procedure. Case Report A 57-year-old man, 4 days after Conventional Coronary Artery Bypass Graft surgery as result of multi-vessel stabile coronary artery disease and history of anterolateral wall myocardial infarction, was admitted to the Eye Clinic due to significant loss of vision in his right eye. The patient had hypertension and was a heavy smoker. On admission, the slit lamp examination revealed a relative afferent pupillary defect in the right eye. The fundus examination showed optic disc edema with the presence of flame hemorrhages. Best corrected visual acuity (BCVA) was 0.02. The results of eye examination and fluorescein angiography confirmed the diagnosis of AION. Anti-aggregation and antithrombotic treatment was continued with steroids and vasodilators. After 7 days of this treatment we noticed the improvement of BCVA to 0.2. At 6-month follow-up, the vision was stable, and fundus examination revealed optic disc atrophy. Conclusions After cardiac surgical operations, such as coronary artery bypass graft procedures, anterior ischemic optic neuropathy may occur. In those cases, close cooperation between the various specialists is necessary. PMID:21629193

  7. Demographic characteristics and outcome of burn patients requiring skin grafts: a tertiary hospital experience

    PubMed Central

    Shlash, Saud Othman Al; Madani, Jamal Omran Al; Deib, Jamal Ismail El; Alsubhi, Fatemah Suliman; Saifi, Sara Saud Al; Helmi, Ayman Mohammed Adel; Al-Mutairi, Sultan Khalaf; Khurram, Javed Akhtar

    2016-01-01

    Split thickness skin graft (STSG) and full thickness skin graft (FTSG) are the integral part of burn wound management. However the impact of these graft types on the outcome still remain a matter of controversy. The purpose of this study was to determine the demographic characteristics and outcome of graft surgery of the patients undergone STSG and FTSG at Plastic Surgery Department of Prince Sultan Military Medical City (PSMMC), Riyadh, Kingdom of Saudi Arabia. This retrospective study included 85 burn patients who received STSG (56 cases) and FTSG (29 cases) at PSMMC during 2010-2015. Demographic characteristics (age, gender, etiology of burn, and area of burn) and outcome (graft loss, graft contraction, skin pigmentation, altered sensation, infection rate and duration of hospital stay) were recorded among the patients who received STSG or FTSG. Out of 85 patients 50 patients were male and 35 female with a ratio of 1.42:1. The patients under the age of 10 years comprised the largest burn group with 28 cases (32.9%) out of total 85 patients. The number of patients above the age of 30 years was relatively smaller. Flame (49.3%) and scald (27%) burns constituted the majority of burn cases. The incidence of contraction among STSG (12.5%) and in FTSG (17.2%) cases was similar. Altered sensation was observed in 7.05% of STSG patients and 13.7% of FTSG cases. Loss of graft was observed in 16% of STSG and 20.6% of FTSG patients. The pigmentation was quite similar in STSG (21.4%) and FTSG (24. 1%). The hospitalization time in FTSG (28 days) patients was also comparable with STSG (26.9 days) group. This study showed that majority of the skin graft cases at PSMMC were male under the age of 30 years mostly affected by flame or scald burns. The outcome following STSG and FTSG surgery was comparable with no significant advantage of one over the other. It may be deduced that both STSG and FTSG have relative merits and demerits and either of these grafting procedure may be

  8. Phase I/II Clinical Evaluation of StrataGraft: A Consistent, Pathogen-Free Human Skin Substitute

    PubMed Central

    Schurr, Michael J.; Foster, Kevin N.; Centanni, John M.; Comer, Allen R.; Wicks, April; Gibson, Angela L.; Thomas-Virnig, Christina L.; Schlosser, Sandy J.; Faucher, Lee D.; Lokuta, Mary A.; Allen-Hoffmann, B. Lynn

    2009-01-01

    Background Large wounds often require temporary allograft placement to optimize the wound bed and prevent infection until permanent closure is feasible. We developed and clinically tested a second-generation living human skin substitute (StrataGraft). StrataGraft provides both a dermis and a fully-stratified, biologically-functional epidermis generated from a pathogen-free, long-lived human keratinocyte progenitor cell line, Neonatal Immortalized KeratinocyteS (NIKS). Methods Histology, electron microscopy, quantitative polymerase chain reaction, and bacterial growth in vitro were used to analyze human skin substitutes generated from primary human keratinocytes or NIKS cells. A phase I/II, National Institute of Health-funded, randomized, safety, and dose escalation trial was performed to assess autograft take in 15 patients 2 weeks after coverage with StrataGraft skin substitute or cryopreserved cadaver allograft. Results StrataGraft skin substitute exhibited a fully stratified epidermis with multilamellar lipid sheets and barrier function as well as robust human β defensin-3 mRNA levels. Analysis of the primary endpoint in the clinical study revealed no differences in autograft take between wound sites pretreated with StrataGraft skin substitute or cadaver allograft. No StrataGraft-related adverse events or serious adverse events were observed. Conclusions The major finding of this phase I/II clinical study is that performance of StrataGraft skin substitute was comparable to cadaver allograft for the temporary management of complex skin defects. StrataGraft skin substitute may also eliminate the risk for disease transmission associated with allograft tissue and offer additional protection to the wound bed through inherent antimicrobial properties. StrataGraft is a pathogen-free human skin substitute that is ideal for the management of severe skin wounds before autografting. PMID:19276766

  9. Skin and kidney histological changes in graft-versus-host disease (GVHD) after kidney transplantation.

    PubMed

    Pintar, Tadeja; Alessiani, Mario; Pleskovič, Alojz; Pleskovič, Aleš; Zorc-Pleskovič, Ruda; Milutinović, Aleksandra

    2011-05-01

    Kidney transplantation (Ktx) is generally performed during end stage renal disease due to a loss of the kidneys' ability to filter wastes from the circulatory system. Acute graft-versus-host disease (GVHD) after Ktx is a life-threatening complication that progresses to organ failure, systemic complications, and death. The current study evaluated the significance of histologic findings of GVHD as obtained from skin biopsies following Ktx in swine. A swine model of Ktx with tacrolimus-based immunosuppression was used to assess possible correlations between acute-graft-cellular rejection and skin histological findings for prediction of GVHD. Animals were divided into a Ktx treatment group or a control group with no Ktx and skin and kidney biopsies were histologically assessed at postoperative days 0, 15, 30, 45 and 60. Skin samples were analyzed and classified from grade 1 to 4 of skin GVHD and the major histopathological changes of kidney acute cellular rejection were described using Banff's score system. We observed a significant linear correlation between the histological grading values of skin biopsy changes and the histological grading values of kidney biopsies (Kendall's tau_b=0.993) in the Ktx experimental group. No histological changes were observed in controls. Our findings demonstrate the diagnostic value of staging skin GVHD after Ktx and suggest it's future utility for monitoring long term Ktx-induced changes.

  10. Late Complication after Superficial Femoral Artery (SFA) Aneurysm: Stent-graft Expulsion Outside the Skin

    SciTech Connect

    Pecoraro, Felice Sabatino, Ermanno R.; Dinoto, Ettore; Rosa, Giuliana La; Corte, Giuseppe; Bajardi, Guido

    2015-10-15

    A 78-year-old man presented with a 7-cm aneurysm in the left superficial femoral artery, which was considered unfit and anatomically unsuitable for conventional open surgery for multiple comorbidities. The patient was treated with stent-graft [Viabhan stent-graft (WL Gore and Associates, Flagstaff, AZ)]. Two years from stent-graft implantation, the patient presented a purulent secretion and a spontaneous external expulsion through a fistulous channel. No claudication symptoms or hemorrhagic signs were present. The pus and device cultures were positive for Staphylococcus aureus sensitive to piperacillin/tazobactam. Patient management consisted of fistula drainage, systemic antibiotic therapy, and daily wound dressing. At 1-month follow-up, the wound was closed. To our knowledge, this is the first case of this type of stent-graft complication presenting with external expulsion.

  11. Collagen structural alterations contribute to stiffening of tissue after split-thickness skin grafting.

    PubMed

    Rosin, Nicole L; Agabalyan, Natacha; Olsen, Katherine; Martufi, Giampaol; Gabriel, Vincent; Biernaskie, Jeff; Di Martino, Elena S

    2016-03-01

    The gold standard treatment for full thickness injuries of the skin is autologous split-thickness skin grafting. This involves harvesting the epidermis and superficial dermis from healthy skin and transplanting it onto the prepared wound bed. The donor site regenerates spontaneously, but the appendages and cellular components from the dermal layer are excluded from the graft. As a result, the new tissue is inferior; the healed graft site is dry/itchy, has decreased elasticity, increased fragility, and altered sensory function. Because this dermal layer is composed of collagen and other extracellular matrix proteins, the aim was to characterize the changes in the dermal collagen after split thickness grafting that could contribute to a deficit in functionality. This will serve as a baseline for future studies designed to improve skin function using pharmacological or cell-based therapies for skin repair. A xenograft model whereby human split-thickness grafts were implanted into full-thickness defects on immunocompromised (athymic Nu/Nu) mice was used. The grafts were harvested 4 and 8 weeks later. The collagen microstructure was assessed with second harmonic generation with dual-photon microscopy and light polarization analysis. Collagen fiber stiffness and engagement stretch were estimated by fitting the results of biaxial mechanical tensile tests to a histo-mechanical constitutive model. The stiffness of the collagen fibril-proteoglycan complex increased from 682 ± 226 kPa/sr to 1016 ± 324 kPa/sr between 4 and 8 weeks postgrafting. At the microstructural level there were significant decreases in both thickness of collagen fibers (3.60 ± 0.34 μm vs. 2.10 ± 0.27 μm) and waviness ratio (2.04 ± 0.17 vs. 1.43 ± 0.08) of the collagen fibers postgrafting. The decrease of the macroscopic engagement stretch from 1.19 ± 0.11 to 1.09 ± 0.08 over time postgrafting mirrored the decrease in waviness measured at the microscopic level

  12. Treatment of postburn ear defect with expanded upper arm flap and consequent expansion without skin grafting.

    PubMed

    Hu, Jintian; Liu, Tun; Zhou, Xu; Zhang, Yong-Biao; Zhang, Qingguo

    2014-04-01

    Total ear reconstruction in the postburn auricle is one of the most challenging procedures for plastic surgeons. Adverse factors associated with these procedures include reduced or damaged blood supply, poor elasticity of scar tissue, increased risk of infection, and the possible destruction of skin, temporoparietal fascia, or retroauricular fascia. In cases where patients are severely burned, free flaps, such as radial forearm flaps, contralateral temporoparietal fascial flaps, or omental flaps, can be used as framework envelopes. In this work, we introduced a novel method of expanded upper arm flap transfer, followed by an expansion method of total ear reconstruction without skin grafting.

  13. An overview of factors maximizing successful split-thickness skin grafting in diabetic wounds

    PubMed Central

    Donegan, Ryan J.; Schmidt, Brian M.; Blume, Peter A.

    2014-01-01

    Open wounds, from ulcerations or slow healing, are one of the comorbidities in diabetic patients that can lead to amputation. Therefore, an optimal way to close and heal wounds quickly in diabetic patients is required. Split-thickness skin grafts (STSG) offer a quick method of wound closure for diabetic patients. This article review will look at causes of failure in STSG, and ways to optimize success.

  14. [Modification of seaweed polysaccharide-agarose and its application as skin dressing (III)--skin regeneration with agarose grafting hyaluronic acid sponge].

    PubMed

    Huang, Jianyan; Zhang, Lingmin; Chu, Bin; Chen, Peng; Tang, Shunqing

    2011-02-01

    In this paper, a kind of skin dressing, agarose- grafting- hyaluronic acid (Ag-g-HA) sponge was applied to test the modified agarose based scaffold for skin regeneration. The bFGF loading agarose-grafting hyaluronan scaffold had homogenous porosities, and the loaded bFGF was bioactive in 2 weeks. The Ag-g-HA sponge was applied into skin of mice, and it was found that the dressing promoted skin regeneration and no infection and leakage in lesion site took place. H&E staining results showed that the repaired skin was similar to autologous skin. These demonstrate that Ag-g-HA sponge has a promise in skin regeneration.

  15. Three-dimensional hyaluronic acid grafts promote healing and reduce scar formation in skin incision wounds.

    PubMed

    Hu, Min; Sabelman, Eric E; Cao, Yang; Chang, James; Hentz, Vincent R

    2003-10-15

    Hyaluronic acid (HA) has been found to play important roles in tissue regeneration and wound-healing processes. Fetal tissue with a high concentration of HA heals rapidly without scarring. The present study employed HA formed into three-dimensional strands with or without keratinocytes to treat full-thickness skin incision wounds in rats. Wound closure rates of HA strand grafts both with and without keratinocytes were substantially enhanced. The closure times of both HA grafts were less than 1 day (average 16 h), about 1/7 that of the contralateral control incisions (114 h, p <.01). Average wound areas after 10 days were HA-only graft: 0.151 mm2 +/- 0.035; HA + cell grafts: 0.143 mm2 +/- 0.036 and controls: 14.434 mm2 +/- 1.175, experimental areas were 1% of the controls (p < 0.01). Transforming growth factor (TGF) beta1 measured by immunostaining was remarkably reduced in HA-treated wounds compared to the controls. In conclusion, HA grafts appeared to produce a fetal-like environment with reduced TGF-beta1, which is known to be elevated in incipient scars. The HA strands with or without cultured cells may potentially improve clinical wound healing as well as reduce scar formation.

  16. [Urethroplasty with buccal mucosa graft or penile skin graft for anterior urethral stricture?].

    PubMed

    Rojas, Alejandro; Saavedra, Alvaro

    2015-06-04

    Currently the treatment for urethral stricture considers various techniques, including augmentation urethroplasty using tissue from different parts of the body. The more used are the buccal mucosa and penile skin, but are there any differences in success between both tissues? Searching in Epistemonikos database, which is maintained by screening 30 databases, we identified one systematic review including 18 primary studies addressing this question, six of them prospective. We combined the evidence using meta-analysis and generated a summary of findings table following the GRADE approach. We concluded there is uncertainty about the superiority of one technique over another because the certainty of the evidence is very low. A new systematic review is urgently needed on this topic as randomized studies have been published after the most recent review, which could provide greater certainty.

  17. Therapeutics for Graft-versus-Host Disease: From Conventional Therapies to Novel Virotherapeutic Strategies.

    PubMed

    Villa, Nancy Y; Rahman, Masmudur M; McFadden, Grant; Cogle, Christopher R

    2016-03-01

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a curative potential for many hematologic malignancies and blood diseases. However, the success of allo-HSCT is limited by graft-versus-host disease (GVHD), an immunological syndrome that involves inflammation and tissue damage mediated by donor lymphocytes. Despite immune suppression, GVHD is highly incident even after allo-HSCT using human leukocyte antigen (HLA)-matched donors. Therefore, alternative and more effective therapies are needed to prevent or control GVHD while preserving the beneficial graft-versus-cancer (GVC) effects against residual disease. Among novel therapeutics for GVHD, oncolytic viruses such as myxoma virus (MYXV) are receiving increased attention due to their dual role in controlling GVHD while preserving or augmenting GVC. This review focuses on the molecular basis of GVHD, as well as state-of-the-art advances in developing novel therapies to prevent or control GVHD while minimizing impact on GVC. Recent literature regarding conventional and the emerging therapies are summarized, with special emphasis on virotherapy to prevent GVHD. Recent advances using preclinical models with oncolytic viruses such as MYXV to ameliorate the deleterious consequences of GVHD, while maintaining or improving the anti-cancer benefits of GVC will be reviewed. PMID:27011200

  18. Therapeutics for Graft-versus-Host Disease: From Conventional Therapies to Novel Virotherapeutic Strategies

    PubMed Central

    Villa, Nancy Y.; Rahman, Masmudur M.; McFadden, Grant; Cogle, Christopher R.

    2016-01-01

    Allogeneic hematopoietic stem cell transplantation (allo-HSCT) has a curative potential for many hematologic malignancies and blood diseases. However, the success of allo-HSCT is limited by graft-versus-host disease (GVHD), an immunological syndrome that involves inflammation and tissue damage mediated by donor lymphocytes. Despite immune suppression, GVHD is highly incident even after allo-HSCT using human leukocyte antigen (HLA)-matched donors. Therefore, alternative and more effective therapies are needed to prevent or control GVHD while preserving the beneficial graft-versus-cancer (GVC) effects against residual disease. Among novel therapeutics for GVHD, oncolytic viruses such as myxoma virus (MYXV) are receiving increased attention due to their dual role in controlling GVHD while preserving or augmenting GVC. This review focuses on the molecular basis of GVHD, as well as state-of-the-art advances in developing novel therapies to prevent or control GVHD while minimizing impact on GVC. Recent literature regarding conventional and the emerging therapies are summarized, with special emphasis on virotherapy to prevent GVHD. Recent advances using preclinical models with oncolytic viruses such as MYXV to ameliorate the deleterious consequences of GVHD, while maintaining or improving the anti-cancer benefits of GVC will be reviewed. PMID:27011200

  19. Revision of Perineal Urethrostomy Using a Meshed Split-Thickness Skin Graft

    PubMed Central

    Lumen, N.; Houtmeyers, P.; Monstrey, S.; Spinoit, A.-F.; Oosterlinck, W.; Hoebeke, P.

    2014-01-01

    Perineal urethrostomy is considered to be the last option to restore voiding in complex/recurrent urethral stricture disease. It is also a necessary procedure after penectomy or urethrectomy. Stenosis of the perineal urethrostomy has been reported in up to 30% of cases. There is no consensus on how to treat a stenotic perineal urethrostomy, but, in general, a form of urinary diversion is offered to the patient. We present the case of a young male who underwent perineal urethrostomy after urethrectomy for urethral cancer. The postoperative period was complicated by wound dehiscence with subsequent complete obliteration of the perineal urethrostomy. Revision surgery was performed with reopening of the obliterated urethral stump and coverage of the skin defect between the urethra and the perineal/scrotal skin with a meshed split-thickness skin graft. To date, this patient is voiding well and satisfied with the offered solution. PMID:24575117

  20. About ATMPs, SOPs and GMP: The Hurdles to Produce Novel Skin Grafts for Clinical Use

    PubMed Central

    Hartmann-Fritsch, Fabienne; Marino, Daniela; Reichmann, Ernst

    2016-01-01

    Background The treatment of severe full-thickness skin defects represents a significant and common clinical problem worldwide. A bio-engineered autologous skin substitute would significantly reduce the problems observed with today's gold standard. Methods Within 15 years of research, the Tissue Biology Research Unit of the University Children's Hospital Zurich has developed autologous tissue-engineered skin grafts based on collagen type I hydrogels. Those products are considered as advanced therapy medicinal products (ATMPs) and are routinely produced for clinical trials in a clean room facility following the guidelines for good manufacturing practice (GMP). This article focuses on hurdles observed for the translation of ATMPs from research into the GMP environment and clinical application. Results and Conclusion Personalized medicine in the field of rare diseases has great potential. However, ATMPs are mainly developed and promoted by academia, hospitals, and small companies, which face many obstacles such as high financial burdens. PMID:27781022

  1. Forty-Year Follow-up of Full-Thickness Skin Graft After Thermal Burn Injury to the Volar Hand

    PubMed Central

    Kasdan, Morton L.; Wilhelmi, Bradon J.

    2016-01-01

    Background: The hands are commonly affected in severe thermal burn injuries. Resulting contractures lead to significant loss of function. Burn contracture release and skin grafting are necessary to restore hand function. We report a case in which surgical reconstruction of a volar hand burn was performed with full-thickness skin grafting. The patient had a 40-year follow-up to assess the function and cosmesis of the repaired hand. Methods: We report a case in which a 15-month-old boy presented after receiving third-degree burns to the left volar hand, including the flexural aspects of the index, long, and ring fingers by placing it on a hot kitchen stove burner. The patient subsequently underwent scar contracture release and full-thickness skin grafting. Results: Eleven years after reconstruction, further contractures developed associated with the patient's growth, which were reconstructed with repeat full-thickness skin graft from the inguinal region. No recurrence was witnessed afterward and 40 years after initial injury, the patient maintains full activities of daily living and use of his hand in his occupation. Conclusions: There is debate regarding the superiority of split-thickness versus full-thickness grafts during reconstruction. Our case strengthens the argument for durability of a full-thickness skin graft following thermal burn injury. PMID:27555888

  2. A Comparative Animal Study of Tendon Grafts Healing After Remnant-Preserving Versus Conventional Anterior Cruciate Ligament Reconstruction

    PubMed Central

    Zhang, Lei; Jiang, Kan; Chai, Hao; Zhou, Mei; Bai, Jingping

    2016-01-01

    Background The aim of this study was to determine if anterior cruciate ligament (ACL) reconstruction by remnant preservation promotes cell proliferation, vascularization, proprioception recovery, and improved biomechanical properties of the tendon grafts. Material/Methods 75 New Zealand rabbits were randomly assigned into the control group (group A), conventional ACL reconstruction group (group B), ACL reconstruction using remnant preservation and graft through remnant sleeve technique group (group C), and ACL reconstruction using remnant preservation and remnant tensioning technique group (group D). The remnant and healing of tendon grafts in groups C and D were observed at 3, 6, and 12 weeks after surgery, and the mRNA expression levels of VEGF, NT-3 and GAP-43 in ACL (group A) or tendon graft samples (groups B, C, and D) were determined by real-time PCR. Tendon graft cell count, microvessel density (MVD), and proprioceptors were determined by H&E staining, CD34, and S-100 immunohistochemical staining. The biomechanical properties of the tendon graft at week 12 in groups B, C, and D were examined by using a tensile strength test. Results Remnant and tendon grafts were not healed at 3, 6, and 12 weeks after the operation in groups C and D. VEGF, NT-3, and GAP-43 mRNA expressions in groups B, C, and D were higher than those in group A (P<0.05), but no significant difference was observed between groups B, C, and D (P>0.05). Furthermore, tendon graft cell count, MVD, proprioception, and biomechanical properties showed no significant differences (P>0.05) among groups B, C, and D at various time points. Conclusions There was no significant difference in cell proliferation, vascularization, proprioception recovery, or biomechanical properties of the tendon grafts between remnant-preserving and conventional ACL reconstruction methods. PMID:27669454

  3. Surveillance of patients after abdominal aortic aneurysm repair with endovascular grafting or conventional treatment.

    PubMed

    Raithel, D

    1998-12-01

    At Nuremberg Southern Hospital we have been using endovascular therapy for aortic aneurysms for the past 3 years. Between August 1994 and August 1997, 193 patients with infrarenal aortic aneurysms were treated with endovascular stent grafts. Besides using commercially available modular systems of the Stentor type (MinTec/Vanguard*, Boston Scientific) we also participated in a multicenter study implanting EGS devices (EVT in 65 patients). Follow-up examinations must strive to detect thrombotic complications as well as endoleaks with high sensitivity and specificity. To avoid aneurysm rupture significant increase in aneurysm diameter must be detected in a timely fashion to select patients for additional corrective endovascular procedures or conversion to open surgical therapy. A close follow-up regimen therefore is absolutely mandatory for all patients undergoing endovascular aortic grafting, particularly when new prosthetic devices are being introduced. Prosthetic devices that have been adequately tested using controlled study designs and are commercially available may be followed-up using a standardized follow up scheme as delineated. Particularly during the first postoperative year color duplex with use of an intravenous ultrasound enhancing agent has been used successfully to detect even minor endoleaks originating from retrograde perfusion via aortic side branches (lumbar or inferior mesenteric artery). Only patients with documented endoleaks or suspected outflow obstruction requiring further intervention need to undergo diagnostic arteriography. After conventional aneurysm repair yearly duplex scans are usually sufficient to follow the normal patient. Patients who have undergone endovascular therapy, however need to be followed much closer using duplex as well as abdominal CT scans. This will logically result in significantly higher follow up costs. Periinterventional costs of endovascular aortic reconstruction currently exceed those of conventional aortic

  4. Utilities of Split-Thickness Skin Grafting for Male Genital Reconstruction

    PubMed Central

    Alwaal, Amjad; McAninch, Jack W.; Harris, Catherine R.; Breyer, Benjamin N.

    2016-01-01

    Objective To report our successful outcomes of genital split-thickness skin graft (STSG) in covering major skin loss and providing good functional and cosmetic outcomes. Materials and Methods A retrospective chart review was performed for all adult urology patients who underwent STSG at our institution from 1998 to 2014. Patients had a wide range of disease etiologies, including tissue loss (eg post-Fournier's gangrene), lymphedema, buried penis, foreign body injection, and tumors. Results A total of 54 patients were identified with the following breakdown of etiology: 13 patients with tissue loss (eg post-Fournier's gangrene), 13 with lymphedema, 12 with buried penis, 8 with foreign body injection, 4 with hidradenitis suppurativa, and 4 with tumors. Fifty-two out of 54 patients had more than 90% graft take, with maintained or improved erection, normal voiding, good cosmetic outcome as judged by the patient and the examining surgeon, and normal mobility. One patient died at 3 months due to cardiovascular cause, and 1 patient had a poor take of the graft. Conclusion We show the wide variety of indications for STSG use, the ease of the technique, and its successful outcomes. We believe this procedure should be offered to patients as a first-line treatment and also as a last resort when other more conservative approaches fail. PMID:26190089

  5. Measuring skin penetration by confocal Raman microscopy (CRM): correlation to results from conventional experiments

    NASA Astrophysics Data System (ADS)

    Lunter, Dominique; Daniels, Rolf

    2016-03-01

    Confocal Raman microscopy has become an advancing technique in the characterization of drug transport into the skin. In this study the skin penetration of a local anesthetic from a semisolid preparation was investigated. Furthermore, the effect of the chemical enhancers propylene glycol and POE-23-lauryl ether on its penetration was investigated. The results show that confocal Raman microscopy may provide detailed information on the penetration of APIs into the skin and may elucidate their distribution within the skin with high resolution. The results of the CRM analysis are fully in line with those of conventional permeation and penetration experiments.

  6. Subjective and objective observation of skin graft recovery on Indonesian local cat with different periods of transplantation time

    PubMed Central

    Erwin; Gunanti; Handharyani, Ekowati; Noviana, Deni

    2016-01-01

    Aim: The success of a skin graft in a cat is highly dependent on the granulation formed by the base of recipient bed. Granulation by the base of recipient bed will form after several days after injury. This research aimed to observe subjective and objective profile of skin graft recovery on forelimb of cats with different periods of donor skin placement. Materials and Methods: Nine male Indonesian local cats aged 1-2 years old, weighing 3-4 kg were divided into three groups. The first surgery for creating defect wound of 2 cm×2 cm in size was performed in the whole group. The wound was left for several days with the respective interval for each group, respectively: Group I (for 2 days), Group II (for 4 days), and Group III (for 6 days). In the whole group, the second surgery was done by the harvesting skin of thoracic area which then applied on recipient bed of respective groups. Result: The donor skin on Group II was accepted faster compared to Group I and Group III. The donor skin did not show color differences compared to surrounding skin, painless, bright red in bleeding test had faster both hair growth and drug absorption. Test toward the size of donor skin and the effect of drugs did not show a significant difference between each group. Conclusion: The observe subjective and objective profile of skin graft recovery on forelimb of cats on Group II were accepted faster compared to Group I and III. PMID:27284224

  7. Stepwise surgical approach to diabetic partial foot amputations with autogenous split thickness skin grafting

    PubMed Central

    Ramanujam, Crystal L.; Zgonis, Thomas

    2016-01-01

    In the surgical treatment of severe diabetic foot infections, substantial soft tissue loss often accompanies partial foot amputations. These sizeable soft tissue defects require extensive care with the goal of expedited closure to inhibit further infection and to provide resilient surfaces capable of withstanding long-term ambulation. Definitive wound closure management in the diabetic population is dependent on multiple factors and can have a major impact on the risk of future diabetic foot complications. In this article, the authors provide an overview of autogenous skin grafting, including anatomical considerations, clinical conditions, surgical approach, and adjunctive treatments, for diabetic partial foot amputations. PMID:27283728

  8. Composite versus conventional coronary artery bypass grafting strategy for the anterolateral territory: study protocol for a randomized controlled trial

    PubMed Central

    2013-01-01

    Background In severe coronary artery disease, coronary artery bypass grafting (CABG) surgery is indicated to re-establish an adequate blood supply to the ischemic myocardium. Effectiveness of CABG surgery for symptom relief and mortality decrease should therefore depend on bypass graft patency. As bypass using a left internal mammary artery (LIMA)-to-left anterior descending coronary artery (LAD) anastomosis allows the best results in terms of graft patency, we designed a new surgical technique using a saphenous vein graft as a venous bridge to distribute the LIMA flow to the cardiac anterolateral territory. This novel strategy could extend the patency benefits associated to the LIMA. Other potential benefits of this technique include easier surgical technique, possibility to use saphenous vein grafts as vein patch angioplasty, shorter saphenous vein grafts requirement and reduced or eliminated manipulations of the ascendant aorta (and associated stroke risk). Methods/Design Between July 2012 and 2016, 200 patients undergoing a primary isolated CABG surgery using cardiopulmonary bypass with a LAD bypass graft and at least another target on the anterolateral territory will be randomized (1:1) according to 1) the new composite strategy and 2) the conventional strategy with a LIMA-to-LAD anastomosis and revascularization of the other anterolateral target(s) with a separated aorto-coronary saphenous vein graft. The primary objective of the trial is to assess whether the composite strategy allows non-inferior anterolateral graft patency index (proportion of non-occluded CABGs out of the total number of CABGs) compared to the conventional technique. The primary outcome is the anterolateral graft patency index, evaluated at one year by 256-slice computed tomography angiography. Ten years of clinical follow-up is planned to assess clinical outcomes including death, myocardial infarction and need for revascularization. Discussion This non-inferiority trial has the potential

  9. Squamous cell carcinoma arising on a skin graft 64 years after primary injury.

    PubMed

    Guenther, Nina; Menenakos, Charalambos; Braumann, Chris; Buettemeyer, Rolf

    2007-01-01

    Malignant degeneration of a chronic wound is often described by the term, Marjolin's ulcer. We present a case of a squamous cell carcinoma that developed in a patient 64 years after the initial injury during World War II. Tissue contusion and detachment required repeated surgery and full skin grafting in several hospitals. The patient had a persistent ulcer in the right popliteal region for the last 3 years. Excisional biopsy in our department showed a bifocal low-grade invasive squamous cell carcinoma of the skin. Because of extensive inflammation and previous scar formation it was difficult to determine the status of the surgical margins. Therefore, we proceeded with amputation at the right thigh. Some 6 months after surgery the general condition of the patient remains excellent. PMID:17498446

  10. Differential cytokine expression in skin graft healing in inducible nitric oxide synthase knockout mice.

    PubMed

    Most, D; Efron, D T; Shi, H P; Tantry, U S; Barbul, A

    2001-10-01

    Inducible nitric oxide synthase (iNOS) and its product, nitric oxide, have been shown to play important roles in wound biology. The present study was performed to investigate the role of iNOS in modulating the cytokine cascade during the complex process of skin graft wound healing.Fifteen iNOS-knockout mice and 15 wild-type C57BL/6J mice were subjected to autogenous 1-cm2 intrascapular full-thickness skin grafts. Three animals in each group were killed on postoperative days 3, 5, 7, 10, and 14. Specimens were then analyzed using nonisotopic in situ hybridization versus mRNA of tumor growth factor-beta1, vascular endothelial growth factor, iNOS, endothelial nitric oxide synthase (eNOS), tumor necrosis factor-alpha, and basic fibroblast growth factor, as well as positive and negative control probes. Positive cells in both grafts and wound beds were counted using a Leica microgrid. Scar thickness was measured with a Leica micrometer. Data were analyzed using the unpaired Student's t test. Expression of iNOS was 2- to 4-fold higher in knockout mice than in wild-type mice on postoperative days 5, 7, and 14. Expression of eNOS was 2- to 2.5-fold higher in knockout mice than in wild-type mice on postoperative days 5 and 7. Tumor necrosis factor-alpha expression was 2- to 7-fold higher in knockout mice than in wild-type mice on all postoperative days. In contrast, expression levels of angiogenic/fibrogenic cytokines (vascular endothelial growth factor, basis fibroblast growth factor, and tumor growth factor-beta1) were 2.5- to 4-fold higher in wild-type mice than in knockout mice. Scars were 1.5- to 2.5-fold thicker in knockout mice than in wild-type mice at all time points. All of the above results represent statistically significant differences (p < 0.05). Significantly different patterns of cytokine expression were seen in knockout and wild-type mice. Although the scar layer was thicker in knockout mice, it showed much greater infiltration with inflammatory cells. These

  11. Evaluation of human amniotic membrane as a wound dressing for split-thickness skin-graft donor sites.

    PubMed

    Loeffelbein, Denys J; Rohleder, Nils H; Eddicks, Matthias; Baumann, Claudia M; Stoeckelhuber, Mechthild; Wolff, Klaus-D; Drecoll, Enken; Steinstraesser, Lars; Hennerbichler, Simone; Kesting, Marco R

    2014-01-01

    Human amniotic membrane (HAM) has been used as a biomaterial in various surgical procedures and exceeds some qualities of common materials. We evaluated HAM as wound dressing for split-thickness skin-graft (STSG) donor sites in a swine model (Part A) and a clinical trial (Part B). Part A: STSG donor sites in 4 piglets were treated with HAM or a clinically used conventional polyurethane (PU) foil (n = 8 each). Biopsies were taken on days 5, 7, 10, 20, 40, and 60 and investigated immunohistochemically for alpha-smooth muscle actin (αSMA: wound contraction marker), von Willebrand factor (vWF: angiogenesis), Ki-67 (cell proliferation), and laminin (basement membrane integrity). Part B: STSG donor sites in 45 adult patients (16 female/29 male) were treated with HAM covered by PU foam, solely by PU foam, or PU foil/paraffin gauze (n = 15 each). Part A revealed no difference in the rate of wound closure between groups. HAM showed improved esthetic results and inhibitory effects on cicatrization. Angioneogenesis was reduced, and basement membrane formation was accelerated in HAM group. Part B: no difference in re-epithelialization/infection rate was found. HAM caused less ichor exudation and less pruritus. HAM has no relevant advantage over conventional dressings but might be a cost-effective alternative.

  12. Platelet growth factors from allogeneic platelet-rich plasma for clinical improvement in split-thickness skin graft

    PubMed Central

    Sonker, Atul; Dubey, Anju; Bhatnagar, Ankur; Chaudhary, Rajendra

    2015-01-01

    Background and objectives: Platelets are a source of numerous growth factors which facilitate repair and healing. Thus platelet rich plasma has been increasingly used as a treatment modality in the field of reconstructive surgeries for wound healing. This preliminary study was carried out to explore whether platelet growth factors from platelet rich plasma could be used for enhancement of split thickness skin graft survival. Materials and Methods: Twenty patients (13 males and 7 females) requiring split thickness skin graft for various clinical reasons were enrolled in the study. Platelet rich plasma was collected by apheresis and frozen at −80° C. It was thawed at room temperature immediately before its intended application. PRP was applied only on one half of the wound, while another half served as control. Patient was followed for 6 weeks. The effect was assessed at first dressing in terms of graft uptake and subsequently as time taken for complete healing. Results: There was 100% uptake of the graft in the area where platelet rich plasma was applied. In the control area, there was complete graft loss in 4 cases, partial loss in 7 cases and complete uptake in 9 cases. Conclusion: This study demonstrated promising results on application of PRP to split thickness skin grafts. Further randomized studies with greater sample size may be undertaken to establish platelet rich plasma as a validated treatment modality. PMID:26420935

  13. Use of 1540nm fractionated erbium:glass laser for split skin graft resurfacing: a case study.

    PubMed

    Narinesingh, S; Lewis, S; Nayak, B S

    2013-09-01

    The field of laser skin resurfacing has evolved rapidly over the past two decades from ablative lasers, to nonablative systems using near-infrared, intense-pulsed light and radio-frequency systems, and most recently fractional laser resurfacing. Although fractional thermolysis is still in its infancy, its efficacy in in the treatment of skin disorders have been clearly demonstrated. Here we present a case report on the safety and efficacy of a 1540nm erbium:glass laser in the treatment of the waffle pattern of a meshed skin graft in a 38-year-old patient with type V skin in the Caribbean.

  14. Transplantation of skin grafts and organs infected with Toxoplasma gondii as a source of toxoplasmosis in immunocompromised mice.

    PubMed

    Belal, Usama Salah; Norose, Kazumi; Mohamed, Rabie Mohamed; Naoi, Koji; Yano, Akihiko

    2011-01-01

    The possibility of Toxoplasma gondii infection resulting from transplantation of a skin graft and various organs has been investigated. The parasite was detected in very low numbers in all organs examined in wild-type (WT) BALB/c (B/c) mice that received skin grafts from infected interferon gamma knockout (GKO) B/c mice both with and without sulfamethoxazole treatment; all recipient mice survived. In contrast, transplantation of skin grafts from untreated infected WT B/c mice to naïve GKO B/c mice led to the death of all recipients within 20 days post-transplantation; T. gondii was found to be disseminated in all organs examined. Similar results were obtained after transplantation of skin from untreated and treated GKO B/c mice to naïve GKO B/c mice, whereas the recipient GKO B/c mice died within 10 days after intraperitoneal transplantation of lung, heart, brain or small intestine from infected untreated GKO B/c mice. These results indicate that skin grafts as well as various organs infected with T. gondii can be sources of infection in immunocompromised hosts. Toxoplasmosis should therefore be taken into consideration during organ transplantation to immunocompromised hosts.

  15. Computer-Aided Diagnosis of Skin Lesions Using Conventional Digital Photography: A Reliability and Feasibility Study

    PubMed Central

    Chang, Wen-Yu; Huang, Adam; Yang, Chung-Yi; Lee, Chien-Hung; Chen, Yin-Chun; Wu, Tian-Yau; Chen, Gwo-Shing

    2013-01-01

    Background Computer-aided diagnosis (CADx) software that provides a second opinion has been widely used to assist physicians with various tasks. In dermatology, however, CADx has been mostly limited to melanoma or melanocytic skin cancer diagnosis. The frequency of non-melanocytic skin cancers and the accessibility of regular digital macrographs have raised interest in developing CADx for broader applications. Objectives To investigate the feasibility of using CADx to diagnose both melanocytic and non-melanocytic skin lesions based on conventional digital photographic images. Methods This study was approved by an institutional review board, and the requirement to obtain informed consent was waived. In total, 769 conventional photographs of melanocytic and non-melanocytic skin lesions were retrospectively reviewed and used to develop a CADx system. Conventional and new color-related image features were developed to classify the lesions as benign or malignant using support vector machines (SVMs). The performance of CADx was compared with that of dermatologists. Results The clinicians' overall sensitivity, specificity, and accuracy were 83.33%, 85.88%, and 85.31%, respectively. New color correlation and principal component analysis (PCA) features improved the classification ability of the baseline CADx (p = 0.001). The estimated area under the receiver operating characteristic (ROC) curve (Az) of the proposed CADx system was 0.949, with a sensitivity and specificity of 85.63% and 87.65%, respectively, and a maximum accuracy of 90.64%. Conclusions We have developed an effective CADx system to classify both melanocytic and non-melanocytic skin lesions using conventional digital macrographs. The system's performance was similar to that of dermatologists at our institute. Through improved feature extraction and SVM analysis, we found that conventional digital macrographs were feasible for providing useful information for CADx applications. The new color

  16. Collagen hydrogels strengthened by biodegradable meshes are a basis for dermo-epidermal skin grafts intended to reconstitute human skin in a one-step surgical intervention.

    PubMed

    Hartmann-Fritsch, Fabienne; Biedermann, Thomas; Braziulis, Erik; Luginbühl, Joachim; Pontiggia, Luca; Böttcher-Haberzeth, Sophie; van Kuppevelt, Toin H; Faraj, Kaeuis A; Schiestl, Clemens; Meuli, Martin; Reichmann, Ernst

    2016-01-01

    Extensive full-thickness skin loss, associated with deep burns or other traumata, represents a major clinical problem that is far from being solved. A promising approach to treat large skin defects is the use of tissue-engineered full-thickness skin analogues with nearly normal anatomy and function. In addition to excellent biological properties, such skin substitutes should exhibit optimal structural and mechanical features. This study aimed to test novel dermo-epidermal skin substitutes based on collagen type I hydrogels, physically strengthened by two types of polymeric net-like meshes. One mesh has already been used in clinical trials for treating inguinal hernia; the second one is new but consists of a FDA-approved polymer. Both meshes were integrated into collagen type I hydrogels and dermo-epidermal skin substitutes were generated. Skin substitutes were transplanted onto immuno-incompetent rats and analyzed after distinct time periods. The skin substitutes homogeneously developed into a well-stratified epidermis over the entire surface of the grafts. The epidermis deposited a continuous basement membrane and dermo-epidermal junction, displayed a well-defined basal cell layer, about 10 suprabasal strata and a stratum corneum. Additionally, the dermal component of the grafts was well vascularized.

  17. Dermal penetration and systemic distribution of sup 14 C-labeled vitamin E human skin grafted athymic nude mice

    SciTech Connect

    Klain, G.J.

    1989-03-13

    In vivo percutaneous penetration and tissue distribution of 14C-labeled vitamin E applied to human skin grafted onto athymic nude mice were determined. At 1 hr, mouse skin contained the highest level of radioactivity, followed by the muscle, blood, liver, lung, adipose tissue, spleen, kidney, brain, heart, and eyes. A linear increase with time in tissue radioactivity was observed throughout the 24 hr experimental period. At 4 and 24 hrs skin grafts were highly radioactive. At 4 hrs the epidermis and the upper portion of the dermis contained more radioactivity than the remaining portion of the dermis. In contrast, at 24 hrs the highest level of radioactivity was detected in the lower dermis. No radioactivity was detected in expired air while 0.2% of the dose was found in the urine. The data show that vitamin E does penetrate skin and that the dermis acts as a barrier or reservoir for this highly lipophilic compound.

  18. In Vivo Assessment of Printed Microvasculature in a Bilayer Skin Graft to Treat Full-Thickness Wounds

    PubMed Central

    Yanez, Maria; Rincon, Julio; Dones, Aracely; De Maria, Carmelo; Gonzales, Raoul

    2015-01-01

    Chronic wounds such as diabetic foot ulcers and venous leg ulcers are common problems in people suffering from type 2 diabetes. These can cause pain, and nerve damage, eventually leading to foot or leg amputation. These types of wounds are very difficult to treat and sometimes take months or even years to heal because of many possible complications during the process. Allogeneic skin grafting has been used to improve wound healing, but the majority of grafts do not survive several days after being implanted. We have been studying the behavior of fibroblasts and keratinocytes in engineered capillary-like endothelial networks. A dermo-epidermal graft has been implanted in an athymic nude mouse model to assess the integration with the host tissue as well as the wound healing process. To build these networks into a skin graft, a modified inkjet printer was used, which allowed the deposit of human microvascular endothelial cells. Neonatal human dermal fibroblast cells and neonatal human epidermal keratinocytes were manually mixed in the collagen matrix while endothelial cells printed. A full-thickness wound was created at the top of the back of athymic nude mice and the area was covered by the bilayered graft. Mice of the different groups were followed until completion of the specified experimental time line, at which time the animals were humanely euthanized and tissue samples were collected. Wound contraction improved by up to 10% when compared with the control groups. Histological analysis showed the neoskin having similar appearance to the normal skin. Both layers, dermis and epidermis, were present with thicknesses resembling normal skin. Immunohistochemistry analysis showed favorable results proving survival of the implanted cells, and confocal images showed the human cells' location in the samples that were collocated with the bilayer printed skin graft. PMID:25051339

  19. Excision, skin grafting, corticosteroids, adjuvant radiotherapy, pressure therapy, and emancipation: the ESCAPE model for successful taming of giant auricular keloids.

    PubMed

    Masoodi, Zulqarnain; Ahmad, Imran; Khurram, M Fahud; Haq, Ansarul

    2014-09-01

    The authors treated 24 giant auricular keloids (mean size, 11 cm) from January 2008 to July 2012 using a novel protocol consisting of complete excision, skin grafting, a 1-time intraoperative injection of triamcinolone, immediate radiotherapy, and sustained pressure therapy. At 1 year, the success rate was 87.5%.

  20. Columella Lengthening with a Full-Thickness Skin Graft for Secondary Bilateral Cleft Lip and Nose Repair

    PubMed Central

    Lee, Yoon Seok; Shin, Dong Hyeok; Choi, Hyun Gon; Kim, Jee Nam; Lee, Myung Chul; Kim, Soon Heum; Kim, Cheol Keun; Jo, Dong In

    2015-01-01

    Background Various techniques for lengthening short columellae have been used for bilateral cleft nose repair. However, previous methods have not yielded satisfactory results. We performed a full-thickness skin graft to lengthen short columellae during secondary cleft nose repair in adult patients. Methods Ten bilateral cleft lip and nose patients underwent secondary cheiloplasty with open rhinoplasty between July 2008 and August 2014. The patients underwent a full-thickness skin graft on the medial crura to elongate the columella. The average age of the patients at the time of surgery was 22.2 years. Nasal profiles were evaluated before and after the operation using the photogrammetric method. Results The nasal profiles were improved in all patients, and all skin grafts were well taken, with the exception of one patient. Columellar height, nostril height, and columella-lip angle increased, and nasal width decreased significantly. The ratios of columellar height to nasal height, columellar height to nasal width, and nasal height to nasal width increased to a statistically significant extent. Conclusions Columella lengthening with a full-thickness skin graft is a simple and effective method for the repair of severely short columellae in bilateral cleft nose patients. We had satisfactory outcomes, with good color matching and aesthetically pleasing contours. PMID:26618116

  1. One-stage, simultaneous skin grafting with artificial dermis and basic fibroblast growth factor successfully improves elasticity with maturation of scar formation.

    PubMed

    Hamuy, Rodrigo; Kinoshita, Naoshi; Yoshimoto, Hiroshi; Hayashida, Kenji; Houbara, Seiji; Nakashima, Masahiro; Suzuki, Keiji; Mitsutake, Norisato; Mussazhanova, Zhanna; Kashiyama, Kazuya; Hirano, Akiyoshi; Akita, Sadanori

    2013-01-01

    The efficacy of one-stage artificial dermis and skin grafting was tested in a nude rat model. Reconstruction with artificial dermis is usually a two-stage procedure with 2- to 3-week intermission. If one-stage use of artificial dermis and split-thickness skin grafting are effective, the overall burden on patients and the medical cost will markedly decrease. The graft take rate, contraction rate, tissue elasticity, histology, morphometric analysis of the dermal thickness, fibroblast counting, immunohistochemistry of α-smooth muscle actin, matrix metalloproteinase-2, CD31, and F4/80, as well as gelatin zymography, real-time reverse transcriptase polymerase chain reaction for matrix metalloproteinase-2, and electron microscopy, were investigated from day 3 to 3 months postoperatively. The graft take rate was good overall in one-stage artificial dermis and skin grafting groups up to 3 weeks, and the contraction rate was greater in the two-staged artificial dermis and skin grafting group than in the skin grafting alone or one stage of artificial dermis and skin grafting groups. Split-thickness skin grafting with artificial dermis and basic fibroblast growth factor at a concentration of 1 μg/cm(2) showed significantly greater elasticity by Cutometer, and the dermal thickness was significantly thinner, fibroblast counting was significantly greater, and the α-smooth muscle actin expression level was more notable with a more mature blood supply in the dermis and more organized dermal fibrils by electron microscopy at 3 weeks. Thus, one-stage artificial dermis and split-thickness skin grafting with basic fibroblast growth factor show a high graft take rate and better tissue elasticity determined by Cutometer analysis, maturity of the dermis, and increased fibroblast number and blood supply compared to a standard two-stage reconstruction.

  2. Estimates of ozone depletion and skin cancer incidence to examine the Vienna Convention achievements

    NASA Astrophysics Data System (ADS)

    Slaper, Harry; Velders, Guus J. M.; Daniel, John S.; de Gruijl, Frank R.; van der Leun, Jan C.

    1996-11-01

    DEPLETION of the ozone layer has been observed on a global scale1, and is probably related to halocarbon emissions. Ozone depletion increases the biologically harmful solar ultraviolet radiation reaching the surface of the Earth, which leads to a variety of adverse effects, including an increase in the incidence of skin cancer. The 1985 Vienna Convention provided the framework for international restrictions on the production of ozone-depleting substances. The consequences of such restrictions have not yet been assessed in terms of effects avoided. Here we present a new method of estimating future excess skin cancer risks which is used to compare effects of a 'no restrictions' scenario with two restrictive scenarios specified under the Vienna Convention: the Montreal Protocol, and the much stricter Copenhagen Amendments. The no-restrictions and Montreal Protocol scenarios produce a runaway increase in skin cancer incidence, up to a quadrupling and doubling, respectively, by the year 2100. The Copenhagen Amendments scenario leads to an ozone minimum around the year 2000, and a peak relative increase in incidence of skin cancer of almost 10% occurring 60 years later. These results demonstrate the importance of the international measures agreed upon under the Vienna Convention.

  3. Estimates of ozone depletion and skin cancer incidence to examine the Vienna Convention achievements.

    PubMed

    Slaper, H; Velders, G J; Daniel, J S; de Gruijl, F R; van der Leun, J C

    1996-11-21

    Depletion of the ozone layer has been observed on a global scale, and is probably related to halocarbon emissions. Ozone depletion increases the biologically harmful solar ultraviolet radiation reaching the surface of the Earth, which leads to a variety of adverse effects, including an increase in the incidence of skin cancer. The 1985 Vienna Convention provided the framework for international restrictions on the production of ozone-depleting substances. The consequences of such restrictions have not yet been assessed in terms of effects avoided. Here we present a new method of estimating future excess skin cancer risks which is used to compare effects of a 'no restrictions' scenario with two restrictive scenarios specified under the Vienna Convention: the Montreal Protocol, and the much stricter Copenhagen Amendments. The no-restrictions and Montreal Protocol scenarios produce a runaway increase in skin cancer incidence, up to a quadrupling and doubling, respectively, by the year 2100. The Copenhagen Amendments scenario leads to an ozone minimum around the year 2000, and a peak relative increase in incidence of skin cancer of almost 10% occurring 60 years later. These results demonstrate the importance of the international measures agreed upon under the Vienna Convention.

  4. Surface functionalization of bioactive glasses with natural molecules of biological significance, part II: Grafting of polyphenols extracted from grape skin

    NASA Astrophysics Data System (ADS)

    Zhang, Xin; Ferraris, Sara; Prenesti, Enrico; Verné, Enrica

    2013-12-01

    Polyphenols, as one of the most important family of phytochemicals protective substances from grape fruit, possess various biological activities and health-promoting benefits, for example: inhibition of some degenerative diseases, cardiovascular diseases and certain types of cancers, reduction of plasma oxidative stress and slowing aging. The combination of polyphenols and biomaterials may have good potential to reach good bioavailability and controlled release, as well as to give biological signaling properties to the biomaterial surfaces. In this research, conventional solvent extraction was developed for obtaining polyphenols from dry grape skins. The Folin&Ciocalteu method was used to determine the amount of total polyphenols in the extracts. Surface functionalization of two bioactive glasses (SCNA and CEL2) was performed by grafting the extracted polyphenols on their surfaces. The effectiveness of the functionalization was tested by UV spectroscopy, which analyzes the amount of polyphenols in the uptake solution (before and after functionalization) and on solid samples, and XPS, which analyzes the presence of phenols on the material surface.

  5. Topical negative pressure coupled with split-thickness skin grafting for the treatment of hidradenitis suppurativa: a case report.

    PubMed

    Jianbing, Tang; Biao, Cheng; Qin, Li; Yanhong, Wu

    2015-06-01

    Hidradenitis suppurativa is a cutaneous, chronic, recurrent inflammatory disease. Here, we report the case of a 66-year-old man who had hidradenitis suppurativa in the buttocks. He suffered from diabetes mellitus. In the past, he had perianal abscesses. Because of improper treatment of furuncle infections in the buttocks, skin ulcers formed, which worsened and resulted in multiple fistulas. The skin lesion surface was large and the infection was severe. After wound debridement treatment, topical negative pressure and nutritional support were given. After one and a half months, the wound healed with split-thickness skin grafting. In a 2-year follow-up, there was no evidence of hidradenitis suppurativa recurrence.

  6. The new reconstruction technique in the treatment of the skin cancers located on the eyelid: Posterior temporalis fascia composite graft

    PubMed Central

    Copcu, Eray; Sivrioglu, Nazan

    2004-01-01

    Background Difficulty of reconstruction of the eyelids arises from the need to reconstruct different supporting and covering structures in a single operation. Defects in the anterior lamella of the eyelids can be readily repaired with skin grafts or flaps but posterior lamellar reconstruction needs more complex applications. Methods We performed posterior lamellar eyelid reconstruction with posterior parts of the temporalis fascia, since their anatomical and histological features are very similar to the defects. Nine patients with skin tumors located on the periorbital region were treated with local skin flaps and deep layer of the temporalis fascia. Results Grafts were harvested very easily. There was no complication related with graft or donor site. Biopsy was performed in three cases and normal conjunctival elements were seen. Functional and acceptable aesthetically results were achieved in all patients. Conclusion Ideal reconstructive material for replacement of the posterior lamina is still lacking. Tarsal reconstruction can be made with deep temporalis fascia with success since the thickness of the both tissues are very similar and also since the loose areolar layer of the temporalis fascia is very thin and highly vascularized, this layer can be used in reconstruction of the conjunctiva. According to our knowledge this is the first report of using of the posterior part of temporalis fascia as a composite graft in the literature. PMID:15306033

  7. Appearance of a syndrome similar to graft versus host reaction in C57 B1/6 mice bearing skin allogenic graft.

    PubMed

    Nedelea, M; Dima, S

    1975-01-01

    A syndrome similar to GVHR is described in mice of C57B1/6 strain during the WHT/Ht skin allografts rejection period. In all the cases the described thymus involution was associated with the hypertrophy of lymph nodes. Their volume increase is due to the high number of blastic pyroninophilic and plasma cells concomitant with small lymphocytes depletion in the cortical area, and with a very pronounced hypertrophy of medullary cords by presence of a high number of plasmocytes and blastic cells. These changes have been noticed only in some animals sacrified during the first days after grafting and never later one. In agreement with the scarce data of the literature, we think that the immunocompetent passenger lymphocyte comprised in the skin grafts constitute an immunologic organ able to induce a GVHR at the beginning of the period of graft survival on the host. This GVHR, generally mild and without clinical and microscopic signs, becomes obvious only in animals which, for unknown reasons, present a low immunologic defense capacity. In these animals the described process seems to be reversible.

  8. Local immunostimulation leading to rejection of accepted male skin grafts by female mice as a model for cancer immunotherapy

    PubMed Central

    Bourdeaux, Christophe; Lurquin, Christophe; Jacquemart, Isabelle; Lethé, Bernard; Brasseur, Francis; van Baren, Nicolas; Baurain, Jean-François; Dyson, Julian; Van Snick, Jacques; Uyttenhove, Catherine; Boon, Thierry

    2014-01-01

    Female mice of inbred strain CBA do not reject syngeneic male skin grafts even though they mount a T-cell response against the male-specific HY antigen. We show that local immunostimulation performed by injecting cytokines and Toll-like receptor ligands in close vicinity to the graft causes rejection. We feel that this approach should be tested in tumor-bearing human patients in combination with antitumor vaccination. Relief of intratumor immunosuppression may increase considerably the fraction of patients who respond to vaccination directed against tumor antigens recognized by T cells. PMID:24550491

  9. Provocation of skin graft rejection across murine class II differences by non--bone-marrow-derived cells

    SciTech Connect

    Stuart, P.M.; Beck-Maier, B.; Melvold, R.W.

    1984-04-01

    We have evaluated the relative contribution of bone-marrow-derived cells to skin allograft immunogenicity in mice differing only at class II major histocompatibility genes by using bone marrow radiation chimeras as donors. The mouse strains used were C57BL/6Kh (B6) and B6.C-H-2bm12 (bm12), which differ only at at A beta gene of the I region of the mouse H-2 complex. Our results demonstrated that skin from (B6----bm12) chimeras was accepted by bm12 recipients and rejected by B6 mice in a manner indistinguishable from that of normal bm12 skin. Likewise, naive bm12 mice rejected (bm12----B6) chimeric skin and normal B6 skin equally well, and B6 animals accepted both types of skin grafts. Our data argues that the donor cell-type leading to graft rejection across limited I region differences is not of bone marrow origin, and that these cells must--at least under certain circumstances--express class II antigens.

  10. Ex-vivo gene therapy restores LEKTI activity and corrects the architecture of Netherton syndrome-derived skin grafts.

    PubMed

    Di, Wei-Li; Larcher, Fernado; Semenova, Ekaterina; Talbot, Gill E; Harper, John I; Del Rio, Marcela; Thrasher, Adrian J; Qasim, Waseem

    2011-02-01

    Netherton syndrome (NS) is a debilitating congenital skin disorder caused by mutations in the SPINK5 gene encoding the lymphoepithelial Kazal-type-related inhibitor (LEKTI). It is characterized by defective keratinization, recurrent infections, and hypernatraemic dehydration with a mortality rate of about 10% in the first year of life. Currently, there are no curative treatments for NS. We have developed a HIV-1 based, self-inactivating lentiviral vector to express SPINK5 in keratinocytes as part of an ex-vivo gene therapy strategy for NS. High transduction efficiency was achieved in NS keratinocytes and reconstitution of LEKTI expression was confirmed in previously deficient cells. These genetically corrected keratinocytes were further tested in an in vitro organotypic culture (OTC) system and in vivo mouse/human skin engraftment model. Results showed correction of epidermal architecture in both OTCs and regenerated skin grafts. Importantly, the results from corrected skin grafts indicated that even where detectable LEKTI expression was restored to a limited numbers of cells, a wider bystander benefit occurred around these small populations. As LEKTI is a secreted protein, the genetically modified graft may provide not only an immediate local protective barrier, but also act as a source of secreted LEKTI providing a generalized benefit following ex-vivo gene therapy.

  11. Ex-vivo Gene Therapy Restores LEKTI Activity and Corrects the Architecture of Netherton Syndrome-derived Skin Grafts

    PubMed Central

    Di, Wei-Li; Larcher, Fernado; Semenova, Ekaterina; Talbot, Gill E; Harper, John I; Del Rio, Marcela; Thrasher, Adrian J; Qasim, Waseem

    2011-01-01

    Netherton syndrome (NS) is a debilitating congenital skin disorder caused by mutations in the SPINK5 gene encoding the lymphoepithelial Kazal-type-related inhibitor (LEKTI). It is characterized by defective keratinization, recurrent infections, and hypernatraemic dehydration with a mortality rate of about 10% in the first year of life. Currently, there are no curative treatments for NS. We have developed a HIV-1 based, self-inactivating lentiviral vector to express SPINK5 in keratinocytes as part of an ex-vivo gene therapy strategy for NS. High transduction efficiency was achieved in NS keratinocytes and reconstitution of LEKTI expression was confirmed in previously deficient cells. These genetically corrected keratinocytes were further tested in an in vitro organotypic culture (OTC) system and in vivo mouse/human skin engraftment model. Results showed correction of epidermal architecture in both OTCs and regenerated skin grafts. Importantly, the results from corrected skin grafts indicated that even where detectable LEKTI expression was restored to a limited numbers of cells, a wider bystander benefit occurred around these small populations. As LEKTI is a secreted protein, the genetically modified graft may provide not only an immediate local protective barrier, but also act as a source of secreted LEKTI providing a generalized benefit following ex-vivo gene therapy. PMID:20877344

  12. Versatility of full thickness skin-subcutaneous fat grafts as interpositional material in the management of temporomandibular joint ankylosis.

    PubMed

    Thangavelu, A; Santhosh Kumar, K; Vaidhyanathan, A; Balaji, M; Narendar, R

    2011-01-01

    The authors present a review of seven patients (eight joints) with temporomandibular ankylosis treated between 2007 and 2008. The aim of this retrospective study was to present the experience of using full thickness skin-subcutaneous fat grafts, harvested from the patient's abdomen as interpositional material after gap arthroplasty. All patients presented with osseous ankylosis and were graded according to Topazian's classification. Postoperative follow up ranged from 12 to 24 months. Maximal inter-incisal opening (MIO) on presentation ranged from 0 to 8mm, which stabilized to 27-44mm at follow up. There was no evidence of re-ankylosis. This study found merit in the use of autogenous full thickness skin-subcutaneous fat graft as an interpositional material for up to 2 years following ankylosis release.

  13. Mixed allogeneic reconstitution (A+B----A) to induce donor-specific transplantation tolerance. Permanent acceptance of a simultaneous donor skin graft

    SciTech Connect

    Ildstad, S.T.; Wren, S.M.; Oh, E.; Hronakes, M.L. )

    1991-06-01

    Mixed allogeneic reconstitution, in which a mixture of T-cell-depleted bone marrow of syngeneic host and allogeneic donor type is transplanted into a lethally irradiated recipient (A+B----A), results in mixed lymphopoietic chimerism with engraftment of a mixture of both host and donor bone marrow elements. Recipients are specifically tolerant to donor both in vitro and in vivo. Donor-specific skin grafts survive indefinitely when they are placed after full bone marrow repopulation at 28 days, while third-party grafts are rapidly rejected. To determine whether a delay of a month or more for full bone marrow repopulation is required before a donor-specific graft can be placed, we have now examined whether tolerance induction can be achieved if a graft is placed at the time of bone marrow transplantation. Permanent acceptance of donor-specific B10.BR skin grafts occurred when mixed allogeneic chimerism (B10+B10.BR----B10) was induced and a simultaneous allogeneic donor graft placed. In vitro, mixed reconstituted recipients were specifically tolerant to the B10.BR donor lymphoid cells but fully reactive to MHC-disparate third-party (BALB/c; H-2dd) when assessed by mixed lymphocyte reaction (MLR) and cell-mediated lympholysis (CML) assays. These data therefore indicate that a donor-specific graft placed at the time of mixed allogeneic reconstitution is permanently accepted without rejection. To determine whether an allogeneic skin graft alone without allogeneic bone marrow would be sufficient to induce tolerance, syngeneic reconstitution (B10----B10) was carried out, and a simultaneous B10.BR allogeneic skin graft placed. Although skin grafts were prolonged in all recipients, all grafts rejected when full lymphopoietic repopulation occurred at 28 days.

  14. The influence of stromal cells on the pigmentation of tissue-engineered dermo-epidermal skin grafts.

    PubMed

    Biedermann, Thomas; Böttcher-Haberzeth, Sophie; Klar, Agnieszka S; Widmer, Daniel S; Pontiggia, Luca; Weber, Andreas D; Weber, Daniel M; Schiestl, Clemens; Meuli, Martin; Reichmann, Ernst

    2015-03-01

    It has been shown in vitro that melanocyte proliferation and function in palmoplantar skin is regulated by mesenchymal factors derived from fibroblasts. In this study, we investigated in vivo the influence of mesenchymal-epithelial interactions in human tissue-engineered skin substitutes reconstructed from palmar- and nonpalmoplantar-derived fibroblasts. Tissue-engineered dermo-epidermal analogs based on collagen type I hydrogels were populated with either human palmar or nonpalmoplantar fibroblasts and seeded with human nonpalmoplantar-derived melanocytes and keratinocytes. These skin substitutes were transplanted onto full-thickness skin wounds of immunoincompetent rats. Four weeks after transplantation the development of skin color was measured and grafts were excised and analyzed with regard to epidermal characteristics, in particular melanocyte number and function. Skin substitutes containing palmar-derived fibroblasts in comparison to nonpalmoplantar-derived fibroblasts showed (a) a significantly lighter pigmentation; (b) a reduced amount of epidermal melanin granules; and (c) a distinct melanosome expression. However, the number of melanocytes in the basal layer remained similar in both transplantation groups. These findings demonstrate that human palmar fibroblasts regulate the function of melanocytes in human pigmented dermo-epidermal skin substitutes after transplantation, whereas the number of melanocytes remains constant. This underscores the influence of site-specific stromal cells and their importance when constructing skin substitutes for clinical application. PMID:25300246

  15. The Influence of Stromal Cells on the Pigmentation of Tissue-Engineered Dermo-Epidermal Skin Grafts

    PubMed Central

    Biedermann, Thomas; Böttcher-Haberzeth, Sophie; Klar, Agnieszka S.; Widmer, Daniel S.; Pontiggia, Luca; Weber, Andreas D.; Weber, Daniel M.; Schiestl, Clemens; Meuli, Martin

    2015-01-01

    It has been shown in vitro that melanocyte proliferation and function in palmoplantar skin is regulated by mesenchymal factors derived from fibroblasts. In this study, we investigated in vivo the influence of mesenchymal–epithelial interactions in human tissue-engineered skin substitutes reconstructed from palmar- and nonpalmoplantar-derived fibroblasts. Tissue-engineered dermo-epidermal analogs based on collagen type I hydrogels were populated with either human palmar or nonpalmoplantar fibroblasts and seeded with human nonpalmoplantar-derived melanocytes and keratinocytes. These skin substitutes were transplanted onto full-thickness skin wounds of immunoincompetent rats. Four weeks after transplantation the development of skin color was measured and grafts were excised and analyzed with regard to epidermal characteristics, in particular melanocyte number and function. Skin substitutes containing palmar-derived fibroblasts in comparison to nonpalmoplantar-derived fibroblasts showed (a) a significantly lighter pigmentation; (b) a reduced amount of epidermal melanin granules; and (c) a distinct melanosome expression. However, the number of melanocytes in the basal layer remained similar in both transplantation groups. These findings demonstrate that human palmar fibroblasts regulate the function of melanocytes in human pigmented dermo-epidermal skin substitutes after transplantation, whereas the number of melanocytes remains constant. This underscores the influence of site-specific stromal cells and their importance when constructing skin substitutes for clinical application. PMID:25300246

  16. A Simple Dressing Technique Following Dermofasciectomy and Full Thickness Skin Grafting of the Fingers in the Treatment of Severe Dupuytren's Contracture.

    PubMed

    Tanagho, Andy; Beaumont, Jan; Thomas, Roshin

    2015-12-01

    Dupuytren's disease with severe finger contractures and recurrent contractures following previous surgery often have extensive skin involvement. In these severe cases, excision of the diseased chord along with the involved skin is a good option to reduce the risk of recurrance. The resulting skin defect can be covered with a full thickness skin graft (FTSG) or a cross finger flap. Cross finger flaps have donor finger morbidity and hence a full thickness graft is usually preferred. The FTSG extending to the midlateral margins on both sides of the finger reduces the risk of joint contracture due to graft shrinkage. Once the FTSG is sutured in place, the standard practice is to compress and secure the graft to its recipient bed with a tie-over dressing and this can be time consuming. We present a simple dressing technique to secure the FTSG without the need for a tie-over dressing.

  17. Split-Thickness Skin Grafts Remain the Gold Standard for the Closure of Large Acute and Chronic Wounds

    PubMed Central

    Simman, Richard; Phavixay, Laemthong

    2012-01-01

    Healing large chronic and acute wounds is a challenging task for wound care providers. It requires numerous visits and frequent dressing changes and often involves expensive therapeutic modalities. Our primary and ultimate goal is to heal these wounds as quickly as possible. In a prepared wound bed, covered with granulation tissue and free of infection, skin graft is the gold standard procedure to achieve this goal. One should keep in mind that not all patients are good candidates for surgery. PMID:24525612

  18. Management of pediatric skin-graft donor sites: a randomized controlled trial of three wound care products.

    PubMed

    Brenner, Maria; Hilliard, Carol; Peel, Glynis; Crispino, Gloria; Geraghty, Ruth; OʼCallaghan, Gill

    2015-01-01

    Skin grafts are used to treat many types of skin defects in children, including burns, traumatic wounds, and revision of scars. The objective of this prospective randomized controlled trial was to compare the effectiveness of three dressing types for pediatric donor sites: foam, hydrofiber, and calcium alginate. Children attending a pediatric Burns & Plastics Service from October 2010 to March 2013, who required a split-skin graft, were recruited to the trial. Patients were randomly assigned to the two experimental groups, foam or hydrofiber, and to the control group, calcium alginate. Data were gathered on the management of exudate, assessment of pain, time to healing, and infection. Fifty-seven children aged 1 to 16 years (mean = 4.9 years) were recruited to the trial. Fifty-six patients had evaluable data and one participant from the control group was lost to follow-up. Most children required skin grafting for a burn injury (78%). The median size of the donor site was 63.50 cm (8-600 cm). There was a statistically significant difference in time to healing across the three dressing groups (x [2, n = 56] = 6.59, P = .037). The calcium alginate group recorded a lower median value of days to healing (median = 7.5 days) compared to the other two groups, which recorded median values of 8 days (hydrofiber) and 9.5 days (foam). The greatest leakage of exudate, regardless of dressing type, occurred on day 2 after grafting. No statistically significant difference was found in leakage of exudate, pain scores, or infection rates across the three groups. Calcium alginate emerged as the optimum dressing for pediatric donor site healing in this trial.

  19. Approaches to repigmentation of vitiligo skin: new treatment with ultrasonic abrasion, seed-grafting and psoralen plus ultraviolet A therapy.

    PubMed

    Tsukamoto, Katsuhiko; Osada, Atsushi; Kitamura, Reiko; Ohkouchi, Masayuki; Shimada, Shinji; Takayama, Osami

    2002-10-01

    Vitiligo vulgaris is a common disease throughout the world although its pathogenesis is not yet known. The most frequent treatment used for vitiligo is PUVA (psoralen plus ultraviolet A) and topical steroids but against stable refractory vitiligo, various other surgical techniques have been developed such as autografting, epidermal grafting with suction blisters, epithelial sheet grafting, and transplantation of cultured melanocytes. We have discovered a new method using ultrasonic abrasion, seed-grafting and PUVA therapy. The ultrasonic surgical aspirator abrades only the epidermis of recipient sites. This easily and safely removes only the epidermis, even on spotty lesions or intricate regions which are difficult to remove using a conventional motor-driven grinder or liquid nitrogen. Epidermal seed-grafting can cover more area than sheet-grafting, and subsequent PUVA treatment can enlarge the area of pigmentation with coalescence of adjacent grafts. In this article, we provide a general overview of the current surgical therapies including our method for treating stable refractory vitiligo.

  20. Prospective, double-blinded, randomised controlled trial assessing the effect of an Octenidine-based hydrogel on bacterial colonisation and epithelialization of skin graft wounds in burn patients

    PubMed Central

    W, Eisenbeiß; F, Siemers; G, Amtsberg; P, Hinz; B, Hartmann; T, Kohlmann; A, Ekkernkamp; U, Albrecht; O, Assadian; A, Kramer

    2012-01-01

    Background: Moist wound treatment improves healing of skin graft donor site wounds. Microbial colonised wounds represent an increased risk of wound infection; while antimicrobially active, topical antiseptics may impair epithelialization. Objectives: The aim of this prospective randomised controlled clinical trial was to examine the influence of an Octenidine-dihydrochloride (OCT) hydrogel on bacterial colonisation and epithelialization of skin graft donor sites. Methods: The study was designed as a randomised, double-blinded, controlled clinical trial. Skin graft donor sites from a total of 61 patients were covered either with 0.05% OCT (n=31) or an OCT-free placebo wound hydrogel (n=30). Potential interaction with wound healing was assessed by measuring the time until 100% re-epithelialization. In addition, microbial wound colonisation was quantitatively determined in all skin graft donor sites. Results: There was no statistically significant difference in the time for complete epithelialization of skin graft donor sites in the OCT and the placebo group (7.3±0.2 vs. 6.9±0.2 days; p=0.236). Microbial wound colonisation was significantly lower in the OCT group than in the placebo group (p=0.014). Conclusions: The OCT-based hydrogel showed no delay in wound epithelialization and demonstrated a significantly lower bacterial colonisation of skin graft donor site wounds. PMID:23071904

  1. The measurement of water activity in allogeneic skin grafts preserved using high concentration glycerol or propylene glycol.

    PubMed

    Ross, Alexandra; Kearney, John N

    2004-01-01

    In the presence of free water, many degradation reactions can occur within stored tissues including enzymatic digestion, oxidation (peroxidation) and hydrolytic reactions, as well as the detrimental effects of microbial growth, therefore most long-term banking techniques are designed to avoid free water. One method currently used for banking of skin grafts is the use of high concentration (85%) glycerol as a preservative. In this case, the glycerol was assumed to dehydrate the skin by osmosis and diffusion out of the cells and skin matrix respectively. We have recently shown that this assumption is incorrect and the converse occurs, i.e. glycerol enters the skin and sequesters the water. It was therefore essential to determine whether enough water had been immobilised to prevent degradation of the tissue. Using an instrument (Pawkit) designed to measure water activity (aw) it was shown that a stepwise reduction in aw was achieved when the skin was immersed in 50 and 85% glycerol or propylene glycol, respectively. At the end of the glycerolisation process, the final aw was shown to be circa 0.3. An aw of 0.3 is known to minimise lipid peroxidation and reduce other degradation reaction rates to very low levels. It was concluded that the current glycerolisation protocol results in effective sequestration of water avoiding degradation of the skin during storage. The method presented should be used as a quality control step to confirm adequacy of preservation for each batch of glycerolised skin. PMID:15256838

  2. The measurement of water activity in allogeneic skin grafts preserved using high concentration glycerol or propylene glycol.

    PubMed

    Ross, Alexandra; Kearney, John N

    2004-01-01

    In the presence of free water, many degradation reactions can occur within stored tissues including enzymatic digestion, oxidation (peroxidation) and hydrolytic reactions, as well as the detrimental effects of microbial growth, therefore most long-term banking techniques are designed to avoid free water. One method currently used for banking of skin grafts is the use of high concentration (85%) glycerol as a preservative. In this case, the glycerol was assumed to dehydrate the skin by osmosis and diffusion out of the cells and skin matrix respectively. We have recently shown that this assumption is incorrect and the converse occurs, i.e. glycerol enters the skin and sequesters the water. It was therefore essential to determine whether enough water had been immobilised to prevent degradation of the tissue. Using an instrument (Pawkit) designed to measure water activity (aw) it was shown that a stepwise reduction in aw was achieved when the skin was immersed in 50 and 85% glycerol or propylene glycol, respectively. At the end of the glycerolisation process, the final aw was shown to be circa 0.3. An aw of 0.3 is known to minimise lipid peroxidation and reduce other degradation reaction rates to very low levels. It was concluded that the current glycerolisation protocol results in effective sequestration of water avoiding degradation of the skin during storage. The method presented should be used as a quality control step to confirm adequacy of preservation for each batch of glycerolised skin.

  3. Skin regenerated from cultured epithelial autografts on full-thickness burn wounds from 6 days to 5 years after grafting. A light, electron microscopic and immunohistochemical study.

    PubMed

    Compton, C C; Gill, J M; Bradford, D A; Regauer, S; Gallico, G G; O'Connor, N E

    1989-05-01

    Regeneration of skin from cultured keratinocyte autografts used in the treatment of full-thickness burn wounds was studied in 21 pediatric patients from 6 days to 5 years after grafting. Findings were compared both to controls of age- and site-matched normal skin and to controls for epithelial wound-healing, re-epithelialized interstices of meshed split-thickness skin grafts of comparable postgrafting age. Six days after transplantation, a mildly hypertrophic, flat epidermis with all normal strata had regenerated, and the process of de novo dermal-epidermal junction formation had begun. Hemidesmosomes, basal lamina, and anchoring fibrils reformed conjointly in punctate fashion along the attachment face of the grafts. Within 3 to 4 weeks, the dermal-epidermal junction was complete, but full maturation of anchoring fibrils required more than a year. The process was comparable to that observed in meshed graft interstices. Rete ridges regenerated from 6 weeks to 1 year after grafting. The subjacent connective tissue initially healed to form normal scar, but it remodeled dramatically, regenerated elastin, and resembled a true dermis within 4 to 5 years. Meshed-graft interstice controls showed no rete ridge regeneration, subepithelial connective tissue remodeling, or elastin production up to 5 years after grafting. Langerhans cells repopulated grafts within 1 week, and normal population densities were reached within 2 to 6 months. After 1 year, Langerhans cell densities were increased compared with normal skin but were lower than those in age-matched meshed graft controls. Melanocytes were present in cultures at the time of transplantation, but functional epidermal melanin units were not seen in groin- or axilla-derived grafts for 6 to 8 weeks or in sole-derived epidermis until a year or more after transplantation. Normal histologic features were maintained for years after grafting. Transitory pathologic changes including parakeratosis, dyskeratosis, and intraepithelial

  4. USE OF CORTICAL BONE FENESTRATION, AUTOGENOUS FREE SKIN GRAFT, AND THERMOGRAPHY FOR WOUND TREATMENT AND MONITORING IN A RED WOLF (CANIS RUFUS GREGORYI).

    PubMed

    Hurley-Sanders, Jennifer L; Sladky, Kurt K; Nolan, Elizabeth C; Loomis, Michael R

    2015-09-01

    A 2-yr-old female red wolf (Canis rufus gregoryi) sustained a degloving injury to the left thoracic limb while in a display habitat. Initial attempts to resolve the extensive wound by using conservative measures were unsuccessful. Subsequent treatment using a free skin graft consisted first of establishment of an adequate granulation bed via cortical bone fenestration. After establishment of a healthy granulation bed was achieved, free skin graft was harvested and transposed over the bed. To monitor viability and incorporation of the graft, serial thermographic imaging was performed. Thermography noninvasively detects radiant heat patterns and can be used to assess vascularization of tissue, potentially allowing early detection of graft failure. In this case, thermography documented successful graft attachment.

  5. The role of full-thickness skin grafting and steroid injection in the treatment of auricular keloids.

    PubMed

    Brown, Nefertiti A; Ortega, F Raymond

    2010-05-01

    Keloids are a response to wound healing that occurs due to hyperproliferation of dermal collagen in response to skin injury (Olabanji et al, Surg Pract. 2005;9:2-7). Multiple modalities have been described in the literature to target these lesions, but treatment and prevention remain a challenge because of the high rate of recurrence (Brissett and Sherris, Facial Plast Surg. 2001;17:263-272; Kelly, Dermatol Ther. 2004;17:212-218; Robles and Berg, Clin Dermatol. 2007;25:26-32; Porter, Otolaryngol Clin North Am. 2002;35:207-220, viii). We studied the rate of recurrence of auricular keloids through a technique previously described in the literature (Converse and Stallings, Plast Reconstr Surg. 1972;49:461-463), but over a series of patients. Keloids were treated with total excision in combination with coverage of the resulting defect with a full-thickness skin graft and intradermal injection of triamcinolone acetonide solution at the periphery of the donor and recipient sites. From April 2006 to February 2007, 10 patients with auricular keloids were done using this technique, and during an 11-month follow-up no recurrence was observed. These results support that full-thickness skin grafts can be used to address keloid lesions without recurrence.

  6. Chronic transplantation immunity in newts: temperature susceptibility of an effector phase in allo-skin graft rejection.

    PubMed

    Kinefuchi, Kenjiroh; Kushida, Yoshihiro; Johnouchi, Masato; Shimizu, Yuiko; Ohneda, Hikaru; Fujii, Masato; Hosono, Masamichi

    2011-07-01

    Urodele amphibians are unique due to their greatly reduced immune responsiveness compared to bony fishes, which show acute immune responsiveness. In newts, the mean survival time of allogenic skin grafts in the transplantation immunity was 48.8 ± 8.3 days at 25°C, suggesting that it occurs in a chronic manner. The graft rejection process was categorized into three stages: a latent stage with frequent blood circulation, or the immune induction phase; a vascular stoppage stage with dominant infiltrating cells of T cells; and a rejection stage showing the change of the dominant cells to monocytes/macrophages, probably as effector cells, tetntatively referred to as the immune effector phase. The immune induction phase is susceptible to the cyclophosphamide (CY) mitosis inhibitor, but not to a temperature shift from 18 to 27°C, while the immune effector phase is susceptible to temperature shifts, but not CY-treatment, although the temperature shift failed to shorten the graft survival time to less than 25 days, which nearly equals that of the secondary set of grafts where the lack of complete blood circulation is remarkable and graft rejection is resistant to CY-treatment. In contrast, a very low temperature (5-10°C) completely prevented effector generation in newts; in frogs, however, it is reported that such low temperatures did not prevent the generation of effectors. Taken together, these data suggest that chronic responses in newts are due to effector cells other than cytotoxic T cells; possible effector cells are discussed.

  7. Free flap transplantation combined with skin grafting and vacuum sealing drainage for repair of circumferential or sub-circumferential soft-tissue wounds of the lower leg

    PubMed Central

    Li, Run-guang; Ren, Gao-hong; Tan, Xiong-jin; Yu, Bin; Hu, Ji-jie

    2013-01-01

    Background This study is aimed at evaluating the operation techniques and clinical significance of free flap transplantation combined with skin grafting and vacuum sealing drainage (VSD) in repairing severe traumatic extensive circumferential or semi-circumferential soft-tissue defects of the lower leg. Material/Methods Thirty patients with severe lower leg injuries were treated by free flap transplantation combined with skin grafting and VSD from January 2008 to June 2011. The size of the wounds ranged from 23×8 cm to 44×28 cm and all affected more 70% of the low leg circumferential area. Wounds were complicated by exposure, necrosis, or infection of deep tissues. The wounds were first debrided and covered by VSD. When the condition of the wound had improved (5 to 7 days later), free flaps were harvested to reconstruct damaged tissue and skin grafts and VSD was used to cover granulation tissues around the transplanted flap. Results Granulation tissues developed and the area requiring flap cover decreased in all 30 patients after debridement and VSD. In 28 of 30 cases, the transplanted flaps grew well without complication. Peripheral necrosis was observed in only 2 cases, which required a second debridement and skin graft. Ten wound areas covered by grafts were left with scattered peripheral wounds, which healed with the help of 1 more skin graft or dressing change. Morphological appearance and functional recovery were satisfactory in all 30 cases. Conclusions Initial debridement and the temporary VSD cover followed after several days by free flap transplantation combined with skin grafting and VSD protection is a reliable treatment regimen for traumatic large circumferential or sub-circumferential soft tissue wounds of the lower leg with deep tissue exposure. PMID:23807087

  8. Hemicellulose dressing versus rayon dressing in the re-epithelialization of split-thickness skin graft donor sites: a multicenter study.

    PubMed

    Ferreira, Lydia M; Blanes, Leila; Gragnani, Alfredo; Veiga, Daniela F; Veiga, Frederico P; Nery, Gilka B; Rocha, Gustavo Henrique H R; Gomes, Heitor C; Rocha, Mario G; Okamoto, Regina

    2009-08-01

    The aim of this study was to compare the effectiveness of a hemicellulose dressing with that of rayon dressing in the healing of split-thickness skin graft donor sites. Twenty-eight patients were selected from five different hospitals and randomized into two groups: hemicellulose dressing group and rayon dressing group. All patients underwent split-thickness skin grafting for various reasons, and the skin graft donor site wounds were covered with hemicellulose dressing (n=14) or rayon dressing (n=14). The donor site was assessed on postoperative days 1, 7, 14, 21, and 28 for hyperemia, pruritus, pain, exudate level, and adherence of the wound dressing. At the 60-day follow-up visit, the donor site was assessed again for pruritus and pain. Touch-pressure, thermal, and pain sensibility tests were performed preoperatively and on postoperative day 60 together with the assessment of color and texture of the re-epithelialized area. In all patients, re-epithelialization was completed between 14 and 21 days after surgery. There were no significant differences between the two groups with regard to pain, hyperemia, pruritus, exudate, and final appearance (color and texture) of the skin graft donor site. The rayon dressing provided significantly better adherence than the hemicellulose dressing, and both dressings showed similar results with regard to the parameters evaluated when used in the treatment of split-thickness skin graft donor sites.

  9. Silver percutaneous absorption after exposure to silver nanoparticles: a comparison study of three human skin graft samples used for clinical applications.

    PubMed

    Bianco, C; Adami, G; Crosera, M; Larese, F; Casarin, S; Castagnoli, C; Stella, M; Maina, G

    2014-11-01

    Silver nanoparticles (AgNPs) are increasingly applied to a wide range of materials for biomedical use. These enable a close contact with human skin, thanks to the large release of silver ions that is responsible for a broad spectrum of antimicrobial activity. Silver can permeate the skin; however, there are no data available on silver permeation through skin grafts commonly used in burns recovery. The aim of our study was to evaluate silver penetration using fresh, cryopreserved, and glycerolized human skin grafts after exposure to a suspension of AgNPs in synthetic sweat using a Franz diffusion cell apparatus for 24 h. Silver permeation profiles revealed a significantly higher permeation through glycerolized skin compared with both fresh and cryopreserved skin: 24-h silver flux penetration was 0.2 ng cm(-2) h(-1) (lag time: 8.2 h) for fresh skin, 0.3 ng cm(-2) h(-1) (lag time: 10.9 h) for cryopreserved skin, and 3.8 ng cm(-2) h(-1) (lag time: 6.3 h) for glycerolized skin. Permeation through glycerolized skin is significantly higher compared to both fresh and cryopreserved skin. This result can generate relevant clinical implications for burns treatment with products containing AgNPs.

  10. Fast and Standardized Skin Grafting of Leg Wounds With a New Technique: Report of 2 Cases and Review of Previous Methods

    PubMed Central

    Hamnerius, Nils; Wallin, Ewa; Svensson, Åke; Stenström, Pernilla

    2016-01-01

    Background: Chronic leg ulcers remain a challenge to the treating physician. Such wounds often need skin grafts to heal. This necessitates a readily available, fast, simple, and standardized procedure for grafting. Objectives: The aim of this work was to test a novel method developed for outpatient transplant procedures. Methods: The procedure employs a handheld disposable dermatome and a roller mincer that cut the skin into standardized micrografts that can be spread out onto a suitable graft bed. Wounds were followed until healed and photographed. Results: The device was successfully used to treat and close a traumatic lower limb wound and a persistent chronic venous leg ulcer. The donor site itself healed by secondary intent with minimal cosmetic impairment. Conclusion: The method was successfully used to graft 2 lower extremity wounds. PMID:27004083

  11. Non-myeloablative conditioning is sufficient to induce mixed chimerism and subsequent acceptance of donor specific cardiac and skin grafts.

    PubMed

    Liu, Chi; Zhu, Ping; Saito, Taro; Isaka, Yoshitaka; Nagahara, Yukitoshi; Zhuang, Jian; Li, Xiao-Kang

    2013-07-01

    Organ transplant recipients have elevated cancer and viral infection risks due to immunosuppression and long-term results of organ transplantation remain unsatisfactory, mainly because of chronic rejection. The purpose of the current study is to establish a nonmyeloablative perioperative regimen, able to induce mixed chimerism and tolerance of allografts. To establish a nonmyeloablative perioperative regimen, we used Busulfan, an important component of many bone marrow transplantation preparative regimens for a variety of non-neoplastic diseases as an alternative to total body irradiation (TBI), and FTY720, a unique immunosuppression agent, inhibition lymphocyte homing. We found that creating a lymphohematopoietic chimera in which donor and recipient hematopoiesis coexist resulted in prolongation of the donor specific heart and skin allografts. Consistent with graft survival, pathological analysis indicated that the allografts from tolerant recipients were free of myocardial injury and had only a few interstitial infiltrates, and obliterative vasculopathy was not observed. Furthermore, we found that Treg cells were increased in the long-term graft acceptance recipients. Our data revealed that the therapeutic potential for using hematopoietic chimerism in non-myeloablated recipients hope the advances in rodent models described above in the development of minimal, nontoxic host conditioning regimens for mixed chimerism induction and subsequent acceptance of donor specific grafts. PMID:23428909

  12. Granzyme B Contributes to the Optimal Graft-Versus-Tumor Effect Mediated by Conventional CD4+ T Cells

    PubMed Central

    Du, Wei; Leigh, Nicholas D.; Bian, Guanglin; Alqassim, Emad; O'Neill, Rachel E.; Mei, Lin; Qiu, Jingxin; Liu, Hong; McCarthy, Philip L.; Cao, Xuefang

    2016-01-01

    Granzyme B (GzmB) is a key cytotoxic molecule utilized by T cells to kill pathogen-infected cells or transformed tumor cells. Previous studies using allogeneic hematopoietic cell transplantation (allo-HCT) murine models showed that GzmB is required for CD8+ T cells to cause graft-versus-host disease (GVHD). However, our recent study demonstrated that GzmB-mediated damage of CD8+ T cells diminished their graft-versus-tumor (GVT) activity. In this study, we examined the role of GzmB in GVT effect mediated by conventional CD4+CD25− T cells (CD4+ Tcon). GzmB−/−CD4+ Tcon cells exhibited decreased GVT activity compared to wild-type (WT) CD4+ Tcon cells, suggesting that GzmB is required for the optimal GVT activity of CD4+ Tcon cells. On the other hand, GzmB−/− CD4+CD25+ regulatory T cells were as suppressive as WT regulatory T cells in suppressing GVT activity, which is consistent with our previous report showing that GzmB is not required for regulatory T cell-mediated suppression of GVHD. These results demonstrate that GzmB causes opposite impacts on GVT effect mediated by CD4+CD25− versus CD8+ T cells. Interestingly, GzmB−/− total T cells exhibited GVT activity equivalent to that of WT total T cells, suggesting that the opposite impacts of GzmB on the GVT effect of CD4+CD25− versus CD8+ T cells may neutralize each other, which can only be observed when an individual T cell subset is examined. Importantly, these differential roles suggest that targeting GzmB in selective T cell subsets may have the potential to enhance the beneficial GVT effect.

  13. Prolongation of GFP-expressed skin graft after intrathymic injection of GFP positive splenocytes in adult rat

    NASA Astrophysics Data System (ADS)

    Hakamata, Yoji; Igarashi, Yuka; Murakami, Takashi; Kobayashi, Eiji

    2006-02-01

    GFP is a fluorescent product of the jellyfish Aequorea victoria and has been used for a variety of biological experiments as a reporter molecule. While GFP possesses advantages for the non-invasive imaging of viable cells, GFP-positive cells are still considered potential xeno-antigens. It is difficult to observe the precise fate of transplanted cells/organs in recipients without immunological control. The aim of this study was to determine whether intrathymic injection of GFP to recipients and the depletion of peripheral lymphocytes could lead to donor-specific unresponsiveness to GFP-expressed cell. LEW rats were administered intraperitoneally with 0.2 ml of anti-rat lymphocyte serum (ALS) 1 day prior to intrathymic injection of donor splenocytes or adeno-GFP vector. Donor cells and vector were non-invasively inoculated into the thymus under high frequency ultrasound imaging using an echo-guide. All animals subsequently received a 7 days GFP-expressed skin graft from the same genetic background GFP LEW transgenic rat. Skin graft survival was greater in rats injected with donor splenocytes (23.6+/-9.1) compared with adeno-GFP (13.0+/-3.7) or untreated control rats (9.5+/-1.0). Intrathymic injection of donor antigen into adult rats can induce donor-specific unresponsiveness. Donor cells can be observed for a long-term in recipients with normal immunity using this strategy.

  14. Local full-thickness skin graft of the donor arm--a novel technique for the reduction of donor site morbidity in radial forearm free flap.

    PubMed

    Riecke, B; Assaf, A T; Heiland, M; Al-Dam, A; Gröbe, A; Blessmann, M; Wikner, J

    2015-08-01

    A novel technique to reduce donor site morbidity after radial forearm free flap (RFFF) harvest, using a local full-thickness skin graft (FTSG), is described. Thirty consecutive patients undergoing RFFF for head and neck reconstruction were enrolled in a prospective study. Donor site defect closure was performed with spindle-shaped FTSGs excised from the wavelike skin incision made for the vascular pedicle. Both the removal site of the FTSG on the volar forearm and the covered RFFF donor site healed uneventfully in 29 cases, with no impairment of function related to the skin graft. No skin graft failure and no exposure, tenting, or adherence of the flexor tendons occurred. All patients expressed satisfaction with postoperative pain, the functional outcome, and cosmetic appearance. Primary donor site defect closure could be achieved in all cases with the use of a local FTSG. This graft can be gained at the access incision for the vascular pedicle, avoids expansion of the incision for a local flap technique, and does not prolong wound healing, and thus reduces both donor site and graft site morbidity of the RFFF. This technique leads to an inconspicuous aesthetic result with no apparent relevant functional deficits and avoids the need for a second donor site.

  15. Luminescent and transparent nanopaper based on rare-earth up-converting nanoparticle grafted nanofibrillated cellulose derived from garlic skin.

    PubMed

    Zhao, Jingpeng; Wei, Zuwu; Feng, Xin; Miao, Miao; Sun, Lining; Cao, Shaomei; Shi, Liyi; Fang, Jianhui

    2014-09-10

    Highly flexible, transparent, and luminescent nanofibrillated cellulose (NFC) nanopaper with heterogeneous network, functionalized by rare-earth up-converting luminescent nanoparticles (UCNPs), was rapidly synthesized by using a moderate pressure extrusion paper-making process. NFC was successfully prepared from garlic skin using an efficient extraction approach combined with high frequency ultrasonication and high pressure homogenization after removing the noncellulosic components. An efficient epoxidation treatment was carried out to enhance the activity of the UCNPs (NaYF4:Yb,Er) with oleic acid ligand capped on the surface. The UCNPs after epoxidation then reacted with NFC in aqueous medium to form UCNP-grafted NFC nanocomposite (NFC-UCNP) suspensions at ambient temperature. Through the paper-making process, the assembled fluorescent NFC-UCNP hybrid nanopaper exhibits excellent properties, including high transparency, strong up-conversion luminescence, and good flexibility. The obtained hybrid nanopaper was characterized by transmission electron microscopy (TEM), atomic force microscope (AFM), Fourier transform infrared spectroscopy (FTIR), field emission-scanning electron microscope (FE-SEM), up-conversion luminescence (UCL) spectrum, and ultraviolet and visible (UV-vis) spectrophotometer. The experimental results demonstrate that the UCNPs have been successfully grafted to the NFC matrix with heterogeneous network. And the superiorly optical transparent and luminescent properties of the nanopaper mainly depend on the ratio of UCNPs to NFC. Of importance here is that, NFC and UCNPs afford the nanopaper a prospective candidate for multimodal anti-counterfeiting, sensors, and ion probes applications.

  16. Evaluation of a computer-aided skin cancer diagnosis system for conventional digital photography with manual segmentation

    NASA Astrophysics Data System (ADS)

    Huang, Adam; Chang, Wen-Yu; Hsieh, Cheng-Han; Liu, Hsin-Yi; Chen, Gwo-Shing

    2014-03-01

    We evaluate a computer-aided diagnosis (CADx) system developed for both melanocytic and non-melanocytic skin lesions by using conventional digital photographs with lesion boundaries manually marked by a dermatologist. Clinical images of skin lesions taken by conventional digital cameras can capture useful information such as shape, color, and texture for diagnosing skin cancer. However, shape/border features are difficult to analyze automatically because skin surface reflections may change skin color and make segmentation a challenging task. In this study, two non-medical users manually mark the boundaries of a dataset of 769 (174 malignant, 595 benign) conventional photographs of melanocytic and non-melanocytic skin lesions. A state-of-the-art software system for segmenting color images, JSEG, is also tested on the same dataset. Their results are compared to a dermatologist's markings, which are used as the gold standard in this study. The human users' markings are relatively close to the gold standard and achieve an overlapping rate of 70.4% (+/- 15.3%, std) and 74.5% (+/- 14.7%, std). Compared to human users, JSEG only succeeds in segmenting 636 (82.7%) out of 769 lesions and achieves an overlapping rate of 72.4% (+/-20.4%) for these 636 lesions. The estimated area under the receiver operating characteristic curve (AUC) of the CADx by using lesion boundary markings of users 1, 2, and JSEG are 0.915, 0.940, and 0.857 respectively. Our preliminary results indicate that manual segmentation can be repeated relatively consistent compared to automatic segmentation.

  17. Dermal papilla cells improve the wound healing process and generate hair bud-like structures in grafted skin substitutes using hair follicle stem cells.

    PubMed

    Leirós, Gustavo José; Kusinsky, Ana Gabriela; Drago, Hugo; Bossi, Silvia; Sturla, Flavio; Castellanos, María Lía; Stella, Inés Yolanda; Balañá, María Eugenia

    2014-10-01

    Tissue-engineered skin represents a useful strategy for the treatment of deep skin injuries and might contribute to the understanding of skin regeneration. The use of dermal papilla cells (DPCs) as a dermal component in a permanent composite skin with human hair follicle stem cells (HFSCs) was evaluated by studying the tissue-engineered skin architecture, stem cell persistence, hair regeneration, and graft-take in nude mice. A porcine acellular dermal matrix was seeded with HFSCs alone and with HFSCs plus human DPCs or dermal fibroblasts (DFs). In vitro, the presence of DPCs induced a more regular and multilayered stratified epidermis with more basal p63-positive cells and invaginations. The DPC-containing constructs more accurately mimicked the skin architecture by properly stratifying the differentiating HFSCs and developing a well-ordered epithelia that contributed to more closely recapitulate an artificial human skin. This acellular dermal matrix previously repopulated in vitro with HFSCs and DFs or DPCs as the dermal component was grafted in nude mice. The presence of DPCs in the composite substitute not only favored early neovascularization, good assimilation and remodeling after grafting but also contributed to the neovascular network maturation, which might reduce the inflammation process, resulting in a better healing process, with less scarring and wound contraction. Interestingly, only DPC-containing constructs showed embryonic hair bud-like structures with cells of human origin, presence of precursor epithelial cells, and expression of a hair differentiation marker. Although preliminary, these findings have demonstrated the importance of the presence of DPCs for proper skin repair. PMID:25161315

  18. Dermal Papilla Cells Improve the Wound Healing Process and Generate Hair Bud-Like Structures in Grafted Skin Substitutes Using Hair Follicle Stem Cells

    PubMed Central

    Leirós, Gustavo José; Kusinsky, Ana Gabriela; Drago, Hugo; Bossi, Silvia; Sturla, Flavio; Castellanos, María Lía; Stella, Inés Yolanda

    2014-01-01

    Tissue-engineered skin represents a useful strategy for the treatment of deep skin injuries and might contribute to the understanding of skin regeneration. The use of dermal papilla cells (DPCs) as a dermal component in a permanent composite skin with human hair follicle stem cells (HFSCs) was evaluated by studying the tissue-engineered skin architecture, stem cell persistence, hair regeneration, and graft-take in nude mice. A porcine acellular dermal matrix was seeded with HFSCs alone and with HFSCs plus human DPCs or dermal fibroblasts (DFs). In vitro, the presence of DPCs induced a more regular and multilayered stratified epidermis with more basal p63-positive cells and invaginations. The DPC-containing constructs more accurately mimicked the skin architecture by properly stratifying the differentiating HFSCs and developing a well-ordered epithelia that contributed to more closely recapitulate an artificial human skin. This acellular dermal matrix previously repopulated in vitro with HFSCs and DFs or DPCs as the dermal component was grafted in nude mice. The presence of DPCs in the composite substitute not only favored early neovascularization, good assimilation and remodeling after grafting but also contributed to the neovascular network maturation, which might reduce the inflammation process, resulting in a better healing process, with less scarring and wound contraction. Interestingly, only DPC-containing constructs showed embryonic hair bud-like structures with cells of human origin, presence of precursor epithelial cells, and expression of a hair differentiation marker. Although preliminary, these findings have demonstrated the importance of the presence of DPCs for proper skin repair. PMID:25161315

  19. Dermal papilla cells improve the wound healing process and generate hair bud-like structures in grafted skin substitutes using hair follicle stem cells.

    PubMed

    Leirós, Gustavo José; Kusinsky, Ana Gabriela; Drago, Hugo; Bossi, Silvia; Sturla, Flavio; Castellanos, María Lía; Stella, Inés Yolanda; Balañá, María Eugenia

    2014-10-01

    Tissue-engineered skin represents a useful strategy for the treatment of deep skin injuries and might contribute to the understanding of skin regeneration. The use of dermal papilla cells (DPCs) as a dermal component in a permanent composite skin with human hair follicle stem cells (HFSCs) was evaluated by studying the tissue-engineered skin architecture, stem cell persistence, hair regeneration, and graft-take in nude mice. A porcine acellular dermal matrix was seeded with HFSCs alone and with HFSCs plus human DPCs or dermal fibroblasts (DFs). In vitro, the presence of DPCs induced a more regular and multilayered stratified epidermis with more basal p63-positive cells and invaginations. The DPC-containing constructs more accurately mimicked the skin architecture by properly stratifying the differentiating HFSCs and developing a well-ordered epithelia that contributed to more closely recapitulate an artificial human skin. This acellular dermal matrix previously repopulated in vitro with HFSCs and DFs or DPCs as the dermal component was grafted in nude mice. The presence of DPCs in the composite substitute not only favored early neovascularization, good assimilation and remodeling after grafting but also contributed to the neovascular network maturation, which might reduce the inflammation process, resulting in a better healing process, with less scarring and wound contraction. Interestingly, only DPC-containing constructs showed embryonic hair bud-like structures with cells of human origin, presence of precursor epithelial cells, and expression of a hair differentiation marker. Although preliminary, these findings have demonstrated the importance of the presence of DPCs for proper skin repair.

  20. Cytotoxicity testing of topical antimicrobial agents on human keratinocytes and fibroblasts for cultured skin grafts.

    PubMed

    Boyce, S T; Warden, G D; Holder, I A

    1995-01-01

    Cultured epidermal skin has become an adjunctive therapy for treatment of major burn injuries, but its effectiveness is greatly limited because of destruction by microbial contamination. To evaluate candidate antimicrobial agents for use with cultured skin, a combined cytotoxicity-antimicrobial assay system was developed for determination of toxicity to cultured human keratinocytes and fibroblasts and for determination of susceptibility or resistance of common burn wound organisms. Candidate agents including chlorhexidine gluconate, polymyxin B, mupirocin, sparfloxacin, or nitrofurazone were tested separately for inhibition of growth of human cells and for inhibitory activity to microorganisms with the wet disk assay. The data showed that (1) chlorhexidine gluconate (0.05%) was uniformly toxic to both cultured human cells and microorganisms; (2) nitrofurazone (0.02%) had dose-dependent toxicity to human cells and limited effectiveness against gram-negative microorganisms; (3) sparfloxacin (30 micrograms/ml) had low toxicity to human cells and retained antimicrobial activity against both gram-positive and gram-negative bacteria; (4) polymyxin B (400 U/ml) was not toxic to human cells and had intermediate effectiveness on gram-negative bacteria; and (5) mupirocin (48 micrograms/ml) had no toxicity to skin cells and had uniform effectiveness against Staphylococcus aureus including methicillin-resistant Staphylococcus aureus. Selection of topical antimicrobial drugs by these assays may improve effectiveness of cultured skin for burns and may be used to control other surgical wound infections.

  1. Cytotoxicity testing of topical antimicrobial agents on human keratinocytes and fibroblasts for cultured skin grafts.

    PubMed

    Boyce, S T; Warden, G D; Holder, I A

    1995-01-01

    Cultured epidermal skin has become an adjunctive therapy for treatment of major burn injuries, but its effectiveness is greatly limited because of destruction by microbial contamination. To evaluate candidate antimicrobial agents for use with cultured skin, a combined cytotoxicity-antimicrobial assay system was developed for determination of toxicity to cultured human keratinocytes and fibroblasts and for determination of susceptibility or resistance of common burn wound organisms. Candidate agents including chlorhexidine gluconate, polymyxin B, mupirocin, sparfloxacin, or nitrofurazone were tested separately for inhibition of growth of human cells and for inhibitory activity to microorganisms with the wet disk assay. The data showed that (1) chlorhexidine gluconate (0.05%) was uniformly toxic to both cultured human cells and microorganisms; (2) nitrofurazone (0.02%) had dose-dependent toxicity to human cells and limited effectiveness against gram-negative microorganisms; (3) sparfloxacin (30 micrograms/ml) had low toxicity to human cells and retained antimicrobial activity against both gram-positive and gram-negative bacteria; (4) polymyxin B (400 U/ml) was not toxic to human cells and had intermediate effectiveness on gram-negative bacteria; and (5) mupirocin (48 micrograms/ml) had no toxicity to skin cells and had uniform effectiveness against Staphylococcus aureus including methicillin-resistant Staphylococcus aureus. Selection of topical antimicrobial drugs by these assays may improve effectiveness of cultured skin for burns and may be used to control other surgical wound infections. PMID:7775517

  2. Technical innovations in ear reconstruction using a skin expander with autogenous cartilage grafts.

    PubMed

    Dashan, Yu; Haiyue, Jiang; Qinghua, Yang; Bo, Pan; Lin, Lin; Tailing, Wang; Yanmei, Wang; Xiao, Qin; Hongxing, Zhuang

    2008-01-01

    Pioneers such as Tanzer and Brent have established the foundations of microtia reconstruction using an autogenous costal cartilage framework. The framework and its skin coverage are the two limiting factors in ear reconstruction. At the present time autogenous rib cartilage and mastoid skin are still first choice materials for most surgeons. They have the combined advantages of well-matched texture and colour. To reconstruct a symmetrical, accurate, prominent auricle and minimise as much as possible the chest wall deformity caused by rib cartilage harvesting, we set out to improve our techniques for cartilaginous framework definition and to use the remnant ear to enhance the projection of the reconstructed ear. Since 2000, 342 cases (366 ears) were treated using our current techniques. Data pertaining to complications were recorded. Final results were assessed a minimum of 1 year postoperatively. The follow-up period ranged from 1 to 6 years. Most of the patients with microtia were satisfied with the results of their ear reconstruction. In conclusion, our techniques help to reduce the quantity of rib cartilage needed to fabricate ear framework and minimise chest wall deformity. The frameworks are accurate, prominent and stable. Reconstructed ears are similar in colour and appearance to the normal side. Our innovations are practical and reliable for microtia reconstruction using skin expanders in combination with a sculpted autogenous rib cartilage framework.

  3. Is the sensitivity of skin-sparing mastectomy or nipple-sparing mastectomy superior to conventional mastectomy with innervated flap?

    PubMed

    Mori, Hiroki; Okazaki, Mutsumi

    2011-09-01

    The purpose of this study was to investigate sensory recovery in 33 patients who underwent conventional mastectomy, skin-sparing mastectomy, or nipple-sparing mastectomy with immediate breast reconstruction using abdominal flaps. Reconstructions included a pedicled transverse (28 cases) or vertical (five cases) rectus abdominis musculocutaneous flap. Sensory reconstruction was performed in 15 cases by neurorrhaphy using intercostal nerve. Patients were classified into six groups according to type of mastectomy and use of neurorrhaphy. Sensory recovery was estimated by touch, pain, and hot and cold sensation at the nipple, areola, and 4 points at a distance of 2 cm from the areolar circumference. For touch sensation, conventional mastectomy with innervated flap provided greater sensitivity than the other groups (P < 0.05). For pain sensation, conventional mastectomy with innervated flap provided greater sensitivity than the other groups (P< 0.05). In terms of short-term postoperative sensitivity, skin- and nipple-sparing mastectomies with abdominal flap appear inferior to conventional mastectomy with innervated abdominal flap.

  4. Customized Tapered Stent-Grafts in the Endovascular Management of Internal Iliac Artery Aneurysms: A Useful Adjunct to Conventional Endovascular Options

    SciTech Connect

    Haslam, J. Elizabeth Hardman, John; Horrocks, Michael; Fay, Dominic

    2009-01-15

    The endovascular exclusion of an isolated iliac artery aneurysm is recognized as a safe and favorable alternative to open surgical repair, with low associated morbidity and mortality. It has particular advantages in the treatment of internal iliac artery aneurysm (IIAA) given the technical difficulties associated with open surgical repair deep within the pelvis. We describe the use of customized tapered stent-grafts in the exclusion of wide-necked IIAA in five male patients considered high-risk for conventional surgical repair, in whom the common and external iliac artery morphology precluded the use of standard endovascular devices. In each case, IIAA outflow was selectively embolized and the aneurysm neck excluded by placement of a customized tapered stent-graft across the internal iliac artery origin. This technique was extremely effective, with 100% technical success, no serious associated morbidity, and zero mortality. In all five patients sac size was stable or reduced on computed tomography follow-up of up to 3 years (mean, 24.4 months), with a primary patency rate of 100%. We therefore advocate the use of customized tapered stent-grafts as a further endovascular option in the management of IIAA unsuitable for conventional endovascular repair.

  5. Human Regulatory T Cells with Alloantigen Specificity Are More Potent Inhibitors of Alloimmune Skin Graft Damage than Polyclonal Regulatory T Cells

    PubMed Central

    Sagoo, Pervinder; Ali, Niwa; Garg, Garima; Nestle, Frank O.; Lechler, Robert I.; Lombardi, Giovanna

    2013-01-01

    Graft rejection by the immune system is a major cause of transplant failure. Lifelong immunosuppression decreases the incidence of graft rejection; however, nonspecific immunosuppression results in increased susceptibly to infection and cancer. Regulatory T cells (Tregs), which suppress the activation of the immune system and induce tolerance, are currently under evaluation for use in clinical transplantation. Ex vivo expanded polyclonal Tregs that are introduced into transplant recipients alter the balance of T effector cells to Tregs; however, experimental data suggest that alloantigen-specific Tregs would be more effective at preventing graft rejection. We have developed a method to enrich alloantigen-specific human Tregs based on the coexpression of activation markers, CD69 and CD71. These Tregs could be readily expanded in vitro and demonstrated potent antigen-specific suppression. In a humanized mouse model of alloimmune-mediated injury of human skin grafts, alloantigen-specific Tregs resulted in a significant reduction in clinically relevant indicators of dermal tissue injury when compared with polyclonal Tregs, restoring a histology comparable to healthy skin. This method of human allospecific Treg selection should be scalable to the clinic. The improved in vivo efficacy of alloantigen-specific Tregs over polyclonal Tregs shown here suggests that generating “customized” Tregs with defined anti-donor allospecificities may improve current practice in clinical immunotherapy. PMID:21593402

  6. Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model.

    PubMed

    Hasatsri, Sukhontha; Angspatt, Apichai; Aramwit, Pornanong

    2015-01-01

    We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10(-6)). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10(-5)). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

  7. Randomized Clinical Trial of the Innovative Bilayered Wound Dressing Made of Silk and Gelatin: Safety and Efficacy Tests Using a Split-Thickness Skin Graft Model

    PubMed Central

    Hasatsri, Sukhontha; Angspatt, Apichai; Aramwit, Pornanong

    2015-01-01

    We developed the novel silk fibroin-based bilayered wound dressing for the treatment of partial thickness wounds. And it showed relevant characteristics and accelerated the healing of full-thickness wounds in a rat model. This study is the clinical evaluation of the bilayered wound dressing to confirm its safety and efficacy for the treatment of split-thickness skin donor sites. The safety test was performed using a patch model and no evidence of marked and severe cutaneous reactions was found. The efficacy test of the bilayered wound dressing was conducted on 23 patients with 30 split-thickness skin graft donor sites to evaluate healing time, pain score, skin barrier function, and systemic reaction in comparison to Bactigras. We found that the healing time of donor site wounds treated with the bilayered wound dressing (11 ± 6 days) was significantly faster than those treated with Bactigras (14 ± 6 days) (p = 10−6). The wound sites treated with the bilayered wound dressing showed significantly less pain and more rapid skin functional barrier recovery than those treated with Bactigras (p = 10−5). Therefore, these results confirmed the clinical safety and efficacy of the bilayered wound dressing for the treatment of split-thickness skin graft donor sites. PMID:26221170

  8. Successful removal of hyperkeratotic-lichenoid reaction to red ink tattoo with preservation of the whole tattoo using a skin grafting knife.

    PubMed

    Mlakar, Boštjan

    2015-01-01

    With the increasing popularity of tattoo body decorations, reports of medical complications with tattoos have increased in parallel. Although tattoo reactions can resolve spontaneously, they often last for months or even years, despite the various treatment methods. In our case, we present the successful removal of hyperkeratotic-lichenoid reaction to red ink using a simple and cheap skin grafting knife. The entire tattoo was preserved with a good aesthetic result with minimal scarring. PMID:26697733

  9. [Interposition of a full-thickness skin graft in the surgery of temporomandibular joint ankylosis. A study of 31 cases of which 20 had long-term follow-up].

    PubMed

    Guyot, L; Chossegros, C; Cheynet, F; Gola, R; Lachard, J; Blanc, J L

    1995-01-01

    Recurrence is the main problem in temporo-mandibular joint ankylosis treatment. Two therapy are used against this, physiotherapy and surgical joint interposition. Following ankylosis removal, many materials can be interposed but, for us, fullthickness skin graft using Popescu and Vasiliu technique seems to be the best and simplest one. This retrospective study of 31 cases, 20 with long-term follow-up, shows that good results are obtained using this skin graft, with 90% successful rate.

  10. Use of continuous local anesthetic infusion in the management of postoperative split-thickness skin graft donor site pain.

    PubMed

    Hernandez, Jorge L Reguero; Savetamal, Alisa; Crombie, Roselle E; Cholewczynski, Walter; Atweh, Nabil; Possenti, Paul; Schulz, John T

    2013-01-01

    Donor sites from split-thickness skin grafts (STSG) impose significant pain on patients in the early postoperative period. We report the use of continuous local anesthetic infusion as a method for the management of postoperative STSG donor site pain. Patients undergoing single or dual, adjacent STSG harvest from the thigh (eight patients) or back (one patient) were included in this study. Immediately after STSG harvest, subcutaneous catheters were placed for continuous infusion of local anesthetic. Daily donor site-specific pain severity scores were prospectively recorded in nine patients receiving local anesthetic infusion. Patient characteristics, technical aspects, and postoperative complications were identified in the study. The thigh was the anatomic location chosen for most donor sites. A single catheter was placed for donor sites limited to 4 inches in width or less. A dual catheter system was used for those wider than 4 inches. An elastomeric pump delivered continuously a total of 4 ml/hr of a solution of 0.5% bupivacaine. The average anesthetic infusion duration was 3.1 days. A substantial decrease in worst, least, and average donor site pain scores was found from the first 24 hours to the second postoperative day in our patients, a treatment trend that continued through postoperative day 3. One patient developed minor anesthetic leakage from the catheter insertion site; and in three cases, accidental dislodgement of the catheters occurred. There were no cases of donor site secondary infection. All donor sites were completely epithelialized at 1-month follow-up. Continuous local anesthetic infusion is technically feasible and may represent an option for postoperative donor site pain control after STSG harvesting. Relative cost-benefit of the technique remains to be determined. PMID:23271060

  11. Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial

    PubMed Central

    Alvandipour, Mina; Gharedaghi, Babak; Khodabakhsh, Hamed

    2016-01-01

    Purpose Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. Methods This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. Results Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). Conclusion After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC. PMID:27626025

  12. Purse-String Versus Linear Conventional Skin Wound Closure of an Ileostomy: A Randomized Clinical Trial

    PubMed Central

    Alvandipour, Mina; Gharedaghi, Babak; Khodabakhsh, Hamed

    2016-01-01

    Purpose Infection is one of the most frequent complications that can occur after ileostomy closure. The incidence of wound infection depends on the skin closure technique, but there is no agreement on the perfect closure method for an ileostomy wound. The aim of this study was to evaluate the incidence of infection, the patient's approval, and the patient's pain between purse-string closure (PSC) and the usual linear closure (LC) of a stoma wound. Methods This randomized clinical trial enrolled 66 patients who underwent a stoma closure from February 2015 to May 2015 in Sari Emam Khomeini Hospital. Patients were divided into 2 groups according to the stoma closing method: the PSC group (n = 34) and the LC group (n = 32). The incidences of infection for the 2 groups were compared, and the patients' satisfaction and pain with the stoma were determined by using a questionnaire. Results Infection occurred in 1 of 34 PSC patients (2.9%) and in 7 of 32 LC patients (21.8%), and this difference was statistically significant (P = 0.021). Patients in the PSC group were more satisfied with the resulting wound scar and its cosmetic appearance at one month and three months after surgery (P = 0.043). Conclusion After stoma closure, PSC was associated with a significantly lower incidence of wound infection and greater patient satisfaction compared to LC. However, the healing period for patients who underwent PSC was longer than it was for those who underwent LC.

  13. The effect of an arginine-glycine-aspartic acid peptide and hyaluronate synthetic matrix on epithelialization of meshed skin graft interstices.

    PubMed

    Cooper, M L; Hansbrough, J F; Polarek, J W

    1996-01-01

    Keratinocytes and fibroblasts interact with proteins of the extracellular matrix such as fibronectin and vitronectin through RGD (arginine-glycine-aspartic acid) cell-attachment sequences. This study evaluated the ability of a provisional synthetic matrix composed of an RGD peptide and hyaluronic acid to accelerate the epithelialization of the interstices of meshed, human, split-thickness skin when placed on full-thickness wounds of athymic mice. Full-thickness skin defects, sparing the panniculus carnosus, were created on athymic mice and 3:1 meshed, human skin was placed on them. The grafts had four central, isolated interstices, which epithelialized by migration of human keratinocytes. Conditions were either the addition to the wound of the synthetic matrix or a matrix of hyaluronic acid alone. The time to closure of the graft interstices was decreased (p < 0.02) in the wounds treated with the RGD peptide-hyaluronic acid provisional matrix. The resultant epithelium of the closed interstices was significantly thicker 8 days after surgery for the RGD-treated wounds. Basement membrane proteins (laminin and type IV collagen) were also found to be present at the dermoepidermal junction earlier in the RGD-treated wounds. These results imply that use of the RGD peptide conjugate to effect cell-matrix interactions may have clinical significance in the field of wound healing.

  14. Sensing vascularization of ex-vivo produced oral mucosal equivalent (EVPOME) skin grafts in nude mice using optical spectroscopy

    NASA Astrophysics Data System (ADS)

    Vishwanath, Karthik; Gurjar, Rajan; Kuo, Shiuhyang; Fasi, Anthony; Kim, Roderick; Riccardi, Suzannah; Feinberg, Stephen E.; Wolf, David E.

    2014-03-01

    Repair of soft tissue defects of the lips as seen in complex maxillofacial injuries, requires pre-vascularized multi-tissue composite grafts. Protocols for fabrication of human ex-vivo produced oral mucosal equivalents (EVPOME) composed of epithelial cells and a dermal equivalent are available to create prelaminated flaps for grafting in patients. However, invivo assessment of neovascularization of the buried prelaminated flaps remains clinically challenging. Here, we use diffuse reflectance spectroscopy (DRS) and diffuse correlation spectroscopy (DCS) to non-invasively quantify longitudinal changes in the vessel density and blood-flow within EVPOME grafts implanted in the backs of SCID mice and subsequently to determine the utility of these optical techniques for assessing vascularization of implanted grafts. 20 animals were implanted with EVPOME grafts (1x1x0.05 cm3) in their backs. DRS and DCS measurements were obtained from each animal both atop the graft site and far away from the graft site, at one week post-implantation, each week, for four consecutive weeks. DRS spectra were analyzed using an inverse Monte Carlo model to extract tissue absorption and scattering coefficients, which were then used to extract blood flow information by fitting the experimental DCS traces. There were clear differences in the mean optical parameters (averaged across all mice) at the graft site vs. the off-site measurements. Both the total hemoglobin concentration (from DRS) and the relative blood flow (from DCS) peaked at week 3 at the graft site and declined to the off-site values by week 4. The optical parameters remained relatively constant throughout 4 weeks for the off-site measurements.

  15. Skin graft - slideshow

    MedlinePlus

    ... important. Update Date 1/28/2013 Updated by: John A. Daller, MD, PhD, Department of Surgery, Crozer- ... commercial use must be authorized in writing by ADAM Health Solutions. About MedlinePlus Site Map FAQs Contact ...

  16. Outcome of split thickness skin grafting and multiple z-plasties in postburn contractures of groin and perineum: a 15-year experience.

    PubMed

    Sajad, Wani; Hamid, Raashid

    2014-01-01

    Background. Groin and perineal burn contracture is a rare postburn sequel. Such postburn contractures causes distressing symptoms to the patients and in the management of these contractures, both functional and cosmetic appearance should be the primary concern. Aims. To study the outcome of surgical treatment (STSG and multiple Z-plasties) in postburn contractures of groin and perineum. Material and Methods. We conducted a study of 49 patients, with postburn groin and perineal contractures. Release of contracture with split thickness skin grafting (STSG) was done in 44 (89.79%) patients and release of contracture and closure by multiple Z-plasties was done in 5 (10.21%) patients. Results. Satisfactory functional and cosmetic outcome was seen in 44 (89.79%) patients. Minor secondary contractures of the graft were seen in 3 (6.81%) patients who were managed by physiotherapy and partial recurrence of the contracture in 4 (8.16%) patients required secondary surgery. Conclusion. We conclude that postburn contractures of the groin and perineum can be successfully treated with release of contracture followed by STSG with satisfactory functional and cosmetic results. Long term measures like regular physiotherapy, use of pressure garments, and messaging with emollient creams should not be neglected and should be instituted postoperatively to prevent secondary contractures of the graft and recurrence of the contracture. PMID:24967100

  17. Conventional Craniospinal Irradiation with Patient Supine and Source-Skin Distance (SSD) 100 cm for Spinal Field

    SciTech Connect

    Liu Xijun; Yu Jinming; Yu Yonghua; Yin Yong; Wang Bing; Zhang Yong; Kong Lei; Han Dali; Huo Zhijun; Fu Lei

    2011-01-01

    We describe a method of craniospinal irradiation (CSI) in the supine position and at a source-skin distance (SSD) of 100 cm for the spinal fields. The procedure is carried out with a 100-cm isocenter linear accelerator and conventional simulator, and the treatment is delivered with 2 opposed lateral cranial fields at source-axis distance (SAD) of 100 cm and 1 or 2 direct posterior spinal fields at SSD, 100 cm. The half beam-blocked cranial fields with a collimator rotation is used to match the superior border of the spinal field at the level of C2 vertebral body. The length of the spinal field is fixed, and is the same if 2 spinal fields are used. The position of the isocenter of the spine field is defined by longitudinally moving the couch a distance from the isocenter of the cranial fields and adjusting the SSD = 100 cm to the surface of the couch with the gantry rotated to the angle of 180 Degree-Sign (posteroanterior position), and the distance can be calculated easily according to a few parameters. It only needs a simple calculation without couch rotation, extended SSD, or markers. The inferior and superior borders of the spinal field do not require visualization under fluoroscopy when it is beyond the visual field of the simulator. The entire simulation takes no more than 20 minutes. Supine craniospinal treatment using this technique may substitute the traditional prone position as a potentially beneficial alternative to CSI.

  18. Dermoscopic Follow-Up of the Skin towards Acute Graft-versus-Host-Disease in Patients after Allogeneic Hematopoietic Stem Cell Transplantation

    PubMed Central

    Kaminska-Winciorek, Grazyna; Czerw, Tomasz; Kruzel, Tomasz; Giebel, Sebastian

    2016-01-01

    Background. Acute graft-versus-host disease (aGVHD) involving skin is one of the most frequent complications of allogeneic hematopoietic stem cell transplantation (alloHSCT), usually diagnosed based on clinical manifestations. So far, skin biopsy with histopathological evaluation is the only method to confirm the diagnosis. Objective. In this prospective study we monitored alloHSCT recipients by dermoscopy in order to assess its utility as an alternative noninvasive tool to early diagnose acute GVHD. Methods. Thirteen consecutive patients who received alloHSCT were examined clinically and dermoscopically towards aGVHD [days 28 (±7), 56 (±7), and 100 (±7)], as well as in each patient who developed cutaneous aGVHD diagnosed according to clinical criteria (Glucksberg scale). Results. Six patients (46%) developed symptoms of cutaneous acute GVHD (grade 1, n = 3; grade 2, n = 3). Dermoscopic evaluation revealed pinkish or reddish background and well-visible, multiple thin telangiectasias. Conclusion. To our knowledge, this is the first report on the use of dermoscopy to evaluate skin involvement in the course of acute GVHD suggesting its role as a diagnostic tool in follow-up of GVHD, which can be also used before clinical symptoms occur. PMID:27446950

  19. The effects of conventional extracorporeal circulation versus miniaturized extracorporeal circulation on microcirculation during cardiopulmonary bypass-assisted coronary artery bypass graft surgery

    PubMed Central

    Yuruk, Koray; Bezemer, Rick; Euser, Mariska; Milstein, Dan M.J.; de Geus, Hilde H.R.; Scholten, Evert W.; de Mol, Bas A.J.M.; Ince, Can

    2012-01-01

    OBJECTIVES To reduce the complications associated with cardiopulmonary bypass (CPB) during cardiac surgery, many modifications have been made to conventional extracorporeal circulation systems. This trend has led to the development of miniaturized extracorporeal circulation systems. Cardiac surgery using conventional extracorporeal circulation systems has been associated with significantly reduced microcirculatory perfusion, but it remains unknown whether this could be prevented by an mECC system. Here, we aimed to test the hypothesis that microcirculatory perfusion decreases with the use of a conventional extracorporeal circulation system and would be preserved with the use of an miniaturized extracorporeal circulation system. METHODS Microcirculatory density and perfusion were assessed using sublingual side stream dark-field imaging in patients undergoing on-pump coronary artery bypass graft (CABG) surgery before, during and after the use of either a conventional extracorporeal circulation system (n = 10) or a miniaturized extracorporeal circulation system (n = 10). In addition, plasma neutrophil gelatinase-associated lipocalin and creatinine levels and creatinine clearance were assessed up to 5 days post-surgery to monitor renal function. RESULTS At the end of the CPB, one patient in the miniaturized extracorporeal circulation-treated group and five patients in the conventional extracorporeal circulation-treated group received one bag of packed red blood cells (300 ml). During the CPB, the haematocrit and haemoglobin levels were slightly higher in the miniaturized extracorporeal circulation-treated patients compared with the conventional extracorporeal circulation-treated patients (27.7 ± 3.3 vs 24.7 ± 2.0%; P = 0.03; and 6.42 ± 0.75 vs 5.41 ± 0.64 mmol/l; P < 0.01). The density of perfused vessels with a diameter <25 µm (i.e. perfused vessel density) decreased slightly in the conventional extracorporeal circulation-treated group from 16

  20. Δ9-Tetrahydrocannabinol attenuates allogeneic host-versus-graft response and delays skin graft rejection through activation of cannabinoid receptor 1 and induction of myeloid-derived suppressor cells

    PubMed Central

    Sido, Jessica M.; Nagarkatti, Prakash S.; Nagarkatti, Mitzi

    2015-01-01

    Immune cells have been shown to express cannabinoid receptors and to produce endogenous ligands. Moreover, activation of cannabinoid receptors on immune cells has been shown to trigger potent immunosuppression. Despite such studies, the role of cannabinoids in transplantation, specifically to prevent allograft rejection, has not, to our knowledge, been investigated previously. In the current study, we tested the effect of THC on the suppression of HvGD as well as rejection of skin allografts. To this end, we studied HvGD by injecting H-2k splenocytes into H-2b mice and analyzing the immune response in the draining ingLNs. THC treatment significantly reduced T cell proliferation and activation in draining LNs of the recipient mice and decreased early stage rejection-indicator cytokines, including IL-2 and IFN-γ. THC treatment also increased the allogeneic skin graft survival. THC treatment in HvGD mice led to induction of MDSCs. Using MDSC depletion studies as well as adoptive transfer experiments, we found that THC-induced MDSCs were necessary for attenuation of HvGD. Additionally, using pharmacological inhibitors of CB1 and CB2 receptors and CB1 and CB2 knockout mice, we found that THC was working preferentially through CB1. Together, our research shows, for the first time to our knowledge, that targeting cannabinoid receptors may provide a novel treatment modality to attenuate HvGD and prevent allograft rejection. PMID:26034207

  1. [A Case of a Severely Burned Patient with Suspected Takotsubo Cardiomyopathy Who Underwent Immediate Excision and Skin Grafting under General Anesthesia].

    PubMed

    Nakanishi, Mika; Oota, Takako; Kato, Takeshi; Imanishi, Toshihiro

    2015-04-01

    An 88-year-old woman was severely burned on her thigh, leg, arm, buttocks, chest and abdomen in the bathroom and was emergently admitted to our hospital. The burn index was 10.8 and the prognostic burn index (PBI) was 99. The reports of echocardiography, cardiac biomarkers and electrocardiogram showed left ventricular dysfunction with apical akinesis, which was suspected as Takotsubo cardiomyopathy. To avoid poor prognosis because of severe PBI, immediate excision and skin grafting were performed under general anesthesia 23 hours after the burn onset. More infusion and transfusion than the expected amounts were needed during anesthesia and the postoperative 4 days because of cardiac failure and septic shock, which were overcome 14 days after the surgery. The complete early excision was impossible due to cardiac failure, and that the unexcised burn scar exacerbated infection and prevented her from survival. PMID:26419106

  2. Acellular Dermal Matrix Combined with Autologous Skin Grafts for Closure of Chronic Wounds after Reconstruction of Skull Defects with Titanium Mesh.

    PubMed

    Luo, Xu; Lin, Cai; Wang, Xinling; Lin, Xiangwei; He, Sunyue; Liu, Yunfeng; Zhang, Yong; Yang, Ruijin; Zhu, Xinguo

    2016-07-01

    Objective The closure of chronic wounds after skull defect reconstruction with titanium mesh is one of the most challenging problems for plastic and reconstructive surgeons. Current approaches are disappointing. Methods In 10 patients, we explored the role of acellular dermal matrix (ADM) in combination with autologous skin grafts (ASGs) for closure of chronic wounds after skull reconstruction with titanium. Results ADM and ASG survived in all patients. Grade A healing (healing well without defect) was achieved. The average operating time was 30 to 45 minutes, and the average blood loss 30 to 50 mL. After 3 months, the wound was still closed in all patients. Conclusion The combination of ADM plus ASG obtained a high wound closure rate. ADM plus ASG allows avoiding other procedures such as rotational flaps and free flaps that require more operating time, special equipment, and adequate training. PMID:27088591

  3. Late failure of a split-thickness skin graft in the setting of homozygous factor V Leiden mutation: a case report and correlative animal model from the Wound Etiology and Healing (WE-HEAL) study.

    PubMed

    Shanmugam, Victoria K; McNish, Sean; Duncan, Joanna; Root, Brandy; Tassi, Elena; Wellstein, Anton; Kallakury, Bhaskar; Attinger, Christopher E

    2015-10-01

    We present the case of a 53-year-old Caucasian male smoker with remote history of left lower extremity deep venous thrombosis (DVT) and a strong family history of thrombosis, who presented to the Center for Wound Healing at MedStar Georgetown University Hospital with spontaneous left leg ulceration. Prothrombotic evaluation showed homozygosity for the factor V Leiden (FVL) mutation. Therapeutic anticoagulation was commenced with warfarin (Coumadin®) and the patient underwent successful debridement and Apligraf® followed by split-thickness skin graft (STSG) of two wounds. He had an uneventful postoperative course and on the 27th postoperative day the grafts were 95% intact. However, by postoperative day 41 there was 10% graft loss, and over the subsequent 2 weeks both grafts necrosed. On further questioning, it transpired that the patient had discontinued his warfarin on postoperative day 37 because he thought that it was no longer necessary. The patient is enrolled in the Wound Etiology and Healing (WE-HEAL) study, and at the time of the original graft, residual skin fragments from the STSG were transplanted onto a nude mouse for development of an animal model of wound healing. The mouse graft was successful and was harvested at postoperative day 87 for pathological examination. We review the mechanisms by which prothrombotic states, particularly FVL mutation, can contribute to skin graft failure and delayed wound healing. This case highlights the importance of considering prothrombotic conditions in patients with spontaneous leg ulcerations and the impact of therapeutic anticoagulation on healing. It further allows us to demonstrate the efficacy of the animal model in which residual fragments of STSG tissue are utilised for transplant onto nude mice for manipulation in the laboratory. PMID:24028566

  4. Should we consider beating-heart on-pump coronary artery bypass grafting over conventional cardioplegic arrest to improve postoperative outcomes in selected patients?

    PubMed

    Al Jaaly, Emad; Chaudhry, Umar A R; Harling, Leanne; Athanasiou, Thanos

    2015-04-01

    A best evidence topic in cardiac surgery was written according to a structured protocol. The question addressed was whether beating-heart on-pump coronary artery bypass grafting (BH-ONCAB) offered superior mortality and morbidity outcomes when compared with conventional on-pump coronary artery bypass grafting (C-ONCAB). Morbidity outcomes consisted of renal failure, stroke (transient or permanent), myocardial infarction, angina, congestive cardiac failure, reintervention and arrhythmias. Best evidence papers investigating BH-ONCAB versus C-ONCAB were considered. Where data were duplicated, the more credible evidence-based and recently published study was included. Two hundred and thirty-one papers were found using the reported search, of which 11 represented the best evidence to answer the clinical question. Two were prospective randomized controlled trials and the remaining 10 observational studies, of which one was propensity-matched. The authors, journal, date and country of publication, patient group studied, study type, relevant outcomes and results of these papers are tabulated. Five of these studies demonstrated significantly improved mortality following BH-ONCAB; however, one study exhibited better survival after C-ONCAB. Notably, this study incorporated BH-ONCAB patients with significantly more haemodynamic instability, thus possibly explaining the worse mortality outcomes. In terms of morbidity, a slightly more mixed picture is drawn. Five studies report morbidity in favour of BH-ONCAB, whereas three studies include individual outcomes favouring C-ONCAB. The remaining studies showed equivalent mortality and morbidity data. In summary, the results presented here suggest that BH-ONCAB may improve survival following coronary artery bypass surgery. A key observation is that the greatest benefits of BH-ONCAB appear to be in studies including patients with considerably higher risk characteristics at the time of surgery (haemodialysis, end-stage coronary artery

  5. Comparison of thin-film resistance heat-transfer gages with thin-skin transient calorimeter gages in conventional hypersonic wind tunnels

    NASA Technical Reports Server (NTRS)

    Miller, C. G., III

    1981-01-01

    Thin film gages deposited at the stagnation region of small (8.1-mm-diameter) hemispheres and gages mounted flush with the surface of a sharp-leading-edge flat plate were tested in the Langley continuous-flow hypersonic tunnel and in the Langley hypersonic CF4 tunnel. Two substrate materials were tested, quartz and a machinable glass-ceramic. Small hemispheres were also tested utilizing the thin-skin transient calorimeter technique usually employed in conventional tunnels. One transient calorimeter model was a thin shell of stainless steel, and the other was a thin-skin insert of stainless steel mounted into a hemisphere fabricated from a machinable-glass-ceramic. Measured heat-transfer rates from the various hemispheres were compared with one another and with predicted rates. The results demonstrate the feasibility and advantages of using-film resistance heat-transfer gages in conventional hypersonic wind tunnels over a wide range of conditions.

  6. [A case of combination therapy by vacuum assisted closure along with skin graft for scleroderma with common wart].

    PubMed

    Luo, Junjie; Yang, Xinghua

    2016-09-28

    Scleroderma is a kind of connective tissue disease characterized by skin and other systems fibrosis. The underlying mechanisms for this disease are poorly understood due to its complexity. It is very difficult for scleroderma patient to heal the wound due to the special pathological characteristic of scleroderma. PMID:27640802

  7. A novel way to treat skin tears.

    PubMed

    Moradian, Scott; Klapper, Andrew M

    2016-04-01

    Skin tears are one of the most commonly treated wounds in the elderly population. In their most basic form, they are essentially traumatic random pattern flaps. We postulate that the injured blood flow to these skin flaps should be ignored and the tissue should be treated as a skin graft. A case report is presented of an 86-year-old female with an 8 × 3·5 cm skin tear to her right upper extremity after a hip fracture. In addition to conventional wound closure strips re-approximating the tissues, a disposable negative pressure wound therapy device was placed to act as bolster. Upon its removal on day 5, the opposed skin tear tissue was found to be 100% viable. We therefore propose that this update may be an improvement over classical skin tear treatments and should be followed up with a case series.

  8. Effects of low level laser therapy on the prognosis of split-thickness skin graft in type 3 burn of diabetic patients: a case series.

    PubMed

    Dahmardehei, Mostafa; Kazemikhoo, Nooshafarin; Vaghardoost, Reza; Mokmeli, Soheila; Momeni, Mahnoush; Nilforoushzadeh, Mohammad Ali; Ansari, Fereshteh; Amirkhani, Amir

    2016-04-01

    Significant populations in burn centers are diabetic burn patients. Healing process in these patients is more difficult due to diabetes complications. The gold standard treatment for patients with grade 3 burn ulcer is split-thickness skin grafting (STSG), but in the diabetic patients, the rate of graft failure and amputation is high due to impaired tissue perfusion. The technique of low level laser therapy (LLLT) improves tissue perfusion and fibroblast proliferation, increases collagen synthesis, and accelerates wound healing. The purpose of this case report is introducing a new therapeutic method for accelerating healing with better prognosis in these patients. The protocols and informed consent were reviewed according to the Medical Ethics, Board of Shahid Beheshti Medical Sciences (IR.SBMU.RAM.REC.13940.363). Diabetic type 2 patients with 13 grade 3 burn ulcers, candidate for amputation, were enrolled in the study. We used a 650-nm red laser light, 2 J/Cm for the bed of the ulcer and an 810-nm infrared laser light 6 J/Cm(2) for the margins along with intravenous laser therapy with a 660-nm red light, before and after STSG for treating grade 3 burn ulcers in 13 diabetic ulcers. The results of this study showed complete healing in the last 8 weeks for all patients who were candidates for amputation. In this case series, we present 13 cases of diabetic ulcer with type 3 burn wound, candidate for amputation, who healed completely using LLLT and STSG. This is the first time that these two techniques are combined for treatment of burn ulcer in diabetic patients. Using LLLT with STSG might be a promising treatment for burn victims especially diabetic patients.

  9. Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review

    PubMed Central

    Anderson, John J.; Wallin, Kelly J.; Spencer, Loren

    2012-01-01

    We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean healing time for those without complications was 4.9 weeks (3 to 10 weeks). Overall complication rate was 2.8%. Patients with a STSG take of less than 95% had a mean healing time of 7.9 weeks compared to 4.8 weeks for those with a STSG take of 100% (p<0.001). The use of autologous STSG for treatment of non-healing diabetic foot and leg wounds is a viable method for soft tissue closure and may present a low complication rate and a satisfactory rate of healing. PMID:22403742

  10. Split thickness skin grafts for the treatment of non-healing foot and leg ulcers in patients with diabetes: a retrospective review.

    PubMed

    Anderson, John J; Wallin, Kelly J; Spencer, Loren

    2012-01-01

    We retrospectively reviewed 107 diabetic patients who received a split thickness skin graft (STSG) for treatment of a non-healing diabetic foot or leg ulcer to describe healing times based on patient characteristics, comorbidities or complications. The minimum follow-up was 6 months from the time of STSG application. The mean time to healing among all patients was 5.1 weeks (3 to 16 weeks). The mean healing time for patients with complications was 12.0 weeks (10 to 16 weeks) while the mean healing time for those without complications was 4.9 weeks (3 to 10 weeks). Overall complication rate was 2.8%. Patients with a STSG take of less than 95% had a mean healing time of 7.9 weeks compared to 4.8 weeks for those with a STSG take of 100% (p<0.001). The use of autologous STSG for treatment of non-healing diabetic foot and leg wounds is a viable method for soft tissue closure and may present a low complication rate and a satisfactory rate of healing. PMID:22403742

  11. Bone Grafts

    MedlinePlus

    A bone graft transplants bone tissue. Surgeons use bone grafts to repair and rebuild diseased bones in your hips, knees, ... fractures or cancers. Once your body accepts the bone graft, it provides a framework for growth of new, ...

  12. Lipid-colloid dressing shows improved reepithelialization, pain relief, and corneal barrier function in split-thickness skin-graft donor wound healing.

    PubMed

    Tanaka, Katsuya; Akita, Sadanori; Yoshimoto, Hiroshi; Houbara, Seiji; Hirano, Akiyoshi

    2014-09-01

    Donor-site wound healing was tested with a nonadherent petrolatum- and hydrocolloid-impregnated polyester, a lipid-colloid dressing, and a nonadherent polyester dressing, supplemented with petrolatum manually by a physician onsite. Ten patients, 1 woman and 9 men (22 to 79 years old; average 58.4 ± 17.54 years), were enrolled in this prospective comparison study. The split-thickness skin graft was 14.5 ± 7.49 cm long × 8.2 ± 4.07 cm wide (5.5-27 cm long and 4.0-14.0 wide) and 14/1000 inches (0.356 mm) deep. The degree of reepithelialization in lipid-colloid dressing was significantly better than that in polyester mesh dressing, with 1.7 ± 1.00 and 2.8 ± 0.83 for the lipid-colloid dressing and polyester mesh dressing, respectively (P < .05), and degree of pain was significantly lower in lipid-colloid dressing than that in polyester dressing, 1.7 ± 1.11 and 2.9 ± 1.12 for the lipid-colloid dressing and polyester mesh dressing, respectively (P < .01). In moisture meter analyses, the values of effective contact coefficient and corneal thickness in lipid-colloid at wound healing was significantly smaller than those in polyester mesh (effective contact coefficient: 11.7 ± 1.87% and 15.6 ± 3.09% for lipid-colloid and polyester mesh, respectively, P < .05; corneal thickness: 31.1 ± 6.65 µm and 40.7 ± 8.69 µm for lipid-colloid and polyester mesh, respectively, P < .05). No significant difference was observed at 1 month after healing. The nonadherent lipid-colloid polyester dressing has superior wound healing and pain relief and demonstrates better corneal barrier function delineated by effective contact coefficient and corneal thickness at healing in split-thickness donors.

  13. An evaluation of five different dressing materials on split-thickness skin graft donor site and full-thickness cutaneous wounds: an experimental study.

    PubMed

    Uraloğlu, Muhammet; Livaoğlu, Murat; Agdoğan, Özgür; Mungan, Sevdegül; Alhan, Etem; Karaçal, Naci

    2014-02-01

    The objective of this study was to investigate the healing effect of five different products on split-thickness skin graft (STSG) donor sites and full-thickness cutaneous wounds (FTCWs) using an occlusive dressing model. Six groups were included: 1 control and 5 experimental groups, with a total of 24 rats, using an occlusive dressing model. STSG donor sites and FTCWs were established in two separate areas, to the right and left on the animals' backs. Wound sites were dressed with one of the following materials: fine mesh gauze, microporous polysaccharide hemosphere (MPH), clinoptilolite, alginate, hydrogel or biosynthetic wound dressing (Biobran(®) ). These materials were compared in terms of healing rate, healing quality and histopathological findings. Occlusive dressings were applied to each wound on days 0, 3, 5, 7, 10 and 14. Area measurements were taken using images of each dressing. The alginate and clinoptilolite groups gave the best healing rate results for both STSG donor sites (P = 0·003) and FTCWs (P = 0·003). MPH came third in each group. The alginate group produced better results in terms of healing quality criteria, followed by hydrogel, MPH, clinoptilolite and Biobran(®) , in that order. Statistically significant results were obtained in all groups compared to the control group (P < 0·0007). Rapid and good healing quality for both the STSG donor sites and FTCWs were obtained with alginate. Healing with clinoptilolite and MPH was rapid, but poor quality, while slower but good healing quality was obtained with hydrogel. Slower and worse quality healing was obtained with Biobran(®) . PMID:22943661

  14. Distribution of Malassezia species on the skin of patients with atopic dermatitis, psoriasis, and healthy volunteers assessed by conventional and molecular identification methods

    PubMed Central

    2014-01-01

    Background The Malassezia yeasts which belong to the physiological microflora of human skin have also been implicated in several dermatological disorders, including pityriasis versicolor (PV), atopic dermatitis (AD), and psoriasis (PS). The Malassezia genus has repeatedly been revised and it now accommodates 14 species, all but one being lipid-dependent species. The traditional, phenotype-based identification schemes of Malassezia species are fraught with interpretative ambiguities and inconsistencies, and are thus increasingly being supplemented or replaced by DNA typing methods. The aim of this study was to explore the species composition of Malassezia microflora on the skin of healthy volunteers and patients with AD and PS. Methods Species characterization was performed by conventional, culture-based methods and subsequently molecular techniques: PCR-RFLP and sequencing of the internal transcribed spacer (ITS) 1/2 regions and the D1/D2 domains of the 26S rRNA gene. The Chi-square test and Fisher’s exact test were used for statistical analysis. Results Malassezia sympodialis was the predominant species, having been cultured from 29 (82.9%) skin samples collected from 17 out of 18 subjects under the study. Whereas AD patients yielded exclusively M. sympodialis isolates, M. furfur isolates were observed only in PS patients. The isolation of M. sympodialis was statistically more frequent among AD patients and healthy volunteers than among PS patients (P < 0.03). Whether this mirrors any predilection of particular Malassezia species for certain clinical conditions needs to be further evaluated. The overall concordance between phenotypic and molecular methods was quite high (65%), with the discordant results being rather due to the presence of multiple species in a single culture (co-colonization) than true misidentification. All Malassezia isolates were susceptible to cyclopiroxolamine and azole drugs, with M. furfur isolates being somewhat more drug tolerant

  15. Comparison of permeatal medial placement of graft without raising the tympano-meatal flaps to conventional methods of myringoplasty: An experience at tertiary care hospital in Pakistan

    PubMed Central

    Niazi, Saleem Asif; Hassan, Zaheer Ul; Atif, Khaula; Ullah, Saeed

    2016-01-01

    Objective: To compare the results of permeatal approach without raising the tympano-meatal flap to end-aural or post-aural approach in myringoplasty. Methods: This Quasi-experimental study was carried out in CMH (Combined Military Hospital) Peshawar, from August 2006 to July 2013. Three hundred fifty patients of chronic suppurative otitis media (CSOM) with dry central; small, medium and large perforations were selected. They were divided into two groups depending upon the type of approach. In Group-A (n-200); permeatal approach without raising tympano-meatal flap was used; while in Group-B (n-150) end-aural or post-aural approach was used. Subjects were followed up for two years; graft take was checked regularly by examinations of ear under microscope. Data was collected on structured Performa and analysed by SPSS-17. Results: Male and female were 74% and 26% respectively; Age ranged from 15 to 46 Years. There was no significant difference in the graft success at the end of two years in Group-A(80%) and Group-B(85%) (p-0.261). Type of approach had a significant impact on duration of surgery(p<0.001) and post-operative recovery time(p<0.001). Conclusion: The permeatal approach and end-aural/post-aural approach had almost equal graft success rates, but former is more useful as it causes lesser morbidity, decreased post-operative hospital stay and reduced operative time. It is under-utilized and should be employed more frequently. PMID:27648041

  16. A subset of gamma delta T-cell receptor-positive cells produce T-helper type-2 cytokines and regulate mouse skin graft rejection following portal venous pretransplant preimmunization.

    PubMed Central

    Gorczynski, R M; Chen, Z; Hoang, Y; Rossi-Bergman, B

    1996-01-01

    C3H/HeJ mice received B10.BR skin grafts following portal or lateral tail vein infusion of irradiated B10.BR spleen cells. Thereafter mice were injected with anti-alpha beta or anti-gamma delta T-cell receptor (TCR) monoclonal antibody (mAb). Anti-gamma delta TCR mAb abolished the increased graft survival afforded by portal venous (p.v.) immunization, and reversed the bias towards expression of mRNA for type-2 cytokines [interleukin-4 (IL-4), IL-10] seen in lymphoid tissue of p.v.-immunized mice. When gamma delta TCR+ and alpha beta TCR+ cells were isolated from the intestinal epithelial compartment (IEL), liver or Peyer's Patch (PP) of p.v.-immunized mice, the gamma delta TCR+ cells were found to be enriched in cells producing type-2 cytokines on rechallenge with irradiated B10.BR cells in vitro. gamma delta TCR+ cells from p.v.-immunized mice were further expanded in vitro with anti-CD3 and cytokines (combined IL-2 and IL-4). Following expansion these cells were capable of adoptively transferring increased B10.BR skin graft survival to naive mice, and continued to show a bias in type-2 cytokine synthesis after allostimulation in vitro. When gamma delta TCR chain expression was assessed in cells taken from p.v.-immunized mice, or in cells expanded in culture, our data suggest that p.v. immunization leads to oligoclonal, not polyclonal, expansion of those gamma delta TCR+ cells involved in inhibition of graft rejection. Images Figure 2 Figure 3 Figure 4 PMID:8778022

  17. Proximal placement of lateral thigh skin markers reduces soft tissue artefact during normal gait using the Conventional Gait Model.

    PubMed

    Cockcroft, John; Louw, Quinette; Baker, Richard

    2016-11-01

    A primary source of measurement error in gait analysis is soft-tissue artefact. Hip and knee angle measurements, regularly used in clinical decision-making, are particularly prone to pervasive soft tissue on the femur. However, despite several studies of thigh marker artefact it remains unclear how lateral thigh marker height affects results using variants of the Conventional Gait Model. We compared Vicon Plug-in Gait hip and knee angle estimates during gait using a proximal and distal thigh marker placement for ten healthy subjects. Knee axes were estimated by optimizing thigh rotation offsets to minimize knee varus-valgus range during gait. Relative to the distal marker, the proximal marker produced 37% less varus-valgus range and 50% less hip rotation range (p < 0.001), suggesting that it produced less soft-tissue artefact in knee axis estimates. The thigh markers also produced different secondary effects on the knee centre estimate. Using whole gait cycle optimization, the distal marker showed greater minimum and maximum knee flexion (by 6° and 2° respectively) resulting in a 4° reduction in range. Mid-stance optimization reduced distal marker knee flexion by 5° throughout, but proximal marker results were negligibly affected. Based on an analysis of the Plug-in Gait knee axis definition, we show that the proximal marker reduced sensitivity to soft-tissue artefact by decreasing collinearity between the points defining the femoral frontal plane and reducing anteroposterior movement between the knee and thigh markers. This study suggests that a proximal thigh marker may be preferable when performing gait analysis using the Plug-in Gait model.

  18. Proximal placement of lateral thigh skin markers reduces soft tissue artefact during normal gait using the Conventional Gait Model.

    PubMed

    Cockcroft, John; Louw, Quinette; Baker, Richard

    2016-11-01

    A primary source of measurement error in gait analysis is soft-tissue artefact. Hip and knee angle measurements, regularly used in clinical decision-making, are particularly prone to pervasive soft tissue on the femur. However, despite several studies of thigh marker artefact it remains unclear how lateral thigh marker height affects results using variants of the Conventional Gait Model. We compared Vicon Plug-in Gait hip and knee angle estimates during gait using a proximal and distal thigh marker placement for ten healthy subjects. Knee axes were estimated by optimizing thigh rotation offsets to minimize knee varus-valgus range during gait. Relative to the distal marker, the proximal marker produced 37% less varus-valgus range and 50% less hip rotation range (p < 0.001), suggesting that it produced less soft-tissue artefact in knee axis estimates. The thigh markers also produced different secondary effects on the knee centre estimate. Using whole gait cycle optimization, the distal marker showed greater minimum and maximum knee flexion (by 6° and 2° respectively) resulting in a 4° reduction in range. Mid-stance optimization reduced distal marker knee flexion by 5° throughout, but proximal marker results were negligibly affected. Based on an analysis of the Plug-in Gait knee axis definition, we show that the proximal marker reduced sensitivity to soft-tissue artefact by decreasing collinearity between the points defining the femoral frontal plane and reducing anteroposterior movement between the knee and thigh markers. This study suggests that a proximal thigh marker may be preferable when performing gait analysis using the Plug-in Gait model. PMID:26929983

  19. Bioinspired design of nanostructured elastomers with cross-linked soft matrix grafting on the oriented rigid nanofibers to mimic mechanical properties of human skin.

    PubMed

    Wang, Zhongkai; Jiang, Feng; Zhang, Yaqiong; You, Yezi; Wang, Zhigang; Guan, Zhibin

    2015-01-27

    Human skin exhibits highly nonlinear elastic properties that are essential to its physiological functions. It is soft at low strain but stiff at high strain, thereby protecting internal organs and tissues from mechanical trauma. However, to date, the development of materials to mimic the unique mechanical properties of human skin is still a great challenge. Here we report a bioinspired design of nanostructured elastomers combining two abundant plant-based biopolymers, stiff cellulose and elastic polyisoprene (natural rubber), to mimic the mechanical properties of human skin. The nanostructured elastomers show highly nonlinear mechanical properties closely mimicking that of human skin. Importantly, the mechanical properties of these nanostructured elastomers can be tuned by adjusting cellulose content, providing the opportunity to synthesize materials that mimic the mechanical properties of different types of skins. Given the simplicity, efficiency, and tunability, this design may provide a promising strategy for creating artificial skin for both general mechanical and biomedical applications.

  20. Plant grafting.

    PubMed

    Melnyk, Charles W; Meyerowitz, Elliot M

    2015-03-01

    Since ancient times, people have cut and joined together plants of different varieties or species so they would grow as a single plant - a process known as grafting (Figures 1 and 2). References to grafting appear in the Bible, ancient Greek and ancient Chinese texts, indicating that grafting was practised in Europe, the Middle East and Asia by at least the 5(th) century BCE. It is unknown where or how grafting was first discovered, but it is likely that natural grafting, the process by which two plants touch and fuse limbs or roots in the absence of human interference (Figure 3), influenced people's thinking. Such natural grafts are generally uncommon, but are seen in certain species, including English ivy. Parasitic plants, such as mistletoe, that grow and feed on often unrelated species may have also contributed to the development of grafting as a technique, as people would have observed mistletoe growing on trees such as apples or poplars. PMID:25734263

  1. Side-by-side evaluation of a stressed-skin insulated-core panel house and a conventional stud-frame house. Final report

    SciTech Connect

    Rudd, A.; Chandra, S.

    1994-01-14

    Side-by-side energy testing and monitoring was conducted on two houses in Louisville, KY between January--March 1993. Both houses were identical except that one house was constructed with conventional US 2 by 4 studs and a truss roof while the other house was constructed with stress-skin insulated core panels for the walls and second floor ceiling. Air-tightness testing included fan pressurization by blower door, hour long tracer tests using sulphur hexafluoride, and two-week long time-averaged tests using perfluorocarbon tracers. An average of all the air-tightness test results showed the SSIC panel house to have 22 percent less air infiltration than the frame house. Air-tightness testing resulted in a recommendation that both houses have a fresh air ventilation system installed to provide 0.35 air changes per hour continuously. Thermal insulation quality testing was by infrared imaging. Pressure differential testing resulted in recommendations to use sealed combustion appliances, and to allow for more return air flow from closed rooms. This can be accomplished by separate return ducts or transfer ducts which simply connect closed rooms to the main body with a short duct. The SSIC house UA was lower in both cases. By measurement, co-heating tests showed the SSIC panel house total UA to be 12 percent lower than the frame house. Short-term energy monitoring was also conducted for the two houses. A 17 day period of electric heating and a 14 day period of gas furnace heating was evaluated. Monitoring results showed energy savings for the panel house to be 12 percent during electric heating and 15 percent during gas heating. A comparison of the two monitoring periods showed that the lumped efficiency of the gas furnace and air distribution system for both houses was close to 80 percent. Simple regression models using Typical Meteorological Year weather data gave a preliminary prediction of seasonal energy savings between 14 and 20 percent.

  2. Vascular graft infections.

    PubMed

    Hasse, Barbara; Husmann, Lars; Zinkernagel, Annelies; Weber, Rainer; Lachat, Mario; Mayer, Dieter

    2013-01-01

    Vascular procedures are rarely complicated by infection, but if prosthetic vascular graft infection (PVGI) occurs, morbidity and mortality are high. Several patient-related, surgery-related and postoperative risk factors are reported, but they are not well validated. PVGI is due to bacterial colonisation of the wound and the underlying prosthetic graft, generally as a result of direct contamination during the operative procedure, mainly from the patient's skin or adjacent bowel. There is no consensus on diagnostic criteria or on the best management of PVGI. On the basis of reported clinical studies and our own experience, we advocate a surgical approach combining repeated radical local debridement, with graft preservation whenever possible or partial excision of the infected graft, depending on its condition, plus simultaneous negative-pressure wound therapy (NPWT). In addition, antimicrobial therapy is recommended, but there is no consensus on which classes of agent are adequate for the treatment of PVGI and whether certain infections may be treated by means of NPWT alone. Since staphylococci and Gram-negative rods are likely to be isolated, empirical treatment might include a penicillinase-resistant beta-lactam or a glycopeptide, plus an aminoglycoside, the latter for Gram-negative coverage and synergistic treatment of Gram-positive cocci. Additionally, empirical treatment might include rifampicin since it penetrates well into biofilms.

  3. Prevention of experimental autoimmune encephalomyelitis in DA rats by grafting primary skin fibroblasts engineered to express transforming growth factor-beta1.

    PubMed

    Zargarova, T; Kulakova, O; Prassolov, V; Zharmukhamedova, T; Tsyganova, V; Turobov, V; Ivanov, D; Parfenov, M; Sudomoina, M; Chernajovsky, Y; Favorova, O

    2004-08-01

    To determine whether primary fibroblasts producing latent transforming growth factor beta1 (TGF-beta1) are capable of down-regulating experimental autoimmune encephalomyelitis (EAE), a retroviral vector TGF-beta1-pBabe-neo (-5'UTR) was used for efficient gene transfer into primary skin fibroblasts of DA rats. After heat activation, conditioned medium from the transduced fibroblasts was found to inhibit significantly in vitro proliferation of lymphocytes from lymph nodes of DA rats with EAE. Intraperitoneal administration of TGF-beta1-transduced fibroblasts into DA rats during the priming phase of EAE resulted in a significant reduction in mortality and in the mean clinical and EAE scores versus the control immunized animals treated with non-transduced fibroblasts.

  4. Prevention of experimental autoimmune encephalomyelitis in DA rats by grafting primary skin fibroblasts engineered to express transforming growth factor-β1

    PubMed Central

    Zargarova, T; Kulakova, O; Prassolov, V; Zharmukhamedova, T; Tsyganova, V; Turobov, V; Ivanov, D; Parfenov, M; Sudomoina, M; Chernajovsky, Y; Favorova, O

    2004-01-01

    To determine whether primary fibroblasts producing latent transforming growth factor β1 (TGF-β1) are capable of down-regulating experimental autoimmune encephalomyelitis (EAE), a retroviral vector TGF-β1-pBabe-neo (−5′UTR) was used for efficient gene transfer into primary skin fibroblasts of DA rats. After heat activation, conditioned medium from the transduced fibroblasts was found to inhibit significantly in vitro proliferation of lymphocytes from lymph nodes of DA rats with EAE. Intraperitoneal administration of TGF-β1-transduced fibroblasts into DA rats during the priming phase of EAE resulted in a significant reduction in mortality and in the mean clinical and EAE scores versus the control immunized animals treated with non-transduced fibroblasts. PMID:15270848

  5. Effect of skin barrier emulsion cream vs a conventional moisturizer on transepidermal water loss and corneometry in atopic dermatitis: a pilot study.

    PubMed

    Kircik, Leon H

    2014-12-01

    The repair and maintenance of the epidermal barrier is of the utmost importance in the treatment of atopic dermatitis (AD). While barrier creams and emollients are considered to be a foundation of AD therapy, there is little comparative data between various product options. This was a pilot study with a small sample size to investigate the use of skin barrier emulsion cream vs a commonly used moisturizing lotion to improve the epidermal barrier in subjects with atopic dermatitis.

  6. Prosthetic Arteriovenous Graft Contact Dermatitis Masquerading as an Arteriovenous Graft Infection in a Hemodialysis Patient

    PubMed Central

    Ramagiri-Vinod, Nagadarshini; Tahir, Hassan; Narukonda, Sandhya; Joshi, Medha

    2016-01-01

    Prosthetic arteriovenous (AV) graft is the second most common vascular access of choice in hemodialysis patients. Rare complications of such grafts are increasingly seen due to rising population of patients on hemodialysis. Infections and thrombosis are the most common complications. Though metallic implants are known to cause hypersensitivity skin reactions, prosthetic AV grafts are rarely known to cause such kind of reactions due to inert nature of materials used in their preparation. We present a case of 54-year-old male who developed contact dermatitis after AV graft creation which was mistreated initially as infection. PMID:27493977

  7. Skin Dictionary

    MedlinePlus

    ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ...

  8. Dermofat graft in deep nasolabial fold and facial rhytidectomy.

    PubMed

    Hwang, Kun; Han, Jin Yi; Kim, Dae Joong

    2003-01-01

    Fat and dermis or the combined tissues are used commonly in augmentation of the nasolabial fold. Guyuron obtained the dermofat graft from either the suprapubic or the groin region. The thickness of the preauricular skin was measured in seven Korean cadavers, five male and two female. We used the dermofat graft out of the preauricular skin remnant after facial rhytidectomy to augment the deep nasolabial fold in a patient. The average thickness of the epidermis was 56 +/- 12 microm, the dermis was 1820 +/- 265 microm thick, and the subcutaneous tissue was 4783 +/- 137 microm. More dense connective tissues, such as SMAS, are seen in the preauricular skin. The dermofat graft was easily obtained and prepared from the leftover preauricular skin after dissection of the lax skin in face lifting. This technique could be employed effectively and successfully to alleviate a deep nasolabial fold and concomitant facial rhytidectomy in an Asian with a thick preauricular skin.

  9. Collagen Dressing Versus Conventional Dressings in Burn and Chronic Wounds: A Retrospective Study

    PubMed Central

    Singh, Onkar; Gupta, Shilpi Singh; Soni, Mohan; Moses, Sonia; Shukla, Sumit; Mathur, Raj Kumar

    2011-01-01

    Objective: Biological dressings like collagen are impermeable to bacteria, and create the most physiological interface between the wound surface and the environment. Collagen dressings have other advantages over conventional dressings in terms of ease of application and being natural, non-immunogenic, non-pyrogenic, hypo-allergenic, and pain-free. This study aims to compare the efficacy of collagen dressing in treating burn and chronic wounds with that of conventional dressing materials. Materials and Methods: The records of 120 patients with chronic wounds of varied aetiologies and with mean age 43.7 years were collected and analyzed. The patients had been treated either with collagen or other conventional dressing materials including silver sulfadiazine, nadifloxacin, povidone iodine, or honey (traditional dressing material). Patients with co-morbidities that could grossly affect the wound healing like uncontrolled diabetes mellitus, chronic liver or renal disease, or major nutritional deprivation were not included. For the purpose of comparison the patients were divided into two groups; ‘Collagen group’ and ‘Conventional group’, each having 60 patients. For assessment the wound characteristics (size, edge, floor, slough, granulation tissue, and wound swab or pus culture sensitivity results) were recorded. With start of treatment, appearance of granulation tissue, completeness of healing, need for skin grafting, and patients’ satisfaction was noted for each patient in both groups. Results: With two weeks of treatment, 60% of the ‘collagen group’ wounds and only 42% of the ‘conventional group’ wounds were sterile (P=0.03). Healthy granulation tissue appeared earlier over collagen-dressed wounds than over conventionally treated wounds (P=0.03). After eight weeks, 52 (87%) of ‘collagen group’ wounds and 48 (80%) of ‘conventional group’ wounds were >75% healed (P=0.21). Eight patients in the ‘collagen group’ and 12 in the ‘conventional

  10. An assessment of covalent grafting of RGD peptides to the surface of a compliant poly(carbonate-urea)urethane vascular conduit versus conventional biological coatings: its role in enhancing cellular retention.

    PubMed

    Krijgsman, Brandon; Seifalian, Alexander M; Salacinski, Henryk J; Tai, Nigel R; Punshon, Geoff; Fuller, Barry J; Hamilton, George

    2002-08-01

    The aim of sodding prosthetic grafts with endothelial cells (EC) is to establish a functioning antithrombogenic monolayer of EC. Application of basement membrane proteins improves EC adherence on ePTFE grafts. Their addition to a biodurable compliant poly(carbonate-urea)urethane graft (CPU) was studied with respect to EC adherence. Preclot, fibronectin, gelatin, and collagen were coated onto CPU. RGD peptide, heparin, and both RGD and heparin were chemically bonded to CPU. Human umbilical vein EC (HUVEC) labeled with 111-Indium oxine were sodded (1.8 x 10(6) EC/cm(2)) onto native and the modified CPU. The grafts were washed after 90 min and EC retention determined. The experiments were repeated six times. EC retention on native CPU was 1.0 +/- 0.2 x 10(5) EC/cm(2). The application of preclot, fibronectin, gelatin, and collagen did not improve EC retention, which was 0.8 +/- 0.1, 0.4 +/- 0.1, 0.3 +/- 0.08, and 0.5 +/- 0.2 x 10(5) EC/cm(2), respectively. Bonding RGD, heparin, and both RGD and heparin significantly improved EC retention to 1.9 +/- 0.6, 1.7 +/- 0.5, and 2.6 +/- 0.6 x 10(5) EC/cm(2), respectively (p < 0.01). Bonding of RGD, heparin, and both RGD and heparin accelerates and enhances EC retention onto CPU. Simple coating of basement membrane proteins confers no advantage over native CPU.

  11. Sagging Skin

    MedlinePlus

    ... Non-ablative Laser Rejuvenation Non-invasive Body Contouring Treatments Skin Cancer Skin Cancer Information Free Skin Cancer Screenings Skin ... Non-ablative Laser Rejuvenation Non-invasive Body Contouring Treatments Skin Cancer Skin Cancer Information Free Skin Cancer Screenings Skin ...

  12. The effect of conventional surgery and piezoelectric surgery bone harvesting techniques on the donor site morbidity of the mandibular ramus and symphysis.

    PubMed

    Altiparmak, N; Soydan, S S; Uckan, S

    2015-09-01

    The aim of this study was to evaluate the morbidity following bone harvesting at two different intraoral donor sites, mandibular symphysis and ramus, and to determine the effects of piezoelectric and conventional surgical graft harvesting techniques on donor site morbidity. Intraoral block bone grafts were harvested from the symphysis (n=44) and ramus (n=31). The two donor site groups were divided into two subgroups according to the surgical graft harvesting method used (conventional or piezoelectric surgery). Intraoperative and postoperative pain was assessed using a visual analogue scale (VAS). Donor site morbidity and the harvesting techniques were compared statistically. Of 290 teeth evaluated in the symphysis group, four needed root canal treatment after surgery. The incidence of transient paresthesia in the mucosa was significantly higher in the symphysis group than in the ramus group (P=0.004). In the symphysis group, the incidence of temporary skin and mucosa paresthesia was lower in the piezoelectric surgery subgroup than in the conventional surgery subgroup (P=0.006 and P=0.001, respectively). No permanent anaesthesia of any region of the skin was reported in either donor site group. VAS scores did not differ between the ramus and symphysis harvesting groups, or between the piezoelectric and conventional surgery subgroups. When the symphysis was chosen as the donor site, minor sensory disturbances of the mucosa and teeth were recorded. The use of piezoelectric surgery during intraoral harvesting of bone blocks, especially from the symphysis, can reduce these complications.

  13. Skin Diseases: Skin Health and Skin Diseases

    MedlinePlus

    Skip Navigation Bar Home Current Issue Past Issues Skin Diseases Skin Health and Skin Diseases Past Issues / Fall 2008 Table of Contents ... acne to wrinkles Did you know that your skin is the largest organ of your body? It ...

  14. Facial dermis grafts after removal of basal cell carcinomas.

    PubMed

    Han, Seung-Kyu; Yoon, Won-Young; Jeong, Seong-Ho; Kim, Woo-Kyung

    2012-11-01

    Selecting a proper reconstruction method is the key to success in skin cancer management, especially for lesions involving the face. Using a skin graft is usually straightforward when covering a skin defect; however, major concerns in skin grafting include a poor color match in the recipient-site and donor-site morbidity. To overcome these limitations, the authors have developed a dermis graft, which utilizes a de-epithelialized split-thickness skin graft method. The purpose of this retrospective study was to report reliability of dermis grafts after removal of basal cell carcinomas (BCCs) on the face by presenting our clinical experience with them. This study included 38 patients who were treated for facial defects created by resection of BCCs. The locations of the defects were as follows: nose (n = 17), orbital area (n = 14), cheek (n = 4), temple area (n = 2), and forehead (n = 1). The defects ranged in size from 3.3 to 6.5 cm. Functional and cosmetic outcomes, postoperative complications, and patient satisfaction were assessed. The patients were followed up for 12 to 36 months. The entire dermis graft re-epithelialized after grafting within 17 to 27 days. Most of the patients had satisfactory results in both functional and cosmetic matters with high-quality skin characteristics. There were no significant complications and no recurrences were observed during the follow-up period. Patient satisfaction with the dermis graft was also excellent. The dermis graft may be used reliably for covering defects after removal of BCCs on the face. PMID:23172436

  15. [Structure, function and reconstruction of skin surface lipid film].

    PubMed

    Lu, Benrong; Liu, Yi; Li, Shilong; Wang, Gang

    2016-02-01

    After healing of burn wound, skin of scar, transplanted skin grafts, and healed donor site wound suffer from temporary or permanent loss of function of sebaceous glands and dysfunction of skin surface lipid film formation, resulting in desiccation, desquamation, and sensitiveness of the skin, making areas of newly formed skin unsatisfactory. Therefore a good rehabilitation may fail. In this paper, the composition, physiochemical properties, and reconstruction of skin surface lipid film are discussed.

  16. Technique in Cleft Rhinoplasty: The Foundation Graft.

    PubMed

    Gassner, Holger G; Schwan, Franziska; Haubner, Frank; Suárez, Gustavo A; Vielsmeier, Veronika

    2016-04-01

    Secondary cleft rhinoplasty represents a particular surgical challenge. The authors have identified the deficit in skeletal projection of the cleft-sided piriform rim as an important contributor to the pathology. A graft is described to augment the piriform crest on the cleft side. This foundation graft is suture fixated to the piriform crest after complete release of all soft tissue attachments to the alar base. The foundation graft is articulated with a long alar strut graft, which allows for powerful projection of the cleft-sided nasal tip. An advancement flap of vestibular skin is described to correct the vestibular stenosis. A transplant of diced cartilage in fascia is added to augment maxillary soft tissue volume. Subjective and objective measures of form and function are presented in a retrospective series of five cases, illustrating the efficacy of the techniques described. PMID:27097143

  17. Dialysis needle puncture of Wallgrafts placed in polytetrafluoroethylene hemodialysis grafts.

    PubMed

    Rhodes, Erik S; Silas, Anne M

    2005-08-01

    This study evaluates the effect of routine venipuncture at hemodialysis on the durability of Wallgraft covered stents. Thirteen covered stents were placed in six aging, failing polytetrafluoroethylene grafts for treatment of pseudoaneurysms and recurrent stenoses. Four patients did not experience significant graft complications. One graft was ligated for an infected overlying skin ulcer. After surgical revision, the graft remains functional. Another patient experienced fraying of the stent edges and recurrence of a small pseudoaneurysm. Our experience suggests that the Wallgraft covered stent can withstand routine venipuncture at dialysis without flow-limiting stent distortion.

  18. Cutaneous graft-versus-host disease after hematopoietic stem cell transplant - a review*

    PubMed Central

    Villarreal, Cesar Daniel Villarreal; Alanis, Julio Cesar Salas; Pérez, Jose Carlos Jaime; Candiani, Jorge Ocampo

    2016-01-01

    Graft-versus-host disease (GVHD) is a major complication of allogeneic hematopoietic stem cell transplants (allo-HSCT) associated with significant morbidity and mortality. The earliest and most common manifestation is cutaneous graft-versus-host disease. This review focuses on the pathophysiology, clinical features, prevention and treatment of cutaneous graft-versus-host disease. We discuss various insights into the disease's mechanisms and the different treatments for acute and chronic skin graft-versus-host disease. PMID:27438202

  19. Electrostrictive Graft Elastomers

    NASA Technical Reports Server (NTRS)

    Su, Ji (Inventor); Harrison, Joycelyn S. (Inventor); St.Clair, Terry L. (Inventor)

    2003-01-01

    An electrostrictive graft elastomer has a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules. The polar graft moieties have been rotated by an applied electric field, e.g., into substantial polar alignment. The rotation is sustained until the electric field is removed. In another embodiment, a process for producing strain in an elastomer includes: (a) providing a graft elastomer having a backbone molecule which is a non-crystallizable, flexible macromolecular chain and a grafted polymer forming polar graft moieties with backbone molecules; and (b) applying an electric field to the graft elastomer to rotate the polar graft moieties, e.g., into substantial polar alignment.

  20. Fat grafting in facial rejuvenation.

    PubMed

    Marten, Timothy J; Elyassnia, Dino

    2015-04-01

    Patients with significant facial atrophy and age-related loss of facial fat generally achieve suboptimal improvement from both surface treatments of facial skin and surgical lifts. Restoring lost facial volume by fat grafting is a powerful technique that is now acknowledged by most plastic surgeons and other physicians engaged in treating the aging face as one of the most important advances in aesthetic surgery. Properly performed, the addition of fat to areas of the face that have atrophied because of age or disease can produce a significant and sustained improvement in appearance that is unobtainable by other means.

  1. Electromagnetic Navigation for Thoracic Aortic Stent Graft Deployment: A Pilot Study in Swine

    PubMed Central

    Abi-Jaoudeh, Nadine; Glossop, Neil; Dake, Michael; Pritchard, William F.; Chiesa, Alberto; Dreher, Matthew R.; Tang, Thomas; Karanian, John W.; Wood, Bradford J.

    2010-01-01

    Purpose The goal of this study was to determine the feasibility of electromagnetic tracking as a method to augment conventional imaging guidance for the safe delivery, precise positioning, and accurate deployment of thoracic aortic endografts. Materials & Methods Custom guidewires were fabricated and the delivery catheters for thoracic aortic endoprostheses (Gore TAG endoprostheses, W.L. Gore & Assoc. Inc., Flagstaff AZ) were retrofitted with integrated electromagnetic coil sensors enabling realtime endovascular tracking. Pre-procedure thoracic CTA were obtained after placement of fiducial skin patches on the chest wall of three anesthetized swine, enabling automatic registration. The stent graft deployment location target near the subclavian artery was selected on the pre-procedure CTA. Two steps were analyzed: advancing a tracked glidewire to the aortic arch, and positioning the tracked stent graft assembly using electromagnetic guidance alone. Multiple CT scans were performed to evaluate the accuracy of the electromagnetic tracking system by measuring the target registration error which compared the actual position of the tracked devices to the displayed “virtual” electromagnetic-tracked position. Post-deployment CTA and necropsy confirmed stent graft position and subclavian artery patency. Results A stent graft was successfully delivered and deployed in each of the three animals using real-time electromagnetic tracking alone. The mean of the fiducial registration error of the auto-registration was 1.5 mm. Sixteen comparative scans were obtained to determine the target registration error, which was 4.3mm ± 0.97 mm (Range: 3.0 to 6.0mm) for the glidewire sensor coil. The target registration error for the stent graft delivery catheter sensor coil was 2.6 mm ± 0.7 mm (Range: 1.9 to 3.8 mm). The deployment error for the stent graft defined as deployment deviation from target was 2.6mm ± 3.0 mm. Conclusion Delivery and deployment of customized thoracic stent

  2. Bone grafts in dentistry

    PubMed Central

    Kumar, Prasanna; Vinitha, Belliappa; Fathima, Ghousia

    2013-01-01

    Bone grafts are used as a filler and scaffold to facilitate bone formation and promote wound healing. These grafts are bioresorbable and have no antigen-antibody reaction. These bone grafts act as a mineral reservoir which induces new bone formation. PMID:23946565

  3. [Vascular graft prosthesis].

    PubMed

    Chakfé, N; Dieval, F; Thaveau, F; Rinckenbach, S; Hassani, O; Camelot, G; Durand, B; Kretz, J-G

    2004-06-01

    Performed since the 1950s, vascular grafting has opened modern era of vascular surgery. Autologous venous grafts are of first choice for revascularisation of small arteries. Synthetic grafts are mainly modelled using microporous polytetrafluoroethylene or terephtalate polyethylene. These prosthesis are mainly used for revascularization of medium and large size arteries. PMID:15220107

  4. Complications of surgery for radiotherapy skin damage

    SciTech Connect

    Rudolph, R.

    1982-08-01

    Complications of modern surgery for radiotherapy skin damage reviewed in 28 patients who had 42 operations. Thin split-thickness skin grafts for ulcer treatment had a 100 percent complication rate, defined as the need for further surgery. Local flaps, whether delayed or not, also had a high rate of complications. Myocutaneous flaps for ulcers had a 43 percent complication rate, with viable flaps lifting off radiated wound beds. Only myocutaneous flaps for breast reconstruction and omental flaps with skin grafts and Marlex mesh had no complications. The deeper tissue penetration of modern radiotherapy techniques may make skin grafts and flaps less useful. In reconstruction of radiation ulcers, omental flaps and myocutaneous flaps are especially useful, particularly if the radiation damage can be fully excised. The pull of gravity appears detrimental to myocutaneous flap healing and, if possible, should be avoided by flap design.

  5. Circulation, bone scans, and tetracycline labeling in microvascularized and vascular bundle implanted rib grafts

    SciTech Connect

    Lalonde, D.H.; Williams, H.B.; Rosenthall, L.; Viloria, J.B.

    1984-11-01

    The circulation in microvascularized rib grafts has been compared with that in conventional rib grafts and in those augmented by a direct vascular bundle implantation into the bone grafts. A new experimental model has been designed to correlate vascular perfusion, bone scan patterns, tetracycline labeling, and histological findings in these bone grafts. Posterior microvascularized rib grafts were found to have a circulatory pattern identical to that of the normal rib. Failed microvascularized rib grafts were revascularized more slowly than conventional rib grafts. Vascular bundles implanted into rib grafts remained patent and increased the rate of revascularization. The stripping or preservation of periosteum had no observable effects on the rate or pattern of conventional rib graft revascularization. The circulation in rib grafts was accurately reflected in technetium 99 bone scans, as was the patency of the anastomoses of microvascularized rib grafts and of implanted vascular bundles. In contrast, tetracycline labeling was repeatedly observed in avascular areas of bone grafts and, therefore, is not a reliable indicator of bone graft circulation.

  6. Serial QuantiFERON-TB Gold In-Tube assay and tuberculin skin test to diagnose latent tuberculosis in household Mexican contacts: conversion and reversion rates and associated factors using conventional and borderline zone definitions.

    PubMed

    Monárrez-Espino, Joel; Enciso-Moreno, José Antonio; Laflamme, Lucie; Serrano, Carmen J

    2014-11-01

    A cohort of 123 adult contacts was followed for 18-24 months (86 completed the follow-up) to compare conversion and reversion rates based on two serial measures of QuantiFERON (QFT) and tuberculin skin test (TST) (PPD from TUBERSOL, Aventis Pasteur, Canada) for diagnosing latent tuberculosis (TB) in household contacts of TB patients using conventional (C) and borderline zone (BZ) definitions. Questionnaires were used to obtain information regarding TB exposure, TB risk factors and socio-demographic data. QFT (IU/mL) conversion was defined as <0.35 to ≥0.35 (C) or <0.35 to >0.70 (BZ) and reversion was defined as ≥0.35 to <0.35 (C) or ≥0.35 to <0.20 (BZ); TST (mm) conversion was defined as <5 to ≥5 (C) or <5 to >10 (BZ) and reversion was defined as ≥5 to <5 (C). The QFT conversion and reversion rates were 10.5% and 7% with C and 8.1% and 4.7% with the BZ definitions, respectively. The TST rates were higher compared with QFT, especially with the C definitions (conversion 23.3%, reversion 9.3%). The QFT conversion and reversion rates were higher for TST ≥5; for TST, both rates were lower for QFT <0.35. No risk factors were associated with the probability of converting or reverting. The inconsistency and apparent randomness of serial testing is confusing and adds to the limitations of these tests and definitions to follow-up close TB contacts.

  7. Autologous Graft Thickness Affects Scar Contraction and Quality in a Porcine Excisional Wound Model

    PubMed Central

    Rose, Lloyd F.; Wu, Jesse C.; Tucker, David I.; Chan, Maren M.; Christy, Robert J.; Hale, Robert G.; Leung, Kai P.

    2015-01-01

    Background: Texture, color, and durability are important characteristics to consider for skin replacement in conspicuous and/or mobile regions of the body such as the face, neck, and hands. Although autograft thickness is a known determinant of skin quality, few studies have correlated the subjective and objective characters of skin graft healing with their associated morphologic and cellular profiles. Defining these relationships may help guide development and evaluation of future skin replacement strategies. Methods: Six-centimeter-diameter full-thickness wounds were created on the back of female Yorkshire pigs and covered by autografts of variable thicknesses. Skin quality was assessed on day 120 using an observer scar assessment score and objective determinations for scar contraction, erythema, pigmentation, and surface irregularities. Histological, histochemical, and immunohistochemical assessments were performed. Results: Thick grafts demonstrated lower observer scar assessment score (better quality) and decreased erythema, pigmentation, and surface irregularities. Histologically, thin grafts resulted in scar-like collagen proliferation while thick grafts preserves the dermal architecture. Increased vascularity and prolonged and increased cellular infiltration were observed among thin grafts. In addition, thin grafts contained predominately dense collagen fibers, whereas thick grafts had loosely arranged collagen. α-Smooth muscle actin staining for myofibroblasts was observed earlier and persisted longer among thinner grafts. Conclusions: Graft thickness is an important determinant of skin quality. High-quality skin replacements are associated with preserved collagen architecture, decreased neovascularization, and decreased inflammatory cellular infiltration. This model, using autologous skin as a metric of quality, may give a more informative analysis of emerging skin replacement strategies. PMID:26301157

  8. Predicting Hamstring Graft Diameter Using MRI and Anthropometry

    PubMed Central

    Fritsch, Brett A; Mhaskar, Vikram A; An, Vincent Vinh Gia; Scholes, Corey

    2016-01-01

    Objectives: Graft diameter is one variable that may affect outcome of ACL reconstruction. The ability to predict the size of a graft in a given patient pre-operatively may help guide graft selection and preparation technique. Various papers have correlated anthropometric data and MRI tendon measurements to intraoperative graft diameter, although no papers have investigated these together. The intra-operative diameter of a hamstring autograft will be influenced by graft preparation technique. Our study aimed to investigate the prediction of intraoperative graft diameter of 2 different graft construct techniques (4-strand semitendinosus versus quadrupled semitendinosus) using anthropometry and MRI measurements. Methods: Retrospective review of two groups of ACL reconstruction using different graft preparation techniques was performed. “Conventional” 4-strand gracilis + semitendinosus with fixed suspension at the femur and screw fixation at the tibia were compared with quadrupled semitendinosus grafts with adjustable suspensory fixation at each end (Graftlink). Cross-sectional areas (XSA) of the semitendinosus and gracilis tendons was measured in the axial slice of a T2 weighted MRI image using a region-of-interest tool. Stepwise linear regression using intraoperative graft diameter as the dependant variable was performed using MRI XSA of the semitendinosus and gracilis tendons, gender and height as predictors. Results: 129 ACL Reconstruction in 127 patients were done in the time period, 89 of which were done conventionally, and 40 which employed the Graftlink construct. The median graft diameter in the Graftlink group (8.5mm IQR8-9) was greater than that of the conventional group (8mm, IQR 7.5-8) (p < 0.001). MRI XSA of semitendinosus and height were statistically significant predictors of diameter in the Graftlink group (R2 = 51%), whilst MRI XSA of semitendinosus + gracilis and gender were predictors in the conventional group (R2 = 36%). Conclusion: Graftlink

  9. [Innovative wound therapy and skin substitutes for burns].

    PubMed

    Vogt, P M; Kolokythas, P; Niederbichler, A; Knobloch, K; Reimers, K; Choi, C Y

    2007-04-01

    The success of modern burn therapy is based mainly on special burn intensive care, topical treatment, early eschar excision, and wound closure by immediate skin grafting or skin substitutes. This paper describes the current state of wound care and skin substitutes in burn therapy.

  10. Novel biodegradable polymeric flocculant based on polyacrylamide-grafted tamarind kernel polysaccharide.

    PubMed

    Ghosh, Sandipta; Sen, Gautam; Jha, U; Pal, Sagar

    2010-12-01

    Novel biodegradable polymeric flocculants were produced by conventional redox grafting, microwave-initiated and microwave-assisted grafting of acrylamide to tamarind kernel polysaccharide (TKP). The graft copolymers were characterized by viscometry, elemental analysis, molecular weight determination using SLS analysis, and NMR spectroscopy. The flocculation efficiency of the grafting products in kaolin suspension, municipal sewage wastewater and textile industry wastewater was primarily dependent on the length of the grafted polyacrylamide chain. The flocculant obtained by microwave-assisted grafting method was superior to TKP and polyacrylamide-based commercial flocculant (Rishfloc 226 LV) in flocculation tests.

  11. Novel biodegradable polymeric flocculant based on polyacrylamide-grafted tamarind kernel polysaccharide.

    PubMed

    Ghosh, Sandipta; Sen, Gautam; Jha, U; Pal, Sagar

    2010-12-01

    Novel biodegradable polymeric flocculants were produced by conventional redox grafting, microwave-initiated and microwave-assisted grafting of acrylamide to tamarind kernel polysaccharide (TKP). The graft copolymers were characterized by viscometry, elemental analysis, molecular weight determination using SLS analysis, and NMR spectroscopy. The flocculation efficiency of the grafting products in kaolin suspension, municipal sewage wastewater and textile industry wastewater was primarily dependent on the length of the grafted polyacrylamide chain. The flocculant obtained by microwave-assisted grafting method was superior to TKP and polyacrylamide-based commercial flocculant (Rishfloc 226 LV) in flocculation tests. PMID:20702087

  12. Do Stem Cells Have an Effect When We Fat Graft?

    PubMed

    Rinker, Brian D; Vyas, Krishna S

    2016-06-01

    Fat grafting has become a widely accepted modality of soft tissue restoration and has found applications in many areas of aesthetic and reconstructive plastic surgery. Numerous claims have been made regarding the regenerative effects of fat grafting on the recipient bed. The purpose of this paper is to survey the available literature to answer the question of whether fat grafting has a positive effect on the surrounding tissues. It has been convincingly demonstrated that fat grafts contain viable adipose-derived stem cells (ASCs). The fate of these cells is determined by the microenvironment of the recipient bed, but animal studies have shown that a large fraction of ASCs survive engraftment. Numerous clinical studies have demonstrated the positive effects of fat grafting on recipient tissues. Improvement in validated scar scores as well as scar stiffness measurements have been documented after fat grafting of burn scars. Fat grafting has also been convincingly demonstrated to improve the quality of irradiated tissues, as measured by validated clinical scales and staged histology. It is ultimately unclear whether ASCs are responsible for these effects, but the circumstantial evidence is weighty. Fat grafting is effective for volumizing and improving skin quality in the setting of radiation, burns, and other scars. The observed effects are likely due to ASCs, but the evidence does not support the routine use of ASC-enriched fat grafts.

  13. Skin Cancer

    MedlinePlus

    ... are specialized skin cells that produce pigment called melanin. The melanin pigment produced by melanocytes gives skin its color. ... absorbing and scattering the energy. People with more melanin have darker skin and better protection from UV ...

  14. Skin Conditions

    MedlinePlus

    Your skin is your body's largest organ. It covers and protects your body. Your skin Holds body fluids in, preventing dehydration Keeps harmful ... it Anything that irritates, clogs, or inflames your skin can cause symptoms such as redness, swelling, burning, ...

  15. Free Auricular Composite Graft for Acquired Nasal Stenosis

    PubMed Central

    Riley, Charles A.; Lawlor, Claire M.; Gray, Mingyang Liu; Graham, H. Devon

    2016-01-01

    Background: Acquired nasal stenosis poses a reconstructive challenge for the facial plastic surgeon. Many surgical options are available, ranging from primary closure to skin grafts to free flap reconstruction for complex defects. The free auricular composite graft is a single-stage procedure that can be used to repair nasal vestibular stenosis causing nasal obstruction. Case Report: We present the case of a patient with acquired nasal stenosis as a result of prolonged nasal tampon placement secondary to severe epistaxis and subsequent nasal vestibular infection. Repair via auricular composite graft was successful, and we provide a thorough explanation of graft design and operative technique. Conclusion: Free auricular composite grafts can produce desirable functional and aesthetic outcomes and should be considered in patients presenting with acquired nasal stenosis. PMID:27303225

  16. Spiritual and religious aspects of skin and skin disorders.

    PubMed

    Shenefelt, Philip D; Shenefelt, Debrah A

    2014-01-01

    Skin and skin disorders have had spiritual aspects since ancient times. Skin, hair, and nails are visible to self and others, and touchable by self and others. The skin is a major sensory organ. Skin also expresses emotions detectable by others through pallor, coldness, "goose bumps", redness, warmth, or sweating. Spiritual and religious significances of skin are revealed through how much of the skin has been and continues to be covered with what types of coverings, scalp and beard hair cutting, shaving and styling, skin, nail, and hair coloring and decorating, tattooing, and intentional scarring of skin. Persons with visible skin disorders have often been stigmatized or even treated as outcasts. Shamans and other spiritual and religious healers have brought about healing of skin disorders through spiritual means. Spiritual and religious interactions with various skin disorders such as psoriasis, leprosy, and vitiligo are discussed. Religious aspects of skin and skin diseases are evaluated for several major religions, with a special focus on Judaism, both conventional and kabbalistic. PMID:25120377

  17. Spiritual and religious aspects of skin and skin disorders

    PubMed Central

    Shenefelt, Philip D; Shenefelt, Debrah A

    2014-01-01

    Skin and skin disorders have had spiritual aspects since ancient times. Skin, hair, and nails are visible to self and others, and touchable by self and others. The skin is a major sensory organ. Skin also expresses emotions detectable by others through pallor, coldness, “goose bumps”, redness, warmth, or sweating. Spiritual and religious significances of skin are revealed through how much of the skin has been and continues to be covered with what types of coverings, scalp and beard hair cutting, shaving and styling, skin, nail, and hair coloring and decorating, tattooing, and intentional scarring of skin. Persons with visible skin disorders have often been stigmatized or even treated as outcasts. Shamans and other spiritual and religious healers have brought about healing of skin disorders through spiritual means. Spiritual and religious interactions with various skin disorders such as psoriasis, leprosy, and vitiligo are discussed. Religious aspects of skin and skin diseases are evaluated for several major religions, with a special focus on Judaism, both conventional and kabbalistic. PMID:25120377

  18. Hair bleaching and skin burning.

    PubMed

    Forster, K; Lingitz, R; Prattes, G; Schneider, G; Sutter, S; Schintler, M; Trop, M

    2012-12-31

    Hairdressing-related burns are preventable and therefore each case is one too many. We report a unique case of a 16-yr-old girl who suffered full-thickness chemical and thermal burns to the nape of her neck and superficial burns to the occiput after her hair had been dyed blond and placed under a dryer to accelerate the highlighting procedure. The wound on the nape of the neck required surgical debridement and skin grafting. The grafted area resulted in subsequent scar formation.

  19. Facial reconstruction for radiation-induced skin cancer

    SciTech Connect

    Panje, W.R.; Dobleman, T.J. )

    1990-04-01

    Radiation-induced skin cancers can be difficult to diagnose and treat. Typically, a patient who has received orthovoltage radiotherapy for disorders such as acne, eczema, tinea capitis, skin tuberculosis, and skin cancer can expect that aggressive skin cancers and chronic radiodermatitis may develop subsequently. Cryptic facial cancers can lead to metastases and death. Prophylactic widefield excision of previously irradiated facial skin that has been subject to multiple recurrent skin cancers is suggested as a method of deterring future cutaneous malignancy and metastases. The use of tissue expanders and full-thickness skin grafts offers an expedient and successful method of subsequent reconstruction.

  20. Rib Bone Graft Adjusted to Fit the Facial Asymmetry: A Frame Structure Graft.

    PubMed

    Lee, Yoon Ho; Choi, Jong Hwan; Hwang, Kun; Choi, Jun Ho

    2015-10-01

    The authors introduce the concept of a "frame structure graft" in which a harvested rib bone was adjusted to fit facial asymmetry. On the costochondral junction of the sixth or seventh rib, a 5 cm incision was made. Through a subperiosteal dissection, the rib bone was harvested. Using a reciprocating saw, the harvested rib was scored on its anterior surface as well as its posterior surface with a partial depth at different intervals. The harvested rib bone was placed on the skin surface of the unaffected side of the face and a curvature was created exactly matching that of the unaffected side by bending the bone using a greenstick fracture. Thereafter, the graft was adjusted to conceal the asymmetry of the deficient side. The adjusted "frame structure" was transferred to the defect through the incisions on the affected side, and the "frame structure" graft was placed on the mandible or zygoma. The graft fixation was done externally with at least 2 Kirschner wires (K-wires). From January 2005 to August 2013, a total of 30 patients (13 men, 17 women, mean age 25.6 years) received a frame structure graft. All 30 patients achieved good healing at the operation site without complications. Donor-site morbidity as pneumothorax from the rib bone harvest was not found. Merits of this frame structure graft, the authors think, are that this method could allow a similar curvature to the normal side. In addition, the procedure itself is easy. PMID:26468802

  1. Grafting functional antioxidants on highly crosslinked polyethylene

    NASA Astrophysics Data System (ADS)

    Al-Malaika, S.; Riasat, S.; Lewucha, C.

    2016-05-01

    The problem of interference of antioxidants, such as hindered phenols, with peroxide-initiated crosslinking of polyethylene was addressed through the use of functional (reactive) graftable antioxidants (g-AO). Reactive derivatives of hindered phenol and hindered amine antioxidants were synthesised, characterised and used to investigate their grafting reactions in high density polyethylene; both non-crosslinked (PE) and highly peroxide-crosslinked (PEXa). Assessment of the extent of in-situ grafting of the antioxidants, their retention after exhaustive solvent extraction in PE and PEXa, and the stabilising performance of the grafted antioxidants (g-AO) in the polymer were examined and benchmarked against conventionally stabilised crosslinked & non-crosslinked polyethylene. It was shown that the functional antioxidants graft to a high extent in PEXa, and that the level of interference of the g-AOs with the polymer crosslinking process was minimal compared to that of conventional antioxidants which bear the same antioxidant function. The much higher level of retention of the g-AOs in PEXa after exhaustive solvent extraction, compared to that of the corresponding conventional antioxidants, accounts for their superior long-term thermal stabilising performance under severe extractive conditions.

  2. Poly(2-hydroxyethyl methacrylate) (PHEMA) grafted polyethylene/polypropylene (PE/PP) nonwoven fabric by γ-initiation: Synthesis, characterization and benefits of RAFT mediation

    NASA Astrophysics Data System (ADS)

    Kodama, Yasko; Barsbay, Murat; Güven, Olgun

    2014-12-01

    Polyethylene/polypropylene (PE/PP) nonwoven fabrics were functionalized by γ-initiated RAFT mediated grafting of 2-hydroxyethyl methacrylate (HEMA), and the characterization of the grafted samples was carried out using various techniques. FTIR and XPS analysis showed an increase in the oxygenated content till a certain degree of grafting. The results implied a grafting process following the concept of ‘front mechanism’. The initial grafting occurred on the topmost surface layer, and then moved further into the bulk of the polymer matrix. Reversible addition-fragmentation chain transfer (RAFT) mediated grafting yielded a better controlled grafting when compared to those obtained in conventional grafting.

  3. [Experiences with Epigard, a synthetic skin substitute, in the treatment of skin defects].

    PubMed

    Kiffner, E; Bohmert, H

    1976-05-20

    Epigard, a reticulated polyurethane foam laminated to a microporous polypropylene film, has been developed as a substitute for homograft and heterograft skin. After preliminary studies in animals, its clinical advantages and limitations were evaluated in 134 hospitilized patients with burn injuries and other skin defects. Examples for its indications are demonstrated and discussed. It is concluded that Epigard provides a satisfactory substitute for skin grafts with major advantages for ready availability, sterility and reduced cost.

  4. Skin Biomes.

    PubMed

    Fyhrquist, N; Salava, A; Auvinen, P; Lauerma, A

    2016-05-01

    The cutaneous microbiome has been investigated broadly in recent years and some traditional perspectives are beginning to change. A diverse microbiome exists on human skin and has a potential to influence pathogenic microbes and modulate the course of skin disorders, e.g. atopic dermatitis. In addition to the known dysfunctions in barrier function of the skin and immunologic disturbances, evidence is rising that frequent skin disorders, e.g. atopic dermatitis, might be connected to a dysbiosis of the microbial community and changes in the skin microbiome. As a future perspective, examining the skin microbiome could be seen as a potential new diagnostic and therapeutic target in inflammatory skin disorders.

  5. Skin allografts in lethally irradiated animals repopulated with syngeneic hemopoietic cells

    SciTech Connect

    Schwadron, R.B.

    1983-01-01

    Total body irradiation and repopulation with syngeneic hemopoietic cells can be used to induce tolerance to major histocompatibility complex (MHC) mismatched heart and kidney grafts in rats and mice. However, this protocol does not work for MHC mismatched skin grafts in rats or mice. Furthermore, LEW rats that accept WF cardiac allografts after irradiation and repopulation reject subsequent WF skin grafts. Treatment of skin allograft donors with methotrexate prior to grafting onto irradiated and reconstituted mice resulted in doubling of the mean survival time. Analysis of which antigens provoked skin graft rejection by irradiation and reconstituted animals revealed the importance of I region antigens. Cardiac allograft acceptance by irradiated and reconstituted animals is mediated by suppressor cells found in the spleen. Adoptively tolerant LEW rats accepted WF skin grafts in 50% of grafted animals. Analysis of this phenomenon revealed that the adoptive transfer procedure itself was important in achieving skin allograft acceptance by these animals. In general, it seems that the lack of ability of irradiated and reconstituted animals to accept fully MHC disparate skin grafts results from the inability of these animals to suppress lymph node effector cells against I region antigen seen on highly immunogenic allogeneic Langerhans cells in the skin.

  6. The omentum: its use as a free vascularized graft for reconstruction of the head and neck.

    PubMed Central

    Jurkiewicz, M J; Nahai, F

    1982-01-01

    The experience at Emory University Affiliated Hospitals with transplantation of the greater omentum as a free revascularized graft in 18 patients is presented. In each instance, there was realization of the therapeutic objective, either 1) the amelioration of congenital or acquired somatic deformity (14 patients) or 2) the control of infection (4 patients). Because the omentum is a syncytium of blood vessels and a variable amount of fat within redundant leaves of peritoneal membrane laden with macrophages, it is a tissue that serves admirably its extended role as an extracelomic free transplant. The greater omentum has been used for this purpose in five patients with hemifacial atrophy (Romberg's disease); three patients with hemifacial microsomia (first and second branchial arch syndrome); two patients with extensive losses of the maxilla, palate, and face due to a shotgun blast; two patients with atrophy and facial growth arrest due to x-irradiation; and two patients with deformity of the jaw and neck following tumor resection. In three additional patients, the omentum was used to obliterate the dead space after debridement of an infected open frontal sinus following failure of conventional therapy. In one instance, a revascularized free graft of omentum was used to salvage a patient with an exposed irradiated carotid artery graft and skin flap failure following radical neck dissection. In these 18 patients, there were no intra-abdominal complications consequent to harvest of the omentum. In one patient afflicted with hemifacial atrophy, there was spotty necrosis of the overlying attenuated facial skin flap and limited fat necrosis. In the follow-up period of four months to seven years, there has been no instance of late resorption. The method is reliable and has considerable promise in reconstructive surgery. Images Fig. 1a. Fig. 1b. Fig. 2. Fig. 3. PMID:7082067

  7. Arthroscopic posterior cruciate ligament reconstruction using four-strand hamstring tendon graft and interference screws.

    PubMed

    Pinczewski, L A; Thuresson, P; Otto, D; Nyquist, F

    1997-10-01

    We describe an arthroscopic technique for reconstruction of the posterior cruciate ligament (PCL) using a four-strand hamstring tendon graft. The femoral tunnel is drilled via the anterolateral portal and the tibial tunnel through the skin incision from the graft harvest. The graft is pulled through the tunnels with pullout sutures and fastened with interference screws. The results to date are good and the procedure can often be performed as day surgery. PMID:9343661

  8. Calcar bone graft

    SciTech Connect

    Bargar, W.L.; Paul, H.A.; Merritt, K.; Sharkey, N.

    1986-01-01

    A canine model was developed to investigate the use of an autogeneic iliac bone graft to treat the calcar deficiency commonly found at the time of revision surgery for femoral component loosening. Five large male mixed-breed dogs had bilateral total hip arthroplasty staged at three-month intervals, and were sacrificed at six months. Prior to cementing the femoral component, an experimental calcar defect was made, and a bicortical iliac bone graft was fashioned to fill the defect. Serial roentgenograms showed the grafts had united with no resorption. Technetium-99 bone scans showed more uptake at three months than at six months in the graft region. Disulfine blue injection indicated all grafts were perfused at both three and six months. Thin section histology, fluorochromes, and microradiographs confirmed graft viability in all dogs. Semiquantitative grading of the fluorochromes indicated new bone deposition in 20%-50% of each graft at three months and 50%-80% at six months. Although the calcar bone graft was uniformly successful in this canine study, the clinical application of this technique should be evaluated by long-term results in humans.

  9. Grafts in "closed" rhinoplasty.

    PubMed

    Scattolin, A; D'Ascanio, L

    2013-06-01

    Rhinoplasty is a fascinating and complex surgical procedure aiming at attaining a well-functioning and aesthetically pleasant nose. The use of grafts is of the utmost importance for the nasal surgeon to achieve such results. However, the philosophy and technical use of nasal grafts are different in "closed" and "open" rhinoplasty. The aim of this paper is not detailed description of the numerous grafts reported in the literature; we will describe the main principles of grafts use in "closed" rhinoplasty derived from our experience, with special reference to the philosophical and technical differences in their employment between "closed" and "open" rhinoplasty. Some cases are reported as an example of graft use in "endonasal" approach rhinoplasty.

  10. A novel gellan-PVA nanofibrous scaffold for skin tissue regeneration: Fabrication and characterization.

    PubMed

    Vashisth, Priya; Nikhil, Kumar; Roy, Partha; Pruthi, Parul A; Singh, Rajesh P; Pruthi, Vikas

    2016-01-20

    In this investigation, we have introduced novel electrospun gellan based nanofibers as a hydrophilic scaffolding material for skin tissue regeneration. These nanofibers were fabricated using a blend mixture of gellan with polyvinyl alcohol (PVA). PVA reduced the repulsive force of resulting solution and lead to formation of uniform fibers with improved nanostructure. Field emission scanning electron microscopy (FESEM) confirmed the average diameter of nanofibers down to 50 nm. The infrared spectra (IR), differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analysis evaluated the crosslinking, thermal stability and highly crystalline nature of gellan-PVA nanofibers, respectively. Furthermore, the cell culture studies using human dermal fibroblast (3T3L1) cells established that these gellan based nanofibrous scaffold could induce improved cell adhesion and enhanced cell growth than conventionally proposed gellan based hydrogels and dry films. Importantly, the nanofibrous scaffold are biodegradable and could be potentially used as a temporary substrate/or biomedical graft to induce skin tissue regeneration.

  11. Subdominant H60 antigen-specific CD8 T-cell response precedes dominant H4 antigen-specific response during the initial phase of allogenic skin graft rejection

    PubMed Central

    Yoo, Kang Il; Jeon, Ji Yeong; Ryu, Su Jeong; Nam, Giri; Youn, Hyewon; Choi, Eun Young

    2015-01-01

    In allogeneic transplantation, including the B6 anti-BALB.B settings, H60 and H4 are two representative dominant minor histocompatibility antigens that induce strong CD8 T-cell responses. With different distribution patterns, H60 expression is restricted to hematopoietic cells, whereas H4 is ubiquitously expressed. H60-specific CD8 T-cell response has been known to be dominant in most cases of B6 anti-BALB.B allo-responses, except in the case of skin transplantation. To understand the mechanism underlying the subdominance of H60 during allogeneic skin transplantation, we investigated the dynamics of the H60-specific CD8 T cells in B6 mice transplanted with allogeneic BALB.B tail skin. Unexpectedly, longitudinal bioluminescence imaging and flow cytometric analyses revealed that H60-specific CD8 T cells were not always subdominant to H4-specific cells but instead showed a brief dominance before the H4 response became predominant. H60-specific CD8 T cells could expand in the draining lymph node and migrate to the BALB.B allografts, indicating their active participation in the anti-BALB.B allo-response. Enhancing the frequencies of H60-reactive CD8 T cells prior to skin transplantation reversed the immune hierarchy between H60 and H4. Additionally, H60 became predominant when antigen presentation was limited to the direct pathway. However, when antigen presentation was restricted to the indirect pathway, the expansion of H60-specific CD8 T cells was limited, whereas H4-specific CD8 T cells expanded significantly, suggesting that the temporary immunodominance and eventual subdominance of H60 could be due to their reliance on the direct antigen presentation pathway. These results enhance our understanding of the immunodominance phenomenon following allogeneic tissue transplantation. PMID:25676063

  12. Subdominant H60 antigen-specific CD8 T-cell response precedes dominant H4 antigen-specific response during the initial phase of allogenic skin graft rejection.

    PubMed

    Yoo, Kang Il; Jeon, Ji Yeong; Ryu, Su Jeong; Nam, Giri; Youn, Hyewon; Choi, Eun Young

    2015-02-13

    In allogeneic transplantation, including the B6 anti-BALB.B settings, H60 and H4 are two representative dominant minor histocompatibility antigens that induce strong CD8 T-cell responses. With different distribution patterns, H60 expression is restricted to hematopoietic cells, whereas H4 is ubiquitously expressed. H60-specific CD8 T-cell response has been known to be dominant in most cases of B6 anti-BALB.B allo-responses, except in the case of skin transplantation. To understand the mechanism underlying the subdominance of H60 during allogeneic skin transplantation, we investigated the dynamics of the H60-specific CD8 T cells in B6 mice transplanted with allogeneic BALB.B tail skin. Unexpectedly, longitudinal bioluminescence imaging and flow cytometric analyses revealed that H60-specific CD8 T cells were not always subdominant to H4-specific cells but instead showed a brief dominance before the H4 response became predominant. H60-specific CD8 T cells could expand in the draining lymph node and migrate to the BALB.B allografts, indicating their active participation in the anti-BALB.B allo-response. Enhancing the frequencies of H60-reactive CD8 T cells prior to skin transplantation reversed the immune hierarchy between H60 and H4. Additionally, H60 became predominant when antigen presentation was limited to the direct pathway. However, when antigen presentation was restricted to the indirect pathway, the expansion of H60-specific CD8 T cells was limited, whereas H4-specific CD8 T cells expanded significantly, suggesting that the temporary immunodominance and eventual subdominance of H60 could be due to their reliance on the direct antigen presentation pathway. These results enhance our understanding of the immunodominance phenomenon following allogeneic tissue transplantation.

  13. Ceric ion initiated synthesis of polyacrylamide grafted oatmeal: Its application as flocculant for wastewater treatment.

    PubMed

    Bharti, Srijita; Mishra, Sumit; Sen, Gautam

    2013-04-01

    Polyacrylamide grafted oatmeal (OAT-g-PAM) was synthesized by conventional method. The grafting of the PAM chains on the biomaterial backbone was confirmed through intrinsic viscosity study, FTIR spectroscopy, elemental analysis (C, H, N, S and O), SEM morphology and TGA study. The intrinsic viscosity of oatmeal appreciably improved on grafting of PAM chains, thus resulting grafted product with potential application as superior viscosifier. Further, flocculation efficacy of the graft copolymer was studied in coal fine suspension, kaolin suspension, iron-ore suspension and then in municipal wastewater through 'jar test' procedure. PMID:23499093

  14. Ceric ion initiated synthesis of polyacrylamide grafted oatmeal: Its application as flocculant for wastewater treatment.

    PubMed

    Bharti, Srijita; Mishra, Sumit; Sen, Gautam

    2013-04-01

    Polyacrylamide grafted oatmeal (OAT-g-PAM) was synthesized by conventional method. The grafting of the PAM chains on the biomaterial backbone was confirmed through intrinsic viscosity study, FTIR spectroscopy, elemental analysis (C, H, N, S and O), SEM morphology and TGA study. The intrinsic viscosity of oatmeal appreciably improved on grafting of PAM chains, thus resulting grafted product with potential application as superior viscosifier. Further, flocculation efficacy of the graft copolymer was studied in coal fine suspension, kaolin suspension, iron-ore suspension and then in municipal wastewater through 'jar test' procedure.

  15. Skin Complications

    MedlinePlus

    ... drugs that can help clear up this condition. Day-to-Day Skin Care See our tips for daily skin ... Risk? Diagnosis Lower Your Risk Risk Test Alert Day Prediabetes My Health Advisor Tools to Know Your ...

  16. Skin Aging

    MedlinePlus

    ... too. Sunlight is a major cause of skin aging. You can protect yourself by staying out of ... person has smoked. Many products claim to revitalize aging skin or reduce wrinkles, but the Food and ...

  17. Skin tears.

    PubMed

    Baranoski, S

    2001-08-01

    Skin tears are a serious, painful problem for older patients. Find out how your staff can recognize patients at risk, what they can do to prevent skin tears, and how to manage them effectively if they occur.

  18. Skin Pigment

    MedlinePlus

    ... Professional Version Pigment Disorders Overview of Skin Pigment Albinism Vitiligo Hyperpigmentation Melasma Melanin is the brown pigment ... dark-skinned people produce the most. People with albinism have little or no melanin and thus their ...

  19. Infrainguinal anastomotic arterial graft infections treated by selective graft preservation.

    PubMed Central

    Calligaro, K D; Westcott, C J; Buckley, R M; Savarese, R P; DeLaurentis, D A

    1992-01-01

    The purpose of this study was to determine whether the type of graft material and bacteria involved in an infrainguinal arterial anastomotic infection can be used as guidelines for graft preservation. Between 1972 and 1990, the authors treated 35 anastomotic infections involving a common femoral or distal artery. The graft material was Dacron in 14 patients, polytetrafluoroethylene (PTFE) in 14, and vein in 7. Of the 14 Dacron grafts, immediate graft excision was required for overwhelming infection in eight patients (bleeding in five, sepsis in three) and for an occluded graft in one patient. Three of five patients failed attempted graft preservation because of nonhealing wounds. Thus, 12 of the 14 Dacron grafts ultimately required graft excision. Of the 21 "smooth-walled" vein and PTFE grafts, 10 required immediate graft excision for occluded grafts (five PTFE, one vein) or bleeding (three PTFE, one vein). Ten of the remaining 11 (91%) patients with patent "smooth-walled" grafts, intact anastomoses, and absence of sepsis managed by graft preservation healed their wounds and maintained distal arterial perfusion. Wound cultures grew pure gram-positive cocci in 17 of 21 "smooth-walled" graft infections versus 8 of 14 Dacron graft infections. In the absence of systemic sepsis, graft preservation is the treatment of choice for gram-positive infections involving an intact anastomosis of patent PTFE and vein grafts. Regardless of the bacterial cause, the authors recommend that any infrainguinal anastomotic infection of a Dacron graft be treated by immediate excision of all infected graft material. PMID:1632705

  20. Prefabricated Composite Graft for Eyelid Reconstruction.

    PubMed

    Nicoletti, Giovanni; Jaber, Omar; Tresoldi, Marco Mario; Pellegatta, Tommaso; Faga, Angela

    2015-10-01

    The authors propose a prefabricated chondromucosal composite graft to reconstruct full-thickness defects of the lower eyelid. The technique was used in a patient suffering from a locally invasive basal cell carcinoma of the lower eyelid, who had previously undergone an extensive submucosal nasal septum resection. One week prior to the eyelid resection, the anterior skin surface of the auricular concha was replaced with a full-thickness oral mucosa graft. One week later, a full-thickness excision of the right lower eyelid was performed and the prefabricated chondromucosal auricular graft was used to restore the posterior lamella. The anterior lamella was reconstructed with a bipedicled myocutaneous flap from the upper eyelid. Because of the patient's scheduling needs, the medial pedicle of the flap was divided 28 days later and the lateral one after further 37 days. All the procedures were performed under local anesthesia. This technique adds a simple key detail to other time-honored reliable techniques, thus outlining an extremely convenient sequence for full-thickness eyelid reconstruction. The easily prepared prefabricated chondromucosal graft might be associated with any of the previously described flaps, thus providing a versatile and reliable method of posterior lamella reconstruction. PMID:26579869

  1. Crosslinked grafted PVC obtained by direct radiation grafting

    NASA Astrophysics Data System (ADS)

    Hegazy, El-Sayed A.; Dessouki, Ahmed M.; El-Dessouky, Maher M.; El-Sawy, Naeem M.

    Direct radition-induced grafting of 4-vinylpyridine onto both pure and plasticized poly(vinyl chloride) has been studied. The effect of grafting conditions such as solvent, monomer concentration, irradiation dose, and inhibitor concentration on the grafting yield was investigated. The grafting process was enhanced by using distilled water as diluent and higher degrees of grafting were obtained as compared with other solvents used (benzene, methanol, and a mixture of methanol and water). The homopolymerization of 4-vinylpyridine was reduced to a minimum using ammonium ferrous sulfate and the suitable optimum concentration of the inhibitor was found to be 0.25 wt %. It was observed that the degrees of grafting onto plasticized PVC were higher than those onto pure one, at constant grafting conditions. The diffusibility of the monomer solution through the trunk polymers enhanced at higher monomer concentrations. The higher the monomer concentration the higher the degrees of grafting obtained. The dependence of the grafting rate on monomer concentration was found to be 0.15 and 0.4 order for the grafting onto pure and plasticized PVC films, respectively. The degree of grafting, at the higher irradiation doses, deviated from linearity and it tends to level off due to the recombination of some of the free radicals without initiating graft polymerization. Gel determination in the grafted films was investigated. The gel content in both grafted extracted pure and plasticized PVC films increased with the degree of grafting to reach a certain limiting values.

  2. Grafting of Functional Molecules: Insights into Peroxidase-Derived Materials

    NASA Astrophysics Data System (ADS)

    Nyanhongo, Gibson S.; Prasetyo, Endry Nugroho; Kudanga, Tukayi; Guebitz, Georg

    An insight into the progress made in applying heme peroxidases in grafting processes, starting from the production of simple resins to more complex polymers, is presented. The refinement of the different reaction conditions (solvents, concentrations of the reactants) and careful study of the reaction mechanisms have been instrumental in advancing enzymatic grafting processes. A number of processes described here show how peroxidase mediated catalysis could provide a new strategy as an alternative to conventional energy intensive procedures mediated by chemical catalysts.

  3. Proximal Tibial Bone Graft

    MedlinePlus

    ... Complications Potential problems after a PTBG include infection, fracture of the proximal tibia and pain related to the procedure. Frequently Asked Questions If proximal tibial bone graft is taken from my knee, will this prevent me from being able to ...

  4. Sensitive skin.

    PubMed

    Misery, L; Loser, K; Ständer, S

    2016-02-01

    Sensitive skin is a clinical condition defined by the self-reported facial presence of different sensory perceptions, including tightness, stinging, burning, tingling, pain and pruritus. Sensitive skin may occur in individuals with normal skin, with skin barrier disturbance, or as a part of the symptoms associated with facial dermatoses such as rosacea, atopic dermatitis and psoriasis. Although experimental studies are still pending, the symptoms of sensitive skin suggest the involvement of cutaneous nerve fibres and neuronal, as well as epidermal, thermochannels. Many individuals with sensitive skin report worsening symptoms due to environmental factors. It is thought that this might be attributed to the thermochannel TRPV1, as it typically responds to exogenous, endogenous, physical and chemical stimuli. Barrier disruptions and immune mechanisms may also be involved. This review summarizes current knowledge on the epidemiology, potential mechanisms, clinics and therapy of sensitive skin. PMID:26805416

  5. Evaluation of the variable depth resolution of active dynamic thermography on human skin

    NASA Astrophysics Data System (ADS)

    Prindeze, Nicholas J.; Hoffman, Hilary A.; Carney, Bonnie C.; Moffatt, Lauren T.; Loew, Murray H.; Shupp, Jeffrey W.

    2015-06-01

    Active dynamic thermography (ADT) is an imaging technique capable of characterizing the non-homogenous thermal conductance of damaged tissues. The purpose of this study was to determine optimal stimulation parameters and quantify the optical resolution of ADT through various depths of human skin. Excised tissue from plastic surgery operations was collected immediately following excision. A total of 12 thin to thick split-thickness grafts were harvested from 3 patients. Grafts were placed on top of a 3D printed resolution chart and thermal stimulation was applied from a 300W halogen lamp array for between 0.5-10 seconds to determine optimal parameters. Video was captured with a thermal camera, and analysis was performed by reconstructing an image from thermal gradients. In this study ADT resolved 0.445+/-0 lp/mm at a depth of 0.010", 0.356+/-0.048 lp/mm at a depth of 0.015", 0.334+/-0.027 lp/mm at a depth of 0.020" and 0.265+/-0.022 lp/mm at a depth of 0.025". The stimulus energy required for maximum resolution at each depth was 3- 4s, 8s, 12s and 12s respectively. ADT is a sensitive technique for imaging dermal structure, capable of resolving detail as fine as 1124 μm, 1427 μm, 1502 μm and 1893 μm in thin to thick split-thickness skin grafts respectively. This study has characterized a correlation between stimulus input and maximal resolution at differing depths of skin. It has also defined the functional imaging depth of ADT to below the sub-cutis, well below conventional spectrophotometric techniques.

  6. The Palatal Bone Block Graft for Onlay Grafting Combined with Maxillary Implant Placement: A Case Series.

    PubMed

    Gluckman, Howard; Du Toit, Jonathan; Salama, Maurice

    2016-01-01

    The aim of this study was to introduce an intraoral bone block harvesting technique--the palatal bone block graft (PBBG)--as an alternative harvest site for autogenous bone blocks. The PBBG technique was used to onlay graft esthetic zone defects simultaneous to implant placement in five patients. Measurable objectives were used to evaluate outcomes, and treatment was reassessed at up to 6 years. Defects of the maxilla were successfully grafted with PBBG in all five cases, and tissues remained stable at 1- and 6-year follow-ups. Harvesting an autogenous bone block from the palate is an advantageous, predictable, and reproducible method for augmenting buccofacial defects at implant placement, and may be considered as an alternative to conventional intraoral bone block donor sites when treating the maxilla.

  7. Bioglass Activated Skin Tissue Engineering Constructs for Wound Healing.

    PubMed

    Yu, Hongfei; Peng, Jinliang; Xu, Yuhong; Chang, Jiang; Li, Haiyan

    2016-01-13

    Wound healing is a complicated process, and fibroblast is a major cell type that participates in the process. Recent studies have shown that bioglass (BG) can stimulate fibroblasts to secrete a multitude of growth factors that are critical for wound healing. Therefore, we hypothesize that BG can stimulate fibroblasts to have a higher bioactivity by secreting more bioactive growth factors and proteins as compared to untreated fibroblasts, and we aim to construct a bioactive skin tissue engineering graft for wound healing by using BG activated fibroblast sheet. Thus, the effects of BG on fibroblast behaviors were studied, and the bioactive skin tissue engineering grafts containing BG activated fibroblasts were applied to repair the full skin lesions on nude mouse. Results showed that BG stimulated fibroblasts to express some critical growth factors and important proteins including vascular endothelial growth factor, basic fibroblast growth factor, epidermal growth factor, collagen I, and fibronectin. In vivo results revealed that fibroblasts in the bioactive skin tissue engineering grafts migrated into wound bed, and the migration ability of fibroblasts was stimulated by BG. In addition, the bioactive BG activated fibroblast skin tissue engineering grafts could largely increase the blood vessel formation, enhance the production of collagen I, and stimulate the differentiation of fibroblasts into myofibroblasts in the wound site, which would finally accelerate wound healing. This study demonstrates that the BG activated skin tissue engineering grafts contain more critical growth factors and extracellular matrix proteins that are beneficial for wound healing as compared to untreated fibroblast cell sheets.

  8. Foot ischemia after a free fibula flap harvest: immediate salvage with an interpositional sapheneous vein graft.

    PubMed

    Saydam, Funda Akoz; Basaran, Karaca; Ceran, Fatih; Mert, Bulent

    2014-09-01

    The most dreaded major donor-site complication of free fibula flap is a foot ischemia, which is fortunately rare. Various authors have discussed the efficacy of the use of preoperative imaging methods including color Doppler, magnetic resonance angiography, and conventional angiography. A 25-year-old man presented with a 10-cm mandibular defect after a facial gunshot injury. Lower extremity color Doppler revealed triphasic peroneal, tibialis anterior, and posterior artery flows. A fibula osteocutaneous flap was harvested, and the mandible was reconstructed. However, the suture sites at the donor site began to demonstrate signs of necrosis, abscess formation, and widespread cellulitis beginning from postoperative day 9. Angiogram of the lower extremity on the 13th day demonstrated no flow in the right posterior tibial artery distal to the popliteal artery, whereas the anterior tibial artery had weak flow with collateral filling distally. An emergency bypass with a saphenous vein graft between the popliteal artery and the distal posterior tibial artery was performed. Repeated debridements, local wound care, and vacuum-assisted closure were applied. A skin graft was placed eventually. The extremity healed without severe functional disability. In conclusion, although the arterial anatomy is completely normal in preoperative evaluation, vascular complications may still ocur at the donor fibula free flap site. In addition, emergency cardiovascular bypass surgery, as we experienced, may be necessary for limb perfusion. PMID:25119400

  9. Reconstruction after resection of tumors around the knee: role of the free vascularized fibular graft.

    PubMed

    Amr, S M; El-Mofty, A O; Amin, S N; Morsy, A M; El-Malt, O M; Abdel-Aal, H A

    2000-01-01

    We present our experience with reconstruction after resection of tumors around the knee, using free vascularized fibular grafting. The study included 23 patients. The lower femur was involved in 17 cases, the upper tibia in 6. The cases included giant cell tumor of the lower femur (2 patients), giant cell tumor of the upper tibia (1 patient), malignant fibrous histiocytoma of the lower femur (1 patient), parosteal osteosarcoma (1 patient), and periosteal osteosarcoma (1 patient). The remaining patients suffered from conventional osteogenic sarcomas. The size of the defect ranged from 12 to 16 cm in length. Skin flap necrosis after tumor resection was the most common complication encountered. Other complications included peroneal nerve involvement in one case and rupture of the arterial anastomosis in another. All transferred fibulas progressed to union within 7-9 months. Union time of both upper and lower ends of the fibula and time of appearance of periosteal reaction were identical. In evaluating periosteal hypertrophy of the fibula, the hypertrophy (de Boer) index (de Boer HD, Wood MB, J Bone Joint Surg 1989;71B:374-378) proved unreliable. False positive results are obtained, when callus formation around the lower end of the femur is far more abundant than at the upper end of the fibula. For this reason, we introduced the graft index. The latter is the ratio between the diameter of the graft at its thinnest portion at latest follow-up to its diameter on the day of operation, as calculated on plain radiographs. Two of the viable fibulas developed stress fractures after plate removal. Functional and quality-of -life results were satisfactory. It is concluded that the free vascularized fibular graft remains a valuable reconstruction option after the resection of tumors around the knee, provided certain precautions are followed. First, before closure of the wound, the skin flaps should be assessed for their viability. Necrotic parts should be excised. Stable

  10. Successful skin homografting from an identical twin in a severely burned patient.

    PubMed

    Turk, Emin; Karagulle, Erdal; Turan, Hale; Oguz, Hakan; Abali, Ebru Sakallioglu; Ozcay, Necdet; Moray, Gokhan; Haberal, Mehmet

    2014-01-01

    Flame burns are a serious condition and usually have high morbidity and mortality because they affect large areas of the body surface as well as the lungs. In these patients, it is especially difficult to find healthy skin for grafting if they have more than 70% third-degree burns. Repeated autografting or synthetic wound care materials are the only treatment options to cover burned areas. Partial-thickness skin grafting from the patient's identical twin sibling may be an alternative treatment option, if possible. Here, we report a patient with severe flame injury treated with skin from his identical twin. The patient had third-degree burns covering 70% of his body surface. Initial treatment consisted of fluid and electrolyte replacement, daily wound care, and surgical debridements, as well as nutritional support. After initial treatment, we performed a successful skin grafting from his identical twin. Skin grafting between identical twins might be an alternate method for severely burned patients.

  11. Mechanisms of Fat Graft Survival.

    PubMed

    Pu, Lee L Q

    2016-02-01

    Although more fat grafting procedures have been performed by plastic surgeons with the primary goal to restore soft tissue loss, the actual mechanism on how fat graft survives remains less completely understood. An established old theory on fat graft survival is still based on the cell survival theory proposed by Peer in the early 1950s. On the basis of his preliminary experimental study, he proposed that the mechanism of fat graft survival is based on established early blood circulation through anastomosis of the fat graft and host blood vessels. Recently, several investigators have demonstrated new concepts of the fat graft survival: One further advanced the old Peer cell survival theory and another based on new discovery and understanding of adipose-derived stem cells. This article serves as a scientific review on how fat graft survives after in vivo transplantation based on a number of well-conducted experimental studies. Both the graft survival and graft replacement theories on how fat graft survives are true based on the previously mentioned well-conducted experimental studies. Each theory may play a role in fat graft survival. It is possible that graft survival may be more dominant in some patients but the graft replacement may be more dominant in other patients.

  12. Grafts for Ridge Preservation

    PubMed Central

    Jamjoom, Amal; Cohen, Robert E.

    2015-01-01

    Alveolar ridge bone resorption is a biologic phenomenon that occurs following tooth extraction and cannot be prevented. This paper reviews the vertical and horizontal ridge dimensional changes that are associated with tooth extraction. It also provides an overview of the advantages of ridge preservation as well as grafting materials. A Medline search among English language papers was performed in March 2015 using alveolar ridge preservation, ridge augmentation, and various graft types as search terms. Additional papers were considered following the preliminary review of the initial search that were relevant to alveolar ridge preservation. The literature suggests that ridge preservation methods and augmentation techniques are available to minimize and restore available bone. Numerous grafting materials, such as autografts, allografts, xenografts, and alloplasts, currently are used for ridge preservation. Other materials, such as growth factors, also can be used to enhance biologic outcome. PMID:26262646

  13. Skin findings in newborns

    MedlinePlus

    Newborn skin characteristics; Infant skin characteristics; Neonatal care - skin ... the first few weeks of the baby's life. Newborn skin will vary, depending on the length of the pregnancy. Premature infants have thin, transparent skin. The skin of a ...

  14. Outcomes for split-thickness skin transplantation in high-risk patients using octenidine.

    PubMed

    Matiasek, J; Djedovic, G; Unger, L; Beck, H; Mattesich, M; Pierer, G; Koller, R; Rieger, U M

    2015-06-01

    Skin transplantation is a commonly used surgical technique; however, the complication rate, including postoperative infection and delayed wound healing due to inefficient perfusion, is significantly higher in patients suffering from comorbidities. Hence, a subsequent repeat procedure is often necessary. In this report, two case studies are presented in which an octenidine-based antiseptic is used with a tie-over dressing (TOD) instead of povidone iodine (PVP-iodine), following a split-thickness skin graft. The two patients selected were deemed to be at high risk of impaired wound healing due to comorbidities. The first patient, a confirmed smoker with diabetes, presented with a nodular melanoma that was resected and covered with a split-thickness skin graft. After 5 days of negative pressure wound therapy as a TOD, in combination with PVP-iodine, the graft became necrotic. A second split-thickness skin graft was performed and an antiseptic regimen with octenidine in combination with the same TOD resulted in a completely healed transplant. The second patient, also a confirmed smoker with diabetes and receiving oral corticosteroid treatment, was diagnosed with a skin necrosis on her leg. Following the split-thickness skin graft, octenidine and TOD were applied. The patient's skin graft completely healed without any adverse events. These two case studies indicate that the combination of octenidine and TOD following split-thickness skin transplantation is safe, well-tolerated and appears to have positive benefits in the reconstruction of defects in patients with impaired wound healing.

  15. Outcomes for split-thickness skin transplantation in high-risk patients using octenidine.

    PubMed

    Matiasek, J; Djedovic, G; Unger, L; Beck, H; Mattesich, M; Pierer, G; Koller, R; Rieger, U M

    2015-06-01

    Skin transplantation is a commonly used surgical technique; however, the complication rate, including postoperative infection and delayed wound healing due to inefficient perfusion, is significantly higher in patients suffering from comorbidities. Hence, a subsequent repeat procedure is often necessary. In this report, two case studies are presented in which an octenidine-based antiseptic is used with a tie-over dressing (TOD) instead of povidone iodine (PVP-iodine), following a split-thickness skin graft. The two patients selected were deemed to be at high risk of impaired wound healing due to comorbidities. The first patient, a confirmed smoker with diabetes, presented with a nodular melanoma that was resected and covered with a split-thickness skin graft. After 5 days of negative pressure wound therapy as a TOD, in combination with PVP-iodine, the graft became necrotic. A second split-thickness skin graft was performed and an antiseptic regimen with octenidine in combination with the same TOD resulted in a completely healed transplant. The second patient, also a confirmed smoker with diabetes and receiving oral corticosteroid treatment, was diagnosed with a skin necrosis on her leg. Following the split-thickness skin graft, octenidine and TOD were applied. The patient's skin graft completely healed without any adverse events. These two case studies indicate that the combination of octenidine and TOD following split-thickness skin transplantation is safe, well-tolerated and appears to have positive benefits in the reconstruction of defects in patients with impaired wound healing. PMID:26075514

  16. Graft-versus-host disease

    MedlinePlus

    GVHD; Bone marrow transplant - graft-versus-host disease; Stem cell transplant - graft-versus-host disease; Allogeneic transplant - ... GVHD may occur after a bone marrow, or stem cell, transplant in which someone receives bone marrow ...

  17. Synthetic dural graft septoplasty in epistaxis from hereditary hemorrhagic telangiectasia

    PubMed Central

    Burckhardt B, Wilfred

    2013-01-01

    It is an autosomal dominant vascular disorder, which has a variety of clinical manifestations, with epistaxis being one of the most common. Many treatment options exist for epistaxis, but with no consensus on which is the method of choice. We describe the case of a patient with hereditary hemorrhagic telangiectasia (HHT) secondary epistaxis with septoplasty managed with synthetic hard graft, which improved intensity and frequency of bleeding episodes. This technique is a variant of the septodermoplasty described by several authors, but the use of synthetic dura can help in obtaining better results and avoid taking skin grafts from other sites different from the surgical site. PMID:24892618

  18. Oily skin

    MedlinePlus

    ... keep your skin clean using warm water and soap, or a soapless cleanser. Clean your face with astringent pads if frequent face washing causes irritation. Use only water-based or oil-free cosmetics if you have oily skin. Your ...

  19. Aesthetic Total Reconstruction of Lower Eyelid Using Scapha Cartilage Graft on a Vascularized Propeller Flap

    PubMed Central

    Watanabe, Hidekata; Masumoto, Kazuyuki; Kikuchi, Mamoru; Satake, Yoshiyasu; Yanai, Tetsu; Harada, Yoshimi; Ishihara, Yasuhiro; Yasuta, Masato

    2016-01-01

    Background: The aim of this study was to review the results of a cohort of patients based on our experience with a new technique for total lower eyelid reconstruction after a large defect caused by malignant tumor and trauma. A scapha cartilage graft with small skin on a vascularized propeller flap was used for 16 cases requiring lower eyelid reconstruction. Methods: Patients were identified from a database, and a retrospective case note review was conducted. The scapha cartilage graft was sutured to the margin of the defect of the palpebral conjunctiva and tarsus. The propeller flap, rotated by a perforator-based lateral orbital flap or a subcutaneous-based nasolabial flap, was vascularized on the scapha cartilage graft as anterior lining of the lower eyelid. The follow-up, including results of slit-lamp examination, lasted for varying periods, but often it was for 12 months. Results: The scapha cartilage graft with small skin on a vascularized propeller flap was viable in all cases. Slit-lamp examination detected no irritation or injury of the conjunctiva and cornea, and visual acuity was maintained in all cases. A deformity in the donor helix by this technique was also improved by getting a smaller skin harvested from the scapha. Conclusion: Use of the scapha cartilage graft with small skin on a vascularized propeller flap allows for a good fit to the orbit, short operative time under local anesthesia, good graft viability, and a good esthetic result with minimal donor site morbidity. PMID:27200258

  20. Grafting effects on vegetable quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    In the United States, vegetable grafting is rare and few experiments have been done to determine optimal grafting procedures and production practices for different geographical and climatic regions in America. Grafting vegetables to control soilborne disease is a common practice in Asia, parts of E...

  1. Grafting for disease resistance

    Technology Transfer Automated Retrieval System (TEKTRAN)

    The primary purpose of grafting vegetables worldwide has been to provide resistance to soil-borne diseases. The potential loss of methyl bromide as a soil fumigant combined with pathogen resistance to commonly used pesticides will make resistance to soil-borne pathogens even more important in the fu...

  2. Acrylonitrile grafted to PVDF

    DOEpatents

    Yang, Jin; Eitouni, Hany Basam

    2015-03-31

    PVDF-g-PAN has been synthesized by grafting polyacrylonitrile onto polyvinylidene fluoride using an ATRP/AGET method. The novel polymer is ionically conducive and has much more flexibility than PVDF alone, making it especially useful either as a binder in battery cell electrodes or as a polymer electrolyte in a battery cell.

  3. New topical antiandrogenic formulations can stimulate hair growth in human bald scalp grafted onto mice.

    PubMed

    Sintov, A; Serafimovich, S; Gilhar, A

    2000-01-20

    The purpose of this study was to test the ability of topical formulations of finasteride and flutamide to re-enlarge hair follicles in male-pattern baldness. This was evaluated by an experimental model of human scalp skin graft transplanted onto SCID mice. A comparison was made between formulations containing finasteride and flutamide, and a vehicle formulation in terms of the mean hairs per graft, length, diameter of the shafts, and structures of the growth stages of the hair. Flutamide and finasteride had a significantly higher effect (P<0.05) than the placebo in all the tested parameters, but flutamide demonstrated more hair per graft and longer hair shafts than finasteride (P<0.05). The number of hairs per graft for flutamide and finasteride groups were 1.22+/-0. 47 and 0.88+/-0.95 hairs/0.5 mm2 graft, respectively, versus 0. 35+/-0.6 hairs/graft for vehicle-treated graft. Similarly, hair lengths for flutamide and finasteride were 5.82+/-0.50 and 4.50+/-0. 32 mm, respectively, versus 2.83+/-0.18 mm for the vehicle-treated grafts. An in vitro diffusion study of flutamide gel using hairless mouse skin demonstrated the beneficial effect of the vehicle composition in comparison with a hydroalcoholic solution or a gel containing no penetration enhancer. It is therefore suggested that this topical composition containing flutamide or finasteride may effectively result in regression of male-pattern baldness.

  4. Fitting of the dermis-fat grafted socket.

    PubMed

    Przybyla, V A; La Piana, F G; Bergin, D J

    1981-09-01

    Anophthalmic orbits that reject conventional implants may accept the dermis-fat graft. The subsequent fitting of such a socket differs in many important ways from the fitting of sockets containing conventional implants. Before surgery, the ocularist should construct a custom-made scleral ring to be inserted after the operation. This replaces the standard conformer that can erode the underlying dermis. The socket must be observed carefully for any evidence of damage to the conjunctiva-dermis suture line by the ring, and the latter modified or replaced as necessary. Granulation tissue forming around the sutures uniting conjunctiva and dermis may have to be resected and cauterized. Impression molding of an artificial eye is performed five weeks after surgery. The artificial eye always requires modifications over the first six months as the graft recedes due to partial atrophy of the fat of the graft, thus deepening the socket. PMID:7029387

  5. Your Skin

    MedlinePlus

    ... Butterflies? Read This Chloe & Nurb Meet The Brain (Movie) Quiz: Do You Need a Flu Shot? Got ... For Kids For Parents MORE ON THIS TOPIC Movie: Skin Acne Myths Blisters, Calluses, and Corns Fungal ...

  6. Skin Infections

    MedlinePlus

    ... nearby What to Do Teach kids not to pop, pick at, or scratch pimples, pus-filled infections, ... Your Skin Abscess Impetigo Ringworm Cellulitis Should I Pop My Pimple? Tips for Taking Care of Your ...

  7. Skin Cancer

    MedlinePlus

    ... States. The two most common types are basal cell cancer and squamous cell cancer. They usually form on the head, face, ... If not treated, some types of skin cancer cells can spread to other tissues and organs. Treatments ...

  8. Skin Cancer

    MedlinePlus

    ... exposure to ultraviolet light, which is found in sunlight and in lights used in tanning salons. What ... the safe-sun guidelines. 1. Avoid the sun. Sunlight damages your skin. The sun is strongest during ...

  9. Skin Cancer

    MedlinePlus

    ... Review. 17 Wu S, Han J, Laden F, Qureshi AA. Long-term ultraviolet flux, other potential risk factors, ... MR, Shive ML, Chren MM, Han J, Qureshi AA, Linos E. Indoor tanning and non-melanoma skin ...

  10. Hyperelastic skin

    MedlinePlus

    ... is most often seen in people who have Ehlers-Danlos syndrome. People with this disorder have very elastic skin. ... any member of your family been diagnosed with Ehlers-Danlos syndrome? What other symptoms are present? Alternative Names India ...

  11. Skin - clammy

    MedlinePlus

    ... of clammy skin include: Anxiety attack Heart attack Heat exhaustion Internal bleeding Low blood oxygen levels Sepsis (body-wide infection) Severe allergic reaction (anaphylaxis) Severe pain Shock (low blood pressure)

  12. Surface functionalization of degradable polymers by covalent grafting.

    PubMed

    Källrot, Martina; Edlund, Ulrica; Albertsson, A-C

    2006-03-01

    With a new non-destructive and solvent-free photografting technique, N-vinylpyrrolidone was covalently grafted onto the surfaces of degradable polymers; poly(l-lactide), poly(epsilon-caprolactone), poly(lactide-co-glycolide), and poly(trimethylene carbonate). The modified surfaces were characterized by XPS, ATR-FTIR, SEM, and cell growth tests. The wettability was markedly improved, as static contact angles changed from about 80 degrees for the pristine substrates to around 30 degrees after 30min of grafting. Well-defined surface topographies, such as micro-patterns, are preserved in the process since the graft layers are thin. The biological response, measured as cytotoxicity, showed that the modified films provide good substrates, comparable with optimized cell culture plastics, for the adhesion and proliferation of normal human keratinocytes and skin fibroblasts. PMID:16257444

  13. Skin Bioprinting: Impending Reality or Fantasy?

    PubMed

    Ng, Wei Long; Wang, Shuai; Yeong, Wai Yee; Naing, May Win

    2016-09-01

    Bioprinting provides a fully automated and advanced platform that facilitates the simultaneous and highly specific deposition of multiple types of skin cells and biomaterials, a process that is lacking in conventional skin tissue-engineering approaches. Here, we provide a realistic, current overview of skin bioprinting, distinguishing facts from myths. We present an in-depth analysis of both current skin bioprinting works and the cellular and matrix components of native human skin. We also highlight current limitations and achievements, followed by design considerations and a future outlook for skin bioprinting. The potential of bioprinting with converging opportunities in biology, material, and computational design will eventually facilitate the fabrication of improved tissue-engineered (TE) skin constructs, making bioprinting skin an impending reality. PMID:27167724

  14. Senescent Skin

    PubMed Central

    Kushniruk, William

    1974-01-01

    The cutaneous surface is continually influenced by aging and environmental factors. A longer life span is accompanied by an increase in the frequency of problems associated with aging skin. Although most of these changes and lesions are not life threatening, the premalignant lesions must be recognized and treated. The common aging and actinic skin changes are discussed and appropriate management is described. ImagesFig. 1Fig. 2Fig. 3Fig. 4 PMID:20469067

  15. Neuromodulators for Aging Skin

    MedlinePlus

    ... Non-ablative Laser Rejuvenation Non-invasive Body Contouring Treatments Skin Cancer Skin Cancer Information Free Skin Cancer Screenings Skin ... Non-ablative Laser Rejuvenation Non-invasive Body Contouring Treatments Skin Cancer Skin Cancer Information Free Skin Cancer Screenings Skin ...

  16. Highly flexible nitinol mesh to encase aortocoronary saphenous vein grafts: first clinical experiences and angiographic results nine months postoperatively.

    PubMed

    Schoettler, Jan; Jussli-Melchers, Jill; Grothusen, Christina; Stracke, Lars; Schoeneich, Felix; Stohn, Simon; Hoffmann, Grischa; Cremer, Jochen

    2011-10-01

    Saphenous vein graft patency is frequently limited by degeneration. Experimental studies have indicated that rigid external support of venous grafts by a flexible, tubular nitinol mesh may improve graft patency. The study presented was part of a prospective, randomized, multicenter first-in-man trial investigating the safety and effectiveness of nitinol-supported venous grafts in coronary artery bypass graft (CABG) surgery. From our clinic, 25 subjects with multivessel coronary artery disease requiring saphenous vein graft CABG of the right coronary artery (RCA) and the circumflex artery were entered into the trial. Subjects were randomized to receive a mesh-supported graft on one of these arteries; the other vessel received an untreated vein graft. Graft patency was assessed by coronary angiography nine months after surgery. The implantation of mesh grafts was simple and safe. In 10 cases, a nitinol mesh-supported venous graft was anastomosed to the circumflex artery and in 15 cases to the RCA. All patients survived the observation period. A total of 72% of the patients underwent control coronary angiography. The patency rate of mesh-supported grafts was 27.8% nine months postoperatively. Conventional vein grafts showed an 85.7% patency, and arterial grafts had a 100% patency. No complications directly related to the implantation of mesh-supported grafts were observed. The promising experimental results of mesh-supported venous grafts could not be reproduced in the study presented. A critical item seems to be correct selection of nitinol mesh diameter, the anastomotic method and fixation of the mesh tube to the venous graft. PMID:21724659

  17. Siloxane-grafted membranes

    DOEpatents

    Friesen, Dwayne T.; Obligin, Alan S.

    1989-01-01

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional groups. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  18. Siloxane-grafted membranes

    DOEpatents

    Friesen, D.T.; Obligin, A.S.

    1989-10-31

    Composite cellulosic semipermeable membranes are disclosed which are the covalently bonded reaction product of an asymmetric cellulosic semipermeable membrane and a polysiloxane containing reactive functional group. The two reactants chemically bond by ether, ester, amide or acrylate linkages to form a siloxane-grafted cellulosic membrane having superior selectivity and flux stability. Selectivity may be enhanced by wetting the surface with a swelling agent such as water.

  19. Adaptive skin detection based on online training

    NASA Astrophysics Data System (ADS)

    Zhang, Ming; Tang, Liang; Zhou, Jie; Rong, Gang

    2007-11-01

    Skin is a widely used cue for porn image classification. Most conventional methods are off-line training schemes. They usually use a fixed boundary to segment skin regions in the images and are effective only in restricted conditions: e.g. good lightness and unique human race. This paper presents an adaptive online training scheme for skin detection which can handle these tough cases. In our approach, skin detection is considered as a classification problem on Gaussian mixture model. For each image, human face is detected and the face color is used to establish a primary estimation of skin color distribution. Then an adaptive online training algorithm is used to find the real boundary between skin color and background color in current image. Experimental results on 450 images showed that the proposed method is more robust in general situations than the conventional ones.

  20. The biomechanical and histological sequelae of common skin banking methods.

    PubMed

    Wood, Joseph M B; Soldin, Mark; Shaw, Tanya J; Szarko, Matthew

    2014-03-21

    Human skin allografts are used worldwide as an adjunct for the healing of burns when autograft skin is not available or not indicated. Allograft skin comes from human cadaveric donors, and so must be preserved until use. This study forms the first investigation to compare the mechanical and histological integrity of human split-thickness skin grafts preserved by either glycerolisation or cryopreservation (with or without the cryoprotectant DMSO). Stress relaxation was used to assess mechanical properties, whilst histological analysis allowed for evaluation of structural integrity. Preservation of tissue, whether by freezing or glycerolisation, altered the relaxation behaviours of skin. Young's modulus upon initial loading significantly decreased for skin frozen without cryoprotectant, but remained unchanged for skin frozen with cryoprotectant and skin preserved with glycerol. After 1.5h of stress relaxation, both fresh skin and skin frozen without DMSO displayed similar relaxation rates. Samples frozen with DMSO or preserved with glycerol had increased relaxation rate and had not reached load equilibrium within this time. To understand the structural basis for the biomechanical changes, samples were histologically assessed. All preservation protocols resulted in a similar degree of visible damage, but cryopreservation appeared particularly damaging to the extracellular matrix, whereas glycerolisation caused dramatic separation of the epidermis from the underlying dermis. The mechanical property alterations reveal that preservation results in laxity, which clinically could hinder contact dependent healing properties, but alternatively may increase capacity for coverage. The structural changes confirm that preservation techniques do not conserve grafts in an in vivo state.

  1. Phototherapy for sclerosing skin conditions.

    PubMed

    Teske, Noelle M; Jacobe, Heidi T

    2016-01-01

    Phototherapy is an effective treatment strategy for a variety of sclerosing skin conditions. There are a number of phototherapeutic modalities used for the treatment of sclerosing skin conditions, including ultraviolet (UV)A1, broadband UVA, psoralen plus UVA, and narrowband UVB phototherapy. As controlled trials with validated outcome measures are lacking for these therapies, existing evidence is largely level II for morphea and is even more minimal for scleroderma and other sclerosing disorders (scleroderma, lichen sclerosus, and chronic graft-versus-host disease, among others). Studies do suggest that phototherapy may be effective for many of these disorders, including those that have been unresponsive to other therapies. Phototherapy remains an attractive therapeutic option for patients due to its efficacy and favorable risk-versus-benefit profile. Phototherapy also offers a therapeutic alternative to systemic immunosuppressives for patients who cannot tolerate these medications. PMID:27638441

  2. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction. PMID:16875525

  3. [Bone grafts in orthopedic surgery].

    PubMed

    Zárate-Kalfópulos, Barón; Reyes-Sánchez, Alejandro

    2006-01-01

    In orthopedic surgery the demand for the use of bone grafts increases daily because of the increasing quantity and complexity of surgical procedures. At present, the gold standard is the autologous bone graft but the failure rate, morbidity of the donor site and limited availability have stimulated a proliferation for finding materials that work as bone graft substitutes. In order to have good success, we must know the different properties of these choices and the environment where the graft is going to be used. As bone graft substitutes and growth factors become clinical realities, a new gold standard will be defined. Tissue engineering and gene therapy techniques have the objective to create an optimum bone graft substitute with a combination of substances with properties of osteconduction, osteogenesis and osteoinduction.

  4. Transgenic mouse model of malignant skin melanoma.

    PubMed Central

    Mintz, B; Silvers, W K

    1993-01-01

    Tyr-SV40E transgenic mice are specifically susceptible to melanoma due to expression of the oncogene in pigment cells. Mice of the more susceptible lines die young of early-onset eye melanomas, when skin melanomas are still infrequent and benign. To surmount this obstacle, skin from donors of two high-susceptibility lines was grafted to Tyr-SV40E hosts of a low-susceptibility line of the same inbred strain, thereby enabling the skin to outlive the donors and continue to grow in immunocompetent but tolerant hosts. Unexpectedly, donor pigment cells in all the grafts soon selectively proliferated close to areas of greatest wound healing, forming a dense black tracery, especially at the outer rim of the grafts. These lesions slowly grew radially within the grafts, producing irregular greyish patches. Local vertical thickenings then appeared and developed into small melanomas, which soon ulcerated through the epidermis. The tumors rapidly enlarged and became deeply invasive. Discrete black nevi also arose, with many becoming larger and distinctly blue, but those not near areas of pronounced wound healing did not progress to malignancy. In this first series, malignant melanoma resulted in all the grafts from the more susceptible of two donor lines and in some grafts from the other line. Distant metastases occurred in some cases from each line. Most tumors were hypomelanotic and heterogeneous, with lobes or areas differing in melanization. The results strongly suggest that growth factors and cytokines--known to be produced in wound repair--are triggering the growth and malignant conversion of these genetically susceptible melanocytes and that in the graft situation we are merely witnessing a caricature--a usefully exaggerated manifestation of the true events underlying the genesis of melanomas. The striking resemblance to the human malignancy, the genetic uniformity and different susceptibilities of the transgenic lines, and the experimental possibilities in the grafted

  5. Skin biopsy: Biopsy issues in specific diseases.

    PubMed

    Elston, Dirk M; Stratman, Erik J; Miller, Stanley J

    2016-01-01

    Misdiagnosis may result from biopsy site selection, technique, or choice of transport media. Important potential sources of error include false-negative direct immunofluorescence results based on poor site selection, uninformative biopsy specimens based on both site selection and technique, and spurious interpretations of pigmented lesions and nonmelanoma skin cancer based on biopsy technique. Part I of this 2-part continuing medical education article addresses common pitfalls involving site selection and biopsy technique in the diagnosis of bullous diseases, vasculitis, panniculitis, connective tissue diseases, drug eruptions, graft-versus-host disease, staphylococcal scalded skin syndrome, hair disorders, and neoplastic disorders. Understanding these potential pitfalls can result in improved diagnostic yield and patient outcomes.

  6. Antimicrobial Graft Copolymer Gels.

    PubMed

    Harvey, Amanda C; Madsen, Jeppe; Douglas, C W Ian; MacNeil, Sheila; Armes, Steven P

    2016-08-01

    In view of the growing worldwide rise in microbial resistance, there is considerable interest in designing new antimicrobial copolymers. The aim of the current study was to investigate the relationship between antimicrobial activity and copolymer composition/architecture to gain a better understanding of their mechanism of action. Specifically, the antibacterial activity of several copolymers based on 2-(methacryloyloxy)ethyl phosphorylcholine [MPC] and 2-hydroxypropyl methacrylate (HPMA) toward Staphylococcus aureus was examined. Both block and graft copolymers were synthesized using either atom transfer radical polymerization or reversible addition-fragmentation chain transfer polymerization and characterized via (1)H NMR, gel permeation chromatography, rheology, and surface tensiometry. Antimicrobial activity was assessed using a range of well-known assays, including direct contact, live/dead staining, and the release of lactate dehydrogenase (LDH), while transmission electron microscopy was used to study the morphology of the bacteria before and after the addition of various copolymers. As expected, PMPC homopolymer was biocompatible but possessed no discernible antimicrobial activity. PMPC-based graft copolymers comprising PHPMA side chains (i.e. PMPC-g-PHPMA) significantly reduced both bacterial growth and viability. In contrast, a PMPC-PHPMA diblock copolymer comprising a PMPC stabilizer block and a hydrophobic core-forming PHPMA block did not exhibit any antimicrobial activity, although it did form a biocompatible worm gel. Surface tensiometry studies and LDH release assays suggest that the PMPC-g-PHPMA graft copolymer exhibits surfactant-like activity. Thus, the observed antimicrobial activity is likely to be the result of the weakly hydrophobic PHPMA chains penetrating (and hence rupturing) the bacterial membrane. PMID:27409712

  7. Studies on perioperative skin flora.

    PubMed

    Newsom, S W; Rowland, C

    1988-04-01

    Chlorhexidine in spirit is used to reduce the skin bacterial load before surgery; and recently prewashing with chlorhexidine scrub has been advocated. We describe three studies on cardio-thoracic surgical patients--particularly those having coronary artery grafts with long leg and sternal wounds. Two studies compared prewashes with chlorhexidine scrub (Hibiscrub-ICI) or soap. Study Number One (250 patients per group) was of wound infections; and Number Two (25 patients per group) was of alterations in skin flora for 10 days postoperation. Chlorhexidine scrub failed to reduce overall wound infection rates in Study 1, although leg wounds healed more quickly with less inflammation. Study Two showed that the scrub had a significant effect on skin flora that lasted at least 3 days postoperation. Study Number Three was of 100 patients (no chlorhexidine scrub) examined for methicillin-resistant coagulase-negative staphylococci (MRSE) by cultures of swabs from the leg, sternum and chest drain site before and after operation on methicillin agar. Three per cent of patients had MRSE preoperation (1 doctor) and 23% postoperation. One thousand strains were tested by agar dilution against methicillin and chlorhexidine. MRSE had a 2-8-fold increased resistance to chlorhexidine compared to a greater than 256-fold to methicillin. Thus although chlorhexidine has a marked persistent effect on skin flora, emergence of major resistance is unlikely. Use of postoperative chlorhexidine should be investigated further.

  8. Helical CT Angiography of Abdominal Aortic Aneurysms Treated with Suprarenal Stent Grafting: A Pictorial Essay

    SciTech Connect

    Sun Zhonghua

    2003-06-15

    The endovascular repair of abdominal aorticaneurysm (AAA) with stent grafts is rapidly becoming an important alternative to open repair. Suprarenal stent grafting, recently modified from conventional infrarenal stent grafting, is a technique for the purpose of treating patients with inappropriate aneurysm necks.Unlike open repair, the success of endoluminal repair cannot be ascertained by means of direct examination and thus relies on imaging results. The use of conventional angiography for arterial imaging has become less dominant, while helical computed tomography angiography(CTA) has become the imaging modality of choice for both preoperative assessment and postoperative followup after treatment with stent graft implants. There is an increasing likelihood that radiologists will become more and more involved in the procedure of aortic stent grafting and in giving the radiological report on these patients treated with stent grafts. It is necessary for radiologists to be familiar with the imaging findings, including common and uncommon appearances following aortic stent grafting. The purpose of this pictorial essay is to describe and present normal and abnormal imaging appearances following aortic stent grafting based on helical CTA.

  9. Human Split-Thickness Skin Allograft from Brain-Dead Donors

    PubMed Central

    Khodadadi, A.; Olang, O; Makhllough, A; Nozary Heshmati, B.; Azmoudeh Ardalan, F.; Tavakoli, S. A.

    2016-01-01

    Background: Looking for an appropriate skin substitute for temporary and permanent coverage of wounds remains one of the main obstacles of medical researchers. Objective: To investigate the rate of inflammation, symbiosis, and survival of grafted allograft skin from brain-dead donors (BDDs) in rabbits. Methods: After receiving negative serologic tests of BDDs, we prepared partial thickness skin grafts. They were then used in treating wounds of 5 rabbits in comparison with split-thickness skins taken from cardiac dead donors. Results: On histopathological examinations, we found no difference between the skins. All samples were separated from the baseline in 15–20 days. Conclusion: Gamma-irradiated freeze-dried human split-thickness skin taken from BDDs is safe and can be used for the treatment of deep skin burns. PMID:27721966

  10. Hand rejuvenation with structural fat grafting.

    PubMed

    Coleman, Sydney R

    2002-12-01

    A simple, reliable technique of autologous fat grafting for long-lasting rejuvenation of the dorsum of the hand is presented. With this technique, small intact parcels of fatty tissue are harvested with a syringe and a blunt 3-mm cannula. Then, most of the nonviable components are removed from the harvested subcutaneous material by centrifugation, decanting, and wicking. Finally, a 17-gauge blunt cannula places the fat in minuscule parcels of tissue with many passes through five or six tiny incisions in the hand. Separation of the tiny parcels of fat maximizes contact between the surfaces of the transplanted fat and surrounding recipient tissues to encourage integration, anchoring, and long-term survival. Structured, purposeful placement of a thin layer of transplanted fat rejuvenates the dorsal hand by restoring a slight fullness to atrophic subcutaneous tissue, by softening the color and definition of exposed extensor tendons and dorsal hand veins, and by supporting the aging skin.

  11. How to Check Your Skin for Skin Cancer

    MedlinePlus

    ... Home Cancer Types Skin Cancer Skin Cancer Patient Skin Cancer Treatment Melanoma Treatment Merkel Cell Carcinoma Treatment Skin Cancer Prevention Skin Cancer Screening Health Professional Skin Cancer Treatment Melanoma Treatment Merkel Cell Carcinoma Treatment Skin Cancer ...

  12. Pediatric burn wound impetigo after grafting.

    PubMed

    Aikins, Kimberly; Prasad, Narayan; Menon, Seema; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Modern burn care techniques have reduced the risk of infection of the acute burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial abscesses and ulceration has been termed burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric burns were treated with skin grafts, with 7% developing burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with conservative management (96 days), followed by antibacterial dressings (37 days), oral antibiotics (36 days), topical steroids (16 days), and oral antibiotics in combination with topical steroids (13.5 days). Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral antibiotics plus topical steroids should be considered. PMID:24823337

  13. Pediatric burn wound impetigo after grafting.

    PubMed

    Aikins, Kimberly; Prasad, Narayan; Menon, Seema; Harvey, John G; Holland, Andrew J A

    2015-01-01

    Modern burn care techniques have reduced the risk of infection of the acute burn wound, resulting in more rapid healing and a lower incidence of graft loss. Secondary breakdown may still occur. The loss of epithelium in association with multifocal superficial abscesses and ulceration has been termed burns impetigo. This may result in considerable morbidity and require prolonged treatment. The events preceding development, the impact on the patient, and the ideal treatment appear unclear and poorly reported. In 5 years, between 2006 and 2011, 406 pediatric burns were treated with skin grafts, with 7% developing burns impetigo. Time to resolution ranged from 5 to 241 days: the mean time to complete healing was greatest with conservative management (96 days), followed by antibacterial dressings (37 days), oral antibiotics (36 days), topical steroids (16 days), and oral antibiotics in combination with topical steroids (13.5 days). Burns impetigo resulted in significant morbidity, requiring multiple visits to the treatment center and prolonged symptoms. Delay in diagnosis and treatment resulted in worse outcomes. Prompt consideration of burns impetigo should occur when postgraft patients present with suggestive clinical signs and treatment with oral antibiotics plus topical steroids should be considered.

  14. Listeria monocytogenes Endovascular Graft Infection

    PubMed Central

    Heysell, Scott K.; Hughes, Molly A.

    2016-01-01

    Although best managed by surgical resection, we present a case of Listeria monocytogenes endovascular graft infection alternatively treated with graft retention and antibiotic induction followed by a lifelong suppressive course. The epidemiological, pathological, and clinical features of this unique entity are reviewed. PMID:26835477

  15. Grafting effects on vegetable quality

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Vegetable grafting began in the 1920s to control soil-borne disease. It is now a common practice in Asia, parts of Europe, and the Middle East. In Japan and Korea most of the cucurbits and tomatoes (Lycopersicon esculentum Mill.) grown are grafted. This practice is rare in the U.S. and there have...

  16. Polyether/Polyester Graft Copolymers

    NASA Technical Reports Server (NTRS)

    Bell, Vernon L., Jr.; Wakelyn, N.; Stoakley, D. M.; Proctor, K. M.

    1986-01-01

    Higher solvent resistance achieved along with lower melting temperature. New technique provides method of preparing copolymers with polypivalolactone segments grafted onto poly (2,6-dimethyl-phenylene oxide) backbone. Process makes strong materials with improved solvent resistance and crystalline, thermally-reversible crosslinks. Resulting graft copolymers easier to fabricate into useful articles, including thin films, sheets, fibers, foams, laminates, and moldings.

  17. Bypass graft imaging and coronary anomalies in MDCT.

    PubMed

    Fernandez, Gabriel C

    2005-02-01

    Coronary artery bypass graft (CABG) is used to restore the blood flow in an ischemic area of myocardium using conduits bypassing a diseased coronary artery. Until now, conventional angiography has been the recognized technique to study patients with bypass grafts. Nowadays, non-invasive methods such as multi-detector CT (MDCT) emerge as reliable imaging methods in the study of CABG. Thus, radiologists play an important role in this field, not only to define if the bypass graft is occluded or stenosed but also to report further information such as CABG technique performed, type of conduit used or pre-operative findings. This paper analyzes the most practical information that the radiologist must know in a study of CABG. Another theme which will be briefly described is the use of MDCT in coronary anomalies studies, with particular emphasis on the course of the abnormal vessel and its relation to great vessels. PMID:15801059

  18. Skin and Neourethral Necrosis in Staged Hypospadias Repair

    PubMed Central

    Mahdavi, Alireza; Sarafi, Mehdi

    2016-01-01

    Complications in hypospadias surgery are not uncommon however penile skin or flap necrosis is rarely reported. Ischemia of the flap or graft is a major complication in two stage repair of hypospadias. A 2-year old boy with proximal penile hypospadias, operated earlier for chordee correction and urethral plate formation with a preputial flap, presented for stage 2 repair. Ten days after surgery patient developed skin and neourethral necrosis. Early debridement was done followed by coverage with scrotal flaps. PMID:27398320

  19. Effect of a selective thromboxane synthase inhibitor on arterial graft patency and platelet deposition in dogs

    SciTech Connect

    McDaniel, M.D.; Huntsman, W.T.; Miett, T.O.; Cronenwett, J.L.

    1987-08-01

    This study examined the effect of selective thromboxane synthase inhibition and nonselective cyclooxygenase inhibition on vascular graft patency and indium 111-labeled platelet deposition in 35 mongrel dogs undergoing carotid artery replacement with 4 mm X 4 cm polytetrafluoroethylene (PTFE) (one side) and Dacron (opposite side) end-to-end grafts. Aspirin-dipyridamole therapy improved one-week graft patency, from 46% in untreated dogs to 93% in treated dogs. Thromboxane synthase inhibition (U-63557A) improved graft patency in these dogs to 81%. Both drug treatments reduced platelet deposition on Dacron and PTFE grafts by 48% to 68% compared with control dogs. Dacron grafts accumulated significantly more platelets than PTFE grafts but had comparable patency rates. Low-dose aspirin therapy had no significant effect on either graft patency or platelet deposition. All treatment groups showed a 60% to 76% reduction in serum thromboxane B2, but only thromboxane synthase inhibitor treatment increased plasma 6-keto-prostaglandin F1 alpha by 100%. Selective thromboxane synthase inhibition improved small-caliber prosthetic graft patency to the same extent as did conventional cyclooxygenase inhibition in this preliminary study.

  20. [Stent Grafting for Aortic Dissection].

    PubMed

    Uchida, Naomichi

    2016-07-01

    The purpose of stent graft for aortic dissection is to terminate antegrade blood flow into the false lumen through primary entry. Early intervention for primary entry makes excellent aortic remodeling and emergent stent grafting for complicated acute type B aortic dissection is supported as a class I. On the other hand stent grafting for chronic aortic dissection is controversial. Early stent grafting is considered with in 6 months after on-set if the diameter of the descending aorta is more than 40 mm. Additional interventions for residual false lumen on the downstream aorta are still required. Stent graft for re-entry, candy-plug technique, and double stenting, other effective re-interventions were reported. Best treatment on the basis of each anatomical and physical characteristics should be selected in each institution. Frozen elephant trunk is alternative procedure for aortic dissection without the need to take account of proximal anatomical limitation and effective for acute type A aortic dissection. PMID:27440026

  1. Radiation grafting on natural films

    NASA Astrophysics Data System (ADS)

    Lacroix, M.; Khan, R.; Senna, M.; Sharmin, N.; Salmieri, S.; Safrany, A.

    2014-01-01

    Different methods of polymer grafting using gamma irradiation are reported in the present study for the preparation of newly functionalized biodegradable films, and some important properties related to their mechanical and barrier properties are described. Biodegradable films composed of zein and poly(vinyl alcohol) (PVA) were gamma-irradiated in presence of different ratios of acrylic acid (AAc) monomer for compatibilization purpose. Resulting grafted films (zein/PVA-g-AAc) had their puncture strength (PS=37-40 N mm-1) and puncture deformation (PD=6.5-9.8 mm) improved for 30% and 50% PVA in blend, with 5% AAc under 20 kGy. Methylcellulose (MC)-based films were irradiated in the presence of 2-hydroxyethyl methacrylate (HEMA) or silane, in order to determine the effect of monomer grafting on the mechanical properties of films. It was found that grafted films (MC-g-HEMA and MC-g-silane) using 35% monomer performed higher mechanical properties with PS values of 282-296 N mm-1 and PD of 5.0-5.5 mm under 10 kGy. Compatibilized polycaprolactone (PCL)/chitosan composites were developed via grafting silane in chitosan films. Resulting trilayer grafted composite film (PCL/chitosan-g-silane/PCL) presented superior tensile strength (TS=22 MPa) via possible improvement of interfacial adhesion (PCL/chitosan) when using 25% silane under 10 kGy. Finally, MC-based films containing crystalline nanocellulose (CNC) as a filling agent were prepared and irradiated in presence of trimethylolpropane trimethacrylate (TMPTMA) as a grafted plasticizer. Grafted films (MC-g-TMPTMA) presented superior mechanical properties with a TS of 47.9 MPa and a tensile modulus (TM) of 1792 MPa, possibly due to high yield formation of radicals to promote TMPTMA grafting during irradiation. The addition of CNC led to an additional improvement of the barrier properties, with a significant 25% reduction of water vapor permeability (WVP) of grafted films.

  2. Cutaneous skin tag

    MedlinePlus

    Skin tag; Acrochordon; Fibroepithelial polyp ... have diabetes. They are thought to occur from skin rubbing against skin. ... The tag sticks out of the skin and may have a short, narrow stalk connecting it to the surface of the skin. Some skin tags are as long as ...

  3. The skin tumor: a reconstructive challenge.

    PubMed

    Rosenfield, L K

    1993-10-01

    The type of reconstruction performed following skin tumor surgery is directly related to the type, extent, and site of the skin tumor. The skin tumors with which the plastic surgeon is most often confronted are the basal and squamous cell cancers and melanoma. It is well documented that the incidence of these tumors are increasing at an alarming rate. This is believed to be primarily due to excessive sun exposure and the thinning of the protective ozone layer. Under these circumstances, the plastic surgeon today must be well equipped to not only treat these tumors, as well as other rarer diseases, but also to reconstruct the sometimes challenging resulting defects. The guiding reconstructive principle is as Ralph Millard admonished: Replace lost tissue with like tissue. A skin graft at the tip of the nose can be very distracting due to its patch-like, depressed appearance. In contrast, a full-thickness skin flap would allow the reconstructive "material" to blend in with its surroundings for a more impressive result. The plastic surgeon has several items in his armamentarium to assist in the execution of this principle. Some of the techniques are based on age-old ideas, while others represent very recent, almost revolutionary advances. These advances include: 1. The introduction of the tissue expander: This concept has allowed the plastic surgeon to reconstruct defects that would would have normally required disfiguring skin grafts or free tissue transfers. 2. The elucidation of the vascular supply to the skin and underlying muscles and fascia: This knowledge has endowed the plastic surgeon with a tremendous pallet of reliable flaps to reconstruct a particular defect.

  4. Solid phase graft copolymerization of acrylic monomers onto thermoplastics and their use as blend compatibilizers

    NASA Astrophysics Data System (ADS)

    Subramanian, Srinivas

    This research work is an extension of some of the earlier work done on the development of solid phase grafting technique to graft various monomers onto polymers as well as postulation of the usefulness of the graft copolymers thus synthesized. Polystyrene grafted with acrylic acid, previously developed in bench scale, was synthesized in pilot-plant scale batches. Process parameter studies on the grafting of acrylic acid onto polypropylene and developmental studies on the grafting of maleic anhydride onto polystyrene were also done. Polymers grafted with polar molecules such as maleic anhydride and acrylic acid have been used to compatibilize immiscible blends of polar and non-polar polymers. On the same note, the applicability of the solid phase graft copolymers as blend compatibilizers were investigated and their performance was compared to commercially available compatibilizers. Solid phase graft copolymerization process is a technique to synthesize graft copolymers. Some of its salient features are use of minimal solvent to conduct the reaction and easy equipment modification. It is a low pressure and low temperature process. This technique provides a viable alternative to the environmentally hazardous, and time consuming conventional process currently in use. Hence, development of this technique could be beneficial not only to the plastics industry, but also to mankind. Also, this technique provides a low-cost and extremely easy method to develop graft copolymers such as acrylic acid functionalized polymers that are rapidly gaining popularity as blend compatibilizers and polymer reinforcing agents. A study that proves the potential of these solid phase graft copolymers as good blend compatibilizers for industrially important immiscible polymers will develop interest in the industries about this grafting process. The free radical solid phase graft copolymerization process was carried in a modified Brabender-type mixer fitted with specially designed blades to

  5. [Intra-graft balloon pumping--a clinical case report].

    PubMed

    Nagata, M; Tashiro, T; Tanaka, K; Haruta, Y; Todo, K

    1991-12-01

    A 29-year-old female underwent tube graft replacement of distal aortic arch and descending aorta for dissecting aneurysm. After 42 minutes of aortic cross-clamping the patient was initially weaned satisfactorily from cardiopulmonary bypass (CPB). However, cardiac arrhythmia and cardiac arrest necessitated reestablishment of CPB. Electro-cardiography showed inferior myocardial infarction. To wean CPB intraaortic balloon pumping (IABP) was mandatory. But because of dissecting aortic aneurysm IABP in conventional method was contra-indicated. Intra graft balloon pumping (IGBP) was initiated while the patient was on full CPB. A low-porosity woven Dacron tube graft (22 mm) was anastomosed end-to-side to ascending aorta. A balloon was inserted into the tube graft to establish IGBP. This IGBP provided effective circulatory assist. The patient was weaned from CPB 1 hours after reestablishment of IGBP. Postoperative course was stable. The patient was returned to the operating room for removal of the balloon 3 days postoperatively. We reported the case for whom IGBP was effective. IGBP was effective circulatory support for the patient when conventional use of IABP was contra-indicated. PMID:1774515

  6. 3D Stereoscopic Visualization of Fenestrated Stent Grafts

    SciTech Connect

    Sun Zhonghua; Squelch, Andrew; Bartlett, Andrew; Cunningham, Kylie; Lawrence-Brown, Michael

    2009-09-15

    The purpose of this study was to present a technique of stereoscopic visualization in the evaluation of patients with abdominal aortic aneurysm treated with fenestrated stent grafts compared with conventional 2D visualizations. Two patients with abdominal aortic aneurysm undergoing fenestrated stent grafting were selected for inclusion in the study. Conventional 2D views including axial, multiplanar reformation, maximum-intensity projection, and volume rendering and 3D stereoscopic visualizations were assessed by two experienced reviewers independently with regard to the treatment outcomes of fenestrated repair. Interobserver agreement was assessed with Kendall's W statistic. Multiplanar reformation and maximum-intensity projection visualizations were scored the highest in the evaluation of parameters related to the fenestrated stent grafting, while 3D stereoscopic visualization was scored as valuable in the evaluation of appearance (any distortions) of the fenestrated stent. Volume rendering was found to play a limited role in the follow-up of fenestrated stent grafting. 3D stereoscopic visualization adds additional information that assists endovascular specialists to identify any distortions of the fenestrated stents when compared with 2D visualizations.

  7. Vulvar lichen sclerosus: A new regenerative approach through fat grafting.

    PubMed

    Boero, Veronica; Brambilla, Massimiliano; Sipio, Elisa; Liverani, Carlo A; Di Martino, Mirella; Agnoli, Benedetta; Libutti, Giada; Cribiù, F M; Del Gobbo, Alessandro; Ragni, Enrico; Bolis, Giorgio

    2015-12-01

    OBJECTIVE. The aim of this study was to evaluate the efficacy of fat grafting in the treatment of severe vulvar lichen sclerosus (LS). Our primary outcome was to assess the improvement of mucocutaneous trophism, the resolution/reduction of symptoms, and the histological features of the vulvar skin after treatment. The secondary outcome was to evaluate the improvement in life quality, and in resumption and quality of sexual life. METHODS. Between 2011 and 2014, 36 patients were offered fat grafting to treat LS. Inclusion criteria were age between 25 and 80 years, histopathologic diagnosis of LS, good health, failure of previous first line treatments. RESULTS. 34 out of 36 patients (94%) showed a better vulvar trophismof the skin and mucosae; 27 (75%) had an improvement in caliber and elasticity of the vaginal introitus; clitoris burying degree was reduced in 18 patients (50%), 30 (83%) reported an increased volume of labia major a and minor a, 34 (94%) had a complete disappearance of scratching lesions, and 28 (78%) showed a remission of white lesions. Eventually 34 patients (95%) stopped using topical corticosteroids routinely. The improvement in life quality was significant for both DLQI (p b 0001) and FSFI (p b 0001). CONCLUSIONS. Fat grafting may have a role as a support and completion treatment in selected cases of women with vulvar LS who do not respond to first line therapy or in severe cases where the anatomical impairment does not allow a regular sexual function and a good quality of life. PMID:26499935

  8. 3D multislice CT angiography in post-aortic stent grafting: a pictorial essay.

    PubMed

    Sun, Zhonghua

    2006-01-01

    Helical CT angiography has been widely used in both pre- and post-aortic stent grafting and it has been confirmed to be the preferred modality when compared to conventional angiography. The recent development of multislice CT (MSCT) has further enhanced the applications of CT angiography for aortic stent grafting. One of the advantages of MSCT angiography over conventional angiography is that the 3D reconstructions, based on the volumetric CT data, provide additional information during follow-up of aortic stent grafting. While endovascular repair has been increasingly used in clinical practice, the use of 3D MSCT imaging in endovascular repair continues to play an important role. In this pictorial essay, we aimed to discuss the diagnostic performance of 3D MSCT angiography in post aortic stent grafting, including the most commonly used surface shaded display, curvilinear reformation, the maximum intensity projection, volume rendering and virtual endoscopy. The advantages and disadvantages of each 3D reconstruction are also explored.

  9. Treatment with mPEG-SPA improves the survival of corneal grafts in rats by immune camouflage.

    PubMed

    Wang, Shuangyong; Li, Liangliang; Liu, Ying; Li, Chaoyang; Zhang, Min; Wang, Bowen; Huang, Zheqian; Gao, Xinbo; Wang, Zhichong

    2015-03-01

    We investigated the immune camouflage effects of methoxy polyethylene glycol succinimidyl propionate (mPEG-SPA) on corneal antigens and explored a novel approach for reducing corneal antigenicity, thereby decreasing corneal graft rejection. Importantly, this approach did not alter normal local immunity. Corneal grafts were treated with mPEG-SPA 5KD or 20KD (3% W/V), which could shield major histocompatibility antigen class I molecules (RT1-A) of corneal grafts. Skin grafts of Wistar rats were transplanted to SD rats. Then the splenic lymphocytes were isolated from SD rats. Subsequently, the lymphocytes were co-cultured with autologous corneal grafts or untreated corneal grafts and PEGylated grafts treated with mPEG-SPA 5KD or 20KD obtained from the counterpart skin donors, which were used as autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group, respectively. Lymphocyte proliferation was lower in mPEG-SPA 5KD group and mPEG-SPA 20KD group than in the allogeneic control. SD rats with corneal neovascularisation were used as recipients for high-risk corneal transplantation and were randomly divided into four groups: autologous control, allogeneic control, mPEG-SPA 5KD group and mPEG-SPA 20KD group. The recipients received corneal grafts from Wistar rats. Corneal graft survival was prolonged and graft rejection was reduced in the mPEG-SPA 5KD group and the mPEG-SPA 20KD group compared to the allogeneic control. Thus, we think that mPEG-SPA could immunologically camouflage corneal antigens to prolong corneal grafts survival in high-risk transplantation.

  10. The application of intraoperative transit time flow measurement to accurately assess anastomotic quality in sequential vein grafting

    PubMed Central

    Yu, Yang; Zhang, Fan; Gao, Ming-Xin; Li, Hai-Tao; Li, Jing-Xing; Song, Wei; Huang, Xin-Sheng; Gu, Cheng-Xiong

    2013-01-01

    OBJECTIVES Intraoperative transit time flow measurement (TTFM) is widely used to assess anastomotic quality in coronary artery bypass grafting (CABG). However, in sequential vein grafting, the flow characteristics collected by the conventional TTFM method are usually associated with total graft flow and might not accurately indicate the quality of every distal anastomosis in a sequential graft. The purpose of our study was to examine a new TTFM method that could assess the quality of each distal anastomosis in a sequential graft more reliably than the conventional TTFM approach. METHODS Two TTFM methods were tested in 84 patients who underwent sequential saphenous off-pump CABG in Beijing An Zhen Hospital between April and August 2012. In the conventional TTFM method, normal blood flow in the sequential graft was maintained during the measurement, and the flow probe was placed a few centimetres above the anastomosis to be evaluated. In the new method, blood flow in the sequential graft was temporarily reduced during the measurement by placing an atraumatic bulldog clamp at the graft a few centimetres distal to the anastomosis to be evaluated, while the position of the flow probe remained the same as in the conventional method. This new TTFM method was named the flow reduction TTFM. Graft flow parameters measured by both methods were compared. RESULTS Compared with the conventional TTFM, the flow reduction TTFM resulted in significantly lower mean graft blood flow (P < 0.05); in contrast, yielded significantly higher pulsatility index (P < 0.05). Diastolic filling was not significantly different between the two methods and was >50% in both cases. Interestingly, the flow reduction TTFM identified two defective middle distal anastomoses that the conventional TTFM failed to detect. Graft flows near the defective distal anastomoses were improved substantially after revision. CONCLUSIONS In this study, we found that temporary reduction of graft flow during TTFM seemed to

  11. Antibiotic therapy of aortic graft infection: treatment and prevention recommendations.

    PubMed

    Hodgkiss-Harlow, Kelley D; Bandyk, Dennis F

    2011-12-01

    Surgical site infection (SSI) after aortic intervention, an uncommon but serious vascular condition, requires patient-specific antibiotic therapy. Effective treatment and prevention requires the vascular surgeon to be cognizant of changing SSI microbiology, advances in antibiotic delivery, and patient characteristics. The majority of aortic graft infections are caused by Gram-positive bacteria, with methicillin-resistant Staphylococcus aureus now the prevalent pathogen. Nasal carriage of methicillin-sensitive or methicillin-resistant S aureus strains, diabetes mellitus, recent hospitalization, a failed arterial reconstruction, and the presence of a groin incision are important SSI risk factors. Overall, the aortic SSI rate is higher than predicted by the Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance risk category system; ranging from 5% after open or endovascular aortic interventions to as high as 10% to 15% after aortofemoral bypass or uni-aortoiliac grafting with femorofemoral bypass. Perioperative measures to reduce S aureus nares and skin colonization, administration of antibiotic prophylaxis, meticulous wound closure/care, and therapy directed to optimize patient host defense regulation mechanisms (eg, temperature, oxygenation, blood sugar) can minimize SSI occurrence. Antibiotic therapy for aortic graft infection should utilize bactericidal drugs that penetrate bacteria biofilms and can be delivered to the surgical site both parenterally and locally in the form of antibiotic-impregnated beads or prosthetic grafts.

  12. Are Aortic Stent Grafts Safe in Pregnancy?

    PubMed Central

    Khandanpour, Nader; Mehta, Tapan A.; Adiseshiah, M.; Meyer, Felicity J.

    2015-01-01

    Aortic stent grafts are increasingly used to treat aortic aneurysms and also other aortic pathologies. The safety of aortic stent grafts in pregnancy has never been studied or reported. We report on two cases of aortic stent grafts in pregnant women and discuss the effect of pregnancy on these aortic stent grafts. PMID:26229702

  13. Progress and opportunities for tissue-engineered skin

    NASA Astrophysics Data System (ADS)

    MacNeil, Sheila

    2007-02-01

    Tissue-engineered skin is now a reality. For patients with extensive full-thickness burns, laboratory expansion of skin cells to achieve barrier function can make the difference between life and death, and it was this acute need that drove the initiation of tissue engineering in the 1980s. A much larger group of patients have ulcers resistant to conventional healing, and treatments using cultured skin cells have been devised to restart the wound-healing process. In the laboratory, the use of tissue-engineered skin provides insight into the behaviour of skin cells in healthy skin and in diseases such as vitiligo, melanoma, psoriasis and blistering disorders.

  14. Fat Grafting for Facial Filling and Regeneration.

    PubMed

    Coleman, Sydney R; Katzel, Evan B

    2015-07-01

    Plastic surgeons have come to realize that fat grafting can rejuvenate an aging face by restoring or creating fullness. However, fat grafting does much more than simply add volume. Grafted fat can transform or repair the tissues into which it is placed. Historically, surgeons have hesitated to embrace the rejuvenating potential of fat grafting because of poor graft take, fat necrosis, and inconsistent outcomes. This article describes fat grafting techniques and practices to assist readers in successful harvesting, processing, and placement of fat for optimal graft retention and facial esthetic outcomes.

  15. Computational fluid dynamics evaluation of the cross-limb stent graft configuration for endovascular aneurysm repair.

    PubMed

    Shek, Tina L T; Tse, Leonard W; Nabovati, Aydin; Amon, Cristina H

    2012-12-01

    The technique of crossing the limbs of bifurcated modular stent grafts for endovascular aneurysm repair (EVAR) is often employed in the face of splayed aortic bifurcations to facilitate cannulation and prevent device kinking. However, little has been reported about the implications of cross-limb EVAR, especially in comparison to conventional EVAR. Previous computational fluid dynamics studies of conventional EVAR grafts have mostly utilized simplified planar stent graft geometries. We herein examined the differences between conventional and cross-limb EVAR by comparing their hemodynamic flow fields (i.e., in the "direct" and "cross" configurations, respectively). We also added a "planar" configuration, which is commonly found in the literature, to identify how well this configuration compares to out-of-plane stent graft configurations from a hemodynamic perspective. A representative patient's cross-limb stent graft geometry was segmented using computed tomography imaging in Mimics software. The cross-limb graft geometry was used to build its direct and planar counterparts in SolidWorks. Physiologic velocity and mass flow boundary conditions and blood properties were implemented for steady-state and pulsatile transient simulations in ANSYS CFX. Displacement forces, wall shear stress (WSS), and oscillatory shear index (OSI) were all comparable between the direct and cross configurations, whereas the planar geometry yielded very different predictions of hemodynamics compared to the out-of-plane stent graft configurations, particularly for displacement forces. This single-patient study suggests that the short-term hemodynamics involved in crossing the limbs is as safe as conventional EVAR. Higher helicity and improved WSS distribution of the cross-limb configuration suggest improved flow-related thrombosis resistance in the short term. However, there may be long-term fatigue implications to stent graft use in the cross configuration when compared to the direct

  16. Use of overlapping buccal mucosa graft urethroplasty for complex anterior urethral strictures

    PubMed Central

    2015-01-01

    Complex anterior urethral stricture disease typically manifests as a symptomatic, severely narrowed, long stricture (or multiple strictures) in which conventional excision and/or augmentation is not feasible. Overlapping buccal mucosal graft urethroplasty (OBMGU) is an innovative hybrid technique, combining the well-established principles of dorsal and ventral graft augmentation to allow single stage reconstruction of complex anterior urethral strictures. In this review, we discuss the rationale, techniques, and outcomes of OBMGU for complex anterior urethral strictures. PMID:26813234

  17. Overexpression of vascular endothelial growth factor accelerates early vascularization and improves healing of genetically modified cultured skin substitutes.

    PubMed

    Supp, Dorothy M; Boyce, Steven T

    2002-01-01

    Cultured skin substitutes (CSS) lack a vascular plexus, leading to slower vascularization after grafting than split-thickness skin autograft. CSS containing keratinocytes genetically modified to overexpress vascular endothelial growth factor (VEGF) were previously shown to exhibit enhanced vascularization up to 2 weeks after grafting to athymic mice. The present study examines whether enhanced vascularization compared with controls persists after stable engraftment is achieved and analyzes VEGF expression, wound contraction, and engraftment. Control and VEGF-modified (VEGF+) CSS were grafted onto full-thickness wounds in athymic mice. VEGF expression was detected in VEGF+ CSS 14 weeks after grafting. Graft contraction was significantly lower in VEGF+ CSS compared with controls, suggesting more stable engraftment and better tissue development. Positive HLA-ABC staining, indicating persistence of human cells, was seen in 86.7% (13/15) of grafted VEGF+ CSS, compared with 58.3% (7/12) of controls. Differences in dermal vascularization between control and VEGF+ grafts were significant 1 week after surgery, but not at later times. However, the distribution of vessels was different, with more vessels in the upper dermis of VEGF+ grafts. These results suggest that VEGF overexpression in genetically modified CSS acts to accelerate early graft vascularization and can contribute to improved healing of full-thickness skin wounds.

  18. Behavior of grafted polymers on nanofillers and their influence on polymer nanocomposite properties

    NASA Astrophysics Data System (ADS)

    Dukes, Douglas Michael

    Polymer nanocomposites continue to receive wide-spread acclaim for their potential to improve composite materials beyond conventional macroscale fillers. The improvement lies both in the altered properties of the particle itself and in the interaction region surrounding the filler. As the surface area of the filler increases, a greater volume fraction of this interphase region is present in the composite. However, simply minimizing the particle size to maximize surface area introduces additional problems; the larger specific surface area promotes aggregation to reduce the surface energy. Since the composite's properties are largely tied to the morphology, aggregation prevents control over the dispersion state of the filler, and thus the properties. Therefore, disaggregation and morphology control are vital to achieving designable nanocomposites. To accomplish both tasks, this thesis focuses on the behavior of grafted polymer coatings on nanoparticles and their in uence on the macroscopic properties. Grafted chains play an integral role in both morphology control and reinforcement. To investigate the behavior of polymer brushes on nanoparticles, polystyrene was grafted on 15 nm silica particles at varying graft densities and molecular weights. Dynamic light scattering studies in dilute solution were performed to obtain the brush height as a function of both graft density and molecular weight. Three distinct regimes of behavior exist, the "mushroom", the semi-dilute polymer brush (SDPB), and the concentrated polymer brush (CPB) regimes. In the CPB regime, which is an extraordinary configuration of highly-stretched chains on densely grafted surfaces, the brush height h was found to scale as h ∝ N4/5, where N is the degree of polymerization. This result is contrary to the observed scaling of the CPB in flat interface systems, where h ∝ N1. To explore the behavior of grafted chains in the melt, molecular dynamics simulations were performed on grafted nanoparticles

  19. Off-Pump Coronary Artery Bypass Grafting and Transaortic Transcatheter Aortic Valve Replacement.

    PubMed

    Dellis, Sophia L; Akujuo, Adanna C; Bennett, Edward V; Britton, Lewis W

    2016-07-01

    We sought to demonstrate the effectiveness of off-pump coronary artery bypass grafting and transcatheter aortic valve replacement in two patients with porcelain aortas and lesions that could not be optimally treated with percutaneous coronary intervention. Patients with aortic stenosis and coronary artery disease who are too high-risk for conventional surgical aortic valve replacement and coronary artery bypass grafting due to comorbidities and porcelain aorta, and who do not have the appropriate anatomy for percutaneous coronary intervention should be considered for concomitant transcatheter aortic valve replacement and off-pump coronary artery bypass grafting. doi: 10.1111/jocs.12762 (J Card Surg 2016;31:435-438). PMID:27196956

  20. Skin Keratins.

    PubMed

    Wang, Fengrong; Zieman, Abigail; Coulombe, Pierre A

    2016-01-01

    Keratins comprise the type I and type II intermediate filament-forming proteins and occur primarily in epithelial cells. They are encoded by 54 evolutionarily conserved genes (28 type I, 26 type II) and regulated in a pairwise and tissue type-, differentiation-, and context-dependent manner. Keratins serve multiple homeostatic and stress-enhanced mechanical and nonmechanical functions in epithelia, including the maintenance of cellular integrity, regulation of cell growth and migration, and protection from apoptosis. These functions are tightly regulated by posttranslational modifications as well as keratin-associated proteins. Genetically determined alterations in keratin-coding sequences underlie highly penetrant and rare disorders whose pathophysiology reflects cell fragility and/or altered tissue homeostasis. Moreover, keratin mutation or misregulation represents risk factors or genetic modifiers for several acute and chronic diseases. This chapter focuses on keratins that are expressed in skin epithelia, and details a number of basic protocols and assays that have proven useful for analyses being carried out in skin.

  1. Skin Keratins

    PubMed Central

    Wang, Fengrong; Zieman, Abigail; Coulombe, Pierre A.

    2016-01-01

    Keratins comprise the type I and type II intermediate filament-forming proteins and occur primarily in epithelial cells. They are encoded by 54 evolutionarily conserved genes (28 type I, 26 type II) and regulated in a pairwise and tissue type-, differentiation-, and context-dependent manner. Keratins serve multiple homeostatic and stress-enhanced mechanical and nonmechanical functions in epithelia, including the maintenance of cellular integrity, regulation of cell growth and migration, and protection from apoptosis. These functions are tightly regulated by posttranslational modifications as well as keratin-associated proteins. Genetically determined alterations in keratin-coding sequences underlie highly penetrant and rare disorders whose pathophysiology reflects cell fragility and/or altered tissue homeostasis. Moreover, keratin mutation or misregulation represents risk factors or genetic modifiers for several acute and chronic diseases. This chapter focuses on keratins that are expressed in skin epithelia, and details a number of basic protocols and assays that have proven useful for analyses being carried out in skin. PMID:26795476

  2. Functional analysis of keratinocytes in skin color using a human skin substitute model composed of cells derived from different skin pigmentation types.

    PubMed

    Yoshida, Yasuko; Hachiya, Akira; Sriwiriyanont, Penkanok; Ohuchi, Atsushi; Kitahara, Takashi; Takema, Yoshinori; Visscher, Marty O; Boissy, Raymond E

    2007-09-01

    Skin color is one of the most distinct features in the human race. To assess the mechanisms of skin color variation, human skin substitutes (HSS) were constructed by grafting mixtures of cultured keratinocytes and melanocytes from a combination of donor skin types, together with light skin derived fibroblasts, into chambers inserted onto the back skin of severe combined immunodeficient (SCID) mice. The resulting complexion coloration of the HSS was relatively darker and lighter when dark and light skin derived keratinocytes, respectively, were combined with melanocytes derived from either light or dark skin. The melanin content in the epidermis and the maturation stage of melanosomes in basal keratinocytes were significantly increased in the HSS composed of dark compared to light skin derived keratinocytes. In addition, the ratio of individual/clustered melanosomes in recipient keratinocytes was increased in the former as opposed to the latter HSS. The genetic expression of endothelin-1, proopiomelanocortin, microphthalmia-associated transcription factor, tyrosinase, GP100, and MART1 were increased in HSS composed of dark vs. light skin derived keratinocytes. These data suggest that our HSS is a promising melanogenic model that demonstrates the role of the keratinocyte in regulating in part both melanogenesis and distribution of transferred melanosomes.

  3. Research Techniques Made Simple: Skin Carcinogenesis Models: Xenotransplantation Techniques.

    PubMed

    Mollo, Maria Rosaria; Antonini, Dario; Cirillo, Luisa; Missero, Caterina

    2016-02-01

    Xenotransplantation is a widely used technique to test the tumorigenic potential of human cells in vivo using immunodeficient mice. Here we describe basic technologies and recent advances in xenotransplantation applied to study squamous cell carcinomas (SCCs) of the skin. SCC cells isolated from tumors can either be cultured to generate a cell line or injected directly into mice. Several immunodeficient mouse models are available for selection based on the experimental design and the type of tumorigenicity assay. Subcutaneous injection is the most widely used technique for xenotransplantation because it involves a simple procedure allowing the use of a large number of cells, although it may not mimic the original tumor environment. SCC cell injections at the epidermal-to-dermal junction or grafting of organotypic cultures containing human stroma have also been used to more closely resemble the tumor environment. Mixing of SCC cells with cancer-associated fibroblasts can allow the study of their interaction and reciprocal influence, which can be followed in real time by intradermal ear injection using conventional fluorescent microscopy. In this article, we will review recent advances in xenotransplantation technologies applied to study behavior of SCC cells and their interaction with the tumor environment in vivo.

  4. Bone Grafting the Cleft Maxilla

    MedlinePlus

    ... amount of bone from one place (usually the hip, head, ribs, or leg) and placing it in ... adjacent teeth into the bone graft; 2) prosthetic replacement (dental bridge); or 3) dental metallic bone implants. ...

  5. Bovine Dermal Matrix as Coverage of Facial Nerve Grafts

    PubMed Central

    Kappos, E. A.; Engels, P. E.; Wettstein, R.; Schaefer, D. J.; Kalbermatten, D. F.

    2014-01-01

    Introduction. Soft tissue defects over functional structures represent a challenge for the reconstructive surgeon. Often complex, reconstructive procedures are required. Occasionally, elderly or sick patients do not qualify for these extensive procedures. Case. We present the case of a 91-year-old lady with large hemifacial defect with exposed bone and nerves after tumor resection. We first performed radical resection including the fascia of the temporalis muscle and the frontal branch of the facial nerve. Due to the moribund elderly patient with a potentially high perioperative risk, we decided against flap reconstruction but to use bovine collagen/elastin matrix and split thickness skin graft. Results. No postoperative complications occurred and STSG and matrix healed uneventfully. Discussion. In selected cases, where complex reconstruction is not appropriate, this procedure can be a safe, easy, and fast alternative for covering soft tissue defects even on wound grounds containing nerve grafts. PMID:24550990

  6. Lichenoid Variant of Chronic Cutaneous Graft Versus Host Reaction Post Blood Transfusion: A Rare Event Post Blood Transfusion

    PubMed Central

    Ramakrishnaiah, Pushpa Kodipalya; Lakshman, Archana; Aradhya, Sacchidanand Sarvajnamurthy; Veerabhadrappa, Nataraja Holavanahally

    2015-01-01

    Chronic graft versus host disease (GVHD) is a less frequently seen disease that occurs post solid organ or bone marrow transplantation. Chronic GVHD occurring post blood transfusion is an even more uncommon disease. It can present either as a lichenoid disease or as a sclerodermatous disease involving multiple systems. In this article, we report a case of chronic graft versus host reaction occurring in skin secondary to blood transfusion. PMID:26538747

  7. Extra corporeal shockwave lithotripsy resulting in skin burns--a report of two cases.

    PubMed

    Rao, Sandhya R; Ballesteros, Natalia; Short, Kerry L; Gathani, Krishna K; Ankem, Murali K

    2014-01-01

    Severe skin injury after extracorporeal shock wave lithotripsy (ESWL) is rare. We describe two patients who suffered full thickness skin burns following ESWL for renal calculi. One patient was treated conservatively and the other underwent debridement with skin grafting. We speculate that failure of the thermostatic mechanism of the lithotripter, leading to overheating of the water-filled cushion, resulted in this very rare adverse event. Proper preoperative patient counseling regarding the risk of serious burn injuries will help to avoid potential litigation.

  8. Nonallograft osteoconductive bone graft substitutes.

    PubMed

    Bucholz, Robert W

    2002-02-01

    An estimated 500,000 to 600,000 bone grafting procedures are done annually in the United States. Approximately (1/2) of these surgeries involve spinal arthrodesis whereas 35% to 40% are used for general orthopaedic applications. Synthetic bone graft substitutes currently represent only 10% of the bone graft market, but their share is increasing as experience and confidence in their use are accrued. Despite 15 to 20 years of clinical experience with various synthetic substitutes, there have been few welldesigned, controlled clinical trials of these implants. Synthetic bone graft substitutes consist of hydroxyapatite, tricalcium phosphate, calcium sulfate, or a combination of these minerals. Their fabrication technique, crystallinity, pore dimensions, mechanical properties, and resorption rate vary. All synthetic porous substitutes share numerous advantages over autografts and allografts including their unlimited supply, easy sterilization, and storage. However, the degree to which the substitute provides an osteoconductive structural framework or matrix for new bone ingrowth differs among implants. Disadvantages of ceramic implants include brittle handling properties, variable rates of resorption, poor performance in diaphyseal defects, and potentially adverse effects on normal bone remodeling. These inherent weaknesses have refocused their primary use to bone graft extenders and carriers for pharmaceuticals. The composition, histologic features, indications, and clinical experience of several of the synthetic bone graft substitutes approved for orthopaedic use in the United States are reviewed. PMID:11937865

  9. Bilateral internal thoracic artery grafting

    PubMed Central

    2013-01-01

    The effectiveness of the left internal mammary artery graft to the anterior descending coronary artery as a surgical strategy has been shown to improve the survival rate and decrease the risk of adverse cardiac events in patients undergoing coronary bypass surgery. These clinical benefits appear to be related to the superior short and long-term patency rates of the internal thoracic artery graft. Although the advantages of using of both internal thoracic arteries (ITA) for bypass grafting have taken longer to prove, recent results from multiple data sets now support these findings. The major advantage of bilateral ITA grafting appears to be improved survival rate, while the disadvantages of complex ITA grafting include the increased complexity of operation, and an increased risk of wound complications. While these short-term disadvantages have been mitigated in contemporary surgical practice, they have not eliminated. Bilateral ITA grafting should be considered the procedure of choice for patients undergoing coronary bypass surgery that have a predicted survival rate of longer than ten years. PMID:23977627

  10. Costal Grafting in Mandibular Reconstruction

    PubMed Central

    Bourlet, Jerôme; Château, Joseph; Jacquemart, Mathieu; Dufour, Clémence; Mojallal, Ali; Gleizal, Arnaud

    2015-01-01

    Background: Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery, and free fibular flap is the gold standard for this indication. However, there are alternatives; nonvascular bone grafting is one of them, and we present the costal grafting for mandibular reconstruction, a classic technique that is reliable, efficient, and produced less morbidity than the technique of using composite free flaps. Method: A 9-year retrospective review of 54 patients treated surgically for mandibular reconstruction was performed. The criterion mainly analyzed was graft survival. The surgical technique was described in detail. Results: A total of 54 patients with mandibular bone defect were identified. Five symphysis, 46 corpus, and 20 ramus defects were considered. These patients underwent reconstruction by costal grafting, and the engrafting was successful in 92.6% of cases. Dental rehabilitation with dental implants was realized in 70% of cases. Conclusions: The approach described in this article allowed the authors to obtain good results with costal grafting for mandibular reconstruction and dental rehabilitation. Costal grafting is a good alternative for fibula free flap in specific indications. Reconstruction of mandibular bone defect is a common indication in craniomaxillofacial surgery. Since the 1980s, the gold standard for these defects is the use of free fibular flap.1 In some cases, this technique is contradicted; the surgeon then has several possibilities for the use of free osteomyocutaneous flaps (iliac crest, scapula, and serrato-costal flaps).2–8 PMID:26893990

  11. Sterilization of skin allografts by ionizing radiation.

    PubMed

    Bourroul, Selma Cecília; Herson, Marisa Roma; Pino, Eddy; Matho, Monica Beatriz

    2002-11-01

    The skin has a fundamental role in the viability of human body. In the case of extensive wounds, skin allografts provide an alternative to cover temporarily the damaged areas. After donor screening and preservation in glycerol 85%, the skin can be stored in a Skin Bank. Glycerol at this concentration has a bacteriostatic effect after certain time of preservation. On the other hand, skin sterilization by ionizing radiation may reduce the quarentine period for transplantation in patients. The objective of this work was to evaluate allograft sterilization using two sources of ionizing radiation. Through the analysis of stress-strain, it was intended to verify possible effects of the radiation on the structure of preserved grafts. Three groups of skin samples were selected. The first group was maintained in the initial conditions, not irradiated. The second was exposed to cobalt-60, while the third one was irradiated using an Dynamitron Accelerator JOB188 electron beam. The irradiation dose was 25 kGy for both tests. Both irradiation sources, and the Instron Universal Machine used for biomechanical experiments, are installed at the Centro de Tecnologia das Radiações/Instituto de Pesquisas Energéticas e Nucleares (São Paulo, Brazil). According to the preliminary results, biomechanical characteristics of the samples irradiated seem to be maintained with regard to the non irradiated group.

  12. Tokamak coordinate conventions: COCOS

    NASA Astrophysics Data System (ADS)

    Sauter, O.; Medvedev, S. Yu.

    2013-02-01

    Dealing with electromagnetic fields, in particular current and related magnetic fields, yields "natural" physical vector relations in 3-D. However, when it comes to choosing local coordinate systems, the "usual" right-handed systems are not necessarily the best choices, which means that there are several options being chosen. In the magnetic fusion community such a difficulty exists for the choices of the cylindrical and of the toroidal coordinate systems. In addition many codes depend on knowledge of an equilibrium. In particular, the Grad-Shafranov axisymmetric equilibrium solution for tokamak plasmas, ψ, does not depend on the sign of the plasma current Ip nor that of the magnetic field B0. This often results in ill-defined conventions. Moreover the sign, amplitude and offset of ψ are of less importance, since the free sources in the equation depend on the normalized radial coordinate. The signs of the free sources, dp/dψ and dF2/dψ (p being the pressure, ψ the poloidal magnetic flux and F=RBφ), must be consistent to generate the current density profile. For example, RF and CD calculations (Radio Frequency heating and Current Drive) require an exact sign convention in order to calculate a co- or counter-CD component. It is shown that there are over 16 different coordinate conventions. This paper proposes a unique identifier, the COCOS convention, to distinguish between the 16 most-commonly used options. Given the present worldwide efforts towards code integration, the proposed new index COCOS defining uniquely the COordinate COnventionS required as input by a given code or module is particularly useful. As codes use different conventions, it is useful to allow different sign conventions for equilibrium code input and output, equilibrium being at the core of any calculations in magnetic fusion. Additionally, given two different COCOS conventions, it becomes simple to transform between them. The relevant transformations are described in detail.

  13. History of graft-versus-host disease.

    PubMed

    Vriesendorp, Huib M; Heidt, Peter J

    2016-08-01

    Nuclear warfare at the end of World War II inspired Dick W. van Bekkum to study total-body irradiation (TBI) in animal models. After high-dose TBI, mice died from "primary disease" or bone marrow (BM) aplasia. Intravenous administration of allogeneic BM cells delayed mortality but did not prevent it. Initially the delayed deaths were said to be caused by "secondary disease," which was later renamed graft-versus-host disease (GvHD). GvHD is caused by donor T lymphocytes that destroy recipient cells in skin, intestinal mucosa, bile ducts, and lymph nodes. GvHD is opposed by host-versus-graft disease (HvGD), in which host T lymphocytes destroy the administered allogeneic BM cells, including the administered T lymphocytes of the BM donor. In 1960, van Bekkum became the director of the Radiobiological Institute of the Dutch Organization for Applied Scientific Research TNO, Rijswijk, The Netherlands, where he built a multidisciplinary team that defined the variables controlling the outcome of a BM transplant. The team published their early results in the Journal of Experimental Hematology [1981;9:904-916 and 1956;4:482-488]. Later, protocols were established for BM transplantation (BMT) in patients with severe combined immunodeficiency disease, leukemia, lymphoma, and other diseases of the hematopoietic system. This review honors the scientific contributions made by Dick van Bekkum and his team in defining the four dominant variables for improving the therapeutic ratio of allogeneic BMT and in fostering the international collaboration necessary to translate this knowledge into current clinical practice. PMID:27235758

  14. Skin (Pressure) Sores

    MedlinePlus

    ... Topic Skin dryness Next Topic Sleep problems Skin (pressure) sores A skin or pressure sore develops when the blood supply to an ... is bedridden or always in a wheelchair puts pressure on the same places much of the time. ...

  15. Layers of the Skin

    MedlinePlus

    ... produce the skin coloring or pigment known as melanin, which gives skin its tan or brown color ... Sun exposure causes melanocytes to increase production of melanin in order to protect the skin from damaging ...

  16. Learning about Skin Cancer

    MedlinePlus

    ... have red or blond hair and blue or light-colored eyes - although anyone can get skin cancer. Skin cancer is related to lifetime exposure to UV radiation, therefore most skin cancers appear after age ...

  17. Scalded skin syndrome

    MedlinePlus

    Ritter disease; Staphylococcal scalded skin syndrome (SSS) ... Scalded skin syndrome (SSS) is caused by infection with certain strains of Staphylococcus bacteria. The bacteria produce a toxin that causes the skin ...

  18. Skin Cancer Treatment

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  19. Stages of Skin Cancer

    MedlinePlus

    ... Skin Cancer Skin color and being exposed to sunlight can increase the risk of nonmelanoma skin cancer ... carcinoma include the following: Being exposed to natural sunlight or artificial sunlight (such as from tanning beds) ...

  20. Dry Skin (Xerosis)

    MedlinePlus

    ... skin, which may bleed if severe. Chapped or cracked lips. When dry skin cracks, germs can get ... cause the skin to become dry, raw, and cracked. Swimming : Some pools have high levels of chlorine, ...

  1. Basal cell skin cancer

    MedlinePlus

    ... occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. This type of skin ... skin cancer is to reduce your exposure to sunlight . Always use sunscreen: Apply sunscreen with sun protection ...

  2. Skin Cancer Foundation

    MedlinePlus

    ... Cancer Infographics Children For Your Eyes Clothing Shade Sunscreen Sunburn Seal of Recommendation Are You at Risk? ... Defense The Mini Skin Cancer Prevention Handbook A "Sunscreen Gene"? Skin Cancer Facts & Statistics The Skin Cancer ...

  3. Chronic graft versus host disease and nephrotic syndrome.

    PubMed

    Barbouch, Samia; Gaied, Hanene; Abdelghani, Khaoula Ben; Goucha, Rim; Lakhal, Amel; Torjemen, Lamia; Hamida, Fethi Ben; Abderrahim, Ezzedine; Maiz, Hedi Ben; Adel, Khedher

    2014-09-01

    Disturbed kidney function is a common complication after bone marrow transplantation. Recently, attention has been given to immune-mediated glomerular damage related to graft versus host disease (GVHD). We describe a 19-year-old woman who developed membranous glomerulonephritis after bone marrow transplantation (BMT). Six months later, she developed soft palate, skin and liver lesions considered to be chronic GVHD. Fifteen months after undergoing BMT, this patient presented with nephrotic syndrome. A renal biopsy showed membranous glomerulonephritis associated with a focal segmental glomerulosclerosis. She was started on corticosteroid treatment with good outcome. PMID:25193909

  4. Chronic graft versus host disease and nephrotic syndrome.

    PubMed

    Barbouch, Samia; Gaied, Hanene; Abdelghani, Khaoula Ben; Goucha, Rim; Lakhal, Amel; Torjemen, Lamia; Hamida, Fethi Ben; Abderrahim, Ezzedine; Maiz, Hedi Ben; Adel, Khedher

    2014-09-01

    Disturbed kidney function is a common complication after bone marrow transplantation. Recently, attention has been given to immune-mediated glomerular damage related to graft versus host disease (GVHD). We describe a 19-year-old woman who developed membranous glomerulonephritis after bone marrow transplantation (BMT). Six months later, she developed soft palate, skin and liver lesions considered to be chronic GVHD. Fifteen months after undergoing BMT, this patient presented with nephrotic syndrome. A renal biopsy showed membranous glomerulonephritis associated with a focal segmental glomerulosclerosis. She was started on corticosteroid treatment with good outcome.

  5. Interpretation of Conventional Mass

    NASA Astrophysics Data System (ADS)

    Lee, Sungjun; Kim, Kwang Pyo

    The conventional mass is not a precise physical quantity but useful virtual one in mass metrology. Because the precise level of conventional mass is related to the OIML class, it is necessary to check if the assignment of weight class is under control. The documents of OIML (International Organization of Legal Metrology) D 28 and R 111 describe the limitation of the quantity in real application. In this presentation, we are trying to interpret and review the concept of conventional mass, for example, by estimating buoyancy deviation and maximum permissible error, in weight calibrations in Korea. Note from Publisher: This article contains the abstract only.

  6. Bone graft substitute: allograft and xenograft.

    PubMed

    Shibuya, Naohiro; Jupiter, Daniel C

    2015-01-01

    Rapid bone graft incorporation for structural rigidity is essential. Early range of motion, exercise, and weight-bearing are keys to rehabilitation. Structural and nonstructural bone grafts add length, height, and volume to alter alignment, function, and appearance. Bone graft types include: corticocancellous autograft, allograft, xenograft, and synthetic graft. Autogenic grafts are harvested from the patient, less likely to be rejected, and more likely to be incorporated; however, harvesting adds a procedure and donor site complication is common. Allografts, xenografts, and synthetic grafts eliminate secondary procedures and donor site complications; however, rejection and slower incorporation can occur.

  7. Craniofacial Bone Grafting: Wolff's Law Revisited

    PubMed Central

    Oppenheimer, Adam J.; Tong, Lawrence; Buchman, Steven R.

    2008-01-01

    Bone grafts are used for the reconstruction of congenital and acquired deformities of the facial skeleton and, as such, comprise a vital component of the craniofacial surgeon's armamentarium. A thorough understanding of bone graft physiology and the factors that affect graft behavior is therefore essential in developing a more intelligent use of bone grafts in clinical practice. This article presents a review of the basic physiology of bone grafting along with a survey of pertinent concepts and current research. The factors responsible for bone graft survival are emphasized. PMID:22110789

  8. A novel gellan-PVA nanofibrous scaffold for skin tissue regeneration: Fabrication and characterization.

    PubMed

    Vashisth, Priya; Nikhil, Kumar; Roy, Partha; Pruthi, Parul A; Singh, Rajesh P; Pruthi, Vikas

    2016-01-20

    In this investigation, we have introduced novel electrospun gellan based nanofibers as a hydrophilic scaffolding material for skin tissue regeneration. These nanofibers were fabricated using a blend mixture of gellan with polyvinyl alcohol (PVA). PVA reduced the repulsive force of resulting solution and lead to formation of uniform fibers with improved nanostructure. Field emission scanning electron microscopy (FESEM) confirmed the average diameter of nanofibers down to 50 nm. The infrared spectra (IR), differential scanning calorimetry (DSC) and X-ray diffraction (XRD) analysis evaluated the crosslinking, thermal stability and highly crystalline nature of gellan-PVA nanofibers, respectively. Furthermore, the cell culture studies using human dermal fibroblast (3T3L1) cells established that these gellan based nanofibrous scaffold could induce improved cell adhesion and enhanced cell growth than conventionally proposed gellan based hydrogels and dry films. Importantly, the nanofibrous scaffold are biodegradable and could be potentially used as a temporary substrate/or biomedical graft to induce skin tissue regeneration. PMID:26572421

  9. Cincinnati; Our Convention City

    ERIC Educational Resources Information Center

    Borchin, Anna

    1970-01-01

    During Easter week, 1971, Cincinnati will be the hostess of the 50th anniversary convention of the Catholic Library Association. Items of historical interest concerning the city are briefly described. (NH)

  10. Excision and Fat Grafting of Nasal Tip Dermoid Cysts Through an Open Rhinoplasty Approach.

    PubMed

    Pierce, Charles A; Konofaos, Petros; Alvarez, Sonia; Wallace, Robert D

    2016-01-01

    Nasal tip dermoid cysts that are present in pediatric patients can be complicated by mass effect causing compression and distortion of underlying cartilaginous structures. The purpose of this report is to describe a single surgeon's technique and results of nasal tip dermoid cyst excision in pediatric patients through an open rhinoplasty approach followed by tip reconstruction and immediate fat grafting. A series of 3 pediatric patients presented with 1 to 1.5 cm nasal tip dermoid cysts that were causing distortion of the lower lateral cartilages. All 3 underwent excision of the cyst through an open rhinoplasty approach. The nasal tip was reconstructed with interdomal sutures and immediate fat grafting. Fat grafts were harvested from the abdominal wall and implanted in the nasal tip. The grafts filled the resulting dead space and were secured with the fibrin glue. The soft tissue was redraped, and the skin was closed. The final postoperative result, 2 years after surgical intervention, included a well-proportioned and appropriately shaped nasal tip without obvious incisional scars in all patients. The skin overlying the previously excised dermoid cyst was supple and healthy. Excision of nasal tip dermoid cysts in pediatric patients can be approached through an open rhinoplasty approach, tip reconstruction, and immediate fat grafting. This approach can provide assistance in correcting contour deformities and may help preserve an at-risk soft-tissue envelope. PMID:26681174

  11. Skin friction drag measurements by LDV.

    PubMed

    Mazumder, M K; Wanchoo, S; McLeod, P C; Ballard, G S; Mozumdar, S; Caraballo, N

    1981-08-15

    A laser Doppler velocimeter employing a microscope objective as the receiving lens has been developed for measuring fluid velocity inside the boundary layer flow field with a spatial resolution of 40 microm. The method was applied for direct measurement of aerodynamic skin friction drag from the measured velocity gradient at the wall. Experimental results obtained on skin friction and on velocity components in a turbulent boundary layer on a low speed wind tunnel showed good agreement with previously reported data using conventional instruments such as hot-wire anemometers and Preston tubes. The method thus provides a tool for measurement and control of skin friction on aerodynamic bodies without perturbing the flow field.

  12. Plant grafting: new mechanisms, evolutionary implications

    PubMed Central

    Goldschmidt, Eliezer E.

    2014-01-01

    Grafting, an old plant propagation practice, is still widely used with fruit trees and in recent decades also with vegetables. Taxonomic proximity is a general prerequisite for successful graft-take and long-term survival of the grafted, composite plant. However, the mechanisms underlying interspecific graft incompatibility are as yet insufficiently understood. Hormonal signals, auxin in particular, are believed to play an important role in the wound healing and vascular regeneration within the graft union zone. Incomplete and convoluted vascular connections impede the vital upward and downward whole plant transfer routes. Long-distance protein, mRNA and small RNA graft-transmissible signals currently emerge as novel mechanisms which regulate nutritional and developmental root/top relations and may play a pivotal role in grafting physiology. Grafting also has significant pathogenic projections. On one hand, stock to scion mechanical contact enables the spread of diseases, even without a complete graft union. But, on the other hand, grafting onto resistant rootstocks serves as a principal tool in the management of fruit tree plagues and vegetable soil-borne diseases. The ‘graft hybrid’ historic controversy has not yet been resolved. Recent evidence suggests that epigenetic modification of DNA-methylation patterns may account for certain graft-transformation phenomena. Root grafting is a wide spread natural phenomenon; both intraspecific and interspecific root grafts have been recorded. Root grafts have an evolutionary role in the survival of storm-hit forest stands as well as in the spread of devastating diseases. A more fundamental evolutionary role is hinted by recent findings that demonstrate plastid and nuclear genome transfer between distinct Nicotiana species in the graft union zone, within a tissue culture system. This has led to the formation of alloploid cells that, under laboratory conditions, gave rise to a novel, alloploid Nicotiana species

  13. Graft Diameter matters in Hamstring ACL reconstruction

    PubMed Central

    Clatworthy, Mark

    2016-01-01

    Objective: Recently techniques have been developed to increase graft diameter in hamstring ACL reconstruction with the hope to decrease graft failure. To date there is limited evidence to show that a smaller graft diameter results in a higher ACL failure rate. Method: The factors for failure in 1480 consecutive single surgeon hamstring ACL reconstructions were evaluated prospectively. Patients were followed for 2-15 years. A multivariate analysis was performed which looked at graft size, age, sex, time to surgery, meniscal integrity, meniscal repair and ACL graft placement to determine whether graft diameter matters in determining the failure of hamstring ACL reconstruction. Results: Graft diameters ranged from 6-10 mm. The mean graft diameter for all patients was 7.75 mm. 83 ACL reconstructions failed. The mean size of graft failures was 7.55 mm ACL reconstructions that failed had a significantly smaller hamstring graft diameter p=0.001. The Hazard Ratio for a smaller diameter graft is 0.517 p=<0.0001. For every 1 mm decrease in graft diameter there is a 48.3% higher chance of failure. The multivariate analysis showed a hazard ratio of 0.543 p=0.002. For every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure. Conclusion: Smaller diameter hamstring grafts do have a higher failure rate. Grafts ≤ 7.5 mm had twice the failure rate of grafts ≥8 mm using a multivariate analysis for every 1 mm decrease in graft diameter there is a 45.7% higher chance of failure.

  14. The effect of tail skin on the morphology and morphogenesis of limb regenerates in the red-backed salamander, Plethodon cinereus.

    PubMed

    Dinsmore, C E

    1982-10-01

    Tail skin cuffs have been grafted to the upper forelimb of red-backed salamanders in either normal or 180 degrees-rotated dorsoventral orientation. Subsequent amputation through the graft region resulted in arrested regeneration, distally deficient or typical four-digit regenerates. Distribution was not substantially influenced by graft orientation nor were there any supernumerary limbs induced by the axially dislocated tail skin on the limb stumps. Furthermore, regenerates bore no indication of tail-like structures other than large granular skin glands proximally. These data indicate that, unlike limb skin, tail skin is not morphogenetically active in the epimorphic process of limb regeneration. In addition, the species used in this study is a fin-less, round-tailed salamander. It is therefore suggested that the previously reported morphogenetic effects of tail skin on limb regeneration may be related to the presence of tail fins on the species studied.

  15. Inhibition of protein adsorption and cell adhesion on PNIPAAm-grafted polyurethane surface: effect of graft molecular weight.

    PubMed

    Zhao, Tieliang; Chen, Hong; Zheng, Jun; Yu, Qian; Wu, Zhaoqiang; Yuan, Lin

    2011-06-15

    In this work, the effect of molecular weight (MW) of surface grafted poly(N-isopropylacrylamide) (PNIPAAm) on protein adsorption and cell adhesion was investigated systematically. PNIPAAm-grafted polyurethane (PU) surfaces of varying graft MW were prepared via conventional radical polymerization. The MW was controlled by adjusting the monomer concentration. Fibrinogen (Fg) and human serum albumin (HSA) were selected as model proteins and their adsorption from phosphate-buffered saline (PBS, pH 7.4) and blood plasma at 37°C was measured using a radiolabeling method and immunoblot analysis respectively. It was found that in both media, as the MW increased, the adsorption of these two proteins decreased gradually reaching a plateau value at MW above 7.9×10(4). Compared to the unmodified PU, the surface grafted with PNIPAAm of MW 14.6×10(4) reduced the adsorption of Fg and HSA in PBS by 91% and 86%, respectively. Moreover, the surfaces with higher MW PNIPAAm showed minimal adhesion of L929 cells presumably due to the absence of cell-adhesive proteins on the surfaces. PMID:21093225

  16. Continuous pulse amplitude monitoring of infrainguinal bypass grafts in the first 24 postoperative hours.

    PubMed

    Blankensteijn, J D; Abbott, W M

    1996-07-01

    To evaluate continuous pulse amplitude monitoring (CPAM) as a method for early postoperative graft surveillance following infrainguinal bypass surgery, a prospective observational study was carried out in 34 consecutive infrainguinal bypass grafts. CPAM tracings were compared with pre- and postoperative pulse palpation, ankle/brachial index (ABI) measurements, and pulse volume recordings (PVR). The utility of each method was defined by its ability to demonstrate graft patency in the first 24 hours. Pulse palpation was considered a useful monitoring tool if a postoperative pedal pulse was found in the absence of palpable preoperative pulses. The ABI qualified in this respect if a postoperative increase of at least 0.25 could be demonstrated; for PVR tracings an increase of at least one category was required. The utility of CPAM was established by an increase of at least 5 mm compared to the preoperative values. There were no early graft failures. We were therefore unable to calculate the ability of the studies to predict graft failure. The percentages (95% confidence limits) for which pulse palpation, ABI, and PVR were found capable of demonstrating graft patency were 50% (range 34% to 66%), 53% (range 36% to 70%), and 71% (range 54% to 83%), respectively. CPAM appeared to be far superior to these three methods with a utility of 94% (range 81% to 98%; p < 0.05). Patient and operator acceptability of CPAM was high. Skin pressure problems are a potential risk if the CPAM probe is left attached to the skin for more than 24 hours. CPAM was a valuable and reliable means of monitoring infrainguinal vascular reconstructions. Apart from being inexpensive, continuous, objective, and simple, CPAM is noninvasive and painless. It is advisable to remove the probe 24 hours after surgery, when the most crucial period for graft monitoring has passed. PMID:8879395

  17. Costal Cartilage Grafts in Rhinoplasty.

    PubMed

    Fedok, Fred G

    2016-01-01

    Cartilage grafts are regularly used in rhinoplasty. Septal and auricular donor sites are commonly used. Many situations compel the surgeon to use other alternative donor sites, including revision rhinoplasty and trauma. Many patients have a small amount of native septal cartilage and are unable to provide adequate septal cartilage to be used for frequently performed rhinoplasty maneuvers. The rib cage provides an enormous reserve of costal cartilage that can be carved into a variety of necessary grafts. A description of the technique of harvesting costal cartilage, a review of complications and management, and illustrative cases examples are included. PMID:26616708

  18. Bacillary angiomatosis in an immunocompetent child with a grafted traumatic wound.

    PubMed

    Turgut, Mehmet; Alabaz, Derya; Karakaş, Mehmet; Kavak, Meric; Aksaray, Necmi; Alhan, Emre; Cevlik, Filiz; Tuncer, Ilhan

    2004-10-01

    Bacillary angiomatosis is an infectious disease which usually develops in immunocompromised patients. Contact with cats is implicated in its pathogenesis. We report a seven-year-old immunocompetent boy with bacillary angiomatosis without a history of direct contact with cats. The clinical diagnosis of bacillary angiomatosis was made following histopathological examination of a biopsy sample from the infected facial wound, in the vicinity of which angiomatous lesions had developed. Surprisingly, similar lesions also appeared at the donor site of the skin graft which was grafted on the facial wound. This case demonstrates that bacillary angiomatosis may also be seen in immunocompetent patients and that it may contaminate wounds without the intermediary of cats.

  19. The Use of Flaps and Grafts in the Treatment of Urethral Stricture Disease

    PubMed Central

    Wisenbaugh, Eric S.; Gelman, Joel

    2015-01-01

    The use of various grafts and flaps plays a critical role in the successful surgical management of urethral stricture disease. A thorough comprehension of relevant anatomy and principles of tissue transfer techniques are essential to understanding the appropriate use of grafts or flaps to optimize outcomes. We briefly review these principles and discuss which technique may be best suited for a given anterior urethral stricture, depending on the location and length of the stricture, the presence or absence of an intact corpus spongiosum, and the availability of adequate and healthy penile skin. PMID:26664357

  20. Complicated Skin and Skin Structure Infection After Erysipelas: Urgent Need for Antibiosis and Surgery.

    PubMed

    Wollina, Uwe; Langner, Dana; Heinig, Birgit; Schönlebe, Jacqueline; Nowak, Andreas

    2016-03-01

    Erysipelas are common soft tissue infections responding to first-line antibiosis. Because of factors of related to responsible bacteria and host, complications can occur that need extensive surgery in addition to intensified drug therapy. We report on a 65-year-old woman with leg ulcer who developed an absceding and necrotizing panniculitis of the affected leg complicating erysipelas. Escherichia coli and Pseudomonas aeruginosa were identified. Debridement and surgical removal of inflamed subcutaneous adipose tissue was decisive to interrupt the process. Wound bed preparation was realized by vacuum-assisted closure. Final wound closure was done by split-skin mesh graft. Complicated skin and skin structure infections need a combined approach of intensified antibiosis and surgery to save life.

  1. [Skin tumors in facial plastic surgery].

    PubMed

    Heppt, W

    2009-04-01

    As the incidence of facial skin tumors is rising, otorhinolaryngologists are becoming more and more involved in the field of facial plastic surgery. The most common tumor locations on the head are the sun-exposed areas such as the nose, forehead, cheek, and auricle. The most common histologic findings are actinic keratosis and basal cell carcinoma. In planning tumor resection and defect repair, many factors, including histology, size, and localization of the tumor as well as conditions of the adjacent skin, must be considered. The key to defect repair after tumor resection is to choose the most appropriate technique from a range of possibilities. Because of skin laxity, most small and midsize facial defects can be closed directly or with high-tension sutures under skin expansion. More extensive defects and those located in critical areas require pedicled flaps or free grafts transferring skin from adjacent or distant areas. In patients with recurrent or deeply infiltrative tumors, reconstructive procedures of the facial nerve, parotid duct, and lacrimal duct might be needed. This is also true for reconstruction of the anatomic framework of the eyelids, the nose, and the pinna. PMID:19347378

  2. Recanalization of an Occluded Infrainguinal Vein Graft Complicated by Graft Aneurysm

    SciTech Connect

    Kakani, Nirmal; Travis, Simon; Hancock, John

    2007-11-15

    The technique of subintimal angioplasty has been described for the recanalisation of native vessels after occlusion of infrainguinal vascular bypass grafts. We report a case in which an attempt at such treatment resulted in inadvertent but successful recanalisation of the occluded vein graft instead. This was complicated by graft perforation and subsequent graft aneurysm which was successfully treated with a covered stent.

  3. Rapid, facile microwave-assisted synthesis of xanthan gum grafted polyaniline for chemical sensor.

    PubMed

    Pandey, Sadanand; Ramontja, James

    2016-08-01

    Grafting method, through microwave radiation procedure is extremely productive in terms of time consumption, cost effectiveness and environmental friendliness. In this study, conductive and thermally stable composite (mwXG-g-PANi) was synthesized by grafting of aniline (ANi) on to xanthan gum (XG) using catalytic weight of initiator, ammonium peroxydisulfate in the process of microwave irradiation in an aqueous medium. The synthesis of mwXG-g-PANi were confirm by FTIR, XRD, TGA, and SEM. The influence of altering the microwave power, exposure time of microwave, concentration of monomer and the amount of initiator of graft polymerization were studied over the grafting parameters, for example, grafting percentage (%G) and grafting efficiency (%E). The maximum %G and %E achieved was 172 and 74.13 respectively. The outcome demonstrates that the microwave irradiation strategy can increase the reaction rate by 72 times over the conventional method. Electrical conductivity of XG and mwXG-g-PANi composite film was performed. The fabricated grafted sample film were then examined for the chemical sensor. The mwXG-g-PANi, effectively integrated and handled, are NH3 sensitive and exhibit a rapid sensing in presence of NH3 vapor. Chemiresistive NH3 sensors with superior room temperature sensing performance were produced with sensor response of 905 at 1ppb and 90% recovery within few second. PMID:27118045

  4. Primary Breast Augmentation with Fat Grafting.

    PubMed

    Coleman, Sydney R; Saboeiro, Alesia P

    2015-07-01

    The controversy over fat grafting to the breasts has now been settled. In 2009, the American Society of Plastic Surgeons Fat Graft Task Force stated that "Fat grafting may be considered for breast augmentation and correction of defects associated with medical conditions and previous breast surgeries; however, results are dependent on technique and surgeon expertise." This article discusses the history, indications, planning, complications, and present technique of fat grafting to the breast using the Coleman technique.

  5. Enhanced vascularization of cultured skin substitutes genetically modified to overexpress vascular endothelial growth factor.

    PubMed

    Supp, D M; Supp, A P; Bell, S M; Boyce, S T

    2000-01-01

    Cultured skin substitutes have been used as adjunctive therapies in the treatment of burns and chronic wounds, but they are limited by lack of a vascular plexus. This deficiency leads to greater time for vascularization compared with native skin autografts and contributes to graft failure. Genetic modification of cultured skin substitutes to enhance vascularization could hypothetically lead to improved wound healing. To address this hypothesis, human keratinocytes were genetically modified by transduction with a replication incompetent retrovirus to overexpress vascular endothelial growth factor, a specific and potent mitogen for endothelial cells. Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates inoculated with human fibroblasts and either vascular endothelial growth factor-modified or control keratinocytes were prepared, and were cultured in vitro for 21 d. Northern blot analysis demonstrated enhanced expression of vascular endothelial growth factor mRNA in genetically modified keratinocytes and in cultured skin substitutes prepared with modified cells. Furthermore, the vascular endothelial growth factor-modified cultured skin substitutes secreted greatly elevated levels of vascular endothelial growth factor protein throughout the entire culture period. The bioactivity of vascular endothelial growth factor protein secreted by the genetically modified cultured skin substitutes was demonstrated using a microvascular endothelial cell growth assay. Vascular endothelial growth factor-modified and control cultured skin substitutes were grafted to full-thickness wounds on athymic mice, and elevated vascular endothelial growth factor mRNA expression was detected in the modified grafts for at least 2 wk after surgery. Vascular endothelial growth factor-modified grafts exhibited increased numbers of dermal blood vessels and decreased time to vascularization compared with controls. These results indicate that genetic modification of

  6. Allergy testing - skin

    MedlinePlus

    Patch tests - allergy; Scratch tests - allergy; Skin tests - allergy; RAST test ... There are three common methods of allergy skin testing. The skin prick test involves: Placing a small amount of substances that may be causing your symptoms on the skin, most often ...

  7. Comparative assessment of cultured skin substitutes and native skin autograft for treatment of full-thickness burns.

    PubMed Central

    Boyce, S T; Goretsky, M J; Greenhalgh, D G; Kagan, R J; Rieman, M T; Warden, G D

    1995-01-01

    OBJECTIVE: Comparison of cultured skin substitutes (CSSs) and split-thickness autograft (STAG) was performed to assess whether the requirement for autologous skin grafts may be reduced in the treatment of massive burns. SUMMARY BACKGROUND DATA: Cultured skin substitutes consisting of collagen-glycosaminoglycan substrates populated with autologous fibroblasts and keratinocytes have been demonstrated to close full-thickness skin wounds in athymic mice and to express normal skin antigens after closure of excised wounds in burn patients. METHODS: Data were collected from 17 patients between days 2 and 14 to determine incidence of exudate, incidence of regrafting, coloration, keratinization, and percentage of site covered by graft (n = 17). Outcome was evaluated on an ordinal scale (0 = worst; 10 = best) beginning at day 14, with primary analyses at 28 days (n = 10) and 1 year (n = 4) for erythema, pigmentation, epithelial blistering, surface roughness, skin suppleness, and raised scar. RESULTS: Sites treated with CSSs had increased incidence of exudate (p = 0.06) and decreased percentage of engraftment (p < 0.05) compared with STAG. Outcome parameters during the first year showed no differences in erythema, blistering, or suppleness. Pigmentation was greater, scar was less raised, but regrafting was more frequent in CSS sites than STAG. No differences in qualitative outcomes were found after 1 year, and antibodies to bovine collagen were not detected in patient sera. CONCLUSIONS: These results suggest that outcome of engrafted CSSs is not different from STAG and that increased incidence of regrafting is related to decreased percentage of initial engraftment. Increased rates of engraftment of CSSs may lead to improved outcome for closure of burn wounds, allow greater availability of materials for grafting, and reduce requirements for donor skin autograft. Images Figure 1. Figure 2. PMID:8526581

  8. Organosiloxane-grafted natural polymer coatings

    DOEpatents

    Sugama, Toshifumi

    1998-01-01

    A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation.

  9. New variant for whole pancreas grafting

    SciTech Connect

    Kootstra, G.; van Hooff, J.P.; Joerning, P.J.L.; Leunissen, K.M.; van der Linden, C.J.; Beukers, E.; Buurman, W.A.

    1987-02-01

    A new variant for whole pancreas grafting is described in which a segment of the duodenum and the spleen is included in the graft. The graft is placed extraperitoneally as in kidney transplantation. The exocrine drainage is with side-to-side anastomosis between duodenum and bladder. The spleen is irradiated to prevent the occurrence of GVHD, as is reported in splenic transplantation.

  10. Convents as homes.

    PubMed

    Arias, Enrique Alberto

    2005-01-01

    The present article discusses convents as homes. Resulting from the study of a Gregorian source presently housed at DePaul University's Richardson library, this article probes the complexities and restrictions of convent life in 17th century Spain. The Sanctoral de Visperas (1653) functions as a backdrop for a consideration of how singing chant and attendant rituals enriched the lives of nuns. Also included are references to nuns from this period who were outstanding musicians and poets and whose works have recently received enthusiastic attention. PMID:16556588

  11. Convents as homes.

    PubMed

    Arias, Enrique Alberto

    2005-01-01

    The present article discusses convents as homes. Resulting from the study of a Gregorian source presently housed at DePaul University's Richardson library, this article probes the complexities and restrictions of convent life in 17th century Spain. The Sanctoral de Visperas (1653) functions as a backdrop for a consideration of how singing chant and attendant rituals enriched the lives of nuns. Also included are references to nuns from this period who were outstanding musicians and poets and whose works have recently received enthusiastic attention.

  12. The Right Gastroepiploic Artery Graft for Coronary Artery Bypass Grafting: A 30-Year Experience

    PubMed Central

    Suma, Hisayoshi

    2016-01-01

    Throughout its 30-year history, the right gastroepiploic artery (GEA) has been useful for in situ grafts in coronary artery bypass grafting (CABG). The early graft patency rate is high, and the late patency rate has improved by using the skeletonized GEA graft and proper target selection, which involves having a target coronary artery with a tight >90% stenosis. Total arterial revascularization with the internal thoracic artery and GEA grafts is an option for achieving better outcomes from CABG procedures. PMID:27525230

  13. The Turkish delight: a pliable graft for rhinoplasty.

    PubMed

    Erol, O O

    2000-05-01

    In nose surgery, carved or crushed cartilage used as a graft has some disadvantages, chiefly that it may be perceptible through the nasal skin after tissue resolution is complete. To overcome these problems and to obtain a smoother surface, the authors initiated the use of Surgicel-wrapped diced cartilage. This innovative technique has been used by the authors on 2365 patients over the past 10 years: in 165 patients with traumatic nasal deformity, in 350 patients with postrhinoplasty deformity, and in 1850 patients during primary rhinoplasty. The highlights of the surgical procedure include harvested cartilage (septal, alar, conchal, and sometimes costal) cut in pieces of 0.5 to 1 mm using a no. 11 blade. The fine-textured cartilage mass is then wrapped in one layer of Surgicel and moistened with an antibiotic (rifamycin). The graft is then molded into a cylindrical form and inserted under the dorsal nasal skin. In the lateral wall and tip of the nose, some overcorrection is performed depending on the type of deformity. When the mucosal stitching is complete, this graft can be externally molded, like plasticine, under the dorsal skin. In cases of mild-to-moderate nasal depression, septal and conchal cartilages are used in the same manner to augment the nasal dorsum with consistently effective and durable results. In cases with more severe defects of the nose, costal cartilage is necessary to correct both the length of the nose and the projection of the columella. In patients with recurrent deviation of the nasal bridge, this technique provided a simple solution to the problem. After overexcision of the dorsal part of deviated septal cartilage and insertion of Surgicel-wrapped diced cartilage, a straight nose was obtained in all patients with no recurrence (follow-up of 1 to 10 years). The technique also proved to be highly effective in primary rhinoplasties to camouflage bone irregularities after hump removal in patients with thin nasal skin and/or in cases when

  14. Polyether-polyester graft copolymer

    NASA Technical Reports Server (NTRS)

    Bell, Vernon L. (Inventor)

    1987-01-01

    Described is a polyether graft polymer having improved solvent resistance and crystalline thermally reversible crosslinks. The copolymer is prepared by a novel process of anionic copolymerization. These polymers exhibit good solvent resistance and are well suited for aircraft parts. Previous aromatic polyethers, also known as polyphenylene oxides, have certain deficiencies which detract from their usefulness. These commercial polymers are often soluble in common solvents including the halocarbon and aromatic hydrocarbon types of paint thinners and removers. This limitation prevents the use of these polyethers in structural articles requiring frequent painting. In addition, the most popular commercially available polyether is a very high melting plastic. This makes it considerably more difficult to fabricate finished parts from this material. These problems are solved by providing an aromatic polyether graft copolymer with improved solvent resistance and crystalline thermally reversible crosslinks. The graft copolymer is formed by converting the carboxyl groups of a carboxylated polyphenylene oxide polymer to ionic carbonyl groups in a suitable solvent, reacting pivalolactone with the dissolved polymer, and adding acid to the solution to produce the graft copolymer.

  15. [The perfusate culture--bacteriologic monitoring of kidney grafts].

    PubMed

    Buchholz, B; Zastrow, F; Lison, A E; Ritzerfeld, W

    1985-01-01

    Since the kidney recipient's immune system is entirely suppressed, any bacterial contamination from a graft might be hazardous. Major statistics [1,3,4,5] reveal a mortality as high as 10% due to infectious and gastrointestinal complications. From July 1979 to December 1983 114 kidney grafts have been done in our center. After transplantation none of the patients died as a result of complications due to infection. Microbiologic examination of the perfusate is obligatory to detect contamination. It was used in 145 donor nephrectomies; 28% of the perfusate culture samples were positive: In 4 of 5 cases (81%) the bacteria isolated were of the non-pathogenic type seen in the normal flora of the skin (Staphylococcus epidermidis). Introduction of cover drapes lowered the positive culture rate to 8%. Isolation of S. epidermidis after desinfection of the skin (6x) with 70% spore-free alcohol is proof of the extraordinary sensitivity of the method used. The outstanding clinical importance of this method is the rapid information obtained on any contamination and the early suggestion concerning the first choice of antibiotic. Though E.coli and Pseudomonas aeruginosa were found in the culture, no clinical infection was seen under adequate antimicrobial therapy. Among 114 kidney transplantations in our center no patient died of bacterial infection. Our experience points out that the effect of general antibiotic prophylaxis is negligible. Instead, the effect of early application of antibiotics in accordance with the results of the perfusate culture is superior.

  16. FETAL RESPONSE TO ANTIGENIC STIMULUS. IV. REJECTION OF SKIN HOMOGRAFTS BY THE FETAL LAMB.

    PubMed

    SILVERSTEIN, A M; PRENDERGAST, R A; KRANER, K L

    1964-01-01

    The fetal lamb was found to reject orthotopic skin homografts applied at any time after the 77th day of gestation. Prior to this, grafts remained in place without stimulating any detectable immunologic response. Once the fetus achieves the ability to reject the graft, the process occurs with the same competence and rapidity as in the adult. Graft rejection in the fetal lamb is unaccompanied by formation of plasma cells or by the production of typical immunoglobulins, thus supporting the suggestion that circulating antibody does not play an obligatory role in the process.

  17. Convention Problems - 1787.

    ERIC Educational Resources Information Center

    Hanson, Deroy L.

    Designed to motivate eighth-grade civics students in the study of the United States Constitution, this game is intended to simulate the basic problems faced by the delegates to the Philadelphia Convention of 1787. The four parts of the game introduce the governmental concepts of the bicameral legislature, the executive branch, the judicial branch,…

  18. AB023. Penile augmentation surgery: characteristics of artificial graft material and preoperative preparation

    PubMed Central

    Lee, Woong Hee

    2015-01-01

    Penile augmentation surgical procedure includes diverse graft materials such as artificial collagen material as well as dermo-fat graft. Important factors of postoperative satisfaction are natural appearance of genitalia at the flaccid state and minimal resorption of graft volume. Artificial collagen materials and acellular dermal matrix are available for surgical procedure with variable size. History of penile augmentation surgery: Pediatric penile surgical procedure for lengthening and reconstructive surgery was developed as penile plastic surgical procedure combined with dermo-fat graft. In 1971, Kelly, Eraklis et al. reported preservation of dorsal neurovascular bundle and division of corporal crus from ischiopubic ramus for penile lengthening procedure. In 1974, Johnson reported the surgical cases in epispadias patient as division of crus from ischiopubic ramus and penile skin graft. The procedures include division of suspensory ligament and blunt dissection of fundiform ligament. In 1970’s Horton reported suprapubic fat resection and Z-plasty with anchoring on Scarpa’s fascia for lengthening procedure. In 1980’s several fat injection procedures in Darto’s fascia have been reported for girth enhancement but they were lack of reproducibility. (1year Resorption 50%) Later reports the result of cystic nodule, lump formation and fat migration. In 1990’s V-Y plasty for lengthening was reported. Historically illegal liquid injection materials with non-medical hands were reported as correction or reconstructive procedures for removal and treatment of deformed genitalia. In 1992 Horton reported flank abdominal free dermo-fat graft to Darto’s fascia. This procedure showed fair graft survival rate and developed to buttock skin crease dermo-fat graft. Medical grade silicone; long-term implantable; Gortex plate, polytetrafluoroethylene (PTFE); Acelluar dermal graft/(Alloderm, Surederm); Acellular xenogeniccollagen structure/(Lyoplant, Terudermis); Autologous

  19. Ovarian Grafts 10 Days after Xenotransplantation: Folliculogenesis and Recovery of Viable Oocytes

    PubMed Central

    Campos-Junior, Paulo Henrique Almeida; Alves, Thalys Jair Melo; Dias, Marco Tulio; Assunçao, Carolina Marinho; Munk, Michele; Mattos, Matheus Silvério; Kraemer, Lucas Rocha; Almeida, Brígida Gomes; Russo, Remo Castro; Barcelos, Lucíola; Camargo, Luiz Sérgio Almeida; Viana, Joao Henrique Moreira

    2016-01-01

    Ovarian xenotransplantation is a promising alternative to preserve fertility of oncologic patients. However, several functional aspects of this procedure remained to be addressed. The aim of this study was evaluate the feasibility of xenotransplantation as a strategy to maintain bovine ovarian grafts and produce oocytes. Adult ovarian cortical pieces were xenotransplanted to the dorsal subcutaneous of female NOD-SCID mice (n = 62). Grafts were recovered ten days after xenotransplantation. Host and graft weights; folliculogenesis progression; blood perfusion, relative gene expression and number of macrophage and neutrophil of xenografts; in vitro developmental competence of graft-derived oocytes were evaluated. Folliculogenesis was supported in the grafts, as indicated by the presence of primordial, primary, secondary, antral, and atretic follicles. The xenografts showed a greater volumetric density of atretic follicles and higher hyperemia and number of host-derived macrophage and neutrophil (P<0.05), when compared to non-grafted fragments. There was a higher blood perfusion under the back skin in the transplantation sites of host animals than in control and non-grafted (P<0.01). BAX and PRDX1 genes were up-regulated, while BCL2, FSHR, IGF1R and IGF2R were down-regulated, when compared to the control (P<0.01). Twenty seven oocytes were successfully harvested from grafts, and some of these oocytes were able to give rise to blastocysts after in vitro fertilization. However, cleavage and blastocyst rates of xenograft derived oocytes were lower than in control (P<0.01). Despite showing some functional modifications, the ovarian xenografts were able to support folliculogenesis and produce functional oocytes. PMID:27362486

  20. Ovarian Grafts 10 Days after Xenotransplantation: Folliculogenesis and Recovery of Viable Oocytes.

    PubMed

    Campos-Junior, Paulo Henrique Almeida; Alves, Thalys Jair Melo; Dias, Marco Tulio; Assunçao, Carolina Marinho; Munk, Michele; Mattos, Matheus Silvério; Kraemer, Lucas Rocha; Almeida, Brígida Gomes; Russo, Remo Castro; Barcelos, Lucíola; Camargo, Luiz Sérgio Almeida; Viana, Joao Henrique Moreira

    2016-01-01

    Ovarian xenotransplantation is a promising alternative to preserve fertility of oncologic patients. However, several functional aspects of this procedure remained to be addressed. The aim of this study was evaluate the feasibility of xenotransplantation as a strategy to maintain bovine ovarian grafts and produce oocytes. Adult ovarian cortical pieces were xenotransplanted to the dorsal subcutaneous of female NOD-SCID mice (n = 62). Grafts were recovered ten days after xenotransplantation. Host and graft weights; folliculogenesis progression; blood perfusion, relative gene expression and number of macrophage and neutrophil of xenografts; in vitro developmental competence of graft-derived oocytes were evaluated. Folliculogenesis was supported in the grafts, as indicated by the presence of primordial, primary, secondary, antral, and atretic follicles. The xenografts showed a greater volumetric density of atretic follicles and higher hyperemia and number of host-derived macrophage and neutrophil (P<0.05), when compared to non-grafted fragments. There was a higher blood perfusion under the back skin in the transplantation sites of host animals than in control and non-grafted (P<0.01). BAX and PRDX1 genes were up-regulated, while BCL2, FSHR, IGF1R and IGF2R were down-regulated, when compared to the control (P<0.01). Twenty seven oocytes were successfully harvested from grafts, and some of these oocytes were able to give rise to blastocysts after in vitro fertilization. However, cleavage and blastocyst rates of xenograft derived oocytes were lower than in control (P<0.01). Despite showing some functional modifications, the ovarian xenografts were able to support folliculogenesis and produce functional oocytes. PMID:27362486

  1. Vascular grafting strategies in coronary intervention

    NASA Astrophysics Data System (ADS)

    Knight, Darryl; Gillies, Elizabeth; Mequanint, Kibret

    2014-06-01

    With the growing need for coronary revascularizations globally, several strategies to restore blood flow to the heart have been explored. Bypassing the atherosclerotic coronary arteries with autologous grafts, synthetic prostheses and tissue-engineered vascular grafts continue to be evaluated in search of a readily available vascular graft with clinically acceptable outcomes. The development of such a vascular graft including tissue engineering approaches both in situ and in vitro is herein reviewed, facilitating a detailed comparison on the role of seeded cells in vascular graft patency.

  2. Design and nondestructive imaging of a bioengineered vascular graft endothelium

    NASA Astrophysics Data System (ADS)

    Whited, Bryce Matthew

    continuously tracking EC migration and endothelialization of a bioengineered graft in a bioreactor. Overall, these results demonstrate that aligned scaffold topographies enhance EC adherence under fluid flow and the FOB imaging system is a promising tool to monitor endothelium development and response to fluid flow in a manner that has not previously been afforded using conventional imaging methods.

  3. Delayed Graft Function in Living-Donor Kidney Transplant: A Middle Eastern Perspective.

    PubMed

    Al Otaibi, Torki; Ahmadpoor, Pedram; Allawi, Ali Abdulmajid Dyab; Habhab, Wael Taher; Khatami, Mohammad Reza; Nafar, Mohsen; Glotz, Denis

    2016-02-01

    With an increased incidence of living-donor kidney transplants, in response to increasing unmet needs for renal transplant, a clear understanding of determinants of posttransplant outcomes is essential. The importance of delayed graft function in deceased-donor kidney transplant is now part of conventional medical wisdom, due to the large amount of evidence focused on this aspect. However, the same is not true for living-donor kidney transplant, partly due to lack of evidence on this crucial clinical question and partly due to lack of awareness about this issue. The current review aims to highlight the importance of delayed graft function as a crucial determinant of outcomes in living-donor kidney transplant. An exhaustive search of online medical databases was performed with appropriate search criteria to collect evidence about delayed graft function after living-donor kidney transplant, with a special focus on studies from the Middle East. Data on incidence, impact, risk factors, and possible prevention modalities of delayed graft function in patients undergoing living-donor kidney transplant are presented. A key finding of this review is that contemporary incidence rates reported from the Middle East are comparatively higher than those reported from outside the region. Although in absolute terms the incidence is lower than deceased donor kidney transplant, the effects of delayed graft function on graft rejection and graft and patient survival are sufficiently large to warrant the formulation of specific treatment protocols. Key to formulating prevention and treatment strategies is identifying discrete risk factors for delayed graft function. Although this evidence is scant, an overview has been provided. Further studies examining different aspects of delayed graft function incidence after living-donor kidney transplant are urgently needed to address a so far little known clinical question.

  4. Endovascular Therapy is Effective Treatment for Focal Stenoses in Failing Infrapopliteal Vein Grafts

    PubMed Central

    Westin, Gregory G.; Armstrong, Ehrin J.; Javed, Usman; Balwanz, Christopher R.; Saeed, Haseeb; Pevec, William C.; Laird, John R.; Dawson, David L.

    2014-01-01

    Objective To evaluate the efficacy of endovascular therapy for maintaining patency and preserving limbs among patients with failing infrapopliteal bypass grafts. Methods We gathered data from a registry of catheter-based procedures for peripheral artery disease. Of 1554 arteriograms performed from 2006 to 2012, 30 patients had interventions for failing bypass vein grafts to infrapopliteal target vessels. The first intervention for each patient was used in this analysis. Duplex ultrasonography was used within 30 days after intervention and subsequently at 3-6 month intervals for graft surveillance. Results Interventions were performed for duplex ultrasonography surveillance findings in 21 patients and for symptoms of persistent or recurrent critical limb ischemia in 9 patients. Procedural techniques included cutting balloon angioplasty (83%), conventional balloon angioplasty (7%), and stent placement (10%). Procedural success was achieved in all cases. There were no procedure-related complications, amputations, or deaths within 30 days. By Kaplan-Meier analysis, 37% were free from graft restenosis at 12 months and 31% were at 24 months. Receiver operating characteristic analysis indicated that a lesion length of 1.75 cm best predicted freedom from restenosis (C statistic: 0.74). Residual stenosis (P=0.03), patency without reintervention (P=0.01), and assisted patency with secondary intervention (P=0.02) rates were superior for short lesions compared to long lesions. The cohort had acceptable rates of adverse clinical outcomes, with 96% of patients free from amputation at both 12 and 24 months; clinical outcomes were also better in patients with short lesions. Conclusions In this single-center experience with endovascular therapies to treat failing infrapopliteal bypass grafts, rates of limb preservation were high, but the majority of patients developed graft restenosis within 12 months. Grafts with longer stenoses fared poorly by comparison. These data suggest that

  5. The Pi Graft for Correction of Severe Saddle Nose Deformity.

    PubMed

    Zelken, Jonathan; Chang, Chun-Shin; Hsiao, Yen-Chang

    2016-08-01

    Saddle nose deformity is challenging because there is both aesthetic and functional compromise, and high rates of recurrence have been reported. Autologous costal cartilage is the widely preferred medium for reconstruction, but there may be room for improvement in the configuration of the cartilage struts. The pi graft is stabilized at two points, proximally and distally, distinguishing it from the traditional L-strut. Indications include severe (Types III and IV) saddle nose deformity with collapse of the mid-vault, and recurrence after prior reconstruction. Costal cartilage is harvested and three struts are crafted to make the foundation layer: a dorsal strut, caudal strut, and mid-vault strut. An aesthetic layer is composed of a carefully crafted dorsal graft and tip graft. Three men and 11 women were treated from 2013 to 2015 using this method for severe saddle nose deformity. Aesthetic and functional outcomes were evaluated. Patients were followed up for 12 months (range, 8-14 months). There was no recurrence of deformity or warping of the aesthetic or foundation layers. All patients were guided to anticipate refinement of the tip at 3 months to ease the burden on the skin envelope in stage I, but only five patients (35.7%) opted for it, as the remaining patients were satisfied with their appearance. The pi graft is a composite reconstructive method that is designed to minimize warping and recurrence of the saddle nose deformity. This method was successful in this series, although objective comparisons with traditional methods were not made. PMID:27494591

  6. Use of a piezoelectric film sensor for monitoring vascular grafts.

    PubMed

    Gupta, S K; Dietzek, A M; Veith, F J; Torres, M; Kram, H B; Wengerter, K R

    1990-08-01

    Detection of failing arterial reconstructions requires intensive surveillance by frequent physical examination and noninvasive laboratory testing. However, many grafts fail during the intervals between these examinations. For this reason, we have developed an implantable miniaturized piezoelectric flow detection device whose function can be monitored externally by radiotransmission across the skin. Sensors were constructed from ultrathin polyvinylidene fluoride (PVF2) with piezoelectric activity and attached with silicone fixative to 6-mm polytetrafluoroethylene grafts. Ten of these grafts were placed in mongrel dogs as iliofemoral bypasses. Real time data were acquired from the sensors at a rate of 200 Hz, using a DATAQ A/D data acquisition board and CODAS data acquisition software, while simultaneous blood flow (using an electromagnetic flowmeter) and intraluminal pressure were processed by using separate channels of the same data acquisition board. The data were stored on computer storage media and analyzed by the ASYST software, which allows simultaneous signal curves to be compared using regression analysis. In the resting state, the mean blood flow was 123 +/- 16 mL and the mean intraluminal pressure was 124/78 mm Hg, and there was perfect correlation between the PVF2 sensor and the flowmeter and between the sensor and the intraluminal pressure (correlation coefficient, r greater than or equal to 0.99 and r greater than or equal to 0.93, respectively). A tourniquet was applied to the iliac artery proximal to the graft to reduce the flow to approximately half of the resting state (mean flow after tourniquet: 66 +/- 6 mL/minute). Signal tracings from the three sources showed a remarkable similarity with a very high correlation coefficient (r greater than or equal to 0.99 between sensor and flowmeter and r greater than or equal to 0.92 between sensor and the pressure signal). These preliminary results show that the sensors made from low-profile and low-mass PVF2

  7. Microwave assisted synthesis of guar gum grafted sodium acrylate/cloisite superabsorbent nanocomposites: reaction parameters and swelling characteristics.

    PubMed

    Likhitha, M; Sailaja, R R N; Priyambika, V S; Ravibabu, M V

    2014-04-01

    In this study, superabsorbent nanocomposites of guar gum grafted sodium acrylate have been synthesized via both microwave and conventional techniques. The reaction parameters of both techniques were optimized and the microwave assisted method was proved to have higher grafting yield with lesser time of reaction as compared to the conventional method. X-ray diffraction and scanning electron microscopy analyses revealed that cloisite was exfoliated and uniformly dispersed in guar gum grafted sodium acrylate matrix. The results show that introducing cloisite into the guar gum grafted sodium acrylate network improved the swelling capability and the swelling rate of the superabsorbent nanocomposite was found to be enhanced at an optimal loading of 10% cloisite. The nanocomposites showed high water absorbency within a wide pH range. Preliminary studies on crystal violet dye removal showed promising results. PMID:24530336

  8. Estrogens and aging skin

    PubMed Central

    Thornton, M. Julie

    2013-01-01

    Estrogen deficiency following menopause results in atrophic skin changes and acceleration of skin aging. Estrogens significantly modulate skin physiology, targeting keratinocytes, fibroblasts, melanocytes, hair follicles and sebaceous glands, and improve angiogenesis, wound healing and immune responses. Estrogen insufficiency decreases defense against oxidative stress; skin becomes thinner with less collagen, decreased elasticity, increased wrinkling, increased dryness and reduced vascularity. Its protective function becomes compromised and aging is associated with impaired wound healing, hair loss, pigmentary changes and skin cancer.   Skin aging can be significantly delayed by the administration of estrogen. This paper reviews estrogen effects on human skin and the mechanisms by which estrogens can alleviate the changes due to aging. The relevance of estrogen replacement, selective estrogen receptor modulators (SERMs) and phytoestrogens as therapies for diminishing skin aging is highlighted. Understanding estrogen signaling in skin will provide a basis for interventions in aging pathologies. PMID:24194966

  9. Advances in Skin Substitutes—Potential of Tissue Engineered Skin for Facilitating Anti-Fibrotic Healing

    PubMed Central

    Varkey, Mathew; Ding, Jie; Tredget, Edward E.

    2015-01-01

    Skin protects the body from exogenous substances and functions as a barrier to fluid loss and trauma. The skin comprises of epidermal, dermal and hypodermal layers, which mainly contain keratinocytes, fibroblasts and adipocytes, respectively, typically embedded on extracellular matrix made up of glycosaminoglycans and fibrous proteins. When the integrity of skin is compromised due to injury as in burns the coverage of skin has to be restored to facilitate repair and regeneration. Skin substitutes are preferred for wound coverage when the loss of skin is extensive especially in the case of second or third degree burns. Different kinds of skin substitutes with different features are commercially available; they can be classified into acellular skin substitutes, those with cultured epidermal cells and no dermal components, those with only dermal components, and tissue engineered substitutes that contain both epidermal and dermal components. Typically, adult wounds heal by fibrosis. Most organs are affected by fibrosis, with chronic fibrotic diseases estimated to be a leading cause of morbidity and mortality. In the skin, fibroproliferative disorders such as hypertrophic scars and keloid formation cause cosmetic and functional problems. Dermal fibroblasts are understood to be heterogeneous; this may have implications on post-burn wound healing since studies have shown that superficial and deep dermal fibroblasts are anti-fibrotic and pro-fibrotic, respectively. Selective use of superficial dermal fibroblasts rather than the conventional heterogeneous dermal fibroblasts may prove beneficial for post-burn wound healing. PMID:26184327

  10. [Neonatal conventional ventilation guidelines].

    PubMed

    2001-09-01

    Respiratory pathology is a frequent problem in Neonatal Intensive Care Units; the last few years, our knowledge about its management has improved enormously. Conventional Ventilatory support is a high-specialized technique that maintains a correct alveolar gas exchange while the primary aetiology is to present some clinical guidelines for every professional working with newborns who have respiratory failure improves. The aim of this document is to present some clinical guidelines for every professional working with newborns who have respiratory pathology

  11. Laparoscopic versus conventional appendectomy.

    PubMed Central

    Vallina, V L; Velasco, J M; McCulloch, C S

    1993-01-01

    OBJECTIVE: The goal of this study was to prospectively define the impact of laparoscopy on the management of patients with a presumed diagnosis of appendicitis. SUMMARY BACKGROUND DATA: While the role of laparoscopy in the management of cholelithiasis is well established, its impact on the management of acute appendicitis needs to be objectively defined and compared to that of conventional management. Several authors have predicted that laparoscopic appendectomy will become the preferred treatment for appendicitis. METHODS: Two groups of consecutive patients with similar clinical characteristics of acute appendicitis were compared. Data on the laparoscopic group were compiled prospectively on standardized forms; data on the conventional group were collected retrospectively. Operative time, hospital stay, analgesia, cost, and return to normal activities were noted. RESULTS: Seventeen consecutive patients who underwent appendectomy were compared to 18 consecutive patients who underwent laparoscopy (16 of these 18 had laparoscopic appendectomy). There was no significant difference between the two groups in terms of clinical characteristics and appendiceal histopathology. The mean operative times were 61 +/- 4.1 minutes and 46 +/- 2.9 minutes for the laparoscopy and conventional groups, respectively (p < 0.01). Hospital stay was significantly shorter in the laparoscopic appendectomy group, with 81% of patients being discharged on their first postoperative day (p < 0.001). The laparoscopic appendectomy patients required significantly less narcotic analgesia (p < 0.02). Return to normal activity was not significantly different between the two groups. The average total cost of laparoscopic appendectomy was 30% greater than that of conventional appendectomy. CONCLUSIONS: Laparoscopy is a useful adjunct to the management of patients with a presumed clinical diagnosis of acute appendicitis. PMID:8239785

  12. Viral Skin Diseases.

    PubMed

    Ramdass, Priya; Mullick, Sahil; Farber, Harold F

    2015-12-01

    In the vast world of skin diseases, viral skin disorders account for a significant percentage. Most viral skin diseases present with an exanthem (skin rash) and, oftentimes, an accompanying enanthem (lesions involving the mucosal membrane). In this article, the various viral skin diseases are explored, including viral childhood exanthems (measles, rubella, erythema infectiosum, and roseola), herpes viruses (herpes simplex virus, varicella zoster virus, Kaposi sarcoma herpes virus, viral zoonotic infections [orf, monkeypox, ebola, smallpox]), and several other viral skin diseases, such as human papilloma virus, hand, foot, and mouth disease, molluscum contagiosum, and Gianotti-Crosti syndrome.

  13. [Sarcoidosis of the skin].

    PubMed

    Suga, Y; Ogawa, H

    1994-06-01

    Sarcoidosis is characterized by formation of epithelioid-cell tubercules, without caseation, of the affected organ systems. The mediastinum, peripheral lymph nodes and eyes, in addition to the skin, are most frequently affected. Between 10% and 30% of patients with systemic sarcoidosis in Japan have skin lesions. Skin sarcoidosis is morphologically classified into three basic groups, erythema nodosum, scar sarcoidosis and skin sarcoid. Skin sarcoid is characterized by specific cutaneous lesions of sarcoidosis, and may take nodular, plaque, angiolupoid, subcutaneous and some other forms. Clinical manifestations of the cutaneous lesions are usually asymptomatic and polymorphous. Skin biopsy is, however, often highly useful for confirming a diagnosis of sarcoidosis.

  14. Viral Skin Diseases.

    PubMed

    Ramdass, Priya; Mullick, Sahil; Farber, Harold F

    2015-12-01

    In the vast world of skin diseases, viral skin disorders account for a significant percentage. Most viral skin diseases present with an exanthem (skin rash) and, oftentimes, an accompanying enanthem (lesions involving the mucosal membrane). In this article, the various viral skin diseases are explored, including viral childhood exanthems (measles, rubella, erythema infectiosum, and roseola), herpes viruses (herpes simplex virus, varicella zoster virus, Kaposi sarcoma herpes virus, viral zoonotic infections [orf, monkeypox, ebola, smallpox]), and several other viral skin diseases, such as human papilloma virus, hand, foot, and mouth disease, molluscum contagiosum, and Gianotti-Crosti syndrome. PMID:26612372

  15. Utility of Covered Stents for Revision of Aging Failing Synthetic Hemodialysis Grafts: A Report of Three Cases

    SciTech Connect

    Silas, Anne M. Bettmann, Michael A.

    2003-11-15

    Three aging failing hemodialysis polytetrafluoroethylene bypass shunts, average age 44 months, previously percutaneously revised with balloon angioplasty, presented with pseudoaneurysms and recurrent thrombosis. All were treated with percutaneous covered stent placement within their affected limbs. One graft was ligated 1 month after treatment for infected overlying skin ulcer, though this graft was subsequently surgically revised with interposition graft and the covered stent portion remains functional at 19 month follow-up. The 18- and 13- month follow- up of the remaining 2 patients shows that the covered stents remained patent and they are functional and being successfully and routinely punctured for dialysis. In this elderly population, the use of covered stents may prolong the functional life of failing hemodialysis bypass grafts, reducing the number of percutaneous and surgical interventions and further sparing other vascular access sites.

  16. Robust Lentiviral Gene Delivery But Limited Transduction Capacity of Commonly Used Adeno-Associated Viral Serotypes in Xenotransplanted Human Skin.

    PubMed

    Jakobsen, Maria; Askou, Anne Louise; Stenderup, Karin; Rosada, Cecilia; Dagnæs-Hansen, Frederik; Jensen, Thomas G; Corydon, Thomas J; Mikkelsen, Jacob Giehm; Aagaard, Lars

    2015-08-01

    Skin is an easily accessible organ, and therapeutic gene transfer to skin remains an attractive alternative for the treatment of skin diseases. Although we have previously documented potent lentiviral gene delivery to human skin, vectors based on adeno-associated virus (AAV) rank among the most promising gene delivery tools for in vivo purposes. Thus, we compared the potential usefulness of various serotypes of recombinant AAV vectors and lentiviral vectors for gene transfer to human skin in a xenotransplanted mouse model. Vector constructs encoding firefly luciferase were packaged in AAV capsids of serotype 1, 2, 5, 6, 8, and 9 and separately administered by intradermal injection in human skin transplants. For all serotypes, live bioimaging demonstrated low levels of transgene expression in the human skin graft, and firefly luciferase expression was observed primarily in neighboring tissue outside of the graft. In contrast, gene delivery by intradermally injected lentiviral vectors was efficient and led to extensive and persistent firefly luciferase expression within the human skin graft only. The study demonstrates the limited capacity of single-stranded AAV vectors of six commonly used serotypes for gene delivery to human skin in vivo. PMID:26204415

  17. Experience with banked skin in the Prague Burn Center.

    PubMed

    Broz, L; Vogtová, D; Königová, R

    1999-01-01

    Despite progress in materials science, the use of human allografts and xenografts of pig origin is in the Prague Burn Center among the preferred means of temporary burn wound cover since 1973. True closure is achieved only with living autografts or isografts (identical twins). The method for preparing fresh porcine grafts was introduced in Prague 25 years ago: dermoepidermal sheets are retrieved in strips, are treated with a lavage of chemotherapeutics and antibiotics, are spread onto sterile wet gauze and stored in Pétri dishes at 4 degrees centigrade in a refrigerator. Cellular viability is maintained for 10-14 days when transferred to patients. The Prague Skin Bank commenced its activity in 1986. The Protocol for the cryopreservation of skin was established: the pretreated skin is kept in aluminium vessels in containers with vapours of liquid nitrogen. Cryoprotective Medium is used with 15% glycerol. The skin viability has been verified by investigation of glucose metabolism. The production of fresh and long-term stored viable skin grafts has been increasing continuously and at present, the production represents 2 million square centimeters per year. About 15% of the harvest is distributed to other surgical and trauma departments. Any burn wound dressing may fail due to a failure to use them properly-lack of attention to the details in burn wound care can lead to disappointment.

  18. Subacute radiation dermatitis: a histologic imitator of acute cutaneous graft-versus-host disease

    SciTech Connect

    LeBoit, P.E.

    1989-02-01

    The histopathologic changes of radiation dermatitis have been classified either as early effects (necrotic keratinocytes, fibrin thrombi, and hemorrhage) or as late effects (vacuolar changes at the dermal-epidermal junction, atypical radiation fibroblasts, and fibrosis). Two patients, one exposed to radiation therapeutically and one accidentally, are described. Skin biopsy specimens showed an interface dermatitis characterized by numerous dyskeratotic epidermal cells with lymphocytes in close apposition (satellite cell necrosis); that is, the epidermal changes were similar to those in acute graft-versus-host disease. Because recipients of bone marrow transplants frequently receive total body irradiation as part of their preparatory regimen, the ability of radiation to cause persistent epidermal changes similar to those in acute graft-versus-host disease could complicate the interpretation of posttransplant skin biopsy specimens.

  19. Transcutaneous Raman spectroscopy for assessing progress of bone-graft incorporation in bone reconstruction and repair

    NASA Astrophysics Data System (ADS)

    Okagbare, Paul I.; Esmonde-White, Francis W. L.; Goldstein, Steven A.; Morris, Michael D.

    2011-03-01

    Allografts and other bone-grafts are frequently used for a variety of reconstructive approaches in orthopaedic surgery. However, successful allograft incorporation remains uncertain. Consequently, there is significant need for methods to monitor the fate of these constructs. Only few noninvasive methods can fully assess the progress of graft incorporation and to provide information on the metabolic status of the graft, such as the mineral and matrix composition of the regenerated-tissue that may provide early indications of graft success or failure. For example, Computed-tomography and MRI provide information on the morphology of the graft/host interface. Limited information is also available from DXA. To address this challenge, we present here the implementation of a noninvasive Raman spectroscopy technique for in-vivo assessment of allograft incorporation in animal-model. In an animal use committee approved osseointegration experiment, a 3mm defect is created in rat's tibia. The defect is reconstructed using auto or allograft and Raman spectra are collected at several time-points during healing using an array of optical-fibers in contact with the skin of the rat over the tibia while the rat is anaesthetized. The array allows excitation and collection of Raman spectra through the skin at various positions around the tibia. Raman parameters such as mineral/matrix, carbonate/phosphate and cross-linking are recovered and monitored. The system is calibrated against locally-constructed phantoms that mimic the morphology, optics and spectroscopy of the rat. This new technology provides a non-invasive method for in-vivo assessment of bone-graft incorporation in animal-models and can be adapted for similar study in human subjects.

  20. Antibodies from donor B cells perpetuate cutaneous chronic graft-versus-host disease in mice

    PubMed Central

    Jin, Hua; Ni, Xiong; Deng, Ruishu; Song, Qingxiao; Young, James; Cassady, Kaniel; Zhang, Mingfeng; Forman, Stephen; Martin, Paul J.; Liu, Qifa

    2016-01-01

    Cutaneous sclerosis is one of the most common clinical manifestations of chronic graft-versus-host disease (cGVHD). Donor CD4+ T and B cells play important roles in cGVHD pathogenesis, but the role of antibodies from donor B cells remains unclear. In the current studies, we generated immunoglobulin (Ig)Hµγ1 DBA/2 mice whose B cells have normal antigen-presentation and regulatory functions but cannot secrete antibodies. With a murine cGVHD model using DBA/2 donors and BALB/c recipients, we have shown that wild-type (WT) grafts induce persistent cGVHD with damage in the thymus, peripheral lymphoid organs, and skin, as well as cutaneous T helper 17 cell (Th17) infiltration. In contrast, IgHµγ1 grafts induced only transient cGVHD with little damage in the thymus or peripheral lymph organs or with little cutaneous Th17 infiltration. Injections of IgG-containing sera from cGVHD recipients given WT grafts but not IgG-deficient sera from recipients given IgHµγ1 grafts led to deposition of IgG in the thymus and skin, with resulting damage in the thymus and peripheral lymph organs, cutaneous Th17 infiltration, and perpetuation of cGVHD in recipients given IgHµγ1 grafts. These results indicate that donor B-cell antibodies augment cutaneous cGVHD in part by damaging the thymus and increasing tissue infiltration of pathogenic Th17 cells. PMID:26884373

  1. Endovascular Stent-Graft Repair as a Late Secondary Procedure After Previous Aortic Grafts

    SciTech Connect

    Matsagas, Miltiadis I. Anagnostopoulos, Constantine E.; Papakostas, John C.; DeRose, Joseph J.; Siminelakis, Stavros; Katsouras, Christos S.; Toumpoulis, Ioannis K.; Drossos, George E.; Michalis, Lampros K.

    2006-08-15

    Thoracic and abdominal aortic endovascular procedures as alternatives to aortic reoperations were studied in three different cases. An anastomotic aneurysm after previous thoracic aortic graft for coarctation, a second-stage elephant trunk repair (descending thoracic aortic aneurysm), and a secondary aneurysm proximal to a previous abdominal aortic graft were successfully treated with endovascular stent-grafts. During the follow-up period no lethal events or major aortic or graft-related complications were observed, except a type II endoleak in the anastomotic aortic aneurysm case. An endovascular stent-graft can be safely deployed into a previously implanted vascular graft, avoiding repeat surgery.

  2. Severe combined immunodeficiency mouse and human psoriatic skin chimeras. Validation of a new animal model.

    PubMed Central

    Nickoloff, B. J.; Kunkel, S. L.; Burdick, M.; Strieter, R. M.

    1995-01-01

    Research into the cause and pathophysiological mechanisms underlying expression of psoriatric skin lesions has been hampered by lack of an appropriate animal model for this common and enigmatic cutaneous disease. These studies characterize normal skin, pre-psoriatic skin, and psoriatic plaque skin samples transplanted onto severe combined immunodeficiency mice. In this report we document that 1), normal, prepsoriatic, and psoriatic plaque keratome skin samples can be transplanted onto severe combined immunodeficiency mice reliably with high rates of graft survival (> 85%) and with reproducible changes consistently observed over prolonged periods of engraftment; 2), after transplantation, by clinical assessment and routine light microscopy, normal skin remained essentially normal whereas pre-psoriatic skin became thicker, and psoriatic plaque skin retained its characteristic plaque-type elevation and scale; 3), by using a panel of antibodies and immunohistochemical analysis, the overall phenotype of human cell types (including immunocytes) that persisted in the transplanted skin was remarkably similar to the immunophenotype of pretransplanted skin samples; 4), clearly recognized interface zones between human and murine skin within the epidermal and dermal compartments could be identified by routine microscopy and immunostaining, with focal areas of chimerism; and 5), elevated interleukin 8 cytokine levels were present in transplanted pre-psoriatic and psoriatic plaque skin samples. We conclude that there are many similarities between pre- and post-transplanted human samples of normal and psoriatic skin that are grafted onto severe combined immunodeficiency mice. Thus, we propose that this new animal model is appropriate for additional mechanistic-type studies designed to reveal the underlying genetic/etiological abnormality, as well as better illuminate the pathophysiological basis, for this important skin disease. Images Figure 1 Figure 2 Figure 3 PMID:7887440

  3. The application of new biosynthetic artificial skin for long-term temporary wound coverage.

    PubMed

    Wang, Hsian-Jenn; Chou, Trong-Duo; Tsou, Tai-Li; Chen, Tim-Mo; Chen, Shao-Liang; Chen, Shyi-Gen; Wei, Lin-Gwei; Yeh, Kuan-Jeh; Ko, Yao-Huang; Wang, Chi-Shyran; Lee, Wei-Hwa

    2005-12-01

    Temporary dressings protect wounds from desiccation and infection. In our previous study, we used meshed acellular porcine dermis (APD) to enhance wound healing and decrease wound contraction; however, the wounds showed meshed scar. In this study, we produced an artificial skin composed of a cross-linked silicon sheet on the surface of APD which we have called silicone acellular porcine dermis (SAPD). This new artificial skin can protect the wound long enough to promote wound healing either by second intention or covered long enough until cultured epithelium autograft (CEA) or autologous skin graft can be harvested for permanent coverage. We delivered 4 cm x 5 cm full-thickness wound on the back of 350 g Sprague-Dawley rats. Thirty-six rats were divided into two groups. Eighteen rats had SAPD and the other 18 were covered with Biobrane. The wounds were first examined 2 weeks after grafting and followed weekly for an additional 4 weeks to evaluate the wound and study pathological changes by using H.E. and Masson's stains. Wound size was calculated by ruler and analyzed by Student's t-test. At the 2-week inspection, both SAPD and Biobrane showed tight adherence to the wound with no change of wound size. Both the SAPD and Biobrane dermal templates were pink. In the Biobrane-covered group, the wounds contracted soon after the tie-over dressing was removed. Its dermal layer is a layer of thin porcine dermal substance, which was promptly digested by tissue hyaluronidase and provides no real dermal template. In the SAPD-covered group however, the wound size was maintained significantly from third to sixth week after grafting (p<0.001). SAPD was designed with thick epidermal silicone and a well-organized porcine dermis so that it incorporates into the recipient wound. Clinically the silicone layer of SAPD dislodged from APD about 6-7 weeks after grafting and was followed by dermal matrix exposure and infection. In pathological examination, much like a human skin graft, new

  4. Cadaveric aorta implantation for aortic graft infection.

    PubMed

    Ali, Asad; Bahia, Sandeep S S; Ali, Tahir

    2016-01-01

    This case report describes a 73-year-old gentleman who underwent explantation of an infected prosthetic aorto-iliac graft and replacement with a cryopreserved thoracic and aorto-iliac allograft. The patient has been followed up a for more than a year after surgery and remains well. After elective tube graft repair of his abdominal aortic aneurysm (AAA) in 2003, he presented to our unit in 2012 in cardiac arrest as a result of a rupture of the distal graft suture line due to infection. After resuscitation he underwent aorto-bifemoral grafting using a cuff of the original aortic graft proximally. Distally the new graft was anastomosed to his common femoral arteries, with gentamicin beads left in situ. Post discharge the patient was kept under close surveillance with serial investigations including nuclear scanning, however it became apparent that his new graft was infected and that he would require aortic graft replacement, an operation with a mortality of at least 50%. The patient underwent the operation and findings confirmed a synthetic graft infection. This tube graft was explanted and a cryopreserved aorta was used to the refashion the abdominal aorta and its bifurcation. The operation required a return to theatre day one post operatively for a bleeding side branch, which was repaired. The patient went on to make a full recovery stepping down from the intensive therapy unit day 6 post operatively and went on to be discharged 32 days after his cryopreserved aorta implantation. PMID:27351624

  5. Scaly Skin (Ichthyosis Vulgaris)

    MedlinePlus

    ... should improve by restoring moisture (hydration) to the skin. Creams and ointments are better moisturizers than lotions, and ... Physician May Prescribe To treat the dry, scaly skin of ichthyosis ... cream or lotion containing the following: Prescription-strength alpha- ...

  6. Skin Pigmentation Disorders

    MedlinePlus

    ... skin gets its color from a pigment called melanin. Special cells in the skin make melanin. When these cells become damaged or unhealthy, it affects melanin production. Some pigmentation disorders affect just patches of ...

  7. PPD skin test

    MedlinePlus

    Chernecky CC, Berger BJ. Mantoux skin test (PPD test, purified protein derivative test, Tb test, tuberculin skin test, TST, tuberculosis test) - diagnostic. In: Chernecky CC, Berger BJ, eds. Laboratory Tests and Diagnostic Procedures . ...

  8. Components of skin

    MedlinePlus Videos and Cool Tools

    ... skin layers from the outside environment and contains cells that make keratin, a substance that waterproofs and strengthens the skin. The epidermis also has cells that contain melanin, the dark pigment that gives ...

  9. Squamous cell skin cancer

    MedlinePlus

    ... occur on skin that is regularly exposed to sunlight or other ultraviolet radiation. The earliest form of ... skin cancer is to reduce your exposure to sunlight . Always use sunscreen: Apply sunscreen with sun protection ...

  10. Examine Your Skin

    MedlinePlus

    ... In Memory Melanoma Info Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding Your ... UPDATED: February 5, 2015 Melanoma Facts Melanoma Prevention Sunscreen Suggestions Examine Your Skin Newly Diagnosed? Understanding Your ...

  11. Skin color - patchy

    MedlinePlus

    ... Injury Exposure to radiation (such as from the sun) Exposure to heavy metals Changes in hormone levels Exposure ... example, lighter-skinned people are more sensitive to sun exposure and damage, which raises the risk of skin ...

  12. Fungal Skin Infections

    MedlinePlus

    ... Fungal Skin Infections Overview of Fungal Skin Infections Candidiasis Overview of Dermatophytoses (Ringworm, Tinea) Athlete's Foot Jock ... are caused by yeasts (such as Candida —see Candidiasis ) or dermatophytes, such as Epidermophyton, Microsporum, and Trichophyton ( ...

  13. Self-Assembly of Grafted Nanoparticles for Transport Channels in Membranes

    NASA Astrophysics Data System (ADS)

    Bilchak, Connor; Buenning, Ellie; Durning, Christopher; Kumar, Sanat

    2015-03-01

    Polymer membranes have seen increased application for vapor separations, particularly for natural gas processing and purification. The addition of nanoparticles to such membranes has led to conflicting findings; conventional (Maxwell) composite theory predicts the addition of inert filler to hinder membrane transport properties. However, our research using silica nanoparticles grafted with Poly (Methacrylate) has shown these grafted systems to possess permeabilities similar to those of a pure polymer system increasing penetrant solubility without compromising diffusivity. This is counterintuitive to Maxwell theory. We propose that the grafted nanoparticles self-assemble into an ordered crystal lattice containing low-density ``channels'' which facilitate penetrant uptake. Atomic force microscopy and small-angle neutron scattering experiments appear to confirm this theory. Varying polymer grafting density and chain length is also predicted to alter transport properties, allowing for the fabrication of membrane with tunable diffusivity and selectivity. These grafted nanocomposite systems therefore represent a means of creating robust membranes with transport properties similar to those of conventional polymeric films that may be easily adapted for various separations processes. Corresponding author.

  14. Automatic Skin Color Beautification

    NASA Astrophysics Data System (ADS)

    Chen, Chih-Wei; Huang, Da-Yuan; Fuh, Chiou-Shann

    In this paper, we propose an automatic skin beautification framework based on color-temperature-insensitive skin-color detection. To polish selected skin region, we apply bilateral filter to smooth the facial flaw. Last, we use Poisson image cloning to integrate the beautified parts into the original input. Experimental results show that the proposed method can be applied in varied light source environment. In addition, this method can naturally beautify the portrait skin.

  15. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    PubMed

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft. PMID:26091219

  16. Hybrid Graft Anterior Cruciate Ligament Reconstruction: A Predictable Graft for Knee Stabilization.

    PubMed

    Alvarez-Pinzon, Andres M; Barksdale, Leticia; Krill, Michael K; Leo, Brian M

    2015-06-01

    Trauma to the anterior cruciate ligament (ACL) is a season-ending injury and involves months of activity modification and rehabilitation. The annual incidence of ACL tears in the United States is approximately 200,000, which allows for a broad range of individualized treatment options. Various surgical techniques, including transtibial and independent tunnel drilling, allograft and autograft tissue, and various implants, have been described in the literature. This article describes the indications and technique for a hybrid soft tissue graft for ACL reconstruction. Autologous grafts eliminate the risk of disease transmission and have recently been shown to have a lower rerupture rate, particularly in younger, active patients; however, the harvesting of autologous hamstring grafts carries a risk of donor-site morbidity, iatrogenic injury of the graft, and inadequate graft size. In contrast to a traditional autologous soft tissue graft, the hybrid graft allows for graft size customization for a desired reconstruction, especially in cases where autograft hamstrings may be iatrogenically damaged or of inadequate size when harvested. The goal of a hybrid graft ACL reconstruction is to provide a favorable-sized graft with clinical outcomes comparable with autologous soft tissue grafts. In contrast to a traditional autologous soft tissue graft, this technique provides another option in the event of unforeseen deficiencies or complications associated with harvesting and preparation of the autologous gracilis and semitendinosis soft tissue graft.

  17. Radiation grafting of maleic anhydride onto polypropylene in solid state via ultrafine blend

    NASA Astrophysics Data System (ADS)

    Tan, Xiumin

    2014-05-01

    A novel method to prepare maleic anhydride grafting onto poly (propylene) (PP-g-MAH) was described. It was performed by γ-irradiation in solid state via ultrafine blend in the absence of any initiator and the grafting mechanism was proposed based on the experimental results. First, ultrafine blend of MAH and PP was prepared through ultrasonic initiation in melt state and then cooled rapidly. Second, the blend was radiated by γ-irradiation in the circumstance of atmosphere. Effects of irradiation dose and MAH concentration on the amount of grafted MAH were investigated. Compared with the conventional solid-state radiation grafting method, PP-g-MAH obtained via this method shows a higher graft rate of MAH. This novel method also has the advantages of solventless, energy efficient, low cost and simple operation. Furthermore, it is very easy to get purified products. The molecular structures of grafted copolymer were characterized by Fourier-transform infrared spectroscopy. Differential scanning calorimetry, wide-angle X-ray diffraction and polarized optical microscope were used to determine the degree of crystallinity and crystalline structure.

  18. [Replacement of the aortic root with woven and knitted Dacron composite graft].

    PubMed

    Mashiko, K; Ishii, S; Naganuma, H; Yoshida, S; Seo, A; Sakamoto, H; Mikawa, H; Okuyama, H

    1997-07-01

    Some of the patients with annuloaortic ectasia or Stanford type A require aortic root replacement. If conventional Bentall procedure is employed in such cases, aortic root will become a cylindrical shape totally lacking sinus of Valsalva because the procedure utilizes a straight tube. The sinuses of Valsalva support an important role in opening and closing the valvar leaflets, and opening of the coronary arteries, together with the interleaflet triangles and the sinutubular junction. In this study, we performed aortic root replacement with composite graft which consisted of two types of graft including 30 mm Knitted Dacron Graft (Gelsoft) with different dilation rates and 30 mm Woven Dacron Graft (Hemashield) as well as bioprosthesis (27 mm Carpentier-Edwards), in order to reconstruct sinus of Valsalva. Post-operative angiography revealed an excellent diastolic coronary flow, as evidenced by proximal Knitted graft of 37 mm in diameter, distal Woven graft of 30.3 mm in diameter and Doppler flow DSVR (Diastolic/Systolic Velocity Ration) of 2.2 measured at the left coronary orifice. Since it is difficult to obtain homograft at present, this procedure would be worth trying during aortic root replacement.

  19. Ultrasound image of the skin, apparatus and imaging basics

    PubMed Central

    Malinowska, Sylwia

    2013-01-01

    Ultrasound imaging of the skin is becoming more and more popular. Skin ultrasound examinations are used both in order to assess healthy skin and to evaluate pathological lesions. They are mainly performed in dermatology as well as in broadly understood aesthetic medicine and cosmetology. At present, skin imaging is enabled by high-frequency equipment and high-quality conventional devices. The introduction of high-frequency electronic transducers which are supported by conventional scanners may be a turning point in skin ultrasound equipment. Irrespective of the ultrasound scanner, three layers may be distinguished in the image of the healthy skin: epidermal echo, dermis and subcutaneous tissue. High-frequency equipment allows for detailed imaging of the epidermal echo, dermis and upper part of the subcutaneous tissue. It is also possible to visualize the skin appendages (hair with follicles and nails) as well as slight vessels that run in the dermis and upper subcutaneous tissue. Contrary to high-frequency equipment, conventional scanners do not allow for a detailed assessment of the epidermal and dermal echoes. Instead, they enable the visualization of the entire subcutaneous tissue. The following parameters are used for the assessment of skin ultrasound images: thickness of individual skin layers, caliber of blood vessels, echogenicity of the dermis or its individual layers, echogenicity of the subcutaneous tissue as well as the presence or absence of flow in slight venous vessels. Currently, the studies on the usage of sonoelastography for skin assessment are in progress. Considering the dynamic development of skin imaging equipment and its diagnostic possibilities, one might suspect that high-frequency examinations will become more common and will be fundamental for the evaluation of both healthy and pathologically altered skin. This paper is an introduction to a series of articles on the clinical application of high-frequency ultrasound. The next articles will

  20. Psychoneuroimmunology and the Skin.

    PubMed

    Honeyman, Juan F

    2016-08-23

    The nervous, immune, endocrine and integumentary systems are closely related and interact in a number of normal and pathological conditions. Nervous system mediators may bring about direct changes to the skin or may induce the release of immunological or hormonal mediators that cause pathological changes to the skin. This article reviews the psychological mechanisms involved in the development of skin diseases.

  1. Biology of Skin Color.

    ERIC Educational Resources Information Center

    Corcos, Alain

    1983-01-01

    Information from scientific journals on the biology of skin color is discussed. Major areas addressed include: (1) biology of melanin, melanocytes, and melanosomes; (2) melanosome and human diversity; (3) genetics of skin color; and (4) skin color, geography, and natural selection. (JN)

  2. Skin self-exam

    MedlinePlus

    Skin cancer - self-exam; Melanoma - self-exam; Basal cell cancer - self-exam; Squamous cell - self-exam; Skin mole - self-exam ... Experts do not agree on whether or not skin self-exams should be performed. So there is ...

  3. [Dermatology and skin color].

    PubMed

    Petit, Antoine

    2010-09-01

    Melanin is the pigment that is responsible for skin, hair and eye colours. Genetics and sun exposure are the two key factors that determine skin pigmentation. In dermatology, skin colours is significant, not only for semiology and diagnosis, but also for epidemiology and wounds healing.

  4. Oral disease profiles in chronic graft versus host disease.

    PubMed

    Bassim, C W; Fassil, H; Mays, J W; Edwards, D; Baird, K; Steinberg, S M; Cowen, E W; Naik, H; Datiles, M; Stratton, P; Gress, R E; Pavletic, S Z

    2015-04-01

    At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral c

  5. Oral disease profiles in chronic graft versus host disease.

    PubMed

    Bassim, C W; Fassil, H; Mays, J W; Edwards, D; Baird, K; Steinberg, S M; Cowen, E W; Naik, H; Datiles, M; Stratton, P; Gress, R E; Pavletic, S Z

    2015-04-01

    At least half of patients with chronic graft-versus-host-disease (cGVHD), the leading cause of morbidity and non-relapse mortality after allogeneic stem cell transplantation, have oral manifestations: mucosal lesions, salivary dysfunction, and limited mouth-opening. cGVHD may manifest in a single organ or affect multiple organ systems, including the mouth, eyes, and the skin. The interrelationship of the 3 oral manifestations of cGVHD with each other and with the specific manifestations of extraoral cGVHD has not been studied. In this analysis, we explored, in a large group of patients with cGVHD, the potential associations between: (1) oral mucosal disease and erythematous skin disease, (2) salivary gland dysfunction and lacrimal gland dysfunction, and (3) limited mouth-opening and sclerotic skin cGVHD. Study participants, enrolled in a cGVHD Natural History Protocol (NCT00331968, n = 212), underwent an oral examination evaluating: (1) mucosal cGVHD [NIH Oral Mucosal Score (OMS)], (2) salivary dysfunction (saliva flow and xerostomia), and (3) maximum mouth-opening measurement. Parameters for dysfunction (OMS > 2, saliva flow ≤ 1 mL/5 min, mouth-opening ≤ 35 mm) were analyzed for association with skin cGVHD involvement (erythema and sclerosis, skin symptoms), lacrimal dysfunction (Schirmer's tear test, xerophthalmia), Lee cGVHD Symptom Scores, and NIH organ scores. Oral mucosal disease (31% prevalence) was associated with skin erythema (P < 0.001); salivary dysfunction (11% prevalence) was associated with lacrimal dysfunction (P = 0.010) and xerostomia with xerophthalmia (r = 0.32, P = 0.001); and limited mouth-opening (17% prevalence) was associated with skin sclerosis (P = 0.008) and skin symptoms (P = 0.001). There was no association found among these 3 oral cGVHD manifestations. This analysis supports the understanding of oral cGVHD as 3 distinct diseases: mucosal lesions, salivary gland dysfunction, and mouth sclerosis. Clear classification of oral c

  6. Conventional magnetic superconductors

    DOE PAGESBeta

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led tomore » the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.« less

  7. Conventional magnetic superconductors

    SciTech Connect

    Wolowiec, C. T.; White, B. D.; Maple, M. B.

    2015-07-01

    We discuss several classes of conventional magnetic superconductors including the ternary rhodium borides and molybdenum chalcogenides (or Chevrel phases), and the quaternary nickel-borocarbides. These materials exhibit some exotic phenomena related to the interplay between superconductivity and long-range magnetic order including: the coexistence of superconductivity and antiferromagnetic order; reentrant and double reentrant superconductivity, magnetic field induced superconductivity, and the formation of a sinusoidally-modulated magnetic state that coexists with superconductivity. We introduce the article with a discussion of the binary and pseudobinary superconducting materials containing magnetic impurities which at best exhibit short-range “glassy” magnetic order. Early experiments on these materials led to the idea of a magnetic exchange interaction between the localized spins of magnetic impurity ions and the spins of the conduction electrons which plays an important role in understanding conventional magnetic superconductors. Furthermore, these advances provide a natural foundation for investigating unconventional superconductivity in heavy-fermion compounds, cuprates, and other classes of materials in which superconductivity coexists with, or is in proximity to, a magnetically-ordered phase.

  8. Comparison of a microsliced modified chondroperichondrium shield graft and a temporalis fascia graft in primary type I tympanoplasty: A prospective randomized controlled trial.

    PubMed

    Bhattacharya, Shambhu Nath; Pal, Sudipta; Saha, Somnath; Gure, Prasanta Kumar; Roy, Anupam

    2016-07-01

    We conducted a prospective, randomized, controlled trial to compare outcomes in type I tympanoplasty patients who received an autologous microsliced modified cartilage perichondrium shield graft (cartilage group) and those who received an autologous temporalis muscle fascia graft (fascia group). Our three outcomes measures were (1) anatomic success rates at 3 months, (2) hearing results at 6 months, and (3) rates of morphologic success (i.e., the absence of reperforation, retraction, and graft displacement) at 2 years among those in each group who had an intact graft at 3 months. Of 56 patients who were initially enrolled and who underwent one of these type I tympanoplasty procedures, 51 completed the study-28 in the cartilage group and 23 in the fascia group. The former was made up of 11 males and 17 females, aged 15 to 48 years (mean: 27.4), and the latter included 9 males and 14 females, aged 15 to 52 years (mean: 31.7). The overall graft take rate at 3 months with respect to perforation closure (anatomic success) was 93.3% in the cartilage group and 91.7% in the fascia group, which was not a statistically significant difference. The mean hearing gain at 6 months was 11.7 ± 7.6 dB in the cartilage group and 12.6 ± 6.0 dB in the fascia group-again, not statistically significant. At 2 years, morphologic success rates were 92.3 and 81.0%, respectively-again, not statistically significant. We conclude that autologous microsliced modified cartilage perichondrium shield graft tympanoplasty is as effective as conventional temporalis fascia tympanoplasty in terms of graft take rates and functional results. Indeed, medium-term outcomes (2-yr follow-up) revealed that sustainable morphologic success was actually better with the cartilage technique than with the fascia technique because it was associated with fewer revision surgeries. PMID:27434476

  9. Radiation grafting of styrene onto polyethylene

    NASA Astrophysics Data System (ADS)

    Izumi, Yoshinobu; Nagaike, Hiroshi; Tabuse, Shigehiko; Yoshida, Yoichi; Tagawa, Seiichi

    2001-07-01

    In order to improve the radiation stability of aliphatic polymers, radiation-induced graft polymerization of styrene onto low-density polyethylene (LDPE) has been studied. Two methods, namely, simultaneous irradiation and pre-irradiation method, were treated. In the case of simultaneous irradiation, it was indicated from the dependency of percent graft on monomer concentration and absorbed dose that grafting efficiency was reduced by the increase in the homo-polymerization of styrene. On the other hand, more highly grafting polymer could be prepared by the pre-irradiation method. Depth-profile of grafted phenyl ring was also analyzed by means of micro-FT-IR spectroscopy. Recently, radiation stability of the obtained graft polymer was tested.

  10. Early secondary bone grafting of alveolar cleft defects. A comparison between chin and rib grafts.

    PubMed

    Borstlap, W A; Heidbuchel, K L; Freihofer, H P; Kuijpers-Jagtman, A M

    1990-07-01

    Since 1981 in cleft lip and palate patients a combined surgical-orthodontic procedure has been performed to eliminate the residual alveolar cleft. For early secondary bone grafting (before the eruption of the canine tooth) initially the graft tissue of choice was rib. Since 1984 chin bone has also been used. Sixty one patients with complete unilateral clefts were reviewed (mean age 9.5 years). 15.7% of the rib graft cases showed resorption of the graft of 50% and more. Such resorption was not found in any of the chin graft cases. No complications such as wound dehiscence, sequestration, excessive resorption of bone or recurrence of an oro-nasal fistula were found in the chin graft group. This leads to the conclusion that if enough bone is available in the chin region to bridge the defect, this graft is preferable to a rib graft.

  11. Transdermal drug delivery by in-skin electroporation using a microneedle array.

    PubMed

    Yan, Keshu; Todo, Hiroaki; Sugibayashi, Kenji

    2010-09-15

    The aim of the present work was to develop a minimally invasive system for the delivery of macromolecular drugs to the deep skin tissues, so-called in-skin electroporation (IN-SKIN EP), using a microneedle (MN) electrode array. Fluorescein isothiocyanate (FITC)-dextran (FD-4: average molecular weight, 4.3 kDa) was used as the model macromolecular drug. MNs were arranged to puncture the skin barrier, the stratum corneum, and electrodes were used for EP so that a high electric field could be applied to skin tissues to promote viable skin delivery. In vitro skin permeation experiments showed that IN-SKIN EP had a much higher skin penetration-enhancing effect for FD-4 than MN alone or ON-SKIN EP (conventional EP treatment), and that higher permeation was achieved by applying a higher voltage and longer pulse width of EP. In addition, no marked skin irritation was observed by IN-SKIN EP, which was determined by the LDH leaching test. These results suggest that IN-SKIN EP can be more effectively utilized as a potential skin delivery system of macromolecular drugs than MN alone and conventional ON-SKIN EP. PMID:20619329

  12. Reconstruction of large wounds using a combination of negative pressure wound therapy and punch grafting after excision of acral lentiginous melanoma on the foot.

    PubMed

    Seo, Jimyung; Kim, Jihee; Nam, Kyoung Ae; Zheng, Zhenlong; Oh, Byung Ho; Chung, Kee Yang

    2016-01-01

    Melanoma in darker-pigmented individuals often develops in an acral lentiginous fashion on the foot. After surgical removal of a tumor at this site, repair of the wound can be challenging. This is because there is an insufficient local skin pool and lack of mobility of the skin in this area. Moreover, functional aspects such as walking and weight bearing should be considered. We performed a combination treatment of negative pressure wound therapy (NPWT) and punch grafting on 15 patients, after wide excision of acral lentiginous melanomas on the foot, and compared these to 26 patients who underwent either secondary intention healing (SIH, n = 13) or NPWT (n = 13) alone. The punch grafting with NPWT group showed significantly shorter healing times than those of the other two groups. Evaluation of completely healed wounds using the Vancouver Burn Scar Assessment Scale revealed that the punch grafting group had mean values better, or comparable, to the SIH or NPWT group in four of the five scales (except pigmentation). As for complications, only one patient developed a wound infection after punch grafting. Further, by utilizing NPWT for fixation of punch grafts, it was possible to treat all subjects as outpatients after punch grafting. These results show that a combination treatment of NPWT and punch grafting is an excellent therapeutic option for post-wide excision wounds on the feet, with significantly shortened healing times and favorable cosmetic outcomes. PMID:26173565

  13. Long-term skin damage due to chemical weapon exposure.

    PubMed

    Firooz, Alireza; Sadr, Bardia; Davoudi, Seyed M; Nassiri-Kashani, Mansour; Panahi, Yunes; Dowlati, Yahya

    2011-03-01

    Sulfur mustard (2,2-dichlorodiethyl sulfide: SM), the protagonist of vesicant chemical weapons, was first used in July 1917. Despite prohibition of its production and use by international conventions, it has been used in several conflicts. More than 100,000 soldiers and civilians were injured due to SM exposure during Iran-Iraq war (1980-1988). The acute skin lesions consist of erythema, edema, and blisters. Skin xerosis and pruritus, pigmentation disorders, scars, and cherry angiomas are among the most common long-term skin lesions after contact with SM. Although SM is a well-known carcinogenic substance, skin cancers are rarely reported.

  14. Anyone Can Get Skin Cancer

    Cancer.gov

    No matter if your skin is light, dark, or somewhere in between, everyone is at risk for skin cancer. Learn what skin cancer looks like, how to find it early, and how to lower the chance of skin cancer.

  15. Expert consensus document on the treatment of descending thoracic aortic disease using endovascular stent-grafts.

    PubMed

    Svensson, Lars G; Kouchoukos, Nicholas T; Miller, D Craig; Bavaria, Joseph E; Coselli, Joseph S; Curi, Michael A; Eggebrecht, Holger; Elefteriades, John A; Erbel, Raimund; Gleason, Thomas G; Lytle, Bruce W; Mitchell, R Scott; Nienaber, Christoph A; Roselli, Eric E; Safi, Hazim J; Shemin, Richard J; Sicard, Gregorio A; Sundt, Thoralf M; Szeto, Wilson Y; Wheatley, Grayson H

    2008-01-01

    Between 43,000 and 47,000 people die annually in the United States from diseases of the aorta and its branches and continues to increase. For the thoracic aorta, these diseases are increasingly treated by stent-grafting. No prospective randomized study exists comparing stent-grafting and open surgical treatment, including for disease subgroups. Currently, one stent-graft device is approved by the Food and Drug Administration for descending thoracic aortic aneurysms although two new devices are expected to obtain FDA approval in 2008. Stent-graft devices are used "off label" or under physician Investigational Device Exemption studies for other indications such as traumatic rupture of the aorta and aortic dissection. Early first-generation devices suffered from problems such as stroke with insertion, ascending aortic dissection or aortic penetration from struts, vascular injury, graft collapse, endovascular leaks, graft material failure, continued aneurysm expansion or rupture, and migration or kinking; however, the newer iterations coming to market have been considerably improved. Although the devices have been tested in pulse duplicators out to 10 years, long-term durability is not known, particularly in young patients. The long-term consequences of repeated computed tomography scans for checking device integrity and positioning on the risk of irradiation-induced cancer remains of concern in young patients. This document (1) reviews the natural history of aortic disease, indications for repair, outcomes after conventional open surgery, currently available devices, and insights from outcomes of randomized studies using stent-grafts for abdominal aortic aneurysm surgery, the latter having been treated for a longer time by stent-grafts; and (2) offers suggestions for treatment. PMID:18083364

  16. Hydrocarbon compositions containing polyolefin graft polymers

    SciTech Connect

    Kapuscinski, M.M.; Liu, C.S.; Hart, W.P.; Grina, L.D.

    1987-02-03

    A graft polymer is described comprising an oil-soluble, substantially linear, carbon-carbon backbone polymer having graft polymerized thereon units derived from, as a functional monomer, the reaction product of (i) an unsaturated aldehyde or ketone and (ii) a primary or secondary amine which contains at least one nitrogen atom in a heterocyclic ring. The graft polymer is also described wherein the backbone polymer is a copolymer of ethylene-propylene or a terpolymer of ethylene-propylene-diene monomer.

  17. Organosiloxane-grafted natural polymer coatings

    DOEpatents

    Sugama, Toshifumi

    1998-12-01

    A new family of polysaccharide graft polymers are provided as corrosion resistant coatings having antimicrobial properties which are useful on light metals such as aluminum, magnesium, zinc, steel and their alloys. Methods of making the polysaccharide graft polymers are also included. The methods of making the polysaccharide graft polymers involve reacting a polysaccharide source with an antimicrobial agent under conditions of hydrolysis-condensation. 17 figs.

  18. Preoperative graft assessment in aortocoronary bypass surgery

    PubMed Central

    Tinica, Grigore; Vartic, Cristina Luca; Mocanu, Veronica; Baran, Dana; Butcovan, Doina

    2016-01-01

    Coronary artery bypass graft (CABG) is a surgical procedure able to improve the blood supply to the myocardium. In the present study, the distal segments of grafts taken from the internal thoracic artery (ITA), radial artery (RA) and saphenous vein (SV) for use in aortocoronary bypass surgery were examined. The morphologies of the grafts were investigated in order to draw conclusions concerning their patency and viability. In addition, clinical and laboratory risk factors considered to be significant predictors of lesion severity in graft vessels used in CABGs were investigated. In total, 54 distal graft segments of ITAs, RAs and SVs from 20 men and 6 women aged between 42 and 78 years, were evaluated. Histological analyses were used to visualize graft lesions. Morphometrically, the intimal thickness index (ITI) and luminal narrowing were assessed as an indication of graft patency. The histological changes observed in the graft vessel walls included the presence of distinct atheromatous plaques (fatty streaks in 2 cases) or thickening of the intima (20 cases) and media (17 cases). Morphometric analysis showed that the mean ITI of the vessel conduits was 0.37 in the SVs, 0.95 in the RAs, and 1.66 in the ITAs. No patient had >50% conduit stenosis. By assessing the association between risk factors and graft lesions, it was found that all the patients showed risk factors for atherosclerosis, such as age (61.54%), arterial hypertension (65.38%), hyperlipidemia (65.38%), smoking (34.61%), diabetes mellitus (38.46%) and obesity (15.38%). The presence of pre-existing lesions in bypass grafts may contribute to a reduction in their viability, particularly in the case of venous grafts. Further long-term follow-ups are mandatory to evaluate the consequences of such lesions upon the patency of the grafts. PMID:27446279

  19. Outcomes of AV Fistulas and AV Grafts after Interventional Stent-Graft Deployment in Haemodialysis Patients

    SciTech Connect

    Schmelter, Christopher Raab, Udo; Lazarus, Friedrich; Ruppert, Volker; Vorwerk, Dierk

    2015-08-15

    PurposeThe study was designed to assess outcomes of arteriovenous (AV) accesses after interventional stent-graft deployment in haemodialysis patients.Materials and Methods63 haemodialysis patients with 66 AV fistulas and AV grafts were treated by interventional stent-graft deployment from 2006 to 2012 at our hospital. Data of these patients were retrospectively analysed for location of deployed stent-grafts, occurrence and location of (re-)stenosis and (re-)thrombosis. Complex stenosis was the most frequent indication for stent-graft deployment (45.5 %), followed by complications of angioplasty with vessel rupture or dissection (31.8 %).ResultsA high rate of procedural success was achieved (98.5 %). The most frequent location of the deployed stent-graft was the draining vein (66.7 %). Stent-graft deployment was more frequent in AV grafts than in AV fistulas. Primary patency was 45.5 % at 6 month, 31.3 % at 12 month and 19.2 % at 24 month. Primary patency was significantly better for AV fistulas than for AV grafts with deployed stent-grafts. Patency of the deployed stent-graft was much better than overall AV access primary patency with deployed stent-graft. Re-stenosis with thrombosis was the most frequent indication for re-intervention. Most frequent location of re-stenosis was the draining vein (37.1 %), followed by stenosis at the AV access (29.5 %) and the deployed stent-graft (23.5 %).ConclusionRe-stenosis and re-thrombosis remain frequent in AV fistulas and AV grafts in haemodialysis patients despite stent-graft deployment. Re-stenosis of the deployed stent-graft is, only in the minority of the cases, responsible for AV access dysfunction.

  20. A systematic review on skin complications of bone-anchored hearing aids in relation to surgical techniques.

    PubMed

    Mohamad, Shwan; Khan, Imran; Hey, S Y; Hussain, S S Musheer

    2016-03-01

    A systematic review to study the skin complications associated with the bone-anchored hearing aid in relation to surgical techniques. The following databases have been searched: MEDLINE, EMBASE, the Cochrane Library , Google scholar and the PubMed. The literature search date was from January 1977 until November 2013. Randomised controlled trials and retrospective studies were included. Initial search identified 420 publications. Thirty articles met the inclusion criteria of this review. The most common surgical techniques identified were full-thickness skin graft, Dermatome and linear incision techniques. The result shows that dermatome technique is associated with higher rate of skin complications when compared to linear incision and skin graft techniques. Based on the available literature, the use of a linear incision technique appears to be associated with lower skin complications; however, there is limited data available supporting this. Higher quality studies would allow a more reliable comparison between the surgical techniques.

  1. Custom stent fabrication for free gingival grafts around osseointegrated abutment fixtures.

    PubMed

    Brygider, R M; Bain, C A

    1989-09-01

    The Branemark system of osseointegrated dental implants offers a viable treatment alternative for patients whose conventional prostheses have not been successful. However, the unkeratinized, loosely attached nature of the oral mucosa through which the fixtures may pass often presents a region of easy trauma. A free gingival graft of keratinized tissue from the hard palate can be substituted for these tissues. The success of the graft is dependent upon early healing and protection of the recipient site. This protection can be accomplished by fabrication and use of a custom acrylic resin tissue stent extended beyond the borders of the surgical site. PMID:2681702

  2. Pursuing prosthetic electronic skin.

    PubMed

    Chortos, Alex; Liu, Jia; Bao, Zhenan

    2016-09-01

    Skin plays an important role in mediating our interactions with the world. Recreating the properties of skin using electronic devices could have profound implications for prosthetics and medicine. The pursuit of artificial skin has inspired innovations in materials to imitate skin's unique characteristics, including mechanical durability and stretchability, biodegradability, and the ability to measure a diversity of complex sensations over large areas. New materials and fabrication strategies are being developed to make mechanically compliant and multifunctional skin-like electronics, and improve brain/machine interfaces that enable transmission of the skin's signals into the body. This Review will cover materials and devices designed for mimicking the skin's ability to sense and generate biomimetic signals. PMID:27376685

  3. [Skin diseases and obesity].

    PubMed

    Guerra-Segovia, Carolina; Ocampo-Candiani, Jorge

    2015-01-01

    Obesity is a public health problem worldwide. It predominates in industrialized countries; however, it is prevalent in all nations. It is defined as a condition of excess adipose tissue and is the result of changes in lifestyle, excessive consumption of energy-dense foods with poor nutritional value, physical inactivity and the reduction of open space where one can practice a sport. Although obesity is associated with multiple diseases, it is important to stress that the metabolic changes caused by it affect skin physiology and play a predisposing factor for the development of skin diseases. Very little has been studied on the impact of obesity on the skin. The purpose of this article is to review the most frequently skin diseases in obesity. Some skin pathologies in obesity are caused by changes in skin physiology, others are related to insulin resistance or constitute an exacerbating factor for dermatitis. This article covers the clinical features of obesity related skin disease and its management.

  4. Pursuing prosthetic electronic skin

    NASA Astrophysics Data System (ADS)

    Chortos, Alex; Liu, Jia; Bao, Zhenan

    2016-09-01

    Skin plays an important role in mediating our interactions with the world. Recreating the properties of skin using electronic devices could have profound implications for prosthetics and medicine. The pursuit of artificial skin has inspired innovations in materials to imitate skin's unique characteristics, including mechanical durability and stretchability, biodegradability, and the ability to measure a diversity of complex sensations over large areas. New materials and fabrication strategies are being developed to make mechanically compliant and multifunctional skin-like electronics, and improve brain/machine interfaces that enable transmission of the skin's signals into the body. This Review will cover materials and devices designed for mimicking the skin's ability to sense and generate biomimetic signals.

  5. Graft union formation in artichoke grafting onto wild and cultivated cardoon: an anatomical study.

    PubMed

    Trinchera, Alessandra; Pandozy, Gianmarco; Rinaldi, Simona; Crinò, Paola; Temperini, Olindo; Rea, Elvira

    2013-12-15

    In order to develop a non-chemical method such as grafting effective against well-known artichoke soil borne diseases, an anatomical study of union formation in artichoke grafted onto selected wild and cultivated cardoon rootstocks, both resistant to Verticillium wilt, was performed. The cardoon accessions Belgio (cultivated cardoon) and Sardo (wild cardoon) were selected as rootstocks for grafting combinations with the artichoke cv. Romolo. Grafting experiments were carried out in the autumn and spring. The anatomical investigation of grafting union formation was conducted by scanning electron microscopy (SEM) on the grafting portions at the 3rd, 6th, 10th, 12th day after grafting. For the autumn experiment only, SEM analysis was also performed at 30 d after grafting. A high affinity between artichoke scion and cardoon rootstocks was observed, with some genotype differences in healing time between the two bionts. SEM images of scion/rootstock longitudinal sections revealed the appearance of many interconnecting structures between the two grafting components just 3d after grafting, followed by a vascular rearrangement and a callus development during graft union formation. De novo formation of many plasmodesmata between scion and rootstock confirmed their high compatibility, particularly in the globe artichoke/wild cardoon combination. Moreover, the duration of the early-stage grafting process could be influenced not only by the scion/rootstock compatibility, but also by the seasonal conditions, being favored by lower temperatures and a reduced light/dark photoperiod. PMID:23932643

  6. Graft union formation in artichoke grafting onto wild and cultivated cardoon: an anatomical study.

    PubMed

    Trinchera, Alessandra; Pandozy, Gianmarco; Rinaldi, Simona; Crinò, Paola; Temperini, Olindo; Rea, Elvira

    2013-12-15

    In order to develop a non-chemical method such as grafting effective against well-known artichoke soil borne diseases, an anatomical study of union formation in artichoke grafted onto selected wild and cultivated cardoon rootstocks, both resistant to Verticillium wilt, was performed. The cardoon accessions Belgio (cultivated cardoon) and Sardo (wild cardoon) were selected as rootstocks for grafting combinations with the artichoke cv. Romolo. Grafting experiments were carried out in the autumn and spring. The anatomical investigation of grafting union formation was conducted by scanning electron microscopy (SEM) on the grafting portions at the 3rd, 6th, 10th, 12th day after grafting. For the autumn experiment only, SEM analysis was also performed at 30 d after grafting. A high affinity between artichoke scion and cardoon rootstocks was observed, with some genotype differences in healing time between the two bionts. SEM images of scion/rootstock longitudinal sections revealed the appearance of many interconnecting structures between the two grafting components just 3d after grafting, followed by a vascular rearrangement and a callus development during graft union formation. De novo formation of many plasmodesmata between scion and rootstock confirmed their high compatibility, particularly in the globe artichoke/wild cardoon combination. Moreover, the duration of the early-stage grafting process could be influenced not only by the scion/rootstock compatibility, but also by the seasonal conditions, being favored by lower temperatures and a reduced light/dark photoperiod.

  7. Privileged status of the subcutaneous site for skin allografts in rats.

    PubMed

    Hamilton, M S; Billingham, R E

    1979-09-01

    Evidence is presented that in rats the subcutaneous site can extend privilege to both major histocompatibility complex (MHC)-incompatible (FI X DA)F1 leads to FI and MHC-compatible LEW leads to FI skin allografts, approximately doubling the median survival time of similar grafts transplanted orthotopically. Unlike graft dosage, "gene" dosage was an important variable in that grafts from (FI X DA)F1 donors significantly outlived those from DA strain donors. Prior splenectomy of the hosts did not prejudice the capacity of their subcutaneous sites to extend privilege. It was found that the hemagglutinin response incited by subcutaneous grafts was significantly delayed compared with that evoked by similar grafts transplanted orthotopically or intraperitoneally. This observation, coupled with our inability to demonstrate the passage of India ink to regional lymph nodes after its injection into the dermis of established subcutaneous grafts of syngenic skin, is consistent with the concept that poor endowment of the subcutaneous milieu with both blood and lymph vessels is the principal factor underlying its hospitality to allografts. PMID:386584

  8. Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model.

    PubMed

    Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

    2016-04-29

    Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (Sec(PBMC)), apoptotic PBMCs (Apo-Sec(PBMC)), or controls. The wounds treated with Apo-Sec(PBMC) had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-Sec(PBMC) had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-Sec(PBMC) significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting.

  9. Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model

    PubMed Central

    Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

    2016-01-01

    Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (SecPBMC), apoptotic PBMCs (Apo-SecPBMC), or controls. The wounds treated with Apo-SecPBMC had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-SecPBMC had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-SecPBMC significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting. PMID:27125302

  10. Paracrine Factors from Irradiated Peripheral Blood Mononuclear Cells Improve Skin Regeneration and Angiogenesis in a Porcine Burn Model.

    PubMed

    Hacker, Stefan; Mittermayr, Rainer; Nickl, Stefanie; Haider, Thomas; Lebherz-Eichinger, Diana; Beer, Lucian; Mitterbauer, Andreas; Leiss, Harald; Zimmermann, Matthias; Schweiger, Thomas; Keibl, Claudia; Hofbauer, Helmut; Gabriel, Christian; Pavone-Gyöngyösi, Mariann; Redl, Heinz; Tschachler, Erwin; Mildner, Michael; Ankersmit, Hendrik Jan

    2016-01-01

    Burn wounds pose a serious threat to patients and often require surgical treatment. Skin grafting aims to achieve wound closure but requires a well-vascularized wound bed. The secretome of peripheral blood mononuclear cells (PBMCs) has been shown to improve wound healing and angiogenesis. We hypothesized that topical application of the PBMC secretome would improve the quality of regenerating skin, increase angiogenesis, and reduce scar formation after burn injury and skin grafting in a porcine model. Full-thickness burn injuries were created on the back of female pigs. Necrotic areas were excised and the wounds were covered with split-thickness mesh skin grafts. Wounds were treated repeatedly with either the secretome of cultured PBMCs (Sec(PBMC)), apoptotic PBMCs (Apo-Sec(PBMC)), or controls. The wounds treated with Apo-Sec(PBMC) had an increased epidermal thickness, higher number of rete ridges, and more advanced epidermal differentiation than controls. The samples treated with Apo-Sec(PBMC) had a two-fold increase in CD31+ cells, indicating more angiogenesis. These data suggest that the repeated application of Apo-Sec(PBMC) significantly improves epidermal thickness, angiogenesis, and skin quality in a porcine model of burn injury and skin grafting. PMID:27125302

  11. Nanotribological study of grafted polymer

    NASA Astrophysics Data System (ADS)

    Bouhacina, T.; Aimé, J. P.; Attias, A. J.

    1998-06-01

    The frictional forces between grafted layers, organosilanes and polymer, on silica and a nanotip have been investigated as a function of the tip velocity. From the interpretation of these results and one gets a step forward for more quantitative information. Les forces de friction entre des couches greffées sur silice et une nanopointe ont été étudiées en fonction de la vitesse de la pointe. À partir de l'interprétation de ces résultats on s'avance vers plus d'infor mations quantitatives.

  12. Grafted methylenediphosphonate ion exchange resins

    DOEpatents

    Trochimcznk, Andrzej W.; Gatrone, Ralph C.; Alexandratos, Spiro; Horwitz, E. Philip

    1997-01-01

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorous. The pendent groups have the formula ##STR1## wherein R is hydrogen, a cation or mixtures thereof; and R.sup.1 is hydrogen or an C.sub.1 -C.sub.2 alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange resin are also disclosed.

  13. Grafted methylenediphosphonate ion exchange resins

    DOEpatents

    Trochimcznk, A.W.; Gatrone, R.C.; Alexandratos, S.; Horwitz, E.P.

    1997-04-08

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorus. The pendent groups have the formula as shown in the patent wherein R is hydrogen, a cation or mixtures thereof; and R{sup 1} is hydrogen or an C{sub 1}-C{sub 2} alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange resin are also disclosed.

  14. Grafted methylenediphosphonate ion exchange resins

    SciTech Connect

    Trochimcznk, Andrzej W.; Gatrone, Ralph C.; Alexandratos, Spiro; Horwitz, E. Philip

    1998-01-27

    An ion exchange resin is disclosed that is comprised of an insoluble copolymer onto which are grafted pendent groups that provide 1.0 to about 10 mmol/g dry weight phosphorous. The pendent groups have the formula ##STR1## wherein R is hydrogen, a cation or mixtures thereof; and R.sup.1 is hydrogen or an C.sub.1 -C.sub.2 alkyl group. The resin also contains zero to about 5 mmol/g dry weight of pendent aromatic sulfonate groups. Processes for making and using an ion exchange-resin are also disclosed.

  15. Initiator Effects in Reactive Extrusion of Starch Graft Copolymers

    Technology Transfer Automated Retrieval System (TEKTRAN)

    Graft copolymers of starch with water-soluble polymers such as polyacrylamide have potential applications including hydrogels, superabsorbents, and thickening agents. Reactive extrusion is a rapid, continuous method for production of starch graft copolymers with high reaction and grafting efficienc...

  16. Effect of human skin explants on the neurite growth of the PC12 cell line.

    PubMed

    Lebonvallet, Nicolas; Pennec, Jean-Pierre; Le Gall, Christelle; Pereira, Ulysse; Boulais, Nicholas; Cheret, Jeremy; Jeanmaire, Christine; Danoux, Louis; Pauly, Gilles; Misery, Laurent

    2013-03-01

    The skin is a densely innervated organ. After a traumatic injury, such as an amputation, burn or skin graft, nerve growth and the recovery of sensitivity take a long time and are often incomplete. The roles played by growth factors and the process of neuronal growth are crucial. We developed an in vitro model of human skin explants co-cultured with a rat pheochromocytoma cell line differentiated in neuron in presence of nerve growth factor (NGF). This model allowed the study of the influence of skin explants on nerve cells and nerve fibre growth, probably through mediators produced by the explant, in a simplified manner. The neurite length of differentiated PC12 cells co-cultured with skin explants increased after 6 days. These observations demonstrated the influence of trophic factors produced by skin explants on PC12 cells.

  17. Design and development of multilayer vascular graft

    NASA Astrophysics Data System (ADS)

    Madhavan, Krishna

    2011-07-01

    Vascular graft is a widely-used medical device for the treatment of vascular diseases such as atherosclerosis and aneurysm as well as for the use of vascular access and pediatric shunt, which are major causes of mortality and morbidity in this world. Dysfunction of vascular grafts often occurs, particularly for grafts with diameter less than 6mm, and is associated with the design of graft materials. Mechanical strength, compliance, permeability, endothelialization and availability are issues of most concern for vascular graft materials. To address these issues, we have designed a biodegradable, compliant graft made of hybrid multilayer by combining an intimal equivalent, electrospun heparin-impregnated poly-epsilon-caprolactone nanofibers, with a medial equivalent, a crosslinked collagen-chitosan-based gel scaffold. The intimal equivalent is designed to build mechanical strength and stability suitable for in vivo grafting and to prevent thrombosis. The medial equivalent is designed to serve as a scaffold for the activity of the smooth muscle cells important for vascular healing and regeneration. Our results have shown that genipin is a biocompatible crosslinker to enhance the mechanical properties of collagen-chitosan based scaffolds, and the degradation time and the activity of smooth muscle cells in the scaffold can be modulated by the crosslinking degree. For vascular grafting and regeneration in vivo, an important design parameter of the hybrid multilayer is the interface adhesion between the intimal and medial equivalents. With diametrically opposite affinities to water, delamination of the two layers occurs. Physical or chemical modification techniques were thus used to enhance the adhesion. Microscopic examination and graft-relevant functional characterizations have been performed to evaluate these techniques. Results from characterization of microstructure and functional properties, including burst strength, compliance, water permeability and suture

  18. Grafting techniques for Peyronie’s disease

    PubMed Central

    2016-01-01

    Peyronie’s disease (PD) is a benign fibrotic condition of the penile tunica albuginea. PD can be associated with penile pain, curvature, shortening, and erectile dysfunction (ED). The predominant and most bothersome symptom in affected patients is penile curvature, which can lead to inability to have sexual intercourse. In such cases, surgical correction of the curvature may be required. Plication techniques to correct curvature can cause penile shortening and therefore are generally reserved for curvatures <60°. Penile prosthesis implantation with simultaneous correction of curvature by various means is recommended in PD patients with ED not responding to medical therapy. Grafting techniques are the preferred surgical treatment in patients with penile curvatures >60°, short penis, or hourglass deformity. Patients scheduled for grafting surgery are required to have satisfactory erectile rigidity preoperatively. There are various grafting materials that can be used for closure of the tunica albuginea defect following plaque incision/excision. Both autologous and non-autologous grafts have been used for PD reconstructive surgery, and each graft has its advantages and disadvantages. Novel grafting materials are presented and discussed in this review. A major advantage of the available “off-the-shelf” grafts is that there is no harvesting from a donor site and, thus, morbidity is reduced, and operative times are minimized. Further investigations in regard to tissue-engineered grafts to improve surgical handling and postoperative outcomes are ongoing. Surgeon experience, careful patient selection, patient preference and type of penile deformity affect the choice of graft. This review summarizes the literature within the past 5 years regarding grafting techniques in PD. Surgical outcomes and limitations of grafting techniques are reported. A major objective of this review is dedicated to preoperative considerations and indications for grafting procedures, with

  19. New strategies for preoperative skin antisepsis.

    PubMed

    Ulmer, Miriam; Lademann, Juergen; Patzelt, Alexa; Knorr, Fanny; Kramer, Axel; Koburger, Torsten; Assadian, Ojan; Daeschlein, Georg; Lange-Asschenfeldt, Bernhard

    2014-01-01

    During the past decades, encouraging progress has been made in the prevention of surgical site infections (SSI). However, as SSI still occur today, strategic prevention measures such as standardized skin antisepsis must be implemented and rigorously promoted. Recent discoveries in skin physiology necessitate the development of novel antiseptic agents and procedures in order to ameliorate their efficacy. In particular, alternate target structures in the skin need to be taken into consideration for the development of the next generation of antiseptics. Recent investigations have shown that a high number of microorganisms are located within and in the close vicinity of the hair follicles. This suggests that these structures are an important reservoir of bacterial growth and activity in human skin. To date, it has not been fully elucidated to what extent conventional liquid antiseptics sufficiently target the hair follicle-related microbial population. Modern technologies such as tissue-tolerable plasma (TTP) have been tested for their potential antiseptic efficiency by reducing the bacterial load in the skin and in the hair follicles. First experiments using liposomes to deliver antiseptics into the hair follicles have been evaluated for their potential clinical application. The present review evaluates these two innovative methods for their efficacy and applicability in preoperative skin antiseptics.

  20. Tunable engineered skin mechanics via coaxial electrospun fiber core diameter.

    PubMed

    Blackstone, Britani Nicole; Drexler, Jason William; Powell, Heather Megan

    2014-10-01

    Autologous engineered skin (ES) offers promise as a treatment for massive full thickness burns. Unfortunately, ES is orders of magnitude weaker than normal human skin causing it to be difficult to apply surgically and subject to damage by mechanical shear in the early phases of engraftment. In addition, no manufacturing strategy has been developed to tune ES biomechanics to approximate the native biomechanics at different anatomic locations. To enhance and tune ES biomechanics, a coaxial (CoA) electrospun scaffold platform was developed from polycaprolactone (PCL, core) and gelatin (shell). The ability of the coaxial fiber core diameter to control both scaffold and tissue mechanics was investigated along with the ability of the gelatin shell to facilitate cell adhesion and skin development compared to pure gelatin, pure PCL, and a gelatin-PCL blended fiber scaffold. CoA ES exhibited increased cellular adhesion and metabolism versus PCL alone or gelatin-PCL blend and promoted the development of well stratified skin with a dense dermal layer and a differentiated epidermal layer. Biomechanics of the scaffold and ES scaled linearly with core diameter suggesting that this scaffold platform could be utilized to tailor ES mechanics for their intended grafting site and reduce graft damage in vitro and in vivo.

  1. Biodegradability of poly(3-hydroxybutyrate) film grafted with vinyl acetate: Effect of grafting and saponification

    NASA Astrophysics Data System (ADS)

    Wada, Yuki; Seko, Noriaki; Nagasawa, Naotsugu; Tamada, Masao; Kasuya, Ken-ichi; Mitomo, Hiroshi

    2007-06-01

    Radiation-induced graft polymerization of vinyl acetate (VAc) onto poly(3-hydroxybutyrate) (PHB) film was carried out. At a degree of grafting higher than 5%, the grafted films (PHB-g-VAc) completely lost the enzymatic degradability that is characteristic of PHB due to the grafted VAc covering the surface of the PHB film. However, the biodegradability of the PHB-g-VAc films was recovered when the films were saponified in alkali solution under optimum conditions. Graft chains of the PHB-g-VAc film reacted selectively to become biodegradable polyvinyl alcohol (PVA). The biodegradability of the saponified PHB-g-VAc film increased rapidly with time.

  2. Conventional mechanical ventilation

    PubMed Central

    Tobias, Joseph D.

    2010-01-01

    The provision of mechanical ventilation for the support of infants and children with respiratory failure or insufficiency is one of the most common techniques that are performed in the Pediatric Intensive Care Unit (PICU). Despite its widespread application in the PICUs of the 21st century, before the 1930s, respiratory failure was uniformly fatal due to the lack of equipment and techniques for airway management and ventilatory support. The operating rooms of the 1950s and 1960s provided the arena for the development of the manual skills and the refinement of the equipment needed for airway management, which subsequently led to the more widespread use of endotracheal intubation thereby ushering in the era of positive pressure ventilation. Although there seems to be an ever increasing complexity in the techniques of mechanical ventilation, its successful use in the PICU should be guided by the basic principles of gas exchange and the physiology of respiratory function. With an understanding of these key concepts and the use of basic concepts of mechanical ventilation, this technique can be successfully applied in both the PICU and the operating room. This article reviews the basic physiology of gas exchange, principles of pulmonary physiology, and the concepts of mechanical ventilation to provide an overview of the knowledge required for the provision of conventional mechanical ventilation in various clinical arenas. PMID:20927268

  3. The changing face of graft-versus-host disease.

    PubMed

    Schaffer, Julie V

    2006-12-01

    Despite advances in the procedure and posttransplantation immunosuppressive therapy, more than half of allogeneic hematopoietic stem cell transplant (HSCT) recipients develop graft-versus-host disease (GVHD), which remains a major cause of morbidity and mortality. Modern HSCT protocols have resulted in substantial alterations in the timing and relative incidences of acute and chronic GVHD, making traditional classification schemes obsolete. This article reviews major changes in HSCT during the past decade, evolving concepts of acute and chronic GVHD (including new diagnostic criteria) and the expanding spectrum of cutaneous GVHD. It focuses on observations that have led to a better delineation of the full constellation of skin findings in chronic cutaneous GVHD, including lichen sclerosus, morpheaform lesions, and eosinophilic fasciitis. Recent insights into pathogenesis of GVHD, lessons from GVHD arising in settings outside HSCT, and therapeutic advances also are highlighted.

  4. HISTOPATHOLOGIC DIAGNOSIS OF CHRONIC GRAFT VERSUS HOST DISEASE

    PubMed Central

    Shulman, Howard M.; Cardona, Diana M.; Greenson, Joel K.; Hingorani, Sangeeta; Horn, Thomas; Huber, Elisabeth; Kreft, Andreas; Longerich, Thomas; Morton, Thomas; Myerson, David; Prieto, Victor G.; Rosenberg, Avi; Treister, Nathaniel; Washington, Kay; Ziemer, Mirjana; Pavletic, Steven Z.; Lee, Stephanie J.; Flowers, Mary E.D.; Schultz, Kirk R.; Jagasia, Madan; Martin, Paul J.; Vogelsang, Georgia B.; Kleiner, David E.

    2015-01-01

    The 2005 National Institute of Health (NIH) Consensus Conference outlined histopathological diagnostic criteria for the major organ systems affected by both acute and chronic graft-versus-host disease (GVHD). The 2014 Consensus Conference led to this updated document with new information from histopathological studies of GVHD in the gut, liver, skin and oral mucosa and expanded discussion of GVHD in the lungs and kidneys. The recommendations for final histological diagnostic categories have been simplified from 4 categories to 3: no GVHD, possible, and likely GVHD based on better reproducibility achieved by combining the previous categories of consistent with and definite GVHD into the single category of likely GVHD. Issues remain in the histopathological characterization of GVHD, particularly with respect to the threshold of histological changes required for diagnostic certainty. Guidance is provided for the incorporation of biopsy information into prospective clinical studies of GVHD, particularly with respect to biomarker validation. PMID:25639770

  5. Acute graft-vs-host disease: pathobiology and management.

    PubMed

    Goker, H; Haznedaroglu, I C; Chao, N J

    2001-03-01

    Acute graft-vs-host disease (GVHD) is a major obstacle to safe allogeneic hematopoietic stem cell transplantation (HSCT), leading to a significant morbidity and mortality. GVHD occurs when transplanted donor T lymphocytes react to foreign host cells. It causes a wide variety of host tissue injuries. This review focuses on the pathobiological basis, clinical aspects, and current management strategies of acute GVHD. Afferent phase of acute GVHD starts with myeloablative conditioning, i.e., before the infusion of the graft. Total-body irradiation (TBI) or high-dose chemotherapy regimens cause extensive damage and activation in host tissues, which release inflammatory cytokines and enhance recipient major histocompatibility complex (MHC) antigens. Recognition of the foreign host antigens by donor T cells and activation, stimulation, and proliferation of T cells is crucial in the afferent phase. Effector phase of acute GVHD results in direct and indirect damage to host cells. The skin, gastrointestinal tract, and liver are major target organs of acute GVHD. Combination drug prophylaxis in GVHD is essential in all patients undergoing allogeneic HSCT. Steroids have remained the standard for the treatment of acute GVHD. Several clinical trials have evaluated monoclonal antibodies or receptor antagonist therapy for steroid-resistant acute GVHD, with different successes in a variety of settings. There are some newer promising agents like mycophenolate mofetil, glutamic acid-lysine-alanine-tyrosine (GLAT), rapamycin, and trimetrexate currently entering in the clinical studies, and other agents are in development. Future experimental and clinical studies on GVHD will shed further light on the better understanding of the disease pathobiology and generate the tools to treat malignant disorders with allogeneic HSCT with specific graft-vs-tumor effects devoid of GVHD. PMID:11274753

  6. Cell-Assisted Lipotransfer Improves Volume Retention in Irradiated Recipient Sites and Rescues Radiation-Induced Skin Changes

    PubMed Central

    Luan, Anna; Duscher, Dominik; Whittam, Alexander J.; Paik, Kevin J.; Zielins, Elizabeth R.; Brett, Elizabeth A.; Atashroo, David A.; Hu, Michael S.; Lee, Gordon K.; Gurtner, Geoffrey C.; Longaker, Michael T.; Wan, Derrick C.

    2016-01-01

    Radiation therapy is not only a mainstay in the treatment of many malignancies but also results in collateral obliteration of microvasculature and dermal/subcutaneous fibrosis. Soft tissue reconstruction of hypovascular, irradiated recipient sites through fat grafting remains challenging; however, a coincident improvement in surrounding skin quality has been noted. Cell-assisted lipotransfer (CAL), the enrichment of fat with additional adipose-derived stem cells (ASCs) from the stromal vascular fraction, has been shown to improve fat volume retention, and enhanced outcomes may also be achieved with CAL at irradiated sites. Supplementing fat grafts with additional ASCs may also augment the regenerative effect on radiation-damaged skin. In this study, we demonstrate the ability for CAL to enhance fat graft volume retention when placed beneath the irradiated scalps of immunocompromised mice. Histologic metrics of fat graft survival were also appreciated, with improved structural qualities and vascularity. Finally, rehabilitation of radiation-induced soft tissue changes were also noted, as enhanced amelioration of dermal thickness, collagen content, skin vascularity, and biomechanical measures were all observed with CAL compared to unsupplemented fat grafts. Supplementation of fat grafts with ASCs therefore shows promise for reconstruction of complex soft tissue defects following adjuvant radiotherapy. PMID:26661694

  7. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    PubMed

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis.

  8. Osteogenesis effect of guided bone regeneration combined with alveolar cleft grafting: assessment by cone beam computed tomography.

    PubMed

    Xiao, W-L; Zhang, D-Z; Chen, X-J; Yuan, C; Xue, L-F

    2016-06-01

    Cone beam computed tomography (CBCT) allows for a significantly lower radiation dose than conventional computed tomography (CT) scans and provides accurate images of the alveolar cleft area. The osteogenic effect of guided bone regeneration (GBR) vs. conventional alveolar bone grafting alone for alveolar cleft defects was evaluated in this study. Sixty alveolar cleft patients were divided randomly into two groups. One group underwent GBR using acellular dermal matrix film combined with alveolar bone grafting using iliac crest bone grafts (GBR group), while the other group underwent alveolar bone grafting only (non-GBR group). CBCT images were obtained at 1 week and at 3 months following the procedure. Using Simplant 11.04 software, the bone resorption rate was calculated and compared between the two groups. The bone resorption rate from 1 week to 3 months following bone grafting without the GBR technique was 36.50±5.04%, whereas the bone resorption rate using the GBR technique was 31.69±5.50% (P=0.017). The application of autogenous iliac bone combined with the GBR technique for alveolar bone grafting of alveolar cleft patients can reduce bone resorption and result in better osteogenesis. PMID:26876144

  9. Fat Grafting in Burn Scar Alleviates Neuropathic Pain via Anti-Inflammation Effect in Scar and Spinal Cord.

    PubMed

    Huang, Shu-Hung; Wu, Sheng-Hua; Lee, Su-Shin; Chang, Kao-Ping; Chai, Chee-Yin; Yeh, Jwu-Lai; Lin, Sin-Daw; Kwan, Aij-Lie; David Wang, Hui-Min; Lai, Chung-Sheng

    2015-01-01

    Burn-induced neuropathic pain is complex, and fat grafting has reportedly improved neuropathic pain. However, the mechanism of fat grafting in improving neuropathic pain is unclear. Previous investigations have found that neuroinflammation causes neuropathic pain, and anti-inflammatory targeting may provide potential therapeutic opportunities in neuropathic pain. We hypothesized that fat grafting in burn scars improves the neuropathic pain through anti-inflammation. Burn-induced scar pain was confirmed using a mechanical response test 4 weeks after burn injuries, and autologous fat grafting in the scar area was performed simultaneously. After 4 weeks, the animals were sacrificed, and specimens were collected for the inflammation test, including COX-2, iNOS, and nNOS in the injured skin and spinal cord dorsal horns through immunohistochemistry and Western assays. Furthermore, pro-inflammatory cytokines (IL-1 β and TNF-α) in the spinal cord were collected. Double immunofluorescent staining images for measuring p-IκB, p-NFκB, p-JNK, and TUNEL as well as Western blots of AKT, Bax/Bcl-2 for the inflammatory process, and apoptosis were analyzed. Fat grafting significantly reduced COX2, nNOS, and iNOS in the skin and spinal cord dorsal horns, as well as IL-1β and TNF-α, compared with the burn group. Moreover, regarding the anti-inflammatory effect, the apoptosis cells in the spinal cord significantly decreased after the fat grafting in the burn injury group. Fat grafting was effective in treating burn-induced neuropathic pain through the alleviation of neuroinflammation and ameliorated spinal neuronal apoptosis. PMID:26368011

  10. What is the 'true' function of skin?

    PubMed

    Chuong, C M; Nickoloff, B J; Elias, P M; Goldsmith, L A; Macher, E; Maderson, P A; Sundberg, J P; Tagami, H; Plonka, P M; Thestrup-Pederson, K; Bernard, B A; Schröder, J M; Dotto, P; Chang, C M; Williams, M L; Feingold, K R; King, L E; Kligman, A M; Rees, J L; Christophers, E

    2002-04-01

    Conventional textbook wisdom portrays the skin as an organ that literally enwraps whatever each of us stands for as a more or less functional, individual member of the mammalian species, and has it that the skin primarily establishes, controls and transmits contacts with the external world. In addition, the skin has long been recognized to protect the organism from deleterious environmental impacts (physical, chemical,microbiological), and is well-known as crucial for the maintenance of temperature, electrolyte and fluid balance. Now, ever more studies are being published that show the skin to also operate as a huge and highly active biofactory for the synthesis,processing and/or metabolism of an astounding range of e.g. structural proteins, glycans, lipids and signaling molecules. Increasingly, it becomes appreciated that the skin, furthermore, is an integral component of the immune, nervous and endocrine systems, with numerous lines of cross-talk between these systems established intracutaneously (e.g. Ann NY Acad Sci Vol 885, 1999; Endocrine Rev 21:457-487, 2000; Physiol Rev 80:980-1020, 2001; Exp Dermatol 10: 349-367, 2001). All these emerging cutaneous functions beyond the classical image of the skin as a barrier and sensory organ are immediately relevant for many of the quandaries that clinical dermatology, dermatopathology, and dermatopharmacology are still struggling with to-date, and offer the practising dermatologist attractive new targets for therapeutic intervention. Yet, many of these skin functions are not even mentioned in dermatology textbooks and await systematic therapeutic targeting. Following a suggestion by Enno Christophers, the current 'Controversies' feature brings together an unusually diverse council of biologists and clinicians, who share their thought-provoking views with the readers and allow us to peek into the future of research in cutaneous biology, not the least by reminding us of the -- often ignored -- evolutionary and embryonal

  11. Ethylene vinyl acetate based radiation grafted hydrophilic matrices: Process parameter standardization, grafting kinetics and characterization

    NASA Astrophysics Data System (ADS)

    Chaudhari, C. V.; Mondal, R. K.; Dubey, K. A.; Grover, V.; Panicker, L.; Bhardwaj, Y. K.; Varshney, L.

    2016-08-01

    A transparent, elastomeric, grafted matrix for several potential applications was synthesized by single-step simultaneous radiation grafting of methacrylic acid onto ethylene vinyl acetate (EVA). CuSO4 was found to be the most suitable homo-polymerization inhibitor among different inhibitors tried. The grafting kinetics was found to be a strong function of dose rate (D) and monomer content (M) and an equation relating grafting rate Rg=Kg [M]1.13D0.23 was deduced. Crystallinity of the grafted matrices as assessed from XRD and DSC measurements indicated decrease in crystalline content with increase in grafting yield, suggesting crystalline domain of EVA get disrupted on grafting. Elastic modulus increased linearly with the increase in grafting yield, though elongation at break decreased precipitously from 900% to 30% at even ~9% grafting. Thermo-gravimetric analysis showed three step weight loss of the grafted EVA matrix. The grafting of MAA resulted in increase in surface energy mainly due to enhanced polar component.

  12. Thermal stability of grafted fibers. [Gamma radiation

    SciTech Connect

    Sundardi, F.; Kadariah; Marlianti, I.

    1983-10-01

    Presented the experimental results on the study of thermal stability of grafted fibers, i.e., polypropylene-, polyester-, and rayon-grafted fibers. These fibers were obtained by radiation grafting processes using hydrophylic monomers such as 1-vinyl 2-pyrolidone, acrylic acid, N-methylol acrylamide, and acrylonitrile. The thermal stability of the fibers was studied using a Shimadzu Thermal Analyzer DT-30. The thermal stability of the fibers, which can be indicated by the value of the activation energy for thermal degradation, was not improved by radiation grafting. The degree of improvement depends on the thermal stability of the monomers used for grafting. The thermal stability of a polypropylene fiber, either a grafted or an ungrafted one, was found to be inferior compared to the polyester of a rayon fiber, which may be due to the lack of C=O and C=C bonds in the polypropylene molecules. The thermal stability of a fiber grafted with acrylonitrile monomer was found to be better than that of an ungrafted one. However, no improvement was detected in the fibers grafted with 1-vinyl 2-pyrrolidone monomer, which may be due to the lower thermal stability of poly(1-vinyl-2-pyrrolidone), compared to the polypropylene or polyester fibers. 17 figures, 3 tables.

  13. Skin mirrors human aging.

    PubMed

    Nikolakis, Georgios; Makrantonaki, Evgenia; Zouboulis, Christos C

    2013-12-01

    Abstract Aged skin exhibits disturbed lipid barrier, angiogenesis, production of sweat, immune functions, and calcitriol synthesis as well as the tendency towards development of certain benign or malignant diseases. These complex biological processes comprise endogenous and exogenous factors. Ethnicity also markedly influences the phenotype of skin aging. The theories of cellular senescence, telomere shortening and decreased proliferative capacity, mitochondrial DNA single mutations, the inflammation theory, and the free radical theory try to explain the biological background of the global aging process, which is mirrored in the skin. The development of advanced glycation end-products and the declining hormonal levels are major factors influencing intrinsic aging. Chronic photodamage of the skin is the prime factor leading to extrinsic skin aging. The deterioration of important skin functions, due to intrinsic and extrinsic aging, leads to clinical manifestations, which mirror several internal age-associated diseases such as diabetes, arterial hypertension and malignancies.

  14. Surface zwitterionization of expanded poly(tetrafluoroethylene) membranes via atmospheric plasma-induced polymerization for enhanced skin wound healing.

    PubMed

    Jhong, Jheng-Fong; Venault, Antoine; Hou, Chun-Chung; Chen, Sheng-Han; Wei, Ta-Chin; Zheng, Jie; Huang, James; Chang, Yung

    2013-07-24

    Development of bioinert membranes to prevent blood clotting, tissue adhesion, and bacterial attachment is important for the wound healing process. In this work, two wound-contacting membranes of expanded poly(tetrafluoroethylene) (ePTFE) grafted with zwitterionic poly(sulfobetaine methacrylate) (PSBMA) and hydrophilic poly(ethylene glycol) methacrylate (PEGMA) via atmospheric plasma-induced surface copolymerization were studied. The surface grafting chemical structure, hydrophilicity, and hydration capability of the membranes were determined to illustrate the correlations between bioadhesive properties and wound recovery of PEGylated and zwitterionic ePTFE membranes. Bioadhesive properties of the membranes were evaluated by the plasma protein adsorption, platelet activation, blood cell hemolysis, tissue cell adhesion, and bacterial attachment. It was found that the zwitterionic PSBMA-grafted ePTFE membrane presented high hydration capability and exhibited the best nonbioadhesive character in contact with protein solution, human blood, tissue cells, and bacterial medium. This work shows that zwitterionic membrane dressing provides a moist environment, essential for "deep" skin wound healing observed from the animal rat model in vivo and permits a complete recovery after 14 days, with histology of repaired skin similar to that of normal skin tissue. This work suggests that the bioinert nature of grafted PSBMA polymers obtained by controlling grafting structures gives them great potential in the molecular design of antibioadhesive membranes for use in skin tissue regeneration. PMID:23795955

  15. ESD and the Rio Conventions

    ERIC Educational Resources Information Center

    Sarabhai, Kartikeya V.; Ravindranath, Shailaja; Schwarz, Rixa; Vyas, Purvi

    2012-01-01

    Chapter 36 of Agenda 21, a key document of the 1992 Earth Summit, emphasised reorienting education towards sustainable development. While two of the Rio conventions, the Convention on Biological Diversity (CBD) and the United Nations Framework Convention on Climate Change (UNFCCC), developed communication, education and public awareness (CEPA)…

  16. Modified T-Graft for Extracorporeal Membrane Oxygenation in a Patient with Small-Caliber Femoral Arteries

    PubMed Central

    Calderon, Daniel; El-Banayosy, Aly; Koerner, Michael M.; Reed, Amy B.

    2015-01-01

    Extracorporeal membrane oxygenation (ECMO) is generally used as a last resort to provide cardiopulmonary support in patients whose advanced cardiac or respiratory failure does not respond to less invasive treatments. Lower-limb ischemia secondary to the large diameter of the arterial cannula is one of ECMO's major limitations: in patients who have small-caliber arteries, the cannulas can reduce native blood flow. The creation of a T-graft—a well-described technique to avoid limb ischemia—enables flow into the ECMO cannula without jeopardizing blood flow to the limb. However, leaving the graft exposed through an open groin wound can result in dislodgment, and it increases the risk of infection. We describe our modification of a conventional T-graft in an 18-year-old woman who had systolic heart failure, acute respiratory distress syndrome, and small-caliber femoral vessels. We tunneled a polytetrafluoroethylene graft inside a Dacron graft, then ran the combined graft through a subcutaneous tunnel similar to that created for a peripheral bypass. Thus, the graft was protected from environmental exposure and the risk of infection. Our technique seems safer and more secure than the original T-graft technique, and we recommend its consideration during ECMO cannulation. PMID:26664305

  17. Polyethylene oxide hydration in grafted layers

    NASA Astrophysics Data System (ADS)

    Dormidontova, Elena; Wang, Zilu

    Hydration of water soluble polymers is one of the key-factors defining their conformation and properties, similar to biopolymers. Polyethylene oxide (PEO) is one of the most important biomedical-applications polymers and is known for its reverse temperature solubility due to hydrogen bonding with water. As in many practical applications PEO chains are grafted to surfaces, e.g. of nanoparticles or planar surfaces, it is important to understand PEO hydration in such grafted layers. Using atomistic molecular dynamic simulations we investigate the details of molecular conformation and hydration of PEO end-grafted to gold surfaces. We analyze polymer and water density distribution as a function of distance from the surface for different grafting densities. Based on a detailed analysis of hydrogen bonding between polymer and water in grafted PEO layers, we will discuss the extent of PEO hydration and its implication for polymer conformation, mobility and layer properties. This research is supported by NSF (DMR-1410928).

  18. Skin care and incontinence

    MedlinePlus

    Incontinence - skin care; Incontinence - pressure sore; Incontinence - pressure ulcer ... redness, peeling, irritation, and yeast infections likely. Bedsores ( pressure sores ) may also develop if the person: Has ...

  19. Bacterial Skin Infections.

    PubMed

    Ibrahim, Fadi; Khan, Tariq; Pujalte, George G A

    2015-12-01

    Skin and soft tissue infections account for 0.5% of outpatient visits to primary care. Skin and soft tissue infections can usually be managed in an outpatient setting. However, there are certain circumstances as discussed in this article that require more urgent care or inpatient management. Primary care providers should be able to diagnose, manage, and provide appropriate follow-up care for these frequently seen skin infections. This article provides family physicians with a comprehensive review of the assessment and management of common bacterial skin infections. PMID:26612370

  20. Bacterial Skin Infections.

    PubMed

    Ibrahim, Fadi; Khan, Tariq; Pujalte, George G A

    2015-12-01

    Skin and soft tissue infections account for 0.5% of outpatient visits to primary care. Skin and soft tissue infections can usually be managed in an outpatient setting. However, there are certain circumstances as discussed in this article that require more urgent care or inpatient management. Primary care providers should be able to diagnose, manage, and provide appropriate follow-up care for these frequently seen skin infections. This article provides family physicians with a comprehensive review of the assessment and management of common bacterial skin infections.

  1. The MEK inhibitor trametinib separates murine graft-versus-host disease from graft-versus-tumor effects

    PubMed Central

    Itamura, Hidekazu; Tawara, Isao; Kubota, Yasushi; Kariya, Ryusho; Okada, Seiji; Kimura, Shinya

    2016-01-01

    The efficacy of allogeneic hematopoietic stem cell transplantation for hematologic malignancies is limited by the difficulty in suppressing graft-versus-host disease (GVHD) without compromising graft-versus-tumor (GVT) effects. We previously showed that RAS/MEK/ERK signaling depends on memory differentiation in human T cells, which confers susceptibility to selective inhibition of naive T cells. Actually, antineoplastic MEK inhibitors selectively suppress alloreactive T cells, sparing virus-specific T cells in vitro. Here, we show that trametinib, a MEK inhibitor clinically approved for melanoma, suppresses GVHD safely without affecting GVT effects in vivo. Trametinib prolonged survival of GVHD mice and attenuated GVHD symptoms and pathology in the gut and skin. It inhibited ERK1/2 phosphorylation and expansion of donor T cells, sparing Tregs and B cells. Although high-dose trametinib inhibited myeloid cell engraftment, low-dose trametinib suppressed GVHD without severe adverse events. Notably, trametinib facilitated the survival of mice transplanted with allogeneic T cells and P815 tumor cells with no residual P815 cells observed in the livers and spleens, whereas tacrolimus resulted in P815 expansion. These results confirm that trametinib selectively suppresses GVHD-inducing T cells while sparing antitumor T cells in vivo, which makes it a promising candidate for translational studies aimed at preventing or treating GVHD. PMID:27699218

  2. The MEK inhibitor trametinib separates murine graft-versus-host disease from graft-versus-tumor effects

    PubMed Central

    Itamura, Hidekazu; Tawara, Isao; Kubota, Yasushi; Kariya, Ryusho; Okada, Seiji; Kimura, Shinya

    2016-01-01

    The efficacy of allogeneic hematopoietic stem cell transplantation for hematologic malignancies is limited by the difficulty in suppressing graft-versus-host disease (GVHD) without compromising graft-versus-tumor (GVT) effects. We previously showed that RAS/MEK/ERK signaling depends on memory differentiation in human T cells, which confers susceptibility to selective inhibition of naive T cells. Actually, antineoplastic MEK inhibitors selectively suppress alloreactive T cells, sparing virus-specific T cells in vitro. Here, we show that trametinib, a MEK inhibitor clinically approved for melanoma, suppresses GVHD safely without affecting GVT effects in vivo. Trametinib prolonged survival of GVHD mice and attenuated GVHD symptoms and pathology in the gut and skin. It inhibited ERK1/2 phosphorylation and expansion of donor T cells, sparing Tregs and B cells. Although high-dose trametinib inhibited myeloid cell engraftment, low-dose trametinib suppressed GVHD without severe adverse events. Notably, trametinib facilitated the survival of mice transplanted with allogeneic T cells and P815 tumor cells with no residual P815 cells observed in the livers and spleens, whereas tacrolimus resulted in P815 expansion. These results confirm that trametinib selectively suppresses GVHD-inducing T cells while sparing antitumor T cells in vivo, which makes it a promising candidate for translational studies aimed at preventing or treating GVHD.

  3. Lymphoedema of the penis and scrotum as a sequela of chronic skin infection

    PubMed Central

    Nishimoto, Soh; Kinoshita, Masato; Miyazaki, Yuko; Kawai, Kenichiro; Kakibuchi, Masao

    2016-01-01

    A Japanese male patient presented with an enormously disfigured penis and scrotum. The penis was swollen and distorted rightward, and the skin was hard and lumpy. The patient had had a subdermal abscess for 6 years. The current condition was considered secondary lymphoedema of the penis and scrotum resulting from chronic skin infection. Wide excision of the affected area with bilateral inguinal lymph node dissection were performed. The degloved penile shaft and scrotum were covered with skin grafts, and a satisfactory result was obtained. PMID:27432903

  4. Grafted cellulose for PAHs removal present in industrial discharge waters

    NASA Astrophysics Data System (ADS)

    Euvrard, Elise; Druart, Coline; Poupeney, Amandine; Crini, Nadia; Vismara, Elena; Lanza, Tommaso; Torri, Giangiacomo; Gavoille, Sophie; Crini, Gregorio

    2014-05-01

    Keywords: cellulose; biosorbent; PAHs; polycontaminated wastewaters; trace levels. Polycyclic aromatic hydrocarbons (PAHs), chemicals essentially formed during incomplete combustion of organic materials from anthropogenic activities, were present in all compartments of the ecosystem, air, water and soil. Notably, a part of PAHs found in aquatic system was introduced through industrial discharge waters. Since the Water Framework Directive has classified certain PAHs as priority hazardous substances, industrials are called to take account this kind of organic pollutants in their global environmental concern. Conventional materials such as activated carbons definitively proved their worth as finishing treatment systems but remained costly. In this study, we proposed to use cellulose grafted with glycidyl methacrylate [1] for the removal of PAHs present in discharge waters of surface treatment industries. Firstly, to develop the device, we worked with synthetic solutions containing 16 PAHs at 500 ng/L. Two types of grafted cellulose were tested over a closed-loop column with a concentration of 4g cellulose/L: cellulose C2 with a hydroxide group and cellulose C4 with an amine group. No PAH was retained by the raw cellulose whereas abatement percentages of PAHs were similar between C2 and C4 (94% and 98%, respectively, for the sum of the 16 PAHs) with an experiment duration of 400 min (corresponding to about 20 cycles through grafted cellulose). Secondly, to determine the shorter time to abate the amount maximum of PAHs through the system, a kinetic was realized from 20 min (one cycle) to 400 min with C4. The steady state (corresponding to about 95% of abatement of the total PAHs) was reached at 160 min. Finally, the system was then tested with real industrial discharge waters containing both mineral and organic compounds. The results indicated that the abatement percentage of PAHs was similar between C2 and C4, corroborating the tests with synthetic solution. In return

  5. Nanostructured anti-bacterial poly-lactic-co-glycolic acid films for skin tissue engineering applications.

    PubMed

    Karahaliloğlu, Zeynep; Ercan, Batur; Chung, Stanley; Taylor, Erik; Denkbaş, Emir B; Webster, Thomas J

    2014-12-01

    Major issues faced with the use of today's skin grafts are infection, scar tissue formation, insufficient keratinocyte (or skin producing cells) proliferation and high production costs. To overcome these limitations, we propose here for the first time, a nanofeatured poly(lactide-co-glycolide) (PLGA) membrane as a next generation antibacterial skin graft material. An alkaline surface treatment method was used to create random nanofeatures on PLGA membranes where sodium hydroxide (NaOH) concentration and exposure times were altered to control surface morphology. Most significantly, and without the use of antibiotics, results showed a decrease in Staphylococcus aureus (a dangerous pathogen infecting skin grafts) growth for up to ∼40% after 2 days of culture on nanofeatured PLGA membranes compared to untreated controls. Results also showed that while bacteria growth was stunted, mammalian cell growth was not. Specifically, cell culture results showed an increase in human epidermal keratinocyte density, while the density of scar tissue forming human dermal fibroblasts, did not change on nanofeatured PLGA surfaces compared to the untreated controls after 3 days of culture. These findings indicate that the alkaline treatment of PLGA membranes is a promising quick and effective manner to limit scar tissue formation and bacterial invasion while increasing skin cell proliferation for improving numerous wound-healing applications. PMID:24677536

  6. Nanostructured anti-bacterial poly-lactic-co-glycolic acid films for skin tissue engineering applications.

    PubMed

    Karahaliloğlu, Zeynep; Ercan, Batur; Chung, Stanley; Taylor, Erik; Denkbaş, Emir B; Webster, Thomas J

    2014-12-01

    Major issues faced with the use of today's skin grafts are infection, scar tissue formation, insufficient keratinocyte (or skin producing cells) proliferation and high production costs. To overcome these limitations, we propose here for the first time, a nanofeatured poly(lactide-co-glycolide) (PLGA) membrane as a next generation antibacterial skin graft material. An alkaline surface treatment method was used to create random nanofeatures on PLGA membranes where sodium hydroxide (NaOH) concentration and exposure times were altered to control surface morphology. Most significantly, and without the use of antibiotics, results showed a decrease in Staphylococcus aureus (a dangerous pathogen infecting skin grafts) growth for up to ∼40% after 2 days of culture on nanofeatured PLGA membranes compared to untreated controls. Results also showed that while bacteria growth was stunted, mammalian cell growth was not. Specifically, cell culture results showed an increase in human epidermal keratinocyte density, while the density of scar tissue forming human dermal fibroblasts, did not change on nanofeatured PLGA surfaces compared to the untreated controls after 3 days of culture. These findings indicate that the alkaline treatment of PLGA membranes is a promising quick and effective manner to limit scar tissue formation and bacterial invasion while increasing skin cell proliferation for improving numerous wound-healing applications.

  7. About Skin: Your Body's Largest Organ

    MedlinePlus

    ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ... your skin, hair, and nails Skin dictionary Camp Discovery Good Skin Knowledge lesson plans and activities Video library Find a ...

  8. Kilohertz organic complementary inverters driven by surface-grafting conducting polypyrrole electrodes

    NASA Astrophysics Data System (ADS)

    Zhang, Xi; Zhang, Suna; Li, Liqiang; Chen, Xiaosong; Xu, Zeyang; Wu, Kunjie; Li, Hongwei; Meng, Yancheng; Wang, Wenchong; Hu, Wenping; Chi, Lifeng

    2016-09-01

    Surface-grafting conducting polymer has advantage to circumvent the difficulty in patterning as well as the weak interface adhesion on substrate of the conventional conducting polymer, which would be desirable for its application as electrodes in electronic devices. In this work, the patterned surface-grafting polypyrrole (PPY) is used as electrode, which shows merits such as strong interface adhesion, robustness against solvent treatment, easy scaling-up, and good conductivity. Remarkably, the surface-grafting PPY electrodes can efficiently drive both p-type and n-type organic field-effect transistors. By combining p-/n-type transistors, organic complementary inverters are constructed with PPY electrodes, which exhibit low operational voltage (<8 V), high gain (6-17), and low power dissipation (several tens of nW). The switching voltage is approximately 0.5Vdd with a high noise margin (>70% of 0.5Vdd). Dynamic switching measurements indicate that the inverter has an operational frequency of about 3.3 kHz. This is the first report on kilohertz organic complementary inverter driven with surface-grafting conducting polymer electrodes. High device performance, together with the facile patternability and other merits, may promote the application of surface-grafting conducting polymer electrode in the field of organic electronics.

  9. Surface grafting density analysis of high anti-clotting PU-Si-g-P(MPC) films

    NASA Astrophysics Data System (ADS)

    Lu, Chun-Yan; Zhou, Ning-Lin; Xiao, Ying-Hong; Tang, Yi-Da; Jin, Su-Xing; Wu, Yue; Zhang, Jun; Shen, Jian

    2012-02-01

    Well-defined zwitterionic polymer brushes with good blood compatibility were studied, grafted from polyurethane (PU) substrate (PU-Si-g-P(MPC)) by surface-initiated reverse atom transfer radical polymerization (SI-RATRP). We found that the structure of polymer brushes and hence their properties greatly depend on the grafting density. To solve the problems of the normal method for grafting density measurement, i.e., more requirements for qualified and proficient instrument operator, we established an effective and feasible way instead of the conventional method of spectroscopic ellipsometer combined with gel permeation chromatograph (ELM/GPC) to calculate the grafting density of PU-Si-g-P(MPC) films by using a software named ImageJ 1.44e in combination with scanning electronic microscope (SEM) or atomic microscope (AFM). X-ray photoelectron spectroscopy (XPS), SEM and AFM were employed to analyze the surface topography and changes of elements before and after graft modification of the synthetic PU-Si-g-P(MPC) biofilms.

  10. Towards controlled polymer brushes via a self-assembly-assisted-grafting-to approach

    PubMed Central

    Zhou, Tian; Qi, Hao; Han, Lin; Barbash, Dmitri; Li, Christopher Y.

    2016-01-01

    Precise synthesis of polymer brushes to modify the surface of nanoparticles and nanodevices for targeted applications has been one of the major focuses in the community for decades. Here we report a self-assembly-assisted-grafting-to approach to synthesize polymer brushes on flat substrates. In this method, polymers are pre-assembled into two-dimensional polymer single crystals (PSCs) with functional groups on the surface. Chemically coupling the PSCs onto solid substrates leads to the formation of polymer brushes. Exquisite control of the chain folding in PSCs allows us to obtain polymer brushes with well-defined grafting density, tethering points and brush conformation. Extremely high grafting density (2.12 chains per nm2) has been achieved in the synthesized single-tethered polymer brushes. Moreover, polymer loop brushes have been successfully obtained using oddly folded PSCs from telechelic chains. Our approach combines some of the important advantages of conventionalgrafting-to' and ‘grafting-from' methods, and is promising for tailored synthesis of polymer brushes. PMID:27009369

  11. Towards controlled polymer brushes via a self-assembly-assisted-grafting-to approach

    NASA Astrophysics Data System (ADS)

    Zhou, Tian; Qi, Hao; Han, Lin; Barbash, Dmitri; Li, Christopher Y.

    2016-03-01

    Precise synthesis of polymer brushes to modify the surface of nanoparticles and nanodevices for targeted applications has been one of the major focuses in the community for decades. Here we report a self-assembly-assisted-grafting-to approach to synthesize polymer brushes on flat substrates. In this method, polymers are pre-assembled into two-dimensional polymer single crystals (PSCs) with functional groups on the surface. Chemically coupling the PSCs onto solid substrates leads to the formation of polymer brushes. Exquisite control of the chain folding in PSCs allows us to obtain polymer brushes with well-defined grafting density, tethering points and brush conformation. Extremely high grafting density (2.12 chains per nm2) has been achieved in the synthesized single-tethered polymer brushes. Moreover, polymer loop brushes have been successfully obtained using oddly folded PSCs from telechelic chains. Our approach combines some of the important advantages of conventional `grafting-to' and `grafting-from' methods, and is promising for tailored synthesis of polymer brushes.

  12. A novel animal model for skin flap prelamination with biomaterials

    PubMed Central

    Zhou, Xianyu; Luo, Xusong; Liu, Fei; Gu, Chuan; Wang, Xi; Yang, Qun; Qian, Yunliang; Yang, Jun

    2016-01-01

    Several animal models of skin flap construction were reported using biomaterials in a way similar to prefabrication. However, there are few animal model using biomaterials similar to prelamination, another main way of clinical skin flap construction that has been proved to be reliable. Can biomaterials be added in skin flap prelamination to reduce the use of autogenous tissues? Beside individual clinical attempts, animal model is needed for randomized controlled trial to objectively evaluate the feasibility and further investigation. Combining human Acellular Dermal Matrix (hADM) and autologous skin graft, we prelaminated flaps based on inguinal fascia. One, two, three and four weeks later, hADM exhibited a sound revascularization and host cell infiltration. Prelaminated skin flaps were then raised and microsurgically transplanted back to groin region. Except for flaps after one week of prelamination, flaps from other subgroups successfully reconstructed defects. After six to sixteen weeks of transplantation, hADM was proved to being able to maintain its original structure, having a wealth of host tissue cells and achieving full revascularization.To our knowledge, this is the first animal model of prelaminating skin flap with biomaterials. Success of this animal model indicates that novel flap prelamination with biomaterials is feasible. PMID:27659066

  13. THE CLINICAL SIGNIFICANCE OF THE ARTERIAL KETONE BODY RATIO AS AN EARLY INDICATOR OF GRAFT VIABILITY IN HUMAN LIVER TRANSPLANTATION1,2

    PubMed Central

    Asonuma, K.; Takaya, S.; Selby, R.; Okamoto, R.; Yamamoto, Y.; Yokoyama, T.; Todo, S.; Ozawa, K.; Starzl, T.E.

    2010-01-01

    Arterial ketone body ratio (AKBR) was measured sequentially in 84 liver transplantations (OLTx). These transplantation procedures were classified into 3 groups with respect to graft survival and patient condition at the end of the first month (Group A, the grafts survived longer than 1 month with satisfactory patient condition; Group B, the grafts survived longer than 1 month but the patients were ICU-bound; Group C, the grafts were lost and the patients died or underwent re-OLTx). In Group A, the AKBR was elevated to above 1.0 by the second postoperative day. In Group B, the AKBR was elevated to above 0.7 but stayed below 1.0 during this period. In Group C, the AKBR remained below 0.7 longer than 2 days after operation. Although conventional liver function tests showed significant increases in Groups B and C as compared with Group A, they were less specific in predicting ultimate graft survival. PMID:1987686

  14. Gastroepiploic artery as an in situ coronary artery bypass graft: evaluation of MRI and colour Doppler ultrasound in follow-up.

    PubMed

    Vanninen, R L; Vainio, P A; Manninen, H I; Suhonen, M; Jaakola, P

    1995-01-01

    The right gastroepiploic artery, increasingly used as an in situ coronary artery bypass graft, has good long-term patency. This study aimed to assess the accuracy and limitations of magnetic resonance imaging (MRI) and colour Doppler ultrasound (US) in postoperative follow-up of such cases. In eight consecutive patients (6 men, 2 women, mean age 57 years), conventional angiography, MRI and US were performed to evaluate graft patency. Colour Doppler US, performed within a week of the operation, correctly detected flow in three patent grafts. MRI (1.5 tesla) was performed c. 17 months after surgery, using a spine coil and a coronal two-dimensional Flash-type imaging sequence. At angiography six of the eight gastroepiploic artery grafts were patent, and two were occluded. The sensitivity and specificity of MRI were 100%. This accuracy makes MRI a promising method for noninvasive post-operative evaluation of right gastroepiploic artery graft patency. PMID:7644909

  15. Downhill varices secondary to HeRO graft-related SVC syndrome.

    PubMed

    Pillai, Unnikrishnan; Roopkiranjot, Kahlon; Lakshminarayan, Nandagopal; Balabhadrapatruni, Krishna; Gebregeorgis, Wihib; Kissner, Paul

    2013-01-01

    Tunneled hemodialysis catheters are well-documented causes of benign central vein stenosis, which can be associated with proximal or downhill esophageal varices due to shunting of blood flow from the upper portion of the body through the esophageal venous plexuses. A majority of these cases remain asymptomatic. As a result, studies are largely limited to symptomatic patients, with incidence rates ranging from 16% to 29%. Recently, Hemodialysis Reliable Outflow (HeRO) graft has been introduced as an effective alternate hemodialysis access in catheter-dependent patients, especially in the presence of significant central venous occlusion. It differs from a conventional arteriovenous graft (AVG) by the fact that its venous outflow end is in the right atrium via one of the central veins, bypassing any significant occlusion upstream. Lower intervention rates and reduced incidence of bacteremia make it comparable to conventional tunneled catheters. However, the incidence of central vein occlusion and associated complications with HeRO grafts is unknown. We present the first case of gastrointestinal bleeding from downhill esophageal varices secondary to HeRO-graft-related SVC occlusion.

  16. Skin Diseases: Skin and Sun—Not a good mix

    MedlinePlus

    ... Current Issue Past Issues Skin Diseases Skin and Sun —Not a good mix Past Issues / Fall 2008 ... turn Javascript on. Good skin care begins with sun safety. Whether it is something as simple as ...

  17. Skin Problems in Construction

    MedlinePlus

    ... 3 Keep skin clean Wash with soap and clean water if your skin comes in contact with hazardous ... caustics like wet cement. DO NOT use the water in the bucket used to clean your tools. DO NOT use hand sanitizers. Wash ...

  18. Biothermomechanics of skin tissues

    NASA Astrophysics Data System (ADS)

    Xu, F.; Lu, T. J.; Seffen, K. A.

    Biothermomechanics of skin is highly interdisciplinary involving bioheat transfer, burn damage, biomechanics and neurophysiology. During heating, thermally induced mechanical stress arises due to the thermal denaturation of collagen, resulting in macroscale shrinkage. Thus, the strain, stress, temperature and thermal pain/damage are highly correlated; in other words, the problem is fully coupled. The aim of this study is to develop a computational approach to examine the heat transfer process and the heat-induced mechanical response, so that the differences among the clinically applied heating modalities can be quantified. Exact solutions for temperature, thermal damage and thermal stress for a single-layer skin model were first derived for different boundary conditions. For multilayer models, numerical simulations using the finite difference method (FDM) and finite element method (FEM) were used to analyze the temperature, burn damage and thermal stress distributions in the skin tissue. The results showed that the thermomechanical behavior of skin tissue is very complex: blood perfusion has little effect on thermal damage but large influence on skin temperature distribution, which, in turn, influences significantly the resulting thermal stress field; the stratum corneum layer, although very thin, has a large effect on the thermomechanical behavior of skin, suggesting that it should be properly accounted for in the modeling of skin thermal stresses; the stress caused by non-uniform temperature distribution in the skin may also contribute to the thermal pain sensation.

  19. Skin cancer prevention.

    PubMed

    Kornek, Thomas; Augustin, Matthias

    2013-04-01

    Prevention signifies the avoidance of diseases. It also includes the early detection of diseases and taking measures to avoid worsening of an existing disease. Prevention is divided into primary, secondary and tertiary prevention. The prevention of skin cancer is particularly important due to the rising incidence of skin cancer in recent years. In Germany, 195.000 new cases of skin cancer, including non melanoma skin cancer and melanoma are occurring. Therefore, skin cancer is among the most common cancer diseases. Primary prevention comprises the reduction of skin cancer risk behavior, including education about the danger of UV exposure and the right way of dealing with natural and artificial UV radiation. The implementation of a systematic skin cancer screening in Germany contributes to secondary prevention. First data from the initial project in Schleswig-Holstein, Germany's most northern state, indicate for the first time that the incidence and mortality of melanoma can be reduced by secondary prevention. For tertiary prevention, the national associations recommend a risk-adapted, evidence-based follow-up for all types of skin cancer. From the perspectives of the payers and from the patients, prevention is assessed positively. Prevention can contribute to a reduction of disease burden.

  20. Graft impingement in anterior cruciate ligament reconstruction.

    PubMed

    Iriuchishima, Takanori; Shirakura, Kenji; Fu, Freddie H

    2013-03-01

    Anterior cruciate ligament (ACL) graft impingement is one of the most troubling complications in ACL reconstruction. In the previous strategy of isometric "non-anatomical" ACL reconstruction, posterior tibial tunnel placement and notchplasty were recommended to avoid graft impingement. Recently, the strategy of ACL reconstruction is shifting towards "anatomical" reconstruction. In anatomical ACL reconstruction, the potential risk of graft impingement is higher than in non-anatomical reconstruction because the tibial tunnel is placed at a more anterior portion on the tibia. However, there have been few studies reporting on graft impingement in anatomical ACL reconstruction. This study will provide a review of graft impingement status in both non-anatomical and the more recent anatomical ACL reconstruction techniques. In conclusion, with the accurate creation of bone tunnels within ACL native footprint, the graft impingement might not happen in anatomical ACL reconstruction. For the clinical relevance, to prevent graft impingement, surgeons should pay attention of creating correct anatomical tunnels when they perform ACL reconstruction. Level of evidence IV.