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cardiac wound

Aishwarya Satish, Purna Sai Korrapati
Angiogenesis is a vital component of the orchestrated wound healing cascade and tissue regeneration process, which has a therapeutic prominence in treatment of ischemic vascular diseases and certain cardiac conditions. Based on its eminence, several strategies using growth factors have been studied to initiate angiogenesis. However, growth factors are expensive and have short half-life. In this work, sustained release of triiodothyronine, which plays a crucial role in stimulating growth factors and other signaling pathways that are instrumental in initiating angiogenesis, has been attempted through electrospun polycaprolactone nanofibers...
February 12, 2019: AAPS PharmSciTech
Jennifer Chung, Louis-Mathieu Stevens, Maral Ouzounian, Ismail El-Hamamsy, Ismail Bouhout, François Dagenais, Andréanne Cartier, Mark Peterson, Munir Boodhwani, Ming Hao Guo, John Bozinovski, Michael H Yamashita, Carly Lodewyks, Rony Atoui, Bindu Bittira, Darrin Payne, Christopher Tarola, Michael W A Chu
BACKGROUND: Contemporary outcomes following surgical management of thoracic aortic disease have improved; however, the impact of sex-related differences is poorly understood. METHODS: A total of 1653 patients (498 (30.1%) female) underwent thoracic aortic surgery with hypothermic circulatory arrest between 2002 and 2017 in ten institutions of the Canadian Thoracic Aortic Collaborative. Outcomes of interest were in-hospital death, stroke and a modified Society of Thoracic Surgeons-defined composite (STS-COMP) for mortality or major morbidity (stroke, renal failure, deep sternal wound infection, reoperation, prolonged ventilation)...
February 13, 2019: Circulation
Miguel E Habeych, Pouria Moshayedi, Jon C Rittenberger, Scott R Gunn
A 34-year-old male was brought to the hospital with a chest gunshot wound. Pulseless upon arrival, blood pressure was absent for 10 minutes. A thoracotomy resulted in return of spontaneous circulation. On hospital day 5, with brainstem reflexes present, he was unresponsive to call or pain, exhibited generalized hyperreflexia and bilateral Babinskys. Median nerve somatosensory evoked potentials (mSSEPs) and brainstem auditory evoked potentials were obtained. International Federation of Clinical Neurophysiology recommendations for mSSEPs and brainstem auditory evoked potentials were followed...
February 12, 2019: Clinical and Experimental Emergency Medicine
Omair A Shariq, Kristine T Hanson, Nicholas P McKenna, Scott R Kelley, Eric J Dozois, Amy L Lightner, Kellie L Mathis, Elizabeth B Habermann
BACKGROUND: Metabolic syndrome is associated with poorer postoperative outcomes after various abdominal operations. However, the impact of metabolic syndrome on outcomes after colorectal cancer surgery remains poorly described. OBJECTIVE: The purpose of this study was to determine the association between metabolic syndrome and short-term postoperative outcomes in patients undergoing elective colorectal cancer surgery. DESIGN: This was a retrospective cohort study...
January 31, 2019: Diseases of the Colon and Rectum
C Heus, N Bakker, W M Verduin, H J Doodeman, A P J Houdijk
BACKGROUND: Obesity is becoming a bigger health problem every year. Current research shows that the obesity-related metabolic problems are strongly associated with visceral fat and not subcutaneous fat. Visceral obesity (VO) is associated with a worse postoperative outcome in multiple fields of abdominal surgery. On the other hand, muscle mass is related to better postoperative outcome. In rectal cancer patients, we studied the influence of visceral obesity and muscle mass on postoperative complications...
February 4, 2019: World Journal of Surgery
Faisal G Bakaeen, Osama Haddad, Mudathir Ibrahim, Selena R Pasadyn, Emídio Germano, Salvior Mok, M Scott Halbreiner, Kenneth R McCurry, Douglas R Johnston, Stephanie L Mick, José L Navia, Eric E Roselli, Nicholas G Smedira, Edward G Soltesz, Michael Z Tong, Per Wierup, A Marc Gillinov, Lars G Svensson, Penny L Houghtaling, Eugene H Blackstone, Gösta B Pettersson
OBJECTIVE: The objective of this study was to compare safety and clinical effectiveness of negative-pressure wound therapy (NPWT) with traditional wound therapy for managing noninfected open chests with delayed sternal closure after cardiac surgery. METHODS: From January 2000 to July 2015, 452 of 47,325 patients who underwent full sternotomy left the operating room with a noninfected open chest (0.96%), managed using NPWT in 214-with frequency of use rapidly increasing to near 100%-and traditionally in 238...
November 27, 2018: Journal of Thoracic and Cardiovascular Surgery
Rafik Abusamra, Marek Król, Krzysztof Milewski, Mateusz Kachel, Loai Abudaqa, Justyna Jankowska-Sanetra, Kamil Derbisz, Krzysztof Sanetra, Anna Sobieszek, Piotr P Buszman, Wojciech Wojakowski, Paweł E Buszman, Andrzej Bochenek, Marek Cisowski
BACKGROUND: To perform a retrospective analysis of patients who underwent endoscopic atraumatic coronary artery off-pump bypass grafting (EACAB) in a single center over a period of 11 years. METHODS: Data was acquired from the hospital registry and patient medical records. In order to determine changes in clinical profile, patients were subdivided into three groups regarding year of surgery: 1998-2002 (group 1), 2003-2005 (group 2), 2006-2009 (group 3). In-hospital analysis up to 30 days and long-term observation were conducted...
January 31, 2019: Cardiology Journal
Astrid M Otkjaer, Henrik L Jørgensen, Tine Dalsgaard Clausen, Lone Krebs
INTRODUCTION: To compare short-term maternal outcomes in healthy primiparous women with uncomplicated pregnancies who delivered a singleton child in term by planned cesarean or planned vaginal delivery. MATERIAL AND METHODS: Nationwide population-based cohort study of 145 821 low-risk primiparous women with healthy singletons in cephalic position in Denmark, 2008-2016. Data from the Medical Birth Register and the Danish National Patient Registry were linked and compared according to planned mode of delivery...
January 30, 2019: Acta Obstetricia et Gynecologica Scandinavica
F Schlottmann, P D Strassle, A L Cairns, F A M Herbella, A Fichera, M G Patti
BACKGROUND AND AIMS: Colorectal cancer is the third most common cancer among both men and women in the United States. We aimed to determine racial and socioeconomic disparities in emergent colectomy rates for colorectal cancer in the US Health Care system. MATERIAL AND METHODS: We performed a retrospective analysis of the National Inpatient Sample including adult patients (⩾18 years) diagnosed with colorectal cancer, and who underwent colorectal resection while admitted between 2008 and 2015...
January 29, 2019: Scandinavian Journal of Surgery: SJS
Joshua M Liao, Patrick Chan, Lorraine Cornwell, Peter I Tsai, Joseph H Joo, Faisal G Bakaeen, James D Luketich, Danny Chu
BACKGROUND: Morbidly obese patients (body mass index [BMI] ≥ 35 kg/m2 ) who undergo cardiac surgery involving median sternotomy have a higher-than-normal risk of sternal dehiscence. To explore a potential solution to this problem, we examined the utility of transverse sternal plating for primary sternal closure in morbidly obese cardiac surgical patients. METHODS: We retrospectively reviewed data from cardiac surgical patients who underwent single primary xiphoid transverse titanium plate reinforcement for primary sternal closure from August 2009 to July 2010 (n = 8), and we compared their outcomes with those of patients with BMI ≥35 kg/m2 who underwent cardiac surgery without sternal plate reinforcement from April 2008 to July 2009 (n = 14)...
January 28, 2019: Journal of Cardiothoracic Surgery
Rubbel Singla, Syed M S Abidi, Aqib Iqbal Dar, Amitabha Acharya
Tissue engineering (TE) is an emerging field where alternate/artificial tissues or organ substitutes are implanted to mimic the functionality of damaged or injured tissues. Earlier efforts were made to develop natural, synthetic, or semisynthetic materials for skin equivalents to treat burns or skin wounds. Nowadays, many more tissues like bone, cardiac, cartilage, heart, liver, cornea, blood vessels, and so forth are being engineered using 3-D biomaterial constructs or scaffolds that could deliver active molecules such as peptides or growth factors...
January 28, 2019: Journal of Biomedical Materials Research. Part B, Applied Biomaterials
Rachel E Simpson, Mitchell L Fennerty, Cameron L Colgate, E Molly Kilbane, Eugene P Ceppa, Michael G House, Nicholas J Zyromski, Attila Nakeeb, C Max Schmidt
INTRODUCTION: Optimal pain control post-pancreatoduodenectomy is a challenge. Epidural analgesia (EDA) is increasingly utilized despite inherent risks and unclear effects on outcomes. METHODS: All pancreatoduodenectomies (PD) performed from 1/2013-12/2017 were included. Clinical parameters were obtained from retrospective review of a prospective clinical database, the ACS NSQIP prospective institutional database and medical record review. Chi-Square/Fisher's Exact and Independent-Samples t-Tests were used for univariable analyses; multivariable regression (MVR) was performed...
January 21, 2019: Journal of the American College of Surgeons
Gregory J Landry, Timothy K Liem, Cherrie Z Abraham, Enjae Jung, Gregory L Moneta
INTRODUCTION: The major advantage of endovascular abdominal aortic aneurysm repair (EVAR) over open repair (OAR) is improved perioperative morbidity and mortality. Long term results of the two modalities are comparable. We sought to quantify factors predicting perioperative morbidity and mortality in patients undergoing OAR. METHODS: Consecutive non-ruptured OAR were analyzed for patient demographic factors, perioperative variables including blood pressure, temperature, and glucose control, intraoperative factors, and complications including wound, pulmonary, renal and cardiac, and 30-day mortality...
January 5, 2019: American Journal of Surgery
Jesper Nyman, Peter Svenarud, Jan van der Linden
BACKGROUND: Arterial air embolism during open heart surgery may cause postoperative complications including cerebral injury, myocardial dysfunction, and dysrhythmias. Despite standard de-airing techniques during surgery large amounts of arterial air emboli may still occur, especially during weaning from cardiopulmonary bypass. To prevent this insufflation of carbon dioxide in the wound cavity has been used since the 1950s. The aim of this study was to assess a new mini-diffuser for efficient carbon dioxide de-airing of a minimal invasive cardiothoracic wound cavity model...
January 17, 2019: Journal of Cardiothoracic Surgery
Nicholas Paul Suraci, Bryan Kerner, Salomon Poliwoda, Orlando Santana, Gerald Rosen
A 51-year-old male presented with a wound in his right hand that was suspicious for possible septic emboli of cardiac origin. With transesophageal echocardiography, the patient was found to have a rare quadricuspid aortic valve. This quadricuspid valve can present with variable symptoms and physical exam findings. Due to embryological defects, this pathology is associated with several other anatomical defects that are important to recognize prior to surgical intervention. Transesophaegeal echocardiography remains the gold standard in detection of quadricuspid aortic valve and identification of other possible cardiac lesions...
January 2019: Annals of Cardiac Anaesthesia
Marie-Therese Scaglioni, Pietro Giovanoli, Mario F Scaglioni, Johnson Chia-Shen Yang
BACKGROUND: With the rising number of patients in advanced age receiving microsurgical procedures, coronary artery disease (CAD) and its challenging management is of increasing importance. Evidence based data concerning morbidity and mortality are rare. We present our experiences with this highly selected patient population and propose a preoperative assessment algorithm. PATIENTS AND METHODS: Between January 2006 and May 2016, a total of 57 patients with CAD received 58 free flaps...
January 15, 2019: Microsurgery
Marika Bini Antunes, Lidia Costa, Miguel Carneiro, Filipa Santos, Rita Oliveira, Andreia Ferreira, Marco Sampaio, Rosa Guimarães, Joel Pereira, Helena Neto, Margarida Amil, Jorge Coutinho, Rui Carvalho
In this observational study performed during 45 months we evaluated patients with chronic and recalcitrant diabetic ulcers who were treated with homologous platelet gel. METHODS: platelet gels were obtained from homologous platelet concentrates that were aliquoted and freezed, being then activated with calcium gluconate and applied in the ulcer after cleaning and debridement. We evaluated patient's comorbidities, wound characteristics (size, tissue, inflammatory signs, pain), number and time of treatment as well as outcome (classified as complete epithelialization; partial improvement- 50% reduction in wound size or pain relief; no evolution)...
January 2019: Diabetes & Metabolic Syndrome
Hoda Mojiri-Forushani
Wound healing is a natural response to restore the injured tissue to normal. Wound healing is also complicated process involving different cellular, molecular and biochemical mechanisms and various types of cytokines and growth factors. Calcium channel blockers belong to cardiovascular medicine and administrated to treatment of hypertension, angina and cardiac arrhythmia because of vasodilatory effect. Calcium channel blockers is divided to dihydropyridine and non-dihydropyrine. The potential of both dihydropyridine and non-dihydropyrine calcium channel blockers in wound healing have been reported in different animal models and in vitro previously...
December 2018: Iranian Journal of Basic Medical Sciences
Mhamad Faour, Nicolas S Piuzzi, David P Brigati, Alison K Klika, Michael M Mont, Wael K Barsoum, Carlos Higuera-Rueda
BACKGROUND: Aspirin is established as an effective prophylaxis for venous thromboembolism (VTE) after THA; however, there is no consensus as to whether low- or regular-dose aspirin is more effective at preventing VTE. QUESTIONS/PURPOSES: (1) Is there a difference in the incidence of symptomatic VTE within 90 days of elective THA using low-dose aspirin compared with regular-dose aspirin? (2) Is there a difference in the risk of significant bleeding (gastrointestinal and wound bleeding) and mortality between low- and standard-dose aspirin within 90 days after surgery? METHODS: We retrospectively evaluated 7488 patients in our database who underwent THA between September 2012 and December 2016...
January 4, 2019: Clinical Orthopaedics and related Research
Olimpiu Bota, Christoph Josten, Michael A Borger, Nick Spindler, Stefan Langer
BACKGROUND: Deep sternal wound infection remains a serious complication after cardiac surgery, leading to increased morbidity, mortality, and cost. The goal of our study was to develop a standardized, reproducible method to safely cover deep sternal wounds and ensure improved healing rates. METHODS: The study was developed as a retrospective cohort study. We included 58 patients who received standardized latissimus dorsi flap coverage of a sternum defect wound after poststernotomy mediastinitis at our institution between September 2015 and June 2017...
October 26, 2018: Annals of Thoracic Surgery
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