[Bite Wounds Should not be Irrigated by Syringe. An Anatomic Study]. / Spülen von Bisswunden ist obsolet. Eine anatomische Studie.

In the literature about treatment of animal and human bite injuries, it is often recommended that bite wounds should be cleaned with a syringe and button cannula or plastic catheter. This is supposed to clean deeper wound sections and remove contamination and foreign bodies. Recent papers recommend cautious irrigation without high pressure. MATERIAL AND METHOD: In eight cadavers, artificial bite wounds were produced in typical locations. These wounds were irrigated by syringe and button cannula using diluted ink. The pressure of irrigation was limited to "no noticeable pressure". RESULTS: In all cases, more than half of the irrigation volume remained inside the victim´s organism, following anatomic structures and spreading over large areas. CONCLUSION: Irrigation fails to clean the wound but increases the risk of contaminating the surrounding structures. Hence, the authors recommend that bite wounds should not be irrigated by syringe and button cannula.

[Deep sternal wound infection after sternotomy - Report of the consensus workshop of the German-Speaking Society for Microsurgery of Peripheral Nerves and Vessels (DAM)]. / Der tiefe sternale Wundinfekt nach Sternotomie.

Deep sternal wound infection (TSWI) is a potentially life-threatening complication that may occur after median sternotomy, contributing to prolonged hospital stay and increased health care costs. Bacterial infection is often characterized by biofilm formation on implant material and/or dead bone. Diagnosis is made upon clinical signs and symptoms of local and systemic infection. Early multidisciplinary decision making is needed for optimal patient care. Repeated surgical wound debridements accompanied by wound conditioning are performed until clean circumstances are achieved. Thereafter, wound closure and defect reconstruction are obtained using a variety of pedicled and microvascular flaps.

Teaching surgery, radiology and anatomy together: the mix enhances motivation and comprehension.

PURPOSE: Preclinical and clinical topics are often separated in medical education. For example, surgery and radiology are often taught much later than anatomy. The aim of this study was to establish and to evaluate an interdisciplinary course combining these closely related subjects to enhance medical comprehension. METHODS: Two tutorials each lasting one term were offered to second year medical students, in which clinical topics were implemented linking anatomy to surgical and radiological knowledge. A questionnaire was used to evaluate the success of this approach. RESULTS: The motivation of the students was above average and the practical work was done accurately. The students confirmed that the course improved anatomical comprehension (>95%) and that the learned matters were relevant for their future (90%). Furthermore, interest in the subjects was higher after the course (>85%). Critical suggestions were to extend the course and to include more topics. CONCLUSIONS: A mix of surgery, radiology and anatomy is a teaching concept, which leads to high acceptance and interest in medical students.

In vivo tracking of rat preadipocytes after autologous transplantation.

Recent research suggests that transplantation of adipocyte precursors may solve some of the problems encountered with autologous adipocyte transplantation. Numerous earlier and recent in vitro studies have proved that preadipocytes, under certain circumstances, will differentiate into adipocytes and will build up a vacuole. The in vivo control of the success to implant a single-cell suspension of viable preadipocytes and to breed them to mature fat cells has, until now, been lacking. In a Lewis rat model, preadipocytes were harvested by digestion of fat tissue with collagenase type II, separated by repeated centrifugation, incubated with PKH26 (a nontoxic fluorescent surface marker), and reimplanted into the donor animal. In a follow-up of 6 months, the gradual differentiation of the fluorescent graft cells toward adipocytes could be observed using the confocal microscope. The observed changes in the graft cells were in exact accordance with the authors' expectations, which were based on the in vitro studies in literature. This study encourages further research of manipulated preadipocytes, feeding patterns, and so forth.

Measurement in vivo of the survival rate in autologous adipocyte transplantation.

Up until now, research on fat cells has been unable to prove their survival rate objectively in vivo. In this article, the first application of the cell surface marker PKH26 in the fat cells of rats is reported. In a study of 48 Lewis rats, this method enabled the objective stereometry of viable and necrotic grafts after variable follow-up times in groups of eight animals each. The best survival rate was 30.41 percent, and the best implantation site was the interscapular subcutis. During follow-up, a characteristic change in size of the viable fat cells matched the in vitro findings of various investigators. Because of the surface marking, it could be proved that the viable cells found after 6 months were transplanted cells that had undergone a cycle of fat deprivation and regaining. This is proof of the cell survival theory postulated by Peer in 1950.

Unexpected durability of PKH 26 staining on rat adipocytes.

In a case of autologous mature fat cell transplantation to an individual rat, persistence of adipose staining with PKH26 was detected 14.5 months later. Fluorescent fat cells with spotty surface markings were easily visible. Such a long period of persistence and stability of staining exceeds the expectation from previous reports, and the given half-life of the substance. This finding encourages the use of the dye for long-term follow-up of connective tissue cells, especially adipocytes and preadipocytes, following transplantation.