RESUMEN
Flexor sheath infection is a hand surgery emergency, and emergent washout is the accepted practice to prevent digital amputation. The authors describe surgical steps to optimize flexor sheath irrigation.
Asunto(s)
Tendones/cirugía , Tenosinovitis/cirugía , Disección , Mano , Humanos , Irrigación TerapéuticaRESUMEN
The basement membrane of the bronchial epithelium separates the epithelial and mesenchymal compartments. Basement membrane pores allow cells to cross this boundary. We present a method for preparation of samples of human basement membrane allowing us easy visualisation and characterisation of the distribution and persistence of these pores. Columnar epithelial cells were removed from airway samples with gentle scraping with a circular glass coverslip. In contrast, the underlying basal cells required incubation once in dithiothreitol and twice in ethylenediaminetetraacetic acid. Scanning electron microscopy (SEM) at each stage of the epithelial stripping process showed the selective removal of epithelial cells with eventual visualisation of the pores. Using confocal microscopy on blocks of viable tissue, pores were shown to persist in culture for at least 5 days, despite the presence of viable cells in the submucosa. The distribution of pores in tissues determined by SEM was compared to simulations of three distribution patterns (random, clumped, and distributed). The pattern of pores in the samples was consistent with a random distribution. We suggest that basement membrane pores can be generated by the passage of infiltrating cells into the epithelium providing a network suitable for intraepithelial surveillance.