Quantification of Erythema Associated With Varying Suture Materials in Facial Surgery Repair: A Randomized Prospective Study.

BACKGROUND: A common concern among patients following Mohs micrographic surgery (MMS) is scar appearance and residual erythema. However, few studies have quantitatively compared scar erythema between different suture materials. OBJECTIVE: To quantify erythema intensity (EI) associated with use of percutaneous nylon, irradiated polyglactin-910 (IPG) and fast-absorbing gut (FG) sutures on facial sites. METHODS: After undergoing MMS, 210 patients were randomized to one of 2 groups. Patients in the first group (n = 105) had their defects repaired half with continuous IPG sutures and the other half with nylon sutures; the second group (n = 105) received IPG and FG sutures. Standardized photographs of scars were taken at 1 week, 2 months, and 6 months postoperatively and computer-assisted image analysis was used to quantify EI. RESULTS: The average EI was comparable between all 3 suture materials at 1 week, 2 months, and 6 months. From 1 week to 2 months, EI in nylon, IPG, and FG sutures decreased by 24.8%, 12.8%, and 17.9% (p < .05), respectively. There was no statistically significant difference in EI among suture types between 2 and 6 months. CONCLUSION: Erythema decreased significantly during early scar maturation in all groups and was comparable between all suture materials at 1 week, 2 months, and 6 months.

Inclusão da ligadura da artéria e veia córnea com abraçadeira de naylon para descorna em bovinos / Inclusion of ligadura artery and vein cornea naylon with the clamp to dehorning in cattle / Inclusión de ligadura arteria y la vena cornea naylon con la pinza para descorne de los bovinos

A descorna cirúrgica a campo ainda e uma prática comum em animais de produção, apesar deste procedimento na maioria ainda se realizado por leigos, ou realizada em animais com menos de um ano de idade com ferro candente (avermelhado), esta conduta geralmente é efetuada na propriedade, sendo executada pelo próprio proprietário ou funcionário. O presente experimento usando anestesia geral e bloqueio local do nervo córneo e circularmente na base do corno com abraçadeira de naylon para sutura de pele, associada a ligadura da artéria e veia cornual mostrou ser eficiente reduzindo o tempo cirúrgico a campo e promovendo uma prevenção antecipada de hemorragia que é frequente para este procedimento.(AU)

The surgical dehorning the field and still a common practice in farm animals, although this procedure in most still held by lay people, or performed on animals less than one year old with red-hot iron (red), this conduct is usually done on the property, being executed by the owner himself or employee. This experiment using general anesthesia and local lock of corneal nerve and round the horn base with clamp naylon for skin suture, associated with ligature of the artery and vein cornual is efficient by reducing surgical time field and promoting an early prevention of bleeding is frequent for this procedure.(AU)

El quirúrgica descorne el campo quieto y una práctica común en los animales de granja, aunque este procedimiento en la mayoría todavía en manos de los laicos, o lleva a cabo en animales de menos de un año de edad con hierro al rojo vivo (rojo), este comportamiento se realiza generalmente en la propiedad, los trabajos realizados por el propietario o el propio empleado. Este experimento usando anestesia bloques general y local de los nervios de la córnea y alrededor de la base del cuerno con naylon pinza de sutura de la piel, asociados con la ligadura de la vena y la arteria cornual fue eficiente que reduce el tiempo quirúrgico el campo y la promoción de una prevención temprana sangrado que es común para este procedimiento.(AU)

Quantification of Erythema Associated With Continuous Versus Interrupted Nylon Sutures in Facial Surgery Repair: A Randomized Prospective Study.

BACKGROUND: Patients are often concerned about the cosmetic appearance of scars following Mohs micrographic surgery (MMS), including residual erythema. However, few studies have compared the cosmetic outcomes between different suturing techniques. OBJECTIVE: To compare the erythema intensity (EI) associated with interrupted sutures (IS) and continuous sutures (CS), and the degree of its reduction over time. MATERIALS AND METHODS: Mohs micrographic surgery patients were randomized to have half of their defect repaired with IS and the other half with CS. Postoperatively, subjects were assessed at 1 week, 2 months, and 6 months and close-up photographs of their scars were taken. Computer-assisted image analysis was utilized to quantify the EI in each half-scar. RESULTS: The average EI of IS was greater than that of CS by 9.3% at 1 week (p < .001) and 7.2% at 2 months (p < .021) but comparable at 6 months. These differences were clinically detectable, but EI differences resolved by 6 months in most cases. At 6 months, EI regressed by 33.5% in IS and 26.3% in CS. CONCLUSION: Continuous sutures are associated with less erythema during early scar maturation but are comparable to IS at 6 months. These results may guide the choice of suturing technique to improve early cosmetic outcomes and overall patient satisfaction.

Intracapsular hemorrhage rates in non-fixated nylon sheet orbital implants for orbital fracture management.

PURPOSE: To examine the incidence of intracapsular hemorrhage in orbital fracture repair with non-fixated nylon sheet implants. METHODS: A retrospective chart review of 227 patients presenting from January 2013 to December 2016 for orbital fracture repair with nylon sheet implants. RESULTS: Of the 331 orbital fractures repaired over 4 years, a total of 227 met inclusion criteria. The average implant thickness was 0.38 mm and no implants were fixated. Four total implants (1.8%) were removed due to complications; one each secondary to exploration for ongoing postoperative diplopia, immediate post-operative orbital hemorrhage, a cystic mass anterior to the implant, and pain. There were no cases of intracapsular hemorrhage nor infection for any of the 227 patients over 4 years. CONCLUSIONS: To the authors knowledge, this represents the largest case series to date to assess the rate of intracapsular hemorrhage in non-fixated nylon sheet orbital implants. In the 227 cases reviewed over a 4-year period, there were no cases of intracapsular hemorrhage. This suggests a much lower complication rate than previously reported. PRéCIS: A case series of 227 patients who underwent orbital fracture repair with non-fixated nylon sheet implants.

A comparison of long-term outcomes of nanohydroxyapatite/polyamide-66 cage and titanium mesh cage in anterior cervical corpectomy and fusion: A clinical follow-up study of least 8 years.

OBJECTIVES: The nanohydroxyapatite/polyamide-66 (n-HA/PA66) cage is a novel biomimetic nonmetal cage device that is now used in some medical centers, while the titanium mesh cage (TMC) is a typical metal cage device that has been widely used for decades. This study was performed to compare the long-term outcomes of these two different cages in patients undergoing anterior cervical corpectomy. PATIENTS AND METHODS: This retrospective study involved 107 patients who underwent single-level anterior corpectomy using either a TMC (n = 52) or an n-HA/PA66 cage (n = 55) for treatment of cervical degenerative disease with a minimum follow-up of 8 years. Their radiographic data (cage subsidence, fusion status, segmental sagittal alignment, and cervical spine degeneration) and clinical data [visual analog scale (VAS) and Japanese Orthopedic Association (JOA) scores] were evaluated preoperatively, postoperatively, and at the final follow-up. RESULTS: The mean duration of follow-up was 103.6 ± 6.3 months in the n-HA/PA66 group and 102.4 ± 4.6 months in the TMC group. The n-HA/PA66 group and the TMC group had similar final fusion rates (97% vs. 94%, respectively). The final n-HA/PA66 cage subsidence was 2.4 ± 1.0 mm with 18.2% subsidence of >3 mm, which was significantly lower than the respective 3.0 ± 0.7 mm and 40.4% for the TMC (p < 0.01). The n-HA/PA66 group also had better JOA scores than the TMC group (p < 0.01). No significant difference in the segmental sagittal alignment, cervical lordosis, or VAS score was observed between the two groups (p = 0.18, 0.42, and 0.17, respectively). CONCLUSIONS: The n-HA/PA66 cage is associated with excellent radiographic fusion, lower subsidence and better clinical outcomes than the TMC within 8 years after single-level anterior cervical corpectomy. With the addtional benefit of radiolucency, the n-HA/PA66 cage could be superior to the TMC in anterior cervical construction.

Endometrial Mesenchymal Stem/Stromal Cells Modulate the Macrophage Response to Implanted Polyamide/Gelatin Composite Mesh in Immunocompromised and Immunocompetent Mice.

The immunomodulatory properties of human endometrial mesenchymal stem cells (eMSC) have not been well characterised. Initial studies showed that eMSC modulated the chronic inflammatory response to a non-degradable polyamide/gelatin mesh in a xenogeneic rat skin wound repair model, but the mechanism remains unclear. In this study, we investigated the immunomodulatory effect of eMSC on the macrophage response to polyamide/gelatin composite mesh in an abdominal subcutaneous wound repair model in C57BL6 immunocompetent and NSG (NOD-Scid-IL2Rgamma null ) immunocompromised mice to determine whether responses differed in the absence of an adaptive immune system and NK cells. mCherry lentivirus-labelled eMSC persisted longer in NSG mice, inducing longer term paracrine effects. Inclusion of eMSC in the mesh reduced inflammatory cytokine (Il-1ß, Tnfα) secretion, and in C57BL6 mice reduced CCR7+ M1 macrophages surrounding the mesh on day 3 and increased M2 macrophage marker mRNA (Arg1, Mrc1, Il10) expression at days 3 and 7. In NSG mice, these effects were delayed and only observed at days 7 and 30 in comparison with controls implanted with mesh alone. These results show that the differences in the immune status in the two animals directly affect the survival of xenogeneic eMSC which leads to differences in the short-term and long-term macrophage responses to implanted meshes.

Biodegradable vascular stents with high tensile and compressive strength: a novel strategy for applying monofilaments via solid-state drawing and shaped-annealing processes.

Monofilaments such as those consisting of polyamide (PA), polydioxanone (PDS), and poly(vinylidene fluoride) (PVDF), have been commonly used in various industries. However, most are non-biodegradable, which is unfavorable for many biomedical applications. Although biodegradable polymers offer significant benefits, they are still limited by their weak mechanical properties, which is an obstacle for use as a biomaterial that requires high strength. To overcome the current limitations of biodegradable monofilaments, a novel solid-state drawing (SSD) process was designed to significantly improve the mechanical properties of both PA and poly(l-lactic acid) (PLLA) monofilaments in this study. Both PA and PLLA monofilaments exhibited more than two-fold increased tensile strength and a highly reduced thickness using SSD. In X-ray diffraction and scanning electron microscopy analyses, it was determined that SSD could not only promote the α-crystal phase, but also smoothen the surface of PLLA monofilaments. To apply SSD-monofilaments with superior properties to cardiovascular stents, a shaped-annealing (SA) process was designed as the follow-up process after SSD. Using this process, three types of vascular stents could be fabricated, composed of SSD-monofilaments: double-helix, single-spring and double-spring shaped stents. The annealing temperature was optimized at 80 °C to minimize the loss of mechanical and physical properties of SSD-monofilaments for secondary processing. All three types of vascular stents were tested according to ISO 25539-2. Consequently, it was confirmed that spring-shaped stents had good recovery rate values and a high compressive modulus. In conclusion, this study showed significantly improved mechanical properties of both tensile and compressive strength simultaneously and extended the potential for biomedical applications of monofilaments.

Comparação de resultado estético em cicatrizes com uso de fios cirúrgicos e Prineo® / Comparison between surgical sutures and Prineo® in terms of esthetic result and scar formation

Introdução: Cicatrização de ferida é um processo bem organizado que tem como finalidade a reparação tecidual completa. Colas e adesivos tópicos oferecem uma alternativa não invasiva, de retirada fácil e espontânea; boa força tênsil; menor tempo de aplicação, sendo o Prineo® uma cola adesiva associada a uma malha de poliéster aplicados sobre a ferida. Método: Trata-se de um estudo transversal retrospectivo com análise de 101 procedimentos cirúrgicos no período de 2012 a 2014, nos quais a síntese da ferida operatória ocorreu com fios cirúrgicos de náilon ou Prineo®, sendo aplicada análise estatística. Resultados: Neste estudo, seis pacientes apresentaram dermatite de contato ao uso do Prineo® com significância estatística (p = 0,042). O uso desse sistema diminuiu a taxa de alargamento cicatricial (p < 0,05). O presente trabalho não apresentou diferença estatística (p = 0,068) na qualidade da cicatriz entre os pacientes que utilizaram Prineo® em relação ao grupo controle, demonstrando que em ambos os grupos o resultado cicatricial foi de excelente (87%) a bom (27%) na sua maioria. Conclusão: Conclui-se no estudo que os pacientes que utilizaram o sistema de octil-2-cianocrilato associado a malha, Prineo®, apresentaram menores índices de alargamento cicatricial, dependentes de uma espessura de derme satisfatória, e maiores taxas de dermatites por contato em relação àqueles em que a ferida foi encerrada com fios cirúrgicos. Os dois grupos demonstraram qualidades cicatriciais excelentes a bons, sem diferença estatística em tais resultados estéticos cicatriciais.

Introduction: Wound healing is a well-organized, directed process of tissue repair. The process can be expedited using topical glues and adhesives, which offer a non-invasive, easily removable alternative to suturing. Furthermore, such products have good tensile strength and involve lower application time. In particular, the Prineo® adhesive is applied to a polyester mesh that covers the wound. Method: We carried out a retrospective, cross-sectional study, with subsequent statistical analysis , involving 101 surgical procedures in which wound closure was performed using either nylon sutures or Prineo®. All the procedures were performed between 2012 and 2014. Results: Six patients had contact dermatitis after Prineo® was used, with statistical significance (p = 0.042). Furthermore, Prineo® decreased the rate of scar enlargement (p < 0.05) . There was no statistical difference between the Prineo® and suture groups in terms of scar quality (p = 0.068); in both groups, the scar result was mostly excellent (87 %) to good (27%). Conclusion: Patients whose wounds were closed using Prineo® a system involving octyl-2-cyanoacrylate and an associated polyester mesh displayed lower rates of scar enlargement, which depended on whether the thickness of the dermis was satisfactory. However, the same patients had higher rates of contact dermatitis than those whose wounds were closed using surgical sutures. Both groups showed excellent to good scar quality, with no significant difference in terms of esthetic scar results.

High-performance dendritic contrast agents for X-ray computed tomography imaging using potent tetraiodobenzene derivatives.

The use of computed tomography (CT) for vascular imaging is critical in medical emergencies requiring urgent diagnostic decisions, such as cerebral ischemia and many cardiovascular diseases. Small-molecule iodinated contrast media are often injected intravenously as radiopaque agents during CT imaging to achieve high contrast enhancement of vascular systems. The rapid excretion rate of these agents is overcome by injecting a significantly high dose of iodine, which can have serious side effects. Here we report a simple method to prepare blood-pool contrast agents for CT based on dendrimers for the first time using tetraiodobenzene derivatives as potent radiopaque moieties. Excellent in vivo safety has been demonstrated for these small (13-22nm) unimolecular water-soluble dendritic contrast agents, which exhibit high contrast enhancement in the blood-pool and effectively extend their blood half-lives. Our method is applicable to virtually any scaffold with suitable surface groups and may fulfill the current need for safer, next-generation iodinated CT contrast agents.

Reação tipo corpo estranho a preenchimento facial com poliamida / Foreign body reaction to polyamide filling in the face

O uso de substâncias para preenchimento dérmico é crescente, e o número de complicações devido à sua utilização, significativo. Neste trabalho, relatamos um caso de granulomas de corpo estranho após preenchimento facial com gel de poliamida, chamado AqualiftTM, produto não encontrável nas bases de dados da literatura científica. São discutidos aspectos clínicos, terapêuticos e histopatológicos. Faz-se uma advertência relativa ao uso desta substância.

Dermal fillers are increasingly used, and the number of complications due to their use is significant. In this work, we report the case of foreign body granulomas due to the facial injection of a polyamide gel, named AqualiftTM, a product not found in scientific literature databases. Clinical, therapeutic and hystopathological aspects are discussed. A warning is made, concerning the use of this substance.

A blinded randomized assessment of laser Doppler flowmetry efficacy in standardizing outcome from intraluminal filament MCAO in the rat.

BACKGROUND: Laser Doppler flowmetry (LDF) is widely used for estimating cerebral blood flow changes during intraluminal middle cerebral artery occlusion (MCAO). No investigation has systematically examined LDF efficacy in standardizing outcome. We examined MCAO histologic and behavioral outcome as a function of LDF measurement. MATERIALS AND METHODS: Rats were subjected to 90min MCAO by 4 surgeons having different levels of MCAO surgical experience. LDF was measured in all rats during ischemia. By random assignment, LDF values were (Assisted) or were not (Blinded) made available to each surgeon during MCAO (n=12-17 per group). Neurologic and histologic outcomes were measured 7 days post-MCAO. A second study examined LDF effects on 1-day post-MCAO outcome. RESULTS: Pooled across surgeons, intra-ischemic %LDF change (P=0.12), neurologic scores (Assisted vs. Blinded=14±6 vs. 13±7, P=0.61, mean±standard deviation) and cerebral infarct volume (162±63mm(3)vs. 143±86mm(3), P=0.24) were not different between groups. Only for one surgeon (novice) did LDF use alter infarct volume (145±28mm(3)vs. 98±61mm(3), P=0.03). LDF use decreased infarct volume coefficient of variation (COV) by 35% (P=0.02), but had no effect on neurologic score COV. COMPARISON WITH EXISTING METHODS: We compared intraluminal MCAO outcome as a function of LDF use. CONCLUSIONS: LDF measurement altered neither neurologic nor histologic MCAO outcome. LDF did not decrease neurologic deficit COV, but did decrease infarct volume COV. LDF may allow use of fewer animals if infarct volume is the primary dependent variable, but is unlikely to impact requisite sample sizes if neurologic function is of primary interest.

Investigating stress shielding spanned by biomimetic polymer-composite vs. metallic hip stem: A computational study using mechano-biochemical model.

Periprosthetic bone loss in response to total hip arthroplasty is a serious complication compromising patient's life quality as it may cause the premature failure of the implant. Stress shielding as a result of an uneven load sharing between the hip implant and the bone is a key factor leading to bone density decrease. A number of composite hip implants have been designed so far to improve load sharing characteristics. However, they have rarely been investigated from the bone remodeling point of view to predict a long-term response. This is the first study that employed a mechano-biochemical model, which considers the coupling effect between mechanical loading and bone biochemistry, to investigate bone remodeling after composite hip implantation. In this study, periprosthetic bone remodeling in the presence of Carbon fiber polyamide 12 (CF/PA12), CoCrMo and Ti alloy implants was predicted and compared. Our findings revealed that the most significant periprosthetic bone loss in response to metallic implants occurs in Gruen zone 7 (-43% with CoCrMo; -35% with Ti) and 6 (-40% with CoCrMo; -29% with Ti), while zone 4 has the lowest bone density decrease with all three implants (-9%). Also, the results showed that in terms of bone remodeling, the composite hip implant is more advantageous over the metallic ones as it provides a more uniform density change across the bone and induces less stress shielding which consequently results in a lower post-operative bone loss (-9% with CF/PA12 implant compared to -27% and -21% with CoCrMo and Ti alloy implants, respectively).

Can metabolic impairments in experimental diabetes be cured with poly(amido)amine (PAMAM) G4 dendrimers? In the search for minimizing of the adverse effects of PAMAM administration.

Poly(amido)amine (PAMAM) G4 dendrimers, given intraperitoneally to diabetic rats, have been reported to scavenge excessive blood glucose and minimize the effects of hyperglycaemia, however, at the cost of reduced survival. This paper is the first to compare the effectiveness of three different routes of PAMAM G4 administration with regard to minimizing the adverse effects of hyperglycaemia in rats. Hence, the aim of the study is to identify the most effective and the least harmful method of dendrimer administration. Control and streptozotocin-diabetic Sprague-Dawley rats were exposed to PAMAM G4 (0.5 µmol/kg b.w.) for 60 days, administered intraperitoneally, intragastrically or subcutaneously. Intraperitoneal and subcutaneous administration of PAMAM G4 was found to be most effective in suppressing the long-term markers of hyperglycaemia, while the intragastric route appeared the least effective. Otherwise, the greatest incidence of adverse effects was associated with intraperitoneal and the lowest with subcutaneous delivery. Harmful effects of intragastrical administration were much lower compared to intraperitoneal route, but at the cost of reduced hypoglycaemizing potential. Otherwise, subcutaneous injection represents the best compromise of moderate PAMAM dendrimer toxicity and effective reduction in the markers of long-term severe hyperglycaemia in chronic experimental diabetes.

Interstitial lung disease due to fumes from heat-cutting polymer rope.

Interstitial lung disease (ILD) due to inhalation of fume/smoke from heating or burning of synthetic polymers has not been reported previously. A fish farm worker developed ILD after cutting rope (polypropylene and nylon) for about 2 hours per day over an extended period using an electrically heated 'knife'. This process produced fume/smoke that entered the workers breathing zone. No other likely cause was identified. This case suggests that exposure to airborne contaminants generated by the heating or burning of synthetic polymers has the potential to cause serious lung disease.

Influence of finishing textile materials on the reduction of skin irritations.

BACKGROUND: An increasing number of people is reported to have sensitive skin. Consequently, the development of textile materials with comfortable wearing properties has become a major interest. One method to create a pleasant sensation of textile materials on the skin is to coat them with silk proteins. This technologically complex procedure requires both optimization and control. METHODS: The present study was aimed to characterize the subjective perception of different textiles and to objectively assess their influence on skin morphology with non-invasive optical techniques like optical coherence tomography (OCT), laser scanning microscopy (LSM) and optical surface profilometry (OP). Furthermore, optical methods were used to characterize surface properties of different textile fabrics. RESULTS: In the present study it could be shown that optical non-invasive methods, as applied in cosmetology and dermatology are suited to characterize the structural properties of fabrics and the effects that textile materials have on the skin. Here, both unfinished textile materials and fabrics finished with silk protein coating were investigated by OCT, LSM and OP. In addition, volunteers were interviewed about their subjective sensation when these fabrics were in contact with their skin. CONCLUSION: The study showed that optical methods could be applied to compare textile materials in vitro, which permit the wearing comfort to be predicted and in vivo perception on the skin.

Contemporary denture base resins: Part 2.

UNLABELLED: Provision of partial and complete dentures constructed from resin is commonplace and a satisfactory outcome requires the consideration of the properties of the resin, the oral tissues and prosthodontic principles. This second of a two-part series examines the advantages and disadvantages of flexible nylon denture base resins, which have found popularity for the provision of partial dentures. Adverse effects of denture base resins are examined and the benefits and shortcomings of softliners are explored. Chairside adjustment and polishing, and denture hygiene are also discussed. CLINICAL RELEVANCE: Knowledge of contemporary denture base resin systems will help to achieve optimal outcomes in removable prosthodontics.

Pharmacokinetics of Py-Im polyamides depend on architecture: cyclic versus linear.

The pharmacokinetic properties of three pyrrole-imidazole (Py-Im) polyamides of similar size and Py-Im content but different shape were studied in the mouse. Remarkably, hairpin and cyclic oligomers programmed for the same DNA sequence 5'-WGGWWW-3' displayed distinct pharmacokinetic properties. Furthermore, the hairpin 1 and cycle 2 exhibited vastly different animal toxicities. These data provide a foundation for design of DNA binding Py-Im polyamides to be tested in vivo.

The effect of two sock fabrics on perception and physiological parameters associated with blister incidence: a field study.

The goal of the present study was to investigate differences in perception and skin hydration at the foot of two sock fabrics with distinct moisture properties in a realistic military setting. Thirty-seven military recruits wore two different socks (PP: 99.6% polypropylene and 0.4% elastane, and BLEND: 50% Merino-wool, 33% polypropylene, and 17% polyamide), one on each foot. Measurements were carried out after a daily 6.5-km march on 4 days. Each participant rated temperature, dampness, friction, and comfort for each foot. On a daily selection of participants, skin hydration was measured on three sites of both feet using a corneometer, and moisture content of the socks was determined. BLEND was rated to be cooler, less damp, and more comfortable (P < 0.05). Two out of three skin sites were drier for BLEND than PP (P < 0.05). Moreover, BLEND stored 2.9 ± 0.3 times more moisture compared to PP. Thus, under the present conditions, socks such as BLEND are to be preferred over polypropylene socks.

Did you choose the right suture material for skin closure in elective caesarean section?

Surgical incision should heal with first intension with minimum deformity. Pain perception during postoperative period (short term) and appreciation of scar (long term) are two key components assessed by patients after a caesarean section. The present study compares these parameters using absorbable and non-absorbable material for skin closure using subcuticular stitch. The study shows a significant difference in pain perception on 1st postoperative week along with shorter duration of hospital stay and patients appreciation of scar quality on long term are significantly better in absorbable suture group.