﻿FN Clarivate Analytics Web of Science
VR 1.0
PT J
AU Rodrigues, AC
   Saad, KR
   Saad, PF
   Otsuki, DA
   dos Santos, LC
   Rasslan, S
   Montero, EFD
   Utiyama, EM
AF Rodrigues, Adilson Costa
   Saad, Karen Ruggeri
   Saad, Paulo Fernandes
   Otsuki, Denise Aya
   dos Santos, Luana Carla
   Rasslan, Samir
   de Souza Montero, Edna Frasson
   Utiyama, Edivaldo M.
TI Continuous peritoneal lavage with vacuum perito-neostomy: an
   experimental study
SO CLINICS
LA English
DT Article
DE Peritonitis; Open Abdomen; Laparostomy; Peritoneal Lavage;
   Vacuum-Assisted Closure; Abdominal Sepsis
ID INTRAABDOMINAL INFECTION; DORSOVENTRAL LAVAGE; MANAGEMENT; SURGERY;
   SALINE
AB OBJECTIVE: Despite advances in diffuse peritonitis treatment protocols, some cases develop unfavorably. With the advent of vacuum therapy, the use of laparostomy to treat peritonitis has gained traction. Another treatment modality is continuous peritoneal lavage. However, maintaining this technique is difficult and has been associated with controversial results. We propose a new model of continuous peritoneal lavage that takes advantage of the features and benefits of vacuum laparostomy.
   METHOD: Pigs (Landrace and Large White) under general anesthesia were submitted to laparostomy through which a multiperforated tube was placed along each flank and exteriorized in the left and lower right quadrants. A vacuum dressing was applied, and intermittent negative pressure was maintained. Peritoneal dialysis solution (PDS) was then infused through the tubes for 36 hours. The stability of peritoneostomy with intermittent infusion of fluids, the system resistance to obstruction and leakage, water balance, hemodynamic and biochemical parameters were evaluated. Fluid disposition in the abdominal cavity was analyzed through CT.
   RESULTS: Even when negative pressure was not applied, the dressing maintained the integrity of the system, and there were no leaks or blockage of the catheters during the procedure. The aspirated volume by vacuum laparostomy was similar to the infused volume (9073.5 +/- 1496.35 mL versus 10165 +/- 235.73 mL, p=0.25), and there were no major changes in hemodynamic or biochemical analysis. According to CT images, 60 ml/kg PDS was sufficient to occupy all intra-abdominal spaces.
   CONCLUSION: Continuous peritoneal lavage with negative pressure proved to be technically possible and may be an option in the treatment of diffuse peritonitis.
C1 [Rodrigues, Adilson Costa] Univ Sao Paulo, Fac Med, Cirurgia, Hosp Clin HCFMUSP, Sao Paulo, SP, Brazil.
   [Saad, Karen Ruggeri; Saad, Paulo Fernandes] Univ Fed Vale Sao Francisco, Fac Med, Petrolina, PE, Brazil.
   [Otsuki, Denise Aya] Univ Sao Paulo, Fac Med FMUSP, Lab Anestesiol LIM 08, Sao Paulo, SP, Brazil.
   [dos Santos, Luana Carla; Rasslan, Samir; de Souza Montero, Edna Frasson] Univ Sao Paulo, Fac Med FMUSP, Lab Fisiopatol Cirurg LIM 62, Sao Paulo, SP, Brazil.
   [Utiyama, Edivaldo M.] Univ Sao Paulo, Hosp Clin HCFMUSP, Fac Med, Clin Cirurg 3, Sao Paulo, SP, Brazil.
C3 Universidade de Sao Paulo; Universidade Federal do Vale do Sao
   Francisco; Universidade de Sao Paulo; Universidade de Sao Paulo;
   Universidade de Sao Paulo
RP Montero, EFD (通讯作者)，Univ Sao Paulo, Fac Med FMUSP, Lab Fisiopatol Cirurg LIM 62, Sao Paulo, SP, Brazil.
EM edna.montero@gmail.com
RI Otsuki, Denise Aya/J-2849-2014; Utiyama, Edivaldo Massazo/K-5804-2018;
   Montero, Edna/AAJ-1372-2021; Saad, Karen/N-5373-2015
OI Otsuki, Denise Aya/0000-0002-7411-3898; Utiyama, Edivaldo
   Massazo/0000-0002-8453-7184; Montero, Edna/0000-0003-1437-1219; Saad,
   Karen/0000-0002-3904-9026; Rodrigues, Adilson/0000-0003-4990-6826
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NR 19
TC 0
Z9 0
U1 0
U2 2
PU HOSPITAL CLINICAS, UNIV SAO PAULO
PI SAO PAULO
PA FAC MEDICINA, UNIV SAO PAULO, SAO PAULO, SP 00000, BRAZIL
SN 1807-5932
EI 1980-5322
J9 CLINICS
JI Clinics
PY 2019
VL 74
AR e937
DI 10.6061/clinics/2019/e937
PG 5
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA IK5NW
UT WOS:000476632900001
PM 31291390
OA Green Submitted, Green Published, gold
DA 2026-07-24
ER

PT J
AU Goh, SSC
AF Goh, Siew S. C.
TI Post-sternotomy mediastinitis in the modern era
SO JOURNAL OF CARDIAC SURGERY
LA English
DT Review
DE cardiac surgery; mediastinitis; sternal wound infections
ID VACUUM-ASSISTED CLOSURE; STERNAL WOUND INFECTIONS; RESISTANT
   STAPHYLOCOCCUS-AUREUS; RIGHT-VENTRICULAR RUPTURE; SURGICAL SITE
   INFECTIONS; INTERNAL THORACIC ARTERY; BODY-MASS INDEX; PRACTICE
   GUIDELINE SERIES; TIGHT GLYCEMIC CONTROL; LONG-TERM SURVIVAL
AB BackgroundPost-sternotomy mediastinitis is associated with significant mortality and morbidity. Despite surgical advances in cardiac surgery and improvements in perioperative care, mediastinitis remains a devastating post-operative complication. This study provides a comprehension review of post-sternotomy mediastinitis in the modern era, and discusses the incidence, risk factors, microbiology, prevention, and management of this complication.
   MethodsThis review was based on a PubMed/MEDLINE literature search up until 9th March 2017 for publications relevant to mediastinitis post-cardiac surgery.
   ResultsThe incidence of mediastinitis post-cardiac surgery varies between 0.3 and 3.4%, and is associated with an in-hospital mortality ranging from from 1.1 to 19%. The risk of developing post-operative mediastinitis is dependent on the patients' co-morbidities (diabetes, obesity, smoking, renal failure) and surgical techniques (bilateral pedicled internal mammary harvest, excessive cautery, long duration of surgery). Preventative measures including skin and nasal decontamination, antibiotic prophylaxis, strict glycemic control, and meticulous surgical techniques are crucial in reducing the risk. Treatment of post-operative mediastinitis include culture-directed antibiotic therapy, early wound exploration, and debridement followed by sternal reconstruction/closure. Vacuum-assisted therapy can be used as a single line therapy or as a bridge to eventual sternal reconstruction/closure.
   ConclusionPost-sternotomy mediastinitis remains a potentially fatal complication of cardiac surgery despite the advancements in the perioperative care in the modern era. Management on preventative measures, prompt diagnosis, and managements are crucial in reducing associated mortality and morbidity.
C1 [Goh, Siew S. C.] Liverpool Hosp, Dept Cardiothorac Surg, Liverpool, NSW 2170, Australia.
C3 Liverpool Hospital
RP Goh, SSC (通讯作者)，Liverpool Hosp, Dept Cardiothorac Surg, Liverpool, NSW 2170, Australia.
EM goh.sschristine@gmail.com
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NR 119
TC 73
Z9 81
U1 0
U2 8
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0886-0440
EI 1540-8191
J9 J CARDIAC SURG
JI J. Card. Surg.
PD SEP
PY 2017
VL 32
IS 9
BP 556
EP 566
DI 10.1111/jocs.13189
PG 11
WC Cardiac & Cardiovascular Systems; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Surgery
GA FG0MG
UT WOS:000409439700006
PM 28833518
DA 2026-07-24
ER

PT J
AU Frykberg, RG
   Gibbons, GW
   Walters, JL
   Wukich, DK
   Milstein, FC
AF Frykberg, Robert G.
   Gibbons, Gary W.
   Walters, Jodi L.
   Wukich, Dane K.
   Milstein, Farrell C.
TI A prospective, multicentre, open-label, single-arm clinical trial for
   treatment of chronic complex diabetic foot wounds with exposed tendon
   and/or bone: positive clinical outcomes of viable cryopreserved human
   placental membrane
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE Chronic; Complex wound; Cryopreserved placental membrane; Diabetes;
   Ulcer
ID VACUUM-ASSISTED CLOSURE; LOWER-EXTREMITY AMPUTATION; AMNIOTIC MEMBRANE;
   ULCERS; THERAPY; CELLS; MANAGEMENT; EFFICACY; BURDEN; SAFETY
AB Complex diabetic foot ulcers (DFUs) with exposed tendon or bone remain a challenge. They are more susceptible to complications such as infection and amputation and require treatments that promote rapid development of granulation tissue and, ultimately, reepithelialisation. The clinical effectiveness of viable cryopreserved human placental membrane (vCHPM) for DFUs has been established in a level 1 trial. However, complex wounds with exposed deeper structures are typically excluded from randomised controlled clinical trials despite being common in clinical practice. We report the results of a prospective, multicentre, open-label, single-arm clinical trial to establish clinical outcomes when vCHPM is applied weekly to complex DFUs with exposed deep structures. Patients with type 1 or type 2 diabetes and a complex DFU extending through the dermis with evidence of exposed muscle, tendon, fascia, bone and/or joint capsule were eligible for inclusion. Of the 31 patients enrolled, 27 completed the study. The mean wound area was 14.6 cm(2), and mean duration was 7.5 months. For patients completing the protocol, the primary endpoint, 100% wound granulation by week 16, was met by 96.3% of patients in a mean of 6.8 weeks. Complete wound closure occurred in 59.3% (mean 9.1 weeks). The 4-week percent area reduction was 54.3%. There were no product-related adverse events. Four patients (13%) withdrew, two (6.5%) for non-compliance and two (6.5%) for surgical intervention.
C1 [Frykberg, Robert G.] Carl T Hayden VA Med Ctr, Dept Podiatry, 650 E Indian Sch Rd, Phoenix, AZ 85012 USA.
   [Gibbons, Gary W.] South Shore Hosp, Ctr Wound Healing, Weymouth, MA USA.
   [Walters, Jodi L.] Southern Arizona VA Hlth Care Syst, Dept Podiatry, Tucson, AZ USA.
   [Wukich, Dane K.] UPMC Mercy, UPMC Wound Healing Serv, Pittsburgh, PA USA.
   [Milstein, Farrell C.] Osiris Therapeut Inc, Columbia, MD USA.
C3 US Department of Veterans Affairs; Veterans Health Administration (VHA);
   Southern Arizona Veterans Affairs Health Care System; Osiris
   Therapeutics
RP Frykberg, RG (通讯作者)，Carl T Hayden VA Med Ctr, Dept Podiatry, 650 E Indian Sch Rd, Phoenix, AZ 85012 USA.
EM Robert.Frykberg@VA.gov
FU Osiris Therapeutics, Inc. (Osiris); Osiris
FX This study was funded by Osiris Therapeutics, Inc. (Osiris). Carl T.
   Hayden VA Medical Center and the Southern Arizona VA Health Care System
   non-profit organisations received funding directly through Cooperative
   Research and Development Agreements with Osiris. South Shore Hospital
   Center for Wound Healing received research funding from Osiris for GG's
   participation in the study. Dr. Gibbons has received honoraria for
   speaking and consulting with Osiris. The institution of DW received
   research funding from Osiris for his participation in the study. FM is
   an employee of Osiris.
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NR 45
TC 60
Z9 72
U1 0
U2 5
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD JUN
PY 2017
VL 14
IS 3
BP 569
EP 577
DI 10.1111/iwj.12649
PG 9
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA FA0BM
UT WOS:000405095800018
PM 27489115
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Liu, YN
   Yan, Y
   Li, SJ
   Liu, H
   Wu, Q
   Zhang, LJ
   Yang, Y
   Chen, JF
AF Liu, Yi-Nan
   Yan, Yan
   Li, Shi-Jie
   Liu, Hui
   Wu, Qi
   Zhang, Li-Jian
   Yang, Yue
   Chen, Jin-Feng
TI Reliable management of post-esophagectomy anastomotic fistula with
   endoscopic trans-fistula negative pressure drainage
SO WORLD JOURNAL OF SURGICAL ONCOLOGY
LA English
DT Article
DE anastomotic fistula; esophagectomy; endoscopic management
ID VACUUM-ASSISTED CLOSURE; LEAKAGE
AB Background: A gastroesophageal anastomotic fistula remains a potentially life-threatening post-esophagectomy complication. To promote fistula closure, we developed a modified endoscopic method of trans-fistula drainage with persistent negative pressure. In this study, we aimed to evaluate the efficacy of this endoscopic therapy.
   Methods: Between June and November 2013, five male patients with post-surgical esophageal leakages who had undergone trans-fistula drainage therapy were treated with the modified endoscopic trans-fistula negative pressure drainage (E-TNPD) method. We placed a nasogastric silicone tube into the paraesophageal cavity through the fistula and accomplished drainage of the infected effusion with continuous negative pressure, resulting in shrinkage of the para-anastomotic cavity and eventual fistula closure. We withdrew the trans-fistula drainage when there were no signs of leakage, as confirmed by esophagography. Final closure was confirmed by esophagography before the patient was allowed to begin oral intake.
   Results: E-TNPD was successful in all five patients. The median duration of drainage until tube removal was 34 days (range: 18 to 81 days). The duration for Cases 1 to 4 was 18 to 28 days. Case 5 suffered from multiple separate leaks at the anastomotic site and the gastric conduit. Complete restoration was achieved in 81 days for this patient. We found that in general, the earlier that trans-fistula drainage was established, the shorter the duration of hospitalization until complete defect closure.
   Conclusions: E-TNPD provided reliable and convenient management of post-surgical gastroesophageal anastomotic fistula and esophageal perforation. This method promoted fistula closure and prevented unnecessary repeated endoscopic examinations, extra equipment and expense.
C1 [Liu, Yi-Nan; Zhang, Li-Jian; Yang, Yue; Chen, Jin-Feng] Peking Univ, Canc Hosp & Inst, Dept Thorac Surg 2, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China.
   [Yan, Yan; Li, Shi-Jie; Wu, Qi] Peking Univ, Canc Hosp & Inst, Endoscopy Ctr, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China.
   [Liu, Hui] Beijing Pharma & Biotech Ctr, Beijing 100193, Peoples R China.
C3 Peking University; Peking University
RP Chen, JF (通讯作者)，Peking Univ, Canc Hosp & Inst, Dept Thorac Surg 2, Key Lab Carcinogenesis & Translat Res,Minist Educ, Beijing 100142, Peoples R China.
EM chengjinfeng123@163.com
RI Zhang, Lijian/OUK-0816-2025
FU Beijing Science New Star Plan [Z11111005450000]; National Nature Science
   Foundation of China [81101598]
FX This study was supported by the Beijing Science New Star Plan
   (Z11111005450000) and the National Nature Science Foundation of China
   (81101598).
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NR 14
TC 14
Z9 16
U1 0
U2 6
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1477-7819
J9 WORLD J SURG ONCOL
JI World J. Surg. Oncol.
PD JUL 30
PY 2014
VL 12
AR 240
DI 10.1186/1477-7819-12-240
PG 6
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA AM4PI
UT WOS:000339837000001
PM 25078091
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Mazzone, L
   Schiestl, C
AF Mazzone, Luca
   Schiestl, Clemens
TI Management of Septic Skin Necroses
SO EUROPEAN JOURNAL OF PEDIATRIC SURGERY
LA English
DT Review
DE septic skin necroses; purpura fulminans; necrotizing fasciitis;
   meningococcal sepsis; Integra artificial skin
ID MENINGOCOCCAL PURPURA FULMINANS; NEONATAL NECROTIZING FASCIITIS;
   VACUUM-ASSISTED CLOSURE; SOFT-TISSUE INFECTIONS; TOXIC-SHOCK-SYNDROME;
   RECONSTRUCTIVE SURGERY; ARTIFICIAL SKIN; WOUND CONTROL; CHILDREN; SEPSIS
AB Necrotizing fasciitis (NF) and purpura fulminans (PF) are conditions with extensive septic skin necroses that are associated with significant morbidity and mortality. NF is caused by fulminant bacterial spread on the superficial muscle fascia, Group A streptococcus being the main microorganism responsible for it. The major challenge NF poses is timely recognition. Although crucial for patient survival, early diagnosis is difficult because paucity of specific early findings does not allow setting NF apart from other, less severe, differential diagnoses. Surgical therapy consists of early and aggressive debridement of all affected tissue, even if large disfiguring wounds are left back. The responsible microorganism for PF in children is predominantly Neisseira meningitidis. Endotoxin triggered misbalance of anticoagulant and procoagulant activities of endothelial cells leads to disseminated intravascular coagulation (DIC) followed by microvascular thrombosis and bleeding, resulting in hemorrhagic skin infarction and limb ischemia. Although survival in PF is not dependent on surgery, and surgery plays not a key role in the early phase of the disease, early surgical consult to assess if limb perfusion can be improved to achieve limb salvage is still absolutely necessary. Debridement should be postponed until clear demarcation has established. Large defects after NF and PF can be successfully reconstructed with vacuum-assisted fixation of Integra (Integra LifeSciences Corporation, Plainsboro, New Jersey, United States) artificial skin before split-thickness skin grafting. This provides good functional and cosmetic results as well as good stump coverage in case of amputation in PF.
C1 [Mazzone, Luca] Univ Childrens Hosp Zurich, Dept Surg, Div Visceral Neonatal & Fetal Surg, CH-8032 Zurich, Switzerland.
   [Schiestl, Clemens] Univ Childrens Hosp Zurich, Pediat Burn Ctr, Div Plast & Reconstruct Surg, Dept Surg, CH-8032 Zurich, Switzerland.
C3 University Children's Hospital Zurich; University Children's Hospital
   Zurich
RP Mazzone, L (通讯作者)，Univ Childrens Hosp Zurich, Dept Pediat Surg, Div Visceral Neonatal & Fetal Surg, Steinwiesstr 75, CH-8032 Zurich, Switzerland.
EM luca.mazzone@kispi.uzh.ch
OI Mazzone, Luca/0000-0002-4344-8441
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NR 54
TC 12
Z9 17
U1 1
U2 10
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY
SN 0939-7248
EI 1439-359X
J9 EUR J PEDIATR SURG
JI Eur. J. Pediatr. Surg.
PD OCT
PY 2013
VL 23
IS 5
BP 349
EP 358
DI 10.1055/s-0033-1352530
PG 10
WC Pediatrics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pediatrics; Surgery
GA 220YO
UT WOS:000324623700003
PM 24008550
DA 2026-07-24
ER

PT J
AU Vertrees, A
   Greer, L
   Pickett, C
   Nelson, J
   Wakefield, M
   Stojadinovic, A
   Shriver, C
AF Vertrees, Amy
   Greer, Lauren
   Pickett, Chris
   Nelson, Jeffery
   Wakefield, Matthew
   Stojadinovic, Alexander
   Shriver, Craig
TI Modern Management of Complex Open Abdominal Wounds of War: A 5-Year
   Experience
SO JOURNAL OF THE AMERICAN COLLEGE OF SURGEONS
LA English
DT Article; Proceedings Paper
CT 93rd Annual Clinical Congress of the American-College-of-Surgeons
CY OCT 07-11, 2007
CL New Orleans, LA
SP Amer Coll Surg
ID DAMAGE CONTROL; VENTRAL HERNIA; CLOSURE; MILITARY
AB BACKGROUND: Optimal management of the open abdomen remains controversial.
   STUDY DESIGN: Retrospective review of patients injured during Operations Enduring Freedom and Iraqi Freedom returning to Walter Reed Army Medical Center (WRAMC) from January 2003 to October 2007 for treatment of open abdomen.
   RESULTS: Three hundred fifty-four patients were evacuated to WRAMC after laparotomy, including 86 patients (24%) with open abdomen. Three transferred patients were excluded. Eighty-three patients, mean age 26 years (range 18 to 54 years), sustaining injury from secondary blast (n = 47), gunshot (n = 29), and blunt trauma (n = 7) were studied. Surgical management included early definitive abdominal closure (EDAC, n = 56; 67%), primary fascial closure (n = 15; 18%), planned ventral hernia (PVH, n = 9; 11 %) and vacuum-assisted closure with AlloDerm (n = 3; 4%). EDAC closure involves serial closure with Gore-Tex Dualmesh and final closure supplemented with polypropylene mesh (62%) or AlloDerm (31%). There was no substantial difference in injury mechanism, age, length of evacuation to WRAMC, or Injury Severity Score (average 30) according to closure type. Complications included removal of infected prosthetic mesh in 4 EDAC closure patients (5%). Overall morbidity was lowest (60%) in primary repair patients (p = 0.01). Rates of deep venous thrombosis, pulmonary embolism, abdominal wall hematoma, and infection did not differ between groups. Fistula rate was increased with PVH (20%). Two patients with PVH died. PVH and EDAC mesh complications have been minimized in the last 2 years of the study.
   CONCLUSIONS: Primary closure of fascia is ideal but not always possible. Early definitive closure has avoided PVH. Mesh-related complications have decreased with time. (J Am Coll Surg 2008;207:801-809. (C) 2008 by the American College of Surgeons)
C1 [Vertrees, Amy; Greer, Lauren; Pickett, Chris; Nelson, Jeffery; Wakefield, Matthew; Stojadinovic, Alexander; Shriver, Craig] Walter Reed Army Med Ctr, Washington, DC 20307 USA.
C3 United States Department of Defense; United States Army; Walter Reed
   National Military Medical Center
RP Vertrees, A (通讯作者)，Walter Reed Army Med Ctr, Bldg 2,5th Floor,6900 Georgia Ave NW, Washington, DC 20307 USA.
EM amy.vertrees@amedd.army.mil
RI ; Wakefield, Matthew/A-7795-2008
OI Stojadinovic, Alexander/0000-0002-2829-8967; 
CR [Anonymous], 1998, ABBR INJ SCAL AIS 19
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NR 16
TC 56
Z9 63
U1 0
U2 6
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1072-7515
EI 1879-1190
J9 J AM COLL SURGEONS
JI J. Am. Coll. Surg.
PD DEC
PY 2008
VL 207
IS 6
BP 801
EP 809
DI 10.1016/j.jamcollsurg.2008.08.014
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 382GE
UT WOS:000261592800002
PM 19183525
DA 2026-07-24
ER

PT J
AU Morykwas, MJ
   Faler, BJ
   Pearce, DJ
   Argenta, LC
AF Morykwas, MJ
   Faler, BJ
   Pearce, DJ
   Argenta, LC
TI Effects of varying levels of subatmospheric pressure on the rate of
   granulation tissue formation in experimental wounds in swine
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; TRIAL
AB The use of subatmospheric pressure to promote wound healing has increased in popularity during the last several years. The original studies on granulation tissue formation used a 125-mmHg vacuum. The use of alternative sources of subatmospheric pressure has led to many questions regarding efficacy or risk. In this report a swine model is used to quantify and compare the effects of low vacuum suction (25 mmHg) and high vacuum suction (500 mmHg) produced by various vacuum pumps and wall suction systems with the standard 125-mmHg vacuum. Additionally, the effects of an unregulated air leak in the sealing system were examined. All four wound treatments were examined on each of 4 pigs. Wounds were treated until one of the wounds had granulated to a level flush with the surrounding tissue. Wounds treated with the standard 125-mmHg vacuum had filled with granulation tissue by day 8. At this time wounds treated with 25 mmHg had filled 21.2% with new granulation tissue, and wounds treated with 500 mmHg had filled 5.9% with new tissue. Wounds treated with 125 mmHg with a hole in the sealing drape had increased in size 197% because of the debridement of necrotic tissue. In conclusion, wounds treated with a 125-mmHg vacuum exhibited a significant (p < 0.0001) increase in the rate of granulation tissue formation compared with treatment at 25 mmHg or 500 mmHg. The presence of an unregulated air leak in the sealing drape results in significant progression (p < 0.0001) of the wound secondary to dehydration and progressive necrosis.
C1 Wake Forest Univ, Bowman Gray Sch Med, Dept Plast & Reconstruct Surg, Winston Salem, NC 27157 USA.
C3 Wake Forest University; Wake Forest Baptist Medical Center
RP Morykwas, MJ (通讯作者)，Wake Forest Univ, Bowman Gray Sch Med, Dept Plast & Reconstruct Surg, Med Ctr Blvd, Winston Salem, NC 27157 USA.
OI Morykwas, Michael/0009-0001-5547-5172
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   ARGENTA LC, 1990, ESSENTIALS PLASTIC M, P103
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   Mullner T, 1997, BRIT J PLAST SURG, V50, P194, DOI 10.1016/S0007-1226(97)91369-2
NR 7
TC 264
Z9 336
U1 0
U2 18
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD NOV
PY 2001
VL 47
IS 5
BP 547
EP 551
DI 10.1097/00000637-200111000-00013
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 491JK
UT WOS:000172105100013
PM 11716268
DA 2026-07-24
ER

PT J
AU Xu, ZY
   Cui, XY
   Chu, HB
   Wan, H
   Xie, YB
   Wang, Y
   Ni, QB
   Ding, XL
   Song, GH
AF Xu, Ziyu
   Cui, Xinyu
   Chu, Houbin
   Wan, Hao
   Xie, Yunbo
   Wang, Ying
   Ni, Qingbin
   Ding, Xiaolin
   Song, Guohua
TI Hydrogen-Enriched Hyaluronic Acid Dressing Ameliorates Diabetic Foot
   Ulcer via Promoting Mitophagy
SO JOURNAL OF DIABETES
LA English
DT Article
DE diabetic foot ulcer; hydrogen-enriched hyaluronic acid dressing;
   mitophagy; SIRT3
ID PROTECTS; PINK1
AB Objective Diabetic foot ulcer (DFU) is one of the most common chronic complications of diabetes. This study developed a hydrogen-enriched hyaluronic acid (HA) dressing and aimed to explore its therapeutic effects and mechanisms in DFU treatment.Methods A combination of vacuum-assisted closure (VSD) and hydrogen-rich saline was used to treat DFU patients and assess the clinical outcomes of wound repair. A rat model of DFU was established, and treatment with hydrogen-enriched HA dressing. Subsequently, the protective effects of the dressing were evaluated, including histological studies, the expression of inflammatory factors and angiogenesis markers. Western blot was used to analyze the expression levels of mitophagy-related proteins. In vitro, the role of HA and hydrogen on cell mitochondrial damage, apoptosis, migration, and markers associated with mitophagy pathways in human foreskin fibroblast-1 (HFF-1) was assessed.Results VSD combined with hydrogen-rich saline significantly enhanced wound healing in patients, while reducing inflammation and oxidative damage. In vivo studies showed that the dressing promoted wound healing, increased collagen deposition, reduced inflammatory cytokines, and enhanced neovascularization. In vitro studies, high glucose induced cell morphological damage and oxidative stress, disrupted mitochondrial membrane potential, leading to apoptosis and attenuating cell migration. However, both HA and hydrogen significantly induced SIRT3 expression and activated the downstream FOXO3A/PINK1-PARKIN signaling pathway, promoting mitochondrial autophagy and reducing cell apoptosis. Furthermore, the SIRT3/SOD2 pathway was also activated, decreasing reactive oxygen species (ROS) production and enhancing migration.Conclusion This study confirmed that the hydrogen-enriched HA dressing has the potential to enhance diabetic wound repair.
C1 [Xu, Ziyu; Cui, Xinyu; Chu, Houbin; Wan, Hao; Xie, Yunbo; Wang, Ying; Ding, Xiaolin; Song, Guohua] Shandong First Med Univ, Affiliated Hosp 2, Tai An, Peoples R China.
   [Xu, Ziyu; Cui, Xinyu; Chu, Houbin; Xie, Yunbo; Wang, Ying; Song, Guohua] Shandong First Med Univ & Shandong Acad Med Sci, Sch Basic Med Sci, Jinan, Peoples R China.
   [Xu, Ziyu] Zaozhuang Municipal Hosp, Zaozhuang, Peoples R China.
   [Ni, Qingbin] Taian Cent Hosp, Tai An, Peoples R China.
C3 Shandong First Medical University & Shandong Academy of Medical Sciences
RP Ding, XL; Song, GH (通讯作者)，Shandong First Med Univ, Affiliated Hosp 2, Tai An, Peoples R China.; Song, GH (通讯作者)，Shandong First Med Univ & Shandong Acad Med Sci, Sch Basic Med Sci, Jinan, Peoples R China.
EM ankle163@163.com; girl_sapphire@hotmail.com
FU National Natural Science Foundation of China [82370446, 81873517]
FX Funding for this research was provided by the National Natural Science
   Foundation of China (No. 82370446 and 81873517).
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NR 50
TC 0
Z9 0
U1 1
U2 1
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1753-0393
EI 1753-0407
J9 J DIABETES
JI J. Diabetes
PD MAR 29
PY 2026
VL 18
IS 4
AR e70209
DI 10.1111/1753-0407.70209
PG 17
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA FU4NX
UT WOS:001727663300001
PM 41906653
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Werenski, JO
   Gonzalez, MR
   Fourman, MS
   Hung, YP
   Lozano-Calderón, SA
AF Werenski, Joseph O.
   Gonzalez, Marcos R.
   Fourman, Mitchell S.
   Hung, Yin P.
   Lozano-Calderon, Santiago A.
TI Does Wound VAC Temporization Offer Patient-Reported Outcomes Similar to
   Single-Stage Excision Reconstruction After Myxofibrosarcoma Resection?
SO ANNALS OF SURGICAL ONCOLOGY
LA English
DT Article
DE Patient-reported outcomes; Soft tissue sarcoma; Wound VAC temporization
ID FROZEN-SECTION; VALIDATION; RECURRENCE; SURVIVAL; PROMIS
AB Background. Vacuum-assisted closure (VAC) temporization is a promising technique to achieve local control in aggressive soft tissue sarcomas. Despite its previously reported efficacy, adoption of VAC temporization remains limited, primarily due to the scarce literature on patient-reported outcomes (PROs) supporting its efficacy. This study compared the postoperative PROs after VAC temporization or single-stage (SS) excision and reconstruction for patients undergoing surgical resection for myxofibrosarcoma management.
   Methods. A retrospective analysis of myxofibrosarcoma patients who underwent surgical resections at our institution from 2016 to 2022 was performed. Postoperative PROs collected prospectively for those treated with VAC temporization or SS excision/reconstruction were compared using a visual analog scale (VAS) for pain and three Patient-Reported Outcomes Measurement Information System (PROMIS) questionnaires: Global Health Short-Form Mental (SF Mental), Global Health Short-Form Physical (SF Physical), and Physical Function Short-Form 10a (SF 10a). Absolute and differential (postoperative minus preoperative) scores at the 1-month, 3-month, 6-month, 1-year, and 2-year time points were compared.
   Results. The analysis included 79 patients (47 treated with VAC temporization and 32 treated with SS excision/reconstruction). All outcomes were similar between the groups except for physical function 1 year after surgery, in which the differential PROMIS SF 10a scores were higher in the SS group (p = 0.001). All the remaining absolute and differential PROMIS and VAS pain scores were similar between the groups at all time points. Postoperative complications did not differ between the groups.
   Conclusion. The PROs for physical and mental health, physical function, and pain were similar between the myxofibrosarcoma patients who had VAC temporization and those who had SS excision/reconstruction after surgical resection.
C1 [Werenski, Joseph O.; Gonzalez, Marcos R.; Lozano-Calderon, Santiago A.] Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthopaed Surg, Orthopaed Oncol Serv, Boston, MA 02115 USA.
   [Fourman, Mitchell S.] Montefiore Einstein, Dept Orthopaed Surg, New York, NY USA.
   [Hung, Yin P.] Harvard Med Sch, Massachusetts Gen Hosp, Div Bone & Soft Tissue Pathol, Dept Pathol, Boston, MA USA.
C3 Harvard University; Harvard University Medical Affiliates; Massachusetts
   General Hospital; Harvard Medical School; Harvard University; Harvard
   University Medical Affiliates; Massachusetts General Hospital; Harvard
   Medical School
RP Lozano-Calderón, SA (通讯作者)，Harvard Med Sch, Massachusetts Gen Hosp, Dept Orthopaed Surg, Orthopaed Oncol Serv, Boston, MA 02115 USA.
RI Hung, Yin Pun/AAV-4868-2021; Gonzalez, Marcos/IAP-3703-2023; Fourman,
   Mitchell/GXF-4477-2022
OI Hung, Yin Pun/0000-0002-8568-1591; Werenski, Joseph/0009-0003-9177-6874;
   
CR Agarwal A, 2022, MED J AUSTRALIA, V216, P9, DOI 10.5694/mja2.51355
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NR 27
TC 9
Z9 9
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 1068-9265
EI 1534-4681
J9 ANN SURG ONCOL
JI Ann. Surg. Oncol.
PD APR
PY 2024
VL 31
IS 4
BP 2757
EP 2765
DI 10.1245/s10434-023-14839-9
EA JAN 2024
PG 9
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA XG7R1
UT WOS:001139621800005
PM 38197999
DA 2026-07-24
ER

PT J
AU Zhao, JC
   Shi, K
   Yu, JA
   Xian, CJ
   Lu, LJ
   Xie, CH
AF Zhao Jing-Chun
   Shi Kai
   Yu Jia-Ao
   Xian Chun-Jing
   Lu Lai-Jin
   Xie Chun-Hui
TI Large heel soft tissue defects managed successfully with reverse medial
   crural fasciocutaneous flap: A 7-year single-center experience with 21
   consecutive cases
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Heel; Wounds and injuries; Reconstruction; Medial crural flap
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; RANDOMIZED
   CONTROLLED-TRIAL; ARTERY PERFORATOR FLAP; LOWER LEG; BACTERIAL
   INOCULATION; CLINICAL-APPLICATION; RECONSTRUCTION; BREAST; MUSCLE
AB The medial crural fasciocutaneous flap is a reliable cutaneous flap that can be used for soft tissue reconstruction in the extremities. The purpose of this article is to evaluate the application and clinical significance of this surgical technique in the reconstruction of heel soft tissue defects. Twenty-one cases of heel soft tissue defect between March 2005 and March 2012 were included in this study. Wound sizes varied from 5.0 x 5.5 to 7.5 x 10.0 cm. All cases were managed with a reverse medial crural fasciocutaneous flap. Patient demographics and case information were analyzed and are reported. The sizes of the reverse medial crural fasciocutaneous flap varied from 6.5 x 10.0 to 9.0 x 15.0 cm; the average size was 7.7 x 13.8 cm. Out of the 21 consecutive cases, 20 flaps survived intact and one flap underwent partial necrosis. Follow-up observations were conducted for 6-36 months. The cosmetic results were satisfactory, without apparent bulkiness; the weight-bearing outcomes were satisfactory. The donor site can be closed primarily or by skin graft. Reverse medial crural fasciocutaneous flap transfer is appropriate for the reconstruction of heel soft tissue defects. The method is safe and can cover large heel defects. (C) 2014 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Zhao Jing-Chun; Shi Kai; Yu Jia-Ao; Xian Chun-Jing; Xie Chun-Hui] Jilin Univ, Hosp 1, Burns & Plast Reconstruct Unit, Changchun 130031, Peoples R China.
   [Lu Lai-Jin] Jilin Univ, Hosp 1, Dept Hand Surg, Changchun 130031, Peoples R China.
C3 Jilin University; Jilin University
RP Lu, LJ (通讯作者)，Jilin Univ, Hosp 1, Dept Hand Surg, Changchun 130031, Peoples R China.
EM bu_dong007@163.com
RI Xie, Chunhui/JEP-0362-2023
CR [Anonymous], WOUNDS
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   Uroskie T, 2001, Foot Ankle Clin, V6, P801, DOI 10.1016/S1083-7515(02)00013-X
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   Zhang S C, 1983, Zhonghua Wai Ke Za Zhi, V21, P743
   Zhao JC, 2013, INT WOUND J
   Zhao JC, 2013, INT WOUND J, V10, P407, DOI 10.1111/j.1742-481X.2012.00997.x
NR 46
TC 5
Z9 10
U1 0
U2 2
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD JAN
PY 2015
VL 68
IS 1
BP 40
EP 48
DI 10.1016/j.bjps.2014.09.041
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA AX0JM
UT WOS:000346638800015
PM 25448373
DA 2026-07-24
ER

PT J
AU Dal-Paz, K
   Oliveira, PRD
   de Paula, AP
   Emerick, MCD
   Pécora, JR
   Lima, ALLM
AF Dal-Paz, Karine
   Oliveira, Priscila R. D.
   de Paula, Adriana P.
   Emerick, Maria Cristina da S.
   Pecora, Jose Ricardo
   Lima, Ana Lucia L. M.
TI Economic impact of treatment for surgical site infections in cases of
   total knee arthroplasty in a tertiary public hospital in Brazil
SO BRAZILIAN JOURNAL OF INFECTIOUS DISEASES
LA English
DT Article
DE hospital acquired infection; surgery; costs
ID NOSOCOMIAL INFECTIONS; EXCESS LENGTH
AB The aim of this study was to estimate the additional cost of treatment of a group of nosocomial infections in a tertiary public hospital. A retrospective observational cohort study was conducted by means of analyzing the medical records of 34 patients with infection after total knee arthroplasty, diagnosed in 2006 and 2007, who met the criteria for nosocomial infection according to the Centers for Disease Control and Prevention. To estimate the direct costs of treatment for these patients, the following data were gathered: length of hospital stay, laboratory tests, imaging examinations, and surgical procedures performed. Their costs were estimated from the minimum values according to the Brazilian Medical Association. The estimated cost of the antibiotics used was also obtained. The total length of stay in the ward was 976 days, at a cost of US$ 18,994.63, and, in the intensive care unit, it was 34 days at a cost of US$ 5,031.37. Forty-two debridement procedures were performed, at a cost of US$ 5,798.06, and 1965 tests (laboratory and imaging) were also performed, at a cost of US$ 15,359.25. US$ 20,845.01 was spent on antibiotics and US$ 1,735.16 on vacuum assisted closure therapy, microsurgical flaps, implant removal, spacer use, and surgical revision. The total additional cost of these cases of hospital infection in 2006 and 2007 was of US$ 91,843.75. Based on that, we demonstrate that the high cost of treatment for hospital infections emphasizes the importance of taking measures to prevent and control hospital infection.
C1 [Dal-Paz, Karine; Oliveira, Priscila R. D.; de Paula, Adriana P.; Lima, Ana Lucia L. M.] Univ Sao Paulo, Infect Serv, Inst Orthoped & Traumatol, Sch Med,Hosp Clin, BR-05508 Sao Paulo, Brazil.
   [Emerick, Maria Cristina da S.] Univ Sao Paulo, Knee Grp, Inst Orthoped & Traumatol, Hosp Clin,Fac Med, BR-05508 Sao Paulo, Brazil.
   [Pecora, Jose Ricardo] Univ Sao Paulo, Management Unit, Inst Orthoped & Traumatol, Hosp Clin,Fac Med, BR-05508 Sao Paulo, Brazil.
C3 Universidade de Sao Paulo; Universidade de Sao Paulo; Universidade de
   Sao Paulo
RP Lima, ALLM (通讯作者)，Rua Dr Ovidio Pires Campos,333 Sala 311-A, BR-05403010 Sao Paulo, Brazil.
EM ccih.iot@hcnet.usp.br
RI Lima, Ana Lucia Munhoz/L-7898-2017; Pécora, José Ricardo/HGD-1086-2022;
   R Oliveira, Priscila/J-7531-2012
OI Lima, Ana Lucia Munhoz/0000-0002-2396-9880; Pécora, José
   Ricardo/0000-0003-1621-5252; R Oliveira, Priscila/0000-0003-1377-6556;
   Dal Paz, Karine/0000-0002-1760-8181
CR *ASS PAUL EST CONT, 2001, PREV INF SIT CIR
   *CDCP, 2007, NAT HEALTHC SAF NETW
   COELLO R, 1993, J HOSP INFECT, V25, P239, DOI 10.1016/0195-6701(93)90110-L
   Defez C, 2008, J HOSP INFECT, V68, P130, DOI 10.1016/j.jhin.2007.11.005
   Del Pozo JL, 2009, NEW ENGL J MED, V361, P787, DOI 10.1056/NEJMcp0905029
   Health Protection Agency, 2005, MAND SURV SURG SIT I
   Izquierdo-Cubas F, 2008, J HOSP INFECT, V68, P234, DOI 10.1016/j.jhin.2007.12.006
   Kirkland KB, 1999, INFECT CONT HOSP EP, V20, P725, DOI 10.1086/501572
   Lima Ana Lúcia Lei Munhoz, 2004, Acta ortop. bras., V12, P236
   Maksimovic J, 2008, CROAT MED J, V49, P58, DOI 10.3325/cmj.2008.1.58
   Mangram AJ, 1999, INFECT CONT HOSP EP, V20, P250, DOI 10.1086/501620
   *NAT NOS INF SURV, 1996, SEM REP
   Reilly J, 2001, J HOSP INFECT, V49, P245, DOI 10.1053/jhin.2001.1086
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   Wilson J, 2008, INFECT CONT HOSP EP, V29, P219, DOI 10.1086/527511
NR 16
TC 23
Z9 27
U1 0
U2 3
PU ELSEVIER BRAZIL
PI RIO DE JANEIRO
PA R SETE SETEMBRO, 111-16, RIO DE JANEIRO, RJ 20050-006, BRAZIL
SN 1413-8670
EI 1678-4391
J9 BRAZ J INFECT DIS
JI Braz. J. Infect. Dis.
PD JUL-AUG
PY 2010
VL 14
IS 4
BP 356
EP 359
DI 10.1016/S1413-8670(10)70075-1
PG 4
WC Infectious Diseases
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases
GA 668JO
UT WOS:000283264800008
PM 20963320
OA Green Submitted, Green Published, gold
DA 2026-07-24
ER

PT J
AU Lee, JC
   Raman, J
   Song, DH
AF Lee, Justine C.
   Raman, Jai
   Song, David H.
TI Primary Sternal Closure with Titanium Plate Fixation: Plastic Surgery
   Effecting a Paradigm Shift
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article; Proceedings Paper
CT 86th Annual Meeting of the American-Association-of-Plastic-Surgeons
CY MAY 22, 2007
CL Coeur dAlene, ID
SP Amer Assoc Plast Surg
ID VACUUM-ASSISTED CLOSURE; MEDIAN STERNOTOMY; RISK-FACTORS; MEDIASTINITIS
AB Background: Postoperative mediastinitis is a serious and potentially lethal complication from cardiac surgery. Although postoperative mediastinitis cannot be reliably predicted, a number of preoperative and intraoperative risk factors have been defined by previous work. The authors now present their cumulative experience with primary sternal fixation of high-risk patients as one preventative measure.
   Methods: A retrospective review from July of 2000 to October of 2006 was performed on 750 patients who had at least three established risk factors for postoperative mediastinitis and received primary titanium plate sternal fixation. Patients were followed for a minimum of 6 weeks and monitored for pain, instability, wound breakdown, and plate migration.
   Results: Rigid plate fixation was completed at the end of the primary cardiac surgical procedure in all 750 patients. Sternal dehiscence occurred in 18 patients (2.4 percent), necessitating reexploration. Four of these patients developed postoperative mediastinitis and had other significant comorbidities, such as ongoing inflammatory breast cancer or pneumonia, that were beyond the typical risk factors identified for developing mediastinitis. Successful sternal fixation was therefore accomplished in 732 patients (97.6 percent). Despite changes in instrumentation and technique, this approach was adopted by the cardiac surgical team consistently after an initial mentoring and training period by the plastic surgeons.
   Conclusions: Primary sternal fixation is a simple and reliable method for prevention of postoperative mediastinitis development in high-risk patients. This technique, conceptualized by plastic surgeons, is now being implemented by cardiac surgeons in increasing numbers. This demonstrates the ability for plastic surgery to initiate a paradigm shift in other fields of medicine and to decrease the complications that primarily affect our practice. (Plast. Reconstr. Surg. 125: 1720, 2010.)
C1 [Lee, Justine C.; Raman, Jai; Song, David H.] Univ Chicago, Med Ctr,Sect Cardiothorac Surg, Dept Surg,Sect Cardiac & Thorac Surg, Plast & Reconstruct Surg Sect, Chicago, IL 60637 USA.
C3 University of Chicago; University of Chicago Medical Center
RP Song, DH (通讯作者)，5841 S Maryland Ave,MC 6035, Chicago, IL 60637 USA.
EM dsong@surgery.bsd.uchicago.edu
RI ; Raman, Jaishankar/K-1219-2019
OI Lee, Justine C/0000-0002-8943-0837; 
CR Abboud CS, 2004, ANN THORAC SURG, V77, P676, DOI 10.1016/S0003-4975(03)01523-6
   Agarwal JP, 2005, PLAST RECONSTR SURG, V116, P1035, DOI 10.1097/01.prs.0000178401.52143.32
   Dickie SR, 2006, ANN PLAS SURG, V56, P680, DOI 10.1097/01.sap.0000202825.41069.c3
   ElOakley RM, 1996, ANN THORAC SURG, V61, P1030, DOI 10.1016/0003-4975(95)01035-1
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   Song DH, 2004, EUR J CARDIO-THORAC, V26, P367, DOI 10.1016/j.ejcts.2004.04.038
   Wu LC, 2005, ANN PLAS SURG, V54, P55, DOI 10.1097/01.sap.0000139564.37314.1f
   Wu LC, 2004, J THORAC CARDIOV SUR, V128, P623, DOI 10.1016/j.jtcvs.2004.02.016
NR 22
TC 18
Z9 22
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD JUN
PY 2010
VL 125
IS 6
BP 1720
EP 1724
DI 10.1097/PRS.0b013e3181d51292
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 605XC
UT WOS:000278380700019
PM 20517097
DA 2026-07-24
ER

PT J
AU Fleck, TM
   Fleck, M
   Moidl, R
   Czerny, M
   Koller, R
   Giovanoli, P
   Hiesmayer, MJ
   Zimpfer, D
   Wolner, E
   Grabenwoger, M
AF Fleck, TM
   Fleck, M
   Moidl, R
   Czerny, M
   Koller, R
   Giovanoli, P
   Hiesmayer, MJ
   Zimpfer, D
   Wolner, E
   Grabenwoger, M
TI The vacuum-assisted closure system for the treatment of deep sternal
   wound infections after cardiac surgery
SO ANNALS OF THORACIC SURGERY
LA English
DT Article
ID MUSCLE FLAPS; RATIONAL APPROACH; STERNOTOMY; MEDIASTINITIS; MANAGEMENT;
   DIFFICULTIES; EXPERIENCE; DEVICE
AB Background. The VAC system (vacuum-assisted wound closure) is a noninvasive active therapy to promote healing in difficult wounds that fail to respond to established treatment modalities. The system is based on the application of negative pressure by controlled suction to the wound surface. The method was introduced into clinical practice in 1996. Since then, numerous studies proved the effectiveness of the VAC System on microcirculation and the promotion of granulation tissue proliferation.
   Methods. Eleven patients (5 men, 6 women) with a median age of 64.4 years (range 50 to 78 years) with sternal wound infection after cardiac surgery (coronary artery bypass grafting = 5, aortic valve replacement = 5, ascending aortic replacement = 1) were fitted with the VAC system by the time of initial surgical debridement.
   Results. Complete healing was achieved in all patients. The VAC system was removed after a mean of 9.3 days (range 4 to 15 days), when systemic signs of infection resolved and quantitative cultures were negative. In 6 patients (54.5%), the VAC system was used as a bridge to reconstructive surgery with a pectoralis muscle flap, and in the remaining 5 patients (45.5%), primary wound closure could be achieved. Intensive care unit stay ranged from 1 to 4 days (median 1 day). Duration of hospital stay varied from 13 to 45 days (median 30 days). In-hospital mortality was 0%, and 30-day survival was 100%.
   Conclusions. The VAC system can be considered as an effective and safe adjunct to conventional and established treatment modalities for the therapy of sternal wound infections after cardiac surgery. (C) 2002 by The Society of Thoracic Surgeons.
C1 Univ Vienna, AKH Vienna, Dept Cardiothorac Surg, A-1090 Vienna, Austria.
   Univ Vienna, Dept Plast & Reconstruct Surg, A-1090 Vienna, Austria.
C3 University of Vienna; University of Vienna
RP Fleck, TM (通讯作者)，Univ Vienna, AKH Vienna, Dept Cardiothorac Surg, Leitstelle 20A,Waehringer Guertel 18-20, A-1090 Vienna, Austria.
RI ; Zimpfer, Daniel/AAQ-9805-2021
OI Czerny, Martin/0000-0003-4766-9775; Zimpfer, Daniel/0000-0002-2185-4895
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Borer A, 2001, ANN THORAC SURG, V72, P515, DOI 10.1016/S0003-4975(01)02812-0
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   El Gamel A, 1998, ANN THORAC SURG, V65, P41, DOI 10.1016/S0003-4975(97)01063-1
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NR 20
TC 123
Z9 143
U1 0
U2 10
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0003-4975
J9 ANN THORAC SURG
JI Ann. Thorac. Surg.
PD NOV
PY 2002
VL 74
IS 5
BP 1596
EP 1600
AR PII S0003-4975(02)03948-6
DI 10.1016/S0003-4975(02)03948-6
PG 5
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 615TG
UT WOS:000179262300035
PM 12440614
DA 2026-07-24
ER

PT J
AU Vos, RJ
   van Putte, BP
   de Mol, BAJM
   Hoogewerf, M
   Mandigers, TJ
   Kloppenburg, GTL
AF Vos, Roemer J.
   van Putte, Bart P.
   de Mol, Bas A. J. M.
   Hoogewerf, Marieke
   Mandigers, Tim J.
   Kloppenburg, Geoffrey T. L.
TI Application of local gentamicin in the treatment of deep sternal wound
   infection: a randomized controlled trial
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE Deep sternal wound infection; Mediastinitis; Gentamicin; Sternal
   refixation
ID VACUUM-ASSISTED CLOSURE; POSTSTERNOTOMY MEDIASTINITIS; REDON DRAINS;
   PROPHYLAXIS; MANAGEMENT; SURGERY; THERAPY; FLAP
AB OBJECTIVES: In patients with deep sternal wound infection (DSWI), primary closure of the sternal bone over high negative pressure Redon drains has shown to be a safe and feasible treatment method. Addition of local gentamicin could accelerate healing and improve clinical outcomes.
   METHODS: We conducted a randomized controlled trial to evaluate the effectiveness of local gentamicin in the treatment of DSWI. In the treatment group, collagenous carriers containing gentamicin were left between the sternal halves during sternal refixation. In the control group, no local antibiotics were used. Primary outcome was hospital stay. Secondary outcomes were mortality, reoperation, wound sterilization time, time till removal of all drains and duration of intravenous antibiotic treatment.
   RESULTS: Forty-one patients were included in the trial of which 20 were allocated to the treatment group. Baseline characteristics were similar in both groups. Drains could be removed after a median of 8.5 days in the treatment group and 14.5 days in the control group (P-value: 0.343). Intravenous antibiotics were administered for a median of 23.5 days in the treatment group and 38.5 days in the control group (P-value: 0.343). The median hospital stay was 27 days in the treatment group and 28 days in the control group (P-value: 0.873). Mortality rate was 10% in the treatment group and 9.5% in the control group (P-value: 0.959). No side effects were observed.
   CONCLUSIONS: This randomized controlled trial showed that addition of local gentamicin in the treatment of DSWI did not result in shorter length of stay.
C1 [Vos, Roemer J.; van Putte, Bart P.; Hoogewerf, Marieke; Mandigers, Tim J.; Kloppenburg, Geoffrey T. L.] St Antonius Hosp, Dept Cardiothorac Surg, Koekoekslaan 1, NL-3435 CM Nieuwegein, Netherlands.
   [van Putte, Bart P.; de Mol, Bas A. J. M.] Univ Amsterdam, Dept Cardiothorac Surg, Med Ctr, Amsterdam, Netherlands.
C3 St. Antonius Hospital Utrecht; University of Amsterdam
RP Vos, RJ (通讯作者)，St Antonius Hosp, Dept Cardiothorac Surg, Koekoekslaan 1, NL-3435 CM Nieuwegein, Netherlands.
EM roemervos@gmail.com
RI Mandigers, Tim/JPW-9275-2023
OI Vos, Roemer/0000-0002-2511-988X; Hoogewerf, Marieke/0000-0002-8415-5282
CR Abu-Omar Y, 2017, EUR J CARDIO-THORAC, V51, P10, DOI 10.1093/ejcts/ezw326
   Berg HF, 2000, ANN THORAC SURG, V70, P924, DOI 10.1016/S0003-4975(00)01524-1
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   DURANDY Y, 1989, J THORAC CARDIOV SUR, V97, P282
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   Luckraz H, 2003, J THORAC CARDIOV SUR, V125, P301, DOI 10.1067/mtc.2003.74
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   Sjögren J, 2005, ANN THORAC SURG, V79, P2049, DOI 10.1016/j.athoracsur.2004.12.048
   Sjögren J, 2006, EUR J CARDIO-THORAC, V30, P898, DOI 10.1016/j.ejcts.2006.09.020
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   Vos RJ, 2012, EUR J CARDIO-THORAC, V42, pE53, DOI 10.1093/ejcts/ezs404
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NR 19
TC 2
Z9 3
U1 0
U2 2
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
EI 1873-734X
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD MAY 2
PY 2022
VL 61
IS 5
BP 1135
EP 1141
DI 10.1093/ejcts/ezab479
EA NOV 2021
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 0Z2VC
UT WOS:000789356600001
PM 34849690
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Tran, BNN
   Johnson, AR
   Shen, CY
   Lee, BT
   Lee, ES
AF Bao Ngoc N Tran
   Johnson, Anna Rose
   Shen, Changyu
   Lee, Bernard T.
   Lee, Edward S.
TI Closed-Incision Negative-Pressure Therapy Efficacy in Abdominal Wall
   Reconstruction in High-Risk Patients: A Meta-analysis
SO JOURNAL OF SURGICAL RESEARCH
LA English
DT Article; Proceedings Paper
CT 3rd Annual Meeting of the Society-of-Asian-Academic-Surgeons (SAAS)
CY SEP 27-28, 2018
CL Milwaukee, WI
SP Soc Asian Acad Surg
DE Closed-incision negative-pressure therapy; Incisional vac; Complex
   abdominal reconstruction
ID AUTOLOGOUS BREAST RECONSTRUCTION; SURGICAL-SITE INFECTIONS;
   VACUUM-ASSISTED CLOSURE; VENTRAL HERNIA REPAIR; BODY-MASS INDEX; WOUND
   THERAPY; COMPLICATIONS; LAPAROTOMY; OUTCOMES; OBESITY
AB Background: Obesity is a known risk factor for surgical complications. Closed-incision negative-pressure therapy (ciNPT) has been used anecdotally in high-risk patients to prevent wound complications and infection. This meta-analysis aims to evaluate the efficacy of ciNPT in reducing the incidence of wound complications and infection in abdominal wall reconstruction.
   Methods: A literature search using the PubMed/MEDLINE databases (2006-2016) was conducted to identify publications comparing ciNPT to standard incisional care for abdominal wall reconstruction. Outcomes of interest included surgical site infection, wound dehiscence, seroma, hematoma, reoperation, and readmission. Overall rates and associations were pooled. A fixed and random effects model was used upon meta-analysis. Publication bias was assessed using funnel plots.
   Results: A total of 11 studies met inclusion criteria. There were 1723 patients included, 681 in the ciNPT group, and 1042 in the standard incisional care group. The majority of patients were obese, diabetic, and had a recent history of smoking. On meta-analysis, the risk of surgical site infection decreased by 51% (relative risk: 0.51, 95% confidence interval [0.41-0.63]). The risk of wound dehiscence decreased by 51% (relative risk: 0.51, 95% confidence interval [0.34-0.76]). There was no significant decreased risk observed with ciNPT use for the outcomes of seroma, hematoma, reoperation, and readmission.
   Conclusions: The use of ciNPT reduced the incidence of infection and wound dehiscence in patients with varying risk factors undergoing abdominal wall reconstruction. Future prospective randomized clinical trials are still needed to determine the efficacy of ciNPT in plastic surgery. Published by Elsevier Inc.
C1 [Bao Ngoc N Tran; Lee, Edward S.] Rutgers New Jersey Med Sch, Dept Surg, Div Plast & Reconstruct Surg, Newark, NJ USA.
   [Johnson, Anna Rose; Shen, Changyu; Lee, Bernard T.] Harvard Med Sch, Div Plast & Reconstruct Surg, Dept Surg, Beth Israel Deaconess Med Ctr, Boston, MA 02115 USA.
C3 Rutgers University System; Rutgers University New Brunswick; Rutgers
   University Biomedical & Health Sciences; Harvard University; Harvard
   University Medical Affiliates; Beth Israel Deaconess Medical Center;
   Harvard Medical School
RP Lee, ES (通讯作者)，Rutgers New Jersey Med Sch, Div Plast Surg, 140 Bergen St,Suite E1620, Newark, NJ 07103 USA.
EM leee9@njms.rutgers.edu
RI ; Lee, Bernard/K-1106-2016
OI Johnson, Anna Rose/0000-0003-0824-1709; Lee,
   Bernard/0000-0002-5533-3166; Lee, Edward/0000-0003-0487-3493
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   Chopra K, 2016, PLAST RECONSTR SURG, V137, P1284, DOI 10.1097/PRS.0000000000002024
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   Malmsjo Malin, 2012, Eplasty, V12, pe5
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NR 45
TC 41
Z9 46
U1 0
U2 17
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0022-4804
EI 1095-8673
J9 J SURG RES
JI J. Surg. Res.
PD SEP
PY 2019
VL 241
BP 63
EP 71
DI 10.1016/j.jss.2019.03.033
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA IC7EX
UT WOS:000471137000011
PM 31009887
DA 2026-07-24
ER

PT J
AU Sears, ED
   Wu, LZ
   Waljee, JF
   Momoh, AO
   Zhong, L
   Chung, KC
AF Sears, Erika D.
   Wu, Lizi
   Waljee, Jennifer F.
   Momoh, Adeyiza O.
   Zhong, Lin
   Chung, Kevin C.
TI The Impact of Deep Sternal Wound Infection on Mortality and Resource
   Utilization: A Population-based Study
SO WORLD JOURNAL OF SURGERY
LA English
DT Article
ID SURGICAL SITE INFECTIONS; VACUUM-ASSISTED CLOSURE; CARDIAC-SURGERY;
   MANAGEMENT APPROACH; NEGATIVE-PRESSURE; RISK-FACTORS; THERAPY; FLAP;
   MEDIASTINITIS; PREDICTORS
AB Recent national infection control efforts have been directed at reducing postsurgical infection rates, related morbidity, and cost. We sought to evaluate population-level rates of deep sternal wound infection (DSWI) after cardiac surgery, associated mortality, and resource use compared to patients undergoing cardiac surgery without postoperative DSWI relative to historical trends.
   We analyzed the MarketScan (A (R)) Commercial Claims Databases from 2009 to 2013 to identify adult patients who developed DSWI after open cardiac surgery. Patients with and without DSWI were compared. The outcomes of interest included 30-day, 90-day, and 1-year in-hospital mortality. Utilization outcomes, including total hospital days and inpatient costs, were calculated in the time period from the index cardiac surgery through 90 days after DSWI diagnosis.
   In this cohort, 176,537 patients underwent one or more cardiac surgery procedures. DSWI occurred in 2835 (1.6 %) patients. One-year mortality for patients with DSWI was 10.7 versus 2.5 % (P < 0.001) in patients without DSWI. Mean hospital days in patients with DSWI were 33 versus 9 days for patients without DSWI (P < 0.001). Mean cost for patients with DSWI was greater than 2.5 times that of patients without DSWI ($211,478 vs $82,089, P < 0.001).
   Treatment of DSWI results in substantial morbidity, mortality, and excess cost for treating facilities. The rates of DSWI have not decreased dramatically over the last 10-20 years. Thus, more attention needs to be focused toward understanding treatment variation that exists in patients diagnosed with DSWI.
C1 [Sears, Erika D.; Wu, Lizi; Waljee, Jennifer F.; Momoh, Adeyiza O.; Zhong, Lin; Chung, Kevin C.] Univ Michigan Hlth Syst, Sect Plast Surg, Dept Surg, Taubman Ctr 2130, 1500 E Med Ctr Dr,SPC 5340, Ann Arbor, MI 48109 USA.
C3 University of Michigan System; University of Michigan
RP Sears, ED (通讯作者)，Univ Michigan Hlth Syst, Sect Plast Surg, Dept Surg, Taubman Ctr 2130, 1500 E Med Ctr Dr,SPC 5340, Ann Arbor, MI 48109 USA.
EM endavis@med.umich.edu
RI ; Waljee, Jennifer/A-1319-2014
OI Chung, Kevin/0000-0002-2822-3164; 
FU Plastic Surgery Foundation; Michigan Institute for Clinical and Health
   Research; National Institute of Arthritis and Musculoskeletal and Skin
   Diseases of the National Institutes of Health [2 K24-AR053120-06];
   Midcareer Investigator Award in Patient-Oriented Research
FX Support for this study was provided in part by the grants from the
   Plastic Surgery Foundation (to Drs. Erika D. Sears and Jennifer F.
   Waljee), the Michigan Institute for Clinical and Health Research (to
   Drs. Adeyiza O. Momoh and Erika D. Sears), and the National Institute of
   Arthritis and Musculoskeletal and Skin Diseases of the National
   Institutes of Health under Award Number 2 K24-AR053120-06, a Midcareer
   Investigator Award in Patient-Oriented Research (to Dr. Kevin C. Chung).
   The content is solely the responsibility of the authors and does not
   necessarily represent the official views of the National Institutes of
   Health.
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NR 26
TC 69
Z9 72
U1 0
U2 5
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0364-2313
EI 1432-2323
J9 WORLD J SURG
JI World J.Surg.
PD NOV
PY 2016
VL 40
IS 11
BP 2673
EP 2680
DI 10.1007/s00268-016-3598-7
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA EA5XP
UT WOS:000386698800018
PM 27283188
DA 2026-07-24
ER

PT J
AU Oetting, P
   Rau, B
   Schlag, PM
AF Oetting, P.
   Rau, B.
   Schlag, P. M.
TI Abdominal vacuum device with open abdomen
SO CHIRURG
LA German
DT Article
DE open abdomen; temporary abdominal closure; vacuum-assisted fascial
   closure; peritonitis; abdominal compartment syndrome; necrotising
   fasciitis
ID ASSISTED FASCIAL CLOSURE; COMPARTMENT SYNDROME; TRAUMA PATIENTS; VENTRAL
   HERNIA; DAMAGE CONTROL; PACK TECHNIQUE; MANAGEMENT
AB Background. For the treatment of peritonitis or abdominal compartment syndrome, an open abdomen can be required. Because of the high complication rate associated with this method, different technical modifications were developed that are now being applied. Abdominal vacuum-assisted closure is increasingly favoured. We analyse our experience with this device in a distinct group of patients from gastrointestinal cancer surgery.
   Patients and method. From June 2003 to December 2005, 36 patients were treated with 151 double-layer abdominal vacuum devices. Indications for applying this device were peritonitis (n=22), abdominal compartment syndrome (n=11), and necrotising fasciitis (n=3). Thirty-four patients gave anamneses of malignoma.
   Results. Overall, the vacuum therapy treatment lasted a median of 13 days (range 348). With it, four enteric fistulas (11%) and four abdominal wall bleedings (11%) occurred. In our patient group, no new intra-abdominal abscesses were observed. Four patients died during treatment with the vacuum-assisted device and four afterward because of multiple organ failure in acute sepsis (in-hospital mortality 22%). Twenty-six patients (72%) underwent direct fascial closure after a median treatment duration of 10 days. Six patients (17%) required synthetic mesh for fascial closure. After a median follow-up of 100 days, two patients developed ventral hernias and two others showed ossification of the scar.
   Conclusion. Compared with other methods of temporary abdominal closure, our experience with the vacuum-assisted device demonstrates its advantages concerning clinical feasibility and the relatively low complication rate. The high rate of direct fascial closure with an acceptable rate of ventral hernias following vacuum-assisted abdominal closure are further benefits of this technique.
C1 Univ Med Berlin, Klin Chirurg & Chirurg Onkol, Robert Rossle Klin Helios Klinikum, D-13125 Berlin, Germany.
C3 Free University of Berlin; Humboldt University of Berlin; Charite
   Universitatsmedizin Berlin; Helios Kliniken
RP Schlag, PM (通讯作者)，Univ Med Berlin, Klin Chirurg & Chirurg Onkol, Robert Rossle Klin Helios Klinikum, Lindenberger Weg 80,Charite Campus Buch, D-13125 Berlin, Germany.
EM pmschlag@charite.de
RI Rau, Beate/JBS-6713-2023
OI Rau, Beate/0000-0001-5820-6907
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NR 30
TC 20
Z9 20
U1 0
U2 2
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0009-4722
EI 1433-0385
J9 CHIRURG
JI Chirurg
PD JUL
PY 2006
VL 77
IS 7
BP 586
EP +
DI 10.1007/s00104-006-1200-9
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 074RP
UT WOS:000239829800003
PM 16788732
DA 2026-07-24
ER

PT J
AU Attinger, CE
   Ducic, I
   Hess, CL
   Basil, A
   Abbruzzesse, M
   Cooper, P
AF Attinger, CE
   Ducic, I
   Hess, CL
   Basil, A
   Abbruzzesse, M
   Cooper, P
TI Outcome of skin graft versus flap surgery in the salvage of the exposed
   Achilles tendon in diabetics versus nondiabetics
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article; Proceedings Paper
CT 16th Annual Meeting of the
   American-Society-for-Reconstructive-Microsurgery
CY JAN 13-15, 2001
CL SAN DIEGO, CA
SP Amer Soc Reconstruct Surg
ID VACUUM-ASSISTED CLOSURE; FOOT WOUNDS; HYPERBARIC-OXYGEN;
   LOWER-EXTREMITY; LATERAL ARM; ULCERS; ARTERY; DEFECTS; LEG; EXPERIENCE
AB Background: Achilles tendon wounds pose a reconstructive dilemma because of the tendon's functional importance and the paucity of soft tissue surrounding the ankle. The currently accepted treatment is to repair the wound with a flap (local, pedicled, or free). In this article, the authors examine whether skin graft coverage of the exposed Achilles tendon is a viable option for reconstruction and whether the comorbidity of diabetes affects the outcome.
   Methods: Forty-five consecutive patients presenting with wounds involving the Achilles tendon in 49 limbs were retrospectively evaluated from the authors' limb salvage registry from 1990 to 1999.
   Results: After initial debridement, the method of reconstruction consisted of closure by secondary intention (n = 6), skin grafting (n = 27), and reconstruction with a flap (n = 10) or free flaps (n = 6). The primary success rate of each procedure was not significantly different: secondary intention, 83 percent; skin graft, 83 percent; local flap, 80 percent; and free flap, 83 percent. The overall wound-healing rate was 96 percent and the limb salvage rate was 98 percent. Six wounds eventually recurred in patients who had undergone skin grafting. All but one went on to heal with conservative therapy. There was no difference in any of the result parameters between diabetics and nondiabetics.
   Conclusions: This study demonstrates that, with a properly prepared wound bed, skin grafting can be as effective as local or free flaps in successfully healing Achilles tendon wounds. Diabetes should not be used as a contraindication to limb salvage in patients who present with Achilles tendon ulceration or gangrene.
C1 Georgetown Univ Hosp, Limb Ctr, Washington, DC 20007 USA.
C3 Georgetown University
RP Attinger, CE (通讯作者)，Georgetown Univ Hosp, Limb Ctr, 3800 Reservoir Rd,NW, Washington, DC 20007 USA.
EM cattinger@aol.com
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NR 34
TC 33
Z9 35
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0032-1052
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD JUN
PY 2006
VL 117
IS 7
BP 2460
EP 2467
DI 10.1097/01.prs.0000219345.73727.f5
PG 8
WC Surgery
WE Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 055DZ
UT WOS:000238431500054
PM 16772957
DA 2026-07-24
ER

PT J
AU Kim, KH
   Kim, KH
   Hwang, NH
   Kim, MJ
   Jeong, HC
   Chae, HK
   Han, JY
   Park, JH
AF Kim, Kyu Hyup
   Kim, Kyul Hee
   Hwang, Na-Hyun
   Kim, Min Jeong
   Jeong, Hyun Cheol
   Chae, Han Kyu
   Han, Ji-Yeon
   Park, Jun Ho
TI Gender-affirming robot-assisted sigmoid vaginoplasty: Outcomes and
   complications from a retrospective review of 12 cases
SO MEDICINE
LA English
DT Article
DE gender-affirming surgery; robot-assisted surgery; sigmoid vaginoplasty;
   transgender women; postoperative complications
ID COLON VAGINOPLASTY; TRANSGENDER WOMEN
AB Gender-affirming surgery significantly improves the quality of life in transfeminine individuals. Among the various techniques available, sigmoid colon vaginoplasty offers both anatomical and functional advantages. However, conventional approaches are associated with high morbidity. Thus, we aimed to evaluate the outcomes of robot-assisted sigmoid vaginoplasty, emphasizing the complications and clinical results. Between July 2021 and March 2023, 12 patients underwent robot-assisted sigmoid vaginoplasty. Preoperative assessments included colonoscopy and abdominal computed tomography. Flap preparation and canal dissection were performed using a da Vinci XI platform. Postoperative management included vacuum-assisted closure dressing, bed rest, and vaginal dilator use. Clinical outcomes, complications, and sexual activity (SA) were retrospectively analyzed. The mean patient age was 27.9 years (95% confidence interval [CI]: 21.8-34.0). The mean total operative time was 544.8 minutes (95% CI: 494.4-595.1). Intraoperative complications were not observed. The mean vaginal length achieved was 14.6 cm (95% CI: 12.9-16.3), with no cases of vaginal stenosis. Positive SA was reported in 75% of the cases. The overall postoperative complication rate was 41.7% (5/12). Complications included ileus (2 cases, Grade II), vaginal prolapse (1 case, Grade IIIa), anastomotic leakage (1 case, Grade IIIb), and colon flap necrosis (1 case, Grade IIIb), all of which were successfully managed. Robot-assisted sigmoid vaginoplasty demonstrated favorable functional and aesthetic outcomes with manageable complications. However, anastomotic leakage and flap necrosis highlight the importance of careful consideration of vascular supply. Further comparative studies are required to evaluate its advantages over peritoneal vaginoplasty.
C1 [Kim, Kyul Hee; Jeong, Hyun Cheol; Park, Jun Ho] Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, Dept Surg, 445 Gil 1 Dong, Seoul 05355, South Korea.
   [Hwang, Na-Hyun; Kim, Min Jeong] Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, Dept Plast Surg, Seoul, South Korea.
   [Hwang, Na-Hyun; Kim, Min Jeong; Jeong, Hyun Cheol; Chae, Han Kyu; Han, Ji-Yeon; Park, Jun Ho] Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, LGBTQ Ctr, Seoul, South Korea.
   [Chae, Han Kyu; Han, Ji-Yeon] Hallym Univ, Kangdong Sacred Heart Hosp, Coll Med, Dept Urol, Seoul, South Korea.
C3 Hallym University; Hallym University; Hallym University; Hallym
   University
RP Park, JH (通讯作者)，Hallym Univ, Coll Med, Kangdong Sacred Heart Hosp, Dept Surg, 445 Gil 1 Dong, Seoul 05355, South Korea.
EM yato31778@hanmail.net; yato31778@hanmail.net; priscah@kdh.or.kr;
   yato31778@hanmail.net; koulich@naver.com; hanqsinopoli@gmail.com;
   jyincomo@gmail.com; zooono@hanmail.net
RI Han, Jiyeon/KII-6637-2024
OI Kim, Kyu Hyup/0009-0003-9032-1835
FU Kangdong Sacred Heart Hospital, Hallym University [2025-01]
FX This research was supported by Kangdong Sacred Hospital Research Fund
   2025 (2025-01).
CR Bizic M, 2014, SCI WORLD J, DOI 10.1155/2014/638919
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NR 24
TC 0
Z9 0
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD FEB 27
PY 2026
VL 105
IS 9
AR e47849
DI 10.1097/MD.0000000000047849
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA EK0YU
UT WOS:001702962900030
PM 41760062
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Galstyan, GM
   Nalbandyan, SA
   Sabirov, KR
   Soboleva, OA
   Kovalenko, A
   Gorgidze, LA
   Zorenko, VY
AF Galstyan, G. M.
   Nalbandyan, S. A.
   Sabirov, K. R.
   Soboleva, O. A.
   Kovalenko, A., V
   Gorgidze, L. A.
   Zorenko, V. Y.
TI TREATMENT TACTICS FOR A PATIENT WITH ACQUIRED HEMOPHILIA: CONTINUOUS
   INFUSION OF RECOMBINANT ACTIVATED COAGULATION FACTOR VII AND THE
   INHIBITOR ERADICATION
SO GEMATOLOGIYA I TRANSFUZIOLOGIYA
LA Russian
DT Article
DE factor VIII; acquired hemophilia A; obstetric bleeding; rFVIIa; factor
   VIII inhibitor; vacuum-assisted laparostomy
ID CONGENITAL HEMOPHILIA; PREGNANCY; ANTIBODY; THERAPY
AB Introduction. Acquired hemophilia is a rare autoimmune disease caused by an inhibitor to clotting factor VIII (FVIII). It complicates the course of many diseases, in particular autoimmune diseases, and in women is often associated with pregnancy.
   Aim - to present a case of successful treatment of a patient with acquired hemophilia using long-term continuous infusion of rFVIIa and inhibitor eradication as a result of immunosuppressive therapy.
   Main findings. A clinical observation of severe hemorrhagic syndrome in a patient with acquired hemophilia associated with pregnancy is presented. Uterine bleeding in the patient after spontaneous delivery, refractory to standard hemorrhagic syndrome treatment, required multiple surgical interventions. Laboratory tests showed prolongation of APTT, CT in the INTEM rotational thromboelastometry test, a decrease in plasma FVIII activity and presence of inhibitor to FVIII. Vacuum-assisted closure was applied to treat infected laparotomy wound. Therapy for acquired hemophilia consisted of hemostatic therapy and the inhibitor eradication. Hemostatic therapy included a continuous infusion of rFVIIa at a rate of 30 mu g/kg/ h with a gradual decrease up to 9.6 mu g/kg/h, as well as its fractional administration before every surgery at a dosage of 80 mu g/kg. The effectiveness of the therapy was assessed by the dynamics of CT in the INTEM test and the shortening of the APTT. The inhibitor eradication was achieved by prednisolone therapy, combined immunosuppression with rituximab and azathioprine, followed by its replacement with cyclophosphamide. As a result, the hemorrhage was stopped, reference plasma activity of FVIII and eradication of the inhibitor were reached.
C1 [Galstyan, G. M.] Natl Med Res Ctr Hematol, Head Resuscitat & Intens Care Dept, Moscow 125167, Russia.
   [Galstyan, G. M.] Natl Med Res Ctr Obstet Gynecol & Perinatol, Dept Anesthesiol & Intens Care, Moscow 125167, Russia.
   [Nalbandyan, S. A.] Natl Med Res Ctr Hematol, Resuscitat & Intens Care Dept, Moscow 125167, Russia.
   [Sabirov, K. R.; Soboleva, O. A.; Kovalenko, A., V] Natl Med Res Ctr Hematol, Dept Surg, Moscow 125167, Russia.
   [Gorgidze, L. A.] Natl Med Res Ctr Hematol, Clin Pathol Express Lab, Resuscitat & Intens Care Unit, Moscow 125167, Russia.
   [Zorenko, V. Y.] Natl Med Res Ctr Hematol, Head Traumatol & Orthoped Dept, Moscow, Russia.
C3 Russian Academy of Medical Sciences; Research Center for Obstetrics,
   Gynecology & Perinatology
RP Galstyan, GM (通讯作者)，Natl Med Res Ctr Hematol, Head Resuscitat & Intens Care Dept, Moscow 125167, Russia.; Galstyan, GM (通讯作者)，Natl Med Res Ctr Obstet Gynecol & Perinatol, Dept Anesthesiol & Intens Care, Moscow 125167, Russia.
EM gengalst@gmail.com; siranushik1995@gmail.com; sabkirill@gmail.com;
   soboleva31@gmail.com; lana380@mail.ru; zorenko.vladimir@mail.ru
RI Galstyan, G.M/H-6398-2016; Lana, Gorgidze/P-8181-2014; /AAU-8827-2020
OI Galstyan, G.M/0000-0001-8818-8949; Nalbandyan,
   Siranush/0000-0002-3009-156X; Lana, Gorgidze/0000-0001-5235-2356;
   Kovalenko, Aleksey/0000-0002-6920-2490; Soboleva,
   Olga/0000-0001-9879-2664; 
CR [Anonymous], 2014, Nova Scotia operational guidelines for aquatic facilities, P1
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NR 30
TC 1
Z9 4
U1 0
U2 1
PU MINISTERSTVO ZDRAVOOKHRANENIYA
PI MOSCOW
PA NAUCHNIY PROEZD 6, B-246 MOSCOW, RUSSIA
SN 0234-5730
J9 GEMATOL TRANSFUZIOL
JI Gematol. Transfuziol.
PY 2022
VL 67
IS 2
BP 282
EP 294
DI 10.35754/0234-5730-2022-67-2-282-294
PG 13
WC Hematology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Hematology
GA 4D8HQ
UT WOS:000847380600010
OA gold
DA 2026-07-24
ER

PT J
AU Gjeorgjievski, M
   Imam, Z
   Cappell, MS
   Jamil, LH
   Kahaleh, M
AF Gjeorgjievski, Mihajlo
   Imam, Zaid
   Cappell, Mitchell S.
   Jamil, Laith H.
   Kahaleh, Michel
TI A Comprehensive Review of Endoscopic Management of Sleeve Gastrectomy
   Leaks
SO JOURNAL OF CLINICAL GASTROENTEROLOGY
LA English
DT Review
DE endobariatric; sleeve gastrectomy; bariatric surgery; endoscopic
   suturing
ID STAPLE-LINE LEAKS; Y GASTRIC BYPASS; VACUUM-ASSISTED CLOSURE; EXPANDING
   METAL STENTS; AMPLATZER VASCULAR PLUG; SELF-EXPANDABLE STENTS; EARLY
   POSTOPERATIVE COMPLICATIONS; INTERNATIONAL CONSENSUS SUMMIT; UPPER
   GASTROINTESTINAL-TRACT; ANAL FISTULA PLUG
AB Background: Bariatric surgery leaks result in significant morbidity and mortality. Experts report variable therapeutic approaches, without uniform guidelines or consensus. Objective: To review the pathogenesis, risk factors, prevention, and treatment of gastric sleeve leaks, with a focus on endoscopic approaches. In addition, the efficacy and success rates of different treatment modalities are assessed. Design: A comprehensive review was conducted using a thorough literature search of 5 online electronic databases (PubMed, PubMed Central, Cochrane, EMBASE, and Web of Science) from the time of their inception through March 2020. Studies evaluating gastric sleeve leaks were included. MeSH terms related to "endoscopic," "leak," "sleeve," "gastrectomy," "anastomotic," and "bariatric" were applied to a highly sensitive search strategy. The main outcomes were epidemiology, pathophysiology, diagnosis, treatment, and outcomes. Results: Literature search yielded 2418 studies of which 438 were incorporated into the review. Shock and peritonitis necessitate early surgical intervention for leaks. Endoscopic therapies in acute and early leaks involve modalities with a focus on one of: (i) defect closure, (ii) wall diversion, or (iii) wall exclusion. Surgical revision is required if endoscopic therapies fail to control leaks after 6 months. Chronic leaks require one or more endoscopic, radiologic, or surgical approaches for fluid collection drainage to facilitate adequate healing. Success rates depend on provider and center expertise. Conclusion: Endoscopic management of leaks post sleeve gastrectomy is a minimally invasive and effective alternative to surgery. Their effect may vary based on clinical presentation, timing or leak morphology, and should be tailored to the appropriate endoscopic modality of treatment.
C1 [Gjeorgjievski, Mihajlo; Imam, Zaid; Cappell, Mitchell S.; Jamil, Laith H.] Oakland Univ, William Beaumont Sch Med, Dept Gastroenterol & Hepatol, Royal Oak, MI 48309 USA.
   [Gjeorgjievski, Mihajlo; Imam, Zaid; Cappell, Mitchell S.; Jamil, Laith H.] Oakland Univ, William Beaumont Sch Med, Dept Med, Royal Oak, MI 48309 USA.
   [Gjeorgjievski, Mihajlo; Kahaleh, Michel] Rutgers Robert Wood Johnson Med Ctr, Dept Gastroenterol, New Brunswick, NJ 08901 USA.
C3 Oakland University; Oakland University; Rutgers University System;
   Rutgers University New Brunswick; Rutgers University Biomedical & Health
   Sciences
RP Kahaleh, M (通讯作者)，Rutgers State Univ, Robert Wood Johnson Univ Hosp, 1 RWJ Pl,MEB 491C, New Brunswick, NJ 08901 USA.
EM mihajlo.gj@gmail.com; zaid.imam@beaumont.org;
   Mitchell.cappell@beaumont.org; laith.jamil@beaumont.org;
   mkahaleh@gmail.com
RI Kahaleh, Michel/A-9408-2011; Imam, Zaid/ABE-6473-2020
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NR 436
TC 25
Z9 30
U1 0
U2 21
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0192-0790
EI 1539-2031
J9 J CLIN GASTROENTEROL
JI J. Clin. Gastroenterol.
PD AUG
PY 2021
VL 55
IS 7
BP 551
EP 576
DI 10.1097/MCG.0000000000001451
PG 26
WC Gastroenterology & Hepatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology
GA TG4LR
UT WOS:000671378800002
PM 33234879
DA 2026-07-24
ER

PT J
AU Al Majid, FM
   Buba, FM
   Barry, M
   Alsharani, F
   Alfawzan, F
AF Al Majid, Fahad M.
   Buba, Faruk M.
   Barry, Mazen
   Alsharani, Fatima
   Alfawzan, Fawzan
TI Incidence, types and outcomes of sternal wound infections after cardiac
   surgery in Saudi Arabia A retrospective medical chart review
SO SAUDI MEDICAL JOURNAL
LA English
DT Review
DE surgical wound infection; sternotomy; risk factors; outcomes
ID SURGICAL-SITE INFECTION; ARTERY-BYPASS GRAFT; RISK-FACTORS;
   ANTIBIOTIC-PROPHYLAXIS; COMPLICATIONS; MEDIASTINITIS; MANAGEMENT
AB Objectives: To determine the incidence, types, risk factors, identify organisms, and assess outcomes of surgical wound infections (SWIs) after cardiac surgery at a tertiary hospital in Riyadh, Saudi Arabia.
   Methods: This historical cohort study reviewed the chart of patients who underwent cardiac surgery at King Khalid University Hospital, Riyadh, Saudi Arabia between January 2009 and December 2014. The proforma contained personal data, comorbidities, type of surgery, microbiological analysis, and management outcomes.
   Results: A total of 1241 patients were enrolled in the study comprising 1,032 (83.2%) men and 209 (16.8%) women. Forty (3.2%) patients developed SWI, of which 32 (2.5%) were superficial and 8 (0.7%) were deep. Gender, obesity, diabetes mellitus, non-use of statins, and coronary artery bypass graft (CABG) surgery were not significant predictors of infection in the study. Methicillin-susceptible Staphylococcus aureus was isolated predominantly in 45%, followed by Klebsiella and Pseudomonas species. Methicillin-resistant Staphylococcus aureus, Enterococcus faecium, and extended beta-lactamase-producing gram-negative organisms were pathogens isolated in last 3 years of the review. Simple and vacuum assisted closure therapies led to complete resolution in 32 (80%) patients, while 8 (20%) developed sternal osteomyelitis. All patients survived except one with a deep SWI who died of uncontrolled sepsis.
   Conclusion: Despite the low incidence of postoperative SWIs, the risk of sternal osteomyelitis development persists. Meticulous choice of CABG components and appropriate postoperative management, especially detecting early signs of SWI could contribute to lower its incidence and complications.
C1 [Al Majid, Fahad M.; Barry, Mazen; Alsharani, Fatima] King Saudi Univ, Dept Infect Dis, Riyadh, Saudi Arabia.
   [Alfawzan, Fawzan] King Khalid Univ Hosp, Dept Med, Riyadh, Saudi Arabia.
   [Buba, Faruk M.] Univ Maiduguri, Coll Med Sci, Dept Med, Maiduguri, Nigeria.
C3 King Saud University; King Khalid University Hospital
RP Al Majid, FM (通讯作者)，King Saudi Univ, Dept Infect Dis, Riyadh, Saudi Arabia.
EM falmajid@gmail.com
RI Barry, Mazin/AAJ-7615-2020
OI Barry, Mazin/0000-0003-2274-007X; alshahrani,
   fatimah/0000-0002-4646-7488
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NR 32
TC 11
Z9 14
U1 0
U2 0
PU SAUDI MED J
PI RIYADH
PA ARMED FORCES HOSPITAL, PO BOX 7897,, RIYADH 11159, SAUDI ARABIA
SN 0379-5284
EI 1658-3175
J9 SAUDI MED J
JI Saudi Med. J.
PD FEB
PY 2020
VL 41
IS 2
BP 177
EP 182
DI 10.15537/smj.2020.2.24843
PG 6
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA OL3QU
UT WOS:000585258200010
PM 32020152
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Willy, C
   von Thun-Hohenstein, H
   von Lübken, F
   Weymouth, M
   Kossmann, T
   Engelhardt, M
AF Willy, C
   von Thun-Hohenstein, H
   von Lübken, F
   Weymouth, M
   Kossmann, T
   Engelhardt, M
TI Experimental principles of the VAC®-therapy -: Pressure values in
   superficial soft ttissue and the applied foam
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Article; Proceedings Paper
CT Three Nations Congress
CY 2003
CL Nuernberg, GERMANY
ID VACUUM-ASSISTED CLOSURE; WOUNDS; DRESSINGS
AB Object of the study: Measurement of the pressure during V.A.C.(R)-therapy in superficial parts of the affected soft tissue as well as at the soft tissue/foam-interface, measurement of pressure values along bigger distances in the foam and the comparison of pressure transfer between polyurethane and polyvinyl-alcohol foams. Material and Methods: A multi-channel electronic transducer-tipped catheter system based on the piezoresistive principle was used. Measurement was performed on a plain table surface, at a bovine muscle as well as in human tibial anterior muscle of a patient after fasciotomy. Applied pressure values by V.A.C.(R)-therapy-units were 50 to 200 mmHg (continuous suction modus). Results: 100% pressure transition through vacuum-therapy-foams to wound surface, almost 100% pressure transition even along 60 cm in very large polyurethan-foams using only one trac-pad connector. Pressure values >125 mm Hg using polyvinyl-alcohol-foams showed a reduction of up to 25% in distances >15 cm from trac-pad-connector. On the surface of the affected soft tissue there are negative and positive pressure values (25% quartile: -25 mm Hg; 75% quartile: + 15 mm Hg). Discussion: Pore walls of the foam can produce positive pressure conditions resulting in soft tissue compression and consecutively hypoperfusion or ischemia. V.A.C.(R)-therapy seems to produce an heterogeneity of pressure distribution at the wound ground leading to pressure gradients and facilitating drainage of interstitial fluid. This mechanism could explain the anti-edema effects of V.A.C.(R)-therapy resulting indirectly in an increased nutritive perfusion.
C1 Bundeswehrkrankenhaus Ulm, Chirurg Klin, D-89081 Ulm, Germany.
   Bundeswehrkrankenhaus Ulm, Urol Abt, Ulm, Germany.
   Alfred Hosp, Ctr Trauma, Melbourne, Vic, Australia.
C3 Ulm University; Military Hospital Ulm; Ulm University; Military Hospital
   Ulm; Florey Institute of Neuroscience & Mental Health; Howard Florey
   Institute Affiliates
RP Willy, C (通讯作者)，Bundeswehrkrankenhaus Ulm, Chirurg Klin, Oberer Eselsberg 40, D-89081 Ulm, Germany.
EM pddrmedchristianwilly@bundeswehr.org
RI /AAJ-3174-2021
CR Isago T, 2003, J DERMATOL, V30, P596, DOI 10.1111/j.1346-8138.2003.tb00441.x
   Isago T, 2003, J DERMATOL, V30, P299, DOI 10.1111/j.1346-8138.2003.tb00391.x
   Maier D, 2000, ZBL CHIR, V125, P82
   Morykwas MJ, 2001, ANN PLAS SURG, V47, P547, DOI 10.1097/00000637-200111000-00013
   Saxena V, 2004, PLAST RECONSTR SURG, V114, P1086, DOI 10.1097/01.prs.0000135330.51408.97
   Wackenfors A, 2004, WOUND REPAIR REGEN, V12, P600, DOI 10.1111/j.1067-1927.2004.12602.x
   Willy C, 1999, J BONE JOINT SURG AM, V81A, P158, DOI 10.2106/00004623-199902000-00003
NR 7
TC 16
Z9 18
U1 0
U2 2
PU JOHANN AMBROSIUS BARTH VERLAG MEDIZINVERLAGE HEIDELBERG GMBH
PI STUTTGART
PA RUEDIGERSTR 14, D-70469 STUTTGART, GERMANY
SN 0044-409X
J9 ZBL CHIR
JI Zent.bl. Chir.
PD APR
PY 2006
VL 131
SU 1
BP S50
EP S61
DI 10.1055/s-2006-921421
PG 12
WC Surgery
WE Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 034DB
UT WOS:000236904100013
PM 16575646
DA 2026-07-24
ER

PT J
AU Chang, CC
   Lan, YT
   Jiang, JK
   Chang, SC
   Yang, SH
   Lin, CC
   Lin, HH
   Wang, HS
   Chen, WS
   Lin, TC
   Lin, JK
AF Chang, Chu-Cheng
   Lan, Yuan-Tzu
   Jiang, Jeng-Kai
   Chang, Shih-Ching
   Yang, Shung-Haur
   Lin, Chun-Chi
   Lin, Hung-Hsin
   Wang, Huann-Sheng
   Chen, Wei-Shone
   Lin, Tzu-Chen
   Lin, Jen-Kou
TI Risk factors for delayed perineal wound healing and its impact on
   prolonged hospital stay after abdominoperineal resection
SO WORLD JOURNAL OF SURGICAL ONCOLOGY
LA English
DT Article
DE Abdominoperineal resection; Perineal wound; Primary closure;
   Hypoalbuminemia; Hospital stay
ID VACUUM-ASSISTED CLOSURE; RECTAL-CANCER; FLAP RECONSTRUCTION;
   COMPLICATIONS; PREDICTORS; THERAPY; SURGERY; REPAIR
AB Background Perineal wound complications are a long-lasting issue for abdominoperineal resection (APR) patients. Complication rates as high as 60% have been reported, with the most common complication being delayed perineal wound healing. The aim of this study was to identify risk factors for delayed perineal wound healing and its impact on prolonged hospital stay. Methods We included low rectal tumor patients who underwent APR at a referral medical center from April 2002 to December 2017; a total of 229 patients were included. The basic characteristics and surgical outcomes of the patients were analyzed to identify risk factors for delayed perineal wound healing (> 30 days after APR) and prolonged hospital stay (post-APR hospital stay > 14 days). Results All patients received primary closure for their perineal wound. The majority of patients were diagnosed with adenocarcinoma (N = 213, 93.1%). In the univariate analysis, patients with hypoalbuminemia (albumin < 3.5 g/dL) had an increased risk of delayed wound healing (39.5% vs. 60.5%, P = 0.001), which was an independent risk factor in the multivariable analysis (OR 2.962, 95% CI 1.437-6.102, P = 0.003). Patients with delayed wound healing also had a significantly increased risk of prolonged hospital stay (OR 6.404, 95% CI 3.508-11.694, P < 0.001). Conclusions Hypoalbuminemia was an independent risk factor for delayed wound healing, which consequently led to a prolonged hospital stay. Further clinical trials are needed to reduce the incidence of delayed perineal wound healing by correcting albumin levels or nutritional status before APR.
C1 [Lan, Yuan-Tzu; Jiang, Jeng-Kai; Chang, Shih-Ching; Lin, Chun-Chi; Lin, Hung-Hsin; Wang, Huann-Sheng; Chen, Wei-Shone; Lin, Tzu-Chen; Lin, Jen-Kou] Taipei Vet Gen Hosp, Dept Surg, Div Colon & Rectal Surg, 201 Sect,2 Shih Pai Rd, Taipei 11217, Taiwan.
   [Lan, Yuan-Tzu; Jiang, Jeng-Kai; Chang, Shih-Ching; Yang, Shung-Haur; Lin, Chun-Chi; Lin, Hung-Hsin; Wang, Huann-Sheng; Chen, Wei-Shone; Lin, Tzu-Chen; Lin, Jen-Kou] Natl Yang Ming Univ, Dept Surg, Taipei, Taiwan.
   [Chang, Chu-Cheng] En Chu Kong Hosp, Taipei, Taiwan.
C3 Taipei Veterans General Hospital; National Yang Ming Chiao Tung
   University
RP Lan, YT (通讯作者)，Taipei Vet Gen Hosp, Dept Surg, Div Colon & Rectal Surg, 201 Sect,2 Shih Pai Rd, Taipei 11217, Taiwan.; Lan, YT (通讯作者)，Natl Yang Ming Univ, Dept Surg, Taipei, Taiwan.
EM ytlan@vghtpe.gov.tw
OI CHUNG, SUN YEE/0009-0000-8371-2035
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NR 29
TC 35
Z9 41
U1 0
U2 7
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1477-7819
J9 WORLD J SURG ONCOL
JI World J. Surg. Oncol.
PD DEC 21
PY 2019
VL 17
IS 1
AR 226
DI 10.1186/s12957-019-1768-4
PG 7
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA JX5JA
UT WOS:000503769900002
PM 31864365
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Leibig, N
   Ha-Phuoc, A
   Stark, GB
   Schmelzeisen, R
   Metzger, MC
   Eisenhardt, SU
   Voss, PJ
AF Leibig, N.
   Ha-Phuoc, A.
   Stark, G. B.
   Schmelzeisen, R.
   Metzger, M. C.
   Eisenhardt, S. U.
   Voss, P. J.
TI Retrospective evaluation of diagnostic accuracy of free flap monitoring
   with the Cook-Swartz-Doppler probe in head and neck reconstruction
SO JOURNAL OF CRANIO-MAXILLOFACIAL SURGERY
LA English
DT Article
DE Cook-Swartz-Doppler probe; Head and neck surgery; Head and neck
   reconstruction; Free flap monitoring; Perfusion control
ID VACUUM-ASSISTED CLOSURE; FREE TISSUE TRANSFERS; EXTREMITY FREE FLAPS;
   IMPLANTABLE DOPPLER; SYSTEM; EXPERIENCE; SALVAGE; RISK
AB The Cook-Swartz-Doppler probe is an easy to handle and reliable tool for free flap monitoring. In the head and neck region different confounders can affect the read out. We therefore analyzed the use of the Doppler probe regarding these potential difficulties and to compare the diagnostic accuracy in arterial or venous monitoring of free flaps in the head and neck region.
   A retrospective study was performed in which all patients were included who underwent free flap surgery in the head and neck region in the Department of Plastic Surgery and the Department of Maxillofacial Surgery of our institution between 2010 and 2018 and were monitored with an implanted Doppler probe.
   147 free tissue transfers were included. No significance was found for arterial and venous placement of the Doppler probe for sensitivity (artery 83.3%; vein 84.6%; p = 0.87), specificity (artery 89.2%; vein 96.1%; p = 0.17) and negative predictive value (artery 96.7%; vein 94.2%; p = 0.55). A better positive predictive value for placing the Doppler probe around the artery (82.7%) than the vein (61.1%) was found in our study (p = 0.056).
   The better positive predictive value in arterial monitoring suggests that this is the more reliable measuring method to assess flap perfusion in the head and neck region. (C) 2019 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.
C1 [Leibig, N.; Ha-Phuoc, A.; Stark, G. B.; Eisenhardt, S. U.] Univ Freiburg, Med Ctr, Dept Plast & Hand Surg, Med Fac, D-79106 Freiburg, Germany.
   [Ha-Phuoc, A.; Schmelzeisen, R.; Metzger, M. C.; Voss, P. J.] Univ Freiburg, Dept Oral & Maxillofacial Surg, Med Ctr, D-79106 Freiburg, Germany.
C3 University of Freiburg; University of Freiburg
RP Eisenhardt, SU (通讯作者)，Univ Freiburg, Med Ctr, Dept Plast & Hand Surg, Med Fac, D-79106 Freiburg, Germany.
EM Nico.leibig@uniklinik-freiburg.de; A.Ha-Phuoc@gmx.de;
   Bjoern.stark@uniklinik-freiburg.de;
   Rainer.schmelzeisen@uniklinik-freiburg.de;
   Marc.metzger@uniklinik-freiburg.de;
   steffen.eisenhardt@uniklinik-freiburg.de; Pit.voss@uniklinik-freiburg.de
RI Voss, Pit/ABE-5710-2020; Eisenhardt, Steffen Ulrich/AAF-8033-2021
OI Metzger, Marc Christian/0000-0002-4893-7594; Eisenhardt, Steffen
   Ulrich/0000-0003-4471-3160
CR Bannasch H, 2008, MICROSURG, V28, P412, DOI 10.1002/micr.20512
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NR 38
TC 13
Z9 15
U1 0
U2 4
PU CHURCHILL LIVINGSTONE
PI EDINBURGH
PA JOURNAL PRODUCTION DEPT, ROBERT STEVENSON HOUSE, 1-3 BAXTERS PLACE,
   LEITH WALK, EDINBURGH EH1 3AF, MIDLOTHIAN, SCOTLAND
SN 1010-5182
EI 1878-4119
J9 J CRANIO MAXILL SURG
JI J. Cranio-MaxilloFac. Surg.
PD DEC
PY 2019
VL 47
IS 12
BP 1973
EP 1979
DI 10.1016/j.jcms.2019.11.001
PG 7
WC Dentistry, Oral Surgery & Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dentistry, Oral Surgery & Medicine; Surgery
GA JV8KY
UT WOS:000502610100021
PM 31810844
DA 2026-07-24
ER

PT J
AU Haslik, W
   Kamolz, LP
   Manna, F
   Hladik, M
   Rath, T
   Frey, M
AF Haslik, W.
   Kamolz, L. -P.
   Manna, F.
   Hladik, M.
   Rath, T.
   Frey, M.
TI Management of full-thickness skin defects in the hand and wrist region:
   first long-term experiences with the dermal matrix Matriderm®
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Collagen-elastin matrix; Dermal substitute; Full-thickness skin defect;
   One-stage grafting; Upper extremity
ID VACUUM-ASSISTED CLOSURE; RECONSTRUCTIVE SURGERY; CLINICAL-TRIAL; BURNS;
   SUBSTITUTES
AB The gold standard for the coverage of full-thickness skin defects is autologous skin grafts. However, poor skin quality and scar contracture are well-known problems in functional, highly strained regions. The use of dermal substitutes is an appropriate way to minimise scar contraction and, thereby, to optimise the quality of the reconstructed skin. The aim of this study was to evaluate the impact of the collagen-elastin matrix, Matriderm (R), for the single-step reconstruction of joint-associated defects of the upper extremity. Seventeen patients with full-thickness skin defects of the upper extremity were treated with the dermal substitute, Matriderm (R), and unmeshed skin graft in the functional critical region of the distal upper extremity in a single-step procedure. The take rate of the matrix-and-skin graft was 96%. Long-term follow-up revealed an overall Vancouver scar scale of 1.7. No limitation concerning hand function was observed; DASH-score analysis revealed excellent hand function in patients with burn injury and patients with a defect due to the harvest of a radial forearm flap achieved satisfying hand function.
   This matrix represents a viable alternative to other types of defect coverage and should therefore be considered in the treatment of skin injuries, especially in very delicate regions such as the joint regions. The possibility of performing a one-stage procedure is supposed to be a major advantage in comparison to a two-stage procedure. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Haslik, W.; Kamolz, L. -P.; Hladik, M.; Rath, T.; Frey, M.] Med Univ Vienna, Dept Surg, Div Plast & Reconstruct Surg, Vienna, Austria.
   [Manna, F.] Childrens Hosp Burlo Garofolo, IRCCS, Dept Surg, Trieste, Italy.
C3 Medical University of Vienna; IRCCS Burlo Garofolo
RP Kamolz, LP (通讯作者)，Univ Vienna, Sch Med, Dept Surg, Div Plast & Reconstruct Surg, Waehringer Guertel 18-20, A-1090 Vienna, Austria.
EM lars-peter.kamolz@meduniwien.ac.at
OI Haslik, Werner/0000-0002-2731-2720; Kamolz,
   Lars-Peter/0000-0002-5975-876X
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NR 14
TC 138
Z9 156
U1 1
U2 21
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD FEB
PY 2010
VL 63
IS 2
BP 360
EP 364
DI 10.1016/j.bjps.2008.09.026
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 551IS
UT WOS:000274201900029
PM 19042169
DA 2026-07-24
ER

PT J
AU Jeffcoate, WJ
   Lipsky, BA
   Berendt, AR
   Cavanagh, PR
   Bus, SA
   Peters, EJG
   van Houtum, WH
   Valk, GD
   Bakker, K
AF Jeffcoate, W. J.
   Lipsky, B. A.
   Berendt, A. R.
   Cavanagh, P. R.
   Bus, S. A.
   Peters, E. J. G.
   van Houtum, W. H.
   Valk, G. D.
   Bakker, K.
CA Three Systematic Review Working Pa
TI Unresolved issues in the management of ulcers of the foot in diabetes
SO DIABETIC MEDICINE
LA English
DT Review
DE diabetic foot; infection; osteomyelitis; systematic review; wound
   healing
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; STAGE RENAL-DISEASE;
   TO-BONE TEST; NONSURGICAL MANAGEMENT; HYPERBARIC-OXYGEN; PLANTAR
   PRESSURE; RANDOMIZED-TRIAL; MAGGOT THERAPY; HEAD RESECTION
AB Management of diabetic foot ulcers presents a major clinical challenge. The response to treatment is often poor and the outcome disappointing, while the costs are high for both healthcare providers and the patient. In such circumstances, it is essential that management should be based on firm evidence and follow consensus. In the case of the diabetic foot, however, clinical practice can vary widely. It is for these reasons that the International Working Group on the Diabetic Foot has published guidelines for adoption worldwide. The Group has now also completed a series of non-systematic and systematic reviews on the subjects of soft tissue infection, osteomyelitis, offloading and other interventions designed to promote ulcer healing. The current article collates the results of this work in order to demonstrate the extent and quality of the evidence which is available in these areas. In general, the available scientific evidence is thin, leaving many issues unresolved. Although the complex nature of diabetic foot disease presents particular difficulties in the design of robust clinical trials, and the absence of published evidence to support the use of an intervention does not always mean that the intervention is ineffective, there is a clear need for more research in the area. Evidence from sound clinical studies is urgently needed to guide consensus and to underpin clinical practice. It is only in this way that patients suffering with these frequently neglected complications of diabetes can be offered the best hope for a favourable outcome, at the least cost.
   Diabet. Med. 25, 1380-1389 (2008).
C1 [Jeffcoate, W. J.] Nottingham Univ Hosp Trust, Foot Ulcer Trials Unit, Dept Endocrinol & Diabet, Nottingham NG5 1PB, England.
   [Lipsky, B. A.] VA Puget Sound HCS, Seattle, WA USA.
   [Berendt, A. R.] Univ Washington, Dept Orthopaed & Sports Med, Seattle, WA 98195 USA.
   [Berendt, A. R.] Nuffield Orthopaed Ctr NHS Turst, Bone Infect Unit, Oxford, England.
   [Bus, S. A.] Univ Amsterdam, Acad Med Ctr, Dept Rehabil, NL-1105 AZ Amsterdam, Netherlands.
   [Peters, E. J. G.] Univ Med Ctr Utrecht, Dept Internal Med & Infect Dis, Utrecht, Netherlands.
   [Valk, G. D.] Univ Med Ctr Utrecht, Dept Internal Med, Utrecht, Netherlands.
   [van Houtum, W. H.] Spaarne Hosp, Dept Internal Med, Hoofddorp, Netherlands.
   [Bakker, K.] IWGDF, Heemstede, Netherlands.
C3 University of Nottingham; Nottingham University Hospital NHS Trust; US
   Department of Veterans Affairs; Veterans Health Administration (VHA);
   Vet Affairs Puget Sound Health Care System; University of Washington;
   University of Washington Seattle; Nuffield Orthopaedic Centre;
   University of Amsterdam; Academic Medical Center Amsterdam; Utrecht
   University; Utrecht University Medical Center; Utrecht University;
   Utrecht University Medical Center; Spaarne Hospital
RP Jeffcoate, WJ (通讯作者)，Nottingham Univ Hosp Trust, Foot Ulcer Trials Unit, Dept Endocrinol & Diabet, City Hosp Campus, Nottingham NG5 1PB, England.
EM wjeffcoate@futu.co.uk
RI Lipsky, Benjamin A/IZE-0823-2023; Peters, Edgar/B-7790-2014
OI Lipsky, Benjamin A/0000-0001-9886-5114; Bus, Sicco/0000-0002-8357-9163; 
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NR 93
TC 67
Z9 81
U1 0
U2 25
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0742-3071
EI 1464-5491
J9 DIABETIC MED
JI Diabetic Med.
PD DEC
PY 2008
VL 25
IS 12
BP 1380
EP 1389
DI 10.1111/j.1464-5491.2008.02573.x
PG 10
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA 377KD
UT WOS:000261249200002
PM 19046235
DA 2026-07-24
ER

PT J
AU Raimond, E
   Mimoun, C
   Menouer, I
   Graesslin, O
   Fauconnier, A
   Huchon, C
AF Raimond, E.
   Mimoun, C.
   Menouer, I.
   Graesslin, O.
   Fauconnier, A.
   Huchon, C.
TI Systematic literature review and meta-analysis of postoperative
   complications of surgical management of vulvar cancer: what is the
   impact of frailty factors?
SO EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY
LA English
DT Review
DE Vulvar cancer; Post-operative complication; Age
ID VACUUM-ASSISTED CLOSURE; QUALITY-OF-LIFE; INGUINAL LYMPHADENECTOMY;
   RISK-FACTORS; SAPHENOUS-VEIN; WOUND COMPLICATIONS; RADICAL VULVECTOMY;
   MORBIDITY; CARCINOMA; LYMPHEDEMA
AB Introduction: Vulvar cancer surgery is associated with high rates of morbidity. Preventing or minimizing these morbidities is an important objective, as they impact on patients' quality of life, and are highly deleterious in frail, aged patients, who represent the majority of those affected by this disease. This systematic literature review and meta-analysis assesses post-operative complications in vulvar cancer surgery, and attempts to identify the impact of frailty factors. Method: A Pubmed search was conducted to identify studies reporting data on complications of vulvar cancer surgery in frail patients, from January 2000 to April 2022, following the recommendations of the PRISMA, and registered in PROSPERO (CRD 42024503036). The evaluation criteria were: age, frailty, and complications. Statistical heterogeneity of results was assessed by graphical representations of confidence intervals (CI) on forest plot and by a Chi2 heterogeneity test. Result: Frailty related to age > 70 years increases the risk of inguinal disunion (OR = 1.89, 95%CI [1.12-3.20]). Frailty (due to age and obesity) does not increase the risk of lymphocele. Frailty factors, such as obesity, are risk factors for inguinal cellulitis (OR = 1.86, 95%CI [1.12-3.08]), and diabetes is a risk factor for inguinal infection. Conclusion: This literature review and meta-analysis precludes drawing any significant clinical conclusion regarding the impact of frailty, in particular age-related frailty, on the occurrence of complications. This is due to different definitions of complications, a lack of precision in the data provided, the variety of surgical techniques performed, the absence of an age group or a frailty group.
C1 [Raimond, E.; Menouer, I.; Graesslin, O.] Reims Champagne Ardennes Univ, Inst Alix De Champagne Univ Hosp, Dept Obstet & Gynaecol, Reims, France.
   [Raimond, E.; Fauconnier, A.] Univ Paris Sud Saclay, EA 7285 Lab Risk Management Womens & Perinatal Hl, Sud Saclay, France.
   [Mimoun, C.; Huchon, C.] Univ Paris Cite, Lariboisiere Univ Hosp, AP HP, Dept Obstet & Gynaecol, Paris, France.
   [Mimoun, C.; Huchon, C.] Paris Cite Univ, Natl Inst Hlth & Med Res, ECEVE U1123, Paris, France.
   [Fauconnier, A.] Intercommunal Hosp Ctr Poissy, Dept Obstet & Gynaecol, Poissy, France.
C3 Universite de Reims Champagne-Ardenne; CHU de Reims; Assistance Publique
   Hopitaux Paris (APHP); Universite Paris Cite; Hopital Universitaire
   Lariboisiere-Fernand-Widal - APHP; Institut National de la Sante et de
   la Recherche Medicale (Inserm); Universite Paris Cite
RP Raimond, E (通讯作者)，Reims Champagne Ardennes Univ, Inst Alix De Champagne Univ Hosp, Dept Obstet & Gynaecol, Reims, France.; Raimond, E (通讯作者)，Univ Paris Sud Saclay, EA 7285 Lab Risk Management Womens & Perinatal Hl, Sud Saclay, France.
EM eraimond@chu-reims.fr
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   Zhang SH, 2000, CANCER-AM CANCER SOC, V89, P1520, DOI 10.1002/1097-0142(20001001)89:7<1520::AID-CNCR15>3.3.CO;2-E
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NR 66
TC 0
Z9 0
U1 1
U2 1
PU ELSEVIER
PI AMSTERDAM
PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
SN 0301-2115
EI 1872-7654
J9 EUR J OBSTET GYN R B
JI Eur. J. Obstet. Gynecol. Reprod. Biol.
PD MAR
PY 2026
VL 319
AR 114974
DI 10.1016/j.ejogrb.2026.114974
EA JAN 2026
PG 22
WC Obstetrics & Gynecology; Reproductive Biology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Obstetrics & Gynecology; Reproductive Biology
GA DF6JX
UT WOS:001682281500001
PM 41619338
OA Bronze
DA 2026-07-24
ER

PT J
AU Andreou, D
   Streitbürger, A
   Guder, W
   Nottrott, M
   Engel, NM
   Podleska, LE
   Hardes, J
AF Andreou, Dimosthenis
   Streitburger, Arne
   Guder, Wiebke
   Nottrott, Markus
   Engel, Nina Myline
   Podleska, Lars Erik
   Hardes, Jendrik
TI Interne Hemipelvektomie: periazetabuläre Resektion mit
   Femurtransposition (Hüftverschiebeplastik)
SO OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE
LA Spanish
DT Review
DE Knochensarkom; Knochenmetastase; Biologische Rekonstruktion; Neogelenk;
   Proximaler Femurersatz; Bone sarcoma; Bone metastasis; Biological
   reconstruction; Neo-joint; Proximal femur replacement
ID TUMORS
AB ObjectiveLong-term stable fixation of the leg to the remaining ilium or sacrum following internal hemipelvectomy including resection of the acetabulum.IndicationsBone sarcomas, soft tissue sarcomas infiltrating the bone, solitary late metastases, acetabular reconstruction failure.ContraindicationsPalliative treatment goal, mutilating resection (especially when the tumor extends beyond the midline of the sacrum).Surgical techniqueFacilitation of stable fixation of the femoral head or proximal femur replacement to the remaining bone (ilium or sacrum,) following periacetabular pelvic resection. Insertion of 2-3 bone anchors in the ilium or sacrum, depending on the extent of tumor resection, alternatively transosseous sutures and attachment of a partially resorbable mesh, closed at the proximal end. Depending on the muscular coverage, repositioning of the hip or bipolar cup proximally. Attachment of the mesh to the remaining hip capsule or the megaprosthesis and the muscles. The reconstruction length must not compromise sufficient muscle coverage.Postoperative managementElastic hip spica. Bed rest for 1-2 weeks, depending on the weight of the leg. Mobilization with a walker or 2 crutches with 20 kg weight bearing for the following 4-6 weeks. Lymphatic drainage/venous foot pump as required. Adjuvant chemo- or radiotherapy as per multidisciplinary tumor board recommendation.ResultsThe goal is the development of a stable scar around the neo-joint with minimal dead space. Young patients can often walk for several kilometers, typically using a walking stick on the contralateral side. Sole lift, lengthening of the femur at a later point if desired. There is a risk of wound-healing disorders or deep infections postoperatively in approximately 30% of cases. In case of infection, removal of the mesh and possibly of the proximal femoral replacement, as well as vacuum-assisted closure therapy may be necessary.
C1 [Andreou, Dimosthenis; Streitburger, Arne; Guder, Wiebke; Nottrott, Markus; Engel, Nina Myline; Podleska, Lars Erik; Hardes, Jendrik] Univ Med Essen, Klin Tumororthopadie & Sarkomchirurg, Hufelandstr 55, D-45147 Essen, Germany.
RP Hardes, J (通讯作者)，Univ Med Essen, Klin Tumororthopadie & Sarkomchirurg, Hufelandstr 55, D-45147 Essen, Germany.
EM jendrik.hardes@uk-essen.de
CR ENNEKING WF, 1978, J BONE JOINT SURG AM, V60, P731, DOI 10.2106/00004623-197860060-00002
   ENNEKING WF, 1993, CLIN ORTHOP RELAT R, P241
   Gebert C, 2011, J SURG ONCOL, V103, P269, DOI 10.1002/jso.21820
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NR 5
TC 1
Z9 1
U1 1
U2 1
PU URBAN & VOGEL
PI MUNICH
PA NEUMARKTER STRASSE 43, D-81673 MUNICH, GERMANY
SN 0934-6694
EI 1439-0981
J9 OPER ORTHOP TRAUMATO
JI Oper. Orthopade Traumatol.
PD FEB
PY 2026
VL 38
IS 1
SI SI
BP 33
EP 43
DI 10.1007/s00064-025-00922-9
EA OCT 2025
PG 11
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA DA9JK
UT WOS:001607266100001
PM 41162767
DA 2026-07-24
ER

PT J
AU Madhuchandra, P
   Balaji, SM
AF Madhuchandra, P.
   Balaji, S. Muthukumar
TI A Novel Approach in the Management of Tibial Plateau Fractures with
   Compartment Syndrome
SO INDIAN JOURNAL OF ORTHOPAEDICS
LA English
DT Article
DE Impending Compartment syndrome; Fasciotomy; Tibial plateau fractures
ID INVASIVE STABILIZATION SYSTEM; FIXATION
AB BackgroundCompartment syndrome in tibial plateau fractures presents a formidable challenge for treating orthopedic surgeons. The most common strategy is early fasciotomy and external fixation, followed by a second stage definitive fixation. We conducted a prospective study of tibial plateau fractures of Schatzker Type V and VI with impending compartment syndrome treated by single-stage double incision fasciotomy and dual internal fixation and Vacuum-Assisted Closure (VAC).Materials and MethodsThe study was between May 2014 and February 2019. 21 patients with impending compartment syndrome who underwent single-stage double incision fasciotomy and Open Reduction and Internal Fixation (ORIF) with dual plate were included in the study. The functional and radiological outcome was measured using the modified Rasmussen functional and radiological scoring and The Western Ontario and McMaster Universities Arthritis Index (WOMAC).ResultsThe mean age of patients was 38.7 years (Standard deviation of & PLUSMN; 9.48). The mean follow-up period was 27 months (Standard deviation of & PLUSMN; 6.51). The mean functional and radiological modified Rasmussen score was 27.28 (range 21 to 29) & 8 (range 7 to 10), respectively. 4 patients had excellent outcomes, and 17 patients had good results. The mean WOMAC score was 8.04 (Standard deviation of & PLUSMN; 5.35). Five patients had a score of 0, 14 patients had a score of 1-10 and 2 had a score of 11-20.ConclusionsThe early double incision fasciotomy and definitive internal fixation with dual plate and VAC as single-stage surgery in patients with impending compartment syndrome help to obtain excellent to good functional outcomes with reduced complications.
C1 [Madhuchandra, P.] BGS Global Inst Med Sci, Dept Orthopaed, Bengaluru, India.
   [Balaji, S. Muthukumar] SRM Inst Sci & Technol, SRM Med Coll & Res Ctr, Dept Orthopaed, Chennai, India.
   [Madhuchandra, P.] 757,5th Main Rd,ISRO Layout, Bangalore 560078, Karnataka, India.
C3 SRM Institute of Science & Technology Chennai
RP Madhuchandra, P (通讯作者)，BGS Global Inst Med Sci, Dept Orthopaed, Bengaluru, India.; Madhuchandra, P (通讯作者)，757,5th Main Rd,ISRO Layout, Bangalore 560078, Karnataka, India.
EM drmadhuchandrap@gmail.com; mkbmkb79@gmail.com
OI P, Madhuchana/0000-0001-9708-9184
CR Akbari Aghdam H, 2019, EUR J ORTHOP SURG TR, V29, P183, DOI 10.1007/s00590-018-2275-y
   Ali AM, 2006, J ORTHOP RES, V24, P2080, DOI 10.1002/jor.20270
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NR 24
TC 2
Z9 4
U1 0
U2 4
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0019-5413
EI 1998-3727
J9 INDIAN J ORTHOP
JI Indian J. Orthop.
PD SEP
PY 2023
VL 57
IS 9
BP 1435
EP 1442
DI 10.1007/s43465-023-00955-x
EA JUL 2023
PG 8
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA P5QR7
UT WOS:001034557800001
PM 37609025
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Pieri, M
   Müller, M
   Scandroglio, AM
   Pergantis, P
   Kretzschmar, A
   Kaufmann, F
   Falk, V
   Krabatsch, T
   Arlt, G
   Potapov, E
   Kukucka, M
AF Pieri, Marina
   Mueller, Marcus
   Scandroglio, Anna Mara
   Pergantis, Panagiotis
   Kretzschmar, Alexandra
   Kaufmann, Friedrich
   Falk, Volkmar
   Krabatsch, Thomas
   Arlt, Georg
   Potapov, Evgenij
   Kukucka, Marian
TI Surgical Treatment of Mediastinitis with Omentoplasty in Ventricular
   Assist Device Patients: Report of Referral Center Experience
SO ASAIO JOURNAL
LA English
DT Article
DE mediastinitis; mortality; ventricular assist device; omentoplasty
ID OMENTAL FLAP; IMPLANTATION; INFECTIONS; EXCHANGE; COVERAGE; OUTCOMES
AB Mediastinitis is more frequent in patients with implantable ventricular assist devices (VADs) than in other cardiac surgery patients and carries significant mortality. We report our experience with a stepwise approach including aggressive debridement, jet lavage, vacuum assisted closure dressing, and finally coverage with well-vascularized and immune-active omental flaps in VAD patients with infective mediastinitis. We retrospectively collected and analyzed data of patients with continuous flow VAD who underwent plasty with the omental flap because of mediastinitis at Deutsches Herzzentrum Berlin between January 1, 2008 and October 30, 2015. Eight hundred forty-five patients underwent VAD implantation during the study period. Omentoplasty due to infective mediastinitis was performed in 17 cases. Nine had a HeartWare HVAD as left ventricular assist device (LVAD), three patients had two HeartWare HVAD as biventricular assist device (BIVAD), four had a HeartMate II LVAD device, and one patient had a Berlin Heart Incor LVAD. The microorganisms most frequently isolated from the sternal wound were Gram-positive Staphylococcus spp. Four cases of bleeding requiring surgical revision were recorded: three of intraabdominal and one of wound bleeding. Eight patients (47%) survived, whereas the other nine patients (53%) died. Sixteen (94%) required intensive care unit admission, and median hospital stay was 21 (1-182) days. Postoperative renal failure requiring dialysis and septic shock requiring vasopressors were associated with hospital mortality (p = 0.009 and p = 0.05, respectively). Early surgical treatment of mediastinitis after VAD implantation with omentoplasty is a valuable strategy in an otherwise dead-end situation. Bleeding should be meticulously controlled in these anticoagulated and fragile patients.
C1 [Pieri, Marina; Scandroglio, Anna Mara] IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Via Olgettina 60, I-20132 Milan, Italy.
   [Mueller, Marcus; Pergantis, Panagiotis; Kretzschmar, Alexandra; Kaufmann, Friedrich; Falk, Volkmar; Krabatsch, Thomas; Arlt, Georg; Potapov, Evgenij] Deutsch Herzzentrum Berlin, Dept Cardiothorac & Vasc Surg, Berlin, Germany.
   [Falk, Volkmar; Krabatsch, Thomas; Potapov, Evgenij] DZHK German Ctr Cardiovasc Res, Partner Site Berlin, Berlin, Germany.
   [Falk, Volkmar] Charite Univ Med Berlin, Dept Cardiothorac Surg, Berlin, Germany.
   [Kukucka, Marian] Deutsch Herzzentrum Berlin, Dept Anesthesiol, Berlin, Germany.
C3 Vita-Salute San Raffaele University; IRCCS Ospedale San Raffaele; German
   Heart Center Berlin; German Centre for Cardiovascular Research; Free
   University of Berlin; Humboldt University of Berlin; Charite
   Universitatsmedizin Berlin; German Heart Center Berlin
RP Pieri, M (通讯作者)，IRCCS San Raffaele Sci Inst, Dept Anesthesia & Intens Care, Via Olgettina 60, I-20132 Milan, Italy.
EM pieri.marina@hsr.it
RI Kukucka, Marian/Q-2226-2018
OI Kukucka, Marian/0000-0001-6201-1600; Pergantis,
   Panagiotis/0000-0001-9635-2999; Falk, Volkmar/0000-0002-7911-8620
FU Deutsches Herzzentrum Berlin
FX The study was supported by departmental funds of the Deutsches
   Herzzentrum Berlin.
CR Castedo E, 2001, CHEST, V120, P1425, DOI 10.1378/chest.120.4.1425
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NR 18
TC 14
Z9 17
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 1058-2916
EI 1538-943X
J9 ASAIO J
JI Asaio J.
PD NOV-DEC
PY 2016
VL 62
IS 6
BP 666
EP 670
DI 10.1097/MAT.0000000000000418
PG 5
WC Engineering, Biomedical; Transplantation
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Engineering; Transplantation
GA EC1OX
UT WOS:000387876500010
PM 27465093
DA 2026-07-24
ER

PT J
AU Srivastava, V
   Yap, CH
   Burdett, C
   Smailes, T
   Kendall, S
   Akowuah, E
AF Srivastava, Vivek
   Yap, Cheng-Hon
   Burdett, Clare
   Smailes, Tracey
   Kendall, Simon
   Akowuah, Enoch
TI 23 Thermoreactive clips do not reduce sternal infection: a
   propensity-matched comparison with sternal wires
SO INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
LA English
DT Article
DE Cardiac other; Chest wall
ID CLOSURE; COMPLICATIONS; SURGERY
AB OBJECTIVES: Sternal stability is essential to prevent serious infective complications after sternotomy. This paper examines whether nitinol thermoreactive clips reduce sternal wound infection rates in obese patients [body mass index (BMI) >= 30] compared with sternal wires.
   METHODS: All patients with BMI >= 30 undergoing cardiac surgery via median sternotomy between February 2008 and February 2013 in our institution were divided into two groups depending on sternal closure technique-sternal wires or thermoreactive clips. Comparison was made using propensity-matched analysis with sternal wound infection as the primary outcome.
   RESULTS: Of 1371 patients, 826 (60%) had thermoreactive clips and 545 (40%) sternal wires. The sternal wires group was older (mean age 66.62 +/- 10.1 vs 64.35 +/- 9.8 years, P = 0.00) with a greater proportion of females (39 vs 26%, P = 0.00). In unmatched group comparison, both superficial sternal wound infection (thermoreactive clips 4% vs wires 3%) and deep infection (thermoreactive clips 3% vs wires 0.6%, P = 0.00) were more common in the thermoreactive clips group. More patients in the thermoreactive clips group required debridement and a larger number had vacuum-assisted closure [thermoreactive clips 10 patients (1%) vs sternal wires 2 (0.4%)]. Propensity-matching yielded two groups of 356 patients. There was no difference in sternal wound infection rates [thermoreactive clips 19 patients (5%) vs sternal wires 15 (4%), P = 0.58] or deep sternal infection rates [thermoreactive clips 9 patients (3%) vs sternal wires 3 (1%), P = 0.11].
   CONCLUSIONS: Thermoreactive clips did not have an advantage in the prevention of superficial or deep sternal wound infection in obese patients undergoing sternotomy.
C1 [Srivastava, Vivek; Burdett, Clare; Smailes, Tracey; Kendall, Simon; Akowuah, Enoch] James Cook Univ Hosp, Dept Cardiothorac Surg, Middlesbrough TS4 3BW, Cleveland, England.
   [Yap, Cheng-Hon] Barwon Hlth, Dept Cardiothorac Surg, Geelong, Vic, Australia.
   [Yap, Cheng-Hon] Monash Univ, Dept Epidemiol & Prevent Med, Melbourne, Vic 3004, Australia.
C3 James Cook University Hospital; Barwon Health; Monash University
RP Srivastava, V (通讯作者)，James Cook Univ Hosp, Dept Cardiothorac Surg, Middlesbrough TS4 3BW, Cleveland, England.
EM srivivek50@hotmail.com
OI Akowuah, Enoch/0000-0002-2429-3579
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NR 18
TC 5
Z9 8
U1 0
U2 3
PU OXFORD UNIV PRESS
PI OXFORD
PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND
SN 1569-9293
EI 1569-9285
J9 INTERACT CARDIOV TH
JI Interact Cardiovasc. Thorac. Surg.
PD DEC
PY 2015
VL 21
IS 6
BP 699
EP 704
DI 10.1093/icvts/ivv238
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA DB2WR
UT WOS:000368371800001
PM 26346231
DA 2026-07-24
ER

PT J
AU Stüben, BO
   Plitzko, GA
   Sauerbeck, J
   Busch, P
   Melling, N
   Reeh, M
   Izbicki, JR
   Rösch, T
   Bachmann, K
   Tachezy, M
AF Stueben, Bjoern-Ole
   Plitzko, Gabriel A.
   Sauerbeck, Julia
   Busch, Philipp
   Melling, Nathaniel
   Reeh, Matthias
   Izbicki, Jakob R.
   Roesch, Thomas
   Bachmann, Kai
   Tachezy, Michael
TI Minimally invasive intrathoracic negative-pressure therapy and flexible
   thoracoscopy (FlexVATS) for patients with pleural empyema
SO SCIENTIFIC REPORTS
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; THORACIC-SURGERY; MANAGEMENT; DECORTICATION;
   INSTILLATION
AB To determine whether a new surgical method using a flexible endoscope (FlexVATS) to perform sparing debridement and apply negative-pressure therapy without extensive decortication may be an alternative treatment option for empyema. Surgical treatment of pleural empyema is associated with considerable postoperative complications and mortality rates, and alternative treatment options are being explored to improve patient outcomes. This was a prospective case series. Seventeen consecutive patients treated with FlexVATS between February 2021 and August 2022 were included in the study. Only patients for whom FlexVATS was the first therapeutic intervention for pleural empyema were included. Treatment success, defined as infection resolution, was the primary endpoint of the study. The secondary endpoints were length of hospital stay, 90-day mortality, and empyema cavity volume reduction. Patients who had previously been treated for pleural empyema by either drainage or surgery were excluded. The trial was performed as a single-centre study at a tertiary medical centre in Germany. In total, 17 patients with pleural empyema were included in the study. The median (IQR) duration of vacuum treatment was 15 days (8-35 days). Twelve of the 17 (71%) patients were successfully treated, and a significant reduction in the empyema cavity volume was observed. 41% of the dressing changes were performed outside the operating room. Compared with a historic cohort of conventionally treated patients (decortication via VATS or thoracotomy), the 90-day mortality rates tended to be lower without reaching statistical significance. Three patients (18%) died in hospital during treatment. No negative pressure-therapy-related complications were observed. FlexVATS therapy is a promising alternative therapy for both healthy and debilitated patients with pleural empyema. Larger randomised trials are required to validate this treatment option.
C1 [Stueben, Bjoern-Ole; Plitzko, Gabriel A.; Busch, Philipp; Melling, Nathaniel; Reeh, Matthias; Izbicki, Jakob R.; Bachmann, Kai; Tachezy, Michael] Univ Med Ctr Hamburg Eppendorf, Dept Gen Visceral & Thorac Surg, Martinistr 52, D-20246 Hamburg, Germany.
   [Sauerbeck, Julia] Univ Med Ctr Hamburg Eppendorf, Dept Diagnost & Intervent Radiol & Nucl Med, Martinistr 52, D-20246 Hamburg, Germany.
   [Roesch, Thomas] Univ Med Ctr Hamburg Eppendorf, Dept Interdisciplinary Endoscopy, Martinistr 52, D-20246 Hamburg, Germany.
C3 University of Hamburg; University Medical Center Hamburg-Eppendorf;
   University of Hamburg; University Medical Center Hamburg-Eppendorf;
   University of Hamburg; University Medical Center Hamburg-Eppendorf
RP Stüben, BO (通讯作者)，Univ Med Ctr Hamburg Eppendorf, Dept Gen Visceral & Thorac Surg, Martinistr 52, D-20246 Hamburg, Germany.
EM stuebenb@me.com
RI /AAN-6043-2021; Tachezy, Michael/AAD-6759-2022; Reeh,
   Matthias/AAB-6917-2022
OI Plitzko, Gabriel/0009-0009-9239-2411; Stüben,
   Björn-Ole/0000-0001-8245-4548; Reeh, Matthias/0000-0001-9111-3905
FU Projekt DEAL
FX Open Access funding enabled and organized by Projekt DEAL.
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NR 27
TC 2
Z9 2
U1 0
U2 1
PU NATURE PORTFOLIO
PI BERLIN
PA HEIDELBERGER PLATZ 3, BERLIN, 14197, GERMANY
SN 2045-2322
J9 SCI REP-UK
JI Sci Rep
PD JUL 5
PY 2023
VL 13
IS 1
AR 10869
DI 10.1038/s41598-023-37961-w
PG 9
WC Multidisciplinary Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Science & Technology - Other Topics
GA L6UU6
UT WOS:001024600400018
PM 37407677
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Campbell, SR
   Shah, C
   Scott, JG
   Mesko, N
   Nystrom, L
   Kolar, M
   Largo, AC
   Kamrava, M
   Mourtada, F
   Naghavi, AO
   Harrison, LB
AF Campbell, Shauna R.
   Shah, Chirag
   Scott, Jacob G.
   Mesko, Nathan
   Nystrom, Lukas
   Kolar, Matthew
   Largo, Abel Cordoba
   Kamrava, Mitchell
   Mourtada, Firas
   Naghavi, Arash O.
   Harrison, Louis B.
TI American Brachytherapy Society (ABS) consensus statement for soft-tissue
   sarcoma brachytherapy
SO BRACHYTHERAPY
LA English
DT Article
DE Soft tissue sarcoma; Brachytherapy; Radiation
ID HIGH-DOSE-RATE; EXTERNAL-BEAM RADIOTHERAPY; LIMB-SPARING SURGERY;
   PROSPECTIVE RANDOMIZED-TRIAL; ADJUVANT RADIATION-THERAPY; PERIOPERATIVE
   INTERSTITIAL BRACHYTHERAPY; RATE INTRAOPERATIVE BRACHYTHERAPY;
   VACUUM-ASSISTED CLOSURE; POSTOPERATIVE RADIOTHERAPY; LOCAL-CONTROL
AB PURPOSE: Growing data supports the role of radiation therapy in the treatment of soft tissue sarcoma (STS). Brachytherapy has been used for decades in the management of STS and can be utilized as monotherapy or as a boost to external beam radiation. We present updated guidelines from the American Brachytherapy Society regarding the utilization of brachytherapy in the management of STS. METHODS AND MATERIALS: Members of the American Brachytherapy Society with expertise in STS and STS brachytherapy created an updated clinical practice guideline including step-by-step details for performing STS brachytherapy based on a literature review and clinical experience. RESULTS: Brachytherapy monotherapy should be considered for lower-recurrence risk patients or after a local recurrence following previous external beam radiation; a brachytherapy boost can be considered in higher-risk patents meeting implant criteria. Multiple dose/fractionation regimens are available, with determination based on tumor location and treatment intent. Techniques to limit wound complications are based on the type of wound closure; wound complication can be mitigated with a delay in the start of brachytherapy with immediate wound closure or by utilizing a staged reconstruction technique, which allows an earlier treatment start with a delayed wound closure. CONCLUSIONS: These updated guidelines provide clinicians with data on indications for STS brachytherapy as well as guidelines on how to perform and deliver high quality STS brachytherapy safely with minimal toxicity. (c) 2021 American Brachytherapy Society. Published by Elsevier Inc. All rights reserved.
C1 [Campbell, Shauna R.; Shah, Chirag; Scott, Jacob G.; Kolar, Matthew] Cleveland Clin, Dept Radiat Oncol, Taussig Canc Inst, 9500 Euclid Ave,CA 50, Cleveland, OH 44195 USA.
   [Mesko, Nathan; Nystrom, Lukas] Cleveland Clin, Dept Orthopaed Surg, Cleveland, OH 44195 USA.
   [Largo, Abel Cordoba] Ctr Oscar Lambert Comprehens Canc Ctr, Dept Radiat Oncol, Lille, France.
   [Kamrava, Mitchell] Cedars Sinai Med Ctr, Dept Radiat Oncol, Los Angeles, CA 90048 USA.
   [Mourtada, Firas] ChristianaCare, Dept Radiat Oncol, Helen F Graham Canc Ctr, Newark, DE USA.
   [Naghavi, Arash O.; Harrison, Louis B.] H Lee Moffitt Canc Ctr & Res Inst, Radiat Oncol, Tampa, FL USA.
C3 Cleveland Clinic Foundation; Cleveland Clinic Foundation; Cedars Sinai
   Medical Center; Helen F. Graham Cancer Center & Research Institute; H
   Lee Moffitt Cancer Center & Research Institute
RP Shah, C (通讯作者)，Cleveland Clin, Dept Radiat Oncol, Taussig Canc Inst, 9500 Euclid Ave,CA 50, Cleveland, OH 44195 USA.
EM shahc4@ccf.org
RI Naghavi, Arash/AHB-4226-2022; Mourtada, Firas/K-9578-2019; Scott,
   Jacob/H-9634-2019; Kamrava, Mitchell/P-9317-2019; Nystrom,
   Lukas/AAJ-9289-2021; Mesko, Nathan/NGR-7162-2025
OI Naghavi, Arash/0000-0002-0884-1942; Campbell,
   Shauna/0000-0002-4486-0294; Mourtada, Firas/0000-0002-4388-5334; Scott,
   Jacob/0000-0003-2971-7673; Kamrava, Mitchell/0000-0003-1744-6271;
   Nystrom, Lukas/0000-0001-8120-2680; 
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NR 178
TC 10
Z9 11
U1 0
U2 10
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1538-4721
EI 1873-1449
J9 BRACHYTHERAPY
JI Brachytherapy
PD NOV-DEC
PY 2021
VL 20
IS 6
BP 1200
EP 1218
DI 10.1016/j.brachy.2021.05.011
EA NOV 2021
PG 19
WC Oncology; Radiology, Nuclear Medicine & Medical Imaging
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Radiology, Nuclear Medicine & Medical Imaging
GA XH5PY
UT WOS:000725487500015
PM 34303600
DA 2026-07-24
ER

PT J
AU Ge, J
   Kong, KY
   Cheng, XQ
   Li, P
   Hu, XX
   Yang, HL
   Shen, MJ
AF Ge, Jun
   Kong, Ke-Yu
   Cheng, Xiao-Qiang
   Li, Peng
   Hu, Xing-Xing
   Yang, Hui-Lin
   Shen, Min-Jie
TI Missed diagnosis of femoral deep artery rupture after femoral shaft
   fracture: A case report
SO WORLD JOURNAL OF CLINICAL CASES
LA English
DT Article
DE Femoral shaft fracture; Femoral deep artery branch rupture; Perforating
   artery rupture; Thigh compartment syndrome; Rhabdomyolysis; External
   fixation; Case report
ID ACUTE COMPARTMENT SYNDROME; INJURY; PSEUDOANEURYSM; RHABDOMYOLYSIS;
   MANAGEMENT
AB BACKGROUND
   Vascular injury is a rare complication of femoral shaft fractures, and rupture of the deep femoral artery is more difficult to diagnose because of its anatomical location and symptoms. Despite its low incidence, deep femoral artery rupture can lead to life-threatening outcomes, such as compartment syndrome, making early identification and diagnosis critical.
   CASE SUMMARY
   A 45-year-old male patient was admitted to our hospital due to right lower limb trauma in a car accident, with complaints of severe pain and swelling on his right thigh. X-ray demonstrated a right femoral shaft fracture. During preparation for emergency surgery, his blood pressure and blood oxygen saturation dropped, and sensorimotor function was lost. Computed tomography angiography was performed immediately to confirm the diagnosis of rupture of the deep femoral artery and compartment syndrome, so fasciotomy and vacuum-assisted closure were performed. Rhabdomyolysis took place after the operation and the patient was treated with appropriate electrolyte correction and diuretic therapy. Twenty days after the fasciotomy, treatment with the Hoffman Type II External Fixation System was planned, but it was unable to be immobilized internally based on a new esophageal cancer diagnosis. We kept the external fixation for 1 year, and 3 years of follow-up showed improvement of the patient's overall conditions and muscle strength.
   CONCLUSION
   For patients with thigh swelling, pain, anemia, and unstable vital signs, anterior femoral artery injury should be highly suspected. Once diagnosed, surgical treatment should be performed immediately and complications of artery rupture must be suspected and addressed in time.
C1 [Ge, Jun; Kong, Ke-Yu; Cheng, Xiao-Qiang; Li, Peng; Hu, Xing-Xing; Yang, Hui-Lin; Shen, Min-Jie] Soochow Univ, Affiliated Hosp 1, Dept Orthopaed Surg, 188 Shizi St, Suzhou 215006, Jiangsu, Peoples R China.
C3 Soochow University - China
RP Shen, MJ (通讯作者)，Soochow Univ, Affiliated Hosp 1, Dept Orthopaed Surg, 188 Shizi St, Suzhou 215006, Jiangsu, Peoples R China.
EM shenminjie@suda.edu.cn
RI Hu, Xingxing/OAJ-6364-2025; Kong, Keyu/MFH-1720-2025
OI Kong, Keyu/0000-0002-5839-6074; Cheng, Xiaoqiang/0000-0002-6853-9083
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NR 30
TC 4
Z9 6
U1 0
U2 4
PU BAISHIDENG PUBLISHING GROUP INC
PI PLEASANTON
PA 7041 Koll Center Parkway, Suite 160, PLEASANTON, CA, UNITED STATES
SN 2307-8960
J9 WORLD J CLIN CASES
JI World J. Clin. Cases
PD JUL 6
PY 2020
VL 8
IS 13
BP 2862
EP 2869
DI 10.12998/wjcc.v8.i13.2862
PG 8
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA MT3RI
UT WOS:000554885100018
PM 32742996
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Harpole, BG
   Wibbenmeyer, LA
   Erickson, BA
AF Harpole, Bethany G.
   Wibbenmeyer, Lucy A.
   Erickson, Bradley A.
TI Genital Burns in the National Burn Repository: Incidence, Etiology, and
   Impact on Morbidity and Mortality
SO UROLOGY
LA English
DT Article
ID THERMALLY INJURED PERINEUM; VACUUM-ASSISTED CLOSURE; EXPERIENCE;
   MANAGEMENT; TRAUMA; RECONSTRUCTION; INFECTION; OUTCOMES; COHORT; CARE
AB OBJECTIVE To better characterize national genital burns (GBs) characteristics using a large burn registry. We hypothesized that mortality and morbidity will be higher in patients with GBs.
   METHODS The National Burn Repository, a large North American registry of hospitalized burn patients, was queried for patients with GB. Burn characteristics and mechanism, demographics, mortality, and surgical interventions were retrieved. Outcomes of interest were mortality, hospital-acquired infection (HAI), and surgical intervention on the genitalia. Adjusted odds ratios (aOR) for outcomes were determined with binomial logistic regression controlling for age, total burn surface area, race, length of stay, gender, and inhalation injury presence.
   RESULTS GBs were present in 1245 cases of 71,895 burns (1.7%). Patients with GB had significantly greater average total burn surface area, length of stay, and mortality. In patients with GB, surgery of the genitalia was infrequent (10.4%), with the aOR of receiving surgery higher among men (aOR 2.7, P < .001) and those with third-degree burns (aOR 3.1, P < .002). Presence of a GB increased the odds of HAI (aOR 3.0, P < .0001) and urinary tract infections (aOR 3.4, P < .0001). GB was also an independent predictor of mortality (aOR 1.54) even after adjusting for the increased HAI risk.
   CONCLUSION GBs are rare but associated with higher HAI rates and higher mortality after adjusting for well-established mortality risk factors. Although a cause and effect relationship cannot be established using these registry data, we believe this study suggests the need for special management considerations in GB cases to improve overall outcomes. (C) 2014 Elsevier Inc.
C1 [Erickson, Bradley A.] Univ Iowa, Carver Coll Med, Dept Urol, Iowa City, IA 52242 USA.
   Univ Iowa, Carver Coll Med, Dept Surg, Iowa City, IA 52242 USA.
C3 University of Iowa; University of Iowa
RP Erickson, BA (通讯作者)，Univ Iowa, Carver Coll Med, Dept Urol, 200 Hawkins Dr 3RCP, Iowa City, IA 52242 USA.
EM brad-erickson@uiowa.edu
OI Wibbenmeyer, Lucy/0000-0003-1424-069X; Erickson,
   Bradley/0000-0001-5237-3464
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NR 29
TC 28
Z9 42
U1 0
U2 5
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0090-4295
EI 1527-9995
J9 UROLOGY
JI Urology
PD FEB
PY 2014
VL 83
IS 2
BP 298
EP 302
DI 10.1016/j.urology.2013.10.039
PG 5
WC Urology & Nephrology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Urology & Nephrology
GA 296ZF
UT WOS:000330223600012
PM 24360072
DA 2026-07-24
ER

PT J
AU Rustad, KC
   Wong, VW
   Gurtner, GC
AF Rustad, Kristine C.
   Wong, Victor W.
   Gurtner, Geoffrey C.
TI The role of focal adhesion complexes in fibroblast mechanotransduction
   during scar formation
SO DIFFERENTIATION
LA English
DT Article
DE Mechanotransduction; Wound healing; Scar; Focal adhesions; Fibroblast
ID VACUUM-ASSISTED CLOSURE; POPULATED COLLAGEN LATTICES; LINKED KINASE ILK;
   SRC FAMILY KINASE; EXTRACELLULAR-MATRIX; CELL-PROLIFERATION; HUMAN-SKIN;
   PYK2; FAK; INTEGRIN
AB Historically, great efforts have been made to elucidate the biochemical pathways that direct the complex process of wound healing; however only recently has there been recognition of the importance that mechanical signals play in the process of tissue repair and scar formation. The body's physiologic response to injury involves a dynamic interplay between mechanical forces and biochemical cues which directs a cascade of signals leading ultimately to the formation of fibrotic scar. Fibroblasts are a highly mechanosensitive cell type and are also largely responsible for the generation of the fibrotic matrix during scar formation and are thus a critical player in the process of mechanotransduction during tissue repair. Mechanotransduction is initiated at the interface between the cell membrane and the extracellular matrix where mechanical signals are first translated into a biochemical response. Focal adhesions are dynamic multi-protein complexes through which the extracellular matrix links to the intracellular cytoskeleton. These focal adhesion complexes play an integral role in the propagation of this initial mechanical cue into an extensive network of biochemical signals leading to widespread downstream effects including the influx of inflammatory cells, stimulation of angiogenesis, keratinocyte migration, fibroblast proliferation and collagen synthesis. Increasing evidence has demonstrated the importance of the biomechanical milieu in healing wounds and suggests that an integrated approach to the discovery of targets to decrease scar formation may prove more clinically efficacious than previous purely biochemical strategies. (c) 2012 International Society of Differentiation. Published by Elsevier B.V. All rights reserved.
C1 [Rustad, Kristine C.; Wong, Victor W.; Gurtner, Geoffrey C.] Stanford Univ, Dept Surg, Stanford, CA 94305 USA.
C3 Stanford University
RP Gurtner, GC (通讯作者)，Stanford Univ, Dept Surg, 257 Campus Dr,GK 201, Stanford, CA 94305 USA.
EM ggurtner@stanford.edu
FU Hagey Family Endowed Fund in Stem Cell Research and Regenerative
   Medicine; Armed Forces Institute of Regenerative Medicine (United States
   Department of Defense); Oak Foundation
FX Funding for fibroblast mechanotransduction research conducted in our
   laboratory has been provided by the Hagey Family Endowed Fund in Stem
   Cell Research and Regenerative Medicine, the Armed Forces Institute of
   Regenerative Medicine (United States Department of Defense), and the Oak
   Foundation.
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NR 53
TC 76
Z9 99
U1 2
U2 44
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0301-4681
EI 1432-0436
J9 DIFFERENTIATION
JI Differentiation
PD OCT
PY 2013
VL 86
IS 3
SI SI
BP 87
EP 91
DI 10.1016/j.diff.2013.02.003
PG 5
WC Cell Biology; Developmental Biology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Developmental Biology
GA 235SM
UT WOS:000325741000003
PM 23623400
DA 2026-07-24
ER

PT J
AU Steiner, CL
   Trentz, O
   Labler, L
AF Steiner, Christian Luzius
   Trentz, Otmar
   Labler, Ludwig
TI Management of Morel-Lavallee Lesion Associated with Pelvic and/or
   Acetabular Fractures
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE Pelvic and acetabular fractures; Soft tissue injuries and infection;
   Wound healing; Hip fracture; Pelvis
ID VACUUM-ASSISTED CLOSURE; DEGLOVING INJURIES; DAMAGE CONTROL; WOUND
   CONTROL; TRAUMA; SEVERITY; THIGH; CARE
AB Objective: Management of Morel-Lavallee soft tissue lesion (MILL) in patients with associated pelvic and/or acetabular fractures is still under discussion. Especially, the sequence of treatment of MLL soft tissue management and osteosynthesis of pelvic and acetabular injury remains controversial.
   Methods: We report all consecutive patients with MILL associated with pelvic ring and/or acetabular fractures during an 8-year period at our hospital. Surgical access and techniques were analyzed concerning complications and outcome.
   Results: Altogether, 20 patients were included in the study. One patient was treated conservatively and MLL healed without complications; 19 patients had an operative treatment of MILL In 15 patients debridement was performed within one day after injury and in four patients with delay Of 5 days at least. Ten patients had surgery for an associated pelvic ring or acetabular fracture. In four of them MILL was operated before, in six patients simultaneously to osteosynthesis. In three patients, the same surgical approach for osteosynthesis and debridement of MLL was used; none of them showed postoperative complications. Altogether, in nine operated patients (47.4%) MLL healed without any complications. Nine operated patients presented prolonged wound healing, however, during long term follow-up, all patients showed complete healing of the MILL One patient died during resuscitive surgical procedures.
   Conclusions: We recommend debridement for early and delayed treatment of MILL Osteosynthesis during first debridement may be performed without adverse outcome. Identical surgical access for both procedures can be used. In case of repeated surgical debridement VAC (R) therapy may be a helpful tool for dead space reduction and wound conditioning.
C1 [Steiner, Christian Luzius; Trentz, Otmar; Labler, Ludwig] Univ Zurich Hosp, Dept Surg, Div Trauma Surg, CH-8091 Zurich, Switzerland.
C3 University of Zurich; University Zurich Hospital
RP Steiner, CL (通讯作者)，Univ Zurich Hosp, Dept Surg, Div Trauma Surg, Ramistr 100, CH-8091 Zurich, Switzerland.
EM christian.steiner@usz.ch
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NR 29
TC 22
Z9 27
U1 0
U2 6
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD DEC
PY 2008
VL 34
IS 6
BP 554
EP 560
DI 10.1007/s00068-007-7056-y
PG 7
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA 384EB
UT WOS:000261726000006
PM 26816279
OA Green Accepted
DA 2026-07-24
ER

PT J
AU Sosa, IJ
   Reyes, O
   Kuffler, DP
AF Sosa, Ivan J.
   Reyes, Onix
   Kuffler, Damien P.
TI Elimination of a pressure ulcer with electrical stimulation - a case
   study
SO PUERTO RICO HEALTH SCIENCES JOURNAL
LA English
DT Article
DE pressure ulcers; ulcer elimination; wound healing
ID NERVE-GROWTH-FACTOR; TRANSCUTANEOUS OXYGEN-TENSION; HORMONE REPLACEMENT
   THERAPY; VACUUM-ASSISTED CLOSURE; DIABETIC FOOT ULCERS;
   HYPERBARIC-OXYGEN; DOUBLE-BLIND; SPINAL-CORD; METALLOPROTEINASE
   INHIBITOR; ANTIBACTERIAL ACTIVITY
AB Pressure ulcers, also called decubitus ulcers, are a common challenge of humanity and are exceptionally difficult to heal. They are wounds that are initiated by relatively short periods of pressure on the skin that blocks blood circulation causing the skin and underlying tissues to die, leading to an open wound. Pressure release can prevent further tissue degeneration, and some ulcers heal and disappear by themselves. However, many pressure ulcers never heal and continue to grow in diameter and depth. By one year, such unhealing ulcers are referred to as chronic ulcers. Chronic ulcers frequently jeopardize the life of the patient due to infections that become increasingly deep until they invade bones and the circulatory system. We report on a patient with a chronic pressure ulcer at his coccyx prominence. Fourteen months after the ulcer had appeared, a surface pulse electromagnetic force (PEMF) stimulator was applied over T7 - T8, 45 cm cephalic to the ulcer, as part of a nerve stimulation study. Although the ulcer had continued to grow both in diameter and depth for 14 months and showed no signs of healing, within 6 days of applying the PEMF stimulator, the ulcer began to heal and was fully eliminated after 3 months. We concluded that the electrical stimulation induced the healing of the pressure ulcer. The ulcer, elimination is quite surprising due to the exceptionally low electric field-force being generated by the stimulator at a distance of 45 cm.
C1 [Kuffler, Damien P.] Univ Puerto Rico, Inst Neurobiol, San Juan, PR 00901 USA.
   [Sosa, Ivan J.] Univ Puerto Rico, Sect Neurol Surg, San Juan, PR 00901 USA.
   [Reyes, Onix] Doctors Ctr Hosp, Manati, PR USA.
C3 University of Puerto Rico; University of Puerto Rico
RP Kuffler, DP (通讯作者)，Univ Puerto Rico, Inst Neurobiol, 201 Blvd Valle,Med Sci Campus, San Juan, PR 00901 USA.
EM dkuffler@hotmail.com
RI Sosa, Ivan/JTU-7107-2023; /ABV-7119-2022
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NR 77
TC 6
Z9 6
U1 0
U2 10
PU UNIV PUERTO RICO MEDICAL SCIENCES CAMPUS
PI SAN JUAN
PA OFFICE DEAN ACADEMIC AFFAIRS BOX 365067, SAN JUAN, PR 00936-5067 USA
SN 0738-0658
J9 P R HEALTH SCI J
JI P. R. Health Sci. J.
PD JUN
PY 2008
VL 27
IS 2
BP 175
EP 179
PG 5
WC Public, Environmental & Occupational Health
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Public, Environmental & Occupational Health
GA 335SJ
UT WOS:000258310400009
PM 18616047
DA 2026-07-24
ER

PT J
AU Leppäniemi, A
AF Leppaniemi, Ari
TI Open abdomen after severe acute pancreatitis
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE acute pancreatitis; open abdomen; abdominal compartment syndrome;
   laparostomy; emergency surgery
ID ABDOMINAL COMPARTMENT SYNDROME; VACUUM-ASSISTED CLOSURE; WALL
   RECONSTRUCTION; MANAGEMENT; NECROSIS; REPAIR
AB The need for surgical decompression for abdominal compartment syndrome is becoming more frequent in patients with severe acute pancreatitis, especially in association with massive fluid resuscitation at the early stages of the disease. Decompression can be achieved with either a full-thickness laparostomy that can be performed through a vertical midline or transverse subcostal incision, or by performing a subcutaneous linea alba fasciotomy. Following a full-thickness laparostomy the open abdomen can be best managed with some form of negative abdominal pressure dressing. During dressing changes every 2-3 days, every attempt should be made to gradually close the fascial incision starting from edges, but avoiding recurrent abdominal compartment syndrome. Gradual closure is more likely to succeed in association with a negative fluid balance. Peripancreatic exploration or necrosectomy is seldom required at the initial laparostomy, unless performed for late onset abdominal compartment syndrome associated with infected peripancreatic necrosis. Primary fascial closure should always be attempted. if impossible and there is no need for subsequent abdominal re-exploration, the open wound should be covered with split-thickness skin grafting directly over the bowel loops. After a maturation period of 9-12 months definitive repair of the abdominal wall defect is performed utilizing the components separation technique, mesh repair, or a pedicular or microvascular tensor facia lata flap. Knowledge of the available decompression and reconstruction options is essential for individualized management of patients with severe acute pancreatitis and abdominal compartment syndrome. More research and comparative studies are needed to determine the most successful methods to be used.
C1 Univ Helsinki, Meilahti Hosp, Dept Surg, HUS, Helsinki 00029, Finland.
C3 University of Helsinki; Helsinki University Central Hospital
RP Leppäniemi, A (通讯作者)，Univ Helsinki, Meilahti Hosp, Dept Surg, HUS, Haartmaninkatu 4,POB 340, Helsinki 00029, Finland.
EM ari.leppaniemi@hus.fi
RI Leppäniemi, Ari/GQZ-7991-2022
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NR 29
TC 10
Z9 12
U1 0
U2 1
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD FEB
PY 2008
VL 34
IS 1
BP 17
EP 23
DI 10.1007/s00068-008-7169-y
PG 7
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA 314FA
UT WOS:000256793700004
PM 26815486
DA 2026-07-24
ER

PT J
AU Beyazal, OF
   Yanartas, M
AF Beyazal, Osman Fehmi
   Yanartas, Mehmed
TI Which Sternal Closure Technique is More Beneficial in Cardiac Surgery:
   Simple Wire, Figure-of-8, or Their Combination?
SO BRAZILIAN JOURNAL OF CARDIOVASCULAR SURGERY
LA English
DT Article
DE Sternum; Surgical Wound Dehiscence; Wound Infection; Cardiac Surgery;
   Decompression
ID PREVENT DEHISCENCE; OBESE-PATIENTS; COMPLICATIONS; INFECTIONS
AB Introduction: The aims of this study are to compare sternal closure techniques (single, figure-of-8, and combined use) in patients undergoing cardiac surgery and to investigate their relationship with postoperative sternal complications. Method: Between 2023 and 2024, 645 patients (470 males; mean age 58.5 +/- 11.1 years) who underwent cardiac surgery were evaluated. The patients were divided into three groups: Group 1, simple wire (n = 141); Group 2, figure-of-8 (n = 224); and Group 3, combination of these two techniques (n = 280). Preoperative and perioperative data, postoperative complications, and sternal complications were compared between these groups. Result: The distribution ratio of the groups is 141 (22%), 224 (35%), and 280 (43%) in Groups 1, 2, and 3, respectively.There was no significantdifference between the groups regarding basic demographic characteristics, comorbidities, and operative data. There was no difference between the groups in terms of postoperative exploration, delayed chest closure, subxiphoid decompression, superficial sternal wound infection (SSWI), deep sternal wound infection (DSWI), vacuum-assisted closure usage, intubation time, intensive care unit stay, and mortality. The hospital stay was found to be shorter in Group 3 compared to the other groups (median 8 days-7 days, P = 0.02). Conclusion: In patients undergoing cardiac surgery, we found no difference in sternal complications (DSWI, SSWI) between the three most commonly used closure techniques (simple wire,figure-of-8, and theircombination). We found that the length of hospital stay was shorter in patients with the combined technique than in the other two techniques.
C1 [Beyazal, Osman Fehmi; Yanartas, Mehmed] Istanbul Basaksehir Cam & Sakura City Hosp, Dept Cardiovasc Surg, Istanbul, Turkiye.
RP Beyazal, OF (通讯作者)，Istanbul Basaksehir Cam & Sakura City Hosp, Dept Cardiovasc Surg, Istanbul, Turkiye.
EM osmanfehmibeyazal@gmail.com
RI Yanartas, Mehmed/PBV-0293-2025; Beyazal, Osman/IZP-6892-2023
CR Almdahl SM, 2013, SCAND CARDIOVASC J, V47, P247, DOI 10.3109/14017431.2012.761723
   Asghar A, 2020, J PAK MED ASSOC, V70, P2001, DOI 10.5455/JPMA.20135
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   Schwann TA, 2021, ANN THORAC SURG, V111, P600, DOI 10.1016/j.athoracsur.2020.05.044
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   Wangsgard C, 2008, J CARDIOTHORAC SURG, V3, DOI 10.1186/1749-8090-3-52
NR 17
TC 0
Z9 0
U1 3
U2 3
PU SOC BRASIL CIRURGIA CARDIOVASC
PI SAO PAULO SP
PA RUA AFONSO CELSO, 1178, SAO PAULO SP, 04119-061, BRAZIL
SN 0102-7638
EI 1678-9741
J9 BRAZ J CARDIOV SURG
JI Braz. J. Cardiovasc. Surg.
PY 2025
VL 40
IS 6
AR e20250011
DI 10.21470/1678-9741-2025-0011
PG 8
WC Cardiac & Cardiovascular Systems; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Surgery
GA CM9SA
UT WOS:001669621100003
PM 41100641
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Kozlow, JH
   Patel, SP
   Jejurikar, S
   Pannucci, CJ
   Cederna, PS
   Brown, DL
AF Kozlow, Jeffrey H.
   Patel, Shaun P.
   Jejurikar, Sameer
   Pannucci, Christopher J.
   Cederna, Paul S.
   Brown, David L.
TI Complications after sternal reconstruction: a 16-y experience
SO JOURNAL OF SURGICAL RESEARCH
LA English
DT Article
DE Sternal; Wound; Reconstruction; Flap; Risks; Complications
ID VACUUM-ASSISTED CLOSURE; WOUND INFECTIONS; CARDIAC-SURGERY; MUSCLE
   FLAPS; MEDIASTINITIS; OUTCOMES; PREDICTORS; MANAGEMENT; SURVIVAL;
   THERAPY
AB Background: Unlike risk factors associated with sternotomy complications, those associated with sternal reconstruction have not been well elucidated. We sought to examine complication rates after sternal wound reconstruction and to identify perioperative risk factors associated with these complications.
   Methods: We evaluated the records of 230 consecutive patients who underwent sternal reconstruction with muscle flaps after cardiac surgery. Patient demographics, clinical comorbidities, and operative procedure types were evaluated against two outcome variablesd-major complications and reconstructive failure.
   Results: The mean age of our cohort was 62 y. Major complications (readmission, reoperation, or death) occurred in 76 patients (33%), including mortality rate of 3.5%. Obesity, chronic obstructive pulmonary disease, and type of reconstructive procedure correlated with an increased risk of major complications. Reconstructive failure occurred in 39 patients (17%) and was associated with female gender, obesity, previous coronary artery bypass graft procedure, and prior left internal mammary artery usage. Regression analyses demonstrated that obesity is independently associated with an increased risk of major complications and that women are at an increased risk of reconstructive failure. Reconstructions involving the rectus abdominis were correlated with an increased risk of major complications, but this difference was not significant in multiple regression analysis.
   Conclusions: Usual risk factors for sternal wound development after cardiac surgery include diabetes, age, obesity, tobacco use, history of stroke, bilateral left internal mammary artery harvest, and significant blood transfusion. In distinction, this study found that the risks independently associated with major complications and reconstructive failures after reconstruction of sternal wounds are limited to obesity and female gender. (C) 2015 Elsevier Inc. All rights reserved.
C1 [Kozlow, Jeffrey H.; Patel, Shaun P.; Jejurikar, Sameer; Pannucci, Christopher J.; Cederna, Paul S.; Brown, David L.] Univ Michigan Hlth Syst, Dept Surg, Sect Plast Surg, Ann Arbor, MI 48109 USA.
C3 University of Michigan System; University of Michigan
RP Brown, DL (通讯作者)，Univ Michigan Hlth Syst, Dept Surg, Taubman Ctr 2130, Sect Plast Surg, 1500 E Med Ctr Dr, Ann Arbor, MI 48109 USA.
EM davbrown@umich.edu
RI Brown, David/KIL-0589-2024
OI Brown, David/0000-0002-5889-9886; Patel, Shaun/0000-0002-0578-5666
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NR 24
TC 13
Z9 13
U1 0
U2 2
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0022-4804
EI 1095-8673
J9 J SURG RES
JI J. Surg. Res.
PD MAR
PY 2015
VL 194
IS 1
BP 154
EP 160
DI 10.1016/j.jss.2014.09.044
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA CC5FH
UT WOS:000350384000021
PM 25541237
DA 2026-07-24
ER

PT J
AU Mohr, Z
   Hirche, C
   Gretschel, S
   Bembenek, A
AF Mohr, Z.
   Hirche, C.
   Gretschel, S.
   Bembenek, A.
TI Risk Factors for the Development of Lymphatic Fistula after Ilioinguinal
   Lymph Node Dissection before Isolated Limb Perfusion and its Potential
   Clinical Relevance
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Article
DE lymph fistula; radical lymph node dissection; VAC (R) therapy; isolated
   limb perfusion
ID POSTOPERATIVE MORBIDITY; OPERATIVE MORBIDITY; MALIGNANT-MELANOMA;
   COMPLICATIONS; RADIOTHERAPY; ETIOLOGY
AB Introduction: After ilioinguinal radical lymph node dissection (RLND), the therapy for lymph fistulas constitutes a challenge. Risk factors for the genesis of lymph fistulas have not been sufficiently evaluated. We investigated possible factors that could influence the development of lymph fistulas in patients suffering from malignant melanoma after iloinguinal RLND.
   Patient and Methods: The analysis was related to patients with intransit and lymphonodal metastasised malignant melanoma of the lower limb, who underwent RLND and isolated limb perfusion (ILP). Prospective data acquisition from patients undergoing ilioinguinal RLND and ILP in a one-step approach was performed. The association of lymph fistulas to risk factors was calculated using chi-squared, linear-by-linear test and ROC curves. As possible risk factors we investigated the presence of prior surgery and diabetes mellitus typeII in the medical history, chemotherapeutics, patient age and the body mass index (BMI).
   Results: Postoperative lymph fistula occurred in 11 of 108 patients (10.2 %). A significant association to lymph fistulas was found in BMI (30.2 +/- 7.0 kg/m(2), p<0.02). Other parameters, such as prior surgery (82% vs. 71%), diabetes mellitus typeII (9% vs. 11.7%), chemotherapeutics and patient age (mean 67.8 vs. 62.4 years) showed no influence.
   Conclusion: Our results indicate that the incidence of lymph fistulas after RLND and ILP of malignant melanoma of the lower limb was associated with an increased BMI. Thus, for the prevention of lymph fistulae, an initially alternative wound-closure dressing like vacuum assisted closure (V.A.C.) dressing could be of clinical relevance for obese patients.
C1 [Bembenek, A.] Klinikum Reg Hannover, Viszeralchirurg Klin, D-30655 Hannover, Germany.
   [Mohr, Z.; Hirche, C.; Gretschel, S.; Bembenek, A.] Charite, Robert Rossle Klin, Klin Chirurg & Chirurg Onkol, D-13353 Berlin, Germany.
   [Mohr, Z.] Klinikum Stadt Ludwigshafen Rhein, Ludwigshafen, Germany.
C3 Free University of Berlin; Humboldt University of Berlin; Charite
   Universitatsmedizin Berlin; Ludwigshafen Hospital
RP Bembenek, A (通讯作者)，Klinikum Reg Hannover, Viszeralchirurg Klin, Sieben Stucken 2-4, D-30655 Hannover, Germany.
EM andreas.bembenek@krh.eu
RI Hirche, Christoph/GYA-4981-2022
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NR 37
TC 6
Z9 7
U1 0
U2 3
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY
SN 0044-409X
EI 1438-9592
J9 ZBL CHIR
JI Zent.bl. Chir.
PD AUG
PY 2011
VL 136
IS 4
BP 386
EP U110
DI 10.1055/s-0030-1262547
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 831GW
UT WOS:000295718400012
PM 21341181
DA 2026-07-24
ER

PT J
AU Leininger, BE
   Rasmussen, TE
   Smith, DL
   Jenkins, DH
   Coppola, C
AF Leininger, Brian E.
   Rasmussen, Todd E.
   Smith, David L.
   Jenkins, Donald H.
   Coppola, Christopher
TI Experience with wound VAC and delayed primary closure of contaminated
   soft tissue injuries in Iraq
SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
LA English
DT Article; Proceedings Paper
CT 19th Annual Meeting of the Eastern-Association-for-the-Surgery-of-Trauma
CY JAN 10-14, 2006
CL Orlando, FL
SP Eastern Assoc Surg Trauma
DE wound VAC; delayed primary closure; high-energy soft tissue injury;
   Iraq; war wounds; contaminated; contaminated wounds; wound management;
   military trauma
ID ASSISTED CLOSURE; THERAPY
AB Backgound: Wartime missile injuries are frequently high-energy wounds that devitalize and contaminate tissue, with high risk for infection and wound complications. Debridement, irrigation, and closure by secondary intention are fundamental principles for the management of these injuries. However, closure by secondary intention was impractical in Iraqi patients. Therefore, wounds were closed definitively before discharge in all Iraqi patients treated for such injures at our hospital. A novel wound management protocol was developed to facilitate this practice, and patient outcomes were tracked. This article describes that protocol and discusses the outcomes in a series of 88 wounds managed with it.
   Methods. High-energy injuries were treated with rapid aggressive debridement and pulsatile lavage, then covered with negative pressure (vacuum-assisted closure [VAC]) dressings. Patients underwent serial operative irrigation and debridement until wounds appeared clean to gross inspection, at which time they were closed primarily. Patient treatment and outcome data were recorded in a prospectively updated database.
   Results. Treatment and outcomes data from September 2004 through May 2005 were analyzed retrospectively. There were 88 high-energy soft tissue wounds identified in 77 patients. Surprisingly, for this cohort of patients the wound infection rate was 0% and the overall wound complication rate was 0%.
   Conclusion: This series of 88 cases is the first report of the use of a negative pressure dressing (wound VAC) as part of the definitive management of high-energy soft tissue wounds in a deployed wartime environment. Our experience with these patients suggests that conventional wound management doctrine may be improved with the wound VAC, resulting in earlier more reliable primary closure of wartime injuries.
C1 Wilford Hall USAF Med Ctr, Dept Surg, Lackland AFB, TX 78236 USA.
C3 United States Department of Defense; United States Air Force
RP Leininger, BE (通讯作者)，Wilford Hall USAF Med Ctr, Dept Surg, 2200 Bergquist Dr,Suite 1, Lackland AFB, TX 78236 USA.
EM brian.leininger@lackland.af.mil
RI Rasmussen, Todd/Y-2122-2019
OI Rasmussen, Todd/0000-0003-1120-4116; Coppola,
   Christopher/0000-0002-2683-4324
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   *BORD I WALT REED, 2004, EM WAR SURG
   Bucalo Brian, 1993, Wound Repair and Regeneration, V1, P181, DOI 10.1046/j.1524-475X.1993.10308.x
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NR 10
TC 157
Z9 189
U1 0
U2 10
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0022-5282
J9 J TRAUMA
JI J. Trauma-Injury Infect. Crit. Care
PD NOV
PY 2006
VL 61
IS 5
BP 1207
EP 1211
DI 10.1097/01.ta.0000241150.15342.da
PG 5
WC Critical Care Medicine; Surgery
WE Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 105TB
UT WOS:000242054100030
PM 17099530
DA 2026-07-24
ER

PT J
AU Kneser, U
   Bach, AD
   Polykandriotis, E
   Kopp, J
   Horch, RE
AF Kneser, U
   Bach, AD
   Polykandriotis, E
   Kopp, J
   Horch, RE
TI Delayed reverse sural flap for staged reconstruction of the foot and
   lower leg
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article; Proceedings Paper
CT 34th Annual Meeting of the German-Association-of-Plastic-Surgeons
CY SEP, 2004
CL Dusseldorf, GERMANY
SP German Assoc Plast Surg
ID FASCIOCUTANEOUS FLAP; NEUROFASCIOCUTANEOUS FLAPS; CLINICAL-EXPERIENCE;
   ARTERY FLAPS; COVERAGE; MUSCLE; WOUNDS; HEEL
AB Background: Soft-tissue defects of the foot and lower leg caused by traumatic injury, tumor ablation, or infection associated with osteomyelitis often require coverage by flaps. One excellent option for reconstruction of these defects is the distally based neurofasciocutaneous sural flap. It allows rapid and reliable coverage of defects from the distal third of the lower leg to the forefoot without significant functional donor-site morbidity. However, the maximal size of the flap is limited by the delicate perfusion of the arterial network associated with the superficial sensory nerve. Delay procedures may increase the reliability of large sural flaps.
   Methods: The authors successfully used delayed sural flaps based on a two-step procedure for the treatment of 11 patients (three women and eight men, age 50.1 +/- 20.0 years) with osteomyelitis (n = 3), melanoma (n = 3), sat-coma (n = 1), squamous cell carcinoma (n = 1), posttraumatic defects (n = 2), and recurrent gouty ulcer (n = 1). The delay period ranged from 7 to 15 days (9.7 3.1), the length of the flap was from 9 to 19 (14.8 +/- 3.0) cm, and the width of the flap from 7 to 12 (9.2 +/- 1.3) cm. Temporary wound Coverage was achieved by vacuum-assisted closure during the delay period.
   Results: All defects were covered successfully without major complications.
   Conclusions: The delay procedure positively affects the viability of large sural neurofasciocutaneous flaps. The authors recommend this modification for patients with large defects at the distal third of the lower leg or foot, requiring a two-step surgical approach due to the underlying disease.
C1 Univ Erlangen Nurnberg, Med Ctr, Dept Plast & Hand Surg, D-91054 Erlangen, Germany.
C3 University of Erlangen Nuremberg
RP Kneser, U (通讯作者)，Univ Erlangen Nurnberg, Med Ctr, Dept Plast & Hand Surg, Krankenhausstr 12, D-91054 Erlangen, Germany.
EM ulrich.kneser@chir.imed.uni-erlangen.de
RI Horch, Raymund E/H-8128-2019
OI Horch, Raymund E/0000-0002-6561-2353; Polykaniotis,
   Elias/0000-0002-8152-6420
CR Al-Qattan MM, 2001, ANN PLAS SURG, V47, P269, DOI 10.1097/00000637-200109000-00009
   Almeida MF, 2002, PLAST RECONSTR SURG, V109, P583, DOI 10.1097/00006534-200202000-00027
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NR 27
TC 108
Z9 141
U1 0
U2 1
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD DEC
PY 2005
VL 116
IS 7
BP 1910
EP 1917
DI 10.1097/01.prs.0000189204.71906.c2
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 990SA
UT WOS:000233762300010
PM 16327603
DA 2026-07-24
ER

PT J
AU Li, HW
   Qu, XH
   Mao, YQ
   Dai, KR
   Zhu, ZN
AF Li, Huiwu
   Qu, Xinhua
   Mao, Yuanqing
   Dai, Kerong
   Zhu, Zhenan
TI Custom Acetabular Cages Offer Stable Fixation and Improved Hip Scores
   for Revision THA With Severe Bone Defects
SO CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
LA English
DT Article
ID ANTIPROTRUSIO CAGE; RECONSTRUCTION; ARTHROPLASTY; ALLOGRAFT; RING;
   DEFICIENCY; MANAGEMENT; COMPONENT; CUP; OSTEOLYSIS
AB Revision THA is particularly challenging in hips with severe acetabular bone loss. When the extent or geometry of the acetabular bone loss precludes more-straightforward techniques such as jumbo hemispheric cementless shells, reconstruction with morselized allograft protected by a custom cage may offer an alternative, but, to our knowledge, few series have reported on results with this approach.
   For patients with severe (Paprosky IIIB) defects, we asked: do individualized custom cages result in (1) improved Harris hip scores; (2) restoration of hip center; and (3) a low incidence of surgical complications?
   Twenty-six patients (26 hips) with a massive acetabular defect were involved in this study from 2003 to 2013. During this period, one patient was lost to followup and one died, leaving 24 patients (eight males, 16 females) in this retrospective analysis. The customized cages were individualized to each patient's bone defect based on rapid-prototype three-dimensional printed models. Mean followup was 67 months (range, 24-120 months). Harris hip scores were assessed before surgery and at each followup. Postoperative radiographs were evaluated for cage position, migration, and graft incorporation. Complications and reoperations were assessed by chart review.
   The mean Harris hip score improved from 36 (SD, 8; range, 20-49) to 82 (SD, 18; range, 60-96) (p < 0.001). Individualized custom cages resulted in generally reliable restoration of the hip center. No rerevisions have been performed. None of the cups showed radiographic migration, but one cage was believed to be loose, based on a circumferential 2-mm radiolucent line. Cancellous allografts appeared to be incorporated in 23 of 24 patients. One deep infection and one superficial infection were observed and treated with irrigation, d,bridement, and vacuum-sealing drainage. One dislocation and one suspected injury of the superior gluteal nerve also were observed and treated conservatively.
   Individualized custom cages using rapid prototyping and three-dimensional printing appeared to provide stable fixation and improved hip scores at short-term followup in this small, single-center series. As further improvements in the design and manufacturing process are made, future studies should evaluate larger patient groups for longer times, and, ideally, compare this approach with alternatives for these complex bone defects.
   Level IV, therapeutic study.
C1 [Li, Huiwu; Qu, Xinhua; Mao, Yuanqing; Dai, Kerong; Zhu, Zhenan] Shanghai Jiao Tong Univ, Sch Med, Dept Orthopaed, Shanghai Peoples Hosp 9, Shanghai 200011, Peoples R China.
C3 Shanghai Jiao Tong University
RP Zhu, ZN (通讯作者)，Shanghai Jiao Tong Univ, Sch Med, Dept Orthopaed, Shanghai Peoples Hosp 9, Shanghai 200011, Peoples R China.
EM zhenan_zhu@126.com
RI Qu, Xinhua/Q-3950-2016
OI Qu, Xinhua/0000-0002-8889-0890; li, huiwu/0000-0002-2084-2737
FU Shanghai Natural Science Foundation [15ZR1424800]; Scientific Research
   Foundation for the Returned Overseas Chinese Scholars, Ministry of
   Education of China [201550002]
FX Each author certifies that he or she, or a member of his or her
   immediate family, has no funding or commercial associations (eg,
   consultancies, stock ownership, equity interest, patent/licensing
   arrangements, etc) that might pose a conflict of interest in connection
   with the submitted article. One the authors (HL) have received funding
   from the Shanghai Natural Science Foundation (Grant No. 15ZR1424800) and
   Scientific Research Foundation for the Returned Overseas Chinese
   Scholars, Ministry of Education of China (Grant No. 201550002).
CR Abolghasemian M, 2014, BONE JOINT J, V96B, P195, DOI 10.1302/0301-620X.96B2.31907
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   Perka C, 2001, J ARTHROPLASTY, V16, P568, DOI 10.1054/arth.2001.23919
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NR 37
TC 70
Z9 93
U1 0
U2 29
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0009-921X
EI 1528-1132
J9 CLIN ORTHOP RELAT R
JI Clin. Orthop. Rel. Res.
PD MAR
PY 2016
VL 474
IS 3
BP 731
EP 740
DI 10.1007/s11999-015-4587-0
PG 10
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA DD8BV
UT WOS:000370150000023
PM 26467611
OA Bronze
DA 2026-07-24
ER

PT J
AU Li, RG
   Zhu, GZ
   Chen, CJ
   Chen, YR
   Ren, GH
AF Li, Runguang
   Zhu, Guozheng
   Chen, Chaojie
   Chen, Yirong
   Ren, Gaohong
TI Bone Transport for Treatment of Traumatic Composite Tibial Bone and Soft
   Tissue Defects: Any Specific Needs besides the Ilizarov Technique?
SO BIOMED RESEARCH INTERNATIONAL
LA English
DT Article
ID FREE-FLAP TRANSPLANTATION; VACUUM SEALING DRAINAGE; FIBULAR GRAFT;
   RECONSTRUCTION; MANAGEMENT; DISTRACTION; FRACTURES; OUTCOMES
AB Objective. To evaluate the surgical efficacy of bone transport (Ilizarov technique) plus "shortening-lengthening," "flap surgery," and "open bone transport" as individualized treatments for traumatic composite tibial bone and soft tissue defects. Methods. We retrospectively analyzed sixty-eight cases (mean age: 35.69 years, (range, 16-65)) treated from July 2014 to June 2017, including 29 middle, 18 distal, and 21 proximal tibial bone defects (4-18 cm, mean: 7.97 cm) with soft tissue defects (2.5 cm x 4.0 cm to 30.0 cm x 35.0 cm after debridement). We adopted the bone transport external fixator to fix the fracture after debriding the defect parts. In the meantime, we adopted the "shortening-lengthening technique," "flap surgery," and "open bone transport" as individualized treatment based on the location, range, and severity of the composite tibial bone and soft tissue defects. Postoperative follow-up was carried out. Surgical efficacy was assessed based on (1) wound healing; (2) bone defect healing rate; (3) external fixation time and index; (4) incidence/recurrence of deep infection; (5) postoperative complications; and (6) Association for the Study and Application of the Methods of Ilizarov (ASAMI) score. Results. The mean duration from injury to reconstruction was 22 days (4-80 d), and the mean postoperative follow-up period was 30.8 months (18-54 m). After the repair and reconstruction, 2 open bone transport patients required infected bone removal first before continuing the bone transport treatment. No deep infection (osteomyelitis) occurred or recurred in the remaining patients, and no secondary debridement was required. Some patients had complications after surgery. All the postoperative complications, including flap venous crisis, nail channel reaction, bone nonunion, mechanical axis deviation, and refracture, were improved or alleviated. External fixation time was 12.5 +/- 3.41 months, and the index was 1.63 +/- 0.44. According to the ASAMI score, 76.47% of the outcomes were good/excellent. Conclusion. The Ilizarov technique yields satisfactory efficacy for composite tibial bone and soft tissue defects when combined with "shortening-lengthening technique," "flap surgery," and "open bone transport" with appropriate individualized treatment strategies.
C1 [Li, Runguang] Southern Med Univ, Affiliated Hosp 3, Dept Orthoped, Guangzhou 510610, Peoples R China.
   [Li, Runguang] Orthopaed Hosp Guangdong Prov, Guangzhou 510610, Peoples R China.
   [Li, Runguang] Acad Orthopaed Guangdong Prov, Guangzhou 510610, Peoples R China.
   [Zhu, Guozheng; Chen, Yirong; Ren, Gaohong] Southern Med Univ, Nanfang Hosp, Dept Orthopaed, Guangzhou 510515, Peoples R China.
   [Zhu, Guozheng; Chen, Yirong; Ren, Gaohong] Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Bone & Cartilage Regenerat, Guangzhou 510515, Peoples R China.
   [Chen, Chaojie] Panyu Hosp Chinese Med, Dept Orthoped, Guangzhou 511400, Peoples R China.
C3 Southern Medical University - China; Southern Medical University -
   China; Southern Medical University - China
RP Ren, GH (通讯作者)，Southern Med Univ, Nanfang Hosp, Dept Orthopaed, Guangzhou 510515, Peoples R China.; Ren, GH (通讯作者)，Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Bone & Cartilage Regenerat, Guangzhou 510515, Peoples R China.
EM lirunguang79@163.com; guoz.zhu@gmail.com; 1247833854@qq.com;
   chenyirongy@163.com; rengaohongn@163.com
RI Chen, Chaojie/PCQ-6635-2025; Chen, Yirong/T-8449-2019
OI Gaohong, Ren/0000-0002-4941-6723; Zhu, Guozheng/0000-0003-3811-6976;
   Runguang, Li/0000-0002-4703-7180
FU Shanghai Wang Zheng-guo Trauma Medical Development Foundation
   [2017KJB-GK-001]; National Natural Science Foundation of China
   [81101366]; Natural Science Foundation of Guangdong Province
   [2018A030313640, 2019A1515012176]
FX This work was supported by the Shanghai Wang Zheng-guo Trauma Medical
   Development Foundation (2017KJB-GK-001), the National Natural Science
   Foundation of China (81101366), and the Natural Science Foundation of
   Guangdong Province (approval nos. 2018A030313640 and 2019A1515012176).
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NR 42
TC 20
Z9 26
U1 0
U2 12
PU HINDAWI LTD
PI LONDON
PA ADAM HOUSE, 3RD FLR, 1 FITZROY SQ, LONDON, W1T 5HF, ENGLAND
SN 2314-6133
EI 2314-6141
J9 BIOMED RES INT
JI Biomed Res. Int.
PD FEB 24
PY 2020
VL 2020
AR 2716547
DI 10.1155/2020/2716547
PG 13
WC Biotechnology & Applied Microbiology; Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Biotechnology & Applied Microbiology; Research & Experimental Medicine
GA KX8JU
UT WOS:000522122000015
PM 32185197
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Chen, HQ
   Zhao, XF
   Gao, S
   Qin, CJ
   Zhao, GQ
AF Chen, Haiqiong
   Zhao, Xufei
   Gao, Shi
   Qin, Chaojin
   Zhao, Guoqiang
TI Diagnosis and treatment of chronic infection after internal fixation for
   long bone fractures in children: a report of 6 cases
SO SEMINARS IN PEDIATRIC SURGERY
LA English
DT Article
DE Children long bone fracture; Chronic infection; Internal fixation
   retention; Treatment features
ID CHRONIC OSTEOMYELITIS
AB Objective: : To analyze the diagnosis and treatment of infection following internal fixation for long bone fractures in children. Methods: From January 2022 to 2024, 6 children with chronic infection following internal fixation for long bone fractures were admitted to the Department of Trauma. All the cases showed chronic infection with nonunion of the fracture, including 4 males and 2 females, 4 cases of falling from height, 1 case of traffic accident and 1 case of falling injury. The patients were treated with repeated debridement, antibiotic calcium sulfate filling, bone grafting, and intravenous antibioticsstable. The patients were followed up for at least 3 months after discharge, the symptoms, signs, and imaging changes were observed, and the Paley Fracture Healing Score.1 was recorded at the last follow-up. Results: All patients on admission showed different degrees of fracture nonunion or thinning of the fracture on X-rays, but the internal fixation was stable and the infection site was covered by soft tissue. All patients retained their implants and were treated 2-5 vacuum sealing drainage (VSD), antibiotic calcium sulfate combined with bone graft local anti-infection treatment. Secondly, Linezolid was the main antibiotic used in the perioperative and postoperative period, and Rifampicin (RFP) was added to 3 cases. Bacterial culture showed that 3 cases were Gram-positive bacteria (G+), 1 case was Serratia marcescens, and Sulperazon were added, Pseudomonas aeruginosa and Klebsiella variicola (Gram-negative bacteria, G-) were isolated from the 2 cases, and Meropenem and Imipenem (IPM) were added to increase the antimicrobial spectrum, respectively. All patients were followed up for 4-14 months, with an average of 7.8 months and achieved clinical healing without recurrence of infection. According to the Paley Fracture Healing Score1, the results were excellent in 5 patients and good in 1 patient. Conclusion: In 6 children with chronic infection after internal fixation of fracture, imaging showed nonunion of fracture. In order to avoid secondary internal fixation of fracture or later orthopedic surgery, careful retention of internal fixation, thorough debridement, local antibiotic filling and release of anti-infection, combined with systemic antibiotic treatment for a sufficient period, and constant monitoring of inflammatory indicators were performed. Infection control and fracture healing can be achieved clinically.
C1 [Chen, Haiqiong; Zhao, Xufei; Gao, Shi; Qin, Chaojin; Zhao, Guoqiang] Zhejiang Univ, Childrens Hosp, Natl Clin Res Ctr Childrens Hlth & Dis, Dept Traumatol,Sch Med, hangzhou, Peoples R China.
C3 Zhejiang University
RP Zhao, GQ (通讯作者)，Zhejiang Univ, Childrens Hosp, Natl Clin Res Ctr Childrens Hlth & Dis, Dept Traumatol,Sch Med, hangzhou, Peoples R China.
EM friendlongzju@163.com
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NR 34
TC 0
Z9 0
U1 0
U2 0
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1055-8586
EI 1532-9453
J9 SEMIN PEDIATR SURG
JI Semin. Pediatr. Surg.
PD FEB
PY 2026
VL 40
AR 151589
DI 10.1016/j.sempedsurg.2026.151589
EA FEB 2026
PG 6
WC Pediatrics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pediatrics; Surgery
GA FV1JC
UT WOS:001728126000001
PM 41692667
OA hybrid
DA 2026-07-24
ER

PT J
AU Zha, YJ
   Hua, KH
   Gong, MQ
   Jiang, XY
AF Zha, Yejun
   Hua, Kehan
   Gong, Maoqi
   Jiang, Xieyuan
TI Chronic type C3 distal humeral fracture associated with massive bone
   defects treated by open reduction and internal fixation with iliac crest
   autografts: a case report
SO BMC MUSCULOSKELETAL DISORDERS
LA English
DT Article
DE Distal humeral fracture; Chronic intercondylar fracture; Bone defect;
   Open reduction and internal fixation; Iliac crest autograft
AB BackgroundChronic intercondylar fractures of the distal humerus with massive bone defects and severe comminution in the metaphysis are rare and complex injuries that are challenging for surgeons to treat, as reconstructing the triangular structure of the distal humerus is difficult and may have a severe impact on functional outcomes, especially in young patients, for whom total elbow arthroplasty is usually not a suitable option due to significant impairment in upper limb strength. Here, we report a patient in such scenario who was young and active and was treated by structural iliac bone autografting and internal fixation.Case presentationA 26-year-old male patient experienced a major car accident and was diagnosed with an open fracture (Gustilo-Anderson type IIIB) of the right distal humerus with massive bone defects and severe intra-articular involvement, without neurovascular injuries or other associated injuries. Surgical debridement, negative pressure vacuum sealing drainage, and immobilization by braces were initially performed, and the wound was closed after 15days. When the wound had finally healed and the soft tissue was in good condition without infection or effusion 45days later, this young and active patient was diagnosed with a chronic type C3 distal humeral fracture associated with massive bone defects at the supracondylar level in both columns and severe comminution at the trochlear groove. We performed surgical debridement and arthrolysis around the fracture site, and then, we successfully reconstructed the triangular structure of the distal humerus using structural iliac crest autografts in both columns as well as in the defective trochlear groove. Finally, internal fixation via a parallel double-plate configuration was performed. Over a follow-up period of 3years, the patient achieved almost full recovery of range of motion and an excellent functional score, without minor or major postoperative complications.ConclusionIn this study, we proposed a surgical reconstruction strategy for complex chronic distal humeral fractures associated with massive bone defects and severe articular involvement in young and active patients using metaphyseal shortening and structural iliac crest bone autografting together with open reduction and internal fixation via a parallel configuration.
C1 [Zha, Yejun; Hua, Kehan; Gong, Maoqi; Jiang, Xieyuan] Beijing Jishuitan Hosp, Dept Orthoped Trauma, 31 Xinjiekou East St, Beijing 100035, Peoples R China.
RP Jiang, XY (通讯作者)，Beijing Jishuitan Hosp, Dept Orthoped Trauma, 31 Xinjiekou East St, Beijing 100035, Peoples R China.
EM jxy0845@sina.com
RI ZHA, Yejun/KCK-2028-2024
FU Beijing Natural Science Foundation [L192049]; Beijing Municipal Health
   Commission [BMHC2019-9]; Ministry of Science and Technology of the
   People's republic of China [2017YFC0110603]
FX 1. Funder: Beijing Natural Science Foundation Grant name (number):
   Beijing Natural Science Foundation (L192049). 2. Funder: Beijing
   municipal health commission Grant name (number): Beijing Municipal
   Health Commission (BMHC2019-9). 3. Funder: Ministry of Science and
   Technology of the People's republic of China Grant name (number):
   National Key R&D Program of China (2017YFC0110603).
CR Barco R, 2017, J BONE JOINT SURG AM, V99, P1524, DOI 10.2106/JBJS.16.01222
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NR 23
TC 2
Z9 5
U1 0
U2 3
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1471-2474
J9 BMC MUSCULOSKEL DIS
JI BMC Musculoskelet. Disord.
PD APR 7
PY 2021
VL 22
IS 1
AR 338
DI 10.1186/s12891-021-04199-4
PG 8
WC Orthopedics; Rheumatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Rheumatology
GA RK0NR
UT WOS:000638002700004
PM 33827519
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Manterola, C
   Rivadeneira, J
   Holguín, JP
   García, MF
   Munoz, G
AF Manterola, Carlos
   Rivadeneira, Josue
   Holguin, Juan Pablo
   Garcia, Maria Fernanda
   Munoz, Georgina
TI Open Abdomen. Overall Review of the Evidence
SO INTERNATIONAL JOURNAL OF MORPHOLOGY
LA English
DT Article
DE Open abdomen techniques; Abdominal traumainjuries; Intraabdominal
   infections; Negative-Pressure wound detherapy; Fascial closure; Vacuum
   sealing drainage; Vacuum- deassisted closure
ID PRESSURE WOUND THERAPY; TEMPORARY ABDOMINAL CLOSURE; DAMAGE-CONTROL
   LAPAROTOMY; PRIMARY FASCIAL CLOSURE; INTRAABDOMINAL PRESSURE;
   ABBREVIATED LAPAROTOMY; COMPARTMENT SYNDROME; MARLEX MESH; MANAGEMENT;
   QUALITY
AB The open abdomen (OA) is a technical innovation that has enhanced the surgical understanding of damage control surgery (DCS), temporary abdominal closure, staged abdominal reconstruction, visceral care, and abdominal wal reconstruction. The aim of this study was to report the existing evidence on the use of OA in patients with intra-abdominalBjarnason, hypertension (IAH), abdominal compartment syndrome (ACS), DCS for trauma, and the prevention and treatment of IAH and ACS. overview was conducted. Primary or secondary articles evaluating the outcomes of OA in adults, for septic or traumatic indications, published between 2010 and 2023 were considered. The following meta-search engines, libraries, and databases were reviewed: Database, BIREME-BVS, SciELO, Cochrane Central Register Controlled Trials, WoS, MEDLINE, EMBASE, and SCOPUS. Risk of bias assessment was applied using the SIGN design. Subsequently, the levels of evidence were classified according to the Oxford CEBM proposal. Methodological quality (MQ) was determined using AMSTAR 2 for systematic reviews (SR), modified Jadad for clinical trials (CT), and MInCir-T for observational studies (OS) and therapy related CT. Finally, the evidence was graded using the GRADE system. A total of 33 studies were analyzed (9 SR, 3 CT, and 21 OS, representing a population of 26,519 patients with O A). In subjects with OA due to IAH, the evidence regarding morbidity and mortality is scarce and heterogeneous. In adults with abdominal trauma OA, better outcomes are observed when negative pressure closure techniques are applied compared to passive temporary closure. existing evidence to recommend commercial devices over homemade devices is weak. Systematic and routine measurement of intraabdominal pressure would be justified as a method for detecting and ACS in patients with OA due to IAH or trauma. The available relaci & oacute;nevidence regarding the effectiveness of OA techniques in patients datoswith trauma and IAH in the presented situations is based on a few y studies, mostly of low MQ. Therefore, new high-quality comparative studies with an adequate number of patients are needed to clarify estudio. current uncertainty.
C1 [Manterola, Carlos; Rivadeneira, Josue; Holguin, Juan Pablo; Garcia, Maria Fernanda; Munoz, Georgina] Univ La Frontera, Programa Doctorado Ciencias Med, Temuco, Chile.
   [Manterola, Carlos] Univ La Frontera, Ctr Estudios Morfol & Quirurg CEMyQ, Temuco, Chile.
   [Holguin, Juan Pablo; Munoz, Georgina] Univ Azuay, Cuenca, Ecuador.
   [Garcia, Maria Fernanda] Univ Cent Ecuador, Quito, Ecuador.
C3 Universidad de La Frontera; Universidad de La Frontera; Universidad del
   Azuay; Universidad Central del Ecuador
RP Manterola, C (通讯作者)，Univ La Frontera, Programa Doctorado Ciencias Med, Francisco Salazar 01145, Temuco, Chile.; Manterola, C (通讯作者)，Univ La Frontera, CEMyQ, Francisco Salazar 01145, Temuco, Chile.
EM carlos.manterola@ufrontera.cl
RI Manterola, Carlos/F-8826-2013; Holguín C, Juan Pablo/HJP-5829-2023;
   García-Aguilera, María Fernanda/MGW-6733-2025; Rivadeneira,
   Josue/QJV-7394-2026
OI Holguín C, Juan Pablo/0000-0002-6844-3962; García-Aguilera, María
   Fernanda/0000-0002-5375-3474; 
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NR 86
TC 0
Z9 0
U1 0
U2 0
PU SOC CHILENA ANATOMIA
PI TEMUCO
PA CASILLA 54-D, TEMUCO, 00000, CHILE
SN 0717-9502
EI 0717-9367
J9 INT J MORPHOL
JI Int. J. Morphol.
PD FEB
PY 2025
VL 43
IS 1
BP 275
EP 293
PG 19
WC Anatomy & Morphology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Anatomy & Morphology
GA 0MA8W
UT WOS:001450583300036
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Eser, C
   Ceylan, OIK
   Gencel, E
   Tabakan, I
   Kokacya, O
   Yavuz, M
AF Eser, Cengiz
   Ceylan, Ozgun Ilke Karagoz
   Gencel, Eyuphan
   Tabakan, Ibrahim
   Kokacya, Omer
   Yavuz, Metin
TI Reconstruction of Achilles region defects: A single-centre experience
SO INTERNATIONAL JOURNAL OF CLINICAL PRACTICE
LA English
DT Article
DE Achilles; flap; graft; reconstruction; tendon
ID SOFT-TISSUE DEFECTS; PERFORATOR FLAPS; MICROSURGICAL RECONSTRUCTION;
   STAGE RECONSTRUCTION; TENDON DEFECTS; SKIN; KEYSTONE; LEG;
   SUPERMICROSURGERY; ANGIOGRAPHY
AB Background Reconstruction of Achilles tendon and the overlying tissue defects is a challenging undertaking. The spectrum of available repair methods range from secondary healing to the use of free flaps. The aim of this study was to discuss reconstruction options and to help the surgeon to select reliable approach to achieve favourable outcomes. Method In this study, we retrospectively evaluated 14 patients who underwent reconstruction of Achilles region defect between 2016 and 2019 at a single centre. Results Reconstructions were performed with secondary healing (n = 2), negative pressure wound therapy and skin grafting (n = 2), free flaps (n = 6) and local and distant flaps (n = 4). Satisfactory aesthetic and functional outcomes were achieved in all patients. One patient developed partial skin graft loss. Marginal necrosis occurred in one of the local flaps. Wound dehiscence and flap retraction occurred in one of the free (superficial circumflex iliac artery perforator) flaps. One patient undergoing reconstruction with ulnar artery perforator flap developed intraoperative atrial fibrillation; the operation was terminated and reconstruction completed with skin grafting. Conclusion Orthoplastic reconstruction should be kept in mind for Achilles tendon defects. The use of special digital imaging techniques facilitates flap surgery and helps minimise the risk of flap complications. Conventional approaches are suitable for shallow small skin lesions. Local flaps are good options for deeper skin defects owing to superior aesthetic outcomes. Super-thin free flaps offer a distinct advantage in skillful hands. The use of multi-content free chimeric flaps for reconstruction of complex defects facilitates better anatomical repair. Cross leg or flow-through flaps may be considered in patients with compromised distal circulation. Selection of the most reliable approach for Achilles reconstruction is a key imperative to achieve favourable outcomes.
C1 [Eser, Cengiz; Ceylan, Ozgun Ilke Karagoz; Gencel, Eyuphan; Tabakan, Ibrahim; Kokacya, Omer; Yavuz, Metin] Cukurova Univ, Dept Plast Reconstruct & Aesthet Surg, Fac Med, TR-01030 Adana, Turkey.
C3 Cukurova University
RP Kokacya, O (通讯作者)，Cukurova Univ, Dept Plast Reconstruct & Aesthet Surg, Fac Med, TR-01030 Adana, Turkey.
EM kokacya@yahoo.com
RI eser, cengiz/E-8482-2018; /E-9525-2018; /E-7681-2018; Kokaçya,
   Ömer/T-2210-2018
OI Kokaçya, Ömer/0000-0002-1650-5957
CR Abraham JT, 2017, CLIN PLAST SURG, V44, P385, DOI 10.1016/j.cps.2016.12.005
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NR 40
TC 1
Z9 1
U1 0
U2 1
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1368-5031
EI 1742-1241
J9 INT J CLIN PRACT
JI Int. J. Clin. Pract.
PD DEC
PY 2021
VL 75
IS 12
AR e14908
DI 10.1111/ijcp.14908
EA SEP 2021
PG 9
WC Medicine, General & Internal; Pharmacology & Pharmacy
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Pharmacology & Pharmacy
GA XW2FF
UT WOS:000700740200001
PM 34547158
DA 2026-07-24
ER

PT J
AU Sorour, AA
   Kirksey, L
   Ambur, V
   Bena, J
AF Sorour, Ahmed A.
   Kirksey, Levester
   Ambur, Vishnu
   Bena, James
TI Surgical Site Complications After Complex Iliofemoral Reconstruction and
   the Role of Negative Pressure Wound Therapy: A Retrospective,
   Single-center Study
SO WOUNDS-A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE
LA English
DT Article
DE closed incision negative pressure therapy; surgical incision; surgical
   wound; infection; femoral endarterectomy; wound healing
ID INFECTIONS; INCISION; COST
AB Introduction. Surgical site infection (SSI) of groin incisions after vascular surgery is a significant source of morbidity and is associated with high rates of readmission and reoperation, as well as longer hospital length of stay. The patient-reported health care experiences are diminished for those in whom SSI complications occur. Previous studies have analyzed patients undergoing all types of surgery requiring groin incision. The role of closed incision negative pressure therapy (CiNPT) as an adjunct to the primarily closed femoral incision after vascular surgery is unclear. Materials and Methods. This retrospective single-center study focuses on complex iliofemoral reconstruction with extensive dissection, including profundoplasty. The role of CiNPT and short-term outcomes are analyzed. Multivariable logistic regression was used to identify factors that place patients at high risk for SSI. A prediction model was performed to predict high-risk patients. Results. A total of 337 patients who underwent 422 femoral endarterectomies (85 bilateral) were included. The overall SSI rate was 16.1% (9.3% Szilagyi grade II and III), and SSI was associated with a 44% readmission rate, 38% reoperation rate, and longer mean length of stay (8.5 days vs 5.1 days; P =.02). No differences in SSI were evident between the CiNPT (n = 47) and standard dressing cohorts. The final prediction model used 5 variables: obesity (body mass index > 30), insulin use, chronic obstructive pulmonary disease (COPD), immunosuppression, and surgical duration. Conclusions. Patients with obesity, COPD, and insulin-dependent diabetes mellitus are at increased risk for SSI after femoral incisions for peripheral revascularization. A prediction model may assist in identifying patients at high risk for SSI so that targeted risk reduction strategies can be implemented to decrease morbidity and economic costs. Targeted use of CiNPT may help reduce the severity of SSI in these at-risk patients.
C1 [Sorour, Ahmed A.; Kirksey, Levester; Ambur, Vishnu; Bena, James] Cleveland Clin, Heart Vasc & Thorac Inst, Dept Vasc Surg, Cleveland, OH USA.
   [Kirksey, Levester] Cleveland Clin, Dept Vasc Surg, Cleveland, OH USA.
C3 Cleveland Clinic Foundation; Cleveland Clinic Foundation
RP Kirksey, L (通讯作者)，Cleveland Clin, Desk H32,9500 Euclid Ave, Cleveland, OH 44195 USA.
EM kirksel@ccf.org
OI Sorour, Ahmed/0000-0002-9664-1093
CR 3M Health Care, EV BROCH EXP FDA IND
   Acosta S, 2017, BJS-BRIT J SURG, V104, pE75, DOI 10.1002/bjs.10403
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   Boltz MM, 2011, SURGERY, V150, P934, DOI 10.1016/j.surg.2011.04.006
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NR 21
TC 7
Z9 7
U1 0
U2 1
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 1044-7946
EI 1943-2704
J9 WOUNDS
JI Wounds-Compend. Clin. Res. Pract.
PD APR
PY 2022
VL 34
IS 4
BP E22
EP E28
DI 10.25270/wnds/2022.e22e28
PG 7
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA D0PD2
UT WOS:000965823600002
PM 35797556
DA 2026-07-24
ER

PT J
AU Shakir, S
   Messa, CA
   Broach, RB
   Rheumtulla, IA
   Chatman, B
   D'Angelantonio, A
   Levin, LS
   Kovach, SJ 
   Serletti, JM
   Fischer, JP
AF Shakir, Sameer
   Messa, Charles A.
   Broach, Robyn B.
   Rheumtulla, Irfan A.
   Chatman, Brett
   D'Angelantonio, Albert
   Levin, L. Scott
   Kovach, Stephen J., III
   Serletti, Joseph M.
   Fischer, John P.
TI Indications and Limitations of Bilayer Wound Matrix-Based Lower
   Extremity Reconstruction: A Multidisciplinary Case-Control Study of 191
   Wounds
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID OUTCOMES; FLAP; DEFECTS; INTEGRA; FOOT
AB Background:
   Little is known about the efficacy of newer skin substitute scaffolds to reconstruct complex lower extremity wounds. The investigators present a multihospital experience of reconstructive surgeons utilizing collagen-GAG bilayer wound matrix in lower extremity soft-tissue reconstruction with the goals to (1) characterize a suitable patient population, (2) categorize failures to optimize patient selection, and (3) determine wound factors affecting success.
   Methods:
   Subjects underwent collagen-GAG-based lower extremity wound reconstruction from May of 2010 to June of 2017. The primary outcome variable was 180-day graft success, defined as eventual split-thickness skin grafting after bilayer wound matrix application; failure was defined as inadequate wound bed for split-thickness skin grafting, requirement for vascularized tissue transfer, or eventual amputation. Eligible subjects had at least one lower extremity wound and were at least 18 years old. Exclusion criteria included third-degree burn wounds or failure to follow up for at least 60 days postoperatively. Predictor variables included demographics, medical comorbidities, perioperative characteristics, postoperative complications, and cost-related data for each hospitalization.
   Results:
   There were 147 subjects with 191 wounds. Mean patient age was 60.1 years (range, 21.0 to 95.6 years), and mean body mass index was 30.5 kg/m(2) (range, 14.4 to 64.7 kg/m(2)). Average wound size was 73.1 +/- 137.7 cm(2), with 49.0 percent of subjects receiving adjunct postoperative negative-pressure wound therapy. Seventy percent of wounds were successfully healed at 180 days. Most were localized between the knee and ankle (50.8 percent) or foot (46.1 percent). Tendon exposure (p < 0.05), bone exposure (p < 0.01), and bone excision (p < 0.04) were associated with reconstructive failure.
   Conclusions:
   The authors present the largest reported multihospital, multidisciplinary experience with collagen-GAG wound matrix for lower extremity reconstruction. Tendon and/or bone exposure and socioeconomic factors were associated with failure.
C1 Univ Penn, Dept Surg, Div Plast Surg, Philadelphia, PA 19104 USA.
   Univ Penn, Dept Orthoped Surg, Philadelphia, PA 19104 USA.
C3 University of Pennsylvania; University of Pennsylvania
RP Fischer, JP (通讯作者)，Univ Penn, Div Plast Surg, 14th Floor,South Pavil,3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA.
EM John.Fischer2@uphs.upenn.edu
RI ; Messa, Charles/AAK-6833-2021
OI Shakir, Sameer/0000-0003-0992-0308; 
CR Bekara F, 2016, PLAST RECONSTR SURG, V137, P314, DOI 10.1097/PRS.0000000000001891
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   Weigert R, 2015, J COSMET LASER THER, V17, P321, DOI 10.3109/14764172.2015.1027231
NR 16
TC 33
Z9 36
U1 0
U2 4
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD MAR
PY 2020
VL 145
IS 3
BP 813
EP 822
DI 10.1097/PRS.0000000000006609
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA LH1TC
UT WOS:000528570700067
PM 32097330
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Gombert, A
   Van Vuuren, TMAJ
   Barbati, ME
   Toonder, IM
   Van Laanen, JHH
   Wittens, C
   Houman, HJ
AF Gombert, Alexander
   Van Vuuren, Timme M. A. J.
   Barbati, Mohammad E.
   Toonder, Irwin M.
   Van Laanen, Jorinde H. H.
   Wittens, Cees
   Houman, Houman Jalaie
TI Closed incisional negative pressure therapy may reduce surgical site
   infection rate following endophlebectomy with complementary
   polytetrafluoroethylene arteriovenous fistula of the common femoral vein
SO JOURNAL OF VASCULAR SURGERY-VENOUS AND LYMPHATIC DISORDERS
LA English
DT Article
DE cINPT; Prevena; Endophlebectomy; Polytetrafluoroethylene; Arteriovenous
   fistula; Surgical site infections; Deep venous recanalization
ID WOUND COMPLICATIONS; EDITORS CHOICE; DISEASE; RECANALIZATION;
   ENDOVENECTOMY; PREVENTION; MANAGEMENT
AB Objective: Surgical desobliteration or endophlebectomy of the common femoral vein during deep venous recanalization with complementary polytetrafluoroethylene (PTFE) arteriovenous fistula (AVF), may lead to higher rates of surgical site infection (SSI). It has been reported that closed incisional negative pressure wound therapy (cINPT) may decrease SSI rates after different surgical procedures. The aim of this study was to determine the potential effect of cINPT on the SSI rate of femoral endophlebectomy with a complimentary PTFE AVF.
   Methods: Patients with recanalization of the femoral-iliac veins and femoral endophlebectomy with a complementary PTFE AVF and postoperative cINPT were identified. SSI, patency, and complication rates were analyzed.
   Results: This study included 65 patients with a mean age of 41 +/- 14 years. The mean procedure time was 240 +/- 11.9 minutes. Primary patency rate was 69.2% and secondary patency rate was 78.4%. SSI classified as Szilagyi I, II, and III occurred in 7.6% (n = 5), 3% (n = 2), and 7.6% (n = 5), respectively, with an overall SSI rate of 18.2%. Surgical wound revision with the application of a vacuum pump was required in 10.7% (n = 7). A multivariate analysis showed that the duration of the surgical procedure (P =.003) as well as lymphatic fistulas (P =.044) to have a significant impact on the SSI rate.
   Conclusions: Endophlebectomy with complementary PTFE AVF of the femoral vein is related to an increased rate of lymphatic leakage and SSI. Lymphatic fistula and the duration of surgery could be assessed as relevant influencing factors of SSI. Application of cINPT in this surgical setting may reduce the SSI rate. Despite this potential improvement, SSI rates still limit the clinical success of a deep venous recanalization.
C1 [Gombert, Alexander; Barbati, Mohammad E.; Houman, Houman Jalaie] Rhein Westfal TH Aachen, European Vasc Ctr Aachen Maastricht, Univ Hosp Aachen, Pauwelsstr 30, D-52074 Aachen, Germany.
   [Van Vuuren, Timme M. A. J.; Toonder, Irwin M.; Van Laanen, Jorinde H. H.; Wittens, Cees] Maastricht Univ Hosp, Univ Hosp Aachen, European Vasc Ctr Aachen Maastricht, Maastricht, Netherlands.
C3 Maastricht University; RWTH Aachen University; RWTH Aachen University
   Hospital; RWTH Aachen University; RWTH Aachen University Hospital;
   Maastricht University; Maastricht University Medical Centre (MUMC)
RP Gombert, A (通讯作者)，Rhein Westfal TH Aachen, European Vasc Ctr Aachen Maastricht, Univ Hosp Aachen, Pauwelsstr 30, D-52074 Aachen, Germany.
EM agombert@ukaachen.de
RI ; Barbati, Mohammad Esmaeil/F-5529-2016; Toonder, Irwin/LSK-9695-2024
OI Gombert, Alexander/0000-0002-8451-2913; Barbati, Mohammad
   Esmaeil/0000-0003-0709-8533; 
CR Allegranzi Benedetta, 2016, Lancet Infect Dis, V16, pe276, DOI [10.1016/s1473-3099(16)30402-9, 10.1016/s1473-3099(16)30398-x, 10.1016/S1473-3099(16)30398-X]
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   Hawn MT, 2011, ANN SURG, V254, P494, DOI 10.1097/SLA.0b013e31822c6929
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   Mostbeck A, 1999, Wien Med Wochenschr, V149, P87
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   Raju S, 1999, J VASC SURG, V29, P1050, DOI 10.1016/S0741-5214(99)70246-6
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   SZILAGYI DE, 1972, ANN SURG, V176, P321, DOI 10.1097/00000658-197209000-00008
   Vogel D, 2012, J VASC SURG, V55, P129, DOI 10.1016/j.jvs.2011.05.017
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   Wittens C, 2015, EUR J VASC ENDOVASC, V49, P678, DOI 10.1016/j.ejvs.2015.02.007
NR 27
TC 7
Z9 8
U1 0
U2 1
PU ELSEVIER
PI AMSTERDAM
PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
SN 2213-333X
J9 J VASC SURG-VENOUS L
JI J. Vasc. Surg.-Venous Lymphat. Dis.
PD JAN
PY 2020
VL 8
IS 1
BP 89
EP 94
DI 10.1016/j.jvsv.2019.08.010
PG 6
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA KS3OM
UT WOS:000518221600014
PM 31653533
OA Green Published, Bronze
DA 2026-07-24
ER

PT J
AU Huang, XX
   Meng, XB
AF Huang, Xinxin
   Meng, Xubiao
TI Meta-analysis on the safety and efficacy of different dressings in the
   treatment of diabetic foot ulcers
SO OPEN MEDICINE
LA English
DT Article
DE dressings; diabetic foot ulcer (DFU); healing; wound infection; ulcer
   area
ID PRESSURE WOUND THERAPY; DOUBLE-BLIND; SILVER; MULTICENTER; CLOSURE
AB Introduction: Diabetic foot ulcers (DFU) are a common and severe complication of diabetes, associated with high morbidity, infection risk, and amputation rates. Various dressings have been applied in clinical practice, yet their comparative safety and efficacy remain unclear. This study aimed to systematically evaluate different dressings for DFU treatment through meta-analysis.<br /> Content: Relevant studies from Chinese and English databases were retrieved and analyzed. A total of 25 studies involving 2,421 patients were included. Dichotomous data analysis showed that the experimental group had a significantly higher complete wound healing rate than the control group (OR=4.62, 95 % CI: 3.10-6.90, p<0.01), a significantly lower incidence of wound infection (OR=0.63, 95 % CI: 0.43-0.93, p=0.02), and no significant difference in amputation rate (OR=0.62, 95 % CI: 0.34-1.14, p=0.12). Continuous data analysis indicated that the experimental group had higher wound healing scores (MD=25.77, 95 % CI: 2.33-49.20, p=0.03), greater ulcer area reduction (MD=27.96, 95 % CI: 21.93-34.00, p<0.01), and shorter healing time (MD=-11.41, 95 % CI: -14.35 to -8.47, p<0.01). Meta-regression analysis suggested that publication year, blinding, and outcome indicators contributed to heterogeneity (p<0.05).<br /> Summary: Activated carbon cloth (ACC), negative pressure wound therapy (NPWT), and olive oil dressings demonstrated favorable safety and efficacy, although each has distinct advantages. Clinical selection should therefore be individualized according to patient conditions and wound characteristics.<br /> Outlook: Future studies with larger sample sizes and higher methodological quality are needed to further validate these findings and reduce heterogeneity, thereby providing more robust evidence for clinical decision-making.
C1 [Huang, Xinxin; Meng, Xubiao] Cent South Univ, Haikou Hosp, Xiangya Sch Med, Haikou 570208, Peoples R China.
RP Meng, XB (通讯作者)，Cent South Univ, Haikou Hosp, Xiangya Sch Med, Haikou 570208, Peoples R China.
EM MengXubiao2001@163.com
FU Hainan Provincial Natural Science Foundation [822MS201]
FX This research was supported by the Hainan Provincial Natural Science
   Foundation (No. 822MS201).
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NR 51
TC 0
Z9 0
U1 0
U2 0
PU DE GRUYTER POLAND SP Z O O
PI WARSAW
PA BOGUMILA ZUGA 32A STR, 01-811 WARSAW, MAZOVIA, POLAND
SN 2391-5463
J9 OPEN MED-WARSAW
JI Open Med.
PD JAN 23
PY 2026
VL 21
IS 1
AR 20261459
DI 10.1515/med-2026-1459
PG 15
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA KB9FH
UT WOS:001803296300001
PM 42368733
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Cooper, HJ
   Roc, GC
   Bas, MA
   Berliner, ZP
   Hepinstall, MS
   Rodriguez, JA
   Weiner, LS
AF Cooper, H. John
   Roc, Gilbert C.
   Bas, Marcel A.
   Berliner, Zachary P.
   Hepinstall, Matthew S.
   Rodriguez, Jose A.
   Weiner, Lon S.
TI Closed incision negative pressure therapy decreases complications after
   periprosthetic fracture surgery around the hip and knee
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Closed incision negative pressure therapy; Surgical site infections;
   Prevention; Periprosthetic fracture; Hip; Knee; Quality improvement
ID SURGICAL-SITE INFECTIONS; WOUND THERAPY; HIGH-RISK; FEMUR FRACTURES;
   UNITED-STATES; REVISION HIP; ARTHROPLASTY; PREVENTION; MORTALITY;
   MANAGEMENT
AB Introduction: Periprosthetic fractures (PPFXs) are becoming increasingly common following total hip arthroplasty (THA) and total knee arthroplasty (TKA). Patients sustaining PPFXs face considerable perioperative morbidity, with relatively increased rates of surgical site infection. We sought to evaluate the efficacy of closed-incision negative-pressure wound therapy (ciNPT) in decreasing perioperative wound complications following lower extremity periprosthetic fracture surgery.
   Methods: We performed a retrospective review of 69 consecutive patients who underwent surgery to address lower extremity periprosthetic fractures around hip or knee implants performed over a 6.5-year period. The population was divided into two groups based on the surgical dressing used at the conclusion of the procedure: (1) a sterile, antimicrobial hydrofiber dressing, or (2) ciNPT. There were no baseline demographic differences between the two groups. Rates of wound complications, surgical site infection, and reoperation related to the surgical site were compared between groups. Continuous variables were analyzed using a student's t-test, and categorical variables using either chi-square or fisher's exact test.
   Results: Patients treated with ciNPT developed fewer wound complications (4% vs. 35%; p = 0.002), fewer deep infections (0% vs. 25%; p = 0.004), and underwent fewer reoperations related to the surgical site (4% vs. 25%; p = 0.021) compared to patients treated with standard of care.
   Conclusions: Our findings suggest that ciNPT may reduce wound complications, SSIs, and reoperations in patients undergoing lower extremity periprosthetic fracture surgery. This is the first study to investigate ciNPT as a treatment for periprosthetic fracture surgery, and has the potential to change the postoperative management of these patients. (C) 2017 Elsevier Ltd. All rights reserved.
C1 [Cooper, H. John] Columbia Univ, Med Ctr, Dept Orthoped Surg, Div Hip & Knee Reconstruct, New York, NY USA.
   [Roc, Gilbert C.; Bas, Marcel A.; Berliner, Zachary P.; Hepinstall, Matthew S.] Northwell Hlth Syst, Lenox Hill Hosp, Dept Orthopaed Surg, Ctr Joint Preservat & Reconstruct, New York, NY USA.
   [Rodriguez, Jose A.] Hosp Special Surg, Dept Orthoped Surg, Adult Reconstruct & Joint Replacement Serv, 535 E 70th St, New York, NY 10021 USA.
   [Weiner, Lon S.] Northwell Hlth Syst, Lenox Hill Hosp, Dept Orthopaed Surg, Div Orthopaed Trauma, New York, NY USA.
C3 Columbia University; Northwell Health; Northwell Health
RP Cooper, HJ (通讯作者)，Columbia Univ, Med Ctr, Dept Orthoped Surg, 622 West 168th St,PH-11, New York, NY 10032 USA.
EM hjc2008@cumc.columbia.edu
RI Cooper, H./H-3488-2019; Hepinstall, Matthew/AAG-9271-2019
OI Hepinstall, Matthew/0000-0001-6002-8580
FU KCI
FX One of the authors (HJC) is a paid consultant for the manufacturer (KCI)
   of the device (Prevena) discussed in the manuscript. Multiple authors
   (HJC, MSH, JAR, LSW) have financial relationships (consultancy,
   royalties, speakers bureau, research support) from several implant
   companies, which are not relevant to the current manuscript. For the
   remaining authors, none were declared.
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NR 42
TC 44
Z9 48
U1 0
U2 3
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD FEB
PY 2018
VL 49
IS 2
BP 386
EP 391
DI 10.1016/j.injury.2017.11.010
PG 6
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA FX9TX
UT WOS:000426451500038
PM 29174454
OA hybrid
DA 2026-07-24
ER

PT J
AU Chetter, IC
   Oswald, AV
   Fletcher, M
   Dumville, JC
   Cullum, NA
AF Chetter, I. C.
   Oswald, A. V.
   Fletcher, M.
   Dumville, J. C.
   Cullum, N. A.
TI A survey of patients with surgical wounds healing by secondary
   intention; an assessment of prevalence, aetiology, duration and
   management
SO JOURNAL OF TISSUE VIABILITY
LA English
DT Article
DE Surgical wounds; Secondary intention
ID PILONIDAL-SINUS; RISK
AB Background: Surgical wounds healing by secondary intention (SWHSI) are often difficult and costly to treat. There is a dearth of clinical and research information regarding SWHSI. The aim of this survey was to estimate the prevalence of SWHSI and to characterise the aetiology, duration and management of these wounds.
   Methods: Anonymised data were collected from patients with SWHSI receiving treatment in primary, secondary and community settings. Over a two weeks period, data were collected on the patients, their SWHSI, clinical and treatment details.
   Results: Data were collected from 187 patients with a median age of 58.0 (95% CI = 55 to 61) years. The prevalence of SWHSI was 0.41 (95% CI = 0.35 to 0.47) per 1000 population. More patients with SWHSI were being treated in community (109/187, 58.3%) than in secondary (56/187, 29.9%) care settings. Most patients (164/187, 87.7%) had one SWHSI and the median duration of wounds was 28.0 (95% CI = 21 to 35) days. The most common surgical specialities associated with SWHSI were colorectal (80/187, 42.8%), plastics (24/187, 12.8%) and vascular (22/187, 11.8%) surgery. Nearly half of SWHSI were planned to heal by secondary intention (90/187, 48.1%) and 77/187 (41.2%) were wounds that had dehisced. Dressings were the most common single treatment for SWHSI, received by 169/181 (93.4%) patients. Eleven (6.1%) patients were receiving negative pressure wound therapy.
   Conclusions: This survey provides a previously unknown insight into the occurrence, duration, treatment and types of surgery that lead to SWHSI. This information will be of value to patients, health care providers and researchers. (C) 2017 The Authors. Published by Elsevier Ltd on behalf of Tissue Viability Society.
C1 [Chetter, I. C.; Oswald, A. V.] Hull & East Yorkshire NHS Trust, Hull York Med Sch, Acad Vasc Surg Unit, Kingston Upon Hull, N Humberside, England.
   [Fletcher, M.] Marfleet Primary Hlth Care Ctr, City Hlth Care Partnership CIC, Kingston Upon Hull, N Humberside, England.
   [Dumville, J. C.; Cullum, N. A.] Univ Manchester, Sch Nursing Midwifery & Social Work, Manchester, Lancs, England.
C3 University of York - UK; University of Hull; University of Manchester
RP Chetter, IC (通讯作者)，Hull & East Yorkshire NHS Trust, Acad Vasc Surg Unit, Anlaby Rd, Kingston Upon Hull HU3 2JZ, N Humberside, England.
EM ian.chetter@hey.nhs.uk
RI Cullum, Nicky/F-2438-2011; Dumville, Jo/O-7867-2014
OI Cullum, Nicky/0000-0003-2631-123X; Dumville, Jo/0000-0002-6546-3685;
   chetter, ian/0000-0002-2566-6859
FU National Institute for Health Research (NIHR) under its Programme Grants
   for Applied Research Programme [RP-PG 0609-10171]; National Institute
   for Health Research [RP-PG-0609-10171, NF-SI-0512-10028] Funding Source:
   researchfish; National Institutes of Health Research (NIHR)
   [RP-PG-0609-10171] Funding Source: National Institutes of Health
   Research (NIHR)
FX This paper presents independent research funded by the National
   Institute for Health Research (NIHR) under its Programme Grants for
   Applied Research Programme (Grant Reference Number RP-PG 0609-10171).
   The views expressed in this paper are those of the authors and not
   necessarily those of the NHS, the NIHR or the Department of Health.
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NR 24
TC 31
Z9 34
U1 0
U2 6
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0965-206X
J9 J TISSUE VIABILITY
JI J. Viab.
PD MAY
PY 2017
VL 26
IS 2
BP 103
EP 107
DI 10.1016/j.jtv.2016.12.004
PG 5
WC Dermatology; Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Dermatology; Nursing
GA EW0YA
UT WOS:000402215900004
PM 28049612
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Grauhan, O
   Navasardyan, A
   Hofmann, M
   Müller, P
   Stein, J
   Hetzer, R
AF Grauhan, Onnen
   Navasardyan, Artashes
   Hofmann, Michael
   Mueller, Peter
   Stein, Julia
   Hetzer, Roland
TI Prevention of poststernotomy wound infections in obese patients by
   negative pressure wound therapy
SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
LA English
DT Article
ID OPEN-HEART-SURGERY; CARDIAC-SURGERY; POSTOPERATIVE MEDIASTINITIS;
   SURGICAL INCISIONS; DEHISCENCE; MANAGEMENT; STERNOTOMY; DEEP
AB Objective: The majority of wound infections after median sternotomy in obese patients are triggered by the breakdown of skin sutures and subsequent seepage of skin flora. The purpose of this study was to evaluate negative pressure wound dressing treatment for the prevention of infection. We hypothesized that negative pressure wound dressing treatment for 6 to 7 days applied immediately after skin closure reduces the numbers of wound infections.
   Methods: In a prospective study, 150 consecutive obese patients (body mass index >= 30) with cardiac surgery performed via median sternotomy were analyzed. In the negative pressure wound dressing treatment group (n = 75), a foam dressing (Prevena, KCI, Wiesbaden, Germany) was placed immediately after skin suturing, and negative pressure of-125 mm Hg was applied for 6 to 7 days. In the control group (n = 75), conventional wound dressings were used. The primary end point was wound infection within 90 days. Mann-Whitney U test and Fisher exact test were used. Freedom from infection was estimated by Kaplan-Meier analysis.
   Results: Three of 75 patients (4%) with continuous negative pressure wound dressing treatment had wound infections compared with 12 of 75 patients (16%) with conventional sterile wound dressing (P = .0266; odds ratio, 4.57; 95% confidence interval, 1.23-16.94). Wound infections with Gram-positive skin flora were found in only 1 patient in the negative pressure wound dressing treatment group compared with 10 patients in the control group (P = .0090; odds ratio, 11.39; 95% confidence interval, 1.42-91.36).
   Conclusions: Negative pressure wound dressing treatment over clean, closed incisions for the first 6 to 7 postoperative days significantly reduces the incidence of wound infection after median sternotomy in a high-risk group of obese patients. (J Thorac Cardiovasc Surg 2013; 145:1387-92)
C1 [Grauhan, Onnen; Navasardyan, Artashes; Hofmann, Michael; Mueller, Peter; Stein, Julia; Hetzer, Roland] Deutsch Herzzentrum Berlin, Dept Cardiothorac & Vasc Surg, D-13353 Berlin, Germany.
C3 German Heart Center Berlin
RP Grauhan, O (通讯作者)，Deutsch Herzzentrum Berlin, Augustenburger Pl 1, D-13353 Berlin, Germany.
EM grauhan@dhzb.de
CR [Anonymous], EPIDEMIOLOGY
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NR 22
TC 147
Z9 173
U1 0
U2 16
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0022-5223
EI 1097-685X
J9 J THORAC CARDIOV SUR
JI J. Thorac. Cardiovasc. Surg.
PD MAY
PY 2013
VL 145
IS 5
BP 1387
EP 1392
DI 10.1016/j.jtcvs.2012.09.040
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 129LJ
UT WOS:000317840600038
PM 23111014
OA Bronze
DA 2026-07-24
ER

PT J
AU Schneiter, D
   Grodzki, T
   Lardinois, D
   Kestenholz, PB
   Wojcik, J
   Kubisa, B
   Pierog, J
   Weder, W
AF Schneiter, Didier
   Grodzki, Tomasz
   Lardinois, Didier
   Kestenholz, Peter B.
   Wojcik, Janusz
   Kubisa, Bartosz
   Pierog, Jaroslaw
   Weder, Walter
TI Accelerated treatment of postpneumonectomy empyema: A binational
   long-term study
SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
LA English
DT Article; Proceedings Paper
CT 87th Annual Meeting of the American-Association-for-Thoracic-Surgery
CY MAY 05-09, 2007
CL Washington, DC
SP Amer Assoc Thorac Surg
ID BRONCHOPLEURAL FISTULA; CLAGETT PROCEDURE; MANAGEMENT; IRRIGATION;
   CLOSURE
AB Objective: Postpneumonectomy empyema remains a clinical challenge. We proposed an accelerated therapy without an open chest window 5 years ago. This concept was evaluated on a larger scale in 2 centers in 2 different countries.
   Methods: Between July 1995 and October 2005, 75 consecutive patients with postpneumonectomy empyema were treated in Szczecin, Poland ( n = 35), and Zurich, Switzerland ( n 5 40). The therapy consisted of repeated open surgical debridement of the pleural cavity after achievement of general anesthesia, a negative pressure wound therapy of the temporarily closed chest cavity filled with povidone-iodine soaked towels, and continuous suction and systemic antimicrobial therapy. If present, bronchopleural fistulae were closed and reinforced either with a muscle flap or the omentum. Finally, the pleural space was filled with an antibiotic solution and definitively closed.
   Results: Of 75 patients ( 63 men; median age, 59 years; age range, 19 - 82 years), postpneumonectomy empyema was present on the right in 46 patients ( 32 with bronchopleural fistula) and in 29 patients ( 12 with bronchopleural fistula) on the left. Median time between pneumonectomy and postpneumonectomy empyema was 131 days ( range, 7 - 7200 days). Bronchopleural fistulae have been closed and additionally reinforced by means of different methods ( omentum, 18; muscle, 11; pericardial fat, 5; azygos vein, 1). The chest was definitively closed within 8 days in 94.6% of patients. The median hospitalization time was 18 days ( range, 9 - 134 days). Postpneumonectomy empyema was successfully treated in 97.3% of patients, including 10 ( 13%) patients who needed a second treatment cycle. Three ( 4%) patients died within 90 days. The median follow-up time was 29.5 moths ( range, 3 - 107 months).
   Conclusions: Treatment of postpneumonectomy empyema with the accelerated treatment is effective and safe. Our results are superior compared with those in reported series using a ( temporary) chest fenestration. Patients appreciate the physical integrity of the chest.
C1 [Weder, Walter] Univ Zurich Hosp, Div Thorac Surg, CH-8091 Zurich, Switzerland.
   [Grodzki, Tomasz; Wojcik, Janusz; Kubisa, Bartosz; Pierog, Jaroslaw] Pomeranian Med Univ, Szczecin Zdunowo, Poland.
C3 University of Zurich; University Zurich Hospital; Pomeranian Medical
   University
RP Weder, W (通讯作者)，Univ Zurich Hosp, Div Thorac Surg, CH-8091 Zurich, Switzerland.
EM walter.weder@usz.ch
RI Wójcik, Janusz/HNI-1040-2023
OI Kubisa, Bartosz/0000-0003-1226-7020
CR Abbas AE, 2002, CURR OPIN PULM MED, V8, P327, DOI 10.1097/00063198-200207000-00015
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NR 19
TC 65
Z9 73
U1 0
U2 5
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0022-5223
J9 J THORAC CARDIOV SUR
JI J. Thorac. Cardiovasc. Surg.
PD JUL
PY 2008
VL 136
IS 1
BP 179
EP 185
DI 10.1016/j.jtcvs.2008.01.036
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 322OT
UT WOS:000257385900026
PM 18603072
OA Bronze
DA 2026-07-24
ER

PT J
AU Vidiscák, M
   Hajská, M
   Dubovsky, M
   Peter, Z
   Panyko, A
AF Vidiscak, Marian
   Hajska, Marianna
   Dubovsky, Martin
   Peter, Zahorec
   Panyko, Arpad
TI Negative Pressure Wound Therapy with Instillation in Polymorbid Surgical
   Patients: A Retrospective Single-Centre Analysis
SO BRATISLAVA MEDICAL JOURNAL
LA English
DT Article
DE Negative pressure; Instillation; Efficacy; Wound treatment
ID RECOMMENDATIONS
AB BackgroundNegative pressure wound therapy with instillation (NPWTi) represents an advanced wound management modality that combines the mechanical effects of negative pressure with cyclic instillation of topical solutions. Although its efficacy has been demonstrated in selected indications, clinical experience from general surgery departments remains limited.AimTo describe clinical experience with NPWTi in a general surgery setting, assess its effectiveness, and evaluate the potential association between treatment failure and patient multimorbidity.MethodsA retrospective single-centre analysis was conducted in 15 adult patients treated with NPWTi between 2021 and 2025. NPWTi was applied using the 3M (TM) V.A.C. Ulta Therapy Unit with four instillation cycles per day and a 15-min dwell time, employing an electrochemically activated mineral salt solution. Demographic data, wound characteristics, treatment parameters, comorbidities, and laboratory markers were analysed. Treatment was assessed as successful, in the case of wound cleanse and healing promotion, that enabled subsequent wound reconstruction, all other outcomes were classified as failure. Associations between treatment outcomes and comorbidities, including multimorbidity, were evaluated by statistical analysis.ResultsThe mean patient age was 64.3 +/- 13.5 years. Overall treatment success was achieved in 11 patients (73%), while treatment failure occurred in 4 patients (27%). NPWTi was most used for abscesses, postoperative wound dehiscence, and diabetic foot syndrome with gangrene. Cardiovascular disease, diabetes mellitus, and obesity were highly prevalent. Multimorbidity was present in 14 patients. No statistically significant association was observed between multimorbidity and NPWTi treatment outcome (p = 1.00).ConclusionIn this cohort of predominantly elderly and polymorbid patients, NPWTi demonstrated a high success rate and appeared effective across a broad spectrum of complex surgical wounds. These findings support NPWTi as a valuable adjunctive therapy in high-risk patient populations, although larger prospective studies are required to further define its role and optimal indications.
C1 [Vidiscak, Marian; Hajska, Marianna; Dubovsky, Martin; Panyko, Arpad] Comenius Univ, Fac Med, Dept Surg 4, Bratislava, Slovakia.
   [Peter, Zahorec] Comenius Univ, Fac Med, Dept Burns & Reconstruct Surg, Bratislava, Slovakia.
C3 Comenius University Bratislava; Comenius University Bratislava
RP Hajská, M (通讯作者)，Comenius Univ, Fac Med, Dept Surg 4, Bratislava, Slovakia.
EM marianna.hajska@fmed.uniba.sk
RI Panyko, Arpád/AAQ-6309-2020; Vidiscak, Marian/AAZ-6765-2021
OI Hajská, Marianna/0000-0002-0822-8929
FU Comenius University in Bratislava
FX Open access funding provided by The Ministry of Education, Science,
   Research and Sport of the Slovak Republic in cooperation with Centre for
   Scientific and Technical Information of the Slovak Republic
CR Acosta S., 2025, INT WOUND J, V22, DOI 10.1111/iwj.70791
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   Back DA, 2013, INT WOUND J, V10, P32, DOI 10.1111/iwj.12183
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   Bernatchez SF., 2024, ADV WOUND CARE, V13, P5
   Dalla Paola L, 2013, INT WOUND J, V10, P25, DOI 10.1111/iwj.12174
   De Pellegrin L, 2025, J CLIN MED, V14, DOI [10.3390/jcm14082730, 10.3390/jcm14082730]
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NR 21
TC 0
Z9 0
U1 0
U2 0
PU SPRINGERNATURE
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON, N1 9XW, ENGLAND
SN 0006-9248
EI 1336-0345
J9 BRATISL MED J
JI Bratisl. Med. J.
PD MAY
PY 2026
VL 127
IS 5
BP 1949
EP 1955
DI 10.1007/s44411-026-00569-3
EA MAR 2026
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA GQ9TD
UT WOS:001712571400001
OA gold
DA 2026-07-24
ER

PT J
AU Lewandowski, LR
   Potter, BK
   Murray, CK
   Petfield, J
   Stinner, DJ
   Krauss, M
   Weintrob, AC
   Tribble, DR
   Ganesan, A
   Warkentien, T
   Hsu, JR
   Fraser, J
   Bennett, D
   McClung, A
   Bradley, W
   Greenberg, L
   Xu, JH
AF Lewandowski, Louis R.
   Potter, Benjamin K.
   Murray, Clinton K.
   Petfield, Joseph
   Stinner, Daniel J.
   Krauss, Margot
   Weintrob, Amy C.
   Tribble, David R.
   Ganesan, Anuradha
   Warkentien, Tyler
   Hsu, Joseph R.
   Fraser, Jamie
   Bennett, Denise
   McClung, Adriana
   Bradley, William
   Greenberg, Lauren
   Xu, Jiahong
CA Trauma Infect Dis Outcomes Study G
TI Osteomyelitis Risk Factors Related to Combat Trauma Open Femur
   Fractures: A Case-Control Analysis
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE osteomyelitis; open fractures; femur; combat-related trauma;
   trauma-related infections
ID FEMORAL-SHAFT FRACTURES; OPERATION IRAQI FREEDOM; PRESSURE WOUND
   THERAPY; INFECTIOUS COMPLICATIONS; PROSPECTIVE COHORT; TIBIAL FRACTURES;
   DEEP INFECTION; WAR INJURIES; MANAGEMENT; CLASSIFICATION
AB Objectives: To identify the risk factors for osteomyelitis development in US military personnel with combat-related, open femur fractures? Design: Retrospective observational case-control study. Setting: US military regional hospital in Germany and tertiary care hospitals in United States (2003-2009). Patients/Participants: One hundred three patients with open femur fractures who met diagnostic osteomyelitis criteria (medical record review verification) were classified as cases. Sixty-four patients with open femur fractures who did not meet osteomyelitis diagnostic criteria were included as controls. Main Outcome Measurements: The main outcome measurements were multivariable odds ratios (ORs) and 95% confidence interval (CI). Results: Among patients with surgical implants, osteomyelitis cases had significantly longer time to definitive orthopaedic surgery compared with controls (median: 21 vs. 13 days). Independent predictors for osteomyelitis risk were Gustilo-Anderson classification (transfemoral amputation OR: 19.3; CI: 3.0-123.0) and Orthopaedic Trauma Association Open Fracture Classification for muscle loss (OR: 5.7; CI: 1.3-25.1) and dead muscle (OR: 32.9; CI: 5.4-199.1). Being injured between 2003 and 2006, antibiotic bead use, and foreign body plus implant(s) at fracture site were also risk factors. Conclusions: Patients with open femur fractures resulting in significant muscle damage have the highest osteomyelitis risk. Foreign body contamination was only significant when an implant was present. Increased risk with antibiotic bead use is likely a surrogate for clinical suspicion of contamination with complex wounds. The timeframe association is likely due to changing trauma system patterns around 2006-2007 (eg, increased negative pressure wound therapy, reduced high-pressure irrigation, decreased crystalloid use, and delayed definitive internal fixations).
C1 [Lewandowski, Louis R.; Potter, Benjamin K.] Uniformed Serv Univ Hlth Sci, Walter Reed Natl Mil Med Ctr, Dept Surg, Bethesda, MD 20814 USA.
   [Lewandowski, Louis R.] US Naval Hosp, Dept Orthopaed, Ginowan, Okinawa, Japan.
   [Murray, Clinton K.; Petfield, Joseph; Stinner, Daniel J.] Brooke Army Med Ctr, JBSA Ft Sam Houston, San Antonio, TX USA.
   [Krauss, Margot] Westat Corp, Rockville, MD USA.
   [Weintrob, Amy C.; Tribble, David R.] Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biostat, Infect Dis Clin Res Program, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA.
   [Weintrob, Amy C.] Henry M Jackson Fdn Adv Mil Med Inc, Bethesda, MD USA.
   [Weintrob, Amy C.] Walter Reed Natl Mil Med Ctr, Infect Dis, Bethesda, MD USA.
C3 Uniformed Services University of the Health Sciences - USA; Walter Reed
   National Military Medical Center; United States Department of Defense;
   United States Army; Brooke Army Medical Center; Westat; Uniformed
   Services University of the Health Sciences - USA; Henry M. Jackson
   Foundation for the Advancement of Military Medicine, Inc; Walter Reed
   National Military Medical Center
RP Tribble, DR (通讯作者)，Uniformed Serv Univ Hlth Sci, Dept Prevent Med & Biostat, Infect Dis Clin Res Program, 4301 Jones Bridge Rd, Bethesda, MD 20814 USA.
EM David.Tribble@usuhs.edu
RI Potter, Benjamin/U-1769-2019; Stinner, Daniel/KSM-9513-2024
OI Petfield, Joseph/0000-0002-4488-1247; Hsu, Joseph/0000-0001-9341-2554;
   Stinner, Daniel/0000-0002-8981-6262
FU Infectious Disease Clinical Research Program, a DoD program through the
   Uniformed Services University of the Health Sciences, Department of
   Preventive Medicine and Biostatistics; National Institute of Allergy and
   Infectious Diseases, National Institutes of Health [Y1-AI-5072];
   Department of the Navy under the Wounded, Ill, and Injured Program
FX Supported by the Infectious Disease Clinical Research Program, a DoD
   program executed through the Uniformed Services University of the Health
   Sciences, Department of Preventive Medicine and Biostatistics. This
   project is funded by the National Institute of Allergy and Infectious
   Diseases, National Institutes of Health, under Inter-Agency Agreement
   Y1-AI-5072, and Department of the Navy under the Wounded, Ill, and
   Injured Program.
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   2004, J BONE JOINT SURG BR, V86, P556, DOI DOI 10.1302/0301-620X.86B4.14097
NR 64
TC 8
Z9 12
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0890-5339
EI 1531-2291
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD APR
PY 2019
VL 33
IS 4
BP E110
EP E119
DI 10.1097/BOT.0000000000001397
PG 10
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA HY0MQ
UT WOS:000467806500001
PM 30570616
DA 2026-07-24
ER

PT J
AU Guo, XS
   Mu, DL
   Gao, FQ
AF Guo, Xiaoshuang
   Mu, Dali
   Gao, Fuqiang
TI Efficacy and safety of acellular dermal matrix in diabetic foot ulcer
   treatment: A systematic review and meta-analysis
SO INTERNATIONAL JOURNAL OF SURGERY
LA English
DT Review
DE Diabetic foot ulcer; Acellular matrix; Standard of care; Meta-analysis;
   Randomized controlled trial
ID REGENERATIVE TISSUE MATRIX; CLINICAL-TRIAL; MULTICENTER; TEMPLATE; SKIN;
   MANAGEMENT
AB Background: Diabetic foot ulcer(DFU) is a chronic, refractory disease in need of multidisciplinary endeavour, miscellaneous strategies have been adopted to address this annoying issue, including acellular dermal matrix(ADM)/negative pressure wound therapy/standard of care (SOC) etc. However, consensus has not been reached. As a promising procedure, the efficacy and safety of ADM remains controversial. We therefore performed a meta-analysis of randomized controlled trials (RCTs) to compare the efficacy and safety of acellular dermal matrix to standard of care in DFU.
   Methods: Databases, including Pubmed, Medline, Embase and Cochrane library were searched to identify RCTs comparing ADM to SOC in DFU patients. The outcomes mainly included complete wound healing, mean time to heal and adverse events.
   Results: A total of 632 DFU patients from 6 RCTs were subjected to meta-analysis. The results showed that compared with the merely SOC, the complete healing rate in ADM group was higher both at 12 weeks [risk ratio (RR) 2.31, 95% confidence interval (CI) 1.42 to 3.76] and 16 weeks [RR 1.57, 95% CI 1.28 to 1.93]. The mean time to complete wound healing was shorter in ADM group [MD = -2.98, 95% CI: -5.15 to -0.82]. The occurrence of adverse event in both groups showed no significant difference [RR 0.98, 95% CI 0.58 to 1.67].
   Conclusion: Compared with standard of care, acellular dermal matrix may accelerate the healing velocity of uninfected, non-ischemic, full-thickness diabetic foot ulcer. Acellular dermal matrix showed superiority compared with standard of care alone, while generating no more complications. (C) 2017 IJS Publishing Group Ltd. Published by Elsevier Ltd. All rights reserved.
C1 [Guo, Xiaoshuang; Mu, Dali] Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Breast Plast & Reconstruct Surg Ctr, 33 Badachu Rd, Beijing 100144, Peoples R China.
   [Guo, Xiaoshuang; Mu, Dali] Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Inst, 33 Badachu Rd, Beijing 100144, Peoples R China.
   [Gao, Fuqiang] China Japan Friendship Hosp, Dept Orthoped Surg, 2 Yinghua Dongjie Rd, Beijing 100029, Peoples R China.
C3 Chinese Academy of Medical Sciences - Peking Union Medical College;
   Plastic Surgery Hospital - CAMS; Peking Union Medical College; Chinese
   Academy of Medical Sciences - Peking Union Medical College; Plastic
   Surgery Hospital - CAMS; Peking Union Medical College; China-Japan
   Friendship Hospital
RP Mu, DL (通讯作者)，Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Breast Plast & Reconstruct Surg Ctr, 33 Badachu Rd, Beijing 100144, Peoples R China.; Mu, DL (通讯作者)，Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Inst, 33 Badachu Rd, Beijing 100144, Peoples R China.
EM gxsinjnu@126.com; doctormu2015@163.com; gaofuqiang@bjmu.edu.cn
OI Mu, Dali/0000-0002-8062-4504
CR [Anonymous], INT WOUND J
   [Anonymous], INT WOUND J
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NR 39
TC 65
Z9 74
U1 0
U2 26
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 1743-9191
EI 1743-9159
J9 INT J SURG
JI Int. J. Surg.
PD AUG
PY 2017
VL 40
BP 1
EP 7
DI 10.1016/j.ijsu.2017.02.008
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA EW4QQ
UT WOS:000402486400001
PM 28232031
DA 2026-07-24
ER

PT J
AU Sivash, I
   Koval, B
AF Sivash, Iurii
   Koval, Boris
TI NPWT in combat-related extremity vascular injuries: a case series and
   safety algorithm
SO BMJ MILITARY HEALTH
LA English
DT Article; Early Access
DE TRAUMA MANAGEMENT; Combat Disorders; WOUND MANAGEMENT; SURGERY; Vascular
   surgery; Trauma management
ID PRESSURE WOUND THERAPY; MANAGEMENT; MILITARY; CLOSURE; IRAQ
AB Introduction Combat extremity vascular injuries are frequently associated with extensive soft-tissue loss and contamination, increasing the risk of infection, graft thrombosis and erosion-related bleeding (ERB). Negative pressure wound therapy (NPWT) is widely used to manage complex combat wounds, but evidence regarding its use after vascular reconstruction remains limited.Methods We retrospectively analysed 69 patients with combat-related vascular injuries who underwent NPWT at a Role IV (Echelon of Care in the Military Medical System) facility in Ukraine during 2022. NPWT applications were categorised into two predefined groups: an interface group-NPWT applied adjacent to exposed vascular reconstructions using a protective multilayer system (n=28); and a covered group-NPWT applied over established soft-tissue or muscle flap coverage (n=41). Outcomes included ERB, graft thrombosis, infectious complications and limb loss. NPWT was applied as part of staged wound management following debridement and revascularisation.Results ERB occurred exclusively in the interface group (9/28, 32.1%) and was not observed in the covered group (0/41). ERB events were observed only prior to stable soft-tissue or flap coverage. Graft thrombosis (14.3% vs 4.9%), wound infection (10.7% vs 2.4%) and secondary amputations (7.1% vs 0%) were more frequent in the interface group. Overall limb salvage was 97.1%. Two ERB risk windows were observed: postoperative days 7-10 (mechanical) and 18-30 (infection-related).Conclusions NPWT may be incorporated into staged wound management following combat-related extremity vascular reconstruction; however, outcomes differed according to the soft-tissue coverage strategy employed. Application of NPWT near exposed vascular repairs was associated with a higher ERB rate and should be considered a short-term temporising strategy when immediate definitive coverage is not feasible, and only within a controlled Role IV environment. Early definitive soft-tissue or muscle coverage remains the preferred protective strategy whenever feasible.
C1 [Sivash, Iurii; Koval, Boris] Bogomolets Natl Med Univ, Kiev, Ukraine.
   [Sivash, Iurii; Koval, Boris] Main Mil Clin Hosp, Natl Mil Med Clin Ctr, Dept Vasc Surg, Kiev, Ukraine.
C3 Bogomolets National Medical University
RP Sivash, I (通讯作者)，Bogomolets Natl Med Univ, Kiev, Ukraine.; Sivash, I (通讯作者)，Main Mil Clin Hosp, Natl Mil Med Clin Ctr, Dept Vasc Surg, Kiev, Ukraine.
EM y.sivash@gmail.com; kovalboris@gmail.com
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NR 30
TC 0
Z9 0
U1 0
U2 0
PU BMJ PUBLISHING GROUP
PI LONDON
PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
SN 2633-3767
EI 2633-3775
J9 BMJ MILITARY HEALTH
JI BMJ Military Health
PD 2026 MAR 25
PY 2026
DI 10.1136/military-2025-003192
EA MAR 2026
PG 8
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA FV1LT
UT WOS:001728132900001
PM 41881513
OA hybrid
DA 2026-07-24
ER

PT J
AU Hayasaka, M
   Landy, HJ
   Forbes, L
   Barger, A
   Gangii, SN
   Saade, G
   Kawakita, T
AF Hayasaka, Misa
   Landy, Helain J.
   Forbes, Lauren
   Barger, Abigail
   Gangii, Salimah Navaz
   Saade, George
   Kawakita, Tetsuya
TI Surgical site infections after cesarean delivery
SO AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY
LA English
DT Review
DE cesarean delivery; surgical site infection; wound complications;
   endometritis; necrotizing soft tissue infection
ID ADJUNCTIVE AZITHROMYCIN PROPHYLAXIS; SOFT-TISSUE INFECTIONS; PRESSURE
   WOUND THERAPY; SAFETY CHECKLIST; RISK-FACTORS; POSTPARTUM ENDOMETRITIS;
   ANTIBIOTIC-THERAPY; DISEASES SOCIETY; EXTREME OBESITY; UNITED-STATES
AB Surgical site infections represent a persistent and clinically relevant complication of cesarean delivery, contributing substantially to postpartum morbidity, hospital readmission, and pregnancy-related mortality. As cesarean delivery has escalated to the most common major operation worldwide-now comprising 21% of global births and 32% in the United States-the burden of postcesarean surgical site infections, reported in 3% to 15% of cases, remains unacceptably high despite advances in perioperative antisepsis, antibiotic prophylaxis, and prevention bundles. This review provides an updated comprehensive overview of postcesarean SSIs, including their definitions, risk factors, microbiology, clinical presentation, evaluation, prevention strategies, and management. Postcesarean surgical site infections are classified as superficial incisional, deep incisional, organ/space infections such as postpartum endometritis, and necrotizing soft tissue infections. The microbiologic spectrum varies by infection type and includes both monomicrobial and polymicrobial pathogens. Clinical presentations range from localized incisional symptoms to systemic signs, with necrotizing soft tissue infections requiring urgent recognition due to their aggressive clinical course and high mortality. Key risk factors include prolonged rupture of membranes, labor, higher body mass index, intraamniotic infection, and longer operative time. Prevention necessitates a multifaceted approach. In the preoperative phase, interventions include patient preparation and operative field antisepsis. Intraoperative strategies focus on surgical technique. Postoperative care centers on appropriate antibiotic prophylaxis and wound management. For established surgical site infections, the cornerstone of management is timely incision and drainage. Meticulous wound care, often involving serial dressing changes or negative pressure wound therapy, supports appropriate healing. Targeted antibiotic therapy is initiated when systemic signs or extensive local findings are present and is tailored to the specific clinical scenario. Addressing surgical site infections associated with cesarean delivery requires a comprehensive, multidisciplinary, and evidence-based approach. A sustained commitment to optimizing and implementing refined protocols is imperative to improve maternal infectious outcomes.
C1 [Hayasaka, Misa; Forbes, Lauren; Barger, Abigail; Gangii, Salimah Navaz; Saade, George; Kawakita, Tetsuya] Old Dominion Univ ODU, Dept Obstet & Gynecol, Macon & Joan Brock Virginia Hlth Sci, Norfolk, VA 23529 USA.
   [Landy, Helain J.] MedStar Georgetown Univ Hosp, Obstet & Gynecol, Washington, DC USA.
C3 Georgetown University
RP Kawakita, T (通讯作者)，Old Dominion Univ ODU, Dept Obstet & Gynecol, Macon & Joan Brock Virginia Hlth Sci, Norfolk, VA 23529 USA.
EM tetsuya.x.kawakita@gmail.com
RI Kawakita, Tetsuya/H-7559-2019; Landy, Helain/AAC-4016-2019
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NR 130
TC 0
Z9 0
U1 2
U2 2
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0002-9378
EI 1097-6868
J9 AM J OBSTET GYNECOL
JI Am. J. Obstet. Gynecol.
PD JAN
PY 2026
VL 233
IS 6
SU S
BP S524
EP S540
DI 10.1016/j.ajog.2025.08.008
EA JAN 2026
PG 17
WC Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Obstetrics & Gynecology
GA CT0IE
UT WOS:001673733000022
PM 41485839
OA Bronze
DA 2026-07-24
ER

PT J
AU Petric, M
   Plevel, D
   Trsan, U
   Trotovsek, B
AF Petric, Miha
   Plevel, Danaja
   Trsan, Uros
   Trotovsek, Blaz
TI A Decade-Long Case Series Report on the Surgical Management of
   Complicated Umbilical Hernia in Patients with Decompensated Liver
   Cirrhosis Utilizing Incisional Negative Pressure Therapy
SO MEDICINA-LITHUANIA
LA English
DT Article
DE complicated umbilical hernia; liver cirrhosis; incisional negative
   pressure therapy
ID MELD; MORTALITY; REPAIR; MODEL
AB Background and Objectives. Umbilical hernia is particularly common among patients with liver cirrhosis, affecting about 20% of this group, compared to 3-8.5% in healthy individuals. This increased prevalence is mainly due to weakened abdominal fascia, elevated intra-abdominal pressure, and malnutrition. The rapid progression of umbilical hernias often leads to complications such as skin necrosis, perforation, and strangulation. Historically, patients with liver cirrhosis and complicated umbilical hernia have faced high morbidity and mortality rates. However, recent advancements in perioperative management, especially in controlling ascites, have improved outcomes in elective treatments. Despite these advancements, managing patients with decompensated liver cirrhosis and complicated umbilical hernia in emergency settings remain a significant surgical challenge. Materials and Methods: We conducted a retrospective review of patients treated for complicated umbilical hernia at the University Medical Centre Ljubljana from 2015 to 2024, using prospectively collected data. This analysis involved implementing hernioplasty combined with incisional negative pressure wound therapy (iNPWT) as part of the surgical protocol. The primary endpoint of our study was the rate of local complications, while the secondary endpoints included the rate of systemic complications and 90-day mortality. Results: We treated 28 consecutive patients with complicated umbilical hernia and liver cirrhosis. Local wound complications were observed in three (10.7%) patients. Systemic complications developed in 10 patients (35.7%). The median duration of hospitalization was 8 days (range: 5-29), and no readmissions were recorded within the 30-day period. Two (7.1%) patients died within 90 days. Conclusions: Our experience indicates that iNPWT, when combined with surgical repair, can be safely utilized, yielding outcomes comparable to elective hernia repairs, even in emergency contexts. Further randomized controlled trials are necessary to validate these findings and optimize treatment protocols.
C1 [Petric, Miha; Plevel, Danaja; Trsan, Uros; Trotovsek, Blaz] Univ Med Ctr Ljubljana, Dept Abdominal Surg, Ljubljana 1000, Slovenia.
   [Petric, Miha; Trotovsek, Blaz] Univ Ljubljana, Med Fac, Ljubljana 1000, Slovenia.
C3 University Medical Centre Ljubljana; University of Ljubljana
RP Petric, M (通讯作者)，Univ Med Ctr Ljubljana, Dept Abdominal Surg, Ljubljana 1000, Slovenia.; Petric, M (通讯作者)，Univ Ljubljana, Med Fac, Ljubljana 1000, Slovenia.
EM miha.petric@kclj.si; danaja.plevel@kclj.si; uros.trsan@kclj.si;
   blaz.trotovsek@kclj.si
RI Petric, Miha/NMJ-5615-2025
OI Petric, Miha/0000-0002-1002-4853
CR Adiamah A, 2024, HERNIA, V28, P109, DOI 10.1007/s10029-023-02898-6
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NR 39
TC 0
Z9 0
U1 0
U2 0
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
SN 1010-660X
EI 1648-9144
J9 MEDICINA-LITHUANIA
JI Med. Lith.
PD JUL 12
PY 2025
VL 61
IS 7
AR 1262
DI 10.3390/medicina61071262
PG 9
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 5HF1R
UT WOS:001535614100001
PM 40731891
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Schulz, SA
   Schaefer, S
   Richards, DC
   Karagiannidis, C
   Thomaidis, P
   Heiss, MM
   Bulian, DR
AF Schulz, Sissy-A.
   Schaefer, Simone
   Richards, Dana C.
   Karagiannidis, Christian
   Thomaidis, Panagiotis
   Heiss, Markus M.
   Bulian, Dirk R.
TI The Need for Emergency Laparotomy With Open Abdomen Therapy in the
   Course of ECMO-A Retrospective Analysis of Course and Outcome
SO FRONTIERS IN SURGERY
LA English
DT Article
DE open abdomen; laparostoma; ECMO; abdominal compartment syndrome; NPWT
ID ABDOMINAL COMPARTMENT SYNDROME; EXTRACORPOREAL MEMBRANE-OXYGENATION;
   INTRAABDOMINAL HYPERTENSION; DECOMPRESSIVE LAPAROTOMY; CLOSURE;
   MANAGEMENT; PATIENT
AB Background:Abdominal compartment syndrome (ACS) can occur in patients placed on extra corporeal membrane oxygenation (ECMO). This implies the necessity of decompressive laparotomy followed by an open abdomen (OA) to prevent complications such as multi-organ-failure or death.
   Methods:We searched for ECMO patients in our hospital database between July 2015 and April 2020 and selected those with an emergency laparotomy and OA therapy. Of these, we analyzed only patients who were treated with an OA after establishing the ECMO regarding patient-related parameters like sex, age, height, weight, and indications for ECMO as well as outcome parameters like complete fascial closure rate, mortality, length of stay in intensive care unit (ICU), length and kind of OA therapy, number of surgical procedures, dressing changes concerning negative pressure wound therapy (NPWT), and number of surgical revisions.
   Results:In eight out of 421 patients (1.9%), a laparostoma had to be created during ECMO support. For temporary closure, either NPWT, abdominal packing, or both were used. The median length of OA therapy was 17 days, and the median length of stay in ICU was 42 days in total. The median number of surgical procedures and NPWT dressing changes was seven. In three of the eight patients, a surgical revision was necessary. The total mortality rate was 50%. In 75%, the fascia could be closed. Two patients died before final closure. In all deceased patients, an abdominal packing was necessary during the course of treatment; in the survivors, only once. No enteroatmospheric fistula or abscesses occurred.
   Conclusions:ACS in patients placed on ECMO is a very rare condition with a considerable mortality rate but high secondary closure rate of the fascia. A necessary abdominal packing due to a severe bleeding seems to be a risk factor with a potentially fatal outcome.
C1 [Schulz, Sissy-A.; Richards, Dana C.; Thomaidis, Panagiotis; Heiss, Markus M.; Bulian, Dirk R.] Witten Herdecke Univ, Cologne Merheim Med Ctr CMMC, Dept Abdominal Tumor Transplant & Vasc Surg, Cologne, Germany.
   [Schaefer, Simone; Karagiannidis, Christian] Witten Herdecke Univ, Cologne Merheim Med Ctr CMMC, ARDS & ECMO Ctr, Dept Pneumol & Crit Care Med, Cologne, Germany.
RP Bulian, DR (通讯作者)，Witten Herdecke Univ, Cologne Merheim Med Ctr CMMC, Dept Abdominal Tumor Transplant & Vasc Surg, Cologne, Germany.
EM dirk.bulian@uni-wh.de
RI Bulian, Dirk Rolf/GQY-7923-2022; Karagiannidis, M.D, Pr.
   Christian/PFI-9363-2025
OI Bulian, Dirk Rolf/0000-0002-1311-7326; Karagiannidis, M.D, Pr.
   Christian/0000-0003-3247-2849
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NR 25
TC 8
Z9 8
U1 0
U2 3
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD SEP 4
PY 2020
VL 7
AR 63
DI 10.3389/fsurg.2020.00063
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA NU7JV
UT WOS:000573817300001
PM 33102513
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Palomar-Albert, D
   Zamora-Ortiz, J
   Palomar-Llatas, F
   Escudero-Martínez, M
   Naranjo-Cuellar, A
   Pastor-Orduña, MI
AF Palomar-Albert, David
   Zamora-Ortiz, Jorge
   Palomar-Llatas, Federico
   Escudero-Martinez, Marta
   Naranjo-Cuellar, Alba
   Pastor-Orduna, Maria Isabel
TI Longitudinal Observational Study on Quality of Life in Patients with
   Chronic Wounds Using DLQI and EQ-5D
SO MEDICINA-LITHUANIA
LA English
DT Article
DE chronic wounds; quality of life; DLQI; EQ-5D; longitudinal study; wound
   treatment; observational study; patient-centered care; venous ulcers
ID LEG ULCERS; GUIDELINES
AB Background and Objectives: Chronic wounds severely impair patients' quality of life (QoL), impacting physical, emotional, and functional well-being. Understanding the multidimensional effects of treatment is key to implementing effective, patient-centered care strategies. This study aimed to assess changes in QoL among patients with chronic wounds using the Dermatology Life Quality Index (DLQI) and EuroQol-5D (EQ-5D), comparing outcomes across treatment modalities. Materials and Methods: A longitudinal observational study was conducted between 2019 and 2024 across three hospitals in the Valencian Community. A total of 278 patients with venous lower-limb ulcers of more than six weeks' duration were included. Quality-of-life assessments were performed at baseline, one-month follow-up, and discharge. Treatments included alginate, foam, moist wound healing (MWH), compression therapy, and negative-pressure wound therapy (NPWT). Statistical analysis involved Friedman's test and repeated-measures ANOVA. Results: Significant improvements were observed in overall QoL across most treatment modalities. EQ-5D scores progressively increased, while DLQI scores decreased. Pain, embarrassment, and limitations in daily life (e.g., shopping and social activities) showed marked reductions. MWH and foam demonstrated the most favorable impact on QoL, while NPWT showed more modest improvements, possibly due to patient complexity. Notably, the variable "sexuality" remained unchanged (mean = 0.00), possibly due to underreporting or communication barriers. Conclusions: Chronic wound treatments significantly improve patients' quality of life, particularly in terms of pain and social functioning. The use of combined tools (DLQI and EQ-5D) allows for a more comprehensive understanding of these outcomes. These findings highlight the importance of tailoring wound care to individual needs and addressing psychosocial domains, including sexuality. Community nursing, nutritional support, and long-term follow-up should be incorporated into care plans to optimize results, especially in older adults.
C1 [Palomar-Albert, David; Palomar-Llatas, Federico; Escudero-Martinez, Marta; Naranjo-Cuellar, Alba; Pastor-Orduna, Maria Isabel] Catholic Univ Valencia SanVicente Martir, Integr & Skin Care, Integr & Skin Care Res Grp, Valencia 46001, Spain.
   [Zamora-Ortiz, Jorge] Valencia Gen Hosp Dept, Ulcers Unit, Valencia 46014, Spain.
   [Pastor-Orduna, Maria Isabel] Catholic Univ Valencia San Vicente Martir, Doctoral Sch, Valencia 46001, Spain.
   [Pastor-Orduna, Maria Isabel] Sagunto Hosp, Adv Nursing Unit Rheumatol & Rehabil, Sagunto 46500, Spain.
C3 Universidad Catolica de Valencia San Vicente Martir
RP Pastor-Orduña, MI (通讯作者)，Catholic Univ Valencia SanVicente Martir, Integr & Skin Care, Integr & Skin Care Res Grp, Valencia 46001, Spain.; Pastor-Orduña, MI (通讯作者)，Catholic Univ Valencia San Vicente Martir, Doctoral Sch, Valencia 46001, Spain.; Pastor-Orduña, MI (通讯作者)，Sagunto Hosp, Adv Nursing Unit Rheumatol & Rehabil, Sagunto 46500, Spain.
EM david.palomar@ucv.es; jorzaor@gmail.com; federico.palomar@ucv.es;
   marta.escudero@ucv.es; albanaranjo_89@hotmail.com; pastor_marord@gva.es
OI Pastor-Orduna, Maria-Isabel/0000-0003-4849-5922
CR Augustin M., 2012, Wound Repair Regen, V20, P434
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NR 21
TC 2
Z9 2
U1 1
U2 3
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
SN 1010-660X
EI 1648-9144
J9 MEDICINA-LITHUANIA
JI Med. Lith.
PD MAY 17
PY 2025
VL 61
IS 5
AR 907
DI 10.3390/medicina61050907
PG 12
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 3BR3D
UT WOS:001496501600001
PM 40428865
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Baker, BG
   Pieri, A
AF Baker, Benjamin G.
   Pieri, Andrew
TI Assessment of Patient-Reported Outcomes for Closed-Incision Negative
   Pressure Therapy with Wide-Coverage Dressings in Simple Mastectomy and
   Immediate Implant-Based Breast Reconstruction
SO ADVANCES IN WOUND CARE
LA English
DT Article
DE closed-incision negative pressure wound therapy; mastectomy; oncology
   surgery; seroma
ID QUALITY-OF-LIFE; WOUND THERAPY; KNEE ARTHROPLASTY; CANCER; SCALE; AGE
AB Objective: A new configuration of closed-incision negative pressure therapy (ciNPT) dressings now covers the incision and a broader area of peri-incisional tissues. We have implemented these ciNPT dressings following simple mastectomy (SM) or skin-sparing mastectomy with implant-based reconstruction (IBR). This study assesses patient-reported outcomes of this new protocol. Approach: Patients underwent SM or IBR for breast cancer. ciNPT with wide-coverage dressings were placed over the entire breast, and -125 mmHg was applied for 14 days. Upon dressing removal, patients rated their experience using the Wound-Q (TM) Suction Device Scale and recorded their satisfaction on a Likert scale ranging 1-5. Results: Thirteen SM patients and 12 IBR patients were included in the study. The median age was 62 years, and SM patients were significantly older (p < 0.01). Patients rated the ciNPT device highest on items relating to its function and appearance, and lowest on noise and interference with sleep and physical activity. The overall mean score for the combined cohort was 64.8/100. The mean score for SM patients (74.8 +/- 19.9) was significantly greater than for IBR patients (53.9 +/- 9.6, p < 0.01). The mean overall patient satisfaction rating was 3.92 on a 5-point scale; 4.0 in the SM group and 3.8 in the IBR group. Innovation: This study is the first to report on the patient experience with these newly available wide-coverage ciNPT dressings. Conclusion: Overall, the dressing was well-tolerated by patients, and satisfaction was high. The positive reception of ciNPT with wide-coverage dressings supports continued use at our hospital.
C1 [Baker, Benjamin G.] Manchester Univ NHS Fdn Trust, Manchester, England.
   [Pieri, Andrew] Royal Victoria Infirm, Queen Victoria Rd, Newcastle Upon Tyne NE1 4LP, England.
C3 Manchester University NHS Foundation Trust; Newcastle University - UK
RP Pieri, A (通讯作者)，Royal Victoria Infirm, Queen Victoria Rd, Newcastle Upon Tyne NE1 4LP, England.
EM andrew.pieri@nuth.nhs.uk
CR Ailaney N, 2021, J ARTHROPLASTY, V36, P2402, DOI 10.1016/j.arth.2020.11.039
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NR 22
TC 0
Z9 0
U1 0
U2 2
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 2162-1918
EI 2162-1934
J9 ADV WOUND CARE
JI Adv. Wound Care
PD JUN 1
PY 2025
VL 14
IS 6
BP 279
EP 284
DI 10.1089/wound.2023.0116
EA JUL 2024
PG 6
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 3DA2J
UT WOS:001268871200001
PM 38695108
OA hybrid
DA 2026-07-24
ER

PT J
AU Low, EZ
   Nugent, TS
   O'Sullivan, NJ
   Kavanagh, D
   Larkin, JO
   McCormick, PH
   Mehigan, BJ
   Kelly, ME
AF Low, Ernest Z.
   Nugent, Timothy S.
   O'Sullivan, Niall J.
   Kavanagh, Dara
   Larkin, John O.
   McCormick, Paul H.
   Mehigan, Brian J.
   Kelly, Michael E.
TI Application of PREVENA (Surgical Incision Protection System) in reducing
   surgical site infections following reversal of ileostomy or colostomy:
   the PRIC study protocol
SO INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
LA English
DT Article
DE Reversal surgery; Ileostomy; Colostomy; Colorectal surgery; Negative
   pressure dressings; Surgical site infection; PREVENA therapy
ID PRESSURE WOUND THERAPY; CONVENTIONAL PRIMARY CLOSURE; ANTERIOR
   RESECTION; STOMA REVERSAL; METAANALYSIS; EXPERIENCE; MANAGEMENT; IMPACT
AB Aim There is a current lack of evidence in the literature to support the routine use of negative pressure wound therapy (NPWT) to reduce the risk of surgical site infections (SSI) in the setting of ileostomy or colostomy reversal. The aim of this study is to examine whether routine NPWT confers a lower rate of SSI than conventional dressings following reversal of ileostomy or colostomy. Methods The PRIC study is a randomized, controlled, open-label, multi-centre superiority trial to assess whether routine NPWT following wound closure confers a lower rate of SSI following reversal of ileostomy or colostomy when compared to conventional dressings. Participants will be consecutively identified and recruited. Eligible participants will be randomized in a 1:1 allocation ratio, to receive either the NPWT (PREVENA) dressings or conventional dressings which will be applied immediately upon completion of surgery. PREVENA dressings will remain applied for a duration of 7 days. Surgical wounds will then be examined on post-operative day seven as well as during follow-up appointments in OPD for any evidence of SSI. In the interim, public health nurses (PHN) will provide out-patient support services incorporating wound assessment and care as part of a routine basis. Study investigators will liaise with PHN to gather the relevant data in relation to the time to wound healing. Our primary endpoint is the incidence of SSI within 30 days of stoma reversal. Secondary endpoints include measuring time to wound healing, evaluating wound healing and aesthetics and assessing patient satisfaction. Conclusion The PRIC study will assess whether routine NPWT following wound closure is superior to conventional dressings in the reduction of SSI following reversal of ileostomy or colostomy and ascertain whether routine NPWT should be considered the new standard of care.
C1 [Low, Ernest Z.; Nugent, Timothy S.; Larkin, John O.; McCormick, Paul H.; Mehigan, Brian J.; Kelly, Michael E.] St James Hosp, Dept Colorectal Surg, Trinity Coll Dublin, Dublin, Ireland.
   [O'Sullivan, Niall J.; Kavanagh, Dara] Tallaght Univ Hosp, Dept Colorectal Surg, Dublin, Ireland.
C3 Trinity College Dublin
RP Low, EZ (通讯作者)，St James Hosp, Dept Colorectal Surg, Trinity Coll Dublin, Dublin, Ireland.
EM lowe@tcd.ie
RI Kelly, Michael E/AAF-1917-2021
OI Kelly, Michael E/0000-0002-0757-6411
FU IReL Consortium
FX Open Access funding provided by the IReL Consortium.
CR Acelity.com, 2020, PREVENA TRADE THER
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NR 29
TC 5
Z9 8
U1 2
U2 10
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0179-1958
EI 1432-1262
J9 INT J COLORECTAL DIS
JI Int. J. Colorectal Dis.
PD MAY
PY 2022
VL 37
IS 5
BP 1215
EP 1221
DI 10.1007/s00384-022-04153-3
EA APR 2022
PG 7
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA 0Z8MH
UT WOS:000789000700002
PM 35487978
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Scheuermann-Poley, C
   Wagner, C
   Hoffmann, J
   Moter, A
   Willy, C
AF Scheuermann-Poley, C.
   Wagner, C.
   Hoffmann, J.
   Moter, A.
   Willy, C.
TI The significance of biofilm for the treatment of infections in
   orthopedic surgery. 2017 Update
SO UNFALLCHIRURG
LA German
DT Article
DE Implant-associated infections; Antiseptic agents; Negative pressure
   wound therapy instillation; Debridement; Fluorescence in situ
   hybridization
ID STAPHYLOCOCCUS-EPIDERMIDIS BIOFILM; IN-SITU HYBRIDIZATION; BONE-CEMENT;
   IMPLANT INFECTIONS; PSEUDOMONAS-AERUGINOSA; ANTIMICROBIAL PEPTIDES;
   PERIPROSTHETIC INFECTIONS; BACTERIAL BIOFILMS; INHIBITS BIOFILM; AUREUS
AB Background. The increase in endoprosthetic and osteosynthetic surgical treatment is associated with a simultaneous increase in implant-associated infections (surgical site infections, SSI). Biofilms appear to play a significant role in the diagnosis and treatment of these infections and heavily contaminated wounds. This article aims to provide a current overview of biofilm and its relevance in orthopedic surgery.
   Materials and methods. A computer-assisted literature search of MedLine (PubMed) was performed using key word combinations with "biofilm" (as of March 2017).
   Results. Biofilm, a polymicrobial organization and life form surrounded by a polysaccharide matrix, refers to an adaptation strategy of bacteria in unfavorable living conditions (e.g. under antibiotic therapy). Biofilms can develop after 6 h in highly contaminated wounds. In acute and chronic infections, biofilms can occur in 30-80 % of the cases. Only planktonic bacteria (high metabolic activity, cultivable) can be detected in standard microbiological cultures, biofilms, however, cannot. Molecular microscopic methods, such as fluorescence in situ hybridization (FISH), enable the detection of bacteria in biofilms. The core concepts of anti-biofilm therapy include the prevention of biofilm and early surgical debridement, followed by the local and/or systemic administration of antibiotics as well as the local application of antiseptics.
   Conclusions. The development of biofilm should be anticipated in strongly contaminated wounds as well as in acute and chronic infection sites. The best strategy to combat biofilms is to prevent their development. Standard microbiological culture methods do not enable the detection of biofilm. Therefore, the implementation of molecular biological detection methods (z. B. FISH) is important. Further anti-biofilm strategies are being investigated experimentally, but there are no real options for clinical use as of yet.
C1 [Scheuermann-Poley, C.] Bundeswehrkrankenhaus Berlin, Abt Unfallchirurg Orthopadie Sept & Plast Chirurg, Berlin, Germany.
   [Wagner, C.] Klinikum Ingolstadt, Zentrum Orthopadie & Unfallchirurg, Ingolstadt, Germany.
   [Hoffmann, J.; Moter, A.] Deutsch Herzzentrum Berlin, Biofilmzentrum, Berlin, Germany.
   [Willy, C.] Bundeswehrkrankenhaus Berlin, Klin Unfallchirurg, Sept Rekonstrukt Chirurg,Orthopadie, Forsch & Behandlungszentrum Sept Defektwunden, Scharnhorststr 13, D-10115 Berlin, Germany.
C3 German Heart Center Berlin
RP Willy, C (通讯作者)，Bundeswehrkrankenhaus Berlin, Klin Unfallchirurg, Sept Rekonstrukt Chirurg,Orthopadie, Forsch & Behandlungszentrum Sept Defektwunden, Scharnhorststr 13, D-10115 Berlin, Germany.
EM christianwilly@bundeswehr.org
RI Moter, Annette/IAL-9880-2023; /AAJ-3174-2021
OI Moter, Annette/0000-0003-1318-5780; 
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NR 140
TC 7
Z9 8
U1 0
U2 29
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0177-5537
EI 1433-044X
J9 UNFALLCHIRURG
JI Unfallchirurg
PD JUN
PY 2017
VL 120
IS 6
BP 461
EP 471
DI 10.1007/s00113-017-0361-y
PG 11
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA EW8TH
UT WOS:000402790500006
PM 28540567
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Kaiser, S
   Verboket, RD
   Frank, J
   Marzi, I
   Janko, M
AF Kaiser, S.
   Verboket, R. D.
   Frank, J.
   Marzi, I.
   Janko, M.
TI Effectiveness of combined local therapy with antibiotics and fibrin vs.
   vacuum-assisted wound therapy in soft tissue infections: a retrospective
   study
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE Infection; VAC; NPWT; Spray; Antibiotic; Fibrin; New therapy
ID SURGICAL SITE INFECTION; IN-VITRO; SEALANTS; DELIVERY; SYSTEM; GLUE;
   VANCOMYCIN; RELEASE; METAANALYSIS; DEFINITIONS
AB Purpose Soft tissue infections can be severe and life-threatening. Their treatment consists currently in radical surgical wound debridement and combined systemic antimicrobial therapy. Different side effects are possible. Local antibiotic therapy represents a new approach to reduce side effects and improve healing. The aim of this study is to assess the effectiveness of the local sprayed use of antibiotics with fibrin sealing compared with negative pressure wound therapy as an established treatment of soft-tissue infections. Methods In this retrospective study, patients with soft tissue infections who underwent surgical treatment were analysed. One group consists of patients, who received local fibrin-antibiotic spray (FAS) (n = 62). Patients treated by vacuum-assisted wound therapy (VAWT) as the established treatment were the control group (n = 57). Main outcomes were differences in the success of healing, the duration until healing and the number of needed operations. Results Clinical healing could be achieved for 55 patients (98.21%) in the FAS group vs. 47 patients (92.16%) in the VAWT group (p = 0.19). Time to require this was 10.65 +/- 10.38 days in the FAS group and 22.85 +/- 14.02 days in the VAWT group (p < 0.001). In the FAS group, patients underwent an average of 1.44 +/- 0.72 vs.3.46 +/- 1.66 operations in the VAWT group (p < 0.001). Conclusion Compared to vacuum-assisted wound therapy in soft tissue infections, local fibrin-antibiotic spray shows faster clinical healing and less needed operations. Leading to shorter hospital stays and more satisfied patients. The combination of sprayed fibrin and antibiotics can be seen as a promising and effective method.
C1 [Kaiser, S.; Verboket, R. D.; Frank, J.; Marzi, I.; Janko, M.] Goethe Univ Frankfurt, Univ Hosp, Dept Trauma Hand & Reconstruct Surg, Theodor Stern Kai 7, D-60590 Frankfurt, Germany.
C3 Goethe University Frankfurt; Goethe University Frankfurt Hospital
RP Verboket, RD (通讯作者)，Goethe Univ Frankfurt, Univ Hosp, Dept Trauma Hand & Reconstruct Surg, Theodor Stern Kai 7, D-60590 Frankfurt, Germany.
EM verboket@med.uni-frankfurt.de
RI Verboket, René Danilo/ABA-3870-2020
OI Verboket, René Danilo/0000-0003-1086-4016
FU Johann Wolfgang Goethe-Universitt, Frankfurt am Main (1022)
FX No Statement Available
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NR 61
TC 1
Z9 1
U1 0
U2 2
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD AUG
PY 2024
VL 50
IS 4
SI SI
BP 1559
EP 1567
DI 10.1007/s00068-024-02483-1
EA MAR 2024
PG 9
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA I1I2R
UT WOS:001180363600002
PM 38466400
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Buckarma, ELN
   Rivera, M
   Schiller, H
   Loomis, E
AF Buckarma, Eee L. N.
   Rivera, Mariela
   Schiller, Henry
   Loomis, Erica
TI Outcomes After the Implementation of Practice Management Guidelines for
   the Treatment of Cardiovascular Implantable Device Pocket Infections
SO JOURNAL OF SURGICAL RESEARCH
LA English
DT Article
DE Cardiovascular implantable device; Pocket infection; Wound care; Wound
   vacuum therapy
ID CARDIOVERTER-DEFIBRILLATORS; PACEMAKERS; LAPAROTOMY; CLOSURE
AB Background: Treatment of cardiovascular implantable device pocket infections (CIDPIs) requires a multimodal approach that includes antimicrobials, device explantation, and local wound care. Our institution implemented a practice management guideline (PMG) to standardize the care of CIDPIs and engage our acute care surgeons in 2013. Our PMG includes wound culture, complete capsulectomy, pulse lavage, and the placement of a negative pressure wound therapy appliance at the time of device extraction. Forty-eight hours later, wounds are irrigated and closed in a delayed primary fashion over drains. Our objective was to compare the outcomes of patients who underwent device extraction before and after the implementation of the PMG for the treatment of CIDPIs.
   Methods: An IRB-approved retrospective review of 155 patients at our institution from 2012 to 2015 who underwent device explantation. Evaluated outcomes measured included days from device explant to wound closure, and postoperative complications. Outcomes data were analyzed before (pre-PMG) and after (post-PMG) enactment of the PMG.
   Results: Fifty-eight patients (42 males; mean age 68 years) were managed prior to PMG implementation; 97 (72 males; mean age 67) were managed after. Mean days from device explantation to wound closure were compared (pre-PMG 6 +/- 3.5 and post-PMG 2.8 +/- 1.8), and time to closure was reduced by 3-d post-PMG implementation (P < 0.05). No increase in surgical site infection, hematoma, or unplanned return to operating room was demonstrated between groups (P < 0.05).
   Conclusions: The implementation of a PMG for the management of CIDPIs is effective in reducing the number of days to pocket wound closure; acute care surgeons are well equipped to participate in this practice and improve patient outcomes. (C) 2018 Elsevier Inc. All rights reserved.
C1 [Buckarma, Eee L. N.; Rivera, Mariela; Schiller, Henry; Loomis, Erica] Mayo Clin, Dept Surg, 200 First St Southwest, Rochester, MN 55905 USA.
C3 Mayo Clinic
RP Buckarma, ELN (通讯作者)，Mayo Clin, Dept Surg, 200 First St Southwest, Rochester, MN 55905 USA.
EM Buckarma.EeeLN@mayo.edu
RI Rivera, Mariela/PGU-3948-2026
CR Agrawal V, 2017, INDIAN J SURG, V79, P124, DOI 10.1007/s12262-015-1438-x
   Anghel EL, 2016, PLAST RECONSTR SURG, V138, p82S, DOI 10.1097/PRS.0000000000002651
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   Uslan DZ, 2007, ARCH INTERN MED, V167, P669, DOI 10.1001/archinte.167.7.669
NR 11
TC 1
Z9 1
U1 0
U2 3
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0022-4804
EI 1095-8673
J9 J SURG RES
JI J. Surg. Res.
PD DEC
PY 2018
VL 232
BP 643
EP 646
DI 10.1016/j.jss.2018.07.065
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA GY1YP
UT WOS:000448333700089
PM 30463786
DA 2026-07-24
ER

PT J
AU Pang, CJ
   Huo, XY
   Liu, Y
   Yang, ZY
   Liu, L
   Fan, XB
   Xu, SW
AF Pang, Chao-Jian
   Huo, Xiao-Yan
   Liu, Yuan
   Yang, Zong-You
   Liu, Lu
   Fan, Xiao-Bo
   Xu, Shang-Wen
TI Characteristics of hand injuries caused by corn-husker equipment: a new
   type of agricultural injury
SO FRONTIERS IN SURGERY
LA English
DT Article
DE hand; agricultural; infection; corn-husker; type
ID SOFT-TISSUE; FUNGAL-INFECTIONS; MANAGEMENT; EXPERIENCE; EFFICACY;
   THERAPY; CLOSURE; CARE
AB Objectives This study aims to describe the nature and incidence of hand injuries caused by corn-husker machines, as well as the accident conditions and treatment experiences.Methods This retrospective investigation included 34 patients treated at a single institution from August 2018 to August 2021 with postoperative follow-up of more than 12 months. The Hand Injury Severity Scoring System (HISS) was applied to identify the degree of hand injury. Depending on the type of damage, different surgical methods were used, including debridement and suturing, amputation, fracture fixation, negative pressure wound therapy (NPWT), skin flap and skin graft procedures, replantation, and tendon repair. Bacterial culture and antibiotic sensitivity tests were performed when wound secretions were present.Results The average age was 42.1 years, and 76.4% of the patients were male. 17.6% were classified as HISS I, 20.6% each as HISS II and HISS III, and 41.2% as HISS IV. Among the 83 injured fingers (6 thumbs, 13 index, 12 middle, 10 ring, and 7 little fingers), the finger amputation rate was 57.8%. The most common complication was infection, with 13 cases of postoperative infection, resulting in an infection rate of 38.2%. Although NPWT played an important role in treatment, there was no significant difference in infection rates between wounds treated with NPWT and those treated without. Median hospitalization duration was 35 days (IQR: 27-45); median treatment cost was $4740 (IQR: $3255-$6215). Infections significantly impacted both hospitalization duration and treatment costs.Conclusion Corn-husker machine-related hand injuries represent a new type of hand trauma and are often severely mutilating. The selection of appropriate surgical methods and the prevention of infection are crucial aspects in treating such injuries.
C1 [Pang, Chao-Jian; Huo, Xiao-Yan; Liu, Yuan; Fan, Xiao-Bo] First Hosp Handan, Dept Orthopaed Surg, Handan, Hebei, Peoples R China.
   [Yang, Zong-You] Hebei Med Univ, Hosp 3, Dept Orthopaed Surg, Shijiazhuang, Hebei, Peoples R China.
   [Liu, Lu] Hebei Prov Hosp Tradit Chinese Med, Dept Hlth Management, Shijiazhuang, Hebei, Peoples R China.
   [Xu, Shang-Wen] First Hosp Handan, Dept Hand Surg, Handan, Hebei, Peoples R China.
C3 Hebei Medical University; Hebei University of Chinese Medicine
RP Pang, CJ (通讯作者)，First Hosp Handan, Dept Orthopaed Surg, Handan, Hebei, Peoples R China.
EM pangchaojian@163.com
RI ; pang, Chaojian/IAO-4104-2023
OI Yang, Zong-You/0009-0006-6103-3457; 
FU Key Medical Research Projects of Hebei Province [20210568]; Special TCM
   Innovation Project of Hebei Provincial Department of Science and
   Technology [223777130D]; Scientific Research Project of Hebei Province
   Administration of Traditional Chinese Medicine [2024215]
FX The author(s) declare that financial support was received for the
   research and/or publication of this article. Supported by the Key
   Medical Research Projects of Hebei Province (Grant No. 20210568);
   Special TCM Innovation Project of Hebei Provincial Department of Science
   and Technology, No. 223777130D; and Scientific Research Project of Hebei
   Province Administration of Traditional Chinese Medicine, No. 2024215.
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NR 30
TC 0
Z9 0
U1 0
U2 3
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD JUN 20
PY 2025
VL 12
AR 1471142
DI 10.3389/fsurg.2025.1471142
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 4NO6M
UT WOS:001522271100001
PM 40620699
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Di Nunzio, TGR
   Farhadi, J
   Grufman, V
   Speck, NE
AF Di Nunzio, Tiago G. Reina
   Farhadi, Jian
   Grufman, Vendela
   Speck, Nicole E.
TI Optimizing perioperative care in autologous breast reconstruction: a
   narrative review
SO GLAND SURGERY
LA English
DT Article
DE Autologous breast reconstruction; perioperative optimization;
   nutritional support; metabolic modulation; wound healing
ID HYPERBARIC-OXYGEN TREATMENT; NEGATIVE-PRESSURE THERAPY; GUIDELINE
   CLINICAL NUTRITION; QUALITY-OF-LIFE; ENHANCED RECOVERY; WOUND THERAPY;
   DONOR-SITE; CANCER-PATIENTS; POSTOPERATIVE COMPLICATIONS; REPERFUSION
   INJURY
AB Background and Objective: Autologous breast reconstruction is a complex microsurgical procedure in which perioperative management critically influences surgical and patient-reported outcomes. Several physiological and perioperative strategies-including oxygenation enhancement, metabolic modulation, nutritional support and wound care-remain underexplored in this specific setting. This narrative review summarizes evidence on emerging approaches to perioperative optimization in autologous breast reconstruction and discusses their potential to improve recovery and long-term outcomes. Methods: A narrative literature review was conducted using PubMed (MEDLINE, Bethesda, MD, USA) and Scopus (Elsevier, Amsterdam, The Netherlands) for studies published in English up to October 2025. Reference lists of key reviews and consensus statements were manually screened to identify additional relevant publications. The selected literature was analyzed thematically to highlight evolving concepts and their reported impact on reconstructive outcomes. Key Content and Findings: Emerging strategies target perioperative physiology through systemic and local interventions. Hyperbaric oxygen therapy and closed-incision negative pressure wound therapy demonstrate potential benefits in improving perfusion, reducing edema, and lowering wound-related complications. Antioxidant and metabolic modulation, perioperative protein optimization, and preoperative carbohydrate loading may attenuate catabolic stress and support microvascular stability. Structured drain care and infection-prevention protocols further contribute to safer recovery. Evidence remains heterogeneous and limited in scope, but collectively these approaches point toward a more comprehensive and individualized perioperative management paradigm in reconstructive breast surgery. Conclusions: Optimizing perioperative care in autologous breast reconstruction requires an integrated framework that aligns surgical precision with systemic support. Emerging biological and metabolic interventions may complement established recovery practices, potentially improving flap outcomes and overall patient well-being. Prospective multicenter studies are needed to standardize protocols and determine their clinical impact.
C1 [Di Nunzio, Tiago G. Reina; Farhadi, Jian; Grufman, Vendela; Speck, Nicole E.] Affidea Plast Surg Grp, Seefeldstr 214, CH-8008 Zurich, Switzerland.
   [Farhadi, Jian] Univ Basel, Fac Med, Basel, Switzerland.
   [Speck, Nicole E.] Univ Hosp Basel, Dept Plast Reconstruct Aesthet & Hand Surg, Basel, Switzerland.
C3 University of Basel; University of Geneva; University of Basel
RP Di Nunzio, TGR (通讯作者)，Affidea Plast Surg Grp, Seefeldstr 214, CH-8008 Zurich, Switzerland.
EM dr.reinadinunzio@gmail.com
OI Reina Di Nunzio, Tiago Guillermo/0009-0005-8065-3865
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NR 125
TC 0
Z9 0
U1 0
U2 0
PU AME PUBLISHING COMPANY
PI SHATIN
PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG
   00000, PEOPLES R CHINA
SN 2227-684X
EI 2227-8575
J9 GLAND SURG
JI Gland Surg.
PD FEB 28
PY 2026
VL 15
IS 2
AR 51
DI 10.21037/gs-2025-1-539
PG 17
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA EW8GR
UT WOS:001711622300016
PM 41808815
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Davenport, T
   Dirks, R
   Kelso, MR
   Low, M
AF Davenport, Thomas
   Dirks, Ryan
   Kelso, Martha R.
   Low, Mervin
TI CELLULAR, ACELLULAR AND MATRIX-LIKE PRODUCTS (CAMPS) IN PRESSURE
   INJURIES
SO JOURNAL OF WOUND CARE
LA English
DT Article
ID DIABETIC FOOT ULCERS; SKIN SUBSTITUTES; EXTRACELLULAR-MATRIX;
   SURGICAL-TREATMENT; WOUND THERAPY; MANAGEMENT; FACILITIES; EFFICACY;
   IMPACT; SAFETY
AB The high prevalence and recurrence of pressure injuries (PIs) require new treatment strategies. The goals of PI treatment and research should be holistic, encompassing quality of life, symptom control, patient-directed goals of care and survival, as well as cure. Cellular, acellular and matrix-like products (CAMPs) are advanced wound-care tools that promote innate healing processes, such as stimulating fibroblast activity, granulation tissue formation and keratinocyte migration. CAMPs have been shown to be safe and effective in full-thickness PIs and other hard-to-heal wounds. Indications for CAMPs should include early application in complex wounds, multiple comorbidities or impaired healing capacity, with or without exposed deep structures. Patient selection should consider absolute and relative contraindications for CAMPs, as well as differential diagnoses for PIs, such as skin failure and malignant or atypical wounds. Patients treated with CAMPs require optimisation of offloading, mobility and tissue perfusion, along with addressing nicotine use and polypharmacy, as well as skin protection, nutrition and psychosocial support. Application of CAMPs must be preceded by wound-bed preparation encompassing tissue debridement, inflammation/infection control, moisture management and optimisation of patient and social factors. CAMPs should be applied in a clean environment following instructions for use, potentially supported by negative pressure wound therapy. Use of CAMPs requires ongoing documentation and re-assessment of treatment efficacy and quality of life, with onward referral for osteomyelitis, fistulas or other arterial disease. CAMPs use should be based in multidisciplinary collaboration and supported by patient and professional education. The appropriate use of CAMPs in PIs should be applied across all payors and relevant sites of service. Research on CAMPs in PIs should make wider use of real-world data to support the limited number and narrow scope of randomised control trials.
C1 [Davenport, Thomas] New York Plast Surg Grp, New York, NY 10028 USA.
   [Dirks, Ryan] United Wound Healing, Puyallup, WA USA.
   [Kelso, Martha R.] Wound Care Plus LLC, Blue Springs, MO USA.
   [Low, Mervin] Newport Wound, Newport Beach, CA USA.
RP Davenport, T (通讯作者)，New York Plast Surg Grp, New York, NY 10028 USA.
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NR 85
TC 0
Z9 0
U1 0
U2 0
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2052-2916
J9 J WOUND CARE
JI J. Wound Care
PD DEC
PY 2025
VL 34
IS 12
SU D
PG 20
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA AB6NS
UT WOS:001644293600001
DA 2026-07-24
ER

PT J
AU Zhang, HW
   Lu, WF
AF Zhang, Huiwen
   Lu, Weifeng
TI Successful treatment with decompressive laparotomy for abdominal
   compartment syndrome induced by asparaginase-associated pancreatitis in
   a pediatric patient with acute lymphoblastic leukemia: a case report
SO TRANSLATIONAL PEDIATRICS
LA English
DT Article
DE Acute lymphoblastic leukemia (ALL); asparaginase-associated pancreatitis
   (AAP); abdominal compartment syndrome (ACS); decompressive laparotomy
   (DL); case report
ID PERSISTENT INFLAMMATION-IMMUNOSUPPRESSION; INTRAABDOMINAL HYPERTENSION;
   DEFINITIONS; CONSENSUS
AB Background: Asparaginase (ASP) has significantly improved the complete remission rate and long-term event-free survival in children with acute lymphoblastic leukemia (ALL). Asparaginase-associated pancreatitis (AAP) is a potentially toxic side effect of ASP, which may even lead to fatal abdominal compartment syndrome (ACS) in extreme cases. Currently, there is no consensus on the indications for decompressive laparotomy (DL), including when to initiate it, what criteria to use for decision-making, or how to perform the procedure. Moreover, available research data remain limited. Case Description: We present a case of a 2-year-old boy with ALL who developed ACS, a fatal complication of severe acute pancreatitis (SAP) following treatment with pegaspargase (PEG-ASP). Massive transfusion stabilized his hemodynamics and intraluminal contents were evacuated, yet his symptoms progressed. Consequently, the patient underwent DL and continuous venovenous hemodiafiltration (CVVHDF) with ultrafiltrati on. Postoperative complications including enteroatmospheric fistulas and abdominal abscesses were gradually corrected by negative-pressure wound therapy (NPWT). The boy was discharged from the intensive care unit (ICU) on the 93rd day after hospital admission. During followup, the child's abdominal symptoms gradually improved, and bridging therapy with blinatumomab was administered. Conclusions: In this case, a pediatric ALL patient developed life-threatening complications following PEG-ASP administration, which were ultimately successfully managed through multidisciplinary intervention. When pediatric hematology-oncology patients develop ACS, clinicians should carefully evaluate the oncological context and thoroughly assess the risks of surgical versus conservative management for this potentially fatal condition. Optimal timing of surgical intervention combined with advanced perioperative care is critical for achieving favorable outcomes. We strongly recommend conducting highquality clinical research to establish evidence-based treatment guidelines.
C1 [Zhang, Huiwen; Lu, Weifeng] Nanjing Med Univ, Childrens Hosp, Dept Surg Intens Care Unit, 72 Guangzhou Rd, Nanjing 210008, Peoples R China.
C3 Nanjing Medical University
RP Lu, WF (通讯作者)，Nanjing Med Univ, Childrens Hosp, Dept Surg Intens Care Unit, 72 Guangzhou Rd, Nanjing 210008, Peoples R China.
EM luweifengmm@163.com
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NR 23
TC 0
Z9 1
U1 0
U2 0
PU AME PUBLISHING COMPANY
PI SHATIN
PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG
   00000, PEOPLES R CHINA
SN 2224-4336
EI 2224-4344
J9 TRANSL PEDIATR
JI Transl. Pediatr.
PD MAY
PY 2025
VL 14
IS 5
BP 1050
EP 1058
DI 10.21037/tp-24-440
PG 9
WC Pediatrics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pediatrics
GA 3YA3D
UT WOS:001511713000025
PM 40519724
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Monsch, GM
   Etienne, H
   Hillinger, S
   Caviezel, C
   Lauk, O
   Opitz, I
   Schneiter, D
AF Monsch, Gian-Marco
   Etienne, Harry
   Hillinger, Sven
   Caviezel, Claudio
   Lauk, Olivia
   Opitz, Isabelle
   Schneiter, Didier
TI Accelerated treatment concept in postpneumonectomy empyema with
   bronchopleural fistula
SO SCIENTIFIC REPORTS
LA English
DT Article
DE Postpneumonectomy empyema; Bronchopleural fistula; Accelerated treatment
   concept (Zurich concept)
ID SURGICAL-MANAGEMENT; RISK-FACTORS; LUNG-CANCER; PNEUMONECTOMY;
   DEBRIDEMENT; PREVENTION; SPACE
AB Treatment of postpneumonectomy empyema remains challenging, especially in presence of bronchopleural fistula. We analysed clinical outcome data of patients with and without bronchopleural fistula undergoing an accelerated empyema treatment concept. From November 2005 to July 2020, all patients with postpneumonectomy empyema were included. Therapy consisted of repeated surgical debridement of the pleural cavity, evaluation for loco-regional flap, negative pressure wound therapy and definitive closure after installation an antibiotic solution in the cavity. Primary endpoint was perioperative mortality, focusing on comparison between patients with (= group A) and without bronchopleural fistula (= group B). Secondary endpoints were empyema resolution/recurrence and length of stay. 58 patients underwent the treatment concept: 19 (32.8%) with bronchopleural fistula. Patients' mean age was 62.7 +/- 11.5 years. Nine patients (15.5%) deceased within 30 days: 3 (15.8%) in group A, 6 (15.4%) in group B. 90-days mortality tends to be lower in group A (n = 3 (15.8%)) compared to group B (n = 11 (28.2%)) (p = 0.078). Incidence of postoperative complication was 63.2% (n = 12) in group A compared to 56.4% (n = 22) in group B (p = 0.316). Postpneumonectomy empyema resolution was 100% in the cohort. 3 patients (15.8%) in the group A and 3 (7.7%) in group B (p = 0.175) developed an empyema-recurrence, successfully managed with the treatment concept again. Mean hospital length of stay was lower in group A (24.6 +/- 9.5 days vs 27.2 +/- 24.3 days in group B; p = 0.329). With our accelerated treatment concept, postpneumonectomy empyema with bronchopleural fistula could effectively and safely be treated while maintaining integrity of the chest wall.Clinical Registration Number: KEK-ZH-NR: 2021-01114.
C1 [Monsch, Gian-Marco; Etienne, Harry; Hillinger, Sven; Caviezel, Claudio; Lauk, Olivia; Opitz, Isabelle; Schneiter, Didier] Univ Hosp Zurich, Dept Thorac Surg, Raemistr 100, CH-8091 Zurich, Switzerland.
C3 University of Zurich; University Zurich Hospital
RP Schneiter, D (通讯作者)，Univ Hosp Zurich, Dept Thorac Surg, Raemistr 100, CH-8091 Zurich, Switzerland.
EM didier.schneiter@usz.ch
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NR 29
TC 2
Z9 2
U1 1
U2 2
PU NATURE PORTFOLIO
PI BERLIN
PA HEIDELBERGER PLATZ 3, BERLIN, 14197, GERMANY
SN 2045-2322
J9 SCI REP-UK
JI Sci Rep
PD DEC 30
PY 2024
VL 14
IS 1
AR 31837
DI 10.1038/s41598-024-83334-2
PG 9
WC Multidisciplinary Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Science & Technology - Other Topics
GA Q7I6J
UT WOS:001386372100044
PM 39738609
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Loftus, TJ
   Bihorac, A
   Ozrazgat-Baslanti, T
   Jordan, JR
   Croft, CA
   Smith, RS
   Efron, PA
   Moore, FA
   Mohr, AM
   Brakenridge, SC
AF Loftus, Tyler J.
   Bihorac, Azra
   Ozrazgat-Baslanti, Tezcan
   Jordan, Janeen R.
   Croft, Chasen A.
   Smith, Robert Stephen
   Efron, Philip A.
   Moore, Frederick A.
   Mohr, Alicia M.
   Brakenridge, Scott C.
TI ACUTE KIDNEY INJURY FOLLOWING EXPLORATORY LAPAROTOMY AND TEMPORARY
   ABDOMINAL CLOSURE
SO SHOCK
LA English
DT Article
DE Acute care surgery; acute kidney injury; exploratory laparotomy;
   mortality; open abdomen; temporary abdominal closure
ID DAMAGE-CONTROL LAPAROTOMY; OPEN ABDOMEN; MANAGEMENT; TRAUMA; SEPSIS;
   COAGULOPATHY; THERAPY; SURGERY
AB Background: Acute kidney injury (AKI) following exploratory laparotomy and temporary abdominal closure (TAC) is poorly understood but clinically significant. We hypothesized that the prevalence of AKI would be highest 96 h following TAC, early hypoxemia would predict AKI, and that AKI would be an independent predictor of mortality. Methods: We performed a retrospective analysis of 251 acute care surgery patients managed with TAC by negative pressure wound therapy (NPWT). Kidney Disease: Improving Global Outcomes AKI stages were assessed on admission, initial TAC, and following TAC at 48 h, 96 h, and 7 d. Multivariate regression was performed to identify risk factors for AKI and inpatient mortality. Results: Fifty-seven percent of all patients developed AKI within 7 days of laparotomy (stage 1: 14%, 2: 21%, 3: 22%). The prevalence of AKI peaked 48 h following TAC, and stage correlated with inpatient mortality (stage 0: 7%, 1: 13%, 2: 19%, 3: 37%, P < 0.001). Overall mortality was 14%. Factors predictive of stage 2 or 3 AKI at 48 h included age >65 years (OR 2.6 [ 95% CI 1.4-4.9]), NPWT output >30 mL/h from first TAC to 48 h (2.0 [1.1-3.9]), and three parameters at initial laparotomy: mean arterial pressure <60 mm Hg (2.9 [1.0-8.5]), temperature <36 degrees C (2.1 [1.1-3.8]), and anion gap >21 mEq/L (1.9 [1.0-3.7]). AKI was an independent predictor of inpatient mortality (5.5 [2.5-11.8]). Conclusions: AKI is common following TAC, reaches greatest prevalence 48 h after initial laparotomy, and is associated with increased mortality. NPWT fluid loss is a risk factor for AKI that is unique to TAC patients.
C1 [Loftus, Tyler J.; Bihorac, Azra; Ozrazgat-Baslanti, Tezcan; Jordan, Janeen R.; Croft, Chasen A.; Smith, Robert Stephen; Efron, Philip A.; Moore, Frederick A.; Mohr, Alicia M.; Brakenridge, Scott C.] Univ Florida Hlth, Dept Surg, Gainesville, FL USA.
   [Loftus, Tyler J.; Bihorac, Azra; Ozrazgat-Baslanti, Tezcan; Jordan, Janeen R.; Croft, Chasen A.; Smith, Robert Stephen; Efron, Philip A.; Moore, Frederick A.; Mohr, Alicia M.; Brakenridge, Scott C.] Univ Florida Hlth, Sepsis & Crit Illness Res Ctr, Gainesville, FL USA.
   [Bihorac, Azra; Ozrazgat-Baslanti, Tezcan] Univ Florida Hlth, Dept Med, Gainesville, FL USA.
C3 State University System of Florida; University of Florida; State
   University System of Florida; University of Florida; State University
   System of Florida; University of Florida
RP Brakenridge, SC (通讯作者)，Univ Florida Hlth, 1600 SW Archer Rd Room M-602, Gainesville, FL 32610 USA.
EM Scott.Brakenridge@surgery.ufl.edu
RI ; Brakenridge, Scott/AAD-6691-2019; Mohr, Alicia/E-3016-2015; Loftus,
   Tyler/J-7761-2016; Bihorac, Azra/Q-6500-2016
OI Smith, Robert/0000-0002-0455-6415; Brakenridge,
   Scott/0000-0002-7327-3718; Mohr, Alicia/0000-0003-1732-1313; Loftus,
   Tyler/0000-0001-5354-443X; Bihorac, Azra/0000-0002-5745-2863
FU National Institute of General Medical Sciences (NIGMS) [R01
   GM105893-01A1, R01 GM113945-01, P50 GM111152-01]; NIGMS [T32 GM-08721];
   National Center for Advancing Translational Sciences of the National
   Institutes of Health [UL1TR001427]; National Center for Advancing
   Translational Sciences [UL1TR001427] Funding Source: NIH RePORTER;
   National Institute of General Medical Sciences [T32GM008721,
   R01GM110240, R01GM105893] Funding Source: NIH RePORTER; National
   Institute on Aging [P30AG028740] Funding Source: NIH RePORTER
FX The authors were supported in part by grants R01 GM105893-01A1 (AMM),
   R01 GM113945-01 (PAE), and P50 GM111152-01 (SCB, AB, TO-B, PAE, FAM,
   AMM) awarded by the National Institute of General Medical Sciences
   (NIGMS). TJL was supported by a post-graduate training grant (T32
   GM-08721) in burns, trauma, and perioperative injury by NIGMS. Research
   reported in this publication was supported by the National Center for
   Advancing Translational Sciences of the National Institutes of Health
   under Award Number UL1TR001427.
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NR 25
TC 6
Z9 6
U1 0
U2 1
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 1073-2322
EI 1540-0514
J9 SHOCK
JI Shock
PD JUL
PY 2017
VL 48
IS 1
BP 5
EP 10
DI 10.1097/SHK.0000000000000825
PG 6
WC Critical Care Medicine; Hematology; Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Hematology; Surgery; Cardiovascular System
   & Cardiology
GA FA7DM
UT WOS:000405605100002
PM 28009772
DA 2026-07-24
ER

PT J
AU Chang, CD
   Rodriguez-Mantilla, I
   Herrera, AC
   Molina, LA
   D'Amico, GA
   Berner, JE
   Marcasciano, M
   Chen, HC
AF Chang, Chad
   Rodriguez-Mantilla, Ivan
   Herrera, Andres Camilo
   Molina, Luis Arturo
   D'Amico, Giuseppe Antonio
   Berner, Juan Enrique
   Marcasciano, Marco
   Chen, Hung-Chi
TI Donor site in anterolateral thigh (ALT) free flaps: A systematic review
   of closure techniques and introduction of a management algorithm
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Review
DE Anterolateral thigh flap; ALT flap; Closure technique; Donor site
ID TISSUE; MORBIDITY; REPAIR
AB The anterolateral thigh (ALT) free flap is widely used in reconstructive microsurgery for its versatility and reliability, yet donor site management becomes challenging when flap dimensions exceed those for tension-free primary closure. The flap width-to-thigh circumference ratio (FW/TCR) is a potentially valuable objective decision-making tool. Given the heterogeneity of the reported closure techniques, this review aimed to map current techniques, identify gaps in evidence and propose a FW/TCR-based algorithm to standardise ALT donor site closure. A review of PubMed/MEDLINE, EMBASE, Cochrane Library and AMED databases was conducted from inception to October 2023, including English-language studies focused on ALT donor site closures. Data on closure techniques, outcomes, and complications were extracted. Overall, 27 studies met the inclusion criteria, describing direct primary closure, locoregional flaps, skin grafting, and adjunctive methods such as negative pressure wound therapy, acellular dermal matrices and tissue expansion. Direct primary closure was generally reported as feasible for FW/TCR < 16%. Once FW/TCR exceeded 30%, skin grafting or alternative solutions such as 'kiss' (split skin paddle) flaps were more frequently described. In the intermediate range (16-30%), locoregional flaps were commonly employed to avoid graft-related morbidity. Drawing on these findings, we propose a FW/TCR-based algorithm: (1) direct closure for FW/TCR < 16%, (2) locoregional flaps for FW/TCR 16-30%, and (3) grafting or alternative techniques if FW/TCR exceeds 30%. Standardising closure strategies using these thresholds may reduce donor site morbidity and optimise patient outcomes. Further high-level comparative studies are necessary to validate and refine these recommendations. (c) 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Chang, Chad; Rodriguez-Mantilla, Ivan; Marcasciano, Marco; Chen, Hung-Chi] China Med Univ Hosp, Dept Surg, Div Plast & Reconstruct Surg, Taichung, Taiwan.
   [Chang, Chad] Royal Victoria Infirm, Dept Plast & Reconstruct Surg, Queen Victoria Rd, Newcastle Upon Tyne, England.
   [Rodriguez-Mantilla, Ivan] Hosp San Jose, Fdn Univ Ciencias Salud, Dept Plast & Reconstruct Surg, Bogota, Colombia.
   [Herrera, Andres Camilo; Molina, Luis Arturo] Univ Rosario, Sch Med, Bogota, Colombia.
   [Herrera, Andres Camilo] Clin Univ Colombia, Dept Plast & Reconstruct Surg, Bogota, Colombia.
   [Molina, Luis Arturo] Univ El Bosque, Dept Epidemiol, Bogota, Colombia.
   [D'Amico, Giuseppe Antonio; Marcasciano, Marco] Magna Graecia Univ Catanzaro, Unit Plast & Reconstruct Surg, Dept Expt & Clin Med, Catanzaro, Italy.
   [D'Amico, Giuseppe Antonio] Univ Hosp Messina AOU Gaetano Martino, Dept Plast & Reconstruct Surg, Messina, Italy.
   [Berner, Juan Enrique] Univ Texas Hlth Sci Ctr San Antonio, Div Plast & Reconstruct Surg, Dept Surg, San Antonio, TX USA.
   [Chen, Hung-Chi] China Med Univ Hosp, Int Ctr, Taichung, Taiwan.
C3 China Medical University Taiwan; China Medical University Hospital -
   Taiwan; Newcastle University - UK; Fundacion Universitaria de Ciencias
   de la Salud (FUCS); Universidad del Rosario; Universidad El Bosque;
   Magna Graecia University of Catanzaro; University of Texas System;
   University of Texas at San Antonio; China Medical University Taiwan;
   China Medical University Hospital - Taiwan
RP Chang, CD (通讯作者)，Royal Victoria Infirm, Dept Plast & Reconstruct Surg, Queen Victoria Rd, Newcastle Upon Tyne, England.
EM Changchad@doctors.org.uk
RI ; Chang, Chad/GNH-6300-2022; Berner, Juan Enrique/AAI-1244-2021;
   Marcasciano, Marco/HZJ-0259-2023
OI D’Amico, Giuseppe Antonio/0009-0005-1540-2357; Chang,
   Chad/0000-0003-2908-0318; Molina, Luis Arturo/0009-0007-3211-1206;
   Berner, Juan Enrique/0000-0003-2178-5161; 
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NR 31
TC 1
Z9 1
U1 0
U2 1
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD JUN
PY 2025
VL 105
BP 243
EP 259
DI 10.1016/j.bjps.2025.04.008
EA MAY 2025
PG 17
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 2LG6N
UT WOS:001485338200002
PM 40318362
DA 2026-07-24
ER

PT J
AU Pathinathan, K
   Sial, A
   Khalil, O
   Ghahreman, A
   Diwan, A
AF Pathinathan, Kalaventhan
   Sial, Alisha
   Khalil, Osama
   Ghahreman, Ali
   Diwan, Ashish
TI Strategies to prevent post-operative surgical site infection in spinal
   surgery: a narrative review
SO EUROPEAN SPINE JOURNAL
LA English
DT Review
DE Postoperative spine infections; Prevention of postoperative spine
   infections; Multidisciplinary approach; Risk factors of post-operative
   spine infections
ID RISK
AB Background Post-operative surgical site infections (SSIs) remain a major source of morbidity following spinal surgery, contributing to prolonged hospitalisations, re-operation, implant failure and increased healthcare costs. Despite advances in surgical technique and peri-operative care, SSI prevention in spine surgery remains challenging. Objective To provide a narrative synthesis of contemporary evidence relating to the prevention of SSIs in spinal surgery across the pre-operative, intra-operative, and post-operative phases, with additional emphasis on emerging and translational technologies. Methods A structured literature review of MEDLINE/PubMed (1990-2024) was performed. Systematic reviews, randomized controlled trials, high-quality cohort studies, and major international guideline statements were selectively included to synthesise current preventive strategies in spinal surgery. Results SSI prevention in spinal surgery requires a multimodal peri-operative strategy. Pre-operative optimisation includes smoking cessation, glycaemic control, nutritional assessment, anaemia correction, and targeted Staphylococcus aureus screening and decolonisation. Intra-operative measures supported by moderate-to-high-quality evidence include chlorhexidine-alcohol skin preparation, weight-adjusted antibiotic prophylaxis with appropriate re-dosing, dilute povidone-iodine irrigation, meticulous tissue handling, and intrawound vancomycin powder in selected high-risk posterior instrumented cases. Post-operative interventions such as extended occlusive dressings, silver-impregnated dressings, and prophylactic negative-pressure wound therapy may reduce SSI risk in high-risk populations. Prolonged post-operative antibiotic administration beyond 24 h has not demonstrated additional benefit and may increase antimicrobial resistance. Emerging technologies targeting biofilm formation and antimicrobial resistance represent promising future directions. Conclusions Preventing SSIs in spinal surgery requires an integrated peri-operative approach informed by evolving evidence. While several strategies are supported by consistent data, significant gaps remain, particularly regarding emerging technologies. Ongoing high-quality clinical studies are needed to refine SSI prevention frameworks in spine surgery.
C1 [Pathinathan, Kalaventhan; Sial, Alisha; Khalil, Osama; Ghahreman, Ali; Diwan, Ashish] UNSW Sydney, Sydney, Australia.
RP Diwan, A (通讯作者)，UNSW Sydney, Sydney, Australia.
EM kalaventhansurgery@gmail.com; a.sial@unsw.edu.au;
   fellow@spine-service.org; draghahreman@gmail.com; a.diwan@unsw.edu.au
RI ; Diwan, Ashish/OPN-6729-2025; Pathinathan, Kalaventhan/ABQ-1538-2022
OI Khalil, Osama/0009-0002-8977-7520; 
FU University of New South Wales
FX Open Access funding enabled and organized by CAUL and its Member
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NR 44
TC 0
Z9 0
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0940-6719
EI 1432-0932
J9 EUR SPINE J
JI Eur. Spine J.
PD JUL
PY 2026
VL 35
IS 7
SI SI
BP 4198
EP 4206
DI 10.1007/s00586-026-09911-3
EA APR 2026
PG 9
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA LD5QZ
UT WOS:001733037900001
PM 41936664
OA hybrid
DA 2026-07-24
ER

PT J
AU Liu, Q
   Zhang, N
   Li, ZN
   He, HM
AF Liu, Qian
   Zhang, Ning
   Li, Zhengnan
   He, Hongmei
TI Efficacy of autologous platelet-rich plasma gel in the treatment of
   refractory pressure injuries and its effect on wound healing time and
   patient quality of life
SO CLINICS
LA English
DT Article
DE Crush Injuries; Autologous Platelet-Rich Plasma Gel; Wound Healing;
   Quality of Life
ID REJUVENATION; REGENERATION; VALIDATION
AB OBJECTIVES: To evaluate the efficacy of autologous platelet-rich plasma (PRP) gel in the treatment of refractory pressure injuries and its effect on wound healing time and quality of life of patients.
   METHODS: A random number table method was used to group 102 patients with refractory pressure injuries into either a control group (CG) (51 cases) receiving negative pressure wound therapy (NPWT) or a study group (SG) (51 cases) receiving NPVVT + PRP gel.
   RESULTS: The total efficacy rate in the SG (92.16%) was higher than that in the CG (76.47%) (p < 0.05). The SG exhibited lower visual analog scale (VAS) scores and pressure ulcer scale for healing (PUSH) scores, smaller wound sizes and depths, and shorter wound healing times than the CG after 21 days of treatment (p < 0.05). After 6 months of treatment, the SG scored higher than the CG on the psychological, physiological, social functions, and daily activity domains on the World Health Organization Quality of Life (WHOQOL-BREF) scale (p < 0.05). The incidence of postoperative complications in the SG (13.73%) was not significantly different from that of the CG (7.84%) (p > 0.05).
   CONCLUSION: In the treatment of refractory pressure injuries, PRP gel can accelerate wound healing, reduce wound pain, shorten the treatment cycle, regulate tissue inhibitor matrix metalloproteinase-1 (TIMP-1) and matrix metalloproteinase-9 (MMP-9) levels and the expression of specific proteins in granulation tissue, reduce the levels of the inflammatory factors interleukin-1 beta (IL-1 beta), IL-8, and tumor necrosis factor-alpha (TNF-alpha), and improve the quality of life of patients without increasing complications.
C1 [Liu, Qian; Li, Zhengnan] Ganzhou Peoples Hosp, Dept Sports Med, Ganzhou 341000, Jiangxi, Peoples R China.
   [Zhang, Ning; He, Hongmei] Ganzhou Peoples Hosp, Dept Gastroenterol, Ganzhou 341000, Jiangxi, Peoples R China.
RP He, HM (通讯作者)，Ganzhou Peoples Hosp, Dept Gastroenterol, Ganzhou 341000, Jiangxi, Peoples R China.
EM qviyq9@163.com
RI Zhang, Xiaoning/AAD-5635-2020
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NR 25
TC 20
Z9 24
U1 0
U2 20
PU HOSPITAL CLINICAS, UNIV SAO PAULO
PI SAO PAULO
PA FAC MEDICINA, UNIV SAO PAULO, SAO PAULO, SP 00000, BRAZIL
SN 1807-5932
EI 1980-5322
J9 CLINICS
JI Clinics
PY 2021
VL 76
AR e2355
DI 10.6061/clinics/2021/e2355
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA QI5LL
UT WOS:000619018900001
PM 33567047
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Colak, B
   Kirazli, H
   Ece, I
   Yormaz, S
   Sahin, M
AF Colak, Bayram
   Kirazli, Halil
   Ece, Ilhan
   Yormaz, Serdar
   Sahin, Mustafa
TI COMPARISION OF VACUUM-ASISTED CLOSURE AND INTRALESIONAL EPIDERMAL GROWTH
   FACTOR IN THE TREATMENT OF DIABETIC FOOT WOUNDS PATIENTS
SO ACTA MEDICA MEDITERRANEA
LA English
DT Article
DE Growth factor; diabetic foot; negative pressure; wound
ID LOWER-EXTREMITY ULCERS; ASSISTED CLOSURE; THERAPY; PRESSURE; TRIAL
AB Introduction: Diabetes mellitus (DM) is a common public health problem all over the world with serious complications. The mortality rate is 40% within 5 years in patients with major amputation due to diabetic foot wounds (DFW). Therefore, a nonsurgical but effective treatment method is needed for the treatment of DFW. In this study, we aimed to compare the results of intralesional epidermal growth factor (EGF) injection and negative pressure wound therapy (NPWT) for the treatment of DFW.
   Materials and methods: The medical records of patients who were treated for DFW with EGF or NPWT between February 2017 and December 2017 were retrospectively reviewed. Patients demographics, wound characteristics, allergic reactions and treatment responses were evaluated.
   Results: Amongst 42 patients, 20 patients were treated with the injection of EGF and 22 patients treated with NPWT. The duration of diabetes was higher in EGF group when compared to the NPWT group without a statistically significance (EGF: 20,7 years, NPWT: 16,9 years). According to the Wagner-Meggitt classification, the grade of the wounds was comparable in both groups. A complete response were obtained in 17 (85%) patients and 50% wound closure was achieved in the other patients in EGF group. In the NPWT group complete response rate was 45.4%. No major amputation was performed in any patient. In NPWT group, 13 (59%) of wouds were closed with split-thickness skin graft, only 3 patients (15%) of the EGF group were required a skin graft. The main advers affect of the EGF injection was an elevated fasting blood glucose level. In both groups, A decreased HbA1c levels were found after the wound treatment.
   Conclusion: Both administration of intralesional EGF and NPWT are safe, effective and non-surgical methods for the treatment of DFW. NPWT is seems to be a more effective treatment modality for infected wounds.
C1 [Colak, Bayram; Kirazli, Halil; Ece, Ilhan; Yormaz, Serdar; Sahin, Mustafa] Selcuk Univ, Fac Med, Dept Gen Surg, Konya, Turkey.
C3 Selcuk University
RP Colak, B (通讯作者)，Selcuk Univ, Fac Med, Dept Gen Surg, Konya, Turkey.
EM bayro.99@gmail.com
RI Ece, ilhan/AAR-9923-2020; çolak, bayram/ABQ-2400-2022; sahin,
   mustafa/AAH-3394-2019
OI çolak, bayram/0000-0003-1403-6963; sahin, mustafa/0000-0002-4718-0083
CR Acosta Jorge Berlanga, 2006, Int Wound J, V3, P232, DOI 10.1111/j.1742-481X.2006.00237.x
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NR 47
TC 1
Z9 1
U1 0
U2 7
PU CARBONE EDITORE
PI PALERMO
PA VIA QUINTINO SELLA, 68, PALERMO, 90139, ITALY
SN 0393-6384
EI 2283-9720
J9 ACTA MEDICA MEDITERR
JI Acta Medica Mediterr.
PY 2018
VL 34
IS 5
BP 1245
EP 1252
PG 8
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA GL3JV
UT WOS:000437030700013
DA 2026-07-24
ER

PT J
AU Tolonen, M
   Mentula, P
   Sallinen, V
   Rasilainen, S
   Bäcklund, M
   Leppäniemi, A
AF Tolonen, Matti
   Mentula, Panu
   Sallinen, Ville
   Rasilainen, Suvi
   Backlund, Minna
   Leppaniemi, Ari
TI Open abdomen with vacuum-assisted wound closure and mesh-mediated
   fascial traction in patients with complicated diffuse secondary
   peritonitis: A single-center 8-year experience
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article; Proceedings Paper
CT National Operative Days Conference
CY NOV 16, 2016
CL Helsinki, FINLAND
DE Intestinal fistula; intra-abdominal infections; negative-pressure wound
   therapy; second-look surgery
ID NEGATIVE-PRESSURE THERAPY; DAMAGE CONTROL SURGERY; ABDOMINAL
   COMPARTMENT; SEVERE SEPSIS; MANAGEMENT; PARADIGM; SCORE
AB BACKGROUND: Open abdomen (OA) treatment in patients with peritonitis is increasing worldwide. Various temporary abdominal closure devices are being used. This study included patients with complicated diffuse secondary peritonitis, OA, and vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM). The aim of this study was to describe mortality and major morbidity in terms of delayed primary fascial closure and enteroatmospheric fistula rates.
   METHODS: This was a single-academic-center retrospective study of consecutive patients with diffuse peritonitis, OA, and VAWCM between years 2008 and 2016. Descriptive and univariate analyses were performed.
   RESULTS: Forty-one patients were identified and analyzed. Median age was 59 years, preoperative septic shock was diagnosed in 54% (n = 22), and 59% (n = 24) had a postoperative peritonitis. Mortality was 29%(n = 12), and 76%(n = 31) of patients were admitted in the intensive care unit. The median duration of OA was 7 days with a median of two dressing changes. Delayed primary fascial closure rate among survivors was 92% (n = 33), and enteroatmospheric fistulas developed in 7% (n = 3). In a subgroup analysis, patients with OA in the primary laparotomy for peritonitis (n = 27) were compared with patients with OA in the subsequent laparotomies (n = 14). There were no significant differences between groups.
   CONCLUSIONS: The VAWCM technique in patients with complicated secondary diffuse peritonitis and OA yields excellent results in terms of delayed primary fascial closure rate and a low number of enteroatmospheric fistulas. It seems to be safe to close the abdomen at the index laparotomy, if possible, even if there is a risk of a need of OA later. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
C1 [Tolonen, Matti; Mentula, Panu; Sallinen, Ville; Rasilainen, Suvi; Leppaniemi, Ari] Helsinki Univ Hosp, Dept Abdominal Surg, Abdominal Ctr, Haartmaninkatu 4, Helsinki 00290, Finland.
   [Tolonen, Matti; Mentula, Panu; Sallinen, Ville; Rasilainen, Suvi; Backlund, Minna; Leppaniemi, Ari] Univ Helsinki, Helsinki, Finland.
   [Sallinen, Ville] Helsinki Univ Hosp, Dept Transplantat & Liver Surg, Abdominal Ctr, Helsinki, Finland.
   [Backlund, Minna] Helsinki Univ Hosp, Dept Anesthesiol Intens Care & Pain Med, Div Intens Care Med, Helsinki, Finland.
C3 University of Helsinki; Helsinki University Central Hospital; University
   of Helsinki; University of Helsinki; Helsinki University Central
   Hospital; University of Helsinki; Helsinki University Central Hospital
RP Tolonen, M (通讯作者)，Helsinki Univ Hosp, Dept Abdominal Surg, Abdominal Ctr, Haartmaninkatu 4, Helsinki 00290, Finland.
EM matti.tolonen@hus.fi
RI Mentula, Panu/H-9025-2019; Leppäniemi, Ari/GQZ-7991-2022; Sallinen,
   Ville/AAG-2285-2021; Tolonen, Matti/I-9970-2019
OI Mentula, Panu/0000-0002-6516-3797; 
FU Helsinki University Central Hospital; Mary and Georg Ehrnrooth's
   Foundation; Martti I. Turunen Foundation; Vatsatautien Tutkimussaatio
   Foundation
FX This study was financially supported by Helsinki University Central
   Hospital Research Funds (Government Research Funds), Mary and Georg
   Ehrnrooth's Foundation, Martti I. Turunen Foundation, and Vatsatautien
   Tutkimussaatio Foundation.
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NR 40
TC 35
Z9 48
U1 0
U2 4
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD JUN
PY 2017
VL 82
IS 6
BP 1100
EP 1105
DI 10.1097/TA.0000000000001452
PG 6
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC General & Internal Medicine; Surgery
GA EV5MV
UT WOS:000401811900022
PM 28338592
DA 2026-07-24
ER

PT J
AU Björck, M
   Wanhainen, A
AF Bjorck, M.
   Wanhainen, A.
TI Management of Abdominal Compartment Syndrome and the Open Abdomen
SO EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
LA English
DT Review
DE Abdominal aortic aneurysm; Abdominal compartment syndrome; Consensus
   guidelines; Grading of recommendations; Intra-abdominal hypertension;
   Open abdomen; Rupture; Temporary abdominal closure
ID CLINICAL-PRACTICE GUIDELINES; MEDIATED FASCIAL TRACTION; ASSISTED WOUND
   CLOSURE; INTRAABDOMINAL HYPERTENSION; INTERNATIONAL-CONFERENCE;
   ENDOVASCULAR REPAIR; AORTOILIAC SURGERY; DAMAGE CONTROL; SIGMOID COLON;
   PRESSURE
AB Objectives: The management of the abdominal compartment syndrome (ACS) and the open abdomen (OA) are important to improve survival after major vascular surgery, in particular ruptured abdominal aortic aneurysm (RAAA). The aim is to summarize contemporary knowledge in this field.
   Methods: The consensus definitions of the World Society of the Abdominal Compartment Syndrome (WSACS) that were published in 2006 and the clinical practice guidelines published in 2007 were updated in 2013. Structured clinical questions were formulated (modified Delphi method), and the evidence base to answer those questions was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) guidelines.
   Results: Most of the previous definitions were kept untouched, or were slightly modified. Four new definitions were added, including a definition of OA and of lateralization of the abdominal wall, an important clinical problem to approach during prolonged OA treatment. A classification system of the OA was added.
   Seven recommendations were formulated, in summary: Trans-bladder intra-abdominal pressure (IAP) should be monitored in patients at risk. Protocolized monitoring and management are recommended, and decompression laparotomy if ACS. When OA, protocolized efforts to obtain an early abdominal fascial closure, and strategies utilizing negative pressure wound therapy should be used, versus not. In most cases the evidence was graded as weak or very weak. In six of the structured clinical questions, no recommendation could be made.
   Conclusion: This review summarizes changes in definitions and management guidelines of relevance to vascular surgery, and data on the incidence of ACS after open and endovascular aortic surgery. (C) 2013 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
C1 [Bjorck, M.; Wanhainen, A.] Uppsala Univ, Dept Surg Sci, Vasc Surg Sect, SE-75185 Uppsala, Sweden.
C3 Uppsala University
RP Björck, M (通讯作者)，Uppsala Univ, Dept Surg Sci, SE-75185 Uppsala, Sweden.
EM martin@bjorck.pp.se
RI Bjorck, Martin/A-4104-2008
CR Abouassaly CT, 2010, J TRAUMA, V69, P557, DOI 10.1097/TA.0b013e3181e77ca4
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NR 40
TC 47
Z9 63
U1 0
U2 13
PU W B SAUNDERS CO LTD
PI LONDON
PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND
SN 1078-5884
EI 1532-2165
J9 EUR J VASC ENDOVASC
JI Eur. J. Vasc. Endovasc. Surg.
PD MAR
PY 2014
VL 47
IS 3
BP 279
EP 287
DI 10.1016/j.ejvs.2013.12.014
PG 9
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA AC1OI
UT WOS:000332265500011
PM 24447530
DA 2026-07-24
ER

PT J
AU Raber, MH
   Steenvoorde, P
   de Wit, R
AF Raber, Menno Hendrikus
   Steenvoorde, Pascal
   de Wit, Ralph
TI Stomal Mucocutaneous Dehiscence as a Complication of a Dynamic Wound
   Closure System Following Laparostomy: A Case Report
SO OSTOMY WOUND MANAGEMENT
LA English
DT Article
DE stoma; laparostomy; dynamic wound closure; complications
ID MANAGEMENT
AB Dynamic retention suture techniques that allow gradual reapproximation of abdominal midline muscles and fascia as well as sufficient freedom of movement for breathing and patient care commonly are used to prevent lateral retraction of the abdominal fascia in patients whose abdominal wound closure must be delayed. A 58-year-old otherwise healthy man was admitted with severe abdominal sepsis and following surgery, which included the creation of a stoma, a dynamic wound closure system was applied. Mucocutaneous stomal dehiscence was observed a few days after starting the treatment. The complication was believed to have occurred as a result of traction on the proximal end of the stoma (the bowel inside the abdomen) due to tension on the sutures of the small part of the bowel outside the abdomen. Definite, primary closure of the abdominal fascia was achieved after 16 days, at which point the stoma was reinserted with good results. Since using a modified procedure that involves cutting a groove in the protective drape and carefully placing two flaps around the stoma, this complication has not been observed with similar patients in the authors' facility. This complication is not unique to this wound closure system; it also has been reported with other treatment modalities such as negative pressure wound therapy. The relatively small number of patients requiring delayed closure of the abdomen, coupled with the uniqueness of each case due to a wide variety of indications and comorbidities, hampers the development of evidence-based guidelines of care for these patients. A worldwide data exchange that includes patient experiences and descriptions of successful and failed attempts to address problems and complications in these patients is necessary. In the meantime, experiences with these types of wounds need to be shared in the literature.
C1 [Raber, Menno Hendrikus; Steenvoorde, Pascal] Med Spectrum Twente, Dept Gen Surg, NL-7500 KA Enschede, Netherlands.
   [de Wit, Ralph] Med Spectrum Twente, Intens Care Unit, NL-7500 KA Enschede, Netherlands.
C3 Medical Spectrum Twente; Medical Spectrum Twente
RP Raber, MH (通讯作者)，Med Spectrum Twente, Dept Gen Surg, NL-7500 KA Enschede, Netherlands.
EM m.raber@mst.nl
CR BAGI P, 1992, DIS COLON RECTUM, V35, P739, DOI 10.1007/BF02050321
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   Steenvoorde P, 2009, OSTOMY WOUND MANAG, V55, P44
NR 6
TC 1
Z9 1
U1 0
U2 0
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 0889-5899
EI 1943-2720
J9 OSTOMY WOUND MANAG
JI Ostomy Wound Manag.
PD JAN
PY 2011
VL 57
IS 1
BP 34
EP 37
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 727XU
UT WOS:000287837400009
PM 21252398
DA 2026-07-24
ER

PT J
AU Kitaguchi, D
   Forgione, A
   Innocenzi, C
   Yang, YC
   Espínola, F
   Giménez, M
   Oda, T
   Marescaux, J
AF Kitaguchi, Daichi
   Forgione, Antonello
   Innocenzi, Chiara
   Yang, Yuchuan
   Espinola, Federico
   Gimenez, Mariano
   Oda, Tatsuya
   Marescaux, Jacques
TI A systematic review and Bayesian network meta-analysis of randomized
   controlled trials on multiple skin closure techniques following stoma
   closure
SO COLORECTAL DISEASE
LA English
DT Review
DE network meta-analysis; stoma closure; surgical stomas; surgical wound
   infection; wound healing
ID SURGICAL SITE INFECTION; CARE-ASSOCIATED INFECTIONS; PRESSURE WOUND
   THERAPY; CLINICAL-TRIAL; CONVENTIONAL CLOSURE; ILEOSTOMY CLOSURE;
   REVERSAL; APPROXIMATION; PREVENTION; OUTCOMES
AB Background: Surgical site infection (SSI) is one of the most frequent complications after stoma closure. It is associated with prolonged recovery, increased healthcare costs and impaired quality of life. Several skin closure techniques have been proposed to reduce SSI. However, most previous studies relied on pairwise comparisons, leaving uncertainty about the relative effectiveness of different approaches. This study aimed to compare skin closure methods after stoma closure using a systematic review and Bayesian network meta-analysis. Methods: MEDLINE (PubMed), Embase and the Cochrane Library were searched. A total of 23 randomized controlled trials enrolling 1851 adult patients who underwent stoma closure were included. Skin closure methods included linear closure, purse-string closure and gunsight closure, with or without negative pressure wound therapy or a subcutaneous drain. The primary outcome was SSI. Secondary outcomes were length of hospital stay and time to complete wound healing. Results: Across all studies, purse-string closure was associated with a markedly lower incidence of SSI as compared to linear closure (risk ratio: 0.18, 95% credible intervals: 0.07-0.37). No significant differences were observed between groups regarding hospital stay. However, wound healing was generally slower after purse-string closure, ranking lowest among evaluated techniques in time to complete wound healing. The overall certainty of evidence was moderate, and results were consistent across sensitivity analyses. Conclusions: Purse-string closure is likely to be associated with the lowest risk of SSI after stoma closure. However, it may be associated with delayed wound healing. Consequently, further refinement of this technique or the development of combination strategies is necessary to optimize both infection prevention and wound-healing outcomes.
C1 [Kitaguchi, Daichi; Forgione, Antonello; Innocenzi, Chiara; Yang, Yuchuan; Espinola, Federico; Gimenez, Mariano; Marescaux, Jacques] Res Inst Digest Canc IRCAD, Strasbourg, France.
   [Kitaguchi, Daichi; Oda, Tatsuya] Univ Tsukuba, Inst Med, Dept Gastrointestinal Hepatobiliary Pancreat Surg, Tsukuba, Ibaraki, Japan.
   [Innocenzi, Chiara] Fdn Policlin Univ Agostino Gemelli IRCCS, Dept Women Children & Publ Hlth Sci, Rome, Italy.
C3 University of Tsukuba; Catholic University of the Sacred Heart; IRCCS
   Policlinico Gemelli
RP Forgione, A (通讯作者)，Res Inst Digest Canc IRCAD, Strasbourg, France.
EM antonello.forgione@ircad.fr
RI ; Innocenzi, Chiara/QLV-8592-2026
OI Kitaguchi, Daichi/0000-0002-8197-6317; 
FU Japan Agency for Medical Research and Development [JP256f0137008]
FX This research was partially supported by AMED under Grant Number
   JP256f0137008.
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NR 49
TC 0
Z9 0
U1 0
U2 0
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1462-8910
EI 1463-1318
J9 COLORECTAL DIS
JI Colorectal Dis.
PD MAR
PY 2026
VL 28
IS 3
AR e70412
DI 10.1111/codi.70412
PG 11
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA FJ1GA
UT WOS:001719973800007
PM 41786646
DA 2026-07-24
ER

PT J
AU Wu, N
   Li, LP
AF Wu, Nan
   Li, Luping
TI 被撤回的出版物: A review on wound management strategies in enhanced recovery
   after craniotomy: An in-depth analysis of their influence on patient
   recovery and surgical outcomes (Retracted article. See vol. 22, 2025)
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Review; Retracted Publication
DE craniotomy; enhanced recovery; neurosurgery; patient outcomes; wound
   management
ID POSTOPERATIVE PAIN; ELECTIVE CRANIOTOMY; SITE INFECTIONS; SURGERY;
   ADHESIVES
AB Craniotomy, an essential neurosurgical operation, poses distinct difficulties in the realm of post-operative care, specifically with regard to the management of wounds. Efficient wound management is critical in order to optimize the surgical outcomes, reduce complications and facilitate a speedier recovery. The purpose of this comprehensive review was to assess contemporary wound management approaches as they pertain to improved recovery following craniotomy. This was achieved by contrasting conventional methods with more recent and innovative techniques and analysing the effects of these approaches on patient recovery and surgical results. An exhaustive literature search was undertaken, comprising narrative reviews, clinical studies, peer-reviewed articles and expert opinions. The emphasis was on the evolution of wound management strategies and techniques utilized after cranial section, as well as their contributions to patient recovery. The analysis reveals that while conventional wound management methods, including suturing and antiseptics, continue to be essential, innovative strategies such as negative pressure wound therapy, skin adhesives and advanced pain management protocols are becoming increasingly recognized. It has been demonstrated that these novel approaches improve recovery by decreasing the incidence of infections, enhancing patient comfort and producing superior cosmetic results. Nevertheless, obstacles continue to endure, including patient-specific variables, technological and financial considerations and the enduring consequences of recovery. Thus the treatment of wounds during craniotomy recuperation necessitates an integrated strategy that incorporates conventional techniques alongside contemporary advancements. Progress in this domain necessitates the customization of approaches to suit the unique requirements of each patient, the resolution of identified obstacles and an emphasis on ongoing investigation and interdisciplinary cooperation. The ever-changing terrain of wound management approaches underscores the ever-changing character of neurosurgical treatment and the continuous endeavour to enhance patient results following cranial resection.
C1 [Wu, Nan; Li, Luping] Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Nursing Dept, Hangzhou 310020, Zhejiang, Peoples R China.
C3 Zhejiang University
RP Wu, N (通讯作者)，Zhejiang Univ, Sir Run Run Shaw Hosp, Sch Med, Nursing Dept, Hangzhou 310020, Zhejiang, Peoples R China.
EM wunan13516720027@163.com
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NR 72
TC 7
Z9 8
U1 0
U2 10
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD JAN
PY 2024
VL 21
IS 1
AR e14595
DI 10.1111/iwj.14595
PG 12
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA EX7Q8
UT WOS:001142302300001
PM 38272808
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Jain, NS
   Horn, CB
   Centeno, AAC
   Ilahi, ON
   Mazuski, JE
   Bocchichio, GV
   Punch, LJ
AF Jain, Nirbhay S.
   Horn, Christopher B.
   Centeno, Adrian A. Coleoglou
   Ilahi, Obeid N.
   Mazuski, John E.
   Bocchichio, Grant V.
   Punch, Laurie J.
TI Femoral Osteomyelitis Caused by Cladophialophora in a Patient
   without Known Immunocompromise
SO SURGICAL INFECTIONS
LA English
DT Article
DE chronic osteomyelitis; fungal infection; girdlestone arthroplasty;
   osteomyelitis
ID PRESSURE WOUND THERAPY
AB Background: Chronic osteomyelitis associated with a stage IV decubitus ulcer is a challenging condition to manage, characterized by frequent relapses and need for long-term anti-microbial therapy. Although gram-positive cocci are the most common causes, fungal infections have been reported, usually in immunocompromised hosts. We present a case of Cladophialophora osteomyelitis in a patient without known immunocompromised that was managed with a Girdlestone pseudoarthroplasty. Case Report: A 70-year-old male presented to our emergency room with fever, right hip pain, and purulent drainage from a right greater trochanter stage IV decubitus ulcer. His medical history was significant for T10 paraplegia secondary to spinal ependymomas and multiple spinal procedures, as well as significant recent weight loss. Past operations included multiple spinal procedures and repair of a right intertrochanteric femoral fracture with a plate and lateral compression screws. This led to post-operative decubitus ulcer formation over the right greater trochanter, requiring a gracilis flap. The flap remained intact for three years, then re-ulcerated. He subsequently developed femoral head osteomyelitis. To facilitate the treatment, the hardware was removed three weeks prior to presentation. With evidence of worsening osteomyelitis and a new soft-tissue infection, a Girdlestone procedure was performed. Intra-operatively, he was noted to have a pathological intertrochanteric fracture. Soft-tissue cultures yielded Pseudomonas aeruginosa; bone cultures grew Streptococcus dysgalactiae and Cladophialophora spp. Post-operatively, his wound was managed with negative pressure wound therapy with instillation and dwell (NPWTi-d). Delayed primary closure over a drain and topical negative pressure was done four days later. His course was uneventful, and he was discharged six days later. At his four-month follow-up, the wound was completely healed. Conclusion: Invasive fungal infections are rare in immunocompetent individuals. Cladophialophora osteomyelitis has been found in immunocompromised individuals with concomitant cerebral abscesses. To our knowledge, this is the first case of osteomyelitis without previously known immunocompromise.
C1 [Jain, Nirbhay S.] Washington Univ, Sch Med, St Louis, MO USA.
   [Horn, Christopher B.; Centeno, Adrian A. Coleoglou; Ilahi, Obeid N.; Mazuski, John E.; Bocchichio, Grant V.; Punch, Laurie J.] Washington Univ, Dept Surg, St Louis, MO USA.
C3 Washington University (WUSTL); Washington University (WUSTL)
RP Centeno, AAC (通讯作者)，Washington Univ, Sch Med, Dept Surg, Campus Box 8109,660 South Euclid Ave, St Louis, MO 63110 USA.
EM coleogloua@wustl.edu
OI Horn, Christopher/0000-0003-0717-3601; Ilahi, Obeid/0000-0003-0719-2554
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NR 12
TC 1
Z9 1
U1 0
U2 6
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1096-2964
EI 1557-8674
J9 SURG INFECT
JI Surg. Infect.
PD JUL
PY 2018
VL 19
IS 5
BP 544
EP 547
DI 10.1089/sur.2018.046
EA JUN 2018
PG 4
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases; Surgery
GA GL0WY
UT WOS:000435154400001
PM 29893620
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Raihane, AS
   Deusch, GM
   Liu, CR
   Najafi, B
   Deng, WQ
   Dark, NG
   Armstrong, DG
AF Raihane, Ahmed Sami
   Deusch, Gabriela Morales
   Liu, Charles
   Najafi, Bijan
   Deng, Wuquan
   Dark, Natasha G.
   Armstrong, David G.
TI Spooky action at a distance: neuromodulation, physiologic distress
   signals, and limb preservation
SO BURNS & TRAUMA
LA English
DT Review
DE Diabetic foot ulcer; Chronic limb-threatening ischemia; Neuromodulation;
   Remote ischemic conditioning; Angiogenesis, Limb preservation
ID SPINAL-CORD STIMULATION; DIABETIC FOOT ULCERS; CHRONIC PAIN; INDUCED
   OSTEOGENESIS; PERIOSTEAL DISTRACTION; ISCHEMIA; THERAPY;
   PATHOPHYSIOLOGY; PROLIFERATION; MECHANISMS
AB The rising global prevalence of chronic conditions, notably obesity and type 2 diabetes, demands innovative approaches to mitigate their health and economic impacts. Complications, including neuropathy and chronic limb-threatening ischemia (CLTI), dramatically increase the risk of lower limb amputation, cardiovascular events, and cerebrovascular events, underscoring the urgent need for effective interventions. Emerging neuromodulation and regenerative strategies provide novel approaches to addressing diabetes-related complications. High-frequency (10-kHz) spinal cord stimulation demonstrates marked pain relief and sensory improvement in patients with refractory painful diabetic neuropathy. Peripheral focused ultrasound, including splenic-targeted stimulation, shows promise in reducing systemic inflammation, accelerating wound repair, and enhancing vascular function. Remote ischemic conditioning leverages brief controlled ischemic reperfusion cycles to enhance microcirculation and promote diabetic foot ulcer (DFU) healing. In severe cases, surgical techniques such as tibial transverse transport and lateral tibial periosteum distraction stimulate angiogenesis and enhance distal limb perfusion. Integrated wound care protocols, incorporating these procedures alongside debridement, negative pressure wound therapy, and skin grafting, may further optimize outcomes. Collectively, these therapies address both local and systemic pathophysiology, frequently producing physiologic effects at sites distant from the primary intervention. These seemingly disparate therapies represent a single unifying concept: generating a physiologic effect at locations remote from the primary target. This systematic approach, engaging neural, vascular, and immune pathways, may be key to improving outcomes in DFUs and CLTI. Early clinical data appears promising; however, larger randomized trials are required to validate efficacy, refine patient selection, and determine optimal integration with standard care. If confirmed, these strategies may shift management toward patient-centered, regenerative interventions that preserve limbs, reduce recurrence, and enhance quality of life for the expanding global patient population. Further research is warranted to confirm or refute these early promising physiologic effects.
C1 [Raihane, Ahmed Sami; Dark, Natasha G.] Univ New Mexico, Dept Surg, Sch Med, Div Plast & Reconstruct Surg, 1 Univ New Mexico,MSC10 5550, Albuquerque, NM 87131 USA.
   [Deusch, Gabriela Morales] Pasadena City Coll, 1570 E Colorado Blvd, Pasadena, CA 91106 USA.
   [Liu, Charles] Univ Southern Calif, Neurorestorat Ctr, 1200 N State St, Los Angeles, CA 90033 USA.
   [Liu, Charles] Univ Southern Calif, Dept Neurol Surg, Keck Sch Med, 1200 N State St, Los Angeles, CA 90033 USA.
   [Liu, Charles] Rancho Amigos Natl Rehabil Ctr, 7601 Imperial Hwy, Downey, CA 90242 USA.
   [Najafi, Bijan] Univ Calif Los Angeles, Dept Surg, David Geffen Sch Med, 10833 Conte Ave, Los Angeles, CA 90095 USA.
   [Deng, Wuquan] Chongqing Univ, Chongqing Univ Cent Hosp, Chongqing Emergency Med Ctr, Sch Med, 1 Jiankang Rd, Chongqing 400014, Peoples R China.
   [Armstrong, David G.] Univ Southern Calif, Dept Surg, Keck Sch Med, 1520 San Pablo St, Los Angeles, CA 90033 USA.
C3 University of New Mexico; University of Southern California; University
   of Southern California; University of California System; University of
   California Los Angeles; University of California Los Angeles Medical
   Center; David Geffen School of Medicine at UCLA; Chongqing University;
   University of Southern California
RP Raihane, AS (通讯作者)，Univ New Mexico, Dept Surg, Sch Med, Div Plast & Reconstruct Surg, 1 Univ New Mexico,MSC10 5550, Albuquerque, NM 87131 USA.
EM araihane@salud.unm.edu
RI Najafi, Bijan/AAK-5650-2020
FX No funding was received for this study.
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   Zeng ZS, 2019, J ORTHOP TRANSL, V19, P133, DOI 10.1016/j.jot.2019.04.005
   Zhao DY, 2016, BIOMED RES INT, V2016, DOI 10.1155/2016/2075317
   Zhao SC, 2024, FRONT ENDOCRINOL, V15, DOI 10.3389/fendo.2024.1420232
   Zhao Xiaoming, 2020, Zhongguo Xiu Fu Chong Jian Wai Ke Za Zhi, V34, P969, DOI 10.7507/1002-1892.201911104
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NR 127
TC 0
Z9 0
U1 0
U2 0
PU OXFORD UNIV PRESS
PI OXFORD
PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND
SN 2321-3868
EI 2321-3876
J9 BURNS TRAUMA
JI Burns Trauma
PY 2026
VL 14
AR tkag017
DI 10.1093/burnst/tkag017
PG 17
WC Emergency Medicine; Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Dermatology; Surgery
GA KO4ML
UT WOS:001811789600001
PM 42441071
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Coccolini, F
   Gubbiotti, F
   Ceresoli, M
   Tartaglia, D
   Fugazzola, P
   Ansaloni, L
   Sartelli, M
   Kluger, Y
   Kirkpatrick, A
   Amico, F
   Catena, F
   Chiarugi, M
AF Coccolini, Federico
   Gubbiotti, Francesca
   Ceresoli, Marco
   Tartaglia, Dario
   Fugazzola, Paola
   Ansaloni, Luca
   Sartelli, Massimo
   Kluger, Yoram
   Kirkpatrick, Andrew
   Amico, Francesco
   Catena, Fausto
   Chiarugi, Massimo
CA IROA Study Grp
TI Open Abdomen and Fluid Instillation in the Septic Abdomen: Results from
   the IROA Study
SO WORLD JOURNAL OF SURGERY
LA English
DT Article
ID FASCIAL CLOSURE; PERITONEAL RESUSCITATION; MANAGEMENT; PRESSURE; THERAPY
AB Background Open abdomen (OA) is a surgical option that can be used in patients with severe peritonitis. Few evidences exist to recommend the use of intraperitoneal fluid instillation associated with OA in managing septic abdomen. Materials and methods A prospective analysis of adult patients enrolled in the International Register of Open Abdomen (trial registration: NCT02382770) was performed. Results A total of 387 patients were enrolled in two groups: 84 with peritoneal fluid instillation (FI) and 303 without (NFI). The groups were homogeneous for baseline characteristics. Overall complications were 92.9% in FI and 86.3% in NFI (p = 0.106). Complications during OA were 72.6% in FI and 59.9% in NFI (p = 0.034). Complications after definitive closure were 70.8% in FI and 61.1% in NFI (p = 0.133). Entero-atmospheric fistula was 13.1% in FI and 12% in NFI (p = 0.828). Fascial closure was 78.6% in FI and 63.7% in NFI (p = 0.02). Analysis of FI in negative pressure wound therapy (NPWT) showed: Overall morbidity in NPWT was 94% and in non-NPWT 91.2% (p = 0.622) and morbidity during OA was 68% and 79.4% (p = 0.25), respectively. Definitive fascial closure in NPWT was 87.8% and 96.8% in non-NPWT (p = 0.173). Overall mortality was 40% in NPWT and 29.4% in non-NPWT (p = 0.32) and morality during OA period was 18% and 8.8% (p = 0.238), respectively. Conclusion We found intraperitoneal fluid instillation during open abdomen in peritonitic patients to increase the complication rate during the open abdomen period, with no impact on mortality, entero-atmospheric fistula rate and opening time. Fascial closure rate is increased by instillation. Fluid instillation is feasible even when associated with nonnegative pressure temporary abdominal closure techniques.
C1 [Coccolini, Federico; Tartaglia, Dario; Chiarugi, Massimo] Pisa Univ Hosp, Gen Emergency & Trauma Surg Dept, Via Paradisia 1, I-56124 Pisa, Italy.
   [Gubbiotti, Francesca] Ancona Hosp, Gen Surg Dept, Ancona, Italy.
   [Ceresoli, Marco] Milano Bicocca Univ Hosp, Gen & Emergency Surg Dept, Monza, Italy.
   [Fugazzola, Paola; Ansaloni, Luca] Bufalini Hosp, Gen Emergency & Trauma Surg Dept, Cesena, Italy.
   [Sartelli, Massimo] Macerata Hosp, Gen & Emergency Surg Dept, Macerata, Italy.
   [Kluger, Yoram] Rambam Med Ctr, Gen Surg Dept, Tel Aviv, Israel.
   [Kirkpatrick, Andrew] Foothills Med Ctr, Dept Surg, Calgary, AB, Canada.
   [Amico, Francesco] Univ Newcastle, John Hunter Hosp, Dept Surg, Trauma Serv, Newcastle, NSW, Australia.
   [Catena, Fausto] Parma Univ Hosp, Emergency Surg Dept, Parma, Italy.
C3 University of Pisa; Azienda Ospedaliero Universitaria Pisana; Technion
   Israel Institute of Technology; Rambam Health Care Campus; University of
   Calgary; University Calgary Hospital; John Hunter Hospital; University
   of Newcastle; University of Parma; University Hospital of Parma
RP Coccolini, F (通讯作者)，Pisa Univ Hosp, Gen Emergency & Trauma Surg Dept, Via Paradisia 1, I-56124 Pisa, Italy.
EM federico.coccolini@gmail.com
RI Ansaloni, Luca/AAJ-6507-2020; /AAD-7440-2020; Tartaglia,
   Dario/AAJ-1735-2020; Ceresoli, Marco/GMW-5356-2022; Fugazzola,
   Paola/AAH-4680-2019; Chiarugi, Massimo/ABQ-7280-2022; Ansaloni,
   Luca/AAP-9134-2020
OI Ansaloni, Luca/0000-0001-6427-0307; Fugazzola,
   Paola/0000-0002-6227-9276; amico, francesco/0000-0002-8217-9379;
   Chiarugi, Massimo/0000-0001-6905-2499; Ansaloni,
   Luca/0000-0001-6427-0307
FU Universita di Pisa within the CRUI-CARE Agreement
FX Open access funding provided by Universita di Pisa within the CRUI-CARE
   Agreement.
CR Alvarez PS, 2018, ANN MED SURG, V36, P246, DOI 10.1016/j.amsu.2018.10.007
   Andreano M, 2017, ANN ITAL CHIR, V88, P412
   [Anonymous], 2017, World Journal of Emergency Surgery
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NR 33
TC 8
Z9 14
U1 1
U2 11
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0364-2313
EI 1432-2323
J9 WORLD J SURG
JI World J.Surg.
PD DEC
PY 2020
VL 44
IS 12
BP 4032
EP 4040
DI 10.1007/s00268-020-05728-3
EA AUG 2020
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA OI2OY
UT WOS:000562325000001
PM 32833107
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Darras, O
   Yacoub, S
   Mordukhovich, I
   Phuyal, D
   Woo, KP
   Rosen, MJ
   Gurunian, R
   Bishop, SN
AF Darras, Osama
   Yacoub, Sara
   Mordukhovich, Isaac
   Phuyal, Diwakar
   Woo, Kimberly P.
   Rosen, Michael J.
   Gurunian, Raffi
   Bishop, Sarah N.
TI Successful Abdominal Wall Reconstruction Following Liposuction
   Catastrophe
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE abdominal wall reconstruction; liposuction; microsurgery; flap; patient
   safety
ID NECROTIZING FASCIITIS SECONDARY; ANTEROLATERAL THIGH FLAP; COMPONENT
   SEPARATION; ALGORITHM; PATIENT
AB BackgroundDevastating abdominal injuries may result from liposuction, which can lead to necrotizing fasciitis and loss of abdominal domain. This may necessitate reconstructing the abdominal wall to improve the patient's quality of life.ObjectivesThe study aims to raise awareness among the readers of this catastrophic complication. Guidelines for preoperative assessment, and intraoperative measures to reduce abdominal complications along with the importance of early recognition, diagnostic tools, and treatment strategies were provided.MethodsWe reported a patient who underwent abdominal wall reconstruction following liposuction-inflicted abdominal injury and necrotizing fasciitis. Subsequently, a literature search was conducted to review abdominal wall reconstructive techniques following liposuction-inflicted abdominal injuries. Algorithms for patient safety followed this.ResultsThe patient developed necrotizing fasciitis due to liposuction cannula bowel perforation leading to loss of abdominal domain. This was reconstructed with a transversus abdominis release trial with mesh followed by bilateral pedicled neurotized anterolateral thigh flaps with vastus lateralis. The review of the literature included 10 papers describing different techniques of abdominal reconstruction. Common treatment techniques following liposuction-inflicted abdominal injuries were negative pressure wound therapy and skin grafting.ConclusionsAnterolateral thigh flaps are an excellent option that provides functional and structural repair. Neurotization of the muscle helps protect the muscle from atrophy. The review of the literature showed a lack of abdominal wall reconstruction using musculocutaneous flaps following liposuction-inflicted abdominal injuries.Communicating symptom awareness to patients and the medical team is essential for quickly identifying potential visceral injury after liposuction, ensuring prompt management and improved outcomes.ConclusionsAnterolateral thigh flaps are an excellent option that provides functional and structural repair. Neurotization of the muscle helps protect the muscle from atrophy. The review of the literature showed a lack of abdominal wall reconstruction using musculocutaneous flaps following liposuction-inflicted abdominal injuries.Communicating symptom awareness to patients and the medical team is essential for quickly identifying potential visceral injury after liposuction, ensuring prompt management and improved outcomes.
C1 [Darras, Osama; Yacoub, Sara; Mordukhovich, Isaac; Phuyal, Diwakar; Gurunian, Raffi; Bishop, Sarah N.] Cleveland Clin, Dept Plast Surg, Cleveland, OH USA.
   [Woo, Kimberly P.; Rosen, Michael J.] Cleveland Clin, Dept Gen Surg, Cleveland, OH USA.
   [Gurunian, Raffi] Cleveland Clin Abu Dhabi, Dept Plast Surg, Abu Dhabi, U Arab Emirates.
C3 Cleveland Clinic Foundation; Cleveland Clinic Foundation; Cleveland
   Clinic Foundation
RP Bishop, SN (通讯作者)，9500 Euclid Ave, Cleveland, OH 44195 USA.
EM omdarras@gmail.com; sgy16@case.edu; ixm124@case.edu;
   diwakar.ph123@gmail.com; wook2@ccf.org; rosenm@ccf.org; gurunir@ccf.org;
   BISHOPS@ccf.org
OI Darras, Osama/0000-0002-5051-0581; Mordukhovich,
   Isaac/0009-0003-4682-411X
CR Abraham PF, 2020, BMJ CASE REP, V13, DOI 10.1136/bcr-2020-234924
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   Bekeny JC, 2024, AESTHET PLAST SURG, V48, P946, DOI 10.1007/s00266-023-03567-w
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NR 32
TC 2
Z9 2
U1 2
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD AUG
PY 2025
VL 95
IS 2
BP 132
EP 137
DI 10.1097/SAP.0000000000004404
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 5BK0K
UT WOS:001531661400005
PM 40396685
DA 2026-07-24
ER

PT J
AU Lumsden, EJ
   Kimble, RM
   McMillan, C
   Storey, K
   Ware, RS
   Griffin, B
AF Lumsden, Emma Joan
   Kimble, Roy M.
   McMillan, Catherine
   Storey, Kristen
   Ware, Robert S.
   Griffin, Bronwyn
TI Protocol for a feasibility, acceptability and safety study of the PICO
   device (negative pressure wound therapy) in acute paediatric burns
SO BMJ OPEN
LA English
DT Article
DE surgery; paediatric surgery; qualitative research; statistics & research
   methods; clinical trials; wound management
ID ASSESSMENT SCALE; SAMPLE-SIZE; PILOT; PAIN; ULTRASOUND; CHILDREN;
   QUALITY; TOOL
AB IntroductionNegative pressure wound therapy (NPWT) in acute burn care may decrease the time to re-epithelialisation by more than 20%. Despite this, the perceived burden of use; including therapeutic, physical and financial, have limited the use of NPWT in acute burn care. This might be minimised by using the small, ultraportable, single-use NPWT device PICO as opposed to larger devices, which to date has never been studied in acute burn care. This research will; therefore, primarily assess the feasibility, acceptability and safety of PICO in paediatric burns. Secondary outcomes include time to re-epithelialisation, pain, itch, cost and scar formation.Methods and analysisThis protocol details a clinical trial methodology and is pre-results. This single site, prospective, pilot randomised controlled trial will be conducted in an Australian quaternary paediatric burns centre. Participants must be aged <= 16 years, otherwise well and managed within 24 hours of sustaining a burn that fits beneath a PICO dressing. Thirty participants will be randomised to one of three groups: group A: Mepitel and ACTICOAT, group B: Mepitel, ACTICOAT and PICO and group C: Mepitel, ACTICOAT Flex and PICO. Patient outcomes will be recorded at each dressing change to assess efficacy and safety outcomes until 3 months postburn wound re-epithelialisation. Surveys, randomisation and data storage will be undertaken via online platforms and physical data storage collated at the Centre for Children's Health Research, Brisbane, Australia. Analysis will be done by using StataSE 17.0 statistical software.Ethics and disseminationEthics has been obtained from Queensland Health and Griffith Human Research Ethics committees including a site-specific approval. These data will be disseminated via clinical meetings, conference presentations and peer-reviewed journals.
C1 [Lumsden, Emma Joan; Kimble, Roy M.; Ware, Robert S.; Griffin, Bronwyn] Griffith Univ, Fac Hlth, Southport, Qld, Australia.
   [Lumsden, Emma Joan; Kimble, Roy M.; McMillan, Catherine; Storey, Kristen] Queensland Childrens Hosp, Burns Dept, South Brisbane, Qld, Australia.
   [Lumsden, Emma Joan; Kimble, Roy M.; Griffin, Bronwyn] Ctr Childrens Hlth Res, Burns & Trauma Res Grp, Brisbane, Qld, Australia.
   [Ware, Robert S.; Griffin, Bronwyn] Griffith Univ, Menzies Hlth Inst Queensland, Nathan, Qld, Australia.
C3 Griffith University; Childrens Health Queensland Hospital & Health
   Service; Queensland Childrens Hospital; Griffith University
RP Lumsden, EJ (通讯作者)，Griffith Univ, Fac Hlth, Southport, Qld, Australia.; Lumsden, EJ (通讯作者)，Queensland Childrens Hosp, Burns Dept, South Brisbane, Qld, Australia.; Lumsden, EJ (通讯作者)，Ctr Childrens Hlth Res, Burns & Trauma Res Grp, Brisbane, Qld, Australia.
EM emma.lumsden@health.qld.gov.au
RI Griffin, Bronwyn/AEB-6299-2022; Ware, Robert/B-2024-2014; Kimble,
   Roy/B-4160-2011
OI Griffin, Bronwyn/0000-0002-6182-9125; Ware, Robert/0000-0002-6129-6736;
   Luden, Emma/0000-0002-5437-9701; 
FU Smith Nephew; Smith and Nephew [IIS721]
FX This research was grant funded by Smith & Nephew which partially funded
   the trial. They had no input into study design. Smith and Nephew grant
   number IIS721.
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NR 37
TC 3
Z9 3
U1 0
U2 0
PU BMJ PUBLISHING GROUP
PI LONDON
PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
SN 2044-6055
J9 BMJ OPEN
JI BMJ Open
PD MAY
PY 2023
VL 13
IS 5
DI 10.1136/bmjopen-2022-068499
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA I3JU6
UT WOS:001001783700072
PM 37137557
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Robertson, MJ
   Lee, RC
   Bergin, PF
   Graves, ML
   Russell, G
AF Robertson, Michael J.
   Lee, Rowdy C.
   Bergin, Patrick F.
   Graves, Matthew L.
   Russell, George, V
TI Complications of Morbid Obesity in the Treatment of Acetabular
   Fractures: Re-evaluating Outcomes a Decade Later
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE acetabulum; acetabular fracture; orthopaedic trauma; obesity; morbid
   obesity; severe obesity; wound vac; negative pressure wound therapy;
   wound complication; polytrauma; complications
ID HETEROTOPIC OSSIFICATION PROPHYLAXIS; OPERATIVE TREATMENT; RISK;
   INDOMETHACIN; INCREASES; HIP
AB Objectives: To determine the rate of perioperative complications between morbidly obese (body mass index greater than 40 kg/m(2)) and nonmorbidly obese patients undergoing operative treatment of acetabular fractures across 2 periods (2000-2005 and 2012-2019). Design: Retrospective, case-control study. Setting: Level I academic trauma center. Patients: Four hundred thirty-five consecutive patients from 2000 to 2005 and 216 consecutive patients from 2012 to 2019 with acetabular fractures treated by a single surgeon. Intervention: Operative fixation of acetabular fracture. Main Outcome Measurements: Outcome variables include positioning time, operative time, estimated blood loss, hospital stay, wound complications, and perioperative complications. Results: Twenty-eight morbidly obese and 188 nonmorbidly obese patients from 2012 to 2019, as well as 41 morbidly obese patients and 394 nonmorbidly obese patients from 2000 to 2005 were included in the study. The relative risk (RR) of wound complications between 2012 and 2019 groups was significantly higher for morbidly obese patients (RR = 5.31, P = 0.009) but has decreased significantly for morbidly obese patients between 2000-2005 and 2012-2019 (RR = 0.31, P = 0.017). The rate of total perioperative complications was similar between morbidly obese and nonmorbidly obese groups from 2012 to 2019 (21% vs. 8%, P = 0.230). For morbidly obese patients, the rate of total perioperative complications decreased significantly between 2000-2005 and 2012-2019 (63% vs. 21% P = 0.010). Conclusion: Acetabular fracture surgery can be safely performed in morbidly obese patients. Although obesity remains a significant risk factor for wound complications, the risk for morbidly obese patients has decreased significantly since our initial investigation because of adaptations to surgical techniques and surgeon's experience.
C1 [Robertson, Michael J.; Lee, Rowdy C.; Bergin, Patrick F.; Graves, Matthew L.; Russell, George, V] Univ Mississippi, Dept Orthoped, Med Ctr, 2500 North State St, Jackson, MS 39216 USA.
C3 University of Mississippi; University of Mississippi Medical Center
RP Robertson, MJ (通讯作者)，Univ Mississippi, Dept Orthoped, Med Ctr, 2500 North State St, Jackson, MS 39216 USA.
EM mjrobertson@umc.edu
RI Russell, George/LQL-0206-2024
CR BROOKER AF, 1973, J BONE JOINT SURG AM, VA 55, P1629, DOI 10.2106/00004623-197355080-00006
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NR 25
TC 3
Z9 3
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0890-5339
EI 1531-2291
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD FEB
PY 2022
VL 36
IS 2
BP 87
EP 92
DI 10.1097/BOT.0000000000002199
PG 6
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA YK3LB
UT WOS:000745117700014
PM 34620777
DA 2026-07-24
ER

PT J
AU McGinness, K
   Phelan, DHK
AF McGinness, Kristen
   Phelan, Dorothy H. Kurtz
TI Use of Viable Cryopreserved Umbilical Tissue for Soft Tissue Defects in
   Patients With Gas Gangrene: A Case Series
SO WOUNDS-A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE
LA English
DT Article
DE gas gangrene; viable cryopreserved umbilical tissue; surgical; placental
   tissue; amputation
ID DIABETIC FOOT ULCERS; AMNIOTIC MEMBRANE; CLOSURE; CELLS
AB Introduction: Gas gangrene is a rapidly progressive bacterial infection leading to necrosis that usually develops as a result of trauma or postoperative complications. This condition requires early diagnosis with immediate surgical intervention. With a poor prognosis, a high incidence of amputation, and comorbidities such as diabetes and peripheral vascular disease, patients with gas gangrene are put at further risk for surgical complications. Objective: This case series reports the clinical outcomes of using a commercially available viable cryopreserved umbilical tissue (vCUT) in the surgical management of 10 patients (9 males, 1 female) with acute lower extremity gas gangrene. Materials and methods: All 10 patients had aggressive debridement and irrigation, followed by an intraoperative application of vCUT to cover the large, complex wounds with exposed bone, tendon, and soft tissue, which was fenestrated and sutured to the surrounding skin edges. Results: The average wound size following debridement was 45.9 cm2 (range, 8 cm2-105 cm2). Average percent area reduction of the wounds at 4 weeks post-vCUT application was 68.4% (range, 49%-99.5%). The average length of hospital stay was 9 days (range, 2-16 days), and postdischarge patients were treated with negative pressure wound therapy and standard of care (nonadherent dressing, dry gauze, and mild compression) until wound closure was achieved (average, 3.3 months [range, 1.25-4.5 months]). With a 1-time application of vCUT, all patients reached complete wound closure with decreased time to closure, fewer complications, and a shorter duration of hospitalization as compared with traditional inpatient management of gas gangrene (incision and drainage with staged procedures). Conclusions: The positive clinical outcomes indicate that vCUT may be an effective aid as an intraoperative application to cover wounds following aggressive debridement in the presence of gas gangrene.
C1 [McGinness, Kristen] Yale New Haven Northeast Med Grp Podiatry, Greenwich, CT USA.
   [Phelan, Dorothy H. Kurtz] Osiris Therapeut Inc, Columbia, MD USA.
C3 Osiris Therapeutics
RP Phelan, DHK (通讯作者)，Osiris Therapeut Inc, Dept Med Affairs, 7015 Albert Einstein Dr, Columbia, MD 21046 USA.
EM dphelan@osiris.com
FU Osiris Therapeutics, Inc.
FX Dr. Kurtz Phelan is a paid employee of Osiris Therapeutics, Inc.
   Manuscript production support was provided by Osiris Therapeutics, Inc.
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NR 15
TC 9
Z9 10
U1 0
U2 5
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 1044-7946
EI 1943-2704
J9 WOUNDS
JI Wounds-Compend. Clin. Res. Pract.
PD APR
PY 2018
VL 30
IS 4
BP 90
EP 95
PG 6
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA GQ7HI
UT WOS:000441907100006
PM 29718818
DA 2026-07-24
ER

PT J
AU Riza, SM
   Porosnicu, AL
   Sinescu, RD
AF Riza, Stefania-Mihaela
   Porosnicu, Andrei-Ludovic
   Sinescu, Ruxandra Diana
TI A Comprehensive Literature Review on the Therapeutic Potential of
   Platelet-Rich Plasma for Diabetic Foot Management: Insights from a Case
   of a Neglected Deep Plantar Abscess
SO HEALTHCARE
LA English
DT Review
DE chronic wounds; diabetic foot ulcers (DFUs); platelet-rich plasma (PRP);
   regenerative medicine; limb salvage surgery; growth factors;
   angiogenesis; re-epithelialization; wound healing; tissue regeneration;
   chronic wound management; advanced wound therapy
ID GROWTH-FACTORS; ULCERS; INFECTION; GEL; DIAGNOSIS; EXOSOMES; EFFICACY
AB Background: Diabetic foot ulcers (DFUs) remain a major complication of diabetes, characterized by impaired wound healing, high infection risk, and an increased likelihood of limb amputation. Platelet-rich plasma (PRP) has emerged as a promising adjunctive therapy due to its regenerative properties, promoting angiogenesis, modulating inflammation, and accelerating tissue repair. Methods: This literature review explores the current evidence regarding the use of PRP in the management of DFUs. It was conducted using the PubMed database to evaluate the efficacy of PRP in DFUs. The search was restricted to studies published in the last 10 years, including randomized controlled trials, meta-analyses, and systematic reviews. The inclusion criteria focused on studies assessing PRP as a standalone treatment or in combination with other wound care strategies, evaluating key clinical outcomes such as wound healing rates, infection control, tissue regeneration, and amputation prevention. Results: A total of 35 studies met the inclusion criteria, including 11 meta-analyses, 15 review articles, and 9 clinical trials. PRP demonstrated potential benefits in accelerating wound healing, reducing inflammation, and promoting granulation tissue formation. Additionally, PRP combined with negative-pressure wound therapy (NPWT) showed superior outcomes in reducing amputation rates. However, findings varied based on patient characteristics, PRP preparation techniques, and treatment protocols. Conclusions: PRP represents a valuable adjunct in DFU management, contributing to improved healing outcomes and reduced complications. However, the lack of standardized protocols and variability in clinical results highlight the need for further large-scale, multicenter studies to establish its definitive role in diabetic wound care.
C1 [Riza, Stefania-Mihaela; Porosnicu, Andrei-Ludovic; Sinescu, Ruxandra Diana] Carol Davila Univ Med & Pharm, Dept Plast Surg & Reconstruct Microsurg, Bucharest 050474, Romania.
   [Riza, Stefania-Mihaela; Porosnicu, Andrei-Ludovic; Sinescu, Ruxandra Diana] Elias Emergency Univ Hosp, Dept Plast Surg & Reconstruct Microsurg, Bucharest 011461, Romania.
C3 Carol Davila University of Medicine & Pharmacy
RP Porosnicu, AL (通讯作者)，Carol Davila Univ Med & Pharm, Dept Plast Surg & Reconstruct Microsurg, Bucharest 050474, Romania.; Porosnicu, AL (通讯作者)，Elias Emergency Univ Hosp, Dept Plast Surg & Reconstruct Microsurg, Bucharest 011461, Romania.
EM stefania-mihaela.riza@drd.umfcd.ro; andrei.porosnicu@umfcd.ro;
   ruxandra.sinescu@umfcd.ro
RI Porosnicu, Andrei Ludovic/PXW-4532-2026; Riza, Stefania/MDT-6082-2025;
   Sinescu, Ruxana Diana/ABD-2479-2020
OI Sinescu, Ruxana Diana/0000-0002-7591-0987
FU University of Medicine and Pharmacy Carol Davila
FX The publication of this paper was supported by the University of
   Medicine and Pharmacy Carol Davila through the Institutional Program
   "Publish not Perish".
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NR 48
TC 1
Z9 1
U1 4
U2 8
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2227-9032
J9 HEALTHCARE-BASEL
JI Healthcare
PD MAY 13
PY 2025
VL 13
IS 10
AR 1130
DI 10.3390/healthcare13101130
PG 12
WC Health Care Sciences & Services; Health Policy & Services
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Health Care Sciences & Services
GA 3AJ2B
UT WOS:001495613300001
PM 40427966
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Hernigou, P
   Hernigou, J
   Scarlat, M
AF Hernigou, Philippe
   Hernigou, Jacques
   Scarlat, Marius
TI The Dark Age of medieval surgery in France in the first part of Middle
   Age (500-1000): royal touch, wound suckers, bizarre medieval surgery,
   monk surgeons, Saint Healers, but foundation of the oldest worldwide
   still-operating hospital
SO INTERNATIONAL ORTHOPAEDICS
LA English
DT Article
DE Middle Ages surgery; Wound suckers; Debridement in Middle Ages; Medieval
   negative pressure wound therapy; Bizarre medieval surgery; Cautery;
   Blood-letting; Leech therapy; Maggot therapy; Trepanning; Monk surgeons;
   Saint Healers; Royal touch; &#8220; Hotel Dieu&#8221; hospital; Clovis;
   Charlemagne
ID HISTORY; LEG
AB Purpose During the Middle Ages, the Christian church established itself as the dominant force over all aspects of medieval life, including the practice of medicine. As the Church's influence expanded across Europe, the role of lay practitioners in medicine declined, and clerics gradually assumed the role of healers in surgical practice as the cure of the soul was felt to take precedence over cure of bodily ills. Material and methods A retrospective analysis of hospital foundation, old-school surgical techniques still used today was performed during the first part of the Middle Age. Results The Hospital Hotel Dieu in Paris was founded and remains the oldest worldwide still-operating hospital. The monastery became a resting place for travelers, as well as a place of refuge for the sick. As this role expanded, monks often developed considerable surgical expertise. This led to fierce competition for saintly relics and pilgrims. Among the myriad of saints to whom powers of healing were ascribed, the names of Damian and Cosmas figure prominently in medical history. Old-school medieval surgery was also performed with some bizarre techniques such as lip service by wound suckers, cautery, blood-letting, leech therapy, and maggot therapy. Conclusion This account of surgery before it became scientific is based on a chronology that runs from the Clovis baptism to the reign of Charlemagne; much of the medicine in this period was based on ancient doctrines; indeed, much of the development of medicine in the period called as "Dark Age" was due to the slow and difficult business of recovering and trying to understand ancient medicine
C1 [Hernigou, Philippe] Univ Paris East, Orthoped Dept, Henri Mondor Hosp, Paris, France.
   [Hernigou, Jacques] EpiCURA Hosp, Dept Orthopaed & Traumatol Surg, Baudour Hornu, St Ghislain, Belgium.
   [Scarlat, Marius] Grp ELSAN, Clin Chirurg St Michel, Dept Chirurg Orthoped, Av Orient, F-83100 Toulon, France.
C3 Assistance Publique Hopitaux Paris (APHP); Universite
   Paris-Est-Creteil-Val-de-Marne (UPEC); Hopital Universitaire
   Henri-Mondor - APHP
RP Hernigou, P (通讯作者)，Univ Paris East, Orthoped Dept, Henri Mondor Hosp, Paris, France.
EM philippe.hernigou@wanadoo.fr
RI Hernigou, Jacques/AAO-6778-2020
OI Hernigou, Jacques/0000-0001-9402-6401
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NR 21
TC 14
Z9 19
U1 0
U2 6
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0341-2695
EI 1432-5195
J9 INT ORTHOP
JI Int. Orthop.
PD JUN
PY 2021
VL 45
IS 6
BP 1633
EP 1644
DI 10.1007/s00264-020-04914-1
EA JAN 2021
PG 12
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA SN4BQ
UT WOS:000604803500005
PM 33394075
DA 2026-07-24
ER

PT J
AU Popivanov, G
   Cirocchi, R
   Penchev, D
   Kjossev, K
   Konaktchieva, M
   Mutafchiyski, V
AF Popivanov, Georgi
   Cirocchi, Roberto
   Penchev, Dimitar
   Kjossev, Kirien
   Konaktchieva, Marina
   Mutafchiyski, Ventsislav
TI Successful Negative Pressure Therapy of Enteroatmospheric Fistula after
   Right Colectomy for Complicated Crohn's Disease -A Proposal for a
   Three-Drain Wound-Separation Technique
SO MEDICINA-LITHUANIA
LA English
DT Article
DE enteroatmospheric fistula; frozen abdomen; modified technique; staged
   wound closure
ID OPEN ABDOMEN; NUTRITION; CLOSURE; TRAUMA
AB Enteroatmospheric fistulas (EAFs) are still the worst complication of the open abdomen. They lead to a significantly prolonged intensive care unit and hospital stay and to high mortality. Despite the various techniques described in the literature EAFs remain "a nightmare" for the patient, the surgeon, and the hospital. Here we describe a case of right colectomy for obstructing Crohn's disease in a 26-year-old. On the 19th postoperative day, he developed a superficial EAF. Due to the frozen abdomen, neither resection of the anastomosis, nor implementation of the known techniques for treatment of EAFs were possible. This prompted us to modify the Pepe technique. The EAF was isolated from the upper and lower parts of the wound through deep-skin and subcutaneous sutures and the application of two small pieces of non-adherent plastic foil. The lower holes of a single drain, put through a piece of black foam, were placed over the fistula. The upper holes, which were enveloped with the foam, remained in contact with the wound. The drain was connected to a negative pressure of 125 mmHg. NPWT (negative pressure wound therapy) was also applied by two separate sponges and drains in the upper and lower part. The mainstay of EAF treatment is the isolation of the EAF from the abdominal cavity and subcutaneous tissue, supported by control of the sepsis and adequate nutrition. The proposed technique is applicable in cases with a single, superficial EAF on the background of the frozen abdomen with minimal lateral fascial retraction. As of today, due to the rarity of the condition and lack of randomized trials, EAFs still represents a unique challenge often requiring improvisation.
C1 [Popivanov, Georgi; Penchev, Dimitar; Kjossev, Kirien; Mutafchiyski, Ventsislav] Mil Med Acad, Dept Surg, Sv G Sofiiski Str 3, Sofia 1606, Bulgaria.
   [Cirocchi, Roberto] Univ Perugia, Dept Surg Sci, I-06123 Perugia, Italy.
   [Konaktchieva, Marina] Mil Med Acad, Dept Gastroenterol Hepatol & Transplantol, Sv G Sofiiski Str 3, Sofia 1606, Bulgaria.
C3 Military Medical Academy Sofia; University of Perugia; Military Medical
   Academy Sofia
RP Popivanov, G (通讯作者)，Mil Med Acad, Dept Surg, Sv G Sofiiski Str 3, Sofia 1606, Bulgaria.
EM gerasimpopivanov@rocketmail.com; roberto.cirocchi@unipg.it;
   d.k.penchev@gmail.com; kirienkt@gmail.com;
   marina.konaktchieva@yahoo.com; ventzimm@gmail.com
RI Kjossev, Kirien/KQV-3036-2024; Cirocchi, Roberto/I-1197-2014; Popivanov,
   Georgi/IVH-4670-2023
OI Cirocchi, Roberto/0000-0002-2457-0636; Popivanov,
   Georgi/0000-0001-9618-3187
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NR 14
TC 2
Z9 4
U1 0
U2 5
PU MDPI
PI BASEL
PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND
SN 1010-660X
EI 1648-9144
J9 MEDICINA-LITHUANIA
JI Med. Lith.
PD FEB
PY 2022
VL 58
IS 2
AR 199
DI 10.3390/medicina58020199
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA ZK0IR
UT WOS:000762681700001
PM 35208523
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Yakkanti, RR
   Mohile, N
   Cohen-Levy, WB
   Haziza, S
   Lavelle, MJ
   Bellam, KG
   Quinnan, SM
AF Yakkanti, Ramakanth R.
   Mohile, Neil, V
   Cohen-Levy, Wayne B.
   Haziza, Sagie
   Lavelle, Matthew J.
   Bellam, Krishna G.
   Quinnan, Stephen M.
TI Perioperative management of acetabular and pelvic fractures:
   evidence-based recommendations
SO ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
LA English
DT Article
DE Pelvic fracture; Acetabular fracture; Concept review; Time to fixation;
   Tranexamic acid; Heterotopic ossification
ID VENA-CAVA FILTERS; PRESSURE WOUND THERAPY; BLOOD-CELL SALVAGE;
   PREVENTING HETEROTOPIC OSSIFICATION; SURGICAL SITE INFECTIONS;
   TRANEXAMIC ACID; TRAUMA PATIENTS; VENOUS THROMBOEMBOLISM; RISK-FACTORS;
   INTERNAL-FIXATION
AB Purpose The American Academy of Orthopaedic Surgeons does not currently provide clinical practice guidelines for management of PAF. Accordingly, this article aims to review and consolidate the relevant historical and recent literature in important topics pertaining to perioperative management of PAF. Methods A thorough literature review using PubMed, Cochrane and Embase databases was performed to assess preoperative, intraoperative and postoperative management of PAF fracture. Topics reviewed included: time from injury to definitive fixation, the role of inferior vena cava filters (IVCF), tranexamic acid (TXA) use, intraopoperative cell salvage, incisional negative pressure wound therapy (NPWT), intraoperative antibiotic powder use, heterotopic ossification prophylaxis, and pre- and postoperative venous thromboembolism (VTE) prophylaxis. Results A total of 126 articles pertaining to the preoperative, intraoperative and postoperative management of PAF were reviewed. Articles reviewed by topic include 13 articles pertaining to time to fixation, 23 on IVCF use, 14 on VTE prophylaxis, 20 on TXA use, 10 on cell salvage, 10 on iNPWT 14 on intraoperative antibiotic powder and 20 on HO prophylaxis. An additional eight articles were reviewed to describe background information. Five articles provided information for two or more treatment modalities and were therefore included in multiple categories when tabulating the number of articles reviewed per topic. Conclusion The literature supports the use of radiation therapy for HO prophylaxis, early (< 5 days from injury) surgical intervention and the routine use of intraoperative TXA. The literature does not support the routine use of iNPWT or IVCF. There is inadequate information to make a recommendation regarding the use of cell salvage and wound infiltration with antibiotic powder. While the routine use of chemical VTE prophylaxis is recommended, there is insufficient evidence to recommend the optimal agent and duration of therapy.
C1 [Yakkanti, Ramakanth R.; Mohile, Neil, V; Haziza, Sagie; Lavelle, Matthew J.] Univ Miami, Dept Orthopaed Surg, Univ Hosp, 1321 NW 14th St,Suite 306, Miami, FL 33125 USA.
   [Cohen-Levy, Wayne B.] Case Western Reserve Univ, Univ Hosp, Cleveland, OH 44106 USA.
   [Bellam, Krishna G.] Brown Univ, Warren Alpert Med Sch, Providence, RI 02912 USA.
   [Quinnan, Stephen M.] Paley Orthoped & Spine Inst, W Palm Beach, FL USA.
C3 University of Miami; University System of Ohio; Case Western Reserve
   University; University Hospitals of Cleveland; Brown University
RP Haziza, S (通讯作者)，Univ Miami, Dept Orthopaed Surg, Univ Hosp, 1321 NW 14th St,Suite 306, Miami, FL 33125 USA.
EM Sagiehaziza@gmail.com
RI Yakkanti, Ramakanth/AAC-4316-2020
OI Yakkanti, Ramakanth/0000-0001-7112-0139; Haziza,
   Sagie/0000-0003-2799-1134
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NR 126
TC 7
Z9 10
U1 0
U2 5
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0936-8051
EI 1434-3916
J9 ARCH ORTHOP TRAUM SU
JI Arch. Orthop. Trauma Surg.
PD MAR
PY 2023
VL 143
IS 3
BP 1311
EP 1321
DI 10.1007/s00402-021-04278-0
EA DEC 2021
PG 11
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA ER9Y8
UT WOS:000725382200001
PM 34854977
DA 2026-07-24
ER

PT J
AU Husu, HL
   Leppäniemi, AK
   Mentula, PJ
AF Husu, Henrik Leonard
   Leppaniemi, Ari Kalevi
   Mentula, Panu Juhani
TI Who would benefit from open abdomen in severe acute pancreatitis?-a
   matched case-control study
SO WORLD JOURNAL OF EMERGENCY SURGERY
LA English
DT Article
DE Abdominal compartment syndrome; Abdominal vac; Acute pancreatitis;
   Circulatory failure; Intra-abdominal hypertension; ICU; Laparostomy;
   Multiple organ failure; Necrotizing pancreatitis; Negative-pressure
   wound therapy; NPWT; Open abdomen; Organ failure; Renal failure; Severe
   acute pancreatitis; VAWCM; Vacuum-assisted wound closure; Mesh-mediated
   fascial traction
ID ABDOMINAL COMPARTMENT SYNDROME; PRESSURE WOUND THERAPY; INTRAABDOMINAL
   HYPERTENSION; DECOMPRESSIVE LAPAROTOMY; ISCHEMIA; GUIDELINES; MORTALITY;
   CLOSURE
AB Background Selection of patients for open abdomen (OA) treatment in severe acute pancreatitis (SAP) is challenging. Treatment related morbidity and risk of adverse events are high; however, refractory abdominal compartment syndrome (ACS) is potentially lethal. Factors influencing the decision to initiate OA treatment are clinically important. We aimed to study these factors to help understand what influences the selection of patients for OA treatment in SAP. Methods A single center study of patients with SAP that underwent OA treatment compared with conservatively treated matched controls. Results Within study period, 47 patients treated with OA were matched in a 1:1 fashion with conservatively treated control patients. Urinary output under 20 ml/h (OR 5.0 95% CI 1.8-13.7) and ACS (OR 4.6 95% CI 1.4-15.2) independently associated with OA treatment. Patients with OA treatment had significantly more often visceral ischemia (34%) than controls (6%), P = 0.002. Mortality among patients with visceral ischemia was 63%. Clinically meaningful parameters predicting developing ischemia were not found. OA treatment associated with higher overall 90-day mortality rate (43% vs 17%, P = 0.012) and increased need for necrosectomy (55% vs 21%, P = 0.001). Delayed primary fascial closure was achieved in 33 (97%) patients that survived past OA treatment. Conclusion Decreased urine output and ACS were independently associated with the choice of OA treatment in patients with SAP. Underlying visceral ischemia was strikingly common in patients undergoing OA treatment, but predicting ischemia in these patients seems difficult.
C1 [Husu, Henrik Leonard; Leppaniemi, Ari Kalevi; Mentula, Panu Juhani] Univ Helsinki, Dept Gastrointestinal Surg, POB 340, FI-00029 Helsinki, Finland.
   [Husu, Henrik Leonard; Leppaniemi, Ari Kalevi; Mentula, Panu Juhani] Helsinki Univ Hosp, POB 340, FI-00029 Helsinki, Finland.
C3 University of Helsinki; University of Helsinki; Helsinki University
   Central Hospital
RP Husu, HL (通讯作者)，Univ Helsinki, Dept Gastrointestinal Surg, POB 340, FI-00029 Helsinki, Finland.
EM henrik.husu@hus.fi
RI Leppäniemi, Ari/GQZ-7991-2022; Mentula, Panu/H-9025-2019
OI Husu, Henrik/0000-0002-7024-8373; Mentula, Panu/0000-0002-6516-3797
FU governmental competitive funds for medical research; Medical Society of
   Finland; Perklens Foundation; Helsinki University Library
FX This study was supported by governmental competitive funds for medical
   research, a research grant from The Medical Society of Finland, and a
   research grant from Perklens Foundation. Open access funded by Helsinki
   University Library.
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NR 21
TC 7
Z9 12
U1 0
U2 5
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-7922
J9 WORLD J EMERG SURG
JI World J. Emerg. Surg.
PD JUN 10
PY 2021
VL 16
IS 1
AR 32
DI 10.1186/s13017-021-00376-x
PG 8
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA SV4NH
UT WOS:000663797200004
PM 34112205
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Dhayat, SA
   Schacht, R
   Mennigen, R
   Palmes, D
   Vogel, T
   Vowinkel, T
   Senninger, N
   Laukoetter, MG
AF Dhayat, Sameer A.
   Schacht, Rosanna
   Mennigen, Rudolf
   Palmes, Daniel
   Vogel, Thomas
   Vowinkel, Thorsten
   Senninger, Norbert
   Laukoetter, Mike Georg
TI Long-Term Quality of Life Assessment After Successful Endoscopic Vacuum
   Therapy of Defects in the Upper Gastrointestinal Tract Quality of Life
   After EVT
SO JOURNAL OF GASTROINTESTINAL SURGERY
LA English
DT Article
DE Negative-pressure wound therapy; Upper gastrointestinal tract;
   Anastomotic leakage; Quality of life
ID ASSISTED CLOSURE; ANASTOMOTIC LEAKAGE; TREATMENT OPTIONS; MANAGEMENT;
   ESOPHAGECTOMY; PERFORATIONS; STENT; COMPLICATIONS; GASTRECTOMY
AB BackgroundAccumulating evidence indicates that anastomotic leakages and perforations of the upper gastrointestinal tract (uGIT) can be treated successfully with endoscopic vacuum therapy (EVT). So far, no data is available regarding the long-term quality of life (QoL) after successful EVT of defects in the uGIT.MethodsWe present a prospective survey on long-term Qol of 52 patients treated by EVT for defects of the uGIT. Results are compared with 63 of 221 patients treated by esophagectomy without anastomotic insufficiency (w/o EVT) between 12/2011 and 12/2015. The Gastrointestinal Quality of Life-Index (GIQLI) score was determined by a 36-item questionnaire of 25 respondents with EVT and 50 respondents w/o EVT.ResultsThe response rate was 78.95% (75/95) including 25 survey respondents who were treated with EVT for anastomotic insufficiency secondary to esophagectomy or gastrectomy (n=19), iatrogenic esophageal perforation (n=4), and Boerhaave syndrome (n=2) and 50 respondents with complication-free esophagectomy w/o EVT. The median follow-up was 19months for EVT patients and 21months for patients w/o EVT. Except for social function (p=0.009) in favor for patients w/o EVT, the median GIQLI score did not differ significantly between both study groups concerning the categories symptoms', emotions', physical functions', and medical treatment' resulting in a total median GIQLI score of 83 in EVT versus 96.5 in patients w/o EVT (p=0.185). Spearman Rho analysis revealed that a high GIQLI score correlated with a low ASA score (p<0.001), a benign pathology (p=0.001), and a hospital stay less than 21days (p<0.001).ConclusionEVT in the uGIT is well tolerated by the patients and accompanied by a satisfactory long-term QoL.
C1 [Dhayat, Sameer A.; Schacht, Rosanna; Mennigen, Rudolf; Palmes, Daniel; Vogel, Thomas; Vowinkel, Thorsten; Senninger, Norbert; Laukoetter, Mike Georg] Univ Hosp Muenster, Dept Gen & Visceral Surg, Albert Schweitzer Campus 1,Bldg W1, D-48149 Munster, Germany.
C3 University of Munster
RP Laukoetter, MG (通讯作者)，Univ Hosp Muenster, Dept Gen & Visceral Surg, Albert Schweitzer Campus 1,Bldg W1, D-48149 Munster, Germany.
EM laukoetter@uni-muenster.de
OI Dhayat, SA/0000-0002-5314-9736
CR Ahrens M, 2010, ENDOSCOPY, V42, P693, DOI 10.1055/s-0030-1255688
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NR 30
TC 11
Z9 16
U1 0
U2 2
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1091-255X
EI 1873-4626
J9 J GASTROINTEST SURG
JI J. Gastrointest. Surg.
PD FEB
PY 2019
VL 23
IS 2
BP 280
EP 287
DI 10.1007/s11605-018-4038-9
PG 8
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA HM4UY
UT WOS:000459471700008
PM 30430432
DA 2026-07-24
ER

PT J
AU Tapking, C
   Panayi, A
   Haug, V
   Palackic, A
   Houschyar, KS
   Claes, KEY
   Kuepper, S
   Vollbach, F
   Kneser, U
   Hundeshagen, G
AF Tapking, C.
   Panayi, A.
   Haug, V.
   Palackic, A.
   Houschyar, K. S.
   Claes, K. E. Y.
   Kuepper, S.
   Vollbach, F.
   Kneser, U.
   Hundeshagen, G.
TI Use of the modified meek technique for the coverage of extensive burn
   wounds
SO BURNS
LA English
DT Article
DE Burn; Skin graft; Meek micrografting; Wound healing
ID 5 YEARS EXPERIENCE; MANAGEMENT
AB Introduction: Autologous split thickness skin grafting using meshing technique remains the preferred option for the management of deep dermal and full thickness burns. The limited donor site availability seen in patients with extensive burns, however, restricts use of the mesh grafting technique for skin expansion. Meek micrografting was developed to allow for greater expansion, and, therefore, more reliable treatment of extensive burns. This study aimed to present our outcomes using the Meek micrografting technique and identify risk factors for graft failure. Methods: A retrospective review of patients admitted to our large academic hospital who were treated with the Meek micrografting technique from 2013 to 2022 was conducted. Patient demographics, surgical characteristics and outcomes were reported. Regression analyses were performed to identify factors that influence graft take and reoperation rate. Results: A total of 73 patients with a mean age of 45.7 +/- 19.9 years and mean burn size of 60.0 +/- 17.8%TBSA, with 45.3 +/- 14.9% TBSA being third degree burns, received Meek transplantation. The mean graft take after removal of the pre-folded polyamide gauze at the tenth post-operative day was 75.8 +/- 14.7%. Pre-treatment with use of an allograft, longer waiting time between admission and Meek grafting and transplantation over a dermal matrix were identified as positive predictors for graft take, while age was established as a negative predictor. Conclusion: By examining the outcomes of the Meek micrografting technique in extensive burn wounds we identified that preconditioning of the wound bed, through allograft or negative pressure wound therapy application, positively correlates with improved outcomes, including higher graft take. At the same time, older age was seen to negatively correlate with graft take. Overall, Meek transplantation displays a favorable safety profile
C1 [Tapking, C.; Panayi, A.; Haug, V.; Palackic, A.; Vollbach, F.; Kneser, U.; Hundeshagen, G.] Heidelberg Univ, Dept Hand Plast & Reconstruct Surg, BG Unfallklin Ludwigshafen, Microsurg,Burn Ctr, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany.
   [Houschyar, K. S.] Univ Hosp Aachen, Dept Dermatol & Allergol, Aachen, Germany.
   [Claes, K. E. Y.] Ghent Univ Hosp, Burn Ctr, Dept Plast & Reconstruct Surg, Ghent, Belgium.
   [Kuepper, S.] Unfallkrankenhaus Berlin, Burns Ctr & Plast Surg, Berlin, Germany.
C3 Ruprecht Karls University Heidelberg; RWTH Aachen University; RWTH
   Aachen University Hospital; Ghent University; Ghent University Hospital
RP Hundeshagen, G (通讯作者)，Heidelberg Univ, Dept Hand Plast & Reconstruct Surg, BG Unfallklin Ludwigshafen, Microsurg,Burn Ctr, Ludwig Guttmann Str 13, D-67071 Ludwigshafen, Germany.
EM gabriel.hundeshagen@bgu-ludwigshafen.de
RI Panayi, Adriana/HHT-0513-2022; Claes, Karel/AAP-5220-2021
OI Panayi, Adriana/0000-0003-4053-9855; 
CR Almodumeegh A, 2017, INT WOUND J, V14, P601, DOI 10.1111/iwj.12650
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   Hsieh CS, 2008, BURNS, V34, P350, DOI 10.1016/j.burns.2007.05.005
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NR 31
TC 12
Z9 13
U1 1
U2 7
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0305-4179
EI 1879-1409
J9 BURNS
JI Burns
PD MAY
PY 2024
VL 50
IS 4
BP 1003
EP 1010
DI 10.1016/j.burns.2024.01.005
EA APR 2024
PG 8
WC Critical Care Medicine; Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Dermatology; Surgery
GA QZ3A8
UT WOS:001224640400008
PM 38383170
DA 2026-07-24
ER

PT J
AU Gatti, G
   Benussi, B
   Brunetti, D
   Ceschia, A
   Porcari, A
   Biondi, F
   Castaldi, G
   Luzzati, R
   Sinagra, G
   Pappalardo, A
AF Gatti, Giuseppe
   Benussi, Bernardo
   Brunetti, Davide
   Ceschia, Alessandro
   Porcari, Aldostefano
   Biondi, Federico
   Castaldi, Gianluca
   Luzzati, Roberto
   Sinagra, Gianfranco
   Pappalardo, Aniello
TI The fate of patients having deep sternal infection after bilateral
   internal thoracic artery grafting in the negative pressure wound therapy
   era
SO INTERNATIONAL JOURNAL OF CARDIOLOGY
LA English
DT Article
DE Arterial grafts; Coronary artery bypass grafting; Mortality/survival;
   Risk factors; Sternal wound infection
ID SURGICAL-SITE INFECTIONS; LONG-TERM SURVIVAL; BYPASS GRAFT;
   RISK-FACTORS; DIABETIC-PATIENTS; ROUTINE USE; CORONARY; SURGERY;
   REVASCULARIZATION; MEDIASTINITIS
AB Background: Late survival of patients having deep sternal wound infection (DSWI) after bilateral internal thoracic artery (BITA) grafting is largely unexplored.
   Methods: Outcomes of 3391 consecutive BITA patients were reviewed retrospectively. Patients with DSWI after surgery (n = 142, 4.2%) were compared with those having no sternal complications (n = 3177). Predictors of DSWI and of mortality during the follow-up period were found with negative-binomial and Cox proportional-hazards regression, respectively. One-to-one propensity score-matched analysis, which considered simultaneously baseline patient characteristics, operative data, and postoperative complications was performed. The resulting matched pairs were compared for non-parametric estimates of late survival. The same comparison was performed in matched pairs having no major complications (except DSWI) early after surgery.
   Results: In-hospital mortality was higher in DSWI cohort than in patients having no sternal complications (5.6% vs. 1.8%, p = 0.0035). Almost all of postoperative complications were more frequent in DSWI patients. Female sex, obesity, chronic lung disease, renal impairment, extracardiac arteriopathy, congestive heart failure, and urgent/emergency priority were predictors of DSWI common to two DSWI risk models that were developed. DSWI was independent predictor of reduced late survival (multiple covariates-adjusted hazard ratio [HR], 1.91, p < 0.0001). The propensity matching resulted in 135 pairs with same in-hospital mortality (5.2%). Estimates of freedom from all-cause death were lower in DSWI cohort (HR, 1.92, p < 0.0001), even when only pairs (n = 59) having nomajor postoperative complications (except DSWI) were considered (HR, 1.84, p = 0.026).
   Conclusions: DSWI after BITA use seems to reduce late survival even after adjusting for baseline patient characteristics and concomitant postoperative complications. (c) 2018 Elsevier B.V. All rights reserved.
C1 [Gatti, Giuseppe; Benussi, Bernardo; Ceschia, Alessandro; Porcari, Aldostefano; Biondi, Federico; Castaldi, Gianluca; Sinagra, Gianfranco; Pappalardo, Aniello] Univ Hosp Trieste, Cardiothorac & Vasc Dept, Trieste, Italy.
   [Brunetti, Davide] Univ Hosp Trieste, Dept Med Sci, Trieste, Italy.
   [Luzzati, Roberto] Univ Hosp Trieste, Div Infect Dis, Trieste, Italy.
C3 University of Trieste; University Trieste Hospital; University of
   Trieste; University Trieste Hospital; University of Trieste; University
   Trieste Hospital
RP Gatti, G (通讯作者)，Osped Cattinara, Div Cardiac Surg, Via P Valdoni 7, I-34148 Trieste, Italy.
EM giuseppe.gatti@asuits.sanita.fvg.it
RI Porcari, Aldostefano/AAU-8846-2021; Sinagra, Gianfranco/AAE-3943-2020;
   /ABE-8809-2020; Gatti, Giuseppe/A-3849-2017; Luzzati,
   Roberto/AAU-6939-2021
OI Porcari, Aldostefano/0000-0003-3307-0825; Gatti,
   Giuseppe/0000-0002-9996-6133; Luzzati, Roberto/0000-0001-5546-0715
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NR 50
TC 15
Z9 15
U1 0
U2 2
PU ELSEVIER IRELAND LTD
PI CLARE
PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000,
   IRELAND
SN 0167-5273
EI 1874-1754
J9 INT J CARDIOL
JI Int. J. Cardiol.
PD OCT 15
PY 2018
VL 269
BP 67
EP 74
DI 10.1016/j.ijcard.2018.07.090
PG 8
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA GT6FP
UT WOS:000444606500014
PM 30049494
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Chaboyer, W
   Ellwood, D
   Thalib, L
   Kumar, S
   Mahomed, K
   Kang, E
   Gillespie, BM
AF Chaboyer, Wendy
   Ellwood, David
   Thalib, Lukman
   Kumar, Sailesh
   Mahomed, Kassam
   Kang, Evelyn
   Gillespie, Brigid M.
TI Incidence and predictors of surgical site infection in women who are
   obese and give birth by elective caesarean section: A secondary analysis
SO AUSTRALIAN & NEW ZEALAND JOURNAL OF OBSTETRICS & GYNAECOLOGY
LA English
DT Article
DE caesarean section; obesity; risk factor; surgical site infection; wound
   complication
ID RISK-FACTORS; INCISION
AB Background Surgical site infection (SSI) after a caesarean section is of concern (CS) is of concern to both clinicians and women themselves. Aims The aim of this study is to identify the cumulative incidence and predictors of SSI in women who are obese and give birth by elective CS. Materials and Methods The method used was planned secondary analysis of data from women with a pre-pregnancy body mass index (BMI) >= 30 kg/m(2) giving birth by elective CS in a multicentre randomised controlled trial of a prophylactic closed-incision negative pressure wound therapy dressing. Data were collected from medical records, direct observations of the surgical site and self-reported signs and symptoms from October 2015 to December 2019. The Centers for Disease Control and Prevention definition was used to identify SSI. Women were followed up once in hospital just before discharge and then weekly for four weeks after discharge. Blinded outcome assessors determined SSI. After the cumulative incidence of SSI was calculated, multiple variable logistic regression models were used to identify independent risk factors for SSI. Results SSI incidence in 1459 women was 8.4% (122/1459). Multiple variable-adjusted odds ratios (OR) for SSI were BMI >= 40 kg/m(2) (OR 1.55, 95% confidence interval (CI) 1.30-1.86) as compared to BMI 30-34.9 0 kg/m(2), >= 2 previous pregnancies (OR 1.38, 95% CI 1.00-1.80) as compared to no previous pregnancies and pre-CS vaginal cleansing (OR 0.55, 95% CI 0.33-0.99). Conclusions Our findings may inform preoperative counselling and shared decision-making regarding planned elective CS for women with pre-pregnancy BMI >= 30 kg/m(2).
C1 [Chaboyer, Wendy; Gillespie, Brigid M.] Griffith Univ, NHMRC Ctr Res Excellence Wiser Wound Care, Gold Coast, Qld 4222, Australia.
   [Chaboyer, Wendy; Gillespie, Brigid M.] Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld 4222, Australia.
   [Ellwood, David] Griffith Univ, Gold Coast Univ Hosp, Sch Med, Gold Coast, Qld, Australia.
   [Thalib, Lukman] Istanbul Aydin Univ, Fac Med, Dept Biostat, Istanbul, Turkey.
   [Kumar, Sailesh] Univ Queensland, Fac Med, Dept Obstet & Gynaecol, Brisbane, Qld, Australia.
   [Kumar, Sailesh] Mater Mothers Hosp, Brisbane, Qld, Australia.
   [Mahomed, Kassam] Univ Queensland, Ipswich Hosp, Dept Obstet & Gynaecol, Ipswich, Qld, Australia.
   [Mahomed, Kassam] Univ Queensland, Ipswich Hosp, Fac Med, Ipswich, Qld, Australia.
   [Kang, Evelyn] Griffith Univ, Menzies Hlth Inst Queensland, Sch Nursing & Midwifery, Gold Coast, Qld, Australia.
   [Gillespie, Brigid M.] Griffith Univ, Gold Coast Univ Hosp, Gold Coast, Qld, Australia.
C3 Griffith University; Menzies Health Institute Queensland; Griffith
   University; Griffith University; Gold Coast University Hospital;
   Istanbul Aydin University; University of Queensland; Mater Health
   Services; Mater Mothers' Hospital; University of Queensland; University
   of Queensland; Menzies Health Institute Queensland; Griffith University;
   Griffith University; Gold Coast University Hospital
RP Chaboyer, W (通讯作者)，Griffith Univ, NHMRC Ctr Res Excellence Wiser Wound Care, Gold Coast, Qld 4222, Australia.; Chaboyer, W (通讯作者)，Griffith Univ, Menzies Hlth Inst Queensland, Gold Coast, Qld 4222, Australia.
EM w.chaboyer@griffith.edu.au
RI ; Ellwood, David/C-8208-2015; Thalib, Lukman/HAI-7553-2022; Chaboyer,
   Wendy/F-9588-2018; Kumar, Sailesh/M-3207-2014; Mahomed,
   Kassam/M-1335-2013; Gillespie, Brigid/E-7799-2012
OI Kang, Evelyn/0000-0001-8253-1638; Ellwood, David/0000-0003-4512-6443;
   Thalib, Lukman/0000-0002-1211-6495; Chaboyer, Wendy/0000-0001-9528-7814;
   Kumar, Sailesh/0000-0003-0832-4811; Gillespie,
   Brigid/0000-0003-3186-5691
FU National Health and Medical Research Council [APP1081026]
FX We thank Nicky Cullum, Joan Webster and Jennifer Whitty for their
   contribution as chief investigators of the parent trial. National Health
   and Medical Research Council project grant APP1081026 $2,285,351.
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NR 33
TC 5
Z9 6
U1 0
U2 4
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0004-8666
EI 1479-828X
J9 AUST NZ J OBSTET GYN
JI Aust. N. Z. J. Obstet. Gynaecol.
PD APR
PY 2022
VL 62
IS 2
BP 234
EP 240
DI 10.1111/ajo.13428
EA SEP 2021
PG 7
WC Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Obstetrics & Gynecology
GA 0V3KL
UT WOS:000695012300001
PM 34506037
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Othman, S
   Messa, CA
   Elfanagely, O
   Bormann, B
   Mellia, JA
   Broach, RB
   Kovach, SJ
   Fischer, JP
AF Othman, Sammy
   Messa, Charles A.
   Elfanagely, Omar
   Bormann, Bradford
   Mellia, Joseph A.
   Broach, Robyn B.
   Kovach, Stephen J.
   Fischer, John P.
TI Sticking to What Matters: A Matched Comparative Study of Fibrin Glue and
   Mechanical Fixation for Split-Thickness Skin Grafts in the Lower
   Extremity
SO INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS
LA English
DT Article
DE wound; fibrin glue; split-thickness skin graft; skin graft; fibrin
   fixation; fibrin sealant; wound healing
ID BURN WOUNDS; SEALANT; STAPLES; COST; ADHERENCE; EFFICACY; TRIAL
AB Background: Split-thickness skin grafts (STSGs) remain a valuable tool in the reconstructive surgeons' armamentarium. Staple or suture mechanical fixation (MF) serves as the gold standard of care, though fibrin glue (FG) has gained popularity as a fixation modality. We compare STSG outcomes following application of FG versus MF through a study of lower extremity wounds. Methods: A retrospective review (2016-2019) of patients who underwent a STSG was performed. Two cohorts consisting of patients undergoing a STSG with FG or MF (suture or staple) were matched according to wound size, wound location, and body mass index. Results: A total of 67 patients with 79 wounds were included (FG: n = 30, wounds = 39; MF: n = 37; wounds = 40). There was no significant difference between groups regarding time to 100% graft take (FG: 39 days, MF: 35.1 days; P < .384) or 180-day graft complications (FG: 10.3%, MF: 15%; P < .737). Adjusted operative time for FG (51.8 min) was lower than for MF cases (67.5 min) at a level that approached significance (P < .094). FG patients were significantly less likely to require a postoperative wound vacuum-assisted closure (VAC) (FG: 16.7%; MF: 76.7%; P < .001) and required a significantly lower number of 30-day postoperative visits (FG: 1.5 +/- .78 visits; MF: 2.5 +/- .03 visits; P < .001). The MF group had higher mean aggregate charges ($211,090) compared with the FG group (mean: $149,907), although these were not statistically significant (P > .05). Conclusion: The use of FG for STSG shows comparable clinical outcomes to MF, with a significantly decreased need for postoperative wound VAC, the number of 30-day postoperative visits, and a lower wound-adjusted operative time.
C1 [Othman, Sammy; Messa, Charles A.; Elfanagely, Omar; Bormann, Bradford; Mellia, Joseph A.; Broach, Robyn B.; Kovach, Stephen J.; Fischer, John P.] Univ Penn, Philadelphia, PA 19104 USA.
C3 University of Pennsylvania
RP Fischer, JP (通讯作者)，Univ Penn Hlth Syst, Penn Presbyterian Med Ctr, Dept Surg, Div Plast Surg, 51 N 39th St,Wright Saunders Room 250, Philadelphia, PA 19104 USA.
EM john.fischer2@pennmedicine.upenn.edu
RI ; Messa IV, Charles/AAK-6833-2021
OI Othman, Sammy/0000-0002-8814-1048; Messa IV, Charles/0000-0001-5466-0846
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NR 30
TC 4
Z9 4
U1 0
U2 1
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 1534-7346
EI 1552-6941
J9 INT J LOW EXTR WOUND
JI Int. J. Low. Extrem. Wounds
PD JUN
PY 2024
VL 23
IS 2
BP 231
EP 237
AR 15347346211047748
DI 10.1177/15347346211047748
EA OCT 2021
PG 7
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA OV3G1
UT WOS:000705138100001
PM 34605281
DA 2026-07-24
ER

PT J
AU Wasiak, J
   Cleland, H
AF Wasiak, J.
   Cleland, H.
TI Topical negative pressure (TNP) for partial thickness burns
SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS
LA English
DT Review
ID SUBATMOSPHERIC PRESSURE; WOUND PROGRESSION; THERAPY; PATIENT
AB Background A burn wound is a complex and evolving injury, with both local and systemic consequences. Treatment includes using variety of dressings, but newer strategies such as topical negative pressure therapy have been developed to try and promote the wound healing process and minimize burn wound progression to involve deeper tissue in the acute phase. Topical negative pressure uses a suction force to drain excess fluids.
   Objectives To assess the effectiveness of TNP for those people with partial thickness burns.
   Search strategy We searched the Cochrane Wounds Group Specialised Register ( searched April 2007), the Cochrane Central Register of Controlled Trials ( CENTRAL)( The Cochrane Library Issue 2, 2007), Ovid MEDLINE ( 1950 to April Week 4 2007), Ovid EMBASE ( 1980 to Week 18 2007) and Ovid CINAHL ( 1982 to April Week 4 2007).
   Selection criteria All randomised controlled trials (RCTs) and controlled clinical trials (CCTs) that evaluated the safety and effectiveness of TNP for partial thickness burns.
   Data collection and analysis Two authors using standardised forms extracted the data independently. Each trial was assessed for internal validity with differences resolved by discussion. A narrative synthesis of results was undertaken as the absence of missing data, poor reporting, or both precluded the authors to undertake any formal statistical analysis.
   Main results One RCT satisfied the inclusion criteria. The methodological quality of the trial was poor.
   Authors' conclusions There is a paucity of high quality RCTs on TNP for partial thickness burn injury with insufficient sample size and adequate power to detect differences, if there are any, between TNP and conventional burn wound therapy dressings. Topical negative pressure (TNP) therapy is the application of negative pressure across a wound to aid in wound healing. In this instance, the pressure is used to aid and drain excess fluid, reduce infection rates and increase localised blood flow, thereby supplying the burn wound with oxygen and nutrition to promote accelerated healing. Alternative names for TNP include vacuum-assisted closure (VAC) and sealed surface wound suction.
C1 Alfred Hosp, Victorian Adult Burns Serv, Commercial Rd, Melbourne, Vic 3004, Australia.
C3 Florey Institute of Neuroscience & Mental Health; Howard Florey
   Institute Affiliates
RP Wasiak, J (通讯作者)，Alfred Hosp, Victorian Adult Burns Serv, Commercial Rd, Melbourne, Vic 3004, Australia.
EM J.Wasiak@alfred.org.au
RI Wasiak, Jason/GSE-3418-2022
OI Wasiak, Jason/0000-0002-5194-1586
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NR 30
TC 15
Z9 16
U1 0
U2 7
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1469-493X
EI 1361-6137
J9 COCHRANE DB SYST REV
JI Cochrane Database Syst Rev.
PY 2007
IS 3
AR CD006215
DI 10.1002/14651858.CD006215
PG 12
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 191FZ
UT WOS:000248118000091
PM 17636835
DA 2026-07-24
ER

PT J
AU Sánchez, ML
   Valdez, H
   Conde, M
   Viaña-Mendieta, P
   Boccaccini, AR
AF Sanchez, Mirna L.
   Valdez, Hugo
   Conde, Micaela
   Viana-Mendieta, Pamela
   Boccaccini, Aldo R.
TI Polymers and Bioactive Compounds with a Macrophage Modulation Effect for
   the Rational Design of Hydrogels for Skin Regeneration
SO PHARMACEUTICS
LA English
DT Article
DE biomaterials; inmunomodulation; macrophages M1-M2; polymers;
   wound-healing
ID NLRP3 INFLAMMASOME; EQUINE PERICARDIUM; ACTIVATION; QUERCETIN;
   POLARIZATION; ELIMINATION; WOUNDS; INJURY
AB The development of biomaterial platforms for dispensing reagents of interest such as antioxidants, growth factors or antibiotics based on functional hydrogels represents a biotechnological solution for many challenges that the biomedicine field is facing. In this context, in situ dosing of therapeutic components for dermatological injuries such as diabetic foot ulcers is a relatively novel strategy to improve the wound healing process. Hydrogels have shown more comfort for the treatment of wounds due to their smooth surface and moisture, as well as their structural affinity with tissues in comparison to hyperbaric oxygen therapy, ultrasound, and electromagnetic therapies, negative pressure wound therapy or skin grafts. Macrophages, one of the most important cells of the innate immune system, have been described as the key not only in relation to the host immune defense, but also in the progress of wound healing. Macrophage dysfunction in chronic wounds of diabetic patients leads to a perpetuating inflammatory environment and impairs tissue repair. Modulating the macrophage phenotype from pro-inflammatory (M1) to anti-inflammatory (M2) could be a strategy for helping to improve chronic wound healing. In this regard, a new paradigm is found in the development of advanced biomaterials capable of inducing in situ macrophage polarization to offer an approach to wound care. Such an approach opens a new direction for the development of multifunctional materials in regenerative medicine. This paper surveys emerging hydrogel materials and bioactive compounds being investigated to induce the immunomodulation of macrophages. We propose four potential functional biomaterials for wound healing applications based on novel biomaterial/bioactive compound combination that are expected to show synergistic beneficial outcomes for the local differentiation of macrophages (M1-M2) as a therapeutic strategy for chronic wound healing improvement.
C1 [Sanchez, Mirna L.; Conde, Micaela] Univ Nacl Quilmes, Dept Ciencia & Tecnol, Lab Farmacol Mol, B-1876 Bernal, Argentina.
   [Sanchez, Mirna L.; Boccaccini, Aldo R.] Univ Erlangen Nurnberg, Inst Biomat, Dept Mat Sci & Engn, Cauerstr 6, D-91058 Erlangen, Germany.
   [Valdez, Hugo] CINDEFI Ctr Invest & Desarrollo Fermentac Ind, Fac Ciencias Exactas, Lab Microbiol Celular & Inmunomecanismos, B1900AJL, La Plata, Argentina.
   [Viana-Mendieta, Pamela] Tecnol Monterrey, Inst Invest Obes, Monterrey 64849, Mexico.
C3 University of Erlangen Nuremberg; Tecnologico de Monterrey
RP Sánchez, ML (通讯作者)，Univ Nacl Quilmes, Dept Ciencia & Tecnol, Lab Farmacol Mol, B-1876 Bernal, Argentina.; Sánchez, ML; Boccaccini, AR (通讯作者)，Univ Erlangen Nurnberg, Inst Biomat, Dept Mat Sci & Engn, Cauerstr 6, D-91058 Erlangen, Germany.; Valdez, H (通讯作者)，CINDEFI Ctr Invest & Desarrollo Fermentac Ind, Fac Ciencias Exactas, Lab Microbiol Celular & Inmunomecanismos, B1900AJL, La Plata, Argentina.
EM mirna.sanchez@fau.de; hvaldez@exactas.unlp.edu.ar;
   aldo.boccaccini@fau.de
RI ; Boccaccini, Aldo/C-7905-2013
OI Viaña Mendieta, Pamela/0000-0003-2975-8440; Sánchez,
   Mirna/0000-0002-1372-4169; Boccaccini, Aldo/0000-0002-7377-2955; Valdez,
   Hugo Alberto/0000-0002-1130-1875
FU CONICET
FX MLS and HAV are members of CONICET. MLS thanks CONICET for the external
   fellowship. Images were created using Adobe Illustrator.
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NR 87
TC 12
Z9 14
U1 3
U2 25
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 1999-4923
J9 PHARMACEUTICS
JI Pharmaceutics
PD JUN
PY 2023
VL 15
IS 6
AR 1655
DI 10.3390/pharmaceutics15061655
PG 17
WC Pharmacology & Pharmacy
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pharmacology & Pharmacy
GA K9JC0
UT WOS:001019515500001
PM 37376103
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Arnold, M
   Yanez, C
   Yanez, B
AF Arnold, Malgorzata
   Yanez, Cecilia
   Yanez, Blanca
TI Wound Healing in the Long-Term Acute Care Setting Using an Air Fluidized
   Therapy/Continuous Low-Pressure Therapeutic Bed A Multiple Case Series
SO JOURNAL OF WOUND OSTOMY AND CONTINENCE NURSING
LA English
DT Article
DE Air fluidized therapy; Complex wounds; Pressure injury; Pressure ulcer;
   Support surface
AB BACKGROUND:
   We evaluated a new bed that updates the functionality of the current air fluidized therapy (AFT)/continuous low-pressure (CLP) pressure redistributing beds. This bed was evaluated in conjunction with standard wound care interventions in a long-term acute care hospital (LTACH). The AFT feature is designed to provide pressure distribution via a fluid-like medium that forces air though millions of tiny silicone beads that float the patient's body to achieve maximum immersion and envelopment. The CLP feature of the bed provides pressure distribution for the upper body. Standard wound care was provided that included debridement, topical treatments, and biophysical therapies such as negative pressure wound therapy, as indicated.
   CASES:
   Our multiple case series comprised 10 medically compromised patients with 25 wounds. Their mean age was 63 years, 50% were male, and the mean cumulative Braden Scale score was 12.4 out of 23, indicating a high risk for pressure injury (PI). Seven of 10 patients were incontinent of urine, 6 had fecal incontinence, and 2 had ostomies. Types of wounds treated included 2 large tissue defects from surgical excisions for the treatment of gangrene and 23 PIs. On admission, wounds had an average surface area of 139.1 cm(2). The mean percentage of reduction in wound surface area was 59.3% over an average of 31.3 days of therapy. No new wounds formed during their course of care despite being at elevated risk.
   CONCLUSIONS:
   Findings from this multiple case series suggest that the AFT/CLP bed facilitates healing of advanced wounds in medically complex patients when included as part of a wound care program. Despite mild to high risk, no new PIs developed, and severe PIs and large tissue defects significantly improved or completely resolved. One hundred percent of surveyed staff members recommend use of the AFT/CLP bed.
C1 [Arnold, Malgorzata; Yanez, Cecilia; Yanez, Blanca] Specialty Hosp, Hinsdale, IL USA.
RP Arnold, M (通讯作者)，7058 Toscana Ct, Naples, FL 34114 USA.
EM margiearnold@comcast.net
FU Hill-Rom
FX Hill-Rom provided the devices and study support for this project.
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   [Anonymous], 2012, CCHCS CARE GUIDE WOU
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   [Haesler E. National Pressure Ulcer Advisory Panel European Pressure Ulcer Advisory Panel Pan Pacific Pressure Injury Alliance National Pressure Ulcer Advisory Panel European Pressure Ulcer Advisory Panel Pan Pacific Pressure Injury Alliance National Pressure Ulcer Advisory Panel European Pressure Ulcer Advisory Panel Pan Pacific Pressure Injury Alliance National Pressure Ulcer Advisory Panel European Pressure Ulcer Advisory Panel Pan Pacific Pressure Injury Alliance], 2014, PREVENTION TREATMENT
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   [No title captured]
NR 10
TC 6
Z9 6
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 1071-5754
EI 1528-3976
J9 J WOUND OSTOMY CONT
JI J. Wound Ostomy Cont. Nurs.
PD MAY-JUN
PY 2020
VL 47
IS 3
BP 284
EP 290
DI 10.1097/WON.0000000000000646
PG 7
WC Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Nursing
GA LP5GR
UT WOS:000534346400011
PM 32384532
OA hybrid
DA 2026-07-24
ER

PT J
AU Çetinkaya, RA
   Yenilmez, E
   Petrone, P
   Yilmaz, S
   Bektöre, B
   Simsek, B
   Atik, TK
   Özyurt, M
   Ünlü, A
AF Cetinkaya, Riza Aytac
   Yenilmez, Ercan
   Petrone, Patrizio
   Yilmaz, Soner
   Bektore, Bayhan
   Simsek, Berksan
   Atik, Tugba Kula
   Ozyurt, Mustafa
   Unlu, Aytekin
TI Platelet-rich plasma as an additional therapeutic option for infected
   wounds with multi-drug resistant bacteria: in vitro antibacterial
   activity study
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE Platelet-rich plasma; Infected wounds; Multi-drug-resistant bacteria
ID GROWTH FACTOR-BB; ANTIMICROBIAL ACTIVITY; DIABETIC ULCERS; GEL;
   EFFICACY; BECAPLERMIN; SAFETY; RABBIT
AB PurposeInfected wounds, such as diabetic foot infections, are mostly polymicrobial and microorganisms have high resistance rates to antimicrobials. Infected wounds in diabetic patients have high cost, morbidity, and mortality rates. Based on these facts, there is a need for supportive localized treatment options such as platelet-rich plasma (PRP) implementations. Demonstrating the in vitro antimicrobial effect, our aim was to lead up to clinical trials of localized PRP implementations in infected wounds such as diabetic foot infections. In this study, we aimed to demonstrate the in vitro antibacterial activity of PRP against methicilin-resistant Staphylococcus aureus (MRSA) and three more multi-drug resistant bacteria species that are important and hard-to-treat in wound infections.Materials and methodsIn vitro antimicrobial activity of autologous PRP, platelet-poor plasma (PPP), and phosphate-buffered saline (PBS) on methicillin-resistant Staphylococcus aureus, vancomycin-resistant Enterococcus spp., extended spectrum beta lactamase producing Klebsiella pneumoniae, and carbapenem-resistant Pseudomonas aeruginosa was compared by assessment of bacterial growth on agar plates and antimicrobial susceptibility test results.ResultsWhen compared to control group, PRP and PPP significantly suppressed bacterial growth of MRSA, K. pneumoniae, and P. aeruginosa at 1st, 2nd, 5th, and 10th hours of incubation (p<0.05). VRE was the only bacteria that PRP and PPP showed limited activity against. When compared to PPP, PRP showed higher activity against MRSA, K. pneumoniae, and P. aeruginosa. However, the differences between PRP and PPP were statistically significant only against MRSA and P. aeruginosa at the first hour of incubation.ConclusionsEmerging PRP and other platelet-derived products seem to be promising alternative tools besides antibiotic treatment, debridement, negative pressure wound therapy, hyperbaric oxygen therapy, and other treatment options for treating diabetic foot infections.
C1 [Cetinkaya, Riza Aytac; Yenilmez, Ercan] Univ Hlth Sci, Sultan Abdulhamid Han Training & Educ Hosp, Dept Infect Dis, Istanbul, Turkey.
   [Petrone, Patrizio] NYU, Winthrop Hosp, Dept Surg, 222 Stn Plaza North,Suite 603, Long Isl City, NY 11501 USA.
   [Yilmaz, Soner] Univ Hlth Sci, Gulhane Training & Educ Hosp, Blood & Training Ctr, Ankara, Turkey.
   [Bektore, Bayhan] Kars Harakani State Hosp, Dept Microbiol, Kars, Turkey.
   [Simsek, Berksan] Univ Hlth Sci, Okmeydani Res & Training Hosp, Dept Microbiol, Transfus Ctr, Kasimpasa Campus, Istanbul, Turkey.
   [Atik, Tugba Kula] Balikesir State Hosp, Dept Microbiol, Transfus Ctr, Balikesir, Turkey.
   [Ozyurt, Mustafa] Bilim Univ, Dept Microbiol, Istanbul, Turkey.
   [Unlu, Aytekin] Gulhane Training & Res Hosp, Dept War Surg, Ankara, Turkey.
   [Petrone, Patrizio] New York Med Coll, Valhalla, NY 10595 USA.
C3 University of Health Sciences Turkey; New York University; University of
   Health Sciences Turkey; Kars State Hospital; Istanbul Okmeydani Training
   & Research Hospital; University of Health Sciences Turkey; Balikesir
   Ataturk State Hospital; Balikesir State Hospital; Demiroglu Bilim
   University; Gulhane Training & Research Hospital; New York Medical
   College
RP Petrone, P (通讯作者)，NYU, Winthrop Hosp, Dept Surg, 222 Stn Plaza North,Suite 603, Long Isl City, NY 11501 USA.; Petrone, P (通讯作者)，New York Med Coll, Valhalla, NY 10595 USA.
EM patrizio.petrone@gmail.com
RI Yenilmez, Ercan/GRJ-4261-2022; Bektore, Bayhan/AAC-6916-2020; UNLU,
   AYTEKIN/C-6555-2017; Cetinkaya, Riza/A-1714-2018; Petrone,
   Patrizio/AAQ-7986-2020; YILMAZ, Soner/AAW-6789-2021
OI Yenilmez, Ercan/0000-0002-1145-8856; Bektore,
   Bayhan/0000-0002-1225-7693; Petrone, Patrizio/0000-0002-7629-1663; 
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NR 33
TC 38
Z9 45
U1 0
U2 39
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD JUN
PY 2019
VL 45
IS 3
BP 555
EP 565
DI 10.1007/s00068-018-0957-0
PG 11
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA ID8IO
UT WOS:000471927600024
PM 29700554
DA 2026-07-24
ER

PT J
AU Suzuki, K
   Michael, G
   Tamire, Y
AF Suzuki, K.
   Michael, G.
   Tamire, Y.
TI Viable intact cryopreserved human placental membrane for a non-surgical
   approach to closure in complex wounds
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE complex wound; non-surgical; outpatient; placental membrane; Grafix
ID DIABETIC FOOT ULCERS; PERCENT AREA REDUCTION; AMNIOTIC MEMBRANE; TENDON;
   COVERAGE; DERMIS; BONE
AB Objective: Advances in wound treatment have yielded successful approaches to complex wound closure through plastic surgery or other staged surgical methods. However, not all patients or wounds are candidates for such increasingly rigorous levels of interventions. The exploration of non-surgical treatment options that promote anatomical and functional tissue replacement on an outpatient basis without donor site morbidity is necessary to maximise opportunities for patient mobility and rehabilitation. The native components found in human placental membranes may offer alternative properties for the clinical management of these complex wounds.
   Method: A 10-month, single-centre effectiveness review was conducted on the clinical outcomes in patients (n=12) treated with Grafix, a viable intact cryopreserved human placental membrane (vCPM), for complex wounds characterised by exposed bone, tendon, muscle, or hardware. Wounds were treated with routine standard of care in addition to weekly grafting with a vCPM.
   Results: The average baseline wound area and duration at presentation were 17.5 cm(2) and 11.2 weeks. All twelve cases resulted in granulation over the exposed structures followed by complete wound re-epithelialisation without the concomitant use of negative pressure wound therapy, hyperbaric oxygen therapy, or surgical intervention. The mean 4-week percentage area reduction was 62.5%. The mean time to closure was 10 weeks with a mean graft use of 8.1 grafts. Of the wounds seven (58%) presented with exposed tendon associated with an actively moving joint, the functional integrity of which was maintained with a return to the previous range of motion upon wound closure.
   Conclusion: These outcomes illustrate that vCPM is a clinically effective option in the non-surgical management of complex wounds in the outpatient setting, contributing to timely definitive closure without the risk of associated donor site morbidity.
C1 [Suzuki, K.] Cedars Sinai Med Ctr, Tower Wound Care, Los Angeles, CA 90048 USA.
   [Michael, G.; Tamire, Y.] Osiris Therapeut Inc, Columbia, MD USA.
C3 Cedars Sinai Medical Center; Osiris Therapeutics
RP Suzuki, K (通讯作者)，Cedars Sinai Med Ctr, Tower Wound Care, Los Angeles, CA 90048 USA.
EM medicalinformation@osiris.com
CR Bhavsar Dhaval, 2008, Eplasty, V8, pe33
   Black Joyce, 2007, Urol Nurs, V27, P144
   Blume PA, 2010, INT WOUND J, V7, P480, DOI 10.1111/j.1742-481X.2010.00728.x
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NR 31
TC 15
Z9 18
U1 0
U2 8
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD OCT
PY 2016
VL 25
IS 10
SU S
BP S25
EP S31
DI 10.12968/jowc.2016.25.Sup10.S25
PG 6
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA ED6HM
UT WOS:000388956700005
PM 27681807
OA Bronze
DA 2026-07-24
ER

PT J
AU Clinker, C
   Scaife, J
   Kahan, A
   Cordoba, N
   Russell, KW
   Jones, TW
AF Clinker, Christopher
   Scaife, Jack
   Kahan, Anastasia
   Cordoba, Nicolas
   Russell, Katie W.
   Jones, Trahern W.
TI Salvage of the infected Nuss bar: a protocol and institutional
   experience
SO PEDIATRIC SURGERY INTERNATIONAL
LA English
DT Article
DE Nuss procedure; Implant infection; Pectus excavatum; Hardware salvage;
   Pediatric surgery
ID MINIMALLY INVASIVE REPAIR; PECTUS EXCAVATUM REPAIR; RISK-FACTORS;
   COMPLICATIONS; MANAGEMENT; RAVITCH
AB Background Surgical implant infections often necessitate early hardware removal, complicating patient care. Nuss bars are placed via minimally invasive surgery to correct pectus excavatum. While rare, Nuss bar infections may be salvaged with prolonged antibiotics. However, no standardized protocols exist to guide management and prevent premature removal. Methods This study describes the implementation of a Nuss bar infection salvage protocol. This protocol was developed and implemented for six adolescent patients who underwent minimally-invasive Nuss bar implantations for pectus excavatum and suffered subsequent device-related infection between October 2021 and October 2024. Infection was determined both clinically and intraoperatively and confirmed with positive culture results. Detailed chart review was completed in patients who had infections. Results 221 Nuss procedures were performed during the study period with six patients found to have an implant infection for an infection rate of 2.7%. Infections presented from 9 to 61 days following initial placement, with a median of 26 days. Five of six infections were associated with growth of Staphylococcus aureus. Four of these were methicillin-sensitive, while one was methicillin-resistant. The sixth patient's intraoperative cultures were positive for Pseudomonas aeruginosa. Based on the developed protocol, all patients underwent 2-4 operative washouts and debridement procedures with negative pressure wound therapy between procedures. They were initially treated with broad-spectrum antibiotics and culture-directed antibiotic therapy for a total of 12 weeks. Five of six patients were transitioned to early oral antibiotics at discharge, and one required 12 weeks of intravenous antibiotics due to severe oral aversion. All patients retained their hardware and had no evidence of relapse of infection following completion of their salvage therapy. Conclusions Nuss bar infections are rare. Experience has demonstrated successful salvage with a standardized protocol incorporating 12 weeks of directed antibiotic therapy, serial washouts, and close follow-up, with no relapses of infection.
C1 [Clinker, Christopher; Scaife, Jack; Kahan, Anastasia; Russell, Katie W.] Univ Utah, Dept Surg, Div Pediat Surg, 100 North Mario Capecchi Dr Suite 3800, Salt Lake City, UT 84113 USA.
   [Clinker, Christopher] Univ Calif Davis, Dept Surg, Sacramento, CA 95616 USA.
   [Cordoba, Nicolas; Jones, Trahern W.] Univ Utah, Dept Pediat, Div Pediat Infect Dis, Salt Lake City, UT USA.
C3 Utah System of Higher Education; University of Utah; University of
   California System; University of California Davis; Utah System of Higher
   Education; University of Utah
RP Clinker, C (通讯作者)，Univ Utah, Dept Surg, Div Pediat Surg, 100 North Mario Capecchi Dr Suite 3800, Salt Lake City, UT 84113 USA.; Clinker, C (通讯作者)，Univ Calif Davis, Dept Surg, Sacramento, CA 95616 USA.
EM cclinker@ucdavis.edu
RI Scaife, Jack/JDD-9282-2023
CR Albano M, 2019, ANTIMICROB AGENTS CH, V63, DOI 10.1128/AAC.00959-19
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NR 20
TC 0
Z9 0
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0179-0358
EI 1437-9813
J9 PEDIATR SURG INT
JI Pediatr. Surg. Int.
PD DEC 15
PY 2025
VL 42
IS 1
AR 39
DI 10.1007/s00383-025-06275-5
PG 6
WC Pediatrics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pediatrics; Surgery
GA X0331
UT WOS:001640201000001
PM 41396327
DA 2026-07-24
ER

PT J
AU Corradini, L
   Marcaccini, G
   Seth, I
   Rozen, WM
   Biagiotti, C
   Cuomo, R
   Giardino, FR
AF Corradini, Luca
   Marcaccini, Gianluca
   Seth, Ishith
   Rozen, Warren M.
   Biagiotti, Camilla
   Cuomo, Roberto
   Giardino, Francesco Ruben
TI AI vs. MD: Benchmarking ChatGPT and Gemini for Complex Wound Management
SO JOURNAL OF CLINICAL MEDICINE
LA English
DT Article
DE large language models; wound management; complex wounds; chronic wounds;
   ChatGPT; Gemini; teleconsultation; artificial intelligence
ID CHALLENGES; DIAGNOSIS; SKIN
AB Background: The management of hard-to-heal wounds poses a major clinical challenge due to heterogeneous etiology and significant global healthcare costs (estimated at USD 148.64 billion in 2022). Large Language Models (LLMs), such as ChatGPT and Gemini, are emerging as potential decision-support tools. This study aimed to rigorously assess the accuracy and reliability of ChatGPT and Gemini in the visual description and initial therapeutic management of complex wounds based solely on clinical images. Methods: Twenty clinical images of complex wounds from diverse etiologies were independently analyzed by ChatGPT (version dated 15 October 2025) and Gemini (version dated 15 October 2025). The models were queried using two standardized, concise prompts. The AI responses were compared against a clinical gold standard established by the unanimous consensus of an expert panel of three plastic surgeons. Results: Statistical analysis showed no significant difference in overall performance between the two models and the expert consensus. Gemini achieved a slightly higher percentage of perfect agreement in management recommendations (75.0% vs. 60.0% for ChatGPT). Both LLMs demonstrated high proficiency in identifying the etiology of vascular lesions and recognizing critical "red flags," such as signs of ischemia requiring urgent vascular assessment. Noted divergences included Gemini's greater suspicion of potential neoplastic etiology and the models' shared error in suggesting Negative Pressure Wound Therapy (NPWT) in a case potentially contraindicated by severe infection. Conclusions: LLMs, particularly ChatGPT and Gemini, demonstrate significant potential as decision-support systems and educational tools in wound care, offering rapid diagnosis and standardized initial management, especially in non-specialist settings. Instances of divergence in systemic treatments or in atypical presentations highlight the limitations of relying on image-based reasoning alone. Ultimately, LLMs serve as powerful, scalable assets that, under professional supervision, can enhance diagnostic speed and improve care pathways.
C1 [Corradini, Luca; Marcaccini, Gianluca; Cuomo, Roberto; Giardino, Francesco Ruben] Univ Siena, Dept Med Surg & Neurosci, Plast Surg Unit, I-53100 Siena, Italy.
   [Seth, Ishith; Rozen, Warren M.] Peninsula Hlth, Frankston Hosp, Dept Plast & Reconstruct Surg, Frankston, Vic 3199, Australia.
   [Seth, Ishith] Monash Univ, Fac Med & Surg, Peninsula Clin Sch, Frankston, Vic 3199, Australia.
   [Biagiotti, Camilla] Univ Pisa, Dept Civil & Ind Engn DICI, Largo Lucio Lazzarino, I-56122 Pisa, Italy.
C3 University of Siena; Peninsula Health; Frankston Hospital; Monash
   University; University of Pisa
RP Marcaccini, G (通讯作者)，Univ Siena, Dept Med Surg & Neurosci, Plast Surg Unit, I-53100 Siena, Italy.
EM l.corradini@student.unisi.it; g.marcaccini@student.unisi.it;
   warrenrozen@hotmail.com; roberto.cuomo@unisi.it
RI ; Cuomo, Roberto/AFI-8757-2022; Marcaccini, Gianluca/NMK-1104-2025;
   Seth, Ishith/IXX-0725-2023; Rozen, Warren Matthew/AAE-6296-2022
OI Corradini, Luca/0009-0004-6935-5034; Cuomo, Roberto/0000-0002-8396-095X;
   Biagiotti, Camilla/0009-0001-7005-4018; Marcaccini,
   Gianluca/0000-0002-8621-8216; Seth, Ishith/0000-0001-5444-8925; Rozen,
   Warren Matthew/0000-0002-4092-182X
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   Salbas A, 2025, DIAGNOSTICS, V15, DOI 10.3390/diagnostics15151919
   Sallam M, 2023, HEALTHCARE-BASEL, V11, DOI 10.3390/healthcare11060887
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   Sen CK, 2025, ADV WOUND CARE, V14, P429, DOI 10.1177/21621918251359554
   Seth I, 2025, INFORMATICS-BASEL, V12, DOI 10.3390/informatics12030086
   Soenksen LR, 2021, SCI TRANSL MED, V13, DOI 10.1126/scitranslmed.abb3652
   Swanson T, 2022, J WOUND CARE, V31, pS10, DOI 10.12968/jowc.2022.31.Sup12.S10
   Zada T, 2025, JMIR FORM RES, V9, DOI [10.2196/66207, 10.2196/66207]
   Zhou LX, 2024, NATURE, V634, P61, DOI 10.1038/s41586-024-07930-y
NR 34
TC 0
Z9 0
U1 0
U2 0
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2077-0383
J9 J CLIN MED
JI J. Clin. Med.
PD DEC 13
PY 2025
VL 14
IS 24
AR 8825
DI 10.3390/jcm14248825
PG 21
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA AF4BF
UT WOS:001646831900001
PM 41464727
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Ceran, F
   Bozkurt, M
   Karakol, P
AF Ceran, Fatih
   Bozkurt, Mehmet
   Karakol, Percin
TI Effectiveness of the combined therapy in the treatment of chronic
   non-healing wounds in patients with autoimmune diseases
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Autoimmune; Chronic wounds; Acellular dermal; NPWT; Skin grafts; Bone
   marrow aspirate; matrix
ID NEGATIVE-PRESSURE DRESSINGS; MESENCHYMAL STEM-CELLS; THICKNESS
   SKIN-GRAFTS; FOREFOOT SURGERY; BURNS; MANAGEMENT
AB Objective: Autoimmune diseases are systemic conditions that can have negative effects on wound healing. The objective of the present study was to investigate the efficacy of combining bone marrow-derived mesenchymal stem cells (BM-MSCs), acellular dermal matrix (ADM), split-thickness skin graft (STSG), and negative-pressure wound therapy (NPWT) for treating patients with autoimmune diseases and chronic non-healing wounds. Methods: Thirty-four patients with autoimmune diseases and non-healing chronic wounds of the lower extremities between 2012 and 2023 were included in the study. Among these, 18 patients had Beh & ccedil;et's disease, 8 patients had polyarteritis nodosa, and 8 patients had systemic lupus erythematosus. All patients underwent split-thickness skin grafting in external centers. The wounds were debrided, and BM-MSCs concentrate was injected into the wound base. A suitable ADM was applied to the wound. STSG were adapted onto the ADM. The grafts were closed with NPWT. Results: Patients were followed-up for an average of 1.2 years. No necrosis was observed at the wound sites of the post-operative patients. During long-term follow-up, no wounds were observed at the same sites. Conclusion: Although autoimmune diseases fall within the scope of rheumatology, the treatment of chronic non-healing wounds that accompany such diseases requires a multidisciplinary approach. We demonstrated that the combined use of BM-MSCs, ADM, STSG, and NPWT presents an effective approach in the healing of these types of wounds. (c) 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Ceran, Fatih] Biruni Univ, Dept Plast Reconstruct & Aesthet Surg, Med Fac, Istanbul, Turkiye.
   [Bozkurt, Mehmet; Karakol, Percin] Bagcilar Training & Res Hosp, Dept Plast Reconstruct & Aesthet Surg, Istanbul, Turkiye.
C3 Biruni University; Istanbul Bagcilar Training & Research Hospital
RP Ceran, F (通讯作者)，Eski Londra Asfalti 10, TR-34295 Istanbul, Turkiye.
EM fatihcrn@hotmail.com
RI Ceran, Fatih/JPK-6708-2023; BOZKURT, Mehmet/KFR-6152-2024
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NR 33
TC 5
Z9 5
U1 0
U2 2
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD FEB
PY 2025
VL 101
BP 126
EP 133
DI 10.1016/j.bjps.2024.11.033
EA DEC 2024
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA S5H4B
UT WOS:001398526900001
PM 39731901
DA 2026-07-24
ER

PT J
AU Liu, YL
   Shi, Y
   Zhu, JY
   Chen, XD
   Yang, RH
   Shu, B
   Zhou, ZH
   Liu, J
   Wu, RQ
   Xie, JL
AF Liu, Yiling
   Shi, Yan
   Zhu, Junyou
   Chen, XiaoDong
   Yang, RongHua
   Shu, Bin
   Zhou, Ziheng
   Liu, Jian
   Wu, Ri-qiang
   Xie, Julin
TI Study on the Effect of the Five-in-One Comprehensive Limb Salvage
   Technologies of Treating Severe Diabetic Foot
SO ADVANCES IN WOUND CARE
LA English
DT Article
DE diabetic foot ulcer; NPWT; revascularization; wound healing; amputation
ID VASCULAR-SURGERY; MANAGEMENT; ULCERS; REVASCULARIZATION; ASSOCIATION;
   GUIDELINES; DIAGNOSIS; ISCHEMIA; THERAPY; SOCIETY
AB Objective: To explore the clinical efficacy and advantages of five-in-one comprehensive limb salvage technologies for the treatment of severe diabetic foot ulcer (DFU). Approach: Clinical data for 120 patients with severe DFU treated between January 2012 and December 2017 were analyzed retrospectively. The control group (48 cases) was treated with traditional therapies, including controlling blood sugar, improving microcirculation, preserving nerve function, and dressing changes, whereas the experimental group (72 cases) was treated with traditional therapy combined with additional techniques, such as early and thorough debridement, negative pressure wound therapy, revascularization, and skin graft or flap. Ankle-brachial index (ABI), transcutaneous oxygen pressure (TcPO2), wound healing rate, healing time, ulcer recurrence rate, and amputation rate were recorded. Results: Compared with the control group, the experimental group significantly improved wound healing rate (93.1% vs. 72.9%; p < 0.01), decreased wound healing time (16.2 +/- 5.4 days vs. 32.2 +/- 7.8 days; p < 0.05), reduced major limb amputation rate (1.4% vs. 10.4%, p < 0.05), and ulcer recurrence rate (5.6% vs. 14.6%; p < 0.05). There were no significant differences in amputation rate between experimental and control group (29.2% vs. 33.3%, p = 0.628). After revascularization, the revascularization group showed significantly improved ABI (0.75 +/- 0.21 vs. 0.35 +/- 0.16, p < 0.05) and TcPO2 (36 +/- 6 mmHg vs. 15 +/- 4 mmHg, p < 0.05). Innovation: We propose a five-in-one comprehensive treatment method, which provides a multidisciplinary cooperative model for comprehensive medical and surgical treatments for DFU. Conclusion: The five-in-one comprehensive limb salvage treatment technologies played a vital role in enhancing the healing rate of severe DFU, shortening the healing time, and reducing the rate of recurrence and major amputation, thus improving the overall quality of life.
C1 [Liu, Yiling; Zhu, Junyou; Shu, Bin; Zhou, Ziheng; Liu, Jian; Xie, Julin] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Burn Surg, Guangzhou 510080, Guangdong, Peoples R China.
   [Shi, Yan] Jiangxi Maternal & Child Hlth Hosp, Med Cosmetol Dept, Nanchang, Jiangxi, Peoples R China.
   [Chen, XiaoDong; Yang, RongHua] First Peoples Hosp Foshan, Dept Burn Surg, Foshan, Peoples R China.
   [Wu, Ri-qiang] Yunfu City Peoples Hosp, Dept Burn Surg, Yunfu, Peoples R China.
C3 Sun Yat Sen University
RP Xie, JL (通讯作者)，Sun Yat Sen Univ, Affiliated Hosp 1, Dept Burn Surg, Guangzhou 510080, Guangdong, Peoples R China.
EM sysxiej190@sohu.com
RI Liu, Yiling/LBH-4975-2024; 谢举临, Julin Xie/LXA-4344-2024; yan,
   shi/HNI-1042-2023
OI yan, shi/0000-0002-3838-2337
FU National Natural Science Foundation of China [81871566, 81671935];
   Science and Technology Planning Project of Guangdong Province, China
   [2017A040405026]; Science and Technology Planning Project of Guangzhou
   City [2018-0402-SF-0686]; Natural Science Foundation of Guangdong
   Province, China [2017A030313619]
FX None declared. This study was supported by the National Natural Science
   Foundation of China (Grant No. 81871566, 81671935), the Science and
   Technology Planning Project of Guangdong Province, China (Grant No.
   2017A040405026), and the Science and Technology Planning Project of
   Guangzhou City (Grant No. 2018-0402-SF-0686), and the Natural Science
   Foundation of Guangdong Province, China (Grant No. 2017A030313619).
CR Armstrong DG, 2017, NEW ENGL J MED, V376, P2367, DOI 10.1056/NEJMra1615439
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NR 27
TC 6
Z9 9
U1 0
U2 26
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 2162-1918
EI 2162-1934
J9 ADV WOUND CARE
JI Adv. Wound Care
PD DEC 1
PY 2020
VL 9
IS 12
BP 676
EP 685
DI 10.1089/wound.2018.0903
EA NOV 2019
PG 10
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA OH8LY
UT WOS:000497398400001
PM 33124965
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Zhou, D
   Wang, W
AF Zhou, Dian
   Wang, Wen
TI Safety and Efficacy of Beraprost Sodium Combined with Negative Pressure
   Drip Irrigation in the Treatment of Diabetic Foot Ulcer: A Retrospective
   Cohort Study
SO INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS
LA English
DT Article; Early Access
DE Beraprost sodium; negative pressure drip irrigation; diabetic foot
   ulcer; safety; efficacy; retrospective cohort study
ID SKIN BLOOD-FLOW; WOUND THERAPY; MELLITUS
AB Background: Diabetic foot ulcer (DFU) is a major cause of infection-related hospitalization and amputation. Negative-pressure wound therapy with instillation and dwell time (NPWTi-d) is used for complex DFU, and beraprost sodium (BS), an oral prostacyclin analogue, may improve microcirculation; evidence for their combination is limited. Objective: To assess the safety and effectiveness of NPWTi-d plus BS versus NPWTi-d alone and BS with standard wound care in DFU. Methods: We retrospectively reviewed hospitalized DFU patients treated from February 2019 to April 2024. Of 667 screened patients, 590 met inclusion criteria and were grouped by therapy: NPWTi-d (n = 190), BS plus standard care (n = 200), and NPWTi-d plus BS (n = 200). Primary outcomes were 12-week healing rate, time to healing, and ulcer area reduction (ImageJ). Secondary outcomes included reinfection and DFU-related readmission at 12 weeks, 6 months, and 12 months, and quality of life (DFU-SF). Results: At 12 weeks, NPWTi-d plus BS achieved faster healing than NPWTi-d alone (mean difference 2.6 days; 95% CI 0.1-5.3; P = 0.042) and greater area reduction at weeks 8-12 (P < 0.05). DFU-SF improved in all groups, with consistently higher scores in the combination group (P < 0.001). Reinfection and readmission increased overtime in all groups; between-group differences were small and may reflect residual confounding. No treatment-related serious adverse events were documented. No major bleeding, symptomatic hypotension, or treatment discontinuation due to intolerance was documented during the 12-week treatment period; minor adverse events may be underreported due to the retrospective design. Conclusions: In this retrospective cohort, adding oral BS to NPWTi-d was associated with faster wound closure and better DFU-related quality of life. Prospective controlled studies are needed to confirm these findings.
C1 [Zhou, Dian] Jiangnan Univ, Affiliated Hosp, Burn & Trauma Treatment Ctr, Wuxi, Jiangsu, Peoples R China.
   [Wang, Wen] Jiangnan Univ, Wuxi 2 Peoples Hosp, Dept Endocrinol, Med Ctr, 68 Zhongshan Rd, Wuxi 214000, Jiangsu, Peoples R China.
C3 Jiangnan University; Jiangnan University
RP Wang, W (通讯作者)，Jiangnan Univ, Wuxi 2 Peoples Hosp, Dept Endocrinol, Med Ctr, 68 Zhongshan Rd, Wuxi 214000, Jiangsu, Peoples R China.
EM wangwen2405@126.com
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   Zhao Y, 2022, COMPUT MATH METHOD M, V2022, DOI 10.1155/2022/7540020
NR 28
TC 0
Z9 0
U1 0
U2 0
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 1534-7346
EI 1552-6941
J9 INT J LOW EXTR WOUND
JI Int. J. Low. Extrem. Wounds
PD 2026 MAR 24
PY 2026
DI 10.1177/15347346261435112
EA MAR 2026
PG 10
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA FL4MC
UT WOS:001721554500001
PM 41873580
OA Bronze
DA 2026-07-24
ER

PT J
AU Caputo, GG
   Scarabosio, A
   Di Filippo, J
   Pagotto, A
   Tascini, C
   Berkane, Y
   Parodi, PC
AF Caputo, Glenda Giorgia
   Scarabosio, Anna
   Di Filippo, Jacopo
   Pagotto, Alberto
   Tascini, Carlo
   Berkane, Yanis
   Parodi, Pier Camillo
TI Redefining infection management in implant-based breast reconstruction:
   Insights and innovations from an 11-year retrospective analysis
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Implant infection; Breast reconstruction; Breast infection; Infection
   diagnosis; Film Array; Molecular biology
ID METHICILLIN-RESISTANT; BIOFILM; PREVENTION; SEROMA
AB Background: Infections associated with implant-based breast reconstructive surgery are challenging for both patients and surgeons, often implying high recurrence rate, long treatments (both medical and surgical management), multiple invasive procedures, and delay of the end-result and, in some cases, even reconstruction failure. Early diagnosis is crucial but not always easy to achieve. Various treatment options are available and have been described in literature, with no clear winning strategy. Recent improvements in microbiological and therapeutic tools have led the authors to question what would be considered the best plan for reconstruction salvage approach. Methods: All patients who underwent implant-based breast reconstruction between 2012 and 2023 were enrolled. Clinical records regarding infections and treatment were retrospectively analyzed. Results: Among a total of 506 patients, 26 (5.14%) developed implant-associated infections. Discussing the results, we realized that previous protocol was old-fashioned and required improvements. Through a multidisciplinary approach, a new prevention and treatment algorithm was derived. First, microbiological screening through nasal and rectal swab allows for proper decontamination prior to intervention. However, the keystone improvement consists in the use of molecular biology analysis, thus minimizing diagnosis timing and allowing targeted antibiotic therapy shortly after the removal of the infected implant. In addition, a fundamental role is played using instillation negative pressure wound therapy as a temporary spacer to ensure the maintenance of the periprosthetic pocket. Conclusions: By following these precise steps in case of implant-associated infection, treatment can be optimized to reduce both therapy and hospitalization time, allowing the patient to achieve a reconstruction in a relatively short period. Level of evidence: IV (c) 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Caputo, Glenda Giorgia; Scarabosio, Anna; Di Filippo, Jacopo; Parodi, Pier Camillo] Univ Udine, Dept Med Area DMED, Plast Surg Div, I-33100 Udine, Italy.
   [Caputo, Glenda Giorgia; Scarabosio, Anna; Di Filippo, Jacopo; Pagotto, Alberto; Tascini, Carlo; Parodi, Pier Camillo] Azienda Sanit Univ Friuli Cent ASUFC, I-33100 Udine, Italy.
   [Scarabosio, Anna] Massachusetts Gen Hosp, Div Plast & Reconstruct Surg, Boston, MA 02114 USA.
   [Scarabosio, Anna; Berkane, Yanis] Harvard Med Sch, Boston, MA 02114 USA.
   [Pagotto, Alberto; Tascini, Carlo] Univ Udine, Dept Med DMED, Infect Dis Div, I-33100 Udine, Italy.
   [Berkane, Yanis] Rennes Univ Hosp Ctr, Dept Plast Reconstruct & Aesthet Surg, Rennes, France.
   [Berkane, Yanis] Rennes Univ, INSERM, UMR1236, SITI Lab, Rennes, France.
   [Berkane, Yanis] Massachusetts Gen Hosp, Dept Surg, Vascularized Composite Allotransplantat Lab, Boston, MA 02114 USA.
C3 University of Udine; Harvard University; Harvard University Medical
   Affiliates; Massachusetts General Hospital; Harvard University; Harvard
   Medical School; University of Udine; CHU Rennes; Universite de Rennes;
   Institut National de la Sante et de la Recherche Medicale (Inserm);
   Universite de Rennes; Harvard University; Harvard University Medical
   Affiliates; Massachusetts General Hospital
RP Scarabosio, A (通讯作者)，Univ Udine, Dept Med Area DMED, Plast Surg Div, I-33100 Udine, Italy.; Scarabosio, A (通讯作者)，Azienda Sanit Univ Friuli Cent ASUFC, I-33100 Udine, Italy.
EM scarabosioanna@gmail.com
RI Parodi, Pier/AAG-8676-2019; Tascini, Carlo/L-5942-2017; Caputo,
   Glenda/AAT-6653-2020; Berkane, Yanis/ADJ-3663-2022; Scarabosio,
   Anna/HDO-1595-2022
OI Pagotto, Alberto/0000-0002-0772-1869; Di Filippo,
   Jacopo/0000-0002-3017-7152; Berkane, Yanis/0000-0003-4190-5132;
   Scarabosio, Anna/0000-0003-2993-8580
CR [Anonymous], Protocol for the Prevention and Management of Complications Related to ADM Implant-Based Breast Reconstructions Prevention Und Komplikationsmanagement Beim Einsatz Acellulerer Gewebematrix (ADM) Bei Der Implantatbasierten Brustrekonstruktion
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NR 43
TC 6
Z9 6
U1 1
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD JAN
PY 2025
VL 100
BP 82
EP 92
DI 10.1016/j.bjps.2024.10.037
EA NOV 2024
PG 11
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA O4J4W
UT WOS:001370810000001
PM 39608140
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Lu, HY
   Mao, YC
   Liu, PY
   Lai, KL
   Wu, CY
   Tsai, YC
   Yen, JH
   Chen, IC
   Lai, CS
AF Lu, Hsiao-Yu
   Mao, Yan-Chiao
   Liu, Po-Yu
   Lai, Kuo-Lung
   Wu, Cheng-Yeu
   Tsai, Yueh-Chi
   Yen, Jung-Hsing
   Chen, I. -Chen
   Lai, Chih-Sheng
TI Clinical predictors of early surgical intervention in patients with
   venomous snakebites
SO EUROPEAN JOURNAL OF MEDICAL RESEARCH
LA English
DT Article
DE Early surgical intervention; Venomous snakebite; Naja atra; Antivenom;
   Envenomation
ID PROTOBOTHROPS-MUCROSQUAMATUS BITE; PRESSURE WOUND THERAPY; NAJA-ATRA
   SNAKEBITE; COMPARTMENT SYNDROME; MANAGEMENT; ENVENOMATION; DEBRIDEMENT;
   FASCIOTOMY; NECROSIS
AB BackgroundVenomous snakebites induce tissue destruction and secondary infection; however, the optimal timing of surgical intervention for these complications remains unknown. This study assessed the clinical predictors of early surgical intervention in patients with snakebites.MethodsThis retrospective study included 63 patients (45 men and 18 women) with venomous snakebites. In addition to the snake species, the demographics, affected body parts, clinical characteristics, and ultrasound findings of the patients in the surgical (32 patients) and nonsurgical (31 patients) groups were analyzed and compared.ResultsA higher incidence of acute compartment syndrome, local ecchymosis, skin necrosis, bullae, blisters, and fever was found in the surgical group than in the nonsurgical group, and ultrasound findings of the absence of Doppler flow were more frequently noted in the surgical group than in the nonsurgical group. After adjustment using a multivariate logistic regression model, only advanced age, Naja atra bite, local ecchymosis, and bulla or blister formation remained significant factors for surgical intervention. Furthermore, comparison of the outcomes of patients who received early (<= 24 h) and late (> 24 h) surgical intervention revealed that the duration of continuous negative pressure wound therapy (6 vs. 15 days; P = 0.006), duration of hospital stay (13 vs. 26 days; P = 0.002), and duration of outpatient follow-up (15 vs. 36 days; P < 0.001) were significantly lower in patients who received early surgical intervention. The final reconstructive surgery was simple among the patients who received surgical intervention within 24 h of being bitten (P = 0.028).ConclusionIn patients with snakebites, advanced age, high-risk clinical manifestations (e.g., local ecchymosis and bulla or blister formation), and Naja atra envenomation are predictors of surgical intervention within 24 h.
C1 [Lu, Hsiao-Yu] Taichung Vet Gen Hosp, Dept Orthoped, Taichung, Taiwan.
   [Mao, Yan-Chiao] Taichung Vet Gen Hosp, Dept Emergency Med, Div Clin Toxicol, Taichung, Taiwan.
   [Mao, Yan-Chiao] Taipei Vet Gen Hosp, Dept Med, Div Clin Toxicol & Occupat Med, Taipei, Taiwan.
   [Mao, Yan-Chiao] Natl Def Med Ctr, Sch Med, Taipei, Taiwan.
   [Mao, Yan-Chiao] Natl Yang Ming Univ, Inst Environm & Occupat Hlth Sci, Sch Med, Taipei, Taiwan.
   [Liu, Po-Yu] Taichung Vet Gen Hosp, Dept Internal Med, Div Infect, Taichung, Taiwan.
   [Liu, Po-Yu] Natl Chung Hsing Univ, Rong Hsing Res Ctr Translat Med, Taichung, Taiwan.
   [Lai, Kuo-Lung] Taichung Vet Gen Hosp, Dept Internal Med, Div Allergy Immunol & Rheumatol, Taichung, Taiwan.
   [Wu, Cheng-Yeu; Tsai, Yueh-Chi; Yen, Jung-Hsing; Chen, I. -Chen; Lai, Chih-Sheng] Taichung Vet Gen Hosp, Dept Surg, Div Plast & Reconstruct Surg, Taichung, Taiwan.
   [Tsai, Yueh-Chi; Lai, Chih-Sheng] Natl Chung Hsing Univ, Coll Med, Dept Postbaccalaureate Med, Taichung, Taiwan.
C3 Taichung Veterans General Hospital; Taichung Veterans General Hospital;
   Taipei Veterans General Hospital; National Defense Medical University;
   National Yang Ming Chiao Tung University; Taichung Veterans General
   Hospital; National Chung Hsing University; Taichung Veterans General
   Hospital; Taichung Veterans General Hospital; National Chung Hsing
   University
RP Lai, CS (通讯作者)，Taichung Vet Gen Hosp, Dept Surg, Div Plast & Reconstruct Surg, Taichung, Taiwan.; Lai, CS (通讯作者)，Natl Chung Hsing Univ, Coll Med, Dept Postbaccalaureate Med, Taichung, Taiwan.
EM 6790pocket626@gmail.com
RI ; Liu, Po-Yu/AHB-4861-2022
OI Tsai, Yueh-Chi/0000-0002-4512-3456; Liu, Po-Yu/0000-0001-8006-4917; Lai,
   Chih-Sheng/0000-0001-6940-866X; Wu, Cheng-Yeu/0000-0002-8341-7965; Lai,
   Kuo-lung/0000-0003-0867-9612
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NR 44
TC 12
Z9 14
U1 0
U2 12
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 0949-2321
EI 2047-783X
J9 EUR J MED RES
JI Eur. J. Med. Res.
PD MAR 21
PY 2023
VL 28
IS 1
AR 131
DI 10.1186/s40001-023-01101-x
PG 9
WC Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Research & Experimental Medicine
GA 9Z4CA
UT WOS:000951088900002
PM 36945006
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Jhamb, S
   Vangaveti, VN
   Malabu, UH
AF Jhamb, Shaurya
   Vangaveti, Venkat N.
   Malabu, Usman H.
TI Genetic and molecular basis of diabetic foot ulcers: Clinical review
SO JOURNAL OF TISSUE VIABILITY
LA English
DT Review
DE Diabetic foot ulcer; Wound; Genetic and molecular aspects
ID PRESSURE WOUND THERAPY; TRANSGENERATIONAL EPIGENETIC INHERITANCE;
   ENDOTHELIAL GROWTH-FACTOR; SHOCK-WAVE THERAPY; METABOLIC MEMORY;
   RECEPTOR 2; COMPLICATIONS; ANGIOGENESIS; EXPRESSION; DISEASE
AB Diabetic Foot Ulcers (DFUs) are major complications associated with diabetes and often correlate with peripheral neuropathy, trauma and peripheral vascular disease. It is necessary to understand the molecular and genetic basis of diabetic foot ulcers in order to tailor patient centred care towards particular patient groups. This review aimed to evaluate whether current literature was indicative of an underlying molecular and genetic basis for DFUs and to discuss clinical applications. From a molecular perspective, wound healing is a process that transpires following breach of the skin barrier and is usually mediated by growth factors and cytokines released by specialised cells activated by the immune response, including fibroblasts, endothelial cells, phagocytes, platelets and keratinocytes. Growth factors and cytokines are fundamental in the organisation of the molecular processes involved in making cutaneous wound healing possible. There is a significant role for single nucleotide polymorphism (SNPs) in the fluctuation of these growth factors and cytokines in DFUs. Furthermore, recent evidence suggests a key role for epigenetic mechanisms such as DNA methylation from long standing hyperglycemia and non-coding RNAs in the complex interplay between genes and the environment. Genetic factors and ethnicity can also play a significant role in the development of diabetic neuropathy leading to DFUs. Clinically, interventions which have improved outcomes for people with DFUs or those at risk of DFUs include some systemic therapeutic drug interventions which improve microvascular blood flow, surgical interventions, human growth factors, and hyperbaric oxygen therapy, negative pressure wound therapy, skin replacement or shockwave therapy and the use of topical treatments. Future treatment modalities including stem cell and gene therapies are promising in the therapeutic approach to prevent the progression of chronic diabetic complications. (C) 2016 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.
C1 [Jhamb, Shaurya; Vangaveti, Venkat N.; Malabu, Usman H.] James Cook Univ, Coll Med & Dent, TREAD, 100 Angus Smith Dr, Douglas, Qld 4814, Australia.
C3 James Cook University
RP Malabu, UH (通讯作者)，James Cook Univ, Coll Med & Dent, TREAD, 100 Angus Smith Dr, Douglas, Qld 4814, Australia.; Malabu, UH (通讯作者)，Townsville Hosp, 100 Angus Smith Dr, Douglas, Qld 4814, Australia.
EM usman.malabu@jcu.edu.au
RI Malabu, Usman Hammawa/K-2055-2013
OI Malabu, Usman Hammawa/0000-0003-4899-7228
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   Zhang ZX, 2016, EXP THER MED, V11, P397, DOI 10.3892/etm.2015.2917
NR 99
TC 86
Z9 111
U1 2
U2 62
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0965-206X
J9 J TISSUE VIABILITY
JI J. Viab.
PD NOV
PY 2016
VL 25
IS 4
BP 229
EP 236
DI 10.1016/j.jtv.2016.06.005
PG 8
WC Dermatology; Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Dermatology; Nursing
GA ED0QL
UT WOS:000388546900008
PM 27372176
DA 2026-07-24
ER

PT J
AU Li, QH
   Situ, CY
   Ji, Y
   Zhen, ZJ
AF Li, Qing-Han
   Situ, Cui-Yao
   Ji, Yong
   Zhen, Zuo-Jun
TI Differences between conventional wound closure and a closed suction
   irrigation method for the prevention of surgical site infection-a
   comparative study
SO ANNALS OF PALLIATIVE MEDICINE
LA English
DT Article
DE Closed suction irrigation method; dressing; dirty wound; surgical site
   infection; wound infection
ID VACUUM-ASSISTED CLOSURE; THERAPY
AB Background: Wound infections can lead to high risks of postoperative septic complications. To date, the efficacy of a closed suction irrigation method of wound closure on the rate of postoperative wound infection in patients is poorly understood. Therefore, comparing this new strategy with conventional primary wound closure on the incidence of postoperative wound infection can provide value for clinical treatment.
   Methods: Our study focused on retrospective research for patients with open abdominal wounds. All patients were referred by tertiary hospitals and registered in our hospital from January 2009 to July 2019. According to wound types, patients were divided into two groups, namely patients with wounds primarily closed as the control group and patients with wounds sutured by closed suction irrigation after primary closure as the study group.
   Results: A total of 159 patients were collected in our present research, with 86 as study subjects and 73 as control subjects. The wound infection rate was significantly lower in the study group than the control group (P=0.017). The time interval for diagnosing wound infection from the primary operation was 4.895 +/- 0.875 days for the study group and 4.509 +/- 0.697 days for the control group. The length of hospital stay and the time taken for the wound to heal completely was shorter in patients in the study group compared to patients in the control group (8.046 +/- 2.110 vs. 8.983 +/- 2.887 days and 8.092 +/- 3.258 vs. 10.328 +/- 6.074 days, respectively).
   Conclusions: The closed suction irrigation method significantly reduced postoperative wound infection rates in patients with a high risk of postoperative septic complications. The discoveries of our investigation should be further validated in large scope randomized controlled trials.
C1 [Li, Qing-Han; Situ, Cui-Yao; Ji, Yong; Zhen, Zuo-Jun] First Peoples Hosp Foshan, Dept Hepatobiliary Surg, Foshan, Peoples R China.
RP Zhen, ZJ (通讯作者)，First Peoples Hosp Foshan, Dept Hepatobiliary Surg, Foshan, Peoples R China.
EM zzjun@fsyyy.com
FU Science and Technology Project of Guangdong Province [2014A020209003];
   Shanghai Tongshu Biotechnology Co., Ltd.
FX The study was supported by Science and Technology Project of Guangdong
   Province (2014A020209003), and sponsored by Shanghai Tongshu
   Biotechnology Co., Ltd.
CR Braakenburg A, 2006, PLAST RECONSTR SURG, V118, P390, DOI 10.1097/01.prs.0000227675.63744.af
   Bratzler DW, 2006, CLIN INFECT DIS, V43, P322, DOI 10.1086/505220
   Broex ECJ, 2009, J HOSP INFECT, V72, P193, DOI 10.1016/j.jhin.2009.03.020
   Granick MS, 2007, OSTOMY WOUND MANAG, V53, P64
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   Machen Shaun, 2007, US Army Med Dep J, P17
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   Vuerstaek JDD, 2006, J VASC SURG, V44, P1029, DOI 10.1016/j.jvs.2006.07.030
NR 12
TC 0
Z9 1
U1 0
U2 2
PU AME PUBLISHING COMPANY
PI SHATIN
PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG
   00000, PEOPLES R CHINA
SN 2224-5820
EI 2224-5839
J9 ANN PALLIAT MED
JI Ann. Pallliat. Med.
PD NOV
PY 2020
VL 9
IS 6
BP 4174
EP 4178
DI 10.21037/apm-20-2154
PG 5
WC Health Care Sciences & Services
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Health Care Sciences & Services
GA PA3MQ
UT WOS:000595542800053
PM 33302678
OA gold
DA 2026-07-24
ER

PT J
AU Pronk, AJM
   Van Oostendorp, JY
   Han-Geurts, IJM
   Madelska, S
   Buskens, CJ
   Bemelman, WA
   Madelski, M
   Breeczewski, S
   Przybylska, K
   Michalowska, M
   Banasiewicz, T
   ten Bokkel-Huinink, T
   Barnier, R
   Van Langen, R
AF Pronk, A. J. M.
   Van Oostendorp, J. Y.
   Han-Geurts, I. J. M.
   Madelska, S.
   Buskens, C. J.
   Bemelman, W. A.
   Madelski, M.
   Breeczewski, S.
   Przybylska, K.
   Michalowska, M.
   Banasiewicz, T.
   Ten Bokkel-Huinink, T.
   Barnier, R.
   Van Langen, R.
TI Semiflex-assisted vacuum therapy for perianal fistulas: the Semiflex
   pilot study
SO TECHNIQUES IN COLOPROCTOLOGY
LA English
DT Article
DE Perianal fistulas; Vaccuumtherapy; Surgery
ID CROHNS-DISEASE
AB IntroductionPerianal fistulas often require multiple surgical interventions because of their chronic nature. Various sphincter-sparing techniques achieve clinical closure rates of up to 70%, yet recurrence remains a major challenge. Vacuum-assisted closure (VAC) therapy has shown promise in wound healing, but its application in perianal fistulas remains largely unexplored. The Semiflex catheter was developed to facilitate outpatient vacuum therapy without the need for general anesthesia during catheter exchanges. This pilot study aimed to evaluate the feasibility and clinical applicability of the Semiflex catheter in perianal fistula management.MethodsThe Semiflex pilot study was a two-part feasibility trial. The first part assessed proof of principle in ten patients, while the second part, a multicentre study, aimed to confirm feasibility in 20 patients. Feasibility included smoothness of insertion and changing of the Semiflex catheters, capability of proper fixation of the Semiflex catheter, maintaining vacuum for more than 48 h, and compliance to the therapy in terms of pain and discomfort. The protocol was scored feasible if at least 50% of the exchanges met all these criteria in at least 70% of patients. Secondary outcomes included clinical fistula closure, radiological healing, and treatment-related adverse events.ResultsTwenty patients were included (median age 39.5 years; 70% Crohn's disease). Thirteen Semiflex treatments were scored as feasible, below the predefined threshold. Clinical fistula closure was observed in 50% of patients, but none showed radiological healing at 3 months. One serious adverse event occurred, requiring early treatment discontinuation, while minor complications, including local skin reactions and pressure sores, were managed conservatively.ConclusionsSemiflex therapy was feasible in a subset of patients and allowed outpatient treatment. However, maintaining vacuum and achieving long-term fistula closure remains challenging. While Semiflex may have a role in perianal fistula management, further research is needed to refine patient selection and optimize its application.
C1 [Pronk, A. J. M.; Van Oostendorp, J. Y.; Buskens, C. J.; Bemelman, W. A.] Univ Amsterdam, Med Ctr, Dept Surg, Locat VUMC, De Boelelaan 1117, NL-1081HV Amsterdam, Netherlands.
   [Van Oostendorp, J. Y.; Han-Geurts, I. J. M.] Proctos Kliniek, Dept Surg, Bilthoven, Netherlands.
   [Madelska, S.] Semiflex Dome Syst Ltd, Poznan, Poland.
C3 University of Amsterdam
RP Pronk, AJM; Bemelman, WA (通讯作者)，Univ Amsterdam, Med Ctr, Dept Surg, Locat VUMC, De Boelelaan 1117, NL-1081HV Amsterdam, Netherlands.
EM a.pronk@amsterdamumc.nl; w.a.bemelman@amsterdamumc.nl
RI Bemelman, Wilhelmus/AAA-1635-2021
CR Adegbola SO, 2020, HEALTH QUAL LIFE OUT, V18, DOI 10.1186/s12955-020-01622-7
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   Yamashiro Toshifumi, 2023, Adv Exp Med Biol, V1436, P131, DOI 10.1007/5584_2023_773
NR 13
TC 0
Z9 0
U1 0
U2 0
PU SPRINGER-VERLAG ITALIA SRL
PI MILAN
PA VIA DECEMBRIO, 28, MILAN, 20137, ITALY
SN 1123-6337
EI 1128-045X
J9 TECH COLOPROCTOL
JI Tech. Coloproctology
PD DEC 8
PY 2025
VL 30
IS 1
AR 7
DI 10.1007/s10151-025-03240-1
PG 7
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA P3292
UT WOS:001633474300001
PM 41359090
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Argenta, LC
   Zheng, ZL
   Bryant, A
   Tatter, SB
   Morykwas, MJ
AF Argenta, Louis C.
   Zheng, Zhenlin
   Bryant, Allyson
   Tatter, Stephen B.
   Morykwas, Michael J.
TI A New Method for Modulating Traumatic Brain Injury With Mechanical
   Tissue Resuscitation
SO NEUROSURGERY
LA English
DT Article
DE Subatmospheric pressure treatment; Tissue resuscitation; Traumatic brain
   injury
ID CONTROLLED CORTICAL IMPACT; MAGNETIC-RESONANCE-SPECTROSCOPY;
   VACUUM-ASSISTED CLOSURE; SUBATMOSPHERIC PRESSURE; COMPARTMENT SYNDROME;
   COGNITIVE DEFICITS; MR SPECTROSCOPY; CEREBRAL EDEMA; WOUND FLUID; RAT
   MODELS
AB BACKGROUND: Traumatic brain injuries remain a treatment enigma with devastating late results. As terminally differentiated tissue, the brain retains little capacity to regenerate, making early attempts to preserve brain cells after brain injury essential.
   OBJECTIVE: To resuscitate damaged tissue by modulating edema, soluble cytokines, and metabolic products in the "halo" of damaged tissue around the area of central injury that progressively becomes compromised. By re-equilibrating the zone of injury milieu, it is postulated neurons in this area will survive and function.
   METHODS: Mechanical tissue resuscitation used localized, controlled, subatmospheric pressure directly to the area of controlled cortical impact injury and was compared with untreated injured controls and with sham surgery in a rat model. Functional outcome, T2 magnetic resonance imaging hyperintense volume, magnetic resonance imaging spectroscopy metabolite measurement, tissue water content, injury cavity area, and cortical volume were compared.
   RESULTS: There were significant differences between mechanical tissue resuscitation treated and untreated groups in levels of myoinositol, N-acetylaspartate, and creatine. Treated animals had significantly less tissue swelling and density than the untreated animals. Nonviable brain tissue areas were smaller in treated animals than in untreated animals. Treated animals performed better than untreated animals in functional tests. Histological analysis showed the remaining viable ipsilateral cerebral area was 58% greater for treated animals than for untreated animals, and the cavity for treated animals was 95% smaller than for untreated animals 1 month after injury.
   CONCLUSION: Mechanical tissue resuscitation with controlled subatmospheric pressure can significantly modulate levels of excitatory amino acids and lactate in traumatic brain injury, decrease the water content and volume of injured brain, improve neuronal survival, and speed functional recovery.
C1 [Argenta, Louis C.; Zheng, Zhenlin; Bryant, Allyson; Morykwas, Michael J.] Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Winston Salem, NC USA.
   [Tatter, Stephen B.] Wake Forest Univ Hlth Sci, Dept Neurosurg, Winston Salem, NC USA.
C3 Wake Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine
RP Argenta, LC (通讯作者)，Wake Forest Univ, Bowman Gray Sch Med, Dept Plast & Reconstruct Surg, 300 S Hawthorne Rd, Winston Salem, NC 27157 USA.
EM largenta@wfubmc.edu
RI ; Tatter, Stephen/AAD-6524-2021
OI Morykwas, Michael/0009-0001-5547-5172; Tatter,
   Stephen/0000-0002-1063-0431
FU Wake Forest University Department of Plastic and Reconstructive Surgery;
   REPAIRx Laboratories of the Department of Plastic and Reconstructive
   Surgery
FX This study was supported in part by funds from the Cheek Endowment of
   Wake Forest University Department of Plastic and Reconstructive Surgery.
   Support was also obtained from REPAIRx Laboratories of the Department of
   Plastic and Reconstructive Surgery. Wake Forest Health Sciences has
   applied for patents related to this material. No licenses or royalties
   have been granted. The authors have no personal financial or
   institutional interest in any of the drugs, materials, or devices
   described in this article.
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NR 79
TC 11
Z9 13
U1 0
U2 4
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-396X
EI 1524-4040
J9 NEUROSURGERY
JI Neurosurgery
PD MAY
PY 2012
VL 70
IS 5
BP 1281
EP 1295
DI 10.1227/NEU.0b013e3182446760
PG 15
WC Clinical Neurology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Surgery
GA 933VA
UT WOS:000303390400060
PM 22157550
DA 2026-07-24
ER

PT J
AU Reimer, S
   Seyfried, F
   Flemming, S
   Brand, M
   Weich, A
   Widder, A
   Plassmeier, L
   Kraus, P
   Döring, A
   Hering, I
   Hankir, MK
   Meining, A
   Germer, CT
   Lock, JF
   Groneberg, K
AF Reimer, Stanislaus
   Seyfried, Florian
   Flemming, Sven
   Brand, Markus
   Weich, Alexander
   Widder, Anna
   Plassmeier, Lars
   Kraus, Peter
   Doering, Anna
   Hering, Ilona
   Hankir, Mohammed K.
   Meining, Alexander
   Germer, Christoph-Thomas
   Lock, Johan F.
   Groneberg, Kaja
TI Evolution of endoscopic vacuum therapy for upper gastrointestinal
   leakage over a 10-year period: a quality improvement study
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article
DE Anastomotic leak; Gastrointestinal perforation; Esophageal perforation;
   Endoluminal; Vacuum-assisted closure; Negative pressure
ID ANASTOMOTIC LEAKAGE; ASSISTED CLOSURE; ESOPHAGECTOMY; CONSENSUS; SOCIETY
AB Background Endoscopic vacuum therapy (EVT) is an effective treatment option for leakage of the upper gastrointestinal (UGI) tract. The aim of this study was to evaluate the clinical impact of quality improvements in EVT management on patients' outcome. Methods All patients treated by EVT at our center during 2012-2021 were divided into two consecutive and equal-sized cohorts (period 1 vs. period 2). Over time several quality improvement strategies were implemented including the earlier diagnosis and EVT treatment and technical optimization of endoscopy. The primary endpoint was defined as the composite score MTL30 (mortality, transfer, length-of-stay > 30 days). Secondary endpoints included EVT efficacy, complications, in-hospital mortality, length-of-stay (LOS) and nutrition status at discharge. Results A total of 156 patients were analyzed. During the latter period the primary endpoint MTL30 decreased from 60.8 to 39.0% (P = .006). EVT efficacy increased from 80 to 91% (P = .049). Further, the need for additional procedures for leakage management decreased from 49.9 to 29.9% (P = .013) and reoperations became less frequent (38.0% vs.15.6%; P = .001). The duration of leakage therapy and LOS were shortened from 25 to 14 days (P = .003) and 38 days to 25 days (P = .006), respectively. Morbidity (as determined by the comprehensive complication index) decreased from 54.6 to 46.5 (P = .034). More patients could be discharged on oral nutrition (70.9% vs. 84.4%, P = .043). Conclusions Our experience confirms the efficacy of EVT for the successful management of UGI leakage. Our quality improvement analysis demonstrates significant changes in EVT management resulting in accelerated recovery, fewer complications and improved functional outcome.
C1 [Reimer, Stanislaus; Brand, Markus; Weich, Alexander; Kraus, Peter; Meining, Alexander; Groneberg, Kaja] Univ Hosp Wurzburg, Dept Gastroenterol, Wurzburg, Germany.
   [Flemming, Sven; Widder, Anna; Plassmeier, Lars; Doering, Anna; Hering, Ilona; Hankir, Mohammed K.; Germer, Christoph-Thomas; Lock, Johan F.] Univ Hosp Wurzburg, Dept Gen Visceral Transplant Vasc & Pediat Surg, Wurzburg, Germany.
   [Seyfried, Florian] Univ Hosp Wurzburg, Ctr Operat Med ZOM, Dept Gen Visceral Transplantat Vasc & Pediat Surg, Wurzburg, Germany.
C3 University of Wurzburg; University of Wurzburg; University of Wurzburg
RP Seyfried, F (通讯作者)，Univ Hosp Wurzburg, Ctr Operat Med ZOM, Dept Gen Visceral Transplantat Vasc & Pediat Surg, Wurzburg, Germany.
EM Seyfried_F@ukw.de
RI Flemming, Sven/AAA-9950-2020; Weich, Alexander/ACW-1676-2022; Hankir,
   Mohammed/IZD-4807-2023; Lock, Johan/AAA-8114-2020
OI Meining, Alexander/0009-0001-3773-138X; Lock, Johan/0000-0002-9007-3937;
   Brand, Markus/0000-0002-3495-5206
FU Projekt DEAL
FX Open Access funding enabled and organized by Projekt DEAL. None.
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NR 25
TC 20
Z9 20
U1 0
U2 7
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD DEC
PY 2022
VL 36
IS 12
BP 9169
EP 9178
DI 10.1007/s00464-022-09400-w
EA JUL 2022
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 6D1PZ
UT WOS:000827370700006
PM 35852622
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Cheng, LF
   Lee, JT
   Chou, TD
   Chiu, TF
   Sun, TB
   Wang, CH
   Chien, SH
   Wang, HJ
AF Cheng, LF
   Lee, JT
   Chou, TD
   Chiu, TF
   Sun, TB
   Wang, CH
   Chien, SH
   Wang, HJ
TI Experience with elastic rubber bands for the tie-over dressing in skin
   graft
SO BURNS
LA English
DT Article
DE elastic rubber bands; tie-over dressing; dynamic; reproducible
ID VACUUM-ASSISTED CLOSURE
AB We derived a dressing using elastic rubber bands to tie over the skin graft. This is a simple, easy to perform, timesaving, inexpensive and reliable method for applying pressure over the skin graft compared with traditional methods. Between September 2002 and August 2004, we have used the present dressing technique in 35 patients with 36 grafts in various parts of the body. We chose this method, because of some anatomic areas, such as back, and buttock, which are frequently quite difficult to maintain pressure dressings in place, minimal movement can cause the skin graft to dislodge. The elastic rubber bands, rather than threads, are used as tie-over. Such a dressing permits expansion and contraction, providing a dynamic quality in the most difficult anatomic locations. The patient group consisted of 23 males and 12 females. The age ranged from 34 to 82 years (mean 52.4 years). Defect size ranged from 3 x 2.5 to 30 x 20 cm 2 (mean 11.2 x 7.0 cm(2) in size). The average follow-up was 5.8 months (range: 1-12 months). Among the 36 grafts in our study, all grafts except four showed good to excellent results. The mean graft successful rate is 88%. With our procedure no hematoma formation or shearing force (except one case) occurred in this group of patients during the phase of revascularization, there was, hence, good fixation of the graft by the "tie-over" dressing using elastic rubber bands compared with conventional tie-over dressing, especially in skin grafts of the back site of body and at large graft area. However, it is not suitable for the potentially infectious granulation beds, especially near joint area. (c) 2005 Elsevier Ltd and ISBI. All rights reserved.
C1 Buddhist Tzu Chi Gen Hosp, Dept Surg, Div Plast Surg, Hualien 970, Taiwan.
C3 Buddhist Tzu Chi General Hospital; Hualien Tzu Chi Hospital
RP Cheng, LF (通讯作者)，Buddhist Tzu Chi Gen Hosp, Dept Surg, Div Plast Surg, 707,Sec 3,Chung Yang Rd, Hualien 970, Taiwan.
EM e54978@ms6.hinet.net
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 10
TC 20
Z9 20
U1 0
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0305-4179
EI 1879-1409
J9 BURNS
JI Burns
PD MAR
PY 2006
VL 32
IS 2
BP 212
EP 215
DI 10.1016/j.burns.2005.08.026
PG 4
WC Critical Care Medicine; Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Dermatology; Surgery
GA 016PK
UT WOS:000235632000013
PM 16448764
DA 2026-07-24
ER

PT J
AU Ali, I
   Mourad, F
AF Ali, Ihab
   Mourad, Faisal
TI Dual Topical Antibiotic Application Prior to Sternotomy Closure Reduces
   Sternal Wound Infection Rates: A Simple Solution to a Grave Morbidity
SO HEART SURGERY FORUM
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; CARDIAC-SURGERY; PREVENTION; MEDIASTINITIS;
   GENTAMICIN; MANAGEMENT; PENETRATION; PREVALENCE; VANCOMYCIN; OUTCOMES
AB Background: A significant cohort of patients who undergo cardiac surgery suffer from diabetes and atherosclerosis. These patients have impaired tissue perfusion, hence a reduction in antibiotic concentration in the subcutaneous tissues at the side of the mammary artery harvesting. Topical application of gentamicin and vancomycin before wound closure broadens the antibiotic spectrum and reduces the incidence of deep sternal wound infection. In this article, we compare the use of single versus dual application of vancomycin and/or gentamicin in sternotomy wounds in a single tertiary center.
   Methods: An observational cohort analysis with three sequential patient groups (N = 2550) was performed at Ain Shams University Hospital in Cairo. A control group (N = 850), vancomycin only group (N = 850), and vancomycin plus gentamicin group (N = 850) were included in the study, during the three-year period from January 2017 to December 2019. Patients who had minimal access surgery were excluded from this study. The presence of an infected postoperative sternotomy wound was assessed in all patients.
   Results: The presence of an infected sternotomy wound (El Oakley class 2B) was present in 38 patients (4.5%) in the control group, in 19 patients (2.2%) in the vancomycin group, and in nine patients (1.1%) in the dual antibiotic group, respectively (P < .001). In contrast to the usual, we had a proliferous growth of gram-negative organisms 29 (3.4%) in the control group, 10 (1.2%) in the vancomycin group, and five (0.6%) in the dual antibiotic group, respectively (P < .001).
   Conclusion: Deep sternal wound infection is a major cause of post-cardiac surgery morbidity and prolonged hospital stay. Adding the simple step of topical application of vancomycin and gentamicin to the sternotomy wound at the end of the procedure appeared to significantly reduce deep wound infection rates.
C1 [Ali, Ihab; Mourad, Faisal] Ain Shams Univ, Cardiothorac Surg Dept, Fac Med, Cairo, Egypt.
C3 Egyptian Knowledge Bank (EKB); Ain Shams University
RP Ali, I (通讯作者)，Ain Shams Univ Hosp, Fac Med, Cardiothorac Surg Dept, Cardiothorac Surg, Abbasyia Sq, Cairo 11355, Egypt.
EM dribababdelrazek@hotmail.com
RI Mourad, Faisal/R-8430-2016; Ali, Ihab/G-8097-2019
OI Mourad, Faisal/0000-0002-3885-877X; Ali, Ihab/0000-0003-1231-3808
CR Abu-Omar Y, 2017, EUR J CARDIO-THORAC, V51, P10, DOI 10.1093/ejcts/ezw326
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NR 33
TC 2
Z9 2
U1 0
U2 0
PU IMR PRESS
PI ROBINSON
PA 112 ROBINSON RD, ROBINSON, SINGAPORE
SN 1098-3511
EI 1522-6662
J9 HEART SURG FORUM
JI Heart Surg. Forum
PY 2021
VL 24
IS 4
BP E598
EP E603
DI 10.1532/hsf.3881
PG 6
WC Cardiac & Cardiovascular Systems; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Surgery
GA TM8XR
UT WOS:000675830500002
PM 34473034
OA gold
DA 2026-07-24
ER

PT J
AU Zheng, ZL
   Morykwas, M
   Campbell, D
   McGee, M
   Hollingsworth, C
   Adams, F
   Mays, J
   Tatter, S
   Argenta, L
AF Zheng, Zhen-Lin
   Morykwas, Michael
   Campbell, Douglas
   McGee, Maria
   Hollingsworth, Charlotte
   Adams, Farren
   Mays, Jennifer
   Tatter, Stephen
   Argenta, Louis
TI Mechanical Tissue Resuscitation at the Site of Traumatic Brain Injuries
   Reduces the Volume of Injury and Hemorrhage in a Swine Model
SO NEUROSURGERY
LA English
DT Article
DE Magnetic resonance imaging analysis; Mechanical tissue resuscitation;
   Subatmospheric pressure treatment; Swine model; Traumatic brain injury
ID VACUUM-ASSISTED CLOSURE; CONTROLLED CORTICAL IMPACT; PERISTERNAL
   THORACIC WALL; PRESSURE WOUND THERAPY; BLOOD-FLOW; EDEMA;
   PATHOPHYSIOLOGY; FOOTBALL; RAT
AB BACKGROUND: Traumatic brain injuries (TBIs) continue to be a devastating problem with limited treatment options. Previous research applying controlled vacuum to TBI in a rat model resulted in smaller injuries and more rapid recovery.
   OBJECTIVE: To examine the effects of the application of a controlled vacuum (mechanical tissue resuscitation) to TBI in a large-animal model. The magnitude of vacuum, length of application, and length of delay between injury and the application of mechanical tissue resuscitation were investigated.
   METHODS: Localized, controlled cortical injuries were created in swine. Vacuums of -50 and -100 mm Hg were compared. Mechanical tissue resuscitation for 3 or 5 days was compared. Delays of 0, 3, or 6 hours between the creation of the TBI and the initiation of mechanical tissue resuscitation were examined. Analysis included histological assessments, computed tomographic perfusion, and magnetic resonance imaging (T2, proton magnetic spectra).
   RESULTS: A -100 mm Hg vacuum resulted in significantly smaller mean contused brain and hemorrhage volumes compared with -50 mm Hg and controls. Magnetic resonance spectra of treated animals returned to near baseline values. All 10 animals with 5-day mechanical tissue resuscitation treatment survived. Three of 6 animals treated for 3 days died after the discontinuation of treatment. A 3-hour delay resulted in similar results as immediate treatment. A 6-hour delay produced significant, but lesser responses.
   CONCLUSION: Application of mechanical tissue resuscitation to TBI was efficacious in the large-animal model. Application of -100 mm Hg for 5 days resulted in significantly improved outcomes. Delays of up to 3 hours between injury and the initiation of treatment did not diminish the efficacy of the mechanical tissue resuscitation treatment.
C1 [Zheng, Zhen-Lin; Morykwas, Michael; McGee, Maria; Hollingsworth, Charlotte; Adams, Farren; Mays, Jennifer; Argenta, Louis] Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Winston Salem, NC 27157 USA.
   [Campbell, Douglas] Wake Forest Univ Hlth Sci, Dept Gen Surg, Winston Salem, NC 27157 USA.
   [Tatter, Stephen] Wake Forest Univ Hlth Sci, Dept Neurosurg, Winston Salem, NC 27157 USA.
C3 Wake Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine
RP Argenta, L (通讯作者)，Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Med Ctr Blvd, Winston Salem, NC 27157 USA.
EM largenta@wakehealth.edu
RI ; Tatter, Stephen/AAD-6524-2021
OI Morykwas, Michael/0009-0001-5547-5172; Tatter,
   Stephen/0000-0002-1063-0431
FU US Army [W81XWH-09-1-0437]; Cheek Research Endowment of Wake Forest
   University
FX This study was supported by grant W81XWH-09-1-0437 from the US Army and
   by the Cheek Research Endowment of the Wake Forest University. A patent
   covering the technique described in this article has been issued to some
   of the authors (LA, MM, ST) and Wake Forest Health Services. The authors
   have no personal, financial, or institutional interest in any of the
   drugs, materials, or devices described in this article.
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NR 33
TC 9
Z9 11
U1 0
U2 2
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 0148-396X
EI 1524-4040
J9 NEUROSURGERY
JI Neurosurgery
PD AUG
PY 2014
VL 75
IS 2
BP 152
EP 161
DI 10.1227/NEU.0000000000000341
PG 10
WC Clinical Neurology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Surgery
GA AM8PE
UT WOS:000340138400030
PM 24618796
DA 2026-07-24
ER

PT J
AU Jannasch, O
   Tautenhahn, J
   Lippert, H
   Meyer, F
AF Jannasch, O.
   Tautenhahn, J.
   Lippert, H.
   Meyer, F.
TI Temporary Abdominal Closure and Early and Late Pathophysiological
   Consequences of Treating an Open Abdomen
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Review
DE open abdomen; laparostomy; ventral hernia; intestinal fistula; abdominal
   compartment syndrome; therapeutic management
ID VACUUM-ASSISTED CLOSURE; QUALITY-OF-LIFE; COMPARTMENT SYNDROME; FASCIAL
   CLOSURE; ENTEROCUTANEOUS FISTULAS; DYNAMIC RETENTION; TRAUMA PATIENTS;
   PACK TECHNIQUE; WALL DEFECTS; MANAGEMENT
AB Background: The open abdomen (OA) is a severe disease pattern accompanied by high morbidity and mortality. It is either result of a surgical disease or approach. The aim of this review article is to provide a systematic overview on the options of a temporary closure of the abdominal wall including early and late consequences in the treatment of an open abdomen based on the current medical literature.
   Methods: Topic-related, selective, PubMed-based literature search of the last decade including historically relevant references combined with own clinical experiences.
   Results: The initial course is marked by problems in intensive care. The most frequent causes of death are ventilatory problems, acute renal failure, persisting infections and sepsis as well as multiorgan failure. Intensive care duration ranges from 13 to 65 days. Perioperative mortality is accounted for 10-52%. Specific complications can be seen in surviving patients such as enteroatmospheric fistula (1.3-41%), ventral hernia (32-100%), intraabdominal abscess formation (2.1-21%), intestinal adhesions and digestion disturbances, neurological und psychological problems (approximately 20%) as well as heterotopic ossification (17-25%).
   Discussion: Application of a temporary abdominal closure aims to avoid those complications. Furthermore, time and effort for care and treatment are recommended to be reduced as patients comfort should be improved, simultaneously. Primary fascial closure is of utmost importance to reach this goal. Procedures with highest fascial closure rate (Wittmann patch, STAR, 75-93%; dynamic retention sutures, 61-91%; V.A.C., 69-84%) have lowest mortality.
   Conclusion: Type and severity of the various early and late consequences in the treatment of an open abdomen are substantially determined by the complication-inducing causes and the basic disease as well as by the options of an efficient, even in some cases temporary closure of the abdominal wall.
C1 [Jannasch, O.; Lippert, H.; Meyer, F.] Univ Klinikum Magdeburg AoR, Klin Allgemein Viszeral & Gefasschirurg, D-39120 Magdeburg, Germany.
   [Tautenhahn, J.] Klinikum Magdeburg gGmbH, Klin Gefasschirurg, Magdeburg, Germany.
C3 University Hospital Magdeburg
RP Jannasch, O (通讯作者)，Univ Klinikum Magdeburg AoR, Klin Allgemein Viszeral & Gefasschirurg, Leipziger Str 44, D-39120 Magdeburg, Germany.
EM olof.jannasch@med.ovgu.de
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NR 72
TC 11
Z9 13
U1 0
U2 6
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY
SN 0044-409X
EI 1438-9592
J9 ZBL CHIR
JI Zent.bl. Chir.
PD DEC
PY 2011
VL 136
IS 6
BP 575
EP 584
DI 10.1055/s-0031-1271347
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 883BS
UT WOS:000299608200011
PM 21365535
DA 2026-07-24
ER

PT J
AU Bloom, JA
   Tian, TN
   Homsy, C
   Singhal, D
   Salehi, P
   Chatterjee, A
AF Bloom, Joshua A.
   Tian, Tina
   Homsy, Christopher
   Singhal, Dhruv
   Salehi, Payam
   Chatterjee, Abhishek
TI A Cost-Utility Analysis of the Use of Closed-Incision Negative Pressure
   System in Vascular Surgery Groin Incisions
SO AMERICAN SURGEON
LA English
DT Article
DE cost-utility; cost-effectiveness; femoral-popliteal bypass;
   closed-incision negative pressure therapy
ID VACUUM-ASSISTED CLOSURE; WOUND THERAPY; COMPONENTS SEPARATION;
   INFECTION; COMPLICATIONS; PREVENTION; MANAGEMENT; RECONSTRUCTION;
   PERSPECTIVE; MESH
AB Objective Closed-incision negative pressure therapy (CINPT) with the Prevena system has been used and clinically evaluated in high-risk groin incisions to reduce the risk of postoperative complications. We performed a cost-effectiveness analysis evaluating CINPT in femoral-popliteal bypass with prosthetic graft. Methods A literature review looking at prospective randomized trials determined the probabilities and outcomes for femoral-popliteal bypass with and without CINPT. Reported utility scores were used to estimate the quality adjusted life years (QALYs) associated with a successful procedure and postoperative complications. Medicare current procedure terminology and diagnosis-related group codes were used to assess the costs for a successful surgery and associated complications. A decision analysis tree was constructed with rollback analysis to highlight the more cost-effective strategy. An incremental cost-effectiveness ratio (ICER) analysis was performed with a willingness to pay at $50,000. Deterministic and probabilistic sensitivity analyses were performed to validate the robustness of the results, and to accommodate for the uncertainty in the literature. Results Femoral-popliteal bypass with CINPT is less costly ($40,138 vs $41,774) and more effective (6.14 vs 6.13) compared to without CINPT. This resulted in a negative ICER of -234,764.03, which favored CINPT, indicating a dominant strategy. In one-way sensitivity analysis, surgery without CINPT was more cost-effective if the probability of successful surgery falls below 84.9% or if the cost of CINPT exceeds $3139. Monte Carlo analysis showed a confidence of 99.07% that CINPT is more cost-effective. Conclusions Despite the added device cost of CINPT, it is cost-effective in vascular surgical operations using groin incisions.
C1 [Bloom, Joshua A.; Tian, Tina] Tufts Med Ctr, Dept Surg, 800 Washington St, Boston, MA 02111 USA.
   [Homsy, Christopher; Chatterjee, Abhishek] Tufts Med Ctr, Div Plast & Reconstruct Surg, Dept Surg, Boston, MA 02111 USA.
   [Singhal, Dhruv] Beth Israel Deaconess Med Ctr, Dept Surg, Div Plast & Reconstruct Surg, 330 Brookline Ave, Boston, MA 02215 USA.
   [Salehi, Payam] Tufts Med Ctr, Div Vasc Surg, Dept Surg, Boston, MA 02111 USA.
C3 Tufts Medical Center; Tufts Medical Center; Harvard University; Harvard
   University Medical Affiliates; Beth Israel Deaconess Medical Center;
   Tufts Medical Center
RP Bloom, JA (通讯作者)，Tufts Med Ctr, Dept Surg, 800 Washington St, Boston, MA 02111 USA.
EM bloomjosha@gmail.com
RI Bloom, Joshua/W-6427-2019; Salehi, Payam/AAP-6921-2021
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NR 46
TC 10
Z9 10
U1 0
U2 4
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 0003-1348
EI 1555-9823
J9 AM SURGEON
JI Am. Surg.
PD JUN
PY 2023
VL 89
IS 6
BP 2237
EP 2246
AR 00031348221087395
DI 10.1177/00031348221087395
EA APR 2022
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA N6RL5
UT WOS:000780163200001
PM 35392664
DA 2026-07-24
ER

PT J
AU Hutchison, RL
   Craw, JR
AF Hutchison, R. L.
   Craw, J. R.
TI Use of acellular dermal regeneration template combined with NPWT to
   treat complicated extremity wounds in children
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE acellular dermal regeneration template; NPWT; paediatrics; outpatients
ID VACUUM-ASSISTED-CLOSURE; ARTIFICIAL SKIN; SUBATMOSPHERIC PRESSURE;
   PEDIATRIC WOUNDS; INTEGRA; MANAGEMENT; THERAPY; EXPERIENCE;
   RECONSTRUCTION; INJURIES
AB Objective: The treatment of open wounds with exposed bone, tendon, or nerve is a challenging reconstructive problem, especially in children. The purpose of this study is to evaluate the safety and effectiveness of using acellular dermal templates combined with negative pressure wound dressings in the treatment of complicated paediatric soft tissue extremity wounds.
   Method: A retrospective review of eight patients treated with acellular dermal templates for closure of complicated extremity wounds was performed. After debridement, all patients were treated with a template and a negative pressure wound treatment (NPWT) system.
   Results: The average age was 8.8 years with 4 females and 4 males. Four wounds were at the foot/ankle, with tendon exposed in all 4, nerve in 2, and bone in 3. There were 3 lower leg wounds, all with exposed bone. One patient had arm/hand wounds with exposed tendon. The size of the wounds and dermal graft averaged 86cm(2) and 57cm(2). The average time to wound closure was 65 days. The majority of the treatment was received as an outpatient, including NPWT. For inpatient and outpatient care, the average number of sponge system changes was 2.6 compared to 4.6, and time between changes was 3.5 compared to 6.8 days. Each patient had only one procedure each for application of the dermal substitute and later one skin grafting procedure. Complications were minimal, and all patients healed their wounds without the need of flaps. One patient required wound revision.
   Conclusion: Our study demonstrates that a dermal template combined with NPWT can safely and effectively be used to treat complicated wounds in children. Closure was obtained without flaps, the majority of the treatment time was spent in the outpatient setting, and the complication rate was low.
C1 [Hutchison, R. L.] Childrens Mercy Hosp & Clin, Div Orthopaed Surg, Kansas City, MO USA.
   [Hutchison, R. L.; Craw, J. R.] Univ Missouri, Kansas City Sch Med, Dept Orthopaed Surg, Kansas City, MO 64110 USA.
C3 Children's Mercy Hospital; University of Missouri System; University of
   Missouri Kansas City
RP Hutchison, RL (通讯作者)，Childrens Mercy Hosp & Clin, Div Orthopaed Surg, Kansas City, MO USA.
EM rlhutchison@cmh.edu
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NR 32
TC 18
Z9 23
U1 0
U2 13
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
J9 J WOUND CARE
JI J. Wound Care
PD DEC
PY 2013
VL 22
IS 12
BP 708
EP 712
DI 10.12968/jowc.2013.22.12.708
PG 5
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 267GQ
UT WOS:000328085200006
PM 24335895
DA 2026-07-24
ER

PT J
AU Kelm, J
   Schmitt, E
   Anagnostakos, K
AF Kelm, J
   Schmitt, E
   Anagnostakos, K
TI VAC®-therapy: A treatment option for wound healing complications after
   Achilles tendon reconstruction
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Article; Proceedings Paper
CT Three Nations Congress
CY 2003
CL Nurnberg, GERMANY
DE Achilles tendon; wound healing complications; VAC (R)-therapy
ID VACUUM-ASSISTED CLOSURE; PRESSURE; THERAPY
AB Introduction: The postoperative course after Achilles tendon reconstruction is associated with a high incidence rate of infections and wound healing complications, which can lead to protracted healing process and, hence, limit the clinical outcome. Patient-Methods: A 66-year-old male was referred to our clinic with an Achilles tendon rupture. MRI confirmed the diagnosis, an augmented tenoplasty was performed for tendon reconstruction. 11 weeks after surgery the patient presented himself again with an open wound and local infection signs. Results: The surgical treatment included debridement and jet lavage. The V.A.C.(R)-device with the white polyvinyl sponge at an initial pressure of 200 mm Hg was used. A pathogen organism could not be identified. For infection eradication a broad spectrum systemic antibiosis (cefuroxime and gentamicin) was applicated. On 3., 6. and 14. day the dressings were changed and the wound was revised under progredient closure. At beginning formation of granulation tissue the pressure was reduced to 150-100 mmHg. At decreasing blood inflammation parameters and amelioration of the local wound condition the patient could check out after 3 weeks hospitalization. After further successful ambulant management by means of the V.A.C.(R)-therapy a meshgraft transplantation was performed (enlargement factor 1.5; layer thickness 0.3 mm). The V.A.C.(R)-device was applied again at a pressure of 150 mm Hg with a single dressing change after 5 days. At a follow-up of 31 months no further complications occurred. Discussion: The V.A.C.(R)-therapy seems to be a valuable tool in the treatment of wounds with a critical local vascularity. After successful wound preconditioning the healing process of skin grafts transplants can be also optimised by means of the V.A.C.(R)-device.
RP Kelm, J (通讯作者)，Univ Klinikum Saarlandes, Kirrbergerstr 1, D-66421 Homburg, Germany.
EM jk66421@hotmail.com
RI Anagnostakos, Konstantinos/MGC-8753-2025
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Dalton GP, 2001, CLIN ORTHOP RELAT R, P133
   FLEISCHMANN W, 1993, UNFALLCHIRURG, V96, P488
   Heugel JR, 2002, J BURN CARE REHABIL, V23, P167, DOI 10.1097/00004630-200205000-00005
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   Morykwas MJ, 1999, J BURN CARE REHABIL, V20, P15, DOI 10.1097/00004630-199901001-00003
   Morykwas MJ, 1997, ANN PLAS SURG, V38, P553, DOI 10.1097/00000637-199706000-00001
   SCHUMPELICK V, 1997, OPERATIONSATLAS CHIR, P655
   Webb LX, 2001, UNFALLCHIRURG, V104, P918, DOI 10.1007/PL00002776
NR 9
TC 3
Z9 3
U1 0
U2 1
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA Oswald-Hesse-Strasse 50, D-70469 STUTTGART, GERMANY
SN 0044-409X
EI 1438-9592
J9 ZBL CHIR
JI Zent.bl. Chir.
PD APR
PY 2006
VL 131
SU 1
BP S96
EP S99
DI 10.1055/s-2006-921509
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 034DB
UT WOS:000236904100022
PM 16575655
DA 2026-07-24
ER

PT J
AU Alhan, D
   Sahin, I
   Güzey, S
   Aykan, A
   Zor, F
   Öztürk, S
   Nisanci, M
   Özerhan, IH
AF Alhan, Dogan
   Sahin, Ismail
   Guzey, Serbulent
   Aykan, Andac
   Zor, Fatih
   Ozturk, Serdar
   Nisanci, Mustafa
   Ozerhan, Ismail Hakki
TI Staged repair of severe open abdomens due to high-energy gunshot
   injuries with early vacuum pack and delayed tissue expansion and
   dual-sided meshes
SO ULUSAL TRAVMA VE ACIL CERRAHI DERGISI-TURKISH JOURNAL OF TRAUMA &
   EMERGENCY SURGERY
LA English
DT Article
DE Dual meshes; gunshot injury; open abdomen; tissue expansion; vacuum
   assisted closure
ID ABDOMINAL-WALL RECONSTRUCTION; PLANNED VENTRAL HERNIA; COMPONENTS
   SEPARATION; DEFECTS; CLOSURE; MANAGEMENT; EXPANDERS; TRAUMA; FLAP
AB BACKGROUND: Open abdomen is a salvage procedure that prevents catastrophes after severe intraabdominal traumas. However, following this life saving attempt, it is mostly not feasible to close the abdomen immediately after the recovery of intraabdominal injuries. Consequently, a staged reconstruction is required, and the first stage is usually a temporary closing approach. At the end of this stage, resulting giant "ventral hernia" is a burden for both the patient and the surgeon. Therefore a permanent repair is subsequently needed. Although there are many treatment modalities described for this goal, etiologies like high-energy gunshots may cause an exactly nuisance scene which can limit treatment options and reduce final success. Herein, it was the objective of this study to present our staged protocol to restore the abdominal wall defect and strategy for optimizing the results in such conundrum cases.
   METHODS: Treatment was performed on nine male patients suffering from severe open abdomen due to high-energy gunshot injury. In all patients, temporary closure was provided by negative pressure wound treatment applied directly to the viscera and followed by skin grafting. Late permanent closure was performed with the lamination of expanded abdominal skin and dual-sided meshes.
   RESULTS: The follow-up period ranged between 24 months to 4.5 years (mean, 3 years). During this period, no recurrence of ventral hernia, enteric fistula formation, abdominal infection and seroma formation was observed in any patient.
   CONCLUSION: In this study, NPWT, tissue expansion and dual-sided mesh were used together as a staged procedure for optimizing the results in the clinical scenario of an open abdomen due to high-energy gunshot wound. Results were highly satisfactory for patients and acceptable aesthetically.
C1 [Alhan, Dogan] Eskisehir Mil Hosp, Dept Plast Reconstruct & Aesthet Surg, Eskisehir, Turkey.
   [Sahin, Ismail; Aykan, Andac; Zor, Fatih; Ozturk, Serdar] Gulhane Mil Med Acad, Dept Plast Reconstruct & Aesthet Surg, Ankara, Turkey.
   [Guzey, Serbulent] Kasimpasa Mil Hosp, Dept Plast Reconstruct & Aesthet Surg, Istanbul, Turkey.
   [Nisanci, Mustafa] Aesthet Surg Ctr, Ankara, Turkey.
   [Ozerhan, Ismail Hakki] Gulhane Mil Med Acad, Dept Gen Surg, Ankara, Turkey.
C3 Eskisehir Military Hospital; Gulhane Training & Research Hospital;
   Kasimpasa Military Hospital; Gulhane Training & Research Hospital
RP Güzey, S (通讯作者)，Kasimpasa Asker Hastanesi, Plast Rekonstrktif & Estet Cerrahi Klin, Istanbul, Turkey.
EM drserbulent@yahoo.com
RI /D-9282-2016; Nişancı, Mustafa/JBJ-1029-2023; Zor, Fatih/B-4818-2017;
   OZERHAN, ISMAIL HAKKI/H-8689-2012
OI Zor, Fatih/0000-0002-5851-0711; OZERHAN, ISMAIL
   HAKKI/0000-0001-7142-9793
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NR 25
TC 5
Z9 5
U1 0
U2 5
PU TURKISH ASSOC TRAUMA EMERGENCY SURGERY
PI ISTANBUL
PA KOPRULU MEHMET PASA SOC, DENIZ ABDAL MAH, DADASOGLU AP, 25-1 SEHREMINI,
   ISTANBUL, 00000, TURKEY
SN 1306-696X
J9 ULUS TRAVMA ACIL CER
JI Ulus. Travma Acil Cerrahi Derg.
PD NOV
PY 2015
VL 21
IS 6
BP 457
EP 462
DI 10.5505/tjtes.2015.05942
PG 6
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA DB1LG
UT WOS:000368269100007
PM 27054636
OA Bronze
DA 2026-07-24
ER

PT J
AU Lin, CJ
   Lin, CW
   Wu, SH
   Cheng, HM
AF Lin, Chun-Jun
   Lin, Cheng-Wei
   Wu, Szu-Hsien
   Cheng, Hao-Min
TI Effectiveness of Maggot Debridement Therapy for Chronic Wounds: A
   Systematic Review and Meta-Analysis of Randomised Controlled Trials
SO WOUND REPAIR AND REGENERATION
LA English
DT Review
DE chronic wound; debridement; maggot debridement therapy; meta-analysis;
   systemic review; wound healing
ID VENOUS LEG ULCERS; DIABETIC FOOT ULCERS; STAPHYLOCOCCUS-AUREUS; LARVAL
   THERAPY; CHYMOTRYPSIN; DEGRADATION; SECRETIONS; BIOFILMS; ETIOLOGY;
   SLOUGH
AB The research underscores an important gap in the management of chronic wounds, which frequently exhibit resistance to standard therapies. Maggot debridement therapy shows promise in removing necrotic tissue; however, data comparing its efficacy to conventional treatments is limited. We conducted a systematic review and meta-analysis of randomised controlled trials to assess the effectiveness of maggot debridement therapy versus conventional therapies, including commonly used wound care interventions such as hydrogel dressings, compression therapy, vacuum-assisted closure (VAC) therapy, sharp debridement, and so on. The population was defined as patients with chronic wounds, including venous leg ulcers, arterial ulcers, mixed arterial-venous leg ulcers, diabetic foot ulcers, and full-thickness burns. Primary outcomes assessed were the proportion of wound healing and time to wound healing, while secondary outcomes were time to wound debridement, reduction of slough, infection-free rate, eradication of Staphylococcus aureus and Pseudomonas aeruginosa, and ulcer-related pain. Ten randomised controlled trials involving 839 participants were incorporated. Maggot debridement therapy markedly decreased the duration of wound debridement compared to conventional treatment (hazard ratio: 5.16, p = 0.0006) and showed a borderline significant reduction in slough during the first week (mean difference: 17.06, p = 0.05). Maggot debridement therapy and conventional treatment did not vary in the proportion of wound healing (p = 0.17), time to wound healing (p = 0.14), infection-free rates (p = 0.10), eradication of Staphylococcus aureus (p = 0.11) and Pseudomonas aeruginosa (p = 0.46), or ulcer-related pain (p = 0.54). Maggot debridement therapy may be an effective preliminary debridement technique for wound bed preparation in chronic wounds, especially before advanced interventions such as skin grafting, and is particularly advantageous for chronic wounds unresponsive to conventional therapies. Further research is required to confirm the findings.
C1 [Lin, Chun-Jun; Lin, Cheng-Wei; Cheng, Hao-Min] Taipei Vet Gen Hosp, Dept Med Educ, Taipei, Taiwan.
   [Wu, Szu-Hsien; Cheng, Hao-Min] Natl Yang Ming Chiao Tung Univ, Sch Med, Sch Med, Taipei, Taiwan.
   [Wu, Szu-Hsien] Taipei Vet Gen Hosp, Div Plast & Reconstruct Surg, Taipei, Taiwan.
   [Cheng, Hao-Min] Taipei Vet Gen Hosp, Div Evidence Based Med, Taipei, Taiwan.
   [Cheng, Hao-Min] Natl Yang Ming Chiao Tung Univ, Inst Publ Hlth, Sch Med, Taipei, Taiwan.
   [Cheng, Hao-Min] Natl Yang Ming Chiao Tung Univ, Community Med Res Ctr, Sch Med, Taipei, Taiwan.
C3 Taipei Veterans General Hospital; National Yang Ming Chiao Tung
   University; Taipei Veterans General Hospital; Taipei Veterans General
   Hospital; National Yang Ming Chiao Tung University; National Yang Ming
   Chiao Tung University
RP Cheng, HM (通讯作者)，Taipei Vet Gen Hosp, Dept Med Educ, Taipei, Taiwan.; Wu, SH; Cheng, HM (通讯作者)，Natl Yang Ming Chiao Tung Univ, Sch Med, Sch Med, Taipei, Taiwan.; Wu, SH (通讯作者)，Taipei Vet Gen Hosp, Div Plast & Reconstruct Surg, Taipei, Taiwan.; Cheng, HM (通讯作者)，Taipei Vet Gen Hosp, Div Evidence Based Med, Taipei, Taiwan.; Cheng, HM (通讯作者)，Natl Yang Ming Chiao Tung Univ, Inst Publ Hlth, Sch Med, Taipei, Taiwan.; Cheng, HM (通讯作者)，Natl Yang Ming Chiao Tung Univ, Community Med Res Ctr, Sch Med, Taipei, Taiwan.
EM shwu3@vghtpe.gov.tw; hmcheng@vghtpe.gov.tw
RI ; Cheng, Hao-min/L-2576-2018
OI Lin, Cheng-Wei/0009-0000-4525-8804; Cheng, Hao-min/0000-0002-3885-6600;
   Lin, Chun-Jun/0009-0007-1903-5763
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NR 64
TC 1
Z9 1
U1 6
U2 9
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1067-1927
EI 1524-475X
J9 WOUND REPAIR REGEN
JI Wound Repair Regen.
PD SEP
PY 2025
VL 33
IS 5
AR e70095
DI 10.1111/wrr.70095
PG 14
WC Cell Biology; Dermatology; Medicine, Research & Experimental; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Dermatology; Research & Experimental Medicine; Surgery
GA 9DG0P
UT WOS:001603576900008
PM 41042019
DA 2026-07-24
ER

PT J
AU Wichmann, D
   Fusco, S
   Werner, CR
   Voesch, S
   Duckworth-Mothes, B
   Schweizer, U
   Stueker, D
   Koenigsrainer, A
   Thiel, K
   Quante, M
AF Wichmann, Doerte
   Fusco, Stefano
   Werner, Christoph R.
   Voesch, Sabrina
   Duckworth-Mothes, Benedikt
   Schweizer, Ulrich
   Stueker, Dietmar
   Koenigsrainer, Alfred
   Thiel, Karolin
   Quante, Markus
TI Endoscopic Management for Post-Surgical Complications after Resection of
   Esophageal Cancer
SO CANCERS
LA English
DT Review
DE esophageal cancer; endoscopic complication management; postsurgical
   complication
ID VACUUM-ASSISTED CLOSURE; MINIMALLY INVASIVE ESOPHAGECTOMY; MANAGING
   ANASTOMOTIC LEAKAGE; REFRACTORY GASTROPARESIS; RETROSPECTIVE ANALYSIS;
   SUBMUCOSAL DISSECTION; BOTULINUM-TOXIN; RESCUE THERAPY; RISK-FACTORS;
   STENT
AB Simple Summary Flexible endoscopy has an important part in the diagnosis and treatment of postoperative complications after oncologically intended esophagectomy. Endoscopy offers the possibility of effective therapy with minimal invasiveness at the same time, and the use of endoscopic therapy procedures can avoid re-operations. In this review we present the advantages of endoscopic treatment opportunities during the last 20 years regarding patients' treatment after esophageal cancer resection. According to prevalence and clinical relevance, four relevant postoperative complications were identified and their endoscopic treatment procedures discussed. All endoscopic therapy procedures for anastomotic bleeding, anastomotic insufficiencies, anastomotic stenosis and postoperative delayed gastric emptying are presented, including innovative developments. Background: Esophageal cancer (EC) is the sixth-leading cause of cancer-related deaths in the world. Esophagectomy is the most effective treatment for patients without invasion of adjacent organs or distant metastasis. Complications and relevant problems may occur in the early post-operative course or in a delayed fashion. Here, innovative endoscopic techniques for the treatment of postsurgical problems were developed during the past 20 years. Methods: Endoscopic treatment strategies for the following postoperative complications are presented: anastomotic bleeding, anastomotic insufficiency, delayed gastric passage and anastomotic stenosis. Based on a literature review covering the last two decades, therapeutic procedures are presented and analyzed. Results: Addressing the four complications mentioned, clipping, stenting, injection therapy, dilatation, and negative pressure therapy are successfully utilized as endoscopic treatment techniques today. Conclusion: Endoscopic treatment plays a major role in both early-postoperative and long-term aftercare. During the past 20 years, essential therapeutic measures have been established. A continuous development of these techniques in the field of endoscopy can be expected.
C1 [Wichmann, Doerte; Duckworth-Mothes, Benedikt; Schweizer, Ulrich; Stueker, Dietmar; Koenigsrainer, Alfred; Thiel, Karolin; Quante, Markus] Univ Hosp Tubingen, Dept Gen Visceral & Transplantat Surg, Hoppe Seyler Str 3, D-72076 Tubingen, Germany.
   [Fusco, Stefano; Werner, Christoph R.; Voesch, Sabrina] Univ Hosp Tubingen, Dept Gastroenterol Gastrointestinal Oncol Hepatol, Otfried Muller Str 10, D-72076 Tubingen, Germany.
C3 Eberhard Karls University of Tubingen; Eberhard Karls University
   Hospital; Eberhard Karls University of Tubingen; Eberhard Karls
   University Hospital
RP Wichmann, D (通讯作者)，Univ Hosp Tubingen, Dept Gen Visceral & Transplantat Surg, Hoppe Seyler Str 3, D-72076 Tubingen, Germany.
EM doerte.wichmann@med.uni-tuebingen.de;
   stefano.fusco@med.uni-tuebingen.de;
   christoph.werner@med.uni-tuebingen.de;
   sabrina.voesch@med.uni-tuebingen.de;
   benedikt.mothes@med.uni-tuebingen.de;
   ulrich.schweizer@med.uni-tuebingen.de;
   dietmar.stueker@med.uni-tuebingen.de;
   karolin.thiel@med.uni-tuebingen.de; karolin.thiel@med.uni-tuebingen.de;
   markus.quante@med.uni-tuebingen.de
RI Fusco, Stefano/JYQ-3117-2024
OI Fusco, Stefano/0000-0001-6093-4567; Quante, Markus/0000-0002-2206-107X;
   , Doerte/0000-0002-8832-5031; Duckworth-Mothes,
   Benedikt/0000-0002-2352-2325
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NR 116
TC 7
Z9 10
U1 2
U2 9
PU MDPI
PI BASEL
PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND
EI 2072-6694
J9 CANCERS
JI Cancers
PD FEB
PY 2022
VL 14
IS 4
AR 980
DI 10.3390/cancers14040980
PG 15
WC Oncology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology
GA ZL5TB
UT WOS:000763738400001
PM 35205730
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Maduba, CC
   Nnadozie, UU
   Modekwe, VI
   Onah, II
AF Maduba, Charles Chidiebele
   Nnadozie, Ugochukwu Uzodimma
   Modekwe, Victor Ifeanyichukwu
   Onah, Ifeanyichukwu Igwilo
TI Split Skin Graft Take in Leg Ulcers: Conventional Dressing Versus
   Locally Adapted Negative Pressure Dressing
SO JOURNAL OF SURGICAL RESEARCH
LA English
DT Article
DE Graft take; Leg ulcers; Negative pressure dressing; Split-thickness skin
   grafting; Conventional dressing
ID VACUUM-ASSISTED CLOSURE; WOUND THERAPY; EXPERIENCE
AB Background: Split-thickness skin grafting is widely used in the management of leg ulcers but is fraught with suboptimal take especially in less than ideal wound beds. The use of negative pressure dressing to prepare wound beds is an established practice. However, its use to improve graft survival is yet to be a common practice. We aim to compare quantitative and qualitative split thickness skin graft take in leg and foot ulcers using either traditional wound dressing or negative pressure dressing methods.
   Methods: Sixty-two cases were recruited for the study and assigned into two groups of 31 cases each by convenient sampling method. Group A patients had negative pressure dressings in both phases, whereas group B patients had traditional wound dressing in both phases. The percentage skin graft take for both groups, and the pattern of complications were assessed. Results were analyzed using IBM SPSS statistics for windows (version 21.0; IBM Corp, Armonk, NY). Student t-test was used to compare the percentage graft take, whereas Chi-square was used to compare significance of complications in both dressing methods.
   Results: The negative pressure dressing showed better skin graft take with mean value of 99.2 +/- 0.95% compared with traditional dressing with mean take of 89.7 +/- 6.44%, which was statistically significant with a P value of <0.001. The complication rate was 12.9% in the negative pressure dressing group and 96.8% in the traditional wound dressing group, showing about 7.5 times more complication in the traditional wound dressing. This is statistically significant with a P value < 0.001.
   Conclusions: Negative pressure dressing for split-thickness skin graft contributes significantly to improved split-thickness skin graft take with reduced complication rate as compared with conventional wound dressing method. (C) 2020 Elsevier Inc. All rights reserved.
C1 [Maduba, Charles Chidiebele; Nnadozie, Ugochukwu Uzodimma] Alex Ekwueme Fed Univ, Dept Surg, Teaching Hosp, Abakaliki, Nigeria.
   [Nnadozie, Ugochukwu Uzodimma] Ebonyi State Univ, Dept Surg, Abakaliki, Nigeria.
   [Modekwe, Victor Ifeanyichukwu] Nnamdi Azikiwe Univ, Dept Surg, Div Paediat Surg, Teaching Hosp, Nnewi, Nigeria.
   [Onah, Ifeanyichukwu Igwilo] Natl Orthopaed Hosp, Dept Plast Surg, Enugu, Nigeria.
RP Maduba, CC (通讯作者)，Alex Ekwueme Fed Univ, Dept Surg, Teaching Hosp Abakaliki, PMB 102, Abakaliki, Ebonyi State, Nigeria.
EM charlesmaduba@gmail.com
RI Nnadozie, Ugochukwu/AFS-5496-2022; Modekwe, Victor/AAY-9300-2021
CR Anderson JJ, 2012, DIABET FOOT ANKLE, V3, DOI 10.3402/dfa.v3i0.10204
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NR 18
TC 16
Z9 18
U1 0
U2 8
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0022-4804
EI 1095-8673
J9 J SURG RES
JI J. Surg. Res.
PD JUL
PY 2020
VL 251
BP 296
EP 302
DI 10.1016/j.jss.2020.01.029
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA LT2SB
UT WOS:000536920900038
PM 32199338
DA 2026-07-24
ER

PT J
AU Castellanos, G
   Bernabé-García, A
   Moraleda, JM
   Nicolás, FJ
AF Castellanos, Gregorio
   Bernabe-Garcia, Angel
   Moraleda, Jose M.
   Nicolas, Francisco J.
TI Amniotic membrane application for the healing of chronic wounds and
   ulcers
SO PLACENTA
LA English
DT Article
DE Amniotic membrane; Wound healing; Chronic wounds; TGF-beta; Cell
   migration; Negative pressure therapy
ID GROWTH-FACTOR-BETA; VACUUM-ASSISTED CLOSURE; TRANSFORMING
   GROWTH-FACTOR-BETA-1; CONDITIONED MEDIUM; BED PREPARATION; C-JUN; CELLS;
   TRANSPLANTATION; AP-1; FIBRONECTIN
AB Wound healing usually follows a predictable sequence and prognosis of events. Its evolutionary process is the result of a complicated interaction between patient-related factors, the wound, the treatment used and the skills and knowledge of the professionals who treat them. Only through a meticulous initial assessment of the wound is it possible to identify the factors that contribute to its complexity. The challenge for professionals will be to implement efficient therapies at the right time and in the most costefficient way in order to reduce associated problems, treat the symptoms and expectations of the patients and achieve adequate wound healing whenever possible. This is particularly evident in big chronic wounds with considerable tissue loss, which become senescent in the process of inflammation or proliferation losing the ability to epithelialize. Generally, chronic wounds do not respond to current treatments, therefore they need special interventions. AM is a tissue of particular interest as a biological dressing and it has well-documented reepithelialization effects which are in part related to its capacity to synthesize and release biological active factors. Our studies have demonstrated that amniotic membrane (AM) is able to induce epithelialization in chronic wounds that were unable to epithelialize. AM induces several signaling pathways that are involved in cell migration and/or proliferation. Additionally, AM is able to selectively antagonize the anti-proliferative effect of transforming growth factor-alpha (TGF-beta) by modifying the genetic program that TGF-beta induces on keratinocytes. The combined effect of AM on keratinocytes, promoting cell proliferation/migration and antagonizing the effect of TGF-beta is the perfect combination, allowing chronic wounds to move out of their non-healing state and progress into epithelialization. (C) 2017 Elsevier Ltd. All rights reserved.
C1 [Castellanos, Gregorio] Virgen de la Arrixaca Univ Clin Hosp, Surg Serv, Murcia, Spain.
   [Bernabe-Garcia, Angel; Nicolas, Francisco J.] Virgen de la Arrixaca Univ Clin Hosp, Mol Oncol & TGF, Res Unit, Murcia, Spain.
   [Moraleda, Jose M.] Virgen de la Arrixaca Univ Clin Hosp, Cell Therapy Unit, Murcia, Spain.
C3 Hospital Clinico Universitario Virgen de la Arrixaca; Hospital Clinico
   Universitario Virgen de la Arrixaca; Hospital Clinico Universitario
   Virgen de la Arrixaca
RP Nicolás, FJ (通讯作者)，Virgen de la Arrixaca Univ Clin Hosp, Crta Madrid Cartagena S-N, Murcia 30120, Spain.
EM franciscoj.nicolas2@carm.es
RI Nicolás, Francisco José/H-9422-2019; Moraleda, Jose M/AAB-4119-2020;
   Bernabé-García, Ángel/AAB-2934-2020
OI Nicolás, Francisco José/0000-0002-3969-1430; Moraleda, Jose
   M/0000-0001-9080-1466; Bernabé-García, Ángel/0000-0002-2266-5949
FU Fundacion Seneca de la Region de Murcia [12035/PI/09]; Instituto de
   Salud Carlos III; Fondo de Investigaciones Sanitarias; Instituto de
   Salud Carlos III-Subdireccion General de Evaluacion y Fomento de la
   Investigacion [PI13/00794]; Fondos FEDER (ERDF funds) [EC10-019];
   Hospital Clinico Universitario Virgen de la Arrixaca
FX We would like to thank other members of the different laboratories who
   contribute in our dailytask of increasing our knowledge of AM and
   chronic wound healing. Ana M Garcia, Maria D. Lopez and Monica Rodriguez
   working in the clean room and providing AM. Paola Romencin, Jose E.
   Millan, David Garcia and Noemi Marin, working on AM and animal models,
   and Miguel Blanquer, working in the cell therapy group. Antonio Pinero
   working in the general and digestive system surgery. Antonia Alcaraz,
   Catalina Ruiz-Canada, Ania Mrowiec, Eva M. Garcia, and Sergio Liarte
   working on molecular aspects of AM and wound healing using cell models.
   This work was supported by a grant from the Fundacion Seneca de la
   Region de Murcia (Grant no.: 12035/PI/09) and a grant from the Instituto
   de Salud Carlos III, Fondo de Investigaciones Sanitarias. Plan Estatal
   I+D+i and the Instituto de Salud Carlos III-Subdireccion General de
   Evaluacion y Fomento de la Investigacion (Grant no.: PI13/00794)
   http://www.isciii.es/Fondos FEDER (ERDF funds)
   http://ec.europa.eu/regional_policy/es/funding/erdf/ (Grant no.:
   EC10-019). We are indebted to the Hospital Clinico Universitario Virgen
   de la Arrixaca for stronglysupporting this research.
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NR 109
TC 85
Z9 94
U1 0
U2 12
PU W B SAUNDERS CO LTD
PI LONDON
PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND
SN 0143-4004
EI 1532-3102
J9 PLACENTA
JI Placenta
PD NOV
PY 2017
VL 59
BP 146
EP 153
DI 10.1016/j.placenta.2017.04.005
PG 8
WC Developmental Biology; Obstetrics & Gynecology; Reproductive Biology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Developmental Biology; Obstetrics & Gynecology; Reproductive Biology
GA FO3ID
UT WOS:000416720100021
PM 28413063
DA 2026-07-24
ER

PT J
AU Kanda, N
   Morimoto, N
   Ayvazyan, AA
   Takemoto, S
   Kawai, K
   Nakamura, Y
   Sakamoto, Y
   Taira, T
   Suzuki, S
AF Kanda, Norikazu
   Morimoto, Naoki
   Ayvazyan, Artem A.
   Takemoto, Satoru
   Kawai, Katsuya
   Nakamura, Yoko
   Sakamoto, Yuki
   Taira, Tsuguyoshi
   Suzuki, Shigehiko
TI Evaluation of a novel collagen-gelatin scaffold for achieving the
   sustained release of basic fibroblast growth factor in a diabetic mouse
   model
SO JOURNAL OF TISSUE ENGINEERING AND REGENERATIVE MEDICINE
LA English
DT Article
DE bFGF; artificial skin; collagen-gelatin sponge; scaffold; sustained
   release; wound healing; diabetic mice
ID VACUUM-ASSISTED CLOSURE; ARTIFICIAL DERMIS; HYPERBARIC-OXYGEN;
   SOFT-TISSUE; FACTOR BFGF; SKIN; MICROSPHERES; PRESSURE; DEFECTS; THERAPY
AB The objective of this study was to evaluate the ability of a scaffold, collagen-gelatin sponge (CGS), to release basic fibroblast growth factor (bFGF) in a sustained manner, using a pressure-induced decubitus ulcer model involving genetically diabetic mice. We confirmed that CGSs impregnated with a bFGF concentration of up to 50 mu g/cm(2) were able to sustain the release of bFGF throughout their biodegradation. We prepared decubitus ulcers on diabetic mice. After debriding the ulcers, we implanted CGSs (diameter 8mm) impregnated with normal saline solution (NSS) or bFGF solution (7, 14, 28 or 50 mu g/cm(2)). At 1 and 2weeks after implantation, the mice were sacrificed and tissue specimens were obtained. The wound area, neoepithelium length and numbers and total area of newly formed capillaries were evaluated. The CGSs impregnated with NSS became infected and degraded, whereas the CGSs impregnated with 7 or 14 mu g/cm(2) bFGF displayed accelerated dermis-like tissue formation and the CGSs impregnated with 14 mu g/cm(2) bFGF produced significant improvements in the remaining wound area, neoepithelium length and numbers and total area of newly formed capillaries compared with the NSS group. No significant difference was observed between the NSS and 50 mu g/cm(2) bFGF groups. CGSs impregnated with 7-14 mu g/cm(2) bFGF accelerated wound healing, and an excess amount of bFGF did not increase the wound-healing efficacy of the CGSs. Our CGS is a scaffold that can release positively charged growth factors such as bFGF in a sustained manner and shows promise as a scaffold for skin regeneration. Copyright (c) 2012 John Wiley & Sons, Ltd.
C1 [Kanda, Norikazu; Morimoto, Naoki; Ayvazyan, Artem A.; Kawai, Katsuya; Nakamura, Yoko; Suzuki, Shigehiko] Kyoto Univ, Grad Sch Med, Dept Plast & Reconstruct Surg, Sakyo Ku, Kyoto, Japan.
   [Takemoto, Satoru] Matsue City Hosp, Dept Plast & Reconstruct Surg, Matsue, Shimane, Japan.
   [Sakamoto, Yuki; Taira, Tsuguyoshi] Gunze Res & Dev Ctr, Ayabe, Kyoto, Japan.
C3 Kyoto University
RP Kanda, N (通讯作者)，Kyoto Univ, Grad Sch Med, Dept Plast & Reconstruct Surg, Sakyo Ku, 54 Kawahara Cho Shogoin, Kyoto, Japan.
EM nkanda@kuhp.kyoto-u.ac.jp
OI Morimoto, Naoki/0000-0002-0712-3172
FU Japan Science and Technology Agency
FX This work was supported by a grant from the Japan Science and Technology
   Agency.
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NR 52
TC 55
Z9 63
U1 0
U2 30
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1932-6254
EI 1932-7005
J9 J TISSUE ENG REGEN M
JI J. Tissue Eng. Regen. Med.
PD JAN
PY 2014
VL 8
IS 1
BP 29
EP 40
DI 10.1002/term.1492
PG 12
WC Cell & Tissue Engineering; Biotechnology & Applied Microbiology; Cell
   Biology; Engineering, Biomedical
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Biotechnology & Applied Microbiology; Engineering
GA 282TR
UT WOS:000329197000003
PM 22628359
OA Green Accepted
DA 2026-07-24
ER

PT J
AU Chopra, SS
   Hünerbein, M
AF Chopra, Sascha Santosh
   Huenerbein, Michael
TI The effect of endoscopic treatment on healing of anastomotic leaks after
   anterior resection of rectal cancer
SO SURGERY
LA English
DT Article
ID TOTAL MESORECTAL EXCISION; VACUUM-ASSISTED CLOSURE; PELVIC DRAINAGE;
   RISK-FACTORS; SURGERY; STOMA; STENT
AB Background. Despite surgical advances, anastomotic leaks remain a major complication ater rectal resection. Endoscopic techniques are increasingly used as an alternative or in addition to conventional operative therapy of anastomotic leakage. We have analyzed the impact of endoscopic treatment on the outcome of patients with leaks after resection of rectal cancer.
   Methods. From January 2000 to December 2005, rectal resection was performed in 274 patients with rectal cancer A nastomotic leakage was observed in 29 patients (11%). Nine of these patients received a Protective ileostomy. The remaining 20 patients underwent either conventional operative or endoscopic treatment. Both groups were analyzed regarding complications, necessity of operative reintervention., hospitalization, anastomotic healing time, and stoma reversal rate.
   Results. The endoscopic group included 13 patients who underwent endoscopic debridement in combination with stenting, endoluminal vacuum. therapy, or fibrin injection. The remaining 7 patients underwent reoperation-secondary ileostomy creation (n = 4), Hartmann procedure (n = 2), or anastomotic repair (n = 1). Stoma creation was necessary in 7 of 13 patients (54%) in the endoscopic group and in 6 of 7 patients (86%) in the operative group. There were no significant differences regarding postoperative septicemia (39 vs 43%), duration of intensive care (13 vs 11 days), or time of hospitalization (25 vs 26 days) for endoscopic and conventional therapies. Mean healing time of the anastomotic leak in the endoscopic rind conventional group was 105 anti 173 days, respectively. The stoma reversal rate was similar in both groups (50 vs 57%), but the overall rate of patients without colostomy was higher in the endoscopic group (77 vs 57%).
   Conclusion. Endoscopic therapy in combination with effective operative drainage may support healing of anastomotic leaks after rectal resection. However, the majority of patients require operative reintervention with bowel diversion despite endoscopic treatment. (Surgery 2009,145:182-8.)
C1 [Huenerbein, Michael] Univ Med Berlin, Dept Surg & Surg Oncol, D-13125 Berlin, Germany.
   Helios Hosp Berlin, D-13125 Berlin, Germany.
C3 Free University of Berlin; Humboldt University of Berlin; Charite
   Universitatsmedizin Berlin
RP Hünerbein, M (通讯作者)，Univ Med Berlin, Dept Surg & Surg Oncol, Campus Berlin Buch,Schwanebecker Chaussee 50,Char, D-13125 Berlin, Germany.
EM michael.huenerbein@charite.de
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NR 25
TC 49
Z9 55
U1 0
U2 2
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0039-6060
J9 SURGERY
JI Surgery
PD FEB
PY 2009
VL 145
IS 2
BP 182
EP 188
DI 10.1016/j.surg.2008.09.012
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 404KU
UT WOS:000263151200008
PM 19167973
DA 2026-07-24
ER

PT J
AU Nasca, MR
   Shih, AT
   West, DP
   Martinez, WM
   Micali, G
   Landsman, AS
AF Nasca, Maria R.
   Shih, Alan T.
   West, Dennis P.
   Martinez, Wanda M.
   Micali, Giuseppe
   Landsman, Adam S.
TI Intermittent pressure decreases human keratinocyte proliferation in
   vitro
SO SKIN PHARMACOLOGY AND PHYSIOLOGY
LA English
DT Article
DE mechanical stress; pressure loads; cultured human keratinocytes; wound
   healing; foot ulcers; diabetes
ID HUMAN EPIDERMAL-KERATINOCYTES; VACUUM-ASSISTED CLOSURE; MECHANICAL
   STRETCH; GROWTH-FACTOR; PROTEIN-KINASE; STRAIN; STIMULATION; TISSUE;
   PHOSPHORYLATION; DIFFERENTIATION
AB Background: The aim of this study was to investigate the correlation between pressure changes and keratinocyte proliferation by determining whether keratinocytes exposed to altered mechanical pressures would proliferate at different rates compared to control cells not subjected to pressure changes. Methods: Tissue culture flasks of human keratinocytes plated at an approximate density of 15,000 cells/cm(2) undergoing an intermittent cyclic pressure of 362 mm Hg at a frequency of 2.28 or 5.16 cycles/min (0.038 or 0.086 Hz) for 8 h were compared to control flasks grown at ambient room pressure. An in-line pressure transducer was used to monitor and adjust pressure within the cell chambers, using a solenoid valve. A thymidine incorporation assay assessed the amount of cell proliferation in each set of experiments. Results: Differences in proliferation between keratinocytes subjected to cyclic pressure changes and control cells were found to be statistically significant (p < 0.05) in 4 out of 5 proliferation assays. Also, a higher frequency of pressure changes consistently generated a reduced proliferation rate compared to that seen in cells exposed to a lower frequency of pressure changes. Conclusion: These data indicate that keratinocytes undergoing intermittent pressure changes exhibit decreased proliferation rates compared to controls. Furthermore, an increased frequency rate seems to have a greater effect on proliferation than low-frequency rate pressure changes, suggesting that the stress caused by frequently changed pressure may play a greater role in reducing keratinocyte proliferation than the actual magnitude of load applied to the cells. Our results support the current treatment protocol of reducing speed and duration of walking on the site of the wound to promote healing of foot ulcers.
   Copyright (c) 2007 S. Karger AG, Basel.
C1 Northwestern Univ, Feinberg Med Sch, Dept Dermatol, Chicago, IL 60611 USA.
   Univ Catania, Dermatol Clin, Catania, Italy.
   Northwestern Univ, Feinberg Med Sch, Dr William M Scholl Coll Podiat Med, Chicago, IL 60611 USA.
   Univ Wisconsin, Sch Med, Madison, WI USA.
   Harvard Univ, Sch Med, Beth Israel Deaconess Med Ctr, Dept Surg, Boston, MA USA.
C3 Northwestern University; Feinberg School of Medicine; University of
   Catania; Northwestern University; Feinberg School of Medicine;
   University of Wisconsin System; University of Wisconsin Madison; Harvard
   University; Harvard University Medical Affiliates; Beth Israel Deaconess
   Medical Center; Harvard Medical School
RP West, DP (通讯作者)，Northwestern Univ, Feinberg Med Sch, Dept Dermatol, 675 N St Clair St,Suite 19-200, Chicago, IL 60611 USA.
EM dwest@northwestern.edu
RI MICALI, Giuseppe/K-6848-2016; Nasca, Maria Rita/ADN-9004-2022
OI MICALI, Giuseppe/0000-0002-5157-3939; West, Dennis
   Paul/0000-0002-9107-6697; Nasca, Maria Rita/0000-0002-7107-9487
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NR 30
TC 7
Z9 7
U1 0
U2 6
PU KARGER
PI BASEL
PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND
SN 1660-5527
J9 SKIN PHARMACOL PHYS
JI Skin Pharmacol. Physiol.
PY 2007
VL 20
IS 6
BP 305
EP 312
DI 10.1159/000108146
PG 8
WC Dermatology; Pharmacology & Pharmacy
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Pharmacology & Pharmacy
GA 225WV
UT WOS:000250549800006
PM 17851275
DA 2026-07-24
ER

PT J
AU Auerswald, S
   Schreml, S
   Meier, R
   Soares, AB
   Niyazi, M
   Marschner, S
   Belka, C
   Canis, M
   Haubner, F
AF Auerswald, Steffen
   Schreml, Stephan
   Meier, Robert
   Blancke Soares, Alexandra
   Niyazi, Maximilian
   Marschner, Sebastian
   Belka, Claus
   Canis, Martin
   Haubner, Frank
TI Wound monitoring of pH and oxygen in patients after radiation therapy
SO RADIATION ONCOLOGY
LA English
DT Article
DE Wound healing; Radiotherapy; Luminescence; pH; Oxygen
ID VACUUM-ASSISTED CLOSURE; HUMAN STRATUM-CORNEUM; NECK REGION; IN-VIVO;
   HEAD; PROLIFERATION; RADIOTHERAPY; MIGRATION; GRADIENT; IMPACT
AB Objectives Postradiogenic wound healing disorders are an important clinical problem. While a variety of treatment modalities are available, there is no strategy to objectively judge treatment success. The aim of this study was to evaluate a 2D luminescence imaging system for pH and oxygen in non-healing wounds after radiotherapy. Methods Luminescence 2D imaging was performed with the VisiSens (Presens, Regensburg, Germany) 2D imaging systems A1 and A2 for oxygen and pH, respectively. Biocompatible planar luminescent sensor foils were applied to non-irradiated and irradiated skin as well as to radiogenic wounds of five patients and the pH and the oxygen saturation was determined. Results pH measurements showed significant differences between non-irradiated skin (6.46 +/- 0.18) and irradiated skin (6.96 +/- 0.26). Radiogenic wounds exhibited the highest pH values (7.53 +/- 0.26). Oxygen measurements revealed a mean oxygen saturation of non-irradiated skin of 6.19 +/- 0.83 mmHg. The highest value of oxygen saturation (28.4 +/- 2.4 mmHg) was found on irradiated skin while irradiated wounds had a poor oxygen saturation (9.4 +/- 2.2 mmHg) (mean +/- s.e.m.). Conclusion We found that routine measurement of pH and pO2 in patients could be easily integrated into the clinical routine. The results of the measurements show unfavorable pH and oxygen saturation conditions for wound healing in irradiated wounds. Interestingly, irradiated wounds exhibit a more pronounced hypoxia than irradiated skin which is reflected by an altered pH and pO2 compared to unirradiated skin, which has the potential to serve as a prognostic marker in the future. In addition to the objectification of the treatment success of postradiogenic wound healing disorders, the extent of skin toxicity could already be predicted during radiotherapy with this method.
C1 [Auerswald, Steffen] Univ Med Ctr Regensburg, Dept Otorhinolaryngol, Regensburg, Germany.
   [Schreml, Stephan] Univ Med Ctr Regensburg, Dept Dermatol, Regensburg, Germany.
   [Meier, Robert] Presens, Biopk, Regensburg, Germany.
   [Blancke Soares, Alexandra; Canis, Martin; Haubner, Frank] Univ Med Ctr Munich, Klinikum Grosshadern, Dept Otorhinolaryngol, Marchioninistr 15, D-81377 Munich, Germany.
   [Niyazi, Maximilian; Belka, Claus] Univ Med Ctr Munich, Dept Radiat Oncol, Munich, Germany.
   [Marschner, Sebastian] German Canc Res Ctr, German Canc Consortium DKTK, Heidelberg, Germany.
C3 University of Regensburg; University of Regensburg; University of
   Munich; Helmholtz Association; German Cancer Research Center (DKFZ)
RP Haubner, F (通讯作者)，Univ Med Ctr Munich, Klinikum Grosshadern, Dept Otorhinolaryngol, Marchioninistr 15, D-81377 Munich, Germany.
EM frank.haubner@med.uni-muenchen.de
RI Marschner, Sebastian/HMD-2437-2023; Haubner, Frank/HJB-0079-2022;
   Schreml, Stephan/GPX-0593-2022
OI Haubner, Frank/0000-0001-6198-2966; Niyazi,
   Maximilian/0000-0002-7711-9486; Schreml, Stephan/0000-0002-2820-1942
FU German Government [KF2525609AK4]
FX The study was supported by the German Government (ZIM Project Number:
   KF2525609AK4).
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NR 47
TC 33
Z9 34
U1 2
U2 26
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1748-717X
J9 RADIAT ONCOL
JI Radiat. Oncol.
PD NOV 11
PY 2019
VL 14
IS 1
AR 199
DI 10.1186/s13014-019-1413-y
PG 9
WC Oncology; Radiology, Nuclear Medicine & Medical Imaging
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Radiology, Nuclear Medicine & Medical Imaging
GA JO7DO
UT WOS:000497736300002
PM 31711506
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Canavese, F
   Marengo, L
   Corradin, M
   Mansour, M
   Samba, A
   Andreacchio, A
   Rousset, M
   Dimeglio, A
AF Canavese, Federico
   Marengo, Lorenza
   Corradin, Marco
   Mansour, Mounira
   Samba, Antoine
   Andreacchio, Antonio
   Rousset, Marie
   Dimeglio, Alain
TI Deep postoperative spine infection treated by negative pressure therapy
   in patients with progressive spinal deformities
SO ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
LA English
DT Article
DE Deep spine infection; Children; Adolescents; Sublaminar bands; Hybrid
ID VACUUM-ASSISTED CLOSURE; NEUROMUSCULAR SCOLIOSIS; SURGERY; FUSION;
   INSTRUMENTATION; EXPERIENCE; MANAGEMENT; WOUNDS
AB The aim of the study is to review the outcome of using the VAC system in children and adolescents who have developed postoperative spinal infection after posterior instrumented spinal fusion, and to evaluate whether this technique is also feasible in patients treated with posterior instrumented fusion with polyester sublaminar bands.
   A total of 11 out of 118 consecutive children and adolescents (5 males) with deep postoperative spinal infection were identified; infections were categorised as early (acute), delayed (subacute) or late (chronic) according to time of onset. Irrespective of the etiology and the onset, all the deep infections were managed with the reported technique. All the patients had regular clinical and radiological follow-up.
   Eight out of 11 patients developed an early (72.7%), 2 a delayed (18.2%) and 1 a late deep postoperative infection (9.1%); 7 out of 11 (63.6%) showed severe mental compromise. No statistically significant differences were observed for mean number of VAC dressing changes (p = 0.81) and mean length of hospitalisation comparing patients with early infection versus patients with delayed or late infections (p = 0.32). Mean number of VAC dressing changes (p = 0.02) and mean number of hospitalisation days (p = 0.05) were higher in patients with underlying neurological disorders than in those without, while mean length of hospitalisation was longer in neuromuscular patients.
   The application of the VAC system, as an adjunct to surgical debridement and adequate antibiotic therapy, is a reliable method for the treatment of postoperative infection in children and adolescents undergoing spinal instrumentation and fusion. It can reduce the need for further complex soft-tissue procedure, removal of hardware with consequent loss of correction, and pseudoarthrosis. Finally, the use of VAC therapy is not contraindicated in patients treated with hybrid constructs with sublaminar bands.
   III.
C1 [Canavese, Federico; Marengo, Lorenza; Corradin, Marco; Mansour, Mounira; Samba, Antoine; Rousset, Marie] Univ Hosp Estaing, Dept Pediat Surg, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand, France.
   [Andreacchio, Antonio] Regina Margherita Children Hosp, Pediat Orthopaed Dept, Piazza Polonia 94, I-10126 Turin, Italy.
   [Dimeglio, Alain] Clin St Roch, Dept Orthoped Surg, Bat B 550 Ave Colonel Andre Pavelet, F-34070 Montpellier, France.
C3 Universite Clermont Auvergne (UCA); CHU Clermont Ferrand; A.O.U. Citta
   della Salute e della Scienza di Torino; Universite de Montpellier
RP Canavese, F (通讯作者)，Univ Hosp Estaing, Dept Pediat Surg, 1 Pl Lucie & Raymond Aubrac, F-63003 Clermont Ferrand, France.
EM canavese_federico@yahoo.fr
RI Marengo, Lorenza/AAB-8689-2021; Andreacchio, Antonio/I-1421-2019
OI Marengo, Lorenza/0000-0003-2236-6866; CANAVESE,
   Federico/0000-0002-6114-5372; Andreacchio, Antonio/0000-0001-7729-3890
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NR 22
TC 14
Z9 16
U1 0
U2 9
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0936-8051
EI 1434-3916
J9 ARCH ORTHOP TRAUM SU
JI Arch. Orthop. Trauma Surg.
PD APR
PY 2018
VL 138
IS 4
BP 463
EP 469
DI 10.1007/s00402-017-2860-2
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA FZ5IO
UT WOS:000427625900004
PM 29270822
DA 2026-07-24
ER

PT J
AU Rasilainen, SK
   Mentula, PJ
   Leppäniemi, AK
AF Rasilainen, S. K.
   Mentula, P. J.
   Leppaniemi, A. K.
TI Vacuum and mesh-mediated fascial traction for primary closure of the
   open abdomen in critically ill surgical patients
SO BRITISH JOURNAL OF SURGERY
LA English
DT Article
ID ABDOMINAL COMPARTMENT SYNDROME; INTRAABDOMINAL HYPERTENSION; TEMPORARY
   CLOSURE; ASSISTED CLOSURE; AORTIC-ANEURYSM; OPEN MANAGEMENT;
   RECONSTRUCTION; DECOMPRESSION; PERITONITIS; LAPAROTOMY
AB Background: Several temporary abdominal closure techniques have been used in the management of open abdomen. Failure to achieve delayed primary fascial closure results in a large ventral hernia. This retrospective analysis evaluated whether the use of vacuum-assisted closure and mesh-mediated fascial traction (VACM) as temporary abdominal closure improved the delayed primary fascial closure rate compared with non-traction methods.
   Methods: Patients treated with an open abdomen between 2004 and 2010 were analysed.
   Results: Among 50 patients treated with VACM and 54 using non-traction techniques (control group), the delayed primary fascial closure rate was 78 and 44 per cent respectively (P < 0.001); rates among those who survived to abdominal closure were 93 and 59 per cent respectively. Independent predictors of delayed primary fascial closure in multivariable logistic regression analysis were the use of VACM (odds ratio (OR) 4.43, 95 per cent confidence interval 1.64 to 11.99) and diagnosis other than peritonitis, severe acute pancreatitis or ruptured abdominal aortic aneurysm (OR 3.45, 1.07 to 11.04), which represented the main diagnoses. Prophylactic open abdomen was used to inhibit the development of intra-abdominal hypertension more frequently in the VACM group (28 versus 7 per cent; P = 0.008). Twelve per cent of patients in the VACM group developed an enteroatmospheric fistula compared with 19 per cent of control patients. Among survivors, three of 31 treated with VACM and 17 of 36 controls were left with a planned ventral hernia (P = 0.001).
   Conclusion: The indication for open abdomen contributed to the probability of delayed primary fascial closure. VACM resulted in a higher fascial closure rate and lower planned hernia rate than methods that did not provide fascial traction. Copyright (c) 2012 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.
C1 [Rasilainen, S. K.; Mentula, P. J.; Leppaniemi, A. K.] Helsinki Univ Cent Hosp, Dept Abdominal Surg, Helsinki, Finland.
C3 University of Helsinki; Helsinki University Central Hospital
RP Rasilainen, SK (通讯作者)，Pihlajatie 6 A,POB 02270, Espoo, Finland.
EM suvi.rasilainen@hus.fi
RI Leppäniemi, Ari/GQZ-7991-2022; Mentula, Panu/H-9025-2019
OI Mentula, Panu/0000-0002-6516-3797
CR Acosta S, 2011, BRIT J SURG, V98, P735, DOI 10.1002/bjs.7383
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NR 37
TC 107
Z9 122
U1 0
U2 7
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0007-1323
EI 1365-2168
J9 BRIT J SURG
JI Br. J. Surg.
PD DEC
PY 2012
VL 99
IS 12
BP 1725
EP 1733
DI 10.1002/bjs.8914
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 032NZ
UT WOS:000310727300016
PM 23034811
OA Bronze
DA 2026-07-24
ER

PT J
AU Li, XM
   Li, R
   Luo, XL
   Chen, T
   Wu, J
AF Li, Xiaomin
   Li, Rui
   Luo, Xiangli
   Chen, Teng
   Wu, Jian
TI Giant Morel-Lavallée lesion complicated with open pelvic fracture: a
   rare case report
SO FRONTIERS IN SURGERY
LA English
DT Article
DE Morel-Lavall & eacute;e lesion; open pelvic fracture; misdiagnosis; case
   report; rare
ID MOREL-LAVALLEE LESION; CLINICAL PRESENTATION; MANAGEMENT; DRAINAGE
AB Background Morel-Lavall & eacute;e lesion (MLL) is a rare closed degloving injury from high-energy shear/crush trauma, often linked to pelvic/acetabular fractures. Due to limited clinical awareness, it is highly prone to misdiagnosis, potentially causing severe complications like infection and skin necrosis. Existing literature rarely documents giant MLL with open pelvic fractures. This article reports such a case in an obese patient after heavy-object impact, aiming to enhance understanding and improve management of complex injuries.Case presentation A 27-year-old male sustained lumbosacral giant MLL and open pelvic fracture from workplace heavy-object crush. The MLL was unrecognized for two weeks at another hospital. Upon transfer, he had hemorrhagic shock, fluctuating lumbosacral swelling, and localized skin necrosis. Imaging showed comminuted left iliac fracture with extensive soft tissue edema and gas.Management A three-stage surgery was used. Stage 1: muscle debridement, fracture fixation, and vacuum-assisted closure (VAC) to address acute injury and control infection. Stage 2: debridement, antibiotic-loaded bone cement implantation, and continued VAC for osteomyelitis treatment and bone healing. Stage 3: flap reconstruction and skin grafting to restore soft tissue integrity.Outcome The patient was discharged one month postoperatively with viable skin grafts. At 3-month follow-up, fracture and wound healed well, confirming the staged approach's effectiveness.Conclusion MLL is often overlooked in high-energy trauma, emphasizing early comprehensive exams plus imaging to avoid misdiagnosis. For MLL with fractures, staged treatment is advisable: early radical debridement and VAC to control infection, followed by fixation and soft tissue reconstruction when stable. VAC reduces infection risk by minimizing exudation and promoting granulation. Obese patients, with loose adipose compartments, face higher MLL risk and need special attention. Future research should explore minimally invasive techniques to optimize outcomes.
C1 [Li, Xiaomin; Li, Rui] China Acad Chinese Med Sci, Wangjing Hosp, Dept Orthoped, Beijing, Peoples R China.
   [Luo, Xiangli; Wu, Jian] Gansu Prov Peoples Hosp, Dept Orthoped, Lanzhou, Peoples R China.
   [Chen, Teng] Gansu Univ Chinese Med, Dept Endocrinol, Affiliated Hosp, Lanzhou, Peoples R China.
C3 Wang Jing Hospital, CACMS; China Academy of Chinese Medical Sciences;
   Gansu University of Chinese Medicine
RP Luo, XL (通讯作者)，Gansu Prov Peoples Hosp, Dept Orthoped, Lanzhou, Peoples R China.
EM liuang1997@126.com
RI LI, RUI/NQF-9317-2025
OI Li, Xiaomin/0000-0003-3094-1816
FU Gansu Provincial Science and Technology Plan Project; Wangjing Hospital
   of China Academy of Chinese Medical Sciences and Gansu Provincial
   People's Hospital
FX The authors would like to thank Wangjing Hospital of China Academy of
   Chinese Medical Sciences and Gansu Provincial People's Hospital for
   their surgical guidance and assistance. Special thanks also go to
   Professor Jian Wu for the financial support.
CR Agha RA, 2020, INT J SURG, V84, P231, DOI 10.1016/j.ijsu.2020.11.005
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NR 28
TC 0
Z9 1
U1 2
U2 3
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD AUG 12
PY 2025
VL 12
AR 1639073
DI 10.3389/fsurg.2025.1639073
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 6LQ6P
UT WOS:001556307200001
PM 40874241
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Casella, D
   Fusario, D
   Pesce, AL
   Marcasciano, M
   Lo Torto, F
   Luridiana, G
   De Luca, A
   Cuomo, R
   Ribuffo, D
AF Casella, Donato
   Fusario, Daniele
   Pesce, Anna Lisa
   Marcasciano, Marco
   Lo Torto, Federico
   Luridiana, Gianluigi
   De Luca, Alessandro
   Cuomo, Roberto
   Ribuffo, Diego
TI Portable Negative Pressure Wound Dressing in Oncoplastic Conservative
   Surgery for Breast Cancer: A Valid Ally
SO MEDICINA-LITHUANIA
LA English
DT Article
DE wound healing; oncoplastic; breast cancer; negative pressure
ID VACUUM-ASSISTED CLOSURE; CONSERVING SURGERY; THERAPY; STANDARDIZATION;
   IMMEDIATE; OUTCOMES; REDUCTION
AB Background and Objectives: The use of oncoplastic techniques has spread widely in the last decade, with an expansion of the indications and demonstration of excellent oncological safety profiles. A potential downside may be the increased complication rates, which could influence the timing of adjuvant therapy. To date, there is increasing evidence that negative pressure therapy on closed wounds can reduce complication rates after surgery. From this perspective, we tested the use of portable negative pressure wound dressings (NPWDs) in oncoplastic surgery to minimize early post-operative admissions to the outpatient clinic and prevent surgical complications. Materials and Methods: An observational prospective cohort study was conducted on a population of patients who underwent quadrantectomy and wise-pattern reduction mammoplasty for breast cancer. The primary objective of the study is represented by the evaluation of the impact of NPWD on post-operative outcomes in an oncoplastic surgery setting. Patients enrolled between January 2021 and January 2023 were divided into two groups, the conventional dressing (CD) group and the NPWD group, by a simple randomization list. Results: A total of 100 patients were enrolled, with 52 in the CD group and 48 in the NPWD group. The use of NPWD significantly reduced the wound dehiscence rate (2.0% vs. 7.7% p = 0.002) and the number of one-month postoperative admissions to our clinic (3.8 +/- 1.1 vs. 5.7 +/- 1.3 p = 0.0009). Although not significant, it is possible to note a trend of reduction of clinically relevant postoperative total complications in patients treated with NPWDs. Conclusions: NPWDs may represent a useful tool in the post-surgical management of complex oncoplastic procedures, ensuring less wound dehiscence. Furthermore, the use of these dressings led to a significant reduction in admissions to the clinic, promoting a lower use of resources by hospitals and effective prevention of possible complications.
C1 [Casella, Donato; Fusario, Daniele; Pesce, Anna Lisa; Cuomo, Roberto] Univ Siena, Dept Med Surg & Neurosci, I-53100 Siena, Italy.
   [Marcasciano, Marco] Univ Catanzaro Magna Graecia, Unit Plast & Reconstruct Surg, I-88100 Catanzaro, Italy.
   [Lo Torto, Federico; Ribuffo, Diego] Sapienza Univ Roma, Dept Plast Reconstruct & Aesthet Surg, I-00185 Rome, Italy.
   [Luridiana, Gianluigi] ARNAS Brotzu, Businco Oncol Hosp, Unit Oncol & Breast Surg, I-09047 Cagliari, Italy.
   [De Luca, Alessandro] Sapienza Univ Roma, Dept Surg, I-00185 Rome, Italy.
C3 University of Siena; Magna Graecia University of Catanzaro; Sapienza
   University Rome; Sapienza University Rome
RP Fusario, D (通讯作者)，Univ Siena, Dept Med Surg & Neurosci, I-53100 Siena, Italy.
EM donato.casella@unisi.it; dani.fusario@gmail.com;
   annalisa.pesce@student.unisi.it; dott.marcomarcasciano@gmail.com;
   federico.lotorto@uniroma1.it; gianluigi.luridiana@aob.it;
   dr.aless.deluca@gmail.com; roberto.cuomo@unisi.it;
   diego.ribuffo@uniroma1.it
RI de luca, alessandro/AAE-5524-2020; Cuomo, Roberto/AFI-8757-2022; Torto,
   Federico/AAY-1852-2021; Marcasciano, Marco/HZJ-0259-2023; Fusario,
   Daniele/ISA-5809-2023; RIBUFFO, Diego/HLG-3305-2023
OI de luca, alessandro/0000-0003-0897-3547; Cuomo,
   Roberto/0000-0002-8396-095X; Fusario, Daniele/0000-0002-2804-2814;
   RIBUFFO, Diego/0000-0002-1844-7850; Casella, Donato/0000-0003-3946-2029
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NR 44
TC 8
Z9 8
U1 1
U2 1
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
SN 1010-660X
EI 1648-9144
J9 MEDICINA-LITHUANIA
JI Med. Lith.
PD OCT
PY 2023
VL 59
IS 10
AR 1703
DI 10.3390/medicina59101703
PG 9
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA X0IN0
UT WOS:001095374900001
PM 37893421
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Betz, V
   van Ackeren, V
   Scharsack, E
   Stark, B
   Mueller, CT
   Loske, G
AF Betz, V.
   van Ackeren, V.
   Scharsack, E.
   Stark, B.
   Mueller, C. T.
   Loske, G.
TI Intrathoracic negative pressure therapy for pleural empyema using an
   open-pore drainage film
SO CHIRURGIE
LA English
DT Article
DE Bacterial infection; Thoracotomy; Drainage; Lung; Video-assisted
   thoracic surgery
ID VACUUM-ASSISTED CLOSURE; MANAGEMENT; PERFORATION
AB BackgroundWe report our initial experience with intrathoracic negative pressure therapy (ITNPT) in the stage-adjusted treatment of pleural empyema (PE) based on a case series.Materials and methodsITNPT represents a further development for intrathoracic use. After thoracic surgical open debridement, an intrathoracic negative pressure dressing was inserted. The drainage elements were a thin open-pore double-layer drainage film (OF) with open-pore polyurethane foams (PUF). Only the OF was placed in direct contact with the lung parenchyma. Negative pressure was generated using an electronic pump (continuous suction, -75 mm Hg). In revision thoracotomies, ITNPT was stopped or continued depending on local findings.ResultsIn total, 31 patients with stage II and III pleural empyema underwent ITNPT, which was administered during the primary procedure (n = 17) or at revision (n = 14). Treatment duration was a mean of 10 days (2-18 days) with a mean change interval of 4 days (2-6 days). Intrathoracic negative pressure dressings were applied a mean of 3.5 (1-6) times. The empyema cavity continuously reduced in size and was cleansed by the suction. The OF has a minimum intrinsic volume with maximum absorption surface. Once negative pressure is established, there is no intrathoracic dead volume and the parenchyma can expand. The protective material properties of OF make ITNPT suitable for the treatment of pleural empyema. Targeted local intrathoracic drainage of the septic focus is a possible adjunct to surgery. The surgical dressings must be changed repeatedly. The method is suitable for the treatment of complex stage II and III pleural empyemas.ConclusionThe OF can be used as an intrathoracic drainage element for ITNPT in pleural empyema. This new application option expands the range of indications for negative pressure therapy.
C1 [Betz, V.; van Ackeren, V.; Scharsack, E.; Stark, B.; Mueller, C. T.; Loske, G.] Marienkrankenhaus Kathol Marienkrankenhaus GmbH, Hamburg, Germany.
RP Betz, V (通讯作者)，Marienkrankenhaus Kathol Marienkrankenhaus GmbH, Hamburg, Germany.
EM viktoria.betz@web.de
CR Adams O, S2K LEITLINIE MANAGE
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NR 30
TC 1
Z9 1
U1 1
U2 3
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 2731-6971
EI 2731-698X
J9 CHIRURGIE
JI Chirurgie
PD JUN
PY 2023
VL 94
IS 6
SI SI
BP 530
EP 543
DI 10.1007/s00104-023-01827-8
EA MAR 2023
PG 14
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA H1YG5
UT WOS:000952463600001
PM 36920498
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU López-Cano, M
   García-Alamino, JM
   Antoniou, SA
   Bennet, D
   Dietz, UA
   Ferreira, F
   Fortelny, RH
   Hernandez-Granados, P
   Miserez, M
   Montgomery, A
   Morales-Conde, S
   Muysoms, F
   Pereira, JA
   Schwab, R
   Slater, N
   Vanlander, A
   Van Ramshorst, GH
   Berrevoet, F
AF Lopez-Cano, M.
   Garcia-Alamino, J. M.
   Antoniou, S. A.
   Bennet, D.
   Dietz, U. A.
   Ferreira, F.
   Fortelny, R. H.
   Hernandez-Granados, P.
   Miserez, M.
   Montgomery, A.
   Morales-Conde, S.
   Muysoms, F.
   Pereira, J. A.
   Schwab, R.
   Slater, N.
   Vanlander, A.
   Van Ramshorst, G. H.
   Berrevoet, F.
TI EHS clinical guidelines on the management of the abdominal wall in the
   context of the open or burst abdomen
SO HERNIA
LA English
DT Review
DE Guidelines; Open abdomen; Burst abdomen; Evisceration; Fascial
   dehiscence; Hernia; Abdominal wall closure
ID VACUUM-ASSISTED CLOSURE; TOPICAL NEGATIVE-PRESSURE; MEDIATED FASCIAL
   TRACTION; HERNIA SOCIETY GUIDELINES; DAMAGE-CONTROL LAPAROTOMY; DELAYED
   PRIMARY CLOSURE; COMPARTMENT SYNDROME; WOUND DEHISCENCE; COMPONENTS
   SEPARATION; INCISIONAL HERNIA
AB PurposeTo provide guidelines for all surgical specialists who deal with the open abdomen (OA) or the burst abdomen (BA) in adult patients both on the methods used to close the musculofascial layers of the abdominal wall, and regarding possible materials to be used.MethodsThe guidelines were developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) approach including publications up to January 2017. When RCTs were available, outcomes of interest were quantitatively synthesized by means of a conventional meta-analysis. When only observational studies were available, a meta-analysis of proportions was done. The guidelines were written using the AGREE II instrument.ResultsFor many of the Key Questions that were researched, there were no high quality studies available. While some strong recommendations could be made according to GRADE, the guidelines also contain good practice statements and clinical expertise guidance which are distinct from recommendations that have been formally categorized using GRADE.RecommendationsWhen considering the OA, dynamic closure techniques should be prioritized over the use of static closure techniques (strong recommendation). However, for techniques including suture closure, mesh reinforcement, component separation techniques and skin grafting, only clinical expertise guidance was provided. Considering the BA, a clinical expertise guidance statement was advised for dynamic closure techniques. Additionally, a clinical expertise guidance statement concerning suture closure and a good practice statement concerning mesh reinforcement during fascial closure were proposed. The role of advanced techniques such as component separation or relaxing incisions is questioned. In addition, the role of the abdominal girdle seems limited to very selected patients.
C1 [Lopez-Cano, M.] Univ Autonoma Barcelona, Abdominal Wall Surg Unit, Dept Gen Surg, Hosp Univ Vall dHebron, Passeig Vall dHebron 119-129, Barcelona 08035, Spain.
   [Garcia-Alamino, J. M.] Univ Oxford, DPhil Programme Evidence Based Healthcare, Oxford, England.
   [Antoniou, S. A.] Royal Devon & Exeter NHS Fdn Trust, Dept Colorectal Surg, Exeter, Devon, England.
   [Bennet, D.] Royal Bournemouth & Christchurch Hosp, Castle Lane East, Bournemouth BH7 7DW, Dorset, England.
   [Dietz, U. A.] Cantonal Hosp Olten, Dept Gen & Visceral Surg, Olten, Switzerland.
   [Ferreira, F.] Pedro Hispano Hosp, Dept Surg Upper Gastrointestinal & Abdominal Wall, Porto, Portugal.
   [Ferreira, F.] Porto Hosp, Dept Gen Surg, CUF, Porto, Portugal.
   [Fortelny, R. H.] Wilhelminenspital Stadt Wien, Dept Gen Visceral & Oncol Surg, Vienna, Austria.
   [Fortelny, R. H.] Sigmund Freud Univ Vienna, Med Fac, Vienna, Austria.
   [Hernandez-Granados, P.] Hosp Univ Fdn Alcorcon, Unidad Cirugia Gen, Madrid, Spain.
   [Miserez, M.] Univ Hosp Leuven, Dept Abdominal Surg, Leuven, Belgium.
   [Montgomery, A.] Lund Univ, Dept Surg, Malmo Univ Hosp, Malmo, Sweden.
   [Morales-Conde, S.] Univ Hosp Virgen Rocio, Unit Innovat Minimally Invas Surg, Gen & Digest Surg Unit, Seville, Spain.
   [Muysoms, F.] Maria Middelares Hosp, Dept Surg, Ghent, Belgium.
   [Pereira, J. A.] Univ Pompeu Fabra, Serv Cirurgia Gen, Hosp del Mar, Dept Ciencies Expt & Salut, Parc Salut Mar, Barcelona, Spain.
   [Schwab, R.] Fed Armed Forces Cent Hosp, Gen & Thorac Surg, Koblenz, Germany.
   [Slater, N.] Radboud Univ Nijmegen, Dept Plast & Reconstruct Surg, Med Ctr, Nijmegen, Netherlands.
   [Vanlander, A.; Berrevoet, F.] Ghent Univ Hosp, Dept Gen & HPB Surg & Liver Transplantat, Ghent, Belgium.
   [Van Ramshorst, G. H.] Netherlands Canc Inst, Amsterdam, Netherlands.
C3 Hospital Universitari Vall d'Hebron; Autonomous University of Barcelona;
   University of Oxford; University of Exeter; Kantonsspital Olten;
   Wilhelminenspital; Alcorcon Foundation University Hospital; KU Leuven;
   University Hospital Leuven; Lund University; Skane University Hospital;
   Virgen del Rocio University Hospital; Pompeu Fabra University; Hospital
   del Mar Research Institute; Hospital del Mar; Radboud University
   Nijmegen; Ghent University; Ghent University Hospital; Netherlands
   Cancer Institute
RP López-Cano, M (通讯作者)，Univ Autonoma Barcelona, Abdominal Wall Surg Unit, Dept Gen Surg, Hosp Univ Vall dHebron, Passeig Vall dHebron 119-129, Barcelona 08035, Spain.
EM mlpezcano@gmail.com
RI Fortelny, René/AAD-5922-2021; Berrevoet, Frederik/A-6117-2008; Antoniou,
   Stavros/I-6844-2019; López-Cano, Manuel/H-2465-2011; Vanlander,
   Aude/AAP-3342-2021; Pereira Rodríguez, José Antonio/I-2408-2014;
   Morales-Conde, Salvador/W-9865-2019; van Ramshorst,
   Gabrielle/H-9140-2019
OI Pereira Rodríguez, José Antonio/0000-0003-2457-6955; Morales-Conde,
   Salvador/0000-0003-2833-0717; , marc/0000-0002-7047-6114; van Ramshorst,
   Gabrielle/0000-0002-5368-582X
FU European Hernia Society; ACELITY(R)
FX These guidelines were investigator-initiated collaboration, supported by
   the European Hernia Society and an educational grant from ACELITY (R).
   The funders had no role in the design or conduct of the study,
   collection, analysis and interpretation of the data, or preparation,
   review or approval of the guidelines. Final decisions regarding the key
   questions or other issues that arose during the guidelines development
   process were solely the responsibility of the guidelines development
   group.
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NR 137
TC 66
Z9 79
U1 1
U2 11
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 1265-4906
EI 1248-9204
J9 HERNIA
JI Hernia
PD DEC
PY 2018
VL 22
IS 6
BP 921
EP 939
DI 10.1007/s10029-018-1818-9
PG 19
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HC8RC
UT WOS:000452070700004
PM 30178226
OA Green Published
DA 2026-07-24
ER

PT J
AU Semsarzadeh, NN
   Tadisina, KK
   Maddox, J
   Chopra, K
   Singh, DP
AF Semsarzadeh, Nina N.
   Tadisina, Kashyap K.
   Maddox, John
   Chopra, Karan
   Singh, Devinder P.
TI Closed Incision Negative-Pressure Therapy Is Associated with Decreased
   Surgical-Site Infections: A Meta-Analysis
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; MICROVASCULAR BLOOD-FLOW; WOUND-THERAPY;
   MANAGEMENT-SYSTEM; CARE; SURGERY; PREVENTION; DEHISCENCE; DRESSINGS
AB Background: Negative-pressure therapy has recently been used over closed incisions to decrease surgical-site occurrences, including infection and dehiscence. A meta-analysis was performed to evaluate the effectiveness of closed incision negative-pressure therapy in lowering the incidence of surgical-site infections compared with standard dressings.
   Methods: A literature search was conducted to find publications comparing closed incision negative-pressure therapy to standard incisional care. A fixed-effects model was used to assess between-study and between-incision location subgroup heterogeneity and effect size. Funnel plots were used to assess publication bias.
   Results: The overall weighted average rates of surgical-site infection in the closed incision negative-pressure therapy and control groups were 6.61 percent and 9.36 percent, respectively. This reflects a relative reduction in surgical site infection rate of 29.4 percent. A decreased likelihood of surgical-site infection was evident in the closed incision negative-pressure therapy group compared with the control group across all studies, and across all four incision location subgroups. Across all studies, odds of surgical-site infections decreased 0.564 (p < 0.00001). After excluding groin incision studies because of heterogeneity following sensitivity analysis, the odds of surgical-site infection decrease was still 0.496 (p < 0.00001). In addition, overall rates of dehiscence in closed incision negative-pressure therapy and control groups were 5.32 percent and 10.68 percent, respectively.
   Conclusions: The results of this meta-analysis suggest that closed incision negative-pressure therapy is a potentially effective method for reducing surgical-site infections. It also appears that closed incision negative-pressure therapy may be associated with a decreased incidence of dehiscence, but the published data available were too heterogeneous to perform meta-analysis.
C1 [Singh, Devinder P.] Univ Maryland, Sch Med, Div Plast Surg, Baltimore, MD 21201 USA.
   Johns Hopkins Univ Hosp, Dept Plast & Reconstruct Surg, Baltimore, MD 21287 USA.
   Walter Reed Natl Mil Med Ctr, Dept Gen Surg, Bethesda, MD USA.
   Univ Illinois, Coll Med, Chicago, IL USA.
C3 University System of Maryland; University of Maryland Baltimore; Johns
   Hopkins University; Johns Hopkins Medicine; Walter Reed National
   Military Medical Center; University of Illinois System; University of
   Illinois Chicago; University of Illinois Chicago Hospital
RP Singh, DP (通讯作者)，Univ Maryland, Sch Med, Div Plast Surg, 22 S Greene St, Baltimore, MD 21201 USA.
EM dsingh@smail.umaryland.edu
RI Singh, Devinder/AAN-4716-2021
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NR 52
TC 125
Z9 136
U1 0
U2 13
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD SEP
PY 2015
VL 136
IS 3
BP 592
EP 602
DI 10.1097/PRS.0000000000001519
PG 11
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA CQ5ZI
UT WOS:000360683800001
PM 26313829
DA 2026-07-24
ER

PT J
AU Rasilainen, SK
   Juhani, MP
   Kalevi, LA
AF Rasilainen, Suvi Kaarina
   Juhani, Mentula Panu
   Kalevi, Leppaniemi Ari
TI Microbial colonization of open abdomen in critically ill surgical
   patients
SO WORLD JOURNAL OF EMERGENCY SURGERY
LA English
DT Article
DE Open abdomen; Laparostomy; Temporary abdominal closure; Microbial
   colonization
ID ASSISTED WOUND CLOSURE; ABDOMINAL COMPARTMENT SYNDROME; MEDIATED FASCIAL
   TRACTION; INTRAABDOMINAL HYPERTENSION; DAMAGE CONTROL; ENTEROATMOSPHERIC
   FISTULAS; PERITONEAL-CAVITY; ENTERIC FISTULA; OPEN MANAGEMENT; VACUUM
AB Introduction: This study was designed to describe the time-course and microbiology of colonization of open abdomen in critically ill surgical patients and to study its association with morbidity, mortality and specific complications of open abdomen. A retrospective cohort analysis was done.
   Methods: One hundred eleven consecutive patients undergoing vacuum-assisted closure with mesh as temporary abdominal closure method for open abdomen were analyzed. Microbiological samples from the open abdomen were collected. Statistical analyses were performed using Fisher's exact test for categorical variables. Mann-Whitney U test was used when comparing number of temporary abdominal closure changes between colonized and sterile patients. Kaplan-Meier analysis was done to calculate cumulative estimates for colonization. Cox regression analyses were performed to analyze risk factors for colonization.
   Results: Microbiological samples were obtained from 97 patients. Of these 76 (78 %) were positive. Sixty-one (80 %) patients were colonized with multiple micro-organisms and 27 (36 %) were cultured positive for candida species. The duration of open abdomen treatment adversely affected the colonization rate. Thirty-three (34 %) patients were colonized at the time of laparostomy. After one week of open abdomen treatment 69, and after two weeks 76 patients were colonized with cumulative colonization estimates of 74 % and 89 %, respectively. Primary fascial closure rate was 80 % (61/76) and 86 % (18/21) for the colonized and sterile patients, respectively. The rate of wound complications did not significantly differ between these groups.
   Conclusions: Microbial colonization of open abdomen is associated with the duration of open abdomen treatment. Wound complications are common after open abdomen, but colonization does not seem to have significant effect on these. The high colonization rate described herein should be taken into account when primarily sterile conditions like acute pancreatitis and aortic aneurysmal rupture are treated with open abdomen.
C1 [Rasilainen, Suvi Kaarina] Jorvi Hosp, Dept Abdominal Surg, Espoo 150, Finland.
   [Juhani, Mentula Panu; Kalevi, Leppaniemi Ari] Univ Helsinki, Cent Hosp, Dept Abdominal Surg, Helsinki, Finland.
C3 University of Helsinki; Helsinki University Central Hospital
RP Rasilainen, SK (通讯作者)，Jorvi Hosp, Dept Abdominal Surg, Espoo 150, Finland.
EM rasilainensuvi@gmail.com
RI Mentula, Panu/H-9025-2019
OI Mentula, Panu/0000-0002-6516-3797
FU Helsinki University Hospital
FX This study was financially supported only by a Helsinki University
   Hospital research grant for emergency abdominal-surgery.
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NR 38
TC 15
Z9 19
U1 0
U2 6
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-7922
J9 WORLD J EMERG SURG
JI World J. Emerg. Surg.
PD JUN 25
PY 2015
VL 10
AR 25
DI 10.1186/s13017-015-0018-5
PG 8
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA CL7LP
UT WOS:000357153900001
PM 26136816
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Arul, GS
   Sonka, BJ
   Lundy, JB
   Rickard, RF
   Jeffery, SLA
AF Arul, G. Suren
   Sonka, B. J.
   Lundy, J. B.
   Rickard, R. F.
   Jeffery, S. L. A.
TI Management of complex abdominal wall defects associated with penetrating
   abdominal trauma
SO JOURNAL OF THE ROYAL ARMY MEDICAL CORPS
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; PLANNED VENTRAL HERNIA; DAMAGE CONTROL; STAGED
   MANAGEMENT; NEGATIVE-PRESSURE; WOUND CLOSURE; LAPAROTOMY; ABDOMEN
AB Introduction The paradigm of Damage Control Surgery (DCS) has radically improved the management of abdominal trauma, but less well described are the options for managing the abdominal wall itself in an austere environment. This article describes a series of patients with complex abdominal wall problems managed at the UK-led Role 3 Medical Treatment Facility (MTF) in Camp Bastion, Afghanistan.
   Method Contemporaneous review of a series of patients with complex abdominal wall injuries who presented to the Role 3 MTF between July and November 2012.
   Results Five patients with penetrating abdominal trauma associated with significant damage to the abdominal wall were included. All patients were managed using DCS principles, leaving the abdominal wall open at the end of the first procedure. Subsequent management of the abdominal wall was determined by a multidisciplinary team of general and plastic surgeons, intensivists and specialist nurses. The principles of management identified included minimising tissue loss on initial laparotomy by joining adjacent wounds and marginal debridement of dead tissue; contraction of the abdominal wall was minimised by using topical negative pressure dressing and dermal-holding sutures. Definitive closure was timed to allow oedema to settle and sepsis to be controlled. Closure techniques include delayed primary closure with traction sutures, components separation, and mesh closure with skin grafting.
   Discussion A daily multidisciplinary team discussion was invaluable for optimal decision making regarding the most appropriate means of abdominal closure. Dermal-holding sutures were particularly useful in preventing myostatic contraction of the abdominal wall. A simple flow chart was developed to aid decision making in these patients. This flow chart may prove especially useful in a resource-limited environment in which returning months or years later for closure of a large ventral hernia may not be possible.
C1 [Arul, G. Suren] 212 Field Hosp, Sheffield, S Yorkshire, England.
   [Sonka, B. J.] William Beaumont Army Med Ctr, Dept Surg, El Paso, TX 79920 USA.
   [Lundy, J. B.] Joint Base Sane Antonio, San Antonio Mil Med Ctr, San Antonio, TX USA.
   [Rickard, R. F.; Jeffery, S. L. A.] Royal Ctr Def Med, Dept Surg, Birmingham, W Midlands, England.
   [Rickard, R. F.] Derriford Hosp, Plymouth PL6 8DH, Devon, England.
C3 William Beaumont Army Medical Center; Brooke Army Medical Center; Royal
   Centre for Defence Medicine; Derriford Hospital
RP Arul, GS (通讯作者)，Birmingham Childrens Hosp, Dept Surg, Steelhouse Lane, Birmingham B4 6NH, W Midlands, England.
EM surenarul@doctors.org.uk
RI ; jeffery, steven/A-5207-2013
OI Arul, Gularaj Suren/0000-0002-1586-6857; jeffery,
   steven/0000-0001-6587-5412
CR [Anonymous], J TRAUMA
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NR 30
TC 5
Z9 6
U1 0
U2 5
PU BMJ PUBLISHING GROUP
PI LONDON
PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
SN 0035-8665
EI 2052-0468
J9 J ROY ARMY MED CORPS
JI J. R. Army Med. Corps
PD MAR
PY 2015
VL 161
IS 1
BP 46
EP 52
DI 10.1136/jramc-2014-000276
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA CC7VB
UT WOS:000350575400011
PM 24817321
DA 2026-07-24
ER

PT J
AU Rimann, M
   Hall, H
AF Rimann, Markus
   Hall, Heike
TI Non-viral and local gene medicine for improvement of cutaneous wound
   healing
SO GENE THERAPY AND MOLECULAR BIOLOGY
LA English
DT Review
DE wound healing; local gene therapy; gene medicine; non-viral gene
   delivery systems; matrix-mediated gene delivery; PLL-g-PEG nanoparticles
ID FIBROBLAST-GROWTH-FACTOR; VACUUM-ASSISTED-CLOSURE; POLY-L-LYSINE;
   IN-VIVO; CELLULAR UPTAKE; INFLAMMATORY RESPONSE; CONTROLLED-RELEASE;
   PLASMID DNA; DELIVERY; THERAPY
AB Deficient vascularisation is a major clinical incidence and affects wound healing especially in elderly people as well as in diabetes patients. Many studies and different technologies aim to locally increase blood perfusion and improve the endogenous wound healing capacity and thereby ameliorate the patient's life quality. Gene therapy has gained a lot of attention for treatment of chronic diseases, cancer and genetic disorders. It is also considered as a valuable alternative for conventional protein therapy, since it overcomes inherent problems that are associated with administration of protein drugs in terms of bioavailability, systemic toxicity, in vivo clearance rate and manufacturing costs. For this reason safe and efficient delivery systems for therapeutic DNA are developed. Polycationic substances have been shown to form complexes with DNA and are widely used as an attractive alternative to viral vectors in gene therapy. One promising approach consists in the usage of grafted copolymers of poly-L-lysine (PLL) and poly( ethylene glycol) ( PEG) that forms stable complexes with plasmid DNA, which are highly transfection-efficient and are suitable to deliver DNA from 3D-fibrin wound healing matrices. A gene of interest to be delivered should stimulate endogenous wound healing and may consist of a stabilized form of hypoxia-inducible factor-1 alpha (HIF-1 alpha Delta ODD), a transcription factor that ultimately leads to the increase in vascular endothelial growth factor-A (VEGF-A) expression that in turn activates angiogenesis followed by wound healing. Local administration of a matrix-mediated DNA delivery system on cutaneous wounds will be a big step in the direction of specific gene medicine and might represent a powerful tool in clinical wound therapy.
C1 [Rimann, Markus; Hall, Heike] ETH, Dept Mat, CH-8093 Zurich, Switzerland.
C3 Swiss Federal Institutes of Technology Domain; ETH Zurich
RP Hall, H (通讯作者)，ETH, Dept Mat, HCI E415,Wolfgang Pauli Str 10, CH-8093 Zurich, Switzerland.
EM heike.hall@mat.ethz.ch
OI Rimann, Markus/0000-0002-4605-8190
FU Gebert Ruf Foundation, Switzerland [GRS-053/05]
FX This study was supported by Gebert Ruf Foundation (GRS-053/05),
   Switzerland.
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NR 130
TC 3
Z9 4
U1 0
U2 17
PU GENE THERAPY PRESS
PI ATHENS
PA GREGORIOU AFXENTIOU 7, ALIMOS, ATHENS, 17455, GREECE
SN 1529-9120
J9 GENE THER MOL BIOL
JI Gene Ther. Mol. Biol.
PD JUN
PY 2009
VL 13
IS 1
BP 53
EP 63
PG 11
WC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology;
   Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Biochemistry & Molecular Biology; Biotechnology & Applied Microbiology;
   Research & Experimental Medicine
GA 470RR
UT WOS:000267997900007
DA 2026-07-24
ER

PT J
AU Rabelo, LG
   Rabelo, CM
   Petursdottir, A
   Steinthorsson, AS
   Gudbjartsson, T
AF Rabelo, Luis Gisli
   Rabelo, Carlos Magnus
   Petursdottir, Astridur
   Steinthorsson, Arni Steinn
   Gudbjartsson, Tomas
TI Nationwide trends in incidence of deep sternal wound infection after
   cardiac surgery and its association with long-term mortality
SO JOURNAL OF CARDIOTHORACIC SURGERY
LA English
DT Article
DE Deep sternal wound infection; Post-sternotomy mediastinitis; Cardiac
   surgery; Mediastinitis; Incidence; Mortality; Nationwide
ID VACUUM-ASSISTED CLOSURE; OPEN-HEART-SURGERY; RISK-FACTORS; THERAPY;
   MEDIASTINITIS; MANAGEMENT
AB Background: While early outcomes of deep sternal wound infection (DSWI) after cardiac surgery are well documented, its association with long-term mortality remains less clear. We aimed to investigate trends in DSWI incidence in a well-defined nationwide cohort and evaluate its association with long-term mortality. Materials and methods: This observational study investigated all DSWI patients after cardiac surgery via sternotomy at Landspitali University Hospital from 2001-2024, with incidence assessed across 4-year intervals. Incidence of DSWI was evaluated from 2001-2024, while survival analyses were restricted to patients operated between 2001-2017 to allow adequate long-term follow-up and ensure comparability with respect to the surgical era. Long-term survival was assessed using Kaplan-Meier graphs and a Cox regression model with time-splitting at 90 days and 5 years. Median follow-up was 9.2 [5.7-13.0] years, and survival analyses were truncated at 10 years to ensure comparable observation time between groups. Results: Out of 4596 patients who underwent cardiac surgery via median sternotomy, 53 (1.2%) developed DSWI. The incidence declined from 2.5% in 2001-2004 to 0% in 2021-2024 (p<0.001), with no DSWI cases identified after 2017. DSWI patients were older and had a higher comorbidity burden compared to the non-DSWI cohort. Patients in the DSWI group had an approximately twofold higher risk of mortality 5 to 10 years after surgery than the non-DSWI patients (aHR = 1.9, 95% CI=1.1-3.3). Conclusions: Rates of DSWI after cardiac surgery in Iceland have significantly decreased over the last 24 years, with no cases diagnosed from 2018 to 2024. This decline is important since DSWI remains associated with increased health care costs, but more importantly, higher long-term mortality after cardiac surgery.
C1 [Rabelo, Luis Gisli; Steinthorsson, Arni Steinn; Gudbjartsson, Tomas] Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.
   [Rabelo, Luis Gisli; Rabelo, Carlos Magnus; Gudbjartsson, Tomas] Univ Iceland, Fac Med, Reykjavik, Iceland.
   [Petursdottir, Astridur] Linkoping Univ Hosp, Dept Surg, Linkoping, Sweden.
C3 Landspitali National University Hospital; University of Iceland;
   Linkoping University
RP Gudbjartsson, T (通讯作者)，Landspitali Univ Hosp, Dept Cardiothorac Surg, Reykjavik, Iceland.; Gudbjartsson, T (通讯作者)，Univ Iceland, Fac Med, Reykjavik, Iceland.
EM tomasgud@landspitali.is
FU Helga Jonsdottir & Sigurlidi Kristjansson Memorial Fund; Landspitali
   University Hospital Research Fund; University of Iceland Research Fund
FX This work was supported by funding from the University of Iceland
   Research Fund, the Landspitali University Hospital Research Fund, and
   the Helga Jonsdottir & Sigurlidi Kristjansson Memorial Fund.
CR Baillot R, 2010, EUR J CARDIO-THORAC, V37, P880, DOI 10.1016/j.ejcts.2009.09.023
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NR 26
TC 0
Z9 0
U1 0
U2 0
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1749-8090
J9 J CARDIOTHORAC SURG
JI J. Cardiothorac. Surg.
PD MAY 6
PY 2026
VL 21
IS 1
AR 428
DI 10.1186/s13019-026-04216-4
EA MAY 2026
PG 10
WC Cardiac & Cardiovascular Systems; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Surgery
GA JR2AG
UT WOS:001796031000001
PM 42092932
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Haricharan, L
   Harshith, N
   Shah, HM
   Mittal, P
AF Haricharan, L.
   Harshith, N.
   Shah, Harshad Mohan
   Mittal, Prabhat
TI The Role of Ilizarov Technique in Chronic Non-healing Wounds of the
   Lower Limb: A Prospective Observational Study
SO INDIAN JOURNAL OF ORTHOPAEDICS
LA English
DT Article; Early Access
DE Ilizarov external fixator; Corticotomy; Tibial fractures; Chronic
   wounds; Wound healing; Bates-Jensen criteria
ID BONE TRANSPORT; MANAGEMENT
AB Introduction Chronic non-healing wounds, defined as wounds persisting for more than six weeks without demonstrable healing despite appropriate standard care, often complicate open tibial fractures due to soft-tissue loss, infection, and vascular compromise. Although initially designed for bone reconstruction, the Ilizarov technique also promotes soft-tissue repair via histogenesis and neoangiogenesis through the principle of distraction histogenesis. Materials and Methods This prospective observational study (August 2016-January 2020) included 87 patients (4-76 years) with complex lower-limb wounds associated with fractures, non-unions, or osteomyelitis, treated with the Ilizarov external fixator (IEF). Exclusion criteria were venous ulcers, nerve injuries, and dermatological wounds. Wounds were evaluated using the Bates-Jensen criteria by a single assessor to minimize bias. Data collected included demographics, comorbidities (including alcohol and smoking status), infection status, and adjunctive interventions, such as corticotomy, vacuum-assisted closure (VAC), and skin grafting. Results Complete healing occurred in 83.91% of patients. Corticotomy was performed in 67.82% of cases. No significant association was observed between healing and age, sex, comorbidities, or duration of fixator use; however, this study was underpowered to assess the independent impact of comorbidities. All four pediatric patients (< 10 years) healed completely. VAC therapy and skin grafting improved wound closure rates. Complications occurred in 11.49% of patients, including isolated cases of gangrene, infection recurrence, and one amputation, but no implant failures were reported. Conclusion The Ilizarov method, particularly when combined with corticotomy, is effective for managing chronic lower-limb wounds. Adjunctive VAC therapy and skin grafting further enhance outcomes. The Bates-Jensen score is a reliable predictor of healing progression. This approach is effective across diverse age groups, including young children (n = 4), all of whom achieved complete healing.
C1 [Haricharan, L.] Shri Atal Bihari Vajpayee Med Coll & Res Inst, Dept Orthopaed, Bengaluru, India.
   [Harshith, N.] Sapthagiri Inst Med Sci & Res Ctr, Dept Orthopaed, Bengaluru, India.
   [Mittal, Prabhat] Amandeep Hosp, Dept Orthopaed, Amritsar, India.
RP Mittal, P (通讯作者)，Amandeep Hosp, Dept Orthopaed, Amritsar, India.
EM haricharanl195@gmail.com; harshithortho@gmail.com;
   harshadmohanshah@gmail.com; prabhatmittal28@gmail.com
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   Zhu YL, 2024, ORTHOP SURG, V16, P2221, DOI 10.1111/os.14217
NR 32
TC 0
Z9 0
U1 0
U2 0
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0019-5413
EI 1998-3727
J9 INDIAN J ORTHOP
JI Indian J. Orthop.
PD 2025 DEC 6
PY 2025
DI 10.1007/s43465-025-01617-w
EA DEC 2025
PG 9
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA O3398
UT WOS:001632478500001
DA 2026-07-24
ER

PT J
AU Othman, S
   Stranix, JT
   Piwnica-Worms, W
   Bauder, A
   Azoury, SC
   Elfanagely, O
   Klifto, KM
   Levin, LS
   Kovach, SJ
AF Othman, Sammy
   Stranix, John T.
   Piwnica-Worms, William
   Bauder, Andrew
   Azoury, Said C.
   Elfanagely, Omar
   Klifto, Kevin M.
   Levin, L. Scott
   Kovach, Stephen J.
TI Microvascular free tissue transfer for reconstruction of complex lower
   extremity trauma: Predictors of complications and flap failure
SO MICROSURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; OPEN TIBIAL FRACTURES;
   MICROSURGICAL RECONSTRUCTION; COVERAGE; INJURY; OUTCOMES; AMPUTATION;
   LEG
AB Background Despite advanced wound care techniques, open fractures in the setting of lower extremity trauma remain a challenging pathology, particularly when free tissue transfer is required for coverage. We aimed to evaluate factors associated with flap failure in this setting using a large, heterogeneous patient population. Methods Retrospective review of patients who underwent traumatic lower extremity free flap reconstruction (2002-2019). Demographics wound/vessel injury characteristics, pre and perioperative factors, and flap outcomes were analyzed. Results One hundred eighty-eight free flaps met inclusion criteria, with 23 partial (12.2%) and 13 total (6.9%) flap failures. Angiography was performed in 87 patients, with arterial injury suffered in 43.1% of those evaluated. Time to flap coverage varied within 3 days (4.5%), 10 days (17.3%), or 30 days of injury (42.7%). In all, 41 (21.8%) subjects suffered from major flap complications, including failure and takebacks. Multivariate regression demonstrated the presence of posterior tibial (PT) artery injury predictive of both flap-failure (Odds ratio [OR] = 11.4, p < .015) and major flap complications (OR = 12.1, p < .012). Immunocompromised status was also predictive of flap failure (OR = 12.6, p < .004) and major complications (OR = 11.6, p < .007), while achieving flap coverage within 30 days was protective against flap complications (OR = 0.413, p < .049). Defect size, infection, and injury location were not associated with failure. Conclusions When examining a large, heterogeneous patient cohort, free flap outcomes in the setting of lower extremity open fractures can be influenced by multiple factors. This presence of PT artery injury, flap coverage beyond 30 days of injury, and immunocompromised status appear predictive of flap complications in this context.
C1 [Othman, Sammy; Piwnica-Worms, William; Bauder, Andrew; Azoury, Said C.; Elfanagely, Omar; Klifto, Kevin M.; Levin, L. Scott; Kovach, Stephen J.] Univ Penn Hlth Syst, Dept Surg, Div Plast Surg, Philadelphia, PA USA.
   [Stranix, John T.] Univ Virginia Hlth Syst, Dept Plast Surg, Charlottesville, VA USA.
   [Levin, L. Scott; Kovach, Stephen J.] Univ Penn Hlth Syst, Dept Orthoped Surg, Philadelphia, PA USA.
C3 University of Pennsylvania; University of Virginia; University of
   Virginia (UVA) Health System; University of Pennsylvania
RP Othman, S (通讯作者)，Univ Penn, Perelman Ctr Adv Med, Div Plast Surg, South Pavil,14th Floor 3400 Civ Ctr Blvd, Philadelphia, PA 19104 USA.
EM sothman13@gmail.com
RI ; Klifto, Kevin/AAG-9339-2019
OI Othman, Sammy/0000-0002-8814-1048; Klifto, Kevin/0000-0002-2742-4319
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 31
TC 19
Z9 21
U1 0
U2 2
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0738-1085
EI 1098-2752
J9 MICROSURG
JI Microsurgery
PD JAN
PY 2023
VL 43
IS 1
BP 5
EP 12
DI 10.1002/micr.30785
EA JUL 2021
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 7S7HA
UT WOS:000669980700001
PM 34228378
DA 2026-07-24
ER

PT J
AU Brewer, MB
   Ochoa, CJ
   Woo, K
   Wartman, SM
   Nikolian, V
   Han, S
   Weaver, FA
   Rowe, VL
AF Brewer, Michael B.
   Ochoa, Christian J.
   Woo, Karen
   Wartman, Sarah M.
   Nikolian, Vahagn
   Han, Sukgu
   Weaver, Fred A.
   Rowe, Vincent L.
TI Sartorius Muscle Flaps for Vascular Groin Wound Complications
SO AMERICAN SURGEON
LA English
DT Article
ID INFECTED PROSTHETIC GRAFTS; VACUUM-ASSISTED CLOSURE; SURGICAL SITE
   INFECTIONS; ABDOMINIS DONOR-SITE; SELECTIVE PRESERVATION; BACTERIAL
   INOCULATION; ARTERIAL GRAFTS; MANAGEMENT; SURGERY; COVERAGE
AB Sartorius myoplasty (SM) has been used as an adjunct for soft tissue coverage in vascular groin wound complications. However, the reliability of SM as a primary muscle flap has been questioned. The purpose of this study is to determine the reliability of SM performed by vascular surgeons in the management of vascular groin wound complications. A retrospective review was performed on all patients who underwent SM from 1997 to 2012. The three indications for SM were prophylactic, infection, and noninfectious wound complication. Failure of SM was defined as operative reintervention for bleeding, persistent wound drainage, or infection. A total of 99 patients underwent 103 SM procedures. The patients were 43 per cent male and 57 per cent female; the mean age was 69 years. The indication for SM was infectious in 62 cases (60%), prophylactic in 21 cases (20%), and noninfectious in the remaining 20 cases. Failure of SM occurred in 11 cases (11%). Of these, salvage bypass and/or salvage muscle flap was required in eight cases (73%). When salvage bypass was required, extra-anatomic obturator bypass was performed in 80 per cent of cases. Salvage wound coverage included rectus abdominus flap (60%), rotational flap (20%), and skin grafting (20%). Seventy-three per cent of failures came from the infectious wound group. The most common reason for SM failure was hemorrhage (45%). In 82 per cent of the cases, the sartorius muscle was still viable at reoperation and was used for continued muscle coverage. SM performed by the vascular surgeon provides reliable soft tissue coverage for vascular groin wound complications and should be used as the primary muscle flap in the majority of patients. In cases of SM failure, the vascular surgeon should consider other more extensive muscle flap options.
C1 [Brewer, Michael B.; Ochoa, Christian J.; Weaver, Fred A.; Rowe, Vincent L.] Univ So Calif, Div Vasc Surg, Dept Surg, Los Angeles, CA 90033 USA.
   [Woo, Karen; Wartman, Sarah M.; Han, Sukgu] Univ So Calif, Dept Surg, Los Angeles, CA 90033 USA.
   [Nikolian, Vahagn] Univ So Calif, Keck Sch Med, Los Angeles, CA 90033 USA.
C3 University of Southern California; University of Southern California;
   University of Southern California
RP Woo, K (通讯作者)，Univ So Calif, Keck Sch Med, Div Vasc Surg, Surg,Dept Surg,Healthcare Consultat Ctr 2, 1520 San Pablo St,Suite 4300, Los Angeles, CA 90033 USA.
EM karen.woo@med.usc.edu
OI Nikolian, Vahagn/0000-0001-6028-8614
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NR 41
TC 21
Z9 23
U1 0
U2 4
PU SOUTHEASTERN SURGICAL CONGRESS
PI CUMMING
PA 115 SAMARITAN DR, #200, CUMMING, GA 30040-2354 USA
SN 0003-1348
EI 1555-9823
J9 AM SURGEON
JI Am. Surg.
PD NOV
PY 2015
VL 81
IS 11
BP 1163
EP 1169
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA DB4BU
UT WOS:000368458500030
PM 26672588
DA 2026-07-24
ER

PT J
AU Yan, HD
   Gao, WY
   Li, ZJ
   Wang, CY
   Liu, S
   Zhang, F
   Fan, CY
AF Yan, Hede
   Gao, Weiyang
   Li, Zhijie
   Wang, Chunyang
   Liu, Shen
   Zhang, Feng
   Fan, Cunyi
TI The management of degloving injury of lower extremities: Technical
   refinement and classification
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Degloving injury; lower extremity; full-thickness skin graft;
   classification
ID VACUUM-ASSISTED CLOSURE; CIRCUMFERENTIALLY AVULSED SKIN; GRAFTS; FLAP
AB BACKGROUND: Degloving injuries are severe and frequently underestimated lesions. Lower extremities are the most commonly affected limbs. This injury is associated with a high morbidity and mortality if mismanaged. The treatment of such patients still varies, clinical indicators for its prognosis are scarce, and some technical protocols are also controversial.
   METHODS: Between August 2002 and July 2011, 102 patients with skin avulsion of 129 lower extremities were treated with immediate full-thickness skin graft following a protocol of radical debridement. The full-thickness skin grafts were processed with sharp scalpels in situ. They were further secured with multiple sutures after repositioning to improve skin graft take. Outcomes were evaluated based on different patterns and age groups.
   RESULTS: Three patterns of injury, that is, a purely degloving injury (Pattern 1), a degloving injury with the involvement of deep soft tissues (Pattern 2), and a degloving injury with long-bone fractures (Pattern 3), were revealed. Among the three patterns, much higher primary healing rates were observed in Patterns 1 and 2. Younger patients in Pattern 3 achieved a higher primary healing rate than the old ones, whereas no differences of primary healing rate regarding different age groups were noted in Patterns 1 and 2.
   CONCLUSION: The degloving injuries of the lower extremities can be generally divided into three patterns. The preparation of full-thickness skin graft with scalpels is very simple and prompt. The management of degloving injury of the lower extremity with immediate full-thickness skin grafting following the protocol of radical debridement is feasible. Age has little impact on the skin graft take except for severe cases (Pattern 3) in which old age is an indicator of unfavorable prognosis and special attention is required. (J Trauma Acute Care Surg. 2013;74: 604-610. Copyright (C) 2013 by Lippincott Williams & Wilkins)
C1 [Yan, Hede; Wang, Chunyang; Liu, Shen; Fan, Cunyi] Shanghai Jiao Tong Univ, Sch Med, Peoples Hosp 6, Dept Orthoped, Shanghai 200233, Peoples R China.
   [Yan, Hede; Gao, Weiyang; Li, Zhijie] Wenzhou Med Coll, Affiliated Hosp 2, Div Plast & Hand Surg, Dept Orthoped, Wenzhou, Peoples R China.
   [Zhang, Feng] Univ Mississippi, Med Ctr, Div Plast Surg, Jackson, MS 39216 USA.
C3 Shanghai Jiao Tong University; Wenzhou Medical University; University of
   Mississippi; University of Mississippi Medical Center
RP Fan, CY (通讯作者)，Shanghai Jiao Tong Univ, Sch Med, Peoples Hosp 6, Dept Orthoped, 600 Yishan Rd, Shanghai 200233, Peoples R China.
EM fancunyi888@hotmail.com
RI Li, Zhijie/A-8562-2016; fan, cunyi/ABI-7199-2020
OI fan, cunyi/0000-0002-7854-5233
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NR 27
TC 26
Z9 41
U1 0
U2 8
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD FEB
PY 2013
VL 74
IS 2
BP 604
EP 610
DI 10.1097/TA.0b013e31827d5e00
PG 7
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 108UH
UT WOS:000316321200053
PM 23354258
DA 2026-07-24
ER

PT J
AU Pastier, C
   Collard, MK
   Challine, A
   Chafai, N
   O'Connell, LV
   Voron, T
   Lefevre, JH
   Parc, Y
AF Pastier, Clement
   Collard, Maxime K.
   Challine, Alexandre
   Chafai, Najim
   O'Connell, Lauren V.
   Voron, Thibault
   Lefevre, Jeremie H.
   Parc, Yann
TI Timing of Curative Surgery in Postoperative Enterocutaneous Fistulas
SO ANNALS OF SURGERY
LA English
DT Article
DE digestive fistula; enterocutaneous fistula; stoma
ID VACUUM-ASSISTED CLOSURE; SMALL-BOWEL; OPEN ABDOMEN; SURGICAL-TREATMENT;
   EXTERNAL FISTULAS; MANAGEMENT; NUTRITION; MORTALITY; READMISSION;
   RECURRENCE
AB Objective:Evaluate the feasibility of early radical enterocutaneous fistula (ECF) surgery.Background:After failure of medical treatment for ECF, the optimal timing of surgical reintervention remains debated.Methods:Patients undergoing radical ECF surgery to treat postoperative small bowel- ECFs and/or colon-ECFs (2005-2024) were retrospectively included. Success was defined as no remnant ECF or ECF-related stoma at the most recent follow-up and absence of 90-day postoperative mortality. Early ECF surgery was defined as planned surgery (urgent procedures excluded) occurring within 4 months of the last abdominal procedure.Results:Among 200 patients (median 62 years; 43% female; 40% American Society of Anesthesiologists >= 3), 77% had small bowel-ECF only, 12% colon-ECF only and 11%. both. Eighty-two percent were referred, with a median delay of 48 days [interquartile range (IQR): 8-200] after ECF diagnosis. Referral center management lasted 34 days (IQR: 3-90), with 10% exceeding 120 days. After excluding 22 emergency procedures, early ECF surgery was performed in 39% (70/178). Early-surgery patients had fewer respiratory comorbidities (9% vs 21%; P = 0.036) and shorter ECF diagnosis-to-transfer interval (16 days vs 145; P = 0.001). Early surgery did not impact operative time (P = 0.312), mortality (P = 0.091), severe morbidity (P = 0.867), and reoperations (P = 0.511). After a median follow-up of 12 months, the success rate was 74% (permanent stomas = 11%; recurrence = 17%). American Society of Anesthesiologists >= 3 (P = 0.012) and malignancies (P = 0.010) were independently associated with failure on multivariate analysis, whereas ECF-origin (P = 0.924) and surgical timing (P = 0.438) were not.Conclusions:For postoperative small bowel/colon ECF, the success rate of radical surgery is 74%. Early surgery seems feasible (39%) and does not compromise success. Further prospective studies are needed.
C1 [Pastier, Clement; Collard, Maxime K.; Challine, Alexandre; Chafai, Najim; Voron, Thibault; Lefevre, Jeremie H.; Parc, Yann] Sorbonne Univ, Hop St Antoine, AP HP, Dept Digest Surg, Paris, France.
   [O'Connell, Lauren V.] St Vincents Univ Hosp, Dept Colorectal Surg, Elm Pk, Dublin, Ireland.
C3 Assistance Publique Hopitaux Paris (APHP); Sorbonne Universite; Hopital
   Universitaire Saint-Antoine - APHP; University College Dublin; Saint
   Vincent's University Hospital
RP Lefevre, JH (通讯作者)，Sorbonne Univ, Hop St Antoine, AP HP, Dept Digest Surg, Paris, France.
EM clement.pastier@wanadoo.fr; maxime.collard@aphp.fr;
   alexandre.challine@aphp.fr; najim.chafai@aphp.fr;
   laurenoconnell@rcsi.ie; thibault.voron@aphp.fr; jeremie.lefevre@aphp.fr;
   yann.parc@aphp.fr
RI ; VORON, Thibault/AAE-7806-2021; alexandre, challine/JZE-4926-2024;
   Collard, Maxime/L-3159-2019; Connell, Lauren/AAM-1698-2020
OI lefevre, jeremie/0000-0001-7601-7464; 
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NR 60
TC 2
Z9 3
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0003-4932
EI 1528-1140
J9 ANN SURG
JI Ann. Surg.
PD NOV
PY 2025
VL 282
IS 5
BP 772
EP 781
DI 10.1097/SLA.0000000000006897
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 8LR8Z
UT WOS:001591650000028
PM 40794442
DA 2026-07-24
ER

PT J
AU Clifford, RE
   Fowler, H
   Govindarajah, N
   Vimalachandran, D
   Sutton, PA
AF Clifford, R. E.
   Fowler, H.
   Govindarajah, N.
   Vimalachandran, D.
   Sutton, P. A.
TI Early anastomotic complications in colorectal surgery: a systematic
   review of techniques for endoscopic salvage
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Review
DE Colorectal; Anastomotic leak; Stricture; Colonoscopy; Endoscopy
ID VACUUM-ASSISTED CLOSURE; ENDO-SPONGE TREATMENT; MESORECTAL EXCISION;
   ANTERIOR RESECTION; RECTAL-CANCER; LEAKAGE; MANAGEMENT; THERAPY; STENTS;
   EXPERIENCE
AB BackgroundAnastomotic complications following colorectal surgery are associated with significant morbidity and mortality. For patients in whom systemic sepsis is absent or well controlled, minimal access techniques, such as endoscopic therapies, are being increasingly employed to reduce the morbidity of surgical re-intervention. In this review, we aim to assess the utility of endoscopic management in the acute setting of colorectal anastomotic complications, focusing on anastomotic leak.MethodA literature search was performed for published full text articles using the PubMed, Cochrane and Scopus databases using the search criteria string colorectal anastomotic (leak OR bleed), endoscopy, endoscopic management. Additional papers were detected by scanning the references of relevant papers. Data were extracted from each study by two authors onto a dedicated pro-forma. Given the nature of the data extracted, no meta-analysis was performed.ResultsA total of 89 papers were identified, 16 of which were included in this review; an additional 14 papers were obtained from reference searches. In patients who are not physiologically compromised, there are promising data regarding the salvage rate of stents, over-the-scope endoscopic clips, vacuum therapy and fibrin glue in the early management of colorectal anastomotic leak. There is no consensus regarding the optimal approach, and data to assist the physician in patient selection are lacking. Whilst data on salvage (i.e. healing and avoidance of surgery) are well understood, no data on functional outcomes are reported.ConclusionEndoscopic therapy in the management of stable patients with colorectal anastomotic leaks appears safe and in selected patients is associated with high rates of technical success. Challenges remain in selecting the most appropriate strategy, patient selection, and understanding the functional and long-term sequelae of this approach. Further evidence from large prospective cohort studies are needed to further evaluate the role of these novel strategies.
EM rachael.clifford@liverpool.ac.uk
RI ; vimalachandran, dale/J-5693-2019
OI Sutton, Paul/0000-0002-7452-0282; vimalachandran,
   dale/0000-0001-5817-8969; Govindarajah, Naren/0000-0002-1417-2220;
   Clifford, Rachael/0000-0001-7065-0197
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NR 55
TC 35
Z9 46
U1 0
U2 7
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD APR
PY 2019
VL 33
IS 4
BP 1049
EP 1065
DI 10.1007/s00464-019-06670-9
PG 17
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HR5YL
UT WOS:000463223600004
PM 30675662
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Nickerson, TP
   Zielinski, MD
   Jenkins, DH
   Schiller, HJ
AF Nickerson, Terry P.
   Zielinski, Martin D.
   Jenkins, Donald H.
   Schiller, Henry J.
TI The Mayo Clinic experience with Morel-Lavallee lesions: Establishment of
   a practice management guideline
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Closed degloving injury; Morel-Lavallee lesion; posttraumatic seroma
ID CLOSED DEGLOVING INJURIES; THIGH; SCLERODHESIS; EFFUSIONS
AB BACKGROUND: Although uncommon, Morel-Lavallee lesions (also called closed degloving injuries) are associated with considerable morbidity in trauma patients. There is lack of consensus regarding proper management of these lesions. Management options include nonoperative therapies, along with percutaneous and operative techniques. We sought to define the factors associated with failure of percutaneous aspiration to better identify patients requiring immediate operative management.
   METHODS: We retrospectively searched our prospectively collected database for patient records containing the terms Morel-Lavallee, closed degloving injury, or posttraumatic seroma from February 2, 2004, through December 23, 2011. Treatment methods included compression wraps or observation (nonoperative management), percutaneous aspiration, or operative management with incision/drainage or formal debridement of skin and soft tissues that resulted in wound vacuum-assisted closure placement and/or split-thickness skin graft (operative management). The treatment groups were compared using univariate analysis and chi(2) testing.
   RESULTS: We identified 79 patients with 87 Morel-Lavallee lesions in the setting of trauma. Most were caused by motor vehicle collisions (25%). No difference was observed between the treatment groups in sex, body mass index, anticoagulation treatment, diabetes mellitus, smoking history, or alcohol use. The percutaneous aspiration group had higher rates of recurrence (56% vs. 19% and 15% in nonoperative and operative groups, respectively). The percentage of patients who had aspiration of more than 50 mL of fluid was higher for lesions that recurred than for lesions that resolved (83% vs. 33%, p = 0.02).
   CONCLUSION: Aspiration of more than 50 mL of fluid from Morel-Lavallee lesions was much more common among lesions that recurred (83%) than among those that resolved (33%). We therefore recommend that aspiration of more than 50 mL of fluid from a Morel-Lavallee lesion prompts operative intervention. We have now adopted this as a practice management guideline. Copyright (C) 2014 by Lippincott Williams & Wilkins
C1 [Nickerson, Terry P.; Zielinski, Martin D.; Jenkins, Donald H.; Schiller, Henry J.] Mayo Clin, Div Trauma Crit Care & Gen Surg, Rochester, MN 55905 USA.
C3 Mayo Clinic
RP Schiller, HJ (通讯作者)，Mayo Clin, Div Trauma Crit Care & Gen Surg, 200 First St SW, Rochester, MN 55905 USA.
EM schiller.henry@mayo.edu
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NR 18
TC 112
Z9 153
U1 0
U2 10
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD FEB
PY 2014
VL 76
IS 2
BP 493
EP 497
DI 10.1097/TA.0000000000000111
PG 5
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA AH8KG
UT WOS:000336386100036
PM 24458056
DA 2026-07-24
ER

PT J
AU Wills, A
   Obermair, A
AF Wills, Angela
   Obermair, Andreas
TI A review of complications associated with the surgical treatment of
   vulvar cancer
SO GYNECOLOGIC ONCOLOGY
LA English
DT Review
DE Vulvar cancer; Complications; Morbidity; Prevention; Inguino-femoral
   lymphadenectomy
ID SENTINEL LYMPH-NODE; VACUUM-ASSISTED CLOSURE; SQUAMOUS-CELL CARCINOMA;
   GYNECOLOGIC-ONCOLOGY-GROUP; HYPERBARIC-OXYGEN THERAPY; INGUINAL-FEMORAL
   LYMPHADENECTOMY; QUALITY-OF-LIFE; RADICAL VULVECTOMY;
   SARTORIUS-TRANSPOSITION; SAPHENOUS-VEIN
AB Objective. The mainstay of treatment for most vulvar malignancies is surgery to the vulva with lymphadenectomy to the inguino-femoral areas, plus radiotherapy or/and chemotherapy for locally advanced, or recurrent disease. Treatment is associated with significant physical, sexual, and psychological morbidity. The high morbidity rate has resulted in a continuing shift in treatment paradigms that focus on treatments that reduce morbidity without compromising cure rates. This paper reviews the complications associated with contemporary surgical treatment for vulva cancer and discusses preventative strategies.
   Methods. A review of the English literature was undertaken for articles published between 1965 and August 31, 2012 to identify articles that assessed complications resulting from surgery to the vulva or groins in patients with vulva cancer. Two independent researchers selected and qualitatively analyzed the articles using a predetermined protocol.
   Results. The heterogeneity of articles and differences in definitions and outcomes made this unsuitable for meta-analysis. Most studies advocated for change in surgical technique to reduce complications associated with inguino-femoral lymphadenectomy and surgery to the vulva, with varying success. The most effective means of preventing complications is by omitting systematic lymph node dissection. This can be achieved safely through sentinel lymph node biopsy. Saphenous vein sparing, VTE prophylaxis, the use of flaps and grafts, and preoperative counseling are additional ways to decrease morbidity.
   Conclusion. Despite technical advances, complications following surgical treatment for vulva cancer remain high. More research, particularly multi centered randomized controlled trials to improve the quality of evidence and studies that focus on complications as an outcome measure and analyze individual surgeon complication rates, are needed. Measures also need to be standardized throughout the gynecologic oncology community to allow for better comparison between studies. Crown Copyright (C) 2013 Published by Elsevier Inc. All rights reserved.
C1 [Wills, Angela; Obermair, Andreas] Univ Queensland, Queensland Ctr Gynaecol Oncol, Brisbane, Qld, Australia.
C3 University of Queensland
RP Obermair, A (通讯作者)，Royal Brisbane & Womens Hosp, Queensland Ctr Gynaecol Canc, 6th Floor,Ned Hanlon Bldg,Butterfield St, Herston, Qld 4029, Australia.
EM Obermair@powerup.com.au
RI ; Obermair, Andreas/IZP-8773-2023
OI Obermair, Andreas/0000-0003-2199-1117; 
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NR 86
TC 111
Z9 120
U1 0
U2 9
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0090-8258
EI 1095-6859
J9 GYNECOL ONCOL
JI Gynecol. Oncol.
PD NOV
PY 2013
VL 131
IS 2
BP 467
EP 479
DI 10.1016/j.ygyno.2013.07.082
PG 13
WC Oncology; Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Obstetrics & Gynecology
GA 244ZE
UT WOS:000326427900034
PM 23863358
DA 2026-07-24
ER

PT J
AU Jäger, C
   Zeichen, J
AF Jaeger, C.
   Zeichen, J.
TI Acute lower leg compartment syndrome
SO OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE
LA German
DT Article
DE Compartment syndrome; Lower extremity; Decompression; Dermatofasciotomy
ID VACUUM-ASSISTED CLOSURE; INTRAMUSCULAR PRESSURE; TIBIAL FRACTURES;
   FASCIOTOMY; DERMATOFASCIOTOMY; THERAPY
AB Decompression of all four muscle compartments of the lower leg to normalize tissue pressure and prevent permanent neuromuscular dysfunction.
   Incipient compartment syndrome (characterized by excessive pain, muscle pain on extension, tensely swollen and shiny skin, and Delta p > 30 mmHg without neuromuscular deficit) and no clinical improvement after conservative treatment and/or acute compartment syndrome (symptoms as for incipient compartment syndrome with neuromuscular deficit and Delta p < 30 mmHg).
   None. There is some dispute about indications and timing of fasciotomy and necrectomy when the need for dermatofasciotomy is recognized late (e.g. intubated intensive care patients).
   In unilateral compartment release as described by Matsen, the lateral compartment is decompressed first through a parafibular approach. After identification of the anterior and superficial posterior compartments by transverse incision of the fasciae, these muscles are also decompressed longitudinally. Finally, the deep posterior compartment beneath the lateral compartment is decompressed. In bilateral dermatofasciotomy, the fasciae of the anterior and lateral compartments are incised through a proximal anterolateral approach and the superficial and deep posterior compartments through a distal dorsomedial approach.
   Synthetic skin substitute or vacuum-assisted wound closure until definitive closure by secondary suture or mesh grafting after about 5 days. Patient mobilization generally depends on the concomitant bone injury.
   During the period from October 2001 to November 2008, 37 dermatofasciotomies were performed at our hospital to treat acute posttraumatic compartment syndrome. On the day of dismissal, symptoms of neuromuscular dysfunction after acute compartment syndrome had not disappeared completely in 5 patients. One patient received intermittent dialysis for acute kidney failure after crush syndrome. There were perioperative complications in a total of 6 patients: iatrogenic neurotomy (n=1), hematoma requiring revision (n=2), deep wound infection (n=2), and superficial disturbed wound healing (n=1).
C1 [Jaeger, C.; Zeichen, J.] Johannes Wesling Klinikum Minden, Klin Unfallchirurg & Orthopadie, D-32429 Minden, Germany.
C3 Ruhr University Bochum
RP Jäger, C (通讯作者)，Johannes Wesling Klinikum Minden, Klin Unfallchirurg & Orthopadie, Hans Nolte Str 1, D-32429 Minden, Germany.
EM christian.jaeger@klinikum-minden.de
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NR 24
TC 4
Z9 5
U1 0
U2 19
PU URBAN & VOGEL
PI MUNICH
PA NEUMARKTER STRASSE 43, D-81673 MUNICH, GERMANY
SN 0934-6694
EI 1439-0981
J9 OPER ORTHOP TRAUMATO
JI Oper. Orthopade Traumatol.
PD FEB
PY 2011
VL 23
IS 1
BP 5
EP 14
DI 10.1007/s00064-010-0010-x
PG 10
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA 726WS
UT WOS:000287758100002
PM 21340447
DA 2026-07-24
ER

PT J
AU Palmieri, L
   Corallino, D
   Herencia, IEC
   Meoli, F
   Paganini, AM
AF Palmieri, Livia
   Corallino, Diletta
   Herencia, Ingrid Elva Cordova
   Meoli, Francesca
   Paganini, Alessandro M.
TI Endo-SPONGE pulley system for the treatment of chronic anastomotic
   leakage after rectal resection. A case report
SO ANNALI ITALIANI DI CHIRURGIA
LA English
DT Article
DE Anastomotic leakage (AL); Anterior rectal resection; Endo-SPONGE;
   Endoscopic-Interventional radiology; Pulley system
ID TRANSANAL ENDOSCOPIC MICROSURGERY; LOCO-REGIONAL RESECTION;
   VACUUM-ASSISTED CLOSURE; QUALITY-OF-LIFE; ANTERIOR RESECTION; CANCER;
   MANAGEMENT; RECURRENCE; THERAPY; ELRR
AB AIM: Anastomotic leakage (AL) after anterior rectal resection unresponsive to diverting ileostomy is difficult to manage. Endoscopic vacuum-assisted (E-VAC) wound closure system is a new approach based on co-axial sponge positioning under endoscopic control. If the abscess is not co-axial, however, endoscopic positioning is not feasible. Aim is to report an original method of sponge positioning.
   CASE EXPEFUENCE: A 62-year-old woman with chronic AL after anterior rectal resection for cancer was referred. AL had been treated with diverting ileostomy without healing. Due to the peri-rectal abscess anatomy, standard E-VAC positioning was not possible. A combined endoscopic-interventional radiology procedure for Endo-SPONGE (R) (B. Braun Aesculap AG, Germany) positioning was thus employed. Under general anesthesia, a guidewire was passed after small counter-incision on the left gluteus and through the left levator muscle, reaching the anastomotic dehiscence and rectal lumen through the chronic abscess. The guidewire was retrieved through the anus and connected to a long silk thread. By retracting the trans-gluteal guidewire, the silk thread was pulled through the abscess to exit from the gluteal skin incision. A tailored Endo-SPONGE (R) was then connected to the trans-anal silk thread. By pulling on the gluteal silk thread, the sponge was positioned inside the abscess. The silk thread remained in place under a medication for sponge replacements.
   DISCUSSION AND RESULTS: Twelve Endo-SPONGE replacements under sedation were required until AL completely resolved after 35 days.
   CONCLUSION: When traditional endoscopic sponge insertion into AL is not possible, this original "pulley system" proved effective for sponge introduction and replacement.
C1 [Palmieri, Livia; Corallino, Diletta; Herencia, Ingrid Elva Cordova; Meoli, Francesca; Paganini, Alessandro M.] Sapienza Univ, Dept Gen Surg & Surg Specialties Paride Stefanini, Rome, Italy.
C3 Sapienza University Rome
RP Palmieri, L (通讯作者)，Sapienza Univ Rome, Dept Gen Surg & Surg Specialties Paride Stefanini, Azienda Policlin Umberto I, Viale Policlin 155, I-00161 Rome, Italy.
EM livia.palmieri@alice.it
RI Paganini, Alessandro/H-8615-2019
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NR 30
TC 1
Z9 1
U1 0
U2 1
PU EDIZIONI LUIGI POZZI
PI ROME
PA VIA PANAMA 68, 00198 ROME, ITALY
SN 0003-469X
EI 2239-253X
J9 ANN ITAL CHIR
JI Ann. Ital. Chir.
PD SEP-OCT
PY 2020
VL 91
IS 5
BP 538
EP 543
AR PII S0003469X2003328X
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA PC2RU
UT WOS:000596855100014
PM 33295302
DA 2026-07-24
ER

PT J
AU Salica, A
   Weltert, L
   Scaffa, R
   Guerrieri, L
   Nardella, S
   Bellisario, A
   De Paulis, R
AF Salica, Andrea
   Weltert, Luca
   Scaffa, Raffaele
   Guerrieri, Lorenzo
   Nardella, Saverio
   Bellisario, Alessandro
   De Paulis, Ruggero
TI Negative pressure wound treatment improves Acute Physiology and Chronic
   Health Evaluation II score in mediastinitis allowing a successful
   elective pectoralis muscle flap closure: Six-year experience of a single
   protocol
SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; PERISTERNAL THORACIC WALL; CARDIAC-SURGERY;
   POSTSTERNOTOMY MEDIASTINITIS; RISK-FACTORS; BLOOD-FLOW; INFECTION;
   COMPLICATIONS; THERAPY; DEBRIDEMENT
AB Objectives: Optimal management of poststernotomy mediastinitis is controversial. Negative pressure wound treatment improves wound environment and sternal stability with low surgical invasiveness. Our protocol was based on negative pressure followed by delayed surgical closure. The aim of this study was to provide the results at early follow-up and to identify the risk factors for adverse outcome.
   Methods: In 5400 cardiac procedures, 44 consecutive patients with mediastinitis were enrolled in the study. Mediastinitis treatment was based on urgent debridement and negative pressure as the first-line approach. After wound sterilization, chest closure was achieved by elective pectoralis muscle advancement flap. Each patient's hospital data were collected prospectively. Variables included patient demographics and clinical and biological data. Acute Physiology and Chronic Health Evaluation (APACHE) II score was calculated at the time of diagnosis and 48 hours after debridement. Focus outcome measures were mediastinitis-related death and need for reintervention after pectoralis muscle closure.
   Results: El Oakley type I and type IIIA mediastinitis were the most frequent types (63.6%). Methicillin-resistant Staphylococcus aureus was present in 25 patients (56.8%). Mean APACHE II score was 19.4 +/- 4 at the time of diagnosis, and 30 patients (68.2%) required intensive care unit transfer before surgical debridement. APACHE II score improved 48 hours after wound debridement and negative pressure application (mean value, 19.4 +/- 4 vs 7.2 +/- 2; P = .005) independently of any other variables included in the study. One patient in septic shock at the time of diagnosis died (2.2%).
   Conclusions: Negative pressure promotes a significant improvement in clinical status according to APACHE II score and allows a successful elective surgical closure.
C1 [Salica, Andrea; Weltert, Luca; Scaffa, Raffaele; Guerrieri, Lorenzo; Nardella, Saverio; Bellisario, Alessandro; De Paulis, Ruggero] European Hosp, Dept Cardiac Surg, I-00149 Rome, Italy.
RP De Paulis, R (通讯作者)，European Hosp, Div Cardiac Surg, Via Portuense 700, I-00149 Rome, Italy.
EM depauli@tin.it
RI Salica, Andrea/GSN-3794-2022; De Paulis, Ruggero/P-2408-2015; Scaffa,
   Raffaele/GRJ-8591-2022
OI WELTERT, Luca Paolo/0000-0001-6094-8280; De Paulis,
   Ruggero/0000-0002-3603-2202; Scaffa, Raffaele/0000-0002-9048-631X
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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   Petzina R, 2006, EUR J CARDIO-THORAC, V30, P85, DOI 10.1016/j.ejcts.2006.04.009
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   Song DH, 2003, PLAST RECONSTR SURG, V111, P92, DOI 10.1097/01.PRS.0000037686.14278.6A
   Trouillet JL, 2005, J THORAC CARDIOV SUR, V129, P518, DOI 10.1016/j.jtcvs.2004.07.027
   Vos RJ, 2012, INTERACT CARDIOV TH, V14, P17, DOI 10.1093/icvts/ivr049
   Wackenfors A, 2005, ANN THORAC SURG, V79, P1724, DOI 10.1016/j.athoracsur.2004.10.053
NR 30
TC 8
Z9 10
U1 0
U2 1
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0022-5223
EI 1097-685X
J9 J THORAC CARDIOV SUR
JI J. Thorac. Cardiovasc. Surg.
PD NOV
PY 2014
VL 148
IS 5
BP 2397
EP 2403
DI 10.1016/j.jtcvs.2014.04.025
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA AT7QM
UT WOS:000345132600129
PM 24836724
OA Bronze
DA 2026-07-24
ER

PT J
AU Acartürk, TO
AF Acarturk, Tahsin Oguz
TI Treatment of large ischial ulcers communicating with the hip joint with
   proximal femoral resection and reconstruction with a combined vastus
   lateralis, vastus intermedius and rectus femoris musculocutaneous flap
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Vastus lateralis; Vastus intermedius; Rectus femoris; Pressure sore;
   Flap; Vacuum-assisted closure; Lateral circumflex femoral artery;
   Girdlestone arthroplasty
ID PRESSURE SORES; MYOCUTANEOUS FLAP; THIGH FLAP; ARTHROPLASTY; MUSCLE;
   MANAGEMENT; INFECTION; CLOSURE
AB Pressure ulcers which communicate with the hip joint are very difficult to treat. Often, the hip joint is infected with osteomyelitis of the proximal femur resulting in bouts of sepsis and flap failure. These patients require proximal femoral resection and wide debridementin order to eradicate the infection, which in turn results in large and deep cavities. Reconstruction requires either a muscle flap or even a total thigh flap if the defect is very large and the pelvis is involved.
   In a series of six ischial or ischio-trochanteric pressure sores communicating with the hip joint, following multiple serial debridements, the vastus lateralis, vastus intermedius and rectus femoris muscles were raised as a single musculocutaneous flap ('three muscle flap'), based on the descending branch of the lateral femoral circumflex artery, and transposed into the defect. All patients were paraplegics and had signs of sepsis during admission. Two patients had prior failed reconstructions within 3 months of admission and the others had not been operated on before. The external skin defect of the ulcers ranged from 7 x 5 cm to 30 x 12 cm. After 12 months follow up there was no recurrence of pressure sores or sepsis.
   The 'three muscle flap' offers the advantage of providing large bulk to fill deep cavities, while preserving the rest of the thigh. The flap elevation is fast and safe and the vascular pedicle is reliable. This technique is not for simple pressure sores, but should be reserved for large pressure sores complicated with large cavities created after resection of the proximal femur. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 Cukurova Univ, Sch Med, Dept Plast Reconstruct & Aesthet Surg, TR-01330 Adana, Turkey.
C3 Cukurova University
RP Acartürk, TO (通讯作者)，Cukurova Univ, Sch Med, Dept Plast Reconstruct & Aesthet Surg, TR-01330 Adana, Turkey.
EM toacarturk@yahoo.com
RI Acarturk, Tahsin/MIT-6667-2025
CR BERGER SR, 1994, ANN PLAS SURG, V33, P548, DOI 10.1097/00000637-199411000-00014
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NR 16
TC 24
Z9 26
U1 0
U2 1
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD NOV
PY 2009
VL 62
IS 11
BP 1497
EP 1502
DI 10.1016/j.bjps.2008.04.063
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 536XW
UT WOS:000273078200025
PM 18718837
DA 2026-07-24
ER

PT J
AU Olejnik, J
   Vokurka, J
   Vician, M
AF Olejnik, Juraj
   Vokurka, Jiri
   Vician, Marek
TI Acute necrotizing pancreatitis: Intra-abdominal vacuum sealing after
   necrosectomy
SO HEPATO-GASTROENTEROLOGY
LA English
DT Article
DE severe acute pancreatitis; acute necrotizing pancreatitis; infected
   pancreatic necrosis; pancreatic necrosectomy; intra-abdominal vacuum
   sealing; bursostomy; laparostomy
ID OPEN ABDOMEN; CLOSURE; MANAGEMENT
AB Background: Cases of acute pancreatitis with infected pancreatic necrosis warrant consideration of surgical interventions designed to achieve the goal of pancreatic debridement and drainage. Notable experience with the use of vacuum assisted closure for abdominal wall defects was an assumption for its peripancreatic application after debridement in septic patients with infected pancreatic necrosis confirmed by radiological evidence of gas or results of fine needle aspiration. The goal of this study was to evaluate our own experience with this new therapeutic technique.
   Methods: This study is a multi-center retrospective analysis and comparison of 2 groups of patients with severe sepsis and a proven pancreatic source of infection. Group A consisted of 67 patients, 42 men and 25 women with ages ranging from 19-90 years (mean 48.0), who were treated surgically between 2002 and 2006 using a combination of laparostomy, multiple irrigations and abdominal drainage. Group B consisted of 39 patients, 28 men and 11 women aged from 18-87 years (mean 51.8), who were treated between 2002 and 2006 using the former techniques with the addition of an intra-abdominal vacuum assisted negative pressure therapy system.
   Results: The number of repeat laparotomies with debridement of the open abdominal wound in general anesthesia in group A ranged from 5-18 over 10-33 days (median 21) of surgical treatment period. The number of repeat laparotomies in group B decreased to 3-9 and the surgical treatment period decreased to 9-29 days (median 16). Seventeen patients (25.4%) in group A died because of severe sepsis and multiple organ failure, compared to 7 patients (17.9%) in group B.
   Conclusion: Authors confirmed significant reduction of morbidity and mortality with the use of the intra-abdominal vacuum assisted system in the treatment of localized pancreatic source of sepsis.
C1 [Olejnik, Juraj; Vician, Marek] Slovak Med Univ, Derers Univ Hosp, Dept Surg, Bratislava, Slovakia.
   [Vokurka, Jiri] Masaryk Univ, St Anna Univ Hosp, Fac Med, Dept Surg 1, Brno, Czech Republic.
C3 Slovak Medical University Bratislava; St. Anne's University Hospital
   Brno (FNUSA); Masaryk University
RP Olejnik, J (通讯作者)，Slovak Med Univ, Derers Univ Hosp, Dept Gen Surg, Limbova 5, Bratislava 83305, Slovakia.
EM olejnik@chello.sk
CR Adam U, 1997, LANGENBECK ARCH CHIR, V382, pS18, DOI 10.1007/PL00014638
   Balthazar EJ, 2002, RADIOLOGY, V223, P603, DOI 10.1148/radiol.2233010680
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   Büchler MW, 2000, ANN SURG, V232, P619
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   De Waele JJ, 2004, CRIT CARE, V8, pR504, DOI 10.1186/cc2991
   Fabian TC, 2007, SURG CLIN N AM, V87, P73, DOI 10.1016/j.suc.2006.09.011
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   OLEJNIK J, 2004, LEK OBZOR, V53, P261
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NR 18
TC 9
Z9 13
U1 0
U2 4
PU H G E UPDATE MEDICAL PUBLISHING S A
PI ATHENS
PA PO BOX 17257, ATHENS GR-10024, GREECE
SN 0172-6390
J9 HEPATO-GASTROENTEROL
JI Hepato-Gastroenterol.
PD MAR-APR
PY 2008
VL 55
IS 82-83
BP 315
EP 318
PG 4
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA 304YC
UT WOS:000256144000005
PM 18613356
DA 2026-07-24
ER

PT J
AU Jovic, MS
   Sudecki, BJ
   Radosavljevic, IL
   Jovanovic, MD
   Stojicic, MT
   Subotic, JDI
   Nejkovic, ND
   Inic, ZM
   Stojanovic, MM
   Jeremic, JV
AF Jovic, Marko S.
   Sudecki, Branko J.
   Radosavljevic, Ivan Ljubisa
   Jovanovic, Milan D.
   Stojicic, Milan T.
   Subotic, Jelena D. Isakovic
   Nejkovic, Natasa D.
   Inic, Zorka M.
   Stojanovic, Marina M.
   Jeremic, Jelena V.
TI The Use of Integra Dermal Regeneration Template in Exposed Bone
   Reconstruction: A Case Report with Systematic Literature Review
SO JOURNAL OF CLINICAL MEDICINE
LA English
DT Review
DE Integra; burns; bone devoid of periosteum; burring; dermal regeneration
   template; bone; scalp; skin grafting
ID THICKNESS SCALP DEFECTS; VACUUM-ASSISTED CLOSURE; SOFT-TISSUE COVERAGE;
   ARTIFICIAL DERMIS; SKIN; MANAGEMENT; WOUNDS; BURNS; SUBSTITUTE;
   EXPERIENCE
AB Background/Objectives: Integra Dermal Regeneration Template (IDRT) has emerged as a viable reconstructive option in exposed avascular structures, such as exposed bone devoid of periosteum. This systematic review aimed at examining success rates by comparing different wound types and their characteristics, as well as the surgical methods involved. Methods: A systematic review was conducted to identify studies using IDRT in the reconstruction of defects with exposed bone devoid of periosteum. Primary outcomes of interest were IDRT and skin graft success rates, followed by patient and wound characteristics, and different surgical methods used. The results were accompanied by an illustrative case report of IDRT-based hand reconstruction after a deep burn injury. Results: The review included 40 studies, with a total of 202 individual defects. The primary indication for IDRT-based reconstruction was post-oncologic defects in the elderly population. Although surgeons mostly used burring/fenestration as a bone preparation method prior to IDRT placement, decorticated bones showed faster grafting time (23.8 vs. 27.9 days). The average success rate of IDRT was 87.54% (+/- 25.9), with an excellent IDRT take rate (100%) observed in more than 50% of cases. In the majority of cases (95.5%), the skin graft acceptance rate was deemed to be higher than 95%, with an average graft take of 98.8%. Conclusions: The results of this review support the use of IDRT in managing complex defects involving exposed bone, offering fast coverage with good functional restoration, without any donor site morbidity. Additionally, bone preparation methods also play an important role in IDRT-based reconstruction by shortening the grafting time.
C1 [Jovic, Marko S.; Sudecki, Branko J.; Radosavljevic, Ivan Ljubisa; Jovanovic, Milan D.; Stojicic, Milan T.; Subotic, Jelena D. Isakovic; Jeremic, Jelena V.] Univ Clin Ctr Serbia, Clin Burns Plast & Reconstruct Surg, Belgrade 11000, Serbia.
   [Jovic, Marko S.; Jovanovic, Milan D.; Stojicic, Milan T.; Inic, Zorka M.; Stojanovic, Marina M.; Jeremic, Jelena V.] Univ Belgrade, Fac Med, Belgrade 11000, Serbia.
   [Nejkovic, Natasa D.; Stojanovic, Marina M.] Univ Clin Ctr Serbia, Ctr Anesthesiol, Belgrade 11000, Serbia.
   [Inic, Zorka M.] Inst Oncol & Radiol Serbia, Belgrade 11000, Serbia.
C3 University of Belgrade; University of Belgrade; University of Belgrade;
   Institute for Oncology & Radiology of Serbia (IORS); University of
   Belgrade
RP Jovic, MS (通讯作者)，Univ Clin Ctr Serbia, Clin Burns Plast & Reconstruct Surg, Belgrade 11000, Serbia.; Jovic, MS (通讯作者)，Univ Belgrade, Fac Med, Belgrade 11000, Serbia.
EM marko.jovic@med.bg.ac.rs
RI Suđecki, Branko/IQW-1683-2023
OI Suđecki, Branko/0000-0001-5898-5912; Radosavljevic,
   Ivan/0000-0003-4189-5368; Stojicic, Milan/0000-0002-4545-4335; Jeremic,
   Jelena/0000-0001-8297-0243
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NR 65
TC 3
Z9 3
U1 1
U2 1
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2077-0383
J9 J CLIN MED
JI J. Clin. Med.
PD APR 25
PY 2025
VL 14
IS 9
AR 2971
DI 10.3390/jcm14092971
PG 18
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 2MY1R
UT WOS:001486474600001
PM 40364002
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Wiedemann, D
   Vill, D
   Bonaros, N
   Laufer, G
   Schachner, T
   Kocher, A
AF Wiedemann, D.
   Vill, D.
   Bonaros, N.
   Laufer, G.
   Schachner, T.
   Kocher, A.
TI Topical use of autologous fibrin glue in high-risk CABG patients
SO EUROPEAN SURGERY-ACTA CHIRURGICA AUSTRIACA
LA English
DT Article
DE Autologous fibrin glue; coronary artery bypass grafting; wound healing;
   sternum instability
ID STERNAL WOUND COMPLICATIONS; PLATELET GEL; INFECTIONS; MORTALITY;
   GROWTH; PLASMA
AB BACKGROUND: Surgical site wound complications following cardiothoracic surgery are associated with increased costs, morbidity, and mortality. Several factors have been shown to be associated with an increase in deep and superficial wound healing problems. Recent publications have suggested protective effects of topical autologous blood components with regard to wound healing disturbances after various surgical procedures. The aim of this retrospective analysis was to assess the impact of autologous fibrin glue on surgical site complications in high-risk coronary artery bypass graft patients. METHODS: 1394 consecutive patients who underwent CABG surgery from a single centre were included in the study. Autologous fibrin glue was used in 122 patients (8.8%) with elevated risk for wound complications according to institutional guidelines. The demography of both groups was compared and the following outcome variables were analyzed: deep sternal wound infection, sternal re-wiring, bleeding, re- exploration rate, and the use of a vacuum assisted closure system. RESULTS: No treatment-related adverse events were noted. The group of patients who received autologous fibrin sealant had significantly higher BMI levels, included more diabetics and repeat cardiac procedures and they underwent percutaneous coronary intervention more often. Furthermore, they were more likely to receive bilateral mammary artery grafts. Despite the high-risk profile of the Fibrin glue group rates of revision, deep sternal wound healing problems tended to be lower than in the control group. CONCLUSIONS: In our experience autologous fibrin glue does not invoke any adverse events and serves as a useful adjunct to haemostasis in cardiac surgery. However, the incidence of wound disturbances was similar in both arms of the study. In light of the ever-increasing clinical use a prospective randomized controlled trial examining the impact of autologous fibrin glue is warranted.
C1 [Wiedemann, D.; Vill, D.; Bonaros, N.; Schachner, T.] Med Univ Innsbruck, Ctr Operat Med, Dept Heart Surg, A-6020 Innsbruck, Austria.
   [Wiedemann, D.; Laufer, G.; Kocher, A.] Med Univ Vienna, Dept Surg, Div Cardiac Surg, Vienna, Austria.
C3 Medical University of Innsbruck; Medical University of Vienna
RP Wiedemann, D (通讯作者)，Med Univ Innsbruck, Ctr Operat Med, Dept Heart Surg, Anichstr 35, A-6020 Innsbruck, Austria.
EM dominik.wiedemann@i-med.ac.at
RI Schachner, Thomas/AFS-7473-2022; Kocher, Alfred/OIS-7365-2025; Bonaros,
   nikolaos/N-7236-2017; Wiedemann, Dominik/AAH-2649-2020
OI Schachner, Thomas/0000-0002-5865-2787; Kocher,
   Alfred/0000-0002-2818-2227; Bonaros, nikolaos/0000-0002-7656-5812;
   Wiedemann, Dominik/0000-0002-2055-8293
CR Bhanot Sumeet, 2002, Facial Plast Surg, V18, P27, DOI 10.1055/s-2002-19824
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NR 19
TC 3
Z9 3
U1 0
U2 6
PU SPRINGER WIEN
PI WIEN
PA SACHSENPLATZ 4-6, PO BOX 89, A-1201 WIEN, AUSTRIA
SN 1682-8631
EI 1682-4016
J9 EUR SURG
JI Eur. Surg.
PD OCT
PY 2011
VL 43
IS 5
BP 309
EP 314
DI 10.1007/s10353-011-0039-6
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 852OQ
UT WOS:000297367700009
DA 2026-07-24
ER

PT J
AU Dedmond, BT
   Kortesis, B
   Punger, K
   Simpson, J
   Argenta, J
   Kulp, B
   Morykwas, M
   Webb, LX
AF Dedmond, Barnaby T.
   Kortesis, Bill
   Punger, Kathleen
   Simpson, Jordan
   Argenta, Joseph
   Kulp, Brenda
   Morykwas, Michael
   Webb, Lawrence X.
TI Subatmospheric pressure dressings in the temporary treatment of soft
   tissue injuries associated with type III open tibial shaft fractures in
   children
SO JOURNAL OF PEDIATRIC ORTHOPAEDICS
LA English
DT Article
DE open fracture; tibia fracture; pediatric fracture; pediatric limb
   trauma; limb salvage
ID VACUUM-ASSISTED CLOSURE; ANTIBIOTIC-THERAPY; LOWER-EXTREMITY; WOUND
   CONTROL; RECONSTRUCTION; MANAGEMENT; CLASSIFICATION; COMPLICATIONS;
   EXPERIENCE; INFECTION
AB Purpose: This study was designed to evaluate the use of subatmospheric pressure dressings on high-energy open tibial shaft fractures in children. We hypothesized that the use of a negative-pressure dressing in these fractures would result in a decreased incidence of infection and decreased need for pedicled muscle flaps and free tissue transfer.
   Methods: A retrospective case series of 15 consecutive pediatric patients with 16 type III open tibial shaft fractures (8 type I IIA, 7 type IIIB, and I type I IIC). The patients' age ranged from 2 to 17 years. All patients underwent a standard protocol of serial irrigation and debridement of the open wound with bony stabilization. Temporary coverage of the open wound was obtained with the use of a subatmospheric pressure dressing until definitive wound coverage or closure.
   Results: Infection occurred in 5 of 16 fractures, 2 requiring antibiotics alone (1 type IIIA and 1 type IIIB) and 3 requiring surgical intervention (2 type IIIB and 1 type IIIC). Seven of 16 (3 type IIIA, 3 type IIIB, and 1 type IIIC) fractures required repeat surgical intervention to facilitate bony healing. Only 3 patients required free tissue transfers or rotational muscle flaps for coverage, a 50% decrease compared with the initial classification.
   Conclusions: Compared with other described methods, the use of subatmospheric pressure dressings in the temporary treatment of soft tissue wounds associated with high-energy open tibial shaft may reduce the need for major soft tissue coverage procedures. Its effect on infection and fracture healing rates requires further study.
   Significance: A reduction in the need for major soft tissue coverage procedures with the use of negative-pressure dressings in this setting should result in decreased morbidity for these patients and in decreased social and financial costs.
C1 Lexington Orthopaed, W Columbia, SC 29169 USA.
   Wake Forest Univ, Dept Orthopaed Surg, Winston Salem, NC 27109 USA.
   Wake Forest Univ, Dept Plast Surg, Winston Salem, NC 27109 USA.
C3 Wake Forest University; Wake Forest University
RP Dedmond, BT (通讯作者)，Lexington Orthopaed, 110 E Med Lane,Suites 220 & 235, W Columbia, SC 29169 USA.
EM dedmoba@yahoo.com
OI Morykwas, Michael/0009-0001-5547-5172
CR Arca MJ, 2005, PEDIATR SURG INT, V21, P532, DOI 10.1007/s00383-005-1465-y
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NR 29
TC 45
Z9 58
U1 0
U2 4
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0271-6798
EI 1539-2570
J9 J PEDIATR ORTHOPED
JI J. Pediatr. Orthop.
PD NOV-DEC
PY 2006
VL 26
IS 6
BP 728
EP 732
DI 10.1097/01.bpo.0000242434.58316.ad
PG 5
WC Orthopedics; Pediatrics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Pediatrics
GA 157CB
UT WOS:000245695100006
PM 17065934
DA 2026-07-24
ER

PT J
AU Wesslén, C
   Wahlgren, CM
AF Wesslen, Charlotte
   Wahlgren, Carl-Magnus
TI Contemporary Management and Outcome After Lower Extremity Fasciotomy in
   Non-Trauma-Related Vascular Surgery
SO VASCULAR AND ENDOVASCULAR SURGERY
LA English
DT Article
DE fasciotomy; compartment syndrome; lower extremity ischemia
ID ACUTE COMPARTMENT SYNDROME; ACUTE LIMB ISCHEMIA; AMPUTATION; DIAGNOSIS
AB Introduction: Acute compartment syndrome (ACS) is a challenging and recognized complication to vascular surgery revascularization. The aim of this study was to investigate the current epidemiology, management, and early outcomes of fasciotomy in vascular surgery. Methods: Retrospective cohort study of all patients undergoing lower extremity fasciotomy at a single university center between January 2008 and December 2014. Patient demographics, operative techniques, and outcomes were analyzed. Results: The cohort (n = 113 limbs; 107 patients; 48% women; mean age was 74 (12) years [range, 50-97 years]) included 81 (72%) limbs undergoing revascularization for acute limb ischemia, 7 (6.2%) limbs related to acute aortic disease, and 23 (20%) limbs undergoing elective vascular surgery. Five patients underwent bilateral lower extremity fasciotomy. In all, 64 (57%) limbs had signs of ACS and underwent a therapeutic fasciotomy, while 49 (43%) fasciotomies were prophylactic. There were 20 (18%) fasciotomies performed after endovascular interventions. A 4-compartment fasciotomy was performed in 82% (n = 93) of limbs with a double incision technique. Split thickness skin graft was required in 11% (12/112) and vacuum-assisted closure treatment in 11% (12/111). The mean length of stay in hospital was 11 (9) days. Most common complication was lower extremity nerve deficit 32% (33/104) followed by wound infection 30% (32/108). At 30-day follow-up, amputation rate was 13% (14/107 limbs) and mortality 23% (25/107 patients). In the multivariate logistic regression analysis, prophylactic fasciotomy was associated with amputation (odds ratio: 28.9; 95% confidence interval: 1.96-425; P = .014). Conclusion: Acute compartment syndrome is primarily related to acute ischemic conditions but occurs after both aortic or elective vascular procedures and endovascular treatments. There are significant complications related to lower extremity fasciotomy in vascular surgery.
C1 [Wesslen, Charlotte; Wahlgren, Carl-Magnus] Karolinska Inst, Dept Mol Med & Surg, Solna, Sweden.
   [Wesslen, Charlotte; Wahlgren, Carl-Magnus] Karolinska Univ Hosp, Dept Vasc Surg, Stockholm, Sweden.
C3 Karolinska Institutet; Karolinska Institutet; Karolinska University
   Hospital
RP Wahlgren, CM (通讯作者)，Karolinska Inst, Dept Vasc Surg A2 01, S-17176 Stockholm, Sweden.; Wahlgren, CM (通讯作者)，Karolinska Univ Hosp, S-17176 Stockholm, Sweden.
EM carl.wahlgren@sll.se
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NR 18
TC 21
Z9 26
U1 0
U2 4
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 1538-5744
EI 1938-9116
J9 VASC ENDOVASC SURG
JI Vasc. Endovasc. Surg.
PD OCT
PY 2018
VL 52
IS 7
BP 493
EP 497
DI 10.1177/1538574418773503
PG 5
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA GT3WU
UT WOS:000444435600001
PM 29716475
DA 2026-07-24
ER

PT J
AU Lü, DY
   Li, Z
   Gao, YX
   Luo, CH
   Zhang, F
   Zheng, L
   Wang, JW
   Sun, SJ
   Long, M
AF Lu, Dongyuan
   Li, Zhan
   Gao, Yuxin
   Luo, Chunhua
   Zhang, Fan
   Zheng, Lu
   Wang, Jiawen
   Sun, Shujin
   Long, Mian
TI β1 integrin signaling in asymmetric migration of keratinocytes under
   mechanical stretch in a co-cultured wound repair model
SO BIOMEDICAL ENGINEERING ONLINE
LA English
DT Article
DE Keratinocyte; Mechanical stretch; Fibroblast; beta 1 integrin;
   Mechanotransduction
ID VACUUM-ASSISTED CLOSURE; EXTRACELLULAR-MATRIX; MAP KINASE; INTEGRIN
   ACTIVATION; GENE-EXPRESSION; CELL-MIGRATION; MOTILITY;
   MECHANOTRANSDUCTION; ADHESION; BETA(1)-INTEGRIN
AB Background: Keratinocyte (KC) migration in re-epithelization is crucial in repairing injured skin. But the mechanisms of how mechanical stimuli regulate the migration of keratinocytes have been poorly understood.
   Methods: Human immortalized keratinocyte HaCaT cells were co-cultured with skin fibroblasts on PDMS membranes and transferred to the static stretch device developed in-house for additional 6 day culture under mechanical stretch to mimic surface tension in skin. To detect the expression of proteins on different position at different time points and the effect of beta 1 integrin mechanotransduction on HaCaT migration, Immunofluorescence, Reverse transcription-polymerase chain reaction, Flow cytometry, Western blotting assays were applied.
   Results: Mechanical receptor of beta 1 integrin that recognizes its ligand of collagen I was found to be strongly associated with migration of HaCaT cells since the knockdown of beta 1 integrin via RNA silence eliminated the key protein expression dynamically. Here the expression of vinculin was lower but that of Cdc42 was higher for the cells at outward edge than those at inward edge, respectively, supporting that the migration capability of keratinocytes is inversely correlated with the formation of focal adhesion complexes but positively related to the lamellipodia formation. This asymmetric expression feature was further confirmed by high or low expression of PI3K for outward-or inward-migrating cells. And ERK1/ 2 phosphorylation was up-regulated by mechanical stretch.
   Conclusion: We reported here, a novel mechanotransduction signaling pathways were beta 1 integrin-dependent pattern of keratinocytes migration under static stretch in an in vitro co-culture model. These results provided an insight into underlying molecular mechanisms of keratinocyte migration under mechanical stimuli.
C1 [Lu, Dongyuan; Li, Zhan; Gao, Yuxin; Luo, Chunhua; Zhang, Fan; Zheng, Lu; Wang, Jiawen; Sun, Shujin; Long, Mian] Chinese Acad Sci, Inst Mech, Ctr Biomech & Bioengn, Beijing 100190, Peoples R China.
   [Lu, Dongyuan; Li, Zhan; Gao, Yuxin; Luo, Chunhua; Zhang, Fan; Zheng, Lu; Wang, Jiawen; Sun, Shujin; Long, Mian] Chinese Acad Sci, Inst Mech, Natl Micrograv Lab, Key Lab Micrograv, Beijing 100190, Peoples R China.
   [Lu, Dongyuan; Li, Zhan; Gao, Yuxin; Luo, Chunhua; Zhang, Fan; Zheng, Lu; Wang, Jiawen; Sun, Shujin; Long, Mian] Chinese Acad Sci, Inst Mech, Beijing Key Lab Engn Construct & Mechanobiol, Beijing 100190, Peoples R China.
C3 Chinese Academy of Sciences; Institute of Mechanics, CAS; Chinese
   Academy of Sciences; Institute of Mechanics, CAS; Chinese Academy of
   Sciences; Institute of Mechanics, CAS
RP Long, M (通讯作者)，Chinese Acad Sci, Inst Mech, Ctr Biomech & Bioengn, Beijing 100190, Peoples R China.
EM mlong@imech.ac.cn
RI Zhang, Fan/KFA-3326-2024; WANG, JIAWEN/MYR-5467-2025
FU National Natural Science Foundation of China [31110103918, 31470907]
FX Publication of this article was funded by National Natural Science
   Foundation of China Grants 31110103918 and 31470907.
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NR 51
TC 20
Z9 22
U1 0
U2 23
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1475-925X
J9 BIOMED ENG ONLINE
JI Biomed. Eng. Online
PD DEC 28
PY 2016
VL 15
SU 2
AR 130
DI 10.1186/s12938-016-0263-1
PG 16
WC Engineering, Biomedical
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Engineering
GA EI3XB
UT WOS:000392424700006
PM 28155694
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kempton, LB
   Larson, TB
   Montijo, HE
   Seymour, RB
   Getz, SB
   Bosse, MJ
AF Kempton, Laurence B.
   Larson, Timothy B.
   Montijo, Harvey E.
   Seymour, Rachel B.
   Getz, Stanely B.
   Bosse, Michael J.
TI Increased Cost of Negative Pressure Dressings Is Not Justified for
   Split-Thickness Skin Grafting of Low-Risk Wounds
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE split-thickness skin graft; negative pressure dressing; negative
   pressure therapy; trauma
ID VACUUM-ASSISTED CLOSURE; FOLLOW-UP; THERAPY; BOLSTER; DEVICE;
   MANAGEMENT; FIXATION; DEFECTS; TRAUMA; TRIAL
AB Objectives:(1) To determine whether negative pressure dressings (NPDs) are superior to conventional compressive dressings (CDs) for split-thickness skin grafts (STSGs) placed on healthy, low-risk wounds, (2) To determine the cost difference of NPDs versus that of CDs.Design:Retrospective.Setting:Level I Trauma Center.Patients/Participants:One hundred ninety-five traumatic wounds treated with STSG.Main Outcome Measurements:Patients were assigned outcomes based on postoperative documentation: completely healed, incompletely healed (small areas of graft necrosis), failed, or lost to follow-up. The costs associated with each dressing type were documented.Results:Thirty five of 195 STSGs were lost to follow-up, leaving n = 120 STSG-NPD, n = 40 STSG-CD. Of the remaining 120 STSGs treated with NPD, 91 completely healed, 23 incompletely healed, and 6 failed. Of the 40 STSGs treated with a CD, 37 completely healed, 1 incompletely healed, and 2 failed. Patients treated with CDs had a higher likelihood of healing relative to those treated with the NPD (P = 0.018). Analyzing the outcomes as failed versus not failed revealed no significant difference between the groups (P = 1.00). There were more smokers in the CD group (P = 0.022). In this series, the mean cost associated with NPD compared with that of CD was $2370 more per patient.Conclusions:There is a high rate of successful healing of STSGs for traumatic extremity wounds regardless of the dressing used. The increased cost of NPDs is not justified in wounds that are at a low risk of developing STSG failure.Level of Evidence:Therapeutic Level III. See Instructions for Authors for a complete description of levels of evidence.
C1 [Kempton, Laurence B.; Larson, Timothy B.; Montijo, Harvey E.; Seymour, Rachel B.; Bosse, Michael J.] Carolinas Med Ctr, Dept Orthopaed Surg, Charlotte, NC 28203 USA.
   [Getz, Stanely B.] Carolinas Med Ctr, Dept Gen Surg, Charlotte, NC 28203 USA.
C3 Carolinas Medical Center; Carolinas Medical Center
RP Bosse, MJ (通讯作者)，Carolinas HealthCare Syst, Dept Orthopaed Surg, 1320 Scott Ave, Charlotte, NC 28204 USA.
EM michael.bosse@carolinashealthcare.org
OI Seymour, Rachel/0000-0002-9203-8297
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NR 38
TC 15
Z9 17
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0890-5339
EI 1531-2291
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD JUL
PY 2015
VL 29
IS 7
BP 301
EP 306
DI 10.1097/BOT.0000000000000259
PG 6
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA CK8LW
UT WOS:000356490600001
PM 25463425
DA 2026-07-24
ER

PT J
AU Pan, A
   De Angelis, G
   Nicastri, E
   Sganga, G
   Tacconelli, E
AF Pan, A.
   De Angelis, G.
   Nicastri, E.
   Sganga, G.
   Tacconelli, E.
TI Topical negative pressure to treat surgical site infections, with a
   focus on post-sternotomy infections: a systematic review and
   meta-analysis
SO INFECTION
LA English
DT Article
DE Skin and soft tissue; Infection; Topical negative pressure; Therapy
ID VACUUM-ASSISTED CLOSURE; STERNAL WOUND-INFECTION; POSTSTERNOTOMY
   MEDIASTINITIS; DEFINITIVE CLOSURE; MANAGEMENT; DRAINAGE; THERAPY
AB Topical negative pressure (TNP) has become a common treatment of infected wounds. A systematic review and meta-analysis was performed to investigate TNP efficacy compared to conventional therapy in the treatment of deep surgical site infections (SSIs), particularly post-sternotomy infections.
   MEDLINE, EMBASE, and Cochrane Central Register of Controlled Trials were searched for randomized clinical trials (RCTs) and observational studies comparing TNP to conventional treatment in deep SSIs published up to February 2012. Study quality was evaluated through the GRADE system and bias risk through the Newcastle-Ottawa scale (NOS). Primary outcome was infection cure/wound resolution rate. Secondary outcomes were adverse events, length of stay, mortality, and costs. The results are presented with 95 % confidence intervals (95 % CIs) and report estimates as odds ratios (ORs). Heterogeneity was determined through the I (2) test, with > 50 % being considered significant.
   Among 83 studies retrieved, 12 cohort studies including 873 patients were considered. All the studies were of low quality, 11/12 had a medium risk of bias, and none were RCTs. Wound resolution was obtained more frequently in TNP-treated patients as compared with continuous and closed drainage (OR 6.45, 95 % CI 3.46-12.00). TNP use was associated with significant reduction of length of stay compared with standard of care (mean difference: 8.21, 95 % CI -12.19, -4.23). High heterogeneity was detected between studies, explained by the TNP comparator type.
   The systematic review and meta-analysis suggest that TNP might be more effective than standard therapy in the cure of deep SSIs. However, multicenter RCTs are needed to confirm the potential value of this treatment.
C1 [Pan, A.] Ist Ospitalieri Cremona, Infect & Trop Dis Unit, I-26100 Cremona, Italy.
   [Pan, A.] Hlth & Social Reg Agcy Emilia Romagna, Infect Risk Area, Bologna, Italy.
   [De Angelis, G.; Tacconelli, E.] Univ Cattolica, Dept Infect Dis, Rome, Italy.
   [Nicastri, E.] Natl Inst Infect Dis Lazzaro Spallanzani, Rome, Italy.
   [Sganga, G.] Univ Cattolica, Dept Surg, Div Gen Surg & Organ Transplantat, Rome, Italy.
   [Tacconelli, E.] Univ Tubingen, Dept Infect Dis, Tubingen, Germany.
C3 Catholic University of the Sacred Heart; IRCCS Policlinico Gemelli;
   IRCCS Lazzaro Spallanzani; Catholic University of the Sacred Heart;
   IRCCS Policlinico Gemelli; Eberhard Karls University of Tubingen
RP Pan, A (通讯作者)，Ist Ospitalieri Cremona, Infect & Trop Dis Unit, I-26100 Cremona, Italy.
EM a.pan@ospedale.cremona.it
RI De Angelis, Giulia/G-1905-2018; nicastri, emanuele/K-7780-2016;
   Tacconelli, Evelina/AAC-8200-2019
OI De Angelis, Giulia/0000-0002-7087-7399; nicastri,
   emanuele/0000-0002-5606-8712; 
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NR 27
TC 6
Z9 7
U1 0
U2 12
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0300-8126
EI 1439-0973
J9 INFECTION
JI Infection
PD DEC
PY 2013
VL 41
IS 6
BP 1129
EP 1135
DI 10.1007/s15010-013-0536-6
PG 7
WC Infectious Diseases
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases
GA 253JZ
UT WOS:000327082700010
PM 24097256
DA 2026-07-24
ER

PT J
AU Petzina, R
   Ugander, M
   Gustafsson, L
   Engblom, H
   Hetzer, R
   Arheden, H
   Ingemansson, R
   Malmsjö, M
AF Petzina, Rainer
   Ugander, Martin
   Gustafsson, Lotta
   Engblom, Henrik
   Hetzer, Roland
   Arheden, Hakan
   Ingemansson, Richard
   Malmsjo, Malin
TI Topical negative pressure therapy of a sternotomy wound increases
   sternal fluid content but does not affect internal thoracic artery blood
   flow:: Assessment using magnetic resonance imaging
SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; POSTSTERNOTOMY MEDIASTINITIS; RISK-FACTORS;
   CONVENTIONAL TREATMENT; GREATER OMENTUM; COMPLICATIONS; INFECTION;
   TRANSPOSITION; SURGERY; WALL
AB Objective: Topical negative pressure therapy has excellent healing effects in poststernotomy mediastinitis. Topical negative pressure therapy reduces bacterial counts, increases wound edge microvascular blood flow and granulation tissue formation, and facilitates healing. No study has yet been performed to examine the effect of topical negative pressure on the blood and fluid content in the sternal bone marrow, which is a crucial component in osteitis.
   Methods: Eight pigs underwent median sternotomy, left internal thoracic artery harvesting, followed by topical negative pressure treatment. Magnetic resonance imaging was used to quantify both tissue fluid and/or blood content (T2-weighted short tau inversion recovery [T2-STIR]) and internal thoracic artery blood flow (flow quantification).
   Results: Before application of topical negative pressure, the T2-STIR signal intensity ratio was lower for the left than for the right hemisternum (left, 1.3; right, 2.6), indicating lower levels of tissue fluid content on the left, devascularized side. On application of topical negative pressure, the T2-STIR signal intensity ratio increased immediately for both the sternal bone and the pectoral muscle (left hemisternum after 4 minutes of topical negative pressure: 2.3), leveled off after 4 minutes, and remained unchanged for the ensuing 40 minutes, suggesting movement of fluid and/or blood into the tissue of the wound edge. Topical negative pressure did not affect blood flow in the right internal thoracic artery.
   Conclusions: T2-STIR measurements show that topical negative pressure increases sternotomy wound edge tissue fluid and/or blood content. Topical negative pressure creates a pressure gradient that presumably draws fluid from the surrounding tissue to the sternal wound edge and into the vacuum source. This "endogenous drainage'' may be one possible mechanism by which osteitis is resolved by topical negative pressure in poststernotomy mediastinitis.
C1 Lund Univ, SE-22184 Lund, Sweden.
   [Petzina, Rainer; Gustafsson, Lotta; Malmsjo, Malin] Univ Lund Hosp, Dept Med, S-22185 Lund, Sweden.
   [Engblom, Henrik; Arheden, Hakan] Univ Lund Hosp, Dept Clin Physiol, S-22185 Lund, Sweden.
   [Ingemansson, Richard] Univ Lund Hosp, Dept Cardiothorac Surg, S-22185 Lund, Sweden.
   [Petzina, Rainer; Hetzer, Roland] Deutsch Herzzentrum Berlin, Berlin, Germany.
C3 Lund University; Lund University; Skane University Hospital; Lund
   University; Skane University Hospital; Lund University; Skane University
   Hospital; German Heart Center Berlin
RP Malmsjö, M (通讯作者)，Lund Univ, BMC A13, SE-22184 Lund, Sweden.
EM malin.malmsjo@med.lu.se
RI Ugander, Martin/AAQ-4447-2021
OI Ugander, Martin/0000-0003-3665-2038; Ingemansson,
   Richard/0000-0001-7623-8953; Gustafsson, Lotta/0000-0002-9826-9133;
   Petzina, Rainer/0000-0002-0688-5482; Maljö, Malin/0000-0001-9849-9599
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   Wackenfors A, 2005, ANN THORAC SURG, V79, P1724, DOI 10.1016/j.athoracsur.2004.10.053
NR 28
TC 8
Z9 8
U1 0
U2 3
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0022-5223
EI 1097-685X
J9 J THORAC CARDIOV SUR
JI J. Thorac. Cardiovasc. Surg.
PD MAY
PY 2008
VL 135
IS 5
BP 1007
EP 1013
DI 10.1016/j.jtcvs.2007.09.070
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 295ZH
UT WOS:000255512800007
PM 18455577
OA Bronze
DA 2026-07-24
ER

PT J
AU Salciccia, A
   de Pouyade, G
   Caudron, I
   Ponthier, J
   Serteyn, D
   Sandersen, C
   Deleuze, S
   Grulke, S
AF Salciccia, Alexandra
   de la Rebiere de Pouyade, Geoffroy
   Caudron, Isabelle
   Ponthier, Jerome
   Serteyn, Didier
   Sandersen, Charlotte
   Deleuze, Stefan
   Grulke, Sigrid
TI Surgical Closure of Equine Abdomen, Prevention, and Management of
   Incisional Complications
SO JOVE-JOURNAL OF VISUALIZED EXPERIMENTS
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; EXPLORATORY CELIOTOMY; WOUND THERAPY; HORSES;
   SURGERY
AB Although rarely fatal, complications of ventral midline laparotomy incision in equine patients increase hospitalization cost and duration and may jeopardize return to athletic function. Therefore, many techniques have been developed to reduce their occurrence and expedite their resolution when they occur. Our technique of celiotomy incision closure includes the use of tension sutures (vertical U mattress) of polyglactin 910 on the linea alba , which is then apposed by polyglactin 910 interrupted sutures or a simple continuous pattern suture with a stop midway before routine closure of the superficial layers. The celiotomy incision is protected by an elastic bandage during the immediate postoperative period. This technique has been associated with favorable results: 5.3% confirmed incisional infections after a single celiotomy and 26.7% after repeat celiotomy. The overall incisional complication (serous/sanguineous discharge, hematoma, infection, hernia formation, and complete wound breakdown) occurrence was 9.5% and 33.3% after single and repeat laparotomy, respectively. In cases considered more susceptible to infection (early relaparotomy or laparotomy incisions longer than 30 cm), negative pressure therapy was found easy to apply on closed incisions. No detrimental effects were observed. However, the potential prophylactic benefit of this therapy needs to be confirmed in a larger group. In infected laparotomy wounds requiring drainage, the use of negative pressure therapy seemed to have a positive effect on the formation of granulation tissue. However, there was no control group to allow statistical confirmation. Finally, one case of complete breakdown of the laparotomy incision was managed by stainless steel retention sutures, the application of negative pressure therapy, and a hernia belt. At re-evaluation 15 months post -surgery, several small hernias were detected, but the horse had returned to his previous level of sports performance and had not shown any episode of colic.
C1 [Salciccia, Alexandra; de la Rebiere de Pouyade, Geoffroy; Caudron, Isabelle; Serteyn, Didier; Grulke, Sigrid] Univ Liege, Vet Teaching Hosp, Equine Surg, Liege, Belgium.
   [Ponthier, Jerome; Deleuze, Stefan] Univ Liege, Vet Teaching Hosp, Equine Reprod, Liege, Belgium.
   [Sandersen, Charlotte] Univ Liege, Vet Teaching Hosp, Anesthesia, Liege, Belgium.
C3 University of Liege; University of Liege; University of Liege
RP Salciccia, A (通讯作者)，Univ Liege, Vet Teaching Hosp, Equine Surg, Liege, Belgium.
EM alexandra.salciccia@uliege.be
RI ; Grulke, Sigrid/NTQ-5996-2025
OI deleuze, stefan/0000-0003-3076-5779; 
FX answering the long-term follow-up questionnaire and allowing taking
   pictures of the horse. Finally, the authors thank M. Laurent Leinartz
   for his help in editing the pictures.
CR Agarwal Pawan, 2019, J Clin Orthop Trauma, V10, P845, DOI [10.1016/j.jcot.2019.06.015, 10.1016/j.jcot.2019.06.015]
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NR 33
TC 5
Z9 5
U1 1
U2 4
PU JOURNAL OF VISUALIZED EXPERIMENTS
PI CAMBRIDGE
PA 1 ALEWIFE CENTER, STE 200, CAMBRIDGE, MA 02140 USA
SN 1940-087X
J9 JOVE-J VIS EXP
JI J. Vis. Exp.
PD MAY
PY 2024
IS 207
AR e65546
DI 10.3791/65546
PG 25
WC Multidisciplinary Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Science & Technology - Other Topics
GA A3O4U
UT WOS:001281657200011
PM 38801261
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Roughton, M
   Agarwal, S
   Song, DH
   Gottlieb, LJ
AF Roughton, Michelle
   Agarwal, Shailesh
   Song, David H.
   Gottlieb, Lawrence J.
TI Rigid sternal fixation in the management of pediatric postmedian
   sternotomy mediastinitis: A 20-year study
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Mediastinitis; Pectoralis flaps; Resorbable plates; Sternal plates;
   Congenital; Cardiac
ID VACUUM-ASSISTED CLOSURE; MEDIAN STERNOTOMY; POSTOPERATIVE MEDIASTINITIS;
   CARDIAC-SURGERY; RISK-FACTORS; MUSCLE FLAP; RECONSTRUCTION; INFECTION;
   WOUNDS; DEBRIDEMENT
AB Background and aim: Pediatric patients are at a risk of mediastinitis, a life-threatening complication of median sternotomy, following cardiac surgery for congenital conditions. Our experience with rigid internal sternal fixation in pediatric patients with postmedian sternotomy mediastinitis is presented.
   Methods and materials: A retrospective chart review was performed of patients <18 years of age diagnosed with postoperative mediastinitis between January 1, 1990 and December 31, 2009. Charts were reviewed for demographic data, cardiac history, causative microorganism, and infectious risk factors. The methods of surgical intervention including flap coverage and use and type of sternal plating (resorbable and/or titanium) were also recorded. The primary end point of interest was overall survival.
   Results: Twenty-five pediatric patients were diagnosed with postoperative mediastinitis. Rigid fixation of the sternum following debridement was performed in 20 patients (age range: 1 month-18 years), all of whom successfully tolerated the procedure. Resorbable plates were used in 13 patients. Five patients did not undergo rigid fixation due to either serious ill-health or lack of adequate sternal bone stock. No patient experienced recurrent sternal wound infection. A total of 20 patients (80%) survived to discharge. Three patients succumbed to their heart condition prior to rigid fixation, one died following sternal closure from unrelated causes, and one patient was lost to follow-up.
   Conclusions: Post-sternotomy mediastinitis in pediatric patients may be addressed using wide debridement, rigid sternal fixation, and flap coverage. In our series of 25 patients with pediatric mediastinitis, none died from mediastinitis. Placement of hardware did not adversely affect patient survival. This study demonstrates the feasibility of rigid sternal fixation. (C) 2015 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Agarwal, Shailesh] Univ Michigan, Sch Med, Sect Plast Surg, Ann Arbor, MI USA.
   [Roughton, Michelle] Univ N Carolina, Med Ctr, Div Plast & Reconstruct Surg, Chapel Hill, NC USA.
   [Song, David H.; Gottlieb, Lawrence J.] Univ Chicago, Sect Plast & Reconstruct Surg, Med Ctr, Chicago, IL 60637 USA.
C3 University of Michigan System; University of Michigan; University of
   North Carolina; University of North Carolina Chapel Hill; University of
   Chicago; University of Chicago Medical Center
RP Gottlieb, LJ (通讯作者)，Univ Chicago, Sect Plast & Reconstruct Surg, 5841 S Maryland Ave,MC 6035, Chicago, IL 60637 USA.
EM lgottlie@surgery.bsd.uchicago.edu
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NR 36
TC 4
Z9 4
U1 0
U2 3
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD DEC
PY 2015
VL 68
IS 12
BP 1656
EP 1661
DI 10.1016/j.bjps.2015.08.014
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA CX7OA
UT WOS:000365890300012
PM 26386647
DA 2026-07-24
ER

PT J
AU Succar, J
   Douaiher, J
   Lancerotto, L
   Li, Q
   Yamaguchi, R
   Younan, G
   Pejler, G
   Orgill, DP
AF Succar, Julien
   Douaiher, Jeffrey
   Lancerotto, Luca
   Li, Qiong
   Yamaguchi, Ryushiro
   Younan, George
   Pejler, Gunnar
   Orgill, Dennis P.
TI The Role of Mouse Mast Cell Proteases in the Proliferative Phase of
   Wound Healing in Microdeformational Wound Therapy
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; IMMUNE CELLS; CHYMASE; FIBRONECTIN; TRYPTASE;
   ACTIVATION; TISSUE; ANGIOGENESIS; MATRIX; LINK
AB Background: Stored in the secretory granules of cutaneous mouse mast cells are mouse mast cell proteases (mMCP-4, -5, and -6). Using transgenic mouse lines that lacked these enzymes, it was shown that mMCP-4 and mMCP-5 modulate the outcome of burn-induced skin injury. Whether or not these proteases also play a role in the repair of surgically damaged skin, with or without microdeformational wound therapy, remains to be determined.
   Methods: Wild-type C57BL/6 mice and transgenic C57BL/6 mouse lines lacking mMCP-4, -5, or -6 were subjected to surgical wounding of their skin. Wounds were splinted with a stabilizing patch, and the mice received either microdeformational wound therapy (n = 5) or occlusive dressing (n = 5) for 7 days. Wound healing parameters were assessed in the proliferative phase.
   Results: Cell proliferation in the wounded wild-type mice receiving microdeformational wound therapy was 60 +/- 3 percent. Cell proliferation was only 35 +/- 5 percent, 25 +/- 5 percent, and 45 +/- 4 percent for the treated mMCP-4, mMCP-5, and mMCP-6 null mice, respectively (p = 0.005). Blood vessel sprouting was higher in the control mice with microdeformational wound therapy (170 +/- 40 vessels/high-power field) compared with mouse mast cell protease 6 null mice with microdeformational wound therapy (70 +/- 20 vessels/high-power field; p = 0.005), and higher in the control mice with occlusive dressing (110 +/- 30 vessels/high-power field) compared with mMCP-4 null mice with occlusive dressing (50 +/- 20 vessels/high-power field; p = 0.01). Qualitatively, the granulation tissue of all the protease-deficient groups receiving microdefoimational wound therapy was disrupted.
   Conclusion: Results suggest that mouse mast cell proteases 4, 5, and 6 are mediators of the critical role mast cells play in microdefoi national wound therapy in the proliferative phase of healing.
C1 Univ Kentucky, Dept Gen Surg, Lexington, KY 40506 USA.
   Johns Hopkins Univ, Dept Gen Surg, Baltimore, MD 21218 USA.
   Univ Padua, Dept Plast Surg, I-35100 Padua, Italy.
   Changzheng Hosp, Dept Plast Surg, Shanghai, Peoples R China.
   Mito Chuo Hosp, Dept Surg, Mito, Ibaraki, Japan.
   Inova Fairfax Hosp, Dept Gen Surg, Falls Church, VA USA.
   Swedish Univ Agr Sci, Dept Anat Physiol & Biochem, S-90183 Umea, Sweden.
   Brigham & Womens Hosp, Div Plast Surg, Boston, MA 02115 USA.
   Harvard Univ, Sch Med, Cambridge, MA 02138 USA.
C3 University of Kentucky; Johns Hopkins University; University of Padua;
   Naval Medical University; Inova Fairfax Hospital; Swedish University of
   Agricultural Sciences; Harvard University; Harvard University Medical
   Affiliates; Brigham & Women's Hospital; Harvard University
RP Orgill, DP (通讯作者)，75 Francis St, Boston, MA 02115 USA.
EM dorgill@partners.org
RI ; Orgill, Dennis/H-7596-2019; Lancerotto, Luca/A-5745-2013
OI Younan, George/0000-0001-8502-4850; 
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   Younan GJ, 2011, PLAST RECONSTR SURG, V128, p649E, DOI 10.1097/PRS.0b013e318230c55d
   Zhao XY, 2008, MOL CELL BIOCHEM, V310, P159, DOI 10.1007/s11010-007-9676-2
NR 54
TC 14
Z9 18
U1 0
U2 12
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD SEP
PY 2014
VL 134
IS 3
BP 459
EP 467
DI 10.1097/PRS.0000000000000432
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA AO1JU
UT WOS:000341069200008
PM 24814421
DA 2026-07-24
ER

PT J
AU Wójcik, JZ
   Safranow, K
   Pieróg, J
   Wójcik, NJ
   Wojtys, ME
   Grodzki, T
AF Wojcik, Janusz Zenon
   Safranow, Krzysztof
   Pierog, Jaroslaw
   Wojcik, Norbert Janusz
   Wojtys, Malgorzata Edyta
   Grodzki, Tomasz
TI Does postpneumonectomy empyema improve long-term survival for patients
   with lung cancer?
SO NEOPLASMA
LA English
DT Article
DE empyema; lung cancer; accelerated treatment
ID VACUUM-ASSISTED CLOSURE; ACCELERATED TREATMENT; PNEUMONECTOMY;
   IMMUNOTHERAPY; THORACOPLASTY; IRRIGATION; MANAGEMENT
AB Postpneumonectomy empyema (PPE) is life-threatening morbidity that affects up to 10% of patients and carries a 9???13% mortality risk. Treatment can take a long time, and the prognosis is uncertain. Forty years ago, improved survival was reported among patients with lung cancer and pleural empyema compared to those with lung cancer and no empyema. Here we investigated this potential association among patients with PPE. The present study included 38 patients who underwent pneumonectomy between 1995???2007 (7 females, 31 males, median age of 62 years) and then developed PPE, which was treated with the accelerated treatment (AT) method. Thirty-five of these patients had been diagnosed with lung cancer (including one case of carcinoid with infiltration), of whom 31 were matched with 31 lung cancer patients who underwent uncomplicated pneumonectomy at the same center between 1997-2009. The two groups did not significantly differ regarding sex, age, histology, TNM, FEV1, major co-morbidities, or received neoadjuvant or adjuvant therapy. Thirty-five (92.1%) patients from the initial group were treated successfully and the 5-and 10-year survival rates were 69% and 51%, respectively. Comparison between the matched groups revealed longer survival rates in the empyema group (5-year, 70%; 10-year, 49%) compared to the group without empyema (5-year, 38%; 10-year, 18%). Compared to the group without empyema, the empyema group showed significantly longer survival for all-cause mortality (p=0.004) and a lower incidence of cancer unrelated mortality (p=0.02). The two groups did not significantly differ with regard to cancer-related mortality (p=0.09). In conclusion, accelerated treatment is a safe and effective method for the treatment of pleural empyema after pneumonectomy. The presently achieved results indicate improvement in survival of lung cancer patients with PPE in comparison to lung cancer patients after uncomplicated pneumonectomy.
C1 [Wojcik, Janusz Zenon; Pierog, Jaroslaw; Wojcik, Norbert Janusz; Wojtys, Malgorzata Edyta; Grodzki, Tomasz] Pomeranian Med Univ, Lung Dis Inst, Thorac Surg & Transplantat Dept, Szczecin, Poland.
   [Safranow, Krzysztof] Pomeranian Med Univ, Lung Dis Inst, Dept Biochem & Med Chem, Szczecin, Poland.
C3 Pomeranian Medical University; Pomeranian Medical University
RP Wójcik, NJ (通讯作者)，Pomeranian Med Univ, Lung Dis Inst, Thorac Surg & Transplantat Dept, Szczecin, Poland.
EM noert@wp.pl
RI Wójcik, Janusz/HNI-1040-2023; Safranow, Krzysztof/B-5127-2015; Wojtyś,
   Małgorzata/AAI-1798-2019
CR Bagan P, 2006, J THORAC CARDIOV SUR, V132, P708, DOI 10.1016/j.jtcvs.2006.05.014
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NR 24
TC 1
Z9 1
U1 0
U2 1
PU AEPRESS SRO
PI BRATISLAVA
PA BAJZOVA 7, BRATISLAVA, 821 08, SLOVAKIA
SN 0028-2685
EI 1338-4317
J9 NEOPLASMA
JI Neoplasma
PY 2022
VL 69
IS 3
BP 723
EP 728
DI 10.4149/neo_2022_211207N1746
PG 6
WC Oncology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology
GA 2M9IH
UT WOS:000818004200005
PM 35330999
OA Bronze
DA 2026-07-24
ER

PT J
AU Uhl, C
   Götzke, H
   Woronowicz, S
   Betz, T
   Töpel, I
   Steinbauer, M
AF Uhl, Christian
   Goetzke, Hannah
   Woronowicz, Sandra
   Betz, Thomas
   Toepel, Ingolf
   Steinbauer, Markus
TI Treatment of Lymphatic Complications after Common Femoral Artery
   Endarterectomy
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article
ID VACUUM-ASSISTED-CLOSURE; LYMPHOCUTANEOUS FISTULAS; VASCULAR PROCEDURES;
   FIBRIN GLUE; MANAGEMENT; THERAPY; RECONSTRUCTION; RADIOTHERAPY; SURGERY;
   BYPASS
AB Background: This study analyzes the outcome of lymphatic complications after a standard vascular procedure.
   Methods: This is a retrospective study including patients who had a lymphatic complication after endarterectomy and patch of the common femoral artery in our clinic between March 2007 and June 2018. Therapy of choice was selected according to wound situation and amount of lymphatic liquid. If signs of a wound infection occurred, a surgical therapy was performed; in all other cases a nonsurgical treatment (conservative treatment, radiotherapy) was chosen.
   Results: We performed 977 index operations, a lymphatic complication occurred in 112 cases (11.5%). In 69 cases the lymphatic complication presented as lymphatic fistula (Group 1), in 43 cases as lymphorrhea from the wound (Group 2). Nonsurgical treatment was done in 66 cases (Group 1: 76.8% vs. Group 2: 30.2%; P < 0.000), and a surgical treatment was necessary in 46 cases (Group 1: 23.2% vs. Group 2: 69.8%; P < 0.000). Indication for surgery was Szilagyi 1 infection in 25 cases, Szilagyi 2 infection in 11 cases, and Szilagyi 3 infection in 10 cases. Patients with Szilagyi 1 infections received negative wound pressure therapy (NWPT). A muscle flap in combination with an NWPT was performed in patients with Szilagyi 2 infections. In Szilagyi 3 infections, the patch was replaced; additionally, a muscle flap and an NWPT were performed. The median hospital stay was 13 days in the nonsurgical group and 22.5 days in the surgical group. We had no bleeding complications and no reinfection during follow-up. The median observation period was 23.0 months. Age >= 80 years was associated with an increased risk for lymphatic complications.
   Conclusions: The therapy of lymphatic complications should be done in accordance with clinical symptoms. A nonsurgical treatment is often sufficient. However, in cases of a wound infection different surgical treatments are necessary.
C1 [Uhl, Christian; Goetzke, Hannah; Woronowicz, Sandra; Betz, Thomas; Toepel, Ingolf; Steinbauer, Markus] BHB, Dept Vasc Surg, Regensburg, Germany.
RP Uhl, C (通讯作者)，Krankenhaus Barmherzige Bruder Regensburg, Dept Vasc Surg, Prufeninger Str 86, D-93049 Regensburg, Germany.
EM christian.uhl@barm-herzige-regensburg.de
RI Uhl, Christian/GRJ-3390-2022
OI Uhl, Christian/0000-0001-9367-882X
CR Aydin U, 2015, VASCULAR, V23, P41, DOI 10.1177/1708538114529950
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   Siracuse JJ, 2013, J VASC SURG, V57, P700, DOI 10.1016/j.jvs.2012.09.049
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NR 21
TC 17
Z9 17
U1 0
U2 1
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 0890-5096
EI 1615-5947
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD JAN
PY 2020
VL 62
BP 382
EP 386
DI 10.1016/j.avsg.2019.06.011
PG 5
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA JV1GK
UT WOS:000502115400053
PM 31449944
DA 2026-07-24
ER

PT J
AU Kao, AM
   Cetrulo, LN
   Baimas-George, MR
   Prasad, T
   Heniford, BT
   Davis, BR
   Kasten, KR
AF Kao, Angela M.
   Cetrulo, Lawrence N.
   Baimas-George, Maria R.
   Prasad, Tanushree
   Heniford, Brant Todd
   Davis, Bradley R.
   Kasten, Kevin R.
TI Outcomes of open abdomen versus primary closure following emergent
   laparotomy for suspected secondary peritonitis: A propensity-matched
   analysis
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article; Proceedings Paper
CT Owen Wangensteen Scientific Forum / 104th Annual Clinical Congress and
   Scientific Forum of the American-College-of-Surgeons (ACS)
CY OCT 20-25, 2018
CL Boston, MA
SP Amer Coll Surg
DE Open abdomen; vacuum-assisted closure; on-demand laparotomy; emergency;
   peritonitis
ID DAMAGE-CONTROL; MANAGEMENT; COMPLICATIONS
AB BACKGROUND Optimal management following index laparotomy is poorly defined in secondary peritonitis patients. Although "open abdomen" (OA), or temporary abdominal closure with planned relaparotomy, is used to reassess bowel viability or severity of contamination, recent studies demonstrate comparable morbidity and mortality with primary abdominal closure (PC). This study evaluates differences between OA and PC following emergent laparotomy. METHODS Using the Premier database at a quaternary care center (2012-2016), nontrauma patients with secondary peritonitis requiring emergent laparotomy were identified (N = 534). Propensity matching for PC (n = 331; 62%) or OA (n = 203; 38%) was performed using variables: Mannheim Peritonitis Index, lactate, and vasopressor requirement. One hundred eleven closely matched pairs (PC:OA) were compared. RESULTS Five hundred thirty-four patients (55.0% female; mean age, 59.6 +/- 15.5 years) underwent emergent laparotomy. Of the OA patients, 136 (67.0%) had one relaparotomy, while 67 (33.0%) underwent multiple reoperations. Compared to daytime cases, laparotomies performed overnight (6 pm-6 am) had more temporary closures with OA (42.8% OA vs. 57.2% PC, p = 0.04). When assessing by surgeon type, PC was performed in 78.7% of laparotomies by surgical subspecialties compared to 56.7% (p < 0.0001) of acute care surgeons. After propensity matching, OA patients had increased postoperative complications (71.2% vs. 41.4%, p < 0.0001), mortality (22.5% vs. 11.7%, p = 0.006), and longer median length of stay (13 vs. 9 days, p = 0.0001). CONCLUSION Open abdomen was performed in 38.0% of patients, with one-third of those requiring multiple reoperations. Complications, mortality rates, and costs associated with OA were significantly increased when compared to PC. Given these findings, future studies are needed to determine appropriate indications for OA.
C1 [Kao, Angela M.; Cetrulo, Lawrence N.; Baimas-George, Maria R.; Prasad, Tanushree; Heniford, Brant Todd; Davis, Bradley R.; Kasten, Kevin R.] Carolinas Med Ctr, Dept Surg, Div Gastrointestinal & Minimally Invas Surg, Charlotte, NC 28203 USA.
C3 Carolinas Medical Center
RP Kasten, KR (通讯作者)，1025 Morehead Med Dr,Suite 300, Charlotte, NC 28203 USA.
EM kevin.kasten@atriumhealth.org
OI Baimas-George, Maria/0000-0002-6649-4627
CR Bleszynski MS, 2016, AM J SURG, V211, P926, DOI 10.1016/j.amjsurg.2016.01.012
   Coccolini F, 2017, WORLD J EMERG SURG, V12, P1, DOI DOI 10.1186/s13017-016-0112-3
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   Holzheimer RG., 2001, Surgical Treatment: Evidence-Based and Problem- Oriented
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NR 22
TC 29
Z9 33
U1 0
U2 1
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD SEP
PY 2019
VL 87
IS 3
BP 623
EP 629
DI 10.1097/TA.0000000000002345
PG 7
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC General & Internal Medicine; Surgery
GA IU8KC
UT WOS:000483829500021
PM 31045736
DA 2026-07-24
ER

PT J
AU Poncelet, AJ
   Lengele, B
   Delaere, B
   Zech, F
   Glineur, D
   Funken, JC
   El Khoury, G
   Noirhomme, P
AF Poncelet, Alain Jean
   Lengele, Benoit
   Delaere, Benedicte
   Zech, Francis
   Glineur, David
   Funken, Jean-Christophe
   El Khoury, Gebrine
   Noirhomme, Philippe
TI Algorithm for primary closure in sternal wound infection: a single
   institution 10-year experience
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE surgery cardiothoracic; bypass coronary surgery; mediastinitis; decision
   making
ID LONG-TERM SURVIVAL; VACUUM-ASSISTED CLOSURE; BYPASS GRAFT-SURGERY;
   POST-STERNOTOMY MEDIASTINITIS; RISK-FACTORS; CARDIAC-SURGERY;
   POSTSTERNOTOMY MEDIASTINITIS; POSTOPERATIVE MEDIASTINITIS;
   COMPLICATIONS; MICROBIOLOGY
AB Objectives: To evaluate a simple treatment algorithm in sternal wound infection (SWI) allowing for primary closure and to describe the different surgical techniques and their associated morbidity and mortality. Methods: A retrospective analysis of all patients operated on between 1996 and 2004 in a single tertiary care institution. All epidemiological and surgical data were prospectively collected in our database. Univariate and multivariate analysis were used to determine preoperative and perioperative risks factors for 90-day and long-term mortality. Results: Out of 5905 procedures, 146 sternal wound infections were documented (2.4%). The respective incidence of SWI for CABG, isolated valve, or combined procedures were 2.8%, 1.1%, and 3.2%. Pathogens involved were S. epidermidis (44.5%), S. aureus (31.5%), and gram-negative rods (19.2%). Reoperation was required in 131/146 patients. Mean time to the first re-operation was 17.3 +/- 12 days. Modalities of treatment consisted of drainage atone (44 patients), rewiring (25 patients), debridement, rewiring and mediastinal lavage (52 patients), and partial/complete sternal resection (10 patients). Additional procedures were required in 49 patients (37.7%). The 90-day mortality for uninfected patients and patients with superficial SWI were 4.4% and 2.8% (p = 0.78) whereas for patients with deep SWI, 90-day mortality was 14.5% (DSWI vs others, p < 0.0001). Conclusions: Deep sternal wound infection (DSWI) remains a dreadful complication in contemporary cardiac surgery while risk factors are currently well defined. Using a simple approach of primary closure together with liberal use of vascularized flaps has allowed us to achieve satisfactory short-term outcome in this subset of patients. (c) 2007 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
C1 [Glineur, David; Funken, Jean-Christophe; El Khoury, Gebrine; Noirhomme, Philippe] Catholic Univ Louvain, Clin Univ St Luc, Dept Thorac & Cardiovasc Surg, B-1200 Brussels, Belgium.
   [Delaere, Benedicte; Zech, Francis] Catholic Univ Louvain, Clin Univ St Luc, Dept Infect Dis, B-1200 Brussels, Belgium.
   [Lengele, Benoit] Catholic Univ Louvain, Clin Univ St Luc, Dept Plast & Reconstruct Surg, B-1200 Brussels, Belgium.
C3 Universite Catholique Louvain; Cliniques Universitaires Saint-Luc;
   Universite Catholique Louvain; Cliniques Universitaires Saint-Luc;
   Universite Libre de Bruxelles; Universite Catholique Louvain; Cliniques
   Universitaires Saint-Luc
RP Poncelet, AJ (通讯作者)，Catholic Univ Louvain, Clin Univ St Luc, Cardio Vasc & Thoracic Surg Unit, Ave Hippocrate 10, B-1200 Brussels, Belgium.
EM poncelet@chir.ucl.ac.be
RI Poncelet, Alain/ABD-2969-2022
OI Zech, Francis/0000-0002-5224-3712
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NR 22
TC 20
Z9 22
U1 0
U2 3
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
EI 1873-734X
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD FEB
PY 2008
VL 33
IS 2
BP 232
EP 238
DI 10.1016/j.ejcts.2007.11.016
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 270XC
UT WOS:000253752500022
PM 18082415
OA Bronze
DA 2026-07-24
ER

PT J
AU Anslot, C
   Hulin, S
   Durandy, Y
AF Anslot, Christine
   Hulin, Sylvie
   Durandy, Yves
TI Postoperative mediastinitis in children: Improvement of simple primary
   closed drainage
SO ANNALS OF THORACIC SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; PEDIATRIC CARDIAC-SURGERY; POSTSTERNOTOMY
   MEDIASTINITIS; RISK-FACTORS; FULMINANT MEDIASTINITIS; REDON CATHETERS;
   BLOOD CULTURE; MUSCLE FLAP; MANAGEMENT; INFECTION
AB Background. Mediastinitis is a significant cause of postoperative morbidity. In 1989, we proposed simple primary closed drainage as a new treatment. Our goal is to describe improvements made to the original technique.
   Methods. After wound debridement, infected areas were drained with Redon catheters connected to strong negative-pressure drainage bottles. Mediastinal effluents were cultured every day, and the catheters were withdrawn when the effluent culture was negative for microorganisms. Patients were classified into three groups: isolated mediastinitis ( group 1), mediastinitis associated with endocarditis ( group 2), and mediastinitis associated with other organ failure ( group 3).
   Results. Sixty-four patients were treated during a 10-year period: 15 neonates, 33 infants, and 16 children. Group 1 consisted of 40 patients. The time to mediastinal sterilization was 4 days ( range, 1 to 14 days), and the antibiotic course was 11 days ( range, 7 to 28 days), with a hospital stay of 13 days ( range, 10 to 30 days). No deaths occurred in this group. Group 2 consisted of 7 patients. The time to mediastinal sterilization was 8 days ( range, 3 to 10 days), and the antibiotic course was 30 days ( range, 26 to 37 days), with a hospital stay of 37 days ( range, 20 to 54 days). One patient in group 2 did not survive. Group 3 consisted of 17 patients. The time to mediastinal sterilization was 6 days ( range, 1 to 10 days), and the antibiotic course was 15 days ( range, 10 to 31 days), with a hospital stay of 20 days ( range, 18 to 36 days). Two patients in group 3 did not survive. None of the deaths was directly related to mediastinitis, as the mediastinum was sterile in all 3 patients before death.
   Conclusions. This simple treatment was efficient and reliable in achieving mediastinal sterilization. In addition, short antibiotic courses decreased restraint, which is poorly tolerated in pediatric patients.
C1 Inst Hosp Jacques Cartier, Intens Care Unit Pediat Cardiac Surg, F-91300 Massy, France.
C3 Jacques Cartier Private Hospital
RP Durandy, Y (通讯作者)，Inst Hosp Jacques Cartier, Intens Care Unit Pediat Cardiac Surg, Ave Noyer Lambert, F-91300 Massy, France.
EM iciprea@icip.org
CR Abu-Omar Y, 2003, ANN THORAC SURG, V76, P974, DOI 10.1016/S0003-4975(03)00180-2
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NR 24
TC 10
Z9 11
U1 0
U2 1
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0003-4975
EI 1552-6259
J9 ANN THORAC SURG
JI Ann. Thorac. Surg.
PD AUG
PY 2007
VL 84
IS 2
BP 423
EP 428
DI 10.1016/j.athoracsur.2007.03.064
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 192HS
UT WOS:000248192400009
PM 17643610
DA 2026-07-24
ER

PT J
AU Alnemri, A
   Moroco, A
   Garg, N
   Bridgham, K
   Davis, M
   Kaki, P
   McCann, A
   Thal, A
   Krein, H
   Heffelfinger, R
AF Alnemri, Angela
   Moroco, Annie
   Garg, Neha
   Bridgham, Kelly
   Davis, Matt
   Kaki, Praneet
   McCann, Adam
   Thal, Arielle
   Krein, Howard
   Heffelfinger, Ryan
TI Timing of Split Thickness Skin Grafting for Radial Forearm Free Flaps on
   Donor Site Morbidity
SO MICROSURGERY
LA English
DT Article
DE dermal regeneration matrix; donor site morbidity; free flap
   reconstruction
ID INTEGRA ARTIFICIAL DERMIS; CLINICAL-TRIAL; RECONSTRUCTION; FULL;
   CLOSURE; HEAD
AB Introduction The radial forearm free flap (RFFF) is a versatile free flap in the reconstruction of head and neck defects. There is little consensus on the optimal technique for reconstructing RFFF donor site defects. Our group previously reported early results using staged reconstruction with initial placement of Integra, a dermal regeneration matrix, followed by a split thickness skin graft (STSG), resulting in excellent aesthetic and functional outcomes. Here we provide our long-term experience using staged STSG compared to primary STSG for the reconstruction of RFFF donor site defects.Methods Patients undergoing RFFF reconstruction of head and neck defects at a single institution between May 2012 and April 2023 were retrospectively reviewed. Primary versus staged STSG placement was compared in terms of donor site morbidity.Results A total of 179 patients were included: 46 (25.7%) primary STSG and 133 (73.3%) staged STSG. Following primary STSG, 34 (73.9%) patients had a vacuum-assisted closure (VAC) and 12 (26.1%) had an iodine-coated petroleum gauze bolster placed. In the staged STSG group, all patients had a VAC after Integra placement. After the second stage, 30 (22.6%) patients had a VAC, and 103 (77.4%) patients had a bolster placed. Compared to the staged group, the primary group had a significantly higher rate of skin graft breakdown (21.7% vs. 6.0%; p = 0.008) and tendon exposure (19.6% vs. 3.8%; p = 0.002). In the staged group, bolster placement was associated with a lower rate of skin graft breakdown compared to VAC (2.9% vs. 16.7%; p = 0.015).Conclusion When reconstructing donor site defects following RFFFs, staged reconstruction with initial placement of Integra followed by STSG and bolster placement may result in lower rates of skin graft breakdown and tendon exposure.
C1 [Alnemri, Angela; Moroco, Annie; Garg, Neha; Bridgham, Kelly; McCann, Adam; Thal, Arielle; Krein, Howard; Heffelfinger, Ryan] Thomas Jefferson Univ Hosp, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19107 USA.
   [Davis, Matt; Kaki, Praneet] Thomas Jefferson Univ, Sidney Kimmel Med Coll, Philadelphia, PA USA.
C3 Thomas Jefferson University; Thomas Jefferson University
RP Alnemri, A (通讯作者)，Thomas Jefferson Univ Hosp, Dept Otolaryngol Head & Neck Surg, Philadelphia, PA 19107 USA.
EM angela.alnemri2@jefferson.edu
RI Heffelfinger, Ryan/PWF-5484-2026; THAL, Arielle/IQV-1528-2023
OI THAL, Arielle/0000-0002-7498-8512; Bridgham, Kelly/0000-0001-7043-0602
CR Abbate V, 2021, J CRANIOFAC SURG, V32, pE205, DOI 10.1097/SCS.0000000000006808
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NR 37
TC 1
Z9 1
U1 0
U2 0
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0738-1085
EI 1098-2752
J9 MICROSURG
JI Microsurgery
PD JAN 7
PY 2026
VL 46
IS 1
AR e70174
DI 10.1002/micr.70174
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA AS3UK
UT WOS:001655620700001
PM 41499483
OA Bronze
DA 2026-07-24
ER

PT J
AU Chen, XH
   Deng, ZL
   He, YF
   Lu, F
   Yuan, Y
AF Chen, Xihang
   Deng, Zilong
   He, Yunfan
   Lu, Feng
   Yuan, Yi
TI Mechanical Strain Promotes Proliferation of Adipose-Derived Stem Cells
   Through the Integrin β1-Mediated RhoA/Myosin Light Chain Pathway
SO TISSUE ENGINEERING PART A
LA English
DT Article
DE ADSCs; strain; adipose tissue; proliferation; integrin; GTPase RhoA;
   p-MLC
ID VACUUM-ASSISTED CLOSURE; CYTOSKELETAL TENSION; FAT; REGENERATION; RGD;
   MECHANOTRANSDUCTION; DIFFERENTIATION; TRANSDUCTION; FIBRONECTINS;
   ACTIVATION
AB External volume expansion (EVE) promotes proliferation of adipose-derived stem cells (ADSCs) during adipose tissue regeneration. However, the mechanism by which EVE is translated into biochemical signals and subsequently induces proliferation of ADSCs is poorly understood. Here, we investigated the strain in adipose tissue and mechanochemical signaling upon EVE in rats. In addition, the effect of mechanical strain on proliferation of ADSCs was assessed using a custom-built Flexcell device. The level of strain in adipose tissue upon EVE peaked at week 1 and then decreased over time, and the cell proliferation rate was similarly affected. Mechanical strain-dependent activation of integrin beta 1 and the RhoA/myosin light chain (MLC) pathway was involved in cell proliferation. The proliferation rate of ADSCs was higher under 12% mechanical strain than under 6% and 0% mechanical strain in vitro. Mechanical strain-dependent activation of integrin beta 1 promoted activation of the small GTPase RhoA and phosphorylation of MLC. Furthermore, knockdown of integrin beta 1 attenuated activation of the RhoA/MLC pathway and proliferation of ADSCs in response to mechanical strain. Taken together, this study provides the first evidence of mechanochemical signaling in response to EVE. These data may help elucidate the effects of different strain levels on adipose tissue regeneration.
   Impact statement
   External volume expansion (EVE) induces adipose tissue regeneration and has great therapeutic potential to correct soft tissue defects. This study showed that EVE promotes proliferation of adipose-derived stem cells by activating integrin beta 1 and its crucial downstream signaling molecules, namely the small GTPase RhoA and p-myosin light chain. The findings of this study may assist clinical tissue engineering applications and provide new insights into the regulation of adipose tissue regeneration in clinical practice.
C1 [Chen, Xihang; He, Yunfan; Lu, Feng; Yuan, Yi] Southern Med Univ, Dept Plast & Reconstruct Surg, Nanfang Hosp, 1838 Guangzhou North Rd, Guangzhou 510515, Peoples R China.
   [Deng, Zilong] Southern Med Univ, Nanfang Hosp, Dept Stomatol, Guangzhou, Peoples R China.
   [Deng, Zilong] Southern Med Univ, Coll Stomatol, Guangzhou, Peoples R China.
C3 Southern Medical University - China; Southern Medical University -
   China; Southern Medical University - China
RP Lu, F; Yuan, Y (通讯作者)，Southern Med Univ, Dept Plast & Reconstruct Surg, Nanfang Hosp, 1838 Guangzhou North Rd, Guangzhou 510515, Peoples R China.
EM doctorlufeng@hotmail.com; yuanyinfyy@outlook.com
RI He, yunfan/KRO-4274-2024
FU National Nature Science Foundation of China [81671931, 81701920,
   81871573]; President Foundation of Nanfang Hospital [2016C032, 2016b001,
   2019C010]
FX This work was supported by the National Nature Science Foundation of
   China (81671931, 81701920, 81871573) and the President Foundation of
   Nanfang Hospital (2016C032, 2016b001, 2019C010).
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NR 55
TC 13
Z9 14
U1 1
U2 12
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1937-3341
EI 1937-335X
J9 TISSUE ENG PT A
JI Tissue Eng. Part A
PD SEP 1
PY 2020
VL 26
IS 17-18
BP 939
EP 952
DI 10.1089/ten.tea.2019.0266
EA MAR 2020
PG 14
WC Cell & Tissue Engineering; Cell Biology; Engineering, Biomedical;
   Materials Science, Biomaterials
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Engineering; Materials Science
GA NQ0CK
UT WOS:000525233400001
PM 32066340
DA 2026-07-24
ER

PT J
AU Mencio, MA
   Ontiveros, E
   Burdick, JS
   Leeds, SG
AF Mencio, Marissa A.
   Ontiveros, Estrellita
   Burdick, James S.
   Leeds, Steven G.
TI Use of a novel technique to manage gastrointestinal leaks with
   endoluminal negative pressure: a single institution experience
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article
DE Esophageal perforation; Endoluminal vacuum therapy; Gastrointestinal
   leaks; Anastomotic leak; Bariatric complication; Sleeve leak
ID VACUUM-ASSISTED CLOSURE; SYSTEM E-VAC; ANASTOMOTIC INSUFFICIENCY; SLEEVE
   GASTRECTOMY; GASTRIC LEAKS; THERAPY; PERFORATIONS; ESOPHAGECTOMY;
   COMPLICATIONS; METAANALYSIS
AB Perforations and anastomotic leaks of the gastrointestinal tract are severe complications, which carry high morbidity and mortality and management of these is a multi-disciplinary challenge. The use of endoluminal vacuum (EVAC) therapy has recently proven to be a useful technique to manage these complications. We report our institution's experience with this novel technique in the chest, abdomen, and pelvis.
   This is a retrospective review of an IRB approved registry of all EVAC therapy patients from July 2013 to December 2016. A total of 55 patients were examined and 49 patients were eligible for inclusion: 15 esophageal, 21 gastric, 3 small bowel, and 10 colorectal defects. The primary endpoint was closure rate of the GI tract defect with EVAC therapy.
   Fifteen (100%) esophageal defects closed with EVAC therapy. Mean duration of therapy was 27 days consisting of an average of 6 endosponge changes every 4.8 days. Eighteen (86%) gastric defects closed with EVAC therapy. Mean duration of therapy was 38 days with a mean of 9 endosponge changes every 5.3 days. Three (100%) small bowel defects closed with EVAC therapy. Mean duration of therapy was 13.7 days with a mean of 2.7 endosponge changes every 4.4 days. Six (60%) colorectal defects closed with EVAC therapy. Mean duration of therapy was 23.2 days, consisting of a mean of 6 endosponge changes every 4.0 days. There were two deaths, which were not directly related to EVAC therapy and occurred outside the measured 30-day mortality.
   Our experience demonstrates that EVAC therapy is feasible and effective for the management of gastrointestinal perforations/leaks throughout the GI tract and can be considered as a safe alternative to surgical intervention in select cases.
C1 [Mencio, Marissa A.; Ontiveros, Estrellita; Leeds, Steven G.] Baylor Univ, Div Minimally Invas Surg, Med Ctr Dallas, 3500 Gaston Ave,1st Floor Roberts Hosp, Dallas, TX 75246 USA.
   [Burdick, James S.] Baylor Univ, Med Ctr Dallas, Dept Gastroenterol, Dallas, TX USA.
C3 Baylor University; Baylor University Medical Center; Baylor University
   Medical Center; Baylor University
RP Leeds, SG (通讯作者)，Baylor Univ, Div Minimally Invas Surg, Med Ctr Dallas, 3500 Gaston Ave,1st Floor Roberts Hosp, Dallas, TX 75246 USA.
EM Steven.Leeds@BSWHealth.org
CR Ahrens M, 2010, ENDOSCOPY, V42, P693, DOI 10.1055/s-0030-1255688
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NR 27
TC 43
Z9 52
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD JUL
PY 2018
VL 32
IS 7
BP 3349
EP 3356
DI 10.1007/s00464-018-6055-x
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA GI4SN
UT WOS:000434361600040
PM 29362911
DA 2026-07-24
ER

PT J
AU Benninger, E
   Laschke, MW
   Cardell, M
   Keel, M
   Seifert, B
   Trentz, O
   Menger, MD
   Meier, C
AF Benninger, Emanuel
   Laschke, Matthias W.
   Cardell, Markus
   Keel, Marius
   Seifert, Burkhardt
   Trentz, Otmar
   Menger, Michael D.
   Meier, Christoph
TI Intra-Abdominal Pressure Development After Different Temporary Abdominal
   Closure Techniques in a Porcine Model
SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
LA English
DT Article
DE Temporary abdominal closure; Intra-abdominal pressure; Abdominal
   compartment syndrome; Animal model; Abdominal injuries; Intra-abdominal
   hypertension
ID COMPARTMENT SYNDROME; OPEN ABDOMEN; FASCIAL CLOSURE; SILO CLOSURE;
   TRAUMA; HYPERTENSION; WOUNDS
AB Background: Decompressive laparotomy followed by temporary abdominal closure (TAC) is an established prophylaxis and treatment for abdominal compartment syndrome. The herein presented study aimed at the comparison of volume reserve capacity and development of intra-abdominal hypertension after forced primary abdominal closure and different TAC techniques in a porcine model.
   Methods: Eight anesthesized and mechanically ventilated domestic pigs underwent a standardized midline laparotomy. A bag was placed into the abdominal cavity. Before abdominal closure, the bag was prefilled with 3,000 mL water to simulate increased intra-abdominal volume. The intra-abdominal pressure (IAP) was then increased in 2 mm Hg steps up to 30 turn Hg by adding volume (volume reserve capacity) to the intra-abdominal bag. Volume reserve capacity with the corresponding IAP were analyzed and compared for primary abdominal closure, bag silo closure, a zipper system, and vacuum-assisted closure (VAC) with different negative pressures (-50, -100, and -150 mm Hg). Hemodynamic and pulmonary parameters were monitored throughout the experiment.
   Results: Volume reserve capacity was the highest for bag silo closure followed by the zipper system and VAC with primary abdominal closure providing the least volume reserve capacity in the whole LAP range. Of interest, VAC -50 nun Hg resulted in a lower volume reserve capacity when compared with VAC -100 and -150 mm Hg. Pulmonary and hemodynamic parameters demonstrated no significant differences between primary abdominal closure and the evaluated TAC techniques at all IAP levels.
   Conclusions: The present experimental in vivo study indicates that bag silo closure and zipper systems may be favorable TAC techniques after decompressive laparotomy. In contrast, the VAC techniques resulted in lower volume reserve capacity and therefore may bear an increased risk for recurrent intra-abdominal hypertension in the initial phase after decompressive laparotomy.
C1 [Benninger, Emanuel; Cardell, Markus; Keel, Marius; Trentz, Otmar; Meier, Christoph] Univ Zurich Hosp, Div Trauma Surg, CH-8091 Zurich, Switzerland.
   [Laschke, Matthias W.; Menger, Michael D.] Univ Saarland, Inst Clin & Expt Surg, D-6600 Saarbrucken, Germany.
   [Seifert, Burkhardt] Univ Zurich, ISPM, Biostat Unit, Zurich, Switzerland.
C3 University of Zurich; University Zurich Hospital; Saarland University;
   University of Zurich
RP Meier, C (通讯作者)，Univ Zurich Hosp, Div Trauma Surg, Raemistr 100, CH-8091 Zurich, Switzerland.
EM christoph.meier@usz.ch
OI Seifert, Burkhardt/0000-0002-5829-2478; Laschke, Matthias
   W/0000-0002-7847-8456
CR [Anonymous], SPSS COMP PROGR VERS
   [Anonymous], EUR J TRAUMA
   Balogh Z, 2003, J TRAUMA, V54, P848, DOI 10.1097/01.TA.0000070166.29649.F3
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NR 24
TC 17
Z9 18
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0022-5282
EI 1529-8809
J9 J TRAUMA
JI J. Trauma-Injury Infect. Crit. Care
PD APR
PY 2009
VL 66
IS 4
BP 1118
EP 1124
DI 10.1097/TA.0b013e3181820d94
PG 7
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 431KI
UT WOS:000265059800029
PM 19359923
OA Green Accepted
DA 2026-07-24
ER

PT J
AU Selçuk, E
   Erem, M
   Yildirim, S
   Çopuroglu, C
   Çiftdemir, M
   Erkal, D
AF Selcuk, Esref
   Erem, Murat
   Yildirim, Savas
   Copuroglu, Cem
   Ciftdemir, Mert
   Erkal, Dogukan
TI Risk factors and rates of revision amputation following ischemic lower
   major limb amputations: A 10-year retrospective analysis
SO JOINT DISEASES AND RELATED SURGERY
LA English
DT Article
DE Amputation; chronic limb threatening ischemia; reoperation; risk
   factors; peripheral arterial disease
ID PERIPHERAL ARTERY-DISEASE; MORTALITY; THERAPY
AB Objectives: This study aimed to evaluate the rates and risk factors associated with revision amputation following ischemic lower major limb amputations, focusing on cases related to peripheral arterial disease. Patients and methods: This retrospective study included 253 patients (174 males, 79 females; mean age: 73.1 +/- 12.2 years; range, 44 to 99 years) who underwent ischemic foot amputation between December 2012 and December 2022. Eligible patients were over 18 years old and had major lower extremity amputations due to peripheral arterial disease or chronic arterial occlusion. Exclusions were made for amputations due to diabetic foot conditions, trauma, tumors, or osteomyelitis and minor lower extremity amputations. Results: Above-knee amputations were the most common type of amputation, accounting for 56.5% (n=143) of cases. Revision amputations occurred in 27.3% (n=69) of patients, with significantly higher rates in those with open wounds at first admission (chi-square [chi(2) ]=9.81, p=0.002). Patients with occlusion at the popliteal artery level had a higher rate of revision amputation following below-knee amputation (p=0.034). Each additional year of age decreased the likelihood of revision amputation by 2.3% (p=0.049). Vacuum-assisted closure therapy was associated with higher revision rates (chi(2) =22.71, p<0.001). Patients who developed infections (n=40) had a significantly higher rate of revision amputations (n=26, p<0.001). Elevated preoperative C-reactive protein levels were also correlated with an increased risk of revision (p=0.006). Conclusion: Patients with ischemic lower limb amputations, particularly those presenting with open wounds, are at higher risk for revision amputation. Elevated preoperative C-reactive protein levels, infections, age, and the initial level of amputation significantly impact the likelihood of reamputation.
C1 [Selcuk, Esref; Erem, Murat; Yildirim, Savas; Copuroglu, Cem; Ciftdemir, Mert; Erkal, Dogukan] Trakya Univ, Fac Med, Dept Orthoped & Traumatol, Edirne, Turkiye.
C3 Trakya University
RP Selçuk, E (通讯作者)，Trakya Univ, Tip Fak, Ortoped & Travmatol Anabilim Dali, TR-22030 Edirne, Turkiye.
EM trkesref@hotmail.com
RI yıldırım, savaş/ACV-1803-2022; selçuk, eşref/HDM-6006-2022; Erem,
   Murat/P-6240-2018
OI yıldırım, savaş/0000-0003-0677-4720; Çiftdemir,
   Mert/0000-0002-9677-2819; selçuk, eşref/0000-0002-1657-1110; Erem,
   Murat/0000-0002-9743-5515; Erkal, Doğukan/0000-0001-7390-5781
CR Aday AW, 2021, CIRC RES, V128, P1818, DOI 10.1161/CIRCRESAHA.121.318535
   Atik OS, 2023, JOINT DIS RELAT SURG, V34, DOI 10.52312/jdrs.2023.57916
   Barnes JA, 2020, ARTERIOSCL THROM VAS, V40, P1808, DOI 10.1161/ATVBAHA.120.314595
   Behrendt CA, 2018, EUR J VASC ENDOVASC, V56, P391, DOI 10.1016/j.ejvs.2018.04.017
   Birmpili P, 2023, BJS-BRIT J SURG, V110, P958, DOI 10.1093/bjs/znad134
   Chan AS, 2019, VASCULAR, V27, P8, DOI 10.1177/1708538118797544
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   Wilkin G, 2014, J BONE JOINT SURG AM, V96A, P1378, DOI 10.2106/JBJS.M.01010
NR 21
TC 5
Z9 5
U1 0
U2 4
PU TURKISH JOINT DISEASES FOUNDATION
PI CANKAYA
PA MUSTAFA KEMAL MAHALLESI, DUMLUPINAR BULVARI 274-2 C2 BLOK OFIS, 5,
   CANKAYA, ANKARA, Turkiye
EI 2687-4792
J9 JOINT DIS RELAT SURG
JI Joint Dis. Relat. Surg.
PY 2025
VL 36
IS 1
BP 174
EP 181
DI 10.52312/jdrs.2025.203
PG 8
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA Q9N5Y
UT WOS:001387855200021
PM 39719915
DA 2026-07-24
ER

PT J
AU Perezgrovas-Olaria, R
   Audisio, K
   Cancelli, G
   Rahouma, M
   Ibrahim, M
   Soletti, G Jr
   Chadow, D
   Demetres, M
   Girardi, LN
   Gaudino, M
AF Perezgrovas-Olaria, Roberto
   Audisio, Katia
   Cancelli, Gianmarco
   Rahouma, Mohamed
   Ibrahim, Mudathir
   Soletti Jr, Giovanni
   Chadow, David
   Demetres, Michelle
   Girardi, Leonard N.
   Gaudino, Mario
TI Deep Sternal Wound Infection and Mortality in Cardiac Surgery: A
   Meta-analysis
SO ANNALS OF THORACIC SURGERY
LA English
DT Review
ID LONG-TERM SURVIVAL; VACUUM-ASSISTED CLOSURE; THORACIC-ARTERY GRAFTS;
   RISK-FACTORS; MEDIASTINITIS; IMPACT; PREVENTION; COMPLICATIONS;
   MANAGEMENT; GUIDELINE
AB BACKGROUND Deep sternal wound infection (DSWI) is a rare but severe complication after cardiac surgical proced-ures and has been associated with increased early morbidity and mortality. Studies reporting long-term outcomes in patients with DSWI have shown contradictory results. We performed a study-level meta-analysis evaluating the impact of DSWI on short-and long-term clinical outcomes.METHODS A systematic literature search was conducted to identify studies comparing short-and long-term outcomes of patients submitted to cardiac surgical procedures who developed DSWI and patients who did not. The primary outcome was overall mortality. Secondary outcomes were in-hospital mortality, follow-up mortality, major adverse cardiovascular events, myocardial infarction, and repeat revascularization. Postoperative outcomes were also investigated.RESULTS Twenty-four studies totaling 407829 patients were included. Overall, 6437 (1.6%) patients developed DSWI. Mean follow-up was 3.5 years. DSWI was associated with higher overall mortality (incidence rate ratio [IRR], 1.99; 95% CI, 1.66-2.38; P < .001), in-hospital mortality (odds ratio, 3.30; 95% CI, 1.88-5.81; P < .001), follow-up mortality (IRR, 2.02; 95% CI, 1.39-2.94; P [ .001), and major adverse cardiovascular events (IRR, 2.04; 95% CI, 1.60-2.59; P < .001). No differences in myocardial infarction and repeat revascularization were found, but limited studies reported those out-comes. DSWI was associated with longer postoperative hospitalization, stroke, myocardial infarction, and respiratory and renal failure. Sensitivity analyses on isolated coronary artery bypass grafting studies and by adjustment method were consistent with the main analysis. CONCLUSIONS Compared with patients who did not develop DSWI, patients with DSWI after cardiac surgical procedures had increased risk of death as well as short-and long-term adverse clinical outcomes.
C1 [Gaudino, Mario] Weill Cornell Med, Dept Cardiothorac Surg, 525 E 68th St, New York, NY 10065 USA.
   Maimonides Hosp, Dept Gen Surg, Brooklyn, NY USA.
   Weill Cornell Med, Samuel J Wood Lib, New York, NY 10065 USA.
   Weill Cornell Med, CV Starr Biomed Informat Ctr, New York, NY 10065 USA.
C3 Cornell University; Weill Cornell Medicine; Maimonides Medical Center;
   Cornell University; Weill Cornell Medicine; Cornell University; Weill
   Cornell Medicine
RP Gaudino, M (通讯作者)，Weill Cornell Med, Dept Cardiothorac Surg, 525 E 68th St, New York, NY 10065 USA.
EM mfg9004@med.cornell.edu
RI Rahouma, Mohamed/H-8964-2016; IBRAHIM, MUDATHIR/AAZ-1557-2020
OI IBRAHIM, MUDATHIR/0000-0002-6345-1533; Soletti,
   Giovanni/0000-0002-8691-5951; Demetres, Michelle/0000-0002-4997-7707
FU Enrico ed Enrica Sovena Foundation, Italy
FX Gianmarco Cancelli is supported by a grant from the Enrico ed Enrica
   Sovena Foundation, Italy.
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   Schimmer C, 2008, ANN THORAC SURG, V86, P1897, DOI 10.1016/j.athoracsur.2008.08.071
   Schwann TA, 2021, ANN THORAC SURG, V111, P600, DOI 10.1016/j.athoracsur.2020.05.044
   Sears ED, 2016, WORLD J SURG, V40, P2673, DOI 10.1007/s00268-016-3598-7
   Shapira OM, 2018, NEW ENGL J MED, V378, P2134, DOI 10.1056/NEJMe1804750
   Sjögren J, 2005, ANN THORAC SURG, V80, P1270, DOI 10.1016/j.athoracsur.2005.04.010
   Steingrimsson S, 2008, SCAND CARDIOVASC J, V42, P208, DOI 10.1080/14017430801919557
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   Zia A, 2020, SURG INFECT, V21, P323, DOI 10.1089/sur.2018.142
NR 44
TC 47
Z9 60
U1 2
U2 8
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 0003-4975
EI 1552-6259
J9 ANN THORAC SURG
JI Ann. Thorac. Surg.
PD JAN
PY 2023
VL 115
IS 1
BP 272
EP 280
DI 10.1016/j.athoracsur.2022.04.054
EA DEC 2022
PG 9
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 7S7ZV
UT WOS:000910971300001
PM 35618048
DA 2026-07-24
ER

PT J
AU Lee, ZH
   Stranix, JT
   Rifkin, WJ
   Daar, DA
   Anzai, L
   Ceradini, DJ
   Thanik, V
   Saadeh, PB
   Levine, JP
AF Lee, Z-Hye
   Stranix, John T.
   Rifkin, William J.
   Daar, David A.
   Anzai, Lavinia
   Ceradini, Daniel J.
   Thanik, Vishal
   Saadeh, Pierre B.
   Levine, Jamie P.
TI Timing of Microsurgical Reconstruction in Lower Extremity Trauma: An
   Update of the Godina Paradigm
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; FREE-FLAP
   RECONSTRUCTION; OPEN TIBIAL FRACTURES; FREE TISSUE TRANSFER; LOWER-LIMB
   INJURY; COVERAGE; MANAGEMENT; OUTCOMES; SURGERY
AB Background: Marko Godina, in his landmark paper in 1986, established the principle of early flap coverage for reconstruction of traumatic lower extremity injuries. The aim of this study was to determine how timing influences outcomes in lower extremity traumatic free flap reconstruction based on Godina's original findings. Methods: A retrospective review identified 358 soft-tissue free flaps from 1979 to 2016 for below knee trauma performed within 1 year of injury. Patients were stratified based on timing of coverage: 3 days or less (early), 4 to 90 days (delayed), and more than 90 days (late). The delayed group was further divided into two groups: 4 to 9 days and 10 to 90 days. Flap outcomes were examined based on timing of reconstruction. Results: Flaps performed within 3 days after injury compared with between 4 to 90 days had decreased risk of major complications (OR, 0.40, p = 0.04). A receiver operating curve demonstrated day 10 to be the optimal day for predicting flap success. Flaps performed less than or equal to 3 days versus 4 to 9 days had no differences in any flap outcomes. In contrast, flaps performed within 4 to 9 days of injury compared to within 10 to 90 days were associated with significantly lower total flap failure rates (relative risk, 0.29, p = 0.025) and major complications (relative risk, 0.37, p = 0.002). Conclusions: Early free flap reconstruction performed within 3 days of injury had superior outcomes compared with the delayed (4 to 90 day) group, consistent with Godina's original findings. However, as an update to his paradigm, this ideal early period of reconstruction can be safely extended to within 10 days of injury without an adverse effect on outcomes.
C1 [Lee, Z-Hye; Stranix, John T.; Rifkin, William J.; Daar, David A.; Anzai, Lavinia; Ceradini, Daniel J.; Thanik, Vishal; Saadeh, Pierre B.; Levine, Jamie P.] New York Univ Langone Hlth, Hansjorg Wyss Dept Plast Surg, 305 East 33rd St, New York, NY 10016 USA.
C3 New York University
RP Lee, ZH (通讯作者)，New York Univ Langone Hlth, Hansjorg Wyss Dept Plast Surg, 305 East 33rd St, New York, NY 10016 USA.
EM z-hye.lee@med.nyu.edu
RI ; Rifkin, William/AAG-1533-2020
OI Stranix, John/0000-0002-9770-6127; Thanik, Vishal/0000-0001-5637-3824;
   Rifkin, William/0000-0002-2314-4125; Levine, Jamie/0009-0009-6163-8490;
   Saadeh, Pierre/0000-0001-9818-8598
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 23
TC 81
Z9 97
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD SEP
PY 2019
VL 144
IS 3
BP 759
EP 767
DI 10.1097/PRS.0000000000005955
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA IU7BM
UT WOS:000483739400075
PM 31461042
DA 2026-07-24
ER

PT J
AU Kuriyama, M
   Yoshida, Y
   Ninomiya, H
   Yamamoto, S
   Sasaguri, S
   Akita, S
   Mitsukawa, N
AF Kuriyama, Motone
   Yoshida, Yukitaka
   Ninomiya, Hitoshi
   Yamamoto, Shin
   Sasaguri, Shiro
   Akita, Shinsuke
   Mitsukawa, Nobuyuki
TI Efficacy of a novel strategy for poststernotomy deep sternal infection
   after thoracic aorta replacement using a prosthetic graft
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Deep sternal wound; infections; Mediastinitis; Sternal osteomyelitis;
   Aortic replacement; Prosthetic graft; Strategy
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; RISK-FACTORS;
   CARDIAC-SURGERY; POSTOPERATIVE MEDIASTINITIS; CONVENTIONAL TREATMENT;
   CLOSED DRAINAGE; OSTEOMYELITIS; MANAGEMENT; FLAPS
AB Background: Poststernotomy deep sternal wound infections are persistent and occasionally fatal, especially in cases involving prosthetic grafts, because of their complicated structure and virtual impossibility of removal. We aimed to verify the influence of cooperation with plastic surgeons and our novel strategy for treating deep sternal wound infection after aortic replacement on cardiovascular surgery outcomes.
   Patients and Methods: Nine hundred eighty-three consecutive patients were divided into two groups: an early group (2012-2013) and a late group (2014-2015). The late group had received cooperatively improved perioperative wound management: our novel strategy of deep sternal infection based on radical debridement and immediate reconstruction decided by reference to severities of the patient's general condition and widespread infection by early intervention of plastic surgeons. The groups were analysed retrospectively. Binary variables were analysed statistically with the Fisher exact test and continuous variables with the Mann-Whitney U test. Inter-group differences were assessed with the chi-square test.
   Results: Twenty of 390 cases in the early group and 13 of 593 cases in the late group were associated with deep sternal infection. Morbidity rates of deep sternal wound infection and associated mortality rates 1 year after reconstruction surgery were significantly less (p < 0.05 for both) in the late group.
   Conclusions: Intervention by plastic surgeons improved perioperative wound management outcomes. Our treatment strategy for deep sternal wound infection also reduced associated mortality rates. Facilities should consider the early inclusion of plastic surgeons in the treatment of patients undergoing aortic replacement to facilitate better outcomes. (C) 2018 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Kuriyama, Motone; Yoshida, Yukitaka] Kochi Med Sch Hosp, Dept Plast & Reconstruct Surg, 185-1 Kohasu,Oko Cho, Nankoku, Kochi 7838505, Japan.
   [Kuriyama, Motone; Yamamoto, Shin; Sasaguri, Shiro] Kawasaki Saiwai Hosp, Aort Ctr, Kawasaki, Kanagawa, Japan.
   [Ninomiya, Hitoshi] Kochi Univ, Kochi Med Sch, Integrated Ctr Adv Med Technol, Nankoku, Kochi, Japan.
   [Akita, Shinsuke; Mitsukawa, Nobuyuki] Chiba Univ, Dept Plast Reconstruct & Aesthet Surg, Chiba, Japan.
C3 Kochi University; Kochi University; Chiba University
RP Kuriyama, M (通讯作者)，Kochi Med Sch Hosp, Dept Plast & Reconstruct Surg, 185-1 Kohasu,Oko Cho, Nankoku, Kochi 7838505, Japan.
EM jm-motone-k@kochi-u.ac.jp
OI Mitsukawa, Nobuyuki/0000-0002-0234-8241; Akita,
   Shinsuke/0000-0001-7075-6602; Kuriyama, Motone/0000-0002-1424-7501
CR Baillot R, 2010, EUR J CARDIO-THORAC, V37, P880, DOI 10.1016/j.ejcts.2009.09.023
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NR 39
TC 3
Z9 4
U1 0
U2 2
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD MAY
PY 2018
VL 71
IS 5
BP 699
EP 709
DI 10.1016/j.bjps.2018.02.004
PG 11
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA GD6WO
UT WOS:000430649700011
PM 29500112
DA 2026-07-24
ER

PT J
AU Rajput, S
   Kuruoglu, D
   Salinas, CA
   Sen, I
   Kalra, M
   Moran, SL
AF Rajput, Sanjna
   Kuruoglu, Doga
   Salinas, Cristina A.
   Sen, Indrani
   Kalra, Manju
   Moran, Steven L.
TI Flap management of groin wounds following vascular procedures: A review
   of 270 flaps for vascular salvage
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Review
DE Vascular bypass; Groin; Flap; Rectus femoris flap; Sartorius flap
ID PROPHYLACTIC MUSCLE FLAPS; VACUUM-ASSISTED CLOSURE; RECTUS FEMORIS FLAP;
   BACTERIAL INOCULATION; INFECTION; COVERAGE
AB Background: Groin dehiscence following vascular procedures results in morbidity for patients with peripheral vascular disease. Controversy exists around the indications for flap coverage. We present an institutional experience with flap reconstruction of groin wounds after vascular procedures to identify predictors of beneficial outcomes.Patients and methods: A retrospective review of patients who had flap coverage for infected/ nonhealing groin wounds following a vascular procedure between 1998 and 2021 was performed. Demographics and clinical characteristics, including flap and vascular graft type, were collected along with major complications. Univariate and multivariable logistic regression analyses were performed to assess the associations between procedures and major complications.Results: A total of 270 flaps were transferred to 237 patients. Thirty-three patients had bi- lateral wounds. The mean age and BMI were 67 +/- 11 years and 27.9 +/- 6.3 kg/m2, respectively. Flaps included rectus femoris (n = 142), sartorius (n = 118), rectus abdominis (n = 7), and gracilis (n = 3). Covered vascular grafts included prosthetic materials (n = 200) and autografts (n = 70). The median length of hospital stay after surgery was 10 days (interquartile range=12), and the mean follow-up was 29.1 +/- 39.2 months. The major complication rate was 38.5% with wound infection being the most common. Flaps successfully prevented the infection-related removal of the grafts in 98.9% of cases. Multivariable analysis revealed no significant associa- tions between variables and having a major complication. Conclusions: Flap coverage of the inguinal vessels can be performed safely with favorable limb salvage. Wound complications were high, but graft salvage was excellent. Rectus femoris and sartorius muscle flaps were the most common flaps, yielding comparable outcomes.(c) 2023 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Rajput, Sanjna; Salinas, Cristina A.] Mayo Clin, Alix Sch Med, Rochester, MN USA.
   [Kuruoglu, Doga; Moran, Steven L.] Mayo Clin, Dept Surg, Div Plast Surg, Rochester, MN USA.
   [Sen, Indrani; Kalra, Manju] Mayo Clin, Dept Surg, Div Vasc & Endovasc Surg, Rochester, MN USA.
   [Moran, Steven L.] Mayo Clin, Dept Surg, Div Plast Surg, 200 1st St SW, Rochester, MN 55905 USA.
C3 Mayo Clinic; Mayo Clinic; Mayo Clinic; Mayo Clinic
RP Moran, SL (通讯作者)，Mayo Clin, Dept Surg, Div Plast Surg, 200 1st St SW, Rochester, MN 55905 USA.
EM Moran.Steven@mayo.edu
RI ; Kuruoglu, Doga/AAM-7907-2021; RAJPUT, SANJNA/PDW-3907-2025
OI Rajput, Sanjna/0000-0002-8305-421X; Kuruoglu, Doga/0000-0002-7008-5033; 
CR Ali AT, 2016, J VASC SURG, V64, P452, DOI 10.1016/j.jvs.2016.03.010
   Alkon JD, 2005, PLAST RECONSTR SURG, V115, P776, DOI 10.1097/01.PRS.0000152436.50604.04
   Berríos SI, 2017, JAMA SURG, V152, P784, DOI 10.1001/jamasurg.2017.0904
   Bhangu A, 2013, JAMA SURG, V148, P779, DOI 10.1001/jamasurg.2013.2336
   CHANG N, 1982, PLAST RECONSTR SURG, V70, P1
   Chatterjee A, 2015, PLAST RECONSTR SURG, V135, P1707, DOI 10.1097/PRS.0000000000001267
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   Fischer JP, 2013, J PLAST RECONSTR AES, V66, P1396, DOI 10.1016/j.bjps.2013.06.014
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   Mirzabeigi MN, 2017, ANN VASC SURG, V43, P232, DOI 10.1016/j.avsg.2017.02.010
   Morasch MD, 2004, J VASC SURG, V39, P1277, DOI 10.1016/j.jvs.2004.02.011
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   Ryer EJ, 2020, J VASC SURG, V71, P905, DOI 10.1016/j.jvs.2019.05.052
   Sörelius K, 2019, IN VIVO, V33, P1, DOI 10.21873/invivo.11431
   Verma H, 2015, INT WOUND J, V12, P317, DOI 10.1111/iwj.12110
   Wallace AB, 2022, ANN VASC SURG, V78, P77, DOI 10.1016/j.avsg.2021.05.049
   World Health Organization (WHO), WHO/Europe | Nutrition-Body mass index-BMI
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   Wübbeke LF, 2020, J VASC SURG, V72, P1050, DOI 10.1016/j.jvs.2019.11.031
   Yeager R A, 1992, Ann Vasc Surg, V6, P485
NR 22
TC 13
Z9 16
U1 0
U2 1
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD MAR
PY 2023
VL 78
BP 38
EP 47
DI 10.1016/j.bjps.2023.01.028
EA FEB 2023
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA G7ZB5
UT WOS:000991283700001
PM 36822101
DA 2026-07-24
ER

PT J
AU Wakabayashi, N
   Sakai, A
   Takada, H
   Hoshi, T
   Sano, H
   Ichinose, S
   Suzuki, H
   Ogawa, R
AF Wakabayashi, Nao
   Sakai, Atsushi
   Takada, Hiroya
   Hoshi, Takayuki
   Sano, Hitomi
   Ichinose, Shizuko
   Suzuki, Hidenori
   Ogawa, Rei
TI Noncontact Phased-Array Ultrasound Facilitates Acute Wound Healing in
   Mice
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article; Proceedings Paper
CT 48th Annual Meeting of the Japanese-Society-for-Wound-Healing
CY NOV 29-30, 2018
CL Tokyo, JAPAN
SP Japanese Soc Wound Healing
ID VACUUM-ASSISTED CLOSURE; SHOCK-WAVE THERAPY; ANGIOGENESIS; ROLES
AB Background:
   The authors developed a noncontact low-frequency ultrasound device that delivers high-intensity mechanical force based on phased-array technology. It may aid wound healing because it is likely to be associated with lower risks of infection and heat-induced pain compared with conventional ultrasound methods. The authors hypothesized that the microdeformation it induces accelerates wound epithelialization. Its effects on key wound-healing processes (angiogenesis, collagen accumulation, and angiogenesis-related gene transcription) were also examined.
   Methods:
   Immediately after wounding, bilateral acute wounds in C57BL/6J mice were noncontact low-frequency ultrasound- and sham-stimulated for 1 hour/day for 3 consecutive days (10 Hz/90.6 Pa). Wound closure (epithelialization) was recorded every 2 days as the percentage change in wound area relative to baseline. Wound tissue was procured on days 2, 5, 7, and 14 (five to six per time point) and subjected to histopathology with hematoxylin and eosin and Masson trichrome staining, CD31 immunohistochemistry, and quantitative polymerase-chain reaction analysis.
   Results:
   Compared to sham-treated wounds, ultrasound/phased-array-treated wounds exhibited significantly accelerated epithelialization (65 +/- 27 percent versus 30 +/- 33 percent closure), angiogenesis (4.6 +/- 1.7 percent versus 2.2 +/- 1.0 percent CD31(+) area), and collagen deposition (44 +/- 14 percent versus 28 +/- 13 percent collagen density) on days 5, 2, and 5, respectively (all p < 0.05). The expression of Notch ligand delta-like 1 protein (Dll1) and Notch1, which participate in angiogenesis, was transiently enhanced by treatment on days 2 and 5, respectively.
   Conclusions:
   The authors' noncontact low-frequency ultrasound phased-array device improved the wound-healing rate. It was associated with increased early neovascularization that was followed by high levels of collagen-matrix production and epithelialization. The device may expand the mechanotherapeutic proangiogenesis field, thereby helping stimulate a revolution in infected wound care.
C1 Nippon Med Sch, Dept Plast Reconstruct & Aesthet Surg, Tokyo, Japan.
   Nippon Med Sch, Dept Pharmacol, Tokyo, Japan.
   Pixie Dust Technol, Dept R&D, Tokyo, Japan.
C3 Nippon Medical School; Nippon Medical School
RP Takada, H (通讯作者)，Nippon Med Sch, Dept Plast Reconstruct & Aesthet Surg, Bunkyo Ku, 1-1-5 Sendagi, Tokyo 1138602, Japan.
EM h-takada@nms.ac.jp
OI Takada, Hiroya/0000-0003-4825-1493; Sakai, Atsushi/0000-0002-3996-8022
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NR 30
TC 13
Z9 15
U1 0
U2 15
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD FEB
PY 2020
VL 145
IS 2
BP 348E
EP 359E
DI 10.1097/PRS.0000000000006481
PG 12
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA LH1RS
UT WOS:000528567100021
PM 31985636
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Mirzabeigi, MN
   Fischer, JP
   Basta, MN
   Fracol, M
   Kovach, SJ
   Wu, LC
   Serletti, JM
   Low, DW
   Kanchwala, S
AF Mirzabeigi, Michael N.
   Fischer, John P.
   Basta, Marten N.
   Fracol, Megan
   Kovach, Stephen J.
   Wu, Liza C.
   Serletti, Joseph M.
   Low, David W.
   Kanchwala, Suhail
TI Managing Groin Wounds after Infrainguinal Vascular Procedures: Examining
   the Reoperative Events and Complication Profile of Muscle Flap
   Reconstruction
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; RECTUS FEMORIS FLAP; SZILAGYI GRADE III;
   NEGATIVE-PRESSURE; GRAFT INFECTION; SARTORIUS; MANAGEMENT; THERAPY;
   SURGERY; SALVAGE
AB Background: The literature has been void of large outcome studies detailing the efficacy and complication profile of muscle flap reconstruction of complex groin wounds. Furthermore, a first-line choice for muscle flap selection remains unclear. The aim of this study is 2-fold: (1) to examine the complication profile and associated risk factors following muscle flap coverage and (2) to provide a compared efficacy analysis of the sartorius muscle flap (SMF) versus the rectus femoris flap (RFF) in the treatment of wounds following an infrainguinal vascular procedure.
   Methods: A retrospective review of records was performed on all patients undergoing complex groin wound reconstruction from January 2005 to September 2014.
   Results: A total of 201 flaps were performed on 184 patients. There were no sentinel bleeding events through the course of graft salvage or perioperative morbidity beyond local wound complications. Coronary artery disease (P = 0.049), dyslipidemia (P < 0.001), diabetes (P = 0.047), and history of multiple prior infrainguinal procedures (P = 0.029) were associated with increased complications following groin wound reconstruction. There was no statistically significant difference in complications in comparing the RFF versus the SMF (27.9% vs. 38.9% respectively; P = 0.109). There was no significant difference in the rates of graft salvage in comparing the RFF versus the SMF (21.6% vs. 16.1%, respectively; P = 0.459).
   Conclusions: Muscle flap coverage can be safely employed for vascular graft salvage. Medical comorbidities and multiple prior infrainguinal procedures are predictive of perioperative complications. The SMF and RFF demonstrated equivocal rates of complications and graft salvage. Given that the RFF risks increased functional morbidity and necessitates a second donor site, the SMF may be considered as an effective first-line approach for reconstruction of complex groin wounds.
C1 [Mirzabeigi, Michael N.; Fischer, John P.; Basta, Marten N.; Fracol, Megan; Kovach, Stephen J.; Wu, Liza C.; Serletti, Joseph M.; Low, David W.; Kanchwala, Suhail] Univ Penn Hlth Syst, Dept Surg, Div Plast Surg, Philadelphia, PA USA.
C3 University of Pennsylvania
RP Mirzabeigi, MN (通讯作者)，Dept Surg, Div Plast Surg, South Pavilion,7th Floor,3400 Civic Ctr Blvd, Philadelphia, PA 19104 USA.
EM michael.mirzabeigi@uphs.upenn.edu
RI Basta, Marten/I-8953-2019
OI Basta, Marten/0000-0002-9937-5886
CR Alkon JD, 2005, PLAST RECONSTR SURG, V115, P776, DOI 10.1097/01.PRS.0000152436.50604.04
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NR 40
TC 18
Z9 19
U1 0
U2 3
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0890-5096
EI 1615-5947
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD AUG
PY 2017
VL 43
BP 232
EP 241
DI 10.1016/j.avsg.2017.02.010
PG 10
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA FG8SH
UT WOS:000410706700025
PM 28478163
DA 2026-07-24
ER

PT J
AU Tubaki, VR
   Rajasekaran, S
   Shetty, AP
AF Tubaki, Vijay Ramappa
   Rajasekaran, S.
   Shetty, Ajoy Prasad
TI Effects of Using Intravenous Antibiotic Only Versus Local
   Intrawound Vancomycin Antibiotic Powder Application in Addition to
   Intravenous Antibiotics on Postoperative Infection in Spine Surgery in
   907 Patients
SO SPINE
LA English
DT Article
DE local antibiotics; vancomycin powder; wound infection; spine surgery;
   safety
ID CARE-ASSOCIATED INFECTIONS; SURGICAL SITE INFECTIONS; VACUUM-ASSISTED
   CLOSURE; WOUND INFECTIONS; EXPERIMENTAL OSTEOMYELITIS; DELIVERY-SYSTEM;
   CALCIUM-SULFATE; OPEN FRACTURES; IN-VITRO; PROPHYLAXIS
AB Study Design. A prospective randomized controlled trial.
   Objective. To assess the ability of local vancomycin powder in controlling postoperative infection in spine surgery.
   Summary of Background Data. Despite improvements through the use of prophylactic systemic antibiotics, surgical site infections remain a significant problem in spine surgical procedures. Various retrospective and prospective studies have reported the efficacy of local application of vancomycin powder in reducing the infection in animal and human studies. However, there were no randomized control trials that reported on its efficacy.
   Methods. Prospective randomized controls of 907 patients with various spinal pathologies were treated surgically during a period of 18 months. The control group received standard systemic prophylaxis only, whereas the treatment group received vancomycin powder in the surgical wound in addition to systemic prophylaxis. Patient demographics, comorbidities, level of spinal pathology, estimated blood loss, nutritional status, and hemoglobin were recorded. Incidence of infection was the primary outcome evaluated.
   Results. There were 8 infections (1.68%) in the control group (6 instrumented and 2 noninstrumented, 6 deep and 2 superficial) with bacteria cultured in 3 (1 Escherichia coli and 2 Staphylococcus aureus). In the treatment group, 7 infections (1.61%) were observed (6 instrumented and 1 noninstrumented surgical procedures, 6 deep and 1 superficial) with bacteria cultured in 3 (1 Staphylococcus aureus and 2 Klebsiella). No adverse effects were observed from the use of vancomycin powder. Statistically no significant difference was seen in infection rate between the treatment group and control group.
   Conclusion. The local application of vancomycin powder in surgical wounds did not significantly reduce the incidence of infection in patients with surgically treated spinal pathologies. The use of vancomycin powder may not be effective when incidence of infection is low.
C1 [Tubaki, Vijay Ramappa; Rajasekaran, S.; Shetty, Ajoy Prasad] Ganga Hosp, Dept Orthopaed & Spine Surg, Coimbatore 641011, Tamil Nadu, India.
RP Rajasekaran, S (通讯作者)，Ganga Hosp, Dept Orthopaed & Spine Surg, 313 Mettupalayam Rd, Coimbatore 641011, Tamil Nadu, India.
EM sr@gangahospital.com
RI shetty, Ajoy/AFB-1748-2022; Rajasekaran, Shanmuganathan/ABG-7570-2020
OI Shetty, Ajoy/0000-0001-5885-7152
FU Ganga Orthopaedic Research and Education Foundation
FX Ganga Orthopaedic Research and Education Foundation funds were received
   to support this work.
CR [Anonymous], EUR SPINE J S4
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NR 42
TC 181
Z9 217
U1 0
U2 23
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0362-2436
EI 1528-1159
J9 SPINE
JI SPINE
PD DEC 1
PY 2013
VL 38
IS 25
BP 2149
EP 2155
DI 10.1097/BRS.0000000000000015
PG 7
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA 299FP
UT WOS:000330381500013
PM 24048091
DA 2026-07-24
ER

PT J
AU Ross, RE
   Aflaki, P
   Gendics, C
   Lantis, JC
AF Ross, R. E.
   Aflaki, P.
   Gendics, C.
   Lantis, J. C., II
TI Complex lower extremity wounds treated with skin grafts and NPWT: a
   retrospective review
SO JOURNAL OF WOUND CARE
LA English
DT Review
DE split-thickness skin grafts; negative wound pressure therapy; lower
   extremity wounds
ID VACUUM-ASSISTED CLOSURE; NEGATIVE-PRESSURE DRESSINGS; FOREARM DONOR
   SITE; LEG ULCERS; BOLSTER; DEVICE; SURVIVAL
AB Objective: To evaluate a single centre experience with the use of NPWT for securing split-thickness skin grafts in the management of specifically lower extremity chronic wounds, including revascularised arterial wounds, amputations, diabetic and venous leg ulcers.
   Method:A seven-year retrospective review of a prospectively maintained database of all the patients who underwent primary split-thickness skin grafts (STSG) with immediate postoperative NPWT for at least 96 hours was carried out. The percentage graft take after removal of NPWT device and clinical follow-up date were reviewed.
   Results: A total of 59 skin grafts procedures had adequate follow up to be reviewed. This included 39% post-debridement/ amputation wounds in patients that presented with diabetic foot infection/ gangrene, 31% venous leg ulcers, and 31% other post-surgical wounds (arterial ulcers that had undergone revascularisation). The mean percentage graft survival after removal of VAC was 94%; 63% of cases had complete graft survival, 25% had 90-99% survival, and 8.5% had 80-89% survival. Outpatient follow up ranged from 2 weeks to 5 years (mean of 10 months). Fifteen per cent of patients were lost to follow up, and of the remaining patients, 76% remained completely healed, 10% remained partially healed, and 14% lost the entire STSG.
   Conclusion: Patients with STSG secured with NPWT required fewer repeated grafting procedures, had very high initial graft survival with complete recipient bed coverage, and had good long term wound closure rates compared with historical controls. While retrospective reviews, such as this, support NPWT as a good method of STSG affixation, the paucity of reviews of other methods does not allow for good historic comparison, so a well enrolled prospective trial would be of use.
C1 [Ross, R. E.; Aflaki, P.; Gendics, C.; Lantis, J. C., II] Columbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Div Vasc Endovasc Surg, New York, NY 10027 USA.
C3 Mount Sinai West; Columbia University; Mount Sinai Morningside
RP Ross, RE (通讯作者)，Columbia Univ, Coll Phys & Surg, St Lukes Roosevelt Hosp Ctr, Div Vasc Endovasc Surg, New York, NY 10027 USA.
EM Jcl161@columbia.edu
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   Zuhaili B, 2010, PLAST RECONSTR SURG, V125, P855, DOI 10.1097/PRS.0b013e3181ccdc42
NR 30
TC 20
Z9 24
U1 0
U2 19
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD OCT
PY 2011
VL 20
IS 10
BP 490
EP +
DI 10.12968/jowc.2011.20.10.490
PG 5
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 931BR
UT WOS:000303189700007
PM 22067888
DA 2026-07-24
ER

PT J
AU van Koperen, PJ
   Henegouwen, MIV
   Rosman, C
   Bakker, CM
   Heres, P
   Slors, JFM
   Bemelman, WA
AF van Koperen, P. J.
   Henegouwen, M. I. van Berge
   Rosman, C.
   Bakker, C. M.
   Heres, P.
   Slors, J. F. M.
   Bemelman, W. A.
TI The Dutch multicenter experience of the Endo-Sponge treatment for
   anastomotic leakage after colorectal surgery
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article; Proceedings Paper
CT 16th Annual Meeting of the European-Association-of-Endoscopic-Surgery
   (EAES)
CY JUN 11-14, 2008
CL Stockholm, SWEDEN
SP European Assoc Endoscop Surg (EAES)
DE Anastomotic leakage; Rectal surgery; Vacuum-assisted closure
ID RECTAL-CANCER; RISK-FACTORS; MESORECTAL EXCISION; ANTERIOR RESECTION;
   IMPACT
AB Anastomotic leakage is a feared complication following colorectal surgery and is associated with early and long-term morbidity and mortality. The presacral cavity as the result of leakage can be treated with an endo-sponge (B-Braun Medical). The aim of this study was to assess the effectiveness of endo-sponge treatment of the presacral cavity as the result of anastomotic leakage in the Netherlands.
   Between July 2006 and April 2008, 16 patients (M/F = 9:7) with median age 64 years (range 19-78 years) who underwent surgery for rectal cancer (n = 13) or ulcerative colitis (n = 3) were treated with the endo-sponge treatment after anastomotic leakage.
   Of the 16 patients, eight patients started with the endo-sponge treatment within 6 weeks after the initial surgery. In these patients the endo-sponge was placed after a median of 24 days (range 13-39 days) following surgery. In the remaining eight patients the endo-sponge treatment was started later than 6 weeks after the initial surgery. In this group there was a median of 74 days (range 43-1,602 days) between surgery and the start of endo-sponge placement. There was closure in six out of eight patients (75%) in the group that started with the endo-sponge treatment within 6 weeks of surgery compared with three out of eight patients (38%) in the group that started later (p = 0.315). Closure was achieved in a median of 40 (range 28-90) days with a median number of 13 sponge replacements (range 8-17).
   Endo-sponge placement can be helpful in the treatment for anastomotic leakage after colorectal surgery and might prevent a chronic presacral sinus. However, it is not yet clear if this new treatment modality results in quicker healing.
C1 [van Koperen, P. J.; Henegouwen, M. I. van Berge; Slors, J. F. M.; Bemelman, W. A.] Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1100 A2 Amsterdam DD, Netherlands.
   [Rosman, C.] Canisius Wilhelmina Hosp, Dept Surg, Nijmegen, Netherlands.
   [Bakker, C. M.] Atrium Med Ctr, Dept Gastroenterol, Heerlen, Netherlands.
   [Heres, P.] Waterland Hosp, Dept Surg, Purmerend, Netherlands.
C3 University of Amsterdam; Canisius-Wilhelmina Hospital; Atrium Medical
   Center
RP Bemelman, WA (通讯作者)，Univ Amsterdam, Acad Med Ctr, Dept Surg, POB 22660, NL-1100 A2 Amsterdam DD, Netherlands.
EM p.j.vankoperen@amc.uva.nl; w.a.bemelman@amc.uva.nl
RI rosman, camiel/F-9059-2016; Bemelman, Wilhelmus/AAA-1635-2021
OI rosman, camiel/0000-0002-9152-3987; van Berge Henegouwen,
   Mark/0000-0001-8689-3134; 
CR Hallbook O, 1996, BRIT J SURG, V83, P60, DOI 10.1002/bjs.1800830119
   Hunter Judith E, 2007, Int Wound J, V4, P256, DOI 10.1111/j.1742-481X.2007.00361.x
   Jestin P, 2008, COLORECTAL DIS, V10, P715, DOI 10.1111/j.1463-1318.2007.01466.x
   Jung SH, 2008, DIS COLON RECTUM, V51, P902, DOI 10.1007/s10350-008-9272-x
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NR 16
TC 119
Z9 133
U1 0
U2 4
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD JUN
PY 2009
VL 23
IS 6
BP 1379
EP 1383
DI 10.1007/s00464-008-0186-4
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 451GG
UT WOS:000266458100033
PM 19037698
OA Green Published, Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Smet, H
   Hirt, J
   Hahnloser, D
   Grass, F
AF Smet, Heloise
   Hirt, Jeanne
   Hahnloser, Dieter
   Grass, Fabian
TI Surgical approach to intraabdominal sepsis: a damage control approach
   can reduce stoma rates
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article
DE Staged; Damage control; Complicated diverticulitis; Two-stage
ID ACUTE DIVERTICULITIS; HARTMANNS PROCEDURE; PRIMARY ANASTOMOSIS
AB BackgroundIn patients with perforated diverticulitis and/or intraabdominal sepsis (IAS), the best surgical strategy remains controversial. While open, non-restorative Hartmann's procedure represents the procedure of choice in many centers, ostomy-sparing and minimally invasive techniques have been increasingly utilized due to short- and long-term benefits, including a reduced stoma rate. This dynamic manuscript illustrates strategic and technical considerations of the standardized institutional staged or damage control approach to IAS.TechniqueThe institutional strategy to IAS is demonstrated through an emergency procedure for perforated Hinchey IV diverticulitis in a 70-year-old woman developing an acute abdomen. After a diagnostic laparoscopy, stercoral peritonitis was confirmed and the patient underwent laparotomy. A two-stage approach (stage 1: damage control with resection of the perforated sigmoid, abdominal lavage, vacuum-assisted closure (VAC) - stage 2 (36-48 h later and during daytime): primary colorectal anastomosis and abdominal closure) was performed. While laparoscopic exploration represents the standard approach in hemodynamically stable patients, the staged procedure (resection and sepsis control) helped refine the definite strategy (goal of reconstruction and no ostomy) in a clinically improved patient during the second step. The patient recovered well during the critical therapeutic window, allowing to perform primary anastomosis and a stoma-free discharge.DiscussionClinical condition during surgery, surgeon expertise, and comorbidities are key determinants to decide whether to proceed to primary anastomosis in the case of IAS. An institutional series of our group revealed feasibility and safety of the staged approach, with 65% stoma-free patients at discharge. A standardized algorithm based on intraoperative hemodynamic parameters intends to guide surgical decision-making during staged procedures to seek optimized conditions allowing to proceed to primary anastomosis.ConclusionA staged approach according to a predefined decisional framework may help decrease the need for ostomy creation in patients with IAS.
C1 [Smet, Heloise; Hirt, Jeanne; Hahnloser, Dieter; Grass, Fabian] Univ Lausanne UNIL, Lausanne Univ Hosp CHUV, Dept Visceral Surg, Rue Bugnon 46-BH 10-222, CH-1011 Lausanne, Switzerland.
C3 University of Lausanne; Centre Hospitalier Universitaire Vaudois (CHUV)
RP Grass, F (通讯作者)，Univ Lausanne UNIL, Lausanne Univ Hosp CHUV, Dept Visceral Surg, Rue Bugnon 46-BH 10-222, CH-1011 Lausanne, Switzerland.
EM fabian.grass@chuv.ch
RI Hahnloser, Dieter/J-6714-2017
OI Smet, Héloïse/0000-0001-9665-9552
FU University of Lausanne
FX Open access funding provided by University of Lausanne.
CR Antoniou SA, 2025, SURG ENDOSC, V39, P673, DOI 10.1007/s00464-024-11445-y
   Bova R, 2024, ANTIBIOTICS-BASEL, V13, DOI 10.3390/antibiotics13080776
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NR 23
TC 1
Z9 1
U1 1
U2 1
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD DEC
PY 2025
VL 39
IS 12
BP 8710
EP 8715
DI 10.1007/s00464-025-12303-1
EA OCT 2025
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA X2807
UT WOS:001596144800001
PM 41116058
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Du, XY
   Liu, WY
   Xu, BY
   Luan, J
   Liu, CJ
AF Du, Xingyi
   Liu, Wenyue
   Xu, Boyang
   Luan, Jie
   Liu, Chunjun
TI Novel Noninvasive Hybrid Flap Preconditioning Surpasses Surgical Delay
   in the Murine Model
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; SKIN FLAP; MECHANISM; ANGIOGENESIS; VEGF
AB Background:Ischemic necrosis in the distal portion of a flap is a challenging complication in plastic surgery. The authors hypothesized that a novel hybrid flap preconditioning (HFP) device combining foam-mediated external suction and nonsurgical delay can promote skin flap survival better than surgical delay.Method:Twenty-eight mice were divided into 4 groups: a control group, in which a 4 x 1.5-cm dorsal flap was made with no preconditioning; a surgical delay group, in which surgical delay occurred 7 days before flap elevation; a foam-mediated external suction (FMES) group, in which foam-mediated external suction at -100 mm Hg was used 5 hours a day for 6 days, and the flap was elevated on the seventh day; and a hybrid flap preconditioning (HFP) group, in which silicone strips were applied along the contour of the foam interface. The same negative-pressure protocol was used as in the FMES group. Seven days after flap elevation, macroscopic, histologic, and Western blot analyses were performed.Results:The flap survival rate was 46.25% (8.12%) in the control group, 68.72% (7.00%) in the surgical delay group, 57.03% (8.17%) in the FMES group, and 80.66% (3.27%) in the HFP group. Immunohistologic analysis of CD31+ cells in the distal end of viable tissue procured 7 days after flap elevation showed significantly higher angiogenesis in the surgical delay and HFP groups. Western blot results showed an increased expression of vascular endothelial growth factor in the surgical delay and HFP groups.Conclusions:The authors developed and fabricated a novel HFP device combining foam-mediated external suction and nonsurgical delay. The concept of HFP has proved to promote flap survival better than surgical delay.Clinical Relevance Statement:This study presented an innovative noninvasive method of flap preconditioning, which has been demonstrated to be superior to surgical delay in a murine model and holds promise for potential application in clinical settings.
C1 [Du, Xingyi; Liu, Wenyue; Xu, Boyang; Luan, Jie; Liu, Chunjun] Chinese Acad Med Sci, Plast Surg Hosp Inst, Peking Union Med Coll, Dept Oncoplast & Reconstruct Breast Surg, Beijing, Peoples R China.
C3 Chinese Academy of Medical Sciences - Peking Union Medical College;
   Peking Union Medical College
RP Luan, J; Liu, CJ (通讯作者)，Chinese Acad Med Sci, Plast Surg Hosp Inst, Peking Union Med Coll, 33 Badachu Rd, Beijing 100144, Peoples R China.
EM luanjieplastic@126.com; lancet007@126.com
FU Funds of Peking Union Medical College, Plastic Surgery Hospital
   [YS202016]; Capital's Funds for Health Improvement and Research
   [2024-1-4041]; National Key Clinical Specialty Discipline Construction
   Program of China [112621048]
FX This study was funded by The Funds of Peking Union Medical College,
   Plastic Surgery Hospital (grant YS202016 to Dr. Chunjun Liu), Capital's
   Funds for Health Improvement and Research (grant 2024-1-4041 to Dr.
   Chunjun Liu), and the National Key Clinical Specialty Discipline
   Construction Program of China (grant 112621048 to Dr. Luan).
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NR 22
TC 1
Z9 1
U1 1
U2 9
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD NOV
PY 2024
VL 154
IS 5
BP 1003
EP 1012
DI 10.1097/PRS.0000000000011305
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA K7S9X
UT WOS:001345851100031
PM 38265270
DA 2026-07-24
ER

PT J
AU Elsayed, RS
   Carey, J
   Cohen, RG
   Barr, ML
   Baker, CJ
   Starnes, VA
   Bowdish, ME
AF Elsayed, Ramsey S.
   Carey, Joseph
   Cohen, Robbin G.
   Barr, Mark L.
   Baker, Craig J.
   Starnes, Vaughn A.
   Bowdish, Michael E.
TI Early onset of deep sternal wound infection after cardiac surgery is
   associated with decreased survival: A propensity weighted analysis
SO JOURNAL OF CARDIAC SURGERY
LA English
DT Article
DE cardiac surgery; mediastinitis; sternal wound infection
ID VACUUM-ASSISTED CLOSURE; CARE-ASSOCIATED INFECTIONS; RISK-FACTORS;
   MANAGEMENT; MEDIASTINITIS; THERAPY; PREVENTION; MORTALITY; IMPACT
AB Objectives To compare outcomes after the development of early (<= 30 days) versus delayed (>30 days) deep sternal wound infection (DSWI) after cardiac surgery. Methods Between 2005 and 2016, 64 patients were treated surgically for DSWI following cardiac surgery. Thirty-three developed early DSWI, while 31 developed late DSWI. The mean follow-up was 34.1 +/- 32.3 months. Results Survival for the entire cohort at 1, 3, and 5 years was 93.9%, 85.1%, and 80.8%, respectively. DSWI diagnosed early and attempted medical management was strongly associated with overall mortality (hazard ratio [HR], 25.0 and 9.9; 95% confidence intervals [CIs], 1.18-52.8 and 1.28-76.5; p-value .04 and .04, respectively). Survival was 88.1%, 77.0%, 70.6% and 100%, 94.0% and 94.0% at 1, 3, and 5 years in the early and late DSWI groups, respectively (log-rank = 0.074). Those diagnosed early were more likely to have a positive wound culture (odds ratio [OR], 0.06; 95% CI, 0.01-0.69; p = .024) and diagnosed late were more likely to be female (OR, 8.75; 95% CI, 2.0-38.4; p = .004) and require an urgent DSWI procedure (OR, 9.25; 95% CI, 1.86-45.9; p = .007). Both early diagnosis of DSWI and initial attempted medial management were strongly associated with mortality (HR, 7.48; 95% CI, 1.38-40.4; p = .019 and HR, 7.76; 95% CI, 1.67-35.9; p = .009, respectively). Conclusions Early aggressive surgical therapy for DSWI after cardiac surgery results in excellent outcomes. Those diagnosed with DSWI early and who have failed initial medical management have increased mortality.
C1 [Elsayed, Ramsey S.; Carey, Joseph; Cohen, Robbin G.; Barr, Mark L.; Baker, Craig J.; Starnes, Vaughn A.; Bowdish, Michael E.] Univ Southern Calif, Dept Cardiothorac Surg, Keck Sch Med USC, 1520 San Pablo St,HCC II Suite 4300, Los Angeles, CA 90033 USA.
   [Bowdish, Michael E.] Univ Southern Calif, Dept Prevent Med, Keck Sch Med USC, Los Angeles, CA 90033 USA.
C3 University of Southern California; University of Southern California
RP Elsayed, RS (通讯作者)，Univ Southern Calif, Dept Cardiothorac Surg, Keck Sch Med USC, 1520 San Pablo St,HCC II Suite 4300, Los Angeles, CA 90033 USA.
EM Ramsey.Elsayed@med.usc.edu
RI Baker, Craig/KGL-3776-2024; Elsayed, Ramsey/AAE-9363-2020
OI Elsayed, Ramsey/0000-0003-3957-4100
FU Department of Surgery of the Keck School of Medicine of USC
   [UM1-HL11794]; National Heart Lung and Blood Institute of the National
   Institutes of Health; National Heart Lung and Blood Institute
   [UM1HL117924] Funding Source: NIH RePORTER
FX Research reported in this publication was supported by the Department of
   Surgery of the Keck School of Medicine of USC. MEB is partially
   supported by UM1-HL11794 from the National Heart Lung and Blood
   Institute of the National Institutes of Health.
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NR 23
TC 3
Z9 4
U1 1
U2 2
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0886-0440
EI 1540-8191
J9 J CARDIAC SURG
JI J. Card. Surg.
PD DEC
PY 2021
VL 36
IS 12
BP 4509
EP 4518
DI 10.1111/jocs.16009
EA SEP 2021
PG 10
WC Cardiac & Cardiovascular Systems; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Surgery
GA WP4MO
UT WOS:000700169800001
PM 34570388
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Fourman, MS
   Ramsey, DC
   Newman, ET
   Schwab, JH
   Chen, YL
   Hung, YP
   Chebib, I
   Deshpande, V
   Nielsen, GP
   DeLaney, TF
   Mullen, JT
   Raskin, KA
   Calderón, SAL
AF Fourman, Mitchell S.
   Ramsey, Duncan C.
   Newman, Erik T.
   Schwab, Joseph H.
   Chen, Yen-Lin
   Hung, Yin P.
   Chebib, Ivan
   Deshpande, Vikram
   Nielsen, G. Petur
   DeLaney, Thomas F.
   Mullen, John T.
   Raskin, Kevin A.
   Calderon, Santiago A. Lozano
TI Assessing the Safety and Utility of Wound VAC Temporization of the
   Sarcoma or Benign Aggressive Tumor Bed Until Final Margins Are Achieved
SO ANNALS OF SURGICAL ONCOLOGY
LA English
DT Article
ID SOFT-TISSUE SARCOMA; PROGNOSTIC-FACTORS; LOCAL RECURRENCE; THERAPY;
   EXTREMITY; SURVIVAL
AB Background Local recurrence of microinvasive sarcoma or benign aggressive pathologies can be limb- and life-threatening. Although frozen pathology is reliable, tumor microinvasion can be subtle or missed, having an impact on surgical margins and postoperative radiation planning. The authors' service has begun to temporize the tumor bed after primary tumor excision with a wound vacuum-assisted closure (VAC) pending formal margin analysis, with coverage performed in the setting of final negative margins. Methods This retrospective analysis included all patients managed at a tertiary referral cancer center with VAC temporization after soft tissue sarcoma or benign aggressive tumor excision from 1 January 2000 to 1 January 2019 and at least 2 years of oncologic follow-up evaluation. The primary outcome was local recurrence. The secondary outcomes were distant recurrence, unplanned return to the operating room for wound/infectious indications, thromboembolic events, and tumor-related deaths. Results For 62 patients, VAC temporization was performed. The mean age of the patients was 62.2 +/- 22.3 years (median 66.5 years; 95% confidence interval [CI] 61.7-72.5 years), and the mean age-adjusted Charlson Comorbidity Index was 5.3 +/- 1.9. The most common tumor histology was myxofibrosarcoma (51.6%, 32/62). The mean volume was 124.8 +/- 324.1 cm(3), and 35.5% (22/62) of the cases were subfascial. Local recurrences occurred for 8.1% (5/62) of the patients. Three of these five patients had planned positive margins, and 17.7% (11/62) of the patients had an unplanned return to the operating room. No demographic or tumor factors were associated with unplanned surgery. Conclusions The findings showed that VAC-temporized management of microinvasive sarcoma and benign aggressive pathologies yields favorable local recurrence and unplanned operating room rates suggestive of oncologic and technical safety. These findings will need validation in a future randomized controlled trial.
C1 [Fourman, Mitchell S.; Ramsey, Duncan C.; Newman, Erik T.; Raskin, Kevin A.; Calderon, Santiago A. Lozano] Massachusetts Gen Hosp, Dept Orthopaed Surg, Orthopaed Oncol Serv, Boston, MA 02114 USA.
   [Schwab, Joseph H.] Massachusetts Gen Hosp, Dept Orthopaed Surg, Spine Serv, Boston, MA 02114 USA.
   [Chen, Yen-Lin; DeLaney, Thomas F.] Massachusetts Gen Hosp Canc Ctr, Dept Radiat Oncol, Boston, MA USA.
   [Hung, Yin P.; Chebib, Ivan; Deshpande, Vikram; Nielsen, G. Petur] Massachusetts Gen Hosp, Dept Pathol, Boston, MA 02114 USA.
   [Mullen, John T.] Massachusetts Gen Hosp, Dept Surg, Surg Oncol Serv, Boston, MA 02114 USA.
C3 Harvard University; Harvard University Medical Affiliates; Massachusetts
   General Hospital; Harvard University; Harvard University Medical
   Affiliates; Massachusetts General Hospital; Harvard University; Harvard
   University Medical Affiliates; Massachusetts General Hospital; Harvard
   University; Harvard University Medical Affiliates; Massachusetts General
   Hospital; Harvard University; Harvard University Medical Affiliates;
   Massachusetts General Hospital
RP Calderón, SAL (通讯作者)，Massachusetts Gen Hosp, Dept Orthopaed Surg, Orthopaed Oncol Serv, Boston, MA 02114 USA.
EM slozanocalderon@mgh.harvard.edu
RI ; Fourman, Mitchell/GXF-4477-2022; Ramsey, Duncan/GVU-7429-2022; Hung,
   Yin Pun/AAV-4868-2021; Deshpande, Vikram/AEN-2602-2022
OI Schwab, Joseph/0000-0002-2059-7559; Fourman,
   Mitchell/0000-0001-5886-546X; Ramsey, Duncan/0000-0003-2058-9556; Hung,
   Yin Pun/0000-0002-8568-1591; HUITRON, EFREN/0009-0008-2046-3359
CR Bianchi G, 2017, Musculoskelet Surg, V101, P243, DOI [10.1007/s12306-017-0475-y, 10.1007/s12306-017-0475-y]
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NR 31
TC 12
Z9 13
U1 0
U2 3
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 1068-9265
EI 1534-4681
J9 ANN SURG ONCOL
JI Ann. Surg. Oncol.
PD APR
PY 2022
VL 29
IS 4
BP 2290
EP 2298
DI 10.1245/s10434-021-11023-9
EA NOV 2021
PG 9
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA ZV7LQ
UT WOS:000716290400003
PM 34751874
DA 2026-07-24
ER

PT J
AU Assadian, O
   Kammerlander, G
   Geyrhofer, C
   Luch, G
   Doppler, S
   Tuchmann, F
   Eberlein, T
   Leaper, D
AF Assadian, Ojan
   Kammerlander, Gerhard
   Geyrhofer, Claudia
   Luch, Gerlinde
   Doppler, Stefan
   Tuchmann, Felix
   Eberlein, Thomas
   Leaper, David
TI Use of wet-to-moist cleansing with different irrigation solutions to
   reduce bacterial bioburden in chronic wounds
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE bacteria; chronic wound; wet-to-moist cleaning phase; wound irrigation
ID VACUUM-ASSISTED CLOSURE; THERAPY; SWAB
AB Objective: The influence of different irrigation solutions, in conjunction with wet-to-moist cleansing, on the reduction of sessile, non-planktonic bacteria which colonise wounds, has not been investigated. In this study, the antibacterial effect of different irrigation solutions, during a 20-minute wet-to-moist cleansing, has been evaluated in chronic wounds.
   Methods: This study was designed as a prospective cohort study with 12 study arms and was conducted between June 2011 and April 2016. Patients with chronic wounds present for more than three months, irrespective of previous treatments, were recruited into this study. Quantitative wound swabs were obtained before and after a 20-minute, wet-to-moist cleansing, using different wound irrigation solutions. Sterile 0.9% saline served as a control.
   Results: We recruited 308 patients, of which 260 patients with 299 chronic wounds were eligible for analysis. Staphylococcus aureus was the most common recovered (25.5%) microorganism, of which 8% were meticillin-resistant Staphylococcus aureus (MRSA) strains. Although 0.9% saline supported cleansing of the wound bed, it did not significantly reduce the bacterial burden. The highest reduction of bacterial burden was achieved with an aqueous solution containing betaine, zinc and polyhexamethylene biguanide (polihexanide; In RF=3.72), followed by a 3% saline solution containing 0.2% sodium hypochlorite (In RF=3.40). The most statistically significant reduction of bacterial burden, although not the highest, was achieved with povidone-iodine (In RF=2.98; p=0.001) and an irrigation solution containing sea salt 1.2% and NaOCl 0.4% (In RF=2.51; p=0.002).
   Conclusion: If a reduction of bacterial burden is warranted, wound irrigation solutions containing a combination of hypochlorite/hypochlorous acid, or antiseptics such as polihexanide, octenidine or povidone-iodine, ought to be considered.
C1 [Assadian, Ojan] Med Univ Vienna, Dept Hosp Epidemiol & Infect Control, Vienna Gen Hosp, Vienna, Austria.
   [Assadian, Ojan] Univ Huddersfield, Sch Human & Hlth Sci, Inst Skin Integr & Infect Prevent, Huddersfield, W Yorkshire, England.
   [Kammerlander, Gerhard; Geyrhofer, Claudia; Luch, Gerlinde; Eberlein, Thomas] CWM Acad, Zurich, Switzerland.
   [Kammerlander, Gerhard; Geyrhofer, Claudia; Luch, Gerlinde; Eberlein, Thomas] WCC Wound Competence Ctr, Linz, Austria.
   [Doppler, Stefan] Kepler Univ Hosp, Dept Pathol & Microbiol, Neuromed Campus, Linz, Austria.
   [Tuchmann, Felix] Med Univ Vienna, Dept Dermatol, Vienna, Austria.
   [Leaper, David] Univ Newcastle Tyne, Surg, Newcastle Upon Tyne, Tyne & Wear, England.
   [Leaper, David] Imperial Coll, London, England.
C3 Medical University of Vienna; University of Huddersfield; Kepler
   University Hospital; Medical University of Vienna; Newcastle University
   - UK; Imperial College London
RP Assadian, O (通讯作者)，Med Univ Vienna, Dept Hosp Epidemiol & Infect Control, Vienna Gen Hosp, Vienna, Austria.; Assadian, O (通讯作者)，Univ Huddersfield, Sch Human & Hlth Sci, Inst Skin Integr & Infect Prevent, Huddersfield, W Yorkshire, England.
EM ojan.assadian@meduniwien.ac.at
RI Assadian, Ojan/GVT-8804-2022
FU Altrazeal Europe Ltd.; Antiseptica chem. GmbH; B. Braun Melsungen AG;
   Ethicon Ltd.; Lohmann & Rauscher GmbH Co. KG; Mundipharma GmbH; Nawa
   Heilmittel GmbH; Quantum Management Service GmbH; Schulke Mayr GmbH; 3M
   Deutschland GmbH
FX Professor Assadian was member of the Hutchinson Sante's medical advisory
   board and Molnlycke Medical Advisory Board. He declares having received
   consulting and lecture fees travel compensation, and speakers' honoraria
   from Altrazeal Europe Ltd., Antiseptica chem. GmbH, B. Braun Melsungen
   AG, Ethicon Ltd., Lohmann & Rauscher GmbH & Co. KG, Mundipharma GmbH,
   Nawa Heilmittel GmbH, Quantum Management & Service GmbH, Schulke & Mayr
   GmbH and 3M Deutschland GmbH in the past. Professor Leaper has received
   travel and accommodation expenses, together with honoraria for teaching
   and participation in advisory/consultation groups from Ethicon Ltd.,
   Pfizer Ltd., Carefusion, and Smith & Nephew. Dr. Eberlein is a member of
   Zuellig Pharma's medical advisory board. He declares having received
   consulting and lecture fees travel compensation, and speakers honoraria
   from Altrazeal Europe Ltd., B. Braun Melsungen AG, Lohmann & Rauscher
   GmbH & Co. KG, Nawa Heilmittel GmbH and 3M Deutschland GmbH in the past.
   None of the companies had any influence on the design of the study or
   interpretation of results. All other authors have no potential conflict
   of interest relevant to this article to report.
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NR 20
TC 19
Z9 22
U1 0
U2 10
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD OCT
PY 2018
VL 27
IS 10
SU S
BP S10
EP S16
DI 10.12968/jowc.2018.27.Sup10.S10
PG 5
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA GW6KR
UT WOS:000447063700003
PM 30307816
DA 2026-07-24
ER

PT J
AU Obremskey, W
   Molina, C
   Collinge, C
   Nana, A
   Tornetta, P
   Sagi, C
   Schmidt, A
   Probe, R
   Ahn, J
   Browner, BD
AF Obremskey, William
   Molina, Cesar
   Collinge, Cory
   Nana, Arvind
   Tornetta, Paul, III
   Sagi, Claude
   Schmidt, Andrew
   Probe, Robert
   Ahn, Jaimo
   Browner, Bruce D.
CA Orthopaedic Trauma Assoc
   Writing Comm
TI Current Practice in the Management of Open Fractures Among Orthopaedic
   Trauma Surgeons. Part A: Initial Management. A Survey of Orthopaedic
   Trauma Surgeons
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE open fractures; antibiotic prophylaxis; time to closure
ID VENTILATOR-ASSOCIATED PNEUMONIA; VACUUM-ASSISTED CLOSURE; OPEN TIBIAL
   FRACTURES; ASPIRATOR BONE-GRAFT; ANTIBIOTIC-THERAPY; PROPHYLACTIC
   ANTIBIOTICS; COMPOUND FRACTURES; INFECTION-RATE; HIP-FRACTURES;
   DOUBLE-BLIND
AB Objectives: Open fractures are one of the injuries with the highest rate of infection that orthopaedic trauma surgeons treat. The main purpose of this survey was to determine current practice and practice variation among Orthopaedic Trauma Association (OTA) members and make treatment recommendations based on previously published resources.
   Design: Survey.
   Setting: Web-based survey.
   Participants: Three hundred seventy-nine orthopaedic trauma surgeons.
   Methods: A 15-item questionnaire-based study titled "OTA Open Fracture Survey" was constructed. The survey was delivered to all OTA membership categories. Different components of the data charts were used to analyze numerous aspects of open fracture management, focusing on parameters of initial and definitive treatment.
   Results: Eighty-six percent of participants responded that a period of time of less than 1 hour is the optimal time to antibiotic administration after identification of open fracture. Despite concerns with nephrotoxicity, 24.0%-76.3% of respondents reported the use of aminoglyco-sides in management of open fractures. A little over half of survey respondents continue antibiotics until next debridement in wounds that were not definitively closed after initial debridement and stabilization.
   Conclusions: Rapid administration of antibiotics in open fracture management is important. Aminoglycoside use is still prevalent despite evidence questioning efficacy and toxicity concerns. Time to debridement of open fractures is controversial among OTA members. Antibiotic administration is commonly continued >48 hours despite concerns raised by Surgical Infection Society and The Eastern Association of the Surgery of Trauma. Regarding study logistics, survey participation reminders should be used when conducting this type of study as it can increase data accrual by 50%.
C1 [Obremskey, William; Molina, Cesar] Vanderbilt Univ, Med Ctr, Orthopaed Trauma Inst, Nashville, TN 37232 USA.
   [Collinge, Cory; Nana, Arvind] John Peter Smith, Dept Orthopaed Surg, Ft Worth, TX USA.
   [Tornetta, Paul, III] Boston Med Ctr, Dept Orthopaed Surg, Boston, MA USA.
   [Sagi, Claude] Univ S Florida, Florida Orthopaed Inst, Orthopaed Trauma Serv, Tampa, FL USA.
   [Sagi, Claude] Univ S Florida, Dept Orthopaed Surg, Tampa, FL USA.
   [Schmidt, Andrew] Hennepin Cty Med Ctr, Dept Orthopaed Surg, Minneapolis, MN 55415 USA.
   [Probe, Robert] Scott & White Healthcare, Dept Orthopaed Surg, Temple, TX USA.
   [Ahn, Jaimo] Hosp Univ Penn, Orthopaed Trauma & Fracture Serv, Philadelphia, PA 19104 USA.
   [Browner, Bruce D.] Univ Connecticut, Ctr Hlth, Dept Orthopaed, Farmington, CT USA.
C3 Vanderbilt University; Boston Medical Center; Florida Orthopaedic
   Institute; State University System of Florida; University of South
   Florida; State University System of Florida; University of South
   Florida; Hennepin County Medical Center; Texas A&M University System;
   Texas A&M University College Station; Texas A&M Health Science Center;
   University of Pennsylvania; University of Connecticut
RP Obremskey, W (通讯作者)，Vanderbilt Univ, Med Ctr, Orthoped Trauma Inst, Dept Orthoped, 1215 21st Ave South,Suite 4200 MCE South Tower, Nashville, TN 37232 USA.
EM william.obremskey@vanderbilt.edu
RI ; Ahn, Jaimo/KVZ-0734-2024; Nana, Arvind/HKE-8178-2023; Obremskey,
   William/HRA-4704-2023
OI Tornetta III, Paul/0000-0002-6448-8864; Schmidt,
   Anew/0000-0002-9740-4049; Molina, Cesar Sebastian/0000-0002-2400-3906;
   Ahn, Jaimo/0000-0001-8151-9987; Nana, Arvind/0000-0002-9702-6383;
   Obremskey, William/0000-0002-8942-1842
FU Department of Defense; Smith Nephew; AO; Synthes; Medtronic, Inc.;
   Stryker Orthopaedics, Mahwah, NJ; National Center for Research Resources
   at the National Center for Advancing Translational Sciences [UL1
   RR024975-01, 2 UL1 TR000445-06]
FX W.T.O. receives consulting fees from legal representatives and his
   institution is receiving a grant from the Department of Defense. P. T.
   is salaried and supported by publication royalties from Smith & Nephew
   and Wolters Kluwer/Lippincott William & Wilkins; holds the intellectual
   property rights/patent and royalties from Smith & Nephew; and receives
   consulting fees from Smith & Nephew. J.A. receives consulting fees from
   AO and Synthes, and his institution is currently receiving a grant from
   the Department of Defense. A. S. is current board member of the
   Orthopaedic Trauma Association, receives consulting and lecture fees
   from Medtronic, Inc., and his institution is currently receiving a grant
   from the Department of Defense. R. P. certifies that he has or may
   receive payments or benefits, during the study period, an amount of US
   $10,000 to US $100,000 from Stryker Orthopaedics, Mahwah, NJ. R P. is on
   the Board of Trustees of Scott & White Healthcare and Chair, Board of
   Directors of Scott & White Memorial Hospital. For the remaining authors
   none were declared.The project described was supported by the National
   Center for Research Resources, Grant UL1 RR024975-01, and is now at the
   National Center for Advancing Translational Sciences, Grant 2 UL1
   TR000445-06. The content is solely the responsibility of the authors and
   does not necessarily represent the official views of the NIH.
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NR 41
TC 60
Z9 75
U1 0
U2 7
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0890-5339
EI 1531-2291
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD AUG
PY 2014
VL 28
IS 8
BP E198
EP E202
PG 5
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA AM8TD
UT WOS:000340149400004
PM 26057885
DA 2026-07-24
ER

PT J
AU Sadigh, PL
   Wu, CJ
   Feng, WJ
   Hsieh, CH
   Jeng, SF
AF Sadigh, Parviz L.
   Wu, Cheng-Jung
   Feng, Wen-Jui
   Hsieh, Ching-Hua
   Jeng, Seng-Feng
TI New double-layer design for 1-stage repair of orocutaneous and
   pharyngocutaneous fistulae in patients with postoperative irradiated
   head and neck cancer
SO HEAD AND NECK-JOURNAL FOR THE SCIENCES AND SPECIALTIES OF THE HEAD AND
   NECK
LA English
DT Article
DE orocutaneous fistula; pharyngocutaneous fistula; double-layer repair;
   head and neck cancer; irradiated tissue
ID VACUUM-ASSISTED CLOSURE; TOTAL LARYNGECTOMY; ISLAND FLAP;
   RECONSTRUCTION; COMPLICATIONS; MANAGEMENT; SURGERY; RADIOTHERAPY;
   THERAPY; SYSTEM
AB Background. The development of a postoperative orocutaneous fistula (OCF) or pharyngocutaneous fistula (PCF) in the irradiated tissues of patients with head and neck cancer represents a high burden of morbidity for the patient. With high postoperative recurrence rates, these fistulae result in a reconstructive challenge for the plastic surgeon. In this study, we propose a new double-layer design to successfully repair these fistulae in a 1-stage reconstruction.
   Methods. Twelve patients with an average age of 56 years (range, 45-67 years) were operated on between January 2006 and December 2012 using this double-layer single-stage technique. All patients had received postoperative radiotherapy after their initial reconstruction. A circumferential turnover flap was designed and raised from the skin surrounding the fistula to recreate inner lining using a tension-free, water-tight repair. No debridement of the fistula itself was performed. The second-layer of the reconstruction, which represents the outer lining, was achievedwith either a local or a free flap.
   Results. Fistula size ranged from 0.8 x 0.5 cm to 3 x 3.2 cm with a mean size of 2 cm(2). The outer lining was achieved using a free flap in 5 cases and a local flap in 7 cases. All the flaps survived completely with no cases of postoperative infection, however, 1 case was complicated by mandibular plate exposure necessitating its removal. No major complication or recurrence has yet been encountered in any of our patients with a mean follow-up of 28 months (range, 12-78 months).
   Conclusion. This 1-stage double-layer design can provide a reliable and relatively straightforward means of repairing OCF and PCF in the irradiated tissues of patients with head and neck cancer. (C) 2015 Wiley Periodicals, Inc.
C1 [Sadigh, Parviz L.; Wu, Cheng-Jung; Jeng, Seng-Feng] I Shou Univ, E Da Hosp, Dept Plast Surg, Kaohsiung, Taiwan.
   [Hsieh, Ching-Hua] Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Kaohsiung, Taiwan.
   [Feng, Wen-Jui] I Shou Univ, E Da Hosp, Dept Management, Kaohsiung, Taiwan.
C3 I Shou University; E-Da Hospital; Chang Gung Memorial Hospital; E-Da
   Hospital; I Shou University
RP Jeng, SF (通讯作者)，E Da Hospi, Dept Plast Surg, 1 Yi Da Rd, Kaohsiung 824, Taiwan.
EM jengfamily@hotmail.com
CR Andrews BT, 2008, ANN OTO RHINOL LARYN, V117, P298, DOI 10.1177/000348940811700410
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NR 26
TC 9
Z9 11
U1 0
U2 2
PU WILEY-BLACKWELL
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1043-3074
EI 1097-0347
J9 HEAD NECK-J SCI SPEC
JI Head Neck-J. Sci. Spec. Head Neck
PD APR
PY 2016
VL 38
SU 1
BP E353
EP E359
DI 10.1002/hed.24000
PG 7
WC Otorhinolaryngology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Otorhinolaryngology; Surgery
GA DK7OU
UT WOS:000375116400032
PM 25581884
DA 2026-07-24
ER

PT J
AU Govaert, GAM
   van Helden, S
AF Govaert, Geertruida A. M.
   van Helden, Svenhjalmar
TI Ty-Raps in Trauma: A Novel Closing Technique of Extremity Fasciotomy
   Wounds
SO JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE
LA English
DT Article
DE Fasciotomy wounds; Ty-Raps; Wound closure; Dermatotraction
ID DELAYED PRIMARY CLOSURE; VACUUM-ASSISTED CLOSURE; DEVICE
AB The challenge of closing extremity fasciotomy wounds is well known to every trauma and orthopedic surgeon. We developed a new, easy, and inexpensive dermatotraction technique based on the simple use of Ty-Raps and report on the first pilot study using this novel technique for the closure of 23 extremity fasciotomy wounds. The Ty-Rap system consists of several combinations of two Ty-Raps and four surgical staples. Immediately after fasciotomy, the system is secured to the skin by the surgical staples, and once the swelling of the affected limb is subsided, the Ty-Raps are tightened every 24 hours to 48 hours until full approximation of the skin edges is achieved. We recorded the time to closure of the wound, the time to removal of the Ty-Raps, and the complications related to the procedure. Also, a cost analyses was calculated. The mean time of approximation of the skin was 6.3 days, and after a further 9.4 days, the Ty-Raps could be removed. The majority of the wounds (91%) healed without complications, and only one patient in our series required a secondary surgical procedure for the closure of one fasciotomy wound. The total cost to close a fasciotomy wound of 30 cm with the use of Ty-Raps is US dollar 23.33. We regard the use of Ty-Raps a good alternative for the current closing techniques of extremity fasciotomy wounds. We value its low cost, general availability, effectiveness, and the fact that, in this pilot study, both the application and the tightening of the Ty-Raps were well tolerated by our patients with a minimal need for secondary procedures. Knowledge of this technique is a useful adjunct to the existing surgical array for every trauma and orthopedic surgeon for the closure of extremity fasciotomy wounds, especially in austere or military environments.
C1 [Govaert, Geertruida A. M.] Maastricht Univ Med Ctr, Dept Surg, NL-6202 AZ Maastricht, Netherlands.
   [van Helden, Svenhjalmar] Isala Clin, Dept Surg, Zwolle, Netherlands.
C3 Maastricht University; Maastricht University Medical Centre (MUMC);
   Isala Clinics
RP Govaert, GAM (通讯作者)，Maastricht Univ Med Ctr, Dept Surg, POB 5800, NL-6202 AZ Maastricht, Netherlands.
EM g.govaert@mumc.nl
OI van Helden, Svenhjalmar/0000-0001-6381-0834; Govaert,
   Geertje/0000-0002-6033-1835
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NR 18
TC 25
Z9 33
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0022-5282
EI 1529-8809
J9 J TRAUMA
JI J. Trauma-Injury Infect. Crit. Care
PD OCT
PY 2010
VL 69
IS 4
BP 972
EP 975
DI 10.1097/TA.0b013e3181f2d9d3
PG 4
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 664KP
UT WOS:000282959100062
PM 20938282
DA 2026-07-24
ER

PT J
AU Wainstein, DE
   Calvi, RJ
   Rezzonico, F
   Deforel, ML
   Perrone, N
   Sisco, P
AF Wainstein, Daniel E.
   Calvi, Rodrigo Juarez
   Rezzonico, Florencia
   Deforel, Maria Luisa
   Perrone, Nora
   Sisco, Pablo
TI Management of enteroatmospheric fistula: A ten-year experience following
   fifteen years of learning
SO SURGERY
LA English
DT Article
ID TOPICAL NEGATIVE-PRESSURE; VACUUM-ASSISTED CLOSURE; ENTEROCUTANEOUS
   FISTULAS; OPEN ABDOMEN; INTESTINAL FAILURE; ABDOMINAL CLOSURE;
   NUTRITION; SURGERY
AB Background: Enteroatmospheric fistulas are a serious complication of Open Abdomen. The goal of this study was to present the strategy and results of enteroatmospheric fistulas treatment during the last 10 years, after a long learning period.Methods: Seventy-seven patients with enteroatmospheric fistulas were treated and the data recorded between 2012 and 2021. For local treatment, 3 negative pressure methods were used, according to the wound characteristics. The results of conservative and surgical treatments were retrospectively identi-fied and described, including nutritional recovery, morbidity and mortality. Predictors of spontaneous closure, as well as risk factors for the fistula's recurrence and mortality were analyzed.Results: Nutritional and clinical recovery was achieved in 66 patients (85.7%). Fourteen patients (18%) were healed without surgery after a median of 57 days (range 35-426 days). Unique lesions (13/46; P = .02, OR 10.23), initial output <= 700 mL/day (9/28; P = .0035, OR 3.79) and deep fistulas (9/12; P = .00001, OR 33.6) were encountered and acknowledged to be as spontaneous closure factors. Fifty-six patients (72.7%) required reconstructive surgery of the intestinal tract after a median of 187 days since last laparotomy (range: 63-455 days). There were 9 postoperative recurrences (16%), 5 of them closed with conservative treatment. No significant risk factors for recurrence nor postoperative mortality were found. Fistula complete closure was achieved in 63 of the 77 patients studied (81.8%), and 7 patients died (9%).Conclusion: The combination of 3 vacuum methods used for enteroatmospheric fistula management was effective. Spontaneous closure of an enteroatmospheric fistula is unlikely but feasible when lesions are single, deep, with limited output, and when intestinal continuity is preserved. Surgical indications are well defined, although mortality and recurrence rates are still high.(c) 2022 Elsevier Inc. All rights reserved.
C1 [Wainstein, Daniel E.; Calvi, Rodrigo Juarez; Rezzonico, Florencia; Perrone, Nora; Sisco, Pablo] Hosp Pirovano, Gen Surg Dept, 3555 Monroe Ave, RA-1428 Buenos Aires, Argentina.
   [Deforel, Maria Luisa] Hosp Pirovano, Nutr Dept, Buenos Aires, Argentina.
RP Calvi, RJ (通讯作者)，Hosp Pirovano, Gen Surg Dept, 3555 Monroe Ave, RA-1428 Buenos Aires, Argentina.
EM wainsteindaniel@yahoo.com.ar; rodrigojuarezcalvi@gmail.com
OI Juarez Calvi, Roigo Naime/0000-0002-9054-8103
CR Adaba F, 2017, CLIN COLON RECT SURG, V30, P215, DOI 10.1055/s-0037-1598163
   Bee TK, 2008, J TRAUMA, V65, P337, DOI 10.1097/TA.0b013e31817fa451
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   Wainstein DE, 2016, REV BRAS CIR CARDIOV, V108, P47
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NR 35
TC 14
Z9 21
U1 1
U2 16
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0039-6060
J9 SURGERY
JI Surgery
PD APR
PY 2023
VL 173
IS 4
BP 1079
EP 1085
DI 10.1016/j.surg.2022.12.001
EA MAR 2023
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA C4ZC9
UT WOS:000962004300001
PM 36653234
DA 2026-07-24
ER

PT J
AU Schulman, AR
   Watson, RR
   Abu Dayyeh, BK
   Bhutani, MS
   Chandrasekhara, V
   Jirapinyo, P
   Krishnan, K
   Kumta, NA
   Melson, J
   Pannala, R
   Parsi, MA
   Trikudanathan, G
   Trindade, AJ
   Maple, JT
   Lichtenstein, DR
AF Schulman, Allison R.
   Watson, Rabindra R.
   Abu Dayyeh, Barham K.
   Bhutani, Manoop S.
   Chandrasekhara, Vinay
   Jirapinyo, Pichamol
   Krishnan, Kumar
   Kumta, Nikhil A.
   Melson, Joshua
   Pannala, Rahul
   Parsi, Mansour A.
   Trikudanathan, Guru
   Trindade, Arvind J.
   Maple, John T.
   Lichtenstein, David R.
TI Endoscopic devices and techniques for the management of bariatric
   surgical adverse events (with videos)
SO GASTROINTESTINAL ENDOSCOPY
LA English
DT Article
ID Y GASTRIC BYPASS; TRANSORAL OUTLET REDUCTION; THE-SCOPE CLIP;
   LAPAROSCOPIC SLEEVE GASTRECTOMY; ARGON PLASMA COAGULATION; EXPANDABLE
   METAL STENTS; GASTROJEJUNAL ANASTOMOTIC STRICTURES; UPPER
   GASTROINTESTINAL-TRACT; VACUUM-ASSISTED CLOSURE; TRANSGASTRIC ERCP EDGE
AB Background and Aims: As the prevalence of obesity continues to rise, increasing numbers of patients undergo bariatric surgery. Management of adverse events of bariatric surgery may be challenging and often requires a multidisciplinary approach. Endoscopic intervention is often the first line of therapy for management of these adverse events. This document reviews technologies and techniques used for endoscopic management of adverse events of bariatric surgery, organized by surgery type.
   Methods: The MEDLINE database was searched through May 2018 for articles related to endoscopic management of adverse events of bariatric interventions by using relevant keywords such as adverse events related to "gastric bypass," "sleeve gastrectomy," "laparoscopic adjustable banding," and "vertical banded sleeve gastroplasty," in addition to "endoscopic treatment" and "endoscopic management," among others. Available data regarding efficacy, safety, and financial considerations are summarized.
   Results: Common adverse events of bariatric surgery include anastomotic ulcers, luminal stenoses, fistulae/leaks, and inadequate initial weight loss or weight regain. Devices used for endoscopic management of bariatric surgical adverse events include balloon dilators (hydrostatic, pneumatic), mechanical closure devices (clips, endoscopic suturing system, endoscopic plication platform), luminal stents (covered esophageal stents, lumen-apposing metal stents, plastic stents), and thermal therapy (argon plasma coagulation, needle-knives), among others. Available data, composed mainly of case series and retrospective cohort studies, support the primary role of endoscopic management. Multiple procedures and techniques are often required to achieve clinical success, and existing management algorithms are evolving.
   Conclusions: Endoscopy is a less invasive alternative for management of adverse events of bariatric surgery and for revisional procedures. Endoscopic procedures are frequently performed in the context of multidisciplinary management with bariatric surgeons and interventional radiologists. Treatment algorithms and standards of practice for endoscopic management will continue to be refined as new dedicated technology and data emerge.
C1 [Schulman, Allison R.] Univ Michigan, Dept Gastroenterol, Michigan Med, Ann Arbor, MI 48109 USA.
   [Watson, Rabindra R.] Calif Pacific Med Ctr, Intervent Endoscopy Serv, Dept Gastroenterol, San Francisco, CA USA.
   [Abu Dayyeh, Barham K.; Chandrasekhara, Vinay] Mayo Clin, Dept Gastroenterol & Hepatol, Rochester, MN USA.
   [Bhutani, Manoop S.] Univ Texas MD Anderson Canc Ctr, Dept Gastroenterol Hepatol & Nutr, Div Internal Med, Houston, TX 77030 USA.
   [Jirapinyo, Pichamol] Brigham & Womens Hosp, Div Gastroenterol Hepatol & Endoscopy, 75 Francis St, Boston, MA 02115 USA.
   [Krishnan, Kumar] Harvard Med Sch, Div Gastroenterol, Dept Internal Med, Boston, MA 02115 USA.
   [Krishnan, Kumar] Massachusetts Gen Hosp, Boston, MA 02114 USA.
   [Kumta, Nikhil A.] Mt Sinai Hosp, Div Gastroenterol, New York, NY 10029 USA.
   [Melson, Joshua] Rush Univ, Div Digest Dis, Dept Internal Med, Med Ctr, Chicago, IL 60612 USA.
   [Pannala, Rahul] Mayo Clin, Dept Gastroenterol & Hepatol, Scottsdale, AZ USA.
   [Parsi, Mansour A.] Tulane Univ, Hlth Sci Ctr, Sect Gastroenterol & Hepatol, New Orleans, LA 70118 USA.
   [Trikudanathan, Guru] Univ Minnesota, Dept Gastroenterol Hepatol & Nutr, Minneapolis, MN USA.
   [Trindade, Arvind J.] Long Isl Jewish Med Ctr, Zucker Sch Med Hofstra Northwell, Dept Gastroenterol, New Hyde Pk, NY 11042 USA.
   [Maple, John T.] Univ Oklahoma, Hlth Sci Ctr, Div Digest Dis & Nutr, Oklahoma City, OK USA.
   [Lichtenstein, David R.] Boston Univ, Sch Med, Boston Med Ctr, Div Gastroenterol, Boston, MA 02118 USA.
C3 University of Michigan System; University of Michigan; California
   Pacific Medical Center; Mayo Clinic; University of Texas System; UTMD
   Anderson Cancer Center; Harvard University; Harvard University Medical
   Affiliates; Brigham & Women's Hospital; Harvard University; Harvard
   Medical School; Harvard University; Harvard University Medical
   Affiliates; Massachusetts General Hospital; Icahn School of Medicine at
   Mount Sinai; Rush University; Mayo Clinic; Mayo Clinic Phoenix; Tulane
   University; University of Minnesota System; University of Minnesota Twin
   Cities; Northwell Health; University of Oklahoma System; University of
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RP Schulman, AR (通讯作者)，Univ Michigan, Dept Gastroenterol, Michigan Med, Ann Arbor, MI 48109 USA.
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NR 176
TC 10
Z9 11
U1 0
U2 7
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0016-5107
EI 1097-6779
J9 GASTROINTEST ENDOSC
JI Gastrointest. Endosc.
PD SEP
PY 2020
VL 92
IS 3
BP 492
EP 507
DI 10.1016/j.gie.2020.04.002
PG 16
WC Gastroenterology & Hepatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology
GA NI3SH
UT WOS:000565275500005
PM 32800313
DA 2026-07-24
ER

PT J
AU Yamamoto, T
   Yamamoto, N
   Yoshimatsu, H
   Seki, Y
   Kajikawa, A
AF Yamamoto, Takumi
   Yamamoto, Nana
   Yoshimatsu, Hidehiko
   Seki, Yukio
   Kajikawa, Akiyoshi
TI Localized Leg Volume Index A New Method for Body
   Type-Corrected Evaluation of Localized Leg Lymphedematous Volume
   Change
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE leg; lymphedema; cancer; circumference; index; volume; lower; extremity;
   volumetry; body; type
ID SOFT-TISSUE SARCOMA; VACUUM-ASSISTED CLOSURE; WOUND COMPLICATIONS; LIMB
   SALVAGE; RISK-FACTORS; MANAGEMENT; RECONSTRUCTION; RESECTION;
   GUIDELINES; THERAPY
AB Background: Volume measurement is one of the most common evaluations for lower-extremity lymphedema. However, volume comparison between different patients with different physique may be inappropriate, and it is difficult to evaluate localized limb volume change using leg volume evaluation.
   Methods: Localized leg volumes (V-k, k = 1-5) and localized leg volume indices (LEVIk) at 5 points (1, thigh; 2, knee; 3, lower leg; 4, ankle; 5, foot) of 106 legs of 53 examinees with no leg edema were calculated based on physical measurements, leg circumferences and lengths, and body mass index (BMI). Interrater and intrarater reliabilities of LEVIk were assessed, and V-k and LEVIk were compared between lower BMI (BMI < 22 kg/m(2)) group and higher BMI (BMI = 22 kg/m(2)) group.
   Results: Interrater and intrarater reliabilities of LEVIk were all high (all: r > 0.98). Between lower and higher BMI groups, significant differenceswere observed in all V-k: V-1 (P = 3.7 x 10(-7)), V-2 (P = 4.7 x 10(-8)), V-3 (P = 4.5 x 10(-5)), V-4 (P = 1.6 x 10(-3)), and V-5 (P = 2.4 x 10(-4)). Regarding LEVI between groups, significant differences were seen in LEVI3 (P = 0.009), LEVI4 (P = 0.004), and LEVI5 (P = 1.3 x 10(-7)); no significant difference was seen in LEVI1 (P = 0.23) or LEVI2 (P = 0.51).
   Conclusions: Localized leg volume index is a highly reproducible and convenient method for evaluation of localized volume change of the lower extremity, which is less affected by body type compared with leg volumetry.
C1 [Yamamoto, Takumi; Yamamoto, Nana] Tokyo Metropolitan Bokutoh Hosp, Dept Plast Surg, Tokyo, Japan.
   [Yamamoto, Takumi; Seki, Yukio; Kajikawa, Akiyoshi] St Marianna Univ, Sch Med, Dept Plast & Reconstruct Surg, Kawasaki, Kanagawa, Japan.
   [Yoshimatsu, Hidehiko] Univ Tokyo, Dept Plast & Reconstruct Surg, Tokyo, Japan.
C3 St Marianna University; University of Tokyo
RP Yamamoto, T (通讯作者)，Tokyo Metropolitan Bokutoh Hosp, Dept Plast Surg, Sumida Ku, 4-23-15 Kotobashi, Tokyo 1300033, Japan.
EM tyamamoto-tky@umin.ac.jp
RI Seki, Yukio/Z-3235-2019; Yoshimatsu, Hidehiko/AAA-8955-2020; Yamamoto,
   Takumi/Y-7658-2019
OI Seki, Yukio/0000-0001-9514-483X; 
FU Tokyo Metropolitan Clinical Research Grant for Special Research
   [H280402001]
FX This study was supported, in part, by Tokyo Metropolitan Clinical
   Research Grant for Special Research H280402001 (to T.Y.).
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   Marré D, 2012, ANN PLAS SURG, V69, P73, DOI 10.1097/SAP.0b013e31821ee497
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   Sanniec KJ, 2013, ANN PLAS SURG, V71, P283, DOI 10.1097/SAP.0b013e31827c7973
   Sarcomaorguk, UND SARC
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NR 31
TC 5
Z9 5
U1 0
U2 8
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD JAN
PY 2018
VL 80
IS 1
BP 64
EP 66
DI 10.1097/SAP.0000000000001197
PG 3
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA FQ9ZG
UT WOS:000418719900016
PM 28737564
DA 2026-07-24
ER

PT J
AU Reeder, S
   de Roos, KP
   de Maeseneer, M
   Sommer, A
   Neumann, HAM
AF Reeder, S.
   de Roos, K-P.
   de Maeseneer, M.
   Sommer, A.
   Neumann, H. A. M.
TI Ulcer recurrence after in-hospital treatment for recalcitrant venous leg
   ulceration
SO BRITISH JOURNAL OF DERMATOLOGY
LA English
DT Article
ID RISK-FACTORS; TRIAL
AB Background Leg ulceration caused by chronic venous disease occurs in 1% of the adult Western population. A majority of these patients is successfully treated in the outpatient setting. A minority of patients is hospitalized, most frequently because of the lack of healing tendency. The literature provides recurrence rates for ulcer disease, but lacks specific data on recurrence rates after in-hospital treatment of recalcitrant venous leg ulcers. Objectives To investigate time to ulcer recurrence after in-hospital treatment of venous leg ulceration. Methods A multicentre, retrospective cohort study of patients admitted for leg ulceration between 1996 and 2007 was conducted. Results Data could be collected for 107 of the patients. Of these, 27 had conservative treatment (bed rest, local wound care, pain management) and 48 patients underwent surgical ulcer treatment with (n=19) or without (n=29) initial vacuum-assisted closure (VAC) treatment. The treatment method was miscellaneous' in the remaining 32 patients. Median admission time was 30days, median percentage of closure at discharge was 95%, and median time to ulcer recurrence 60days. The MannWhitney U-test showed significant differences between the conservative group and the surgery group, the latter having a longer length of hospital stay (P<0.0001) and a higher percentage of ulcer closure (P<0.0001), but there was no difference in time to ulcer recurrence (P=0.273). Comparable differences were demonstrated between the conservative group and the VAC plus surgery group. No significant differences could be demonstrated between the surgically treated patients and those treated by VAC and surgery. Conclusions Hospital stay is significantly shorter in cases of surgical treatment of recalcitrant venous leg ulcers. Most ulcers recur within 2months after hospital discharge. Recurrence of venous leg ulcers after hospital admission is independent of the method of treatment and cause of ulceration.
C1 [Reeder, S.; de Maeseneer, M.; Neumann, H. A. M.] Erasmus MC, Dept Dermatol, Rotterdam, Netherlands.
   [de Roos, K-P.] DermaPark, Dept Dermatol, Uden, Netherlands.
   [de Maeseneer, M.] Univ Antwerp, Fac Med & Hlth Sci, B-2020 Antwerp, Belgium.
   [Sommer, A.] Reinaert Clin, Dept Dermatol, Maastricht, Netherlands.
C3 Erasmus University Rotterdam; Erasmus MC; University of Antwerp;
   Maastricht University
RP Reeder, S (通讯作者)，Erasmus MC, Dept Dermatol, Rotterdam, Netherlands.
EM s.reeder@erasmusmc.nl
RI De Maeseneer, Marianne/KBQ-4711-2024
OI De Maeseneer, Marianne/0000-0003-1114-8150
CR Abbade LPF, 2011, INT J DERMATOL, V50, P405, DOI 10.1111/j.1365-4632.2010.04654.x
   [Anonymous], COCHRANE DATABASE SY
   Barwell JR, 2000, PHLEBOLOGY, V15, P49, DOI 10.1007/s005230070021
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NR 13
TC 12
Z9 19
U1 1
U2 12
PU WILEY-BLACKWELL
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0007-0963
J9 BRIT J DERMATOL
JI Br. J. Dermatol.
PD MAY
PY 2013
VL 168
IS 5
BP 999
EP 1002
DI 10.1111/bjd.12164
PG 4
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 134SC
UT WOS:000318233700013
PM 23253015
DA 2026-07-24
ER

PT J
AU Jiang, T
   Li, J
   Ren, J
AF Jiang, Ting
   Li, Jun
   Ren, Jun
TI Continuous Negative Pressure Drain is Associated with Better Outcome: A
   Randomized Prospective Trial in Plastic Surgery Patients
SO AESTHETIC PLASTIC SURGERY
LA English
DT Article
DE Continuous negative pressure drain; Flap graft; Intermittent drain;
   Plastic surgery
ID VACUUM-ASSISTED CLOSURE; WOUND THERAPY; RECONSTRUCTION; MANAGEMENT;
   DISSECTION; STATE
AB BackgroundA randomized prospective trial to compare the effects on minimizing complications using continuous negative pressure drain and intermittent suction mode in plastic surgeries.MethodsThere were 174 cases of stage II post-auricular flap expansion and ear reconstruction, 76 cases of skin expansion flap repair, 56 cases of breast augmentation surgery, 58 cases of abdominoplasty, and 76 cases with free skin grafts. Patients were randomized to intermittent suction mode group (control group) and continuous negative pressure external drain group (intervention group) stratified by surgery types. In the intervention group, different pressure levels were applied according to the surgery types. The drainage volume, the length of time of external drainage, incidence of seroma, flap necrosis, the first intending healing rate and drain-associated bleeding were recorded and compared.ResultsGenerally, fewer complications and better healing were observed in the intervention group. In patients with stage II post-auricular flap expansion and ear reconstruction, lower incidence of flap necrosis and seroma, higher first intention healing rate, greater drain volume but shorter time of drainage were observed in the intervention group (p<0.05 for all). Similar results were shown in patients with skin expansion flap repair, breast augmentation, abdominoplasty, and free skin grafts. In patients who underwent free skin grafts, a higher graft success rate and lower graft infection rate were also observed (p<0.01 for both). No drain-associated bleeding was observed.ConclusionsA continuous negative pressure drain was associated with better outcomes in patients underwent various plastic surgeries and is a powerful technique in the postoperative management of plastic surgery.Level of Evidence IIThis journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.
C1 [Jiang, Ting; Li, Jun; Ren, Jun] Third Hosp Wuhan City, Dept Med Cosmetol & Plast Surg, 241 Peng Liu Yang Rd, Wuhan 430060, Hubei, Peoples R China.
RP Ren, J (通讯作者)，Third Hosp Wuhan City, Dept Med Cosmetol & Plast Surg, 241 Peng Liu Yang Rd, Wuhan 430060, Hubei, Peoples R China.
EM renjun201847@163.com
FU clinical study of continuous negative pressure drainage in the
   observation of curative effect after plastic surgery, Wuhan Municipal
   Health Bureau [70WX12C43]
FX This work was supported by grants from the clinical study of continuous
   negative pressure drainage in the observation of curative effect after
   plastic surgery, Wuhan Municipal Health Bureau [2012] 70WX12C43.
CR Argenta LC, 2006, PLAST RECONSTR SURG, V117, p127S, DOI 10.1097/01.prs.0000222551.10793.51
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NR 24
TC 17
Z9 19
U1 0
U2 8
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0364-216X
EI 1432-5241
J9 AESTHET PLAST SURG
JI Aesthet. Plast. Surg.
PD FEB
PY 2019
VL 43
IS 1
BP 91
EP 97
DI 10.1007/s00266-018-1246-3
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HJ7TG
UT WOS:000457399600013
PM 30327853
DA 2026-07-24
ER

PT J
AU Yan, HD
   Liu, S
   Gao, WY
   Li, ZJ
   Chen, XL
   Wang, CY
   Zhang, F
   Fan, CY
AF Yan, Hede
   Liu, Shen
   Gao, Weiyang
   Li, Zhijie
   Chen, Xinglong
   Wang, Chunyang
   Zhang, Feng
   Fan, Cunyi
TI Management of Degloving Injuries of the Foot with a Defatted
   Full-Thickness Skin Graft
SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; FREE FLAPS; RECONSTRUCTION; HEEL; SENSATION;
   DEFECTS; SALVAGE; SOLE
AB Background: Degloving injuries of the foot with involvement of the heel and sole occur relatively rarely but pose an extreme challenge to the reconstructive surgeon due to the unique anatomy of the foot. Very limited studies are available regarding the outcomes of reattachment of the degloved skin as a full-thickness graft.
   Methods: Twenty-one patients, including eight children and thirteen adults, were treated for a degloving injury of the foot with an immediate defatted full-thickness skin graft from September 2002 to January 2010. After reattachment to its original anatomical site, the graft was further secured with multiple sutures and was fenestrated to improve skin graft incorporation. Traditional dressings were applied. At the time of follow-up, the clinical outcome was graded with use of the Maryland Foot Score.
   Results: Complete incorporation of the graft occurred in ten of the thirteen adults and seven of the eight children (p > 0.05). Follow-up at an average of 32.8 months (range, twenty-four to sixty months) revealed stable wounds in 81% (seventeen) of the twenty-one patients. All stated that they were satisfied with the cosmetic appearance of the affected foot. At the time of the last follow-up, seventeen of the twenty-one patients had a good to excellent Score according to the Maryland Foot Score. Sensation restoration in the pediatric group started earlier and progressed faster than that in the adult group, but all patients obtained at least protective sensation eventually and none complained of cold intolerance in the foot.
   Conclusions: Degloving injuries can be treated successfully with a defatted full-thickness skin graft followed by conventional dressings in both children and adults. This procedure is relatively simple, without the demands of microsurgical techniques, and can provide good functional and cosmetic results.
C1 [Yan, Hede; Liu, Shen; Gao, Weiyang; Li, Zhijie; Chen, Xinglong; Wang, Chunyang; Zhang, Feng; Fan, Cunyi] Shanghai Jiao Tong Univ, Peoples Hosp 6, Sch Med, Shanghai 200233, Peoples R China.
C3 Shanghai Jiao Tong University
RP Yan, HD (通讯作者)，Shanghai Jiao Tong Univ, Dept Orthoped, Peoples Hosp 6, Sch Med, 600 Yishan Rd, Shanghai 200233, Peoples R China.
EM fancunyi888@hotmail.com
RI fan, cunyi/ABI-7199-2020; Chen, Xinglong/ACE-2741-2022
OI fan, cunyi/0000-0002-7854-5233; 
CR Banwell PE, 2002, BRIT J PLAST SURG, V55, P264, DOI 10.1054/bjps.2001.3819
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NR 25
TC 21
Z9 29
U1 0
U2 16
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0021-9355
EI 1535-1386
J9 J BONE JOINT SURG AM
JI J. Bone Joint Surg.-Am. Vol.
PD SEP 18
PY 2013
VL 95A
IS 18
BP 1675
EP 1681
DI 10.2106/JBJS.L.01085
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 242NX
UT WOS:000326250400006
PM 24048555
DA 2026-07-24
ER

PT J
AU Moisidis, E
   Heath, T
   Boorer, C
   Ho, K
   Deva, AK
AF Moisidis, E
   Heath, T
   Boorer, C
   Ho, K
   Deva, AK
TI A prospective, blinded, randomized, controlled clinical trial of topical
   negative pressure use in skin grafting
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; WOUND CONTROL; COMPLICATIONS; EXPERIENCE;
   DEVICE
AB Topical negative pressure has been demonstrated to improve graft take in a number of noncomparative studies. This study aimed to assess whether split-thickness skin graft take is improved qualitatively or quantitatively with topical negative pressure therapy compared with standard bolster dressings. A blinded, prospective, randomized trial was conducted of 22 adult inpatients of Liverpool Hospital between July of 2001 and July of 2002 who had wounds requiring skin grafting. After grafting, each wound half was randomized to receive either a standard bolster dressing or a topical negative pressure dressing. Skin graft assessment was performed at 2 weeks by a single observer blinded to the randomization. Two patients were lost to follow-up and were excluded from the study. There were 20 patients (12 men and eight women) in the study group. The median patient age was 64 years (range, 27 to 88 years), and the mean wound size was 128 cm(2) (range, 35 to 450 cm(2)). The wound exposed subcutaneous fat in eight patients, muscle in six patients, paratenon in four patients, and deep fascia in two patients. At 2 weeks, wounds that received a topical negative pressure dressing had a greater degree of epithelialization in six cases (30 percent), the same degree of epithelialization in nine cases (45 percent), and less epithelialization in five cases (25 percent) compared with their respective control wounds. Graft quality following topical negative pressure therapy was subjectively determined to be better in 10 cases (50 percent), equivalent in seven cases (35 percent), and worse in three cases (15 percent). Although the quantitative graft take was not significant, the qualitative graft take was found to be significantly better with the use of topical negative pressure therapy (p < 0.05). Topical negative pressure significantly improved the qualitative appearance of split-thickness skin grafts as compared with standard bolster dressings.
C1 Liverpool Hosp, Dept Plast & Maxillofacial Surg, Sydney, NSW, Australia.
C3 Liverpool Hospital
RP Deva, AK (通讯作者)，26 Gibbs St,Suite 7, Miranda, NSW 2228, Australia.
OI Deva, Anand/0000-0002-0314-7177
CR Altman D, 1991, PRACTIAL STAT MED RE
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NR 16
TC 228
Z9 266
U1 0
U2 12
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD SEP 15
PY 2004
VL 114
IS 4
BP 917
EP 922
DI 10.1097/01.PRS.0000133168.57199.E1
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 851NY
UT WOS:000223693000016
PM 15468399
DA 2026-07-24
ER

PT J
AU Betz, V
   van Ackeren, V
   Scharsack, E
   Stark, B
   Müller, CT
   Loske, G
AF Betz, Viktoria
   van Ackeren, Vera
   Scharsack, Ernst
   Stark, Bettina
   Mueller, Christian Theodor
   Loske, Gunnar
TI Intrathoracic negative pressure therapy of pleural empyema using an
   open-pored drainage film
SO CHIRURGIE
LA German
DT Article
DE Primary intervention; Complications; Drainage element; Polyurethane
   foam; Dressing change
ID VACUUM-ASSISTED CLOSURE; MANAGEMENT; PERFORATION
AB Introduction: We report our initial experience with intrathoracic negative pressure therapy (ITNPT) in the stage-adjusted therapy of pleural empyema (PE) based on a case series.Materials and Methods: ITNPT represents a further development in negative pressure therapy that is designed to be used in the thoracic cavity. After thoracic surgical open debridement, an intrathoracic negative pressure dressing was inserted. The drainage elements used were a thin open-pore double-layer drainage film (OF) with open-pore polyurethane foams (PUF). Only the OF was placed in direct contact with the lung parenchyma. Negative pressure was generated using an electronic pump (continuous suction, -75 mm Hg). In revision thoracotomies, ITNPT was stopped or continued depending on local findings.Results: 31 patients with stage II and III pleural empyemas were treated. ITNPT was administered at the time of primary procedure (n = 17) or revision (n = 14). ITNPT was given over a duration of m = 10 days (2-18 days), change interval m = 4 d (2-6 d). The application of intrathoracic negative pressure dressings was performed m = 3.5 (1-6) times.The empyema cavity continuously reduced in size and was cleansed by the suction. The OF has a minimum intrinsic volume with maximum absorption surface. Once negative pressure is established, there is no intrathoracic dead volume and the parenchyma can expand.Discussion: The protective material properties of OF make ITNPT suitable for the treatment of pleural empyema. Targeted local intrathoracic drainage of the septic focus is a possible adjunct to surgery. The treatment regimen requires surgical dressings to be changed repeatedly. The method is suitable for the treatment of complex stage II and III pleural empyemas.Conclusion: The OF can be used as an intrathoracic drainage element for ITNPT in pleural empyema. This new application option expands the range of indications for negative pressure therapy.
C1 [Betz, Viktoria; van Ackeren, Vera; Scharsack, Ernst; Stark, Bettina; Mueller, Christian Theodor; Loske, Gunnar] Katholisches Marienkrankenhaus gGmbH, Klin Allgemein Viszeral Thorax & Gefasschirurg, Alfredstr 9, D-22087 Hamburg, Germany.
C3 St. Marien Hospital
RP Betz, V (通讯作者)，Katholisches Marienkrankenhaus gGmbH, Klin Allgemein Viszeral Thorax & Gefasschirurg, Alfredstr 9, D-22087 Hamburg, Germany.
EM viktoria.betz@web.de
CR Adams O, S2K LEITLINIE MANAGE
   Munguía-Canales DA, 2013, ARCH BRONCONEUMOL, V49, P447, DOI 10.1016/j.arbres.2012.11.003
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   Varker KA, 2006, ANN THORAC SURG, V81, P723, DOI 10.1016/j.athoracsur.2004.10.040
NR 30
TC 2
Z9 2
U1 1
U2 1
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 2731-6971
EI 2731-698X
J9 CHIRURGIE
JI Chirurgie
PD APR
PY 2023
VL 94
IS 4
SI SI
BP 349
EP 360
DI 10.1007/s00104-022-01800-x
EA FEB 2023
PG 12
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA C2AB1
UT WOS:000931710400001
PM 36754892
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Begum, SSS
   Papagiannopoulos, K
AF Begum, Shah S. S.
   Papagiannopoulos, Kostas
TI The Use of Vacuum-Assisted Wound Closure Therapy in Thoracic Operations
SO ANNALS OF THORACIC SURGERY
LA English
DT Article
ID NEGATIVE-PRESSURE; EMPYEMA; MANAGEMENT; POSTPNEUMONECTOMY; PROMOTE;
   DEVICE; TRIAL
AB Background. Conventional treatment of complex, non-resolving empyemas after an episode of pneumonia or a chest operation often requires an open-window thoracostomy. This necessitates frequent, often painful dressing changes and is associated with prolonged hospitalization. The wound is often malodorous, causing significant social distress to patients and unquestionably affects their quality of life. We assessed the value of using vacuum-assisted closure (VAC) therapy in managing patients with a persistent infected pleural space.
   Methods. The study included 10 patients. All patients signed an informed consent and were debriefed before the procedure. An empyema developed in 1 patient after an episode of pneumonia. The other 9 had recently undergone a thoracic surgical procedure. All patients underwent initial open drainage of the pleural cavity and debridement. A VAC therapy system was then inserted intraoperatively or on the first postoperative day. The patients were discharged home with a portable VAC therapy system in situ. Subsequent dressing changes were managed by tissue-viability nurses in the community, without the need for further anesthesia or analgesia. Over a period of time, the cavity was sterilized and eventually obliterated spontaneously.
   Results. All patients were mobilized early and fast-tracked through the hospital. This prevented the need for daily dressing changes; hence, minimizing the disruption of normal activities and reducing the need for nursing care. Overall, the length of hospitalization was shorter, and the VAC therapy facilitated closure of the infected wound cavity. The use of the VAC therapy system negated the need for a second surgical procedure to close the wound cavity. None of the patients reported pain, odor, or inconvenience associated with the VAC therapy system.
   Conclusions. Our observations suggest that the use of VAC therapy to treat such patients is safe, facilitates early discharge and recovery, and offers a "civilized," cost-effective treatment in a community setting.
C1 [Begum, Shah S. S.; Papagiannopoulos, Kostas] St James Univ Hosp, Dept Thorac Surg, Leeds LS9 7TF, W Yorkshire, England.
C3 Saint James's University Hospital
RP Papagiannopoulos, K (通讯作者)，St James Univ Hosp, Dept Thorac Surg, Level 3,Bexley Wing, Leeds LS9 7TF, W Yorkshire, England.
EM kpapagiannopoulos@yahoo.com
OI Papagiannopoulos, Konstantinos/0000-0002-7088-8004
CR Al-Mufarrej F, 2010, SURG TODAY, V40, P711, DOI 10.1007/s00595-008-4096-9
   Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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   Miller JI, 2004, GEN THORACIC SURG, P709
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   Philbeck T E Jr, 1999, Ostomy Wound Manage, V45, P41
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NR 19
TC 15
Z9 20
U1 0
U2 14
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0003-4975
EI 1552-6259
J9 ANN THORAC SURG
JI Ann. Thorac. Surg.
PD DEC
PY 2012
VL 94
IS 6
BP 1835
EP 1840
DI 10.1016/j.athoracsur.2012.08.009
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 041XW
UT WOS:000311436300019
PM 23122932
OA Bronze
DA 2026-07-24
ER

PT J
AU Yang, F
   Liu, D
   Xu, X
   Tian, WL
   Yao, Z
   Wang, CY
   Zhao, RS
AF Yang, Fan
   Liu, Dong
   Xu, Xin
   Tian, Weliang
   Yao, Zheng
   Wang, Chaoyang
   Zhao, Risheng
TI A double-lumen irrigation-suction tube placed during operation could
   reduce the risk of grade C anastomotic leakage resulting from selective
   sigmoid colon cancer radical resection
SO LANGENBECKS ARCHIVES OF SURGERY
LA English
DT Article
DE Anastomotic leakage; Incidence; Sigmoid colon cancer; Drainage
ID VACUUM-ASSISTED CLOSURE; ANTERIOR RESECTION; RECTAL-CANCER; MANAGEMENT;
   LIGATION
AB Aim This study investigated the effect of a double-lumen irrigation-suction tube in reducing the incidence of grade C anastomotic leakage (AL) resulting from a selective sigmoid colon cancer radical resection. Method This multicenter retrospective cohort study reviewed data of patients receiving sigmoid colon cancer radical resection from January 2010 to November 2019. The enrolled patients were divided into the passive drainage tube group and the double-lumen irrigation-suction tube group, based on the use of a double-lumen irrigation-suction tube or a passive drainage tube during the surgery. The effect of double-lumen irrigation-suction tube on the incidence of grade C anastomotic leakage was evaluated. Results Of the 761 patients included in the study, 56 patients (7.36%) experienced AL. Of the 56 patients, 22 were diagnosed with grade C AL. The double-lumen irrigation-suction tube was a protective factor for forming a grade C AL compared with the passive drainage tube (OR = 0.194, 95% CI: 0.055-0.686,p = 0.011). Of the 34 patients with grade A or B AL, 26 patients had spontaneous closure-19 in the double-lumen irrigation-suction tube group and 7 in the passive drainage tube group. The double-lumen irrigation-suction tube (multivariable HR = 3.418, 95% CI: 1.43-11.203,p = 0.038) was associated with spontaneous closure of grade A or B AL. Conclusion Placing a double-lumen irrigation-suction tube may reduce the risk of grade C AL resulting from a selective sigmoid colon cancer radical resection. However, this study had substantial selection bias and the results should be reconfirmed by a randomized clinical trial.
C1 [Yang, Fan; Tian, Weliang] Jinling Hosp, Dept Gen Surg, Nanjing, Jiangsu, Peoples R China.
   [Liu, Dong] Zhengzhou Cent Hosp, Dept Gen Surg, Zhengzhou, Henan, Peoples R China.
   [Xu, Xin; Yao, Zheng; Zhao, Risheng] Nanjing Jiangning Hosp, Dept Gen Surg, Hushan Rd 169, Nanjing, Jiangsu, Peoples R China.
   [Wang, Chaoyang] Huaihe Hosp, Dept Gen Surg, Kaifeng, Henan, Peoples R China.
C3 Zhengzhou University
RP Yao, Z; Zhao, RS (通讯作者)，Nanjing Jiangning Hosp, Dept Gen Surg, Hushan Rd 169, Nanjing, Jiangsu, Peoples R China.
EM dr_yaozheng@163.com; Dr_zhaorisheng@163.com
CR Alves A, 1999, J AM COLL SURGEONS, V189, P554, DOI 10.1016/S1072-7515(99)00207-0
   Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Boström P, 2015, COLORECTAL DIS, V17, P1018, DOI 10.1111/codi.12971
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NR 20
TC 9
Z9 10
U1 0
U2 3
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 1435-2443
EI 1435-2451
J9 LANGENBECK ARCH SURG
JI Langenbecks Arch. Surg.
PD NOV
PY 2020
VL 405
IS 7
BP 1007
EP 1016
DI 10.1007/s00423-020-01959-z
EA AUG 2020
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA NX6YZ
UT WOS:000559236900001
PM 32785785
DA 2026-07-24
ER

PT J
AU Ward, MA
   Hassan, T
   Burdick, JS
   Leeds, SG
AF Ward, Marc A.
   Hassan, Tareq
   Burdick, James S.
   Leeds, Steven G.
TI Endoscopic vacuum assisted wound closure (EVAC) device to treat
   esophageal and gastric leaks: assessing time to proficiency and cost
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article
DE Endoscopic vacuum assisted closure; Proficiency; Cost utilization;
   Anastomotic leak; Intra-abdominal perforation
ID ANASTOMOTIC LEAKAGE; THERAPY
AB Background Endoluminal vacuum therapy (EVAC) is an emerging procedure used to treat anastomotic leaks and/or perforations that would otherwise require surgery. The aim of this study was to determine time to proficiency in EVAC and the cost effectiveness of the procedure.
   Methods We retrospectively reviewed a prospectively maintained IRB approved database for all patients undergoing EVAC after esophageal and gastric complications between October 2013 and December 2017. Proficiency was determined by obtaining predicted estimates and analyzing the point at which average procedure time plateaued based on case volume. Total cost was calculated based on supplies and location where the procedure was performed.
   Results There were 50 patients (17 males, 33 female), with a mean age of 52.1 years. EVAC was placed in 23 (46%) patients with esophageal injuries and 28 (56%) with gastric injuries. Two advanced endoscopists performed all EVAC procedures in this study (1 surgeon, 1 gastroenterologist). The average procedure time for all patients was 43.5 min and the average wheel in/wheel out time for all patients was 75.6 min. Analysis of the trend based on average procedure times for EVAC revealed that proficiency was obtained after 10 cases. Total cost of the procedure is significantly lower in the GI lab compared to the operating room ($4528 vs. $11889). The majority of EVAC were performed in the GI lab (62%) compared to the operating room (38%).
   Conclusion Successful outcomes in managing anastomotic leaks or intestinal perforations non-operatively has led to an increased interest in EVAC. For advanced endoscopists, time to proficiency is approximately 10 cases. Performing the procedure in the GI lab has a 2.5 reduction in total cost compared to the operating room.
C1 [Ward, Marc A.; Hassan, Tareq; Leeds, Steven G.] Baylor Univ, Med Ctr, Dept Minimally Invas Surg, Dallas, TX 75246 USA.
   [Ward, Marc A.; Leeds, Steven G.] Baylor Scott & White Hlth, Ctr Adv Surg, Dallas, TX 75246 USA.
   [Burdick, James S.] Baylor Univ, Med Ctr, Adv Endoscop Consultants, Dallas, TX USA.
   [Leeds, Steven G.] Baylor Univ, Med Ctr, Div Minimally Invas Surg, 3500 Gaston Ave,1st Floor Roberts Bldg, Dallas, TX 75246 USA.
C3 Baylor University Medical Center; Baylor University; Baylor Scott &
   White Health; Baylor University; Baylor University Medical Center;
   Baylor University Medical Center; Baylor University
RP Leeds, SG (通讯作者)，Baylor Univ, Med Ctr, Dept Minimally Invas Surg, Dallas, TX 75246 USA.; Leeds, SG (通讯作者)，Baylor Scott & White Hlth, Ctr Adv Surg, Dallas, TX 75246 USA.; Leeds, SG (通讯作者)，Baylor Univ, Med Ctr, Div Minimally Invas Surg, 3500 Gaston Ave,1st Floor Roberts Bldg, Dallas, TX 75246 USA.
EM Steven.Leeds@BSWHealth.org
OI Ward, Marc/0000-0002-7147-3994
CR Bludau M, 2018, SURG ENDOSC, V32, P1906, DOI 10.1007/s00464-017-5883-4
   Brangewitz M, 2013, ENDOSCOPY, V45, P433, DOI 10.1055/s-0032-1326435
   Goenka MK, 2015, WORLD J GASTRO ENDOS, V7, P702, DOI 10.4253/wjge.v7.i7.702
   Leeds SG, 2016, SURG OBES RELAT DIS, V12, P1278, DOI 10.1016/j.soard.2016.01.017
   Leeds SG, 2016, JAMA SURG, V151, P573, DOI 10.1001/jamasurg.2016.0255
   Mencio MA, 2018, SURG ENDOSC, V32, P3349, DOI 10.1007/s00464-018-6055-x
   Pines G, 2018, J LAPAROENDOSC ADV S, V28, P33, DOI 10.1089/lap.2017.0318
   Schniewind B, 2013, SURG ENDOSC, V27, P3883, DOI 10.1007/s00464-013-2998-0
   Szymanski K, 2018, CASE REP SURG, V2018, DOI 10.1155/2018/2494069
   Wedemeyer J, 2008, GASTROINTEST ENDOSC, V67, P708, DOI 10.1016/j.gie.2007.10.064
   Weidenhagen R, 2008, SURG ENDOSC, V22, P1818, DOI 10.1007/s00464-007-9706-x
NR 11
TC 25
Z9 30
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD DEC
PY 2019
VL 33
IS 12
BP 3970
EP 3975
DI 10.1007/s00464-019-06685-2
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA JT4QX
UT WOS:000500976900013
PM 30747284
DA 2026-07-24
ER

PT J
AU Li, JQ
   Topaz, M
   Xun, WX
   Li, WZ
   Wang, XL
   Liu, HB
   Yuan, YQ
   Chen, SZ
   Li, YJ
   Li, XY
AF Li, Jinqing
   Topaz, Morris
   Xun, Wenxing
   Li, Wangzhou
   Wang, Xiaolin
   Liu, Haibo
   Yuan, Yanqin
   Chen, Shaozong
   Li, Yuejun
   Li, Xueyong
TI New swine model of infected soft tissue blast injury
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Blast injury; animal models; infection; wound healing
ID VACUUM-ASSISTED CLOSURE; WOUNDS; WAR; CASUALTIES; IRAQI
AB BACKGROUND: War injuries, especially blast injuries, have a high risk of infection. However, no animal models of infected war injuries have been built in large animals, which retards both the understanding and the treatment optimization of infected war injuries.
   METHODS: Soft tissue blast injuries were created by explosion of electric detonators in white domestic pigs. The ultra structure of the tissue around the wound was determined by transmission electron microscope. To develop infection of blast injury wounds, the pigs were housed in a standard animal house which was disinfected periodically, and the wounds were left untreated for 3 days. Wound specimens were collected daily to determine the bacterial load and bacterial components. To determine whether infection induces tissue necrosis in infected soft tissue blast injury wounds, uninfected blast injury wounds were created as controls of infected wounds by surgical debridement daily, and the wound area and wound depth of both wounds were measured.
   RESULTS: The wound area and the wound depth of the soft tissue blast injury created in this study fell in the range of human moderate soft tissue war injuries, and the ultra structure of the wounds was comparable with that of human blast injury wounds. The bacterial load of uninfected wounds was under 105 colony forming unit/g during the first 3 days of injury, while that of infected wounds was over 107 colony forming unit/g after 2 days of injury. The infected soft tissue blast injury wounds contained most of the bacteria frequently isolated in battlefield wounds. In addition, infection induced evident tissue necrosis in infected blast injury wounds.
   CONCLUSION: The infected soft tissue blast injury wounds mimic those in human, and they can be used to address key points of treatment optimization. (J Trauma Acute Care Surg. 2012;73:908-913. Copyright (C) 2012 by Lippincott Williams & Wilkins)
C1 [Li, Jinqing; Xun, Wenxing; Li, Wangzhou; Wang, Xiaolin; Liu, Haibo; Yuan, Yanqin; Chen, Shaozong; Li, Yuejun; Li, Xueyong] Fourth Mil Med Univ, Tangdu Hosp, Dept Plast & Burns, Xian 710038, Peoples R China.
   [Topaz, Morris] Hillel Yaffe Med Ctr, Plast Surg Unit, Hadera, Israel.
C3 Air Force Medical University
RP Li, XY (通讯作者)，Fourth Mil Med Univ, Tangdu Hosp, Dept Plast & Burns, Xian 710038, Peoples R China.
EM tdzhxing@fmmu.edu.cn
RI Liu, Haibo/AAI-6812-2020; Liu, Haibo/AAI-6812-2020; Li,
   Jinqing/A-2334-2013
OI Liu, Haibo/0000-0002-6999-8927; Liu, Haibo/0000-0002-4213-2883; Li,
   Jinqing/0000-0003-4635-2661
FU National Natural Science grant [81071570, 30872679]; China National
   Natural Science Committee grant [81071570, 30872679]
FX Supported by National Natural Science grant (No. 81071570 and No.
   30872679) and China National Natural Science Committee grant (No.
   81071570 to J.L. and No. 30872679 to Y.L.).
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   Yvette SM, 2005, 105 GEN M AM SOC MIC
NR 26
TC 9
Z9 12
U1 0
U2 14
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD OCT
PY 2012
VL 73
IS 4
BP 908
EP 913
DI 10.1097/TA.0b013e318253b592
PG 6
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 029OL
UT WOS:000310505100019
PM 22710779
DA 2026-07-24
ER

PT J
AU Ahumada, LA
   de la Torre, JL
   Ray, PD
   Espinosa-de-los-Monteros, A
   Long, JN
   Grant, JH III
   Gardner, PM
   Fix, RJ
   Vásconez, LO
AF Ahumada, LA
   de la Torre, JL
   Ray, PD
   Espinosa-de-los-Monteros, A
   Long, JN
   Grant, JH III
   Gardner, PM
   Fix, RJ
   Vásconez, LO
TI Comorbidity trends in patients requiring sternectorny and reconstruction
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article; Proceedings Paper
CT Annual Meeting of the Southeastern-Society-of-Plastic-Surgeons
CY JUN, 2004
CL Hot Springs, VA
SP SE Soc Plastic Surg
DE stemectomy; flap; mediastinitis; gender
ID CONSECUTIVE OPERATIVE PROCEDURES; STERNAL WOUND COMPLICATIONS;
   VACUUM-ASSISTED CLOSURE; OPEN-HEART-SURGERY; RISK-FACTORS; MUSCLE FLAPS;
   STERNOTOMY; INFECTION; MEDIASTINITIS; IRRIGATION
AB Introduction: The predisposing risk factors for sternal wound infection have been well delineated. However, the indications and comorbidity of patients who require cardiac surgery via the median sternotomy approach have changed over time and subsequently have changed the patient population presenting with sternal wound complications. These trends in cardiac surgery may require an adjustment of the plastic surgical approach and methods to optimize outcomes in the patient population.
   Methods: A retrospective review was performed to identify patients who had undergone sternectomy or sternal debridement followed by flap coverage. A total of 93 cases performed between 1999 and 2004 examined to collect data about the initial presentation, operative procedure, and postoperative care of each patient. The data were then analyzed to identify population characteristics using logistic regression variables to determine univariate and adjusted (multivariable) measures of association with mortality.
   Results: Results of the review indicated that 53% of the patients were male and 47% were female, with a median age of 62 years. Preoperative comorbidities included 64% of the patients were over age 60, 43% had diabetes, 51% had hypertension, 13% had renal insufficiency, and 6% were transplant recipients. The method of reconstruction varied, but the majority were pectoralis advancement flaps. Of the patients who underwent debridement and reconstruction, there was a 16% 30-day mortality. Among these mortalities, the distribution was 33% (5/15) male and 66% (10/15) female.
   Conclusions: Though the incidence of sternal wound problerns is rare (about 1%-5%), there is a significant population of older, renal-insufficient, malnourished patients who present days or weeks after one would normally diagnose and treat a deep sternal wound infection who have a significant mortality rate. Appropriate identification of risk factors, preoperative management and timing for aggressive surgical treatment is required to maximize successful outcomes in this problematic patient population.
C1 UAB, Div Plast Surg, Birmingham, AL 35294 USA.
C3 University of Alabama System; University of Alabama Birmingham
RP de la Torre, JL (通讯作者)，UAB, Div Plast Surg, 510 20th St,South FOT-1164, Birmingham, AL 35294 USA.
EM jdlt@uab.edu
OI de la Torre, Jorge/0000-0002-3937-4769
CR Arnold PG, 1996, PLAST RECONSTR SURG, V98, P804, DOI 10.1097/00006534-199610000-00008
   Berg HF, 2000, ANN THORAC SURG, V70, P924, DOI 10.1016/S0003-4975(00)01524-1
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NR 27
TC 12
Z9 12
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD MAR
PY 2005
VL 54
IS 3
BP 264
EP 268
DI 10.1097/01.sap.0000153096.12780.19
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 900OD
UT WOS:000227223300012
PM 15725829
DA 2026-07-24
ER

PT J
AU Xu, YJ
   Gao, X
   Ding, H
   Bu, XM
   Wang, HB
   Wu, B
AF Xu, Ying-Jie
   Gao, Xu
   Ding, Hao
   Bu, Xian-Min
   Wang, Hai-Bin
   Wu, Bin
TI Effects of 1-stage revascularization and temporary external fixation
   combined with 2-stage Ilizarov technique in the treatment of bone
   defects in lower limb destruction injury: A case report
SO MEDICINE
LA English
DT Article
DE external fixation; Ilizarov bone transport; limb bone defect;
   reascularization
ID FRACTURES; TRANSPORT; MANAGEMENT
AB Rationale: To evaluate the clinical effects of 1-stage revascularization, vacuum sealing drainage covering the wound, temporary external fixation and 2-stage Ilizarov bone transport for the treatment limb destruction injury. Patient concerns and diagnosis: Nine patients with limb destruction injury between September 2014 and June 2019 at our institute were evaluated retrospectively. The age of patient was 21 to 51 years with an average of 33 years. The injuries were caused by vehicle accidents in 4 patients, gunshot in 1 patient, and crushing injuries in 4 patients. All of them had vascular injury. The average length of bone defect was 9.5 (8.3-10) cm. Regular follow-up was performed on wound healing, bone transport time, bone healing time, external fixation index, and limb function. Interventions: All patients underwent 1-stage revascularization and temporary external fixation during emergency surgery, and then gradual bone transport by Ilizarov fixator was performed until the broken fracture site was reunited. Outcomes: Nine patients were followed up for 12 to 48 months (average 30 months). Six patients were treated with autogenous cancellous bone graft for the second time, and 2 patients healed spontaneously. The mean wound healing time was 86 (73-90) days. The bone transport time was 97 (88.3-105.3) days, and the bone mineralization time was 164.5 (156.8-181.3) days, and the healing time of the docking sites was 6.8 (6.1-8.3) months. The external fixator time was 14.5 (12.5-17) months with the external fixation index was 1.5 (1.4-1.8) m/cm. At the last follow-up, according to the Association for the Study of the Method of Ilizarov functional scores, excellent functional outcomes were obtained in 5 patients, good in 1 patients, moderate in 2 patients. According to the Association for the Study of the Method of Ilizarov Radiological System, excellent functional outcomes were obtained in 6 cases and good in 2 cases. Lessons: One-stage revascularization and temporary external fixation combined with 2-stage Ilizarov bone transport technique for the treatment of bone defects in limb destruction injury have satisfactory clinical effects and few complications, and can be applied under the condition of strict understanding of surgical indications.
C1 [Xu, Ying-Jie; Ding, Hao] Jining Med Univ, Dept Clin Med, Jining City, Peoples R China.
   [Gao, Xu] Qingdao Univ, Dept Qingdao Med Coll, Qingdao, Peoples R China.
   [Bu, Xian-Min] Jining 1 Peoples Hosp, Dept Pathol, Jining City, Peoples R China.
   [Wang, Hai-Bin; Wu, Bin] Jining Med Univ, Dept Orthoped, Affiliated Hosp, 89 Guhual Rd, Jining City 272029, Shandong, Peoples R China.
C3 Jining Medical University; Qingdao University; Jining Medical University
RP Wu, B (通讯作者)，Jining Med Univ, Dept Orthoped, Affiliated Hosp, 89 Guhual Rd, Jining City 272029, Shandong, Peoples R China.
EM wb0902@163.com
FU "Jining Medical University Helin Academician Fund" [JYHL2018FMS13];
   "Supporting Fund for Teachers' Research at Jining Medical University
   [JYFC2018FKJ048]; "Jining Science and Technology Bureau Medical Health
   Fund" [2018SMNS002]; Cultivation plan of high-level scientific research
   project of Jining Medical University [JYGC2021FKJ016]; Jining key
   research and development project [2021YXNS029]
FX This study was supported by the "Jining Medical University Helin
   Academician Fund" (grant number JYHL2018FMS13), the "Supporting Fund for
   Teachers' Research at Jining Medical University" (grant number
   JYFC2018FKJ048), the "Jining Science and Technology Bureau Medical
   Health Fund" (grant number 2018SMNS002), Cultivation plan of high-level
   scientific research project of Jining Medical University
   (JYGC2021FKJ016), Jining key research and development project
   (2021YXNS029).
CR Ahmed ASAA, 2019, INJURY, V50, P1731, DOI 10.1016/j.injury.2019.05.011
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NR 18
TC 1
Z9 2
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD AUG 19
PY 2022
VL 101
IS 33
AR e30149
DI 10.1097/MD.0000000000030149
PG 4
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 3V8UT
UT WOS:000841935100074
PM 35984144
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Ma, XY
   Yuan, H
   Cui, D
   Liu, B
   Han, TY
   Yu, HL
   Zhou, DP
AF Ma, Xiang-Yu
   Yuan, Hong
   Cui, Dong
   Liu, Bing
   Han, Tian-Yu
   Yu, Hai-Long
   Zhou, Da-Peng
TI Management of segmental defects post open distal femur fracture using a
   titanium cage combined with the Masquelet technique A single-centre
   report of 23 cases
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Masquelet technique; Open fractures; Distal femur; Segmental bone
   defects; Titanium cage
ID PLATE OSTEOSYNTHESIS MIPO; CANCELLOUS BONE-GRAFT; MESH CAGE; LOCKING
   PLATE; TRANSPORT; RECONSTRUCTION
AB Introduction: The segmental bone defects post open distal femur fracture presents a reconstructive challenge, which often requires extreme solutions. The present study reviewed a new treatment strategy which used a cylindrical titanium mesh cage as an adjunct to the Masquelet technique. Methods: We retrospectively reviewed a consecutive series of 23 patients treated for segmental bone defects post open distal femur fracture using a titanium mesh cage combined with the Masquelet technique under a 2-staged protocol in our institution from 2017 to 2021. The study group consisted of 13 men and 10 women with an average age of 44.1 years. The surgical debridement was performed with antibiotic polymethylmethacrylate (PMMA) cement spacer implanted into the bone defect combined with cement-wrapped plate stabilization, or antibiotic beads with vacuum sealing drainage (VSD) to cover the wound. The second stage of the Masquelet technique for bone defect repair began at least 4-6 weeks after the first stage, once all signs of possible infection were eliminated. After the cement spacer was removed, the definitive reconstruction was completed with ex-change to a cylindrical titanium mesh cage filled with cancellous autograft within the induced membrane. The bone defect with cage was stabilized with a distal femoral Less Invasive Stabilization System (LISS). The radiological and clinical records of the enrolled patients were retrospectively analyzed. Results: The mean follow-up was 38.6 months. The average number of operations before the second stage was 1.3. The mean interval between the two stages was 12.7 weeks. The average length of the defect measured 8.3 cm (ranging from 6.1 to 12.4 cm). All the defects filled with autograft within the cage achieved bony union, with a mean healing time of 8.4 months. At the latest follow-up, the mean knee extension measured 6.2 degrees (ranging from 0 degrees to 20 degrees), and the mean flexion measured 101.8 degrees (ranging from 60 degrees to 120 degrees). Complications included two in-stances of superficial stitch abscess, which eventually healed. Conclusions: The use of a titanium cage implanted into an induced membrane in a 2-staged Masquelet protocol could achieve satisfactory clinical outcomes in cases of segmental defects following open distal femur fractures.
C1 [Ma, Xiang-Yu; Yuan, Hong; Liu, Bing; Han, Tian-Yu; Yu, Hai-Long; Zhou, Da-Peng] Gen Hosp Northern Theatre Command, Dept Orthoped, Shenyang 110016, Liaoning, Peoples R China.
   [Cui, Dong] 967 Hosp PLA Joint Logist Support Force, Dept Cardiol, Dalian 116011, Liaoning, Peoples R China.
RP Zhou, DP (通讯作者)，Gen Hosp Northern Theatre Command, Dept Orthoped, Shenyang 110016, Liaoning, Peoples R China.
EM me3210@163.com
OI Dapeng, Zhou/0000-0001-7455-5699
FU Liaoning Province Natural Science Foundation of China [2021-MS-038,
   2021JH2/10300057]; Shenyang Municipal Science and Technology Foundation
   [22-321-32-07]
FX This work was supported by the grant from Liaoning Province Natural
   Science Foundation of China (No. 2021-MS-038) to Xiang-Yu Ma, Liaoning
   Province Natural Science Foundation of China (No. 2021JH2/10300057) to
   Da-Peng Zhou, and Shenyang Municipal Science and Technology Foundation
   (No. 22-321-32-07) to Da-Peng Zhou.
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   Zhang Q, 2017, J ORTHOP SURG RES, V12, DOI 10.1186/s13018-017-0684-y
   Zhao XR, 2021, J CRANIOFAC SURG, V32, P1182, DOI 10.1097/SCS.0000000000007212
NR 59
TC 6
Z9 6
U1 0
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD DEC
PY 2023
VL 54
IS 12
AR 111130
DI 10.1016/j.injury.2023.111130
EA OCT 2023
PG 7
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA Z2OW3
UT WOS:001110531900001
PM 37890289
DA 2026-07-24
ER

PT J
AU Ye, SM
   Jin, N
   Sun, J
   Zhang, LQ
   Zhang, JS
   Jing, JH
AF Ye, Shuming
   Jin, Neng
   Sun, Jian
   Zhang, Liqian
   Zhang, Jisen
   Jing, Juehua
TI Delayed Reconstruction of the Perforator Pedicle Propeller Flap after
   the Induced Membrane Technique for Gustilo IIIB Open Distal Tibial
   Fracture
SO ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE
LA English
DT Article; Early Access
ID BONE DEFECTS; SOFT-TISSUE; MASQUELET TECHNIQUE; MANAGEMENT;
   OSTEOMYELITIS; EPIDEMIOLOGY; ILIZAROV; FIXATION; TRAUMA
AB Objective This study aimed to evaluate the safety and efficacy of delayed reconstruction of the perforator pedicle propeller flap after the induced membrane technique in the treatment of Gustilo IIIB open distal tibial fracture, and to evaluate the clinical outcome and complications of two different perforator pedicle propeller flaps.
   Methods Thirty-four patients with Gustilo IIIB open distal tibial fractures treated by the induced membrane technique and delayed reconstruction of two different perforator pedicle propeller flaps from May 2017 to March 2022 were retrospectively analyzed. Patients were divided into two groups according to the different kinds of perforator pedicle propeller flaps covered. The operation required two stages. The Radiographic Union Score for Tibial fractures (RUST) was used to evaluate the healing of the tibial bone defect. The American Orthopaedic Foot and Ankle Society (AOFAS) score was used to evaluate ankle function. The complications associated with the technique were recorded.
   Results The number of serial debridements, excluding those performed during emergency and final operations, was a mean of 2.28 +/- 0.83 in the PAPF group and 2.19 +/- 0.83 in the PTAPF group. The PAPF group had a mean bone defect length of 6.76 +/- 0.69 cm, the median healing time of 13.11 +/- 0.96 months, RUST score 12.68 +/- 1.63, and AOFAS score of 84.12 +/- 6.38. On the other hand the PTAPF group's mean bone defect length was 6.73 +/- 0.95 cm, the median healing time 12.63 +/- 1.46 months, RUST score 13.73 +/- 1.53 and AOFAS score 82.79 +/- 5.49. There were no observed significant differences between the two groups in the number of serial debridements, bone defect length, bone union time, RUST score, or AOFAS score (p > 0.05). Flap size ranged from 9 x 6 cm(2) to 14 x 7 cm(2) in the PAPF group and from 9 x 6 cm(2) to 13 x 7 cm(2) in the PTAPF group. There were no severe complications such as flap-related complications or amputation. The differences in complications in the two groups were not statistically significant.
   Conclusion In cases of severe open tibial fracture, the reconstructive method is important. When delayed reconstruction is inevitable, surgeons should first perform radical debridement, followed by vacuum sealing drainage as a bridging therapy; both PAPF and PTAPF can be considered for definitive soft tissue coverage.
C1 [Ye, Shuming] Anhui Med Univ, Affiliated Hosp 2, Dept Orthopaed Surg, Hefei, Peoples R China.
   [Ye, Shuming; Jin, Neng; Sun, Jian; Zhang, Liqian; Zhang, Jisen; Jing, Juehua] Anhui Med Univ, Affiliated Hosp 2, Inst Orthopaed, Res Ctr Translat Med, Hefei, Peoples R China.
   [Jin, Neng; Zhang, Liqian; Zhang, Jisen] Anhui Med Univ, Affiliated Hosp 2, Dept Orthopaed, Hefei, Peoples R China.
   [Sun, Jian; Jing, Juehua] Anhui Med Univ, Affiliated Hosp 2, Dept Orthoped Surg, Hefei, Peoples R China.
C3 Anhui Medical University; Anhui Medical University; Anhui Medical
   University; Anhui Medical University
RP Ye, SM (通讯作者)，Anhui Med Univ, Affiliated Hosp 2, Dept Orthopaed Surg, Furong Rd 678, Hefei 230601, Peoples R China.
EM yeshumingsuda@163.com
FU Hefei Municipal Natural Science Foundation [2021010]; Natural Science
   Foundation of Anhui Province Universities [KJ2020A0182]; Clinical
   Research Cultivation Project of the Second Affiliated Hospital of Anhui
   Medical University [2020LCYB07]; Research Found of Anhui Institute of
   Translational Medicine [2022zhyx-C55]
FX 2021010 | Hefei Municipal Natural Science Foundation | KJ2020A0182 |
   Natural Science Foundation of Anhui Province Universities | 2020LCYB07 |
   Clinical Research Cultivation Project of the Second Affiliated Hospital
   of Anhui Medical University | 2022zhyx-C55 | Research Found of Anhui
   Institute of Translational Medicine
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   Vathulya M, 2021, ARCH PLAST SURG-APS, V48, P417, DOI 10.5999/aps.2020.02089
   Wang P, 2021, INJURY, V52, P988, DOI 10.1016/j.injury.2020.12.009
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NR 35
TC 2
Z9 4
U1 0
U2 6
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 1864-6697
EI 1864-6743
J9 Z ORTHOP UNFALLCHIR
JI Z. Orthop. Unfallchir.
PD 2023 SEP 22
PY 2023
DI 10.1055/a-2151-5175
EA SEP 2023
PG 11
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA S5IC9
UT WOS:001071492600001
PM 37739012
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Wang, JS
   Liu, QZ
   He, D
   Xia, HL
AF Wang, Jingshuang
   Liu, Qizan
   He, Da
   Xia, Hongle
TI EFFECT OF NEGATIVE PRESSURE SEALING AND DRAINAGE (VSD) TECHNIQUE ON
   WOUND INFECTION IN ADULT ORTHOPAEDICS AND ITS INFLUENCE FITNESS
   INDICATOR
SO REVISTA INTERNACIONAL DE MEDICINA Y CIENCIAS DE LA ACTIVIDAD FISICA Y
   DEL DEPORTE
LA English
DT Article
DE Negative pressure sealing and drainage; Adult orthopedic wound
   infection; Inflammatory state; Bacterial negative rate; Wound recovery
ID OPEN FRACTURES; IIIC INJURIES; MANAGEMENT; METAANALYSIS; RISK
AB Objective: To investigate the effect of vacuum sealing drainage (VSD) in the healing of adult orthopedic wound infection, and to explore the effect of intervention on white blood cell (WBC) and C-reactive protein (CRP) levels; Methods: 80 adult Athlete patients with orthopedic wound infection who were healed in our hospital from January 2020 to January 2022 were retrospectively opted as the research subjects, and were divided into the VSD cluster (n=40, receiving VSD technology) and the control cluster according to their healing methods (CG, n=40, receiving conventional gauze dressing healing), the variations in WBC and CRP between the two clusters before healing, on the 5th day of healing, on the 10th day of healing, and on the 15th day of healing were contrasted between the two clusters, and the wound surfaces of the two clusters of athlete patients were contrasted at the above time points. The variation in appearance, the variation in the bacterial negative rate of the wound surface after the intervention was contrasted, and the wounded limb marks of the two clusters of athlete patients were followed up; Results: (1) On the 5th day, 10th day and 15th day of healing, the WBC and CRP levels in the VSD cluster were notably lower than those within the control cluster (P < 0.05); (2) On the 5th day, 10th day and 15th day of healing, the wound appearance marks in the VSD cluster were notably upper than those within the control cluster, and the variation between the clusters was notable (P < 0.05); (3) The wound bacterial conversion rates within the study cluster were 40.00%, 70.00% and 95.00% at 1 month, 2 months and 3 months after operation, respectively, which were notably upper than 17.50%, 47.50% and 80.00% within the control cluster, and the variation between the clusters was notable (P < 0.05); (4) At 1 month, 2 months and 3 months after operation, the Puno limb marks within the study cluster were notably upper than those within the control cluster, and the variation between the clusters was notable (P < 0.05); Conclusion: VSD technology has a good effect on the healing of adult orthopedic wound infection, can notably enhance the athlete patient's inflammatory state, notably enhance the bacterial negative rate of the patient's wound, help to speed up the patient's recovery process, and has positive sense for the athlete patient's wound recovery.
C1 [Wang, Jingshuang; Liu, Qizan; He, Da; Xia, Hongle] Cangzhou Hosp Integrated TCM WM Hebei, Cangzhou 061000, Hebei, Peoples R China.
RP Wang, JS (通讯作者)，Cangzhou Hosp Integrated TCM WM Hebei, Cangzhou 061000, Hebei, Peoples R China.
EM jingshuang1979@163.com
CR Ataya GE, 2019, Jornal Brasileiro de Patologia e Medicina Laboratorial, V55, DOI 10.5935/1676-2444.20190013
   Duan HJ, 2020, J WOUND CARE, V29, P510, DOI 10.12968/jowc.2020.29.9.510
   Foote CJ, 2021, J BONE JOINT SURG AM, V103, P265, DOI 10.2106/JBJS.20.01103
   Garner MR, 2020, J AM ACAD ORTHOP SUR, V28, P309, DOI 10.5435/JAAOS-D-18-00193
   Hand TL, 2020, J BONE JOINT SURG AM, V102, P1468, DOI 10.2106/JBJS.19.01358
   Higgin R, 2021, INJURY, V52, P2434, DOI 10.1016/j.injury.2021.05.042
   Horton SA, 2021, INJURY, V52, P1351, DOI 10.1016/j.injury.2021.03.057
   Huang C G, 2020, Zhonghua Shao Shang Za Zhi, V36, P534, DOI 10.3760/cma.j.cn501120-20200115-00024
   Huang QQ, 2021, TRANSL PEDIATR, V10, P2489, DOI 10.21037/tp-21-399
   Li JM, 2019, MEDICINE, V98, DOI 10.1097/MD.0000000000016481
   Lin CA, 2021, J BONE JOINT SURG AM, V103, P609, DOI 10.2106/JBJS.20.01229
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   Mener A, 2021, J SURG RES, V268, P33, DOI 10.1016/j.jss.2021.05.048
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   Sagi HC, 2021, J ORTHOP TRAUMA, V35, P449, DOI 10.1097/BOT.0000000000002094
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NR 21
TC 0
Z9 0
U1 0
U2 4
PU RED IRIS
PI MADRID
PA EDIF BRONCE, PLAZA DE MANUEL GOMEZ MORENO, S-N 2A PLANTA, MADRID, 28020,
   SPAIN
SN 1577-0354
J9 REV INT MED CIENC AC
JI Rev. Int. Med. Cienc. Act. Fis. Dep.
PD JUN
PY 2023
VL 23
IS 90
BP 170
EP 180
DI 10.15366/rimcafd2023.90.013
PG 11
WC Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Sport Sciences
GA L6FW9
UT WOS:001024212300003
DA 2026-07-24
ER

PT J
AU Sheng, X
   Hu, L
   Li, T
   Zou, Y
   Fu, HY
   Xiong, GP
   Zhu, Y
   Deng, B
   Xiong, LL
   Yin, XL
AF Sheng, Xia
   Hu, Ling
   Li, Ting
   Zou, Yi
   Fu, Hai-Yan
   Xiong, Guo-Ping
   Zhu, Yan
   Deng, Bo
   Xiong, Lei-Lei
   Yin, Xiao-Ling
TI Clinical efficacy and mechanism of the combination of autologous
   platelet-rich gel and recombinant human acidic fibroblast growth factor
   in the management of refractory diabetic foot
SO FRONTIERS IN ENDOCRINOLOGY
LA English
DT Article
DE diabetic foot; oxidative stress; pigment epithelium-derived factor;
   platelet-rich gel; vascular endothelial growth factor
AB Objective This study aims to explore the influence of combining autologous platelet-rich gel (APG) with continuous vacuum-sealed drainage (CVSD) and the exogenous recombinant human acidic fibroblast growth factor (rh-aFGF) on the healing processes of diabetic foot ulcers (DFU). The primary objective is to elucidate the complex molecular mechanisms associated with DFU, providing innovative perspectives for its treatment. Methods Ninety patients diagnosed with DFU were randomly allocated into three distinct groups. Group A underwent CVSD following wound cleansing to facilitate healing. In Group B, in addition to conventional treatment, negative pressure wound therapy was applied, and rh-aFGF was introduced into normal saline for lavage, building upon the procedures of Group A. Group C received APG along with the interventions applied in Group B. The clinical efficacy of each group was systematically observed and analyzed. Additionally, changes in plasma oxidative stress, inflammatory markers, vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor (PEDF) were assessed both before treatment and 14 days post-treatment. Results Following treatment, all groups exhibited commendable clinical efficacy. Group C demonstrated a superior wound healing rate, reduced frequency of dressing changes, and shorter wound healing duration (P< 0.05). Compared to baseline measurements, the levels of superoxide dismutase and PEDF increased, while malondialdehyde, VEGF, interleukin-6, interleukin-8, and monocyte chemotactic factor MCP-1 decreased in the wound tissue across all groups. Notably, Group C showed the most significant improvement in clinical efficacy and fortification of molecular mechanisms against oxidative stress (all P< 0.05). Conclusions The integrative therapeutic approach combining APG with CVSD and rh-aFGF demonstrates notable efficacy in advancing wound healing. This effectiveness is evident through the reduced frequency of dressing changes and alleviation of wound-related pain. Additionally, the treatment regimen improves the cure rate for challenging, refractory wounds. These favorable outcomes can be attributed to the reduction of oxidative stress levels, attenuation of the local inflammatory response, and the enhancement of the balance between PEDF and VEGF.
C1 [Sheng, Xia; Hu, Ling; Li, Ting; Zou, Yi; Fu, Hai-Yan; Xiong, Guo-Ping; Zhu, Yan; Deng, Bo; Xiong, Lei-Lei; Yin, Xiao-Ling] Nanchang Univ, Hosp Nanchang 1, Affiliated Hosp 3, Dept Metab & Endocrinol,Jiangxi Prov Key Lab Metab, Nanchang, Peoples R China.
C3 Nanchang University
RP Hu, L (通讯作者)，Nanchang Univ, Hosp Nanchang 1, Affiliated Hosp 3, Dept Metab & Endocrinol,Jiangxi Prov Key Lab Metab, Nanchang, Peoples R China.
EM drhu_hl1172@163.com
RI Li, Ting/JCN-8036-2023
FU Key Research and Development Projects of Jiangxi Province
   [20203BBG73053]
FX The author(s) declare financial support was received for the research,
   authorship, and/or publication of this article. This study was funded by
   the Key Research and Development Projects of Jiangxi Province (Grant No.
   20203BBG73053).
CR Barc P, 2022, INT J ENV RES PUB HE, V19, DOI 10.3390/ijerph191912818
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NR 17
TC 12
Z9 17
U1 4
U2 19
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 1664-2392
J9 FRONT ENDOCRINOL
JI Front. Endocrinol.
PD OCT 30
PY 2024
VL 15
AR 1374507
DI 10.3389/fendo.2024.1374507
PG 9
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA L8X6Q
UT WOS:001353499700001
PM 39539934
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kim, MJ
   Jeong, YS
   Kim, TW
   Park, DH
   Lee, IJ
AF Kim, Min Ji
   Jeong, Yon Soo
   Kim, Tae Wook
   Park, Dong Ha
   Lee, Il Jae
TI The clinical efficacy of pure-grind acellular dermal matrix without
   gelatin in lower extremity skin defect treatment: A prospective
   randomized study
SO FRONTIERS IN MATERIALS
LA English
DT Article
DE acellular dermal matrix; skin defect; leg ulcer; wound healing; wounds
   and injuries
ID CROSS-LINKING; COVERAGE; SCAFFOLD; PASTE
AB Background: Acellular dermal matrix (ADM) is currently considered as a replacement for lost extracellular matrix. Trials have been conducted on dressing materials with high contents of ADM without any impurities, such as gelatin, which only undergo the grinding process. In this study, we aimed to investigate the clinical application and wound healing effect of pure-grind ADM in lower extremity skin defect treatment. Methods: Patients with skin defects in the lower extremities who did not achieve wound healing within 4 weeks with conservative treatment were enrolled in this study from March 2021 to July 2021. We randomized the patients into two groups. The patients in the experimental group were treated with pure-grind ADM and conventional negative-pressure wound therapy (NPWT), whereas the patients in the control group were only treated with NPWT. Every wound was followed-up for 7 weeks, and complete wound healing was confirmed when the skin defect was fully covered with epithelized tissue. Results: A total of 41 patients were enrolled in this study. Complete wound healing was observed in 73.2% of patients, and 26.8% had an unhealed status until the end of the follow-up. The pure-grind ADM did not promote complete healing (p = 0.796) and was not associated with epithelization time but promoted the velocity of epithelization (experimental 5.58 vs. 3.50 cm(2)/day, p = 0.020). Considering the time of healing, the decrease in wound depth was more extensive (p = 0.021), the speed of granulation tissue formation was higher, and this difference was more evident after 5 weeks of treatment in the experimental group. Conclusion: We demonstrated the clinical efficacy of pure-grind ADM in treatment of lower extremity skin defects. This new type of ADM, without any impurities, is important in wound healing. Its depth filling effect is powerful, and it can promote epithelization velocity and speed of granulation tissue formation.
C1 [Kim, Min Ji; Jeong, Yon Soo; Kim, Tae Wook; Park, Dong Ha; Lee, Il Jae] Ajou Univ, Sch Med, Dept Plast & Reconstruct Surg, Suwon, South Korea.
C3 Ajou University
RP Lee, IJ (通讯作者)，Ajou Univ, Sch Med, Dept Plast & Reconstruct Surg, Suwon, South Korea.
EM i00325@live.co.kr
RI Kim, Taewook/GSD-3143-2022
FU Korea Health Technology R&D Project through the Korea Health Industry
   Development Institute (KHIDI) - Ministry of Health and Welfare, Republic
   of Korea;  [HI20C2140]
FX Funding This research was supported by a grant from the Korea Health
   Technology R&D Project through the Korea Health Industry Development
   Institute (KHIDI), funded by the Ministry of Health and Welfare,
   Republic of Korea (grant number: HI20C2140).
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   Jang HJ, 2018, J BIOMATER APPL, V32, P716, DOI 10.1177/0885328217741758
   Jeon M, 2018, ARCH PLAST SURG-APS, V45, P564, DOI 10.5999/aps.2018.00605
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   Kim GH, 2019, INT J ENV RES PUB HE, V16, DOI 10.3390/ijerph16050704
   Kim YH, 2022, J CLIN MED, V11, DOI 10.3390/jcm11082203
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   Lee M, 2020, WOUNDS, V32, P50
   Li R, 2011, BIOMATERIALS, V32, P4525, DOI 10.1016/j.biomaterials.2011.03.008
   Ma PP, 2020, INT J BIOL MACROMOL, V164, P677, DOI 10.1016/j.ijbiomac.2020.07.019
   Martin Billy R, 2005, Int Wound J, V2, P161, DOI 10.1111/j.1742-4801.2005.00099.x
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   Taylor DA, 2018, ACTA BIOMATER, V74, P74, DOI 10.1016/j.actbio.2018.04.044
   Tognetti L, 2021, DERMATOL THER, V34, DOI 10.1111/dth.14987
   Vidya R, 2017, BREAST J, V23, P670, DOI 10.1111/tbj.12810
   Yim H, 2010, BURNS, V36, P322, DOI 10.1016/j.burns.2009.10.018
   Zhang YZ, 2006, POLYMER, V47, P2911, DOI 10.1016/j.polymer.2006.02.046
   Zhong SP, 2010, WIRES NANOMED NANOBI, V2, P510, DOI 10.1002/wnan.100
NR 32
TC 2
Z9 2
U1 0
U2 3
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-8016
J9 FRONT MATER
JI Front. Mater.
PD NOV 10
PY 2022
VL 9
AR 1013245
DI 10.3389/fmats.2022.1013245
PG 10
WC Materials Science, Multidisciplinary
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Materials Science
GA 6N3HE
UT WOS:000889447800001
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Stansby, G
   Wealleans, V
   Wilson, L
   Morrow, D
   Gooday, C
   Dhatariya, K
AF Stansby, G.
   Wealleans, V.
   Wilson, L.
   Morrow, D.
   Gooday, C.
   Dhatariya, K.
TI Clinical experience of a new NPWT system in diabetic foot ulcers and
   post-amputation wounds
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE wound pain; wound healing; amputation
ID GREAT TOE AMPUTATION; PRESSURE; THERAPY; MULTICENTER
AB Objective: The primary aim of this pilot observational study was to assess the reduction in wound depth and area achieved with a new negative pressure wound therapy (NPWT) system in diabetic patients with foot ulcers and post-amputation wounds. Secondary aims were to assess pain levels, extent of exudate removal, and ease of use of the system for both the patient and care giver.
   Method: Patients in both acute and home care settings were enrolled into this 4-week study. Dressings were changed three times per week. Wound area and depth, exudate removal and pain severity were evaluated at each dressing change. At the final visit, the investigators and patients were surveyed with respect to equipment and dressings used in the study.
   Results: Sixteen patients were enrolled into the study. Data relating to 14 patients with a variety of post-amputation wounds were included in the intention-to-treat (ITT) analysis. The post-amputation wounds showed a general trend for a reduction in the median wound surface area between baseline (22.9cm(2); range 0.5-55) and the final visit (15.3cm(2); range 2.4-63.5). This equates to a median change (calculated from the percentage change in wound area for each patient individually) of -41% (range -82% to + 15%). There was also a general trend in reduction in the median depth between baseline (17mm; range 0-35) to final visit (5mm; range 0-35). One patient presented with a foot ulcer that demonstrated a 50% reduction in depth from baseline to the final assessment. The device effectively managed wound exudate and most patients reported low pain levels during therapy. Ease of use of the system was rated very highly by investigators and patients.
   Conclusion: This pilot study indicates that the use of the new NPWT system can be expected to have a positive effect on the healing of post-amputation wounds and foot ulcers in patients with diabetes. The findings demonstrate that the system is easy to use, effectively controls exudate and minimises pain and inconvenience for patients being treated with NPWT.
C1 [Stansby, G.; Wealleans, V.; Wilson, L.] Freeman Rd Hosp, Newcastle Upon Tyne, Tyne & Wear, England.
   [Morrow, D.; Gooday, C.; Dhatariya, K.] Norfolk & Norwich Univ Hosp, Norwich, Norfolk, England.
C3 Newcastle Freeman Hospital; Newcastle University - UK; Norfolk & Norwich
   University Hospitals NHS Foundation Trust; Norfolk & Norwich University
   Hospital
RP Stansby, G (通讯作者)，Freeman Rd Hosp, Newcastle Upon Tyne, Tyne & Wear, England.
EM Gerard.stansby@nuth.nhs.uk
OI Gooday, Catherine/0000-0001-5026-6788; Stansby,
   Gerard/0000-0001-5539-3049
FU Molnlycke Heath Care (Gothenburg, Sweden); Medela AG (Baar, Switzerland)
FX This study was sponsored by Molnlycke Heath Care (Gothenburg, Sweden)
   and Medela AG (Baar, Switzerland). The authors have no other conflicts
   of interest that are directly relevant to the content of this
   manuscript.
CR Akbari A, 2007, J REHABIL RES DEV, V44, P631, DOI 10.1682/JRRD.2007.01.0002
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   Terrazas SG, 2006, OSTOMY WOUND MANAG, V52, P16
NR 22
TC 16
Z9 20
U1 0
U2 8
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD NOV
PY 2010
VL 19
IS 11
BP 496
EP 502
DI 10.12968/jowc.2010.19.11.79706
PG 6
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA V29CQ
UT WOS:000208726900006
PM 21135798
DA 2026-07-24
ER

PT J
AU Kadiyala, S
   Powis, E
   Mirahmadi, A
   Mercado, C
   Yu, S
   Velichala, SR
   Colannino, A
   Hung, I
   Bikoroti, JB
   Kubwimana, O
   Dusingizimana, LR
   Alayande, BT
   Ingabire, JCA
   Byiringiro, JC
   Rodriguez, EK
   Agarwal-Harding, KJ
AF Kadiyala, Samhita
   Powis, Emily
   Mirahmadi, Alireza
   Mercado, Carlos
   Yu, Sion
   Velichala, Suhas Rao
   Colannino, Alyssa
   Hung, Isabella
   Bikoroti, Joel B.
   Kubwimana, Olivier
   Dusingizimana, Lambert R.
   Alayande, Barnabas Tobi
   Ingabire, J. C. Allen
   Byiringiro, Jean Claude
   Rodriguez, Edward K.
   Agarwal-Harding, Kiran J.
TI A Novel Hybrid Training Model for Open Fracture Management in Rwanda
SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
LA English
DT Article
AB Open fractures are a critical global health challenge that disproportionately affect individuals in low- and middle-income countries (LMICs), primarily due to road traffic collisions. Surgical management of open fractures is 1 of the 3 essential bellwether procedures identified by The Commission on Global Surgery. LancetWe developed and evaluated a novel hybrid course on open fracture management for surgical trainees and practicing surgeons in Rwanda, combining a self-directed, virtual, pre-course curriculum with a live, in-person workshop in Kigali in June 2025 that was simultaneously live-streamed for virtual attendees. Prerecorded multilingual lectures (English and French) and curated peer-reviewed articles provided foundational knowledge in advance and prepared learners for in-person didactics, case discussions, and skills training. The in-person workshop included didactic sessions and discussions of local clinical cases from Rwanda related to open fracture management and other orthopaedic emergencies, along with hands-on practice in fracture external fixation and negative pressure wound therapy using affordable devices designed for resource-constrained practice. The workshop engaged 160 active learners (37 in-person, 123 virtual) and demonstrated high overall satisfaction among 84 survey respondents, with an average rating of 4.6 out of 5. Self-reported confidence in managing open fractures increased substantially following the course, from a mean rating of 3.83 to 4.69 on a 5-point scale (p < 0.001). Most survey respondents reported that the course moderately or significantly improved their knowledge (96.4%) and would change their clinical practice (96.5%). Participant feedback highlighted opportunities for improvement, including extending the workshop duration to increase hands-on time, expanding the content on complex soft-tissue management, and improving the engagement of remote learners through mechanisms such as the provision of low-cost external fixation models for at-home practice. Future directions include integrating the course into medical student and general practitioner education in Rwanda, adapting it for major surgical conferences regionally and internationally, and continuing to prioritize hands-on training modules. Iterative refinement of the course is planned on the basis of participant feedback.
C1 [Kadiyala, Samhita; Powis, Emily; Mirahmadi, Alireza; Mercado, Carlos; Yu, Sion; Velichala, Suhas Rao; Colannino, Alyssa; Hung, Isabella; Rodriguez, Edward K.; Agarwal-Harding, Kiran J.] Harvard Global Orthopaed Collaborat, Boston, MA 02215 USA.
   [Mirahmadi, Alireza; Rodriguez, Edward K.; Agarwal-Harding, Kiran J.] Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA.
   [Bikoroti, Joel B.; Kubwimana, Olivier; Dusingizimana, Lambert R.; Ingabire, J. C. Allen; Byiringiro, Jean Claude] Univ Teaching Hosp Kigali, Kigali, Rwanda.
   [Alayande, Barnabas Tobi] Univ Global Hlth Equ, Ctr Equ Global Surg, Kigali, Rwanda.
C3 Harvard University; Harvard University Medical Affiliates; Beth Israel
   Deaconess Medical Center
RP Agarwal-Harding, KJ (通讯作者)，Harvard Global Orthopaed Collaborat, Boston, MA 02215 USA.; Agarwal-Harding, KJ (通讯作者)，Beth Israel Deaconess Med Ctr, Boston, MA 02215 USA.
EM samhita_kadiyala@hms.harvard.edu; emilypowis@hms.harvard.edu;
   amirahma@bidmc.harvard.edu; carlos@sonaglobal.org;
   sion_yu@universidad.anahuac.mx; suhas@sonaglobal.org;
   alyssa@sonaglobal.org; Isabella_hung@brown.edu;
   drbikorotijoel@gmail.com; oliviee3@gmail.com; duzin83@gmail.com;
   balayande@ughe.org; ijea2000@gmail.com; j.byiringiro@ur.ac.rw;
   ekrodrig@bidmc.harvard.edu; kahardin@bidmc.harvard.edu
RI /AAA-4330-2021; Agarwal-Harding, K/AEU-0518-2022; BYIRINGIRO, JEAN
   CLAUDE/T-9719-2019
OI Mercado, Carlos/0009-0002-1697-1672; RUTAYISIRE, Dusingizimana
   Lambert/0000-0001-5022-6532; Hung, Isabella/0009-0003-5697-9051;
   BYIRINGIRO, JEAN CLAUDE/0000-0002-6445-1797
CR Amlani L, 2024, PAN AFR MED J, V48, DOI 10.11604/pamj.2024.48.151.39732
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   Kadiyala S, 2025, J SURG EDUC, V82, DOI 10.1016/j.jsurg.2025.103661
   Kim WC, 2016, WORLD J SURG, V40, P6, DOI 10.1007/s00268-015-3258-3
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   Nzasabimana P, 2023, BMJ OPEN, V13, DOI 10.1136/bmjopen-2023-075117
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   SONA Global Academy, HOM
   Wu AM, 2021, LANCET HEALTH LONGEV, V2, pE580, DOI 10.1016/S2666-7568(21)00172-0
NR 15
TC 0
Z9 0
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0021-9355
EI 1535-1386
J9 J BONE JOINT SURG AM
JI J. Bone Joint Surg.-Am. Vol.
PD JUN 3
PY 2026
VL 108
IS 11
BP 792
EP 798
DI 10.2106/JBJS.26.00129
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA IY4YG
UT WOS:001783336000017
PM 41973832
DA 2026-07-24
ER

PT J
AU Clark, A
   Abdallah, C
   Ash, M
   Knaus, W
   Brown, C
   Ghareeb, P
AF Clark, Alexa
   Abdallah, Calvin
   Ash, Makenna
   Knaus, William
   Brown, Ciara
   Ghareeb, Paul
TI Re-Evaluation of the Ideal Injury to Flap Time Frame for Lower Extremity
   Free Flap Reconstruction: Is 72 h Still the Gold Standard?
SO MICROSURGERY
LA English
DT Article
ID MICROSURGICAL RECONSTRUCTION; TRAUMA; COVERAGE; COMPLICATIONS;
   FRACTURES; OUTCOMES; UPDATE; FATE
AB Background Traumatic lower extremity injuries often require free tissue transfer (FTT) for limb salvage when local tissue is insufficient. Traditionally, reconstruction within 72 h has been considered optimal; however, advancements in wound management and perioperative care have challenged this paradigm.<br /> Objective To evaluate outcomes of lower extremity FTT based on time from injury to reconstruction.<br /> Methods A retrospective review was performed on patients undergoing lower extremity FTT after trauma at a single Level 1 trauma center (2014-2022). Patients were grouped by time from injury to flap: (< 3 days, 4-21 days, 22-90 days, and > 90 days). Ninety nine percent of patients were managed with negative-pressure wound therapy (NPWT) prior to definitive reconstruction. Outcomes included flap loss, complications, infection, osteomyelitis, nonunion, and amputation. Associations with comorbidities, surgical techniques, and fracture characteristics were assessed.<br /> Results Among 102 patients, timing of reconstruction showed no significant differences in flap loss (p = 0.56), complications (p = 0.42), nonunion (p = 0.54), osteomyelitis (p = 0.19), or amputation (p = 0.58). No independent predictors of flap loss or complications were identified. Nonunion was associated with middle/proximal fracture levels (p = 0.0092), Masquelet technique (p = 0.0004), and higher Modified Frailty Index (p = 0.05). Osteomyelitis correlated with male gender (p = 0.01), proximal fracture level (p = 0.0098), and Masquelet technique (p = 0.0095). Amputation was associated with latissimus and radial forearm flaps (p = 0.0081), ipsilateral femur fracture (p = 0.0063), hypertension (p = 0.011), and higher ASA score (p = 0.0021).<br /> Conclusion In this series, delayed FTT beyond 72 h was not associated with increased flap loss or limb-threatening complications. Delayed reconstruction may optimize patient and wound factors, though aggressive wound management is essential. Given the retrospective design, uneven group sizes, and small early reconstruction cohort, these findings should be interpreted cautiously. Further research with larger cohorts and long-term outcomes is warranted.
C1 [Clark, Alexa; Abdallah, Calvin; Ash, Makenna] Emory Univ, Sch Med, Atlanta, GA USA.
   [Knaus, William; Ghareeb, Paul] Emory Univ, Div Plast & Reconstruct Surg, Atlanta, GA 30322 USA.
   [Brown, Ciara] MD Anderson Canc Ctr, Dept Plast & Reconstruct Surg, Houston, TX USA.
C3 Emory University; Emory University; University of Texas System; UTMD
   Anderson Cancer Center
RP Ghareeb, P (通讯作者)，Emory Univ, Div Plast & Reconstruct Surg, Atlanta, GA 30322 USA.
EM paul.ghareeb@emory.edu
RI Ghareeb, Paul/ABA-7780-2022
CR Ahmed H, 2025, ANN ROY COLL SURG, V107, P383, DOI [10.1308/rcsann.2023.0022, 10.1308/rcsann.2023.0022]
   Barone N, 2024, PRS-GLOB OPEN, V12, DOI 10.1097/GOX.0000000000006003
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   Struebing F, 2022, J PERS MED, V12, DOI 10.3390/jpm12101563
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NR 28
TC 0
Z9 0
U1 0
U2 0
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0738-1085
EI 1098-2752
J9 MICROSURG
JI Microsurgery
PD APR 28
PY 2026
VL 46
IS 4
AR e70228
DI 10.1002/micr.70228
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HE5QS
UT WOS:001752174900001
PM 42047372
DA 2026-07-24
ER

PT J
AU Lee, KI
   Lin, YN
AF Lee, Kuan-, I
   Lin, Yun-Nan
TI One-stage reconstruction of extensive exposed tibia on malnourished
   patient using single-layer Integra and amino acid supplements: A case
   report and literature review
SO MEDICINE
LA English
DT Review
DE artificial dermis; exposed tibia; one-stage reconstruction; skin grafts;
   traumatic injuries
ID DERMAL REGENERATION TEMPLATE; SOFT-TISSUE RECONSTRUCTION; FREE-FLAP;
   SURAL FLAP; LOWER 3RD; EXTREMITY; COVERAGE; DEFECTS; BONE; EXPERIENCE
AB Rationale:Extremity injuries resulting from motor vehicle collisions, especially those leading to bone-exposed wounds, present challenges for achieving effective wound coverage. Such injuries are susceptible to complications including infections, osteomyelitis, and unexpected amputations due to inadequate blood supply. Severe traumatic degloving injuries often entail damage to the surrounding blood vessels, making local or free flaps impractical choices in many cases. Consequently, treatment options may vary based on distinct clinical scenarios, with no standardized guidelines available. Our study introduces an integrated approach utilizing dermal substitutes and skin grafts as a safer treatment modality for managing large-area tibial exposure resulting from traffic accidents.Patient concerns:A 66-year-old male with a compromised nutritional status was struck by a car while riding a motorcycle. Previous attempts using double-layer Integra and negative pressure wound therapy (NPWT) for two-stage reconstruction have been unsuccessful.Diagnoses:Computed tomography imaging studies revealed multiple comminuted and displaced fractures involving the left femoral shaft, left proximal tibia, left patella, and proximal fibula, as well as a fracture of the right fibular shaft and an avulsion fracture of the right distal medial femur. The patient's condition corresponded to Type 3B in the Gustilo classification for open fractures, and the patient had an Injury Severity Score of 25.Interventions:We applied a one-stage reconstruction involving single-layer Integra, split-thickness skin grafts, NPWT, and nutritional supplements containing various amino acids.Outcomes:By implementing an integrated treatment approach and providing diligent wound care over a total of 2 months, the patient achieved successful healing and expressed satisfaction with the postoperative results.Lessons:This study offers insights into the effectiveness of employing one-stage reconstruction for traumatic injuries with extensive exposed tibias. In addition, it underscores the impact of a patient's nutritional status on wound healing and introduces a potential solution for similar challenging cases.
C1 [Lee, Kuan-, I] Kaohsiung Med Univ, Sch Med, Kaohsiung, Taiwan.
   [Lin, Yun-Nan] Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Surg, Div Plast Surg, 100,Tzyou 1st Rd, Kaohsiung 80756, Taiwan.
   [Lin, Yun-Nan] Kaohsiung Med Univ, Coll Med, Sch Postbaccalaureate Med, Kaohsiung, Taiwan.
C3 Kaohsiung Medical University; Kaohsiung Medical University; Kaohsiung
   Medical University Hospital; Kaohsiung Medical University
RP Lin, YN (通讯作者)，Kaohsiung Med Univ, Kaohsiung Med Univ Hosp, Dept Surg, Div Plast Surg, 100,Tzyou 1st Rd, Kaohsiung 80756, Taiwan.
EM m106001097@gmail.com; yunnan1123@gmail.com
RI Lee, Kevin Kuan-I/MSW-7758-2025
OI Lee, Kevin Kuan-I/0000-0001-8248-7761
CR ACLAND RD, 1990, CLIN PLAST SURG, V17, P733
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   Attia A, 2020, JPRAS OPEN, V24, P32, DOI 10.1016/j.jpra.2020.03.004
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   Kamath BJ, 2006, J PLAST RECONSTR AES, V59, P515, DOI 10.1016/j.bjps.2005.09.032
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   Verbelen J, 2016, BURNS, V42, pE31, DOI 10.1016/j.burns.2015.08.013
   Yasuda Tomohiro, 2017, J Orthop Case Rep, V7, P70, DOI 10.13107/jocr.2250-0685.756
   Yeong EK, 2012, ANN PLAS SURG, V69, P607, DOI 10.1097/SAP.0b013e318273f845
   Yoshimatsu H, 2018, MICROSURG, V38, P89, DOI 10.1002/micr.30202
   Zhang ZY, 2015, EUR REV MED PHARMACO, V19, P4707
   Zhu BZ, 2021, J PLAST SURG HAND SU, V55, P1, DOI 10.1080/2000656X.2020.1781140
NR 51
TC 5
Z9 5
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD FEB 2
PY 2024
VL 103
IS 5
AR e37098
DI 10.1097/MD.0000000000037098
PG 8
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA GY9S0
UT WOS:001156361800015
PM 38306507
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Hamid, HA
   Lin, XQ
   Qin, YK
   Akim, AM
   Zhang, LJ
   Wang, J
   Wang, H
   Li, Y
   Teng, XF
   Zhang, SM
   Xu, HY
   Lin, XQ
AF Hamid, Habibah Abdul
   Lin, Xiaoqian
   Qin, Yuan Kun
   Akim, Abdah Md
   Zhang, Longjiu
   Wang, Jue
   Wang, Hui
   Li, Ying
   Teng, Xiaofei
   Zhang, Shangmeng
   Xu, Huanyu
   Lin, Xiaoqing
TI 被撤回的出版物: Best practices for managing malodorous and infected wounds in
   advanced cervical cancer (Retracted article. See vol. 22, 2025)
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article; Retracted Publication
DE photodynamic therapy; topical antibiotic therapy; treatment duration;
   wound characteristics; wound management
ID CARE
AB This cross-sectional study was conducted to examine the most effective strategies for managing malodorous and infected wounds in patients who have been diagnosed with advanced cervical cancer. The research was conducted in Liupanshui, China. The study specifically examined demographic profiles, wound characteristics and effectiveness of wound management approaches. The study incorporated the heterogeneous sample of 289 participants who fulfilled the inclusion criteria. Data collection was conducted via structured questionnaires and medical record evaluations. Descriptive statistics and statistical analyses, such as regression analysis, were utilized to evaluate demographic attributes, wound profiles and effects of different approaches to wound management. The findings unveiled the heterogeneous demographic composition of patients, encompassing differences in socioeconomic standing, educational attainment and age. A wide range of wound characteristics were observed, as 65.7% of lesions during the acute phase with diameter between 2 and 5 centimetres, while 41.5% of lesions had this range. The most prevalent types of infections were those caused by fungi (48.4%), followed by bacterial infections lacking resistance (38.1%). A moderate degree of odour intensity was prevalent, affecting 45.0% of the cases. With maximal odour reduction of 80%, a mean healing time of 25 days and patient satisfaction rating of 4.5 out of 5, Negative Pressure Wound Therapy demonstrated itself to be the most efficacious treatment method. Additional approaches, such as photodynamic therapy and topical antibiotic therapy, demonstrated significant effectiveness, as evidenced by odour reductions of 70% and 75%, respectively, and patient satisfaction ratings of 4.3 and 4.2. Thus, the study determined challenges associated with management of malodorous and infected lesions among patients with advanced cervical cancer. The results underscored the significance of individualized care approaches, drew attention to efficacious wound management techniques and identified critical determinants that impacted patient recuperation. The findings of this study hold potential for advancing palliative care for individuals diagnosed with advanced cervical cancer.
C1 [Hamid, Habibah Abdul; Lin, Xiaoqian] Univ Putra Malaysia, Fac Med & Hlth Sci, Obstet & Gynecol Dept, Serdang, Malaysia.
   [Lin, Xiaoqian; Wang, Hui; Li, Ying; Teng, Xiaofei; Zhang, Shangmeng; Xu, Huanyu] Liupanshui City Women & Childrens Hlth Hosp Guizho, Liupanshui, Peoples R China.
   [Qin, Yuan Kun] Guizhou Med Univ, Guiyang, Peoples R China.
   [Akim, Abdah Md] Univ Putra Malaysia, Fac Med & Hlth Sci, Dept Biomed Sci, Serdang, Malaysia.
   [Zhang, Longjiu; Wang, Jue] Liupanshui City Peoples Hosp Guizhou Prov, Liupanshui, Peoples R China.
   [Lin, Xiaoqing] Shuicheng Dist Maternal & Childrens Hlth Hosp, Liupanshui, Peoples R China.
C3 Universiti Putra Malaysia; Guizhou Medical University; Universiti Putra
   Malaysia
RP Hamid, HA; Lin, XQ (通讯作者)，Univ Putra Malaysia, Fac Med & Hlth Sci, Obstet & Gynecol Dept, Serdang, Malaysia.
EM abdulhamidhabibah@hotmail.com; Ixqfish@163.com
RI MD AKIM, ABDAH/B-1284-2017
CR Archibald LK., 2013, Textbook of neurointensive care, P427, DOI [10.1007/978-1-4471-5226-2_22, DOI 10.1007/978-1-4471-5226-2_22]
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   Yee PP, 2021, BIOESSAYS, V43, DOI 10.1002/bies.202100029
   Zhu JW, 2023, INT WOUND J, V20, P3006, DOI 10.1111/iwj.14175
   Zhu SY, 2023, INT WOUND J, V20, P3491, DOI 10.1111/iwj.14221
NR 23
TC 2
Z9 2
U1 0
U2 1
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD FEB
PY 2024
VL 21
IS 2
AR e14574
DI 10.1111/iwj.14574
PG 7
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA GS1Q6
UT WOS:001154575200001
PM 38379231
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Johnson, AR Jr
   Mooshol, D
   Thakar, V
   Williams, M
AF Johnson, Alton R., Jr.
   Mooshol, Danielle
   Thakar, Vikram
   Williams, Marie
TI Surgical Management of Idiopathic Ulcerative Calcinosis Cutis in the
   Lower Extremity: A Case Report
SO JOURNAL OF FOOT & ANKLE SURGERY
LA English
DT Article
DE acellular dermal matrix; calcium deposits; debridement; excision
AB The purpose of this case study is to describe the surgical treatment of idiopathic ulcerative cutaneous calcinosis or calcinosis cutis of the lower extremity. A 77-year-old Latin American female who reported no significant past medical history presented to our hospital's emergency department from her home complaining of worsening right lower extremity erythema, edema, increased temperature, and pain. It was noted that the patient presented with multiple cutaneous calcified nodules to bilateral lower extremities, which she stated has been present for approximately 40 years. At the time of evaluation, 1 of the nodules on the lateral aspect of the right lower extremity ulcerated and became infected with unknown etiology, which lead to cellulitis of this limb. Radiographic imaging studies of the bilateral lower extremities showed extensive sheetlike soft tissue calcification overlying the middle to distal lower extremities. Serology reports showed the patient was positive for rheumatoid factor, antinuclear antibodies, SS-A/Ro antibody, and SS-B/La antibody. Because of the evidence of frank purulence and cellulitic changes to the infected nodule, the patient was taken to surgery the following day for sharp debridement and biopsy of the site. Postoperatively, there were minimal signs of improved healing to the wound base, although there was evidence of decreased erythema and edema to the extremity after the initial debridement and biopsy. Four days after the initial surgical invention, the patient was taken for a second operative procedure, which included a wide excisional biopsy with application of acellular dermal matrix and negative-pressure therapy. It was during this secondary debridement that further calcified deposits were encountered and specimens were submitted to pathology. Pathologic examination diagnosed the submitted specimen as cutaneous calcinosis. At this time, the patient is currently undergoing local wound care of the soft tissue deficient to her right lower extremity with the assistance of negative-pressure wound therapy with biweekly clinical follow-up. (C) 2019 The Author(s). This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/by-nc-nd/4.0/)
C1 [Johnson, Alton R., Jr.; Mooshol, Danielle; Thakar, Vikram] Aventura Hosp & Med Ctr, 20900 Biscayne Blvd, Aventura, FL 33180 USA.
   [Williams, Marie] Aventura Hosp & Med Ctr, Podiatr Surg, Aventura, FL 33180 USA.
RP Johnson, AR Jr (通讯作者)，Aventura Hosp & Med Ctr, 20900 Biscayne Blvd, Aventura, FL 33180 USA.
EM alton.johnsondpm@gmail.com
OI Johnson, Alton/0000-0001-9606-1147
CR Dhar Dinesh, 2013, Oman Med J, V28, P131, DOI 10.5001/omj.2013.34
   Fairley JA, 2012, DERMATOLOGY GEN MED
   Lobo IMM, 2008, DERMATOL ONLINE J, V14
   ROTHE MJ, 1990, ARCH DERMATOL, V126, P1060, DOI 10.1001/archderm.126.8.1060
NR 4
TC 2
Z9 2
U1 0
U2 0
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1067-2516
EI 1542-2224
J9 J FOOT ANKLE SURG
JI J. Foot Ankle Surg.
PD MAY-JUN
PY 2020
VL 59
IS 3
BP 603
EP 607
DI 10.1053/j.jfas.2019.09.032
PG 5
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA LL4WW
UT WOS:000531558700015
PM 31732275
OA hybrid
DA 2026-07-24
ER

PT J
AU Mii, S
   Tanaka, K
   Kyuragi, R
   Ishimura, H
   Yasukawa, S
   Guntani, A
   Kawakubo, E
AF Mii, Shinsuke
   Tanaka, Kiyoshi
   Kyuragi, Ryoichi
   Ishimura, Hiroshi
   Yasukawa, Shinsuke
   Guntani, Atsushi
   Kawakubo, Eisuke
TI Aggressive Wound Care by a Multidisciplinary Team Improves Wound Healing
   after Infrainguinal Bypass in Patients with Critical Limb Ischemia
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article; Proceedings Paper
CT 27th Annual Winter Meeting of the
   Vascular-and-Endovascular-Surgery-Society (VESS)
CY FEB 02-05, 2017
CL Steamboat Springs, CO
SP Vasc & Endovascular Surg Soc
ID DIABETIC FOOT ULCERS; ENDOVASCULAR TREATMENT; VASCULAR-SURGERY;
   REVASCULARIZATION; CILOSTAZOL; INTERVENTION; METAANALYSIS; MANAGEMENT;
   AMPUTATION; THERAPY
AB Background: A long period is generally required for ischemic ulcer to heal after revascularization. The strategy of postoperative wound care can affect wound healing. This study was conducted to investigate the degree to which aggressive wound care (AWC) by a team of multidisciplinary specialists actually shortens the time to wound healing and increases the rate of wound healing in limbs undergoing surgical bypass for ischemic tissue loss in a real clinical setting.
   Methods: A total of consecutive 126 patients undergoing infrainguinal bypass for tissue loss from April 2011 to March 2015 were reviewed. Prior to March 2013, standard wound care (SWC) including typical daily dressing change with disinfection and irrigation, occasional surgical debridement, and negative pressure wound therapy (when necessary) was performed by vascular surgeons. Thereafter, in addition to SWC, AWC including intense daily bedside surgical debridement under a sciatic nerve block by an anesthesiologist and active skin grafting by a dermatologist, if necessary, was performed. Wound healing and major amputation were defined as the end points. The 1-year outcomes of the 2 groups were calculated using the Kaplan-Meier method and compared, and the significant predictors of each outcome were determined by a Cox proportional hazards analysis.
   Results: The wound healing of the AWC group was superior to that of the SWC group (AWC versus SWC, 1-year wound healing rate: 92% vs. 80%; mean wound healing time: 48 days vs. 82 days; P = 0.011), and no significant difference between the 2 regimens in the freedom from major amputation was observed. AWC, Rutherford 5, no wound infection, normal serum albumin, direct angiosome, and cilostazol use were significant predictors of wound healing, and female gender and no cilostazol use were significant predictors of major amputation by a multivariate analysis.
   Conclusions: Aggressive wound care by the team consisting of multidisciplinary specialists remarkably shortened the time to wound healing and increased the rate of wound healing within 1 year.
C1 [Mii, Shinsuke; Guntani, Atsushi; Kawakubo, Eisuke] Saiseikai Yahata Gen Hosp, Dept Vasc Surg, Kitakyushu, Fukuoka, Japan.
   [Mii, Shinsuke; Tanaka, Kiyoshi; Kyuragi, Ryoichi; Ishimura, Hiroshi; Yasukawa, Shinsuke] Steel Mem Yawata Hosp, Vasc Ctr, Kitakyushu, Fukuoka, Japan.
   [Tanaka, Kiyoshi] Kokura Mem Hosp, Dept Vasc Surg, Kitakyushu, Fukuoka, Japan.
   [Kyuragi, Ryoichi] Kyushu Med Ctr, Dept Vasc Surg, Fukuoka, Japan.
   [Ishimura, Hiroshi] Sakai Orthoped Clin, Fukuoka, Japan.
   [Yasukawa, Shinsuke] Yasukawa Dermatol Clin, Fukuoka, Japan.
C3 Kokura Memorial Hospital
RP Mii, S (通讯作者)，Saiseikai Yahata Gen Hosp, Dept Vasc Surg, Yahatahigashi Ku, 5-9-27 Harunomachi, Kitakyushu, Fukuoka 8050050, Japan.
EM mii@yahata.saiseikai.or.jp
CR Azuma N, 2012, EUR J VASC ENDOVASC, V43, P322, DOI 10.1016/j.ejvs.2011.12.001
   Azuma N, 2014, CIRC J, V78, P1791, DOI 10.1253/circj.CJ-14-0500
   Chung J, 2006, J VASC SURG, V43, P1183, DOI 10.1016/j.jvs.2005.12.068
   Chung J, 2015, J VASC SURG, V61, P162, DOI 10.1016/j.jvs.2014.05.101
   de Franciscis S, 2015, INT WOUND J, V12, P250, DOI 10.1111/iwj.12085
   Elraiyah T, 2016, J VASC SURG, V63, p46S, DOI 10.1016/j.jvs.2015.10.007
   Elraiyah T, 2016, J VASC SURG, V63, p37S, DOI 10.1016/j.jvs.2015.10.002
   Hingorani A, 2016, J VASC SURG, V63, p3S, DOI 10.1016/j.jvs.2015.10.003
   Hioki H, 2015, ANGIOLOGY, V66, P187, DOI 10.1177/0003319714523113
   Ino Kou, 2013, Ann Vasc Dis, V6, P39, DOI 10.3400/avd.oa.13.00010
   Kawarada O, 2014, CIRC J, V78, P1540, DOI 10.1253/circj.CJ-14-0060
   Kobayashi N, 2014, CIRC J, V78, P1746, DOI 10.1253/circj.CJ-14-0171
   Mills JL, 2014, J VASC SURG, V59, P220, DOI 10.1016/j.jvs.2013.08.003
   Neel JD, 2015, J VASC SURG, V61, P960, DOI 10.1016/j.jvs.2014.11.067
   Rashid H, 2013, J VASC SURG, V57, P1219, DOI 10.1016/j.jvs.2012.10.129
   Resnick KA, 2014, ANN VASC SURG, V28, P1513, DOI 10.1016/j.avsg.2014.02.018
   Rutherford RB, 1997, J VASC SURG, V26, P517, DOI 10.1016/S0741-5214(97)70045-4
   Shiraki T, 2015, EUR J VASC ENDOVASC, V49, P565, DOI 10.1016/j.ejvs.2015.01.017
   Söderström M, 2009, J VASC SURG, V49, P932, DOI 10.1016/j.jvs.2008.11.045
   Soga Y, 2011, J VASC SURG, V54, P1659, DOI 10.1016/j.jvs.2011.06.024
   Stoekenbroek RM, 2014, EUR J VASC ENDOVASC, V47, P647, DOI 10.1016/j.ejvs.2014.03.005
   Vartanian SM, 2015, ANN VASC SURG, V29, DOI 10.1016/j.avsg.2014.10.030
NR 22
TC 34
Z9 38
U1 0
U2 9
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0890-5096
EI 1615-5947
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD MAY
PY 2017
VL 41
BP 196
EP 204
DI 10.1016/j.avsg.2016.09.024
PG 9
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery; Cardiovascular System & Cardiology
GA EW6TB
UT WOS:000402642100040
PM 28242396
DA 2026-07-24
ER

PT J
AU Costa, ML
   Achten, J
   Knight, R
   Campolier, M
   Massa, MS
AF Costa, M. L.
   Achten, J.
   Knight, R.
   Campolier, M.
   Massa, M. S.
TI Five- year outcomes for patients sustaining severe fractures of the
   lower limb from the Wound Healing in Surgery for Trauma (WHIST) trial
SO BONE & JOINT JOURNAL
LA English
DT Article
ID SURGICAL SITE INFECTION; MAJOR TRAUMA; NEUROPATHIC CHARACTERISTICS;
   DISPLACED FRACTURE; CHRONIC PAIN; THERAPY; PREVALENCE; DISABILITY;
   EUROQOL; ADULTS
AB Aims The aims of this study were to report the outcomes of patients with a complex fracture of the lower limb in the five years after they took part in the Wound Healing in Surgery for Trauma (WHIST) trial. Methods The WHIST trial compared negative pressure wound therapy (NPWT) dressings with standard dressings applied at the end of the first operation for patients undergoing internal fixation of a complex fracture of the lower limb. Complex fractures included periarticular fractures and open fractures when the wound could be closed primarily at the end of the first debridement. A total of 1,548 patients aged >= 16 years completed the initial follow- up, six months after injury. In this study we report the pre- planned analysis of outcome data up to five years. Patients reported their Disability Rating Index (DRI) (0 to 100, in which 100 = total disability), and health- related quality of life, chronic pain scores and neuropathic pain scores annually, using a self- reported questionnaire. Complications, including further surgery related to the fracture, were also recorded. Results A total of 1,015 of the original patients (66%) provided at least one set of outcome data during the five years of follow- up. There was no evidence of a difference in patient- reported disability between the two groups at five years (NPWT group mean DRI 30.0 (SD 26.5), standard dressing group mean DRI 31.5 (SD 28.8), adjusted difference-0.86 (95% CI-4.14 to 2.40; p = 0.609). There was also no evidence of a difference in the complication rates at this time. Conclusion We found no evidence of a difference in disability ratings between NPWT compared with standard wound dressings in the five years following the surgical treatment of a complex fracture of the lower limb. Patients in both groups reported high levels of persistent disability and reduced quality of life, with little evidence of improvement during this time.
C1 [Costa, M. L.] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Orthopaed Trauma Surg, Oxford, England.
   [Achten, J.] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Oxford Trauma & Emergency Care, Oxford, England.
   [Knight, R.] Univ Oxford, Oxford, England.
   [Campolier, M.; Massa, M. S.] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Oxford, England.
C3 University of Oxford; University of Oxford; University of Oxford;
   University of Oxford
RP Costa, ML (通讯作者)，Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskeleta, Orthopaed Trauma Surg, Oxford, England.
EM matthew.costa@ndorms.ox
RI ; Achten, Juul/KUD-8515-2024
OI Knight, Ruth/0000-0001-6810-2845; Massa, Sofia/0000-0003-3205-6706;
   Achten, Juul/0000-0002-8857-5743; Campolier, Marta/0000-0002-7168-2534;
   Costa, Matthew/0000-0003-3644-1388
FU UK National Institute for Health and Care Research Health Technology
   Assessment (HTA) Programme [14/199/14]; National Institute for Health
   and Care Research (NIHR) Oxford Biomedical Research Centre
FX The authors disclose receipt of the following financial or material
   support for the research, authorship, and/or publication of this
   article: this project was funded by the UK National Institute for Health
   and Care Research Health Technology Assessment (HTA) Programme
   (14/199/14) and was supported by the National Institute for Health and
   Care Research (NIHR) Oxford Biomedical Research Centre. The funder has
   not been involved in the design and conduct of the study; collection,
   management, analysis, and interpretation of the data; preparation,
   review, or approval of the manuscript nor in the decision to submit the
   manuscript for publication. The views expressed are those of the authors
   and not necessarily those of the NHS, the NIHR or the Department of
   Health. Smith & Nephew provided incisional NPWT dressings (PICO Single
   Use Negative Pressure Wound Therapy System) to recruiting centres for
   the purposes of the trial, but had no part in the design, conduct, or
   reporting of the study.
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NR 17
TC 2
Z9 3
U1 1
U2 2
PU BRITISH EDITORIAL SOC BONE & JOINT SURGERY
PI LONDON
PA 22 BUCKINGHAM STREET, LONDON WC2N 6ET, ENGLAND
SN 2049-4394
J9 BONE JOINT J
JI Bone Joint J.
PD AUG
PY 2024
VL 106B
IS 8
BP 858
EP 864
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA A8M3V
UT WOS:001285021200013
PM 39084646
DA 2026-07-24
ER

PT J
AU Gialdini, C
   Chamillard, M
   Diaz, V
   Pasquale, J
   Thangaratinam, S
   Abalos, E
   Torloni, MR
   Betran, AP
AF Gialdini, Celina
   Chamillard, Monica
   Diaz, Virginia
   Pasquale, Julia
   Thangaratinam, Shakila
   Abalos, Edgardo
   Torloni, Maria Regina
   Betran, Ana Pilar
TI Evidence-based surgical procedures to optimize caesarean outcomes: an
   overview of systematic reviews
SO ECLINICALMEDICINE
LA English
DT Review
DE Caesarean section; Surgery; Public health; Systematic review; Maternal
   health
ID SECTION; DELIVERY; CLOSURE; HEALTH; IMPACT
AB Background Caesarean section (CS) is the most performed major surgery worldwide. Surgical techniques used for CS vary widely and there is no internationally accepted standardization. We conducted an overview of systematic reviews (SR) of randomized controlled trials (RCT) to summarize the evidence on surgical techniques or procedures related to CS. Methods Searches were conducted from database inception to 31 January 2024 in Cochrane Database of Systematic Reviews, PubMed, EMBASE, Lilacs and CINAHL without date or language restrictions. AMSTAR 2 and GRADE were used to assess the methodological quality of the SRs and the certainty of evidence at outcome level, respectively. We classi fi ed each procedure-outcome pair into one of eight categories according to effect estimates and certainty of evidence. The overview was registered at PROSPERO (CRD 42023208306). Findings The analysis included 38 SRs (16 Cochrane and 22 non -Cochrane) published between 2004 - 2024 involving 628 RCT with a total of 190,349 participants. Most reviews were of low or critically low quality (AMSTAR 2). The SRs presented 345 procedure-outcome comparisons (237 procedure versus procedure, 108 procedure versus no treatment/placebo). There was insuf fi cient or inconclusive evidence for 256 comparisons, clear evidence of bene fi t for 40, possible bene fi t for 17, no difference of effect for 13, clear evidence of harm for 14, and possible harm for 5. We found no SRs for 7 pre-de fi ned procedures. Skin cleansing with chlorhexidine, Joel-Cohen-based abdominal incision, uterine incision with blunt dissection and cephalad-caudal expansion, cord traction for placental extraction, manual cervical dilatation in pre -labour CS, changing gloves, chromic catgut suture for uterine closure, non-closure of the peritoneum, closure of subcutaneous tissue, and negative pressure wound therapy are procedures associated with bene fi ts for relevant outcomes. Interpretation Current evidence suggests that several CS surgical procedures improve outcomes but also reveals a lack of or inconclusive evidence for many commonly used procedures. There is an urgent need for evidence-based guidelines standardizing techniques for CS, and trials to fi ll existing knowledge gaps.
C1 [Gialdini, Celina; Chamillard, Monica; Diaz, Virginia; Pasquale, Julia] Ctr Rosarino Estudios Perinatales CREP, Rosario, Argentina.
   [Gialdini, Celina] Univ Ramon Llull, Fac Ciencies Salut Blanquerna, Barcelona, Spain.
   [Thangaratinam, Shakila] Univ Birmingham, Inst Metab & Syst Res, Birmingham, England.
   [Abalos, Edgardo] Ctr Estudios Estado & Soc CEDES, Buenos Aires, Argentina.
   [Torloni, Maria Regina] Sao Paulo Fed Univ, Dept Med, Evidence Based Healthcare Postgrad Program, Sao Paulo, Brazil.
   [Betran, Ana Pilar] World Hlth Org, UNDP UNFPA UNICEF WHO World Bank Special Programme, Dept Sexual & Reprod Hlth & Res, Geneva, Switzerland.
C3 Universitat Ramon Llull; University of Birmingham; Universidade Federal
   de Sao Paulo (UNIFESP); World Health Organization
RP Gialdini, C (通讯作者)，Ctr Rosarino Estudios Perinatales CREP, Rosario, Argentina.
EM cgialdini@crep.org.ar
RI Torloni, Maria Regina/IZP-5787-2023; Thangaratinam,
   Shakila/AAP-3724-2021
OI Gialdini, Celina/0009-0004-1150-2142; Abalos,
   Edgardo/0000-0001-6653-429X; Thangaratinam, Shakila/0000-0002-4254-460X
FU UNDP-UNFPA-UNICEF-WHO-World Bank Special Programme of Research,
   Development and Research Training in Human Reproduction (HRP); World
   Health Organization (WHO)
FX Financial support for conducting the overview was provided to Centro
   Rosarino de Estudios Perinatales (CREP) by UNDP-UNFPA-UNICEF-WHO-World
   Bank Special Programme of Research, Development and Research Training in
   Human Reproduction (HRP), a cosponsored programme executed by the World
   Health Organization (WHO).
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NR 72
TC 14
Z9 15
U1 0
U2 3
PU ELSEVIER
PI AMSTERDAM
PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
EI 2589-5370
J9 ECLINICALMEDICINE
JI EClinicalMedicine
PD JUN
PY 2024
VL 72
AR 102632
DI 10.1016/j.eclinm.2024.102632
PG 20
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA TW1Z6
UT WOS:001244218100001
PM 38812964
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Oliveira, IS
   Finelli, CA
   Ribeiro, TC
   Cunha, CC
   Durigon, TS
   Vargas, RP
   Tuma, RB
   Klautau, GB
   Reis, FB
   Salles, MJ
AF Oliveira, Icaro Santos
   Finelli, Carlos Augusto
   Ribeiro, Taiana Cunha
   Cunha, Carolina Coelho
   Durigon, Thomas Stravinskas
   Vargas, Rodrigo Peixoto
   Tuma, Rafael Brull
   Klautau, Giselle Burlamaqui
   dos Reis, Fernando Baldy
   Salles, Mauro Jose
TI The impact of a multidisciplinary team on the management of
   fracture-related infections: A surveillance study in Brazil
SO BRAZILIAN JOURNAL OF INFECTIOUS DISEASES
LA English
DT Article
DE Fracture-related infection; Multidisciplinary teams; Biofilm;
   Osteomyelitis; Antibiotic stewardship; Prevention; Diagnosis
ID GUIDE
AB Background: Fracture-Related Infection (FRI) is an increasing and challenging complication following orthopedic trauma surgery. Preventive and microbial diagnostic measures vary significantly particularly in low- and middleincome countries. The objectives of this national questionnaire were to investigate clinical practices towards preventive and diagnostic strategies adopted by Brazilian orthopedic trauma centers and to assess the impact of Multidisciplinary Teams (MDT) on the management of FRI. Methods: A 34-item electronic questionnaire was developed via REDCap (R) and distributed to all trauma surgeons registered of the Brazilian Society of Orthopedics and Traumatology (SBOT). Results: With a response rate of 24 %, the survey was fully responded by 140 trauma surgeons, 63.6 % of them working in southeast region centers. Collaborative work with MDT focused on musculoskeletal infections was reported by only 41.0 %. Cephalosporins were universally prescribed as Perioperative Antibiotic Prophylaxis (PAP), while association with an aminoglycoside increased (35.0 %) for severe open fracture. One-day duration of PAP for closed fracture was prescribed in 68.1 %, while it often exceeded current recommendations. Diagnostic practices for FRI patients were primarily based on clinical signs and standard radiological and laboratory tests, with limited use of microbiological techniques. Trauma services working collaboratively with MDT significantly improved FRI management, including, use of sonication fluid for diagnosis (46.6 % vs. 26.8 %; p = 0.02), body weight-adjusted antibiotic dosing for PAP (50.0 % vs. 24.4 %; p = 0.02), appropriate duration of PAP according to the severity of soft-tissue damage (80.7 % vs. 59.3 %; p = 0.01), infection risk stratification in elderly patients with fractures (45.6 % vs. 21.0 %; p < 0.001), use of negative-pressure wound therapy (87.9 % vs. 54.9 %; p < 0.001) and regular collaboration with orthoplastic surgeon (44.8 % vs. 17.5 %; p = 0.01). Conclusions: This national survey revealed marked heterogeneity in FRI management across Brazilian trauma services. Ongoing MDT collaboration improved clinical practice, especially diagnostic work-up and antimicrobial stewardship.
C1 [Oliveira, Icaro Santos; Finelli, Carlos Augusto; Cunha, Carolina Coelho; Durigon, Thomas Stravinskas; dos Reis, Fernando Baldy; Salles, Mauro Jose] Univ Fed Sao Paulo UNIFESP, Dept Ortopedia & Traumatol, Escola Paulista Med EPM, Grp Infeccao Musculoesquelet Ortoinfecto, Sao Paulo, SP, Brazil.
   [Oliveira, Icaro Santos; Ribeiro, Taiana Cunha; Vargas, Rodrigo Peixoto; Klautau, Giselle Burlamaqui; Salles, Mauro Jose] Santa Casa Sao Paulo, Fac Ciencias Med, Disciplina Infectol, Sao Paulo, SP, Brazil.
   [Finelli, Carlos Augusto; Cunha, Carolina Coelho; Durigon, Thomas Stravinskas; Tuma, Rafael Brull; Salles, Mauro Jose] Univ Fed Sao Paulo UNIFESP, Dept Med, Div Doencas Infecciosas, Lab Especial Microbiol Clin LEMC,Escola Paulista M, Sao Paulo, SP, Brazil.
C3 Universidade Federal de Sao Paulo (UNIFESP); Universidade Federal de Sao
   Paulo (UNIFESP)
RP Salles, MJ (通讯作者)，Univ Fed Sao Paulo UNIFESP, Dept Ortopedia & Traumatol, Escola Paulista Med EPM, Grp Infeccao Musculoesquelet Ortoinfecto, Sao Paulo, SP, Brazil.; Salles, MJ (通讯作者)，Santa Casa Sao Paulo, Fac Ciencias Med, Disciplina Infectol, Sao Paulo, SP, Brazil.; Salles, MJ (通讯作者)，Univ Fed Sao Paulo UNIFESP, Dept Med, Div Doencas Infecciosas, Lab Especial Microbiol Clin LEMC,Escola Paulista M, Sao Paulo, SP, Brazil.
EM mauro.salles@unifesp.br
RI ; Salles, Mauro Jose/K-4760-2012; Baldy dos Reis, Fernando/HPD-0369-2023
OI Finelli, Carlos Augusto/0000-0002-9602-0529; Brull Tuma,
   Rafael/0009-0006-3091-8594; Durigon, Thomas/0000-0002-4951-0963;
   Oliveira, Ícaro/0009-0007-8130-7926; Salles, Mauro
   Jose/0000-0002-5443-6024; Cunha, Carolina/0000-0002-7140-3152; Ribeiro,
   Taiana/0000-0002-4163-2288; VARGAS, ROIGO/0000-0001-9764-319X; Baldy dos
   Reis, Fernando/0000-0003-2431-2634
FU CNPq [402/2021-4, 516/2021-4]
FX This research is part of a larger project entitled "Epidemiological and
   microbiological analysis of infections associated with orthopedic
   fractures in Brazil: An observational, multicenter cohort study", funded
   by CNPq under process number 402,516/2021-4. However, in this part, no
   specific funding was received from public, commercial, or non-profit
   sector funding agencies.
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NR 48
TC 0
Z9 0
U1 0
U2 2
PU ELSEVIER BRAZIL
PI RIO DE JANEIRO
PA R SETE SETEMBRO, 111-16, RIO DE JANEIRO, RJ 20050-006, BRAZIL
SN 1413-8670
EI 1678-4391
J9 BRAZ J INFECT DIS
JI Braz. J. Infect. Dis.
PD NOV-DEC
PY 2025
VL 29
IS 6
AR 104576
DI 10.1016/j.bjid.2025.104576
EA SEP 2025
PG 8
WC Infectious Diseases
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases
GA 7KB8F
UT WOS:001572899700001
PM 40939442
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Huffman, SS
   Berger, LE
   Li, KR
   Spoer, DL
   Gupta, NJ
   Truong, BN
   Akbari, CM
   Evans, KK
AF Huffman, Samuel S.
   Berger, Lauren E.
   Li, Karen
   Spoer, Daisy L.
   Gupta, Nisha J.
   Truong, Brian N.
   Akbari, Cameron M.
   Evans, Karen K.
TI Muscle versus Fascia Free Tissue Transfer for Treatment of Chronic
   Osteomyelitis in the Comorbid Population
SO JOURNAL OF RECONSTRUCTIVE MICROSURGERY
LA English
DT Article
DE free tissue transfer; free flaps; limb salvage; chronic osteomyelitis;
   wounds
ID RECONSTRUCTION; MANAGEMENT; OUTCOMES; FLAPS; INFECTIONS
AB Background In patients with chronic lower extremity (LE) wounds, chronic osteomyelitis confers additional complexity to achieving adequate treatment. Previous reviews demonstrate increased rates of osteomyelitis recurrence in patients who receive muscle flaps compared with fasciocutaneous flaps for LE limb salvage; however, these studies were not limited to atraumatic populations who receive exclusively free flaps. Thus, this study compared rates of recurrence in chronic osteomyelitis patients undergoing LE reconstruction with fasciocutaneous versus muscle free flaps.Methods Patients undergoing free tissue transfer (FTT) between July 2011 and July 2021 were retrospectively reviewed. Patients were stratified into fasciocutaneous and muscle free flap groups. Primary outcomes included osteomyelitis recurrence, flap complications, limb salvage, and ambulatory status.Results Forty-eight patients with pathologic diagnosis of chronic osteomyelitis of the wound bed were identified, of which 58.3% received fasciocutaneous ( n = 28) and 41.7% received muscle flaps ( n = 20). The most common comorbidities included diabetes mellitus ( n = 29, 60.4%), peripheral neuropathy ( n = 27, 56.3%) and peripheral vascular disease ( n = 24, 50.0%). Methicillin-resistant or methicillin -sensitive Staphylococcus aureus were the most common pathogen in 18.7% ( n = 9) of procedures. The majority of patients underwent a median of three debridements followed by negative pressure wound therapy prior to receiving FTT. At a median follow-up of 16.6 months, the limb salvage and ambulatory rates were 79.2 ( n = 38) and 83.3% ( n = 40), respectively. The overall rate of microsurgical flap success was 93.8% ( n = 45). Osteomyelitis recurred in 25% of patients ( n = 12) at a median duration of 4.0 months. There were no significant differences in rates of osteomyelitis recurrence, flap complications, limb salvage, ambulation, and mortality. On multivariate analysis, flap composition remained a nonsignificant predictor of osteomyelitis recurrence (odds ratio: 0.975, p = 0.973).Conclusion This study demonstrates that flap composition may not influence recurrence of osteomyelitis following free flap reconstruction of chronic LE wounds, suggesting that optimal flap selection should be based on wound characteristics and patient goals.
C1 [Huffman, Samuel S.; Li, Karen; Spoer, Daisy L.; Gupta, Nisha J.; Truong, Brian N.] Georgetown Univ, Sch Med, Dept Plast & Reconstruct Surg, Washington, DC USA.
   [Huffman, Samuel S.; Berger, Lauren E.; Spoer, Daisy L.; Evans, Karen K.] MedStar Georgetown Univ Hosp, Dept Plast & Reconstruct Surg, 3800 Reservoir Rd NW, Washington, DC 20007 USA.
   [Berger, Lauren E.] Rutgers Robert Wood Johnson Med Sch, Plast & Reconstruct Surg Div, New Brunswick, NJ USA.
   [Akbari, Cameron M.] MedStar Georgetown Univ Hosp, Dept Vasc Surg, Washington, DC USA.
C3 Georgetown University; Georgetown University; Rutgers University System;
   Rutgers University New Brunswick; Rutgers University Biomedical & Health
   Sciences; Georgetown University
RP Evans, KK (通讯作者)，MedStar Georgetown Univ Hosp, Dept Plast & Reconstruct Surg, 3800 Reservoir Rd NW, Washington, DC 20007 USA.
EM karen.k.evans@medstar.net
OI Spoer, Daisy/0000-0002-1735-5006; Berger, Lauren/0000-0002-5747-0009;
   Huffman, Samuel/0000-0002-1779-8384; Li, Karen
   RuiRui/0000-0002-6672-949X
CR [Anonymous], Osteomyelitis
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   Richards R R., J BONE JOINT SURG AM
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   Spellberg B, 2012, CLIN INFECT DIS, V54, P393, DOI 10.1093/cid/cir842
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NR 43
TC 4
Z9 4
U1 0
U2 0
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 0743-684X
EI 1098-8947
J9 J RECONSTR MICROSURG
JI J. Reconstr. Microsurg.
PD MAY
PY 2024
VL 40
IS 04
BP 253
EP 261
DI 10.1055/a-2153-2285
EA SEP 2023
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA NC8U4
UT WOS:001073309700001
PM 37579781
DA 2026-07-24
ER

PT J
AU Chang, JW
   Heo, W
   Choi, MSS
   Lee, JH
AF Chang, Jung Woo
   Heo, Woong
   Choi, Matthew Seung Suk
   Lee, Jang Hyun
TI The appropriate management algorithm for diabetic foot A single-center
   retrospective study over 12 years
SO MEDICINE
LA English
DT Article
DE algorithm; diabetic foot; diabetic ulcer; management
ID PERIPHERAL ARTERIAL-DISEASE; ENDOVASCULAR TREATMENT; INFECTIONS; RISK;
   LIMB; SUPERMICROSURGERY; CLASSIFICATION; RECONSTRUCTION; OSTEOMYELITIS;
   REAMPUTATION
AB Background: Diabetic foot management is a challenge for reconstructive surgeons because it combines dramatically decreased circulation and chronic infection. The goal of managing this condition is to maximize viable tissue; however, unsatisfactory results, such as extremity amputation, are unavoidable in some cases. For appropriate management, thorough understanding of diabetic foot and the phased approach to its management is needed. The purpose of this study is to introduce an optimal algorithm for diabetic foot management by analyzing cases >12 years.
   Methods: A total of 274 patients with diabetic foot at Hanyang University Guri Hospital from 2005 to 2017 were reviewed. The management process was divided into 5 steps: patient evaluation, wound preparation, improving vascularity, surgery and dressing, and rehabilitation. Patient evaluation included a microbial culture, evaluation of vascularity, and an osteomyelitis assessment. During wound preparation, debridement and negative-pressure wound therapy were performed. Vascularity was improved by radiological intervention or surgical method. Surgery and dressing were performed depending on the indications. Rehabilitation was started after complete wound healing.
   Results: An infection was confirmed in 213 of 263 patients (81.0%). Of 74 cases in which a vascular study was performed, 83.8% showed arterial occlusion. When surgery was performed with complete eradication of the infection in 155 patients, the rate of revision surgery was 20.6%. The revision rate after surgery with a remnant infection of 66 patients was 40.9% (P=.0003). When surgery was performed after successful revascularization for improving blood flow of 47 patients, the rate of revision surgery was 21.3%. In contrast, the revision rate after surgery with unsuccessful or no revascularization of 174 patients was 28.2% (P=.359).
   Conclusion: Diabetic foot is a debilitating disease arising from multifactorial process. As its management is complex, a comprehensive but accessible treatment algorithm is needed for successful results. For this reason, the appropriate algorithm for diabetic foot management introduced in this study is significant.
C1 [Chang, Jung Woo; Heo, Woong; Choi, Matthew Seung Suk; Lee, Jang Hyun] Hanyang Univ, Coll Med, Guri Hosp, Dept Plast & Reconstruct Surg, 249-1 Gyomun Dong, Guri 471701, Gyeonggi Do, South Korea.
C3 Hanyang University
RP Lee, JH (通讯作者)，Hanyang Univ, Coll Med, Guri Hosp, Dept Plast & Reconstruct Surg, 249-1 Gyomun Dong, Guri 471701, Gyeonggi Do, South Korea.
EM pslee@hanyang.ac.kr
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NR 43
TC 7
Z9 9
U1 0
U2 12
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD JUL
PY 2018
VL 97
IS 27
AR e11454
DI 10.1097/MD.0000000000011454
PG 11
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA GN9YH
UT WOS:000439569200075
PM 29979449
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Currie, RV
   Durand, CJ
   Bond, J
AF Currie, Rachel V.
   Durand, Ciaran J.
   Bond, Jeremy
TI Reducing the incidence of problematic seroma formation and skin necrosis
   post-lymphadenectomy: Triple action of topical tranexamic acid, negative
   pressure wound therapy, and prolonged drainage
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Lymphadenectomy; Lymph node clearance; Lymph node surgery; Inguinal
   dissection; Axillary dissection; Complications
ID LYMPH-NODE DISSECTION; RANDOMIZED CLINICAL-TRIAL; INGUINAL
   LYMPHADENECTOMY; DOUBLE-BLIND; BLOOD-LOSS; SURGERY; MANAGEMENT
AB Background: Axillary and inguinal lymph node dissections are commonly associated with complications that often require additional interventions. Methods: Patients who underwent axillary or inguinal lymphadenectomy via standard procedures were compared to an intervention cohort of patients who underwent axillary or inguinal lymphadenectomy with the use of topical tranexamic acid (TXA) to the wound cavity, a PICO (Smith&Nephew UK) closed-incision negative pressure dressing, and discharged early with a drain in-situ. Results: Seventy-six patients in the control group (mean age 65.8 years, mean BMI 28.4 kg/m(2)) underwent open lymphadenectomy without topical TXA and a simple dressing. Seventy-eight patients were included in the intervention group (mean age 67.1 years, mean BMI 28.5 kg/m(2)). Patients in the intervention group had an inpatient stay of mean 5.6 days fewer than those in the control group (CI 3.09-5.31; p < .0001), an estimated saving to the healthcare trust of  pound 3046.40 (US$3723.61) per patient in "bed days." They had longer drain duration (mean 15 days vs. 8.3 days); however, they had a statistically significant lower risk of seroma formation requiring drainage (6.4% vs. 21%; p = .009), and skin necrosis (0% vs. 6.6%; p = .027). They also had a lower risk of infection (17% vs. 29%), wound dehiscence (15% vs. 25%), and readmission (7.7% vs. 14%), although they were not statistically significant. Patients in the control group were more likely to receive antibiotics as inpatients (51% vs. 7.7%; p < .00001) and on discharge (24% vs. 5%; p < .0011) than those in the intervention group. Conclusions: Topical TXA, PICO dressing, and early discharge with a drain following lymphadenectomy results in a reduced rate of complications. (c) 2024 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Currie, Rachel V.; Durand, Ciaran J.; Bond, Jeremy] Ulster Hosp, Reg Dept Maxillofacial & Plast Surg, Upper Newtownards Rd, Belfast BT16 1RH, North Ireland.
RP Currie, RV (通讯作者)，Ulster Hosp, Reg Dept Maxillofacial & Plast Surg, Upper Newtownards Rd, Belfast BT16 1RH, North Ireland.
EM rcurrie26@qub.ac.uk
FX Funding Many thanks to Mr. Richard Fallis, Specialist Librarian for
   Medicine, Dentistry & Healthcare Sciences at the Healthcare Library of
   Northern Ireland, for his assistance in locating relevant previous
   publications for discussion.
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   Norman G, 2020, COCHRANE DB SYST REV, DOI [10.1002/14651858.CD009261.pub6, 10.1002/14651858.CD009261.pub5]
   Nouraei M, 2013, TURK J MED SCI, V43, P273, DOI 10.3906/sag-1206-37
   OERTLI D, 1994, BRIT J SURG, V81, P856, DOI 10.1002/bjs.1800810621
   Pieszko K, 2023, PLAST RECONSTR SURG, V151, P1123, DOI 10.1097/PRS.0000000000010110
   Poirier A, 2022, J PLAST RECONSTR AES, V75, P4403, DOI 10.1016/j.bjps.2022.08.054
   Shah MUA, 2015, JCPSP-J COLL PHYSICI, V25, P161, DOI 03.2015/JCPSP.161165
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   Stollwerck PL, 2016, GMS INTERDISCIP PLAS, V5, DOI 10.3205/iprs000084
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   Xu DR, 2020, MEDICINE, V99, DOI 10.1097/MD.0000000000019552
NR 36
TC 0
Z9 1
U1 0
U2 0
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD JUL
PY 2024
VL 94
BP 54
EP 61
DI 10.1016/j.bjps.2024.04.065
EA MAY 2024
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA C9I1L
UT WOS:001292416900001
PM 38759512
DA 2026-07-24
ER

PT J
AU Arai, M
   Kim, S
   Ishii, H
   Hagiwara, J
   Kushimoto, S
   Yokota, H
AF Arai, Masatoku
   Kim, Shiei
   Ishii, Hiromoto
   Hagiwara, Jun
   Kushimoto, Shigeki
   Yokota, Hiroyuki
TI The long-term outcomes of early abdominal wall reconstruction by
   bilateral anterior rectus abdominis sheath turnover flap method in
   critically ill patients requiring open abdomen
SO WORLD JOURNAL OF EMERGENCY SURGERY
LA English
DT Article
DE Open abdomen; Negative pressure wound therapy; Abdominal wall
   reconstruction; Abdominal compartment syndrome
ID FASCIAL CLOSURE; TRACTION; REPAIR
AB Background: In a previous study, we reported the usefulness of early abdominal wall reconstruction using bilateral anterior rectus abdominis sheath turnover flap method (turnover flap method) in open abdomen (OA) patients in whom early primary fascial closure was difficult to achieve. However, the long-term outcomes have not been elucidated. In the present study, we aimed to evaluate the procedure, particularly in terms of ventral hernia, pain, and daily activities.
   Methods: Between 2001 and 2013, 15 consecutive patients requiring OA after emergency laparotomy and in whom turnover flap method was applied were retrospectively identified. The long-term outcomes were evaluated based on medical records, physical examinations, CT imaging, and a ventral hernia pain questionnaire (VHPQ).
   Results: The turnover flap method was applied in 2 trauma and 13 non-trauma patients.
   In most of cases, primary fascial closure could not be achieved due to massive visceral edema. The turnover flap method was performed for abdominal wall reconstruction at the end of OA. The median duration of OA was 6 (range 1-42) days. One of the 15 patients died of multiple organ failure during initial hospitalization after the performance of the turnover flap method. Fourteen patients survived, and although wound infection was observed in 3 patients, none showed enteric fistula, abdominal abscess, graft infection, or ventral hernia during hospitalization. However, it was found that 1 patient developed ventral hernia during follow-up at an outpatient visit. Nine of 14 patients were alive and able to be evaluated with a VHPQ (follow-up period: median 10 years; range 3-15 years). Seven out of nine patients were satisfied with this procedure, and none complained of pain or were limited in their daily activities.
   Conclusions: Based on the results of this study, early abdominal reconstruction using the turnover flap method can be considered to be safe and effective as an alternative technique for OA patients in whom primary fascial closure is considered difficult to achieve.
C1 [Arai, Masatoku; Kim, Shiei; Ishii, Hiromoto; Hagiwara, Jun; Yokota, Hiroyuki] Nippon Med Sch, Dept Emergency & Crit Care Med, Bunkyo Ku, 1-1-5 Sendagi, Tokyo 1138603, Japan.
   [Kushimoto, Shigeki] Tohoku Univ, Div Emergency & Crit Care Med, Grad Sch Med, Aoba Ku, 1-1 Seiryo Machi, Sendai, Miyagi 9808574, Japan.
C3 Nippon Medical School; Tohoku University
RP Arai, M (通讯作者)，Nippon Med Sch, Dept Emergency & Crit Care Med, Bunkyo Ku, 1-1-5 Sendagi, Tokyo 1138603, Japan.
EM amasatoku@nms.ac.jp
RI Kushimoto, Shigeki/AET-6785-2022
CR Acosta S, 2016, EUR J VASC ENDOVASC, V51, P371, DOI 10.1016/j.ejvs.2015.10.014
   Arai M, 2018, CHIRURGIA BUCUR
   Arai M, 2015, SURG TODAY, V45, P1335, DOI 10.1007/s00595-015-1133-3
   Chiara O, 2016, J TRAUMA ACUTE CARE, V80, P173, DOI 10.1097/TA.0000000000000882
   Clay L, 2012, LANGENBECK ARCH SURG, V397, P1219, DOI 10.1007/s00423-012-0932-x
   Coccolini F, 2018, WORLD J EMERG SURG, V13, DOI 10.1186/s13017-018-0167-4
   den Hartog D, 2008, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD006438.pub2
   Kirkpatrick AW, 2013, INTENS CARE MED, V39, P1190, DOI 10.1007/s00134-013-2906-z
   Kushimoto S, 2007, WORLD J SURG, V31, P2, DOI 10.1007/s00268-006-0282-3
   Petersson U, 2007, WORLD J SURG, V31, P2133, DOI 10.1007/s00268-007-9222-0
   Rasilainen SK, 2016, SCAND J SURG, V105, P17, DOI 10.1177/1457496915586651
   Regner JL, 2012, WORLD J SURG, V36, P497, DOI 10.1007/s00268-011-1203-7
   RIZK NN, 1991, J ANAT, V175, P1
NR 13
TC 8
Z9 11
U1 0
U2 0
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-7922
J9 WORLD J EMERG SURG
JI World J. Emerg. Surg.
PD SEP 4
PY 2018
VL 13
AR 39
DI 10.1186/s13017-018-0200-7
PG 6
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA GS4VP
UT WOS:000443651600001
PM 30202428
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Ainslie-Garcia, M
   Anderson, LA
   Bloch, BV
   Board, TN
   Chen, AF
   Craigie, S
   Danker, W
   Gunja, N
   Harty, J
   Hernandez, VH
   Lebedeva, K
   Hameed, D
   Mont, MA
   Nunley, RM
   Parvizi, J
   Perka, C
   Piuzzi, NS
   Rolfson, O
   Rychlik, J
   Romanini, E
   Sanz-Ruiz, P
   Sierra, RJ
   Suleiman, L
   Tsiridis, E
   Vendittoli, PA
   Wangen, H
   Zagra, L
AF Ainslie-Garcia, Margaret
   Anderson, Lucas A.
   Bloch, Benjamin V.
   Board, Tim N.
   Chen, Antonia F.
   Craigie, Samantha
   Danker, Walter
   Gunja, Najmuddin
   Harty, James
   Hernandez, Victor H.
   Lebedeva, Kate
   Hameed, Daniel
   Mont, Michael A.
   Nunley, Ryan M.
   Parvizi, Javad
   Perka, Carsten
   Piuzzi, Nicolas S.
   Rolfson, Ola
   Rychlik, Joshua
   Romanini, Emilio
   Sanz-Ruiz, Pablo
   Sierra, Rafael J.
   Suleiman, Linda
   Tsiridis, Eleftherios
   Vendittoli, Pascal-Andr
   Wangen, Helge
   Zagra, Luigi
TI International Delphi Study on Wound Closure and Incision Management in
   Joint Arthroplasty Part 2: Total Hip Arthroplasty
SO JOURNAL OF ARTHROPLASTY
LA English
DT Article
DE total hip arthroplasty (THA); wound closure; incision management;
   modified Delphi study; consensus development; orthopaedic surgery
   practices
ID TOTAL KNEE ARTHROPLASTY; RISK CALCULATOR; INFECTION; CONSENSUS
AB Background: This modi fied Delphi study aimed to develop a consensus on optimal wound closure and incision management strategies for total hip arthroplasty (THA). Given the critical nature of wound care and incision management in in fluencing patient outcomes, this study sought to synthesize evidencebased best practices for wound care in THA procedures. Methods: An international panel of 20 orthopedic surgeons from Europe, Canada, and the United States evaluated a targeted literature review of 18 statements (14 speci fic to THA and 4 related to both THA and total knee arthroplasty). There were 3 rounds of anonymous voting per topic using a modi fied 5 -point Likert scale with a predetermined consensus threshold of >= 75% agreement necessary for a statement to be accepted. Results: After 3 rounds of voting, consensus was achieved for all 18 statements. Notable recommendations for THA wound management included (1) the use of barbed sutures over non -barbed sutures (shorter closing times and overall cost savings); (2) the use of subcuticular sutures over skin staples (lower risk of superficial infections and higher patient preferences, but longer closing times); (3) the use of mesh-adhesives over silver-impregnated dressings (lower rate of wound complications); (4) for at -risk patients, the use of negative pressure wound therapy over other dressings (lower wound complications and reoperations, as well as fewer dressing changes); and (5) the use of triclosan-coated sutures (lower risk of surgical site infection) over standard sutures. Conclusions: Through a structured modified Delphi approach, a panel of 20 orthopedic surgeons reached consensus on all 18 statements pertaining to wound closure and incision management in THA. This study provides a foundational framework for establishing evidence-based best practices, aiming to reduce variability in patient outcomes and to enhance the overall quality of care in THA procedures. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
C1 [Ainslie-Garcia, Margaret; Craigie, Samantha; Lebedeva, Kate; Rychlik, Joshua] EVERSANA, Dept Value & Evidence, Burlington, ON, Canada.
   [Anderson, Lucas A.] Univ Utah, Orthopaed Ctr, Dept Orthopaed, Salt Lake City, UT USA.
   [Bloch, Benjamin V.] City Hosp, Dept Orthopaed, Nottingham Elective Orthopaed Serv, Nottingham, England.
   [Board, Tim N.] Wrightington Hosp, Ctr Hip Surg, Dept Orthopaed, Wigan, England.
   [Chen, Antonia F.] Harvard Med Sch, Brigham & Womens Hosp, Dept Orthopaed Surg, Boston, MA USA.
   [Danker, Walter; Gunja, Najmuddin] J&J MedTech, Hlth Econ & Market Access, Raritan, NJ USA.
   [Harty, James] Cork Univ Hosp, Trauma & Orthopaed Dept, Cork, Ireland.
   [Hernandez, Victor H.] Univ Miami, Jackson Mem Hosp, Dept Orthopaed Surg & Rehabil, Miami, FL USA.
   [Hameed, Daniel; Mont, Michael A.] Sinai Hosp Baltimore, Rubin Inst Adv Orthoped, LifeBridge Hlth, 2401 West Belvedere Ave, Baltimore, MD 21215 USA.
   [Nunley, Ryan M.] Washington Univ, Dept Orthopaed Surg, St Louis, MO USA.
   [Parvizi, Javad] Thomas Jefferson Univ, Rothman Inst, Philadelphia, PA USA.
   [Perka, Carsten] Orthopead Univ Klin Charite, Dept Orthopaed, Ctr Muskuloskeletale Chirurg, Berlin, Germany.
   [Piuzzi, Nicolas S.] Cleveland Clin Fdn, Dept Orthoped Surg, Cleveland, OH USA.
   [Rolfson, Ola] Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Orthopead, Gothenburg, Sweden.
   [Romanini, Emilio] Polo Sanitario San Feliciano, Ctr Hip & Knee Arthroplasty, Rome, Italy.
   [Sanz-Ruiz, Pablo] Univ Complutense Madrid UCM, Fac Med, Dept Surg, Madrid, Spain.
   [Sierra, Rafael J.] Mayo Clin, Dept Orthoped Surg, Rochester, MN USA.
   [Suleiman, Linda] Northwestern Univ, Dept Orthopaed Surg, Feinberg Sch Med, Chicago, IL USA.
   [Tsiridis, Eleftherios] Aristotle Univ Thessaloniki, Gen Hosp Papageorgiou, Acad Orthoped Unit, Med Sch, Thessaloniki, Greece.
   [Vendittoli, Pascal-Andr] Univ Montreal, Maisonneuve Rosemont Hosp, Dept Surg, Montreal, PQ, Canada.
   [Wangen, Helge] Innlandet Hosp Trust, Dept Orthopaed Surg, Elverum, Norway.
   [Zagra, Luigi] IRCCS Ist Ortoped Galeazzi, Hip Dept, Milan, Italy.
C3 Utah System of Higher Education; University of Utah; University of
   Nottingham; Harvard University; Harvard Medical School; Harvard
   University Medical Affiliates; Brigham & Women's Hospital; University
   College Cork; University of Miami; Sinai Hospital of Baltimore;
   Washington University (WUSTL); Rothman Institute; Thomas Jefferson
   University; Cleveland Clinic Foundation; University of Gothenburg;
   Complutense University of Madrid; Mayo Clinic; Northwestern University;
   Feinberg School of Medicine; Aristotle University of Thessaloniki;
   Papageorgiou Hospital; Universite de Montreal; Innlandet Hospital Trust;
   IRCCS Istituto Ortopedico Galeazzi
RP Mont, MA (通讯作者)，Sinai Hosp Baltimore, Rubin Inst Adv Orthoped, LifeBridge Hlth, 2401 West Belvedere Ave, Baltimore, MD 21215 USA.
RI Danker III, Walter/AAP-5078-2020; Zagra, Luigi/PFZ-1383-2026; Bloch,
   Benjamin/I-1041-2019; /I-9296-2019; Rolfson, Ola/AAT-2206-2020; Perka,
   Carsten/ABG-6505-2021; Hernandez, Victor H/AAG-4458-2020; sanz-ruiz,
   pablo/H-6539-2015
OI Danker III, Walter/0000-0002-9741-5821; Perka,
   Carsten/0000-0002-0993-581X; Piuzzi, Nicolas S/0000-0003-3007-7538;
   Hernandez, Victor H/0000-0003-1745-3324; sanz-ruiz,
   pablo/0000-0002-7588-1880
FU Ethicon
FX Funding: This project received financial support from Ethicon.
CR Antonelli B, 2019, ARTHROPLASTY, V1, DOI 10.1186/s42836-019-0003-7
   Beiderbeck D, 2021, METHODSX, V8, DOI 10.1016/j.mex.2021.101401
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   Bozic KJ, 2012, J BONE JOINT SURG AM, V94A, P794, DOI 10.2106/JBJS.K.00072
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   Chen ZM, 2022, J KNEE SURG, V35, P1524, DOI 10.1055/s-0042-1758674
   Chen Zhongming, 2022, SURGICAL TECHNOLOGY INTERNATIONAL-INTERNATIONAL DEVELOPMENTS IN SURGERY AND SURGICAL RESEARCH, V41
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NR 27
TC 12
Z9 14
U1 0
U2 7
PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
PI PHILADELPHIA
PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA
SN 0883-5403
EI 1532-8406
J9 J ARTHROPLASTY
JI J. Arthroplast.
PD JUN
PY 2024
VL 39
IS 6
BP 1524
EP 1529
DI 10.1016/j.arth.2024.01.047
EA MAY 2024
PG 6
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA UF6V0
UT WOS:001246692800001
PM 38325531
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Thiels, CA
   Aho, JM
   Naik, ND
   Zielinski, MD
   Schiller, HJ
   Morris, DS
   Kim, BD
AF Thiels, Cornelius A.
   Aho, Johnathon M.
   Naik, Nimesh D.
   Zielinski, Martin D.
   Schiller, Henry J.
   Morris, David S.
   Kim, Brian D.
TI Infected hardware after surgical stabilization of rib fractures:
   Outcomes and management experience
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Flail chest; hardware infection; rib fracture; SSRF; surgical
   stabilization
ID ANTIBIOTIC-THERAPY; CHEST; OSTEOMYELITIS; DISABILITY; INJURIES; REPAIR;
   TIBIA; PAIN
AB BACKGROUND: Surgical stabilization of rib fracture (SSRF) is increasingly used for treatment of rib fractures. There are few data on the incidence, risk factors, outcomes, and optimal management strategy for hardware infection in these patients. We aimed to develop and propose a management algorithm to help others treat this potentially morbid complication.
   METHODS: We retrospectively searched a prospectively collected rib fracture database for the records of all patients who underwent SSRF from August 2009 through March 2014 at our institution. We then analyzed for the subsequent development of hardware infection among these patients. Standard descriptive analyses were performed.
   RESULTS: Among 122 patients who underwent SSRF, most (73%) were men; the mean (SD) age was 59.5 (16.4) years, and median (interquartile range [IQR]) Injury Severity Score was 17 (13Y22). The median number of rib fractures was 7 (5-9) and 48% of the patients had flail chest. Mortality at 30 days was 0.8%. Five patients (4.1%) had a hardware infection on mean (SD) postoperative day 12.0 (6.6). Median Injury Severity Score (17 [range, 13-42]) and hospital length of stay (9 days [6-37 days]) in these patients were similar to the values for those without infection (17 days [range, 13Y22 days] and 9 days [6-12 days], respectively). Patients with infection underwent a median (IQR) of 2 (range, 2-3) additional operations, which included wound debridement (n = 5), negative-pressure wound therapy (n = 3), and antibiotic beads (n = 4). Hardware was removed in 3 patients at 140, 190, and 192 days after index operation. Cultures grew only gram-positive organisms. No patients required reintervention after hardware removal, and all achieved bony union and were taking no narcotics or antibiotics at the latest follow-up.
   CONCLUSIONS: Although uncommon, hardware infection after SSRF carries considerable morbidity. With the use of an aggressive multimodal management strategy, however, bony union and favorable long-term outcomes can be achieved. Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.
C1 [Thiels, Cornelius A.; Aho, Johnathon M.; Naik, Nimesh D.; Zielinski, Martin D.; Schiller, Henry J.; Morris, David S.; Kim, Brian D.] Mayo Clin, Dept Surg, 200 First St SW, Rochester, MN 55905 USA.
   [Thiels, Cornelius A.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deli, Rochester, MN 55905 USA.
   [Aho, Johnathon M.] Mayo Clin, Dept Physiol & Biomed Engn, Rochester, MN 55905 USA.
C3 Mayo Clinic; Mayo Clinic; Mayo Clinic
RP Kim, BD (通讯作者)，Mayo Clin, Dept Surg, 200 First St SW, Rochester, MN 55905 USA.
EM kim.brian@mayo.edu
RI Morris, David/AAW-1940-2021
OI Thiels, Cornelius/0000-0003-3654-8601
FU Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of
   Health Care Delivery; NHLBI from the National Heart, Lung, and Blood
   Institute a component of the National Institutes of Health [T32
   HL105355]; National Heart Lung and Blood Institute [T32HL105355] Funding
   Source: NIH RePORTER
FX Support was provided by the Mayo Clinic Robert D. and Patricia E. Kern
   Center for the Science of Health Care Delivery (Thiels) and by the NHLBI
   grant T32 HL105355 from the National Heart, Lung, and Blood Institute, a
   component of the National Institutes of Health (Aho).
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NR 20
TC 36
Z9 43
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD MAY
PY 2016
VL 80
IS 5
BP 819
EP 823
DI 10.1097/TA.0000000000001005
PG 5
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA DM9ZB
UT WOS:000376723100027
PM 26891160
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Park, HJ
   You, KH
   Hong, S
   Kim, HN
AF Park, Hyun-Jin
   You, Ki-Han
   Hong, Seokho
   Kim, Hyong Nyun
TI Use of prolonged closed suction drainage for synovial fluid-draining
   wounds around the ankle
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE closed suction drainage; closure; synovial fluid; tendon exposure;
   wound; wound care; wound dehiscence; wound dressing; wound healing
ID SURGICAL SITE INFECTION; MANAGEMENT; SHEATH; CARE; TENOSYNOVITIS;
   ASSOCIATION; COLLAGEN; THERAPY
AB Objective: When synovial fluid drains through a wound, cells necessary to form tissue required for healing are washed away. This results in failure of wound closure, often necessitating a pedicled or free flap reconstruction. We hypothesised that prolonged (>48 hours post surgery) closed suction drainage can reduce the fluid draining through the wound, enabling wound healing and eliminating the need for a pedicled or free flap reconstruction. We also aimed to determine whether prolonged application of closed suction drainage would increase postoperative infection. Method: A retrospective study was performed between August 2015 and December 2020. Patients with fluid-draining wounds around the ankle which had failed to respond to treatment with delayed closure and which required the use of prolonged closed suction drainage were included. Closed suction (Jackson-Pratt, JP) drainage was applied from the time of wound closure until the wound healed. Results: A total of 20 patients (12 male: eight female; mean age: 52 years; range: 21-74 years) were included in the study. The results showed the JP drain being kept for a mean of 14.1 +/- 1.8 (range: 9-16) postoperative days. Prolonged closed suction drainage helped achieve wound closure in 19 (95%) patients. Only one patient with Achilles tendon exposure underwent sural flap surgery. None of the patients developed an infection due to prolonged use of the JP drain. With regards to patient satisfaction, four (21%), 10 (53%), four (21%) and one (5%) patients were 'very satisfied', 'satisfied', 'fair' and 'dissatisfied', respectively, with the results of the treatment technique at follow-up (mean: 29.9; range: 12-72 months). The remaining patient was lost to follow-up. Conclusion: Prolonged application of closed suction drainage made wound closure possible for synovial fluid-draining wounds, eliminating the need for a pedicled or free flap surgery, without increasing the rates of wound infection. This technique could be used as an adjunct to the local flap, negative pressure wound therapy or other reconstructive techniques at the time of revision surgery.
C1 [Park, Hyun-Jin; You, Ki-Han; Hong, Seokho; Kim, Hyong Nyun] Hallym Univ, Coll Med, Kangnam Sacred Heart Hosp, Dept Orthoped Surg, Seoul, South Korea.
C3 Hallym University
RP Kim, HN (通讯作者)，Hallym Univ, Coll Med, Kangnam Sacred Heart Hosp, Dept Orthoped Surg, Seoul, South Korea.
EM hyongnyun@naver.com
RI Park, Hyun Jin/HSG-6465-2023
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NR 36
TC 0
Z9 0
U1 0
U2 0
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2052-2916
J9 J WOUND CARE
JI J. Wound Care
PD MAR
PY 2025
VL 34
SU 3
DI 10.12968/jowc.2022.0029
PG 8
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA Z9K9F
UT WOS:001442019000001
PM 40056381
DA 2026-07-24
ER

PT J
AU Xu, J
   Chen, WL
   He, L
   Feng, SH
   Zhang, JH
   Chang, B
AF Xu, Jun
   Chen, Weiling
   He, Lu
   Feng, Shuhong
   Zhang, Jinghang
   Chang, Bai
TI Most postoperative reserved "normal" metatarsal stumps of diabetic foot
   osteomyelitis are infected but have healing potential
SO FRONTIERS IN ENDOCRINOLOGY
LA English
DT Article
DE diabetic foot osteomyelitis; reserved metatarsal stump; infection;
   conservative surgery; wound healing
ID CONSERVATIVE SURGERY
AB BackgroundAlthough the pathology and bacterial status of the "normal" bone stump after operation of diabetic foot osteomyelitis (DFO) are of great significance for the prognosis of foot wounds, there are only a few studies on this topic; hence, it is clinically relevant and urgent to study this topic. MethodsThe data of 57 inpatients with DFO from June 2021 to April 2022 were collected, all of whom had DFO in the forefoot and underwent conservative surgery. After the surgical removal of necrotic bone, bone biopsies were taken from the necrotic phalangeal bone and the reserved "normal" metatarsal stump. They were cultured, after which antibiotic susceptibility test and pathological screening were carried out. According to clinical judgment, inpatients' wounds were divided into metatarsal affected group and metatarsal unaffected group. We then compared and analyzed the pathological and bacterial characteristics of preserved "normal" bone stump and its effect on wound healing and prognosis. ResultsThe poor concordance rate between deep soft tissue culture and infected phalange culture was only 19.3%. The deep soft tissue (72.6%), infected phalange (70.7%), and metatarsal stump (71.4%) were mainly infected with gram-negative Bacillus. The proportion of Enterococcus spp. increased significantly in bone tissue. Acinetobacter baumannii had the highest drug resistance (88%, 22/25). There was no significant difference in several clinical characteristics and wound healing regardless of whether their metatarsal stumps were affected. Most reserved "normal" metatarsal stumps (84.2%, 48/57) were positive by pathological diagnosis and bacterial culture testing; only 15.7% (9/57) samples were truly sterile. Only 8.3% (4/48) of the former patients healed within 6 months; whereas, all the latter (9/9) patients healed within 6 months. However, the majority (89.6%, 43/48) could heal. There was no difference in operations, skin grafting, negative pressure wound therapy, and mortality between the two groups. ConclusionThe most reserved "normal" metatarsal stumps have been invaded by bacteria. However, the majority stumps can be preserved, and the wound will eventually be healed according to the pathological and bacterial culture results.
C1 [Xu, Jun; Feng, Shuhong; Zhang, Jinghang; Chang, Bai] Tianjin Med Univ, Chu Hsien I Mem Hosp, Dept Diabet Foot, Natl Hlth Commiss Peoples Republ China,Key Lab Hor, Tianjin, Peoples R China.
   [Xu, Jun; He, Lu; Feng, Shuhong; Zhang, Jinghang; Chang, Bai] Tianjin Med Univ, Tianjin Inst Endocrinol, Tianjin, Peoples R China.
   [Chen, Weiling] Beijing Univ Tradit Chinese Med, Dongzhimen Hosp, Dept Dermatol, Beijing, Peoples R China.
   [He, Lu] Tianjin Med Univ, Chu Hsien I Mem Hosp, Dept Clin Lab, Natl Hlth Commiss Peoples Republ China,Key Lab Hor, Tianjin, Peoples R China.
C3 Tianjin Medical University; Tianjin Medical University; Beijing
   University of Chinese Medicine; Tianjin Medical University
RP Chang, B (通讯作者)，Tianjin Med Univ, Chu Hsien I Mem Hosp, Dept Diabet Foot, Natl Hlth Commiss Peoples Republ China,Key Lab Hor, Tianjin, Peoples R China.; Chang, B (通讯作者)，Tianjin Med Univ, Tianjin Inst Endocrinol, Tianjin, Peoples R China.
EM changbai1972@126.com
FU Natural Science Foundation of China [81973614]; Tianjin Key Medical
   Discipline (Specialty) Construction Project [TJYXZDXK-032A]
FX Funding This work was supported by Natural Science Foundation of China
   (81973614). Tianjin Key Medical Discipline (Specialty) Construction
   Project (TJYXZDXK-032A).
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NR 18
TC 2
Z9 6
U1 0
U2 1
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 1664-2392
J9 FRONT ENDOCRINOL
JI Front. Endocrinol.
PD AUG 2
PY 2023
VL 14
AR 1165305
DI 10.3389/fendo.2023.1165305
PG 10
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA P2IA8
UT WOS:001048916100001
PM 37600693
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Winstanley, RJH
   Hadfield, JN
   Walker, R
   Bretherton, CP
   Ashwood, N
   Allison, K
   Trompeter, A
   Eardley, WGP
AF Winstanley, R. J. H.
   Hadfield, J. N.
   Walker, R.
   Bretherton, C. P.
   Ashwood, N.
   Allison, K.
   Trompeter, A.
   Eardley, W. G. P.
CA Open-Fracture Patient Evaluation
TI The Open-Fracture Patient Evaluation Nationwide (OPEN) study THE
   MANAGEMENT OF OPEN FRACTURE CARE IN THE UK
SO BONE & JOINT JOURNAL
LA English
DT Article
ID INITIAL MANAGEMENT; WOUND MANAGEMENT; LOWER-LIMB; INFECTION
AB Aims
   The Open-Fracture Patient Evaluation Nationwide (OPEN) study was performed to provide clarity in open fracture management previously skewed by small, specialist centre studies and large, unfocused registry investigations. We report the current management metrics of open fractures across the UK.
   Method
   Patients admitted to hospital with an open fracture (excluding phalanges or isolated hand injuries) between 1 June 2021 and 30 September 2021 were included. Institutional information governance approval was obtained at the lead site and all data entered using Research Electronic Data Capture software. All domains of the British Orthopaedic Association Standard for Open Fracture Management were recorded.
   Results
   Across 51 centres, 1,175 patients were analyzed. Antibiotics were given to 754 (69.0%) in the emergency department, 240 (22.0%) pre-hospital, and 99 (9.1%) as inpatients. Wounds were photographed in 848 (72.7%) cases. Median time to first surgery was 16 hrs 14 mins (interquartile range (IQR) 8 hrs 29 mins to 23 hrs 19 mins). Complex injuries were operated on sooner (median 12 hrs 51 mins (IQR 4 hrs 36 mins to 21 hrs 14 mins)). Of initial procedures, 1,053 (90.3%) occurred between 8am and 8pm. A consultant orthopaedic surgeon was present at 1,039 (89.2%) first procedures. In orthoplastic centres, a consultant plastic surgeon was present at 465 (45.1%) first procedures. Overall, 706 (60.8%) patients required a single operation. At primary debridement, 798 (65.0%) fractures were definitively fixed, while 734 (59.8%) fractures had fixation and coverage in one operation through direct closure or soft-tissue coverage. Negative pressure wound therapy was used in 235 (67.7%) staged procedures. Following wound closure or soft-tissue cover, 509 (47.0%) patients received antibiotics for a median of three days (IQR 1 to 7).
   Conclusion
   OPEN provides an insight into care across the UK and different levels of hospital for open fractures. Patients are predominantly operated on promptly, in working hours, and at specialist centres. Areas for improvement include combined patient review and follow-up, scheduled operating, earlier definitive soft-tissue cover, and more robust antibiotic husbandry.
C1 [Winstanley, R. J. H.; Hadfield, J. N.; Walker, R.; Bretherton, C. P.; Ashwood, N.; Allison, K.; Trompeter, A.; Eardley, W. G. P.] South Tees Hosp NHS Trust, James Cook Univ Hosp, Middlesbrough, Cleveland, England.
C3 James Cook University Hospital
RP Winstanley, RJH (通讯作者)，South Tees Hosp NHS Trust, James Cook Univ Hosp, Middlesbrough, Cleveland, England.
EM robert.winstanley1@nhs.net
RI ; Bretherton, Christopher/LDE-6304-2024; Ashwood, Neil/L-7881-2019;
   Trompeter, Alex/JCD-4455-2023
OI Winstanley, Robert John Henry/0000-0002-5102-8535; Bretherton,
   Christopher/0000-0001-9569-0734; Neo, Chryssa/0000-0002-3143-3007;
   Walker, Reece/0000-0002-7181-4699; Hadfield, James/0000-0001-7052-8036;
   Allison, Keith/0000-0002-2843-4885; Eardley, Will/0000-0003-1980-8520; 
FU AOUK&I Research Grant
FX The authors disclose receipt of the following financial or material
   support for the research, authorship, and/or publication of this
   article: AOUK&I Research Grant.
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NR 25
TC 9
Z9 14
U1 1
U2 4
PU BRITISH EDITORIAL SOC BONE & JOINT SURGERY
PI LONDON
PA 22 BUCKINGHAM STREET, LONDON WC2N 6ET, ENGLAND
SN 2049-4394
J9 BONE JOINT J
JI Bone Joint J.
PD SEP
PY 2022
VL 104B
IS 9
BP 1073
EP 1080
DI 10.1302/0301-620X.104B9.BJJ-2022-0202.R1
PG 8
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA H2EW1
UT WOS:000994158100011
PM 36047016
DA 2026-07-24
ER

PT J
AU Loftus, TJ
   Jordan, JR
   Croft, CA
   Smith, RS
   Efron, PA
   Mohr, AM
   Moore, FA
   Brakenridge, SC
AF Loftus, Tyler J.
   Jordan, Janeen R.
   Croft, Chasen A.
   Smith, R. Stephen
   Efron, Philip A.
   Mohr, Alicia M.
   Moore, Frederick A.
   Brakenridge, Scott C.
TI Temporary abdominal closure for trauma and intra-abdominal sepsis:
   Different patients, different outcomes
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Damage control surgery; temporary abdominal closure; trauma; sepsis;
   primary fascial closure
ID DAMAGE-CONTROL LAPAROTOMY; PRIMARY FASCIAL CLOSURE; VENTRAL HERNIA
   REPAIR; OPEN ABDOMEN; MANAGEMENT; RESUSCITATION; COAGULOPATHY;
   APPROXIMATION; 100-PERCENT; THERAPY
AB BACKGROUND: Temporary abdominal closure (TAC) after damage control surgery (DCS) for injured patients has been generalized to septic patients. However, direct comparisons between these populations are lacking. We hypothesized that patients with intra-abdominal sepsis would have different resuscitation requirements and lower primary fascial closure rates than trauma patients.
   STUDY DESIGN: We performed a 3-year retrospective cohort analysis of patients managed with TAC for trauma (n = 77) or intra-abdominal sepsis (n = 147). All patients received negative pressure wound therapy (NPWT) TAC with intention for planned relaparotomy and sequential abdominal closure attempts at 24- to 48-hour intervals.
   RESULTS: At presentation, trauma patients had higher rates of hypothermia (31% vs. 18%), severe acidosis (27% vs. 14%), and coagulopathy (68% vs. 48%), and septic patients had higher vasopressor infusion rates (46% vs. 27%). Forty-eight hours after presentation, septic patients had persistently higher vasopressor infusion rates (37% vs. 17%), and trauma patients had received more red blood cell transfusions (6.0 U vs. 0.0 U), fresh frozen plasma (5.0 U vs. 0.0 U), and crystalloid (8,290 vs. 7,159 ml). Among patients surviving to discharge, trauma patients had higher primary fascial closure (PFC) rates (90% vs. 76%). For trauma patients, independent predictors of failure to achieve PCF were >= 2.5 L NPWT output at 48 hours, >= 10 L crystalloid administration at 48 hours, and >= 10 U PRBC + FFP at 48 hours. For septic patients, relaparotomy within 48 hours predicted successful PFC; requirement for >= 3 diagnostic/therapeutic laparotomies predicted failure to achieve PFC.
   CONCLUSIONS: Traumatic injury and intra-abdominal sepsis are associated with distinct pathophysiologic insults, resuscitation requirements, and outcomes. Failure to achieve primary fascial closure in trauma patients was attributable to the triad of hypothermia, acidosis, and coagulopathy; failure to achieve fascial closure in septic patients was dependent upon operative course. Indications and optimal techniques for TAC may differ between these populations. (Copyright (C) 2016 Wolters Kluwer Health, Inc. All rights reserved.)
C1 [Loftus, Tyler J.; Jordan, Janeen R.; Croft, Chasen A.; Smith, R. Stephen; Efron, Philip A.; Mohr, Alicia M.; Moore, Frederick A.; Brakenridge, Scott C.] Univ Florida Hlth, Dept Surg, Gainesville, FL USA.
   [Loftus, Tyler J.; Jordan, Janeen R.; Croft, Chasen A.; Smith, R. Stephen; Efron, Philip A.; Mohr, Alicia M.; Moore, Frederick A.; Brakenridge, Scott C.] Univ Florida Hlth, Sepsis & Crit Illness Res Ctr, Gainesville, FL USA.
C3 State University System of Florida; University of Florida; State
   University System of Florida; University of Florida
RP Brakenridge, SC (通讯作者)，Univ Florida Hlth, 1600 SW Archer Rd,Room M-602, Gainesville, FL 32610 USA.
EM Scott.brakenridge@surgery.ufl.edu
RI Loftus, Tyler/J-7761-2016; Brakenridge, Scott/AAD-6691-2019; Mohr,
   Alicia/E-3016-2015
OI Loftus, Tyler/0000-0001-5354-443X; Brakenridge,
   Scott/0000-0002-7327-3718; Smith, Robert/0000-0002-0455-6415; Mohr,
   Alicia/0000-0003-1732-1313
FU National Institute on Aging [P30 AG028740]; National Institute of
   General Medical Sciences (NIGMS) [R01 GM105893-01A1, P50 GM111152-01];
   NIGMS [T32 GM-08721]; National Institute of General Medical Sciences
   [T32GM008721, R01GM105893] Funding Source: NIH RePORTER; National
   Institute on Aging [P30AG028740] Funding Source: NIH RePORTER
FX The authors have no relevant conflicts of interest. This work has not
   been presented at any meetings and has never been submitted elsewhere.
   The authors were supported in part by grants P30 AG028740 (S.C.B.)
   awarded by the National Institute on Aging and by R01 GM105893-01A1
   (A.M.M.), P50 GM111152-01 (S.C.B., F.A.M., A.M.M.) awarded by the
   National Institute of General Medical Sciences (NIGMS). T.J.L. was
   supported by a postgraduate training grant (T32 GM-08721) in burns,
   trauma, and perioperative injury by NIGMS.
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NR 39
TC 23
Z9 31
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD FEB
PY 2017
VL 82
IS 2
BP 345
EP 350
DI 10.1097/TA.0000000000001283
PG 6
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA EJ8GO
UT WOS:000393463600020
PM 27787442
DA 2026-07-24
ER

PT J
AU Robu, M
   Radulescu, B
   Margarint, I
   Stiru, O
   Antoniac, I
   Gheorghita, D
   Voica, C
   Nica, C
   Cacoveanu, M
   Iliuta, L
   Iliescu, VA
   Moldovan, H
AF Robu, Mircea
   Radulescu, Bogdan
   Margarint, Irina
   Stiru, Ovidiu
   Antoniac, Iulian
   Gheorghita, Daniela
   Voica, Cristian
   Nica, Claudia
   Cacoveanu, Mihai
   Iliuta, Luminita
   Iliescu, Vlad Anton
   Moldovan, Horatiu
TI Surgical Strategy for Sternal Closure in Patients with Surgical
   Myocardial Revascularization Using Mammary Arteries
SO JOURNAL OF CARDIOVASCULAR DEVELOPMENT AND DISEASE
LA English
DT Article
DE coronary artery bypass grafting (CABG); sternal closure; sternal
   osteosynthesis
ID INTERNAL-THORACIC-ARTERY; WOUND-INFECTION; SURGERY; SURVIVAL; OUTCOMES;
   GRAFTS
AB Background: Coronary artery bypass grafting has evolved from all venous grafts to bilateral mammary artery (BIMA) grafting. This was possible due to the long-term patency of the left and right internal mammary demonstrated in angiography studies compared to venous grafts. However, despite higher survival rates when using bilateral mammary arteries, multiple studies report a higher rate of surgical site infections, most notably deep sternal wound infections, a so-called "never event". Methods: We designed a prospective study between 1 January 2022 and 31 December 2022 and included all patients proposed for total arterial myocardial revascularization in order to investigate the rate of surgical site infections (SSI). Chest closure in all patients was performed using a three-step protocol. The first step refers to sternal closure. If the patient's BMI is below 35 kg/m2, sternal closure is achieved using the "butterfly" technique with standard steel wires. If the patient's BMI exceeds 35 kg/m2, we use nitinol clips or hybrid wire cable ties according to the surgeon's preference for sternal closure. The main advantages of these systems are a larger implant-to-bone contact with a reduced risk of bone fracture. The second step refers to presternal fat closure with two resorbable monofilament sutures in a way that the edges of the skin perfectly align at the end. The third step is skin closure combined with negative pressure wound therapy. Results: This system was applied to 217 patients. A total of 197 patients had bilateral mammary artery grafts. We report only 13 (5.9%) superficial SSI and only one (0.46%) deep SSI. The preoperative risk of major wound infection was 3.9 +/- 2.7. Bilateral mammary artery grafting was not associated with surgical site infection in a univariate analysis. Conclusions: We believe this strategy of sternal wound closure can reduce the incidence of deep surgical site infection when two mammary arteries are used in coronary artery bypass surgery.
C1 [Robu, Mircea; Radulescu, Bogdan; Margarint, Irina; Stiru, Ovidiu; Iliescu, Vlad Anton; Moldovan, Horatiu] Carol Davila Univ Med & Pharm, Fac Med, Bucharest 050474, Romania.
   [Robu, Mircea; Radulescu, Bogdan; Stiru, Ovidiu; Iliuta, Luminita; Iliescu, Vlad Anton] CC Iliescu Emergency Inst Cardiovasc Dis, Dept Cardiovasc Surg, Bucharest 022322, Romania.
   [Antoniac, Iulian; Gheorghita, Daniela] Natl Univ Sci & Technol, Fac Mat Sci & Engn, Politehn Bucharest, Bucharest 060042, Romania.
   [Antoniac, Iulian; Moldovan, Horatiu] Acad Romanian Scientists, 54 Spl Independentei, Bucharest 050711, Romania.
   [Voica, Cristian; Nica, Claudia; Cacoveanu, Mihai; Moldovan, Horatiu] Clin Emergency Hosp Bucharest, Dept Cardiovasc Surg, Bucharest 014461, Romania.
C3 Carol Davila University of Medicine & Pharmacy; National University of
   Science & Technology POLITEHNICA Bucharest; Academy of Romanian
   Scientists (AOSR)
RP Robu, M; Radulescu, B (通讯作者)，Carol Davila Univ Med & Pharm, Fac Med, Bucharest 050474, Romania.; Robu, M; Radulescu, B (通讯作者)，CC Iliescu Emergency Inst Cardiovasc Dis, Dept Cardiovasc Surg, Bucharest 022322, Romania.
EM mircea.robu@drd.umfcd.ro; bogdan.radulescu@drd.umfcd.ro;
   irina-maria.margarint@drd.umfcd.ro; ovidiu.stiru@umfcd.ro;
   antoniac.iulian@gmail.com; daniela.mgm8@gmail.com;
   cristianvoica@yahoo.com; bianca.nica@yahoo.com;
   catalin.cacoveanu@gmail.com; luminitailiuta@yahoo.com;
   vladanton.iliescu@gmail.com; h_moldovan@hotmail.com
RI Moldovan, Horatiu/G-8773-2016; Iliuta, Luminita/ITT-1357-2023; robu,
   mircea/IVU-7624-2023; Gheorghita, Daniela/AAH-1893-2020; Iulian,
   Antoniac/D-4802-2014; Stiru, Ovidiu/AAA-5398-2019; Iliescu, Vlad
   Anton/AAA-7692-2019; Voica, Cristian/HTR-7048-2023
OI Moldovan, Horatiu/0000-0002-2241-279X; Iliuta,
   Luminita/0000-0002-1439-5002; robu, mircea/0000-0003-3599-129X;
   Gheorghita, Daniela/0000-0003-3660-8926; Iulian,
   Antoniac/0000-0003-0112-3494; Stiru, Ovidiu/0000-0002-5482-6794;
   Iliescu, Vlad Anton/0000-0001-9069-2722; 
FU University of Medicine and Pharmacy Carol Davila
FX The publication of this paper was supported by the University of
   Medicine and Pharmacy Carol Davila, through the institutional program
   Publish not Perish.
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NR 29
TC 3
Z9 3
U1 0
U2 2
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2308-3425
J9 J CARDIOVASC DEV DIS
JI J. Cardiovasc. Dev. Dis.
PD NOV
PY 2023
VL 10
IS 11
AR 457
DI 10.3390/jcdd10110457
PG 10
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA Z7FN4
UT WOS:001113695400001
PM 37998515
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Lin, XH
   Su, JM
   Yang, ZJ
AF Lin, Xuehong
   Su, Jinman
   Yang, Zhijuan
TI 被撤回的出版物: Optimising wound care for patients with cirrhosis: A study of
   the effect of combination therapy on wound healing (Retracted article.
   See vol. 22, 2025)
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article; Retracted Publication
DE cirrhosis; combination therapy; nutrition; wound healing; wound
   management
AB Cirrhosis, a chronic liver disease, significantly impairs wound healing due to complex alterations in physiology, including compromised immune function, poor nutritional status and altered blood flow. This prospective observational cohort study aimed to evaluate the effectiveness of the multidimensional combination therapy approach in enhancing wound healing among patients diagnosed with cirrhosis. The study was conducted from February to November 2023 in Shanghai, China, including 248 patients with cirrhosis experiencing poor wound healing. The combination therapy consisted of tailored pharmacological treatments, advanced wound dressings, dietitian-directed dietary regimens and supplementary therapies like negative pressure wound therapy (NPWT), stem cell and hyperbaric oxygen therapy. The interventions were customised based on comprehensive initial assessments of liver function, nutritional status and wound characteristics. Follow-ups were conducted to monitor response and adjust treatments accordingly. The patient demographic was varied, predominantly 41-60 years old, with the slight male predominance. The study demonstrated that after 3 months of treatment, wound sizes decreased significantly across all cirrhosis severity levels: mild (2.4-1.7 cm2), moderate (4.1-2.6 cm2) and severe (6.2-4.4 cm2). Healing rates improved to 90% in mild, 75% in moderate and 45% in severe cases over 6 months. Albumin levels increased by the average of +0.3 g/dL to +0.4 g/dL post-treatment across the severity spectrum. However, complication rates escalated with severity: Mild cases had a 10% infection rate, while severe cases had up to 30% infection rate. Combination therapy significantly improved wound healing in cirrhosis patients, with the extent of improvement correlated with the severity of the condition. Tailored, multidisciplinary approaches are critical in managing the intricate wound healing process in cirrhosis, effectively reducing healing times and improving overall treatment outcomes. These findings advocate for personalised care strategies and highlight the potential of integrating various treatment modalities to address the complex needs of this population.
C1 [Lin, Xuehong] Quanzhou First Hosp, Med Imaging Dept, Quanzhou, Peoples R China.
   [Su, Jinman] QingDao Special Servicemen Recuperat Ctr PLA Navy, Recuperat Dept 10, Qingdao, Peoples R China.
   [Yang, Zhijuan] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Dept Gastroenterol, Xian, Peoples R China.
   [Yang, Zhijuan] Fourth Mil Med Univ, Xijing Hosp Digest Dis, Dept Gastroenterol, Xian 710032, Peoples R China.
C3 Air Force Medical University; Air Force Medical University
RP Yang, ZJ (通讯作者)，Fourth Mil Med Univ, Xijing Hosp Digest Dis, Dept Gastroenterol, Xian 710032, Peoples R China.
EM zhijuan_yang0@163.com
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NR 26
TC 7
Z9 7
U1 0
U2 3
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD FEB
PY 2024
VL 21
IS 2
AR e14727
DI 10.1111/iwj.14727
PG 8
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA HU6X8
UT WOS:001162070500001
PM 38356305
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Game, FL
   Hinchliffe, RJ
   Apelqvist, J
   Armstrong, DG
   Bakker, K
   Hartemann, A
   Löndahl, M
   Price, PE
   Jeffcoate, WJ
AF Game, F. L.
   Hinchliffe, R. J.
   Apelqvist, J.
   Armstrong, D. G.
   Bakker, K.
   Hartemann, A.
   Londahl, M.
   Price, P. E.
   Jeffcoate, W. J.
TI A systematic review of interventions to enhance the healing of chronic
   ulcers of the foot in diabetes
SO DIABETES-METABOLISM RESEARCH AND REVIEWS
LA English
DT Article; Proceedings Paper
CT 6th International Symposium on the Diabetic Foot
CY MAY 10-14, 2011
CL Noordwijkerhout, NETHERLANDS
DE diabetes; diabetic foot; ulcer; wound healing; dressing
ID HYPERBARIC-OXYGEN THERAPY; PRESSURE WOUND THERAPY; RANDOMIZED
   CONTROLLED-TRIAL; FIBROBLAST-GROWTH-FACTOR; DOUBLE-BLIND; NEUROPATHIC
   ULCERS; LIMB SALVAGE; MANAGEMENT; PLACEBO; MULTICENTER
AB The outcome of management of diabetic foot ulcers is poor, and there is continuing uncertainty concerning optimal approaches to management. It was for these reasons that in 2006 the International Working Group of the Diabetic Foot (IWGDF) working group on wound healing undertook a systematic review of the evidence to inform protocols for routine care and to highlight areas which should be considered for further study. The same working group has now updated this review by considering papers on the interventions to improve the healing of chronic ulcers published between December 2006 and June 2010. Methodological quality of selected studies was independently assessed by two reviewers using Scottish Intercollegiate Guidelines Network criteria. Selected studies fell into the following ten categories: sharp debridement and wound bed preparation with larvae and hydrotherapy; wound bed preparation using antiseptics, applications and dressing products; resection of the chronic wound; hyperbaric oxygen therapy (HBOT); compression or negative pressure therapy; products designed to correct aspects of wound biochemistry and cell biology associated with impaired wound healing; application of cells, including platelets and stem cells; bioengineered skin and skin grafts; electrical, electromagnetic, lasers, shockwaves and ultrasound; other systemic therapies which did not fit in the above categories. Heterogeneity of studies prevented pooled analysis of results.
   Of the 1322 papers identified, 43 were selected for grading following full text review. The present report is an update of the earlier IWGDF systematic review, but the conclusion is similar: that with the exception of HBOT and, possibly, negative pressure wound therapy, there is little published evidence to justify the use of newer therapies. This echoes the conclusion of a recent Cochrane review and the systematic review undertaken by the National Institute for Health and Clinical Excellence Guidelines Committee in the UK. Analysis of evidence presents considerable difficulties in this field particularly as controlled studies are few and the majority are of poor methodological quality. Copyright (C) 2012 John Wiley & Sons, Ltd.
C1 [Game, F. L.] Derby Hosp NHS Trust, Dept Endocrinol & Diabet, Derby DE22 3NE, England.
   [Game, F. L.; Jeffcoate, W. J.] Nottingham Univ Hosp Trust, Foot Ulcer Trials Unit, Nottingham, England.
   [Hinchliffe, R. J.] St Georges Healthcare NHS Trust, St Georges Vasc Inst, London, England.
   [Apelqvist, J.] Malmo Univ Hosp, Dept Endocrinol, Malmo, Sweden.
   [Armstrong, D. G.] Univ Arizona, Coll Med, So Arizona Limb Salvage Alliance SALSA, Tucson, AZ USA.
   [Bakker, K.] IWGDF, Heemstede, Netherlands.
   [Hartemann, A.] Hop La Pitie Salpetriere, Assistance Publ Hop Paris, Serv Diabetol, Paris, France.
   [Hartemann, A.] Univ P&M Curie, Paris, France.
   [Londahl, M.] Univ Lund Hosp, Dept Endocrinol, S-22185 Lund, Sweden.
   [Londahl, M.] Inst Clin Sci Lund, Lund, Sweden.
   [Price, P. E.] Cardiff Univ, Sch Healthcare Studies, Cardiff, S Glam, Wales.
C3 University of Nottingham; Nottingham University Hospital NHS Trust; City
   St Georges, University of London; Lund University; Skane University
   Hospital; University of Arizona; Assistance Publique Hopitaux Paris
   (APHP); Universite Paris Cite; Hopital Universitaire Saint-Louis - APHP;
   Hopital Universitaire Pitie-Salpetriere - APHP; Sorbonne Universite;
   Sorbonne Universite; Lund University; Skane University Hospital; Cardiff
   University
RP Game, FL (通讯作者)，Derby Hosp NHS Trust, Dept Endocrinol & Diabet, Uttoxeter Rd, Derby DE22 3NE, England.
EM fgame@futu.co.uk
RI ; Price, Patricia/B-5817-2013
OI Game, Frances/0000-0002-5294-4789; Löndahl, Magnus/0000-0003-1522-3920; 
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NR 55
TC 157
Z9 187
U1 0
U2 66
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1520-7552
EI 1520-7560
J9 DIABETES-METAB RES
JI Diabetes-Metab. Res. Rev.
PD FEB
PY 2012
VL 28
SU 1
BP 119
EP 141
DI 10.1002/dmrr.2246
PG 23
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Endocrinology & Metabolism
GA 880AY
UT WOS:000299377700024
PM 22271737
OA Bronze
DA 2026-07-24
ER

PT J
AU Millán-Reyes, MJ
   Afanador-Restrepo, DF
   Carcelén-Fraile, MD
   Aibar-Almazán, A
   Sánchez-Alcalá, M
   Cano-Sánchez, J
   Mesas-Aróstegui, MA
   Castellote-Caballero, Y
AF Millan-Reyes, Maria Juana
   Afanador-Restrepo, Diego Fernando
   Carcelen-Fraile, Maria del Carmen
   Aibar-Almazan, Agustin
   Sanchez-Alcala, Marcelina
   Cano-Sanchez, Javier
   Mesas-Arostegui, Maria Aurora
   Castellote-Caballero, Yolanda
TI Reducing Infections and Improving Healing in Complex Wounds: A
   Systematic Review and Meta-Analysis
SO JOURNAL OF CLINICAL MEDICINE
LA English
DT Review
DE chronic wounds; traumatic injuries; wound healing; surgical site
   infections
ID SURGICAL-SITE INFECTIONS; THERAPY; PREVENTION; TRIAL; MANAGEMENT;
   FRACTURES; DRESSINGS; IRRIGATION; CARE
AB Background and Objectives: Wound management in complex and traumatic injuries remains a significant clinical challenge, with a high risk of surgical site infections (SSIs) and associated complications. This systematic review and meta-analysis aim to evaluate the effectiveness of diverse interventions, including Negative Pressure Wound Therapy (NPWT), advanced dressings, irrigation techniques, antibiotic regimens, and innovative therapies, in improving wound healing outcomes and reducing infection rates. Materials and Methods: An exhaustive literature search focused on the use of NPWT, dressings, and antibiotics in the care of chronic wounds was conducted following PRISMA guidelines in the PubMed, Scopus, Web of Science, and CINAHL databases. Eligible studies included randomized controlled trials and prospective cohorts assessing interventions for wound care in trauma, surgical, and chronic wound settings. The risk of bias was assessed using the ROB2 tool. Subgroup analyses were performed to evaluate the relative risk (RR) of infections based on the intervention type. Results: The analysis included 17 studies spanning diverse geographical and clinical settings. NPWT demonstrated significant benefits in reducing infection rates compared to control groups (RR: 0.590, 95% CI: 0.458-0.760, and p < 0.001). Although advanced dressings demonstrated clinically relevant benefits as reported across the included studies, the meta-analysis did not reveal statistically significant differences (RR: 0.516, 95% CI: 0.242-1.100, and p = 0.087). Antibiotic therapies significantly reduced infections when administered within 24 h of injury, while low-pressure irrigation techniques effectively minimized bacterial contamination without causing tissue damage. Growth factors and honey-based treatments exhibited promising results in accelerating wound healing and reducing infection risks in chronic wounds. Conclusions: NPWT emerges as a highly effective intervention for infection prevention and wound healing, supported by robust evidence. Advanced dressings and innovative therapies show potential but require further research for conclusive evidence. These findings underscore the importance of tailoring wound care strategies to the clinical context and patient needs. Future research should focus on long-term outcomes and cost-effectiveness analyses to enhance the integration of these therapies into clinical practice.
C1 [Millan-Reyes, Maria Juana] Univ Hosp Jaen, Jaen 23007, Spain.
   [Millan-Reyes, Maria Juana; Aibar-Almazan, Agustin; Sanchez-Alcala, Marcelina; Cano-Sanchez, Javier] Univ Jaen, Fac Hlth Sci, Dept Hlth Sci, Jaen 23071, Spain.
   [Afanador-Restrepo, Diego Fernando] Univ Fdn Area Andina Pereira, Fac Hlth Sci & Sport, Pereira 660004, Colombia.
   [Afanador-Restrepo, Diego Fernando] Antonio Jose Camacho Univ Inst, Fac Distance & Virtual Educ, Santiago de Cali 760016, Colombia.
   [Carcelen-Fraile, Maria del Carmen] Univ Atlant Medio, Fac Social Sci, Dept Educ Sci, Las Palmas Gran Canaria 35017, Spain.
   [Mesas-Arostegui, Maria Aurora] Hosp Quiron Marbella, Pediat Endocrinol Dept, Inst Hispalense Pediat, Malaga 29603, Spain.
   [Mesas-Arostegui, Maria Aurora] Hosp Guadix, Pediat Dept, Granada 18500, Spain.
   [Castellote-Caballero, Yolanda] Univ Atlant Medio, Fac Hlth Sci, Dept Hlth Sci, Las Palmas Gran Canaria 35017, Spain.
C3 Universidad de Jaen
RP Carcelén-Fraile, MD (通讯作者)，Univ Atlant Medio, Fac Social Sci, Dept Educ Sci, Las Palmas Gran Canaria 35017, Spain.
EM mjmr0013@red.ujaen.es; carmen.carcelen@pdi.atlanticomedio.es
RI Afanador, Diego Fernando/GLV-4428-2022; Carcelén Fraile, María del
   Carmen/GYJ-3589-2022; Aibar Almazán, Agustín/AAM-9109-2020;
   Afanador-Restrepo, Diego Fernando/GLV-4428-2022
OI Afanador, Diego Fernando/0000-0002-7958-0751; Carcelén Fraile, María del
   Carmen/0009-0000-9186-8865; Aibar Almazán, Agustín/0000-0002-9386-9199;
   , Javier Cano Sánchez/0009-0006-6262-7839; 
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NR 45
TC 15
Z9 16
U1 5
U2 11
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2077-0383
J9 J CLIN MED
JI J. Clin. Med.
PD MAY 7
PY 2025
VL 14
IS 9
AR 3237
DI 10.3390/jcm14093237
PG 13
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 2NH3E
UT WOS:001486712500001
PM 40364268
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Ferreira, SAD
   Gonzlez, CVS
   Thum, M
   Faresin, AAD
   Woo, K
   Santos, VLCD
AF da Costa Ferreira, Suzana Aparecida
   Serna Gonzalez, Carol Viviana
   Thum, Magali
   da Costa Faresin, Adriane Aparecida
   Woo, Kevin
   de Gouveia Santos, Vera Lucia Conceicao
TI Topical therapy for pain management in malignant fungating wounds: A
   scoping review
SO JOURNAL OF CLINICAL NURSING
LA English
DT Review
DE evidence-based nursing; neoplasms; nursing; oncology nursing; pain
   management; patient-centred care; review; topical administration; wounds
   and injuries
ID BREAST-CANCER; CARE
AB Aims and objectives To map and synthesise the existing literature on topical therapies for malignant fungating wounds pain management and the gaps involved. Background Most cancer patients with malignant fungating wounds suffer from wound-related pain, affecting their quality of life. Unfortunately, even though pain is a relevant symptom in cancer and palliative care, little is currently known about topical treatments' availability and impact on pain management. Design A scoping review following JBI (R) methodology Methods Searches were performed in CINAHL, LILACS, Embase, Web of Science, PubMed, Cochrane, NICE, Scopus, JBISRIR and grey literature, in English, Portuguese and Spanish, with no time limit. Two authors independently reviewed all citations and a third was called in case of divergence, and studies in adults with malignant fungal wounds reporting topical pain interventions were included. In addition, a data extraction tool for synthesis and thematic analysis was developed. This study followed the PRISMA-ScR Checklist. Results Seventy publications were selected from 796 records retrieved from databases. The studies mainly included non-systematic reviews and case studies with only six clinical trials. According to the narrative synthesis, twenty therapies were identified, including the use of wound dressings (58.6%), analgesic drugs (55.7%), topical antimicrobials (25.7%), skin barriers (15.7%), cryotherapy (5.7%) and negative pressure wound therapy (4.3%). Therapies were recommended to be applied to the wound bed or the periwound skin. In 68.5% of the studies, a standardised assessment for pain was not described. Conclusions Topical therapies applied to malignant fungating wounds or periwound areas had been examined for pain management. However, their effectiveness was analysed in a few interventional studies, indicating the need for further primary studies to inform evidence-based practice. Implication for practice Highlighted topical therapies for clinical practice consideration are opioids, anaesthetics and antimicrobials, with positive results described in randomised clinical trials. This study did not include patients.
C1 [da Costa Ferreira, Suzana Aparecida] Hlth Consulting & Educ HFSaude, Sao Paulo, Brazil.
   [Serna Gonzalez, Carol Viviana; Thum, Magali] Univ Sao Paulo, Adult Hlth Nursing Grad Program PROESA, Sch Nursing EEUSP, Sao Paulo, Brazil.
   [da Costa Faresin, Adriane Aparecida] Univ Sao Paulo HCFMUSP, Fac Med, Hosp Clin, Sao Paulo State Canc Inst ICESP, Sao Paulo, Brazil.
   [Woo, Kevin] Queens Univ, Sch Nursing, Fac Hlth Sci, Kingston, ON, Canada.
   [de Gouveia Santos, Vera Lucia Conceicao] Univ Sao Paulo, Sch Nursing EEUSP, Med Surg Nursing Dept, Res Grp Enterostomal Therapy Nursing Stomatherapy, Sao Paulo, Brazil.
C3 Universidade de Sao Paulo; Universidade de Sao Paulo; Queens University
   - Canada; Universidade de Sao Paulo
RP Ferreira, SAD (通讯作者)，Hlth Consulting & Educ HFSaude, Sao Paulo, Brazil.
EM suzanaenfer@gmail.com
RI de Gouveia Santos, Vera/H-9924-2012; SERNA GONZÁLEZ, CAROL
   VIVIANA/AAW-8858-2021
OI Thum, Magali/0000-0003-3240-2226; SERNA GONZÁLEZ, CAROL
   VIVIANA/0000-0002-9850-3030; Costa Faresin, Aiane Aparecida
   da/0000-0001-5663-2195
FU Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior [001]
FX Coordenacao de Aperfeicoamento de Pessoal de Nivel Superior, Grant/Award
   Number: 001
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NR 48
TC 6
Z9 6
U1 2
U2 19
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0962-1067
EI 1365-2702
J9 J CLIN NURS
JI J. Clin. Nurs.
PD JUL
PY 2023
VL 32
IS 13-14
BP 3015
EP 3029
DI 10.1111/jocn.16508
EA SEP 2022
PG 15
WC Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Nursing
GA I2EP3
UT WOS:000849505300001
PM 36055976
OA Green Published
DA 2026-07-24
ER

PT J
AU Moukarzel, LA
   Nguyen, N
   Zhou, Q
   Iasonos, A
   Schiavone, MB
   Ramesh, B
   Chi, DS
   Sonoda, Y
   Abu-Rustum, NR
   Mueller, JJ
   Roche, KL
   Jewell, EL
   Broach, V
   Zivanovic, O
   Leitao, MM Jr
AF Moukarzel, Lea A.
   Nguyen, Nguyen
   Zhou, Qin
   Iasonos, Alexia
   Schiavone, Maria B.
   Ramesh, Bhavani
   Chi, Dennis S.
   Sonoda, Yukio
   Abu-Rustum, Nadeem R.
   Mueller, Jennifer J.
   Roche, Kara Long
   Jewell, Elizabeth L.
   Broach, Vance
   Zivanovic, Oliver
   Leitao, Mario M.
TI Association of bowel preparation with surgical-site infection in
   gynecologic oncology surgery: Post-hoc analysis of a randomized
   controlled trial
SO GYNECOLOGIC ONCOLOGY
LA English
DT Article
DE Bowel preparation; Mechanical bowel preparation; Oral antibiotic bowel
   preparation; colon resection; Rectosigmoid resection; Gynecological
   malignancies
ID ELECTIVE COLORECTAL SURGERY; PREOPERATIVE ORAL ANTIBIOTICS; INTRAVENOUS
   ANTIBIOTICS; AMERICAN SOCIETY; ANASTOMOTIC LEAK; COLON; PREVENTION;
   METAANALYSIS; PROPHYLAXIS; REDUCE
AB Objective. To determine the relationship between bowel preparation and surgical-site infection (SSI) inci-dence following colorectal resection during gynecologic oncology surgery.Methods. This post-hoc analysis used data from a randomized controlled trial of patients enrolled from 03/01/ 2016-08/20/2019 with presumed gynecologic malignancy investigating negative-pressure wound therapy among those requiring laparotomy. Patients were treated preoperatively without bowel preparation, oral antibi-otic bowel preparation (OABP), or OABP plus mechanical bowel preparation (MBP) per surgeon preference. Uni-variate and multivariable analyses with stepwise model selection for SSI were performed for confirmed gynecologic malignancies requiring colorectal resection.Results. Of 161 cases, 15 (9%) had no preparation, 39 (24%) OABP only, and 107 (66%) OABP+MBP. The overall SSI rate was 19% (n = 31)-53% (n = 8/15) in the no preparation, 21% (n = 8/39) in the OABP alone, and 14% (n = 15/107) in the OABP+MBP groups (P = 0.003). The difference between OABP and OABP+MBP was non-significant (P = 0.44). The median length of stay was 9 (range, 6-12), 6 (range, 5-8), and 7 days (range, 6-10), respectively (P = 0.045). The overall complication rate (34%; n = 54) did not significantly vary by preparation type (P = 0.23). On univariate logistic regression analysis, OABP (OR, 0.23; 95% CI: 0.06-0.80) and OABP+MBP (OR, 0.14; 95% CI: 0.04-0.45) were associated with decreased SSI risk compared to no preparation (P = 0.004). On multivariate analysis, both methods of preparation retained a significant impact on SSI rates (P = 0.004). Conclusion. Bowel preparation is associated with reduced SSI incidence and is beneficial for patients undergo-ing gynecologic oncology surgery with anticipated colorectal resection. Further investigation is needed to deter-mine whether OABP alone is sufficient.(c) 2022 Elsevier Inc. All rights reserved.
C1 [Moukarzel, Lea A.; Ramesh, Bhavani; Chi, Dennis S.; Sonoda, Yukio; Abu-Rustum, Nadeem R.; Mueller, Jennifer J.; Roche, Kara Long; Jewell, Elizabeth L.; Broach, Vance; Zivanovic, Oliver; Leitao, Mario M.] Mem Sloan Kettering Canc Ctr, Dept Surg, Gynecol Serv, New York, NY 10065 USA.
   [Nguyen, Nguyen] Metropolitan Methodist Hosp, Dept Obstet & Gynecol, San Antonio, TX USA.
   [Zhou, Qin; Iasonos, Alexia] Mem Sloan Kettering Canc Ctr, Dept Epidemiol & Biostat, New York, NY 10065 USA.
   [Schiavone, Maria B.] Holy Name Med Ctr, Teaneck, NJ USA.
   [Chi, Dennis S.; Sonoda, Yukio; Abu-Rustum, Nadeem R.; Mueller, Jennifer J.; Roche, Kara Long; Jewell, Elizabeth L.; Broach, Vance; Zivanovic, Oliver; Leitao, Mario M.] Coll Cornell Univ, Weill Cornell Med, Dept OB GYN, New York, NY USA.
   [Leitao, Mario M.] Mem Sloan Kettering Canc Ctr, Dept Surg, Gynecol Serv, 1275 York Ave, New York, NY 10065 USA.
C3 Memorial Sloan Kettering Cancer Center; Memorial Sloan Kettering Cancer
   Center; Cornell University; Weill Cornell Medicine; Memorial Sloan
   Kettering Cancer Center
RP Leitao, MM Jr (通讯作者)，Mem Sloan Kettering Canc Ctr, Dept Surg, Gynecol Serv, 1275 York Ave, New York, NY 10065 USA.
RI zhou, qin/ISV-5657-2023; Zivanovic, Oliver/AAK-9955-2021
FU NIH/NCI Support Grant [P30 CA008748]; National Cancer Institute
   [P30CA008748] Funding Source: NIH RePORTER
FX This study was funded in part through the NIH/NCI Support Grant P30
   CA008748.
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NR 40
TC 4
Z9 5
U1 0
U2 3
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0090-8258
EI 1095-6859
J9 GYNECOL ONCOL
JI Gynecol. Oncol.
PD JAN
PY 2023
VL 168
BP 100
EP 106
DI 10.1016/j.ygyno.2022.11.003
EA NOV 2022
PG 7
WC Oncology; Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Obstetrics & Gynecology
GA 6Q5EL
UT WOS:000891635900003
PM 36423444
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Sen, CK
AF Sen, Chandan K.
TI Human Wound and Its Burden: Updated 2025 Compendium of Estimates
SO ADVANCES IN WOUND CARE
LA English
DT Editorial Material
DE wound care; smart technologies; wound closure endpoint; wound care
   advocacy; artificial intelligence
ID ARTIFICIAL-INTELLIGENCE; TELEMEDICINE; CARE
AB Chronic wounds are a silent epidemic in the United States, affecting one in six Medicare beneficiaries-about 10.5 million people-and costing Medicare an estimated $22.5 billion annually. While outpatient wound care costs dropped from $10.5 billion in 2014 to $2.5 billion in 2019, physician office costs rose to $4.1 billion, reflecting a shift in care delivery. Globally, wound care expenditure reached a staggering $148.65 billion in 2022. Despite this burden, federal research funding remains disproportionately low. Chronic wounds often recur due to incomplete healing. Many wounds close by resurfacing without discharge but fail to restore the skin's barrier function-measured by transepidermal water loss at the site of closure-making them prone to reopening. Outcomes of recent patient-based studies advocate redefining wound closure endpoint to include full barrier restoration. The 2023 Wound Balance Framework promotes holistic, patient-centered care, while cutting-edge technologies are reshaping the field. Bioengineered skin therapies can reduce healing time. Machine learning tools, such as scanning electron microscopy-based trainable Weka (Waikato Environment for Knowledge Analysis) intelligent segmentation technology, detect biofilms, while other tools predict healing outcomes and amputation risks. Multiomics technologies identify biomarkers such as Fos-related antigen 1 (FOSL1), enabling precision therapies tailored to wound phase and patient biology. Telehealth is proving to be transformative for wound care. A 2023 meta-analysis of 2,397 patients showed it significantly reduced healing time, pain, and amputation rates. Policy is catching up: Centers for Medicare & Medicaid Services doubled allowable skin substitute applications (from four to eight) and extended treatment windows to 16 weeks. The Better Wound Care at Home Act established national payment for disposable negative pressure wound therapy, and the Lymphedema Treatment Act mandated Medicare coverage for compression garments, projected to save $1.3-$1.5 billion over 10 years. Together, these advances signal a shift toward proactive, personalized, and equitable wound care-driven by science, guided by ethics, supported by policy, and centered on patients.
C1 [Sen, Chandan K.] Univ Pittsburgh, McGowan Inst Regenerat Med, Dept Surg, 450 Technol Dr, Pittsburgh, PA 15219 USA.
C3 Pennsylvania Commonwealth System of Higher Education (PCSHE); University
   of Pittsburgh
RP Sen, CK (通讯作者)，Univ Pittsburgh, McGowan Inst Regenerat Med, Dept Surg, 450 Technol Dr, Pittsburgh, PA 15219 USA.
EM c.k.sen@pitt.edu
RI Sen, Chandan/MSW-3479-2025
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NR 77
TC 59
Z9 65
U1 22
U2 49
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 2162-1918
EI 2162-1934
J9 ADV WOUND CARE
JI Adv. Wound Care
PD SEP 1
PY 2025
VL 14
IS 9
BP 429
EP 438
DI 10.1177/21621918251359554
EA JUL 2025
PG 10
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 6TU0Q
UT WOS:001529088600001
PM 40660772
DA 2026-07-24
ER

PT J
AU Brown, S
   Nixon, J
   Ransom, M
   Gilberts, R
   Dewhirst, N
   McGinnis, E
   Longo, R
   Game, F
   Bojke, C
   Chadwick, P
   Chandrasekar, A
   Chetter, I
   Collier, H
   Fernandez, C
   Homer-Vanniasinkam, S
   Jude, E
   Leigh, R
   Lomas, R
   Vowden, P
   Wason, J
   Sharples, L
   Russell, D
AF Brown, Sarah
   Nixon, Jane
   Ransom, Myka
   Gilberts, Rachael
   Dewhirst, Nikki
   McGinnis, Elizabeth
   Longo, Roberta
   Game, Frances
   Bojke, Chris
   Chadwick, Paul
   Chandrasekar, Akila
   Chetter, Ian
   Collier, Howard
   Fernandez, Catherine
   Homer-Vanniasinkam, Shervanthi
   Jude, Edward
   Leigh, Richard
   Lomas, Richard
   Vowden, Peter
   Wason, James
   Sharples, Linda
   Russell, David
TI Multiple Interventions for Diabetic Foot Ulcer Treatment Trial (MIDFUT):
   study protocol for a randomised controlled trial
SO BMJ OPEN
LA English
DT Article
ID COST-EFFECTIVENESS; RISK-FACTORS; MANAGEMENT; INDIVIDUALS; INFECTIONS;
   PREVALENCE; PREVENTION; NEUROPATHY; PREDICTOR; DIAGNOSIS
AB Introduction Diabetes affects more than 425 million people worldwide with a lifetime risk of diabetic foot ulcer (DFU) of up to 25%. Management includes wound debridement, wound dressings, offloading, treatment of infection and ischaemia, optimising glycaemic control; use of advanced adjuvant therapies is limited by high cost and lack of robust evidence.
   Methods and analysis A multicentre, seamless phase II/III, open, parallel group, multi-arm multi-stage randomised controlled trial in patients with a hard-to-heal DFU, with blinded outcome assessment. A maximum of 447 participants will be randomised (245 participants in phase II and 202 participants in phase III). The phase II primary objective will determine the efficacy of treatment strategies including hydrosurgical debridement +/- decellularised dermal allograft, or the combination with negative pressure wound therapy, as an adjunct to treatment as usual (TAU), compared with TAU alone, with patients randomised in a 1:1:1:2 allocation. The outcome is achieving at least 50% reduction in index ulcer area at 4 weeks post randomisation. The phase III primary objective will determine whether one treatment strategy, continued from phase II, reduces time to healing of the index ulcer compared with TAU alone, with participants randomised in a 1:1 allocation. Secondary objectives will compare healing status of the index ulcer, infection rate, reulceration, quality of life, cost-effectiveness and incidence of adverse events over 52 weeks post randomisation. Phase II and phase III primary endpoint analysis will be conducted using a mixed-effects logistic regression model and Cox proportional hazards regression, respectively. A within-trial economic evaluation will be undertaken; the primary economic analysis will be a cost-utility analysis presenting ICERs for each treatment strategy in rank order of effectiveness, with effects expressed as quality-adjusted life years. The trial has predefined progression criteria for the selection of one treatment strategy into phase III based on efficacy, safety and costs at 4 weeks.
C1 [Brown, Sarah; Nixon, Jane; Ransom, Myka; Gilberts, Rachael; Dewhirst, Nikki; McGinnis, Elizabeth; Collier, Howard; Fernandez, Catherine; Russell, David] Univ Leeds, Leeds Inst Clin Trials Res, Clin Trials Res Unit, Leeds, W Yorkshire, England.
   [Dewhirst, Nikki; McGinnis, Elizabeth; Homer-Vanniasinkam, Shervanthi; Russell, David] Leeds Teaching Hosp NHS Trust, Leeds, W Yorkshire, England.
   [Longo, Roberta; Bojke, Chris] Univ Leeds, Acad Unit Hlth Econ, Leeds Inst Hlth Sci, Leeds, W Yorkshire, England.
   [Game, Frances] Derby Teaching Hosp NHS Fundat Trust, Derby, England.
   [Chadwick, Paul] Coll Podiatry, London, England.
   [Chandrasekar, Akila; Lomas, Richard] NHS Blood & Transplant, Liverpool, Merseyside, England.
   [Chetter, Ian] Univ Hull, Kingston Upon Hull, N Humberside, England.
   [Jude, Edward] Tameside Gen Hosp, Manchester, Lancs, England.
   [Leigh, Richard] Royal Free London NHS Fdn Trust, London, England.
   [Vowden, Peter] Bradford Teaching Hosp NHS Fdn Trust, Bradford, W Yorkshire, England.
   [Wason, James] Univ Cambridge, MRC Biostat Unit, Cambridge, England.
   [Wason, James] Newcastle Univ, Populat Hlth Sci Inst, Newcastle Upon Tyne, Tyne & Wear, England.
   [Sharples, Linda] London Sch Hyg & Trop Med, Dept Med Stat, London, England.
C3 University of Leeds; University of Leeds; University of Leeds;
   University of Hull; University of London; University College London;
   Royal Free London NHS Foundation Trust; University of Cambridge; MRC
   Biostatistics Unit; Newcastle University - UK; University of London;
   London School of Hygiene & Tropical Medicine
RP Brown, S (通讯作者)，Univ Leeds, Leeds Inst Clin Trials Res, Clin Trials Res Unit, Leeds, W Yorkshire, England.
EM medsbro@leeds.ac.uk
RI ; Russell, David/IXN-3147-2023; McGinnis, Elizabeth/PNF-2864-2026;
   /R-2354-2019; Longo, Roberta/ABB-5448-2020
OI Sharples, Linda/0000-0003-0894-966X; Game, Frances/0000-0002-5294-4789;
   Gilberts, Rachael/0000-0003-3326-7900; Brown, Sarah
   Tess/0000-0002-1840-3786; McGinnis, Elizabeth/0000-0002-2848-9149;
   Bojke, Chris/0000-0003-2601-0314; chetter, ian/0000-0002-2566-6859;
   Russell, David/0000-0002-1293-5618; Homer-Vanniasinkam,
   Shervanthi/0000-0001-6234-5053; Fernandez,
   Catherine/0000-0001-8561-5642; Wason, James/0000-0002-4691-126X; Ransom,
   Myka/0000-0003-4359-8287; 
FU (National Institute for Health Research) NIHR Health Technology
   Assessment (HTA) Programme [15/08/77]; NHS Blood and Transplant; Medical
   Research Council [MR/N028171/1, MC_UU_00002/6] Funding Source:
   researchfish; National Institute for Health Research [15/08/77] Funding
   Source: researchfish; MRC [MR/N028171/1, MC_UU_00002/6] Funding Source:
   UKRI
FX This study was funded by the (National Institute for Health Research)
   NIHR Health Technology Assessment (HTA) Programme (Project: 15/08/77).
   The views and opinions expressed therein are those of the authors and do
   not necessarily reflect those of the HTA, NIHR, NHS or Department of
   Health. We received product support for Versajet consoles and NPWT pumps
   from Smith & Nephew. We also received support for DCD from NHS Blood and
   Transplant and a 160K pound research support grant to cover excess
   treatment costs for consumables.
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   World Health Organization, 2016, Switzerland
NR 45
TC 11
Z9 15
U1 1
U2 20
PU BMJ PUBLISHING GROUP
PI LONDON
PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
SN 2044-6055
J9 BMJ OPEN
JI BMJ Open
PD APR
PY 2020
VL 10
IS 4
AR e035947
DI 10.1136/bmjopen-2019-035947
PG 12
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA LV0RG
UT WOS:000538150800105
PM 32312727
OA Green Accepted, Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Lee, SY
   Seong, IH
   Park, BY
AF Lee, Seung Yeol
   Seong, Ik Hyun
   Park, Bo Young
TI When is the Critical Time for Soft Tissue Reconstruction of Open Tibia
   Fracture Patients?
SO JOURNAL OF RECONSTRUCTIVE MICROSURGERY
LA English
DT Article
DE reconstruction timing; free flap reconstruction; open fracture
ID FREE-FLAP RECONSTRUCTION; PRESSURE WOUND THERAPY; LOWER-EXTREMITY
   TRAUMA; LOWER-LIMB INJURY; MICROSURGICAL RECONSTRUCTION; COVERAGE;
   MANAGEMENT; TRANSPLANTATION
AB Background The timing of soft tissue reconstruction for soft-tissue defect in patients with open fractures in the lower extremity is known to be critical for successful outcomes. However, medical advances, including development of dressing materials and refinement in the microsurgical techniques, might have undergone modifications in this "critical period." There have been no studies on the role of timing on reconstructive outcomes. Thus, we have analyzed the effect of reconstruction timing on optimal surgical outcomes and complication rates in a single type of lower extremity injury.
   Methods Data of patients who underwent microvascular free tissue transfer with an open fracture in the lower extremity from 2014 through 2016 were retrospectively reviewed ( n =103). Surgical outcomes, including flap complication rate, flap revision rate, and long-term bony complications, were analyzed serially in accordance with time interval until coverage using the receiver operating characteristic (ROC) curve analysis. Significant factors with a p <0.05 in the univariate analysis were included in the multivariate logistic regression model to identify independent risk factors.
   Results A total of 46 patients (33 males and 13 females) were finally included in the study. Based on the association between surgical timing and flap-related complication rate, the best cutoff period for surgery was 33 days, with an area under the curve of 0.658 ( p =0.040). Further, in the revision rate, the cutoff period was identified as 10 days ( p =0.016). Regarding the incidence of bony complications, ROC curve showed that the maximal period until operation was 91 days with no influence on the occurrence of bony complications ( p =0.029).
   Conclusion Although the best method is an early reconstruction, many modalities such as negative pressure wound therapy play a role as a temporary measure. Our study suggests that the acute or early period for successful reconstruction might be extended compared with previous studies.
C1 [Lee, Seung Yeol] Hanyang Univ, Myongji Hosp, Dept Orthopaed Surg, Coll Med, Seoul, South Korea.
   [Seong, Ik Hyun; Park, Bo Young] Ewha Womans Univ, Sch Med, Dept Plast & Reconstruct Surg, 260 Gonghang Daero, Seoul 07804, South Korea.
C3 Hanyang University; Myongji Hospital; Ewha Womans University
RP Park, BY (通讯作者)，Ewha Womans Univ, Sch Med, Dept Plast & Reconstruct Surg, 260 Gonghang Daero, Seoul 07804, South Korea.
EM by.park@ewha.ac.kr
RI ; Lee, Seung/AAX-9451-2020
OI Park, Bo Young/0000-0003-4612-6672; 
FU Basic Science Research Program through the National Research Foundation
   of Korea (NRF) - Ministry of Science and ICT [NRF-2017R1D1A1B03035452,
   2019R1A2C2010150]
FX This researchwas supported by the Basic Science Research Program through
   the National Research Foundation of Korea (NRF) funded by the Ministry
   of Science and ICT (NRF-2017R1D1A1B03035452 and 2019R1A2C2010150).
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NR 24
TC 10
Z9 11
U1 0
U2 4
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 0743-684X
EI 1098-8947
J9 J RECONSTR MICROSURG
JI J. Reconstr. Microsurg.
PD MAR
PY 2021
VL 37
IS 03
BP 249
EP 255
DI 10.1055/s-0040-1717151
EA OCT 2020
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA QP0JH
UT WOS:000578212400006
PM 33058097
DA 2026-07-24
ER

PT J
AU Tutton, E
   Achten, J
   Lamb, SE
   Willett, K
   Costa, ML
AF Tutton, Elizabeth
   Achten, Juul
   Lamb, Sarah E.
   Willett, Keith
   Costa, Matthew L.
CA UK WOLLF Res Collaborators
TI Participation in a trial in the emergency situation: a qualitative study
   of patient experience in the UK WOLLF trial
SO TRIALS
LA English
DT Article
DE Qualitative; Interviews; Experience; Consent; Emergency; Trial
ID OPEN FRACTURE; LOWER-LIMB; MANAGEMENT; CONSENT
AB Background: Patients can struggle to make sense of trials in emergency situations. This study examines patient experience of participating in the United Kingdom, Wound management of Open Lower Limb Fractures (UK WOLLF) study, a trial of standard wound management versus Negative Pressure Wound Therapy (NPWT).
   Methods: The aim of the study was to understand the patient's lived experience of taking part in a trial of wound dressings. Interviews drawing on Phenomenology were undertaken with a purposive sample of 20 patients, on average 12 days into their hospital stay from July 2012-July 2013.
   Results: The participants were vulnerable due to the emotional and physical impact of injury. They expressed their trial experience through the theme of being compromised identified in categories of being dependent being trusting, being grateful and being without experience. Participants felt dependent on and trusted the team to make the right decisions for them and not cause them harm. Their hopes for future recovery were also invested within the expertise of the team. Despite often not being well enough to consent to the study prior to surgery, they wished to be involved as much as possible. In agreeing to take part they expressed gratitude for their care, wanted to be helpful to others and considered the trial interventions to be a small component in relation to the enormity of their injury and broader treatment In making sense of the trial they felt they could not understand the interventions without experience of them but if they received NPWT they developed a strong technological preference for this intervention.
   Conclusions: Patients prefer to be involved in studies within the limits of their capacity, despite not being able to provide informed consent A variety of sources of knowledge may enable participants to feel that they have a better understanding of the interventions. Professional staff need to be aware of the situated nature of decision making where participants invest their hopes for recovery in the team.
C1 [Tutton, Elizabeth] Univ Warwick, Warwick Med Sch, Warwick Res Nursing, Gibbet Hill Campus, Coventry CV4 7AL, W Midlands, England.
   [Tutton, Elizabeth; Willett, Keith] Oxford Univ Hosp NHS Fdn Trust, John Radcliffe Hosp, Kadoorie Ctr, Oxford OX3 9DU, England.
   [Achten, Juul; Lamb, Sarah E.; Costa, Matthew L.] Univ Warwick, Warwick Med Sch, Clin Trials Unit, Gibbet Hill Campus, Coventry CV4 7AL, W Midlands, England.
   [Achten, Juul; Lamb, Sarah E.; Willett, Keith; Costa, Matthew L.] Univ Oxford, Nuffield Dept Orthopaed Rheumatol & Musculoskelet, Oxford OX3 9DU, England.
   [Costa, Matthew L.] Univ Hosp Coventry, Clifford Bridge Rd, Coventry CV2 2DX, W Midlands, England.
   [Costa, Matthew L.] Warwickshire NHS Trust, Clifford Bridge Rd, Coventry CV2 2DX, W Midlands, England.
C3 University of Warwick; Oxford University Hospitals NHS Foundation Trust;
   University of Oxford; University of Warwick; University of Oxford;
   University of Warwick
RP Tutton, E (通讯作者)，Univ Warwick, Warwick Med Sch, Warwick Res Nursing, Gibbet Hill Campus, Coventry CV4 7AL, W Midlands, England.; Tutton, E (通讯作者)，Oxford Univ Hosp NHS Fdn Trust, John Radcliffe Hosp, Kadoorie Ctr, Oxford OX3 9DU, England.
EM liz.tutton@warwick.ac.uk
RI Achten, Juul/KUD-8515-2024
OI Achten, Juul/0000-0002-8857-5743; Costa, Matthew/0000-0003-3644-1388;
   Lamb, Sarah/0000-0003-4349-7195; Tutton, Elizabeth/0000-0003-3973-360X
FU NIHR Health Technology Assessment programme, NIHR HTA [10/57/20];
   Economic and Social Research Council [1499410] Funding Source:
   researchfish; Medical Research Council [G0700452, G0501681] Funding
   Source: researchfish; National Institute for Health Research
   [NF-SI-0616-10103, 14/199/14, 10/57/20] Funding Source: researchfish;
   MRC [G0700452, G0501681] Funding Source: UKRI
FX This study was funded by the NIHR Health Technology Assessment
   programme, NIHR HTA (10/57/20). The views expressed are those of the
   authors and not necessarily those of the NHS, the NIHR or the Department
   of Health.
CR Canvin K, 2006, TRIALS, V7, DOI 10.1186/1745-6215-7-32
   CG138 NCG, 2012, PAT EXP AD NHS SERV
   Costa ML, 2017, BONE JOINT J, V99B, P147, DOI 10.1302/0301-620X.99B2.BJJ-2016-0517.R1
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NR 25
TC 12
Z9 15
U1 0
U2 2
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1745-6215
J9 TRIALS
JI Trials
PD JUN 25
PY 2018
VL 19
AR 328
DI 10.1186/s13063-018-2722-4
PG 7
WC Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Research & Experimental Medicine
GA GL0XY
UT WOS:000436818800001
PM 29941030
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zhang, HL
   Chen, DS
   Song, Q
   Gong, F
   Li, PL
   Li, Y
   Fei, L
   Yang, YC
   Yu, AY
AF Zhang, Hanlin
   Chen, Desheng
   Song, Qiang
   Gong, Fan
   Li, Peiling
   Li, Yu
   Fei, Le
   Yang, Yanchuan
   Yu, Anyang
TI Staged antibiotic-loaded cement-based reconstruction versus flap-based
   reconstruction for complex diabetic foot defects in patients with
   osteoporosis: a retrospective cohort study
SO FRONTIERS IN SURGERY
LA English
DT Article
DE AB-NPWT; antibiotic-loaded bone cement; diabetic foot; diabetic foot
   osteomyelitis; flap transplantation; limb salvage; osteoporosis;
   retrospective cohort study
ID FRACTURE RISK; MELLITUS; TYPE-1
AB Objective: This retrospective cohort study aimed to compare the clinical efficacy and safety of a staged antibiotic-loaded bone cement combined with negative pressure wound therapy (AB-NPWT) pathway vs. flap transplantation in the treatment of chronic foot ulcers with soft tissue defects in patients with type 2 diabetes mellitus (T2DM) and osteoporosis. Methods: We retrospectively analyzed 56 patients with T2DM and osteoporosis who underwent surgical treatment between January 2020 and December 2024. Treatment allocation was non-randomized and determined by the attending surgeon; no formal sample size calculation was performed. In the AB-NPWT group, 5 patients (17.2%) crossed over to receive local flap coverage as part of the staged pathway. The analysis was not adjusted for multiple comparisons. The AB-NPWT group (n = 29) and flap transplantation group (n = 27) were compared for perioperative parameters, wound healing, limb salvage, complications, and AOFAS scores. Adjusted analyses (multivariable regression and propensity score matching) were performed to account for potential confounding. Results: Operative time and blood loss were significantly lower in the AB-NPWT group (both p < 0.001). At 12 months, complete wound healing (86.2% vs. 88.9%, p = 0.754), limb salvage (93.1% vs. 92.6%, p = 1.000), and median healing time (126 vs. 112 days, p = 0.221) did not differ significantly between groups. Complication rates were similar (24.1% vs. 33.3%, p = 0.446), but profiles differed. AOFAS scores at final follow-up were comparable (72.5 +/- 10.3 vs. 75.8 +/- 11.6, p = 0.270). Conclusions: In this retrospective exploratory cohort, no statistically significant between-group differences were detected in the main clinical outcomes. AB-NPWT was associated with reduced surgical trauma, whereas flap transplantation provided definitive coverage in a single operative session after debridement. Treatment selection should be individualized based on wound characteristics, patient systemic status, and healthcare resources. These findings are hypothesis-generating and require confirmation in larger prospective trials.
C1 [Zhang, Hanlin; Chen, Desheng; Song, Qiang; Gong, Fan; Li, Peiling; Li, Yu; Fei, Le; Yang, Yanchuan; Yu, Anyang] Ningxia Med Univ, Peoples Hosp Ningxia Hui Autonomous Reg, Dept Orthoped Ctr, Yinchuan, Ningxia, Peoples R China.
   [Zhang, Hanlin; Chen, Desheng; Song, Qiang; Gong, Fan; Li, Peiling; Li, Yu; Fei, Le; Yang, Yanchuan; Yu, Anyang] Ningxia Med Univ, Clin Med Coll 3, Yinchuan, Ningxia, Peoples R China.
   [Li, Peiling] Ningxia Med Univ, Peoples Hosp Ningxia Hui Autonomous Reg, Gen Practice Dept, Yinchuan, Ningxia, Peoples R China.
C3 Ningxia Medical University; Ningxia Medical University; Ningxia Medical
   University
RP Chen, DS (通讯作者)，Ningxia Med Univ, Peoples Hosp Ningxia Hui Autonomous Reg, Dept Orthoped Ctr, Yinchuan, Ningxia, Peoples R China.; Chen, DS (通讯作者)，Ningxia Med Univ, Clin Med Coll 3, Yinchuan, Ningxia, Peoples R China.
EM charles_cds@163.com
RI Fei, Le/LKL-1104-2024
FU Natural Science Foundation of Ningxia Province [2023AAC03493,
   2024AAC03503]; Key Research and Development Program of Ningxia
   [2026BEH03006]
FX The author(s) declared that financial support was received for this work
   and/or its publication. The Ningxia Natural Science Foundation
   (2023AAC03493, 2024AAC03503), 2026 Ningxia Hui Autonomous Region key
   research and development plan to introduce special projects
   (2026BEH03006).
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NR 24
TC 0
Z9 0
U1 0
U2 0
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD MAY 20
PY 2026
VL 13
AR 1834390
DI 10.3389/fsurg.2026.1834390
EA MAY 2026
PG 17
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA IX9ZA
UT WOS:001782999000001
PM 42245312
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Medina, MM
   Luzarraga, A
   Catalán, S
   Acosta, U
   Hernandez-Fleury, A
   Bebia, V
   Monreal-Clua, S
   Angeles, MA
   Bonaldo, G
   Gil-Moreno, A
   Perez-Benavente, A
   Sanchez-Iglesias, JL
AF Medina, Marta Miguez
   Luzarraga, Ana
   Catalan, Sara
   Acosta, Ursula
   Hernandez-Fleury, Alina
   Bebia, Vicente
   Monreal-Clua, Sonia
   Angeles, Martina Aida
   Bonaldo, Giulio
   Gil-Moreno, Antonio
   Perez-Benavente, Asuncion
   Sanchez-Iglesias, Jose Luis
TI Incisional Hernia in Cytoreductive Surgery for Advanced-Stage Ovarian
   Cancer: A Single-Center Retrospective Study
SO CANCERS
LA English
DT Article
DE ovarian cancer; incisional hernia; small bites technique; ERAS
ID ENHANCED RECOVERY; CHEMOTHERAPY; GUIDELINES; TRIALS
AB Background/Objectives: An incisional hernia (IH) is a frequent postoperative complication after cytoreductive laparotomic surgery for advanced ovarian cancer (AOC). It occurs in 2-22% of patients in the first two years of follow-up, depending on the series. Although different risk factors have been described for various types of malignancies and surgeries, few studies have analyzed the risk factors for hernia development in ovarian cancer (OC). However, none have examined the role of enhanced recovery after surgery (ERAS) programs. Methods: We performed a retrospective study that included patients with AOC and primary or interval debulking surgery through a median laparotomic approach. This study was conducted in Vall d'Hebron Hospital, Barcelona, Spain, between January 2015 and December 2022. Univariate and multivariate regression analyses were conducted. Results: Of the 156 patients included, 30 (19.2%) presented with an IH. The patients with IHs were smokers in a higher proportion to non-smokers (53.9% vs. 16.1%, p = 0.003) and more frequently presented with wound dehiscence (34.4% vs. 15.0%, p = 0.026). Patients in whom negative pressure wound therapy was applied had a hernia less frequently than those who had not had it (12.5% vs. 26.7%, p = 0.043). Similarly, the incidence of hernia decreased when patients went through an ERAS protocol (10.1% vs. 28.8%, p = 0.008). In the multivariate analysis, smoking was the only independent risk factor (RR 10.84, CI 2.76-42.64), and applying an ERAS protocol was seen to be the sole protective factor (RR 0.22, CI 0.08-0.61) against the development of an IH. Conclusions: The implementation of ERAS is highly recommended due to its numerous benefits, most notably the reduction in hernia incidence. Additionally, the preoperative identification of current smokers provides an opportunity for smoking cessation and targeted respiratory prehabilitation, both of which further contribute to IH reduction.
C1 [Medina, Marta Miguez; Luzarraga, Ana; Catalan, Sara; Acosta, Ursula; Hernandez-Fleury, Alina; Bebia, Vicente; Monreal-Clua, Sonia; Angeles, Martina Aida; Bonaldo, Giulio; Gil-Moreno, Antonio; Perez-Benavente, Asuncion; Sanchez-Iglesias, Jose Luis] Hosp Univ Vall dHebron, Dept Gynecol, Gynecol Oncol Unit, Barcelona 08035, Spain.
   [Bebia, Vicente; Angeles, Martina Aida; Gil-Moreno, Antonio; Perez-Benavente, Asuncion] Univ Autonoma Barcelona, Vall dHebron Barcelona Hosp Campus, Gynecol Oncol Div, Barcelona 08035, Spain.
C3 Hospital Universitari Vall d'Hebron; Autonomous University of Barcelona
RP Luzarraga, A (通讯作者)，Hosp Univ Vall dHebron, Dept Gynecol, Gynecol Oncol Unit, Barcelona 08035, Spain.
EM ana.luzarraga@vallhebron.cat
RI ; PEREZ BENAVENTE, ASUNCION/J-8272-2016; Bebia, Vicente/HSD-6708-2023;
   Luzarraga, Ana/JZC-7507-2024; Gil-Moreno, Antonio/C-1122-2016;
   BENAVENTE, ASUNCION/C-5116-2014
OI Míguez Medina, Marta/0000-0001-6401-7192; PEREZ BENAVENTE,
   ASUNCION/0000-0003-1872-9003; Hernandez Fleury,
   Alina/0000-0002-7687-7971; Bebia, Vicente/0000-0001-6434-2112;
   Luzarraga, Ana/0000-0001-6007-0308; Angeles, Martina
   Aida/0000-0003-4401-3084; Gil-Moreno, Antonio/0000-0003-1106-5590; 
CR Bristow RE, 2002, J CLIN ONCOL, V20, P1248, DOI 10.1200/JCO.20.5.1248
   Caglià P, 2014, INT J SURG, V12, pS164, DOI 10.1016/j.ijsu.2014.08.357
   Celiksoy HY, 2024, GINEKOL POL, V95, P190, DOI 10.5603/gpl.95485
   Chambers LM, 2020, AM J OBSTET GYNECOL, V223, DOI 10.1016/j.ajog.2020.05.011
   Colombo M, 1997, OBSTET GYNECOL, V89, P684, DOI 10.1016/S0029-7844(97)00079-3
   Deerenberg EB, 2022, BJS-BRIT J SURG, V109, P1239, DOI 10.1093/bjs/znac302
   du Bois A, 2009, CANCER-AM CANCER SOC, V115, P1234, DOI 10.1002/cncr.24149
   Fagotti A, 2020, INT J GYNECOL CANCER, V30, P1657, DOI 10.1136/ijgc-2020-001640
   Fotopoulou C, 2021, INT J GYNECOL CANCER, V31, P1199, DOI 10.1136/ijgc-2021-002951
   Fotopoulou C, 2017, EUR J OBSTET GYN R B, V213, P123, DOI 10.1016/j.ejogrb.2017.04.016
   Ge LN, 2018, CANCER MANAG RES, V10, P815, DOI 10.2147/CMAR.S161876
   Harlaar JJ, 2009, AM J SURG, V198, P392, DOI 10.1016/j.amjsurg.2008.10.018
   Heger P, 2019, TRIALS, V20, DOI 10.1186/s13063-019-3921-3
   Kehoe S, 2015, LANCET, V386, P249, DOI 10.1016/S0140-6736(14)62223-6
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   Kurnit KC, 2021, OBSTET GYNECOL, V137, P108, DOI 10.1097/AOG.0000000000004173
   Lheureux S, 2019, CA-CANCER J CLIN, V69, P280, DOI 10.3322/caac.21559
   Long KC, 2011, GYNECOL ONCOL, V120, P33, DOI 10.1016/j.ygyno.2010.09.015
   Mithany RH, 2023, CUREUS J MED SCIENCE, V15, DOI 10.7759/cureus.48795
   Nelson G, 2019, INT J GYNECOL CANCER, V29, P651, DOI 10.1136/ijgc-2019-000356
   Patel SV, 2017, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD005661.pub2
   Sánchez-Iglesias JL, 2020, EUR J CANCER, V136, P149, DOI 10.1016/j.ejca.2020.06.011
   Sanders DL, 2023, BRIT J SURG, V110, P1732, DOI 10.1093/bjs/znad284
   Söderbäck H, 2022, LANGENBECK ARCH SURG, V407, P2527, DOI 10.1007/s00423-022-02530-8
   Spencer RJ, 2015, OBSTET GYNECOL, V125, P407, DOI 10.1097/AOG.0000000000000610
   Straubhar AM, 2024, INT J GYNECOL CANCER, V34, P745, DOI 10.1136/ijgc-2023-004966
   Stuart GCE, 2011, INT J GYNECOL CANCER, V21, P750, DOI 10.1097/IGC.0b013e31821b2568
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   Vergote I, 2010, NEW ENGL J MED, V363, P943, DOI 10.1056/NEJMoa0908806
   Walming S, 2017, BMC SURG, V17, DOI 10.1186/s12893-017-0207-0
NR 31
TC 0
Z9 1
U1 0
U2 2
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2072-6694
J9 CANCERS
JI Cancers
PD FEB
PY 2025
VL 17
IS 3
AR 418
DI 10.3390/cancers17030418
PG 13
WC Oncology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology
GA W4N4F
UT WOS:001418360600001
PM 39941787
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Warren, JA
   Love, M
   Cobb, WS
   Beffa, LR
   Couto, FJ
   Hancock, BH
   Morrow, D
   Ewing, JA
   Carbonell, AM
AF Warren, Jeremy A.
   Love, Michael
   Cobb, William S.
   Beffa, Lucas R.
   Couto, Francisco J.
   Hancock, B. H.
   Morrow, D.
   Ewing, Joseph A.
   Carbonell, Alfredo M.
TI Factors affecting salvage rate of infected prosthetic mesh
SO AMERICAN JOURNAL OF SURGERY
LA English
DT Article
DE Mesh infection; Mesh salvage; Enteroprosthetic fistula; Subsequent
   abdominal operations
ID SUBSEQUENT ABDOMINAL OPERATIONS; INCISIONAL HERNIA REPAIR; SYNTHETIC
   MESH; OPEN PLACEMENT; RISK; COMPLICATIONS; PREDICTORS; EXPERIENCE;
   POSITION; OUTCOMES
AB Background: Prosthetic mesh infection (PMI) is a challenging complication of ventral hernia repair (VHR). The sparsity of data leaves only experience and judgment to guide surgical decision-making.
   Methods: Retrospective review of patients diagnosed with PMI. Subsequent abdominal operation (SAO) constitutes any intraabdominal operation occurring after the index hernia repair prior to PMI presen-tation. Any mesh removal was considered salvage failure. Analysis was performed using Chi-square test, Fishers Exact, or Mann-Whitney U test. Analyses completed using R Version 3.0.2.
   Results: We identified 213 instances of PMI. Most cases (58.7%) involved intraperitoneal mesh. Thirty-seven percent of patients had an SAO, only 25.3% of which were clean cases. Enteroprosthetic fistula occurred in 38 patients (17.8%). Mean time to presentation was 19.9 mos after index hernia repair or SAO for infection alone, and 48.1 mos when a fistula was present (p < 0.001). Percutaneous drainage was used to treat 29 cases, successfully in 10 (34.5%), 8 of which were macroporous polypropylene and 2 biologic mesh. Negative pressure wound therapy (NPWT) was used in 46 patients, but successful in only 16 (34.8%), all of which were macroporous polypropylene. Local wound care alone successfully salvaged only 16 of 85 meshes (18.8%), 13 of which were macroporous polypropylene. Macroporous polypropylene mesh was salvaged in 65% of cases overall, and 72.2% when in an extraperitoneal position. Mesh salvage was not possible in any case involving composite or PTFE mesh, and rarely for microporous poly-propylene (7.7%) multifilament polyester (4.2%), or intraperitoneal mesh (2.4%). Closure of the defect after mesh removal significantly lowers recurrence rate (p < 0.001).
   Conclusion: PMI involving composite, PTFE, multifilament polyester, or microporous polypropylene mesh requires explantation in nearly all cases. Infected macroporous polypropylene mesh in an extraperitoneal position is salvageable in most cases. Furthermore, the risk of secondary mesh infection after SAO, particularly with intraperitoneal mesh, should be considered during index VHR. (c) 2020 Elsevier Inc. All rights reserved.
C1 [Warren, Jeremy A.; Cobb, William S.; Carbonell, Alfredo M.] Univ South Carolina, Sch Med Greenville, Columbia, SC 29208 USA.
   [Warren, Jeremy A.; Love, Michael; Cobb, William S.; Beffa, Lucas R.; Couto, Francisco J.; Carbonell, Alfredo M.] Prisma Hlth Upstate, Div Minimally Access & Bariatr Surg, Dept Surg, Greenville, SC USA.
   [Hancock, B. H.; Morrow, D.] Prisma Hlth Upstate, Dept Surg Undergrad Res Program, Greenville, SC USA.
   [Ewing, Joseph A.] Prisma Hlth Upstate, Dept Qual Management, Greenville, SC USA.
C3 University of South Carolina System; University of South Carolina
   Columbia; Prisma Health; Prisma Health; Prisma Health
RP Warren, JA (通讯作者)，Prisma Hlth Upstate, Dept Surg, 701 Grove Rd,ST 3, Greenville, SC 29605 USA.
EM jeremy.warren@prismahealth.org
OI Love, Wes/0009-0000-5201-0807; Carbonell, Alfredo/0009-0005-0787-0505;
   Morrow, Dillon/0000-0002-2096-1496; Hancock,
   Benjamin/0000-0001-9435-6224
CR Abdelfatah MM, 2015, HERNIA, V19, P135, DOI 10.1007/s10029-013-1165-9
   Amid PK., 1997, HERNIA, V1, P15, DOI [DOI 10.1007/BF02426382, 10.1007/BF02427664, DOI 10.1007/BF02427664, 10.1007/bf02426382]
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   Binnebösel M, 2010, HERNIA, V14, P71, DOI 10.1007/s10029-009-0580-4
   Birolini C, 2015, HERNIA, V19, P239, DOI 10.1007/s10029-014-1225-9
   Blatnik JA, 2012, J GASTROINTEST SURG, V16, P2139, DOI 10.1007/s11605-012-1992-5
   Carbonell AM, 2013, J AM COLL SURGEONS, V217, P991, DOI 10.1016/j.jamcollsurg.2013.07.382
   Cobb WS, 2015, J AM COLL SURGEONS, V220, P606, DOI 10.1016/j.jamcollsurg.2014.12.055
   Cobb WS, 2012, AM SURGEON, V78, P864
   Cobb WS, 2009, AM SURGEON, V75, P762
   Cole WC, 2015, HERNIA, V19, P197, DOI 10.1007/s10029-014-1290-0
   Delikoukos S, 2007, Hernia, V11, P15, DOI 10.1007/s10029-006-0131-1
   Engelsman AF, 2007, BIOMATERIALS, V28, P2314, DOI 10.1016/j.biomaterials.2007.01.028
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   Harrell A G, 2006, Hernia, V10, P120, DOI 10.1007/s10029-005-0056-0
   Harth KC, 2011, SURG ENDOSC, V25, P2224, DOI 10.1007/s00464-010-1534-8
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   Heniford BT, 2011, J AM COLL SURGEONS, V212, P502
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   Melvin WV, 2009, AM SURGEON, V75, P767
   Patel PP, 2017, SURG ENDOSC, V31, P823, DOI 10.1007/s00464-016-5038-z
   Pérez-Köhler B, 2016, SURG INFECT, V17, P124, DOI 10.1089/sur.2015.078
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   Sabbagh C, 2012, HERNIA, V16, P445, DOI 10.1007/s10029-012-0931-4
   Sanchez VM, 2011, SURG INFECT, V12, P205, DOI 10.1089/sur.2011.033
   Sanders D, 2013, HERNIA, V17, P779, DOI 10.1007/s10029-013-1124-5
   Shubinets V, 2018, ANN PLAS SURG, V80, P145, DOI 10.1097/SAP.0000000000001189
   Snyder CW, 2011, J AM COLL SURGEONS, V212, P496, DOI 10.1016/j.jamcollsurg.2010.12.004
   Stremitzer S, 2010, WORLD J SURG, V34, P1702, DOI 10.1007/s00268-010-0543-z
   Taylor SG, 1999, BRIT J SURG, V86, P562, DOI 10.1046/j.1365-2168.1999.01072.x
   Voisard G, 2013, HERNIA, V17, P673, DOI 10.1007/s10029-013-1127-2
NR 36
TC 29
Z9 31
U1 0
U2 3
PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
PI BRIDGEWATER
PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA
SN 0002-9610
EI 1879-1883
J9 AM J SURG
JI Am. J. Surg.
PD SEP
PY 2020
VL 220
IS 3
BP 751
EP 756
DI 10.1016/j.amjsurg.2020.01.028
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA NP5JX
UT WOS:000570213500049
PM 32035628
DA 2026-07-24
ER

PT J
AU Moffatt, CJ
   Mapplebeck, L
   Murray, S
   Morgan, PA
AF Moffatt, C. J.
   Mapplebeck, L.
   Murray, S.
   Morgan, P. A.
TI The experience of patients with complex wounds and the use of NPWT in a
   home-care setting
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE developing a wound through crisis; living with a complex wound; NPWT;
   recommendations for care
ID SELF-MANAGEMENT; SOCIAL SUPPORT; ADHERENCE; METAANALYSIS; ULCER; PAIN
AB Objective: To explore the experience of patients living with complex wounds and the impact of undergoing negative pressure wound therapy (NPWT) as part of their treatment.
   Method: Qualitative data were collected from eight patients, using semi-structured interviews. A purposive, stratified sampling approach was used to identify participants with a range of wound types, as well as age and gender. Participants were recruited from one primary care trust and were interviewed, following 10 days of treatment with NPWT. The matrix-based 'Framework' approach, from the National Centre for Social Research, was used to structure the analysis.
   Results:Of the eight participants recruited, five were female and three male,with an age range of 46-77 years. Five overarching categories, with their constituent themes, were identified from the data. The first, developing a wound through crisis, has three themes:a failing body, missed diagnosis and failed professional intervention. The second category, decreased control, has four related themes: poor communication;failed wound healing; poor discharge planning and failure to recover. The third category, increased control, has four themes: understanding what is happening; symptom control; positive professional relationships and returning to health. The fourth category, using NPWT, has two themes: information and understanding of NPWT and expectations and experience of NPWT. The final category sets out participant recommendations about the device and has two themes: device issues and improving professional practice.
   Conclusion: This study investigated the experience of patients undergoing NPWT for complex wounds in the home setting and reveals a number of the psychosocial effects of using this therapy in this environment. Participants saw NPWT as an active intervention, associated with improved wound healing and symptom control. The participant experience described in this study, and the recommendations they make, provide a valuable resource to inform service improvement programmes and wound research.
   Declaration of interest: This study was supported by a research grant from Smith & Nephew Ltd.
C1 [Moffatt, C. J.; Murray, S.; Morgan, P. A.] Derby Hosp NHS Fdn Trust, Lymphoedema Serv, Royal Derby Hosp, Derby, England.
   [Moffatt, C. J.] Univ Nottingham, Sch Nursing Midwifery & Physiotherapy, Queens Med Ctr, Nottingham NG7 2RD, England.
   [Mapplebeck, L.] N E Lincolnshire Care Plus Trust, Lincoln, England.
C3 University of Nottingham; University of Nottingham
RP Moffatt, CJ (通讯作者)，Derby Hosp NHS Fdn Trust, Lymphoedema Serv, Royal Derby Hosp, Derby, England.
EM philip.morgan5@nhs.net
OI Moffatt, Christine/0000-0002-2436-0129
FU Smith Nephew Ltd.
FX This study was supported by a research grant from Smith & Nephew Ltd.
CR [Anonymous], 2009, BMJ
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NR 26
TC 24
Z9 31
U1 0
U2 10
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
J9 J WOUND CARE
JI J. Wound Care
PD NOV
PY 2011
VL 20
IS 11
BP 512
EP +
DI 10.12968/jowc.2011.20.11.512
PG 10
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Dermatology
GA 931BS
UT WOS:000303189800004
PM 22240846
DA 2026-07-24
ER

PT J
AU Gwilym, BL
   Dovell, G
   Dattani, N
   Ambler, GK
   Shalhoub, J
   Forsythe, RO
   Benson, RA
   Nandhra, S
   Preece, R
   Onida, S
   Hitchman, L
   Coughlin, P
   Saratzis, A
   Bosanquet, DC
AF Gwilym, Brenig L.
   Dovell, George
   Dattani, Nikesh
   Ambler, Graeme K.
   Shalhoub, Joseph
   Forsythe, Rachael O.
   Benson, Ruth A.
   Nandhra, Sandip
   Preece, Ryan
   Onida, Sarah
   Hitchman, Louise
   Coughlin, Patrick
   Saratzis, Athanasios
   Bosanquet, David C.
TI Systematic Review and Meta-Analysis of Wound Adjuncts for the Prevention
   of Groin Wound Surgical Site Infection in Arterial Surgery
SO EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
LA English
DT Review
DE Groin incisions; Surgical site infection; Vascular
ID PLATELET-RICH PLASMA; VASCULAR-SURGERY; CLINICAL-TRIAL; SKIN CLOSURE;
   THERAPY; COMPLICATIONS; GENTAMICIN; VANCOMYCIN; MANAGEMENT; REDUCTION
AB Objective: Groin incision surgical site infections (SSIs) following arterial surgery are common and are a source of considerable morbidity. This review evaluates interventions and adjuncts delivered immediately before, during, or after skin closure, to prevent SS's in patients undergoing arterial interventions involving a groin incision.
   Data sources: MEDLINE, EMBASE, and CENTRAL databases were searched.
   Review methods: This review was undertaken according to established international reporting guidelines and was registered prospectively with the International prospective register of systematic reviews (CRD42020185170). The MEDLINE, EMBASE, and CENTRAL databases were searched using pre-defined search terms without date restriction. Randomised controlled trials (RCTs) and observational studies recruiting patients with non-infected groin incisions for arterial exposure were included; SSI rates and other outcomes were captured. Interventions reported in two or more studies were subjected to meta-analysis.
   Results: The search identified 1 532 articles. Seventeen RCTs and seven observational studies, reporting on 3 747 patients undergoing 4 130 groin incisions were included. A total of seven interventions and nine outcomes were reported upon. Prophylactic closed incision negative pressure wound therapy (ciNPWT) reduced groin SSIs compared with standard dressings (odds ratio [OR] 0.34, 95% CI 0.23 - 0.51; p < .001, GRADE strength of evidence: moderate). Local antibiotics did not reduce groin SSIs (OR 0.60 95% CI 0.30 - 1.21 p = .15, GRADE strength: low). Subcuticular sutures (vs. transdermal sutures or clips) reduced groin SSI rates (OR 0.33, 95% CI 0.17 - 0.65, p = .001, GRADE strength: low). Wound drains, platelet rich plasma, fibrin glue, and silver alginate dressings did not show any significant effect on SSI rates.
   Conclusion: There is evidence that ciNPWT and subcuticular sutures reduce groin SSI in patients undergoing arterial vascular interventions involving a groin incision. Local antibiotics did not reduce groin wound SSI, although the strength of this evidence is lower. No other interventions demonstrated a significant effect.
C1 [Gwilym, Brenig L.; Bosanquet, David C.] Royal Gwent Hosp, South East Wales Vasc Network, Newport, Gwent, Wales.
   [Dovell, George; Ambler, Graeme K.] Univ Bristol, Bristol, Avon, England.
   [Dattani, Nikesh] Queen Elizabeth Hosp Birmingham, Birmingham, W Midlands, England.
   [Shalhoub, Joseph; Onida, Sarah] Imperial Coll Healthcare NHS Trust, Imperial Vasc Unit, London, England.
   [Shalhoub, Joseph; Onida, Sarah] Imperial Coll London, Acad Sect Vasc Surg, Dept Surg & Canc, London, England.
   [Forsythe, Rachael O.] Univ Edinburgh, Ctr Cardiovasc Sci, Edinburgh, Midlothian, Scotland.
   [Benson, Ruth A.] Univ Birmingham, Birmingham, W Midlands, England.
   [Nandhra, Sandip] Newcastle Univ, Northern Vasc Ctr, Inst Populat Hlth Sci, Newcastle Upon Tyne, Tyne & Wear, England.
   [Preece, Ryan] Cheltenham Gen Hosp, Cheltenham, Glos, England.
   [Hitchman, Louise] Hull York Med Sch, Kingston Upon Hull, N Humberside, England.
   [Coughlin, Patrick] Univ Cambridge, Cardiovasc Interdisciplinary Res Ctr, Cambridge, England.
   [Saratzis, Athanasios] Univ Leicester, NIHR Leicester Biomed Res Ctr, Dept Cardiovasc Sci, Leicester, Leics, England.
C3 Royal Gwent Hospital; University of Bristol; University of Birmingham;
   Imperial College London; Imperial College London; University of
   Edinburgh; University of Birmingham; Newcastle University - UK;
   Gloucestershire Hospitals NHS Foundation Trust; Cheltenham General
   Hospital; University of Hull; University of York - UK; University of
   Cambridge; University of Leicester
RP Gwilym, BL (通讯作者)，Royal Gwent Hosp, South East Wales Vasc Network, Newport, Gwent, Wales.
EM blgwilym@gmail.com
RI Gwilym, Brenig/AAW-1697-2021; Benson, Ruth A/AFW-3137-2022; Bosanquet,
   David/AAB-1557-2022; Shalhoub, Joseph/P-2171-2014; Saratzis,
   Athanasios/LLM-4349-2024; Hitchman, Louise/KCJ-4849-2024
OI Gwilym, Brenig/0000-0002-5403-8720; Benson, Ruth A/0000-0001-5889-4391;
   Dattani, Nikesh/0000-0003-0495-1666; Dovell, George/0000-0002-2203-9446;
   Onida, Sarah/0000-0001-5926-4578; Bosanquet, David/0000-0003-2304-0489;
   Forsythe, Rachael/0000-0002-3311-9599; Nandhra,
   Sandip/0000-0002-6036-5760; Coughlin, Patrick/0000-0003-1342-1114;
   Shalhoub, Joseph/0000-0003-1011-7440; Saratzis,
   Athanasios/0000-0002-3399-094X; Ambler, Graeme/0000-0002-3024-6365;
   Preece, Ryan/0000-0002-1718-6142; 
FU National Institutes of Health Research (NIHR) [NIHR300059] Funding
   Source: National Institutes of Health Research (NIHR); National
   Institute for Health Research [CL-2014-11-001] Funding Source:
   researchfish; Department of Health [NIHR300059] Funding Source: Medline
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NR 52
TC 44
Z9 47
U1 0
U2 4
PU W B SAUNDERS CO LTD
PI LONDON
PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND
SN 1078-5884
EI 1532-2165
J9 EUR J VASC ENDOVASC
JI Eur. J. Vasc. Endovasc. Surg.
PD APR
PY 2021
VL 61
IS 4
BP 636
EP 646
DI 10.1016/j.ejvs.2020.11.053
EA APR 2021
PG 11
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA RN2KJ
UT WOS:000640180600025
PM 33423912
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Erdil, A
   Celikkol, O
   Caymaz, A
   Son, A
AF Erdil, Aras
   Celikkol, Ongun
   Caymaz, Ahmet
   Son, Aybike
TI Effectiveness of topical vacuum assisted drainage in mandibular third
   molar surgeries: a randomized controlled clinical study
SO BMC ORAL HEALTH
LA English
DT Article
DE Negative pressure wound therapy; Third molar surgery; Edema; Trismus;
   Postoperative pain; Non-pharmacolgical therapy; Postoperative
   complications
ID PRESSURE WOUND THERAPY; CLOSURE; PAIN; COMPLICATIONS; VALIDITY
AB Objective This study aimed to evaluate the clinical efficacy of intraoral vacuum-assisted drainage (VAD) in reducing postoperative inflammatory complications-pain, swelling, and trismus-following the surgical extraction of impacted mandibular third molars (M3M). Materials and methods A prospective, randomized, triple-blinded, sham-controlled clinical trial was conducted with 36 systemically healthy participants undergoing surgical removal of a single M3M. Participants were randomly assigned to either the VAD group (n = 18), receiving three sessions of intraoral negative pressure therapy via a custom-made splint, or the sham-control group (n = 18), in which the apparatus was applied without suction. Primary outcomes included pain intensity, facial swelling, and maximum mouth opening (MMO), measured preoperatively and on the 2nd and 7th postoperative days. Secondary outcomes were NSAID consumption and oral health-related quality of life (OHIP-14). Statistical analysis was conducted with a significance level of 0.05. Results The VAD group showed significantly lower pain scores at all postoperative time points compared to controls (p < 0.05). Swelling was significantly reduced on postoperative day 2 (p = 0.019), and MMO was significantly greater on both postoperative days 2 and 7 (p < 0.001 and p = 0.001, respectively). Nonsteroidal anti-inflammatory drug consumption was significantly lower in the VAD group (8.1 +/- 3.2 vs. 12.8 +/- 4.6 tablets, p = 0.001), and OHIP-14 scores indicated improved quality of life on postoperative day 7 (p = 0.021). Conclusions Within the limitations of this preliminary trial, vacuum-assisted drainage showed potential in reducing early postoperative complications following M3M surgery. These findings support further investigation into its clinical application. Clinical relevance This study introduces an innovative intraoral vacuum-assisted drainage technique that enhances patient recovery after mandibular third molar surgery. By reducing inflammatory complications and analgesic dependency, it offers a promising adjunct to standard postoperative care, particularly in patients where NSAID use is limited or adverse effects are a concern. Trial registration ClinicalTrials.gov Identifier NCT06758258. Date of Registration 26/11/2024 (retrospectively registered).
C1 [Erdil, Aras; Caymaz, Ahmet] Usak Univ, Fac Dent, Dept Oral & Maxillofacial Surg, Usak, Turkiye.
   [Celikkol, Ongun] Adnan Menderes Univ, Fac Dent, Dept Prosthodont, Aydin, Turkiye.
   [Son, Aybike] Usak Univ, Fac Dent, Dept Prosthodont, Usak, Turkiye.
C3 Usak University; Adnan Menderes University; Usak University
RP Erdil, A (通讯作者)，Usak Univ, Fac Dent, Dept Oral & Maxillofacial Surg, Usak, Turkiye.
EM aras.erdil@usak.edu.tr; ongun.celikkol@usak.edu.tr;
   ahmet.caymaz@usak.edu.tr; aybike.son@usak.edu.tr
RI Erdil, Aras/LKO-1120-2024
OI Erdil, Aras/0000-0002-9582-5114; caymaz, ahmet/0009-0005-5699-8425;
   Çelikkol, Ongun/0000-0002-9401-4133
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NR 56
TC 0
Z9 0
U1 2
U2 5
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1472-6831
J9 BMC ORAL HEALTH
JI BMC Oral Health
PD NOV 25
PY 2025
VL 25
IS 1
AR 1838
DI 10.1186/s12903-025-07243-0
PG 17
WC Dentistry, Oral Surgery & Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dentistry, Oral Surgery & Medicine
GA H2139
UT WOS:001625320800001
PM 41291693
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Ciprandi, G
   Kjartanason, H
   Grussu, F
   Baldursson, BT
   Frattaroli, J
   Urbani, U
   Zama, M
AF Ciprandi, Guido
   Kjartanason, Hilmar
   Grussu, Francesca
   Baldursson, Baldur T.
   Frattaroli, Jacopo
   Urbani, Urbano
   Zama, Mario
TI Use of acellular intact fish skin grafts in treating acute paediatric
   wounds during the COVID-19 pandemic: a case series
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE complex wounds; intact fish skin; paediatric complex wounds; skin
   substitutes; wound; wound care; wound dressing; wound healing
ID DERMAL MATRIX; THERAPY
AB Objective: More specific strategies are needed to support children requiring skin grafting. Our goal was to identify procedures that reduce operating times, post-operative complications, pain and length of hospital stay. Patient safety, optimal wound bed support and quick micro-debridement with locoregional anaesthesia were prioritised. Ultimately, a novel acellular fish skin graft (FSG) derived from north Atlantic cod was selected for use.
   Method: We admitted consecutive paediatric patients with various lesions requiring skin grafting for definitive wound closure. All FSGs were applied and bolstered in the operating room following debridement.
   Results: In a cohort of 15 patients, the average age was 8 years and 9 months (4 years 1 month-13 years 5 months). Negative pressure wound therapy (NPWT) was given to 12 patients. Rapid wound healing was observed in all patients, with a wound area coverage of 100% and complete healing in 95% of wounds. Time until engraftment in patients receiving NPWT was reduced by about a half (to an average 12 days) from our standard experience of 21 days. Ten patients received locoregional anaesthesia and were discharged after day surgery. The operating time was <60 minutes, and no complications or allergic reactions were reported. Excellent pliability of the healed wound was achieved in all patients, without signs of itching and scratching in the postoperative period. This case series is the first and largest using FSG to treat paediatric patients with different wound aetiologies. We attribute the rapid transition to acute wound status and the good pliability of the new epidermal-dermal complex to the preserved molecular components of the FSG, including omega-3.
   Conclusion: FSG represents an innovative and sustainable solution for paediatric wound care that results in shorter surgery time and reduced hospital stays, with accelerated wound healing times.
   Declaration of interest: HK and BB are co-founders and current employees of Kerecis Limited. No funding was received for the creation of this manuscript. The authors have no other conflicts of interest to declare.
C1 [Ciprandi, Guido; Grussu, Francesca; Frattaroli, Jacopo; Urbani, Urbano; Zama, Mario] Bambino Gesu Pediat Hosp, Res Inst, Div Plast & Maxillofacial Surg, Rome, Italy.
   [Kjartanason, Hilmar; Baldursson, Baldur T.] Landspitali Univ Hosp, Reykjavik, Iceland.
   [Kjartanason, Hilmar; Baldursson, Baldur T.] Kerecis Ltd, Reykjavik, Iceland.
C3 IRCCS Bambino Gesu; Landspitali National University Hospital
RP Ciprandi, G (通讯作者)，Bambino Gesu Pediat Hosp, Res Inst, Div Plast & Maxillofacial Surg, Rome, Italy.
EM guido.ciprandi@opbg.net
RI Zama, Mario/AAD-6351-2022; frattaroli, jacopo maria/ABC-8342-2021;
   CIPRANDI, GUIDO/AAA-6133-2020; Kjartansson, Hilmar/JYO-5445-2024
OI CIPRANDI, GUIDO/0000-0003-0125-5534; Kjartansson,
   Hilmar/0000-0003-4891-2976
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NR 29
TC 12
Z9 14
U1 1
U2 4
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2052-2916
J9 J WOUND CARE
JI J. Wound Care
PD OCT
PY 2022
VL 31
IS 10
BP 824
EP 831
DI 10.12968/jowc.2022.31.10.824
PG 7
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 5M7DN
UT WOS:000871258000004
PM 36240798
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Grande, R
   Brachini, G
   Sterpetti, AV
   Borrelli, V
   Serra, R
   Pugliese, F
   D'Ermo, G
   Tartaglia, E
   Rubino, P
   Mingoli, A
   Sapienza, P
AF Grande, Raffaele
   Brachini, Gioia
   Sterpetti, Antonio V.
   Borrelli, Valeria
   Serra, Raffaele
   Pugliese, Francesco
   D'Ermo, Giuseppe
   Tartaglia, Elvira
   Rubino, Paolo
   Mingoli, Andrea
   Sapienza, Paolo
TI Local release of metalloproteinases and their inhibitors after a
   successful revascularisation procedure
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE advanced moist wound dressing; CLI; infrapopliteal vein graft; MMPs;
   non-healing ulcers; NPWT; TIMPs
ID CRITICAL LIMB ISCHEMIA; MATRIX METALLOPROTEINASES; RISK STRATIFICATION;
   GROWTH-FACTOR; SURGICAL REVASCULARIZATION; STIMULATION; GUIDELINES;
   AMPUTATION; OUTCOMES; THERAPY
AB An altered balance between metalloproteinases (MMPs) and their inhibitor tissue inhibitor of metalloproteinases (TIMPs) may influence the healing process of a minor amputation following a successful vein graft. To speed up this process, negative pressure wound therapy (NPWT) and advanced moist wound dressing have been proposed. We determined the systemic and local release of MMP-1, -2, -3, -9, TIMP-1, and TIMP-2 by enzyme linked immunosorbent assay (ELISA) technique and their influences in the healing process in 26 patients who underwent minor amputation after a successful revascularisation procedure. Twelve patients (group 1) were medicated with NPWT and 14 (group 2) with advanced moist wound dressing. Plasma samples were collected on the morning of surgery and thereafter at 1, 3, and 5 months; exudates were collected 3 days after surgery when amputation was performed and thereafter at 1, 3, and 5 months. Fifteen age-matched healthy male volunteers served as controls. All wounds healed in 5 +/- 0.5 months. Follow-up plasma and local release of MMP-1, -2, -3, and -9 were overall significantly lower when compared with the preoperative levels, while those of TIMP-1 and -2 were significantly higher with no differences among the groups. Despite no differences in the healing process being observed among the two types of medications, at 1 month the local release of MMP-2 and -9 was significantly lower (P = .013 and .047, respectively) and that of TIMP-1 was significantly higher (P = .042) in group 1 as compared to group 2. A correct and aggressive local approach to the wound is able to promote the healing of the lesion stimulating the extracellular matrix turnover with local MMP/TIMP adequate balance and favouring the creation of granulation tissue. However, a successful restoration of an adequate blood flow remains the key point of a durable and rapid wound healing.
C1 [Grande, Raffaele; Brachini, Gioia; Sterpetti, Antonio V.; D'Ermo, Giuseppe; Mingoli, Andrea; Sapienza, Paolo] Sapienza Univ Rome, Dept Surg Pietro Valdoni, Rome, Italy.
   [Borrelli, Valeria] Sapienza Univ Rome, Dept Diagnost Med, Rome, Italy.
   [Serra, Raffaele] Magna Graecia Univ Catanzaro, Dept Med & Surg Sci, Catanzaro, Italy.
   [Pugliese, Francesco] Sapienza Univ Rome, Dept Emergency, Rome, Italy.
   [Tartaglia, Elvira] Ctr Hosp Sud Francilienne, Dept Gen & Vasc Surg, Paris, France.
   [Rubino, Paolo] Civil Hosp, Dept Vasc Surg, Catanzaro, Italy.
C3 Sapienza University Rome; Sapienza University Rome; Magna Graecia
   University of Catanzaro; Sapienza University Rome
RP Sapienza, P (通讯作者)，Sapienza Univ Rome, Policlin Umberto I, Dept Surg Pietro Valdoni, Surg, Viale Policlin 151, I-00161 Rome, Italy.
EM paolo.sapienza@uniroma1.it
RI D'ERMO, Giuseppe/ABI-1150-2020; Grande, Raffaele/AAO-1388-2020;
   Sapienza, Paolo/AAL-7381-2020; Serra, Raffaele/AAA-6874-2022; Mingoli,
   Andrea/A-2889-2010
OI D'ERMO, Giuseppe/0000-0003-4403-140X; Grande,
   Raffaele/0000-0003-2873-0104; Sapienza, Paolo/0000-0002-0198-7930;
   Brachini, Gioia/0000-0001-6724-5588; 
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NR 46
TC 4
Z9 4
U1 0
U2 9
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD FEB
PY 2020
VL 17
IS 1
BP 149
EP 157
DI 10.1111/iwj.13249
EA OCT 2019
PG 9
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA KC9VQ
UT WOS:000492670100001
PM 31657109
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Hasselmann, J
   Bjork, J
   Svensson-Bjork, R
   Butt, T
   Acosta, S
AF Hasselmann, Julien
   Bjork, Jonas
   Svensson-Bjork, Robert
   Butt, Talha
   Acosta, Stefan
TI Proposed Classification of Incision Complications: Analysis of a
   Prospective Study on Elective Open Lower-Limb Revascularization
SO SURGICAL INFECTIONS
LA English
DT Article
DE complication classification; inguinal arterial revascularization;
   infra-inguinal arterial revascularization
ID SURGICAL SITE INFECTION; RISK-FACTORS; WOUND INFECTIONS; SURGERY; COSTS;
   OUTCOMES; BYPASS; CARE
AB Background: Incision complications (IC) have a significant impact on procedure-related morbidity after lower-limb revascularization. One of the most studied IC is surgical site infection (SSI). Reporting these complications in a uniform way is crucial to evaluate treatment approaches. The aim of this study was to propose a comprehensive classification of IC and apply it to compare SSI with other IC in a trial on elective open lower-limb revascularization procedures.
   Methods: Two hundred twenty-three eligible patients undergoing elective unilateral inguinal and infra-inguinal arterial vascular surgery were extracted from a randomized controlled trial on incisional negative-pressure wound therapy (NPWT) on inguinal vascular surgical incisions. The IC were classified by grades of severity (grade 0-6) that focused on IC-related consequences such as out-patient treatment (grade 1), prolonged in-patient treatment (grade 2), re-admission (grade 3), and re-operation (grade >= 4). An SSI was defined by the ASEPSIS score criteria.
   Results: An SSI was diagnosed in 63 patients (28.3%). Thirty-five of 160 patients (21.8%) not suffering from SSI underwent IC treatment. Treatment for IC was recorded for 25/144 patients (17.4%) with satisfactory site healing as judged by the ASEPSIS score. The median incision-related in-hospital stay in those with SSI (n = 79) and disturbed healing (n = 16) according to the ASEPSIS score was 13 days in both groups (p = 0.53). Five patients had peri-vascular SSI (IC grade 4 n = 4; grade 5 n = 1). The proposed classification of IC and the ASEPSIS score correlated highly (r = 0.77; p < 0.001). Inter-rater reliability for IC grading was substantial for three investigators with different levels of experience (k = 0.81, 0.71, and 0.70).
   Conclusions: The proposed incision classification suggests a comparable clinical significance of vascular IC in terms of IC-related in-patient stay, whether there was a surgical site infection or not. This classification system requires external validation.
C1 [Hasselmann, Julien; Svensson-Bjork, Robert; Butt, Talha; Acosta, Stefan] Skane Univ Hosp, Vasc Ctr, Malmo, Sweden.
   [Hasselmann, Julien; Svensson-Bjork, Robert; Butt, Talha; Acosta, Stefan] Lund Univ, Dept Clin Sci, Ruth Lundskogs Gata 10, Malmo 20502, Sweden.
   [Bjork, Jonas] Lund Univ, Div Occupat & Environm Med, Malmo, Sweden.
   [Bjork, Jonas] Lund Univ Hosp, Forum South, Clin Studies Sweden, Lund, Sweden.
C3 Lund University; Skane University Hospital; Lund University; Lund
   University; Lund University; Skane University Hospital
RP Hasselmann, J (通讯作者)，Lund Univ, Dept Clin Sci, Ruth Lundskogs Gata 10, Malmo 20502, Sweden.
EM Hasselmann999@gmail.com
RI Acosta, Stefan/JAX-3225-2023; Björk, Jonas/AFS-4819-2022; Hasselmann,
   Julien/C-1586-2015
OI Acosta, Stefan/0000-0002-3225-0798; Björk, Jonas/0000-0003-1883-2000;
   Svensson-Björk, Robert/0000-0003-1907-9022
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NR 19
TC 6
Z9 6
U1 0
U2 0
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1096-2964
EI 1557-8674
J9 SURG INFECT
JI Surg. Infect.
PD MAY 1
PY 2020
VL 21
IS 4
BP 384
EP 390
DI 10.1089/sur.2019.144
PG 7
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases; Surgery
GA LJ2YR
UT WOS:000530035700011
PM 31829833
DA 2026-07-24
ER

PT J
AU Sun, XF
   Ni, PW
   Wu, MJ
   Yao, H
   Ye, J
   Ting, X
AF Sun, Xiaofang
   Ni, Pengwen
   Wu, Minjie
   Yao, Huang
   Ye, Junna
   Ting, Xie
TI A Clinicoepidemiological Profile of Chronic Wounds in Wound Healing
   Department in Shanghai
SO INTERNATIONAL JOURNAL OF LOWER EXTREMITY WOUNDS
LA English
DT Article
DE chronic wounds; demography; etiology; therapy; cost
ID VENOUS LEG ULCERS; PRESSURE ULCERS; DIABETIC FOOT; SURGICAL-TREATMENT;
   UNITED-STATES; RISK-FACTORS; PREVALENCE; MANAGEMENT; THERAPY; CHINA
AB The aim of the study was to update the clinical database of chronic wounds in order to derive an evidence based understanding of the condition and hence to guide future clinical management in China. A total of 241 patients from January 1, 2011 to April 30, 2016 with chronic wounds of more than 2 weeks' duration were studied in wound healing department in Shanghai. Results revealed that among all the patients the mean age was 52.5 +/- 20.2 years (range 2-92 years). The mean initial area of wounds was 30.3 +/- 63.0 cm2 (range 0.25-468 cm2). The mean duration of wounds was 68.5 +/- 175.2 months (range 0.5-840 months). The previously reported causes of chronic wounds were traumatic or surgical wounds (n = 82, 34.0%), followed by pressure ulcers (n = 59, 24.5%). To study the effects of age, patients were divided into 2 groups: less than 60 years (<60), and 60 years or older (>= 60). The proportion of wounds etiology between the 2 age groups was analyzed, and there was significant statistical difference (P < .05, 95% confidence interval [CI] = 0.076-0.987). To study the associations between outcome and clinical characteristics in chronic wounds, chi-square test was used. There were significant differences in the factor of wound infection. (P = .035, 95% CI = 0.031-0.038) Regarding therapies, 72.6% (n = 175) of the patients were treated with negative pressure wound therapy. Among all the patients, 29.9% (n = 72) of them were completely healed when discharged while 62.7% (n = 150) of them improved. The mean treatment cost was 12055.4 +/- 9206.3 Chinese Yuan (range 891-63626 Chinese Yuan). In conclusion, traumatic or surgical wounds have recently become the leading cause of chronic wounds in Shanghai, China. Etiology of the 2 age groups was different. Infection could significantly influence the wound outcome.
C1 [Sun, Xiaofang; Ni, Pengwen; Wu, Minjie; Yao, Huang; Ting, Xie] Shanghai Jiao Tong Univ, Shanghai 9th Peoples Hosp, Sch Med, Wound Healing Dept, Shanghai 200011, Peoples R China.
   [Ye, Junna] Shanghai Jiao Tong Univ, Ruijin Hosp, Sch Med, Shanghai 200011, Peoples R China.
C3 Shanghai Jiao Tong University; Shanghai Jiao Tong University
RP Ting, X (通讯作者)，Shanghai Jiao Tong Univ, Shanghai 9th Peoples Hosp, Sch Med, Wound Healing Dept, Shanghai 200011, Peoples R China.
EM doctortingxie@139.com
RI Ye, Junna/ABF-6141-2020; xie, ting/HNC-0777-2023
FU National Natural Science Foundation of China [81671917, 81272111];
   Translational Medical Research Institute Stem Cells and Regenerative
   Medicine Base in Shanghai Jiao Tong University School of Medicine
   [TS201109]; National Scientific & Technology Pillar Program
   [2012BAI11B04]; Major State Basic Research Development Program of China
   [2012CB518100]
FX The author(s) disclosed receipt of the following financial support for
   the research, authorship, and/or publication of this article: This study
   was supported by grants from the National Natural Science Foundation of
   China (81671917, 81272111), Translational Medical Research Institute
   Stem Cells and Regenerative Medicine Base in Shanghai Jiao Tong
   University School of Medicine (TS201109), the National Scientific &
   Technology Pillar Program (2012BAI11B04), and the Major State Basic
   Research Development Program of China (2012CB518100).
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NR 37
TC 21
Z9 32
U1 1
U2 15
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 1534-7346
EI 1552-6941
J9 INT J LOW EXTR WOUND
JI Int. J. Low. Extrem. Wounds
PD MAR
PY 2017
VL 16
IS 1
BP 36
EP 44
DI 10.1177/1534734617696730
PG 9
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA EP7TC
UT WOS:000397579100006
PM 28682680
DA 2026-07-24
ER

PT J
AU Reynolds, IS
   Gleason, L
   Hajjar, R
   Khan, S
   Sanchez, E
   Bews, KA
   Martinez-Jorge, J
   Perry, WR
   Mathis, KL
   McKenna, NP
AF Reynolds, Ian S.
   Gleason, Lauren
   Hajjar, Roy
   Khan, Sidrah
   Sanchez, Emilio
   Bews, Katherine A.
   Martinez-Jorge, Jorys
   Perry, William R.
   Mathis, Kellie L.
   McKenna, Nicholas P.
TI Perineal wound complications after proctectomy for Crohn's disease: the
   impact of the omental pedicle flap and predictors of return to the
   operating room
SO JOURNAL OF GASTROINTESTINAL SURGERY
LA English
DT Article
DE Crohn's disease; Omental pedicle flap; Perineal wound; Proctectomy
ID ABDOMINOPERINEAL RESECTION; OMENTOPLASTY; SINUS; CLOSURE; EXCISION;
   FISTULA; RECTUM
AB Background: The role of omental pedicle flaps (OPFs) in reducing the risk of perineal wound complications and postoperative pelvic abscesses in patients with Crohn's disease remains unclear. This study aimed to determine whether OPFs had any effect on the incidence of perineal wound complications requiring a return to the operating room (OR) or the requirement for radiologic-guided drainage of pelvic abscesses in patients with Crohn's disease who underwent proctectomy. Methods: This was a retrospective, single-center study. The study included patients who underwent proctectomy for Crohn's disease with primary perineal closure, with or without an OPF. The primary outcome measures were return to the OR for perineal wound complications or the requirement for radiologically guided drainage of pelvic abscesses. Results: A total of 219 patients (71 with flap and 148 without flap) underwent proctectomy during the study period. No differences were observed in the rate of unplanned return to the OR (11.27% in the OPF group vs 9.46% in the non-OPF group; P =.81) or the number of patients requiring radiologically guided drainage of pelvic abscesses (11.27% in the OPF group vs 6.76% in the non-OPF group, respectively; P =.30) between the cohorts. Patients in the flap cohort were more likely to have a history of tobacco use (P =.02), fistulizing perianal disease (P =.01), undergo extrasphincteric dissection (P =.03), and use incisional wound vacuum assisted closure (VAC) at the time of surgery (P =.02). Conclusion: Careful patient selection for the OPF might play a role in reducing wound complications to a level similar to that observed in patients with lower-risk perineal wounds. (c) 2025 Society for Surgery of the Alimentary Tract. Published by Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Reynolds, Ian S.; Gleason, Lauren; Hajjar, Roy; Khan, Sidrah; Sanchez, Emilio; Perry, William R.; Mathis, Kellie L.; McKenna, Nicholas P.] Mayo Clin, Div Colon & Rectal Surg, Rochester, MN 55905 USA.
   [Bews, Katherine A.] Mayo Clin, Robert D & Patricia E Kern Ctr Sci Hlth Care Deliv, Rochester, MN USA.
   [Martinez-Jorge, Jorys] Mayo Clin, Div Plast & Reconstruct Surg, Rochester, MN USA.
C3 Mayo Clinic; Mayo Clinic; Mayo Clinic
RP Reynolds, IS; McKenna, NP (通讯作者)，Mayo Clin, Div Colon & Rectal Surg, Rochester, MN 55905 USA.
EM ianreynolds@rcsi.com; mckenna.nicholas@mayo.edu
RI /AAX-9714-2020; McKenna, Nicholas/AFQ-2742-2022; Reynolds, Ian
   Sean/AAF-6332-2020
OI Reynolds, Ian Sean/0000-0002-8790-2538
FU Royal College of Surgeons in Ireland; Health Service Executive National
   Doctors Training and Planning section
FX We wish to acknowledge the Royal College of Surgeons in Ireland and the
   Health Service Executive National Doctors Training and Planning section
   for the travel grant and scholarship provided to Dr Ian Reynolds
   concerning his colon and rectal surgery fellowship at the Mayo Clinic.
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NR 30
TC 5
Z9 5
U1 0
U2 0
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1091-255X
EI 1873-4626
J9 J GASTROINTEST SURG
JI J. Gastrointest. Surg.
PD JUN
PY 2025
VL 29
IS 6
AR 102048
DI 10.1016/j.gassur.2025.102048
EA APR 2025
PG 6
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA 1TZ6N
UT WOS:001473619900001
PM 40187722
DA 2026-07-24
ER

PT J
AU Schorsch, T
   Müller, C
   Loske, G
AF Schorsch, T.
   Mueller, C.
   Loske, G.
TI Endoscopic vacuum therapy of perforations and anastomotic insufficiency
   of the esophagus
SO CHIRURG
LA German
DT Article
DE Postoperative complications; Treatment outcome; Retrospective studies;
   Wound healing; Negative pressure wound therapy
ID ASSISTED CLOSURE; MANAGEMENT; LEAKAGE; ESOPHAGECTOMY; OPTIONS;
   COMPLICATIONS; RESECTION; STENT
AB The high morbidity and mortality of esophageal defects show that the clinical challenge in the treatment of this disease still remains. An innovative method which has been developed in recent years for esophageal leakage is endoscopic vacuum therapy.
   A retrospective analysis of all patients treated for esophageal perforation with endoscopic vacuum therapy in our department was carried out.
   From November 2006 to October 2013 a total of 35 patients were treated with this method and of these 21 had anastomotic leakage, 7 had iatrogenic perforation due to flexible or rigid endoscopy and 7 patients had esophageal defects of various other origins. Drainage systems with an open pore polyurethane tip were placed using a standard endoscope. The vacuum drainage may be positioned either in the esophageal lumen onto the defect or through the defect into the extraluminal wound cavity. The intraluminal or intracavitary vacuum drainage is connected to an electronically controlled vacuum device and a continuous negative pressure of 125 mmHg is maintained for several days. The esophageal lumen or wound cavity collapses around the drainage resulting in intraluminal evacuation and closure of the defect. Under endoscopic monitoring the vacuum system is changed regularly until stable secondary healing of the intracorporeal wound or closure of the transmural defect is achieved.
   In 32 out of 35 patients (91.4 %) healing of defects was achieved after median treatment duration of 11 days (range 4-78 days). The postoperative anastomotic leakage healed in 20 out of 21 patients (95.2 %) after a median of 11 days (range 4-46 days) of therapy. The defects in the 7 patients who were treated for iatrogenic perforation all healed (100 %) after a median treatment time of 5 days (range 4-7 days). There was one case of a recurrent fistula 75 days after treatment. The 90-day mortality in this series of 35 patients was 5.7 %.
   The results of this retrospective study emphasize the increasing importance of endoscopic vacuum therapy in the current literature as an endoscopic treatment method in the management of esophageal perforation and anastomotic leakage.
C1 [Schorsch, T.; Mueller, C.; Loske, G.] Kathol Marienkrankenhaus GmbH, Klin Allgemein Viszeral Thorax & Gefasschirurg, D-22087 Hamburg, Germany.
C3 St. Marien Hospital
RP Loske, G (通讯作者)，Kathol Marienkrankenhaus GmbH, Klin Allgemein Viszeral Thorax & Gefasschirurg, Alfredstr 9, D-22087 Hamburg, Germany.
EM loske.chir@marienkrankenhaus.org
CR Alanezi Khaled, 2004, Ann Thorac Cardiovasc Surg, V10, P71
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NR 35
TC 64
Z9 71
U1 0
U2 1
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0009-4722
EI 1433-0385
J9 CHIRURG
JI Chirurg
PD DEC
PY 2014
VL 85
IS 12
BP 1081
EP 1093
DI 10.1007/s00104-014-2764-4
PG 13
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA AW3ES
UT WOS:000346169400006
PM 24920346
DA 2026-07-24
ER

PT J
AU Xiao, WH
   Ming, XC
   Huang, YX
   Li, JX
   Jiao, QQ
   Yang, J
   Zheng, LY
   Zeng, YF
   Wang, R
   Cheng, SW
   Bian, YY
   Yao, JL
AF Xiao, Weihao
   Ming, Xingchen
   Huang, Yuxi
   Li, Jiaxuan
   Jiao, Qiqi
   Yang, Jian
   Zheng, Linyang
   Zeng, Yunfu
   Wang, Rong
   Cheng, Shaowen
   Bian, Yangyang
   Yao, Jiangling
TI A retrospective analysis of the surgical efficacy for tophi wounds in
   Hainan province
SO FRONTIERS IN SURGERY
LA English
DT Article
DE gout; retrospective studies; surgical procedures; operative; tophi;
   treatment outcome; uric acid
ID CLINICAL CHARACTERISTICS; GOUT; MANAGEMENT
AB Introduction: Gouty tophi are chronic inflammatory nodules resulting from monosodium urate (MSU) crystal deposition, often leading to joint deformity, skin ulceration, and functional impairment. Surgical management remains controversial due to a lack of standardized indications. This study aimed to evaluate the efficacy of surgical treatment for gouty tophi wounds and to explore surgical indications. Methods: This retrospective study consecutively enrolled patients with gouty tophi wounds who underwent surgical treatment at the First Affiliated Hospital of Hainan Medical University, a tertiary hospital in Haikou, Hainan Province, China, between April 2018 and April 2024. Clinical data, including demographic characteristics, infection markers, nutritional parameters, and surgical outcomes, were collected from electronic medical records and paper-based patient charts. Perioperative changes in these indicators were analyzed. The study was reported in accordance with the STROBE guidelines. Results: A total of 130 patients were included, comprising 129 males (99.2%) and 1 female (0.8%), with a mean age of 58.15 +/- 14.04 years. The primary comorbidities included hypertension (43.85%), diabetes mellitus (13.85%), renal insufficiency (11.54%), and hyperlipidemia (8.46%). The primary surgical modalities were lesion excision (41.54%), debridement (34.62%), and vacuum sealing drainage (VSD) (23.08%). Wound healing was achieved in 124 cases (95.38%), with a mean healing time of 31.43 +/- 16.18 days; 5 cases (3.85%) failed to heal, and 1 patient (0.77%) died from multiorgan failure. The positive microbiological culture rate decreased from 21 cases (16.15%) preoperatively to 1 case (0.77%) postoperatively, with Staphylococcus aureus (28.57%) being the predominant preoperative pathogen. Postoperative laboratory parameters showed significant reductions in white blood cell count (WBC, P < 0.05), neutrophil count (NE, P < 0.001), blood urea nitrogen (BUN, P < 0.001), uric acid (P < 0.001), and creatinine (P < 0.001) compared with preoperative values. Albumin levels increased slightly (P > 0.05), while prealbumin levels rose significantly (P < 0.001). Pain scores assessed by the Faces Pain Scale-Revised (FPS-R, P < 0.001) and the Changhai Pain Scale (P < 0.001) also demonstrated marked postoperative declines. Discussion: Surgical management of gouty tophi wounds is associated with favorable wound healing, significant systemic anti-inflammatory and metabolic benefits, and effective pain relief. The low infection rate in ulcerated tophi supports the bacteriostatic role of MSU crystals. Based on these findings, surgical indications include functional impairment, chronic non-healing wounds, refractory pain, and large tophi (>1.5 cm) impeding daily activities. Surgery should be avoided during acute gout flares and in high-risk patients with uncontrolled comorbidities.
C1 [Xiao, Weihao; Ming, Xingchen; Huang, Yuxi; Li, Jiaxuan; Jiao, Qiqi; Yang, Jian; Zheng, Linyang; Zeng, Yunfu; Wang, Rong; Cheng, Shaowen; Bian, Yangyang; Yao, Jiangling] Hainan Med Univ, Dept Wound Repair ,Affiliated Hosp 1, Key Lab Emergency & Trauma,Minist Educ, Key Lab Hainan Trauma & Disaster Rescue, Haikou, Peoples R China.
C3 Hainan Medical University
RP Yao, JL (通讯作者)，Hainan Med Univ, Dept Wound Repair ,Affiliated Hosp 1, Key Lab Emergency & Trauma,Minist Educ, Key Lab Hainan Trauma & Disaster Rescue, Haikou, Peoples R China.
EM yaojiangling917@126.com
FU Hainan Provincial Natural Science Foundation of China [822QN463]; Joint
   Program on Health Science & Technology Innovation of Hainan Province
   [WSJK2025QN076, WSJK2024QN013]; National Natural Science Foundation of
   China [82260373]; Hainan Medical College 2024 Student Innovation and
   Entrepreneurship Training Program [S202511810040,X202411810135]
FX The author(s) declared that financial support was received for this work
   and/or its publication. This work was supported by the Hainan Provincial
   Natural Science Foundation of China (822QN463), and Joint Program on
   Health Science & Technology Innovation of Hainan Province
   (WSJK2025QN076, WSJK2024QN013), National Natural Science Foundation of
   China (82260373), Hainan Medical College 2024 Student Innovation and
   Entrepreneurship Training Program (S202511810040,X202411810135).
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NR 31
TC 0
Z9 0
U1 1
U2 1
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD APR 30
PY 2026
VL 13
AR 1752070
DI 10.3389/fsurg.2026.1752070
EA APR 2026
PG 12
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HY1XX
UT WOS:001765495200001
PM 42147384
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Bakula, B
   Sever, M
   Karacic, A
   Bakula, M
   Grbavac, M
   Romic, I
   Bogut, A
   Zadro, Z
AF Bakula, Branko
   Sever, Marko
   Karacic, Andrija
   Bakula, Mirko
   Grbavac, Martin
   Romic, Ivan
   Bogut, Ante
   Zadro, Zvonko
TI Extensive Abdominal Skin Necrosis Following Anterior Component
   Separation for a Large Ventral Hernia: A Case Report
SO FRONTIERS IN SURGERY
LA English
DT Article
DE hernia recurrence; wound dehiscence; anterior component separation
   (ACS); postoperative complication; skin ischemia
ID INCISIONAL HERNIA; REPAIR
AB Introduction: Hernia surgery is one of the most common operative procedures, performed in about 20 million cases per year all over the world, with ventral hernia accounting for about 30% of the cases. Although the introduction of the anterior component separation (ACS) method, popularized primarily by Oscar Ramirez, has greatly facilitated the closure of the largest abdominal wall defects, the 30-year experience in this technique has pointed to the risk of ischemic skin complications consequential to the major subcutaneous tissue dissection required. The aim of this case presentation of a patient who developed extensive necrosis of the abdominal wall skin following ACS procedure is to emphasize the importance of preserving rectus abdominis perforator blood vessels in order to preserve skin vitality.Case Presentation: We present a case of a 58-year-old female patient with a large recurrent ventral hernia. The hernial defect was closed by placing a large (30 x 25 cm) polypropylene mesh in the retro-rectus space using the Rives-Stoppa technique. To facilitate upper fascia closure ACS according to Ramirez was performed bilaterally. The rectus perforator vessels were not preserved. Recovery of the patient was complicated with the extensive abdominal skin necrosis which was successfully treated with negative pressure wound therapy.Discussion: Transection of the musculocutaneous perforators of the epigastric artery during ACS results with the compromised blood supply of the abdominal skin depending solely upon the intercostal arteries. Skin ischemia following ACS is a serious complication that can be presented with extensive necrosis associated with high morbidity and even mortality, while the treatment is long lasting, complex, and expensive. Considering the ever-increasing prevalence of large ventral hernias, ever greater popularity of the ACS technique, and the growing proportion of surgeons performing large ventral hernia operations independently, we think that the role of preserving perforated rectus vessels has not been emphasized enough. Therefore, the objective of this case study is to stimulate surgeons to preserve skin vascularity and promote it in their routine in order to avoid these severe postoperative complications.
C1 [Bakula, Branko; Sever, Marko; Karacic, Andrija; Grbavac, Martin; Zadro, Zvonko] Univ Hosp Sveti Duh, Dept Surg, Zagreb, Croatia.
   [Bakula, Mirko] Univ Hosp Ctr Zagreb, Dept Urol, Zagreb, Croatia.
   [Romic, Ivan] Univ Hosp Ctr Zagreb, Dept Surg, Zagreb, Croatia.
   [Bogut, Ante] Univ Hosp Mostar, Dept Gastroenterol, Mostar, Bosnia & Herceg.
C3 University of Zagreb; University of Zagreb Hospital; University of
   Zagreb; University of Zagreb Hospital; University of Mostar
RP Bakula, B (通讯作者)，Univ Hosp Sveti Duh, Dept Surg, Zagreb, Croatia.
EM bakulabranko@gmail.com
RI Romic, Ivan/ABF-2138-2021
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NR 25
TC 1
Z9 3
U1 0
U2 6
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD DEC 17
PY 2021
VL 8
AR 779046
DI 10.3389/fsurg.2021.779046
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA YB2BK
UT WOS:000738824300001
PM 34977144
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Manahan, MA
   Buretta, KJ
   Chang, D
   Mithani, SK
   Mallalieu, J
   Shermak, MA
AF Manahan, Michele Ann
   Buretta, Kate J.
   Chang, David
   Mithani, Suhail K.
   Mallalieu, Jesse
   Shermak, Michele A.
TI An Outcomes Analysis of 2142 Breast Reduction Procedures
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE breast reduction; reduction mammaplasty; outcomes analysis
ID BODY-MASS INDEX; POSTOPERATIVE COMPLICATIONS; PEDICLE LENGTH;
   MAMMAPLASTY; SMOKING; SURGERY; OBESITY; RECONSTRUCTION; SATISFACTION;
   MASTOPEXY
AB Background: Breast reduction alleviates macromastia symptoms and facilitates symmetrical breast reconstruction after cancer treatment. We investigated a large series of consecutive breast reductions to study important factors that impact outcomes.
   Methods: An institutional review board-approved, retrospective review of all breast reductions from 1999 to 2009 in a single institution was performed using the medical record for demographics, medical history, physical examination, intraoperative data, and postoperative complications. Multivariate statistical analysis was performed using Stata 1.0. P <= 0.05 defined significance. Results: Seventeen surgeons performed 2152 consecutive breast reductions on 1148 patients using inferior pedicle/Wise pattern (56.4%), medial pedicle/Wise pattern (16.8%), superior pedicle/nipple graft/Wise pattern (15.1%), superior pedicle/vertical pattern (11.6%), and liposuction (0.1%) techniques. Complications included discernible scars (14.5%), nonsurgical wounds (13.5%), fat necrosis (8.2%), infection (7.3%), wounds requiring negative pressure wound therapy or reoperation (1.4%), and seroma (1.2%). Reoperation rates were 6.7% for scars, 1.4% for fat necrosis, and 1% for wounds.
   Body mass index greater than or equal to 35 kg/m(2) increased risk of infections [odds ratio (OR), 2.3, P = 0.000], seromas (OR, 2.9, P = 0.03), fat necrosis (OR, 2.0, P = 0.002), and minor wounds (OR, 1.7, P = 0.001). Cardiac disease increased reoperation for scar (OR, 3.0, P = 0.04) and fat necrosis (OR, 5.3, P = 0.03). Tobacco use increased infection rate (OR, 2.1, P = 0.008). Secondary surgery increased seromas (OR, 12.0, P = 0.001). Previous hysterectomy/ oophorectomy increased risk of wound reoperations (OR, 3.4, P = 0.02), and exogenous hormone supplementation trended toward decreasing infections (OR, 0.5, P = 0.08). chi(2) analysis revealed 7.8% infection risk without exogenous hormone versus 3.8% risk with hormone supplementation (P = 0.02).
   Conclusions: Morbid obesity, tobacco, cardiac history, and secondary surgery negatively impacted breast reduction outcomes. Hormonal status impacted reoperations and infections.
C1 [Manahan, Michele Ann; Buretta, Kate J.; Mallalieu, Jesse; Shermak, Michele A.] Johns Hopkins Med Inst, Dept Plast Surg, Baltimore, MD 21287 USA.
   [Chang, David] Univ San Diego, Dept Surg, San Diego, CA 92110 USA.
   [Mithani, Suhail K.] Duke Univ, Dept Plast Surg, Durham, NC USA.
C3 Johns Hopkins University; Johns Hopkins Medicine; University of San
   Diego; Duke University
RP Manahan, MA (通讯作者)，Johns Hopkins Med Inst, Dept Plast Surg, 601 N Caroline St, Baltimore, MD 21287 USA.
EM mmanahan@jhmi.edu
RI Mithani, Suhail/LBH-9657-2024
OI Mithani, Suhail/0000-0002-3762-0831
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NR 45
TC 65
Z9 70
U1 0
U2 10
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD MAR
PY 2015
VL 74
IS 3
BP 289
EP 292
DI 10.1097/SAP.0b013e31829d2261
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA CB5PC
UT WOS:000349678900006
PM 25668497
DA 2026-07-24
ER

PT J
AU Ainslie-Garcia, M
   Anderson, LA
   Bloch, BV
   Board, TN
   Chen, AF
   Craigie, S
   Danker, W
   Gunja, N
   Harty, J
   Hernandez, VH
   Lebedeva, K
   Mont, MA
   Nunley, RM
   Parvizi, J
   Perka, C
   Piuzzi, NS
   Rolfson, O
   Rychlik, J
   Romanini, E
   Sanz-Ruiz, P
   Sierra, RJ
   Suleiman, L
   Tsiridis, E
   Vendittoli, PA
   Wangen, H
   Zagra, L
AF Ainslie-Garcia, Margaret
   Anderson, Lucas A.
   V. Bloch, Benjamin
   Board, Tim N.
   Chen, Antonia F.
   Craigie, Samantha
   Danker, Walter
   Gunja, Najmuddin
   Harty, James
   Hernandez, Victor H.
   Lebedeva, Kate
   Mont, Michael A.
   Nunley, Ryan M.
   Parvizi, Javad
   Perka, Carsten
   Piuzzi, Nicolas S.
   Rolfson, Ola
   Rychlik, Joshua
   Romanini, Emilio
   Sanz-Ruiz, Pablo
   Sierra, Rafael J.
   Suleiman, Linda
   Tsiridis, Eleftherios
   Vendittoli, Pascal-Andre
   Wangen, Helge
   Zagra, Luigi
TI International Delphi Study on Wound Closure and Dressing Management in
   Joint Arthroplasty: Part 1: Total Knee Arthroplasty
SO JOURNAL OF ARTHROPLASTY
LA English
DT Article
DE total knee arthroplasty; wound closure techniques; dressing management;
   Delphi study; surgical best practices; venous thromboembolism
   prophylaxis
ID RISK CALCULATOR; TOTAL HIP; INFECTION; READMISSION; CONSENSUS; BURDEN
AB Background: The purpose of this modified Delphi study was to obtain consensus on wound closure and dressing management in total knee arthroplasty (TKA). Methods: The Delphi panel included 20 orthopaedic surgeons from Europe and North America. There were 26 statements identified using a targeted literature review. Consensus was developed for the statements with up to three rounds of anonymous voting per topic. Panelists ranked their agreement with each statement on a five-point Likert scale. An a priori threshold of >= 75% was required for consensus. Results: All 26 statements achieved consensus after three rounds of anonymous voting. Wound closure- related interventions that were recommended for use in TKA included: 1) closing in semi -flexion versus extension (superior range of motion); 2) using aspirin for venous thromboembolism prophylaxis over other agents (reduces wound complications); 3) barbed sutures over non-barbed sutures (lower wound complications, better cosmetic appearances, shorter closing times, and overall cost savings); 4) mesh- adhesives over other skin closure methods (lower wound complications, higher patient satisfaction scores, lower rates of readmission); 5) silver-impregnated dressings over standard dressings (lower wound complications, decreased infections, fewer dressing changes); 6) in high -risk patients, negative pressure wound therapy over other dressings (lower wound complications, decreased reoperations, fewer dressing changes); and 7) using triclosan-coated over non-antimicrobial-coated sutures (lower risks of surgical site infection). Conclusions: Using a modified Delphi approach, the panel achieved consensus on 26 statements per- taining to wound closure and dressing management in TKA. This study forms the basis for identifying critical evidence supported by clinical practice for wound management to help reduce variability, advance standardization, and ultimately improve outcomes during TKA. The results presented here can serve as the foundation for knowledge, education, and improved clinical outcomes for surgeons per- forming TKAs. (c) 2024 The Authors. Published by Elsevier Inc. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
C1 [Ainslie-Garcia, Margaret; Craigie, Samantha; Lebedeva, Kate; Rychlik, Joshua] EVERSANA, Dept Value & Evidence, Burlington, ON, Canada.
   [Anderson, Lucas A.] Univ Utah, Orthopaed Ctr, Dept Orthopaed, Salt Lake City, UT USA.
   [V. Bloch, Benjamin] City Hosp, Nottingham Elect Orthopaed Serv, Nottingham, England.
   [Board, Tim N.] Wrightington Hosp, Ctr Hip Surg, Orthopaed, Wigan, England.
   [Chen, Antonia F.] Harvard Med Sch, Brigham & Womens Hosp, Dept Orthopaed Surg, Boston, MA USA.
   [Danker, Walter; Gunja, Najmuddin] J&J MedTech, Hlth Econ & Market Access, Raritan, NJ USA.
   [Harty, James] Cork Univ Hosp, Trauma & Orthopaed Dept, Cork, Ireland.
   [Hernandez, Victor H.] Univ Miami, Jackson Mem Hosp, Dept Orthopaed Surg & Rehabil, Miami, FL USA.
   [Mont, Michael A.] Sinai Hosp Baltimore, LifeBridge Hlth, Rubin Inst Adv Orthoped, Baltimore, MD USA.
   [Nunley, Ryan M.] Washington Univ, Dept Orthopaed Surg, St Louis, MO USA.
   [Parvizi, Javad] Thomas Jefferson Univ, Rothman Inst, Dept Orthopaed, Philadelphia, PA USA.
   [Perka, Carsten] Ctr Muskuloskeletale Chirurg, Orthopad Univ Klin Charite, Berlin, Germany.
   [Piuzzi, Nicolas S.] Cleveland Clin Fdn, Dept Orthoped Surg, Cleveland, OH USA.
   [Rolfson, Ola] Univ Gothenburg, Inst Clin Sci, Sahlgrenska Acad, Dept Orthopead, Gothenburg, Sweden.
   [Romanini, Emilio] Polo Sanit San Feliciano, Ctr Hip & Knee Arthroplasty, Rome, Italy.
   [Sanz-Ruiz, Pablo] Univ Complutense Madrid, Fac Med, Dept Surg, Madrid, Spain.
   [Sierra, Rafael J.] Mayo Clin, Dept Orthoped Surg, Rochester, MN USA.
   [Suleiman, Linda] Northwestern Univ, Feinberg Sch Med, Dept Orthopaed Surg, Chicago, IL USA.
   [Tsiridis, Eleftherios] Aristotle Univ Thessaloniki, Gen Hosp Papageorgiou, Med Sch, Acad Orthoped Unit, Thessaloniki, Greece.
   [Vendittoli, Pascal-Andre] Univ Montreal, Maisonneuve Rosemont Hosp, Dept Surg, Montreal, PQ, Canada.
   [Wangen, Helge] Innlandet Hosp Trust, Dept Orthopaed Surg, Elverum, Norway.
   [Zagra, Luigi] IRCCS Ist Ortoped Galeazzi, Hip Dept, Milan, Italy.
C3 Utah System of Higher Education; University of Utah; University of
   Nottingham; Harvard University; Harvard Medical School; Harvard
   University Medical Affiliates; Brigham & Women's Hospital; University
   College Cork; University of Miami; Sinai Hospital of Baltimore;
   Washington University (WUSTL); Thomas Jefferson University; Rothman
   Institute; Free University of Berlin; Humboldt University of Berlin;
   Charite Universitatsmedizin Berlin; Cleveland Clinic Foundation;
   University of Gothenburg; Complutense University of Madrid; Mayo Clinic;
   Northwestern University; Feinberg School of Medicine; Papageorgiou
   Hospital; Aristotle University of Thessaloniki; Universite de Montreal;
   Innlandet Hospital Trust; IRCCS Istituto Ortopedico Galeazzi
RP Mont, MA (通讯作者)，Sinai Hosp Baltimore, Rubin Inst Adv Orthoped, 2401 West Belvedere Ave, Baltimore, MD 21215 USA.
RI ; Danker III, Walter/AAP-5078-2020; Perka, Carsten/ABG-6505-2021;
   sanz-ruiz, pablo/H-6539-2015; Rolfson, Ola/AAT-2206-2020; Vendittoli,
   Pascal-Andre/J-9621-2013; Bloch, Benjamin/I-1041-2019; /I-9296-2019;
   Zagra, Luigi/PFZ-1383-2026; Hernandez, Victor H/AAG-4458-2020
OI Piuzzi, Nicolas S/0000-0003-3007-7538; Danker III,
   Walter/0000-0002-9741-5821; Perka, Carsten/0000-0002-0993-581X;
   sanz-ruiz, pablo/0000-0002-7588-1880; Bloch,
   Benjamin/0000-0002-2305-7478; Hernandez, Victor H/0000-0003-1745-3324
FU Cincinnati, Ohio
FX We wish to thank Ethicon, Cincinnati, Ohio for the support of this
   project. Special thanks to Stephanie Leon. We would also like to thank
   CRG-EVERSANA, Burlington, Ontario, Canada, for their assistance.
CR Antonelli B, 2019, ARTHROPLASTY, V1, DOI 10.1186/s42836-019-0003-7
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   Tan TL, 2018, J BONE JOINT SURG AM, V100, P777, DOI 10.2106/JBJS.16.01435
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   Zmistowski B, 2013, J BONE JOINT SURG AM, V95A, P1869, DOI 10.2106/JBJS.L.00679
NR 28
TC 13
Z9 17
U1 1
U2 4
PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
PI PHILADELPHIA
PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA
SN 0883-5403
EI 1532-8406
J9 J ARTHROPLASTY
JI J. Arthroplast.
PD APR
PY 2024
VL 39
IS 4
BP 878
EP 883
DI 10.1016/j.arth.2023.12.032
EA MAR 2024
PG 6
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA OS2Q3
UT WOS:001209203400001
PM 38244638
OA hybrid
DA 2026-07-24
ER

PT J
AU Rather, AA
   Fisher, AL
   Chun, D
   Mannion, JD
   Alexander, EL
AF Rather, Assar A.
   Fisher, Adrianne L.
   Chun, Dain
   Mannion, John D.
   Alexander, Edward L.
TI Closed Incisional Negative Pressure Therapy Reduces Perineal Wound
   Complications After Abdominoperineal Resection
SO DISEASES OF THE COLON & RECTUM
LA English
DT Article; Proceedings Paper
CT Annual Scientific Meeting of the
   American-Society-of-Colon-and-Rectal-Surgeons
CY MAY 19-23, 2018
CL Nashville, TN
SP Amer Soc Colon & Rectal Surg
DE Abdominoperineal resection; Closed incision negative pressure therapy;
   Perineal wound complications
ID VACUUM-ASSISTED CLOSURE; RECTAL-CANCER; RISK-FACTORS; IMPACT; DECREASES
AB BACKGROUND: Perineal wound complications after abdominoperineal resection continue to be a significant challenge. Complications, ranging from 14% up to 60%, prolong hospitalization, increase risk of readmission and reoperation, delay the start of adjuvant therapy, and place psychological stress on the patient and family.
   OBJECTIVE: This study aimed to evaluate the impact of closed incision negative pressure therapy on perineal wound healing.
   DESIGN: This was a retrospective study.
   SETTINGS: The study was conducted in an academic community hospital.
   PATIENTS: Patients who underwent abdominoperineal resection from 2012 to 2020 were included.
   MAIN OUTCOME MEASURES: Perineal wound complications within 30 and 180 days were the primary outcome measures.
   RESULTS: A total of 45 patients were included in the study. Of these, 31 patients were managed with closed incision negative pressure therapy. The overall perineal wound complications were less frequent in the closed incision negative pressure therapy group (10/31; 32.2%) compared to the control group (10/14; 71.4%; chi(2)(1) = 5.99 [p = 0.01]). In the closed incision negative pressure therapy group, 2 patients (20%) did not heal within 180 days and no patient required reoperation or readmission. In the control group, 4 patients (44%) had not healed at 180 days and 1 patient required flap reconstruction. When the effect of other variables was controlled, closed incision negative pressure therapy resulted in an 85% decrease in the odds of wound complications (adjusted OR 0.15 [95% CI, 0.03-0.60]; p = 0.01).
   LIMITATIONS: The nonrandomized nature and use of historical controls in this study are its limitations.
   CONCLUSIONS: The ease of application and the overall reduction in the incidence and severity of complications may offer an option for perineal wound management and possibly obviate the need for more expensive therapies. Further prospective controlled trials are required to effectively study its efficacy. See Video Abstract at http:// links.lww.com/DCR/B895.
C1 [Rather, Assar A.; Chun, Dain] Bayhealth Med Ctr, Grad Med Educ Dept, Dover, DE USA.
   [Rather, Assar A.; Fisher, Adrianne L.; Mannion, John D.; Alexander, Edward L.] Bayhealth Med Ctr, Dept Surg, Dover, DE USA.
   [Rather, Assar A.] Bayhealth Med Ctr, Grad Med Educ Dept, Mail Code 3007,640 S State St, Dover, DE 19901 USA.
RP Rather, AA (通讯作者)，Bayhealth Med Ctr, Grad Med Educ Dept, Mail Code 3007,640 S State St, Dover, DE 19901 USA.
EM Assar_Rather@bayhealth.org
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 27
TC 3
Z9 3
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0012-3706
EI 1530-0358
J9 DIS COLON RECTUM
JI Dis. Colon Rectum
PD FEB
PY 2023
VL 66
IS 2
BP 314
EP 321
DI 10.1097/DCR.0000000000002289
PG 8
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Gastroenterology & Hepatology; Surgery
GA L3BA4
UT WOS:001022032900027
PM 35001048
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Fries, CA
   Jeffery, SLA
   Kay, AR
AF Fries, C. A.
   Jeffery, S. L. A.
   Kay, A. R.
TI Topical negative pressure and military wounds-A review of the evidence
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Review
DE Topical negative pressure; Military wounds; Trauma; Debridement
ID VACUUM-ASSISTED CLOSURE; RANDOMIZED-TRIAL; THERAPY; MANAGEMENT
AB Background: Topical negative pressure (TNP) has been used as a method of wound management for some years. Use of TNP is accepted best practice at Role 4. There are advocates of using TNP after initial wound surgery at Role 3 or 2E. The evidence to support forward use of TNP is not comprehensive, especially when considering this narrow cohort of patients and injury pattern. It is the aim of this review to evaluate the current evidence for the use of TNP in all wounds, and to find what evidence there is that may be applicable to military wounds.
   Methods: A literature search of Cinahl, Embase, Medline, ProQuest and the Cochrane Library was conducted; references were cross-referenced. All Randomised Controlled Trials (RCTs) were included in all languages over a comprehensive time period. An interim review was conducted by the Wound Management Working Group of the Academic Department of Military Surgery and Trauma. A further literature review was conducted to find all papers relating to the use of TNP on military wounds.
   Results: 17 reports were reviewed relating to 14 studies including 662 patients. Of these 131 were reported to have had traumatic injuries. Significant results were reported with respect to time to wound healing, patient comfort and reduction in wound volumes. Bacterial load was not affected, in the 3 trials which commented on this, but in 1 there was a significant reduction in wound infections in the TNP group. Several of the trials were small, methodology was not consistent therefore no meta-analysis was possible. 2 papers were found describing case series of military patients being treated with TNP.
   Conclusions: There is very little published evidence in the form of RCTs to support the use of TNP in the acute traumatic military setting. This review supports the requirement for further investigation to evaluate whether this method of wound management has a place forward of Role 4. (C) 2010 Elsevier Ltd. All rights reserved.
C1 [Fries, C. A.; Jeffery, S. L. A.] Selly Oak Hosp, Dept Burns & Plast Surg, Birmingham B29 6JD, W Midlands, England.
   [Kay, A. R.] Frenchay Hosp, Burns Ctr, Bristol BS16 1LE, Avon, England.
RP Fries, CA (通讯作者)，Flat 2,190 Harborne Rd, Birmingham B15 3JJ, W Midlands, England.
EM antonfries@gmail.com
RI jeffery, steven/A-5207-2013; Fries, Charles/LZG-4990-2025
OI jeffery, steven/0000-0001-6587-5412; 
CR Apelqvist J, 2008, AM J SURG, V195, P782, DOI 10.1016/j.amjsurg.2007.06.023
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   MORYKWAS MJ, 2007, ANN PLAST SURG, V38, P553
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NR 24
TC 17
Z9 19
U1 0
U2 7
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD MAY
PY 2011
VL 42
IS 5
BP 436
EP 440
DI 10.1016/j.injury.2010.02.027
PG 5
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA 743XQ
UT WOS:000289053200002
PM 20362982
DA 2026-07-24
ER

PT J
AU Grimm, A
   Dimmler, A
   Stange, S
   Labanaris, A
   Sauer, R
   Grabenbauer, G
   Horch, RE
AF Grimm, Andreas
   Dimmler, Arno
   Stange, Sebastian
   Labanaris, Apostolos
   Sauer, Rolf
   Grabenbauer, Gerhard
   Horch, Raymund E.
TI Expression of HIF-1α in irradiated tissue is altered by topical
   negative-pressure therapy
SO STRAHLENTHERAPIE UND ONKOLOGIE
LA English
DT Article
DE irradiation; tissue oxygenation; topical negative-pressure therapy;
   HIF-1 alpha
ID VACUUM-ASSISTED CLOSURE; SMOOTH-MUSCLE-CELLS; ENDOTHELIAL GROWTH-FACTOR;
   INDUCIBLE FACTOR-I; RECONSTRUCTIVE SURGERY; WOUND CONTROL; NECK-SURGERY;
   HYPOXIA; FLAPS; VASCULARIZATION
AB Background and Purpose: Despite the enormous therapeutic potential of modern radiotherapy, common side effects such as radiation-induced wound healing disorders remain a well-known clinical phenomenon. Topical negative pressure therapy (TNP) is a novel tool to alleviate intraoperative, percutaneous irradiation or brachytherapy. Since TNP has been shown to positively influence the perfusion of chronic, poorly vascularized wounds, the authors applied this therapeutic method to irradiated wounds and investigated the effect on tissue oxygenation in irradiated tissue in five patients.
   Material and Methods: With informed patients' consent, samples prior to and 4 and 8 days after continuous TNP with -125 mmHg were obtained during routine wound debridements. Granulation tissue was stained with hematoxylin-eosin, and additionally with CD31, HIF-1 alpha (hypoxia-inducible factor-1 alpha), and D2-40 to detect blood vessels, measure indirect signs of hypoxia, and lymph vessel distribution within the pre- and post-TNP samples.
   Results: In this first series of experiments, a positive influence of TNP onto tissue oxygenation in radiation-induced wounds could be demonstrated. TNP led to a significant decrease of 53% HIF-1 alpha-positive cell nuclei. At the same time, a slight reduction of CD31-stained capillaries was seen in comparison to samples before TNP. Immunostaining with D2-40 revealed an increased number of lymphatic vessels with distended lumina and an alteration of the parallel orientation within the post-TNP samples.
   Conclusion: This study is, to the authors' knowledge, the first report on a novel previously not described histological marker to demonstrate the effects of TNP on HIF-1 alpha expression as an indirect marker of tissue oxygenation in irradiated wounds, as demonstrated by a reduction of HIF-1 alpha concentration after TNP. Since this observation may be of significant value to develop possible new strategies to treat radiation-induced tissue injury, further investigations of HIF-1 alpha regulation under TNP are warranted.
C1 Univ Erlangen Nurnberg, Dept Plast & Hand Surg, D-91054 Erlangen, Germany.
   Univ Erlangen Nurnberg, Dept Pathol, D-91054 Erlangen, Germany.
   Univ Erlangen Nurnberg, Dept Radiat Oncol, D-91054 Erlangen, Germany.
C3 University of Erlangen Nuremberg; University of Erlangen Nuremberg;
   University of Erlangen Nuremberg
RP Horch, RE (通讯作者)，Univ Erlangen Nurnberg, Dept Plast & Hand Surg, Krankenhausstr 12, D-91054 Erlangen, Germany.
EM Raymund.Horch@chir.imed.uni-erlangen.de
RI Horch, Raymund E/H-8128-2019
OI Horch, Raymund E/0000-0002-6561-2353
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 44
TC 24
Z9 26
U1 0
U2 3
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0179-7158
EI 1439-099X
J9 STRAHLENTHER ONKOL
JI Strahlenther. Onkol.
PD MAR
PY 2007
VL 183
IS 3
BP 144
EP 149
DI 10.1007/s00066-007-1560-1
PG 6
WC Oncology; Radiology, Nuclear Medicine & Medical Imaging
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Radiology, Nuclear Medicine & Medical Imaging
GA 143MC
UT WOS:000244725200006
PM 17340073
DA 2026-07-24
ER

PT J
AU Ratnam, BV
AF Ratnam, B. Venkata
TI Adjustable suture technique based on viscoelastic properties of skin for
   direct closure of a defect after abdominoplasty flap necrosis
SO AESTHETIC PLASTIC SURGERY
LA English
DT Letter
ID WOUND CLOSURE; TRACTION; DEVICE
AB A female abdominoplasty patient with significant associated comorbid factors got terribly upset and apprehensive because of her wound complication. She refused all the existing methods of treatment for closure of her wound. However, invocation of viscoclastic skin properties resulted in direct closure of the wound by gradual pull on the flaps in the required directions using adjustable sutures. The technique is presented because of its usefulness, simplicity, safety, and reproducibility.
   A 35-year-old, morbidly obese, diabetic woman presented with wound dehiscence, infection with Pseudomonas aeruginosa, and marginal necrosis of the inverted "T" closure flaps of her abdominoplasty wound, which had been performed I week earlier (Fig. 1). She refused skin grafting or the use of appliances such as vacuum-assisted closure [1], wires [2,7], frames [3,6] or clips [4] to close the wound. The nature and geometry of the resultant wound after slough excision and wound debridement included the following: center dot Thickened, retracted, stiff, and relatively immobile flaps because of edema, induration, and fibrosis center dot Attainment of direct closure requiring inferomedial flap movements of about 7 cm on the left side and 3 cm on the right side center dot Excessive mobilization of the skin over the mons pubis distorting the external genitalia center dot Risky use of inflatable tissue expanders because of an open wound.
   Using number 1 polypropylene (Prolene; Ethicon, Johnson & Johnson Int'l, Brussels, Belgium) suturematerial, one horizontal mattress suture was applied between each flap and the opposite side of the suprapubic skin, then tied over sterile dental rolls using a "shoelace" type of removable knots, as shown in Fig. 2. On alternate days, after the wound had been cleaned, the dental rolls were changed and the sutures were tightened within the comfort limit of the patient, with relatively more force on the left flap. In the course of about 2 weeks, the flaps got approximated, and the wound was closed with intermittent sutures over a suction drain (Fig. 3). Further wound healing was uneventful (Fig. 4).
C1 New Med Ctr Hosp, Dept Plast Surg, Abu Dhabi, U Arab Emirates.
RP Ratnam, BV (通讯作者)，New Med Ctr Hosp, Dept Plast Surg, POB 46222, Abu Dhabi, U Arab Emirates.
EM bvratnam@emirates.net.ae
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   BASHIR AH, 1987, BRIT J PLAST SURG, V40, P582, DOI 10.1016/0007-1226(87)90151-2
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NR 7
TC 0
Z9 0
U1 0
U2 2
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0364-216X
J9 AESTHET PLAST SURG
JI Aesthet. Plast. Surg.
PD JUL-AUG
PY 2006
VL 30
IS 4
BP 497
EP 499
DI 10.1007/s00266-006-0051-6
PG 3
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 076MD
UT WOS:000239961500027
PM 16855885
DA 2026-07-24
ER

PT J
AU Li, RG
   Zeng, CJ
   Yuan, S
   Hu, JJ
   Zhang, P
   Chen, YBA
   Zhao, SW
   Ren, GH
AF Li, Run-guang
   Zeng, Can-jun
   Yuan, Song
   Hu, Ji-jie
   Zhang, Ping
   Chen, Yun-biao
   Zhao, Shan-wen
   Ren, Gao-hong
TI Reconstruction of Large Area of Deep Wound in the Foot and Ankle with
   Chimeric Anterolateral Thigh Perforator Flap
SO ORTHOPAEDIC SURGERY
LA English
DT Article
DE Free tissue flaps; Perforator flap; Soft tissue injuries; Wound closure
   techniques; Transplantation chimera
ID VACUUM SEALING DRAINAGE; SOFT-TISSUE DEFECTS; MICROSURGICAL
   RECONSTRUCTION; VASCULAR ANATOMY; TRANSPLANTATION; VARIABILITY; THERAPY
AB Objective To evaluate the clinical application and surgical efficacy of the chimeric perforator flap pedicled with the descending branch of the lateral circumflex femoral artery and the lateral thigh muscle flap for the reconstruction of the large area of deep wound in foot and ankle.
   Methods Clinical data of 32 cases who underwent chimeric anterolateral thigh perforator flap to repair the large area of deep wound of the foot and ankle from January 2015 to December 2018 were retrospectively analyzed. The sizes of the defects ranged from 18 cm x 10 cm to 35 cm x 20 cm, with exposed tendon and bone and/or partial defects and necrosis, contaminations, accompanied by different degrees of infection. Following the radical debridement and VSD, chimeric anterolateral thigh perforator flap was employed to repair the deep wounds according to the position, site and deep-tissue injury of the soft-tissue defects. The skin flap and muscle flap were fanned out on the wound, and single- or two-staged split-thickness skin grafting was performed on the muscle flap. The operation time and blood loss were recorded. The survival and healing conditions of the operational site with chimeric anterolateral thigh perforator flap were evaluated post-operationally. Complications at both recipient site and donor site were carefully recorded.
   Results The mean time of the operation was 325.5 min and average blood loss was 424.8 mL. Among the 32 cases, two cases developed vascular crisis, which were alleviated with intensive investigation and treatment; Four cases suffered from partial necrosis of the flap or skin graft on the muscle flap or on the residual local wound, which were improved after treatment of further dressing change and skin grafting. Another four cases experienced post-traumatic osteomyelitis accompanied by bone defect were treated with simple bone grafting or Mesquelet bone grafting at 6-8 months after wound healing. Postoperatively, the wounds were properly healed, and the infection was effectively controlled without sinus tract forming. Overall, all 32 cases received satisfactory efficacy, without influencing subsequent functional reconstruction, and observed infection during the 12-36 months post-operational follow-up.
   Conclusion The chimeric perforator flap pedicled with the descending branch of the lateral circumflex femoral artery and the lateral thigh muscle flap provides an effective and relative safe procedure for the repair of a large area of deep wound in the foot and ankle, particularly with irregular defect or deep dead space.
C1 [Li, Run-guang; Zeng, Can-jun; Zhao, Shan-wen] Southern Med Univ, Ctr Orthopaed Surg, Dept Foot & Ankle Surg, Affiliated Hosp 3, Guangzhou, Peoples R China.
   [Li, Run-guang; Zeng, Can-jun; Zhao, Shan-wen] Orthopaed Hosp Guangdong Prov, Guangzhou, Peoples R China.
   [Li, Run-guang; Zeng, Can-jun; Zhao, Shan-wen] Acad Orthopaed, Guangzhou, Guangdong, Peoples R China.
   [Li, Run-guang; Zeng, Can-jun; Zhao, Shan-wen] Guangdong Prov Key Lab Bone & Joint Degenerat Dis, Guangzhou, Peoples R China.
   [Hu, Ji-jie; Zhang, Ping; Chen, Yun-biao; Ren, Gao-hong] Southern Med Univ, Nanfang Hosp, Dept Orthopaed, Div Orthopaed & Traumatol, Guangzhou 511700, Peoples R China.
   [Hu, Ji-jie; Zhang, Ping; Chen, Yun-biao; Ren, Gao-hong] Southern Med Univ, Nanfang Hosp, Guangdong Prov Key Lab Bone & Cartilage Regenerat, Guangzhou, Peoples R China.
   [Li, Run-guang; Yuan, Song] Linzhi Peoples Hosp, Dept Orthoped, Linzhi, Peoples R China.
C3 Southern Medical University - China; Southern Medical University -
   China; Southern Medical University - China
RP Ren, GH (通讯作者)，Southern Med Univ, Nanfang Hosp, Dept Orthopaed, Div Orthopaed & Traumatol, Guangzhou 511700, Peoples R China.; Ren, GH (通讯作者)，Southern Med Univ, Nanfang Hosp, Key Lab Bone & Cartilage Regenerat Med, Guangzhou 511700, Peoples R China.
EM doctor020@163.com
RI ; Zeng, CanJun/AHC-5294-2022
OI Runguang, Li/0000-0002-4703-7180; 
FU Clinical Research Program of Nanfang Hospital, Southern Medical
   University [2020CR008]; Shanghai Wang Zhengguo Trauma Medical
   Development Foundation [2017KJB-GK-001]; National Natural Science
   Foundation of China [81101366]; Natural Science Foundation of Guangdong
   Province [2018A030313640, 2019A1515012176]
FX This work was supported by Clinical Research Program of Nanfang
   Hospital, Southern Medical University (2020CR008); Shanghai Wang
   Zhengguo Trauma Medical Development Foundation (2017KJB-GK-001) and the
   National Natural Science Foundation of China (81101366), Natural Science
   Foundation of Guangdong Province (Approval no. 2018A030313640,
   2019A1515012176).
CR Ando J, 2019, CASE REP PLAST SURG, V6, P82, DOI 10.1080/23320885.2019.1635023
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NR 32
TC 19
Z9 29
U1 0
U2 6
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1757-7853
EI 1757-7861
J9 ORTHOP SURG
JI Orthop. Surg.
PD JUL
PY 2021
VL 13
IS 5
BP 1609
EP 1617
DI 10.1111/os.13046
EA JUN 2021
PG 9
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA TR6KS
UT WOS:000662735000001
PM 34142464
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Fair, L
   Ward, M
   Vankina, M
   Rana, R
   McGowan, T
   Ogola, G
   Aladegbami, B
   Leeds, S
AF Fair, Lucas
   Ward, Marc
   Vankina, Meghana
   Rana, Rashmeen
   McGowan, Titus
   Ogola, Gerald
   Aladegbami, Bola
   Leeds, Steven
TI Comparison of long-term quality of life outcomes between endoscopic
   vacuum therapy and other treatments for upper gastrointestinal leaks
SO SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES
LA English
DT Article
DE Endoscopic vacuum therapy; EVAC; Endoluminal vacuum therapy; EVT;
   Quality of life; Gastrointestinal complications
ID SLEEVE GASTRECTOMY; ADVANCING AGE; ESOPHAGECTOMY; JEJUNOSTOMY;
   MANAGEMENT; IMPACT
AB Background While endoscopic vacuum assisted closure (EVAC) therapy is a validated treatment for gastrointestinal leaks, its impact on long-term quality of life (QoL) is uncertain. The purpose of this study was to evaluate the impact of successful EVAC management on long-term QoL outcomes.Methods An institutional review board approved prospectively maintained database was retrospectively reviewed to identify patients undergoing treatment for gastrointestinal leaks between June 2012 and July 2022. The Short-Form 36 (SF-36) survey was used to assess QoL. Patients were contacted by telephone and sent the survey electronically. QoL outcomes between patients who underwent successful EVAC therapy and those who required conventional treatment (CT) were analyzed and compared.Results A total of 44 patients (17 EVAC; 27 CT) completed the survey and were included in our analysis. All included patients had foregut leaks with sleeve gastrectomy being the most common sentinel operation (n = 20). The mean time from the sentinel operation was 3.8 years and 4.8 years for the EVAC and CT groups, respectively. When evaluating long-term QoL, the EVAC group scored higher in all QoL domains when compared to the CT group with physical functioning (87.3 vs 69.3, p = 0.04), role limitations due to physical health (84.1 vs 45.7, p = 0.02), energy/fatigue (60.0 vs 40.9, p = 0.04), and social functioning (86.2 vs 64.1, p = 0.04) reaching statistical significance. Overall, patients who achieved organ preservation via successful EVAC therapy scored higher in all domains with role limitations due to physical health (p = 0.04) being statistically significant. In a multivariable regression analysis, increased age and a history of prior abdominal surgery at the time of the sentinel operation were patient characteristics that negatively impacted QoL outcomes.Conclusion Patients with gastrointestinal leaks successfully managed by EVAC therapy have better long-term QoL outcomes when compared to patients undergoing other treatments.
   [GRAPHICS]
C1 [Fair, Lucas; Ward, Marc; Aladegbami, Bola; Leeds, Steven] Baylor Univ, Dept Minimally Invas Surg, Med Ctr, 3417 Gaston Ave,Suite 965, Dallas, TX 75246 USA.
   [Fair, Lucas; Ward, Marc; Aladegbami, Bola; Leeds, Steven] Baylor Scott & White Hlth, Ctr Adv Surg, Dallas, TX 75246 USA.
   [Ward, Marc; Vankina, Meghana; Aladegbami, Bola; Leeds, Steven] Texas A&M Coll Med, Bryan, TX 77807 USA.
   [Fair, Lucas; Rana, Rashmeen; McGowan, Titus; Ogola, Gerald] Baylor Scott & White Hlth, Res Inst, Dallas, TX USA.
C3 Baylor University; Baylor University Medical Center; Baylor Scott &
   White Health; Texas A&M University System; Texas A&M University College
   Station; Texas A&M Health Science Center; Baylor Scott & White Health
RP Leeds, S (通讯作者)，Baylor Univ, Dept Minimally Invas Surg, Med Ctr, 3417 Gaston Ave,Suite 965, Dallas, TX 75246 USA.; Leeds, S (通讯作者)，Baylor Scott & White Hlth, Ctr Adv Surg, Dallas, TX 75246 USA.; Leeds, S (通讯作者)，Texas A&M Coll Med, Bryan, TX 77807 USA.
EM Steven.leeds@bswhealth.org
RI Rana, Rafquat/AFZ-7483-2022
OI Fair, Lucas/0000-0002-6082-5827; McGowan, Titus/0009-0008-9503-6220
CR Archid R, 2021, OBES SURG, V31, P2511, DOI 10.1007/s11695-021-05287-z
   Aziz M, 2021, ENDOSC INT OPEN, V09, pE1371, DOI 10.1055/a-1508-5947
   Baquero GA, 2015, J GERIATR CARDIOL, V12, P465, DOI 10.11909/j.issn.1671-5411.2015.05.018
   Chao GF, 2022, SURG ENDOSC, V36, P3884, DOI 10.1007/s00464-021-08705-6
   Chouillard E, 2014, SURG ENDOSC, V28, P1954, DOI 10.1007/s00464-014-3424-y
   Chung Y, 2021, CLIN ENDOSC, V54, P805, DOI 10.5946/ce.2020.298
   Dhayat SA, 2019, J GASTROINTEST SURG, V23, P280, DOI 10.1007/s11605-018-4038-9
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   Gajdos C, 2013, J AM GERIATR SOC, V61, P1608, DOI 10.1111/jgs.12401
   Ghoneim MM, 2016, BMC SURG, V16, DOI 10.1186/s12893-016-0120-y
   Gujjuri RR, 2021, DIS ESOPHAGUS, V34, DOI 10.1093/dote/doaa085
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NR 36
TC 3
Z9 3
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0930-2794
EI 1432-2218
J9 SURG ENDOSC
JI Surg. Endosc.
PD AUG
PY 2023
VL 37
IS 8
BP 6538
EP 6547
DI 10.1007/s00464-023-10181-z
EA JUN 2023
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA L4YJ0
UT WOS:001009731600006
PM 37308758
DA 2026-07-24
ER

PT J
AU Liu, DX
   Li, XD
   Wang, H
   Qiu, KF
   Du, SX
AF Liu, Dong-xin
   Li, Xue-dong
   Wang, Hu
   Qiu, Kai-feng
   Du, Shi-xin
TI Reconstruction of total degloving injuries of the foot in children
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Degloving injury; foot; children; flap
ID FREE-FLAP RECONSTRUCTION; VACUUM-ASSISTED CLOSURE
AB BACKGROUND: The aim of this study is to introduce experiences of reconstruction of total degloving injuries of the foot in children.
   METHODS: Seven children, five male and two female, were treated for total degloving injury of the foot at our medical institution between January 2002 and December 2008. Patients were between 5 years and 9 years of age with a mean age of 7 years. All injuries involved the total foot. In cases 1-3, the foot was covered by intermediate split-thickness skin graft. In cases 4-7, the dorsal aspect of the foot was covered by full-thickness skin graft obtained from the degloving flap in emergency operation and the planta aspect of the foot was covered by posteriortibial artery flap in the second operation.
   RESULTS: The mean time to wound healing was 29 days to 50 days in cases 1-3 and 21 days to 28 days in cases 4-7. The posteriortibial artery flaps in cases 4-7 all survived. Both the donor and the recipient site healed successfully. All patients were followed for at least 12 months (range, 12-24 months; mean, 17.9 months). All patients showed insensitivity at the recipient sites. No patient complained of cold intolerance in the foot. Cases 1-3 had pain, deformity, and dysfunction to some extent at follow-up. Cases 4-7 did not exhibit pain, deformity, or dysfunction. All toes were amputated in all cases. Patients 1-3 scored fair or poor on the Maryland Foot Score (two fair, one poor), and patients 4-7 scored either good or fair (three good, one fair).
   CONCLUSION: This method, the dorsal aspect of the foot covered by full-thickness skin and the planta aspect of the foot covered by posteriortibial artery flap, is a good choice for treatment of total degloving injury of foot in children. At the same time, the early exercise should be emphasized for the functional recovery. (J Trauma Acute Care Surg. 2012;73: 209-214. Copyright (C) 2012 by Lippincott Williams & Wilkins)
   LEVEL OF EVIDENCE: Therapeutic study, level IV.
C1 [Liu, Dong-xin; Li, Xue-dong; Wang, Hu; Qiu, Kai-feng; Du, Shi-xin] Shantou Univ, Coll Med, Affiliated Hosp 1, Dept Orthopaed Surg, Shantou 515041, Guangdong, Peoples R China.
C3 Shantou University
RP Du, SX (通讯作者)，Shantou Univ, Coll Med, Affiliated Hosp 1, Dept Orthopaed Surg, 57 Chang Ping Rd, Shantou 515041, Guangdong, Peoples R China.
EM ldx1970@163.com
RI Li, Xuedong/JXM-3413-2024; li, xuedong/JYP-4367-2024
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NR 13
TC 11
Z9 16
U1 0
U2 7
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 2163-0755
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD JUL
PY 2012
VL 73
IS 1
BP 209
EP 214
DI 10.1097/TA.0b013e31824bac22
PG 6
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA 979JU
UT WOS:000306814100031
PM 22743388
DA 2026-07-24
ER

PT J
AU Esen, E
   Grieco, MJ
   Erkan, A
   Aytac, E
   Sutter, AG
   Lynn, PB
   Esterow, J
   Moreira, AD
   Kirat, HT
   Remzi, FH
AF Esen, Eren
   Grieco, Michael J.
   Erkan, Arman
   Aytac, Erman
   Sutter, Alton G.
   Lynn, Patricio Bernardo
   Esterow, Joanna
   da Luz Moreira, Andre
   Kirat, Hasan T.
   Remzi, Feza H.
TI Management, Functional Outcomes, and Quality of Life After Development
   of Pelvic Sepsis in Patients Undergoing Re-Do Ileal Pouch Anal
   Anastomosis
SO DISEASES OF THE COLON & RECTUM
LA English
DT Article
DE Ileal pouch anal anastomosis; Pelvic sepsis; Pouch salvage; Re-do IPAA;
   Ulcerative colitis
ID RESTORATIVE PROCTOCOLECTOMY; SEPTIC COMPLICATIONS; IPAA; SURGERY; LEAK
AB BACKGROUND: The data on management and outcomes of pelvic sepsis after re-do IPAA are scarce.
   OBJECTIVE: The aim of this study is to report our management algorithm of pelvic sepsis in the setting of re-do IPAA and compare functional outcomes and quality of life after successful management of pelvic sepsis with a no sepsis control group.
   DESIGN: This is a retrospective cohort study.
   SETTINGS: This investigation is based on a single academic practice group experience on re-do IPAA.
   PATIENTS: Patients who underwent re-do IPAA for ileal pouch failure between September 2016 and September 2020 were included in the study.
   MAIN OUTCOME MEASURES: Management of pelvic sepsis was reported. Functional outcomes, restrictions, and quality-of-life scores were compared between the sepsis and no sepsis groups.
   RESULTS: One-hundred ten patients were included in our study, of whom 25 (22.7%) developed pelvic sepsis. Twenty-three patients presented with pelvic sepsis before ileostomy closure, and 2 patients presented with pelvic sepsis after ileostomy closure. There were 6 pouch failures in the study period due to pelvic sepsis. Our management was successful in 79% of the patients with median follow-up of 26 months. Treatments included interventional radiology abscess drainage (n = 7), IV antibiotics alone (n = 5), interventional radiology drainage and mushroom catheter placement (n = 1), mushroom catheter placement (n = 1), and endoluminal vacuum-assisted closure (n = 1). Average number of bowel movements, urgency, incontinence, pad use, and seepage were comparable between the pelvic sepsis and no pelvic sepsis groups (p > 0.05). Lifestyle alterations, Cleveland Global Quality of Life scores, and happiness with the results of the surgery were similar (p > 0.05).
   LIMITATIONS: This study is limited by its low study power and limited follow-up time.
   CONCLUSIONS: Pelvic sepsis is common after re-do IPAA, and management varies according to the location and size of the abscess/sinus. If detected early, our management strategy was associated with high pouch salvage rates.
C1 [Esen, Eren; Grieco, Michael J.; Erkan, Arman; Sutter, Alton G.; Lynn, Patricio Bernardo; Esterow, Joanna; da Luz Moreira, Andre; Kirat, Hasan T.; Remzi, Feza H.] New York Univ NYU Langone Hlth, NYU Grossman Sch Med, Ctr Inflammatory Bowel Dis, New York, NY USA.
   [Aytac, Erman] Acibadem Mehmet Ali Aydinlar Univ, Sch Med, Istanbul, Turkey.
C3 Acibadem University
RP Remzi, FH (通讯作者)，NYU Langone Hlth, NYU Grossman Sch Med, Ctr Inflammatory Bowel Dis, 305 33rd St, New York, NY 10016 USA.
EM feza.remzi@nyulangone.org
RI Esen, Eren/AAF-3624-2021; Aytac, Erman/HLW-2224-2023; Erkan,
   Arman/Q-1048-2019; Remzi, Feza/AAE-6584-2022; Sutter,
   Alton/GWV-3369-2022
CR Aydinli HH, 2020, DIS COLON RECTUM, V63, P1102, DOI 10.1097/DCR.0000000000001609
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   Chessin DB, 2008, DIS COLON RECTUM, V51, P1312, DOI 10.1007/s10350-008-9413-2
   Esen E, 2021, J LAPAROENDOSC ADV S, V31, P867, DOI 10.1089/lap.2021.0030
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NR 20
TC 1
Z9 1
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0012-3706
EI 1530-0358
J9 DIS COLON RECTUM
JI Dis. Colon Rectum
PD AUG
PY 2022
VL 65
IS 8
BP E790
EP E796
DI 10.1097/DCR.0000000000002337
PG 7
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA 2S8XE
UT WOS:000822069600002
PM 34840297
DA 2026-07-24
ER

PT J
AU Mody, GN
   Nirmal, IA
   Duraisamy, S
   Perakath, B
AF Mody, Gita N.
   Nirmal, Ida Anita
   Duraisamy, Sulochana
   Perakath, Benjamin
TI A Blinded, Prospective, Randomized Controlled Trial of Topical Negative
   Pressure Wound Closure in India
SO OSTOMY WOUND MANAGEMENT
LA English
DT Article
DE wounds; topical negative pressure; developing world; randomized
   controlled trial; South India
ID VACUUM-ASSISTED CLOSURE; FOOT COMPLICATIONS; THERAPY; PREVALENCE;
   MANAGEMENT; AMPUTATION; DRESSINGS
AB Wound closure using topical negative pressure (TNP) has been reported to be effective, but equipment costs can be prohibitive in resource-challenged countries. Because nonhealing wounds are exceedingly common in developing countries such as India, the ability to optimize wound care with limited resources is very important. To investigate the feasibility and efficacy of providing TNP in an Indian medical referral center, a randomized controlled trial comparing a locally constructed TNP device (treatment) to wet-to-dry gauze dressings (control) was conducted. Eligible study participants (N = 48) were recruited from the inpatient wards. Wound etiologies included diabetic foot ulcers (15), pressure ulcers (11), cellulitis/fasciitis (11), and "other" (11). Following enrollment, wound size was assessed using computer-aided measurements of digital photographs and block-randomized to the study arms using a concealed allocation table. Wounds in both treatment groups were debrided before dressing application and patients were followed until wound closure or being lost to follow-up for an average of 26.3 days (+/- 18.5) in the con trol and 33.1 days (+/- 37.3) in the treatment group. No statistically significant differences in time to closure between the two treatment groups were observed except in a subset analysis of pressure ulcers (mean 10 +/- 7.11 days for treatment and 27 +/- 10.6 days in control group, P = 0.05). Direct costs to close a pressure ulcer also were lower in the TNP than in the control group. A review of the literature suggests the outcomes obtained using a locally constructed TNP device are similar to those obtained using commercially available devices. As a result of this study, a dedicated tissue viability team has been established to identify wounds suitable for TNP oversee treatment, monitor the need for surgical debridement, and employ wound healing principles and technology appropriately. These results suggest that inexpensive materials can be utilized for TNP wound closure in a developing country.
C1 [Mody, Gita N.; Nirmal, Ida Anita; Duraisamy, Sulochana; Perakath, Benjamin] Christian Med Coll & Hosp, Dept Surg, S5 Div, Vellore, Tamil Nadu, India.
C3 Christian Medical College & Hospital (CMCH) Vellore
RP Mody, GN (通讯作者)，Brigham & Womens Hosp, Dept Surg, 75 Francis St, Boston, MA 02115 USA.
EM gmody@partners.org
RI Mody, Gita/KQV-0468-2024
OI Mody, Gita/0000-0003-0218-6948
CR Armstrong DG, 2005, LANCET, V366, P1704, DOI 10.1016/S0140-6736(05)67695-7
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NR 30
TC 47
Z9 48
U1 0
U2 14
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 0889-5899
EI 1943-2720
J9 OSTOMY WOUND MANAG
JI Ostomy Wound Manag.
PD DEC
PY 2008
VL 54
IS 12
BP 36
EP 46
PG 11
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 387ZW
UT WOS:000261991100007
PM 19104122
DA 2026-07-24
ER

PT J
AU Hu, Y
   Qin, YY
   Dong, W
   Zhong, YX
   Chu, HB
AF Hu, Yuee
   Qin, Yanyan
   Dong, Wei
   Zhong, Yuxu
   Chu, Haibo
TI Complex intestinal fistula treatment and care: A case report and
   literature review
SO MEDICINE
LA English
DT Article
DE abdominal cocoon; intestinal fistula; nursing; perioperative period;
   traumatic intestinal rupture
ID ABDOMINAL COCOON SYNDROME; MANAGEMENT
AB Rationale:Abdominal cocoon is an uncommon abdominal disease. Intestinal rupture complicated with intestinal fistula rarely occurs in patients with abdominal cocoon.Patient concerns:A 51-year-old man was referred to hospital, with a 4-hour history of abdominal injuries caused by traffic accident. Intraoperatively, the small intestine in the abdominal cavity was surrounded by dense, tough, grayish-white fibrous tissue. There were the rupture of 2 sites in the ileum. The ileum was anastomosed side-to-side using a cutting and closing device. The patient was postoperatively transferred to the intensive care unit and received ventilator-assisted breathing, along with anti-infection and supportive treatments. On the 10th day after surgery, grass green turbid fluid of approximately 150 mL was extracted from the abdominal drainage tube. The secondary laparotomy was performed on the 12th day post-surgery, revealing a 1.5 cm diameter fistula at the end of the ileum.Intervention and outcomes:Nursing strategies included ensuring optimal mechanical ventilation for oxygenation, utilizing Li's double cannula for continuous abdominal irrigation and negative pressure drainage to prevent abdominal abscess formation, emphasizing the importance of enteral nutrition, implementing direct suture treatment to manage retrograde infection and expedite stoma healing, and employing Li's double cannula and vacuum-assisted closure technique to promote incision healing. After 48 days secondary post-surgery, the incision was fully healed, and the patient was discharged home with the stoma bag. Five months later, he was readmitted to the hospital, and the stoma was reversed.Lessons:Intestinal fistula poses a remarkable challenge after abdominal cocoon surgery, typically manifesting 4 to 5 days postoperatively. However, in this case, it occurred on the 10th day, highlighting the critical role of vigilant monitoring of drainage fluid color and volume in postoperative care. Navigating the complex management of intestinal rupture in abdominal cocoon necessitates a more efficacious approach, highlighting the importance of accumulating comprehensive nursing expertise through such cases.
C1 [Hu, Yuee; Qin, Yanyan; Dong, Wei; Chu, Haibo] Tongji Univ, Shanghai East Hosp, Dept Gen Surg, Jiaozhou Branch, Qingdao, Peoples R China.
   [Zhong, Yuxu] Inst Toxicol & Pharmacol, State Key Lab Toxicol & Med Countermeasures, Beijing, Peoples R China.
C3 Tongji University
RP Chu, HB (通讯作者)，Tongji Univ, Shanghai East Hosp, Dept Gen Surg, Jiaozhou Branch, Qingdao, Peoples R China.; Chu, HB (通讯作者)，Tongji Univ, Shanghai East Hosp, Dept Gen Surg, Jiaozhou Branch, Jiaozhou 266300, Peoples R China.
EM huyuee33776@163.com; 13606302128@162.com; dongwei891006@163.com;
   yuxuzhong2008@aliyun.com; haibochuwf@163.com
FU Military Logistic Project of China [AWS17J008]; Medical and health
   Scientific research guidance Project of Qingdao [2023-WJZD055]
FX This work was funded by Military Logistic Project of China (AWS17J008),
   and 2023 Medical and health Scientific research guidance Project of
   Qingdao (2023-WJZD055).
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NR 29
TC 1
Z9 1
U1 0
U2 8
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD NOV 15
PY 2024
VL 103
IS 46
AR e40511
DI 10.1097/MD.0000000000040511
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA M7A5I
UT WOS:001359023400002
PM 39560576
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Roberts, DJ
   Zygun, DA
   Kirkpatrick, AW
   Ball, CG
   Faris, PD
   Bobrovitz, N
   Robertson, HL
   Stelfox, HT
AF Roberts, Derek J.
   Zygun, David A.
   Kirkpatrick, Andrew W.
   Ball, Chad G.
   Faris, Peter D.
   Bobrovitz, Niklas
   Robertson, Helen Lee
   Stelfox, H. Thomas
TI A protocol for a scoping and qualitative study to identify and evaluate
   indications for damage control surgery and damage control interventions
   in civilian trauma patients
SO BMJ OPEN
LA English
DT Article
ID ABDOMINAL COMPARTMENT SYNDROME; VACUUM-ASSISTED CLOSURE; CONTROL
   RESUSCITATION; PLANNED REOPERATION; CONTROL LAPAROTOMY; HEPATIC
   HEMORRHAGE; FASCIAL CLOSURE; OPEN ABDOMEN; VENTRAL HERNIA; WORLD SOCIETY
AB Introduction: Initial abbreviated surgery with planned reoperation (damage control surgery) is frequently used for major trauma patients to rapidly control haemorrhage while limiting surgical stress. Although damage control surgery may decrease mortality risk among the severely injured, it may also be associated with several complications when inappropriately applied. We seek to scope the literature on trauma damage control surgery, identify its proposed indications, map and clarify their definitions, and examine the content and evidence on which they are based. We also seek to generate a comprehensive list of unique indications to inform an appropriateness rating process.
   Methods and analysis: We will search 11 electronic bibliographic databases, included article bibliographies and grey literature sources for citations involving civilian trauma patients that proposed one or more indications for damage control surgery or a damage control intervention. Indications will be classified into a predefined conceptual framework and categorised and described using qualitative content analysis. Constant comparative methodology will be used to create, modify and test codes describing principal findings or injuries (eg, bilobar liver injury) and associated decision variables (eg, coagulopathy) that comprise the reported indications. After a unique list of codes have been developed, we will use the organisational system recommended by the RAND/University of California, Los Angeles (RAND-UCLA) Appropriateness Rating Method to group principal findings or injuries into chapters (subdivided by associated decision variables) according to broader clinical findings encountered during surgical practice (eg, major liver injury).
   Ethics and dissemination: This study will constitute the first step in a multistep research programme aimed at developing appropriate, evidence-informed indications for damage control in civilian trauma patients. With use of an integrated knowledge translation intervention that includes collaboration with surgical practice leaders, this research may allow for development of indications that are more likely to be relevant to and used by surgeons. Ethics approval is not required for this study.
C1 [Roberts, Derek J.; Kirkpatrick, Andrew W.; Ball, Chad G.] Univ Calgary, Dept Surg, Calgary, AB, Canada.
   [Roberts, Derek J.; Kirkpatrick, Andrew W.; Ball, Chad G.; Faris, Peter D.; Stelfox, H. Thomas] Foothills Med Ctr, Calgary, AB, Canada.
   [Roberts, Derek J.; Stelfox, H. Thomas] Univ Calgary, Dept Community Hlth Sci, Calgary, AB, Canada.
   [Roberts, Derek J.; Kirkpatrick, Andrew W.; Ball, Chad G.] Univ Calgary, Reg Trauma Program, Calgary, AB, Canada.
   [Roberts, Derek J.; Stelfox, H. Thomas] Univ Calgary, Dept Crit Care Med, Calgary, AB, Canada.
   [Zygun, David A.] Univ Alberta, Div Crit Care Med, Edmonton, AB, Canada.
   [Ball, Chad G.] Univ Calgary, Dept Oncol, Calgary, AB, Canada.
   [Faris, Peter D.] Univ Calgary, Alberta Hlth Sci Res Res Analyt, Calgary, AB, Canada.
   [Bobrovitz, Niklas] Univ Oxford, Nuffield Dept Primary Care Hlth Sci, Oxford, England.
   [Robertson, Helen Lee] Univ Calgary, Hlth Sci Lib, Calgary, AB, Canada.
   [Stelfox, H. Thomas] Univ Calgary, Dept Med, Calgary, AB, Canada.
C3 University of Calgary; University of Calgary; University Calgary
   Hospital; University of Calgary; University of Calgary; University of
   Calgary; University of Alberta; University of Calgary; University of
   Calgary; University of Oxford; University of Calgary; University of
   Calgary
RP Roberts, DJ (通讯作者)，Univ Calgary, Dept Surg, Calgary, AB, Canada.
EM Derek.Roberts01@gmail.com
RI Robertson, Helen Lee/AAH-2875-2019; Faris, Peter/AAJ-3436-2020; Roberts,
   Derek/L-6229-2019
OI Robertson, Helen Lee/0000-0002-2348-2239; Bobrovitz,
   Niklas/0000-0001-7883-4484; Faris, Peter/0000-0001-5208-817X; Stelfox,
   Henry/0000-0003-1231-1490; 
FU Alberta Innovates-Health Solutions Clinician Fellowship Award; Knowledge
   Translation (KT) Canada Strategic Training in Health Research
   Fellowship; KT Canada Research Stipend; Canadian Institutes of Health
   Research
FX This work is supported by an Alberta Innovates-Health Solutions
   Clinician Fellowship Award, a Knowledge Translation (KT) Canada
   Strategic Training in Health Research Fellowship, a KT Canada Research
   Stipend, and funding from the Canadian Institutes of Health Research
   (all awarded to DJR).
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NR 78
TC 17
Z9 19
U1 0
U2 1
PU BMJ PUBLISHING GROUP
PI LONDON
PA BRITISH MED ASSOC HOUSE, TAVISTOCK SQUARE, LONDON WC1H 9JR, ENGLAND
SN 2044-6055
J9 BMJ OPEN
JI BMJ Open
PY 2014
VL 4
IS 7
AR e005634
DI 10.1136/bmjopen-2014-005634
PG 8
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA AM2ZS
UT WOS:000339720900125
PM 25001397
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kollmann, L
   Reimer, S
   Lock, JF
   Flemming, I
   Widder, A
   May, J
   Krietenstein, L
   Gruber, M
   Meining, A
   Hankir, M
   Germer, CT
   Seyfried, F
AF Kollmann, Lars
   Reimer, Stanislaus
   Lock, Johan Friso
   Flemming, Ilona
   Widder, Anna
   May, Jana
   Krietenstein, Laura
   Gruber, Maximilian
   Meining, Alexander
   Hankir, Mohammed
   Germer, Christoph-Thomas
   Seyfried, Florian
TI Endoscopic vacuum therapy as a first-line treatment option for gastric
   leaks after bariatric surgery: evidence from 10 years of experience
SO SURGERY FOR OBESITY AND RELATED DISEASES
LA English
DT Article
DE Anastomotic leak; Bariatric surgery; Endoluminal; Vacuum-assisted
   closure; Negative pressure
ID SLEEVE GASTRECTOMY; MANAGEMENT; COMPLICATIONS
AB Background: Gastric (anastomotic or staple-line) leaks after bariatric surgery are rare but potentially life-threatening complications. Endoscopic vacuum therapy (EVT) has evolved as the most promising treatment strategy for leaks associated with upper gastrointestinal surgery.Objective: The aim of this study was to evaluate the efficiency of our gastric leak management protocol in all bariatric patients over a 10-year period. Special emphasis was placed on EVT treatment and its outcome as a primary treatment or as a secondary treatment when other approaches failed.Setting: This study was performed at a tertiary clinic and certified center of reference for bariatric surgery.Methods: In this retrospective single-center cohort study, clinical outcomes of all consecutive patients after bariatric surgery from 2012 to 2021 are reported, with special emphasis placed on gastric leak treatment. The primary endpoint was successful leak closure. Secondary endpoints were overall complications (Clavien-Dindo classification) and length of stay.Results: A total of 1046 patients underwent primary or revisional bariatric surgery, of whom 10 (1.0%) developed a postoperative gastric leak. Additionally, 7 patients were transferred for leak management after external bariatric surgery. Of these, 9 patients underwent primary and 8 patients underwent secondary EVT after futile surgical or endoscopic leak management. The efficacy of EVT was 100%, and there were no deaths. Complications did not differ between primary EVT and secondary treatment of leaks. Length of treatment was 17 days for primary EVT versus 61 days for secondary EVT (P 5 .015).Conclusions: EVT for gastric leaks after bariatric surgery led to rapid source control with a 100% success rate both as primary and secondary treatment. Early detection and primary EVT shortened treatment time and length of stay. This study underlines the potential of EVT as a first-line treatment strategy for gastric leaks after bariatric surgery. (Surg Obes Relat Dis 2023;19:1041-1048.)& COPY; 2023 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
C1 [Kollmann, Lars; Lock, Johan Friso; Flemming, Ilona; Widder, Anna; May, Jana; Krietenstein, Laura; Gruber, Maximilian; Hankir, Mohammed; Germer, Christoph-Thomas; Seyfried, Florian] Univ Hosp Wuerzburg, Dept Gen Visceral Transplantat Vasc & Pediat Surg, Wurzburg, Germany.
   [Reimer, Stanislaus; Meining, Alexander] Univ Hosp Wuerzburg, Dept Gastroenterol, Wurzburg, Germany.
   [Seyfried, Florian] Univ Hosp Wurzburg, Ctr Operat Med ZOM, Dept Gen Visceral Transplantat Vasc & Pediat Surg, Upper Gastrointestinal & Bariatr Surg, Oberdurrbacherstr 6, D-97080 Wurzburg, Germany.
C3 University of Wurzburg; University of Wurzburg; University of Wurzburg
RP Seyfried, F (通讯作者)，Univ Hosp Wurzburg, Ctr Operat Med ZOM, Dept Gen Visceral Transplantat Vasc & Pediat Surg, Upper Gastrointestinal & Bariatr Surg, Oberdurrbacherstr 6, D-97080 Wurzburg, Germany.
EM Seyfried_F@ukw.de
RI Lock, Johan/AAA-8114-2020
OI Lock, Johan/0000-0002-9007-3937; Meining, Alexander/0009-0001-3773-138X
CR Aburajab MA, 2017, DIGEST DIS SCI, V62, P3077, DOI 10.1007/s10620-017-4701-0
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NR 31
TC 13
Z9 17
U1 0
U2 1
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1550-7289
EI 1878-7533
J9 SURG OBES RELAT DIS
JI Surg. Obes. Relat. Dis.
PD SEP
PY 2023
VL 19
IS 9
BP 1041
EP 1048
DI 10.1016/j.soard.2023.02.010
EA AUG 2023
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA S9AH5
UT WOS:001074016400001
PM 36948972
DA 2026-07-24
ER

PT J
AU Ubbink, DT
   Westerbos, SJ
   Evans, D
   Land, L
   Vermeulen, H
AF Ubbink, Dirk T.
   Westerbos, Stijn Joel
   Evans, Debra
   Land, Lucy
   Vermeulen, Hester
TI 被撤回的出版物: Topical negative pressure for treating chronic wounds
   (Retracted Article)
SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS
LA English
DT Review; Retracted Publication
ID VACUUM-ASSISTED CLOSURE; SUBATMOSPHERIC PRESSURE; RANDOMIZED-TRIAL;
   THERAPY; MANAGEMENT; ULCERS
AB Background
   Chronic wounds mainly affect the elderly and those with multiple health problems. Despite the use of modern dressings, some of these wounds take a long time to heal, fail to heal, or recur, causing significant pain and discomfort to the person and cost to health services. Topical negative pressure (TNP) is used to promote healing of surgical wounds by using suction to drain excess fluid from wounds.
   Objectives
   To assess the effects of TNP on chronic wound healing.
   Search strategy
   For this second update of this review we searched the Cochrane Wounds Group Specialised Register (December 2007), The Cochrane Central Register of Controlled Trials (CENTRAL) - The Cochrane Library Issue 4, 2007, Ovid MEDLINE - 1950 to November Week 2 2007, Ovid EMBASE - 1982 to 2007 Week 50 and Ovid CINAHL - 1980 to December Week 1 2007. In addition, we contacted authors, companies, manufacturers, and distributors to identify relevant trials and information.
   Selection criteria
   All randomised controlled trials which evaluated the effects of TNP on people with chronic wounds. Data collection and analysis
   Selection of the trials, quality assessment, data abstraction, and data synthesis were done by two authors independently. Disagreements were solved by discussion.
   Main results
   Two trials were included in the original review. A further five trials were included in this second update resulting in a total of seven trials involving 205 participants.
   The seven trials compared TNP with five different comparator treatments. Four trials compared TNP with gauze soaked in either 0.9% saline or Ringer's solution. The other three trials compared TNP with hydrocolloid gel plus gauze, a treatment package comprising papain-urea topical treatment, and cadexomer iodine or hydrocolloid, hydrogels, alginate and foam. These data do not show that TNP significantly increases the healing rate of chronic wounds compared with comparators.
   Data on secondary outcomes such as infection rate, quality of life, oedema, hospitalisation and bacterial load were not reported.
   Authors' conclusions Trials comparing TNP with alternative treatments for chronic wounds have methodological flaws and data do demonstrate a beneficial effect of TNP on wound healing however more, better quality research is needed.
C1 [Ubbink, Dirk T.] Univ Amsterdam, Acad Med Ctr J1b 215, Dept Surg, NL-1100 DE Amsterdam, Netherlands.
   [Ubbink, Dirk T.] Univ Amsterdam, Acad Med Ctr J1b 215, Dept Clin Epidemiol, NL-1100 DE Amsterdam, Netherlands.
   [Evans, Debra] Birmingham City Univ, Div Community Hlth & Social Work, Birmingham, W Midlands, England.
   [Vermeulen, Hester] Univ Amsterdam, Acad Med Ctr, Dept Surg, NL-1100 DE Amsterdam, Netherlands.
   [Vermeulen, Hester] Univ Amsterdam, Acad Med Ctr, Dept Clin Epidemiol, NL-1100 DE Amsterdam, Netherlands.
C3 University of Amsterdam; Academic Medical Center Amsterdam; University
   of Amsterdam; Academic Medical Center Amsterdam; Birmingham City
   University; University of Amsterdam; Academic Medical Center Amsterdam;
   University of Amsterdam; Academic Medical Center Amsterdam
RP Ubbink, DT (通讯作者)，Univ Amsterdam, Acad Med Ctr J1b 215, Dept Surg, Meibergdreef 9,POB 22700, NL-1100 DE Amsterdam, Netherlands.
EM d.ubbink@amc.uva.nl
RI Vermeulen, Hester/P-5739-2016; Ubbink, Dirk/AAF-1266-2021
OI Vermeulen, Hester/0000-0002-0743-2979; Land, Lucy/0000-0001-8634-8056;
   Ubbink, Dirk/0000-0001-9398-8879
CR Altman DG, 2001, ANN INTERN MED, V134, P663, DOI 10.7326/0003-4819-134-8-200104170-00012
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NR 42
TC 76
Z9 90
U1 0
U2 7
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1469-493X
EI 1361-6137
J9 COCHRANE DB SYST REV
JI Cochrane Database Syst Rev.
PY 2008
IS 3
AR CD001898
DI 10.1002/14651858.CD001898.pub2
PG 32
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 328PS
UT WOS:000257810900001
PM 18646080
DA 2026-07-24
ER

PT J
AU Georgiou, I
   Ioannou, CI
   Schmidt, J
   Eschborn, J
   Mostofizadeh-Haghighi, G
   Infanger, M
   Ghods, M
   Kruppa, P
AF Georgiou, Iakovos
   Ioannou, Christos I.
   Schmidt, Jeremias
   Eschborn, Johannes
   Mostofizadeh-Haghighi, Giw
   Infanger, Manfred
   Ghods, Mojtaba
   Kruppa, Philipp
TI Free Flaps in Sternal Osteomyelitis After Median Sternotomy: A Center's
   12-Year Experience
SO JOURNAL OF RECONSTRUCTIVE MICROSURGERY
LA English
DT Article
DE deep sternal wound infection; sternal osteomyelitis; sternal dehiscence;
   free flap reconstruction; chest wall reconstruction; wound infection
ID SURGICAL SITE INFECTION; VACUUM-ASSISTED CLOSURE; FREE-TISSUE TRANSFER;
   WOUND-INFECTION; MUSCLE FLAPS; ARTERIOVENOUS LOOPS; THIGH FLAP;
   RECONSTRUCTION; MANAGEMENT; ARTERY
AB Objective Adequate treatment of deep sternal wound infections (DSWIs) after open thoracic surgery still presents a major challenge. This study retrospectively analyzes the results of a single center's 12-year experience in treating DSWI, with special emphasis on free flap reconstruction.Methods In this single-center, retrospective study, all patients admitted with the diagnosis of DSWI after open thoracic surgery between 2009 and 2020 were included. A comparative analysis was performed between: (1) pedicled versus free flaps, (2) the center's two workhorse flaps-the pedicled latissimus dorsi (pLD) versus free anterolateral thigh (fALT) flaps, as well as (3) myocutaneous (MC) versus fasciocutaneous (FC) flaps. Primary endpoints were length of hospital stay (LOS) after reconstruction and in-hospital mortality.Results Of a total of 165 patients included, 152 underwent DSWI defect reconstruction with a total of 12 different reconstruction methods. Although the defect size was larger in patients who underwent free flap coverage, and the risk profile in the fALT and FC flap groups was higher, the LOS after reconstruction (in days) did not differ significantly between the groups (pedicled vs. free flaps: 23 vs. 28, p > 0.05; pLD vs. fALT: 24.5 vs. 26, p > 0.05; MC vs. FC flaps: 23 vs. 26, p > 0.05). Also, no significant differences were found in terms of in-hospital mortality when comparing the groups (pedicled vs. free flaps: 11.2 vs. 17.4%, p > 0.05; pLD vs. fALT: 11.5 vs. 12.5%, p > 0.05; MC vs. FC flaps: 12.9 vs. 12.5%, p > 0.05)Conclusion With proper patient selection, free tissue transfer is a valuable alternative in the treatment of sternal dehiscence after a DSWI. Furthermore, our data demonstrate that MC flaps are not necessarily superior to FC flaps in the reconstruction of sternal osteomyelitis defects.
C1 [Georgiou, Iakovos; Schmidt, Jeremias; Eschborn, Johannes; Mostofizadeh-Haghighi, Giw; Ghods, Mojtaba; Kruppa, Philipp] Hosp Ernst Bergmann, Dept Plast Aesthet & Reconstruct Microsurg Hand Su, Potsdam, Germany.
   [Ioannou, Christos I.] CYENS Ctr Excellence, Nicosia, Cyprus.
   [Infanger, Manfred] Otto von Guericke Univ, Clin Plast Aesthet & Hand Surg, Magdeburg, Germany.
   [Georgiou, Iakovos] Hosp von Ernst Bergmann, Dept Plast Aesthet & Reconstruct Microsurg Hand Su, Charlottenstr 72, D-14467 Potsdam, Germany.
C3 Klinikum Ernst von Bergmann; Otto von Guericke University
RP Georgiou, I (通讯作者)，Hosp von Ernst Bergmann, Dept Plast Aesthet & Reconstruct Microsurg Hand Su, Charlottenstr 72, D-14467 Potsdam, Germany.
EM iacovos.georgiou@gmail.com
RI ; Eschborn, Johannes/GWQ-3496-2022; Kruppa, Philipp/AAQ-1783-2020
OI Georgiou, Iakovos/0000-0002-1693-3572; Mostofizadeh-Haghighi,
   Giw/0009-0000-6882-1911; Kruppa, Philipp/0000-0003-1654-7257
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NR 54
TC 1
Z9 3
U1 0
U2 1
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 0743-684X
EI 1098-8947
J9 J RECONSTR MICROSURG
JI J. Reconstr. Microsurg.
PD OCT
PY 2023
VL 39
IS 08
BP 601
EP 615
DI 10.1055/s-0043-1761208
EA JAN 2023
PG 15
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA R4VM5
UT WOS:000922200400002
PM 36693394
DA 2026-07-24
ER

PT J
AU Scarci, M
   Abah, U
   Solli, P
   Page, A
   Waller, D
   van Schil, P
   Melfi, F
   Schmid, RA
   Athanassiadi, K
   Uva, MS
   Cardillo, G
AF Scarci, Marco
   Abah, Udo
   Solli, Piergiorgio
   Page, Aravinda
   Waller, David
   van Schil, Paul
   Melfi, Franca
   Schmid, Ralph A.
   Athanassiadi, Kalliopi
   Uva, Miguel Sousa
   Cardillo, Giuseppe
TI EACTS expert consensus statement for surgical management of pleural
   empyema
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE Video-assisted thoracic surgery; Pleural infection; Empyema
ID ASSISTED THORACOSCOPIC SURGERY; COMPLICATED PARAPNEUMONIC EFFUSIONS;
   INTRAPLEURAL STREPTOKINASE; POSTPNEUMONECTOMY EMPYEMA; INTRATHORACIC
   APPLICATION; TUBE THORACOSTOMY; THORACIC-SURGERY; CONTROLLED-TRIAL;
   CHILDREN; DECORTICATION
AB Pleural infection is a frequent clinical condition. Prompt treatment has been shown to reduce hospital costs, morbidity and mortality. Recent advances in treatment have been variably implemented in clinical practice. This statement reviews the latest developments and concepts to improve clinical management and stimulate further research. The European Association for Cardio-Thoracic Surgery (EACTS) Thoracic Domain and the EACTS Pleural Diseases Working Group established a team of thoracic surgeons to produce a comprehensive review of available scientific evidence with the aim to cover all aspects of surgical practice related to its treatment, in particular focusing on: surgical treatment of empyema in adults; surgical treatment of empyema in children; and surgical treatment of post-pneumonectomy empyema (PPE). In the management of Stage 1 empyema, prompt pleural space chest tube drainage is required. In patients with Stage 2 or 3 empyema who are fit enough to undergo an operative procedure, there is a demonstrated benefit of surgical debridement or decortication [possibly by video-assisted thoracoscopic surgery (VATS)] over tube thoracostomy alone in terms of treatment success and reduction in hospital stay. In children, a primary operative approach is an effective management strategy, associated with a lower mortality rate and a reduction of tube thoracostomy duration, length of antibiotic therapy, reintervention rate and hospital stay. Intrapleural fibrinolytic therapy is a reasonable alternative to primary operative management. Uncomplicated PPE [without bronchopleural fistula (BPF)] can be effectively managed with minimally invasive techniques, including fenestration, pleural space irrigation and VATS debridement. PPE associated with BPF can be effectively managed with individualized open surgical techniques, including direct repair, myoplastic and thoracoplastic techniques. Intrathoracic vacuum-assisted closure may be considered as an adjunct to the standard treatment. The current literature cements the role of VATS in the management of pleural empyema, even if the choice of surgical approach relies on the individual surgeon's preference.
C1 [Scarci, Marco; Abah, Udo; Solli, Piergiorgio; Page, Aravinda] Papworth Hosp, Dept Cardiothorac Surg, Cambridge, Cambs, England.
   [Waller, David] Glenfield Hosp, Dept Thorac Surg, Leicester, Leics, England.
   [van Schil, Paul] Univ Antwerp Hosp, Dept Thorac & Vasc Surg, Antwerp, Belgium.
   [Melfi, Franca] Univ Pisana, Azienda Osped, Dept Cardiothorac Surg, Pisa, Italy.
   [Schmid, Ralph A.] Univ Hosp Bern, Div Gen Thorac Surg, CH-3010 Bern, Switzerland.
   [Athanassiadi, Kalliopi] Evangelismos Med Ctr, Unit Thorac Surg, Athens, Greece.
   [Uva, Miguel Sousa] Hosp Cruz Vermelha, Unit Cardiac Surg, Lisbon, Portugal.
   [Cardillo, Giuseppe] Carlo Forlanini Hosp, Az Osped S Camillo Forlanini, Unit Thorac Surg, Rome, Italy.
C3 Papworth Hospital; University Hospitals of Leicester NHS Trust;
   University of Leicester; Glenfield Hospital; University of Antwerp;
   University of Pisa; Azienda Ospedaliero Universitaria Pisana; University
   of Bern; University Hospital of Bern; Evangelismos Hospital; Azienda
   Ospedaliera San Camillo-Forlanini
RP Scarci, M (通讯作者)，Papworth Hosp NHS Fdn Trust, Cambridge CB23 3RE, England.
EM marco.scarci@nhs.net
RI Athanassiadi, Kalliopi/AAO-7787-2021; Van Schil, Paul/AAC-8139-2019;
   Castaldo, Giuseppe/AAC-6782-2022; Scarci, Marco/AAD-5166-2020; solli,
   piergiorgio/AAC-3340-2019; Sousa Uva, Miguel/AAR-9327-2020
OI Scarci, Marco/0000-0002-4459-7721; solli,
   piergiorgio/0000-0002-4890-2578; Schmid, Ralph
   Alexander/0000-0003-0699-079X; melfi, franca/0000-0002-1773-8269; Sousa
   Uva, Miguel/0000-0001-6353-653X
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NR 81
TC 147
Z9 166
U1 1
U2 13
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
EI 1873-734X
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD NOV
PY 2015
VL 48
IS 5
BP 642
EP 653
DI 10.1093/ejcts/ezv272
PG 12
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA CW1PG
UT WOS:000364762900004
PM 26254467
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Rohmiller, MT
   Akbarnia, BA
   Raiszadeh, K
   Raiszadeh, K
   Canale, S
AF Rohmiller, Michael T.
   Akbarnia, Behrooz A.
   Raiszadeh, Kian
   Raiszadeh, Kamshad
   Canale, Sarah
TI Closed Suction Irrigation for the Treatment of Postoperative Wound
   Infections Following Posterior Spinal Fusion and Instrumentation
SO SPINE
LA English
DT Article
DE suction irrigation; postoperative wound infection; posterior
   instrumented spinal fusion; spinal implant removal
ID VACUUM ASSISTED CLOSURE; MANAGEMENT; SURGERY; ADULTS
AB Study Design. Retrospective review of clinical cases.
   Objective. This study describes the success rate of closed suction irrigation system (CSIS) in the treatment of post operative spinal infections.
   Summary of Background Data. Given the widening use of spinal instrumentation, the management of related postoperative deep wound infections has become increasingly important. In the literature, there have been reports of several treatment methods yet no firmly established protocol for management of postoperative deep wound infections exists. The goal of this study was to determine the effectiveness of our protocol employing (CSIS) in the treatment of postoperative deep wound infections.
   Methods. A retrospective record review of 500 posterior instrumented fusions between 1990 and 2002. Twenty-eight consecutive infections (5%) were diagnosed and treated by a standardized treatment protocol of Incision and Drainage, and CSIS. Cultures were obtained, wounds closed primarily, and appropriate intravenous antibiotic treatments initiated.
   For statistical evaluation, patients were assigned a risk factor (RF) described by Levi et al (J Neurosurg. 1997; 86: 975-980). Point values were assigned to medical comorbidities that may contribute to postoperative infection risk; higher RF values indicate an increased risk.
   Results. Twenty-one acute and 7 late (> 6 months) infections were followed for 22.3 months (1-86 months), post-CSIS treatment. Twenty-one (75%) resolved without recurrence with one CSIS treatment. Seven acute infections (25%) required a second course of treatment. Hospitalization for the index procedure averaged 15.4 days; 28.9 days for reinfections. No patient with an acute infection required implant removal.
   The reinfection group had higher blood loss, more levels fused, and longer hospitalization. The reinfection group was comprised entirely of pediatric patients.
   Conclusion. No correlation was found between RF values and greater risk of recurrent infection. Removal of implants is unnecessary in acute infections, provided the infection does not return. CSIS is an effective method for treatment of postoperative wound infections following instrumented spinal fusion avoiding the need for secondary closure.
C1 [Akbarnia, Behrooz A.; Canale, Sarah] San Diego Ctr Spinal Disorders, La Jolla, CA 92037 USA.
   [Rohmiller, Michael T.] Cincinnati Spine Inst, Cincinnati, OH USA.
   [Akbarnia, Behrooz A.] Univ Calif San Diego, Dept Orthoped, San Diego, CA 92103 USA.
   [Raiszadeh, Kian] Kaiser Permanente, San Diego, CA USA.
   [Raiszadeh, Kamshad] La Jolla Spine Inst, La Jolla, CA USA.
C3 University of California System; University of California San Diego;
   Kaiser Permanente
RP Akbarnia, BA (通讯作者)，San Diego Ctr Spinal Disorders, 4130 La Jolla Village Dr,Suite 300, La Jolla, CA 92037 USA.
EM akbarnia@ucsd.edu
RI ; Akbarnia, Behrooz/AAL-8255-2021
OI CANALE, SARAH/0009-0007-3514-6199; 
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NR 17
TC 42
Z9 58
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0362-2436
EI 1528-1159
J9 SPINE
JI SPINE
PD MAR 15
PY 2010
VL 35
IS 6
BP 642
EP 646
DI 10.1097/BRS.0b013e3181b616eb
PG 5
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA 582AG
UT WOS:000276566800008
PM 20139811
DA 2026-07-24
ER

PT J
AU Hierner, R
   Degreef, H
   Vranckx, JJ
   Garmyn, M
   Massagé, P
   van Brussel, M
AF Hierner, R
   Degreef, H
   Vranckx, JJ
   Garmyn, M
   Massagé, P
   van Brussel, M
TI Skin grafting and wound healing -: the "dermato-plastic team approach"
SO CLINICS IN DERMATOLOGY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; LEG ULCERS; STAPHYLOCOCCUS; CIRCULATION
AB Autologous skin grafts are successfully used to close recalcitrant chronic wounds especially at the lower leg. If wound care is done in a dermato-plastic team approach using the "integrated concept," difficulties associated with harvesting the skin graft as well as the complexities associated with inducing closure at the donor and the recipient site can be minimized. In the context of wound healing, skin transplantation can be regarded as (1) a supportive procedure for epithelialization of the wound surface and (2) mechanical stability of the wound ground. By placing skin grafts on a surface, central parts are covered much faster with keratinocytes. Skin (wound) closure is the ultimate goal, as wound closure means resistance to infection. Depending on the thickness of the skin graft, different amounts of dermis are transplanted with the overlying keratinocytes. The dermal component determines the mechanical (resistance to pressure and shear forces, graft shrinkage), functional (sensibility), and aesthetic properties of the graft. Generally speaking, the thicker the graft the better the mechanical, functional, and aesthetic properties, however, the worse the neo- and revascularization. Skin grafts do depend entirely on the re- and neovascularization coming from the wound bed. If the wound bed is seen as a recipient site for tissue graft, the classification of Lexer (Die freien Transplantationen. Stuttgart: Enke; 1924) turned out to be of extreme value. Three grades can be distinguished: "good wound conditions," "moderate wound conditions," and "insufficient wound conditions." Given good wound conditions, skin grafting is feasible. Nevertheless, skin closure alone might not be sufficient to fulfill the criteria of successful defect reconstruction. In case of moderate or insufficient wound conditions, wound bed preparation is necessary. If wound bed preparation is successful and good wound conditions can be achieved, skin grafting is possible. If, however, this attempt is unsuccessful and moderate or "inadequate wound conditions" are persisting, other methods of defect reconstruction such as local flap transfer, distant flap transfer, free (microvascular) flaps, and ultimately amputation must be considered. (c) 2005 Elsevier Inc. All rights reserved.
C1 Catholic Univ Louvain, Burn Ctr, Dept Plast Reconstruct & Aesthet Surg, B-3000 Louvain, Belgium.
   Catholic Univ Louvain, Dept Dermatol, B-3000 Louvain, Belgium.
C3 Universite Catholique Louvain; Universite Catholique Louvain
RP Hierner, R (通讯作者)，Catholic Univ Louvain, Burn Ctr, Dept Plast Reconstruct & Aesthet Surg, Univ Hosp Campus Gasthuisberg, B-3000 Louvain, Belgium.
EM robert.hierner@uz.kuleuven.ac.be
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NR 47
TC 58
Z9 73
U1 0
U2 12
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0738-081X
EI 1879-1131
J9 CLIN DERMATOL
JI Clin. Dermatol.
PD JUL-AUG
PY 2005
VL 23
IS 4
BP 343
EP 352
DI 10.1016/j.clindermatol.2004.07.028
PG 10
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 952ZS
UT WOS:000231045600006
PM 16023929
DA 2026-07-24
ER

PT J
AU Manahan, MA
   Shermak, MA
AF Manahan, Michele A.
   Shermak, Michele A.
TI Massive panniculectomy after massive weight loss
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article; Proceedings Paper
CT 73rd Annual Meeting of the American-Society-of-Plastic-Surgeons
CY OCT 17, 2004
CL Philadelphia, PA
SP Amer Soc Plast Surg
ID ABDOMINAL PANNICULECTOMY; OBESITY SURGERY; MORBID-OBESITY;
   ABDOMINOPLASTY; COMPLICATIONS; LIPECTOMY; FAT; EXCISION
AB Background: Massive weight loss, defined as loss of 50 percent of excess weight, often results in laxity and redundancy of the abdominal skin, causing disabling rashes, pain, physical limitation, back strain, and cosmetic deformity. The heavier the panniculus, the more marked the symptoms. Panniculectomy can treat these symptoms, but the approach must be customized because of complex medical and surgical histories related to obesity and the size of the panniculus. The aim of this study was to analyze a series of massive panniculectomies greater than 10 pounds following massive weight loss and to investigate the outcomes achieved.
   Methods: All patients undergoing massive abdominal panniculectomy by a single plastic surgeon at an academic hospital from October of 2000 to December of 2003 were retrospectively studied. Seven men and 17 women qualified: one woman had a two-stage abdominal panniculectomy, each time with greater than 10-pound abdominal skin resections. All but one patient had gastric bypass. Average weight loss was 171 pounds, with an average maximum body mass index of 70.5 and a minimum body mass index of 43.7 (morbid obesity is defined as a body mass index greater than 40). Patient presentation was regularly complicated by abdominal scars. Abdominal panniculectomy was performed with conservative undermining. Hernias were repaired at the time of surgery. Routine prophylaxis against thromboembolism was performed.
   Results: Average abdominal skin resection was 16.1 pounds, ranging from 10.3 to 49 pounds. Hernia repair was necessary in 13 patients. Additional surgery performed at the time of panniculectomy included skin reduction surgery of the back (40 percent), chest (32 percent), inner thigh (28 percent), and arm (28 percent). Blood transfusion was necessary in five of the cases (20 percent). Length of stay averaged 3 days. Complications included wounds requiring debridement, dressings, vacuum-assisted closure therapy and/or delayed primary closure (20 percent), and seroma requiring drain replacement or dressings (28 percent). Uncomplicated healing occurred in 44 percent of cases.
   Conclusion: Massive abdominal panniculectomy is challenging to plan, execute, and manage after surgery. The authors present their approach to these patients, with acceptable results.
C1 Johns Hopkins Med Inst, Div Plast Surg, Baltimore, MD 21205 USA.
C3 Johns Hopkins University; Johns Hopkins Medicine
RP Shermak, MA (通讯作者)，Johns Hopkins Bayview Med Ctr, Div Plast Surg, Suite A518, Baltimore, MD 21224 USA.
EM masherma@jhmi.edu
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NR 19
TC 56
Z9 63
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD JUN
PY 2006
VL 117
IS 7
BP 2191
EP 2197
DI 10.1097/01.prs.0000218174.89832.78
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 055DZ
UT WOS:000238431500013
PM 16772916
DA 2026-07-24
ER

PT J
AU de Weerd, L
   Solberg, TK
   Weum, S
AF de Weerd, Louis
   Solberg, Tore K.
   Weum, Sven
TI Closure of Complex Posterior Midline Defects After Spinal Surgery With
   Sensate Midline-based Perforator Flaps and the Long-term Results
SO SPINE
LA English
DT Article
DE muscle flap; perforator flap; posterior midline defect; posterior trunk
   defect; spinal reconstruction; surgical site infection; wound management
ID VACUUM-ASSISTED CLOSURE; WOUND THERAPY; MUSCLE; RECONSTRUCTION;
   INFECTION; RISK; MANAGEMENT; COVERAGE; UPDATE
AB Study Design.Prospective study.Objective.Evaluating the use of a midline-based perforator flap for closure of complex midline defects after spine surgery complicated with implant exposure and deep subfascial infection.Summary of Background Data.Traditionally, muscle flaps are used to close complex defects after spine surgery complicated by exposed spinal implants and deep subfascial infections. There are no reports on the long-term results on the use of perforator flaps to close these defects.Methods.Information was prospectively registered of all patients in whom a medial dorsal intercostal artery perforator (MDICAP) flap was used for closure of a complex midline defect with exposed spinal implant and deep subfascial infection after spine surgery.Results.In 9 patients, 10 MDICAP flaps were used. All flaps survived with only 1 flap experiencing marginal flap necrosis. The flaps provided stable coverage of all defects and spinal instrumentation could be retained in all patients. The perforator flaps provided in all patients, except in the patient with a meningomyelocele, protective sensibility in the reconstructed areas. The mean postoperative hospital stay after closure of the defects was 10 days (range 4-21). During follow-up (mean 65 mo, range 7-106) only 1 patient developed an infection in the operated area which occurred 81 months postoperatively. None of the patients had any functional loss at the donor site of the flap.Conclusion.The medial dorsal intercostal artery perforator flap seems to be a reliable alternative for treatment of complex midline defects with exposed spinal implants and deep subfascial surgical site infections. Protective sensibility may be obtained in the reconstructed area with this flap. Donor site morbidity is minimal. In case of recurrence, complex reconstructive procedures using muscle flaps are still possible. The use of this perforator flap may contribute to shorter hospital stays and reduction of costs.
C1 [de Weerd, Louis] Univ Hosp North Norway, Dept Plast Surg & Hand Surg, N-9038 Tromso, Norway.
   [de Weerd, Louis; Solberg, Tore K.; Weum, Sven] UiT Arctic Univ Norway, Dept Clin Med, Med Imaging Res Grp, Tromso, Norway.
   [Solberg, Tore K.] Univ Hosp North Norway, Dept Neurosurg, N-9038 Tromso, Norway.
   [Weum, Sven] Univ Hosp North Norway, Dept Radiol, N-9038 Tromso, Norway.
C3 UiT The Arctic University of Tromso; University Hospital of North
   Norway; UiT The Arctic University of Tromso; UiT The Arctic University
   of Tromso; University Hospital of North Norway; UiT The Arctic
   University of Tromso; University Hospital of North Norway
RP de Weerd, L (通讯作者)，Univ Hosp North Norway, Dept Plast Surg & Hand Surg, N-9038 Tromso, Norway.
EM louis.deweerd@unn.no
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NR 34
TC 14
Z9 16
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0362-2436
EI 1528-1159
J9 SPINE
JI SPINE
PD DEC
PY 2015
VL 40
IS 23
BP E1233
EP E1238
DI 10.1097/BRS.0000000000001048
PG 6
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA DB4RE
UT WOS:000368500000005
PM 26165215
DA 2026-07-24
ER

PT J
AU Edsander-Nord, Å
AF Edsander-Nord, Asa
TI Wound Complications from the Tsunami Disaster: A Reminder of Indications
   for Delayed Closure
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article; Proceedings Paper
CT 7th European Congress of Trauma and Emergency Surgery
CY SEP 06-09, 2006
CL Malmo, SWEDEN
DE Trauma; Plastic and reconstructive surgery; Skin graft; Flap;
   Mycobacteria
ID SOUTHERN THAILAND; MELIOIDOSIS; INFECTIONS; SURVIVORS; VICTIMS; CARE
AB Objectives: To illustrate the character, clinical course and late complications of wounds caused by high energy with severe contamination during a natural disaster, as a basis for designing principles for primary treatment under these conditions.
   Patients and Methods: This paper presents case reports from complicated wounds treated at a specialized unit for wound management in a hospital receiving patients after transfer from primary to definitive treatment.
   Results: Of the Swedish citizens evacuated from the disaster zone in Thailand after the tsunami disaster in 2004, 174 of those arriving at Stockholm Airport were referred to the Karolinska Hospital for treatment, of whom 75 were admitted. Forty of the patients admitted were seen by the surgeons at the Department of Plastic and Reconstructive Surgery because of complicated wounds requiring special treatment. Fifteen of these could be treated as ambulatory patients and 25 required hospitalization for a mean time of 10.5 days (range 1-48). The majority had multiple injuries, 93% on the lower limbs and 47% on the upper limbs. The majority had been primarily closed at primary treatment. Treatment strategies included removal of all sutures, wound excision, secondary healing (38/40, 95%), delayed primary closure (40/40, 100%), vacuum-assisted closure (VAC) (3/40, 8%), split-thickness skin grafts (23/40, 58%), pedicled perforator flap (1/40, 2%) and free flap (1/40, 2%). Amputation was requested in two cases. Aside from long-lasting psychological sequelae and varying degrees of physical disability, unusual late infections occurred with progressing and migrating abscesses. Cultures and skin biopsies from these revealed both mycobacteria and pigmented fungal hyphae.
   Conclusions: The patterns of injury and clinical courses in these patients illustrate the risk of complications in wounds caused by high energy, with severe contamination and which arrive late for primary treatment by staff who are not fully aware of the risk of secondary complications under these conditions. Recommendations for primary treatment should include extensive cleaning, excision of dead tissue and delayed primary closure, according to the well-established principles of management of war wounds, where the conditions are similar.
C1 [Edsander-Nord, Asa] Karolinska Univ Hosp, Dept Reconstruct Plast Surg, S-17176 Stockholm, Sweden.
   [Edsander-Nord, Asa] Karolinska Inst, Stockholm, Sweden.
C3 Karolinska Institutet; Karolinska University Hospital; Karolinska
   Institutet
RP Edsander-Nord, Å (通讯作者)，Karolinska Univ Hosp, Dept Reconstruct Plast Surg, S-17176 Stockholm, Sweden.
EM asa.edsander-nord@karolinska.se
RI Edsander-Nord, Åsa/AAD-4115-2022
CR Andresen D, 2005, LANCET, V365, P876, DOI 10.1016/S0140-6736(05)71046-1
   Chierakul W, 2005, CLIN INFECT DIS, V41, P982, DOI 10.1086/432942
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   LENNQUIST S, 2008, INT J DISAS IN PRESS
   Leppäniemi A, 2005, SCAND J SURG, V94, P5, DOI 10.1177/145749690509400103
   Maegele M, 2005, CRIT CARE MED, V33, P1136, DOI 10.1097/01.CCM.0000163269.42524.50
   Maegele M, 2006, CRIT CARE, V10, DOI 10.1186/cc4868
   MICHELSEN H, 2007, CEFAM, P1
   NIEMINEN T, 2004, EURO SURVEILL, V10
   PARJARINEN J, 2004, INT J DISASTER MED, V3, P82
   Svensson E, 2006, SCAND J INFECT DIS, V38, P71, DOI 10.1080/00365540500264738
   Wuthiekanun V, 2006, J CLIN MICROBIOL, V44, P239, DOI 10.1128/JCM.44.1.239-240.2006
   Yorsaengrat Weerawat, 2006, Journal of the Medical Association of Thailand, V89, P518
   SWEDISH POLICE AUTHO
NR 19
TC 7
Z9 7
U1 0
U2 4
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD OCT
PY 2008
VL 34
IS 5
BP 457
EP 464
DI 10.1007/s00068-008-8802-5
PG 8
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Emergency Medicine
GA 360FH
UT WOS:000260042300006
PM 26815990
OA Bronze
DA 2026-07-24
ER

PT J
AU Schuster, R
   Singh, J
   Safadi, BY
   Wren, SM
AF Schuster, Rob
   Singh, Jaskanwal
   Safadi, Bassem Y.
   Wren, Sherry M.
TI The use of acellular dermal matrix for contaminated abdominal wall
   defects: wound status predicts success
SO AMERICAN JOURNAL OF SURGERY
LA English
DT Article; Proceedings Paper
CT 30th Annual Surgical Symposium of the Association-of-VA-Surgeons
CY MAY 07-09, 2006
CL Cincinnati, OH
SP Assoc VA Surg
DE contaminated; hernia; AlloDerm; acellular dermal matrix; wound
ID INCISIONAL HERNIA; VENTRAL HERNIAS; REPAIR; ALLODERM; MESH;
   RECONSTRUCTION; EXPERIENCE; MANAGEMENT; SURGERY
AB Background: Contaminated abdominal wall fascial defects present a challenging problem. The use of human acellular dermal matrix (AlloDerm; LifeCell Corp., Branchburg, NJ) provides a novel method of primary closure of abdominal wall defects in this setting. The aim of the current study was to determine what factors predicted fascial wall failure as determined by the presence of hernia on follow-up exam after AlloDerm placement.
   Methods: All patients who underwent surgery for contaminated abdominal wall fascial defects with placement of AlloDerm from June 2003 to September 2005 at a tertiary care Veterans Affairs hospital were included in the analysis. Patients were followed until hernia recurrence or last clinic visit.
   Results: Eighteen patients had AlloDerm placed for contaminated fascial defects and all were included in the analysis. Primary wound closure was performed on 12/18 (67%) patients, with 6/18 (33%) patients initially left with open wounds. Patients with open wounds were treated with wound vacuum-assisted closure (VAC) devices (4/6) or saline dressings (2/6). Overall ventral hernia recurrence rate was 50% (9/18) with an average follow up of 9.1 months. Patients who had primary wound closure at the completion of the operation had a 33% (4/12) recurrence rate. Patients who did not have primary wound closure had an 83.3% (5/6) recurrence rate. The significant difference shows (P = .03) that open wound status predicts recurrence. The average size of AlloDerm sheets used was 164.0 cm(2) in the closed group and 146.2 cm(2) in the primary open wound group (P = .64). Average cost per patient was $4680 for AlloDerm.
   Conclusion: These data suggest that an open wound in the postoperative period after AlloDerm placement for treatment of contaminated fascial defects is associated with a high probability of hernia recurrence. Our data do not support the use of this expensive material unless there is a good chance of having a closed wound. (c) 2006 Excerpta Medica Inc. All rights reserved.
C1 Arizona Special Phys, Dept Surg, Gilbert, AZ 85234 USA.
   Palo Alto Vet Hlth Care Syst, Dept Surg, Palo Alto, CA USA.
   Stanford Univ, Dept Surg, Stanford, CA 94305 USA.
C3 US Department of Veterans Affairs; Veterans Health Administration (VHA);
   VA Palo Alto Health Care System; Stanford University
RP Schuster, R (通讯作者)，Arizona Special Phys, Dept Surg, 3921 E Baseline,Suite 200, Gilbert, AZ 85234 USA.
EM robschuster@hotmail.com
RI ; Wren, Sherry/NIS-6346-2025
OI Safadi, Bassem/0000-0002-4473-7202; Wren, Sherry/0000-0002-5723-8226
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NR 20
TC 81
Z9 85
U1 0
U2 2
PU EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
PI BRIDGEWATER
PA 685 ROUTE 202-206 STE 3, BRIDGEWATER, NJ 08807 USA
SN 0002-9610
EI 1879-1883
J9 AM J SURG
JI Am. J. Surg.
PD NOV
PY 2006
VL 192
IS 5
BP 594
EP 597
DI 10.1016/j.amjsurg.2006.08.017
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 102NW
UT WOS:000241820000007
PM 17071190
DA 2026-07-24
ER

PT J
AU Weaver, MJ
   Owen, TM
   Morgan, JH
   Harris, MB
AF Weaver, Michael J.
   Owen, Trevor M.
   Morgan, Jordan H.
   Harris, Mitchel B.
TI Delayed Primary Closure of Fasciotomy Incisions in the Lower Leg: Do We
   Need to Change Our Strategy?
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE tibia; fasciotomy; delayed primary closure; split-thickness skin graft;
   compartment syndrome; trauma
ID ACUTE COMPARTMENT SYNDROME; VACUUM-ASSISTED CLOSURE; TIBIAL FRACTURES;
   PLATEAU FRACTURES; WOUND CLOSURE; TRAUMA; FIXATION; IMPACT
AB Objectives:The primary purpose of this study is to determine whether a strategy of bringing patients back to the operating room for successive debridements allows for the eventual delayed primary closure (DPC) of fasciotomy wounds.Design:Retrospective cohort study. Data were collected from medical records and radiographs.Setting:Two urban level 1 trauma centers.Patients:One hundred four adult patients with acute compartment syndrome in the setting of a tibia fracture (open or closed).Intervention:All patients underwent decompressive fasciotomies with closure by either DPC or split-thickness skin grafting (STSG) during a subsequent surgical procedure.Main Outcome Measure:Number of fasciotomy wounds closed by DPC after the initial fasciotomy procedure.Results:Of the 104 patients brought to the operating room for their first debridement after their fasciotomies, 19 patients (18%) were treated with DPC, whereas 42 patients (40%) were closed with STSG because they were believed to be too swollen to allow for primary closure by the treating surgeon. Three of the remaining 43 patients were treated with DPC during their second debridement. No patients who underwent more than 2 washouts could be treated with DPC. No patients who sustained open fractures were able to be closed by DPC (P = 0.02). Patients who underwent STSG on their first postfasciotomy procedure had a significantly shorter hospital stay than patients who underwent additional procedures before closure (12.2 vs. 17.4 days; P = 0.005).Conclusions:Fasciotomy wounds that are not able to be primarily closed during their first postfasciotomy surgical procedure are rarely closed through DPC techniques. Early skin grafting of these wounds should be considered, especially in the clinical setting of an open injury, because it significantly decreases the length of hospital stay. Other techniques that avoid repeated debridements and attempted closures might also help reduce hospital stay.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.
C1 [Weaver, Michael J.; Morgan, Jordan H.; Harris, Mitchel B.] Harvard Univ, Brigham & Womens Hosp, Sch Med, Dept Orthoped Surg, Boston, MA 02115 USA.
   [Owen, Trevor M.] Virginia Tech Caril Sch Med, Caril Clin Orthopaed, Roanoke, VA USA.
C3 Harvard University; Harvard Medical School; Harvard University Medical
   Affiliates; Brigham & Women's Hospital
RP Weaver, MJ (通讯作者)，Brigham & Womens Hosp, Dept Orthopaed Surg, 75 Francis St, Boston, MA 02115 USA.
EM mjweaver@partners.org
OI Weaver, Michael/0000-0003-1062-8144
CR BLICK SS, 1986, J BONE JOINT SURG AM, V68A, P1348, DOI 10.2106/00004623-198668090-00007
   DELEE JC, 1981, CLIN ORTHOP RELAT R, P175
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NR 19
TC 21
Z9 29
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0890-5339
EI 1531-2291
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD JUL
PY 2015
VL 29
IS 7
BP 308
EP 311
DI 10.1097/BOT.0000000000000278
PG 4
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA CK8LW
UT WOS:000356490600004
PM 25536212
DA 2026-07-24
ER

PT J
AU Lindstedt, S
   Paulsson, P
   Mokhtari, A
   Gesslein, B
   Hlebowicz, J
   Malmsjö, M
   Ingemansson, R
AF Lindstedt, Sandra
   Paulsson, Per
   Mokhtari, Arash
   Gesslein, Bodil
   Hlebowicz, Joanna
   Malmsjo, Malin
   Ingemansson, Richard
TI A compare between myocardial topical negative pressure levels of-25 mmHg
   and-50 mmHg in a porcine model
SO BMC CARDIOVASCULAR DISORDERS
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; LONG-TERM SURVIVAL; ENDOTHELIAL GROWTH-FACTOR;
   LASER DOPPLER FLOWMETRY; BYPASS GRAFT-SURGERY; BLOOD-FLOW;
   CARDIOPULMONARY BYPASS; CONTROLLED-TRIAL; WOUND THERAPY; MEDIASTINITIS
AB Background: Topical negative pressure (TNP), widely used in wound therapy, is known to stimulate wound edge blood flow, granulation tissue formation, angiogenesis, and revascularization. We have previously shown that application of a TNP of -50 mmHg to the myocardium significantly increases microvascular blood flow in the underlying tissue. We have also shown that a myocardial TNP levels between -75 mmHg and -150 mmHg do not induce microvascular blood flow changes in the underlying myocardium. The present study was designed to elucidate the difference between -25 mmHg and -50 mmHg TNP on microvascular flow in normal and ischemic myocardium.
   Methods: Six pigs underwent median sternotomy. The microvascular blood flow in the myocardium was recorded before and after the application of TNP using laser Doppler flowmetry. Analyses were performed before left anterior descending artery (LAD) occlusion (normal myocardium), and after 20 minutes of LAD occlusion (ischemic myocardium).
   Results: A TNP of -25 mmHg significantly increased microvascular blood flow in both normal (from 263.3 +/- 62.8 PU before, to 380.0 +/- 80.6 PU after TNP application, *p = 0.03) and ischemic myocardium (from 58.8 +/- 17.7 PU before, to 85.8 +/- 20.9 PU after TNP application, *p = 0.04). A TNP of -50 mmHg also significantly increased microvascular blood flow in both normal (from 174.2 +/- 20.8 PU before, to 240.0 +/- 34.4 PU after TNP application, *p = 0.02) and ischemic myocardium (from 44.5 +/- 14.0 PU before, to 106.2 +/- 26.6 PU after TNP application, **p = 0.01).
   Conclusion: Topical negative pressure of -25 mmHg and -50 mmHg both induced a significant increase in microvascular blood flow in normal and in ischemic myocardium. The increase in microvascular blood flow was larger when using -25 mmHg on normal myocardium, and was larger when using -50 mmHg on ischemic myocardium; however these differences were not statistically significant.
C1 [Lindstedt, Sandra; Paulsson, Per; Mokhtari, Arash; Ingemansson, Richard] Univ Lund Hosp, Dept Cardiothorac Surg, S-22185 Lund, Sweden.
   [Gesslein, Bodil; Malmsjo, Malin] Univ Lund Hosp, Dept Med, S-22185 Lund, Sweden.
   [Hlebowicz, Joanna] Malmo Univ Hosp, Dept Med, Malmo, Sweden.
C3 Lund University; Skane University Hospital; Lund University; Skane
   University Hospital; Lund University; Skane University Hospital
RP Lindstedt, S (通讯作者)，Univ Lund Hosp, Dept Cardiothorac Surg, S-22185 Lund, Sweden.
EM sandra.lindstedt@skane.se; per.paulsson@skane.se;
   arash.mokhtari@kane.se; bodil.gesslein@med.lu.se;
   joanna.hlebowicz@skane.se; malin.malmsjo@med.lu.se;
   richard.ingemansson@skane.se
RI Lindstedt, Sandra/AEM-2892-2022
OI Lindstedt, Sandra/0000-0003-4484-6473; Ingemansson,
   Richard/0000-0001-7623-8953; Maljö, Malin/0000-0001-9849-9599
FU Anders Otto Sward Foundation/Ulrika Eklund Foundation; Anna Lisa and
   Sven Eric Lundgren's Foundation for Medical Research; Ake Wiberg
   Foundation; M. Bergvall Foundation; Swedish Medical Association; Royal
   Physiographic Society in Lund; Swedish Medical Research Council;
   Crafoord Foundation
FX This study was supported by the Anders Otto Sward Foundation/Ulrika
   Eklund Foundation, Anna Lisa and Sven Eric Lundgren's Foundation for
   Medical Research, the Ake Wiberg Foundation, the M. Bergvall Foundation,
   the Swedish Medical Association, the Royal Physiographic Society in
   Lund, the Swedish Medical Research Council, the Crafoord Foundation.
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NR 29
TC 5
Z9 10
U1 0
U2 1
PU BIOMED CENTRAL LTD
PI LONDON
PA 236 GRAYS INN RD, FLOOR 6, LONDON WC1X 8HL, ENGLAND
SN 1471-2261
J9 BMC CARDIOVASC DISOR
JI BMC Cardiovasc. Disord.
PD JUN 22
PY 2008
VL 8
AR 14
DI 10.1186/1471-2261-8-14
PG 7
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA 456NX
UT WOS:000266854800001
PM 18570679
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Bonnevialle, P
AF Bonnevialle, P.
TI Operative treatment of early infection after internal fixation of limb
   fractures (exclusive of severe open fractures)
SO ORTHOPAEDICS & TRAUMATOLOGY-SURGERY & RESEARCH
LA English
DT Article; Proceedings Paper
CT Congress of the French-Society-for-Orthopedic-Surgery-and-Traumatology
   (SofCOT)
CY NOV 08-11, 2016
CL Paris, FRANCE
SP French Soc Orthoped Surg & Traumatol
DE Surgical-site infection; Superficial incisional surgical-site infection;
   Deep incisional surgical-site infection; ORIF for limb fractures;
   Complications; Nosocomial infection; Antibiotic therapy; Microbiological
   sampling; Multidisciplinary management
ID DEVICE-ASSOCIATED INFECTIONS; SURGICAL SITE INFECTION; RISK-FACTORS;
   JOINT INFECTION; CASE SERIES; SURGERY; COMPLICATIONS; PREVENTION;
   DIAGNOSIS; IMPLANTS
AB Early infection after open reduction and internal fixation (ORIF) of a limb bone is defined as bacteriologically documented, deep and/or superficial surgical-site infection (SSI) diagnosed within 6 months after the surgical procedure. This interval is arbitrarily considered sufficient to obtain fracture healing. The treatment of early infection after ORIF should be decided by a multidisciplinary team. The principles are the same as for revision arthroplasty. Superficial SSIs should be differentiated from deep SSIs, based on the results of bacteriological specimens collected using flawless technique. A turning point in the local microbial ecology occurs around the third or fourth week, when a biofilm develops around metallic implants. This biofilm protects the bacteria. The treatment relies on both non-operative and operative measures, which are selected based on the time to occurrence of the infection, condition of the soft tissues, and stage of bone healing. Both the surgical strategy and the antibiotic regimen should be determined during a multidisciplinary discussion. When treating superficial SSIs after ORIF, soft-tissue management is the main challenge. The treatment differs according to whether the hardware is covered or exposed. Defects in the skin and/or fascia can be managed using reliable reconstructive surgery techniques, either immediately or after a brief period of vacuum-assisted closure. In deep SSIs, deciding whether to leave or to remove the hardware is difficult. If the hardware is removed, the fracture site can be stabilised provisionally using either external fixation or a cement rod. Once infection control is achieved, several measures can be taken to stimulate bone healing before the end of the classical 6-month interval. If the hardware was removed, then internal fixation must be performed once the infection is eradicated. (C) 2016 Published by Elsevier Masson SAS.
C1 [Bonnevialle, P.] CHU Toulouse, Hop PP Riquet, Dept Orthopedie Traumatol, Pl Baylac, F-31052 Toulouse, France.
C3 Universite de Toulouse (EPE); CHU de Toulouse; Communaute d'universites
   et etablissements de Toulouse (Comue)
RP Bonnevialle, P (通讯作者)，CHU Toulouse, Hop PP Riquet, Dept Orthopedie Traumatol, Pl Baylac, F-31052 Toulouse, France.
EM ventre.s@chu-toulouse.fr
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NR 39
TC 16
Z9 28
U1 0
U2 4
PU ELSEVIER MASSON, CORPORATION OFFICE
PI PARIS
PA 65 CAMILLE DESMOULINS CS50083 ISSY-LES-MOULINEAUX, 92442 PARIS, FRANCE
SN 1877-0568
J9 ORTHOP TRAUMATOL-SUR
JI Orthop. Traumatol.-Surg. Res.
PD FEB
PY 2017
VL 103
IS 1
SU S
BP S67
EP S73
DI 10.1016/j.otsr.2016.06.019
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Orthopedics; Surgery
GA FX5QU
UT WOS:000426135500008
PM 28057476
DA 2026-07-24
ER

PT J
AU Naghovi, AO
   Gonzalez, RJ
   Scott, JG
   Kim, Y
   Abuodeh, YA
   Strom, TJ
   Echevarria, M
   Mullinax, JE
   Ahmed, KA
   Harrison, LB
   Fernandez, DC
AF Naghovi, Arash O.
   Gonzalez, Ricardo J.
   Scott, Jacob G.
   Kim, Youngchul
   Abuodeh, Yozan A.
   Strom, Tobin J.
   Echevarria, Michelle
   Mullinax, John E.
   Ahmed, Kamran A.
   Harrison, Louis B.
   Fernandez, Daniel C.
TI Staged reconstruction brachytherapy has lower overall cost in recurrent
   soft-tissue sarcoma
SO JOURNAL OF CONTEMPORARY BRACHYTHERAPY
LA English
DT Article
DE brachytherapy; cost; sarcoma; staged reconstruction; wound-vac
ID VACUUM-ASSISTED CLOSURE; RADIATION-THERAPY; ADJUVANT BRACHYTHERAPY;
   WOUND CONTROL; LOCAL-CONTROL; PRIOR SURGERY; EXTREMITY; RADIOTHERAPY;
   IRRADIATION; AMPUTATION
AB Purpose: Adjuvant brachytherapy (AB) with immediate (IR) and staged reconstruction (SR) are distinct treatment modalities available for patients with recurrent soft tissue sarcoma (STS). Although SR may offer local control and toxicity benefit, it requires additional upfront procedures, and there is no evidence that it improves overall survival. With the importance of value-based care, our goal is to identify which technique is more cost effective.
   Material and methods: A retrospective review of 22 patients with recurrent extremity STS treated with resection followed by AB alone. Hospital charges were used to compare the cost between SR and IR at the time of initial treatment, at 6-month intervals following surgery, and cumulative cost comparisons at 18 months.
   Results: Median follow-up was 31 months. Staged reconstruction (n = 12) was associated with an 18-month local control benefit (85% vs. 42%, p = 0.034), compared to IR (n = 10). Staged reconstruction had a longer hospital stay during initial treatment (10 vs. 3 days, p = 0.002), but at 18 months, the total hospital stay was no longer different (11 vs. 11 days). Initially, there was no difference in the cost of SR and IR. With longer follow-up, cost eventually favored SR, which was attributed primarily to the costs associated with local failure (LF). On multivariate analysis, cost of initial treatment was associated with length of hospital stay ( similar to$4.5K per hospital day, p < 0.001), and at 18 months, the cumulative cost was similar to 175K lower with SR (p = 0.005) and $58K higher with LF (p = 0.02).
   Conclusions: In recurrent STS, SR has a longer initial hospital stay when compared to IR. At 18 months, SR had lower rates of LF, translating to lower total costs for the patient. SR is the more cost-effective brachytherapy approach in the treatment of STS, and should be considered as healthcare transitions into value-based medicine.
C1 [Naghovi, Arash O.; Scott, Jacob G.; Abuodeh, Yozan A.; Strom, Tobin J.; Echevarria, Michelle; Ahmed, Kamran A.; Harrison, Louis B.; Fernandez, Daniel C.] H Lee Moffitt Canc Ctr & Res Inst, Radiat Oncol, 12902 Magnolia Dr, Tampa, FL 33612 USA.
   [Gonzalez, Ricardo J.; Mullinax, John E.] H Lee Moffitt Canc Ctr & Res Inst, Sarcoma Dept, Tampa, FL USA.
   [Kim, Youngchul] H Lee Moffitt Canc Ctr & Res Inst, Dept Biostat & Bioinformat, Tampa, FL USA.
C3 H Lee Moffitt Cancer Center & Research Institute; H Lee Moffitt Cancer
   Center & Research Institute; H Lee Moffitt Cancer Center & Research
   Institute
RP Naghovi, AO (通讯作者)，H Lee Moffitt Canc Ctr & Res Inst, Radiat Oncol, 12902 Magnolia Dr, Tampa, FL 33612 USA.
EM daniel.fernandez@moffitt.org; daniel.fernandez@moffitt.org
RI Scott, Jacob/H-9634-2019; Fernandez, Daniel/ABE-2657-2021; Abuodeh,
   Yazan/C-1361-2017; Mullinax, John/L-2509-2014; Ahmed,
   Kamran/AHC-3488-2022
OI Abuodeh, Yazan/0000-0002-7395-5882; Mullinax, John/0000-0002-9596-6785;
   Ahmed, Kamran/0000-0003-3331-1529
FU National Cancer Institute [P30CA076292] Funding Source: NIH RePORTER;
   NCI NIH HHS [P30 CA076292] Funding Source: Medline
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NR 35
TC 7
Z9 7
U1 0
U2 2
PU TERMEDIA PUBLISHING HOUSE LTD
PI POZNAN
PA KLEEBERGA ST 2, POZNAN, 61-615, POLAND
SN 1689-832X
EI 2081-2841
J9 J CONTEMP BRACHYTHER
JI J. Contemp. Brachytherapy
PD JAN-FEB
PY 2017
VL 9
IS 1
BP 20
EP 29
DI 10.5114/jcb.2017.65641
PG 10
WC Oncology; Radiology, Nuclear Medicine & Medical Imaging
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Radiology, Nuclear Medicine & Medical Imaging
GA EN9CN
UT WOS:000396298400004
PM 28344600
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Canavese, F
   Krajbich, JI
AF Canavese, Federico
   Krajbich, Joseph I.
TI Resection of Plexiform Neurofibromas in Children With Neurofibromatosis
   Type 1
SO JOURNAL OF PEDIATRIC ORTHOPAEDICS
LA English
DT Article
DE neurofibromatosis type 1; plexiform neurofibromas; resection; children
ID VACUUM-ASSISTED CLOSURE; NERVE SHEATH TUMORS; PEDIATRIC-PATIENTS;
   MANAGEMENT; MRI; EXPERIENCE; RECEPTOR
AB Background: Large plexiform neurofibromas can cause significant morbidity, functional impairment, and may be even life threatening. They most commonly arise in association with major nerve trunks and follow the distribution of the involved peripheral nerves, and can be subject to transformation into malignant peripheral nerve sheet tumors. They produce large infiltrative masses, which can involve major portions of the trunk or extremities. The main goal of this project is to analyze our surgical experience with plexiform neurofibromas excision and to describe our surgical technique that may help the surgeon to reduce intraoperative bleeding and facilitate tumor excision.
   Methods: A retrospective chart and radiograph review was carried out for all cases of children with neurofibromatosis type 1 followed at our institution. Patients with plexiform neurofibromas of the trunk or extremities and who underwent surgical resection of the tumor were reviewed.
   Results: Eleven female and 3 male patients with neurofibromatosis type 1 with 20 surgically treated lesions were evaluated. The mean age of the patients at time of surgery was 13.4 years (range, 2.9 to 19.1 y). The average follow-up was 65.5 months (range, 24 to 145 mo). Five lesions (25%) were surgically treated before the age of 10 years and 15 lesions (75%) were treated after the age of 10 years. Further debulking was required in 7 lesions and a below knee amputation was performed in 1 case.
   Conclusions: The main goal of surgical resection of large lesions is to partially restore the normal appearance and function of the affected part and to ameliorate pain, when possible. One of the major complications of this particular surgery is the potential for significant blood loss. This complication seems to be particularly frequent in large plexiform neurofibromas located in those parts of the skeleton where the application of a tourniquet is not possible. Applying large retention sutures during dissection helps in minimizing bleeding and reduces the risk of complications.
   Level of Evidence: Level IV, retrospective study. See the guidelines online for a complete description of level of evidence.
C1 [Canavese, Federico; Krajbich, Joseph I.] Shriners Hosp Children, Dept Pediat Orthopaed, Portland, OR 97239 USA.
RP Canavese, F (通讯作者)，Shriners Hosp Children, Dept Pediat Orthopaed, 3101 SW Sam Jackson Pk Rd, Portland, OR 97239 USA.
EM canavese_federico@yahoo.fr
OI CANAVESE, Federico/0000-0002-6114-5372
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Bredella MA, 2007, AM J ROENTGENOL, V189, P928, DOI 10.2214/AJR.07.2060
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NR 25
TC 60
Z9 75
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0271-6798
J9 J PEDIATR ORTHOPED
JI J. Pediatr. Orthop.
PD APR-MAY
PY 2011
VL 31
IS 3
BP 303
EP 311
DI 10.1097/BPO.0b013e31820cad77
PG 9
WC Orthopedics; Pediatrics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Pediatrics
GA 737AN
UT WOS:000288538700016
PM 21415691
DA 2026-07-24
ER

PT J
AU Heilmann, C
   Stahl, R
   Schneider, C
   Sukhodolya, T
   Siepe, M
   Olschewski, M
   Beyersdorf, F
AF Heilmann, Claudia
   Stahl, Rahel
   Schneider, Christian
   Sukhodolya, Tetyana
   Siepe, Matthias
   Olschewski, Manfred
   Beyersdorf, Friedhelm
TI Wound complications after median sternotomy: a single-centre study
SO INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
LA English
DT Article; Proceedings Paper
CT Annual Techno-College Meeting at the 26th Annual Meeting of the
   European-Association-for-Cardio-Thoracic-Surgery (EACTS)
CY OCT 27-31, 2012
CL Barcelona, SPAIN
SP European Assoc Cardio Thorac Surg, Boston Sci Corp, Techno Coll
DE Median sternotomy; Surgical wound infection; Risk factors
ID VACUUM-ASSISTED CLOSURE; BYPASS GRAFT-SURGERY; STERNAL DEHISCENCE;
   NEGATIVE-PRESSURE; CARDIAC-SURGERY; INFECTION; THERAPY; RISK;
   MEDIASTINITIS; PREVENTION
AB Sternal wound complications following median sternotomy remain a challenge in cardiac surgery. Changes in both patient profile and type of operations have been observed in recent years. Therefore, we analysed current wound healing complications after median sternotomy at our centre.
   All adult patients undergoing a median sternotomy between January 2009 and April 2011 were included in this retrospective analysis. Transplants and assist devices implantations were omitted. We assessed outcome, prognostic factors and microbiological results of standardized wound swabs.
   In total, 1297 patients with an average age of 67.0 +/- 12.7 years were analysed. Operation types included 598 solitary coronary artery bypass grafts (CABGs), 213 solitary valve procedures, 105 CABGs with aortic valve replacement and 116 solitary aortic operations or conduit implantations. Furthermore, 255 of the remaining 265 were combined or otherwise complex procedures. Superficial healing disorders occurred in 43 patients (3.3%), while 33 (2.5%) developed deep wound complications. Six patients with sternal wound complications (7.9%) died in-hospital. In 7 patients, no pathogen was identified and the wound appeared uninfected (21% of all deep complications or 0.05% of all patients). These healing disorders were considered deep dehiscences. Patients with insulin-dependent diabetes mellitus, BMI of > 40 kg/m(2) and who underwent reoperation were prone to superficial infections. Risk factors for all deep sternal wound complications were insulin-dependent diabetes mellitus, COPD and reoperation. Moreover, multivariate analysis revealed 'emergency' as an independent prognostic factor for all sternal wound complications. Microbial swabs of the sternal wound were taken in 82 of the 1297 patients (6.6%). Pathogens of the normal skin flora represented the majority of pathogens in both superficial and deep wound complications. Eight patients with deep, but only 2 patients with superficial complications suffered from polymicrobial infections. All deep polymicrobial infections involved coagulase-negative Staphylococci.
   Wound complications following median sternotomy remain a challenge to cardiac surgery. Redo and emergency operations are the most important risk factors in this contemporary series. More efforts seem mandatory to decrease this arduous morbidity and the costs of prolonged treatment.
C1 [Heilmann, Claudia; Stahl, Rahel; Sukhodolya, Tetyana; Siepe, Matthias; Beyersdorf, Friedhelm] Univ Freiburg, Ctr Heart, Dept Cardiovasc Surg, D-79106 Freiburg, Germany.
   [Schneider, Christian] Univ Freiburg, Med Ctr, Inst Med Mikrobiol & Hyg, D-79106 Freiburg, Germany.
   [Schneider, Christian] Univ Freiburg, Med Ctr, Dept Mikrobiol & Hyg, D-79106 Freiburg, Germany.
   [Olschewski, Manfred] Univ Freiburg, Med Ctr, Dept Med Biometry & Stat, Inst Med Biometry & Med Informat, D-79106 Freiburg, Germany.
C3 University of Freiburg; University of Freiburg; University of Freiburg;
   University of Freiburg
RP Heilmann, C (通讯作者)，Univ Freiburg, Ctr Heart, Dept Cardiovasc Surg, Hugstetter Str 55, D-79106 Freiburg, Germany.
RI Schneider, Christian/OGN-7059-2025; Siepe, Matthias/AAF-9846-2019;
   Heilmann, Claudia/ABH-3446-2021; Beyersdorf, Friedhelm/AAK-3718-2020
OI Siepe, Matthias/0000-0003-3305-9343; Heilmann,
   Claudia/0000-0002-7231-5381; Beyersdorf, Friedhelm/0000-0003-2975-2751
CR Baillot R, 2010, EUR J CARDIO-THORAC, V37, P880, DOI 10.1016/j.ejcts.2009.09.023
   Beckmann A, 2011, EUR J CARDIO-THORAC, V40, P347, DOI 10.1016/j.ejcts.2010.12.016
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NR 22
TC 63
Z9 80
U1 1
U2 10
PU OXFORD UNIV PRESS
PI OXFORD
PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND
SN 1569-9293
EI 1569-9285
J9 INTERACT CARDIOV TH
JI Interact Cardiovasc. Thorac. Surg.
PD MAY
PY 2013
VL 16
IS 5
BP 643
EP 648
DI 10.1093/icvts/ivs554
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 132UX
UT WOS:000318095300021
PM 23355648
DA 2026-07-24
ER

PT J
AU Kaye, AE
   Kaye, AJ
   Pahk, B
   McKenna, ML
   Low, DW
AF Kaye, Alison E.
   Kaye, Adam J.
   Pahk, Brian
   McKenna, Mary L.
   Low, David W.
TI Sternal Wound Reconstruction Management in Different Cardiac
   Populations
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article; Proceedings Paper
CT 26th Annual Meeting of the Northwestern-Society-of-Plastic-Surgeons
CY SEP, 2009
CL Charleston, SC
DE mediastinitis; sternal wound dehiscence; sternal wound reconstruction;
   cardiac surgery; pectoralis flap; omental flap
ID MUSCLE FLAP RECONSTRUCTION; INFECTED MEDIAN STERNOTOMY; VACUUM-ASSISTED
   CLOSURE; OPEN-HEART SURGERY; MEDIASTINAL INFECTION; DEFINITIVE CLOSURE;
   COMPLICATIONS; DEEP; DEBRIDEMENT; TRANSPOSITION
AB Poststernotomy mediastinitis is a feared complication for patients undergoing cardiac surgery associated with high rates of morbidity and mortality. Approximately 15% of patients will ultimately be readmitted for a recurrent sternal wound infection. The objective of this study is to review a large single surgeon experience with sternal wound patients managed with a variety of soft tissue flaps to assess mitigating factors, involved organisms, and treatment protocols as related to specific cardiac populations. Records for 136 sternal reconstruction patients treated from January 2000 to July 2007 were evaluated. Patients underwent a variety of cardiac surgeries including coronary artery bypass grafting (CABG), valve replacement, aortic reconstruction, heart transplantation, lung transplantation, and combinations of these procedures. A total of 39.2% of patients developed a sternal wound during the same admission as their cardiac surgery, at an average of 16.1 days. This rate was only 6% for CABG-only patients and rose to nearly 50% in heart transplant and CABG + valve patients. A total of 78.6% of heart transplant patients with a sternal wound had a history of ventricular assist device and 41% of all patients had at least 1 previous sternotomy. Thirteen patients (9.6%) had 1 or more recurrent infections requiring surgery; 50% occurring in transplant patients, most of whom had diabetes and/or renal insufficiency. The most common presenting symptom was drainage (n = 75, 55.6%) or wound dehiscence (n = 22, 16.3%). Twenty-five different organisms were identified; 26 patients (18.5%) had multiple organisms. Staphylococcus species were most common. Plastic surgery intervention occurred on average 109.2 days after cardiac surgery. CABG and CABG + valve patients most frequently received right pectoralis muscle turnover flaps or left pectoralis muscle advancement flaps. Ten heart transplant patients (37.0%) underwent omental flaps. The 30-day perioperative mortality rate was 13 patients (9.6%).
C1 [McKenna, Mary L.; Low, David W.] Univ Penn, Div Plast Surg, Philadelphia, PA 19104 USA.
   [McKenna, Mary L.; Low, David W.] Univ Penn, Div Cardiovasc Surg, Philadelphia, PA 19104 USA.
   [Kaye, Alison E.; Kaye, Adam J.] Childrens Mercy Hosp, Dept Plast & Reconstruct Surg, Kansas City, MO 64108 USA.
   [Kaye, Alison E.; Kaye, Adam J.] Childrens Mercy Hosp, Dept Gen Surg, Kansas City, MO 64108 USA.
   [Pahk, Brian] NYU, Hosp Joint Dis, Dept Orthoped Surg, New York, NY USA.
C3 University of Pennsylvania; University of Pennsylvania; Children's Mercy
   Hospital; Children's Mercy Hospital; New York University; NYU Langone
   Medical Center; Hospital for Joint Disease NYULMC
RP Low, DW (通讯作者)，Univ Penn, Div Plast Surg, 10 Penn Tower,3400 Spruce St, Philadelphia, PA 19104 USA.
EM david.low@uphs.upenn.edu
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NR 30
TC 21
Z9 25
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD MAY
PY 2010
VL 64
IS 5
BP 658
EP 666
DI 10.1097/SAP.0b013e3181dba841
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 589GO
UT WOS:000277135200032
PM 20395796
DA 2026-07-24
ER

PT J
AU Afsarlar, ÇE
   Yilmaz, E
   Karaman, A
   Karaman, I
   Özgüner, IF
   Erdogan, D
   Çavusoglu, YH
   Maden, HA
AF Afsarlar, Cagatay Evrim
   Yilmaz, Engin
   Karaman, Ayse
   Karaman, Ibrahim
   Ozguner, Ismet Faruk
   Erdogan, Derya
   Cavusoglu, Yusuf Hakan
   Maden, Hasim Ata
TI Treatment of adolescent pilonidal disease with a new modification to the
   Limberg flap: Symmetrically rotated rhomboid excision and lateralization
   of the Limberg flap technique
SO JOURNAL OF PEDIATRIC SURGERY
LA English
DT Article; Proceedings Paper
CT 19th Meeting of the International-Pediatric-Colorectal-Club
CY JUN 11-12, 2012
CL Rome, ITALY
SP Int Pediat Colorectal Club
DE Pilonidal disease; Adolescent; Obesity; Limberg flap; Modified Limberg
   flap
ID VACUUM-ASSISTED CLOSURE; BODY-MASS INDEX; SINUS-DISEASE; TRANSPOSITION
   FLAP; WOUND MANAGEMENT; EXPERIENCE; CHILDREN; SURGERY; ORIGIN
AB Background/Purpose: Pilonidal disease is a common and frustrating problem among adolescents due to its high recurrence rate. The rhomboid excision and Limberg flap techniques promise successful results, but the lower part of the incision left on the intergluteal sulcus is prone to recurrences. Consequently, we have developed a new modification to this technique and have designed a descriptive prospective study to evaluate its efficiency.
   Methods: We conducted this prospective study between March 2011 and March 2012. All of the patients who were operated on for sacrococcygeal pilonidal disease were included in this study. The surgical procedure primarily consisted of symmetrically rotated (clockwise) rhomboid excision and lateralization of the Limberg flap in order to keep the inferior corner of the suture line apart from the intergluteal sulcus.
   Results: A total of 15 adolescents (8 boys and 7 girls) were included in the study group. Of the patients, 47% were normal, 13% were overweight, and 40% were obese. Five patients were operated on under general anesthesia, and 10 were operated on under spinal anesthesia. The length of the flap margins ranged from 2.5 to 7 cm (median=4 cm). The median duration of hospitalization was 5 days, and the median duration of suction drainage was 4 days. The median postoperative follow-up period was 4 months (ranging from 1 to 12 months), and we did not encounter any wound infection or recurrent disease during this period. Only one patient had wound hematoma as a result of drain breakdown and was treated with wound care without any additional complications.
   Conclusion: Although the number of patients in this study was small and the follow-up period was short, we obtained satisfactory results without any recurrence by performing a symmetrically rotated rhomboid excision and lateralized Limberg flap procedure. (C) 2013 Elsevier Inc. All rights reserved.
C1 [Afsarlar, Cagatay Evrim; Yilmaz, Engin; Karaman, Ayse; Karaman, Ibrahim; Ozguner, Ismet Faruk; Erdogan, Derya; Cavusoglu, Yusuf Hakan; Maden, Hasim Ata] Dr Sami Ulus Childrens Hosp, Dept Pediat Surg, Ankara, Turkey.
C3 Dr. Sami Ulus Education & Research Hospital
RP Afsarlar, ÇE (通讯作者)，Babur Cad 44, TR-06080 Ankara, Turkey.
EM drafsarlar@yahoo.com
RI Karaman, İbrahim/AAB-2957-2022; Erdogan, Derya/HPF-5081-2023; Cavusoglu,
   Yusuf Hakan/B-4316-2010; Afşarlar, Çağatay Evrim/LZH-6134-2025; Karaman,
   Ayşe/HHS-0256-2022; OZGÜNER, ISMET FARUK/AAC-5518-2019
OI Cavusoglu, Yusuf Hakan/0000-0002-1300-9376; Afşarlar, Çağatay
   Evrim/0000-0002-7716-8050; Karaman, Ayşe/0000-0001-6860-1222; OZGÜNER,
   ISMET FARUK/0000-0002-8045-9123
CR Akin M, 2010, SURG TODAY, V40, P757, DOI 10.1007/s00595-008-4098-7
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NR 27
TC 27
Z9 30
U1 0
U2 12
PU W B SAUNDERS CO-ELSEVIER INC
PI PHILADELPHIA
PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
SN 0022-3468
EI 1531-5037
J9 J PEDIATR SURG
JI J. Pediatr. Surg.
PD AUG
PY 2013
VL 48
IS 8
BP 1744
EP 1749
DI 10.1016/j.jpedsurg.2013.01.029
PG 6
WC Pediatrics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Pediatrics; Surgery
GA 205AP
UT WOS:000323413000019
PM 23932616
DA 2026-07-24
ER

PT J
AU Stechl, NM
   Baumeister, S
   Grimm, K
   Kraus, TW
   Bockhorn, H
   Exner, KE
AF Stechl, N. M.
   Baumeister, S.
   Grimm, K.
   Kraus, T. W.
   Bockhorn, H.
   Exner, K. E.
TI Microsurgical reconstruction of the pelvic floor after pelvic
   exenteration
SO CHIRURG
LA German
DT Article
DE Rectal cancer; Pelvic exenteration; Microvascular tissue transfer;
   Latissimus dorsi muscle flaps; Postoncological reconstruction
ID RECTAL-CANCER; COLORECTAL-CARCINOMA; RESECTION; RECURRENCE; SURGERY;
   WOUNDS
AB Pelvic exenteration for advanced or recurrent rectal cancer often results in complex defects associated with high complication rates and morbidity for the patients. The goal of therapy is therefore restoration of functional stability and adequate soft tissue coverage, thus enhancing the quality of life with limited life expectancy by an interdisciplinary approach.
   We report on eight patients treated by combined interdisciplinary pelvic exenteration with resection of the sacrum and subsequent coverage of the pelvic floor defect with free latissimus dorsi muscle flaps. All patients were treated in two stages according to a pre-established therapeutic algorithm. First, an abdominal and transsacral pelvic exenenteration was performed with an ileostomy and ileum conduit system and the pelvic floor was closed with vicryl meshes. The open wound was optimized by vacuum-assisted closure (VAC) therapy before reconstruction of the pelvic floor was undertaken 10-12 days later with free latissimus dorsi musculocutaneous flaps either anastomosed to the lower or upper gluteal vessels or to an AV-loop using the saphenous vein as connection to the groin vessels.
   In all cases a sufficient and stable reconstruction of the pelvic floor could be achieved and no flap loss occurred. In three patients a minor wound dehiscence occurred, which could be closed by secondary suture. The time span between the free flap transfer and stable wound closure was 19-28 days. Later complications such as fistula formation and chronic wound infections were not observed. The survival of the patients ranged from 10-36 months.
   The present two-stage concept of pelvic floor reconstruction with free latissimus dorsi muscle flaps for wound closure after pelvic exenteration improves postoperative morbidity and mortality and increases the quality of life of the affected patients. A shortened period of open wound therapy brings additional economic benefits. Because of its anatomical features the free latissimus dorsi flap can be regarded as the method of choice of microsurgical reconstruction within an interdisciplinary concept after pelvic exenteration.
C1 [Stechl, N. M.; Baumeister, S.; Exner, K. E.] Markus Krankenhaus, Klin Plast Wiederherstellungs & Handchirurg, D-60431 Frankfurt, Germany.
   [Grimm, K.; Kraus, T. W.; Bockhorn, H.] Krankenhaus NW Frankfurt, Klin Allgemein & Visceralchirurg, Frankfurt, Germany.
C3 Krankenhaus Nordwest
RP Stechl, NM (通讯作者)，Markus Krankenhaus, Klin Plast Wiederherstellungs & Handchirurg, Wilhelm Epstein Str 4, D-60431 Frankfurt, Germany.
EM N.Stechl@gmx.de
CR Brenner P, 1996, LANGENBECKS ARCH C S, P1167
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NR 22
TC 5
Z9 6
U1 1
U2 5
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0009-4722
J9 CHIRURG
JI Chirurg
PD JUL
PY 2011
VL 82
IS 7
BP 625
EP 630
DI 10.1007/s00104-010-2022-3
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 789JM
UT WOS:000292511800010
PM 21161142
DA 2026-07-24
ER

PT J
AU Schimmer, C
   Gross, J
   Ramm, E
   Morfelda, BC
   Hoffmann, G
   Panholzer, B
   Hedderich, J
   Leyh, R
   Cremer, J
   Petzina, R
AF Schimmer, Christoph
   Gross, Justus
   Ramm, Elena
   Morfelda, Bjoern-Carsten
   Hoffmann, Grischa
   Panholzer, Bernd
   Hedderich, Juergen
   Leyh, Rainer
   Cremer, Jochen
   Petzina, Rainer
TI Prevention of surgical site sternal infections in cardiac surgery: a
   two-centre prospective randomized controlled study
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE Cardiac surgery; Surgical site infection; CABG; Mediastinitis
ID GENTAMICIN-COLLAGEN SPONGE; INTERNAL THORACIC ARTERY; VACUUM-ASSISTED
   CLOSURE; RISK-FACTORS; SKIN SEALANT; WOUND COMPLICATIONS; MEDIASTINITIS;
   BYPASS; IMPACT; THERAPY
AB OBJECTIVES: Surgical site infection (SSI) of the sternum is a devastating complication in cardiac surgery. The aim of this prospective randomized controlled two-centre clinical study was to compare the use of a gentamicin-collagen sponge (Genta-Coll r resorb) and of a cyanoacrylate-based microbial skin sealant (InteguSeal r) on the SSI rate of the sternum.
   METHODS: We analysed data from 996 consecutive patients following isolated coronary artery bypass grafting between 2012 and 2014. The patients were randomized into three groups: standard group (S-group), Genta-Coll group (G-group) and InteguSeal group (I-group). The primary study end-point was to analyse the incidence of superficial and deep sternal SSI. The secondary study end-point was to determine independent risk factors for an increased SSI rate.
   RESULTS: Of the 996 patients investigated, 332 patients were in S-group, 336 patients in G-group and 328 patients in I-group. The mean age was 67.7 +/- 9.4 years, 18.6% were women and the overall SSI rate was 6.2% with 2.2% deep sternal wound infections. SSI rates were 8.3% (S-group), 5.4% (G-group) and 4.9% (I-group) (P 0.16). Multiple regression analysis demonstrated a preoperative body mass index (BMI) of > 30 kg/m2 (P 0.047), re-thoracotomy for postoperative bleeding (P < 0.001) and sternum instability (P < 0.001) as independent predictors for an increased SSI rate.
   CONCLUSIONS: The application of InteguSeal r or Genta-Coll r resorb had no significant influence on the incidence of the sternal SSI rate in 996 consecutive cardiac surgery patients but demonstrated a trend towards a benefit from using these prophylactic approaches. Multiple regression analysis demonstrated a preoperative BMI of > 30 kg/m(2), re-thoracotomy for bleeding and sternum instability as independent predictors for an increased sternal SSI rate.
C1 [Schimmer, Christoph; Morfelda, Bjoern-Carsten; Leyh, Rainer] Univ Hosp Wurzburg, Dept Cardiothorac & Thorac Vasc Surg, Wurzburg, Germany.
   [Gross, Justus; Ramm, Elena; Hoffmann, Grischa; Panholzer, Bernd; Cremer, Jochen; Petzina, Rainer] Univ Hosp Schleswig Holstein, Dept Cardiovasc Surg, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany.
   [Hedderich, Juergen] Univ Hosp Schleswig Holstein, Inst Med Informat & Stat, Campus Kiel, Kiel, Germany.
C3 University of Wurzburg; University of Kiel; Schleswig Holstein
   University Hospital; University of Kiel; Schleswig Holstein University
   Hospital
RP Petzina, R (通讯作者)，Univ Hosp Schleswig Holstein, Dept Cardiovasc Surg, Campus Kiel,Arnold Heller Str 3, D-24105 Kiel, Germany.
EM rainer.petzina@uksh.de
OI Petzina, Rainer/0000-0002-0688-5482
CR [Anonymous], J THORAC CARDIOVASC
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NR 25
TC 32
Z9 39
U1 1
U2 4
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
EI 1873-734X
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD JAN
PY 2017
VL 51
IS 1
BP 67
EP 72
DI 10.1093/ejcts/ezw225
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA EP5JS
UT WOS:000397415400010
PM 27365077
OA Bronze
DA 2026-07-24
ER

PT J
AU Ovaska, MT
   Madanat, R
   Tukiainen, E
   Pulliainen, L
   Sintonen, H
   Mäkinen, TJ
AF Ovaska, Mikko T.
   Madanat, Rami
   Tukiainen, Erkki
   Pulliainen, Lea
   Sintonen, Harri
   Makinen, Tatu J.
TI Flap reconstruction for soft-tissue defects with exposed hardware
   following deep infection after internal fixation of ankle fractures
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Ankle fracture; Infection; Flap reconstruction; Health-related quality
   of life
ID PRESSURE WOUND THERAPY; VACUUM-ASSISTED CLOSURE; BREVIS MUSCLE FLAP;
   LOWER-EXTREMITY TRAUMA; FAILED FREE FLAPS; PERONEUS BREVIS; LOWER LEG;
   SCORING SCALE; COVERAGE; MANAGEMENT
AB The aim of the present study was to determine the outcome for patients treated with flap reconstruction following deep ankle fracture infection with exposed hardware. Out of 3041 consecutive ankle fracture operations in 3030 patients from 2006 to 2011, we identified 56 patients requiring flap reconstruction following deep infection. Thirty-two of these patients could be examined at a follow-up visit. Olerud-Molander Ankle (OMA) score, 15D score, Numeric Rating Scale (NRS), and clinical examination were used to assess the outcome. A total of 58 flap reconstructions were performed in 56 patients with a mean age of 57 years (range 25-93 years) and mean follow-up time of 52 months. The most commonly used reconstruction was a distally based peroneus brevis muscle flap with a split-thickness skin graft. A microvascular free flap was required in only one patient. 22 (39%) patients required subsequent surgical interventions because of a flap-related complication. With flap reconstruction, hardware could eventually be salvaged in 53% of patients with a non-consolidated fracture. The mean OMA score was fair or poor in 53% of the patients, and only 56% had recovered their pre-injury level of function. Half of the patients had shoe wear limitations. The 15D score showed a significantly poorer health-related quality of life compared to an age-standardised sample of the general population. The mean pain NRS was 2.1 (range 0-6), and the mean satisfaction NRS was 6.6 (range 0-10). Our study showed that successful treatment of a soft-tissue defect with exposed hardware following ankle fracture infections can be achieved with local flaps. Despite eventual reconstructive success, complications are common. Patients perceive a poorer health-related quality of life, have shoe wear limitations, and only half of them achieve their pre-injury level of function. (C) 2014 Elsevier Ltd. All rights reserved.
C1 [Ovaska, Mikko T.; Madanat, Rami; Makinen, Tatu J.] Univ Helsinki, Cent Hosp, Dept Orthopaed & Traumatol, SF-00260 Helsinki, Finland.
   [Madanat, Rami] Massachusetts Gen Hosp, Harris Orthopaed Lab, Boston, MA USA.
   [Madanat, Rami] Harvard Univ, Sch Med, Boston, MA USA.
   [Tukiainen, Erkki; Pulliainen, Lea] Univ Helsinki, Cent Hosp, Dept Plast & Reconstruct Surg, SF-00260 Helsinki, Finland.
   [Sintonen, Harri] Univ Helsinki, Dept Publ Hlth, Hjelt Inst, Helsinki 00014, Finland.
   [Makinen, Tatu J.] Mt Sinai Hosp, Div Orthopaed Surg, Toronto, ON M5G 1X5, Canada.
C3 University of Helsinki; Helsinki University Central Hospital; Harvard
   University; Harvard University Medical Affiliates; Massachusetts General
   Hospital; Harvard University; Harvard Medical School; University of
   Helsinki; Helsinki University Central Hospital; University of Helsinki;
   University of Toronto; Sinai Health System Toronto
RP Ovaska, MT (通讯作者)，Univ Helsinki, Cent Hosp, Dept Orthopaed & Traumatol, Topeliuksenkatu 5, SF-00260 Helsinki, Finland.
EM mikko.ovaska@hus.fi
FU Helsinki University Central Hospital; Jane and Aatos Erkko Foundation;
   Paivikki and Sakari Sohlberg Foundation; Paulo Foundation
FX The study was supported by Helsinki University Central Hospital, and by
   grants from the Jane and Aatos Erkko Foundation, the Paivikki and Sakari
   Sohlberg Foundation, and the Paulo Foundation. The funding source had no
   influence or involvement in the study.
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NR 39
TC 17
Z9 19
U1 0
U2 3
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD DEC
PY 2014
VL 45
IS 12
BP 2029
EP 2034
DI 10.1016/j.injury.2014.10.006
PG 6
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA CA1DB
UT WOS:000348652100039
PM 25458066
DA 2026-07-24
ER

PT J
AU Habeeb, TAAM
   Hussain, A
   Shelat, V
   Chiaretti, M
   Bueno-Lledo, J
   Fadrique, AG
   Kalmoush, A
   Elnemr, M
   Safwat, K
   Raafat, A
   Wasefy, T
   Heggy, IA
   Osman, G
   Abdelhady, WA
   Mawla, WA
   Fiad, AA
   Elaidy, MM
   Amr, W
   Abdelhamid, MI
   Abdou, AM
   Ibrahim, AIA
   Baghdadi, MA
AF Habeeb, Tamer A. A. M.
   Hussain, Abdulzahra
   Shelat, Vishal
   Chiaretti, Massimo
   Bueno-Lledo, Jose
   Fadrique, Alfonso Garcia
   Kalmoush, Abd-Elfattah
   Elnemr, Mohamed
   Safwat, Khaled
   Raafat, Ahmed
   Wasefy, Tamer
   Heggy, Ibrahim A.
   Osman, Gamal
   Abdelhady, Waleed A.
   Mawla, Walid A.
   Fiad, Alaa A.
   Elaidy, Mostafa M.
   Amr, Wessam
   Abdelhamid, Mohamed I.
   Abdou, Ahmed Mahmoud
   Ibrahim, Abdelaziz I. A.
   Baghdadi, Muhammad Ali
TI A prospective multicentre study evaluating the outcomes of the abdominal
   wall dehiscence repair using posterior component separation with
   transversus abdominis muscle release reinforced by a retro-muscular
   mesh: filling a step
SO WORLD JOURNAL OF EMERGENCY SURGERY
LA English
DT Article
DE Abdominal wall dehiscence; Incisional hernia; Posterior component
   separation; Retro-muscular mesh
ID VACUUM-ASSISTED CLOSURE; QUALITY-OF-LIFE; WOUND DEHISCENCE; MANAGEMENT;
   CLASSIFICATION; ABDOMEN; COMPLICATIONS; INFECTION
AB BackgroundThis study aimed to evaluate the results of posterior component separation (CS) and transversus abdominis muscle release (TAR) with retro-muscular mesh reinforcement in patients with primary abdominal wall dehiscence (AWD). The secondary aims were to detect the incidence of postoperative surgical site occurrence and risk factors of incisional hernia (IH) development following AWD repair with posterior CS with TAR reinforced by retromuscular mesh.MethodsBetween June 2014 and April 2018, 202 patients with grade IA primary AWD (Bjorck's first classification) following midline laparotomies were treated using posterior CS with TAR release reinforced by a retro-muscular mesh in a prospective multicenter cohort study.ResultsThe mean age was 42 +/- 10 years, with female predominance (59.9%). The mean time from index surgery (midline laparotomy) to primary AWD was 7 +/- 3 days. The mean vertical length of primary AWD was 16 +/- 2 cm. The median time from primary AWD occurrence to posterior CS + TAR surgery was 3 +/- 1 days. The mean operative time of posterior CS + TAR was 95 +/- 12 min. No recurrent AWD occurred. Surgical site infections (SSI), seroma, hematoma, IH, and infected mesh occurred in 7.9%, 12.4%, 2%, 8.9%, and 3%, respectively. Mortality was reported in 2.5%. Old age, male gender, smoking, albumin level < 3.5 gm%, time from AWD to posterior CS + TAR surgery, SSI, ileus, and infected mesh were significantly higher in IH. IH rate was 0.5% and 8.9% at two and three years, respectively. In multivariate logistic regression analyses, the predictors of IH were time from AWD till posterior CS + TAR surgical intervention, ileus, SSI, and infected mesh.ConclusionPosterior CS with TAR reinforced by retro-muscular mesh insertion resulted in no AWD recurrence, low IH rates, and low mortality of 2.5%.Trial registration Clinical trial: NCT05278117.
C1 [Habeeb, Tamer A. A. M.; Elnemr, Mohamed; Safwat, Khaled; Raafat, Ahmed; Wasefy, Tamer; Heggy, Ibrahim A.; Osman, Gamal; Abdelhady, Waleed A.; Mawla, Walid A.; Fiad, Alaa A.; Elaidy, Mostafa M.; Amr, Wessam; Abdelhamid, Mohamed I.; Baghdadi, Muhammad Ali] Zagazig Univ, Fac Med, Dept Gen Surg, Fac Med St 1, Zagazig, Egypt.
   [Hussain, Abdulzahra] Homerton Univ Hosp, London, England.
   [Shelat, Vishal] Tan Tock Seng Hosp, Dept Gen Surg, Singapore, Singapore.
   [Chiaretti, Massimo] Sapienza Univ Rome, Dept Gen Surg, Surg Special & Organ Transplantat Paride Stefanini, Rome, Italy.
   [Bueno-Lledo, Jose] Hosp Univ & Politecn La Fe, Dept Gen Surg, Unit Abdominal Wall Surg, Valencia, Spain.
   [Fadrique, Alfonso Garcia] Inst Valenciano Oncol, Dept Gen Surg, Valencia, Spain.
   [Kalmoush, Abd-Elfattah] Al Azhar Univ, Gen Surg Dept, Cairo, Egypt.
   [Abdou, Ahmed Mahmoud; Ibrahim, Abdelaziz I. A.] Zagazig Univ, Fac Med, Obstet & Gynecol Dept, Zagazig, Egypt.
C3 Egyptian Knowledge Bank (EKB); Zagazig University; University of London;
   Queen Mary University London; Tan Tock Seng Hospital; Sapienza
   University Rome; Hospital Universitari i Politecnic La Fe; Instituto
   Valenciano De Oncologia; Egyptian Knowledge Bank (EKB); Al Azhar
   University; Egyptian Knowledge Bank (EKB); Zagazig University
RP Habeeb, TAAM (通讯作者)，Zagazig Univ, Fac Med, Dept Gen Surg, Fac Med St 1, Zagazig, Egypt.
EM tameralnaimy@hotmail.com
RI Chiaretti, Massimo/L-7800-2015; Alnaimy, Tamer/ABA-4771-2020;
   /W-4599-2019; Shelat, Vishal/ABC-3293-2021; Kalmoush, Abd-Elfattah
   Morsi/ABP-3296-2022; Bueno-Lledó, Jose/I-2674-2019; Ibrahim Abdelhamid,
   Mohamed/AAA-1292-2020
OI Chiaretti, Massimo/0000-0002-9689-7566; Shelat,
   Vishal/0000-0003-3988-8142; Kalmoush, Abd-Elfattah
   Morsi/0000-0001-6927-223X; Bueno-Lledó, Jose/0000-0002-3116-5022;
   Ibrahim Abdelhamid, Mohamed/0000-0003-1296-5435
FU Science, Technology & Innovation Funding Authority (STDF); Egyptian
   Knowledge Bank (EKB)
FX Open access funding provided by The Science, Technology & Innovation
   Funding Authority (STDF) in cooperation with The Egyptian Knowledge Bank
   (EKB).
CR Abbott DE, 2007, AM SURGEON, V73, P1224
   [Anonymous], 2013, Pak J Surg
   Björck M, 2016, SCAND J SURG, V105, P5, DOI 10.1177/1457496916631853
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NR 36
TC 4
Z9 4
U1 0
U2 1
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-7922
J9 WORLD J EMERG SURG
JI World J. Emerg. Surg.
PD MAR 3
PY 2023
VL 18
IS 1
AR 15
DI 10.1186/s13017-023-00485-9
PG 11
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA 9N8XX
UT WOS:000943194000001
PM 36869364
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Dijkstra, EA
   Kahmann, NLE
   Hemmer, PHJ
   Havenga, K
   van Etten, B
AF Dijkstra, E. A.
   Kahmann, N. L. E.
   Hemmer, P. H. J.
   Havenga, K.
   van Etten, B.
TI A low incidence of perineal hernia when using a biological mesh after
   extralevator abdominoperineal excision with or without pelvic
   exenteration or distal sacral resection in locally advanced rectal
   cancer patients
SO TECHNIQUES IN COLOPROCTOLOGY
LA English
DT Article
DE Biological mesh; Permacol; Perineal hernia; Wound healing; Rectal cancer
   surgery; Extralevator abdomino perineal excision; Pelvic exenteration
ID PREOPERATIVE RADIOTHERAPY; WOUND COMPLICATIONS; RISK-FACTORS; FLOOR;
   RECONSTRUCTION; CLOSURE
AB Background Extralevator abdominoperineal excision (ELAPE), abdominoperineal excision (APE) or pelvic exenteration (PE) with or without sacral resection (SR) for locally advanced rectal cancer leaves a significant defect in the pelvic floor. At first, this defect was closed primarily. To prevent perineal hernias, the use of a biological mesh to restore the pelvic floor has been increasing. The aim of this study, was to evaluate the outcome of the use of a biological mesh after ELAPE, APE or PE with/without SR. Methods A retrospective study was conducted on patients who had ELAPE, APE or PE with/without SR with a biological mesh (Permacol (TM)) for pelvic reconstruction in rectal cancer in our center between January 2012 and April 2015. The endpoints were the incidence of perineal herniation and wound healing complications. Results Data of 35 consecutive patients [22 men, 13 women; mean age 62 years (range 31-77 years)] were reviewed. Median follow-up was 24 months (range 0.4-64 months). Perineal hernia was reported in 3 patients (8.6%), and was asymptomatic in 2 of them. The perineal wound healed within 3 months in 37.1% (n = 13), within 6 months in 51.4% (n = 18) and within 1 year in 62.9% (n = 22). In 17.1% (n = 6), the wound healed after 1 year. It was not possible to confirm perineal wound healing in the remaining 7 patients (20.0%) due to death or loss to follow-up. Wound dehiscence was reported in 18 patients (51.4%), 9 of whom needed vacuum-assisted closure therapy, surgical closure or a flap reconstruction. Conclusions Closure of the perineal wound after (EL)APE with a biological mesh is associated with a low incidence of perineal hernia. Wound healing complications in this high-risk group of patients are comparable to those reported in the literature.
C1 [Dijkstra, E. A.] Univ Groningen, Univ Med Ctr Groningen, Dept Med Oncol, Groningen, Netherlands.
   [Kahmann, N. L. E.; Hemmer, P. H. J.; Havenga, K.; van Etten, B.] Univ Groningen, Dept Surg, Univ Med Ctr Groningen, Hanzepl 1,POB 30-001, NL-9700 RB Groningen, Netherlands.
C3 University of Groningen; University of Groningen
RP van Etten, B (通讯作者)，Univ Groningen, Dept Surg, Univ Med Ctr Groningen, Hanzepl 1,POB 30-001, NL-9700 RB Groningen, Netherlands.
EM b.van.etten@umcg.nl
OI van Etten, Boudewijn/0000-0003-2900-2942; Dijkstra,
   Esmée/0000-0002-1205-7616
CR Artioukh DY, 2007, COLORECTAL DIS, V9, P362, DOI 10.1111/j.1463-1318.2006.01159.x
   Bullard KM, 2005, DIS COLON RECTUM, V48, P438, DOI 10.1007/s10350-004-0827-1
   Chadwick MA, 2006, COLORECTAL DIS, V8, P756, DOI 10.1111/j.1463-1318.2006.01029.x
   Christensen HK, 2011, DIS COLON RECTUM, V54, P711, DOI 10.1007/DCR.0b013e3182163c89
   Christian CK, 2005, DIS COLON RECTUM, V48, P43, DOI 10.1007/s10350-004-0855-x
   Foster J D, 2018, Colorectal Dis, V20 Suppl 5, P5, DOI [10.1111/codi.14348, 10.1111/codi.14348]
   Ge W, 2017, ONCOTARGET, V8, P8818, DOI 10.18632/oncotarget.12502
   Gould L, 2019, WOUND REPAIR REGEN, V27, P201, DOI 10.1111/wrr.12707
   Han JG, 2019, DIS COLON RECTUM, V62, P1477, DOI 10.1097/DCR.0000000000001495
   Hellinga J, 2016, ANN SURG ONCOL, V23, P4073, DOI 10.1245/s10434-016-5332-y
   Holm T, 2007, BRIT J SURG, V94, P232, DOI 10.1002/bjs.5489
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   Peacock O, 2012, INT J COLORECTAL DIS, V27, P475, DOI 10.1007/s00384-011-1325-2
   Sayers AE, 2015, COLORECTAL DIS, V17, P351, DOI 10.1111/codi.12843
   Schiltz B, 2017, WORLD J CLIN ONCOL, V8, P249, DOI 10.5306/wjco.v8.i3.249
   Thomas PW, 2019, TECH COLOPROCTOL, V23, P761, DOI 10.1007/s10151-019-02056-0
   Wille-Jorgensen P, 2009, INT J COLORECTAL DIS, V24, P323, DOI 10.1007/s00384-008-0607-9
   Yang Y, 2015, INT J CLIN EXP MED, V8, P14855
   Zhou X, 2015, COLORECTAL DIS, V17, P474, DOI 10.1111/codi.12921
NR 21
TC 16
Z9 19
U1 0
U2 8
PU SPRINGER-VERLAG ITALIA SRL
PI MILAN
PA VIA DECEMBRIO, 28, MILAN, 20137, ITALY
SN 1123-6337
EI 1128-045X
J9 TECH COLOPROCTOL
JI Tech. Coloproctology
PD AUG
PY 2020
VL 24
IS 8
BP 855
EP 861
DI 10.1007/s10151-020-02248-z
EA JUN 2020
PG 7
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA MJ6ZU
UT WOS:000538957100001
PM 32514996
OA Green Accepted, Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Evans, KN
   Forsberg, JA
   Potter, BK
   Hawksworth, JS
   Brown, TS
   Andersen, R
   Dunne, JR
   Tadaki, D
   Elster, EA
AF Evans, Korboi N.
   Forsberg, Jonathan A.
   Potter, Benjamin K.
   Hawksworth, Jason S.
   Brown, Trevor S.
   Andersen, Romney
   Dunne, James R.
   Tadaki, Douglas
   Elster, Eric A.
TI Inflammatory Cytokine and Chemokine Expression is Associated With
   Heterotopic Ossification in High-Energy Penetrating War Injuries
SO JOURNAL OF ORTHOPAEDIC TRAUMA
LA English
DT Article
DE inflammatory cytokines and chemokines; heterotopic ossification; high
   energy way injuries
ID TRAUMATIC BRAIN-INJURY; BONE-FORMATION; RISK-FACTORS; SPINAL-CORD;
   DIFFERENTIATION; OSTEOBLASTS; PREVALENCE; CELLS; INTERLEUKIN-6;
   INDOMETHACIN
AB Objective: Heterotopic ossification (HO) develops frequently after modern high-energy penetrating war injuries. The purpose of this prospective study was to identify and characterize the unique cytokine and chemokine profile associated with the development of HO as it pertained to the systemic inflammatory response after penetrating combat-related trauma.
   Methods: Patients with high-energy penetrating extremity wounds were prospectively enrolled. Surgical debridement along with the use of a pulse lavage and vacuum-assisted-closure device was performed every 48-72 hours until definitive wound closure. Wound bed tissue biopsy, wound effluent, and serum were collected before each debridement. Effluent and serum were analyzed for 22 relevant cytokines and chemokines. Tissue was analyzed quantitatively for bacterial colonization. Correlations between specific wound and patient characteristics were also analyzed. The primary clinical outcome measure was the formation of HO as confirmed by radiographs at a minimum of 2 months of follow-up.
   Results: Thirty-six penetrating extremity war wounds in 24 patients were investigated. The observed rate of HO in the study population was 38%. Of the 36 wounds, 13 (36%) demonstrated HO at a minimum follow-up of 2 months. An elevated injury severity score was associated with the development of HO (P = 0.006). Wound characteristics that correlated with the development of HO included impaired healing (P = 0.005) and bacterial colonization (P < 0.001). Both serum (interleukin-6, interleukin-10, and MCP-1) and wound effluent (IP-10 and MIP-1 alpha) cytokine and chemokine bioprofiles were individually associated and suggestive of the development of HO (P < 0.05).
   Conclusions: A severe systemic and wound-specific inflammatory state as evident by elevated levels of inflammatory cytokines, elevated injury severity score, and bacterial wound colonization is associated with the development of HO. These findings suggest that the development of HO in traumatic combat-related wounds is associated with a hyper-inflammatory systemic response to injury.
C1 [Evans, Korboi N.; Hawksworth, Jason S.; Elster, Eric A.] USN, Regenerat Med Dept, Med Res Ctr, Silver Spring, MD 20910 USA.
   [Evans, Korboi N.; Forsberg, Jonathan A.; Potter, Benjamin K.; Brown, Trevor S.; Andersen, Romney; Tadaki, Douglas] Walter Reed Natl Mil Med Ctr, Integrated Dept Orthoped & Rehabil, Bethesda, MD USA.
   [Evans, Korboi N.; Forsberg, Jonathan A.; Potter, Benjamin K.; Andersen, Romney; Dunne, James R.; Elster, Eric A.] Uniformed Serv Univ Hlth Sci, Bethesda, MD 20814 USA.
   [Hawksworth, Jason S.; Dunne, James R.; Elster, Eric A.] Walter Reed Natl Mil Med Ctr, Integrated Dept Surg, Bethesda, MD USA.
C3 United States Department of Defense; United States Navy; Walter Reed
   National Military Medical Center; Uniformed Services University of the
   Health Sciences - USA; Walter Reed National Military Medical Center
RP Elster, EA (通讯作者)，USN, Regenerat Med Dept, Med Res Ctr, Silver Spring, MD 20910 USA.
EM eric.elster@med.navy.mil
RI Forsberg, Jonathan/K-2116-2012; Brown, Trevor/F-7392-2015; Potter,,
   Benjamin K/U-1769-2019; Elster, Eric/ABG-6091-2021
OI Forsberg, Jonathan/0000-0003-3835-0615; Andersen,
   Romney/0009-0000-3507-7612; Brown, Trevor/0000-0001-7042-785X; Potter,,
   Benjamin K/0000-0002-8771-0317; Elster, Eric/0000-0002-0981-2748
FU US Navy Bureau of Medicine and Surgery under the Medical Development
   Program [PE 0604771N];  [601153N.4508.5180.A0508]
FX Supported by the US Navy Bureau of Medicine and Surgery under the
   Medical Development Program (PE 0604771N). This work was funded by work
   unit number: 601153N.4508.5180.A0508 and approved by the National Naval
   Medical Center Institutional Review Board in compliance with all Federal
   regulations governing the protection of human subjects. The NNMC IRB
   number is NNMC>2005.0069, and the protocol title is "The Use of Vacuum
   Assisted Wound Closure Device in treating Extremity Wounds."
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NR 39
TC 105
Z9 125
U1 0
U2 16
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0890-5339
J9 J ORTHOP TRAUMA
JI J. Orthop. Trauma
PD NOV
PY 2012
VL 26
IS 11
BP E204
EP E213
DI 10.1097/BOT.0b013e31825d60a5
PG 10
WC Orthopedics; Sport Sciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences
GA 028WR
UT WOS:000310456200002
PM 22588530
DA 2026-07-24
ER

PT J
AU Ottomann, C
   Stojadinovic, A
   Lavin, PT
   Gannon, FH
   Heggeness, MH
   Thiele, R
   Schaden, W
   Hartmann, B
AF Ottomann, Christian
   Stojadinovic, Alexander
   Lavin, Philip T.
   Gannon, Francis H.
   Heggeness, Michael H.
   Thiele, Richard
   Schaden, Wolfgang
   Hartmann, Bernd
TI Prospective Randomized Phase II Trial of Accelerated Reepithelialization
   of Superficial Second-Degree Burn Wounds Using Extracorporeal Shock Wave
   Therapy
SO ANNALS OF SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; ANTIINFLAMMATORY ACTION; GROWTH; CELLS;
   SURVIVAL; INCREASE
AB Background: As extracorporeal shock wave therapy (ESWT) can enhance healing of skin graft donor sites, this study focused on shock wave effects in burn wounds.
   Methods: A predefined cohort of 50 patients (6 with incomplete data or lost to follow-up) with acute second-degree burns from a larger study of 100 patients were randomly assigned between December 2006 and December 2007 to receive standard therapy (burn wound debridement/topical antiseptic therapy) with (n = 22) or without (n = 22) defocused ESWT (100 impulses/cm(2) at 0.1 mJ/mm(2)) applied once to the study burn, after debridement. Randomization sequence was computer-generated, and patients were blinded to treatment allocation. The primary endpoint, time to complete burn wound epithelialization, was determined by independent, blinded-observer. A worst case scenario was applied to the missing cases to rule out the impact of withdrawal bias.
   Results: Patient characteristics across the 2 study groups were balanced (P > 0.05) except for older age (53 +/- 17 vs. 38 +/- 13 years, P = 0.002) in the ESWT group. Mean time to complete (>= 95%) epithelialization (CE) for patients that did and did not undergo ESWT was 9.6 +/- 1.7 and 12.5 +/- 2.2 days, respectively (P < 0.0005). When age (continuous variable) and treatment group (binary) were examined in a linear regression model to control the baseline age imbalance, time to CE, age was not significant (P = 0.33) and treatment group retained significance (P < 0.0005). Statistical significance (P = 0.001) was retained when ESWT cases with missing follow-up were assigned the longest time to CE and when controls with missing follow-up were assigned the shortest time to CE.
   Conclusions: In this randomized phase II study, application of a single defocused shock wave treatment to the superficial second-degree burn wound after debridement/topical antiseptic therapy significantly accelerated epithelialization. This finding warrants confirmation in a larger phase III trial (ClinicalTrials.gov identifier: NCT01242423).
C1 [Ottomann, Christian; Hartmann, Bernd] Unfallkrankenhaus Berlin, Zentrum Schwerbrandverletzte Plast Chirurg, Berlin, Germany.
   [Stojadinovic, Alexander] Uniformed Serv Univ Hlth Sci, Dept Surg, Bethesda, MD 20814 USA.
   [Stojadinovic, Alexander] Combat Wound Initiat Program, Rockville, MD USA.
   [Lavin, Philip T.] Boston Biostat Res Fdn, Framingham, MA USA.
   [Gannon, Francis H.; Heggeness, Michael H.] Baylor Coll Med, Houston, TX 77030 USA.
   [Thiele, Richard] Int Zentrum Stosswellentherapie, Berlin, Germany.
   [Schaden, Wolfgang] AUVA Trauma Ctr Meidling, Vienna, Austria.
C3 Uniformed Services University of the Health Sciences - USA; Baylor
   College of Medicine
RP Ottomann, C (通讯作者)，Unfallkrankenhaus Berlin, Zentrum Schwerbrandverletzte Plast Chirurg, Berlin, Germany.
EM christian.ottoman@ukb.de
OI Stojadinovic, Alexander/0000-0002-2829-8967
FU Congressionally directed Combat Wound Initiative; Internationales
   Zentrum fur Stosswellentherapie, Berlin, Germany; TRT LLC; Henry M.
   Jackson Foundation for the Advancement of Military Medicine; Combat
   Wound Initiative; AUVA-Trauma Center; Unfallkrankenhaus Berlin, Zentrum
   fur Schwerbrandverletzte mit Plastischer Chirurgie
FX Professor Schaden owns stock and is a board member of Tissue
   Regeneration Technologies LLC. Dr Richard Thiele owns stock in Tissue
   Regeneration Technologies LLC, and was a former Scientific Advisor to
   the Company. Supported, in part, by the Congressionally directed Combat
   Wound Initiative Program, and the Internationales Zentrum fur
   Stosswellentherapie, Berlin, Germany. The shockwave device used in this
   trial is an investigational device currently used in TRT LLC-sponsored
   FDA trials under the trade name DermaGold.The authors thank Robin Howard
   for her significant contribution to this work. We would also like to
   thank Tiffany Felix for her invaluable assistance, supported in part by
   the Henry M. Jackson Foundation for the Advancement of Military
   Medicine. We are grateful to the members and staff of the Combat Wound
   Initiative Program, the AUVA-Trauma Center, and the Unfallkrankenhaus
   Berlin, Zentrum fur Schwerbrandverletzte mit Plastischer Chirurgie for
   their consistent support of this collaborative research effort.
CR Aicher A, 2006, CIRCULATION, V114, P2823, DOI 10.1161/CIRCULATIONAHA.106.628623
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NR 28
TC 64
Z9 66
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0003-4932
EI 1528-1140
J9 ANN SURG
JI Ann. Surg.
PD JAN
PY 2012
VL 255
IS 1
BP 23
EP 29
DI 10.1097/SLA.0b013e318227b3c0
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 869ZM
UT WOS:000298638900005
PM 21775883
DA 2026-07-24
ER

PT J
AU Verdam, FJ
   Dolmans, DEJGJ
   Loos, MJ
   Raber, MH
   de Wit, RJ
   Charbon, JA
   Vroemen, JPAM
AF Verdam, Froukje J.
   Dolmans, Dennis E. J. G. J.
   Loos, Maarten J.
   Raber, Menno H.
   de Wit, Ralph J.
   Charbon, Jan A.
   Vroemen, Jos P. A. M.
TI Delayed Primary Closure of the Septic Open Abdomen with a Dynamic
   Closure System
SO WORLD JOURNAL OF SURGERY
LA English
DT Article
ID ABDOMINAL COMPARTMENT SYNDROME; GENERAL-SURGERY; WALL DEFECTS;
   MANAGEMENT; TRAUMA; STRATEGY
AB Background The major challenge in the management of patients with an infected open abdomen (OA) is to control septic peritonitis and intra-abdominal fluid secretion, and to facilitate repeated abdominal exploration, while preserving the fascia for delayed primary closure. We here present a novel method for closure of the infected OA, based on continuous dynamic tension, in order to achieve re-approximation of the fascial edges of the abdominal wall.
   Methods Eighteen cases with severe peritonitis of various origin (e.g., gastrointestinal perforations, anastomotic leakage) were primarily stabilized by laparostomy, sealed with either the vacuum-assisted closure abdominal dressing or the Bogota bag. After hemodynamic stabilization and control of the sepsis, the Abdominal Re-approximation Anchor System (ABRA; Canica Design, Almonte, Ontario, Canada) was applied. This system approximates the wound margins through dynamic traction exerted by transfascial elastomers. Before ABRA application, 5/18 patients had a grade 2B, 2/18 a grade 3, and 11/18 a grade or 4 status according to the open abdomen classification of Bjorck.
   Results In this severely ill population the mean time before ABRA system application was 12 days (range: 2-39 days). Two of 18 patients died of non-ABRA-related causes within three weeks. In 14 of the remaining 16 patients (88%) primary abdominal closure of the midline was accomplished in 15 days (range: 7-30 days). The other two patients needed a component separation technique according to Ramirez to reach closure. However, secondary wound dehiscence occurred in both these patients. Two thirds of patients (12/18) developed pressure sores to the skin and/or dermis, but all healed without further complications. During outpatient clinic follow-up, 4/14 successfully closed patients still developed a midline hernia.
   Conclusions Delayed primary closure of OA in septic patients could be achieved in 88% with this new approximation system. However, the risk of hernia development remained. We consider this system a useful tool in the treatment of septic patients with an open abdomen.
C1 [Verdam, Froukje J.; Dolmans, Dennis E. J. G. J.; Vroemen, Jos P. A. M.] Amphia Hosp, Dept Gen Surg, NL-4800 RK Breda, Netherlands.
   [Verdam, Froukje J.] Maastricht Univ, Med Ctr, Dept Gen Surg, Maastricht, Netherlands.
   [Dolmans, Dennis E. J. G. J.] Atrium Med Ctr, Dept Gen Surg, Heerlen, Netherlands.
   [Loos, Maarten J.; Charbon, Jan A.] Maxima Med Ctr, Dept Gen Surg, Veldhoven, Netherlands.
   [Raber, Menno H.; de Wit, Ralph J.] Med Spectrum Twente, Dept Gen Surg, Enschede, Netherlands.
C3 Amphia Hospital; Maastricht University; Atrium Medical Center; Maxima
   Medical Center; Medical Spectrum Twente
RP Verdam, FJ (通讯作者)，Amphia Hosp, Dept Gen Surg, POB 90158, NL-4800 RK Breda, Netherlands.
EM froukjeverdam@yahoo.com; jvroemen@amphia.nl
OI Verdam, Froukje/0000-0002-3986-5250
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NR 25
TC 69
Z9 78
U1 0
U2 7
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0364-2313
EI 1432-2323
J9 WORLD J SURG
JI World J.Surg.
PD OCT
PY 2011
VL 35
IS 10
BP 2348
EP 2355
DI 10.1007/s00268-011-1210-8
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 819EI
UT WOS:000294807800023
PM 21850603
OA hybrid
DA 2026-07-24
ER

PT J
AU Kyriazanos, ID
   Stamos, NP
   Miliadis, L
   Noussis, G
   Stoidis, CN
AF Kyriazanos, Ioannis D.
   Stamos, Nikolaos P.
   Miliadis, Lazaros
   Noussis, Grigorios
   Stoidis, Christos N.
TI Extra-mammary Paget's disease of the perianal region: A review of the
   literature emphasizing the operative management technique
SO SURGICAL ONCOLOGY-OXFORD
LA English
DT Review
DE Extra-mammary Paget's disease; Perianal region; Treatment; Surgery; Wide
   local excision; Flaps
ID WIDE LOCAL EXCISION; MOHS MICROGRAPHIC SURGERY; THICKNESS SKIN-GRAFT;
   V-Y ADVANCEMENT; PHOTODYNAMIC THERAPY; SURGICAL-TREATMENT;
   RECTAL-CARCINOMA; LASER TREATMENT; ISLAND FLAPS; EXTRAMAMMARY
AB The perianal skin is a common area for extra-mammary Paget's disease development. The unique clinical, histopathological, and immunohistochemical features which this medical phenomenon demonstrates, along with its rarity and frequent association with synchronous or metachronous carcinomas, present us with a treatment challenge. In order to organize the surgical treatment, it is important to determine whether the disease is localized exclusively to the perianal skin or associated with metastasis or anorectal carcinomas.
   Despite several controversies concerning its optimal therapeutic management, wide local excision of the skin and subcutaneous tissue in the perianal region is generally recommended for the treatment of the non-invasive form of the disease. Such an aggressive operative management usually results in a large perianal tissue defect, which can not be primarily suppressed without resultant tension and possible complications, requiring a special technique for its coverage. Various techniques have been described in the literature for the treatment of these defects, often associated with unfavourable long term results, i.e. split-thickness skin grafts and vacuum-assisted closure devices. More recently several authors have reported favourable results using various transposition or rotation local skin flaps, myocutaneous flaps of the gluteal and thigh muscles, and V-Y island flaps to cover these areas of tissue loss.
   In this article we present a short review of the literature concerning perianal Paget's disease with special attention to its management and a demonstration of the operative technique we prefer on patients with perianal non-invasive Paget's disease, i.e. wide local excision with a 2 cm margin in the anal mucosa and use of U and V-Y shaped perianal fatty-cutaneous island flaps for reconstruction by covering the bilateral anal skin defects. (C) 2010 Elsevier Ltd. All rights reserved.
C1 [Kyriazanos, Ioannis D.; Stamos, Nikolaos P.; Miliadis, Lazaros; Noussis, Grigorios; Stoidis, Christos N.] Naval & Vet Hosp Athens, Dept Surg, Athens, Greece.
RP Stoidis, CN (通讯作者)，Naval & Vet Hosp Athens, Dept Surg, Athens, Greece.
EM aris.80@hotmail.com
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NR 113
TC 56
Z9 61
U1 0
U2 2
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0960-7404
EI 1879-3320
J9 SURG ONCOL
JI Surg. Oncol.-Oxf.
PD JUN
PY 2011
VL 20
IS 2
BP E61
EP E71
DI 10.1016/j.suronc.2010.09.005
PG 11
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA 766BZ
UT WOS:000290756000001
PM 20884199
DA 2026-07-24
ER

PT J
AU Yu, ZZ
   Jin, SY
   Zang, MQ
   Zhu, S
   Li, SS
   Han, TL
   Chen, ZX
   Liu, YB
AF Yu, Zouzou
   Jin, Shengyang
   Zang, Mengqing
   Zhu, Shan
   Li, Shanshan
   Han, Tinglu
   Chen, Zixiang
   Liu, Yuanbo
TI Successful Reconstruction of Complex Sacrococcygeal Defects Using
   Chimeric Perforator Propeller Flap
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE complex defect; reconstruction; sacrococcygeal region; chimeric
   perforator propeller flap; superior gluteal artery
ID SOFT-TISSUE RECONSTRUCTION; Y ADVANCEMENT FLAP; TOTAL SACRECTOMY; SACRAL
   TUMORS; MUSCLE FLAP; MANAGEMENT; RESECTION; INFECTIONS
AB BackgroundComplex soft tissue defects, which result from the surgical resection of sacral tumors, manifest as a combination of skin defects, dead space, infection, and prosthesis exposure. Because the traditional musculocutaneous flap lacks flexibility because of the close connection between the skin flap and the muscle component, the musculocutaneous flap is not suitable for reconstructing complex soft tissue defects where the dead space and skin defects are located at different sites. Furthermore, the perforator flap is also not appropriate for reconstructing complex defects because it lacks the muscular component. We considered the possibility of using the chimeric perforator propeller flap for reconstructing complex sacrococcygeal defects.MethodsThis study included 7 patients who underwent, between July 2007 and July 2021, the reconstruction of complex soft tissue defects of the sacrococcygeal region using a chimeric perforator propeller flap.ResultsAmong the included cases, the etiologies were chordoma (n = 3), sacral tumor (n = 3), and squamous cell carcinoma (n = 1). In all the cases, vacuum-assisted closure therapy was used to treat wound infections before surgery. The average sizes of the skin and muscle flaps were 195.8 cm2 (range, 100-350 cm2) and 83.6 cm2 (range, 60-140 cm2), respectively. The superior gluteal artery was the source artery for the chimeric perforator propeller flap. The donor sites were primarily closed in all cases. One patient had delayed wound healing, and the secondary wound healed using conservative dressing changes. The other 6 flaps had no complications. The average follow-up time was 5.3 months (range, 1-9 months). Muscle weakness and compromised ambulation in the affected lower extremities were not observed in any of the patients. Furthermore, all 7 patients had no tumor recurrence, prosthesis exposure, and infection events in the sacrococcygeal region.ConclusionsThe chimeric perforator propeller flap may be an option for reconstructing complex soft tissue defects in the sacrococcygeal region.
C1 [Yu, Zouzou; Jin, Shengyang; Zang, Mengqing; Zhu, Shan; Li, Shanshan; Han, Tinglu; Chen, Zixiang; Liu, Yuanbo] Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Dept Plast & Reconstruct Surg, 33 Ba Da Chu Rd, Beijing 100144, Peoples R China.
C3 Chinese Academy of Medical Sciences - Peking Union Medical College;
   Plastic Surgery Hospital - CAMS; Peking Union Medical College
RP Liu, YB (通讯作者)，Chinese Acad Med Sci, Peking Union Med Coll, Plast Surg Hosp, Dept Plast & Reconstruct Surg, 33 Ba Da Chu Rd, Beijing 100144, Peoples R China.
EM pumcyu@126.com; 1181130880@qq.com; zangmengqing@sina.com; tddzs@tom.com;
   lishanshan0308@126.com; yatouhaizhiyun2013@163.com;
   chenzixiangcc@163.com; ybpumc@sina.com
RI Chen, Zixiang/IZP-9251-2023; Zang, Mengqing/JJD-4306-2023; li,
   shanshan/ABD-5803-2021; jin, shengyang/PLC-3075-2026
OI Jin, Shengyang/0009-0003-0837-0882; 
FU Capital's Funds for Health Improvement and Research [2022-1-4041]
FX This study was supported by the Capital's Funds for Health Improvement
   and Research (grant/award number 2022-1-4041).
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NR 38
TC 0
Z9 1
U1 0
U2 7
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD NOV
PY 2023
VL 91
IS 5
BP 597
EP 603
DI 10.1097/SAP.0000000000003698
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA Y4KT0
UT WOS:001104974100010
PM 37823625
DA 2026-07-24
ER

PT J
AU Morgenstjerne-Schwenck, LET
   Knudsen, JT
   Prasad, SC
AF Morgenstjerne-Schwenck, Liv E. T.
   Knudsen, Jane T.
   Prasad, Sumangali C.
TI Efficacy and safety of skin grafting in treatment of vasculitic ulcer
   and pyoderma gangrenosum-A systematic review
SO WOUND REPAIR AND REGENERATION
LA English
DT Review
ID VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY; MYCOPHENOLATE-MOFETIL;
   HYPERBARIC-OXYGEN; CASE SERIES; LEG ULCERS; SURGICAL-MANAGEMENT;
   PATIENT; CYCLOSPORINE; INFECTION
AB Chronic painful ulcers caused by pyoderma gangrenosum (PG) and cutaneous vasculitis remain to be a therapeutic challenge. Skin grafts have been used with success in selected cases but are generally avoided due to the fear of pathergy. The aim of this study was to investigate the safety and efficacy of skin grafting in the treatment of primary vasculitic ulcer (PVU) and PG. MEDLINE, Embase, the Cochrane Library, , and WHO International Clinical Trials Registry Platform (ICTRP) were searched from inception to March 2020. A search for grey literature was conducted in May 2020. We included studies assessing the efficacy and safety of skin grafting in the treatment of PG and PVU. Studies were only included if skin grafting was performed after establishment of PG or PVU diagnosis. A total of 721 articles was identified through the database search of which 92 were included in this study. Ten articles were identified by handsearching the reference list of included studies. Finally, 102 articles describing 212 wounds in 153 patients were included. Complete healing was found in 75.5% of the wounds. The average time to complete was 10.8 weeks (95% CI 6.1-15.6). The mean donor site healing time was 1.9 weeks (95% CI 0.52-3.20). Pathergy was reported in 8 (5.2%) patients. One patient had severe infection related to skin grafting. A statistically significant difference in the number of patients receiving preoperative (P = .0079) and postoperative (P = .002) immunosuppressive therapy was found between the groups with complete healing/reduction and no improvement/aggravation. This systematic review finds the current evidence on efficacy and safety of skin grafting in treatment of PG and PVU to be promising but limited to the size and lack of studies superior to case reports and case series. Future placebo-controlled trials are required to draw a stronger conclusion.
C1 [Morgenstjerne-Schwenck, Liv E. T.; Prasad, Sumangali C.] Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, JB Winslows Vej 19, DK-5000 Odense, Denmark.
   [Knudsen, Jane T.; Prasad, Sumangali C.] Odense Univ Hosp, Dept Dermatovenerol & Allergy, Odense, Denmark.
C3 University of Southern Denmark; University of Southern Denmark; Odense
   University Hospital
RP Morgenstjerne-Schwenck, LET (通讯作者)，Univ Southern Denmark, Fac Hlth Sci, Dept Clin Res, JB Winslows Vej 19, DK-5000 Odense, Denmark.
EM livmorgenstjerne@outlook.dk
OI Knudsen, Jane Thinggaard/0000-0002-3521-4514; Morgenstjerne-Schwenck,
   Liv/0000-0002-4855-004X
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NR 132
TC 7
Z9 10
U1 0
U2 5
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1067-1927
EI 1524-475X
J9 WOUND REPAIR REGEN
JI Wound Repair Regen.
PD MAR
PY 2021
VL 29
IS 2
BP 240
EP 253
DI 10.1111/wrr.12882
EA DEC 2020
PG 14
WC Cell Biology; Dermatology; Medicine, Research & Experimental; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Dermatology; Research & Experimental Medicine; Surgery
GA QR8SI
UT WOS:000603406400001
PM 33377584
OA Green Published, Bronze
DA 2026-07-24
ER

PT J
AU Marangi, GF
   Segreto, F
   Coppola, MM
   Arcari, L
   Gratteri, M
   Persichetti, P
AF Marangi, Giovanni F.
   Segreto, Francesco
   Coppola, Marco Morelli
   Arcari, Lucrezia
   Gratteri, Marco
   Persichetti, Paolo
TI Management of chronic seromas: A novel surgical approach with the use of
   vacuum assisted clousure therapy
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE capsulectomy; chronic seroma; Morel-Lavellee; postoperative
   complication; vacuum-assisted clousure
ID MOREL-LAVALLEE LESION; PREVENTION
AB Postoperative seroma is a common complication of many surgical procedures in which anatomical dead space has been created. A particular case of lesion in which seroma occurs is the Morel-Lavallee lesion (MLL), which is an uncommon closed soft-tissue degloving injury that develops after high-energy trauma or crush injury where shearing forces separate the subcutaneous tissue from the underlying fascia. The diagnostic evaluation begins with an adequate history and physical examination, followed by instrumental research with ultrasonography, computed tomography, and magnetic resonance imaging. Postoperative seromas and MLLs share a similar pathology and natural evolution as both injuries, once chronic, develop a pseudobursa; thus, the authors think that the same treatment algorithm may be suitable for both the lesions. Several strategies for the treatment of post-surgical and post-traumatic seromas have been described in the literature, ranging from conservative measures for acute and small injuries to surgical management and sclerotherapy for chronic and large ones. Despite some seromas resolving with conventional management, lesion recurrence is a matter of concern. The authors present their experience in the treatment of both post-surgical and post-traumatic chronic seromas not responsive to conservative treatments by surgical drainage of the seroma, capsulectomy, and application of vacuum-assisted closure therapy to allow granulation tissue formation, dead spaces obliteration, and wound healing. Primary wound closure with closed suction drain placement and an elastic compression bandaging are finally performed. From 2014 to 2019, a total of 15 patients (9 females and 6 males) were treated for recurrent chronic seromas with the proposed surgical approach. Five cases were MLLs, while 10 cases were postoperative seromas. The patients were between 33 and 79 years old, and they were followed up at 4 weeks and 3 and 6 months after surgery. All 15 patients with chronic seromas not responsive to conservative treatment showed a complete resolution of the lesions with the proposed treatment approach with no evidence of lesion recurrence, proving its effectiveness.
C1 [Marangi, Giovanni F.; Segreto, Francesco; Coppola, Marco Morelli; Arcari, Lucrezia; Gratteri, Marco; Persichetti, Paolo] Campus Biomed Rome Univ, Div Plast Surg, Via A del Portillo 200, I-00100 Rome, Italy.
RP Marangi, GF (通讯作者)，Campus Biomed Rome Univ, Div Plast Surg, Via A del Portillo 200, I-00100 Rome, Italy.
EM g.marangi@unicampus.it
RI Marangi, Giovanni Francesco/AAW-4723-2020; Morelli Coppola,
   Marco/GSE-2476-2022; Gratteri, Marco/KGM-5481-2024
OI Marangi, Giovanni Francesco/0000-0002-7179-3533; Morelli Coppola,
   Marco/0000-0002-8910-6586; Segreto, Francesco/0000-0002-1573-1098;
   Gratteri, Marco/0000-0001-7375-1524
CR Abdalla S, 2018, SURG TECHNOL INT, V33
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NR 21
TC 14
Z9 18
U1 0
U2 3
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD OCT
PY 2020
VL 17
IS 5
BP 1153
EP 1158
DI 10.1111/iwj.13447
EA JUL 2020
PG 6
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA NP6YE
UT WOS:000552426300001
PM 32716145
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Laporte, J
   Herlin, C
   Delicque, J
   Saunière, D
   Perrot, P
   Duteille, F
AF Laporte, J.
   Herlin, C.
   Delicque, J.
   Sauniere, D.
   Perrot, P.
   Duteille, F.
TI Free flaps use in chronic wounds: Retrospective study about 91 cases
SO ANNALES DE CHIRURGIE PLASTIQUE ESTHETIQUE
LA French
DT Article
DE Free flaps; Chronic wound; Osteomyelitis; Microsurgery
ID FASCIOCUTANEOUS FREE FLAPS; SOFT-TISSUE RECONSTRUCTION; VACUUM-ASSISTED
   CLOSURE; OPEN FRACTURES; MICROSURGICAL RECONSTRUCTION; SURGICAL
   DEBRIDEMENT; PERFORATOR FLAPS; MANAGEMENT; COVERAGE; MUSCLE
AB Introduction. - Chronic wounds represent a major health challenge with no current standardized surgical treatment. The use of free flaps is little discussed in the literature, with a supposed propensity to failure given unfavorable local conditions and land often debility. We present here the analysis of our monocentric experience of the use of free flaps in the curative treatment of chronic wounds.
   Patients et methods. - We performed a retrospective monocentric study over 18 years of all free flaps used for the treatment of a chronic wound between January 2001 and September 2016. Several criteria were evaluated on patients, wounds, free flaps used and immediate to late outcomes.
   Results. - Ninety-one patients were included (sex ratio M/F: 3.55) with an average age of 41.6 +/- 16 years. Wounds were localized to the leg in 92.3% of cases and 58% of patients had initial osteomyelitis. The flaps used were predominantly muscle flaps (61.6%). The flaps survival rate was 92.3%. With a mean follow-up of 50 months, the reconstructive failure rate was 20.9%. The presence of a chronic osteomyelitis is the only statistically significant factor of reconstruction failure (P = 0.0169) with a risk of failure multiplied by 5.
   Conclusion. - Our study demonstrates that the reliability of free flaps in the treatment of chronic wounds is comparable, regardless of the time since the initial cutaneous lesion, to that existing in the treatment of acute wounds or in the reconstruction after oncological excision. The presence of a chronic osteomyelitis, however, represents a major risk of reconstruction failure by increasing 5 times the risk of failure. Recent changes in the integumentary reconstruction paradigm of the lower limb will undoubtedly allow in the next few years to establish more rationally the place of muscle free flaps in the therapeutic armamentarium of chronic wounds. (C) 2018 Elsevier Masson SAS. All rights reserved.
C1 [Laporte, J.; Sauniere, D.] Univ Hosp Caremeau Nimes, Plast & Reconstruct Surg Dept, Pl Pr Robert Debre, F-30029 Nimes, France.
   [Herlin, C.] Univ Hosp Lapeyronie Montpellier, Plast & Reconstruct Surg Dept, Ave Doyen Gaston Giraud, F-34090 Montpellier, France.
   [Delicque, J.] Univ Hosp St Eloi Montpellier, Med Imaging Dept, 80 Ave Augustin Fliche, F-34090 Montpellier, France.
   [Perrot, P.; Duteille, F.] Univ Hosp Hotel Dieu Nantes, Plast & Reconstruct Surg Dept, 1 Pl Alexis Ricordeau, F-44000 Nantes, France.
C3 Universite de Montpellier; CHU de Nimes; CHU de Montpellier; Universite
   de Montpellier; CHU de Montpellier; Universite de Montpellier; CHU de
   Montpellier; Nantes Universite; CHU de Nantes
RP Laporte, J (通讯作者)，Univ Hosp Caremeau Nimes, Plast & Reconstruct Surg Dept, Pl Pr Robert Debre, F-30029 Nimes, France.
EM julie.laporte@sfr.fr
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NR 46
TC 2
Z9 3
U1 0
U2 4
PU ELSEVIER
PI BRIDGEWATER
PA 685 ROUTE 202-206, BRIDGEWATER, NJ 08807 USA
SN 0294-1260
EI 1768-319X
J9 ANN CHIR PLAST ESTH
JI Ann. Chir. Plast. Esthet.
PD JUN
PY 2019
VL 64
IS 3
BP 251
EP 258
DI 10.1016/j.anplas.2018.07.014
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA HY3NM
UT WOS:000468033300005
PM 30327209
DA 2026-07-24
ER

PT J
AU Willms, A
   Muysoms, F
   Güsgen, C
   Schwab, R
   Lock, J
   Schaaf, S
   Germer, C
   Richardsen, I
   Dietz, U
AF Willms, A.
   Muysoms, F.
   Guesgen, C.
   Schwab, R.
   Lock, J.
   Schaaf, S.
   Germer, C.
   Richardsen, I.
   Dietz, U.
TI The Open Abdomen Route by EuraHS: introduction of the data set and
   initial results of procedures and procedure-related complications
SO HERNIA
LA English
DT Article
DE Open abdomen; Laparostoma; Peritonitis; Abdominal trauma; Abdominal
   compartement syndrome
ID TEMPORARY ABDOMINAL CLOSURE; PRESSURE WOUND THERAPY; MEDIATED FASCIAL
   TRACTION; VACUUM-ASSISTED CLOSURE; NEGATIVE-PRESSURE; MANAGEMENT; MESH;
   FISTULAS; SURGERY; HERNIA
AB Open abdomen management has become a well-established strategy in the treatment of serious intra-abdominal pathologies. Key objectives are fistula prevention and high fascial closure rates. The current level of evidence on laparostoma is insufficient. This is due to the rareness of laparostomas, the heterogeneity of study cohorts, and broad diversity of techniques. Collecting data in a standardised, multicentre registry is necessary to draw up evidence-based guidelines.
   In order to improve the level of evidence on laparostomy, CAMIN (surgical working group for military and emergency surgery) of DGAV (German Society for General and Visceral Surgery), initiated the implementation of a laparostomy registry. This registry was established as the Open Abdomen Route by EuraHS (European Registry of Abdominal Wall Hernias). Key objectives include collection of data, quality assurance, standardisation of therapeutic concepts and the development of guidelines. Since 1 May 2015, the registry is available as an online database called Open Abdomen Route of EuraHS (European Registry of Abdominal Wall Hernias). It includes 11 categories for data collection, including three scheduled follow-up examinations.
   As part of this pilot study, all entries of the first 120 days were analysed, resulting in a review of 82 patients. At 44%, secondary peritonitis was the predominant indication. The mortality rate was 22%. A comparison of methods with and without fascial traction reveals fascial closure rates of 67% and 25%, respectively (intention-to-treat analysis, p < 0.03). Inert visceral protection was used in 67% of patients and achieved a small bowel fistula incidence of only 5.5%.
   Optimising laparostomy management techniques in order to achieve low incidence of fistulation and high fascial closure rates is possible. The method that ensures the best possible outcome-based on current evidence-would involve fascial traction, visceral protection and negative pressure. The laparostomy registry is a useful tool for quickly generating sufficient evidence for open abdomen treatment.
C1 [Willms, A.; Guesgen, C.; Schwab, R.; Schaaf, S.; Richardsen, I.] German Armed Forces Cent Hosp, Dept Gen Visceral & Thorac Surg, Ruebenacherstr 170, D-56072 Koblenz, Germany.
   [Lock, J.; Dietz, U.] Univ Hosp, Dept Gen Visceral & Transplantat Surg, Wurzburg, Germany.
   [Muysoms, F.] AZ Maria Middelares, Dept Surg, Buitenring Sint Denijs 30, Ghent, Belgium.
C3 University of Wurzburg
RP Willms, A (通讯作者)，German Armed Forces Cent Hosp, Dept Gen Visceral & Thorac Surg, Ruebenacherstr 170, D-56072 Koblenz, Germany.
EM ArnulfWillms@gmx.de
RI Willms, Arnulf/AFN-0812-2022; Lock, Johan/AAA-8114-2020
OI Willms, Arnulf/0000-0001-9998-6735; Lock, Johan/0000-0002-9007-3937
CR Acosta S, 2011, BRIT J SURG, V98, P735, DOI 10.1002/bjs.7383
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   Tsuei BJ, 2004, AM SURGEON, V70, P652
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NR 29
TC 15
Z9 16
U1 0
U2 2
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 1265-4906
EI 1248-9204
J9 HERNIA
JI Hernia
PD APR
PY 2017
VL 21
IS 2
BP 279
EP 289
DI 10.1007/s10029-017-1572-4
PG 11
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA ER3ML
UT WOS:000398700900015
PM 28093615
DA 2026-07-24
ER

PT J
AU Koschnick, M
   Bruener, S
   Germann, G
AF Koschnick, M
   Bruener, S
   Germann, G
TI Free tissue transfer: An advanced strategy for postinfection soft-tissue
   defects in the upper extremity
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article; Proceedings Paper
CT Annual Meeting of the Society-of-Reconstructive-Microsurgery
CY JAN 13-14, 2001
CL SAN DIEGO, CALIFORNIA
SP Soc Reconstruct Microsurg
ID VACUUM-ASSISTED CLOSURE; EMERGENCY FREE FLAPS; OPEN TIBIAL FRACTURES;
   LATERAL ARM FLAP; CLINICAL-EXPERIENCE; WOUND CONTROL; LIMB SALVAGE;
   SKIN-GRAFTS; DONOR SITE; RECONSTRUCTION
AB Surgical treatment of severe, necrotizing infections frequently leave compound defects that require complex reconstructive procedures. In the upper extremity, local flap coverage is limited because of the size of the lesions. Regarding the results of early microsurgical coverage of complex postinfectious defects of the lower extremity, the goal of this study was to evaluate the role of free tissue transfer in the treatment of severe infections in the upper extremity. Between 1994 and 1999, 24 patients with major defects as a result of severe necrotizing infections in the upper extremity underwent free tissue transfer. Parameters assessed included the success of infection control, flap survival rate, salvage of the extremity, and an outcome analysis by the Disability of Arm-Shoulder-Hand score and a visual analog scale. Patient age ranged from 17 to 75 years (average age, 50.8 years). Previous treatment of 11 patients in outlying hospitals included 4.2 operative procedures and a delay of admission to the authors' unit of 89 days. The average defect size after debridement was 10.0 x 14.4 cm. Twenty-four free flaps including 16 muscle or musculocutaneous flaps, 4 chimeric flaps from the subscapular system, and 4 osteocutaneous flaps were performed for reconstruction. The overall flap survival was 95.8%. One temporalis fascia flap (TPF) was lost as a result of vascular thrombosis, and three flaps underwent successful revision of the anastomoses. Eight patients required further minor surgical treatment. The Disability of Arm-Shoulder-Hand score yielded an average of 41.5 points, which represents a moderate impairment of activities of daily living. Visual analog scale assessment demonstrated an overall high satisfaction (9.5 points; range, 1-10 points). The data demonstrate that even in severe necrotizing infections resulting in complex acute or chronic defects, limb salvage and infection control can be achieved successfully with radical debridement and early free tissue transfer.
C1 Univ Heidelberg, Dept Plast Hand & Reconstruct Surg, BG Trauma Ctr, Burn Ctr, Ludwigshafen, Germany.
C3 Ruprecht Karls University Heidelberg
RP Koschnick, M (通讯作者)，St Markus Hosp, Dept Plast Surg, D-60431 Frankfurt, Germany.
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NR 59
TC 13
Z9 18
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0148-7043
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD AUG
PY 2003
VL 51
IS 2
BP 147
EP 154
DI 10.1097/01.SAP.0000058495.72795.B9
PG 8
WC Surgery
WE Conference Proceedings Citation Index - Science (CPCI-S); Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 714LN
UT WOS:000184915900007
PM 12897517
DA 2026-07-24
ER

PT J
AU Pessarelli, T
   Bergna, IMB
   Boemo, C
   De Monti, A
   La Milia, M
   Hervoso, CM
   Pagliarulo, M
   Piagnani, A
   Zago, M
   Amato, A
AF Pessarelli, Tommaso
   Bergna, Irene Maria Bambina
   Boemo, Cinzia
   De Monti, Alberta
   La Milia, Marta
   Marfinati Hervoso, Cristina
   Pagliarulo, Michela
   Piagnani, Alessandra
   Zago, Mauro
   Amato, Arnaldo
TI Interventional Endoscopy for the Management of Post-Surgical Leaks and
   Fistulas: A Scoping Review
SO JOURNAL OF CLINICAL MEDICINE
LA English
DT Review
DE post-surgical leak; post-surgical fistula; interventional endoscopy;
   gastrointestinal endoscopy; over-the-scope clip; endoscopic vacuum
   therapy; VACstent; endoscopic suturing; endoscopic internal drainage
ID VACUUM-ASSISTED CLOSURE; GASTROINTESTINAL DEFECTS; MULTICENTER
   EXPERIENCE; SLEEVE GASTRECTOMY; INTERNAL DRAINAGE; CLINICAL-OUTCOMES;
   THERAPY; STENT; ESOPHAGECTOMY; COMPLICATIONS
AB Background/Objectives: Leaks and fistulas are serious surgical complications associated with substantial morbidity and mortality. Traditional management has relied on surgical reintervention or percutaneous drainage, both of which carry significant risks. In recent decades, interventional endoscopy has emerged as a minimally invasive alternative, offering a growing range of therapeutic options. This scoping review aimed to systematically map the available evidence on endoscopic management of post-surgical leaks and fistulas, with a focus on techniques used, indications, outcomes, and gaps in the literature. Methods: This scoping review was conducted according to PRISMA-ScR guidelines. PubMed/MEDLINE, Embase, and Scopus were searched from inception to 5 December 2025. Eligible studies included original studies, systematic reviews, and narrative reviews reporting therapeutic endoscopic interventions for post-surgical leaks or fistulas in any patient population. Case reports and case series with fewer than 20 patients were excluded. Data were charted on study design, surgical context, endoscopic techniques, and reported outcomes. Results: A total of 69 studies were included, comprising 46 original studies involving 2550 patients, along with 11 systematic reviews and 12 narrative reviews. Endoscopic techniques identified included through-the-scope and over-the-scope clipping, stenting, endoscopic vacuum therapy, internal drainage, tissue sealants, endoscopic suturing, and hybrid devices such as VAC-Stent (R). Reported technical and clinical success rates varied widely across techniques and clinical settings, influenced by defect characteristics, timing of intervention, anatomical location, and operator experience. Endoscopic vacuum therapy was supported by the most consistent evidence, particularly for esophageal and colorectal leaks. Conclusions: Interventional endoscopy represents an increasingly central component in the management of post-surgical leaks and fistulas, enabling individualized, less invasive treatment strategies. However, the current evidence base remains heterogeneous and largely retrospective, underscoring the need for well-designed, multicenter prospective studies.
C1 [Pessarelli, Tommaso; Bergna, Irene Maria Bambina; Boemo, Cinzia; De Monti, Alberta; La Milia, Marta; Marfinati Hervoso, Cristina; Pagliarulo, Michela; Piagnani, Alessandra; Amato, Arnaldo] Osped A Manzoni Hosp, Digest Endoscopy & Gastroenterol Dept, I-23900 Lecce, Italy.
   [Zago, Mauro] Osped A Manzoni Hosp, Dept Gen Surg, I-23900 Lecce, Italy.
RP Amato, A (通讯作者)，Osped A Manzoni Hosp, Digest Endoscopy & Gastroenterol Dept, I-23900 Lecce, Italy.
EM t.pessarelli@asst-lecco.it; i.bergna@asst-lecco.it;
   c.boemo@asst-lecco.it; a.demonti@asst-lecco.it; m.lamilia@asst-lecco.it;
   c.marfinatihervo@asst-lecco.it; m.pagliarulo@asst-lecco.it;
   a.piagnani@asst-lecco.it; m.zago@asst-lecco.it; a.amato@asst-lecco.it
RI Amato, Arnaldo/ABC-5688-2020
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   Mercky P, 2015, DIGEST ENDOSC, V27, P18, DOI 10.1111/den.12295
   Min YW, 2019, BMC SURG, V19, DOI 10.1186/s12893-019-0497-5
   Momblan D, 2023, AM J GASTROENTEROL, V118, P1797, DOI 10.14309/ajg.0000000000002475
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   Reimer S, 2022, SURG ENDOSC, V36, P9169, DOI 10.1007/s00464-022-09400-w
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   Sharaiha RZ, 2016, J CLIN GASTROENTEROL, V50, P388, DOI 10.1097/MCG.0000000000000336
   van Boeckel PGA, 2012, BMC GASTROENTEROL, V12, DOI 10.1186/1471-230X-12-19
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   Vohra I, 2025, CLIN ENDOSC, V58, P53
   Wang QY, 2022, MINIM INVASIV THER, V31, P825, DOI 10.1080/13645706.2021.2010218
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   Xu K, 2016, J SURG RES, V204, P68, DOI 10.1016/j.jss.2016.04.018
   Zhang JJ, 2022, SURG ENDOSC, V36, P5267, DOI 10.1007/s00464-021-08904-1
   Zhong LQ, 2021, FRONT ONCOL, V11, DOI 10.3389/fonc.2021.657955
NR 56
TC 0
Z9 0
U1 0
U2 0
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2077-0383
J9 J CLIN MED
JI J. Clin. Med.
PD MAR 17
PY 2026
VL 15
IS 6
AR 2291
DI 10.3390/jcm15062291
PG 20
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA FR5MI
UT WOS:001725696300001
PM 41899214
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Willms, A
   Güsgen, C
   Schreyer, C
   Becker, HP
   Schwab, R
AF Willms, A.
   Guesgen, C.
   Schreyer, C.
   Becker, H-P.
   Schwab, R.
TI Prevention of Small Bowel Fistulas During Open Abdominal Treatment:
   Lessons Learned
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Article
DE open abdomen; intraabdominal vacuum therapy; VAC (R)-therapy; small
   bowel fistula; abdominal trauma; laparostomy
ID VACUUM-ASSISTED CLOSURE; OPEN ABDOMEN; FASCIAL CLOSURE; WALL DEFECTS;
   TEMPORARY CLOSURE; VENTRAL HERNIA; WOUND CLOSURE; MANAGEMENT; SEPSIS;
   TRAUMA
AB Background: Abdominal vacuum therapy has simplified the treatment of a laparostoma. But is that all that it can achieve? The role of abdominal vacuum therapy concerning the development of small bowel fistulas is still under discussion. Treatment of the bowel surface seems to be crucial for the prevention of fistulas. As military surgeons, we need a simple, standardised regimen, leading to reproducible good results and low complication rates. The question is: are we able to eliminate small bowel fistula during open abdominal treatment?
   Patients and Methods: We analysed 28 consecutive patients with open abdominal treatment in the period of 2004 to 2009. From June 2006 on, we implemented an algorithm, using the KCI V.A.C.(R) Abdominal Dressing (Kinetic Concepts Inc., San Antonio, Texas, USA) and a vicryl mesh between the non-adherent layer and the foam to prevent fascial retraction. The patients treated after the installation of the new algorithm were compared to a group treated from 2004 to May 2006 before its installation. Fistula rates, mortality, the fascial closure rate, the number of abdominal dressing changes and the duration of open abdominal treatment were evaluated.
   Results: After implementation of our new algorithm, the fistula rate decreased from 45% to 0%. The mortality during open abdominal treatment decreased from 45% to 6%. In addition, the duration of open abdominal treatment was reduced as well as the number of dressing changes. The primary fascial closure rate was 87%.
   Conclusion: We implemented a regimen, which is suitable for our mission in Afghanistan, as well as for medical evacuation and for the treatment of patients in our hospitals in Germany. It ensures a standardised treatment of the open abdominal cavity with an ideal protecting treatment of the bowel surface. Our algorithm utilises the advantages of the laparostoma while minimising the complications. The development of a small bowel fistula was eliminated in the evaluated patient group and mortality was clearly reduced.
C1 [Willms, A.; Guesgen, C.; Schreyer, C.; Becker, H-P.; Schwab, R.] Bundeswehrzent Krankenhaus Allgemein Viszeral & T, D-56072 Koblenz, Germany.
RP Willms, A (通讯作者)，Bundeswehrzent Krankenhaus Allgemein Viszeral & T, Rubenacherstr 170, D-56072 Koblenz, Germany.
EM ArnulfWillms@gmx.de
RI Schreyer, Christof/AHC-9023-2022; Willms, Arnulf/AFN-0812-2022
OI Willms, Arnulf/0000-0001-9998-6735
CR An G, 2004, J TRAUMA, V56, P1266, DOI 10.1097/01.TA.0000068241.66186.00
   Banwell Paul E, 2004, Int Wound J, V1, P95, DOI 10.1111/j.1742-4801.2004.00031.x
   Barker DE, 2007, J AM COLL SURGEONS, V204, P784, DOI 10.1016/j.jamcollsurg.2006.12.039
   Becker HP, 2007, SCAND J SURG, V96, P263, DOI 10.1177/145749690709600402
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   BROCK WB, 1995, AM SURGEON, V61, P30
   de Costa A, 2006, ANZ J SURG, V76, P356, DOI 10.1111/j.1445-2197.2006.03638.x
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   Fischer JE, 2008, AM J SURG, V196, P1, DOI 10.1016/j.amjsurg.2008.01.001
   Gäddnäs F, 2007, SCAND J SURG, V96, P301
   Ivatury R, 2009, WORLD J SURG, V33, P1150, DOI 10.1007/s00268-009-0005-7
   Jamshidi R, 2007, ARCH SURG-CHICAGO, V142, P793, DOI 10.1001/archsurg.142.8.793
   Jernigan TW, 2003, ANN SURG, V238, P349, DOI 10.1097/01.sla.0000086544.42647.84
   Kritayakirana Kritaya, 2010, J Emerg Trauma Shock, V3, P118, DOI 10.4103/0974-2700.62106
   Lenz S, 2006, CHIRURG, V77, P580, DOI 10.1007/s00104-006-1206-3
   Lesser T, 2009, ZBL CHIR, V134, P573, DOI 10.1055/s-0028-1098699
   Mathes SJ, 2000, ANN SURG, V232, P586, DOI 10.1097/00000658-200010000-00014
   Mayberry JC, 2004, J TRAUMA, V57, P157, DOI 10.1097/01.TA.0000102411.69521.80
   Miller PR, 2004, ANN SURG, V239, P608, DOI 10.1097/01.sla.0000124291.09032.bf
   Miller RS, 2005, J TRAUMA, V59, P1365, DOI 10.1097/01.ta.0000196004.49422.af
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   Olaison Gunnar, 2005, Lakartidningen, V102, P861
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   Scott BG, 2006, J TRAUMA, V60, P17, DOI 10.1097/01.ta.0000200861.96568.bb
   Shestak KC, 2000, PLAST RECONSTR SURG, V105, P731, DOI 10.1097/00006534-200002000-00041
   Stevens P, 2009, INT WOUND J, V6, P259, DOI 10.1111/j.1742-481X.2009.00614.x
   Subramonia S, 2009, WORLD J SURG, V33, P931, DOI 10.1007/s00268-009-9947-z
   Tsuei BJ, 2004, AM SURGEON, V70, P652
   Utzolino S, 2010, ZBL CHIR, V135, P240, DOI 10.1055/s-0030-1247360
   v Boele H, 2009, WORLD J SURG, V33, P199
   Wild T, 2007, COLORECTAL DIS, V9, P572, DOI 10.1111/j.1463-1318.2007.01309.x
   Wild T, 2004, ZENTRALBL CHIR S1, V129, P7
   Wild T, 2006, ZENTRALBL CHIR S1, V131, P111
   Wondberg D, 2008, WORLD J SURG, V32, P2724, DOI 10.1007/s00268-008-9762-y
NR 37
TC 8
Z9 8
U1 0
U2 2
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA RUDIGERSTR 14, D-70469 STUTTGART, GERMANY
SN 0044-409X
J9 ZBL CHIR
JI Zent.bl. Chir.
PD DEC
PY 2011
VL 136
IS 6
BP 592
EP 597
DI 10.1055/s-0031-1271440
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 883BS
UT WOS:000299608200015
PM 21563053
DA 2026-07-24
ER

PT J
AU Arsalan-Werner, A
   Dick, L
   Arsalan, M
   Wölfle, O
   Walther, T
   Sauerbier, M
AF Arsalan-Werner, Annika
   Dick, Linda
   Arsalan, Mani
   Woelfle, Olaf
   Walther, Thomas
   Sauerbier, Michael
TI Impact of microbial findings on plastic reconstructive surgery outcomes
   in patients with deep sternal wound infection after cardiac surgery
SO JOURNAL OF PLASTIC SURGERY AND HAND SURGERY
LA English
DT Article
DE Deep sternal wound infection; mediastinitis; microbiological germs;
   wound closure; poststernotomy infection
ID VACUUM-ASSISTED CLOSURE; RISK-FACTORS; THERAPY; MEDIASTINITIS;
   MANAGEMENT
AB Deep sternal wound infection (DSWI) is a life threatening complication after cardiac surgery. In severe cases, flaps are needed to cover the wound. However, it is controversial if an aseptic environment is necessary at the time of wound closure. This is a retrospective study of 73 patients with DSWI treated by debridement and local or free flap from June 2008 until December 2017. The influence of positive microbiological findings at the time of plastic reconstructive surgery on reoperation rate and length of in-hospital stay was analyzed. Microbiological exams revealed positive results in 47 (64.4%) and no results in 26 patients. Reoperation had to be performed in 21.3% (positive cultures) versus 15.4% (p = .54), mean in hospital stay was 24.1 days (positive cultures) versus 21.8 days (p = .39) and in-hospital mortality was 6.4% (positive cultures) versus 7.7% (p = .83). Positive microbial findings at the time of plastic reconstructive surgery in patients with DSWI are not associated with a higher reoperation or mortality rate or a longer in-hospital stay. Repeated debridement and vacuum-assisted therapy to achieve negative microbial results might not be necessary in the treatment of these patients.Key messages Positive microbial findings at the time of plastic reconstructive surgery in patients with deep sternal wound infection seems not to be associated with a higher reoperation or mortality rate or a longer in-hospital stay. The influence of positive microbiological findings at the time of plastic reconstructive surgery on reoperation rate and length of in-hospital stay was analyzed in 73 patients with deep sternal wound infection. Microbiological exams revealed positive results in 47 (64.4%) and no results in 26 patients. Reoperation had to be performed in 21.3% (positive cultures) versus 15.4% (p = .54), mean in hospital stay was 24.1 days (positive cultures) versus 21.8 days (p = .39) and in-hospital mortality was 6.4% (positive cultures) versus 7.7% (p = .83).
C1 [Arsalan-Werner, Annika; Dick, Linda; Sauerbier, Michael] Goethe Univ Frankfurt Main, Acad Hosp, BG Trauma Ctr Frankfurt Main, Hand Trauma Ctr FESSH,Dept Plast Hand & Reconstru, Friedberger Landstr 430, D-60389 Frankfurt, Germany.
   [Arsalan, Mani; Walther, Thomas] Goethe Univ Frankfurt Main, Dept Thorac & Cardiovasc Surg, Frankfurt, Germany.
   [Woelfle, Olaf] Main Taunus Hosp GmbH, Dept Plast Hand & Reconstruct Surg, Bad Soden, Germany.
C3 Goethe University Frankfurt; Goethe University Frankfurt
RP Arsalan-Werner, A (通讯作者)，Goethe Univ Frankfurt Main, Acad Hosp, BG Trauma Ctr Frankfurt Main, Hand Trauma Ctr FESSH,Dept Plast Hand & Reconstru, Friedberger Landstr 430, D-60389 Frankfurt, Germany.
EM annika.arsalan-werner@bgu-frankfurt.de
RI Arsalan, Mani/HPG-0671-2023; /AAA-6310-2019
CR Assmann A, 2011, THORAC CARDIOV SURG, V59, P25, DOI 10.1055/s-0030-1250598
   Berdajs DA, 2011, INTERACT CARDIOV TH, V12, P914, DOI 10.1510/icvts.2010.263483
   Biefer HRC, 2012, EUR J CARDIO-THORAC, V42, P306, DOI 10.1093/ejcts/ezr326
   Borger MA, 1998, ANN THORAC SURG, V65, P1050, DOI 10.1016/S0003-4975(98)00063-0
   Braakenburg A, 2006, PLAST RECONSTR SURG, V118, P390, DOI 10.1097/01.prs.0000227675.63744.af
   Cabbabe EB, 2009, PLAST RECONSTR SURG, V123, P1490, DOI 10.1097/PRS.0b013e3181a205f9
   CULLIFORD AT, 1976, J THORAC CARDIOV SUR, V72, P714
   Diefenbeck M, 2011, Z ORTHOP UNFALLCHIR, V149, P324, DOI 10.1055/s-0030-1250694
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   Gummert JF, 2002, THORAC CARDIOV SURG, V50, P87, DOI 10.1055/s-2002-26691
   Gustafsson R, 2002, J THORAC CARDIOV SUR, V123, P895, DOI 10.1067/mtc.2002.121306
   Jang YJ, 2012, ARCH PLAST SURG-APS, V39, P36, DOI 10.5999/aps.2012.39.1.36
   Mangram AJ, 1999, AM J INFECT CONTROL, V27, P97, DOI 10.1016/S0196-6553(99)70088-X
   Misfeld M, 2012, EUR J CARDIO-THORAC, V42, P310, DOI 10.1093/ejcts/ezs113
   Morykwas MJ, 1997, ANN PLAS SURG, V38, P553, DOI 10.1097/00000637-199706000-00001
   Mouës CM, 2004, WOUND REPAIR REGEN, V12, P11, DOI 10.1111/j.1067-1927.2004.12105.x
   Nakano J, 2008, J THORAC CARDIOV SUR, V135, P540, DOI 10.1016/j.jtcvs.2007.11.008
   Phan TQV, 2013, ANN PLAS SURG, V70, P216, DOI 10.1097/SAP.0b013e31823b67ec
   Rao NL, 2011, PLAST RECONSTR SURG, V127, p177S, DOI 10.1097/PRS.0b013e3182001f0f
   Rashed A, 2018, J THORAC DIS, V10, P2412, DOI 10.21037/jtd.2018.03.166
   Singer M, 2016, JAMA-J AM MED ASSOC, V315, P801, DOI 10.1001/jama.2016.0287
   Sjögren J, 2006, EUR J CARDIO-THORAC, V30, P898, DOI 10.1016/j.ejcts.2006.09.020
   Weed T, 2004, ANN PLAS SURG, V52, P276, DOI 10.1097/01.sap.0000111861.75927.4d
NR 23
TC 2
Z9 4
U1 0
U2 3
PU Medical Journal Sweden AB
PI Uppsala
PA Kungsngsvgen 27St, Uppsala, SWEDEN
SN 2000-656X
EI 2000-6764
J9 J PLAST SURG HAND SU
JI J. Plast. Surg. Hand Surg.
PD JUN 1
PY 2020
VL 54
IS 3
BP 182
EP 186
DI 10.1080/2000656X.2020.1738240
EA MAR 2020
PG 5
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA LU7DV
UT WOS:000519483000001
PM 32162994
OA gold
DA 2026-07-24
ER

PT J
AU Kuehn, F
   Schiffmann, L
   Janisch, F
   Schwandner, F
   Alsfasser, G
   Gock, M
   Klar, E
AF Kuehn, Florian
   Schiffmann, Leif
   Janisch, Florian
   Schwandner, Frank
   Alsfasser, Guido
   Gock, Michael
   Klar, Ernst
TI Surgical Endoscopic Vacuum Therapy for Defects of the Upper
   Gastrointestinal Tract
SO JOURNAL OF GASTROINTESTINAL SURGERY
LA English
DT Article
DE Anastomotic leakage; Perforation; Esophageal; Endoscopy; Endoscopic
   vacuum therapy
ID ESOPHAGEAL-PERFORATION; ASSISTED CLOSURE; PRIMARY REPAIR; MANAGEMENT;
   EXPERIENCE; COMPLICATIONS; OPTIONS; CANCER; STENT
AB Introduction Intraluminal therapy used in the gastrointestinal (GI) tract was first shown for anastomotic leaks after rectal resection. Since a few years vacuum sponge therapy is increasingly being recognized as a new promising method for repairing upper GI defects of different etiology. The principles of vacuum-assisted closure (VAC) therapy remain the same no matter of localization: Continuous or intermittent suction and drainage decrease bacterial contamination, secretion, and local edema. At the same time, perfusion and granulation is promoted. However, data for endoscopic vacuum therapy (EVT) of the upper intestinal tract are still scarce and consist of only a few case reports and small series with low number of patients.
   Objectives Here, we present a single center experience of EVT for substantial wall defects in the upper GI tract.
   Methods Retrospective single-center analysis of EVT for various defects of the upper GI tract over a time period of 4 years (2011-2015) with a mean follow-up of 17 (2-45) months was used. If necessary, initial endoscopic sponge placement was performed in combination with open surgical revision.
   Results In total, 126 polyurethane sponges were placed in upper gastrointestinal defects of 21 patients with a median age of 72 years (range, 49-80). Most frequent indication for EVT was anastomotic leakage after esophageal or gastric resection (n = 11) and iatrogenic esophageal perforation (n = 8). The median number of sponge insertions was five (range, 1-14) with a mean changing interval of 3 days (range, 2-4). Median time of therapy was 15 days (range, 3-46). EVT in combination with surgery took place in nine of 21 patients (43 %). A successful vacuum therapy for upper intestinal defects with local control of the septic focus was achieved in 19 of 21 patients (90.5 %).
   Conclusion EVT is a promising approach for postoperative, iatrogenic, or spontaneous lesions of the upper GI tract. In this series, EVT was combined with operative revision in a relevant proportion of patients.
C1 [Kuehn, Florian; Schiffmann, Leif; Janisch, Florian; Schwandner, Frank; Alsfasser, Guido; Gock, Michael; Klar, Ernst] Univ Rostock, Dept Gen Thorac Vasc & Transplantat Surg, Schillingallee 35, D-18057 Rostock, Germany.
   [Schiffmann, Leif] Protestant Hosp Lippstadt, Wiedenbrucker Str 33, D-59555 Lippstadt, Germany.
C3 University of Rostock
RP Kuehn, F (通讯作者)，Univ Rostock, Dept Gen Thorac Vasc & Transplantat Surg, Schillingallee 35, D-18057 Rostock, Germany.
EM florian.kuehn@med.uni-rostock.de
OI Kühn, Florian/0000-0001-9830-3015
CR Abbas G, 2009, SURGERY, V146, P749, DOI 10.1016/j.surg.2009.06.058
   Bartels H, 2008, CHIRURG, V79, P30, DOI 10.1007/s00104-007-1441-2
   Bludau M, 2014, SURG ENDOSC, V28, P896, DOI 10.1007/s00464-013-3244-5
   Braghetto I, 2005, REV MED CHILE, V133, P1233
   Brangewitz M, 2013, ENDOSCOPY, V45, P433, DOI 10.1055/s-0032-1326435
   Brinster CJ, 2004, ANN THORAC SURG, V77, P1475, DOI 10.1016/j.athoracsur.2003.08.037
   Chak A, 2011, J THORAC CARDIOV SUR, V141, P843, DOI 10.1016/j.jtcvs.2010.07.019
   Erdogan A, 2007, WORLD J SURG, V31, P2199, DOI 10.1007/s00268-007-9207-z
   Eroglu A, 2009, DIS ESOPHAGUS, V22, P374, DOI 10.1111/j.1442-2050.2008.00918.x
   Griffiths EA, 2009, DIS ESOPHAGUS, V22, P616, DOI 10.1111/j.1442-2050.2009.00959.x
   Gupta NM, 2004, AM J SURG, V187, P58, DOI 10.1016/j.amjsurg.2002.11.004
   Hölscher AH, 2006, BEST PRACT RES CL GA, V20, P907, DOI 10.1016/j.bpg.2006.05.002
   Kuehn F, 2012, J GASTROINTEST SURG, V16, P2145, DOI 10.1007/s11605-012-2014-3
   Kuehn F, 2014, ENDOSCOPY, V46, pE361, DOI 10.1055/s-0034-1377283
   Liu JF, 2008, WORLD J SURG, V32, P395, DOI 10.1007/s00268-007-9349-z
   Port JL, 2003, ANN THORAC SURG, V75, P1071, DOI 10.1016/S0003-4975(02)04650-7
   Schniewind B, 2013, SURG ENDOSC, V27, P3883, DOI 10.1007/s00464-013-2998-0
   Schorsch T, 2014, CHIRURG, V85, P1081, DOI 10.1007/s00104-014-2764-4
   Schweigert M, 2013, AM SURGEON, V79, P634
   Sung SW, 2002, DIS ESOPHAGUS, V15, P204, DOI 10.1046/j.1442-2050.2002.00251.x
   Vallböhmer D, 2010, DIS ESOPHAGUS, V23, P185, DOI 10.1111/j.1442-2050.2009.01017.x
NR 21
TC 69
Z9 85
U1 1
U2 7
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 1091-255X
EI 1873-4626
J9 J GASTROINTEST SURG
JI J. Gastrointest. Surg.
PD FEB
PY 2016
VL 20
IS 2
BP 237
EP 242
DI 10.1007/s11605-015-3044-4
PG 6
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA DI0BD
UT WOS:000373158900002
PM 26643296
DA 2026-07-24
ER

PT J
AU Ducic, I
   Attinger, CE
AF Ducic, Ivica
   Attinger, Christopher E.
TI Foot and Ankle Reconstruction: Pedicled Muscle Flaps versus Free Flaps
   and the Role of Diabetes
SO PLASTIC AND RECONSTRUCTIVE SURGERY
LA English
DT Article
ID LOWER-EXTREMITY AMPUTATION; SOFT-TISSUE RECONSTRUCTION; VACUUM-ASSISTED
   CLOSURE; ADVANCED STASIS ULCER; OPERATIVE TREATMENT; EXPOSED BONE; MAJOR
   AMPUTATIONS; LIMB AMPUTATION; MODERN SERIES; LOWER LEG
AB Background: The effectiveness of pedicled muscle flaps versus microsurgical free flaps in patients with diabetes mellitus for complex foot and ankle reconstruction has not been well defined.
   Methods: The Georgetown Wound Registry identified all patients who underwent pedicled muscle flap or free flap reconstruction from 1990 to 2000 with 8.1 +/- 3.1-year follow-up. Thirty-eight diabetic and 42 nondiabetic patients were identified. Flap coverage was the reconstructive choice for defects with exposed tendons, joints, or bone, with pedicled muscle flaps always selected for smaller defects.
   Results: Thirty-two patients received 34 pedicled muscle flaps for 34 wounds, whereas 48 received 52 free flaps for 51 wounds. Thirty-one of 34 wounds covered with pedicled muscle flaps went on to heal, for a 91 percent success rate, a 94 percent limb salvage rate, and a 78 percent patient survival rate. There were 15 complications among 45 reconstructive procedures, for an overall 33 percent complication rate. Forty-eight of the 51 wounds covered with free flaps went on to heal, for a 94 percent healing rate, a 96 percent limb salvage rate, and a 77 percent patient survival rate. There were 17 complications among 93 reconstructive procedures, for an 18 percent complication rate.
   Conclusions: Diabetes does not appear to affect the success of pedicled muscle flap or free flap reconstruction except for requiring more debridements, longer healing times, and decreased long-term survival. When compared with historical diabetic controls with amputation, however, limb salvage appears to prolong survival of diabetic patients. Pedicled muscle flaps appear to be as effective as free flaps for the coverage of small complex foot and ankle defects, despite the postoperative complication rate. Diabetes is not a contraindication to either type of flap reconstruction for limb salvage. (Plast. Reconstr. Surg. 128: 173, 2011.) CLINICAL QUESTION/LEVEL OF EVIDENCE: Therapeutic, III.
C1 [Attinger, Christopher E.] Georgetown Univ Hosp, Wound Ctr, Dept Plast Surg, Washington, DC 20007 USA.
C3 Georgetown University
RP Attinger, CE (通讯作者)，Georgetown Univ Hosp, Wound Ctr, Dept Plast Surg, 3800 Reservoir Rd NW, Washington, DC 20007 USA.
EM cattinger@aol.com
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   Argenta LC, 1997, ANN PLAST SURG, V38, P577
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NR 67
TC 67
Z9 76
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0032-1052
EI 1529-4242
J9 PLAST RECONSTR SURG
JI Plast. Reconstr. Surg.
PD JUL
PY 2011
VL 128
IS 1
BP 173
EP 180
DI 10.1097/PRS.0b013e3182173d3a
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 789FJ
UT WOS:000292499600050
PM 21399565
DA 2026-07-24
ER

PT J
AU Germawi, L
   Westenberg, RF
   Wang, F
   Schep, NWL
   Chen, NC
   Eberlin, KR
AF Germawi, Lazin
   Westenberg, Ritsaart F.
   Wang, Frederick
   Schep, Niels W. L.
   Chen, Neal C.
   Eberlin, Kyle R.
TI Factors associated with revision surgery for olecranon bursitis after
   bursectomy
SO JOURNAL OF SHOULDER AND ELBOW SURGERY
LA English
DT Article
DE Bursitis; olecranon; inflammation; bursectomy; revision surgery;
   reoperation; orthopedics
ID RHEUMATOID-ARTHRITIS; ANKLE FRACTURES; RISK-FACTOR; DIAGNOSIS;
   READMISSION; INFECTION; THERAPY
AB Background: The primary aim of our study was to identify the factors associated with revision surgery after bursal excision in patients with olecranon bursitis. The secondary aims were to describe the revision rate after bursectomy and to assess which factors are associated with flap surgery after bursectomy and describe the most common complications after bursectomy of the olecranon bursa.
   Methods: We included 191 adult patients with olecranon bursitis who underwent olecranon bursa excision between January 2002 and October 2018. Patients who were pregnant, patients with incomplete records of the primary surgical procedure, and patients who underwent bursectomy during elbow arthroplasty were excluded. After manual chart review, we found that 22 patients had undergone revision surgery. Bivariate analysis was performed to assess the association between revision surgery and patient characteristics, comorbidities, and clinical characteristics. Additionally, we collected data regarding postoperative complications and intraoperative variables such as the use of drains, vacuum assisted closure therapy, and flap surgery.
   Results: The overall revision rate in our cohort was 11.5% (22 of 191 patients). Bivariate analysis showed that patients who underwent revision surgery were more frequently women (P = .004), more often had a history of ipsilateral (P = .020) or contralateral (P = .012) olecranon bursitis, and more often received a diagnosis of rheumatoid arthritis (P = .001) or diabetes mellitus (P = .019). The most common complications were delayed wound healing (n= 8, 4.2%) and osteomyelitis (n = 8, 4.2%). Flap surgery was performed in 5 patients (2.6%). Bivariate analysis showed that patients with rheumatoid arthritis underwent flap surgery more frequently (P = .011).
   Conclusion: The revision rate after bursectomy for olecranon bursitis was 11.5% (22 of 191 patients). Patients with rheumatoid arthritis, diabetes mellitus, or a history of ipsilateral and contralateral olecranon bursitis and female patients underwent revision surgery after bursectomy for olecranon bursitis more frequently. In addition, patients with rheumatoid arthritis underwent flap surgery after bursectomy more frequently. (C) 2020 Journal of Shoulder and Elbow Surgery Board of Trustees. All rights reserved.
C1 [Germawi, Lazin; Westenberg, Ritsaart F.; Wang, Frederick; Chen, Neal C.] Harvard Med Sch, Massachusetts Gen Hosp, Div Orthopaed, Hand & Upper Extrem Serv, Boston, MA 02115 USA.
   [Westenberg, Ritsaart F.; Schep, Niels W. L.] Maasstad Hosp, Dept Surg, Rotterdam, Netherlands.
   [Eberlin, Kyle R.] Harvard Med Sch, Massachusetts Gen Hosp, Hand Surg Serv, Div Plast Surg, Boston, MA 02115 USA.
C3 Harvard University; Harvard Medical School; Harvard University Medical
   Affiliates; Massachusetts General Hospital; Maasstad Hospital; Harvard
   University; Harvard Medical School; Harvard University Medical
   Affiliates; Massachusetts General Hospital
RP Eberlin, KR (通讯作者)，Harvard Med Sch, Massachusetts Gen Hosp, Plast & Reconstruct Surg, 55 Fruit St,WAC 435, Boston, MA 02115 USA.
EM keberlin@mgh.harvard.edu
RI ; Wang, Frederick/AAT-7555-2021
OI Germawi, Lazin/0000-0001-6165-4399; 
CR Aaron DL, 2011, J AM ACAD ORTHOP SUR, V19, P359, DOI 10.5435/00124635-201106000-00006
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NR 30
TC 9
Z9 13
U1 0
U2 1
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 1058-2746
EI 1532-6500
J9 J SHOULDER ELB SURG
JI J. Shoulder Elbow Surg.
PD MAY
PY 2021
VL 30
IS 5
BP 1135
EP 1141
DI 10.1016/j.jse.2020.09.033
EA APR 2021
PG 7
WC Orthopedics; Sport Sciences; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences; Surgery
GA RT4PC
UT WOS:000644442000032
PM 33144225
DA 2026-07-24
ER

PT J
AU Van den Brande, P
   von Kemp, K
   Aerden, D
   Debing, E
   Vanhulle, A
   Staelens, I
   Haentjens, P
AF Van den Brande, Pierre
   von Kemp, Karl
   Aerden, Dimitri
   Debing, Erik
   Vanhulle, Alain
   Staelens, Ivan
   Haentjens, Patrick
TI Treatment of Lymphocutaneous Fistulas After Vascular Procedures of the
   Lower Limb: Accurate Wound Reclosure and 3 Weeks of Consistent and
   Continuing Drainage
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; GROIN LYMPHATIC COMPLICATIONS; ARTERIAL
   RECONSTRUCTION; THERAPY; LYMPHORRHEA; RADIOTHERAPY; MANAGEMENT;
   LYMPHOCELES; INFECTIONS; SURGERY
AB Background: Lymphocutaneous fistulas occurring after vascular procedures of the lower limb are a rare, but frustrating, complication. Many treatment options exist, but may lead to inconsistent results, with infection, delayed wound healing, and prolonged hospital stay. We present a simple surgical treatment of wound closure and drainage.
   Methods: In this single-center, single-intervention, observational clinical study (case series), prospectively collected data of 23 consecutive lymphocutaneous fistulas in 22 patients (19 male and three female; age, 42 to 91 years) treated between June 2005 and October 2008 were retrospectively analyzed. Twenty-two fistulas were situated in the groin and one at the knee incision. The standardized therapy consisted of the installation of a Redon to drain the lymph, and accurate closure of the wound. Postoperatively, drainage was maintained for 21 days: suction Redon drainage for the first 7 days, passive Redon drainage for the next 7 days, and further drainage in a pouch after removal of the drain for the last 7 days.
   Results: In 19 of the initial 23 lymphocutaneous fistulas, the whole drainage procedure was completed, with healing of the wound, without infection, recurrence, or lymphocele formation after 1 year of follow-up. In these cases, there had been a steady decrease of daily lymph drainage: a mean of 163.4 (standard error on the mean, 39.6) mL on the first day of suction, 56.8 (15.5) mL on the first day of passive drainage, 11.6 (4.3) mL on the last day of passive drainage, and 2.1 (0.9) mL on the 21st day when the drainage treatment was stopped. In four fistulas, this treatment was considered a failure because of inadvertent early drain removal (two cases), infection (one case), and lymphorrhea recurrence with wound breakdown (one case).
   Conclusion: This standardized surgical therapy, consisting of accurate wound closure and 3 weeks of drainage, allowed the healing of 19 of 23 postoperative lymphocutaneous fistulas (an 82. 6 % success rate), without infection, recurrence, or lymphocele formation after 1 year of follow up.
C1 [Van den Brande, Pierre; von Kemp, Karl; Aerden, Dimitri; Debing, Erik; Vanhulle, Alain; Staelens, Ivan] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Dept Vasc Surg, B-1090 Brussels, Belgium.
   [Haentjens, Patrick] Vrije Univ Brussel, Univ Ziekenhuis Brussel, Ctr Outcome Res, B-1090 Brussels, Belgium.
C3 University Hospital Brussels; Universite Libre de Bruxelles; Vrije
   Universiteit Brussel; Vrije Universiteit Brussel; University Hospital
   Brussels
RP Van den Brande, P (通讯作者)，Vrije Univ Brussel, Univ Ziekenhuis Brussel, Dept Vasc Surg, Laarbeeklaan 101, B-1090 Brussels, Belgium.
EM pierre.vandenbrande@uzbrussel.be
RI ; Aerden, Dimitri/AAM-5294-2021; /AAE-4764-2021; /AAH-2578-2019
OI Vanhulle, Alain/0000-0002-0289-850X; Aerden,
   Dimitri/0000-0001-5384-6147; 
CR Abai B, 2007, J VASC SURG, V45, P610, DOI 10.1016/j.jvs.2006.10.043
   Abalmasov KG, 2004, KHIRURGIIA, V3, P23
   AlSalman MMS, 1997, INT SURG, V82, P60
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   Steele SR, 2003, AM J SURG, V186, P9, DOI 10.1016/S0002-9610(03)00113-2
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NR 21
TC 28
Z9 31
U1 0
U2 7
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0890-5096
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD AUG
PY 2012
VL 26
IS 6
BP 833
EP 838
DI 10.1016/j.avsg.2012.02.009
PG 6
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA 974LL
UT WOS:000306436700011
PM 22727062
DA 2026-07-24
ER

PT J
AU Ren, GH
   Li, RG
   Hu, YJ
   Chen, YR
   Chen, CJ
   Yu, B
AF Ren, Gao-hong
   Li, Runguang
   Hu, Yanjun
   Chen, Yirong
   Chen, Chaojie
   Yu, Bin
TI Treatment options for infected bone defects in the lower extremities:
   free vascularized fibular graft or Ilizarov bone transport?
SO JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
LA English
DT Article
DE Bone defect; Bone infection; Ilizarov bone transport; Free vascularized
   fibular graft
ID SOFT-TISSUE DEFECTS; FREE-FLAP TRANSPLANTATION; VACUUM SEALING DRAINAGE;
   DONOR-SITE MORBIDITY; TIBIAL BONE; EXTERNAL FIXATION; ORTHOFIX LRS;
   RECONSTRUCTION; MANAGEMENT; OSTEOMYELITIS
AB Objective The objective was to explore the relative indications of free vascularized fibular graft (FVFG) and Ilizarov bone transport (IBT) in the treatment of infected bone defects of lower extremities via comparative analysis on the clinical characteristics and efficacies. Methods The clinical data of 66 cases with post-traumatic infected bone defects of the lower extremities who underwent FVFG (n = 23) or IBT (n = 43) from July 2014 to June 2018 were retrieved and retrospectively analyzed. Clinical characteristics, operation time, and intraoperative blood loss were statistically compared between two groups. Specifically, the clinical efficacies of two methods were statistically evaluated according to the external fixation time/index, recurrence rate of deep infection, incidence of complications, the times of reoperation, and final functional score of the affected extremities. Results Gender, age, cause of injury, Gustilo grade of initial injury, proportion of complicated injuries in other parts of the affected extremities, and numbers of femoral/tibial defect cases did not differ significantly between treatment groups, while infection site distribution after debridement (shaft/metaphysis) differed moderately, with metaphysis infection little more frequent in the FVFG group (P = 0.068). Femoral/tibial defect length was longer in the FVFG group (9.96 +/- 2.27 vs. 8.74 +/- 2.52 cm,P = 0.014). More patients in the FVFG group presented with moderate or complex wounds with soft-tissue defects. FVFG treatment required a longer surgical time (6.60 +/- 1.34 vs. 3.12 +/- 0.99 h) and resulted in greater intraoperative blood loss (873.91 +/- 183.94 vs. 386.08 +/- 131.98 ml; bothP < 0.05) than the IBT group, while average follow-up time, recurrence rate of postoperative osteomyelitis, degree of bony union, and final functional scores did not differ between treatment groups. However, FVFG required a shorter external fixation time (7.04 +/- 1.72 vs. 13.16 +/- 2.92 months), yielded a lower external fixation index (0.73 +/- 0.28 vs. 1.55 +/- 0.28), and resulted in a lower incidence of postoperative complications (0.87 +/- 0.76 vs. 2.21 +/- 1.78, times/case,P < 0.05). The times of reoperation in the two groups did not differ (0.78 +/- 0.60 vs. 0.98 +/- 0.99 times/case,P = 0.615). Conclusion Both FVFG and IBT are effective methods for repairing and reconstructing infected bone defects of the lower extremities, with unique advantages and limitations. Generally, FVFG is recommended for patients with soft tissue defects, bone defects adjacent to joints, large bone defects (particularly monocortical defects), and those who can tolerate microsurgery.
C1 [Ren, Gao-hong; Hu, Yanjun; Chen, Yirong; Yu, Bin] Southern Med Univ, Nanfang Hosp, Div Orthopaed & Traumatol, Dept Orthopaed, Guangzhou, Peoples R China.
   [Ren, Gao-hong; Hu, Yanjun; Chen, Yirong; Yu, Bin] Southern Med Univ, Nanfang Hosp, Key Lab Bone & Cartilage Regenerat Med, Guangzhou, Peoples R China.
   [Li, Runguang] Southern Med Univ, Affiliated Hosp 3, Dept Orthoped, Guangzhou, Peoples R China.
   [Li, Runguang] Orthopaed Hosp Guangdong Prov, Guangzhou, Peoples R China.
   [Li, Runguang] Acad Orthopaed, Guangzhou, Guangdong, Peoples R China.
   [Li, Runguang] Linzhi Peoples Hosp, Dept Orthoped, Linzhi, Peoples R China.
   [Chen, Chaojie] Panyu Hosp Chinese Med, Dept Orthoped, Guangzhou, Peoples R China.
C3 Southern Medical University - China; Southern Medical University -
   China; Southern Medical University - China
RP Yu, B (通讯作者)，Southern Med Univ, Nanfang Hosp, Div Orthopaed & Traumatol, Dept Orthopaed, Guangzhou, Peoples R China.; Yu, B (通讯作者)，Southern Med Univ, Nanfang Hosp, Key Lab Bone & Cartilage Regenerat Med, Guangzhou, Peoples R China.
EM yubincsgk@163.com
RI ; Chen, Yirong/T-8449-2019; Yu, Bin/KIJ-7006-2024; Chen,
   Chaojie/PCQ-6635-2025
OI Runguang, Li/0000-0002-4703-7180; 
FU Key Projects of President Foundation of Nanfang Hospital, Southern
   Medical University [2017A001]; Natural Science Foundation of Guangdong
   Province [2018A030313640, 2019A1515012176]; National Natural Science
   Foundation of China [81101366, 81572165, 81830079]; Shanghai Wang
   Zhengguo trauma medical development foundation [2017KJB-GK-001]
FX This study was funded by the Key Projects of President Foundation of
   Nanfang Hospital, Southern Medical University (2017A001), Shanghai Wang
   Zhengguo trauma medical development foundation (2017KJB-GK-001), Natural
   Science Foundation of Guangdong Province (Approval no. 2018A030313640,
   2019A1515012176), and National Natural Science Foundation of China
   (81101366, 81572165, 81830079).
CR Abulaiti A, 2017, INJURY, V48, P2842, DOI 10.1016/j.injury.2017.10.036
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NR 38
TC 32
Z9 43
U1 0
U2 14
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-799X
J9 J ORTHOP SURG RES
JI J. Orthop. Surg. Res.
PD SEP 24
PY 2020
VL 15
IS 1
AR 439
DI 10.1186/s13018-020-01907-z
PG 11
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA NY1BW
UT WOS:000576134500001
PM 32972459
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Chang, S
   Wang, Y
   Zhang, ZS
AF Chang, Sheng
   Wang, Yu
   Zhang, Zengshan
TI Impact of VSD therapy on surgical outcomes, inflammatory markers, and
   functional rehabilitation in patients with secondary bone infection
   following tibial fracture surgery
SO FRONTIERS IN CELLULAR AND INFECTION MICROBIOLOGY
LA English
DT Article
DE VSD; bone infection secondary to tibial fracture; distribution of
   pathogenic bacteria; inflammatory factors; bone infection
AB Objective: The aim of this study was to investigate the effect of vacuum sealing drainage (VSD) treatment on surgical indicators, inflammatory factors, and functional recovery in patients with chronic osteomyelitis secondary to open tibial fractures. Methods: In total, 87 patients with secondary bone infection after internal fixation of tibial fracture treated in the Affiliated Hospital of Shandong Second Medical University from December 2020 to June 2022 were selected, all of whom were tibial shaft fractures. Of these, 55 cases of primary open fracture were sutured in the first stage; 32 cases underwent internal fixation after primary debridement at the time of trauma. The patients were treated with surgical debridement, removal of internal fixation, and fixation with an external fixation frame. After debridement, those with local wounds that could not be completely closed and were complicated with exposed bone were randomly selected for either VSD covering treatment (study group, n=46) or bone cement covering treatment (control group, n=41. The distribution of pathogenic bacteria, surgical indicators, inflammatory factors [tumor necrosis factor & hybull;alpha(TNF & hybull;alpha), interleukin & hybull;6 (IL & hybull;6), and C & hybull;reactive protein (CRP) levels], functional recovery [knee, ankle, and limb function recovery], and complications were summarized. Results: There were 87 pathogenic bacteria strains in 87 patients, including 43 Gram & hybull;positive bacteria strains (49.42%), 32 Gram & hybull;negative bacteria strains (36.78%), and 12 fungi strains (13.80%). The number of dressing changes in the study group was less than that in the control group. The infection control time, wound sterility time, hospitalization time, and skin flap transfer operation time in the study group were shorter than those in the control group and the difference was statistically significant (P<0.05). After treatment, the levels of TNF & hybull;alpha, IL & hybull;6, and CRP in the two groups decreased, among which the change in the study group was the most significant and the difference between the two groups was statistically significant (P<0.05). After treatment, the Hospital for Special Surgery Knee Score and Baird-Jackson score of the two groups increased, among which the change in the study group was the most significant and the difference between the two groups was statistically significant (P<0.05). The excellent and good rate of the study group (95.65%) was higher than the excellent and good rate of the control group (80.49%) and the difference was statistically significant (P<0.05). Conclusion: When a wound cannot be closed, VSD treatment of patients with secondary bone infection after internal fixation of tibial fracture can improve the level of surgical indicators and inflammatory factor levels in patients, and promote the recovery of patients' limb function, and is thus worthy of clinical promotion and application.
C1 [Chang, Sheng] Heze Municipal Hosp, Dept Spine Surg, Heze, Peoples R China.
   [Wang, Yu] Qingdao Univ, Dept Anesthesiol, Womens & Childrens Hosp, Qingdao, Peoples R China.
   [Zhang, Zengshan] Shandong Second Med Univ, Affiliated Hosp, Dept Orthoped, Weifang, Peoples R China.
C3 Qingdao University; Shandong Second Medical University
RP Zhang, ZS (通讯作者)，Shandong Second Med Univ, Affiliated Hosp, Dept Orthoped, Weifang, Peoples R China.
EM zengshan1003@163.com
CR Chastain DB, 2019, INT J ANTIMICROB AG, V53, P429, DOI 10.1016/j.ijantimicag.2018.11.023
   Christersson A, 2018, EJNMMI RES, V8, DOI 10.1186/s13550-018-0426-0
   Deng Y, 2023, AGING-US, V15, P7533, DOI 10.18632/aging.204921
   Huang Kai, 2021, Zhongguo Gu Shang, V34, P550, DOI [10.12200/j.issn.1003-0034.2021.06.014, 10.12200/j.issn.1003-0034.2021.06.014]
   Jiang N, 2020, INT ORTHOP, V44, P2457, DOI 10.1007/s00264-020-04737-0
   Krappinger D, 2015, OPER ORTHOP TRAUMATO, V27, P357, DOI 10.1007/s00064-014-0300-9
   Li Y, 2018, J MUSCULOSKEL NEURON, V18, P272
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NR 13
TC 1
Z9 1
U1 1
U2 2
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2235-2988
J9 FRONT CELL INFECT MI
JI Front. Cell. Infect. Microbiol.
PD JAN 17
PY 2025
VL 14
AR 1508424
DI 10.3389/fcimb.2024.1508424
PG 6
WC Immunology; Microbiology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Immunology; Microbiology
GA U3R0A
UT WOS:001410994000001
PM 39897483
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Li, Y
   Zhang, ZB
   Liu, JS
   Wu, ZM
   Sun, XC
   Zhao, YT
   Zhang, XZ
AF Li, Yong
   Zhang, Zhi-bo
   Liu, Ji-song
   Wu, Zhu-min
   Sun, Xin-cheng
   Zhao, Yu-tin
   Zhang, Xiang-zhou
TI Analysis of the therapeutic effect of artificial leather embedding
   combined with fascial sleeve flap transplantation on chronic wounds of
   lower limbs with bone and plate exposure
SO BMC SURGERY
LA English
DT Article
DE Bone exposure; Chronic wound; Plate exposure; Artificial dermis; Flap
ID SKIN; FRACTURES; MUSCLE
AB Background After severe trauma of lower limbs, bone, tendon or plate graft exposure is common. The traditional repair method is to use a variety of skin flap transplantation to cover the exposed part, but the wound often can not heal after operation, or the wound is cracked, ulcer, sinus, bone and steel plate are exposed again after wound healing. The reason for this result is that when the flap is covered, the space around the bone plate is not well closed, forming a dead cavity, blood and exudate accumulation, hematoma formation or infection, and finally the wound ruptures again. In addition, due to the swelling and contracture of the flap after operation, the suture tension between the flap and the receiving area becomes larger, the skin becomes thinner and broken, and then the wound is formed. In order to solve the above problems, we carried out the study of artificial true skin embedding combined with fascial sleeve flap transplantation in the treatment of chronic bone plate exposed wounds of lower limbs. Methods In this paper, 11 cases of chronic wounds with bone exposure and skin necrosis after steel plate implantation were selected. First stage is the wound bed preparation including primary wound expansion, removal of necrotic tissue and incision of sinus wall, removal of deep necrotic bone and fibrotic scarred skin on the outer wall of steel plate to normal tissue on the outer edge of the wound, removal of precipitated peptone and purulent fur in the hole, periphery and bone space of the steel plate, and removal of tendon tissue with basal necrosis and disintegration of the wound. After vacuum sealing drainage (VSD) 1-2 weeks, the peritraumatic basal granulation tissue grew well and there was no necrotic tissue in the wound. In the second stage, the exposed bone was covered with artificial dermis, the steel plate hole or the periphery and the basal space were filled, and the exposed steel plate was completely embedded, and then the fascia sleeve flap was transplanted to cover the wound. The sural neurovascular flap was performed in nine cases and the lateral superior malleolar artery perforator flap in two case. Results The flap survived well in all 11 cases. During the follow-up of 6 months to the removal of the plate, there was no case of rupture, exposure and sinus formation. Conclusions Artificial dermal covering combined with fascial sleeve flap transplantation can effectively avoid wound dehiscence or sinus formation caused by foreign body retention, infection and flap contracture. It has good effect in repairing chronic wounds with bone plate exposure after severe trauma of lower limbs.
C1 [Li, Yong; Zhang, Zhi-bo; Liu, Ji-song; Wu, Zhu-min; Sun, Xin-cheng; Zhao, Yu-tin; Zhang, Xiang-zhou] Third Hosp Bengbu, Dept Burn & Plast Surg, Bengbu 233000, Peoples R China.
RP Liu, JS (通讯作者)，Third Hosp Bengbu, Dept Burn & Plast Surg, Bengbu 233000, Peoples R China.
EM 406084878@qq.com
FU Bengbu science and Technology Bureau [20200324]
FX This study was supported by Bengbu science and Technology Bureau
   (20200324).
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NR 27
TC 6
Z9 10
U1 0
U2 11
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1471-2482
J9 BMC SURG
JI BMC Surg.
PD FEB 26
PY 2022
VL 22
IS 1
AR 69
DI 10.1186/s12893-022-01521-2
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA ZI9RG
UT WOS:000761948600004
PM 35219291
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Holloway, JJ
   Lauer, K
   Kansal, N
   Bongaard, F
   Miller, A
AF Holloway, Janell J.
   Lauer, Kimberly
   Kansal, Nikhil
   Bongaard, Frederic
   Miller, Ashley
TI A Novel Approach to Limb Salvage: Healing Transmetatarsal Amputations
   without a Viable Plantar Flap
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article; Proceedings Paper
CT 44th Vascular Annual Winter Meeting of the Society-for-Vascular-Surgery
   and Vascular-and-Endovascular-Surgery-Society (VESS)
CY JAN 30-FEB 02, 2020
CL Steamboat Springs, CO
SP Vasc & Endovascular Surg Soc, Soc Vasc Surg
ID CONTEMPORARY SERIES; MORTALITY; MORBIDITY
AB Background: The lack of a viable plantar flap in patients undergoing transmetatarsal amputation has been considered an indication for below-knee amputation (BKA). In an effort to reduce limb loss in this patient population, we sought to review our experience with transmetatarsal amputation salvage in patients with an open, guillotine transmetatarsal amputation. We hypothesized that performing a transmetatarsal amputation without a viable flap would extend time of independent ambulation and improve limb salvage.
   Methods: This is a retrospective review of 27 consecutive patients who did not have a viable plantar flap and who underwent an open, guillotine transmetatarsal amputation. Patients presented with a nonviable plantar flap due to either extensive tissue loss on initial presentation, or secondary transmetatarsal amputation (TMA) flap necrosis. Patients initially underwent an open, guillotine TMA for control of infection and debridement of nonviable tissue. To achieve best results, during procedure, the metatarsals were resected to be as flush with soft tissue as possible. Once infection was resolved and all nonviable tissue debrided, negative pressure wound therapy (NPWT) was applied to the open wound. NPWT was continued until a base of granulation tissue covered the previously exposed bone. Wound closure was obtained by either the application of a split-thickness skin graft (STSG) or through continued NPWT allowing the wound to heal by secondary intention.
   Results: Between January 2016 and December 2018, there were 27 open TMAs performed in 27 patients. Two patients did not granulate sufficiently and underwent BKA. Fourteen patients underwent STSG for closure, whereas 11 patients continued with NPWT. In the STSG group, 12 (86%) of the patients are healed, with a median time to complete healing of 75 days (range 28-330 days); the remaining 2 are ambulatory and undergoing continued wound care. In the 11 patients who did not receive STSG, 7 (64%) are healed with a median time to heal of 165 days. Of the remaining 4 patients in this group, 3 are ambulatory and still undergoing wound care, one was lost to follow-up. Overall, 19 patients (70%) have completely healed with a median time to heal of 82 days.
   Conclusions: Limb salvage in patients with a nonviable plantar flap for TMA is possible and should be a considered procedure. This technique has the potential to improve functional outcomes and limb salvage in patients who might otherwise undergo BKA.
C1 [Holloway, Janell J.] Univ Calif Los Angeles, David Geffen Sch Med, Los Angeles, CA 90095 USA.
   [Holloway, Janell J.] Charles R Drew Univ Med & Sci, Coll Med, 1621 E 120th St, Los Angeles, CA 90059 USA.
   [Lauer, Kimberly; Kansal, Nikhil; Bongaard, Frederic; Miller, Ashley] Harbor UCLA Med Ctr, Dept Surg, Torrance, CA 90509 USA.
C3 University of California System; University of California Los Angeles;
   University of California Los Angeles Medical Center; David Geffen School
   of Medicine at UCLA; Charles R. Drew University of Medicine & Science;
   University of California System; University of California Los Angeles;
   University of California Los Angeles Medical Center
RP Miller, A (通讯作者)，Harbor UCLA, Dept Surg, 1000 W Carson St, Torrance, CA 90509 USA.
EM amiller@dhs.lacounty.gov
CR Adams CT, 2019, KNEE AMPUTATION BKA
   Cruz CP, 2003, AM J SURG, V186, P449, DOI 10.1016/j.amjsurg.2003.07.027
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   Frykberg Robert G, 2006, J Foot Ankle Surg, V45, pS1
   Gusenoff JA, 2016, PLAST RECONSTR SURG, V138, P1099, DOI 10.1097/PRS.0000000000002667
   Kennedy Gem, 2019, Ulster Med J, V88, P30
   McCallum R, 2012, J AGING RES
   Nather A, 2013, DIABET FOOT ANKLE, V4, DOI 10.3402/dfa.v4i0.21288
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NR 13
TC 5
Z9 5
U1 0
U2 0
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 0890-5096
EI 1615-5947
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD JAN
PY 2021
VL 70
BP 51
EP 55
DI 10.1016/j.avsg.2020.08.098
PG 5
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery; Cardiovascular System & Cardiology
GA PG6HC
UT WOS:000599833300007
PM 32866571
DA 2026-07-24
ER

PT J
AU Yan, XL
   Fu, XK
   Li, WR
AF Yan, Xiaoling
   Fu, Xiaokui
   Li, Weiren
TI Giant sinus tract formation following percutaneous renal biopsy in a
   patient with systemic lupus erythematosus: A case report
SO MEDICINE
LA English
DT Article
DE case report; giant sinus tract; magnetic resonance imaging; percutaneous
   renal biopsy; systemic lupus erythematosus
ID THERAPY
AB Rationale:Although percutaneous renal biopsy is generally considered safe, it can result in complications such as sinus tract formation, particularly in immunocompromised patients. In systemic lupus erythematosus (SLE), prolonged immunosuppression impairs tissue repair, complicating management. No standardized treatment exists for post-biopsy sinus tracts in SLE, and conventional approaches often yield poor results. A case of a giant sinus tract after renal biopsy in an SLE patient, successfully managed with multidisciplinary therapy, offering a potential reference for similar complex cases.Patient concerns:A 38-year-old woman with an 8-year history of SLE and lupus nephritis was admitted due to persistent redness and exudation at the renal biopsy site for 5 months. Prior treatments at an outside hospital, including intravenous antibiotics, abscess incision and drainage, and routine dressing changes, were ineffective, and her symptoms progressively worsened. Imaging revealed an irregular sinus tract measuring approximately 10 cm x 9 cm in the right lumbar region.Diagnoses:Giant sinus tract formation following percutaneous renal biopsy.Interventions:Standard immunosuppressive therapy was initiated to control SLE. On day 5, the patient underwent debridement combined with negative pressure wound therapy with instillation using hydrogen peroxide. Medications were adjusted with the support of the nephrology department. On day 13, radical excision of the sinus tract, further debridement, and skin flap grafting were performed. Dual-mode negative pressure drainage was applied to accelerate healing, and systemic antibiotics were administered based on culture and sensitivity results.Outcomes:By day 40 of hospitalization, the wound was completely epithelialized, without redness or discharge. The patient achieved complete clinical healing and remained recurrence-free during a 4-year follow-up.Lessons:Despite the relatively low post-procedural infection rate in SLE patients, clinicians should remain vigilant for complications such as sinus tract formation at the biopsy site. Early imaging is essential for timely diagnosis and preventing missed diagnoses. In this case, a combination of immunomodulation, negative pressure wound instillation therapy, and local skin flap reconstruction, along with dual-mode negative pressure drainage, demonstrated high debridement efficiency, minimal trauma, improved healing, better prognosis, and a low recurrence rate.
C1 [Yan, Xiaoling] Guizhou Prov Peoples Hosp, Dept Burn & Plast Surg, Guiyang, Peoples R China.
   [Fu, Xiaokui] Guizhou Med Univ, Affiliated Hosp, Dept Anesthesiol, Guiyang, Peoples R China.
   [Li, Weiren] Guizhou Med Univ, Affiliated Hosp, Dept Burn & Plast Surg, 28 Guiyi St, Guiyang 550001, Peoples R China.
C3 Guizhou Medical University; Guizhou Medical University
RP Li, WR (通讯作者)，Guizhou Med Univ, Affiliated Hosp, Dept Burn & Plast Surg, 28 Guiyi St, Guiyang 550001, Peoples R China.
EM 297357131@qq.com; 809233655@qq.com; hn_yxl0722@163.com
OI 颜, 小玲/0009-0009-3046-626X
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NR 35
TC 0
Z9 0
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD JAN 9
PY 2026
VL 105
IS 2
AR e46780
DI 10.1097/MD.0000000000046780
PG 5
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA DC9YX
UT WOS:001680490400017
PM 41517776
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Ahmed, ME
   Mohammed, MS
   Mahadi, SI
AF Ahmed, M. E.
   Mohammed, M. S.
   Mahadi, S. I.
TI Primary wound closure of diabetic foot ulcers by debridement and
   stitching
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE diabetic foot ulcer; wound closure; stitching
ID THERAPY
AB Objective: The role of stitching in healing diabetic foot ulcers (DFUs) has little attention, with few reports published on the technique. This study aimed to report on the role of stitching in healing of neuropathic DFUs.
   Method: This comparative study was between patients with diabetes with neuropathic foot ulcers who had undergone wound stitching and those on conventional wound care. The study was carried in Jabir Abu Eliz Diabetic Center Khartoum (JADC) during between January 1 2011 and January 1 2013. All patients presented with neuropathic diabetic septic foot on the plantar aspect or extending up the leg were included. Initial surgical sharp debridement under intravenous broad spectrum antibiotics was performed and oral antibiotics were given 3 days later after the results of the bacterial culture were received. Regular wound debridement was performed with the aim of pairing the wound edges for stitching. Primary closure was performed when the wound was clean from any necrotic tissues and partial closure when the wound was still oozy to secure drainage and avoid splaying of the wound edges. All patients were using either crutches or wheel chair initially until any sepsis cleared and then proper off-loading by shoes purpose made in our centre.
   Results: A 160 patients with neuropathic DFUs that needed debridement and frequent dressing changes as outpatients were included. Both groups had the same tap water wound dressing either daily, every other day or every two days according to the wound progress. Absorbent dressings and negative pressure wound therapy (NPWT) were unavailable. Half of the patients (n=80) had debridement, frequent dressing change using tap water throughout the period of study (group 1) while the rest (n=80) in addition to wound debridement underwent stitching of their wounds (group 2). Complete healing was achieved in 46 patients in Group 1 (57.5%) compared with 19 patients (23%) in group 2 (p=0.001). The average number of dressings used was 19 in stitch group compared with 30 in the non-stitch group (p=0.000). The average duration of healing in stitch group was 2.9 months compared with 5.7 months in non-stitch group (p=0.000).
   Conclusion: Stitching of neuropathic DFUs reduced the duration of wound healing and the frequency of wound dressing change.
C1 [Ahmed, M. E.; Mahadi, S. I.] Univ Khartoum, Fac Med, Dept Surg, Khartoum, Sudan.
   [Mohammed, M. S.] Alfred Univ, Alfred, NY 14802 USA.
C3 University of Khartoum; State University of New York (SUNY) System;
   Alfred University
RP Ahmed, ME (通讯作者)，Univ Khartoum, Fac Med, Dept Surg, Khartoum, Sudan.
EM rasheid@usa.net
CR Ahmed ME, 2010, J FOOT ANKLE SURG, V49, P2, DOI 10.1053/j.jfas.2009.07.005
   Chalya Phillipo L, 2011, BMC Res Notes, V4, P365, DOI 10.1186/1756-0500-4-365
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NR 15
TC 6
Z9 7
U1 0
U2 13
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD NOV
PY 2016
VL 25
IS 11
BP 650
EP 654
DI 10.12968/jowc.2016.25.11.650
PG 4
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA EE6GN
UT WOS:000389707600009
PM 27827282
DA 2026-07-24
ER

PT J
AU Elhessy, AH
   Chaudhry, AR
   Hammouda, A
   Giacobbe, SD
   Gesheff, MG
   Conway, JD
AF Elhessy, Ahmed H.
   Chaudhry, Arif R.
   Hammouda, Ahmed, I
   Giacobbe, Shawn D.
   Gesheff, Martin G.
   Conway, Janet D.
TI Experience with negative-pressure wound therapy with instillation in
   complex infected orthopaedic wounds
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE infected orthopaedic wounds; negative&#8208; pressure wound therapy with
   instillation; NPWTi
ID RECOMMENDATIONS; SALINE
AB Chronic exudative wounds are frequently seen in hospitalised patients, consuming hospital resources and leading to increased morbidity. Negative-pressure therapy (NPWT) with topical instillation "NPWTi" may be used to improve the wound healing process, with the unique features (removal of wound exudate, edema reduction, promotion of tissue perfusion and granulation tissue formation, as well as drawing the edges of the wound to facilitate, in addition to the cyclic cleansing mechanism). This report is a descriptive study of our experience with NPWTi on complex infected orthopaedic wounds as a potential method to decrease the need for multiple surgical debridements required for the closure of such wounds. A prospective observational study was conducted. Twenty patients with complex infected orthopaedic wounds were enrolled in our study. These patients were consulted by the Bone and Joint Infection Service and enrolled to receive NPWTi intraoperatively and to be used during their inpatient stay. Twenty patients with 20 complex infected lower limb wounds were included in our study. Of all the 20 wounds, the etiology was post-surgical in 80% (n = 16) and post-traumatic in 20% (n = 4). None of the patients received previous treatment with conventional NPWT before participation in the study. There were 11 males (55%) and 9 females (45%) with an average age of 57 years (22-83). All wounds were located in the lower limbs, with 25% leg (n = 5), 20% thigh (n = 4), 20% knee (n = 4), 20% foot (n = 4), 10% heel (n = 2), and 5% ankle (n = 1). The average length of treatment with NPWTi was 5.2 days (2-10). Successful wound closure within 6 weeks was achieved in 65% of the cases (n = 13). Of the closed wounds (n = 13), 54% (n = 7) were closed primarily and 46% (n = 6) were closed by secondary procedures (skin graft or skin flap). NPWTi is still considered a novel technique that can be used in the management of complex wounds, and the goal of this prospective study is to report our experience with NPWTi in the management of complex infected orthopaedic lower limb wounds. Randomised control studies with optimally matched wounds comparing NPWTi to the conventional methods of treatment are warranted.
C1 [Elhessy, Ahmed H.; Chaudhry, Arif R.; Hammouda, Ahmed, I; Giacobbe, Shawn D.; Gesheff, Martin G.; Conway, Janet D.] Sinai Hosp Baltimore, Int Ctr Limb Lengthening, Rubin Inst Adv Orthoped, Schoeneman Bldg,2nd Floor,2401 West Belvedere Ave, Baltimore, MD 21215 USA.
   [Chaudhry, Arif R.] Omni Cosmet, Wayzata, MN USA.
   [Hammouda, Ahmed, I] Al Azhar Univ Hosp, Dept Orthopaed Surg, Cairo, Egypt.
C3 Sinai Hospital of Baltimore; Egyptian Knowledge Bank (EKB); Al Azhar
   University; Al Azhar University hospital
RP Conway, JD (通讯作者)，Sinai Hosp Baltimore, Int Ctr Limb Lengthening, Rubin Inst Adv Orthoped, Schoeneman Bldg,2nd Floor,2401 West Belvedere Ave, Baltimore, MD 21215 USA.
EM jconway@lifebridgehealth.org
OI Conway, Janet/0000-0001-5694-3081; Elhessy, Ahmed/0000-0003-4556-2325
FU Investigator-Initiated Research Grant from KCI USA, Inc.
FX This study was supported by an Investigator-Initiated Research Grant
   from KCI USA, Inc. JDC reports the following disclosures: Bonesupport
   (consultant), Smith&Nephew (consultant), Zimmer Biomet (consultant),
   Biocomposites (fellowship support), and the University of Florida
   (spouse receives royalties). The following organisations supported the
   corresponding institution's annual course (the Baltimore Limb Deformity
   Course) for orthopaedic surgeons: Biocomposites, DePuy Synthes
   Companies, MHE Coalition, Orthofix, OrthoPediatrics, Pega Medical, Smith
   & Nephew, Stryker, and Zimmer Biomet (all authors).
CR Back DA, 2013, INT WOUND J, V10, P32, DOI 10.1111/iwj.12183
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NR 14
TC 8
Z9 8
U1 0
U2 11
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD DEC
PY 2021
VL 18
IS 6
BP 902
EP 908
DI 10.1111/iwj.13592
EA MAR 2021
PG 7
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA XM0ZU
UT WOS:000634450800001
PM 33783102
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kato, H
   Kano, S
   Yoshimitsu, M
   Nakagawa, Y
   Yasui, Y
   Nakamura, M
   Morita, A
AF Kato, Hiroshi
   Kano, Shinji
   Yoshimitsu, Maki
   Nakagawa, Yua
   Yasui, Yukiko
   Nakamura, Motoki
   Morita, Akimichi
TI Comparative analysis of one-step and two-step full thickness skin
   grafting and secondary intention healing for skin defects after surgical
   management of plantar malignant melanoma
SO JOURNAL OF DERMATOLOGY
LA English
DT Article
DE graft survival; lymph node; melanoma; negative-pressure wound therapy;
   weight-bearing
ID METASTASIS; CLOSURE; FOOT
AB Plantar malignant melanoma is largely managed surgically, particularly in its early stages. However, the plantar region has a lower survival rate of skin grafts than other regions. Furthermore, complete wound healing occurs over a long period of time, postoperatively. Thus, in this study, we retrospectively analyzed the use of skin grafts to reconstruct skin defects, as postoperative complications of plantar malignant melanoma. Forty-nine patients, (23 males, 26 females; mean age 70.4-years) underwent excisional surgery for plantar malignant melanoma at our hospital, between March 2018 and December 2022. The time from initial surgery to wound healing was analyzed, using a multivariate Cox proportional hazards model, to identify related factors. We excluded cases with lesions in non-weight-bearing areas and cases with segmental layer grafts, based on multivariate analysis, to eliminate bias when comparing a one-step resection and reconstruction technique to resection followed by waiting for granulation to occur before reconstruction. Patients were categorized into three cohorts. The first and second cohorts had undergone one-step and two-step skin grafting, respectively. Patients in the third cohort underwent secondary intention healing without skin grafting. The results revealed that the factors associated with wound-healing time included a defect size of >1800 mm2, in addition to two-step and split-thickness skin grafting. Therefore, Kaplan-Meier curves were constructed across the three cohorts, based on the data of 37 patients. Nine cases of non-weight-bearing areas and three cases of split-thickness skin grafts were excluded from the original total of 49 patients. The median times from the initial surgery to wound healing were 14.6, 12.0, and 21.9 weeks for the one- and two-step skin grafting and secondary intention healing cohorts, respectively. A statistically significant difference in the treatment time between the skin grafting and secondary intention healing cohorts was observed (p < 0.001) Moreover, a statistically significant difference in the treatment time between the one- and two-step skin grafting cohorts was noted (p = 0.046). Thus, two-step skin grafting after surgical treatment for plantar malignant melanoma may shorten the overall treatment duration by allowing granulation to occur.
C1 [Kato, Hiroshi; Kano, Shinji; Yoshimitsu, Maki; Nakagawa, Yua; Yasui, Yukiko; Nakamura, Motoki; Morita, Akimichi] Nagoya City Univ, Grad Sch Med Sci, Dept Geriatr & Environm Dermatol, 1-Kawasumi,Mizuho Cho,Mizuho Ku, Nagoya 4678601, Japan.
C3 Nagoya City University
RP Kato, H (通讯作者)，Nagoya City Univ, Grad Sch Med Sci, Dept Geriatr & Environm Dermatol, 1-Kawasumi,Mizuho Cho,Mizuho Ku, Nagoya 4678601, Japan.
EM h-kato@med.naogya-cu.ac.jp
RI ; Nakamura, Motoki/JNT-1917-2023
OI Yasui, Yukiko/0000-0003-0961-6007; Morita, Akimichi/0000-0001-8372-3754;
   Nakamura, Motoki/0000-0003-4431-7782
FX We thank Editage () for English language editing.
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NR 15
TC 4
Z9 4
U1 0
U2 1
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0385-2407
EI 1346-8138
J9 J DERMATOL
JI J. Dermatol.
PD DEC
PY 2024
VL 51
IS 12
BP 1641
EP 1645
DI 10.1111/1346-8138.17398
EA SEP 2024
PG 5
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA O6N7C
UT WOS:001305006800001
PM 39229708
DA 2026-07-24
ER

PT J
AU Petersson, P
   Petersson, U
AF Petersson, Patrik
   Petersson, Ulf
TI Dynamic Fascial Closure With Vacuum-Assisted Wound Closure and
   Mesh-Mediated Fascial Traction (VAWCM) Treatment of the Open Abdomen-An
   Updated Systematic Review
SO FRONTIERS IN SURGERY
LA English
DT Review
DE open abdomen; negative pressure wound therapy (NPWT); vacuum assisted
   wound closure and mesh-mediated fascial traction; VAWCM; dynamic closure
   technique; temporary abdominal closure (TAC)
ID NEGATIVE-PRESSURE; THERAPY; MANAGEMENT; OUTCOMES
AB Introduction: Several different temporary abdominal closure techniques are described in the context of open abdomen treatment. Techniques based on dynamic fascial closure combined with negative pressure therapy have gained popularity and seem to result in the highest fascial closure rates without increased complications and are highlighted in recent guidelines and recommendations. One dynamic closure technique is the vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) technique, first described in 2007. The aim of this systematic review was to evaluate the VAWCM technique regarding a number of short- and long-term results.
   Materials and Methods: A systematic literature search was performed in PubMed, EMBASE, and Cochrane Library databases for articles published between January 1, 2006 and May 8, 2020. The review was independently performed by the two authors according to the PRISMA statements for reporting systematic reviews and meta-analyses. Results were pooled for presentation of weighted means when applicable.
   Results: A total of 220 articles were screened by title and abstract. Thirty-two articles were assessed for eligibility by full-text review and 15 articles finally remained for review. A total of 600 patients treated with VAWCM were included. The pooled weighted means were as follows: fascial closure, 83.5%; enteroatmospheric fistula, 5.6%; planned ventral hernia, 6.2%; in-hospital survival, 72%; and incisional hernia incidence, 40.5%. Long-term survival ranged between 22 and 72%. Quality of life (SF-36) was reported in two studies showing lower scores than the population mean especially in physical domains. Incisional hernia resulted in lower scores in one but not in the other study.
   Discussion: The results of 600 VAWCM-treated patients from 15 studies were evaluated in this systematic review. Earlier findings with high fascial closure rates, low enteroatmospheric fistula, and planned ventral hernia rates as well as high incisional hernia incidences were underlined. Permanent mesh for efficient fascial traction and reinforcement at fascial closure seem to be the next step in evolving an optimal temporary closure technique in open abdomen treatment.
C1 [Petersson, Patrik; Petersson, Ulf] Lund Univ, Fac Med, Dept Clin Sci, Lund, Sweden.
   [Petersson, Patrik; Petersson, Ulf] Skane Univ Hosp, Dept Surg, Malmo, Sweden.
C3 Lund University; Lund University; Skane University Hospital
RP Petersson, P (通讯作者)，Lund Univ, Fac Med, Dept Clin Sci, Lund, Sweden.; Petersson, P (通讯作者)，Skane Univ Hosp, Dept Surg, Malmo, Sweden.
EM patrik.a.petersson@telia.com
OI Kjärsgård Pettersson, Patrik/0000-0003-0250-1004
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NR 32
TC 25
Z9 29
U1 0
U2 2
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD NOV 5
PY 2020
VL 7
AR 577104
DI 10.3389/fsurg.2020.577104
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA OU5VV
UT WOS:000591597300001
PM 33251242
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Leggieri, F
   Ferriani, F
   Di Benedetto, E
   Miani, E
   Festa, E
   Balato, G
   Rossi, SMP
   Benazzo, F
   Baldini, A
AF Leggieri, Filippo
   Ferriani, Francesco
   Di Benedetto, Enrico
   Miani, Enrick
   Festa, Enrico
   Balato, Giovanni
   Rossi, Stefano M. P.
   Benazzo, Francesco
   Baldini, Andrea
TI Time-dependent wound management protocol prevents periprosthetic joint
   infection in total knee arthroplasty with persistent drainage
SO KNEE SURGERY SPORTS TRAUMATOLOGY ARTHROSCOPY
LA English
DT Article
DE DAIR (debridement, antibiotics, and implant retention); periprosthetic
   joint infection (PJI); persistent wound drainage; total knee
   arthroplasty (TKA)
ID SCORING METHOD ASEPSIS; PRIMARY TOTAL HIP; RISK-FACTORS; COMPLICATIONS
AB Purpose: This study aimed to evaluate the success rate of a standardised protocol for managing persistent wound drainage following total knee arthroplasty (TKA). Methods: A prospective observational study was conducted at four institutions between January and June 2022 across primary and revision TKAs. Sixty-two patients (mean age 71.5 +/- 9.3 years; 45.2% male) who experienced postoperative wound drainage after primary (58.1%) or revision (41.9%) TKA were enrolled. The protocol included staged interventions: anticoagulation adjustments and dressing changes during Days 1-3, incisional negative pressure wound therapy during Days 3-5, and wound debridement above the joint capsule if drainage persisted beyond Day 7. Outcomes were evaluated using the ASEPSIS score. The primary outcome was defined as complete wound healing without progression to debridement, antibiotics and implant retention (DAIR) procedure or periprosthetic joint infection (PJI). Results: The mean follow-up was 13.2 months (range, 11.7-15.1 months). The protocol achieved a 91.9% success rate in preventing progression to DAIR. The median number of visits required to achieve wound healing was 3.5 for the cohort. DAIR rate was 8.1% (n = 5), while PJI rate was 1.6% (n = 1). Primary TKA procedures demonstrated more efficient healing trajectories compared to revision cases, requiring fewer clinical visits (median 3 vs. 5, p < 0.001) and shorter hospital stays (mean 4.5 vs. 7.5 days, p = 0.017). Cox proportional hazards model identified intervention type (revision vs. primary, hazard ratio [HR] 0.24, p < 0.001), advanced age (HR: 0.95 per year, p = 0.006), and male gender (HR: 0.45, p = 0.020) as significant independent predictors of increased time required to achieve wound healing. Conclusion: Our standardised wound management protocol achieved a high success rate in preventing progression to PJI following TKA. The time-dependent approach to intervention escalation provides clear clinical decision-making criteria and suggests that early identification and systematic management of wound complications are critical determinants of successful outcomes, particularly for primary TKA procedures.
C1 [Leggieri, Filippo] Univ Firenze, Dept Clin Orthopaed, Azienda Univ Osped Careggi, Florence, Italy.
   [Ferriani, Francesco; Baldini, Andrea] Ist Fiorentino Cura & Assistenza, Orthoped Unit, Florence, Italy.
   [Di Benedetto, Enrico; Miani, Enrick] Azienda Sanitaria Univ Friuli Cent, SOC Ortopedia & Traumatol, Tolmezzo, Italy.
   [Festa, Enrico; Balato, Giovanni] Univ Naples Federico II, Dept Publ Hlth, Orthoped Unit, Naples, Italy.
   [Rossi, Stefano M. P.] Univ Studi Link, Dept Life Sci Hlth & Hlth Profess, Rome, Italy.
   [Rossi, Stefano M. P.] Fdn Poliambulanza, Unita Chirurg Robot UOC Ortoped & Traumatol, Brescia, Italy.
   [Benazzo, Francesco] Fdn Poliambulanza, UOC Ortoped & Traumatol, Brescia, Italy.
   [Benazzo, Francesco] Ist Univ Studi Superiori, Pavia, Italy.
C3 University of Florence; Azienda Ospedaliero Universitaria Careggi;
   University of Naples Federico II
RP Leggieri, F (通讯作者)，Univ Florence, Dept Clin Orthoped, AOU Careggi CTO, Largo Palagi 1, I-50139 Florence, Italy.
EM filippoleggieri@icloud.com
RI ; Benazzo, Francesco/AAV-9990-2020; Rossi, Stefano Marco
   Paolo/KGL-1404-2024; Leggieri, Filippo/JRY-0923-2023; Balato,
   Giovanni/AAC-5951-2022
OI Festa, Enrico/0000-0002-9923-1129; Rossi, Stefano Marco
   Paolo/0000-0003-4395-8457; Leggieri, Filippo/0009-0007-1289-8849;
   baldini, andrea/0000-0002-6073-8491
FU Universita degli Studi di Firenze, as part of the Wiley - CRUI-CARE
   agreement
FX Open access publishing facilitated by Universita degli Studi di Firenze,
   as part of the Wiley - CRUI-CARE agreement. The study followed the
   STROBE guidelines for reporting observational studies.
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NR 32
TC 2
Z9 2
U1 0
U2 0
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 0942-2056
EI 1433-7347
J9 KNEE SURG SPORT TR A
JI Knee Surg. Sports Traumatol. Arthrosc.
PD MAY
PY 2026
VL 34
IS 5
BP 1740
EP 1749
DI 10.1002/ksa.70077
EA SEP 2025
PG 10
WC Orthopedics; Sport Sciences; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Sport Sciences; Surgery
GA HF0II
UT WOS:001583938100001
PM 41020425
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Bruce, J
   Knight, R
   Parsons, N
   Betteridge, R
   Verdon, A
   Brown, J
   Campolier, M
   Achten, J
   Costa, ML
AF Bruce, J.
   Knight, R.
   Parsons, N.
   Betteridge, R.
   Verdon, A.
   Brown, J.
   Campolier, M.
   Achten, J.
   Costa, M. L.
TI Wound photography for evaluation of surgical site infection and wound
   healing after lower limb trauma
SO BONE & JOINT JOURNAL
LA English
DT Article
AB Aims
   Deep surgical site infection (SSI) is common after lower limb fracture. We compared the diagnosis of deep SSI using alternative methods of data collection and examined the agreement of clinical photography and in-person clinical assessment by the Centers for Disease Control and Prevention (CDC) criteria after lower limb fracture surgery.
   Methods
   Data from two large, UK-based multicentre randomized controlled major trauma trials investigating SSI and wound healing after surgical repair of open lower limb fractures that could not be primarily closed (UK WOLLF), and surgical incisions for fractures that were primarily closed (UK WHiST), were examined. Trial interventions were standard wound care management and negative pressure wound therapy after initial surgical debridement. Wound outcomes were collected from 30 days to six weeks. We compared the level of agreement between wound photography and clinical assessment of CDC-defined SSI. We are also assessed the level of agreement between blinded independent assessors of the photographs.
   Results
   Rates of CDC-defined deep SSI were 7.6% (35/460) after open fracture and 6.3% (95/1519) after closed incisional repair. Photographs were obtained for 77% and 73% of WOLLF and WHiST cohorts respectively (all participants n = 1,478). Agreement between photographic-SSI and CDC-SSI was fair for open fracture wounds (83%; k = 0.27 (95% confidence interval (CI) 0.14 to 0.42)) and for closed incisional wounds (88%; k = 0.29 (95% CI 0.20 to 0.37)) although the rate of photographically detected deep SSIs was twice as high as CDC-SSI (12% vs 6%). Agreement between different assessors for photographic-SSI (WOLLF 88%, k = 0.63 (95% CI 0.52 to 0.72); WHiST 89%; k = 0.61 (95% CI 0.54 to 0.69)); and wound healing was good (WOLLF 90%; k = 0.80 (95% CI 0.73 to 0.86); WHiST 87%; k = 0.57 (95% CI 0.50 to 0.64)).
   Conclusion
   Although wound photography was feasible within the research context and inter-rater assessor agreement substantial, digital photographs used in isolation overestimated deep SSI rates, when compared to CDC criteria. Wound photography should not replace clinical assessment in pragmatic trials but may be useful for screening purposes where surgical infection outcomes are paramount.
C1 [Bruce, J.] Univ Warwick, Div Hlth Sci, Warwick Clin Trials Unit, Clin Trials, Coventry, W Midlands, England.
   [Knight, R.; Betteridge, R.; Verdon, A.; Brown, J.; Campolier, M.; Achten, J.; Costa, M. L.] Univ Warwick, Coventry, W Midlands, England.
   [Parsons, N.] Univ Warwick, Warwick Med Sch, Stat & Epidemiol Unit, Med Stat, Coventry, W Midlands, England.
C3 University of Warwick; University of Warwick; University of Warwick
RP Bruce, J (通讯作者)，Univ Warwick, Div Hlth Sci, Warwick Clin Trials Unit, Clin Trials, Coventry, W Midlands, England.
EM julie.bruce@warwick.ac.uk
RI ; Parsons, Nathan/AAX-6265-2020; Achten, Juul/KUD-8515-2024; Bruce,
   Julie/G-7588-2014
OI Parsons, Nick/0000-0001-9975-888X; Achten, Juul/0000-0002-8857-5743;
   Costa, Matthew/0000-0003-3644-1388; Betteridge,
   Victoria/0000-0002-4856-429X; Campolier, Marta/0000-0002-7168-2534;
   Knight, Ruth/0000-0001-6810-2845; Bruce, Julie/0000-0002-8462-7999
FU UK National Institute for Health Research (NIHR) Health Technology
   Assessment (HTA) Programme [10/57/20, 14/199/14]; NIHR Oxford Biomedical
   Research Centre; NIHR Research Capability Funding via University
   Hospitals Coventry and Warwickshire NHS Trust; MRC [G106/1178] Funding
   Source: UKRI
FX This work was supported by the UK National Institute for Health Research
   (NIHR) Health Technology Assessment (HTA) Programme: project numbers
   10/57/20 and 14/199/14 for UK WOLLF and UK WHiST trials respectively.
   Support was also provided by the NIHR Oxford Biomedical Research Centre.
   J. Bruce is supported by NIHR Research Capability Funding via University
   Hospitals Coventry and Warwickshire NHS Trust.
CR Achten J, 2018, BMJ OPEN, V8, DOI 10.1136/bmjopen-2018-022115
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NR 29
TC 9
Z9 15
U1 0
U2 2
PU BRITISH EDITORIAL SOC BONE & JOINT SURGERY
PI LONDON
PA 22 BUCKINGHAM STREET, LONDON WC2N 6ET, ENGLAND
SN 2049-4394
J9 BONE JOINT J
JI Bone Joint J.
PD DEC
PY 2021
VL 103B
IS 12
BP 1802
EP 1808
DI 10.1302/0301-620X.103B12.BJJ-2021-0447
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA VM3AU
UT WOS:000994264100005
PM 34847717
DA 2026-07-24
ER

PT J
AU Carrié, C
   Delzor, F
   Roure, S
   Dubuisson, V
   Petit, L
   Molimard, M
   Breilh, D
   Biais, M
AF Carrie, Cedric
   Delzor, Faustine
   Roure, Stephanie
   Dubuisson, Vincent
   Petit, Laurent
   Molimard, Mathieu
   Breilh, Dominique
   Biais, Matthieu
TI Population Pharmacokinetic Study of the Suitability of Standard Dosing
   Regimens of Amikacin in Critically III Patients with Open-Abdomen and
   Negative-Pressure Wound Therapy
SO ANTIMICROBIAL AGENTS AND CHEMOTHERAPY
LA English
DT Article
DE open abdomen; negative-pressure therapy; amikacin; pharmacokinetics;
   Monte Carlo simulation; intensive care
ID CARE-UNIT PATIENTS; ILL PATIENTS; AMINOGLYCOSIDE THERAPY; NOSOCOMIAL
   PNEUMONIA; PEAK CONCENTRATION; REPLACEMENT; GENTAMICIN; PLASMA; IMPACT;
   SERUM
AB The aim was to assess the appropriateness of recommended regimens for empirical MIC coverage in critically ill patients with open-abdomen and negative-pressure therapy (OA/NPT). Over a 5-year period, every critically ill patient who received amikacin and who underwent therapeutic drug monitoring (TDM) while being treated by OA/NPT was retrospectively included. A population pharmacokinetic (PK) modeling was performed considering the effect of 10 covariates (age, sex, total body weight [TBW], adapted body weight [ABW], body surface area [BSA], modified sepsis-related organ failure assessment [SOFA] score, vasopressor use, creatinine clearance [CLCR], fluid balance, and amount of fluids collected by the NPT over the sampling day) in patients who underwent continuous renal replacement therapy (CRRT) or did not receive CRRT. Monte Carlo simulations were employed to determine the fractional target attainment (FTA) for the PK/pharmacodynamic [PD) targets (maximum concentration of drug [C-max]/MIC ratio of >= 8 and a ratio of the area under the concentration-time curve from 0 to 24 h [AUC(0-24)]/MIC of >= 75). Seventy critically ill patients treated by OA/NPT (contributing 179 concentration values) were included. Amikacin PK concentrations were best described by a two-compartment model with linear elimination and proportional residual error, with a CLCR and ABW as significant covariates for volume of distribution (V) and CLCR for CL. The reported V) in non-CRRT and CRRT patients was 35.8 and 40.2 liters, respectively. In Monte Carlo simulations, ABW-adjusted doses between 25 and 35 mg/kg were needed to reach an FTA of >85% for various renal functions. Despite an increased V and a wide inter-individual variability, desirable PK/PD targets may be achieved using an ABW-based loading dose of 25 to 30 mg/kg. When less susceptible pathogens are targeted, higher dosing regimens are probably needed in patients with augmented renal clearance (ARC). Further studies are needed to assess the effect of OA/NPT on the PK parameters of antimicrobial agents.
C1 [Carrie, Cedric; Roure, Stephanie; Petit, Laurent; Biais, Matthieu] CHU Bordeaux, Anesthesiol & Crit Care Dept, Bordeaux, France.
   [Delzor, Faustine; Breilh, Dominique] Univ Bordeaux, Pharmacokinet & PK PD Grp, INSERM 1034, Bordeaux, France.
   [Delzor, Faustine; Breilh, Dominique] CHU Bordeaux, Pharm & Clin Pharm Dept, Bordeaux, France.
   [Dubuisson, Vincent] CHU Bordeaux, Dept Vasc & Gen Surg, Bordeaux, France.
   [Molimard, Mathieu] CHU Bordeaux, Pharmacol & Toxicol Dept, Bordeaux, France.
   [Molimard, Mathieu; Biais, Matthieu] Univ Bordeaux Segalen, Bordeaux, France.
C3 CHU Bordeaux; Universite de Bordeaux; Institut National de la Sante et
   de la Recherche Medicale (Inserm); Universite de Bordeaux; CHU Bordeaux;
   Universite de Bordeaux; Universite de Bordeaux; CHU Bordeaux; Universite
   de Bordeaux; CHU Bordeaux; Universite de Bordeaux
RP Carrié, C (通讯作者)，CHU Bordeaux, Anesthesiol & Crit Care Dept, Bordeaux, France.
EM cedric.carrie@chu-bordeaux.fr
RI molimard, mathieu/T-2762-2019; Petit, Laurent/M-3888-2019; BREILH,
   Dominique/AAH-8791-2021
OI BREILH, Dominique/0000-0002-3783-2797
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NR 35
TC 18
Z9 19
U1 0
U2 3
PU AMER SOC MICROBIOLOGY
PI WASHINGTON
PA 1752 N ST NW, WASHINGTON, DC 20036-2904 USA
SN 0066-4804
EI 1098-6596
J9 ANTIMICROB AGENTS CH
JI Antimicrob. Agents Chemother.
PD APR
PY 2020
VL 64
IS 4
AR e02098-19
DI 10.1128/AAC.02098-19
PG 10
WC Microbiology; Pharmacology & Pharmacy
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Microbiology; Pharmacology & Pharmacy
GA KX3AB
UT WOS:000521752600035
PM 31964795
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Kirkham, AM
   Candeliere, J
   McIsaac, DI
   Stelfox, HT
   Dubois, L
   Gill, HL
   Brandys, T
   Nagpal, SK
   Roberts, DJ
AF Kirkham, Aidan M.
   Candeliere, Jasmine
   McIsaac, Daniel I.
   Stelfox, Henry T.
   Dubois, Luc
   Gill, Heather L.
   Brandys, Timothy
   Nagpal, Sudhir K.
   Roberts, Derek J.
TI Efficacy of Strategies Intended to Prevent Surgical Site Infection After
   Lower Limb Revascularization Surgery A Systematic Review and
   Meta-Analysis of Randomized Controlled Trials
SO ANNALS OF SURGERY
LA English
DT Review
DE lower limb revascularization surgery; meta-analysis; peripheral artery
   disease; surgical site infection; systematic review
ID PRESSURE WOUND THERAPY; VASCULAR-SURGERY; RISK-FACTORS; CLINICAL-TRIAL;
   GROIN WOUNDS; SKIN CLOSURE; DOUBLE-BLIND; PROPHYLAXIS; MULTICENTER;
   GENTAMICIN
AB Objective:The objective of this study is to evaluate the efficacy of strategies intended to prevent surgical site infection (SSI) after lower limb revascularization surgery. Background:SSIs are common, costly complications of lower limb revascularization surgery associated with significant morbidity and mortality. Methods:We searched MEDLINE, EMBASE, CENTRAL, and Evidence-Based Medicine Reviews (inception to April 28, 2022). Two investigators independently screened abstracts and full-text articles, extracted data, and assessed the risk of bias. We included randomized controlled trials (RCTs) that evaluated strategies intended to prevent SSI after lower limb revascularization surgery for peripheral artery disease. We used random-effects models to pool data and GRADE to assess certainty. Results:Among 6258 identified citations, we included 26 RCTs (n=4752 patients) that evaluated 12 strategies to prevent SSI. Preincision antibiotics [risk ratio (RR)=0.25; 95% CI, 0.11-0.57; n=4 studies; I-2 statistic=7.1%; high certainty] and incisional negative-pressure wound therapy (iNPWT) (RR=0.54; 95% CI, 0.38-0.78; n=5 studies; I-2 statistic=7.2%; high certainty) reduced pooled risk of early (& LE;30 days) SSI. iNPWT also reduced the risk of longer-term (>30 days) SSI (pooled-RR=0.44; 95% CI, 0.26-0.73; n=2 studies; I-2=0%; low certainty). Strategies with uncertain effects on risk of SSI included preincision ultrasound vein mapping (RR=0.58; 95% CI, 0.33-1.01; n=1 study); transverse groin incisions (RR=0.33; 95% CI, 0.097-1.15; n=1 study), antibiotic-bonded prosthetic bypass grafts (RR=0.74; 95% CI, 0.44-1.25; n=1 study; n=257 patients), and postoperative oxygen administration (RR=0.66; 95% CI, 0.42-1.03; n=1 study) (low certainty for all). Conclusions:Preincision antibiotics and iNPWT reduce the risk of early SSI after lower limb revascularization surgery. Confirmatory trials are required to determine whether other promising strategies also reduce SSI risk.
C1 [Kirkham, Aidan M.; McIsaac, Daniel I.; Roberts, Derek J.] Univ Ottawa, Fac Med, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada.
   [Kirkham, Aidan M.; Brandys, Timothy; Nagpal, Sudhir K.; Roberts, Derek J.] Univ Ottawa, Dept Surg, Div Vasc & Endovasc Surg, Ottawa, ON, Canada.
   [Kirkham, Aidan M.; Candeliere, Jasmine; McIsaac, Daniel I.; Roberts, Derek J.] Ottawa Hosp, Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada.
   [McIsaac, Daniel I.] Univ Ottawa, Ottawa Hosp, Dept Anesthesiol, Ottawa, ON, Canada.
   [McIsaac, Daniel I.] Univ Ottawa, Ottawa Hosp, Dept Pain Med, Ottawa, ON, Canada.
   [McIsaac, Daniel I.; Dubois, Luc] Inst Clin Evaluat Sci, Toronto, ON, Canada.
   [Stelfox, Henry T.] Univ Calgary, OBrien Inst Publ Hlth, Dept Crit Care Med, Calgary, AB, Canada.
   [Dubois, Luc] Western Univ, Dept Surg, Div Vasc Surg, London, ON, Canada.
   [Dubois, Luc] Western Univ, Fac Med, Dept Epidemiol & Biostat, London, ON, Canada.
   [Gill, Heather L.] McGill Univ, Dept Surg, Div Vasc Surg, Montreal, PQ, Canada.
C3 University of Ottawa; University of Ottawa; University of Ottawa; Ottawa
   Hospital Research Institute; University of Ottawa; Ottawa Hospital
   Research Institute; University of Ottawa; Ottawa Hospital Research
   Institute; University of Toronto; Institute for Clinical Evaluative
   Sciences (ICES); University of Calgary; Western University (University
   of Western Ontario); Western University (University of Western Ontario);
   McGill University
RP Roberts, DJ (通讯作者)，Univ Ottawa, Fac Med, Sch Epidemiol & Publ Hlth, Ottawa, ON, Canada.; Roberts, DJ (通讯作者)，Univ Ottawa, Dept Surg, Div Vasc & Endovasc Surg, Ottawa, ON, Canada.; Roberts, DJ (通讯作者)，Ottawa Hosp, Ottawa Hosp Res Inst, Clin Epidemiol Program, Ottawa, ON, Canada.
EM akirk032@uottawa.ca; jcand012@uottawa.ca; dmcisaac@toh.ca;
   tstelfox@ucalgary.ca; luc.dubois@lhsc.on.ca; heather.gill@mcgill.ca;
   tbrandys@toh.ca; snagpal@toh.ca; Derek.Roberts01@gmail.com
RI Kirkham, Aidan M/HBZ-9926-2022; Roberts, Derek/L-6229-2019
OI Kirkham, Aidan M/0000-0001-6432-3018; Roberts, Derek/0000-0001-6111-6291
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NR 74
TC 11
Z9 11
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0003-4932
EI 1528-1140
J9 ANN SURG
JI Ann. Surg.
PD SEP
PY 2023
VL 278
IS 3
BP E447
EP E456
DI 10.1097/SLA.0000000000005867
PG 10
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA O9TW8
UT WOS:001047180100018
PM 36994744
DA 2026-07-24
ER

PT J
AU Higuera-Rueda, CA
   Emara, AK
   Nieves-Malloure, Y
   Klika, AK
   Cooper, HJ
   Cross, MB
   Guild, GN
   Nam, D
   Nett, MP
   Scuderi, GR
   Cushner, FD
   Piuzzi, NS
   Silverman, RP
AF Higuera-Rueda, Carlos A.
   Emara, Ahmed K.
   Nieves-Malloure, Yeni
   Klika, Alison K.
   Cooper, Herbert J.
   Cross, Michael B.
   Guild, George N.
   Nam, Denis
   Nett, Michael P.
   Scuderi, Giles R.
   Cushner, Fred D.
   Piuzzi, Nicolas S.
   Silverman, Ronald P.
TI The Effectiveness of Closed-Incision Negative-Pressure Therapy Versus
   Silver-Impregnated Dressings in Mitigating Surgical Site Complications
   in High-Risk Patients After Revision Knee Arthroplasty: The PROMISES
   Randomized Controlled Trial
SO JOURNAL OF ARTHROPLASTY
LA English
DT Article
DE revision knee arthroplasty; closed incision negative pressure wound
   therapy; surgical site complication; surgical site infection;
   readmission; dressing changes
ID JOINT INFECTION; SAMPLE-SIZE; SURGERY; HIP; DIAGNOSIS; DISEASE; RATES
AB Background: Revision total knee arthroplasty (rTKA) is associated with significant risk of wound-related morbidity. The present study aimed to evaluate the 1) efficacy of closed-incision negative-pressure therapy (ciNPT) vs silver-impregnated antimicrobial dressing (AMD) in mitigating postoperative surgical site complications (SSCs), 2) the effect of ciNPT vs AMD on certain postoperative health utilization parameters, and on 3) patient-reported outcomes (PROs) improvement at 90-day postoperative follow-up.
   Methods: This multicenter randomized controlled trial was conducted between December 2017 and August 2019. Patients >= 22 years, at high risk for SSC, and receiving rTKA with full exchange and reimplantation of new prosthetic components or open reduction and internal fixation of periprosthetic fractures were screened for inclusion. Eligible patients were randomized to receive a commercially available ciNPT system or a silver-impregnated AMD (n = 147, each) for minimum of 5-day duration. Primary outcome was the 90-day incidence of SSCs with stratification in accordance with revision type (aseptic/septic). Secondary outcomes were the 90-day health care utilization parameters (readmission, reoperation, dressing changes, and visits) and PROs.
   Results: Of 294 patients randomized (age: 64.9 +/- 9.0 years, female: 59.6%), 242 (82.0%) patients completed the study (ciNPT: n = 124; AMD: n = 118). The incidence of 90-day SSCs was lower for the ciNPT cohort (ciNPT: 3.4% vs AMD: 14.3%; odds ratio (OR): 0.22, 95% confidence interval (0.08, 0.59); P =.0013). Readmission rates (3.4% vs 10.2%, OR: 0.30(0.11, 0.86); P =.0208) and mean dressing changes (1.1 +/- 0.3 vs 1.3 +/- 1.0; P =.0003) were lower with ciNPT. The differences in reoperation rates, number of visits, and PRO improvement between both arms were not statistically significant (P >.05).
   Conclusion: ciNPT is effective in reducing the 90-day postoperative SSCs, readmission, and number of dressing changes after rTKA. Recommending routine implementation would require true-cost analyses. (C) 2021 The Authors. Published by Elsevier Inc.
C1 [Higuera-Rueda, Carlos A.] Cleveland Clin Florida, Dept Orthopaed Surg, Weston, FL USA.
   [Emara, Ahmed K.; Klika, Alison K.; Piuzzi, Nicolas S.] Cleveland Clin Fdn, Dept Orthopaed Surg, Cleveland, OH USA.
   [Nieves-Malloure, Yeni; Silverman, Ronald P.] KCI Acel, San Antonio, TX USA.
   [Cooper, Herbert J.] Columbia Univ, New York Presbyterian Hosp, Dept Orthopaed Surg, Irving Med Ctr, New York, NY USA.
   [Cross, Michael B.; Cushner, Fred D.] Hosp Special Surg, Dept Orthopaed Surg, New York, NY USA.
   [Guild, George N.] Emory Univ, Dept Orthopaed Surg, Atlanta, GA USA.
   [Nam, Denis] Rush Univ, Med Ctr, Midwest Orthopaed, Chicago, IL USA.
   [Nett, Michael P.] Northwell Hlth Phys Partners Orthopaed Inst Babyl, Babylon, NY USA.
   [Scuderi, Giles R.] Northwell Hlth Phys Partners Orthopaed Inst MEETH, New York, NY USA.
C3 Cleveland Clinic Foundation; Cleveland Clinic Foundation; Columbia
   University; Cornell University; Weill Cornell Medicine;
   NewYork-Presbyterian Hospital; Emory University; Rush University
RP Higuera-Rueda, CA (通讯作者)，Cleveland Clin, Levitetz Dept Orthoped Surg, 2950 Cleveland Clin Blvd, Weston, FL 33331 USA.
RI ; Silverman, Ronald/A-5155-2018; Cooper, H./H-3488-2019; Nett,
   Michael/GXA-3548-2022; Emara, Ahmed/AAC-4309-2019
OI Piuzzi, Nicolas S/0000-0003-3007-7538; 
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NR 48
TC 39
Z9 40
U1 0
U2 4
PU CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
PI PHILADELPHIA
PA CURTIS CENTER, INDEPENDENCE SQUARE WEST, PHILADELPHIA, PA 19106-3399 USA
SN 0883-5403
EI 1532-8406
J9 J ARTHROPLASTY
JI J. Arthroplast.
PD JUL
PY 2021
VL 36
IS 7
SU S
BP S295
EP +
DI 10.1016/j.arth.2021.02.076
EA JUN 2021
PG 22
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA SR5HK
UT WOS:000661072200033
PM 33781638
OA hybrid
DA 2026-07-24
ER

PT J
AU Rezk, F
   Stenmarker, M
   Acosta, S
   Johansson, K
   Bengnér, M
   Åstrand, H
   Andersson, AC
AF Rezk, Francis
   Stenmarker, Margaretha
   Acosta, Stefan
   Johansson, Karoline
   Bengner, Malin
   Astrand, Hakan
   Andersson, Ann-Christine
TI Healthcare professionals' experiences of being observed regarding
   hygiene routines: the Hawthorne effect in vascular surgery
SO BMC INFECTIOUS DISEASES
LA English
DT Article
DE Healthcare professionals; Compliance; Adherence to standard precautions;
   Hygiene observation; Hawthorne effect; Hierarchy; Vascular surgery
ID HAND HYGIENE; INFECTION; IMPLEMENTATION; PHYSICIANS; AUDIT
AB BackgroundThe Hawthorne Effect is the change in behaviour by subjects due to their awareness of being observed and is evident in both research and clinical settings as a result of various forms of observation. When the Hawthorne effect exists, it is short-lived, and likely leads to increased productivity, compliance, or adherence to standard protocols. This study is a qualitative component of an ongoing multicentre study, examining the role of Incisional Negative Pressure Wound Therapy after vascular surgery (INVIPS Trial). Here we examine the factors that influence hygiene and the role of the Hawthorne effect on the adherence of healthcare professionals to standard hygiene precautions.MethodsThis is a qualitative interview study, investigating how healthcare professionals perceive the observation regarding hygiene routines and their compliance with them. Seven semi-structured focus group interviews were conducted, each interview included a different staff category and one individual interview with a nurse from the Department for Communicable Disease Control. Additionally, a structured questionnaire interview was performed with environmental services staff. The results were analysed based on the inductive qualitative content analysis approach.ResultsThe analysis revealed four themes and 12 subthemes. Communication and hindering hierarchy were found to be crucial. Healthcare professionals sought more personal and direct feedback. All participants believed that there were routines that should be adhered to but did not know where to find information on them. Staff in the operating theatre were most meticulous in adhering to standard hygiene precautions. The need to give observers a clear mandate and support their work was identified. The staff had different opinions concerning the patient's awareness of the importance of hygiene following surgery. The INVIPS Trial had mediated the Hawthorne effect.ConclusionThe results of this study indicate that the themes identified, encompassing communication, behaviour, rules and routines, and work environment, influence the adherence of healthcare professionals to standard precautions to a considerable extent of which many factors could be mediated by a Hawthorne effect. It is important that managers within the healthcare system put into place an improved and sustainable hygiene care to reduce the rate of surgical site infections after vascular surgery.
C1 [Rezk, Francis; Acosta, Stefan] Lund Univ, Dept Clin Sci, Malmo, Sweden.
   [Rezk, Francis; Astrand, Hakan] Linkoping Univ, Dept Biomed & Clin Sci, Linkoping, Sweden.
   [Rezk, Francis; Stenmarker, Margaretha; Johansson, Karoline; Bengner, Malin; Astrand, Hakan] Reg Jonkoping Cty, Dept Surg, Unit Vasc Surg, Jonkoping, Sweden.
   [Stenmarker, Margaretha] Linkoping Univ, Dept Clin & Expt Med, Linkoping, Sweden.
   [Stenmarker, Margaretha] Univ Gothenburg, Sahlgrenska Acad, Inst Clin Sci, Dept Paediat, Gothenburg, Sweden.
   [Johansson, Karoline; Bengner, Malin] Linkoping Univ, Dept Hlth Med & Caring, Linkoping, Sweden.
   [Andersson, Ann-Christine] Jonkoping Univ, Jonkoping Acad, Jonkoping, Sweden.
C3 Lund University; Linkoping University; Linkoping University; University
   of Gothenburg; Linkoping University; Jonkoping University
RP Rezk, F (通讯作者)，Lund Univ, Dept Clin Sci, Malmo, Sweden.; Rezk, F (通讯作者)，Linkoping Univ, Dept Biomed & Clin Sci, Linkoping, Sweden.
EM francis.rezk@med.lu.se
RI ; Acosta, Stefan/JAX-3225-2023; Andersson, Ann-Christine/IWU-9289-2023
OI Rezk, Francis/0000-0002-1236-6363; Acosta, Stefan/0000-0002-3225-0798; 
FU Swedish Medical Research Council [2019-00435]; Lund University; Swedish
   Research Council [2019-00435] Funding Source: Swedish Research Council
FX This study was made possible by a grant from the Swedish Medical
   Research Council (Official records number 2019-00435); however, the
   funding agency was not involved in any part of the study. Open Access
   funding provided by Lund University.
CR Acosta S, 2017, BJS-BRIT J SURG, V104, pE75, DOI 10.1002/bjs.10403
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NR 41
TC 19
Z9 31
U1 0
U2 11
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1471-2334
J9 BMC INFECT DIS
JI BMC Infect. Dis.
PD MAY 4
PY 2021
VL 21
IS 1
AR 420
DI 10.1186/s12879-021-06097-5
PG 10
WC Infectious Diseases
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Infectious Diseases
GA SD6GX
UT WOS:000651474800011
PM 33947338
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Peters, EJG
   Lipsky, BA
   Senneville, E
   Abbas, ZG
   Aragon-Sanchez, J
   Diggle, M
   Embil, JM
   Kono, S
   Lavery, LA
   Malone, M
   Urbancic-Rovan, V
   Van Asten, SA
AF Peters, Edgar J. G.
   Lipsky, Benjamin A.
   Senneville, Eric
   Abbas, Zulfiqarali G.
   Aragon-Sanchez, Javier
   Diggle, Mathew
   Embil, John M.
   Kono, Shigeo
   Lavery, Lawrence A.
   Malone, Matthew
   Urbancic-Rovan, Vilma
   Van Asten, Suzanne A.
TI Interventions in the management of infection in the foot in diabetes: a
   systematic review
SO DIABETES-METABOLISM RESEARCH AND REVIEWS
LA English
DT Review
DE antibiotics; diabetes mellitus; diabetic foot infection; osteomyelitis;
   surgery; systematic review
ID COLONY-STIMULATING FACTOR; SKIN-STRUCTURE INFECTIONS;
   ANTIBIOTIC-THERAPY; COMPLICATED SKIN; CONTROLLED-TRIAL; DOUBLE-BLIND;
   OPEN-LABEL; PIPERACILLIN-TAZOBACTAM; ADJUNCTIVE THERAPY; INTRAVENOUS
   ANTIBIOTICS
AB The optimal approaches to managing diabetic foot infections remain a challenge for clinicians. Despite an exponential rise in publications investigating different treatment strategies, the various agents studied generally produce comparable results, and high-quality data are scarce. In this systematic review, we searched the medical literature using the PubMed and Embase databases for published studies on the treatment of diabetic foot infections as of June 2018. This systematic review is an update of previous reviews, the first of which was undertaken in 2010 and the most recent in 2014, by the infection committee of the International Working Group of the Diabetic Foot. We defined the context of literature by formulating clinical questions of interest, then developing structured clinical questions (PICOs) to address these. We only included data from controlled studies of an intervention to prevent or cure a diabetic foot infection. Two independent reviewers selected articles for inclusion and then assessed their relevant outcomes and the methodological quality. Our literature search identified a total of 15327 articles, of which we selected 48 for full-text review; we added five more studies discovered by means other than the systematic literature search. Among these selected articles were 11 high-quality studies published in the last 4years and two Cochrane systematic reviews. Overall, the outcomes in patients treated with the different antibiotic regimens for both skin and soft tissue infection and osteomyelitis of the diabetic foot were broadly equivalent across studies, except that treatment with tigecycline was inferior to ertapenem (+/- vancomycin). Similar outcomes were also reported in studies comparing primarily surgical and predominantly antibiotic treatment strategies in selected patients with diabetic foot osteomyelitis. There is insufficient high-quality evidence to assess the effect of various adjunctive therapies, such as negative pressure wound therapy, topical ointments or hyperbaric oxygen, on infection related outcomes of the diabetic foot. In general, the quality of more recent trial designs are better in past years, but there is still a great need for further well-designed trials to produce higher quality evidence to underpin our recommendations.
C1 [Peters, Edgar J. G.] Vrije Univ Amsterdam, Amsterdam UMC, Dept Internal Med, Amsterdam Infect & Immun Inst, NL-1117 Amsterdam, Netherlands.
   [Lipsky, Benjamin A.] Univ Washington, Dept Med, Seattle, WA USA.
   [Senneville, Eric] Univ Lille, Gustave Dron Hosp, Lille, France.
   [Abbas, Zulfiqarali G.] Muhimbili Univ Hlth & Allied Sci, Abbas Med Ctr, Dar Es Salaam, Tanzania.
   [Aragon-Sanchez, Javier] La Paloma Hosp, Las Palmas Gran Canaria, Spain.
   [Diggle, Mathew] Univ Alberta Hosp, Alberta Publ Labs, Edmonton, AB, Canada.
   [Embil, John M.] Univ Manitoba, Winnipeg, MB, Canada.
   [Kono, Shigeo] Kyoto Med Ctr, Natl Hosp Org, WHO Collaborating Ctr Diabet, Kyoto, Japan.
   [Lavery, Lawrence A.] Univ Texas Southwestern Med Ctr Dallas, Dept Plast Surg, Dallas, TX 75390 USA.
   [Lavery, Lawrence A.] Parkland Hosp, Dallas, TX USA.
   [Malone, Matthew] Western Sydney Univ, Sch Med Infect Dis & Microbiol, South West Sydney Local Hlth Dist, Sydney, NSW, Australia.
   [Urbancic-Rovan, Vilma] Univ Ljubljana, Univ Med Ctr, Fac Med, Ljubljana, Slovenia.
   [Urbancic-Rovan, Vilma] Univ Ljubljana, Fac Med, Ljubljana, Slovenia.
   [Van Asten, Suzanne A.] Leiden Univ, Med Ctr, Dept Med Microbiol, Leiden, Netherlands.
C3 Vrije Universiteit Amsterdam; University of Washington; University of
   Washington Seattle; Universite de Lille; Muhimbili University of Health
   & Allied Sciences; University of Alberta; University of Manitoba;
   University of Texas System; University of Texas Southwestern Medical
   Center; Western Sydney University; South Western Sydney Local Health
   District; University of Ljubljana; University Medical Centre Ljubljana;
   University of Ljubljana; Leiden University - Excl LUMC; Leiden
   University; Leiden University Medical Center (LUMC)
RP Peters, EJG (通讯作者)，Amsterdam UMC, VUmc, Dept Internal Med, Room ZH4A46,Boelelaan 1117, NL-1081 HV Amsterdam, Netherlands.
EM e.peters@amsterdamumc.nl
RI Peters, Edgar/B-7790-2014; Aragón-Sánchez, Javier/AAR-9727-2021; Diggle,
   Mathew/JLK-9789-2023; Van Asten, Suzanne/OYE-3899-2025; Lipsky,
   Benjamin/IZE-0823-2023
OI Peters, Edgar/0000-0002-3410-1227; senneville, eric/0000-0002-5720-8908;
   Aragón-Sánchez, Javier/0000-0001-6307-5040; van Asten,
   Suzanne/0000-0002-2753-4577; Lavery, Lawrence/0000-0002-7920-9952; 
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NR 75
TC 42
Z9 49
U1 0
U2 13
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1520-7552
EI 1520-7560
J9 DIABETES-METAB RES
JI Diabetes-Metab. Res. Rev.
PD MAR
PY 2020
VL 36
SU 1
DI 10.1002/dmrr.3282
PG 15
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA MZ6RW
UT WOS:000559257300034
PM 32176437
OA Green Submitted, Green Published, Bronze
DA 2026-07-24
ER

PT J
AU Mackeen, AD
   Sullivan, M
   Berghella, V
AF Mackeen, Awathif Dhanya
   Sullivan, Maranda, V
   Berghella, Vincenzo
TI Evidence-based cesarean delivery: intraoperative management following
   placental delivery until skin closure (part 9)
SO AMERICAN JOURNAL OF OBSTETRICS & GYNECOLOGY MFM
LA English
DT Article
DE abdominal closure; cesarean; intraoperative; meta-analysis; randomized
   controlled trials; skin closure; systematic review; technique; uterine
   closure
ID DOUBLE-LAYER CLOSURE; WOUND COMPLICATIONS; UTERINE INCISION; SECTION;
   PERITONEUM; OUTCOMES; IRRIGATION; TRIAL; NONCLOSURE; PREVENTION
AB This expert review provides recommendations for the cesarean delivery technique after placental delivery to skin closure. After placental delivery sponge curettage may be omitted as it has not been shown to decrease the risk of retained products of conception. Uterine irrigation and mechanical cervical dilation cannot be recommended. Either intra-abdominal or extra-abdominal repair of the hysterotomy is acceptable, with some possible benefits, such as decreased postoperative pain and nausea/vomiting with intra-abdominal repair. There is insufficient evidence to recommend one uterine closure technique over the other with regards to suture type, continuous versus interrupted, locking or non-locking, and one versus two-layer closure. Double-layer uterine closure has been shown to be more beneficial with regards to residual myometrial thickness, and full thickness bites (including the endometrium) should be considered. Glove change by the surgical team is recommended after placental delivery and before closure of the abdominal wall. The following techniques are not recommended: intra-abdominal irrigation, use of adhesion prevention barriers, peritoneal closure, and rectus muscle reapproximation. Based on non-cesarean delivery evidence, fascial closure bites should be at least 5 x 5 mm, with monofilament suture for vertical incisions. As an adjunct to postoperative pain control, surgeons may consider wound infiltration with local anesthesia, either supra- or subfascial. Before closure, subcutaneous irrigation may be performed using saline solution, and routine use of subcutaneous drains is not recommended. Although closure of the subcutaneous layer can be considered in all patients, it should occur when the depth is >= 2 cm. A monofilament absorbable suture, such as poliglecaprone, should be used to close the cesarean skin incision. There is no level 1 evidence evaluating the potential benefit of additional skin adhesive or sterile strips after suture skin closure. If a dressing is preferred over the skin incision, the following approaches may be considered: a dialkylcarbamoyl chloride-impregnated dressing if available or a standard gauze dressing is appropriate. Prophylactic negative pressure wound therapy can be considered in patients with obesity. Vaginal seeding during cesarean delivery is not recommended. El resumen esta disponible en Espanol al final del art & iacute;culo.
C1 [Berghella, Vincenzo] Geisinger, Womens Hlth Serv Line, Div Maternal Fetal Med, Danville, PA 17821 USA.
   Thomas Jefferson Univ, Dept Obstet & Gynecol, Div Maternal Fetal Med, Philadelphia, PA USA.
C3 Thomas Jefferson University
RP Berghella, V (通讯作者)，Geisinger, Womens Hlth Serv Line, Div Maternal Fetal Med, Danville, PA 17821 USA.
EM vincenzo.berghella@jefferson.edu
RI Berghella, Vincenzo/K-8634-2018
OI , Maranda/0000-0003-0191-1909; Mackeen, A. Dhanya/0000-0002-7398-2063
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NR 84
TC 5
Z9 5
U1 0
U2 1
PU ELSEVIER
PI AMSTERDAM
PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
SN 2589-9333
J9 AM J OBST GYNEC MFM
JI Amer. J. Obstet. Gynecol. MFM
PD JAN
PY 2025
VL 7
IS 1
AR 101548
DI 10.1016/j.ajogmf.2024.101548
EA JAN 2025
PG 16
WC Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Obstetrics & Gynecology
GA U2U9R
UT WOS:001410418400001
PM 39547444
DA 2026-07-24
ER

PT J
AU Seng, L
   Drovandi, A
   Fernando, ME
   Golledge, J
AF Seng, Leonard
   Drovandi, Aaron
   Fernando, Malindu E.
   Golledge, Jonathan
TI Opinions about the most appropriate surgical management of
   diabetes-related foot infection: a cross-sectional survey
SO JOURNAL OF FOOT AND ANKLE RESEARCH
LA English
DT Article
DE Clinical practice; Diabetic foot disease; Orthopaedic surgery; Survey;
   Vascular surgery
ID OSTEOMYELITIS
AB Background There is a lack of high quality evidence to guide the optimal management of diabetes-related foot infection, particularly in cases of severe diabetes-related foot infection and diabetes-related foot osteomyelitis. This study examined the opinions of surgeons about the preferred management of severe diabetes-related foot infection. Methods Vascular and orthopaedic surgeons in Australia and New Zealand were invited to complete an online survey via email. The survey included multi-choice and open-ended questions on clinical management of diabetes-related foot infection. Responses of vascular surgeons and orthopaedic surgeons were compared using non-parametric statistical tests. Open-text responses were examined using inductive content analysis. Results 29 vascular and 20 orthopaedic surgeons completed the survey. One-third (28.6%) used best-practice guidelines to assist in decisions about foot infection management. Areas for guideline improvement identified included more specific advice regarding the indications for available treatments, more recommendations about non-surgical patient management and advice on how management can be varied in regions with limited health service resource. The probe-to-bone test and magnetic resonance imaging were the preferred methods of diagnosing osteomyelitis. Approximately half (51.2%) of respondents indicated piperacillin combined with tazobactam as the preferred antibiotic choice for empirical treatment of severe diabetes-related foot infection. Negative pressure wound therapy was the most common way of managing a wound following debridement. All vascular surgeons (100%) made revascularisation decisions based on the severity of ischemia while most orthopaedic surgeons (66.7%) were likely to refer to vascular surgeons to make revascularisation decisions. Vascular surgeons preferred using wound swabs while orthopaedic surgeons favoured tissue or bone biopsies to determine the choice of antibiotic. Respondents perceived a moderate variation in management decisions between specialists and supported the need for randomised controlled trials to test different management pathways. Conclusions Most vascular and orthopaedic surgeons do not use best-practice guidelines to assist in decisions about management of diabetes-related foot infection. Vascular and orthopaedic surgeons appear to have different preferences for wound sampling to determine choice of antibiotic. There is a need for higher quality evidence to clarify best practice for managing diabetes-related foot infection.
C1 [Seng, Leonard; Drovandi, Aaron; Fernando, Malindu E.; Golledge, Jonathan] James Cook Univ, Coll Med & Dent, Queensland Res Ctr Peripheral Vasc Dis, Townsville, Qld 4811, Australia.
   [Fernando, Malindu E.] Univ Newcastle, Fac Hlth & Med, Sch Hlth Sci, Newcastle, NSW, Australia.
   [Fernando, Malindu E.; Golledge, Jonathan] James Cook Univ, Australian Inst Trop Hlth & Med, Ulcer & Wound Healing Consortium UHEAL, Townsville, Qld, Australia.
   [Golledge, Jonathan] Townsville Univ Hosp, Dept Vasc & Endovasc Surg, Townsville, Qld, Australia.
C3 James Cook University; University of Newcastle; James Cook University
RP Golledge, J (通讯作者)，James Cook Univ, Coll Med & Dent, Queensland Res Ctr Peripheral Vasc Dis, Townsville, Qld 4811, Australia.; Golledge, J (通讯作者)，James Cook Univ, Australian Inst Trop Hlth & Med, Ulcer & Wound Healing Consortium UHEAL, Townsville, Qld, Australia.; Golledge, J (通讯作者)，Townsville Univ Hosp, Dept Vasc & Endovasc Surg, Townsville, Qld, Australia.
EM jonathan.golledge@jcu.edu.au
RI ; golledge, jonathan/I-2371-2013; Drovandi, Aaron/KXQ-9788-2024
OI Drovandi, Aaron/0000-0002-8682-1218; golledge,
   jonathan/0000-0002-5779-8848; 
FU James Cook University; National Health and Medical Research Council
   [1117061]; Queensland Government, Australia
FX The study was funded by a grant from James Cook University. JG holds a
   Practitioner Fellowship from the National Health and Medical Research
   Council (1117061) and a Senior Clinical Research Fellowship from the
   Queensland Government, Australia.
CR Commons RJ, 2018, J FOOT ANKLE RES, V11, DOI 10.1186/s13047-018-0256-3
   Diabetes Feet Australia, DEV NEW AUSTR GUID D
   Diabetic Foot Australia, 2021, AUSTR INT GUIDELINES
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NR 19
TC 3
Z9 4
U1 0
U2 8
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
EI 1757-1146
J9 J FOOT ANKLE RES
JI J. Foot Ankle Res.
PD MAR 2
PY 2022
VL 15
IS 1
AR 18
DI 10.1186/s13047-022-00523-w
PG 9
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA ZK1BL
UT WOS:000762730900001
PM 35232476
OA Green Submitted, Green Published, gold
DA 2026-07-24
ER

PT J
AU Neal, TW
   Williams, FC
   Jelmini, J
   Spresser, W
   Schwitzer, D
   Kim, RY
AF Neal, Timothy W.
   Williams, Fayette C.
   Jelmini, Jonathan
   Spresser, Wyatt
   Schwitzer, David
   Kim, Roderick Y.
TI Immediate Teeth in Fibulas Versus Standard Fibula Free Flap: A
   Comparison of Donor Surgical Site Infections
SO JOURNAL OF ORAL AND MAXILLOFACIAL SURGERY
LA English
DT Article
ID RECONSTRUCTION; MORBIDITY
AB Background: Immediate placement of dental implants with dental restoration at the leg donor site requires implant components and prosthetic materials that are not packaged sterile. Purpose: This study aimed to determine if there was a difference in donor surgical site infection between patients that received a fibula free flap with dental implants and immediate teeth (ITFFF: immediate teeth fibula free flap) before flap transfer to the defect site when compared to standard fibula free flaps (SFFFs) without dental implant placement. Study Design, Setting, Sample: A retrospective cohort study was designed and implemented. The study population was composed of patients who underwent free fibula flap transfer for the treatment of benign or malignant conditions of the head and neck from 2015 to 2022. Patients who received immediate dental implants without teeth were excluded, since those implants are sterile and buried under soft tissue. Predictor Variable: The surgical treatment with either ITFFF or SFFF was treated as the primary predictor variable. Main Outcome Variable: The primary outcome variable was postoperative donor surgical site infection. Covariates: There were 12 covariate variables including age, sex, diabetes diagnosis, immunosuppression/prior chemotherapy treatment, body mass index, smoking status, pack year history, pathology treated, technique for fibula donor site closure, skin paddle harvest, skin paddle area (cm 2 ), and negative pressure wound therapy. Analyses: For the effect of the covariates on the primary predictor variable, c 2 analyses and t -tests were used. The effect of the primary predictor variable on the primary outcome was evaluated using c 2 analysis. A P value of < 0.05 was considered statistically significant. Results: There were 37 patients in the ITFFF group and 47 in the SFFF group. The donor site infection rate for the entire study population was 2.38%. In the ITFFF group, there was 1 donor surgical site infection (2.70%), and in the SFFF group there was also 1 donor surgical site infection (2.13%). There was no significant difference in donor surgical site infection between the groups (P = .86). Conclusion and Relevance: This study found no difference in donor surgical site infection rates between patients who received ITFFF versus SFFF. The overall donor surgical site infection rate following fibula free flap is low. (c) 2024 American Association of Oral and Maxillofacial Surgeons J Oral Maxillofac Surg 82:494-500, 2024
C1 [Neal, Timothy W.; Spresser, Wyatt] UT Southwestern, Parkland Mem Hosp, Dept Surg, Div Oral & Maxillofacial Surg, Dallas, TX USA.
   [Williams, Fayette C.; Kim, Roderick Y.] John Peter Smith Hosp Hlth Network, Maxillofacial Oncol & Reconstruct Surg, Ft Worth, TX USA.
   [Jelmini, Jonathan; Schwitzer, David] John Peter Smith Hlth Network, Maxillofacial Oncol & Reconstruct Surg, Ft Worth, TX USA.
   [Neal, Timothy W.] Dept Surg, Div Oral & Maxillofacial Surg, 5323 Harry Hines Blvd, Dallas, TX 75390 USA.
C3 University of Texas System; University of Texas Southwestern Medical
   Center; University of Texas System; University of Texas Southwestern
   Medical Center
RP Neal, TW (通讯作者)，Dept Surg, Div Oral & Maxillofacial Surg, 5323 Harry Hines Blvd, Dallas, TX 75390 USA.
EM Timothy.Neal@UTSouthwestern.edu
OI Jelmini, Jonathan/0000-0003-3984-2195; Schwitzer,
   David/0000-0002-0165-1919
CR Ferri J, 1997, J ORAL MAXIL SURG, V55, P440, DOI 10.1016/S0278-2391(97)90685-6
   Harris BN, 2016, CURR OPIN OTOLARYNGO, V24, P447, DOI 10.1097/MOO.0000000000000286
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   Wolff KD, 2011, J ORAL MAXIL SURG, V69, pE260, DOI 10.1016/j.joms.2010.11.040
NR 12
TC 4
Z9 4
U1 0
U2 1
PU W B SAUNDERS CO-ELSEVIER INC
PI PHILADELPHIA
PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
SN 0278-2391
EI 1531-5053
J9 J ORAL MAXIL SURG
JI J. Oral Maxillofac. Surg.
PD APR
PY 2024
VL 82
IS 4
BP 494
EP 500
DI 10.1016/j.joms.2024.01.002
EA APR 2024
PG 7
WC Dentistry, Oral Surgery & Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dentistry, Oral Surgery & Medicine
GA QR1Y4
UT WOS:001222517900001
PM 38272445
DA 2026-07-24
ER

PT J
AU Kumar, P
AF Kumar, Pramod
TI Fire disaster following LPG tanker explosion at Chala in Kannur (Kerala,
   India): August 27, 2012
SO BURNS
LA English
DT Article
DE LPG; Disaster; Mass burn casualty; LPG tanker burst; Clinical forensic;
   Limited access dressing
ID LIQUID; VESSEL; BLEVE
AB A fire disaster following LPG tanker explosion occurred at Chala bypass, Kannur, Kerala, India on August 27, 2012. The three chambered tanker with total 16 tonnes (162.57 quintal) LPG collided with a road divider and exploded thrice. A total of 41 people became victims during first blast; out of which 20 died in various hospitals. Five people remained inside the house after first blast and escaped unhurt from the zone of accident before second blast. All the victims were transferred to various hospitals; of these, six were transferred to the burns unit of the Kasturba Hospital, Manipal (320 km from Chala). Five (5/6) were transferred within 1-5 days at our burns unit suffered 31-72% total body surface area (TBSA) burn, none had external injuries. One (1/6) was transferred on 20th day as a follow up case of 15% TBSA burn with 4% residual raw area and diabetes mellitus. Except one, all were managed conservatively using Limited access dressings (LAD; Negative Pressure Wound Therapy). One of the patient wound bed prepared under LAD and on 41 post burn day underwent split skin grafting under LAD. Out of the six patients admitted at the burns unit, two (2/6) admitted patients expired (one due to inhalation injury and another due to sepsis with multiple organ failure). One survivor (1/4) developed sepsis related liver dysfunction with hepatomegaly but recovered well. The total hospital stay of survivors at the burns unit varied from 8 to 60 days (mean hospital stay 36.5 days). All the victims who developed psychological symptoms were treated by psychiatrists and counselled before discharge. Three of survivors developed psychological symptoms. Two of them (2/3) developed mixed anxiety-depression disorder (ICD 10 code F41.8) and one of these two showed grief reaction too (ICD 10 code F43.23). One victim (1/3) developed non-organic insomnia (ICD 10 code F51.0) and responded to counselling. The article describes the incident, mechanism of the incident, injuries sustained, author, explanations on pattern of burn and suggestions in relation to future safety measures. (C) 2013 Published by Elsevier Ltd and ISBI.
C1 Kasturba Med Coll & Hosp, Manipal 576104, Karnataka, India.
C3 Manipal Academy of Higher Education (MAHE); Kasturba Medical College,
   Manipal
RP Kumar, P (通讯作者)，Kasturba Med Coll & Hosp, Manipal 576104, Karnataka, India.
EM pkumar86@hotmail.com
RI Kumar, Pramod/L-8280-2015
OI Kumar, Pramod/0000-0001-8831-1804
CR Abbasi T, 2007, J HAZARD MATER, V141, P489, DOI 10.1016/j.jhazmat.2006.09.056
   ARTURSON G, 1987, BURNS, V13, P87, DOI 10.1016/0305-4179(87)90096-9
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   Gong YW, 2004, J HAZARD MATER, V108, P21, DOI 10.1016/j.jhazmat.2004.01.012
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   Kumar P, 2012, INDIAN J PLAST SURG, V45, P302, DOI 10.4103/0970-0358.101304
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   Paltrinieri N, 2012, RISK ANAL, V32, P220
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NR 14
TC 21
Z9 23
U1 0
U2 18
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0305-4179
EI 1879-1409
J9 BURNS
JI Burns
PD NOV
PY 2013
VL 39
IS 7
BP 1479
EP 1487
DI 10.1016/j.burns.2013.04.004
PG 9
WC Critical Care Medicine; Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Dermatology; Surgery
GA 244BT
UT WOS:000326362800023
PM 23639222
DA 2026-07-24
ER

PT J
AU Loftus, TJ
   Jordan, JR
   Croft, CA
   Smith, RS
   Efron, PA
   Moore, FA
   Mohr, AM
   Brakenridge, SC
AF Loftus, Tyler J.
   Jordan, Janeen R.
   Croft, Chasen A.
   Smith, R. Stephen
   Efron, Philip A.
   Moore, Frederick A.
   Mohr, Alicia M.
   Brakenridge, Scott C.
TI Characterization of hypoalbuminemia following temporary abdominal
   closure
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article
DE Albumin; hypoalbuminemia; open abdomen; primary fascial closure;
   temporary abdominal closure
ID OPEN ABDOMEN; NUTRITION SUPPORT; SYSTEMIC INFLAMMATION; INJURY; SEPSIS;
   TRAUMA; MANAGEMENT; ALBUMIN; SHOCK; THERAPY
AB BACKGROUND: The purpose of this study was to characterize associations among serum proteins, negative-pressure wound therapy (NPWT) fluid loss, and primary fascial closure (PFC) following emergent laparotomy and temporary abdominal closure (TAC). We hypothesized that high levels of C-reactive protein (CRP) and NPWT output would be associated with hypoalbuminemia and failure to achieve PFC.
   METHODS: We performed a retrospective analysis of 233 patients managed with NPWT TAC. Serum proteins and resuscitation indices were assessed on admission, initial laparotomy, and then at 48 hours, 96 hours, 7 days, and discharge. Correlations were assessed by Pearson coefficient. Multivariable regression was performed to identify predictors of PFC with cutoff values for continuous variables determined by Youden index.
   RESULTS: Patients who failed to achieve PFC (n = 55) had significantly higher CRP at admission (249 vs. 148 mg/L, p = 0.003), initial laparotomy (237 vs. 154, p = 0.002), and discharge (124 vs. 72, p = 0.003), as well as significantly lower serumalbumin at 7 days (2.3 vs. 2.5 g/dL, p = 0.028) and discharge (2.5 vs. 2.8, p = 0.004). Prealbumin (in milligrams per deciliter) was similar between groups at each time point. There was an inverse correlation between nadir serum albumin and total milliliters of NPWT output (r = -0.33, p < 0.001). Exogenous albumin administration (in grams per day) correlated with higher serum albumin levels at each time point: 48 hours: r = 0.26 (p = 0.002), 96 hours: r = 0.29 (p = 0.002), 7 days: r = 0.40 (p < 0.001). Albumin of less than 2.6 g/dL was an independent predictor of failure to achieve PFC (odds ratio, 2.59; 95% confidence interval, 1.02-6.61) in a multivariate model including abdominal sepsis, body mass index of greater than 40 kg/m(2), and CRP of greater than 250 mg/L.
   CONCLUSIONS: Early and persistent systemic inflammation and high NPWT output were associated with hypoalbuminemia, which was an independent predictor of failure to achieve PFC. The utility of exogenous albumin following TAC requires further study. Copyright (C) 2017 Wolters Kluwer Health, Inc. All rights reserved.
C1 Univ Florida Hlth, Dept Surg, Gainesville, FL 32610 USA.
   Univ Florida Hlth, Sepsis & Crit Illness Res Ctr, Gainesville, FL 32610 USA.
C3 State University System of Florida; University of Florida; State
   University System of Florida; University of Florida
RP Brakenridge, SC (通讯作者)，Univ Florida Hlth, 1600 SW Archer Rd,Room M-602, Gainesville, FL 32610 USA.
EM Scott.Brakenridge@surgery.ufl.edu
RI Brakenridge, Scott/AAD-6691-2019; Mohr, Alicia/E-3016-2015; Loftus,
   Tyler/J-7761-2016
OI Brakenridge, Scott/0000-0002-7327-3718; Mohr,
   Alicia/0000-0003-1732-1313; Loftus, Tyler/0000-0001-5354-443X; Smith,
   Robert/0000-0002-0455-6415
FU National Institute of General Medical Sciences (NIGMS) [R01
   GM105893-01A1, R01 GM113945-01, P50 GM111152-01]; NIGMS [T32GM-08721];
   National Institute of General Medical Sciences [R01GM105893,
   T32GM008721] Funding Source: NIH RePORTER; National Institute on Aging
   [P30AG028740] Funding Source: NIH RePORTER
FX The authors were supported in part by grants R01 GM105893-01A1 (A.M.
   M.), R01 GM113945-01 (P.A.E.), and P50 GM111152-01 (S.C.B., P.A.E., F.A.
   M., A.M.M.) awarded by the National Institute of General Medical
   Sciences (NIGMS). T.J.L. was supported by a postgraduate training grant
   (T32GM-08721) in burns, trauma, and perioperative injury by NIGMS.
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NR 46
TC 8
Z9 9
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD OCT
PY 2017
VL 83
IS 4
BP 650
EP 656
DI 10.1097/TA.0000000000001553
PG 7
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Surgery
GA FH8PN
UT WOS:000411460500013
PM 28837537
OA Green Submitted
DA 2026-07-24
ER

PT J
AU McGraw, C
   Carrick, M
   Ekengren, F
   Berg, G
   Lieser, M
   Orlando, A
   Madayag, R
   Tanner, A
   Kelly, M
   Banton, K
   Bar-Or, D
AF McGraw, Constance
   Carrick, Matthew
   Ekengren, Francie
   Berg, Gina
   Lieser, Mark
   Orlando, Alessandro
   Madayag, Robert
   Tanner, Allen
   Kelly, Michael
   Banton, Kaysie
   Bar-Or, David
TI Severe fungal infections following blunt traumatic injuries: A 5-year
   multicenter descriptive study
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Post-traumatic; Fungal infection; Blunt trauma; Risk factors; Management
ID CUTANEOUS MUCORMYCOSIS; WOUND INFECTIONS; EPIDEMIOLOGY; SECONDARY;
   FRANCE
AB Introduction: The aggressive and timely treatment of post-traumatic fungal infections is the most efficacious way to reduce morbidity and mortality. Compared to the military trauma population, studies reporting on fungal infections in civilian trauma are not well described. The purpose of this study was to describe characteristics of civilian trauma patients who developed fungal infections and to identify common risk factors and report any delays between injury and treatment.
   Methods: This was a five-year (1/1/2013-3/1/2018) retrospective, descriptive study across six level 1 trauma centers. All consecutively admitted trauma patients (>= 18 years) with laboratory-confirmed fungal wound infections were included. Patients with solely candida wound isolates were excluded. Patient demographics, clinical wound and infection characteristics, organisms cultured, treatment modalities, length of stay, in-hospital mortality, and any diagnostic or treatment delays were described.
   Results: Of the 54,521 trauma patients screened for fungal infection, 12 were identified. All patients suffered major injuries after blunt trauma (abbreviated injury score 3-5) and sustained wound contamination, and in nine patients, the cause of injury was motor vehicle. Six had open wounds/fractures on admission. The geographical region with the highest rate of fungal infection was Texas (n = 7), followed by Kansas (N = 3), then Missouri (N = 2). First symptoms of infection (leukocytosis or fever (n = 10)) presented a median of 6.3 (4.1-9.8) days after injury. Wound management entailed a combination of debridements (n = 8), negative pressure wound therapy (n = 9), amputation (n = 6), and antifungal treatment (n = 10). All fungal isolates identified from the wound site were hyphomycetes. A median of 2.1 (1.8-4.0) days passed from diagnosis to first antifungal treatment, and 3 patients died.
   Conclusions: Our study shows the challenges surrounding diagnosis and treatment of fungal infections secondary to trauma. Non-specific fungal infection symptoms, such as leukocytosis and fever, typically presented a week after injury. Vigilance for investigating risk factors and infection symptoms may help clinicians with more timely management of trauma patients with a severe fungal infection. (C) 2019 Elsevier Ltd. All rights reserved.
C1 [McGraw, Constance; Carrick, Matthew; Orlando, Alessandro; Bar-Or, David] Med City Plano, Trauma Res Dept, Plano, TX USA.
   [McGraw, Constance; Ekengren, Francie; Berg, Gina; Orlando, Alessandro; Bar-Or, David] Wesley Med Ctr, Trauma Res Dept, Wichita, KS USA.
   [McGraw, Constance; Lieser, Mark; Orlando, Alessandro; Bar-Or, David] Res Med Ctr, Trauma Res Dept, Kansas City, MO USA.
   [McGraw, Constance; Orlando, Alessandro; Madayag, Robert; Bar-Or, David] St Anthony Hosp, Trauma Res Dept, Lakewood, CO USA.
   [McGraw, Constance; Orlando, Alessandro; Tanner, Allen; Kelly, Michael; Bar-Or, David] Penrose Community Hosp, Trauma Res Dept, Colorado Springs, CO USA.
   [McGraw, Constance; Orlando, Alessandro; Banton, Kaysie; Bar-Or, David] Swedish Med Ctr, Trauma Res Dept, 501 E Hampden Ave,Rm 4-454, Englewood, CO 80113 USA.
RP Bar-Or, D (通讯作者)，Swedish Med Ctr, Trauma Res Dept, 501 E Hampden Ave,Rm 4-454, Englewood, CO 80113 USA.
EM davidbme49@gmail.com
RI /AAE-9328-2020
OI McGraw, Constance/0000-0001-5635-0892
FU Medical City Plano; Wesley Medical Center; Research Medical Center;
   Penrose Hospital; St. Anthony Hospital; Swedish Medical Center
FX The study was investigator-initiated. Internal funding was provided by
   all affiliated institutions (Medical City Plano, Wesley Medical Center,
   Research Medical Center, Penrose Hospital, St. Anthony Hospital, and
   Swedish Medical Center).
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NR 26
TC 1
Z9 2
U1 0
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD DEC
PY 2019
VL 50
IS 12
BP 2234
EP 2239
DI 10.1016/j.injury.2019.10.027
PG 6
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA JS8OR
UT WOS:000500561800013
PM 31630781
DA 2026-07-24
ER

PT J
AU Salinaro, JR
   Jones, PS
   Beatty, AB
   Dotters-Katz, SK
   Kuller, JA
   Kerner, NP
AF Salinaro, Julia R.
   Jones, Penny S.
   Beatty, Amelia B.
   Dotters-Katz, Sarah K.
   Kuller, Jeffrey A.
   Kerner, Nicole P.
TI Optimizing Surgical Wound Care in Obstetrics and Gynecology
SO OBSTETRICAL & GYNECOLOGICAL SURVEY
LA English
DT Review
ID BED PREPARATION; OBESE WOMEN; CESAREAN DELIVERY; SITE INFECTION;
   SURGERY; THERAPY; LAPAROTOMY; RECLOSURE; CLOSURE; HEALTH
AB Importance: Obstetrics and gynecology (OB/GYN) accounts for at least half of all open abdominal surgeries performed. Rates of surgical wound complications after open procedures in OB/GYN range from 5% to 35%. Therefore, optimizing management of surgical wound complications has the potential to significantly reduce cost and morbidity. However, guidelines addressing best practices for wound care in OB/GYN are limited.Objective: The objectives of this review are to describe the fundamentals of wound healing and to evaluate available evidence addressing surgical wound care. Based on these data, we provide recommendations for management of extrafascial surgical wound dehiscence after OB/GYN procedures.Evidence Acquisition: Literature search was performed in PubMed, Medline, OVID, and the Cochrane database. Relevant guidelines, systematic reviews, and original research articles investigating mechanisms of wound healing, types of wound closure, and management of surgical wound complications were reviewed.Results: Surgical wound complications in OB/GYN are associated with significant cost and morbidity. One of the most common complications is extrafascial dehiscence, which may occur in the setting of hematomas, seromas, or infection. Management includes early debridement and treatment of any underlying infection until healthy granulation tissue is present. For wounds healing by secondary intention, advanced moisture retentive dressings reduce time to healing and are cost-effective when compared with conventional wet-to-dry gauze dressings. Negative pressure wound therapy can be applied to deeper wounds healing by secondary intention. Review of published evidence also supports the use of delayed reclosure to expedite wound healing for select patients.Conclusions: Optimizing surgical wound care has the potential to reduce the cost and morbidity associated with surgical wound complications in OB/GYN. Advanced moisture retentive dressings should be considered for wounds healing by secondary intention. Data support delayed reclosure for select patients, although further studies are needed.Target Audience: Obstetricians and gynecologists, family physicians.Learning Objectives: After reading this article, the provider will be better able to explain the clinical significance of surgical wound complications, particularly in OB/GYN; identify the stages of wound healing and types of wound closure; discuss the TIME framework for wound care; and describe a recommended approach for the management of extrafascial wound dehiscence.
C1 [Salinaro, Julia R.; Jones, Penny S.; Beatty, Amelia B.; Dotters-Katz, Sarah K.; Kuller, Jeffrey A.; Kerner, Nicole P.] Duke Univ, Dept Obstet & Gynecol, Durham, NC USA.
   [Salinaro, Julia R.] Duke Univ, Dept Obstet & Gynecol, 200 Trent Dr, Durham, NC 27710 USA.
C3 Duke University; Duke University
RP Salinaro, JR (通讯作者)，Duke Univ, Dept Obstet & Gynecol, 200 Trent Dr, Durham, NC 27710 USA.
EM julia.salinaro@gmail.com; penny.jones@duke.edu; amelia.beatty@duke.edu;
   sarah.dotters-katz@duke.edu; jeffrey.kuller@duke.edu;
   nicole.kerner@duke.edu
OI Kerner, Nicole/0000-0003-4987-7973
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NR 45
TC 6
Z9 7
U1 1
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0029-7828
EI 1533-9866
J9 OBSTET GYNECOL SURV
JI Obstet. Gynecol. Surv.
PD OCT
PY 2023
VL 78
IS 10
BP 598
EP 605
DI 10.1097/OGX.0000000000001204
PG 8
WC Obstetrics & Gynecology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Obstetrics & Gynecology
GA W1BE2
UT WOS:001089041700008
PM 37976315
DA 2026-07-24
ER

PT J
AU Honnegowda, TM
   Kumar, P
   Udupa, EGP
   Sharan, A
   Singh, R
   Prasad, HK
   Rao, P
AF Honnegowda, Thittamaranahalli M.
   Kumar, Pramod
   Udupa, Echalasara G. Padmanabha
   Sharan, Anurag
   Singh, Rekha
   Prasad, Hemanth K.
   Rao, Pragna
TI A comparative study to evaluate the effect of limited access dressing
   (LAD) on burn wound healing
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE Antioxidants (GSH, GPx); Burn wound healing; LAD; MDA; Negative
   pressure; Oxidative stress
ID OXIDATIVE ORGAN DAMAGE; LIPID-PEROXIDATION; THERMAL-INJURY;
   NEGATIVE-PRESSURE; FREE-RADICALS; RAT MODEL; PATHOPHYSIOLOGY;
   INFLAMMATION; THERAPY; PROTEIN
AB Biochemical and histopathological analyses are commonly used objective parameters in research and clinical fields to assess the healing status of burn wounds. In this study, the effect of newer intermittent negative-pressure wound therapy in combination with moist environment [limited access dressing (LAD)] on burn wound healing is studied. Various biochemical parameters like hydroxyproline, hexosamine and total protein, and antioxidants like reduced glutathione (GSH), glutathione peroxidase (GPx) and oxidative biomarker malondialdhyde (MDA) were measured in the granulation tissue. Histopathologically, necrotic tissue, amount of inflammatory infiltrate, angiogenesis and extracellular matrix deposition (ECM) were studied to determine wound healing. A total of 55 patients were divided into two groups as follows: LAD group (n=28) and conventional dressing group (n=27). Patients treated with LAD have shown significant increase in the mean levels of (+/- SD) hydroxyproline (75.2 +/- 26.30 versus 27.8 +/- 15.5; P=0.010), hexosamine (9.0 +/- 1.99 versus 8.0 +/- 1.18; P=0.038), total protein (15.6 +/- 8.23 versus 10.26 +/- 4.94; P=0.003), GSH (7.40 +/- 1.91 versus 5.1 +/- 1.28; P=0.037), GPx (112.6 +/- 46.4 versus 92 +/- 32.4; P=0.016), and decrease in MDA (6.5 +/- 2.24 versus 1 0.6 +/- 3.8; P=0.002). Histopathologically, between LAD and conventional dressing groups, there was a significant difference after 10 days of treatment (mean +/- SE) in necrotic tissue of (LAD versus conventional dressing groups=10 +/- 1.8 versus 11.9 +/- 2.6; P=0.033), inflammatory cells (8.4 +/- 1.9 versus 13 +/- 3.46; P=0.021), new blood vessels (12.5 +/- 2.87 versus 9.4 +/- 1.7; P=0.047), ECM deposit (12.9 +/- 2.41 versus 9.68 +/- 1.3; P=0.018) and showed comparatively fewer inflammatory cells, increased and well-organised extracellular matrix deposit, more angiogenesis in LAD group as compared with that in conventional dressing group. To conclude, LAD exerts its beneficial effects on wound healing by reducing oxidative stress, decreasing necrotic tissue and amount of inflammatory infiltrate, and increasing ECM deposition and angiogenesis.
C1 [Honnegowda, Thittamaranahalli M.; Kumar, Pramod; Sharan, Anurag] Kasturba Med Coll & Hosp, Dept Plast Surg & Burns, Manipal, Karnataka, India.
   [Udupa, Echalasara G. Padmanabha; Prasad, Hemanth K.; Rao, Pragna] Kasturba Med Coll & Hosp, Dept Biochem, Manipal, Karnataka, India.
   [Singh, Rekha] Vydehi Inst Med Sci & Res Ctr, Dept Pathol, Bangalore, Karnataka, India.
   [Kumar, Pramod] King Abdul Aziz Specialist Hosp, Sakaka, Al Jouf, Saudi Arabia.
C3 Manipal Academy of Higher Education (MAHE); Kasturba Medical College,
   Manipal; Manipal Academy of Higher Education (MAHE); Kasturba Medical
   College, Manipal
RP Kumar, P (通讯作者)，King Abdul Aziz Hosp, Sakaka, Al Jouf, Saudi Arabia.
EM pkumar86@hotmail.com
RI Kumar, Pramod/L-8280-2015; Rao, Pragna/H-4636-2019
OI Rao, Pragna/0000-0002-1200-889X
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NR 37
TC 6
Z9 6
U1 0
U2 2
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD OCT
PY 2016
VL 13
IS 5
BP 791
EP 798
DI 10.1111/iwj.12384
PG 8
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA EB8UV
UT WOS:000387667600084
PM 25689953
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Nyffeler, R
   Morgenstern, M
   Osinga, R
   Kuehl, R
   Gahl, B
   Imhof, A
   Meyer, CP
   Mueller, S
   Muri, T
   Schaefer, DJ
   Sendi, P
   Clauss, M
AF Nyffeler, Ramon
   Morgenstern, Mario
   Osinga, Rik
   Kuehl, Richard
   Gahl, Brigitta
   Imhof, Anna
   Meyer, Carl-Philipp
   Mueller, Seraina
   Muri, Thadeus
   Schaefer, Dirk Johannes
   Sendi, Parham
   Clauss, Martin
TI Fracture-related infections of the lower extremity - Analysis of costs
   and their drivers
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Fracture related infection; FRI; Long bone; Length of stay; LOS; Cost
   analysis; Multidisciplinary team; MDT; DRG
ID OPEN TIBIAL FRACTURES; PREVENTION; BONE
AB Objectives: Fracture-related infection (FRI) is a feared complication in orthopaedic trauma surgery. They are associated with multiple surgical interventions and prolonged antibiotic treatment duration, and hence, increased costs. The objective of this study was to assess the costs of FRI treatment in a Tertiary Swiss Trauma Center and to identify the variables associated with increased costs.<br /> Patients and methods: In this retrospective cohort study, 116 patients with an FRI treated in a Swiss tertiary center between 01/2012 and 12/2019 were included. Clinical data and the costs of each hospital stay were evaluated. Predefined variables were categorized as modifiable and non-modifiable factors and examined for their influence on costs and hospital length of stay (LOS) in univariable and multivariable analyses.<br /> Results: The median cost per patient was 39,219 [interquartile range (IQR) 22,657 to 68,588] CHF. The median LOS was 21 [IQR 14 to 36] days. Most patients were male (67%) with a median age of 58 years [40-70]. The median duration of IV antibiotic use was 16 [9-27] days. Costs related to hospitalization (nursing and physiotherapy) accounted for the highest expenses with a relative share of 49%, whereas surgical procedures had a minor impact on the total cost with a relative share of 19%. In the univariable analysis, significant drivers of both costs and LOS were the number of FRI surgeries, the use of negative pressure wound therapy, duration of IV antibiotic treatment, and cases with a change of surgical strategy. After adjustment for patient and treatment factors, duration of IV antibiotics and change of surgical strategy were associated with higher costs.<br /> Conclusions: This study illustrates the financial burden of FRI in a DRG system and identifies potential drivers for these costs. Since repeated surgeries or unplanned surgical revisions are drivers of costs, optimal pre-operative planning and coordination between the involved disciplines is key to minimize costs. Management in multidisciplinary teams that are specialized in the treatment of these complex and cost-intensive patients may therefore reduce the financial burden.
C1 [Nyffeler, Ramon; Morgenstern, Mario; Osinga, Rik; Kuehl, Richard; Muri, Thadeus; Schaefer, Dirk Johannes; Sendi, Parham; Clauss, Martin] Univ Hosp Basel, Ctr Musculoskeletal Infect ZMSI, Basel, Switzerland.
   [Morgenstern, Mario; Sendi, Parham; Clauss, Martin] Univ Hosp Basel, Dept Orthoped & Trauma Surg, Basel, Switzerland.
   [Osinga, Rik; Mueller, Seraina; Schaefer, Dirk Johannes] Univ Hosp Basel, Dept Plast Reconstruct Aesthet & Hand Surg, Basel, Switzerland.
   [Osinga, Rik] Praxis Beim Merian Iselin, CH-4054 Basel, Switzerland.
   [Osinga, Rik] REHAB Basel, Clin Neurorehabil & Paraplegiol, Basel, Switzerland.
   [Kuehl, Richard] Univ Hosp Basel, Dept Infect Dis & Hosp Epidemiol, Basel, Switzerland.
   [Gahl, Brigitta] Univ Basel, Univ Hosp Basel, Basel, Switzerland.
   [Imhof, Anna] Univ Hosp Basel, Dept Finance & Accounting, Basel, Switzerland.
   [Meyer, Carl-Philipp] Univ Hosp Basel, Dept Med Controlling, Basel, Switzerland.
   [Sendi, Parham] Univ Bern, Inst Infect Dis, Bern, Switzerland.
   [Clauss, Martin] Kantonsspital, Spitalstr 21, CH-4031 Basel, Switzerland.
C3 University of Basel; University of Basel; University of Basel;
   University of Basel; University of Basel; University of Basel;
   University of Basel; University of Bern; University of Basel;
   Kantonsspital Aarau AG (KSA)
RP Clauss, M (通讯作者)，Kantonsspital, Spitalstr 21, CH-4031 Basel, Switzerland.
EM martin.clauss@usb.ch
RI Schaefer, Dirk/I-9806-2018; Clauss, Martin/K-9981-2019; Morgenstern,
   Mario/AAL-8268-2020; Sendi, Parham/R-3286-2018; Kuehl,
   Richard/HNB-5234-2023
OI Clauss, Martin/0000-0002-1598-2209; Morgenstern,
   Mario/0000-0001-5108-0731; Sendi, Parham/0000-0002-7347-6312; Kuehl,
   Richard/0000-0002-4959-0983
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NR 27
TC 7
Z9 8
U1 0
U2 0
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD FEB
PY 2025
VL 56
IS 2
AR 112138
DI 10.1016/j.injury.2024.112138
EA DEC 2024
PG 8
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA W9R6C
UT WOS:001421854300001
PM 39742836
OA hybrid
DA 2026-07-24
ER

PT J
AU Dueppers, P
   Bozalka, R
   Kopp, R
   Menges, AL
   Reutersberg, B
   Schrimpf, C
   Rivero, FJM
   Zimmermann, A
AF Dueppers, Philip
   Bozalka, Roland
   Kopp, Reinhard
   Menges, Anna-Leonie
   Reutersberg, Benedikt
   Schrimpf, Claudia
   Rivero, Francisco Jose Moreno
   Zimmermann, Alexander
TI The Use of Intact Fish Skin Grafts in the Treatment of Necrotizing
   Fasciitis of the Leg: Early Clinical Experience and Literature Review on
   Indications for Intact Fish Skin Grafts
SO JOURNAL OF CLINICAL MEDICINE
LA English
DT Review
DE intact fish skin; fish skin grafts; necrotizing fasciitis; wounds;
   chronic wounds; gangrene; skin substitutes; wound healing; negative
   pressure wound therapy; skin transplantation
ID DIABETIC FOOT ULCERS; VEIN-THROMBOSIS; DONOR SITES; MANAGEMENT; WOUNDS;
   MATRIX; OMEGA-3-FATTY-ACIDS; MULTICENTER; OUTCOMES; THERAPY
AB Background: Necrotizing fasciitis (NF) is a serious infectious disease that can initially place the patient's life in danger and, after successful surgical and antibiotic treatment, leaves extensive wounds with sometimes even exposed bones and tendons. Autologous skin grafts are not always possible or require adequate wound bed preparation. Novel intact fish skin grafts (iFSGs; Kerecis (R) Omega3 Wound, Kerecis hf, Isafjordur, Iceland) have already shown their potential to promote granulation in many other wound situations. Faster wound healing rates and better functional and cosmetic outcomes were observed due to their additionally postulated anti-inflammatory and analgesic properties. Therefore, iFSGs may also be essential in treating NF. We present our initial experience with iFSGs in treating leg wounds after NF and review the literature for the current spectrum of clinical use of iFSGs. Case Presentations: We present two male patients (aged 60 and 69 years) with chronic or acute postsurgical extensive leg ulcers six weeks and six days after necrotizing fasciitis, respectively. Both suffered from diabetes mellitus without vascular pathologies of the lower limbs. A single application of one pre-meshed (Kerecis (R) Graftguide) and one self-meshed 300 cm2 iFSG (Kerecis (R) Surgiclose) was performed in our operation room after extensive surgical debridement and single circles of negative wound pressure therapy. Application and handling were easy. An excellent wound granulation was observed, even in uncovered tibia bone and tendons, accompanied by pain relief in both patients. Neither complications nor allergic reactions occurred. The patients received autologous skin grafting with excellent functional and cosmetic outcomes. Conclusions: iFSGs have the potential to play a significant role in the future treatment of NF due to the fast promotion of wound granulation and pain relief. Our experience may encourage surgeons to use iFSGs in NF patients, although high-quality, large-sized studies are still required to confirm these results. The observed effects of iFSGs on wounds associated with NF may be transferred to other wound etiologies as well.
C1 [Dueppers, Philip; Bozalka, Roland; Kopp, Reinhard; Menges, Anna-Leonie; Reutersberg, Benedikt; Schrimpf, Claudia; Zimmermann, Alexander] Univ Zurich UZH, Univ Hosp Zurich USZ, Dept Vasc Surg, Ramistr 100, CH-8091 Zurich, Switzerland.
   [Rivero, Francisco Jose Moreno] Univ Hosp Zurich USZ, Tissue Viabil Serv Wound Care, Ramistr 100, CH-8091 Zurich, Switzerland.
C3 University of Zurich; University Zurich Hospital; University of Zurich;
   University Zurich Hospital
RP Dueppers, P (通讯作者)，Univ Zurich UZH, Univ Hosp Zurich USZ, Dept Vasc Surg, Ramistr 100, CH-8091 Zurich, Switzerland.
EM dr.dueppers@gmail.com
RI ; Dueppers, Philip/AAO-3947-2021; Zimmermann, Alexander/ABB-2989-2020;
   Reutersberg, Benedikt/AAJ-3017-2021
OI Menges, Anna-Leonie/0000-0002-6870-3904; Dueppers,
   Philip/0000-0003-3741-0591; Zimmermann, Alexander/0000-0003-0635-8591;
   Schrimpf, Claudia/0000-0002-5546-0931; Reutersberg,
   Benedikt/0000-0002-9286-8223
FU Kerecis hf,Isafjordur, Iceland
FX This independent article was partially supported by an educational grant
   from Kerecis hf,Isafjordur, Iceland.
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NR 48
TC 16
Z9 19
U1 1
U2 5
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2077-0383
J9 J CLIN MED
JI J. Clin. Med.
PD SEP
PY 2023
VL 12
IS 18
AR 6001
DI 10.3390/jcm12186001
PG 12
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA T5YF4
UT WOS:001078736100001
PM 37762941
OA Green Submitted, Green Accepted, gold
DA 2026-07-24
ER

PT J
AU Tennent, DJ
   Shiels, SM
   Jennings, JA
   Haggard, WO
   Wenke, JC
AF Tennent, David J.
   Shiels, Stefanie M.
   Jennings, Jessica A.
   Haggard, Warren O.
   Wenke, Joseph C.
TI Local control of polymicrobial infections via a dual antibiotic delivery
   system
SO JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
LA English
DT Article
DE Chitosan; Antimicrobial; Polymicrobial
ID SEVERE OPEN FRACTURES; CHITOSAN SPONGES; VANCOMYCIN POWDER; TIBIA
   FRACTURES; THERAPY; BEADS; TIME
AB Background: Contaminated traumatic open orthopedic wounds are frequently complicated by polymicrobial contamination and infection. In high-risk wounds, the standard of care comprises debridement and irrigation combined with antibiotics which can be applied directly or combined with systemic antibiotics. Recently, bioabsorbable chitosan sponges have been shown to be an effective single-agent delivery device for local antibiotics with and without negative pressure wound therapy (NPWT). Severely contaminated orthopedic wounds, however, are often complicated by polymicrobial infections, necessitating multiple antibiotic agents. As such, the purpose of this study was to determine if a chitosan sponge would provide a suitable delivery vehicle for multiple antibiotics for the treatment of a polymicrobial infection in a large animal polytraumatic extremity wound model.
   Methods: A complex polytraumatic extremity wound was created in 11 adult male Boer goats. Each wound was contaminated with a bioluminescent strain of S. aureus (1 ml of 10(8) colony forming units/ml) and of P. aeruginosa (1 ml of 10(8) CFU/ml) which are genetically engineered to allow quantification with a photon-counting camera. Six hours following initial wound creation and contamination, wounds were debrided and irrigated with low-pressure normal saline. The animals were randomized into one of two treatments: wet-to-dry dressings alone or a commercially available chitosan sponge loaded with 1 g vancomycin and 1.2 g of tobramycin. Each animal was then recovered and reimaged 48 h later for total bacteria content; tissue samples were taken from the wound bed to determine relative bacterial colonization.
   Results: All animals in the chitosan sponge group saw significant reductions in overall bacterial load of S. aureus and P. aeruginosa (p = 0.001). The bioluminescence was also significantly reduced compared to the wet-to-dry dressing group (p = 0.0001). Furthermore, whereas the antibiotic sponge group displayed near complete eradication of bacteria, the wounds treated with the wet-to-dry dressings alone displayed a significant 2-log increase in total bacteria at 48 h p = 0. 0001). S. aureus was the predominant species found in the wounds, comprising 95 and 99% of all bacteria found in the chitosan sponge and wet-to-dry, respectively.
   Conclusion: Dual antimicrobial therapy loaded in a chitosan sponge is an effective way to reduce polymicrobial infections traumatic extremity wound.
C1 [Tennent, David J.; Shiels, Stefanie M.; Wenke, Joseph C.] US Army Inst Surg Res, 3855 Roger Brooke Dr, San Antonio, TX 78234 USA.
   [Tennent, David J.] San Antonio Mil Med Ctr, Dept Orthopaed & Rehabil, 3855 Roger Brooke Dr, San Antonio, TX 78234 USA.
   [Tennent, David J.; Shiels, Stefanie M.; Wenke, Joseph C.] Cork Univ Hosp Grp, Cork, Ireland.
C3 United States Department of Defense; United States Army; Brooke Army
   Medical Center
RP Tennent, DJ (通讯作者)，US Army Inst Surg Res, 3855 Roger Brooke Dr, San Antonio, TX 78234 USA.; Tennent, DJ (通讯作者)，San Antonio Mil Med Ctr, Dept Orthopaed & Rehabil, 3855 Roger Brooke Dr, San Antonio, TX 78234 USA.
EM david.j.tennent.mil@mail.mil
RI Jennings, Jessica/PGM-2543-2026
OI Jennings, Jessica Amber/0000-0002-2760-6948
FU U.S. Department of Defense [W81XWH-12-2-0020] Funding Source: Medline
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NR 25
TC 20
Z9 24
U1 2
U2 8
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-799X
J9 J ORTHOP SURG RES
JI J. Orthop. Surg. Res.
PD MAR 15
PY 2018
VL 13
AR 53
DI 10.1186/s13018-018-0760-y
PG 10
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA FZ9AZ
UT WOS:000427903300001
PM 29544509
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Lin, KC
   Huang, FT
   Chen, CY
   Tarng, YW
AF Lin, Kai-Cheng
   Huang, Fu-Ting
   Chen, Chun-Yu
   Tarng, Yih-Wen
TI Is Staged Surgery Always Necessary for Schatzker Type IV-VI Tibial
   Plateau Fractures? A Comparison Study
SO LIFE-BASEL
LA English
DT Article
DE tibia plateau fracture; external fixation; open reduction and internal
   fixation; closed-incision negative-pressure therapy; negative-pressure
   wound therapy; outcome assessment
ID NEGATIVE-PRESSURE THERAPY; WOUND THERAPY; FIXATION; COMPLICATIONS;
   EFFICACY
AB Aims: This study aims to compare the outcomes of immediate (followed by closed-incision negative-pressure therapy use) versus delayed ORIF in patients with Schatzker type IV-VI TPFs. Patients and Methods: A prospective study of patients undergoing ORIF between January 2018 and December 2019 was performed. The inclusion criteria were patients (>18 years) with a closed fracture sent to the emergency room (ER) within 24 h of injury. All the patients underwent preoperative image evaluation. Two senior orthopedic trauma surgeons evaluated the soft tissue condition in the ER by 5P's of the compartment syndrome, judging the timing of the operation of definitive ORIF. Group 1 (n = 16) received delayed ORIF. Group 2 (n = 16) received immediate ORIF and ciNPT use. Patient follow-up occurred after 2 and 6 weeks and 3, 6, and 12 months after surgery. The assessments included the time to definitive fixation, the length of hospital stay, the time to bone union, surgical site complications, and reoperation within 12 months. A universal goniometer was used to measure the postoperative 3 m, 6 m, and 12 m ROM. Results: The patient demographics were similar between the groups (p > 0.05). Group 2 displayed significantly a shorter time to definitive fixation (5.94 +/- 2.02 vs. 0.61 +/- 0.28, p < 0.0001) and hospital stay (14.90 +/- 8/78 vs. 10.30 +/- 6.78, p = 0.0016). No significant difference was observed in the time to bone union, surgical site complication incidence, and reoperation rates (p > 0.05). Flexion and flexion-extension knee ROM were demonstrated to be significantly improved in Group 2, 3, 6, and 12 months postoperatively (p < 0.0001). Conclusions: In this study, early ORIF and ciNPT use resulted in a shorter hospital length of stay, a reduced time to early active motion of the knee, and improved knee ROM. These results suggest that early ORIF with ciNPT for Schatzker type IV-VI TPFs is safe and effective in some patients. However, further research to confirm these findings across larger and more diverse populations is needed.
C1 [Lin, Kai-Cheng; Huang, Fu-Ting; Chen, Chun-Yu; Tarng, Yih-Wen] Kaohsiung Vet Gen Hosp, Dept Otolaryngol, Kaohsiung 813, Taiwan.
C3 Kaohsiung Veterans General Hospital
RP Lin, KC; Huang, FT (通讯作者)，Kaohsiung Vet Gen Hosp, Dept Otolaryngol, Kaohsiung 813, Taiwan.
EM kclin@vghks.gov.tw; fuhuangl@vghks.gov.tw; cychen@vghks.gov.tw;
   ywtrang@vghks.gov.tw
FX We thanks 3M Company (San Antonio, TX, USA) for their aids in this
   study.
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NR 26
TC 2
Z9 5
U1 0
U2 0
PU MDPI
PI BASEL
PA ST ALBAN-ANLAGE 66, CH-4052 BASEL, SWITZERLAND
EI 2075-1729
J9 LIFE-BASEL
JI Life-Basel
PD JUN
PY 2024
VL 14
IS 6
AR 753
DI 10.3390/life14060753
PG 11
WC Biology; Microbiology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Life Sciences & Biomedicine - Other Topics; Microbiology
GA WV6K4
UT WOS:001257685000001
PM 38929737
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Willy, C
   Scheuermann-Poley, C
   Stichling, M
   von Stein, T
   Kramer, A
AF Willy, Christian
   Scheuermann-Poley, Catharina
   Stichling, Marcus
   von Stein, Thomas
   Kramer, Axel
TI Importance of wound irrigation solutions and fluids with antiseptic
   effects in therapy and prophylaxis. update 2017
SO UNFALLCHIRURG
LA German
DT Article
DE Antiseptics Instillation; Wound irrigation; Vacuum assistedwound
   closure; Surgical site infection; Prophylaxis
ID SURGICAL-SITE INFECTION; INSTILLATION; PREVENTION; EFFICACY; SURGERY
AB Introduction. Despite the use of modern antibiotics as well as complex perioperative, intraoperative and postoperative prophylactic measures, the rate of surgical site infections (SSI) could not be significantly reduced. The introduction of biocompatible antiseptic drugs with a high microbiocidal effect provided a successful alternative for infection prevention and therapy, particularly in a time of increasing occurrence of multi-drug resistant pathogens. Hence, questions about the risk-benefit ratio of antiseptic wound irrigation solutions, the prophylactic use of wound irrigation solutions for the reduction of SSI and the effect of negative pressure wound therapy combined with instillation (NPWTi) need to be answered.
   Method. Against the background of our own experiences with the use of antisepticwound irrigation solutions, a literature analysis (e.g. computer-supported MEDLINE, EMBASE and Cochrane database research as of April 2017) was performed.
   Results. Antiseptic fluids can be used both prophylactically and therapeutically, in acute and chronic, clean, contaminated and infected wounds to reduce the posttraumatic and postoperative wound infection rates. The antiseptic solutions that are commonly used in orthopedic and trauma surgery (e.g. PVP-iodine, octenidine, polyhexanide, sodium hypochlorite/hypochlorous acid and acetic acid), have in common that no development of resistance has so far been shown and that when the contraindications are taken into account, the antiseptic effect can develop without any clinically significant local and systemic side effects. As a rule the biocompatibility index is higher than 1 for the substancesmentioned. In addition, they show an antiseptic effect against biofilms and multidrug resistant pathogens. These antiseptic solutions can also be used for NPWTi with some limitations for octenidine.
   Conclusion. As the basic equipment in trauma surgery, a selection of three different antiseptic wound irrigation solutions for the reduction of the rates of posttraumatic and SSI can be recommended. The use of antiseptics should be reviewed on an ongoing basis in the daily clinical routine and particular attention should be paid to unwanted effects in the course of the healing process. After application of 7-14 days, the indications for continuing the use of the antiseptic solutions must be carefully re-evaluated.
C1 [Willy, Christian; Scheuermann-Poley, Catharina; Stichling, Marcus] Bundeswehrkrankenhaus Berlin, Klin Unfallchirurg Orthopadie Sept Rekonstrukt Ch, Forsch & Behandlungszentrum Sept Defektwunden, Scharnhorststr 13, D-10115 Berlin, Germany.
   [von Stein, Thomas] BG Unfallklin Murnau, Abt Sept & Rekonstrukt Chirurg, Murnau, Germany.
   [Kramer, Axel] Univ Med Greifswald, Inst Hyg & Umweltmed, Greifswald, Germany.
C3 Universitat Greifswald; Greifswald Medical School
RP Willy, C (通讯作者)，Bundeswehrkrankenhaus Berlin, Klin Unfallchirurg Orthopadie Sept Rekonstrukt Ch, Forsch & Behandlungszentrum Sept Defektwunden, Scharnhorststr 13, D-10115 Berlin, Germany.
EM christianwilly@bundeswehr.org
CR Abhyankar Suhas V, 2009, J Indian Med Assoc, V107, P904
   [Anonymous], 2016, Global Guidelines for the Prevention of Surgical Site Infection
   [Anonymous], ANTISEPTICS SURG
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NR 42
TC 15
Z9 20
U1 0
U2 15
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0177-5537
EI 1433-044X
J9 UNFALLCHIRURG
JI Unfallchirurg
PD JUL
PY 2017
VL 120
IS 7
BP 549
EP 560
DI 10.1007/s00113-017-0375-5
PG 12
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA FA5SD
UT WOS:000405503000003
PM 28643098
DA 2026-07-24
ER

PT J
AU Leaper, DJ
   Schultz, G
   Carville, K
   Fletcher, J
   Swanson, T
   Drake, R
AF Leaper, David J.
   Schultz, Gregory
   Carville, Keryln
   Fletcher, Jacqueline
   Swanson, Theresa
   Drake, Rebecca
TI Extending the TIME concept: what have we learned in the past 10 years?
SO INTERNATIONAL WOUND JOURNAL
LA English
DT Article
DE Chronic wounds; Debridement; Infection; Inflammation; Moisture balance;
   TIME; Wound bed preparation
ID PRESSURE WOUND THERAPY; RANDOMIZED-CONTROLLED-TRIAL; VENOUS LEG ULCERS;
   NEGATIVE-PRESSURE; NANOCRYSTALLINE SILVER; COST-EFFECTIVENESS; CADEXOMER
   IODINE; BED PREPARATION; DEBRIDEMENT; BIOFILMS
AB The TIME acronym (tissue, infection/inflammation, moisture balance and edge of wound) was first developed more than 10 years ago, by an international group of wound healing experts, to provide a framework for a structured approach to wound bed preparation; a basis for optimising the management of open chronic wounds healing by secondary intention. However, it should be recognised that the TIME principles are only a part of the systematic and holistic evaluation of each patient at every wound assessment. This review, prepared by the International Wound Infection Institute, examines how new data and evidence generated in the intervening decade affects the original concepts of TIME, and how it is translated into current best practice. Four developments stand out: recognition of the importance of biofilms (and the need for a simple diagnostic), use of negative pressure wound therapy (NPWT), evolution of topical antiseptic therapy as dressings and for wound lavage (notably, silver and polyhexamethylene biguanide) and expanded insight of the role of molecular biological processes in chronic wounds (with emerging diagnostics and theranostics). Tissue: a major advance has been the recognition of the value of repetitive and maintenance debridement and wound cleansing, both in time-honoured and novel methods (notably using NPWT and hydrosurgery). Infection/inflammation: clinical recognition of infection (and non infective causes of persisting inflammation) is critical. The concept of a bacterial continuum through contamination, colonisation and infection is now widely accepted, together with the understanding of biofilm presence. There has been a return to topical antiseptics to control bioburden in wounds, emphasised by the awareness of increasing antibiotic resistance. Moisture: the relevance of excessive or insufficient wound exudate and its molecular components has led to the development and use of a wide range of dressings to regulate moisture balance, and to protect peri-wound skin, and optimise healing. Edge of wound: several treatment modalities are being investigated and introduced to improve epithelial advancement, which can be regarded as the clearest sign of wound healing. The TIME principle remains relevant 10 years on, with continuing important developments that incorporate new evidence for wound care.
C1 [Leaper, David J.] Cardiff Univ, Sect Wound Healing, Inst Translat Innovat Methodol & Engagement, Cardiff CF14 4XN, S Glam, Wales.
   [Schultz, Gregory] Univ Florida, Dept Obstet & Gynecol, Inst Wound Res, Gainesville, FL 32611 USA.
   [Carville, Keryln] Silver Chain Nursing Assoc, Osborne Pk, WA, Australia.
   [Carville, Keryln] Curtin Univ Technol, Osborne Pk, WA, Australia.
   [Swanson, Theresa] SW Healthcare, Int Wound Infect Inst, Warrnambool, Vic, Australia.
C3 Cardiff University; State University System of Florida; University of
   Florida; Curtin University
RP Leaper, DJ (通讯作者)，Cardiff Univ, Sect Wound Healing, Inst Translat Innovat Methodol & Engagement, Cardiff CF14 4XN, S Glam, Wales.
EM profdavidleaper@doctors.co.uk
FU BBraun; Convatec; Smith Nephew; Ethicon; Coloplast; Systagenix; KCI;
   Health Point; Hollister Wound Care
FX The authors are grateful to the committee of the International Wound
   Infection Institute for their comments and enhancements to this article.
   The committee members are Terry Swanson - Chair (Australia), David
   Armstrong (USA), Joyce Black (USA), Keryln Carville (Australia), Jose
   Contreras Ruiz (Mexico), Marc Despatis (Canada), Val Edwards-Jones (UK),
   Jacqui Fletcher (UK), Georgina Gethin (Ireland), Jenny Hurlow (USA),
   David Keast (Canada), Patricia Larsen (USA), David Leaper (UK), Heather
   Orsted (Canada), Greg Schultz (USA), Dianne Smith (Australia), Geoff
   Sussman (Australia) and RichardWhite (UK). The authors would also like
   to extend their thanks to the members of the International Advisory
   Board on Wound Bed Preparation, who developed the original TIME
   principles, and to Keith Harding (UK), chair of the International Wound
   Infection Institute, 2007-2012. DJL paid speaker or received research
   grants from BBraun, Convatec, Smith & Nephew, Ethicon, Coloplast,
   Systagenix; GS received research grants from KCI, Health Point, Smith &
   Nephew, and Hollister Wound Care in 2011-2012; KC attended education
   events or presented for Smith & Nephew during 2012; JF paid consultancy
   for KCI, Systagenix, BBraun and Medi in 2011-2012; TS attended education
   events or presented for Coloplast, Smith & Nephew, Convatec,
   Independence Australia, and Molnlycke during 2012; RD undertakes
   freelance writing and editorial assignments.
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NR 90
TC 274
Z9 345
U1 2
U2 95
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1742-4801
EI 1742-481X
J9 INT WOUND J
JI Int. Wound J.
PD DEC
PY 2012
VL 9
SU 2
SI SI
BP 1
EP 19
DI 10.1111/j.1742-481X.2012.01097.x
PG 19
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA 035UR
UT WOS:000310976200001
PM 23145905
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Escobar-Domingo, MJ
   Bustos, VP
   Mahmoud, AA
   Tobin, MJ
   Park, JB
   Lee, DNL
   Rahmani, B
   Knerr, RM
   Merle, C
   Bloom, JA
   Lin, SJ
   Lee, BT
AF Escobar-Domingo, Maria J.
   Bustos, Valeria P.
   Mahmoud, Amir-Ala
   Tobin, Micaela J.
   Park, John B.
   Lee, Daniela
   Rahmani, Benjamin
   Knerr, Reinhard M.
   Merle, Chamilka
   Bloom, Joshua A.
   Lin, Samuel J.
   Lee, Bernard T.
TI Impact of closed-incision negative pressure therapy in donor-site
   complications in DIEP flap breast reconstruction: Analysis of 705
   patients and 1125 flaps
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE Breast Neoplasm; Free Tissue Flaps; Negative Pressure Wound Therapy;
   Female; Postoperative Complications; Retrospective Studies
ID ABDOMINAL-WALL RECONSTRUCTION; WOUND THERAPY; INFECTIONS; DEHISCENCE;
   PERFORATOR; MANAGEMENT; EFFICACY
AB Background: Closed-incision negative pressure therapy (ciNPT) has been shown to reduce complication rates in breast reconstruction (BR). This study aimed to evaluate postoperative outcomes in deep inferior epigastric perforator (DIEP) donor-site incisions managed with ciNPT compared to standard dressings. Methods: We performed a retrospective study of patients >= 18 years who underwent DIEP flap BR from 2015 to 2023. Patients who underwent reconstruction with alternative flaps or converted to transverse rectus abdominus myocutaneous were excluded. Patients were categorized according to the use of ciNPT vs. standard dressings. The unpaired t- and Fisher's Exact tests were used to assess the differences between the groups. Multivariable logistic regression models were used to evaluate postoperative complications. Results: A total of 705 patients were included, with 68 (9.6%) managed with ciNPT. Patients treated with ciNPT had significantly higher mean body mass index (BMI) (34.0 vs. 28.5 kg/m2; p < 0.001) compared to the control group. Higher rates of alcohol use (59.2% vs. 41.2%; p=0.006) and hormonal therapy use (41.3% vs. 17.9%; p < 0.001) were found in the standard dressing group. Univariate analyses showed no significant differences in donor-site postoperative outcomes across the groups. However, multivariate logistic regression models demonstrated a reduced likelihood of surgical site infection (OR 0.187; 95% CI 0.045-0.768); p=0.020), and wound dehiscence (OR 0.338; 95% CI 0.155-0.738); p=0.006) among the ciNPT users. Particularly, in patients with BMI > 30 kg/m2, ciNPT use (OR 0.282; 95% CI 0.098-0.812; p=0.019) was found to be a significant protective factor against wound complications compared to the standard of care. Conclusions: Our findings suggest that ciNPT may improve wound complication rates in DIEP flap donor sites, especially in patients with high BMI. Further research is necessary to elucidate the cost-effectiveness of ciNPT based on the patient risk profiles. (c) 2025 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Escobar-Domingo, Maria J.; Mahmoud, Amir-Ala; Tobin, Micaela J.; Park, John B.; Lee, Daniela; Rahmani, Benjamin; Knerr, Reinhard M.; Merle, Chamilka; Bloom, Joshua A.; Lin, Samuel J.; Lee, Bernard T.] Harvard Med Sch, Beth Israel Deaconess Med Ctr, Div Plast & Reconstruct Surg, Boston, MA USA.
   [Bustos, Valeria P.] Univ Miami, Dept Surg, Div Plast & Reconstruct Surg, Miami, FL USA.
C3 Harvard University; Harvard Medical School; Harvard University Medical
   Affiliates; Beth Israel Deaconess Medical Center; University of Miami
RP Lin, SJ; Lee, BT (通讯作者)，110 Francis St, Boston, MA 02215 USA.
EM sjlin@bidmc.harvard.edu; blee3@bidmc.harvard.edu
RI Escobar-Domingo, María José/JGE-5721-2023; Bloom, Joshua/W-6427-2019;
   Lin, Samuel/P-6158-2019; Lee, Bernard/K-1106-2016
OI Escobar-Domingo, María José/0000-0002-4677-471X; Merle,
   Chamilka/0000-0001-5744-1251; Bloom, Joshua/0000-0001-6413-3986; Lee,
   Daniela/0000-0002-1057-5380; Tobin, Micaela/0000-0002-8905-3250; 
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NR 40
TC 3
Z9 3
U1 0
U2 0
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD JUN
PY 2025
VL 105
BP 177
EP 184
DI 10.1016/j.bjps.2025.04.010
EA JAN 2025
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 2KA2N
UT WOS:001484491600001
PM 40305888
DA 2026-07-24
ER

PT J
AU Tricco, AC
   Antony, J
   Vafaei, A
   Khan, PA
   Harrington, A
   Cogo, E
   Wilson, C
   Perrier, L
   Hui, W
   Straus, SE
AF Tricco, Andrea C.
   Antony, Jesmin
   Vafaei, Afshin
   Khan, Paul A.
   Harrington, Alana
   Cogo, Elise
   Wilson, Charlotte
   Perrier, Laure
   Hui, Wing
   Straus, Sharon E.
TI Seeking effective interventions to treat complex wounds: an overview of
   systematic reviews
SO BMC MEDICINE
LA English
DT Review
DE Complex wound; Effectiveness; Systematic review; Treatment; Ulcer;
   Wounds
ID TOPICAL NEGATIVE-PRESSURE; RANDOMIZED CONTROLLED-TRIALS;
   SILVER-RELEASING DRESSINGS; DIABETIC FOOT ULCERS; VENOUS LEG ULCERS;
   ADJUNCTIVE THERAPY; HYPERBARIC-OXYGEN; SURGICAL WOUNDS; MEASUREMENT
   TOOL; MANAGEMENT
AB Background: Numerous, often multi-faceted regimens are available for treating complex wounds, yet the evidence of these interventions is recondite across the literature. We aimed to identify effective interventions to treat complex wounds through an overview of systematic reviews.
   Methods: MEDLINE (OVID interface, 1946 until October 26, 2012), EMBASE (OVID interface, 1947 until October 26, 2012), and the Cochrane Database of Systematic Reviews (Issue 10 of 12, 2012) were searched on October 26, 2012. Systematic reviews that examined adults receiving care for their complex wounds were included. Two reviewers independently screened the literature, abstracted data, and assessed study quality using the Assessment of Multiple Systematic Reviews (AMSTAR) tool.
   Results: Overall, 99 systematic reviews were included after screening 6,200 titles and abstracts and 422 full-texts; 54 were systematic reviews with a meta-analysis (including data on over 54,000 patients) and 45 were systematic reviews without a meta-analysis. Overall, 44% of included reviews were rated as being of high quality (AMSTAR score >= 8). Based on data from systematic reviews including a meta-analysis with an AMSTAR score >= 8, promising interventions for complex wounds were identified. These included bandages or stockings (multi-layer, high compression) and wound cleansing for venous leg ulcers; four-layer bandages for mixed arterial/venous leg ulcers; biologics, ultrasound, and hydrogel dressings for diabetic leg/foot ulcers; hydrocolloid dressings, electrotherapy, air-fluidized beds, and alternate foam mattresses for pressure ulcers; and silver dressings and ultrasound for unspecified mixed complex wounds. For surgical wound infections, topical negative pressure and vacuum-assisted closure were promising interventions, but this was based on evidence from moderate to low quality systematic reviews.
   Conclusions: Numerous interventions can be utilized for patients with varying types of complex wounds, yet few treatments were consistently effective across all outcomes throughout the literature. Clinicians and patients can use our results to tailor effective treatment according to type of complex wound. Network meta-analysis will be of benefit to decision-makers, as it will permit multiple treatment comparisons and ranking of the effectiveness of all interventions.
C1 [Tricco, Andrea C.; Antony, Jesmin; Vafaei, Afshin; Khan, Paul A.; Harrington, Alana; Cogo, Elise; Wilson, Charlotte; Perrier, Laure; Hui, Wing; Straus, Sharon E.] St Michaels Hosp, Li Ka Shing Knowledge Inst, 209 Victoria St,East Bldg, Toronto, ON M5B 1W8, Canada.
   [Tricco, Andrea C.] Univ Toronto, Dalla Lana Sch Publ Hlth, Div Epidemiol, Toronto, ON M5T 3M7, Canada.
   [Straus, Sharon E.] Univ Toronto, Dept Geriatr Med, Toronto, ON M5S 1A1, Canada.
C3 University of Toronto; Li Ka Shing Knowledge Institute; Saint Michaels
   Hospital Toronto; University of Toronto; University of Toronto
RP Straus, SE (通讯作者)，St Michaels Hosp, Li Ka Shing Knowledge Inst, 209 Victoria St,East Bldg, Toronto, ON M5B 1W8, Canada.
EM sharon.straus@utoronto.ca
RI ; Perrier, Laure/D-4638-2011; Tricco, Andrea/B-9920-2011
OI Cogo, Elise/0000-0003-2480-3652; Vafaei, Afshin/0000-0002-3605-409X;
   Perrier, Laure/0000-0001-9941-7129; Straus, Sharon/0000-0002-6106-832X;
   Khan, Paul/0000-0003-2863-0496; 
FU Toronto Central Local Health Integrated Network; Canadian Institutes for
   Health Research/Drug Safety and Effectiveness Network (CIHR/DSEN); CIHR
FX This project was funded by the Toronto Central Local Health Integrated
   Network. ACT is funded by a Canadian Institutes for Health Research/Drug
   Safety and Effectiveness Network (CIHR/DSEN) New Investigator Award on
   Knowledge Synthesis Methodology. SES is funded by a CIHR tier 1 Research
   Chair in Knowledge Translation.
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NR 125
TC 34
Z9 46
U1 1
U2 72
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1741-7015
J9 BMC MED
JI BMC Med.
PD APR 22
PY 2015
VL 13
AR 89
DI 10.1186/s12916-015-0288-5
PG 23
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA CG4MC
UT WOS:000353258900001
PM 25899006
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Tartaglia, D
   Costa, G
   Camillò, A
   Castriconi, M
   Andreano, M
   Lanza, M
   Fransvea, P
   Ruscelli, P
   Rimini, M
   Galatioto, C
   Chiarugi, M
AF Tartaglia, Dario
   Costa, Gianluca
   Camillo, Antonio
   Castriconi, Maurizio
   Andreano, Mauro
   Lanza, Michele
   Fransvea, Pietro
   Ruscelli, Paolo
   Rimini, Massimiliano
   Galatioto, Christian
   Chiarugi, Massimo
TI Damage control surgery for perforated diverticulitis with diffuse
   peritonitis: saves lives and reduces ostomy
SO WORLD JOURNAL OF EMERGENCY SURGERY
LA English
DT Article
DE Complicated diverticulitis; Damage control surgery; Observational study
ID ACUTE COLONIC DIVERTICULITIS; HARTMANNS PROCEDURE; PRIMARY ANASTOMOSIS;
   EMERGENCY-SURGERY; RESECTION; CLASSIFICATION; MANAGEMENT
AB IntroductionOver the last decade, damage control surgery (DCS) has been emerging as a feasible alternative for the management of patients with abdominal infection and sepsis. So far, there is no consensus about the role of DCS for acute perforated diverticulitis. In this study, we present the outcome of a multi-institutional series of patients presenting with Hinchey's grade III and IV diverticulitis managed by DCS.MethodsAll the participating centers were tertiary referral hospitals. A total of 34 patients with perforated diverticulitis treated with DCS during the period 2011-2017 were included in the study. During the first laparotomy, a limited resection of the diseased segment was performed followed by lavage and use of negative pressure wound therapy (NPWT). After 24/48h of resuscitation, patients returned to the operating room for a second look. Mortality, morbidity, and restoration of bowel continuity were the primary outcomes of the study.ResultsThere were 15 males (44%) and 19 females (56%) with a mean age of 66.9years (SD12.7). Mean BMI was 28.42kg/m(2) (SD +/- 3.33). Thirteen cases (38%) were Wasvary's modified Hinchey's stage III, and 21 cases (62%) Hinchey's stage IV. Mean Mannheim Peritonitis Index (MPI) was 25.12 (SD +/- 6.28). In 22 patients (65%), ASA score was grade III. Twenty-four patients (71%) had restoration of bowel continuity, while 10 (29%) patients had an end colostomy (Hartmann's procedure). Three of these patients received a temporary loop ileostomy. One patient had an anastomotic leak. Mortality rate was 12%. Mean length of hospital stay was 21.9days. At multivariate analysis, male gender (p=0.010) and MPI (p=0.034) correlated with a high percentage of Hartmann's procedures.Conclusion DCS is a feasible procedure for patients with generalized peritonitis secondary to perforated diverticulitis, and it appears to be related to a higher rate of bowel reconstruction. Due to the open abdomen, stay in ICU with prolonged mechanical ventilation is required, but these aggressive measures may be needed by most patients undergoing surgery for perforated diverticulitis, whatever the procedure is done.
C1 [Tartaglia, Dario; Camillo, Antonio; Galatioto, Christian; Chiarugi, Massimo] Univ Pisa, New Santa Chiara Hosp, Emergency Surg Unit, Via Paradisa 2, I-56124 Pisa, Italy.
   [Costa, Gianluca; Fransvea, Pietro] Univ Sapienza, St Andrea Teaching Hosp, Emergency Surg Unit, Rome, Italy.
   [Castriconi, Maurizio; Andreano, Mauro; Lanza, Michele] Osped Cardarelli, Emergency Surg Unit, Naples, Italy.
   [Ruscelli, Paolo; Rimini, Massimiliano] Polytech Univ Marche, Osped Riuniti Teaching Hosp, Emergency Surg Unit, Ancona, Italy.
C3 Santa Chiara Hospital; University of Pisa; Sapienza University Rome;
   Antonio Cardarelli Hospital; Marche Polytechnic University
RP Tartaglia, D (通讯作者)，Univ Pisa, New Santa Chiara Hosp, Emergency Surg Unit, Via Paradisa 2, I-56124 Pisa, Italy.
EM dario261184@gmail.com
RI ruscelli, paolo/AAH-4785-2019; Tartaglia, Dario/AAJ-1735-2020; Fransvea,
   Pietro/AAP-1517-2020; Costa, Gianluca/ABD-7262-2020; Chiarugi,
   Massimo/ABQ-7280-2022; rimini, margherita/ONI-9192-2025
OI ruscelli, paolo/0000-0001-5842-2204; Tartaglia,
   Dario/0000-0003-1615-3370; Fransvea, Pietro/0000-0003-4969-3373; Costa,
   Gianluca/0000-0001-5194-8908; Chiarugi, Massimo/0000-0001-6905-2499; 
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NR 26
TC 37
Z9 46
U1 0
U2 6
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-7922
J9 WORLD J EMERG SURG
JI World J. Emerg. Surg.
PD APR 16
PY 2019
VL 14
AR 19
DI 10.1186/s13017-019-0238-1
PG 6
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA HT9PJ
UT WOS:000464903400001
PM 31015859
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Jia, JW
   Wei, ZY
   Chen, YN
   Chen, SW
   Ma, YP
   Kang, XW
AF Jia, Jingwen
   Wei, Ziyan
   Chen, Yanan
   Chen, Shuwei
   Ma, Yingping
   Kang, Xuewen
TI A Comparative Study of the Improved Negative-Pressure Drainage Tube and
   the Penrose Silicone Drainage Tube: Which Is More Beneficial for Wounds
   from Deep Infections Healing? A Rabbit Model Study
SO INDIAN JOURNAL OF ORTHOPAEDICS
LA English
DT Article
DE Model of infection; Negative-pressure wound therapy; Wound drainage
ID SOFT-TISSUE INJURY; ORTHOPEDIC-SURGERY; INSTILLATION; THERAPY; FOAM
AB Background Postoperative orthopedic wounds frequently lead to deep infections, and conventional drainage tubes exhibit inadequate drainage capacity. This study aimed to assess the efficacy of an innovative and improved negative-pressure wound irrigation drainage tube in enhancing infection control and facilitating wound healing.Methods Forty New Zealand rabbits were randomly assigned to five groups: A (control), B (abscess model), C (Penrose drain), D (improved negative-pressure wound irrigation drainage tube with drainage), and E (improved negative-pressure wound irrigation drainage tube with drainage and irrigation). A deep wound infection model was established, and its success was assessed using Gram staining and mass spectrometry. Daily weight, temperature, and drainage volume were recorded for each rabbit group. In vitro cellular experiments were performed to assess the biocompatibility of the materials. Histological examinations were conducted on postoperative day 14 to evaluate wound healing.Results Bacterial culture demonstrated the consistent presence of primary pathogenic bacteria in all groups, confirming the successful establishment of the model. Following surgery, all rabbit groups showed a consistent increase in body weight with no significant variation (P > 0.05). On day 14, the average skin temperature of Group E was significantly lower than that of the other groups (P < 0.001). The average total drainage volumes on day 14 were 9.03 +/- 0.60 ml for Group C and 10.49 +/- 0.99 ml for Group D, indicating significantly higher drainage in Group D than in Group C (P < 0.05). In vitro experiments demonstrated that the product had no adverse effect on the viability and proliferation of fibroblast cells. Histological analyses indicated that muscle tissue structure was normal in Group A, exhibited cell loss with inflammatory cell infiltration in Group B, displayed slight abnormalities with mild fibrosis in Group C, showed mild irregularities with a relatively organized arrangement of muscle cells in Group D, and remained essentially normal in Group E.Conclusion The improved negative-pressure wound irrigation drainage tube demonstrated distinct advantages over the conventional Penrose silicone drain in controlling inflammation, optimizing wound treatment, and promoting wound healing in deep wound infections.
C1 [Jia, Jingwen; Wei, Ziyan; Chen, Shuwei; Ma, Yingping; Kang, Xuewen] Lanzhou Univ, Dept Orthopaed, Hosp 2, 82 Cuiyingmen, Lanzhou 730000, Gansu, Peoples R China.
   [Chen, Yanan] Gansu Prov Hosp, Lanzhou 730000, Gansu, Peoples R China.
C3 Lanzhou University
RP Ma, YP; Kang, XW (通讯作者)，Lanzhou Univ, Dept Orthopaed, Hosp 2, 82 Cuiyingmen, Lanzhou 730000, Gansu, Peoples R China.
EM 220220904251@lzu.edu.cn; 220220904341@lzu.edu.cn; 1523170692@qq.com;
   625694177@qq.com; 253856962@qq.com; ery_kangxw@lzu.edu.cn
RI Chen, Yanan/E-6385-2013
FU Cuiying Scientific and Technological Innovation Program of Lanzhou
   University Second Hospital; Gansu Provincial Department of Science and
   Technology, Natural Science Foundation Project, A preliminary study on
   the application of a new negative pressure triple lumen drain; Natural
   Science Foundation Project; Gansu Provincial Department of Science and
   Technology, Natural Science Foundation Project
FX The authors thank the financial support of the Cuiying Scientific and
   Technological Innovation Program of Lanzhou University Second Hospital,
   the Gansu Provincial Department of Science and Technology, Natural
   Science Foundation Project, A preliminary study on the application of a
   new negative pressure triple lumen drain in infected wounds in rabbits,
   the Gansu Provincial Department of Science and Technology, Natural
   Science Foundation Project, and the Gansu Provincial Department of
   Science and Technology, Natural Science Foundation Project.
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NR 27
TC 0
Z9 0
U1 1
U2 1
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 0019-5413
EI 1998-3727
J9 INDIAN J ORTHOP
JI Indian J. Orthop.
PD JAN
PY 2026
VL 60
IS 1
BP 110
EP 125
DI 10.1007/s43465-025-01601-4
EA OCT 2025
PG 16
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA CA6QQ
UT WOS:001602975500001
PM 41541031
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Acosta, S
   Seternes, A
   Venermo, M
   Vikatmaa, L
   Sörelius, K
   Wanhainen, A
   Svensson, M
   Djavani, K
   Björck, M
AF Acosta, Stefan
   Seternes, Arne
   Venermo, Maarit
   Vikatmaa, Leena
   Sorelius, Karl
   Wanhainen, Anders
   Svensson, Mats
   Djavani, Khatereh
   Bjorck, Martin
TI Open Abdomen Therapy with Vacuum and Mesh Mediated Fascial Traction
   After Aortic Repair: an International Multicentre Study
SO EUROPEAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY
LA English
DT Article
DE Open abdomen; Aortic repair; Open repair; Endovascular repair; Vacuum
   assisted closure; Mesh mediated fascial traction
ID ABDOMINAL COMPARTMENT SYNDROME; ASSISTED WOUND CLOSURE;
   NEGATIVE-PRESSURE; ENDOVASCULAR REPAIR; ANEURYSM REPAIR; MANAGEMENT;
   INFECTION; METAANALYSIS; LAPAROTOMY; CONSENSUS
AB Objectives: Open abdomen therapy may be necessary to prevent or treat abdominal compartment syndrome (ACS). The aim of the study was to analyse the primary delayed fascial closure (PDFC) rate and complications after open abdomen therapy with vacuum and mesh mediated fascial traction (VACM) after aortic repair and to compare outcomes between those treated with open abdomen after primary versus secondary operation.
   Methods: This was a retrospective cohort, multicentre study in Sweden, Finland, and Norway, including consecutive patients treated with open abdomen and VACM after aortic repair at six vascular centres in 2006-2015. The primary endpoint was PDFC rate.
   Results: Among 191 patients, 155 were men. The median age was 71 years (IQR 66-76). Ruptured abdominal aortic aneurysm (RAAA) occurred in 69.1%. Endovascular/hybrid and open repairs were performed in 49 and 142 patients, respectively. The indications for open abdomen were inability to close the abdomen (62%) at primary operation and ACS (80%) at secondary operation. Duration of open abdomen was 11 days (IQR 7-16) in 157 patients alive at open abdomen termination. The PDFC rate was 91.8%. Open abdomen initiated at primary (N = 103), compared with secondary operation (N = 88), was associated with less severe initial open abdomen status (p = .006), less intestinal ischaemia (p = .002), shorter duration of open abdomen (p = .007), and less renal replacement therapy (RRT, p < .001). In hospital mortality was 39.3%, and after entero-atmospheric fistula (N = 9) was 88.9%. Seven developed graft infection within 6 months, 1 year mortality was 28.6%. Intestinal ischaemia (OR 3.71, 95% CI 1.55-8.91), RRT (OR 3.62, 95% CI 1.72-7.65), and age (OR 1.12, 95% CI 1.06-1.12), were independent factors associated with in hospital mortality, but not open abdomen initiated at primary versus secondary operation.
   Conclusions: VACM was associated with a high PDFC rate after prolonged open abdomen therapy following aortic repair. Patient outcomes seemed better when open abdomen was initiated at primary, compared with secondary operation but a selection effect is possible. (C) 2017 European Society for Vascular Surgery. Published by Elsevier Ltd. All rights reserved.
C1 [Acosta, Stefan] Lund Univ, Dept Clin Sci Malmo, Malmo, Sweden.
   [Acosta, Stefan] Skane Univ Hosp, Dept Cardiothorac & Vasc Surg, Vasc Ctr, Ruth Lundskogsg 10, S-20502 Malmo, Sweden.
   [Seternes, Arne] Trondheim Reg & Univ Hosp, St Olavs Hosp, Dept Vasc Surg, Trondheim, Norway.
   [Venermo, Maarit] Univ Helsinki, Dept Vasc Surg, Helsinki, Finland.
   [Venermo, Maarit; Vikatmaa, Leena] Helsinki Univ Hosp, Helsinki, Finland.
   [Vikatmaa, Leena] Univ Helsinki, Dept Anaesthet Intens Care & Pain Med, Helsinki, Finland.
   [Sorelius, Karl; Wanhainen, Anders; Bjorck, Martin] Uppsala Univ, Sect Vasc Surg, Dept Surg Sci, Uppsala, Sweden.
   [Svensson, Mats] Falun Cent Hosp, Dept Surg, Falun, Sweden.
   [Djavani, Khatereh] Gavle Cent Hosp, Dept Surg, Gavle, Sweden.
C3 Lund University; Lund University; Skane University Hospital; Norwegian
   University of Science & Technology (NTNU); University of Helsinki;
   University of Helsinki; Helsinki University Central Hospital; University
   of Helsinki; Uppsala University; Falun Hospital
RP Acosta, S (通讯作者)，Skane Univ Hosp, Dept Cardiothorac & Vasc Surg, Vasc Ctr, Ruth Lundskogsg 10, S-20502 Malmo, Sweden.
EM Stefan.acosta@med.lu.se
RI Vikatmaa, Leena/AAY-1061-2020; Acosta, Stefan/JAX-3225-2023
OI Acosta, Stefan/0000-0002-3225-0798; Venermo, Maarit/0000-0001-8814-0988
CR Acosta S, 2007, EUR J VASC ENDOVASC, V33, P277, DOI 10.1016/j.ejvs.2006.09.017
   Acosta S, 2011, BRIT J SURG, V98, P735, DOI 10.1002/bjs.7383
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   Bee TK, 2008, J TRAUMA, V65, P337, DOI 10.1097/TA.0b013e31817fa451
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   Cheatham ML, 2013, WORLD J SURG, V37, P2018, DOI 10.1007/s00268-013-2080-z
   Cothren CC, 2006, AM J SURG, V192, P238, DOI 10.1016/j.amjsurg.2006.04.010
   Cristaudo A, 2017, AM SURGEON, V83, P191
   De Waele JJ, 2016, BJS-BRIT J SURG, V103, P709, DOI 10.1002/bjs.10097
   Ersryd S, 2016, EUR J VASC ENDOVASC, V52, P158, DOI 10.1016/j.ejvs.2016.03.011
   FitzGerald SF, 2005, J ANTIMICROB CHEMOTH, V56, P996, DOI 10.1093/jac/dki382
   Fortelny RH, 2014, SURG ENDOSC, V28, P735, DOI 10.1007/s00464-013-3251-6
   Kääriäinen M, 2017, SCAND J SURG, V106, P145, DOI 10.1177/1457496916665542
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   Mayer D, 2009, J VASC SURG, V50, P1, DOI 10.1016/j.jvs.2008.12.030
   Mohan PP, 2014, CARDIOVASC INTER RAD, V37, P337, DOI 10.1007/s00270-013-0665-4
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NR 37
TC 22
Z9 27
U1 0
U2 5
PU W B SAUNDERS CO LTD
PI LONDON
PA 32 JAMESTOWN RD, LONDON NW1 7BY, ENGLAND
SN 1078-5884
EI 1532-2165
J9 EUR J VASC ENDOVASC
JI Eur. J. Vasc. Endovasc. Surg.
PD DEC
PY 2017
VL 54
IS 6
BP 697
EP 705
DI 10.1016/j.ejvs.2017.09.002
PG 9
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA FR4RQ
UT WOS:000419053800005
PM 29033336
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Koncar, I
   Cvetkovic, S
   Dragas, M
   Pejkic, S
   Lazovic, G
   Banzic, I
   Zuvela, M
   Markovic, M
   Davidovic, L
AF Koncar, Igor
   Cvetkovic, Slobodan
   Dragas, Marko
   Pejkic, Sinisa
   Lazovic, Goran
   Banzic, Igor
   Zuvela, Marinko
   Markovic, Miroslav
   Davidovic, Lazar
TI Vacuum-assisted wound closure in vascular surgery - clinical and cost
   benefits in a developing country
SO VOJNOSANITETSKI PREGLED
LA English
DT Article
DE surgical wound infection; surgical wound dehiscence; vascular surgical
   procedures; vacuum; socioeconomic factors; treatment outcome
AB Background/Aim. Surgical and chronic wounds in vascular patients might contribute to limb loss and death. Vacuum-assisted closure (VAC) Kinetic Concepts, Inc. (KCI), has been increasingly used in Western Europe and the USA clinical practice for 15 years. Advantages of this method are faster wound healing, wound approximation, lower wound related treatment costs and improved quality of life during treatment. Evidence related to the usage of VAC therapy in vascular patients and cost effectiveness of VAC therapy in a developing country are lacking. The aim of this study was to explore results of VAC therapy in vascular surgery comparing to conventional methods and to test cost effects in a developing country like Serbia. Methods. All patients with wound infection or dehiscence operated at the tertiary vascular university clinic in the period from January 2011 January 2012, were treated with VAC therapy. The primary endpoint was wound closure, while secondary endpoints were hospital stay, the number of weekly dressings, costs of wound care, working time of medical personnel. The patients were divided into groups according to the wound type and location: wound with exposed synthetic vascular implant (25%), laparotomy (13%), foot amputation (29%), major limb amputation (21%), fasciotomy (13%). The results of primary and secondary endpoint were compared with the results of conventional treatment during the previous year. Results. There was one death (1/42, 2.38%) and one limb loss (1/12, 2.38%) in the VAC group, and 8 deaths (8/38, 21.05%) and 5 (5/38, 13.15%) limb losses in the patients treated with conventional therapy. In the VAC group there was one groin bleeding (1/12, 2.38%), one groin reinfection (1/12, 2.38%) and one resistance to therapy with a consequent limb loss. Costs of hospital stay (p < 0.001) and nursing time < 0.001) were reduced with VAC therapy in the group with exposed graft. Conclusion. VAC therapy is the effective method for care of complicated wounds in vascular surgery. Patients with infection of wound with the exposed synthetic graft significantly benefit form this therapy. Cost effectiveness of VAC therapy is applicable to a developing country scenario, however cautious selection of patients contributes to the effectiveness.
C1 [Koncar, Igor; Cvetkovic, Slobodan; Dragas, Marko; Lazovic, Goran; Zuvela, Marinko; Markovic, Miroslav; Davidovic, Lazar] Univ Belgrade, Fac Med, Belgrade, Serbia.
   [Koncar, Igor; Cvetkovic, Slobodan; Dragas, Marko; Pejkic, Sinisa; Banzic, Igor; Markovic, Miroslav; Davidovic, Lazar] Clin Ctr Serbia, Clin Vasc & Endovasc Surg, Dr Kosta Todorovic 8, Belgrade 11000, Serbia.
   [Lazovic, Goran] Clin Ctr Serbia, Clin Plast & Reconstruct Surg, Dr Kosta Todorovic 8, Belgrade 11000, Serbia.
   [Zuvela, Marinko] Clin Ctr Serbia, Clin Digest Surg, Dr Kosta Todorovic 8, Belgrade 11000, Serbia.
C3 University of Belgrade; University of Belgrade; University of Belgrade;
   University of Belgrade
RP Koncar, I (通讯作者)，Univ Belgrade, Fac Med, Belgrade, Serbia.; Koncar, I (通讯作者)，Clin Ctr Serbia, Clin Vasc & Endovasc Surg, Dr Kosta Todorovic 8, Belgrade 11000, Serbia.
EM dr.koncar@gmail.com
RI ; Lazovic, Goran/CAI-2428-2022
OI Davidovic, Lazar/0000-0002-0529-2378; Dragas, Marko/0000-0001-9500-9195;
   
FU KCI (Kinetic Concepts Inc) for Serbia, Laviefarm Company
FX The study was supported by representative of KCI (Kinetic Concepts Inc)
   for Serbia, Laviefarm Company, that funded all costs of spent material.
CR Albuquerque MLC, 2000, AM J PHYSIOL-HEART C, V279, pH293, DOI 10.1152/ajpheart.2000.279.1.H293
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   Vuerstaek JDD, 2006, J VASC SURG, V44, P1029, DOI 10.1016/j.jvs.2006.07.030
NR 11
TC 4
Z9 5
U1 0
U2 5
PU MILITARY MEDICAL ACAD-INI
PI BELGRADE
PA CRNOTRAVSKA 17, PO BOX 33-35, BELGRADE, 11040, SERBIA
SN 0042-8450
EI 2406-0720
J9 VOJNOSANIT PREGL
JI Vojnosanit. Pregl.
PD JAN
PY 2016
VL 73
IS 1
BP 9
EP 15
DI 10.2298/VSP13122212K
PG 7
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA DC1IE
UT WOS:000368969200002
PM 26964378
DA 2026-07-24
ER

PT J
AU Schewe, S
   Sagebiel, A
   Wakker, J
   Voss, N
   Al Shonikat, R
   Priemel, M
   Reiter, A
   Striefler, J
   Blessmann, M
   Hackert, T
   Dupree, A
AF Schewe, Simone
   Sagebiel, Adrian
   Wakker, Jonas
   Voss, Nina
   Al Shonikat, Ruba
   Priemel, Matthias
   Reiter, Alonja
   Striefler, Jana
   Blessmann, Marco
   Hackert, Thilo
   Dupree, Anna
TI Impact of vacuum assisted wound therapy on wound complications in STS
   surgery- A 3-year retrospective single-centre analysis
SO LANGENBECKS ARCHIVES OF SURGERY
LA English
DT Article
DE Vacuum assisted wound closure; Soft tissue sarcoma; Sarcoma surgery;
   Wound complication; Postoperative complications; Secondary wound closure
ID SOFT-TISSUE SARCOMA; NEGATIVE-PRESSURE; RADIATION; CLOSURE
AB Purpose In sarcomas, surgery is an essential component of therapy. Depending on their location, sarcomas can reach a considerable size, which increases the risk of wound complications (WC) after resections. This often results in longer hospital stays and thus delays further oncological treatment. Therefore, reducing WCs is indispensable for improving treatment. The VAC (Vacuum-Assisted Closure) therapy has been shown to have a positive effect on wound healing, but there are limited studies for its use after sarcoma resections. The aim of this study was to analyze the outcomes of various wound closure techniques. This was intended to identify optimal wound care to prevent WCs and to determine risk factors for complications. Methods This study is a single-center study that included all patients who underwent surgery for sarcomas of the body surface and extremities. A retrospective data analysis was conducted for the years 2021-2023. The primary endpoint was the development of wound complications. Here, primary wound closure was compared with secondary closure after negative wound pressure therapy (NWPT). Secondary endpoints included the impact of drains, subtype, location, and comorbidities. Results A total of 211 patients were examined. The most common histological subtype was liposarcoma (32,88%), followed by undifferentiated sarcoma (19,18%). Wound complications occurred in 30,19% of all cases. The analysis showed that 40,4% of patients with primary wound closure developed a complication, while only 20% of patients with NWPT did. A significant risk factor for the development of a WC was a tumor diameter > 10 cm, which led to a 20,13% higher risk of infection compared to smaller tumors. 68.3% of wound complications occurred in the lower extremity. Additionally, neoadjuvant therapy, longer operation time and immunosuppression were detected as risk factors for a higher complication rate. Conclusions This study highlights the significantly increased risk of WCs in large sarcomas of the lower extremities. VAC therapy showed a significant improvement in wound closure especially in high-risk cases. Based on the results, the use of NWPT can be essential for wound management in sarcomas and improve convalescence and oncological treatment.
C1 [Schewe, Simone; Sagebiel, Adrian; Wakker, Jonas; Voss, Nina; Al Shonikat, Ruba; Hackert, Thilo; Dupree, Anna] Univ Med Ctr Hamburg Eppendorf, Dept Gen Visceral & Thorac Surg, Hamburg, Germany.
   [Priemel, Matthias; Reiter, Alonja] Univ Med Ctr Hamburg Eppendorf, Clin & Polyclin Trauma Surg & Orthoped, Hamburg, Germany.
   [Striefler, Jana] Univ Med Ctr Hamburg Eppendorf, Med Clin & Polyclin Oncol 2, Hematol, Dept Pulmonol, Hamburg, Germany.
   [Blessmann, Marco] Univ Med Ctr Hamburg Eppendorf, Dept Plast Reconstruct & Aesthet Surg, Hamburg, Germany.
C3 University of Hamburg; University Medical Center Hamburg-Eppendorf;
   University of Hamburg; University Medical Center Hamburg-Eppendorf;
   University of Hamburg; University Medical Center Hamburg-Eppendorf;
   University of Hamburg; University Medical Center Hamburg-Eppendorf
RP Schewe, S (通讯作者)，Univ Med Ctr Hamburg Eppendorf, Dept Gen Visceral & Thorac Surg, Hamburg, Germany.
EM s.schewe@uke.de
FU Projekt DEAL
FX Open Access funding enabled and organized by Projekt DEAL.
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NR 38
TC 2
Z9 4
U1 0
U2 0
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 1435-2443
EI 1435-2451
J9 LANGENBECK ARCH SURG
JI Langenbecks Arch. Surg.
PD SEP 25
PY 2025
VL 410
IS 1
AR 277
DI 10.1007/s00423-025-03865-8
PG 13
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 7VU5E
UT WOS:001580845200002
PM 40996557
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Munro, SP
   Dearden, A
   Joseph, M
   O'Donoghue, JM
AF Munro, S. P.
   Dearden, A.
   Joseph, M.
   O'Donoghue, J. M.
TI Reducing donor-site complications in DIEP flap breast reconstruction
   with closed incisional negative pressure therapy: A cost-benefit
   analysis
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE ciNPT; Negative pressure; DIEP; PREVENA; Seroma
ID VACUUM-ASSISTED CLOSURE; PERISTERNAL THORACIC WALL; WOUND THERAPY;
   BLOOD-FLOW; METAANALYSIS; IMPACT
AB Introduction: Deep inferior epigastric perforator (DIEP) flaps are considered the gold standard for autologous breast reconstruction but create large abdominal incisions that risk donor-site morbidity during harvest. Closed incision negative pressure therapy (ciNPT) is emerging as an effective alternative to standard postoperative dressings, but there is a paucity of data in DIEP flap donor sites. Methods: We conducted a retrospective case-control study investigating the use of ciNPT in DIEP flap donor sites at a single institution between March 2017 and September 2021. Patients who underwent microsurgical autologous breast reconstruction with DIEP flaps were included. Patients were divided into those with donor incision sites managed with ciNPT (n = 24) and those with conventional postoperative wound dressings (n = 20). We compared patient de-mographics, wound drainage volumes and postoperative outcomes between the two groups. A cost-benefit analysis was employed to compare the overall costs associated with each compli-cation and differences in length of stay between the two groups. Results: There was no statistically significant difference in age, body mass index (BMI), comor-bidity burden or smoking status between the two groups. Both groups had similar lengths of stay and wound drainage volumes with no readmissions or reoperations in either group. There was a statistically significant reduction in donor-site complications (p = 0.018), surgical site infections (p = 0.014) and seroma formation (p = 0.016) in those with ciNPT. Upon cost-benefit analysis, the ciNPT group had a mean reduction in cost-per-patient associated with postoper-ative complications of 420.77 pound (p = 0.031) and 446.47 pound (p = 0.049) when also accounting for postoperative length of stayConclusion: ciNPT appears to be an effective alternative incision management system with the potential to improve complication rates and postoperative morbidity in DIEP flap donor sites. Our analysis demonstrates improved cost-benefit outweighing the increase in costs associated with ciNPT. We recommend a multicentre prospective trial with formal cost-utility analysis to strengthen these findings. (c) 2022 Published by Elsevier Ltd on behalf of British Association of Plastic, Reconstructive and Aesthetic Surgeons.
C1 [Munro, S. P.; Dearden, A.; Joseph, M.; O'Donoghue, J. M.] Newcastle Upon Tyne Hosp NHS Fdn Trust, Royal Victoria Infirm, Dept Plast & Reconstruct Surg, Newcastle Upon Tyne NE1, England.
   [Munro, S. P.] Royal Victoria Infirm, Dept Plast Surg, Newcastle Upon Tyne NE1 4LP, England.
C3 Newcastle Upon Tyne Hospitals NHS Foundation Trust; Newcastle University
   - UK
RP Munro, SP (通讯作者)，Royal Victoria Infirm, Dept Plast Surg, Newcastle Upon Tyne NE1 4LP, England.
EM samuelpmunro@yahoo.co.uk
OI joseph, martin/0000-0002-9574-1113; Munro, Samuel/0000-0003-0627-9818
CR Abesamis GM, 2019, PRS-GLOB OPEN, V7, DOI 10.1097/GOX.0000000000002141
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NR 25
TC 20
Z9 21
U1 0
U2 0
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 1748-6815
EI 1878-0539
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PD MAR
PY 2023
VL 78
BP 13
EP 18
DI 10.1016/j.bjps.2022.08.003
EA FEB 2023
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA G7TV7
UT WOS:000991147300001
PM 36739647
DA 2026-07-24
ER

PT J
AU Wikkeling, TM
   van ijssel, SA
   van der Laan, MJ
   Zeebregts, CJ
   Saleem, B
AF Wikkeling, Tim M.
   Gijssel, Senne A. van
   Laan, Maarten J. van der
   Zeebregts, Clark J.
   Saleem, Ben R.
TI Treatment of patch infection after carotid endarterectomy: a systematic
   review
SO ANNALS OF TRANSLATIONAL MEDICINE
LA English
DT Review
DE stenosis; carotid endarterectomy (CEA); angioplasty; patch infection
ID RANDOMIZED CONTROLLED-TRIALS; ARTERY RECONSTRUCTION; PRIMARY CLOSURE;
   FALSE ANEURYSM; ANGIOPLASTY; PSEUDOANEURYSM; MANAGEMENT; FLAP
AB Carotid endarterectomy (CEA) with patch angioplasty is a widely used method for treating carotid artery stenosis. Patch infections are extremely rare, but the consequences may be serious. The current gold standard for treatment is patch excision and reconstruction with autologous material. However, no consensus has been reached and other options may be valuable as well in certain cases. The objective of this study was to evaluate the various treatment options for carotid patch infection after CEA with patch angioplasty on the basis of their outcomes (reinfection, ischemic stroke, and infection-related mortality). This systematic review was conducted in accordance with the PRISMA statement. The electronic bibliographic databases PubMed, Cochrane, and EMBASE were searched. Case series and case reports were included. Studies in languages other than English were excluded. Patients who developed a post-operative patch infection of CEA with patch angioplasty were included. Angioplasty could be performed with any type of patch. Patch infection needed to be confirmed by clinical presentation in combination with imaging, culture, or during the operation. The primary outcome measures were reinfection, ischemic stroke, and infection-related mortality. Eleven retrospective case series, two prospective case series, and seventeen case reports were included. The study size was 165 patients (mean age 69.7 years, M/F ratio 1.75:1). One hundred and seventy-one patches developed a patch infection after CEA with patch angioplasty and needed treatment. Treatment strategies included conservative treatment (14.0%), endovascular treatment (4.7%), and open surgery (81.4%). Mean follow-up was 34.8 months and extended up to 180 months. Reinfection rate was 4.7%, ischemic stroke rate 5.8%, and infection-related mortality rate 2.3%. No statistical comparison between treatment options could be performed, because of the heterogeneity of the included studies. Autologous material should be the primary choice of treatment if patch infection is diagnosed after CEA with patch angioplasty. In emergency situations, endovascular treatment, carotid ligation, or abscess drainage could be considered. Endovascular treatment and abscess drainage are temporary solutions. After the patient has recovered sufficiently, a more durable treatment i.e., open surgery is advised. Endo vacuum assisted closure (EndoVAC) seems to be promising. Further research is needed to determine the applicability of each treatment option.
C1 [Wikkeling, Tim M.; Gijssel, Senne A. van; Laan, Maarten J. van der; Zeebregts, Clark J.; Saleem, Ben R.] Univ Groningen, Univ Med Ctr Groningen, Div Vasc Surg, Dept Surg, POB 30-001, NL-9700 RB Groningen, Netherlands.
C3 University of Groningen
RP Saleem, B (通讯作者)，Univ Groningen, Univ Med Ctr Groningen, Div Vasc Surg, Dept Surg, POB 30-001, NL-9700 RB Groningen, Netherlands.
EM b.r.saleem@umcg.nl
RI van der Laan, Maarten/AAQ-3353-2021
OI van der Laan, Maarten/0000-0002-3125-1342
CR Aromataris E., 2020, JBI
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NR 40
TC 7
Z9 9
U1 0
U2 1
PU AME PUBLISHING COMPANY
PI SHATIN
PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG
   00000, PEOPLES R CHINA
SN 2305-5839
EI 2305-5847
J9 ANN TRANSL MED
JI ANN. TRANSL. MED.
PD JUL
PY 2021
VL 9
IS 14
AR 1213
DI 10.21037/atm-20-7531
PG 14
WC Oncology; Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Research & Experimental Medicine
GA UA8SS
UT WOS:000685426700018
PM 34430654
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zhang, GB
   Gao, SH
   Yin, QF
   Qie, P
   Song, YB
   Wang, HE
AF Zhang, Guibin
   Gao, Shuhui
   Yin, Qifan
   Qie, Peng
   Song, Yongbin
   Wang, Huien
TI A retrospective comparative study on the short-term and long-term
   efficacy of different treatments for anastomotic leakage after
   esophagectomy
SO MEDICINE
LA English
DT Article
DE anastomotic fistula; conservative management; endoscopic intervention;
   esophagectomy; quality of life; short-term and long-term efficacy
ID CLASSIFICATION
AB This study aims to evaluate the short-term and long-term efficacy of various treatment modalities for anastomotic leakage following esophagectomy. We conducted a retrospective analysis of patients diagnosed with anastomotic leakage after esophageal surgery from January 2020 to December 2023 at our institution. A total of 385 patients underwent esophagectomy, with 30 patients with anastomotic leakage enrolled. Patients were stratified into 2 groups based on the treatment approach: a control group receiving conservative management (n = 15), and an observation group (n = 15), which underwent endoscopic or surgical interventions. We collected comprehensive patient data, compared clinical outcomes including our institutional clinical efficacy score, evaluated fistula closure rates, and documented the incidence of postoperative complications. The Dysphagia Handicap Index questionnaire was utilized to assess the impact of dysphagia on patients' quality of life. No significant differences were observed in the baseline surgical and demographic characteristics of the 2 groups (P > .05). At 3 and 6 months post-treatment, the clinical treatment effect scores for the observation group (5.67 +/- 0.72 and 8.33 +/- 1.63) were significantly higher than those of the control group (4.73 +/- 0.88 and 6.27 +/- 1.03) (P < .001). Additionally, the effective fistula closure rate was markedly greater in the observation group (73.33%) compared to the control group (53.33%) (P < .05). There was no significant difference in the incidence of complications between the 2 groups (P > .05). Furthermore, the Dysphagia Handicap Index scores, functional, emotional, and physical, were significantly lower in the observation group than in the control group (P < .001). Subgroup analysis showed effective closure rates of 75.0% for stenting, 80.0% for endoscopic vacuum-assisted closure, and 50.0% for reoperation. Endoscopic or surgical interventions demonstrate a significant improvement in fistula closure rates and treatment efficacy in the short term compared to traditional conservative management. Long-term follow-up indicates that these interventions enhance swallowing function and markedly improve quality of life, alleviating emotional and physiological burdens. Importantly, although these approaches are invasive, the complication rates did not increase, underscoring their safety in this cohort.
C1 [Zhang, Guibin; Yin, Qifan; Qie, Peng; Song, Yongbin; Wang, Huien] Hebei Gen Hosp, Dept Thorac Surg, 348 West He Ping Rd, Shijiazhuang 050000, Hebei, Peoples R China.
   [Gao, Shuhui] Hebei Gen Hosp, Dept Resp Med, Shijiazhuang, Hebei, Peoples R China.
RP Song, YB (通讯作者)，Hebei Gen Hosp, Dept Thorac Surg, 348 West He Ping Rd, Shijiazhuang 050000, Hebei, Peoples R China.
EM exca48@163.com; ukgoui@163.com; kzpn80@163.com; nnut80@163.com;
   hebxwk@163.com; lxpz89@163.com
RI Gao, shuhui/KYR-2542-2024
FU Research Fund Project of Hebei Provincial Health Department [20180124]
FX This study was funded by Medical Science Research Project of Hebei
   (20180124).
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NR 28
TC 0
Z9 0
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD NOV 21
PY 2025
VL 104
IS 47
AR e45764
DI 10.1097/MD.0000000000045764
PG 6
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA H3645
UT WOS:001625471400011
PM 41305803
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Hwang, MS
   Britt, CJ
   Vila, PM
   Dang, RP
   Fleming, S
   Patel, AM
   Paniello, RC
   Rich, JT
   Hanasono, MM
   Desai, SC
AF Hwang, Michelle S.
   Britt, Christopher J.
   Vila, Peter M.
   Dang, Rajan P.
   Fleming, Shannon, I
   Patel, Aman M.
   Paniello, Randal C.
   Rich, Jason T.
   Hanasono, Matthew M.
   Desai, Shaun C.
TI Factors associated with skin graft take in fibula and radial forearm
   free flap donor sites
SO AMERICAN JOURNAL OF OTOLARYNGOLOGY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; CONVENTIONAL THERAPY; MORBIDITY; SUCCESS; FOOT
AB Learning objectives: Identify factors associated with skin graft take in fibula free flaps (FFF) and radial forearm free flaps (RFFF) donor sites.
   Study objectives: To determine which factors are associated with decreased skin graft take at the donor site in FFF and RFFF in head and neck patients.
   Design: Retrospective Chart Review Case Series.
   Setting: Multicenter Tertiary Care.
   Methods: A multicenter retrospective review was performed at three institutions identifying patients who underwent free tissue transfer, specifically either FFF or RFFF, between 2007 and 2017. Patient demographics, medical history, and social history were examined including age, gender, BMI, smoking status, diabetes and preoperative anticoagulation use. Preoperative, intraoperative data, and postoperative data were also examined including tourniquet use, type of flap, area of skin graft, if the skin graft had a donor site or if it was taken from the flap, wound NPWT use, cast use, use of physical therapy, DVT prophylaxis, limb ischemia, heparin drip, and postoperative aspirin use. Statistical analysis was used to determine which factors were significantly associated with skin graft take.
   Results: 1415 patients underwent a forearm or fibula flap and 938 patients underwent split-thickness skin graft. Of these, 592 patients had sufficient information and were included in the final analysis. There were 371 males and 220 females. The average age was 55.7. Complete skin graft take was seen in 480 patients (81.1%). On univariate analysis, patients with diabetes (p = .003), type of flap (fibula p < .001), skin graft area (p = .006), tourniquet use (p = .003), DVT prophylaxis (p = .008) and casting (p = .003) were significantly associated with decreased skin graft take rate. In a multivariate analysis, diabetes (OR 2.17 (95%CI 1.16-3.98)), fibula flaps (OR 2.86 (95%CI 1.79-4.76)), an increase in skin graft area (OR 1.01 (95%CI 1.01-1.01)), post-operative aspirin (OR 2.63 (95%CI 1.15-5.88), and casting (OR 2.94 (95%CI 1.22-7.14)) were associated with poor rates of skin graft take.
   Conclusion: Several factors affect skin graft take rate and should be considered when performing a skin graft for a donor site defect.
C1 [Hwang, Michelle S.; Patel, Aman M.; Desai, Shaun C.] Johns Hopkins Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Baltimore, MD 20817 USA.
   [Britt, Christopher J.] Loyola Univ, Med Ctr, Dept Otolaryngol Head & Neck Surg, 2160 S 1st Ave, Maywood, IL 60153 USA.
   [Vila, Peter M.; Dang, Rajan P.; Paniello, Randal C.; Rich, Jason T.] Washington Univ, Sch Med St Louis, Dept Otolaryngol Head & Neck Surg, St Louis, MO 63110 USA.
   [Fleming, Shannon, I; Hanasono, Matthew M.] Univ Texas MD Anderson Canc Ctr, Dept Plast Surg, Houston, TX 77030 USA.
C3 Johns Hopkins University; Loyola University Chicago; Washington
   University (WUSTL); Saint Louis University; University of Texas System;
   UTMD Anderson Cancer Center
RP Desai, SC (通讯作者)，Johns Hopkins Univ, Sch Med, Dept Otolaryngol Head & Neck Surg, Facial Plast & Reconstruct Surg, 6420 Rockledge Dr,Suite 4920, Bethesda, MD 20817 USA.
EM sdesai27@jhmi.edu
RI Vila, Peter/AAF-4272-2019
OI Patel, Aman/0000-0003-0794-041X
CR Azzopardi EA, 2013, ANN PLAS SURG, V70, P23, DOI 10.1097/SAP.0b013e31826eab9e
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NR 30
TC 4
Z9 8
U1 0
U2 5
PU W B SAUNDERS CO-ELSEVIER INC
PI PHILADELPHIA
PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
SN 0196-0709
EI 1532-818X
J9 AM J OTOLARYNG
JI Am. J. Otolaryngol.
PD JUL-AUG
PY 2020
VL 41
IS 4
AR 102536
DI 10.1016/j.amjoto.2020.102536
PG 4
WC Otorhinolaryngology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Otorhinolaryngology
GA MC5YR
UT WOS:000543362600057
PM 32487337
DA 2026-07-24
ER

PT J
AU Tocco, MP
   Ballardini, M
   Masala, M
   Perozzi, A
AF Tocco, Maria Pia
   Ballardini, Milva
   Masala, Marcello
   Perozzi, Antonio
TI Post-sternotomy chronic osteomyelitis: is sternal resection always
   necessary?
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE Post-sternotomy sternocutaneous fistula; Post-sternotomy chronic
   osteomyelitis; Post-sternotomy chronic dehiscence; Chronic sternal wound
   infection
ID POSTOPERATIVE MEDIASTINITIS; ANTIBIOTIC-TREATMENT; WOUND COMPLICATIONS;
   CARDIAC-SURGERY; RISK-FACTORS; MANAGEMENT; MICROBIOLOGY; INFECTIONS
AB The goal of this study was to investigate alternative strategies to the sternal resection in the treatment of post-sternotomy osteomyelitis. We report our experience in the treatment of chronic infection of median sternotomy following open heart surgery without sternal resection.
   A 4-year retrospective study was performed, consisting of 70 patients affected by post-sternotomy sternocutaneous fistulas due to chronic osteomyelitis: 45 patients underwent only medical treatment and 25 underwent steel wire removal and surgical debridement (conservative surgery). Of the 25, 7 patients underwent an additional vacuum assisted closure (VAC) therapy due to widespread infected subcutaneous tissue. The diagnosis of osteomyelitis was supported via 3D CT scan images.
   Complete wound healing was achieved in 67 patients including a patient who achieved healing after being affected by a fistula for over 24 years before coming under our observation, another, affected by mycobacteria other than tuberculosis osteomyelitis, who needed antimicrobial treatment for a period of 30 months and 2 who were affected by Aspergillus infection and needed radical cartilage removal. Fistula relapses were observed in 6 patients of the total 70, possibly due to the too short-term antibiotic therapy used in the presence of coagulase-negative Staphylococcus (CoNS) with multiple resistances and in the presence of Corynebacterium species.
   Post-sternotomy chronic osteomyelitis can be successfully treated mainly by systemic antimicrobial therapy alone, without mandatory surgical treatments, provided that accurate microbiological and radiological studies are performed. The presence of CoNS and Corynebacterium species seemed to be associated with a need for a prolonged combined antimicrobial therapy with a minimum of 6 months up to a maximum of 18 months. The CT scan and the 3D reconstruction of the sternum proved to be a good method to evaluate the status of the sternum and support the treatments. The VAC therapy was not useful in treating osteomyelitis, although, if used appropriately in the postoperative deep sternal wound infection with the sponge fitted between the sternal edges, it seems to be an effective method to eradicate the infection in the sternum and to prevent chronic osteomyelitis.
C1 [Tocco, Maria Pia] San Filippo Neri Hosp, Thorac Surg Unit, Rome, Italy.
   [Ballardini, Milva] San Filippo Neri Hosp, Microbiol Unit, Rome, Italy.
   [Masala, Marcello] San Filippo Neri Hosp, Infect Dis Unit, Rome, Italy.
   [Perozzi, Antonio] San Filippo Neri Hosp, Dept Radiol, Rome, Italy.
C3 San Filippo Neri Hospital; San Filippo Neri Hospital; San Filippo Neri
   Hospital; San Filippo Neri Hospital
RP Tocco, MP (通讯作者)，San Filippo Neri Hosp, Thorac Surg Unit, Via Martinotti 20, Rome, Italy.
EM mptocco@yahoo.it
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NR 14
TC 35
Z9 43
U1 0
U2 6
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD APR
PY 2013
VL 43
IS 4
BP 715
EP 721
DI 10.1093/ejcts/ezs449
PG 7
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 113VB
UT WOS:000316696300017
PM 22869252
OA Bronze
DA 2026-07-24
ER

PT J
AU Le, EL
   McNamara, CT
   Constantine, RS
   Greyson, MA
   Iorio, ML
AF Le, ElliotL. H.
   McNamara, Colin T.
   Constantine, Ryan S.
   Greyson, Mark A.
   Iorio, Matthew L.
TI The Continued Impact of Godina's Principles: Outcomes of Flap Coverage
   as a Function of Time After Definitive Fixation of Open Lower Extremity
   Fractures
SO JOURNAL OF RECONSTRUCTIVE MICROSURGERY
LA English
DT Article
DE Gustilo; lower extremity; open fracture; flap
ID OPEN TIBIAL FRACTURES; VACUUM-ASSISTED CLOSURE; PRESSURE WOUND THERAPY;
   SOFT-TISSUE COVERAGE; LOWER-LIMB INJURY; MICROSURGICAL RECONSTRUCTION;
   MANAGEMENT; TRAUMA; COMPLICATIONS; DELAY
AB Background Early soft tissue coverage of open lower extremity fractures within 72 hours of injury leads to improved outcomes. Little is known about outcomes when definitive fixation is completed first. The purpose of this study is to quantify postoperative outcomes when soft tissue reconstruction is delayed until after definitive open reduction and internal fixation (ORIF) is completed. Methods An insurance claims database was queried for all patients with open lower extremity fractures between 2010 and 2020 who underwent free or axial flap reconstruction after ORIF. This cohort was stratified into three groups: reconstruction performed 0 to 3, 3 to 7, and 7+ days after ORIF. The primary outcome was 90-day complication and reoperation rates. Bivariate and multivariable regression of all-cause complications and reoperations was evaluated for time to flap as a risk factor. Results A total of 863 patients with open lower extremity fractures underwent ORIF prior to flap soft tissue reconstruction. In total, 145 (16.8%), 162 (18.8%), and 556 (64.4%) patients underwent soft tissue reconstruction 0 to 3 days, 4 to 7 days, and 7+ days after ORIF, respectively. The 90-day complication rate of surgical site infections ( SSI; 16.6%, 16,7%, 28.8%; p = 0.001) and acute osteomyelitis (5.5%, 6.2%, 27.7%; p < 0.001) increased with delayed soft tissue reconstruction. Irrigation and debridement rates were directly related to time from ORIF to flap (33.8%, 51.9%, 61.9%; p < 0.001). Hardware removal rates were significantly higher with delayed treatment (10.3%, 9.3%, 39.3%; p < 0.001). The 0 to 3 day (odds ratio [OR] = 0.22; 95% confidence interval [CI]: 0.15, 0.32) and 4 to 7 day (OR = 0.26; 95% CI: 0.17, 0.40) groups showed protective factors against all-cause complications after bivariate and multivariate regression. Conclusion Early soft tissue reconstruction of open lower extremity fractures performed within 7 days of ORIF reduces complication rates and reduces the variability of complication rates including SSIs, acute osteomyelitis, and hardware failure.
C1 [Le, ElliotL. H.] Univ Colorado, Anschutz Med Ctr, Div Plast & Reconstruct Surg, Aurora, CO USA.
   [Iorio, Matthew L.] Univ Colorado, Anschutz Med Ctr, Div Plast & Reconstruct Surg, 12631 E 17th Ave C309 Room 6414, Aurora, CO 80045 USA.
C3 University of Colorado System; University of Colorado Anschutz;
   University of Colorado System; University of Colorado Anschutz
RP Iorio, ML (通讯作者)，Univ Colorado, Anschutz Med Ctr, Div Plast & Reconstruct Surg, 12631 E 17th Ave C309 Room 6414, Aurora, CO 80045 USA.
EM matt.iorio@cuanschutz.edu
RI ; Iorio, Matthew/G-5490-2017
OI Le, Elliot Long Hoang/0000-0001-6722-8243; 
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NR 59
TC 12
Z9 13
U1 0
U2 2
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 0743-684X
EI 1098-8947
J9 J RECONSTR MICROSURG
JI J. Reconstr. Microsurg.
PD OCT
PY 2024
VL 40
IS 08
BP 648
EP 656
DI 10.1055/a-2273-4075
EA MAR 2024
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA F6X9O
UT WOS:001190858100001
PM 38382638
DA 2026-07-24
ER

PT J
AU Santos, J
   Delaplain, PT
   Barie, PS
   Dvorak, J
   Mele, TS
   Gelbard, R
   Guidry, CA
   Schubl, SD
   Surgical Infect Soc
AF Santos, Jeffrey T.
   Delaplain, Patrick S.
   Barie, Philip
   Dvorak, Justin S.
   Mele, Tina
   Gelbard, Rondi A.
   Guidry, Christopher D.
   Schubl, Sebastian
   Surgical Infection Society
TI Different Surgeon, Different Closure: Lack of Consensus on Appropriate
   Closure Technique for Various Case Scenarios
SO SURGICAL INFECTIONS
LA English
DT Article
DE hospital-acquired infection; incision closure; incision management;
   surgical decision making; surgical site infection
ID SURGICAL SITE INFECTION; WOUND CLASSIFICATION DISCREPANCIES;
   CARE-ASSOCIATED INFECTIONS; ANTIMICROBIAL PROPHYLAXIS; POSTOPERATIVE
   INFECTION; PREVENTION; SURVEILLANCE; RISK; RATES; US
AB Background: Many techniques for closure of surgical incisions are available to the surgeon, but there is minimal guidance regarding which technique(s) should be utilized at the conclusion of surgery and under what circumstances.Hypothesis: Management of incisions at the conclusion of surgery lacks consensus and varies among individual surgeons.Methods: The Surgical Infection Society membership was surveyed on the management of incisions at the conclusion of surgery. Several case scenarios were provided to test the influences of operation type, intra-operative contamination, and hemodynamic stability on incision management (e.g., close fascia or skin, use of incision/wound vacuum-assisted closure [VAC] device). Responses by two-thirds of participants were required to achieve consensus. Data analysis by & chi;(2) test and logistic regression, a = 0.05. Response heterogeneity was quantified by the Shannon index (SI).Results: Among 78 respondents, consensus was achieved for elective splenectomy (91% close skin/dry dressing). Open appendectomy and left colectomy/end-colostomy had the greatest heterogeneity (SI, 1.68 and 1.63, respectively). During trauma laparotomy, the majority used damage control for hemodynamic instability (53%-67%) but not for hemodynamically stable patients (0%-1.3%; p < 0.001). Additional consensus was achieved for close skin/dry dressing for hemodynamically stable trauma splenectomy patients (87%) and fascia open/wound VAC for hemodynamically unstable colon resection/anastomosis (67%). Fecal diversion for rectal injury and colon resection/anastomosis (both when hemodynamically stable) had high heterogeneity (SI, 1.56 and 1.48, respectively). In penetrating trauma, sentiment was for more use of wet-to-dry dressings and incision/wound VAC with increased contamination in hemodynamically stable patients.Conclusions: Damage control was favored in hemodynamically unstable trauma patients, with use of wet-to-dry dressings and incision/wound VAC with spillage after penetrating trauma. However, most scenarios did not achieve consensus. High variability of practices regarding incision management at the conclusion of surgery was confirmed. Prospective studies and evidence-based guidance are needed to guide decision making at end-operation.
C1 [Santos, Jeffrey T.; Schubl, Sebastian] Univ Calif Irvine, Dept Surg, 3800 Chapman Ave,Suite 6200, Orange, CA 92868 USA.
   [Delaplain, Patrick S.] Harvard Med Syst, Boston Childrens Hosp, Dept Surg, Boston, MA USA.
   [Barie, Philip] Weill Cornell Med, Dept Surg, Div Trauma Burns Acute & Crit Care, New York, NY USA.
   [Dvorak, Justin S.] Case Western Reserve Univ, MetroHlth Med Ctr, Dept Surg, Div Trauma Crit Care Burns & Acute Care Surg,Sch M, Cleveland, OH USA.
   [Mele, Tina] Univ Western Ontario, Schulich Sch Med & Dent, Dept Surg, Div Gen Surg, London, ON, Canada.
   [Mele, Tina] Univ Western Ontario, Schulich Sch Med & Dent, Dept Surg, Div Crit Care, London, ON, Canada.
   [Gelbard, Rondi A.] Univ Alabama Birmingham, Heersink Sch Med, Dept Surg, Div Trauma & Acute Care Surg, Birmingham, AL USA.
   [Guidry, Christopher D.] Univ Kansas, Med Ctr, Dept Surg, Div Acute Care Surg, Kansas City, KS USA.
C3 University of California System; University of California Irvine;
   Harvard University; Harvard University Medical Affiliates; Boston
   Children's Hospital; Cornell University; Weill Cornell Medicine;
   MetroHealth System; University System of Ohio; Case Western Reserve
   University; Western University (University of Western Ontario); Western
   University (University of Western Ontario); University of Alabama
   System; University of Alabama Birmingham; University of Kansas;
   University of Kansas Medical Center
RP Santos, J (通讯作者)，Univ Calif Irvine, Dept Surg, 3800 Chapman Ave,Suite 6200, Orange, CA 92868 USA.
EM Jwsantos@hs.uci.edu
RI Guidry, Christopher/GRS-5109-2022
OI Mele, Tina/0000-0002-6617-9790
CR Ban KA, 2017, J AM COLL SURGEONS, V224, P59, DOI 10.1016/j.jamcollsurg.2016.10.029
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NR 31
TC 2
Z9 2
U1 0
U2 1
PU SAGE PUBLICATIONS INC
PI THOUSAND OAKS
PA 2455 TELLER RD, THOUSAND OAKS, CA 91320 USA
SN 1096-2964
EI 1557-8674
J9 SURG INFECT
JI Surg. Infect.
PD AUG 1
PY 2023
VL 24
IS 6
BP 541
EP 548
DI 10.1089/sur.2023.143
EA JUL 2023
PG 8
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases; Surgery
GA O0XP5
UT WOS:001030614600001
PM 37462905
DA 2026-07-24
ER

PT J
AU Pauniaho, SL
   Costa, J
   Boken, C
   Turnock, R
   Baillie, CT
AF Pauniaho, Satu-Liisa
   Costa, Janet
   Boken, Carole
   Turnock, Rick
   Baillie, Colin T.
TI Vacuum drainage in the management of complicated abdominal wound
   dehiscence in children
SO JOURNAL OF PEDIATRIC SURGERY
LA English
DT Article
DE VAC therapy; Complex; Abdomen; Wound; Children; Neonate
ID ASSISTED CLOSURE SYSTEM; FISTULA; THERAPY
AB Purpose: The aim of the study was to report the outcomes of the vacuum dressing method (vacuum-assisted closure [VAC]) in the management of "complicated" abdominal wounds in a selected group of children including neonates.
   Methods: All children with vacuum (VAC) dressing-assisted closure of a complex abdominal wound (defined as complete/partial wound dehiscence combined with at least one of stoma, anastomosis, tube enterostomy, or infected patch abdominoplasty) were included in a 2-year study that took place in a single tertiary referral hospital. Retrospective case note analysis was used to determine premorbid diagnosis, management, illness severity markers, morbidity, and outcome.
   Results: Nine children (neonate to 16 years) required 11 continuous episodes of VAC therapy. Abdominal wall dehiscence was complete in 7 and partial in 4 episodes. These were complicated by stomas (8), anastomoses (3), enterocutaneous fistulae (3), tube enterostomy (1), and infected patch abdominoplasty (2). Illness severity was assessed by the following proxy physiologic markers: American Society of Anesthesiologists status 3 or more (10), intensive care unit (ICU) (7), inotropes (4), ventilation (7), septic (C-reactive protein >100 and blood culture-positive) (3), liver impairment (aspartate transaminase >58 and alanine transaminase >36) (4), coagulopathy (international normalized ratio >1.3) (4), proinflammatory state (platelet count >450) (5), and nutritional impairment (albumin <37) (9). The median VAC treatment time was 32 days (range, 9-101 days). Of the changes, 70% required a general anesthetic or sedation on ICU. Control of 10 of I I complex abdominal wounds (including 3 established enterocutaneous fistulae) was achieved using VAC therapy. Complications included nonreduction of laparostomy (1), failure of anastomosis (1), and failure of tube enterostomy diversion (1). Four children died of unrelated causes, 2 of them more than 3 months after VAC therapy.
   Conclusions: in our experience with a small series of patients, VAC therapy is both safe and effective in complex pediatric abdominal wounds in severely ill children. It appears to promote wound closure, controls local sepsis, and can be used to manage established fistulae. However, our results suggest that recent bowel anastomoses may be compromised using VAC, which in this circumstance, should be used with caution. (c) 2009 Elsevier Inc. All rights reserved.
EM satu-liisa.pauniaho@fimnet.fi
OI Pauniaho, Satu-Liisa/0000-0002-8212-9240
CR Adamkova M, 2005, Acta Chir Plast, V47, P24
   Arca MJ, 2005, PEDIATR SURG INT, V21, P532, DOI 10.1007/s00383-005-1465-y
   Bütter A, 2006, J PEDIATR SURG, V41, P940, DOI 10.1016/j.jpedsurg.2006.01.061
   Chavarria-Aguilar M, 2004, J TRAUMA, V56, P560, DOI 10.1097/01.TA.0000115065.39699.6A
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   *KCI EUR HOLD BV, 2007, VAC THER CLIN GUID R
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   Lopez G, 2008, J PEDIATR SURG, V43, P2202, DOI 10.1016/j.jpedsurg.2008.08.067
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NR 18
TC 14
Z9 16
U1 0
U2 2
PU W B SAUNDERS CO-ELSEVIER INC
PI PHILADELPHIA
PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
SN 0022-3468
EI 1531-5037
J9 J PEDIATR SURG
JI J. Pediatr. Surg.
PD SEP
PY 2009
VL 44
IS 9
BP 1736
EP 1740
DI 10.1016/j.jpedsurg.2009.01.009
PG 5
WC Pediatrics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pediatrics; Surgery
GA 497MY
UT WOS:000270065100017
PM 19735817
DA 2026-07-24
ER

PT J
AU Hunili, T
   Erden, S
AF Hunili, Tugba
   Erden, Sevilay
TI Effect of TENS on Vacuum Pain in Acute Soft Tissue Trauma
SO PAIN MANAGEMENT NURSING
LA English
DT Article
ID ELECTRICAL NERVE-STIMULATION; PRESSURE WOUND THERAPY; INTENSITY; REDUCE
AB Backround: In the literature, the effect of TENS on acute pain has been investigated, and no study has been found on its effect on pain associated with VAC application. This randomized controlled trial was designed to assess the efficacy of TENS application in pain caused by vacuum applied in acute soft tissue trauma of the lower extremity. Design and Settings: The study included 40 patients: 20 in the control group, and 20 in the experimental group and was carried out in a university hospital's plastic and reconstructive surgery clinic. Data for the study were gathered using the Patient Information form and the Pain Assessment form. Conventional TENS lasting 30 minutes was applied to the experimental group patients 1 hour before vacuum (vacuum assisted closure [VAC]) insertion and removal by the researcher, and TENS was not applied to the control group. The "Numerical Pain Scale" was used to assess pain in both groups before and after TENS application. In the statistical analysis of the data, the SPSS 23.0 package program was used. In all tests, p < .005 was considered statistically significant. Results: The experimental and control groups of the patients included in the study were homogeneous in terms of demographic characteristics ( p > .05). Furthermore, when the pain levels of the groups were compared over time, it was discovered that the pain levels of the control group were significantly higher than the experimental group at the times of VAC insertion (T3) and VAC removal (T6) ( p < .05). Bonferroni test, one of the post hoc tests, was used to determine in-group significance in both the experimental and control groups, and it was discovered that the difference was between T6 and all other times (T6-T1, T2, T3, T4, T5). Conclusions: The results obtained from our study showed that TENS reduced the pain caused by vacuum applied in acute soft tissue trauma of the lower extremity. It is thought that TENS may not replace traditional analgesics but may help reduce the level of pain and contribute to healing by increasing comfort during painful procedures. & COPY; 2023 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.
C1 [Hunili, Tugba] Cukurova Univ, Balcali Hosp, Plast Surg Dept, Adana, Turkiye.
   [Erden, Sevilay] Fac Hlth Sci, Dept Nursing Adana, Adana, Turkiye.
   [Erden, Sevilay] Fac Hlth Sci, Dept Nursing Adana, TR-01380 Adana, Turkiye.
C3 Cukurova University
RP Erden, S (通讯作者)，Fac Hlth Sci, Dept Nursing Adana, TR-01380 Adana, Turkiye.
EM sevilaygil@gmail.com
FU Cukurova University, Scientific Research Projects Coordination Unit
   [TYL-2019-12404]
FX This study was financially supported by Cukurova University, Scientific
   Research Projects Coordination Unit with the protocol number of
   TYL-2019-12404.
CR Agarwal Pawan, 2019, J Clin Orthop Trauma, V10, P845, DOI [10.1016/j.jcot.2019.06.015, 10.1016/j.jcot.2019.06.015]
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NR 26
TC 3
Z9 3
U1 0
U2 7
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1524-9042
EI 1532-8635
J9 PAIN MANAG NURS
JI Pain Manag. Nurs.
PD AUG
PY 2023
VL 24
IS 4
DI 10.1016/j.pmn.2023.02.001
EA AUG 2023
PG 5
WC Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Nursing
GA P6PT2
UT WOS:001051882600001
PM 36907690
DA 2026-07-24
ER

PT J
AU Nixon, M
   Jackson, B
   Varghese, P
   Jenkins, D
   Taylor, G
AF Nixon, M
   Jackson, B
   Varghese, P
   Jenkins, D
   Taylor, G
TI Methicillin-resistant Staphylococcus aureus on orthopaedic wards
SO JOURNAL OF BONE AND JOINT SURGERY-BRITISH VOLUME
LA English
DT Article
ID HIP FRACTURE; RISK-FACTORS; HOSPITAL ADMISSION; SURGICAL PATIENTS;
   INFECTION; MRSA; COLONIZATION; PREVALENCE; BACTEREMIA; MORTALITY
AB We examined the rates of infection and colonisation by methicillin-resistant Staphylococcus aureus (MRSA) between January 2003 and May 2004 in order to assess the impact of the introduction of an MRSA policy in October 2003, which required all admissions to be screened. Emergency admissions were treated prophylactically and elective beds ring-fenced. A total of 5594 admissions were cross-referenced with 22 810 microbiology results. The morbidity, mortality and cost of managing MRSA-carrying patients, with a proximal fracture of the femur were compared, in relation to age, gender, American Society of Anaesthesiologists grade and residential status, with a group of matched controls who were MRSA-negative.
   In 2004, we screened 1795 of 1796 elective admissions and MRSA was found in 23 (1.3%). We also screened 1122 of 1447 trauma admissions and 43 (3.8%) were carrying MRSA. All ten ward transfers were screened and four (40%) were carriers (all p < 0.001). The incidence of MRSA in trauma patients increased by 2.6% per week of inpatient stay (r = 0.97, p < 0.001). MRSA developed in 2.9% of trauma and 0.2% of elective patients during that admission (p < 0.001). The implementation of the MRSA policy reduced the incidence of MRSA infection by 56% in trauma patients (1.57% in 2003 (17 of 1084) to 0.69% in 2004 (10 of 1447), p = 0.035). Infection with MRSA in elective patients was reduced by 70% (0.56% in 2003 (7 of 1257) to 0.17% in 2004 (3 of 1806), p = 0.06). The cost of preventing one MRSA infection was 3200 pound.
   Although colonisation by MRSA did not affect the mortality rate, infection by MRSA more than doubled it. Patients with proximal fractures of the femur infected with MRSA remained in hospital for 50 extra days, had 19 more days of vancomycin treatment and 26 more days of vacuum-assisted closure therapy than the matched controls. These additional costs equated to 13972 pound per patient.
   From this experience we have been able to describe the epidemiology of MRSA, assess the impact of infection-control measures on MRSA infection rates and determine the morbidity, mortality and economic cost of MRSA carriage on trauma and elective orthopaedic wards.
C1 Glenfield Gen Hosp, Dept Traumat & Orthopaed Surg, Leicester LE3 9QP, Leics, England.
   Leicester Royal Infirm, Dept Microbiol, Leicester LE1 5WW, Leics, England.
C3 University Hospitals of Leicester NHS Trust; University of Leicester;
   Glenfield Hospital; University of Leicester
RP Nixon, M (通讯作者)，15 Chelsea Mews, Nottingham NG12 2NT, England.
EM mfnixon@gmail.com
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NR 25
TC 67
Z9 76
U1 0
U2 3
PU BRITISH EDITORIAL SOC BONE JOINT SURGERY
PI LONDON
PA 22 BUCKINGHAM STREET, LONDON WC2N 6ET, ENGLAND
SN 0301-620X
J9 J BONE JOINT SURG BR
JI J. Bone Joint Surg.-Br. Vol.
PD JUN
PY 2006
VL 88B
IS 6
BP 812
EP 817
DI 10.1302/0301-620X.88B6
PG 6
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 055RQ
UT WOS:000238468500022
PM 16720779
DA 2026-07-24
ER

PT J
AU Griffin, AM
   Dickie, CI
   Catton, CN
   Chung, PWM
   Ferguson, PC
   Wunder, JS
   O'Sullivan, B
AF Griffin, Anthony M.
   Dickie, Colleen I.
   Catton, Charles N.
   Chung, Peter W. M.
   Ferguson, Peter C.
   Wunder, Jay S.
   O'Sullivan, Brian
TI The Influence of Time Interval Between Preoperative Radiation and
   Surgical Resection on the Development of Wound Healing Complications in
   Extremity Soft Tissue Sarcoma
SO ANNALS OF SURGICAL ONCOLOGY
LA English
DT Article
ID POSTOPERATIVE RADIOTHERAPY; IN-VITRO; THERAPY; SURGERY; FIBROBLASTS;
   MORBIDITY; INJURY; HEAD
AB The aim of this study was to determine the relationship of the time interval between completion of preoperative radiation therapy (RT) and surgical resection on wound complications (WCs) in extremity soft tissue sarcoma (STS).
   Overall, 798 extremity STS patients were managed with preoperative RT and surgery from 1989 to 2013. WCs were defined as requiring secondary operations/invasive procedures for wound care, use of vacuum-assisted closure, prolonged dressing changes, or infection within 120 days of surgery.
   Mean tumor size was 8.8 cm. A total of 743 (93 %) tumors were primary presentations, 565 (71 %) patients had lower extremity tumors, and 238 patients (30 %) had a prior unplanned excision. Of 242 patients (30 %) who developed a WC, 206 (37 %) had lower extremity tumors and 36 (15 %) had upper extremity tumors. Mean time from RT completion to surgery was 41.3 (range 4-470) days; 42.0 (range 4-470) days for upper extremity cases, and 41.1 (range 4-109) days for lower extremity cases. Similarly, mean time interval for patients who developed a WC was 40.9 (range 4-100) days, and 41.5 (range 4-470) days for those who did not develop a WC (p = 0.69). Thirty-nine cases (5 %) had surgery within 3 weeks of RT; 15 (38 %) patients developed WCs versus 227 (30 %) patients who had their tumors excised after 3 weeks (p = 0.28). One hundred and twenty-nine (16 %) patients had surgery within 4 weeks, and 39 (30 %) patients developed WCs versus 203 (30 %) patients who had their tumors excised after 4 weeks (p = 1.0). A trend towards a higher rate of WCs was seen for those patients who had surgery after 6 weeks (28 % prior vs. 34 % after; p = 0.08). There was no difference in WCs with intensity-modulated RT (IMRT) versus non-IMRT cases (p = 0.6).
   The time interval between preoperative RT and surgical excision in extremity STS had minimal influence on the development of WCs. Four- or 5-week intervals showed equivalent complication rates between the two groups, suggesting an optimal interval to reduce potential WCs.
C1 [Griffin, Anthony M.; Ferguson, Peter C.; Wunder, Jay S.] Univ Musculoskeletal, Mt Sinai Hosp, Oncol Unit, Toronto, ON, Canada.
   [Dickie, Colleen I.; Catton, Charles N.; Chung, Peter W. M.; O'Sullivan, Brian] Princess Margaret Canc Ctr, Dept Radiat Oncol, Toronto, ON, Canada.
   [Dickie, Colleen I.; Catton, Charles N.; Chung, Peter W. M.; O'Sullivan, Brian] Univ Toronto, Dept Radiat Oncol, Toronto, ON, Canada.
   [Ferguson, Peter C.; Wunder, Jay S.] Univ Toronto, Dept Surg, Div Orthopaed Surg, Toronto, ON, Canada.
C3 University of Toronto; Sinai Health System Toronto; University of
   Toronto; University Health Network Toronto; Princess Margaret Cancer
   Centre; University of Toronto; University of Toronto
RP Griffin, AM (通讯作者)，Univ Musculoskeletal, Mt Sinai Hosp, Oncol Unit, Toronto, ON, Canada.
EM agriffin@mtsinai.on.ca
RI ; Chung, Peter/OJT-1722-2025
OI Chung, Peter/0000-0002-3815-7703; Griffin, Anthony/0000-0003-4462-3974; 
CR Akudugu  JM, 2006, RADIOTHER ONCOL, V78, P17, DOI 10.1016/j.radonc.2005.12.001
   Akudugu JM, 2004, RADIOTHER ONCOL, V72, P103, DOI 10.1016/j.radonc.2004.03.010
   Alektiar KM, 2011, CANCER-AM CANCER SOC, V117, P3229, DOI 10.1002/cncr.25882
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NR 31
TC 38
Z9 40
U1 0
U2 6
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 1068-9265
EI 1534-4681
J9 ANN SURG ONCOL
JI Ann. Surg. Oncol.
PD SEP
PY 2015
VL 22
IS 9
BP 2824
EP 2830
DI 10.1245/s10434-015-4631-z
PG 7
WC Oncology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Oncology; Surgery
GA CO8NA
UT WOS:000359425000006
PM 26018726
DA 2026-07-24
ER

PT J
AU Karatas, ME
   Bayram, Y
   Safak, H
   Kar, I
   Saglam, N
   Uçar, BY
AF Karatas, Muhammed Enes
   Bayram, Yusuf
   Safak, Halid
   Kar, Ilyas
   Saglam, Necdet
   Ucar, Bekir Yavuz
TI Kyphectomy and sliding growing rod technique in patients with congenital
   lumbar kyphosis deformity with myelomeningocele
SO JOURNAL OF ORTHOPAEDIC SURGERY AND RESEARCH
LA English
DT Article
DE Spina bifida; Myelomeningocele; Kyphosis; Kyphectomy; Spine; Sliding
   growing rod
ID LUQUE INSTRUMENTATION; SCOLIOSIS; CHILDREN; MANAGEMENT; FIXATION;
   IMPROVEMENT; EXCISION
AB Objective Neural tube defects are the most common congenital disorders after cardiac anomalies. Lumbar kyphosis deformity is observed in 8-15% of these patients. This deformity severely limits the daily lives of these patients. In our study, we aimed to correct the kyphosis angle of the patients with lumbar kyphosis associated with myelomeningocele (MMC) and allow them to continue their growth without limiting their lung capacity by applying kyphectomy and sliding growing rod technique. Patients and methods In this study, we retrospectively evaluated 24 patients with congenital lumbar kyphosis deformity associated with MMC, aged between 4 and 9 years, and who applied to Umraniye Training and Research Hospital between the dates of 2018 and 2021. We evaluated preoperative and postoperative kyphosis angles, correction rates, bleeding during operations, operation time, level of instrumentation, number of the resected vertebrae, initial levels of the posterior defects, duration of hospital stays, annual lengthening, and weight of the patients. Results Mean age was 5.04 (between 4 and 9). Mean preoperative and early postoperative kyphosis angles were 129.8 degrees (87-175 degrees) and 0.79 degrees (- 20-24 degrees), respectively. The kyphotic deformity correction rate was 99.1%. A difference was found regarding kyphosis measurements between preoperative and early period values (p < 0.05). The annual height lengthening of patients was calculated as 0.74 cm/year and 0.77 cm/year between T1-T12 and T1-S1, respectively. Mean preoperative level of hemoglobin (Hgb) was 11.95, postoperative Hgb value was 10.02, and the decrease was significant (p < 0.05). In terms of complications, 50% (12) had broken/loosen screws, 50% (12) had undergone debridement surgery, 37.5% (9) had vacuum-assisted closure therapy, and 33.3% (8) had to get all of their implants removed. Conclusion We believe that our sliding growing rod technique is a new and updated surgical method that can be applied in these patient groups, facilitating the life, rehabilitation process, and daily care of MMC patients with lumbar kyphosis. This technique seems to be a safe and reliable method which preserves lung capacity and allows lengthening.
C1 [Karatas, Muhammed Enes] Kartal Dr Lutfi Kirdar City Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
   [Bayram, Yusuf] Hisar Intercontinental Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
   [Safak, Halid] Gumushane State Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
   [Kar, Ilyas; Saglam, Necdet] Umraniye Training & Res Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
   [Ucar, Bekir Yavuz] Istanbul Medipol Univ, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
C3 Istanbul Umraniye Training & Research Hospital; Istanbul Medipol
   University
RP Karatas, ME (通讯作者)，Kartal Dr Lutfi Kirdar City Hosp, Dept Orthopaed & Traumatol, Istanbul, Turkiye.
EM menskrts@hotmail.com
RI KARATAŞ, MUHAMMED ENES/JYP-4854-2024; UCAR, BEKİR/AAC-5789-2020
OI KARATAŞ, MUHAMMED ENES/0000-0003-0995-0953; Kar,
   Ilyas/0009-0009-5035-8311; BAYRAM, YUSUF/0000-0003-1777-2800; 
CR Akbar M, 2006, SPINE, V31, P1007, DOI 10.1097/01.brs.0000215018.14774.0f
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NR 35
TC 2
Z9 2
U1 1
U2 3
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1749-799X
J9 J ORTHOP SURG RES
JI J. Orthop. Surg. Res.
PD FEB 3
PY 2024
VL 19
IS 1
AR 114
DI 10.1186/s13018-024-04577-3
PG 8
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA GZ7E2
UT WOS:001156561100002
PM 38308272
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Rickert, M
   Schleicher, P
   Fleege, C
   Arabmotlagh, M
   Rauschmann, M
   Geiger, F
   Schnake, KJ
AF Rickert, M.
   Schleicher, P.
   Fleege, C.
   Arabmotlagh, M.
   Rauschmann, M.
   Geiger, F.
   Schnake, K. J.
TI Management of postoperative wound infections following spine surgery.
   First results of a multicenter study
SO ORTHOPADE
LA German
DT Article
DE Treatment; Debridement; infection; postoperative; Complication,
   postoperative; Spinal column
ID SURGICAL SITE INFECTIONS; VACUUM-ASSISTED CLOSURE; FUSION; RATES;
   INSTRUMENTATION; METAANALYSIS; THERAPY; ADULTS
AB Introduction. The number of spinal surgeries has increased significantly in the last decade, which has led to a correlating increase in the number of problems related to wound healing infection. Current literature has reported a spinal wound infection rate of 0.4 to 20 %. The gold standard for surgical restoration of the infection is to use supportive antibiotics, but this concept of wound management in infections is often not sufficiently standardized and shows a large variance between individual clinics. The present study is to first collect data on the number of wound infections, the clinic's internal standards, the use of methods and tools and the management of revisions in Germany.
   Material and methods. A questionnaire has been designed for detecting the number of postoperative wound infections, which need to be treated surgically, and the various treatment regimens used. The questionnaire was sent to all members of the DWG (n = 1275). An example of the questionnaire was to determine clinical internal standards and the procedure for the initial treatment of wound infection, the procedure for second look surgery and the number of revisions requested to infection healing.
   Results. The study has accepted 67 answer sheets covering a period from June 2013November 2013. On average, the participating hospitals perform 582 spinal operations and an average of 8 revision surgeries due to infection annually. The average rate of infection was 1.7%. 55% reported having no fixed standard of care. 97% reported wound irrigation and debridement during the first revision. Indication for second look revisions was based on the local examination of the wound conditions. On average 2.2 revisions had been performed to reach effective wound healing. 81% of the colleagues showed readiness to participate in a multicenter trial.
   Conclusion. The results show that there is a need for uniform standards in the treatment of postoperative infections. Surgical debridement and lavage have a major role in the treatment of infection. The overall rate of postoperative infections, of the clinics surveyed, was approximately 1.7% per year. The infections were healed with approximately 2 revisions utilizing variety of different treatment strategies.
C1 [Rickert, M.; Fleege, C.; Arabmotlagh, M.; Rauschmann, M.] Orthopad Univ Klin Friedrichsheim gGmbH, Abt Wirbelsaulenorthopadie, Marienburgstr 2, D-60528 Frankfurt, Germany.
   [Schleicher, P.] BG Unfallklin Frankfurt Main, Zentrum Wirbelsaulenchirurg, Frankfurt, Germany.
   [Geiger, F.] Orthopad Fachkliniken Hessing Stiftung, Wirbelsaulenzentrum, Klin Wirbelsaulentherapie, Augsburg, Germany.
   [Schnake, K. J.] Schon Klin Nurnberg Furth, Zentrum Wirbelsaulentherapie, Furth, Germany.
RP Rickert, M (通讯作者)，Orthopad Univ Klin Friedrichsheim gGmbH, Abt Wirbelsaulenorthopadie, Marienburgstr 2, D-60528 Frankfurt, Germany.
EM marcus.rickert@friedrichsheim.de
RI ; Geiger, Florian/LMO-4281-2024
OI Arabmotlagh, Mohammad/0000-0002-7648-7412; 
CR Abdul-Jabbar A, 2013, SPINE, V38, pE1425, DOI 10.1097/BRS.0b013e3182a42a68
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   Sasso RC, 2008, J AM ACAD ORTHOP SUR, V16, P330, DOI 10.5435/00124635-200806000-00005
   Schuster JM, 2010, SPINE, V35, pS125, DOI 10.1097/BRS.0b013e3181d8342c
   Shriver MF, 2015, NEUROSURG FOCUS, V39, DOI 10.3171/2015.7.FOCUS15281
   Smith JS, 2011, SPINE, V36, P556, DOI 10.1097/BRS.0b013e3181eadd41
   Weinstein MA, 2000, J SPINAL DISORD, V13, P422, DOI 10.1097/00002517-200010000-00009
NR 22
TC 5
Z9 10
U1 0
U2 1
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 0085-4530
EI 1433-0431
J9 ORTHOPADE
JI Orthopade
PD SEP
PY 2016
VL 45
IS 9
BP 780
EP +
DI 10.1007/s00132-016-3314-1
PG 7
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA DZ2FF
UT WOS:000385657000009
PM 27514826
DA 2026-07-24
ER

PT J
AU Ghazi, BH
   Carlson, GW
   Losken, A
AF Ghazi, Bahair H.
   Carlson, Grant W.
   Losken, Albert
TI Use of the greater omentum for reconstruction of infected sternotomy
   wounds - A prognostic indicator
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE omentum; reconstruction; infection; sternal wound; mediastinitis
ID VACUUM-ASSISTED CLOSURE; MUSCLE FLAPS; STERNAL WOUNDS; HEART SURGERY;
   CHEST-WALL; MANAGEMENT; TRANSPOSITION; COMPLICATIONS; MEDIASTINITIS;
   EXPERIENCE
AB Introduction: Use of the omentum for poststernotomy mediastinitis is typically viewed as a last resort. Formal debridement and muscle flap coverage is sufficient most of the time; however, there are situations when the omental flap is more appropriate. The purpose of this series is to critically evaluate the outcome in those patients who require omental flap reconstruction of poststernotomy mediastinitis.
   Methods: A retrospective review was performed on consecutive patients undergoing omentum flap transposition for poststernotomy mediastinitis from 1990-2005 at Emory University Hospitals. Data points queried included patient demographics, risk factors, type of reconstruction, and outcome. Patient survival was determined at 60 days and 1, 3, and 5 years postomentum reconstruction using the Social Security Death Index. These data points were compared with age- and risk-matched patients from our institution, treated during the same time period with muscle flaps alone.
   Results: Fifty-two patients had omental flap reconstruction, with an average age of 61 years (range: 35 to 78). The average follow-up was 5.1 years (range: 1 day to 15 years). Methicillin-resistant Staphylococcus aureus (MRSA) was the most common organism identified at time of omental transfer (56%). The omentum was used either for primary reconstruction, n = 35/52 (67%), or as a salvage procedure following failed muscle flap coverage, n = 17/52 (33%). Complications included donor site 27%, flap related 23%, and general 71% of patients. Those patients undergoing salvage reconstruction had a proportionally greater 60-day mortality (24%) and complication rate. The overall mortality was higher in those patients who required an omental flap transfer when compared with 52 muscle-flap controls (42% versus 18% at 3 years).
   Discussion: The greater omentum is still an invaluable tool in the management of mediastinal wound infections when other options have failed or are insufficient. Although reliable and well indicated, the omental flap appears to be a marker for increased mortality, especially when used as a salvage procedure. This association is not directly related to the omental flap but rather to the complexity of the clinical situation leading up to its use. Patients who require omental flap coverage should be counseled and treated appropriately.
C1 [Ghazi, Bahair H.; Carlson, Grant W.; Losken, Albert] Emory Div Plast & Reconstruct Surg, Atlanta, GA 30308 USA.
RP Losken, A (通讯作者)，Emory Div Plast & Reconstruct Surg, 550 Peachtree St,Suite 84300, Atlanta, GA 30308 USA.
EM Albert_losken@emoryhealthcare.org
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   WEINZWEIG N, 1995, ANN PLAS SURG, V34, P471, DOI 10.1097/00000637-199505000-00004
NR 21
TC 25
Z9 27
U1 0
U2 2
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD FEB
PY 2008
VL 60
IS 2
BP 169
EP 173
DI 10.1097/SAP.0b013e318054718e
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 255AA
UT WOS:000252627900012
PM 18216510
DA 2026-07-24
ER

PT J
AU Webb, LX
   Schmidt, U
AF Webb, LX
   Schmidt, U
TI Vacuum therapy for wound management
SO UNFALLCHIRURG
LA German
DT Article
DE vacuum assisted closure; vacuum sealing technique; traumatic wounds;
   wound therapy
ID SUBATMOSPHERIC PRESSURE; ASSISTED CLOSURE; COLONIZATION; DRESSINGS;
   ULCERS
AB Vacuum assisted wound closure (VAC) is a closed system, which applies negative pressure to the wound tissues. Basic studies have shown beneficial effects on wound blood flow and proliferation of healing granulation tissue. Theoretically, the method acts by removal of excess tissue fluid from the extravascular space, which lowers capillary afterload and thereby promotes the microcirculation during the early stages of inflammation. Additionally, the mechanical effect of the vacuum on the tissue at the wound surface appears to have an "llizarovian" effect resulting in an exuberant proliferation of healing granulation tissue.
   This technique has been used in over 2560 patients at the author's institution over the past 10 years for an expanding list of wound applications in several surgical disciplines. Commonly used orthopedic indications include traumatic wounds following debridement, infection (following debridement), fasciotomy wounds for compartment syndrome, and as a dressing for anchoring an applied split thickness skin graft.
   The author's personal experience consists of 269 patients treated and has not been associated with any major complications. A low incidence (2.5%) of localized superficial skin irritation occurred when a portion of the vacuum sponge overlapped the affected area. This problem is avoided by carefully confining the sponge to the wound tissue and avoiding the overlap of normal skin. The technique is contraindicated in patients with an allergy to any of the components which contact the skin such as the polyurethane sponge, the adhesive, or the plastic film applied to seal the system to the skin around the wound. Patients whose skin is thin and easily damaged will not tolerate the pulling off of the adhesive film, which is done at the time of sponge removal/change. Also, patients who are fully anticoagulated or patients with large wound surface areas (e.g., burns) may need careful monitoring of electrolytes, hematocrit, and/or fluid balance in an intensive care or burn unit setting.
   The mainstay of wound care is debridement, and vacuum assisted wound closure is not a substitute for this. ft is a novel and welcome addition to the methods available to surgeons charged with the management of challenging wounds, and its final role in the overall list of adjunctive wound treatment modalities is still seeking a final definition.
C1 Wake Forest Univ, Med Ctr, Dept Orthopaed Surg, Winston Salem, NC USA.
C3 Wake Forest University
RP Schmidt, U (通讯作者)，Hannover Med Sch, Unfallchirurg Klin, Carl Neuberg Str 1, D-30623 Hannover, Germany.
EM schmidt.ulf@mh-hannover.de
CR ALM A, 1989, ACTA DERM-VENEREOL, P1
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NR 29
TC 51
Z9 57
U1 1
U2 10
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0177-5537
EI 1433-044X
J9 UNFALLCHIRURG
JI Unfallchirurg
PD OCT
PY 2001
VL 104
IS 10
BP 918
EP 926
DI 10.1007/PL00002776
PG 9
WC Emergency Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine; Surgery
GA 483AF
UT WOS:000171611000002
PM 11699301
DA 2026-07-24
ER

PT J
AU Ali, U
   Bibo, L
   Pierre, M
   Bayfield, N
   Raichel, L
   Merry, C
   Larbalestier, R
AF Ali, Umar
   Bibo, Liam
   Pierre, Madison
   Bayfield, Nicholas
   Raichel, Lior
   Merry, Chris
   Larbalestier, Robert
TI Deep Sternal Wound Infections After Cardiac Surgery: A New Australian
   Tertiary Centre Experience
SO HEART LUNG AND CIRCULATION
LA English
DT Article
DE Cardiac surgery; Infection; CABG; Sternal wound infection
ID VACUUM-ASSISTED CLOSURE; POSTSTERNOTOMY MEDIASTINITIS; STATIN THERAPY;
   HEART-SURGERY; COMPLICATIONS; POPULATION; MANAGEMENT; ASSOCIATION;
   PRAVASTATIN; DISEASE
AB Background Deep sternal wound infections (DSWI) after cardiac surgery impose a significant burden to patient out- comes and health care costs. The objective of this study is to identify risk factors, microbiological characteristics and protective factors for deep sternal wound infections following cardiac surgery in an Australian hospital.
   Methods We performed a retrospective study on 1,902 patients who underwent cardiac surgery at Fiona Stanley Hospital, a tertiary hospital in Western Australia from February 2015 to April 2019. Patients were grouped into having either deep sternal wound infections or no wound infections.
   Results Of 1,902 patients, 26 (1.4%) patients had DSWI. On multivariate analysis, male gender was associated with DSWI with an adjusted odds ratio of 7.390 (95% CI 1.189-45.918, p=0.032). Increased body mass index (BMI) had an odds ratio of 1.101(95% 1.03-1.18, p=0.008). Increased length of stay (LOS) had an odds ratio of 1.05 (95% CI 1.02-1.08, p=0.002). Left main disease had an odds ratio of 3.076 (95% CI 1.204-7.86, p=0.019). The presence of hypercholesterolaemia had an odds ratio of 0.043 (95% CI 0.009-0.204, p<0.001). Staphylococcus aureus and Staphylococcus epidermidis were the most common organisms found in deep sternal wound infections (23.1% and 26.9% respectively). Polymicrobial growth occurred in 19.2% of patients. One gram of topical cephazolin was applied in 315 patients. None of these patients developed a deep sternal wound infection (p=0.022).
   Conclusion In a large Australian tertiary centre, male gender, increased BMI, presence of left main coronary artery disease, and increased length of hospital stay are significantly associated with the risk of deep sternal wound infections. Staphylococcus aureus and Staphylococcus epidermidis are common organisms in deep sternal wound infections. Topical antibiotics such as cephazolin are useful in preventing deep sternal wound infections. The presence of hypercholesterolaemia is a protective factor and we hypothesise that this is due to long-term statin use.
C1 [Ali, Umar; Bibo, Liam; Pierre, Madison; Bayfield, Nicholas; Raichel, Lior; Merry, Chris; Larbalestier, Robert] Fiona Stanley Hosp, Dept Cardiothorac Surg, Perth, WA, Australia.
C3 South Metropolitan Health Service; Fiona Stanley Fremantle Hospitals
   Group; Fiona Stanley Hospital
RP Ali, U (通讯作者)，3B Boongala Circuit, Canning Vale, WA 6155, Australia.
EM umarali39@gmail.com
RI ; /AAT-7681-2021
OI Pierre, Madison/0000-0002-0282-5714; 
CR Ariyaratnam P, 2010, INTERACT CARDIOV TH, V11, P543, DOI 10.1510/icvts.2010.237883
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NR 31
TC 15
Z9 16
U1 1
U2 6
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1443-9506
EI 1444-2892
J9 HEART LUNG CIRC
JI Heart Lung Circ.
PD OCT
PY 2020
VL 29
IS 10
BP 1571
EP 1578
DI 10.1016/j.hlc.2020.02.003
PG 8
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA OC6XB
UT WOS:000579299200020
PM 32173262
DA 2026-07-24
ER

PT J
AU Davis, LA
   Dandachli, F
   Turcotte, R
   Steinmetz, OK
AF Davis, Laura A.
   Dandachli, Firas
   Turcotte, Robert
   Steinmetz, Oren K.
TI Limb-sparing surgery with vascular reconstruction for malignant lower
   extremity soft tissue sarcoma
SO JOURNAL OF VASCULAR SURGERY
LA English
DT Article
ID THERAPY; AMPUTATION; TUMORS
AB Background: The standard of care for lower extremity soft tissue sarcoma (STS) is limb-sparing surgery. A small subset of these patients will require concomitant vascular reconstruction to ensure adequate resection and to preserve limb viability and function. The aim of this study was to evaluate outcomes in these patients with respect to wound healing and postoperative functional status.
   Methods: Outcomes for a total of 154 patients treated for malignant lower extremity STS during an 8-year period between 2005 and 2013 were entered in a prospective registry. Treatment was by medical management in 3 patients (2%), limb-sparing surgery with vascular reconstruction (LSVR) in 9 patients (6%), and limb-sparing surgery without vascular reconstruction (LS) in 142 patients (92%). The registry and patient records and the intraoperative records were consulted to determine the primary outcomes of patient survival and time for complete wound healing. The functional status of patients was assessed using the Musculoskeletal Tumor Society (MSTS) functional assessment score before surgery and at 6 and 12 months after surgery.
   Results: Mean follow-up time was 74.7 months for the LSVR group and 53.4 months for the LS group. The mean time to complete wound healing was significantly longer in LSVR vs LS patients (88 days vs 34 days, respectively; P=.002), and overall survival was lower in LSVR patients (P=.01). Seven of the 9 LSVR patients required a total of 12 additional procedures to achieve wound healing, including 9 procedures to drain seromas (incision and drainage) with vacuum-assisted closure in 4 cases. Plastic surgery intervention was required in three patients, including one skin graft, one gracilis pedicle flap, and one vertical rectus abdominis myocutaneous flap. There was no significant difference in the mean MSTS scores preoperatively, at 6months, and at 1 year after surgery between the two groups (27, 25, and 29 for LSVR vs 28, 31, and 31 for LS, respectively; P= .63, .11, and .67, respectively).
   Conclusions: The need for vascular reconstruction during limb-sparing surgery for lower extremity malignant STS is rare in a high-volume sarcoma center. Overall survival was lower in these patients, and the time to complete wound healing is prolonged and requires multiple secondary interventions. However, postoperative functional status as assessed by the MSTS is acceptable and comparable to that of patients not requiring vascular reconstruction.
C1 [Davis, Laura A.; Steinmetz, Oren K.] McGill Univ, Div Vasc Surg, Dept Surg, Montreal, PQ H3A 2T5, Canada.
   [Dandachli, Firas; Turcotte, Robert] McGill Univ, Div Orthoped Surg, Dept Surg, Montreal, PQ H3A 2T5, Canada.
C3 McGill University; McGill University
RP Steinmetz, OK (通讯作者)，McGill Univ, Div Vasc Surg, Royal Victoria Hosp, Hlth Ctr,Vasc Lab CRC 4208, 1001 Decarie Blvd, Montreal, PQ H4A 3J1, Canada.
EM oren.steinmetz@muhc.mcgill.ca
FU Division of Vascular Surgery funds
FX This work was funded by Division of Vascular Surgery funds.
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NR 12
TC 23
Z9 27
U1 0
U2 6
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0741-5214
J9 J VASC SURG
JI J. Vasc. Surg.
PD JAN
PY 2017
VL 65
IS 1
BP 151
EP 156
DI 10.1016/j.jvs.2016.05.094
PG 6
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA EF0VT
UT WOS:000390045100046
PM 27687325
OA Bronze
DA 2026-07-24
ER

PT J
AU Liu, X
   An, JJ
   Chen, Y
   Deng, W
   An, XM
   Zhang, H
AF Liu, Xi
   An, Jingjing
   Chen, Yu
   Deng, Wei
   An, Xuemei
   Zhang, Hui
TI Staged surgical treatment of open Lisfranc fracture dislocations using
   an adjustable bilateral external fixator: A retrospective review of 21
   patients
SO ACTA ORTHOPAEDICA ET TRAUMATOLOGICA TURCICA
LA English
DT Review
DE Lisfranc injury; Staged management; External fixation; Infection;
   Anatomical reduction
ID MANAGEMENT; INJURIES; ARTHRODESIS
AB Objective: The aim of this study was to assess the early operative results of a staged progressive reduction technique using a bilateral external fixator in the treatment of patients with open Lisfranc fracture dislocations.
   Methods: In this retrospective study, 21 patients (5 women and 16 men; mean age=44.4 years; age range=24 to 69 years) with open Lisfranc fracture dislocations were included. All the patients were treated in a staged manner from 2012 to 2015. The mean follow-up was 15.4 months (range=12 to 24 months). A two-stage surgical protocol was performed for each patient. At the first stage, a bilateral spanning external fixator was applied across the injured Lisfranc joint, and the length of the disrupted columns was restored by distraction process. Vacuum-assisted closure was used if required. At the second stage, the external fixator was removed, and open reduction and internal fixation were carried out. The time interval between the first and second stages and postoperative complications were documented. To assess the functional status of the patients, the visual analog scale (VAS) and the American Orthopaedic Foot & Ankle Society (AOFAS) midfoot scale were measured at the final follow-up. Radiographic parameters indicating the alignment of the midfoot after the second operation were examined.
   Results: Deep infection in one patient and superficial infection in 2 patients were observed. Venous thrombosis was detected in 3 patients. The mean interval between the first and second stages was 18.6 days (range=8 to 48 days). The first metatarso-cuneiform step-off (p=0.002) and the second metatarso-cuneiform step-off (p=0.000) significantly improved at the final follow-up. The mean VAS score was 2.4 (range=0-5), and the mean AOFAS score was 76.3 (range=63 to 97). Primary arthrodesis was performed in seven patients, and six of the remaining 14 patients developed post-traumatic arthritis.
   Conclusion: With a low risk of complications, the staged progressive reduction protocol using an adjustable bilateral external fixator can be an effective treatment to achieve and maintain anatomic reduction for patients with open Lisfranc fracture dislocations in a short-time follow-up.
C1 [Liu, Xi; An, Jingjing; Zhang, Hui] Sichuan Univ, West China Hosp, Dept Orthopaed Surg, Chengdu, Sichuan, Peoples R China.
   [Chen, Yu; Deng, Wei] Shangjin Nanfu Hosp, Dept Orthopaed Surg, Chengdu, Sichuan, Peoples R China.
   [An, Xuemei] Chengdu Univ TCM, Dept Neurol, Affiliated Hosp, Chengdu, Sichuan, Peoples R China.
C3 Sichuan University; Chengdu University of Traditional Chinese Medicine
RP Zhang, H (通讯作者)，Sichuan Univ, West China Hosp, Dept Orthopaed Surg, Chengdu, Sichuan, Peoples R China.
EM zhanghuishangjin@163.com
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NR 23
TC 4
Z9 6
U1 0
U2 2
PU TURKISH ASSOC ORTHOPAEDICS TRAUMATOLOGY
PI ISTANBUL
PA SEHREMINI MAH KOYUNCU SK CIGDEM APT NO 4 D 5 FATIH, ISTANBUL, 00000,
   TURKEY
SN 1017-995X
J9 ACTA ORTHOP TRAUMATO
JI Acta Orthop. Traumatol. Turc.
PD SEP
PY 2020
VL 54
IS 5
BP 488
EP 496
DI 10.5152/j.aott.2020.19221
PG 9
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA OI4XW
UT WOS:000583284400004
PM 33155557
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Freire-Archer, M
   Sarraj, M
   Koziarz, A
   Thornley, P
   Alshaalan, F
   Alnemari, H
   Kachur, E
   Bhandari, M
   Oitment, C
AF Freire-Archer, Millaray
   Sarraj, Mohamed
   Koziarz, Alex
   Thornley, Patrick
   Alshaalan, Fawaz
   Alnemari, Haitham
   Kachur, Edward
   Bhandari, Mohit
   Oitment, Colby
TI Incidence and Recurrence of Deep Spine Surgical Site Infections A
   Systematic Review and Meta-analysis
SO SPINE
LA English
DT Review
DE deep surgical site infection; spinal surgery; spinal instrumentation;
   infection management; irrigation; debridement; hardware removal; lumbar;
   thoracic
ID POSTOPERATIVE WOUND-INFECTION; VACUUM-ASSISTED-CLOSURE; CLOSED-SUCTION
   IRRIGATION; LUMBAR INTERBODY FUSION; MANAGEMENT; INSTRUMENTATION;
   SURGERY; IMPLANT; THERAPY; DEBRIDEMENT
AB Study Design.Systematic review and meta-analysis. Objective.To determine a pooled incidence rate for deep surgical site infection (SSI) and compare available evidence for deep SSI management among instrumented spinal fusions. Summary of Background Data.Deep SSI is a common complication of instrumented spinal surgery associated with patient morbidity, poorer long-term outcomes, and higher health care costs. Materials and Methods.We systematically searched Medline and Embase and included studies with an adult patient population undergoing posterior instrumented spinal fusion of the thoracic, lumbar, or sacral spine, with a reported outcome of deep SSI. The primary outcome was the incidence of deep SSI. Secondary outcomes included persistent deep SSI after initial debridement, mean number of debridements, and microbiology. The subsequent meta-analysis combined outcomes for surgical site infection using a random-effects model and quantified heterogeneity using the & chi;(2) test and the I-2 statistic. In addition, a qualitative analysis of management strategies was reported. Results.Of 9087 potentially eligible studies, we included 54 studies (37 comparative and 17 noncomparative). The pooled SSI incidence rate was 1.5% (95% CI, 1.1%-1.9%) based on 209,347 index procedures. Up to 25% of patients (95% CI, 16.8%-35.3%), had a persistent infection. These patients require an average of 1.4 (range: 0.8-1.9) additional debridements. Infecting organisms were commonly gram-positive, and among them, staphylococcus aureus was the most frequent (46%). Qualitative analysis suggests implant retention, especially for early deep SSI management. Evidence was limited for other management strategies. Conclusions.The pooled incidence rate of deep SSI post-thoracolumbar spinal surgery is 1.5%. The rate of recurrence and repeat debridement is at least 12%, up to 25%. Persistent infection is a significant risk, highlighting the need for standardized treatment protocols. Our review further demonstrates heterogeneity in management strategies. Large-scale prospective studies are needed to develop better evidence around deep SSI incidence and management in the instrumented thoracolumbar adult spinal fusion population.
C1 [Freire-Archer, Millaray; Thornley, Patrick] McMaster Univ, Fac Hlth Sci, Michael G DeGroote Sch Med, Hamilton, ON, Canada.
   [Sarraj, Mohamed; Bhandari, Mohit; Oitment, Colby] McMaster Univ, Dept Surg, Div Orthopaed Surg, Hamilton, ON, Canada.
   [Koziarz, Alex] McMaster Univ, Dept Radiol, Hamilton, ON, Canada.
   [Thornley, Patrick] Western Univ, London Hlth Sci Ctr, Schulich Sch Med, Combined Neurosurg & Orthopaed Spine Program, London, ON, Canada.
   [Alshaalan, Fawaz] King Faisal Specialist Hosp & Res Ctr, Dept Orthoped Surg, Riyadh, Saudi Arabia.
   [Alnemari, Haitham] King Faisal Med City, Dept Spine, Abha, Saudi Arabia.
   [Alnemari, Haitham] McMaster Univ, Dept Spine, Hamilton, ON, Canada.
   [Kachur, Edward] McMaster Univ, Hamilton Gen Hosp, Div Neurosurg, Hamilton, ON, Canada.
   [Freire-Archer, Millaray] McMaster Univ, Michael G DeGroote Sch Med, 1280 Main St West, Hamilton, ON L8S 4L8, Canada.
C3 McMaster University; McMaster University; McMaster University; Western
   University (University of Western Ontario); London Health Sciences
   Centre; King Faisal Specialist Hospital & Research Center; King Faisal
   Medical City; McMaster University; McMaster University; McMaster
   University Hospital; McMaster University
RP Freire-Archer, M (通讯作者)，McMaster Univ, Michael G DeGroote Sch Med, 1280 Main St West, Hamilton, ON L8S 4L8, Canada.
EM millaray.freirearcher@medportal.ca; mohamed.sarraj@medportal.ca;
   alex.koziarz@medportal.ca; patrick.thornley@medportal.ca;
   fawaznalshaalan@gmail.com; alhaitham78@live.com; edkachur16@gmail.com;
   bhandam@mcmaster.ca; colby.oitment@medportal.ca
OI Oitment, Colby/0000-0003-1351-9410
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NR 82
TC 28
Z9 32
U1 1
U2 18
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0362-2436
EI 1528-1159
J9 SPINE
JI SPINE
PD AUG 15
PY 2023
VL 48
IS 16
BP E269
EP E285
DI 10.1097/BRS.0000000000004713
PG 17
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA N8BM9
UT WOS:001039202100001
PM 37163651
DA 2026-07-24
ER

PT J
AU Pauli, EM
   Krpata, DM
   Novitsky, YW
   Rosen, MJ
AF Pauli, Eric M.
   Krpata, David M.
   Novitsky, Yuri W.
   Rosen, Michael J.
TI Negative Pressure Therapy for High-Risk Abdominal Wall Reconstruction
   Incisions
SO SURGICAL INFECTIONS
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; RANDOMIZED CONTROLLED-TRIAL; SURGICAL SITE
   INFECTION; VENTRAL HERNIA REPAIR; WOUND THERAPY; CARDIAC-SURGERY;
   FRACTURES; MULTICENTER; PREDICTORS; MANAGEMENT
AB Background: A high rate of surgical site infection (SSI) accompanies the repair of large ventral hernias in the presence of bacterial contamination. Recent clinical and laboratory studies suggest that negative-pressure therapy (NPT) applied to closed surgical incisions may reduce the risk of SSI in high-risk populations. We hypothesized that NPT would reduce the risk of SSI in patients undergoing the repair of contaminated ventral hernias.
   Methods: We reviewed retrospectively our prospectively collected database for patients undergoing repair of potentially contaminated and infected ventral hernias with or without NPT. All of the patients had primary wound closure. In the NPT group, a vacuum dressing was applied over the closed midline wound. The primary outcome measure was SSI at 30 d post-operatively.
   Results: We evaluated 119 patients (70 with a standard wound dressing (SWD) and 49 with NPT). The groups were similar in age, gender, body mass index (BMI), the prevalence of chronic obstructive pulmonary disease (COPD), diabetes mellitus (DM), and smoking; and the number of prior abdominal operations. The SWD group had a higher American Society of Anesthesiologists (ASA) score than did the NPT group (3.0 vs. 2.8; p = 0.01). The two groups were similar in the sizes of their hernia defects and duration of surgery, and did not differ in their 30-d rates of SSI (25.8% SWD vs. 20.4% NPT; p = 0.50) or in the distribution of major and minor SSIs (SWD: 6 major, 12 minor vs. NPT: 2 major, 8 minor; p = 0.56). Factors associated with an increased risk of SSI included ASA score (p = 0.02), BMI (p = 0.05), defect area (p < 0.01), DM (p = 0.01), and duration of surgery, (p < 0.01).
   Conclusions: This retrospective, non-randomized study found that NPT in the setting of a closed surgical incision after potentially contaminated or infected ventral hernia repair (VHR) did not reduce the incidence of SSI. Although prophylactic NPT has reduced wound morbidity in some surgical populations, it does not appear to offer the same reduction in wound morbidity in high-risk, contaminated, and potentially contaminated open VHR.
C1 [Pauli, Eric M.; Krpata, David M.; Novitsky, Yuri W.; Rosen, Michael J.] Univ Hosp Case Med Ctr, Case Comprehens Hernia Ctr, Dept Surg, Cleveland, OH USA.
C3 University System of Ohio; Case Western Reserve University; Case Western
   Reserve University Hospital
RP Rosen, MJ (通讯作者)，11100 Euclid Ave,Mail Stop LKS 5047, Cleveland, OH 44106 USA.
EM Michael.Rosen@uhhospitals.org
RI Rosen, Michael/ABA-0409-2022
FU Lifecell, Inc.; Davol, Inc.; W.L. Gore, Inc. (Newark, DE); Cook Group,
   Inc. (Bloomington, IN)
FX Yuri Novitsky serves as a speaker for Lifecell, Inc. (Branchburg, NJ),
   and Davol, Inc. (Warwick, RI), and as a consultant for Davol and for
   Kensey-Nash, Inc. (Exton, PA). Michael Rosen serves as a speaker for
   Lifecell, Inc., and receives research support from Lifecell, Inc.,
   Davol, Inc., W.L. Gore, Inc. (Newark, DE), and the Cook Group, Inc.
   (Bloomington, IN). None of the other authors have relationships to
   disclose.
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NR 34
TC 52
Z9 55
U1 0
U2 11
PU MARY ANN LIEBERT INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1096-2964
J9 SURG INFECT
JI Surg. Infect.
PD JUN
PY 2013
VL 14
IS 3
BP 270
EP 274
DI 10.1089/sur.2012.059
PG 5
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases; Surgery
GA 168LD
UT WOS:000320706300003
PM 23590852
DA 2026-07-24
ER

PT J
AU Cho, EH
   Garcia, R
   Pien, I
   Thomas, S
   Levin, LS
   Hollenbeck, ST
AF Cho, Eugenia H.
   Garcia, Ryan
   Pien, Irene
   Thomas, Steven
   Levin, L. Scott
   Hollenbeck, Scott T.
TI An Algorithmic Approach for Managing Orthopaedic Surgical Wounds of the
   Foot and Ankle
SO CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; OPEN FRACTURES; RECONSTRUCTION; COVERAGE; FLAP;
   MANAGEMENT; TRAUMA
AB Wound breakdown after orthopaedic foot and ankle surgery may necessitate secondary soft tissue coverage. The foot and ankle region is challenging to reconstruct for orthopaedic and plastic surgeons owing to its complex bony anatomy and unique functional demands. Therefore, identifying strategies for plastic surgery of these wounds may help guide surgeons in defining the best treatment plan.
   We evaluated our current algorithmic approach for managing orthopaedic surgical wounds of the foot and ankle with respect to whether (1) prophylactic or simultaneous soft tissue coverage affected wound-healing complications (secondary plastic surgery, orthopaedic hardware removal, malunion, further orthopaedic surgery, ultimate failure) and (2) postoperative referral for soft tissue management was associated with wound location, size, and orthopaedic procedure.
   We retrospectively reviewed 112 patients who underwent elective orthopaedic foot or ankle surgery and required concomitant plastic surgery at our institution. Study end points included secondary plastic surgery procedures, hardware removal for infection, foot or ankle malunion, further orthopaedic surgery, and wound-healing failure as defined by a chronic nonhealing wound or need for amputation. Minimum followup was 0.6 months (mean, 24.9 months; range, 0.6-197 months). Four patients were lost to complete followup. We developed an algorithm that centers on two critical points of care: preoperative evaluation by the orthopaedic surgeon and evaluation and treatment by the plastic surgeon after referral.
   Compared with postoperative intervention, prophylactic or simultaneous soft tissue coverage did not lead to differences in frequency of secondary plastic surgery procedures (p = 0.55), hardware removal procedures (p = 0.13), malunions (p = 0.47), further orthopaedic surgery (p = 0.48), and ultimate failure (p = 0.27). Patients referred postoperatively for soft tissue management most frequently had dorsal ankle wounds (p < 0.001) of smaller size (p = 0.03), most commonly associated with total ankle arthroplasty (p = 0.004).
   Using our algorithmic approach, prophylactic or simultaneous soft tissue coverage did not improve the study end points. In addition, unexpected postoperative wound breakdown necessitating a plastic surgery consultation most commonly occurred on the dorsal ankle after total ankle arthroplasty. Our algorithm facilitates early identification of skin instability and enables prompt soft tissue coverage before or concurrently with orthopaedic procedures. The effect of prophylactic or simultaneous soft tissue coverage on postoperative wound healing requires further investigation.
C1 [Cho, Eugenia H.; Garcia, Ryan; Pien, Irene; Hollenbeck, Scott T.] Duke Univ, Med Ctr, Div Plast & Reconstruct Surg, Durham, NC 27710 USA.
   [Thomas, Steven] Duke Univ, Med Ctr, Dept Biostat & Bioinformat, Durham, NC 27710 USA.
   [Levin, L. Scott] Hosp Univ Penn, Dept Orthopaed, Philadelphia, PA 19104 USA.
C3 Duke University; Duke University; University of Pennsylvania
RP Hollenbeck, ST (通讯作者)，Duke Univ, Med Ctr, Div Plast & Reconstruct Surg, Box 3974, Durham, NC 27710 USA.
EM scott.hollenbeck@DUKE.edu
RI Cho, Eugenia/G-2342-2015
OI Cho, Eugenia/0000-0001-5448-7895
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NR 31
TC 35
Z9 38
U1 0
U2 10
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0009-921X
EI 1528-1132
J9 CLIN ORTHOP RELAT R
JI Clin. Orthop. Rel. Res.
PD JUN
PY 2014
VL 472
IS 6
BP 1921
EP 1929
DI 10.1007/s11999-014-3536-7
PG 9
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA AG8KY
UT WOS:000335668500036
PM 24577615
DA 2026-07-24
ER

PT J
AU Gul, VO
   Destek, S
   Sahin, M
AF Gul, Vahit Onur
   Destek, Sabahattin
   Sahin, Mutlu
TI Analyse of patient characteristics and aetiological causes of
   enterocutaneous fistulas and their impacts on in-hospital mortality: a
   ten-year retrospective cohort study
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE Enterocutaneous fistula; Enteroatmospheric fistula; Aetiology; Mortality
ID VACUUM-ASSISTED CLOSURE; SURGICAL-MANAGEMENT
AB Introduction This study aimed to compare patient characteristics according to the primary aetiology including gunshot wounds in inpatient individuals diagnosed with enterocutaneous fistula (ECF) or enteroatmospheric fistula (EAF) and to evaluate the impacts of these characteristics on all-cause in-hospital mortality. Methods This is a single-centre hospital-based retrospective cohort study conducted with adult patients who were hospitalised for treatment of ECF or EAF. The patients were allocated to three study groups according to their primary aetiology (surgery-related group, gunshot-related group and other-cause group). The demographics and clinical features of the patients were compared between the study groups, furthermore, the impacts of these characteristics on in-hospital mortality were evaluated using Cox Regression Analysis. Results Gunshot-related fistulas were more likely to originate from small intestines, whereas surgery-related fistulas originated from all anatomic sites and those related to other aetiologies often originated from large intestines (p = 0.006). Severe malnutrition was more prevalent in the other-cause group (26.1%) (p < 0.001). Sepsis occurred in 24.3%, 68.8% and 47.8% of the patients (p = 0.008); and the median length of stay was 18.0, 45.0 and 32.0 days (p = 0.025) in the surgery-related group, the gunshot-related group, and the other-cause group, respectively. While the surgery-related and gunshot-related groups had similar and low mortality rates (2.7% and 6.7%, respectively), patients with other reasons had the highest mortality (30.4%). The increase in the duration of output (DOO) was associated with decreased mortality [HR (95%CI): 0.55 (0.39-0.79) p = 0.001], whereas being severely malnourished and having an aetiology of other causes were associated with increased mortality [HR (95%CI): 25.29 (5.20-123.09) and p < 0.001, and HR (95%CI): 9.06 (1.11-73.86) and p = 0.040, respectively]. Conclusions Patient characteristics, clinical manifestations and treatment approach may differ according to primary aetiology in patients with ECF or EAF. Primary aetiology, the decrease in DOO and severe malnourishment have negative impacts on in-hospital mortality.
C1 [Gul, Vahit Onur] Yuksek Ihtisas Univ, Koru Hosp, Dept Obstet & Gynecol, Sch Med, TR-06530 Ankara, Turkiye.
   [Destek, Sabahattin] Uskudar Univ, Dept Gen Surg, Sch Med, TR-34000 Istanbul, Turkiye.
   [Sahin, Mutlu] Nev Hosp Gen Surg, Dept Gen Surg, TR-16000 Bursa, Turkiye.
C3 Koru Hospital; Yuksek Ihtisas University; Uskudar University
RP Gul, VO (通讯作者)，Yuksek Ihtisas Univ, Koru Hosp, Dept Obstet & Gynecol, Sch Med, TR-06530 Ankara, Turkiye.
EM vonurgul@hotmail.com; dr.s.destek@gmail.com; drmutlu@gmail.com
RI gul, vahit/A-2578-2019; Sahin, Mutlu/AAS-1237-2020; Destek,
   Sabahattin/AAG-7226-2020
OI gul, vahit/0000-0001-9071-0732; Sahin, Mutlu/0000-0003-0371-4095;
   Destek, Sabahattin/0000-0002-3569-4386
CR Achával Mora, 2020, Rev. argent. cir., V112, P445, DOI [10.25132/raac.v112.n4.1573.ei, 10.25132/raac.v112.n4.1573.ei]
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NR 30
TC 1
Z9 1
U1 0
U2 4
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD JAN 24
PY 2025
VL 51
IS 1
AR 58
DI 10.1007/s00068-024-02733-2
PG 8
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA T6T6I
UT WOS:001406306800039
PM 39856477
DA 2026-07-24
ER

PT J
AU Plaudis, H
   Rudzats, A
   Melberga, L
   Kazaka, I
   Suba, O
   Pupelis, G
AF Plaudis, Haralds
   Rudzats, Agris
   Melberga, Liene
   Kazaka, Ita
   Suba, Olegs
   Pupelis, Guntars
TI Abdominal negative-pressure therapy: a new method in countering
   abdominal compartment and peritonitis - prospective study and critical
   review of literature
SO ANNALS OF INTENSIVE CARE
LA English
DT Review
ID VACUUM-ASSISTED CLOSURE; INTRAABDOMINAL HYPERTENSION; WOUND CLOSURE;
   INTERNATIONAL-CONFERENCE; OPEN ABDOMEN; EXPERIENCE; MANAGEMENT; EXPERTS;
   TRAUMA; FLUID
AB Background: Application of abdominal negative-pressure therapy (NPT) is lifesaving when conservative measures fail to reduce sustained increase of the intra-abdominal pressure and it is impossible to achieve source control in a single operation due to severe peritonitis. The aim of this study is to share the initial experience with abdominal NPT in Latvia and provide a review of the relevant literature.
   Methods: In total, 22 patients were included. All patients were treated with KCI (R) ABThera (TM) NPT systems. Acute Physiology and Chronic Health Evaluation II (APACHE II) score on admission, daily sequential organ failure assessment score and Mannheim peritonitis index (MPI) were calculated for severity definition. The frequency of NPT system changes, daily amount of aspirated fluid effluent and the time of abdominal closure were assessed. The overall hospital and ICU stay, as well as the outcomes and the complication rate, were analysed.
   Results: A complicated intra-abdominal infection was treated in 18 patients. Abdominal compartment syndrome due to severe acute pancreatitis (SAP), secondary ileus and damage control in polytrauma were indications for NPT in four patients. The median age of the patients was 59 years (range, 28 to 81), median APACHE II score was 15 points (range, 9 to 32) and median MPI was 28 points (range, 21 to 40), indicating a prognostic mortality risk of 60%. Sepsis developed in all patients, and in 20 of them, it was severe. NPT systems were changed on a median of every 4 days, and abdominal closure was feasible on the seventh postoperative day without needing a repeated laparotomy. Two NPT systems were removed due to bleeding from the retroperitoneal space in patients with SAP. Intestinal fistulae developed in three patients that were successfully treated conservatively. Incisional hernia occurred in three patients. The overall ICU and hospital stay were 14 (range, 5 to 56) and 25 days (range, 10 to 87), respectively. Only one patient died, contributing to the overall mortality of 4.5%.
   Conclusions: Application of abdominal NPT could be a very promising technique for the control of sustained intra-abdominal hypertension and management of severe sepsis due to purulent peritonitis. Further trials are justified for a detailed evaluation of abdominal NPT indications.
C1 [Plaudis, Haralds; Rudzats, Agris; Melberga, Liene; Kazaka, Ita; Pupelis, Guntars] Riga East Clin Univ Hosp Gailezers, Dept Gen & Emergency Surg, LV-1038 Riga, Latvia.
   [Suba, Olegs] Riga East Clin Univ Hosp Gailezers, Intens Care Clin, LV-1038 Riga, Latvia.
C3 Riga East University Hospital; Riga East University Hospital
RP Plaudis, H (通讯作者)，Riga East Clin Univ Hosp Gailezers, Dept Gen & Emergency Surg, 2 Hipokrata St, LV-1038 Riga, Latvia.
EM hplaudis@gmail.com
RI /AAS-7471-2020
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NR 36
TC 17
Z9 20
U1 0
U2 6
PU SPRINGEROPEN
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON, N1 9XW, ENGLAND
SN 2110-5820
J9 ANN INTENSIVE CARE
JI Ann. Intensive Care
PY 2012
VL 2
SU 1
AR S23
DI 10.1186/2110-5820-2-S1-S23
PG 6
WC Critical Care Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA V41UF
UT WOS:000209570400023
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zizzo, M
   Ruiz, CC
   Zanelli, M
   Bassi, MC
   Sanguedolce, F
   Ascani, S
   Annessi, V
AF Zizzo, Maurizio
   Ruiz, Carolina Castro
   Zanelli, Magda
   Bassi, Maria Chiara
   Sanguedolce, Francesca
   Ascani, Stefano
   Annessi, Valerio
TI Damage control surgery for the treatment of perforated acute colonic
   diverticulitis A systematic review
SO MEDICINE
LA English
DT Review
DE damage control; diverticular disease; diverticulitis; open abdomen;
   surgery
ID GENERALIZED PERITONITIS; LAPAROSCOPIC LAVAGE; PRIMARY RESECTION;
   DEFINITIONS; GUIDELINES; MANAGEMENT; SECONDARY; SEPSIS; TRIAL
AB Background: Acute colonic diverticulitis (ACD) complications arise in approximately 8% to 35% patients and the most common ones are represented by phlegmon or abscess, followed by perforation, peritonitis, obstruction, and fistula. In accordance with current guidelines, patients affected by generalized peritonitis should undergo emergency surgery. However, decisions on whether and when to operate ACD patients remain a substantially debated topic while algorithm for the best treatment has not yet been determined. Damage control surgery (DCS) represents a well-established method in treating critically ill patients with traumatic abdomen injuries. At present, such surgical approach is also finding application in non-traumatic emergencies such as perforated ACD. Thanks to a thorough systematic review of the literature, we aimed at achieving deeper knowledge of both indications and short- and long-term outcomes related to DCS in perforated ACD. Methods: We performed a systematic literature review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyzes (PRISMA) guidelines. Pubmed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science databases were used to search all related literature. Results: The 8 included articles covered an approximately 13 years study period (2006-2018), with a total 359 patient population. At presentation, most patients showed III and IV American Society of Anesthesiologists (ASA) score (81.6%) while having Hinchey III perforated ACD (69.9%). Most patients received a limited resection plus vacuum-assisted closure at first-look while about half entire population underwent primary resection anastomosis (PRA) at a second-look. Overall morbidity rate, 30-day mortality rate and overall mortality rate at follow-up were between 23% and 74%, 0% and 20%, 7% and 33%, respectively. Patients had a 100% definitive abdominal wall closure rate and a definitive stoma rate at follow-up ranging between 0% and 33%. Conclusion: DCS application to ACD patients seems to offer good outcomes with a lower percentage of patients with definitive ostomy, if compared to Hartmann's procedure. However, correct definition of DCS eligible patients is paramount in avoiding overtreatment. In accordance to 2016 WSES (World Society of Emergency Surgery) Guidelines, DCS remains an effective surgical strategy in critically ill patients affected by sepsis/septic shock and hemodynamical unstability.
C1 [Zizzo, Maurizio; Ruiz, Carolina Castro; Annessi, Valerio] Azienda Unita Sanit Locale IRCCS Reggio Emilia, Surg Oncol Unit, Arcispedale Santa Maria Nuova Reggio Emilia, Vale Risorgimento 80, I-42123 Reggio Emilia, Italy.
   [Zizzo, Maurizio; Ruiz, Carolina Castro] Univ Modena & Reggio Emilia, Clin & Expt Med PhD Program, Modena, Italy.
   [Zanelli, Magda] Azienda Unita Sanit Locale IRCCS Reggio Emilia, Pathol Unit, Arcispedale Santa Maria Nuova Reggio Emilia, Reggio Emilia, Italy.
   [Bassi, Maria Chiara] Azienda Unita Sanit Locale IRCCS Reggio Emilia, Arcispedale Santa Maria Nuova Reggio Emilia, Med Lib, Reggio Emilia, Italy.
   [Sanguedolce, Francesca] Azienda Osped Univ Osped Riuniti Foggia, Pathol Unit, Foggia, FG, Italy.
   [Ascani, Stefano] Azienda Osped Santa Maria Terni, Pathol Unit, Terni, Italy.
C3 IRCCS Arcispedale S. Maria Nuova; Universita di Modena e Reggio Emilia;
   IRCCS Arcispedale S. Maria Nuova; IRCCS Arcispedale S. Maria Nuova;
   University of Foggia
RP Zizzo, M (通讯作者)，Azienda Unita Sanit Locale IRCCS Reggio Emilia, Surg Oncol Unit, Arcispedale Santa Maria Nuova Reggio Emilia, Vale Risorgimento 80, I-42123 Reggio Emilia, Italy.
EM zizzomaurizio@gmail.com
RI Castro Ruiz, Carolina/AAC-5742-2022; Annessi, Valerio/AAC-2812-2020;
   Zizzo, Maurizio/AAE-2724-2020; Bassi, Maria Chiara/J-3703-2018; Zanelli,
   Magda/AAS-7631-2020
OI Zizzo, Maurizio/0000-0001-9841-7856; Bassi, Maria
   Chiara/0000-0002-5418-2837; Zanelli, Magda/0000-0002-8733-9933
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   Sohn MA, 2018, INT J COLORECTAL DIS, V33, P871, DOI 10.1007/s00384-018-3025-7
   Sohn M, 2018, WORLD J SURG, V42, P3189, DOI 10.1007/s00268-018-4585-y
   Strate LL, 2019, GASTROENTEROLOGY, V156, P1282, DOI 10.1053/j.gastro.2018.12.033
   Tartaglia D, 2019, WORLD J EMERG SURG, V14, DOI 10.1186/s13017-019-0238-1
   Weber DG, 2014, BRIT J SURG, V101, pE109, DOI 10.1002/bjs.9360
   Zizzo M, 2018, TECH COLOPROCTOL, V22, P473, DOI 10.1007/s10151-018-1810-5
   Zizzo M, 2018, J INFLAMM RES, V11, P319, DOI 10.2147/JIR.S177481
NR 35
TC 14
Z9 16
U1 0
U2 0
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD NOV 25
PY 2020
VL 99
IS 48
AR e23323
DI 10.1097/MD.0000000000023323
PG 9
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA PB0WH
UT WOS:000596048000043
PM 33235095
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Taras, JS
   Sapienza, A
   Roach, JB
   Taras, JP
AF Taras, John S.
   Sapienza, Anthony
   Roach, Josh B.
   Taras, John P.
TI Acellular Dermal Regeneration Template for Soft Tissue Reconstruction of
   the Digits
SO JOURNAL OF HAND SURGERY-AMERICAN VOLUME
LA English
DT Article
DE Acellular dermal regeneration template; digit; soft-tissue coverage;
   soft-tissue defect; trauma
ID VACUUM-ASSISTED CLOSURE; DEGLOVING INJURIES; FINGERTIP INJURIES;
   MANAGEMENT; BURNS; SUBSTITUTE; EXCISION; SURGERY; DEFECTS; INTEGRA
AB Purpose Trauma to the digits often leaves soft tissue defects with exposed bone, joint, and/or tendon that require soft tissue replacement. The objective of this study was to evaluate the effectiveness of acellular dermal regeneration template combined with full-thickness skin grafting for soft tissue reconstruction in digital injuries with soft tissue defects.
   Methods Acellular dermal regeneration template was used to reconstruct digital injuries with exposed bone, joint, tendon, and/or hardware not amenable to treatment with healing by secondary intention, rotation flaps, or primary skin grafts. Acellular dermal regeneration template was applied to 21 digits in 17 patients. Nineteen digits had exposed bone, 8 digits had exposed tendon, 6 digits had exposed joints, and 2 digits had exposed hardware. The acellular dermal regeneration template was sutured over the soft tissue defect. Over 3 weeks, a neodermis formed. The superficial silicone layer of the acellular dermal regeneration template was removed, and the digits received full-thickness epidermal autografting with cotton bolster.
   Results The duration of postoperative follow-up extended to a minimum of 12 months. For the injury sites where acellular dermal regeneration template was applied, the total area of application ranged from 1 cm(2) to 24 cm(2), with the largest individual site measuring 12 cm2. Twenty of 21 digits demonstrated 100% incorporation of the acellular dermal regeneration template skin substitute. One digit that had sustained multilevel trauma developed necrosis requiring revision amputation. Full-thickness epidermal autografting was performed an average of 24 days after acellular dermal regeneration template skin substitute application and demonstrated a 100% take in 16 of 20 digits and partial graft loss of 15% to 25% in 4 of 20 digits that did not require further treatment.
   Conclusions Acellular dermal regeneration template combined with secondary full-thickness skin grafting is an effective method of skin reconstruction in complex digital injuries with soft tissue defects involving exposed bone, tendon, and joint. The neodermis increases tissue bulk and facilitates epidermal autografting with digital injuries that otherwise would require nap coverage or skeletal shortening of the digit. (J Hand Surg 2010;35A:415-421. (C) 2010 Published by Elsevier Inc. on behalf of the American Society for Surgery of the Hand.)
C1 [Taras, John P.] Philadelphia Hand Ctr, PC, Philadelphia, PA 19107 USA.
   Thomas Jefferson Univ, Jefferson Med Coll, Philadelphia, PA 19107 USA.
   Drexel Univ, Dept Orthopaed Surg, Div Hand Surg, Philadelphia, PA 19104 USA.
C3 Thomas Jefferson University; Drexel University
RP Taras, JP (通讯作者)，Philadelphia Hand Ctr, PC, 834 Chestnut St,Suite G-114, Philadelphia, PA 19107 USA.
EM jstaras@handcenters.com
RI ; /AAC-4104-2019
OI Sapienza, Anthony/0000-0003-2850-4123; 
CR Abai B, 2004, PLAST RECONSTR SURG, V114, P162, DOI 10.1097/01.PRS.0000129078.41960.92
   [Anonymous], 1926, JAMA-J AM MED ASSOC, V87, P1479
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   BURKE JF, 1981, ANN SURG, V194, P413, DOI 10.1097/00000658-198110000-00005
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   Chang Johnny, 2006, Clin Occup Environ Med, V5, P413
   Dantzer E, 2003, BRIT J PLAST SURG, V56, P764, DOI 10.1016/S0007-1226(03)00366-7
   DeFranzo AJ, 1999, PLAST RECONSTR SURG, V104, P2145, DOI 10.1097/00006534-199912000-00031
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   Hart Raymond G., 1993, Emergency Medicine Clinics of North America, V11, P755
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   MATHES SJ, 2005, PLASTIC SURG, V7, P153
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   Pederson WC, 2005, GREENS OPERATIVE HAN, P1648
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   WITTSTADT RA, 2005, MASTERS TECHNIQUES O, P323
   Wolter TP, 2005, BRIT J PLAST SURG, V58, P416, DOI 10.1016/j.bjps.2004.04.008
NR 28
TC 54
Z9 61
U1 0
U2 10
PU W B SAUNDERS CO-ELSEVIER INC
PI PHILADELPHIA
PA 1600 JOHN F KENNEDY BOULEVARD, STE 1800, PHILADELPHIA, PA 19103-2899 USA
SN 0363-5023
J9 J HAND SURG-AM
JI J. Hand Surg.-Am. Vol.
PD MAR
PY 2010
VL 35A
IS 3
BP 415
EP 421
DI 10.1016/j.jhsa.2009.12.008
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 588SB
UT WOS:000277092800009
PM 20138715
DA 2026-07-24
ER

PT J
AU Al, SA
   Asha, W
   Asha, A
   Abou Chaar, MK
   Jarrar, A
   Qawasmi, M
   Salameh, H
   Alsaadi, N
AF Abdel Al, S.
   Asha, W.
   Asha, A.
   Abou Chaar, M. K.
   Jarrar, A.
   Qawasmi, M.
   Salameh, H.
   Alsaadi, N.
TI Chemotherapy extravasation injuries beyond the immediate stage: A series
   of 15 cases treated according to a preset surgical algorithm based on
   time of presentation
SO HAND SURGERY & REHABILITATION
LA English
DT Article
DE Chemotherapy extravasation; Chemotherapy complications; Post-cancer
   reconstruction; Hand injury
ID SUBCUTANEOUS WASH-OUT; CYTOSTATIC AGENTS; MANAGEMENT; PREVENTION;
   DOXORUBICIN; DORSUM; ULCERS
AB Chemotherapy extravasation can cause severe harm. There is a lack of evidence-based standardization on the surgical management of such injuries beyond the immediate stage. In an algorithm connecting presentation time post-injury with surgical treatment could help standardize future treatment. This study prospectively validated a preset standardized surgical algorithm based on presentation time in a consecutive series between October 2017 and October 2020. Chemotherapeutic agent, site and extent of injury, type of surgery and outcome at a minimum of 6 months' follow-up were collected. Seven thousand six hundred twelve individuals received chemotherapy during that period; 15 patients suffered extravasation injuries, 2 of whom were referred from outside our hospital. This algorithm distinguished: A) beyond the immediate stage and up to 2 days, treated with saline subcutaneous washout (SCWO) and vacuum-assisted closure (VAC) dressing; B) 2 to 5 days, open surgical decompression and VAC dressing; C) 5 to 10 days, non-operative management with surveillance; and D) more than 10 days, radical necrotic excision with or without VAC dressing and tissue reconstruction. In 2 patients in Group A and 3 patients in Group B, all vesicant symptoms resolved. Five of the 6 patients in Group C (3 vesicant, 3 non-vesicant) did not progress into necrosis or infection, and 1 case of vesicant extravasation progressed to a localized ulcer beyond this period and, as surgery was refused, led to a chronic ulcer with stiffness; 2 cases of non-vesicant extravasation developed a recall phenomenon but resolved after the third cycle. Of the 4 patients in Group D, all vesicant, 2 were treated with no complications, 1 had complex regional pain syndrome (CRPS) due to late presentation, and 1, referred with necrotizing fasciitis, underwent above-elbow amputation but died due to septic shock. This study demonstrated a uniform surgical approach in a series of 15 cases; larger studies are still needed to validate the efficacy of this protocol in reducing morbidity. (C) 2022 SFCM. Published by Elsevier Masson SAS. All rights reserved.
C1 [Abdel Al, S.; Qawasmi, M.] King Hussein Canc Ctr, Dept Orthoped Oncol Hand & Microsurg, Queen Rania Al Abdulla St 202, Amman 11941, Jordan.
   [Asha, W.; Asha, A.; Abou Chaar, M. K.; Jarrar, A.; Salameh, H.; Alsaadi, N.] King Hussein Canc Ctr, Dept Clin Res, Queen Rania Al Abdulla St 202, Amman 11941, Jordan.
C3 King Hussein Cancer Center; King Hussein Cancer Center
RP Al, SA (通讯作者)，King Hussein Canc Ctr, Dept Orthoped Oncol Hand & Microsurg, Queen Rania Al Abdulla St 202, Amman 11941, Jordan.
EM S.AbdelAlDa.10670@khcc.jo
RI ; Abou Chaar, Mohamad K/AAB-5494-2021; Abdel Al, Samer/ABE-2728-2021;
   Asha, Wafa/OMM-4477-2025
OI Salameh, Hamza/0000-0002-0022-5707; Abou Chaar, Mohamad
   K/0000-0002-9584-2184; Abdel Al, Samer/0000-0001-8354-3323; Alsaadi,
   Nijmeh/0000-0002-4290-0539; 
CR Boulanger J, 2015, SUPPORT CARE CANCER, V23, P1459, DOI 10.1007/s00520-015-2635-7
   Chang R, 2016, OXF MED CASE REP, P259, DOI 10.1093/omcr/omw079
   Conde-Estévez D, 2014, CLIN TRANSL ONCOL, V16, P11, DOI 10.1007/s12094-013-1100-7
   D'Andrea F, 2004, SCAND J PLAST RECONS, V38, P288, DOI 10.1080/02844310410027383
   Damert HG, 2007, HANDCHIR MIKROCHIR P, V39, P409, DOI 10.1055/s-2007-965231
   de Wit M, 2013, ONKOLOGIE, V36, P127, DOI 10.1159/000348524
   Dionyssiou D, 2011, J HAND SURG-EUR VOL, V36E, P66, DOI 10.1177/1753193410379553
   Dougherty L., 2011, Cancer Nursing Practice, V10, P16, DOI DOI 10.7748/CNP2011.06.10.5.16.C8568
   Ener RA, 2004, ANN ONCOL, V15, P858, DOI 10.1093/annonc/mdh214
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   LARSON DL, 1982, CANCER-AM CANCER SOC, V49, P1796, DOI 10.1002/1097-0142(19820501)49:9<1796::AID-CNCR2820490911>3.0.CO;2-M
   LARSON DL, 1990, CLIN PLAST SURG, V17, P509
   LOTH TS, 1991, CLIN ORTHOP RELAT R, P248
   Morykwas MJ, 1999, J SURG ONCOL, V72, P14, DOI 10.1002/(SICI)1096-9098(199909)72:1<14::AID-JSO4>3.0.CO;2-3
   Napoli P, 2005, J SURG ONCOL, V91, P264, DOI 10.1002/jso.20248
   National Cancer Institute, 2010, COMMON TERMINOLOGY C
   Onesti MG, 2017, ANN PLAS SURG, V79, P450, DOI 10.1097/SAP.0000000000001248
   PREUSS P, 1987, ANN PLAS SURG, V19, P323, DOI 10.1097/00000637-198710000-00005
   Salunke AA, 2015, J CANCER RES THER, V11, P835, DOI 10.4103/0973-1482.144589
   Schulmeister Lisa, 2011, Semin Oncol Nurs, V27, P82, DOI 10.1016/j.soncn.2010.11.010
   Simsek T, 2014, TURK J SURG, V30, P153, DOI 10.5152/UCD.2014.2653
   Steiert A, 2011, J PLAST RECONSTR AES, V64, P240, DOI 10.1016/j.bjps.2010.04.040
   Telisselis P, 2010, HANDCHIR MIKROCHIR P, V42, P247, DOI 10.1055/s-0029-1241185
   TSAVARIS NB, 1992, CANCER CHEMOTH PHARM, V30, P330, DOI 10.1007/BF00686305
NR 31
TC 3
Z9 4
U1 1
U2 2
PU ELSEVIER
PI BRIDGEWATER
PA 685 ROUTE 202-206, BRIDGEWATER, NJ 08807 USA
SN 2468-1229
EI 2468-1210
J9 HAND SURG REHABIL
JI Hand Surg. Rehabil.
PD JUN
PY 2022
VL 41
IS 3
BP 391
EP 399
DI 10.1016/j.hansur.2022.02.009
EA MAY 2022
PG 9
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 1T8WJ
UT WOS:000805005700016
PM 35283338
DA 2026-07-24
ER

PT J
AU Mehbod, AA
   Ogilvie, JW
   Pinto, MR
   Schwender, JD
   Transfeldt, EE
   Wood, KB
   Le Huec, JC
   Dressel, T
AF Mehbod, AA
   Ogilvie, JW
   Pinto, MR
   Schwender, JD
   Transfeldt, EE
   Wood, KB
   Le Huec, JC
   Dressel, T
TI Postoperative deep wound infections in adults after spinal fusion -
   Management with vacuum-assisted wound closure
SO JOURNAL OF SPINAL DISORDERS & TECHNIQUES
LA English
DT Article
DE vacuum-assisted closure; postoperative spine infection; spine; infection
ID INSTRUMENTATION; THERAPY; SALVAGE
AB Objective: Vacuum-assisted wound closure (VAC) exposes the wound bed to negative pressure, resulting in removal of edema fluid, improvement of blood supply, and stimulation of cellular proliferation of reparative granulation tissue. It has been used to treat open wounds in the extremities, open sternal wounds, pressure ulcers, and abdominal wall wounds. This study retrospectively reviewed instrumented spine fusions complicated by surgical wound infection and managed by a protocol including the use of VAC in order to evaluate the efficacy of applying vacuum therapy on patients with deep spine infections and exposed instrumentation.
   Methods: Twenty consecutive patients with deep wound infections after undergoing spinal fusion procedures were studied. There were 12 men and 8 women with an average age of 55 years (31-81 years). Eight patients had undergone concomitant anterior and posterior arthrodesis, nine patients had a posterior spinal fusion, and three patients had a transforaminal lumbar interbody fusion. Seven patients had a decompression with exposed. dura. Sixteen patients presented with a draining wound within the first 6 weeks postoperatively (average 24 days). There were four patients who presented with back pain and temperature after 1 year postoperatively (average 3 years). All patients were taken to the operating room for irrigation and debridement followed by placement of the VAC with subsequent delayed closure of the wound.
   Results: There was an average of 1.8 (1-8) irrigation and debridement procedures prior to placement of the VAC. Once the VAC was initiated, there was an average of 2.2 (2-3) procedures until and including closure of the wound. The wound was closed an average of 7 days (5-14 days) after the placement of the initial VAC in the wound. All patients tolerated the VAC without adverse effects. All patients were kept on a 6-week course of intravenous antibiotic therapy. The average follow-up was 10 months (6-24 months). There were no cases of uncontrolled sepsis once the VAC was initiated. All patients achieved a clean closed wound without removal of instrumentation at a minimum follow-up of 6 months.
   Conclusion: VAC therapy is an effective adjunct in closing complex deep spinal wounds with exposed instrumentation.
C1 Twin Cities Spine Ctr, Minneapolis, MN 55404 USA.
   CHU Bordeaux, Dept Pr Chauveaux, Bordeaux, France.
C3 CHU Bordeaux; Universite de Bordeaux
RP Mehbod, AA (通讯作者)，Twin Cities Spine Ctr, 913 E 26 St,Piper Bldg,Suite 600, Minneapolis, MN 55404 USA.
EM AMehbod@yahoo.com
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Aydinli U, 1999, Acta Orthop Belg, V65, P182
   Baynham S A, 1999, Ostomy Wound Manage, V45, P28
   DeFranzo AJ, 2001, PLAST RECONSTR SURG, V108, P1184, DOI 10.1097/00006534-200110000-00013
   Deva A K, 1997, J Wound Care, V6, P311
   Erdmann D, 2001, PLAST RECONSTR SURG, V108, P2066, DOI 10.1097/00006534-200112000-00036
   Garner GB, 2001, AM J SURG, V182, P630, DOI 10.1016/S0002-9610(01)00786-3
   Glassman SD, 1996, SPINE, V21, P2163, DOI 10.1097/00007632-199609150-00021
   Gustafsson R, 2002, J THORAC CARDIOV SUR, V123, P895, DOI 10.1067/mtc.2002.121306
   KLINK BK, 1994, SPINE, V19, P1467, DOI 10.1097/00007632-199407000-00008
   Mendez-Eastman S, 1998, Plast Surg Nurs, V18, P27
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NR 18
TC 99
Z9 131
U1 0
U2 5
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 1536-0652
J9 J SPINAL DISORD TECH
JI J. Spinal Disord. Tech.
PD FEB
PY 2005
VL 18
IS 1
BP 14
EP 17
DI 10.1097/01.bsd.0000133493.32503.d3
PG 4
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA 897PC
UT WOS:000227016100003
PM 15687846
DA 2026-07-24
ER

PT J
AU Landau, AG
   Hudson, DA
   Adams, K
   Geldenhuys, S
   Pienaar, C
AF Landau, Alex G.
   Hudson, Don A.
   Adams, Kevin
   Geldenhuys, Stuart
   Pienaar, Conrad
TI Full-thickness skin grafts: Maximizing graft take using negative
   pressure dressings to prepare the graft bed
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
ID VACUUM-ASSISTED CLOSURE; AVASCULAR DEFECTS; WOUND CONTROL; CONTRACTION;
   FOUNDATION; SURVIVAL; STATE
AB Background: Full thickness skin grafts (FTSGs) remain a good option for resurfacing defects of the face, neck, and dorsum of the feet. It results in soft, pliable, functional skin with minimal contraction. However, FTSG may result in patchy or irregular "take" resulting in recurrent contractures and pigmentary discrepancies. This study examines the use of a negative pressure dressing (NPD) to increase FTSG take.
   Methods: Wounds resulting from trauma, postburn contracture release, and an excision of a congenital nevus were included in the study. The wounds were prepared by surgical excision or debridement. A NPD was then applied for a period of 7 days, at which time the wounds were inspected and, if there was sufficient granulation tissue, covered with a FTSG. If the wound had not yet granulated sufficiently another NPD was placed and reassessed in 7 days. The FTSGs were harvested from the groin and abdominal area exactly to the size of the defect. A sponge bolster dressing was then applied. The take of the FTSG was judged using a grid of 1 x 1-cm squares. The wounds were measured and the amount of graft take was calculated as a percentage of the wound size. Complications in both the wound as well as the donor sites were noted.
   Results: Twenty-four patients were included in the study. The mean age was 6 years (range 1-14 years), including 9 burn contracture excisions, 14 road traffic accident-related injuries, and 1 excision of a congenital nevus. The site involved was the foot (6 patients), ankle (9 patients), axilla (2 patients), forearm (4 patients), face (2 patients), and the neck (1 patient). The average surface area of the defect was 78 cm(2) (range 18-264 cm(2)). Groin skin was harvested in all the cases. The NPD was applied on average for 8 days (range 7-15 days). The mean graft take was 95% (range 70%-100%). Only 1 patient had significant graft loss of 30%. Donor site morbidity was low, attaining primary closure in all but 2. Mean follow-up was 9 months.
   Conclusion: The results of this study confirm that the use of NPD enhances FTSG take.
C1 [Landau, Alex G.; Hudson, Don A.; Adams, Kevin; Geldenhuys, Stuart; Pienaar, Conrad] Univ Cape Town, Groote Schuur Hosp, Dept Plast Surg, ZA-7925 Cape Town, South Africa.
C3 University of Cape Town
RP Hudson, DA (通讯作者)，Groote Schuur Hosp, Dept Plast & Reconstruct Surg, H53 OMB, ZA-7925 Cape Town, South Africa.
EM donald.hudson@uct.ac.za
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
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NR 23
TC 31
Z9 38
U1 0
U2 6
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 0148-7043
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD JUN
PY 2008
VL 60
IS 6
BP 661
EP 666
DI 10.1097/SAP.0b013e318146c288
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 306QZ
UT WOS:000256264200016
PM 18520204
DA 2026-07-24
ER

PT J
AU Matsumiya, H
   Mori, M
   Yoshimatsu, K
   Oyama, R
   Nishizawa, N
   Kanayama, M
   Taira, A
   Shinohara, S
   Kuwata, T
   Takenaka, M
   Kuroda, K
   Tanaka, F
AF Matsumiya, Hiroki
   Mori, Masataka
   Yoshimatsu, Katsuma
   Oyama, Rintaro
   Nishizawa, Natsumasa
   Kanayama, Masatoshi
   Taira, Akihiro
   Shinohara, Shinji
   Kuwata, Taiji
   Takenaka, Masaru
   Kuroda, Koji
   Tanaka, Fumihiro
TI Predictors of successful closure following open-window thoracostomy in
   patients with empyema: a single-center retrospective cohort study
SO JOURNAL OF THORACIC DISEASE
LA English
DT Article
DE Open-window thoracostomy (OWT); empyema; closure; performance status
   (PS)
AB Background: Open-window thoracostomy (OWT) is an effective life-saving treatment for refractory empyema. Nonetheless, the patients' mental and physical suffering due to OWT is not minimal, and open-window closure is desirable if infection control is possible. When planning a treatment strategy after OWT, it is important to predict whether open-window closure is possible before OWT. This study aimed to identify factors related to open-window closure based on patient background factors before OWT. Methods: This observational retrospective cohort study included 42 patients with empyema who underwent OWT at a single institution over a 10-year period from April 2011 to March 2021. Cases in which closure was possible (closure group) were directly compared with cases in which closure was not possible (non-closure group). To identify the factors affecting closure, a logistic regression analysis was conducted to explore the patient background factors immediately before OWT. Results: Closure was possible in 20 patients (closure group) but was not in 22 patients (non-closure group). The closure methods employed for closure were omentum filling in 11 patients, muscle flap filling in 6 patients, breast tissue filling in 1 patient, spontaneous closure in 3 patients, and vacuum-assisted closure (VAC) in 2 patients. The median duration of the open window in the closed-window group was 242 days (35-1,880 days). The strong factors influencing window closure were "no malignant tumor" [odds ratio (OR): 2.68, 95% confidence interval (CI): 0.77-9.38, P=0.12], "no fistula" (OR: 3.41, 95% CI: 0.74-15.68, P=0.12), "age <70 years" (OR: 2.8, 95% CI: 0.78-9.99, P=0.11)", and "hemoglobin (Hb) level >= 9.0 g/dL" (OR: 2.77, 95% CI: 0.69-11.08, P=0.15)," with a significant difference observed for "performance status (PS) 0/1" (OR: 7.0, 95% CI: 1.729-28.336, P=0.006). Conclusions: The PS before OWT is an important factor that affects open-window closure. By preoperatively informing patients with poor PS regarding the possibility of the window not being closed after surgery, we believe that patients and their families will be able to make the necessary adjustments and informed decisions.
C1 [Matsumiya, Hiroki; Mori, Masataka; Yoshimatsu, Katsuma; Oyama, Rintaro; Nishizawa, Natsumasa; Kanayama, Masatoshi; Taira, Akihiro; Shinohara, Shinji; Kuwata, Taiji; Takenaka, Masaru; Kuroda, Koji; Tanaka, Fumihiro] Univ Occupat & Environm Hlth, Sch Med, Dept Surg 2, 1-1 Iseigaoka,Yahatanishi-ku, Kitakyushu, 8078555, Japan.
C3 University of Occupational & Environmental Health - Japan
RP Matsumiya, H (通讯作者)，Univ Occupat & Environm Hlth, Sch Med, Dept Surg 2, 1-1 Iseigaoka,Yahatanishi-ku, Kitakyushu, 8078555, Japan.
EM matsumiyahiroki@med.uoeh-u.ac.jp
RI Kanayama, Masatoshi/ABD-2446-2022
CR Bobbio Antonio, EPIDEMIOLOGY PROGNOS
   CLAGETT OT, 1963, J THORAC CARDIOV SUR, V45, P141, DOI 10.1016/S0022-5223(19)32877-6
   Hato T, 2014, SURG TODAY, V44, P443, DOI 10.1007/s00595-013-0556-y
   Kleeven A, 2023, J THORAC DIS, V15, P7063, DOI 10.21037/jtd-23-684
   Markatis E, 2022, FRONT MED-LAUSANNE, V9, DOI 10.3389/fmed.2022.828783
   Massera F, 2006, ANN THORAC SURG, V82, P288, DOI 10.1016/j.athoracsur.2005.11.046
   Molnar TF, 2007, EUR J CARDIO-THORAC, V32, P422, DOI 10.1016/j.ejcts.2007.05.028
   Reyes KG, 2010, THORAC CARDIOV SURG, V58, P220, DOI 10.1055/s-0029-1240972
   Ricciardi S, 2023, J CLIN MED, V12, DOI 10.3390/jcm12010136
   Sziklavari Z, 2025, ANN THORAC SURG, V119, P1206, DOI [10.1016/j.athoracsur.2024.08.003, 10.1016/j.athoracsur.2024.08.003]
NR 10
TC 1
Z9 2
U1 0
U2 0
PU AME PUBLISHING COMPANY
PI SHATIN
PA FLAT-RM C 16F, KINGS WING PLAZA 1, NO 3 KWAN ST, SHATIN, HONG KONG
   00000, PEOPLES R CHINA
SN 2072-1439
EI 2077-6624
J9 J THORAC DIS
JI J. Thorac. Dis.
PD MAY
PY 2025
VL 17
IS 5
BP 3138
EP 3146
DI 10.21037/jtd-2024-1941
PG 9
WC Respiratory System
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Respiratory System
GA 3YE0J
UT WOS:001511810500032
PM 40529768
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Tereshenko, V
   Schweizer, R
   Waldner, M
   Kim, BS
   Giovanoli, P
   Klein, HJ
AF Tereshenko, Vlad
   Schweizer, Riccardo
   Waldner, Matthias
   Kim, Bong-Sung
   Giovanoli, Pietro
   Klein, Holger Jan
TI Outcome Comparison of Different Reconstructive Approaches for Axillary
   Defects Secondary to Radical Excision of Hidradenitis Suppurativa
SO DERMATOLOGY
LA English
DT Article
DE Hidradenitis suppurativa; Axillary defect; Axillary reconstruction;
   Split-thickness skin graft; Posterior arm flap
ID POSTERIOR ARM FLAP; SURGICAL-TREATMENT; MANAGEMENT; COMPLICATIONS
AB Background: Radical excision of debilitating hidradenitis suppurativa lesions is the only curative approach in the advanced stages of the disease. Different concepts for axillary reconstruction do exist, but data on their clinical outcome are scarce. Methods: This is a retrospective cohort study of two reconstructive methods (posterior arm flap vs. vacuum-assisted closure [VAC] + split-thickness skin graft [STSG]) for axillary defects in patients with severe axillary hidradenitis suppurativa treated at the University Hospital Zurich between 2005 and 2020. Results: A total of 35 patients (mean age 36 +/- 10 years, mean BMI 29 +/- 5 kg/m(2), Hurley stage II-III) with 67 operated axillae were stratified according to their type of reconstruction. Median operation time in the flap group was 144 min (IQR 114-207) (cumulative 181 min [IQR 124-300]) and 50 min (IQR 40-81) in the VAC + STSG group (cumulative 151 min [IQR 94-194], p < 0.01; p = 0.20 [cumulative time]). The cumulative length of stay was 6 +/- 3 days in the flap group and 14 +/- 7 days in the VAC + STSG group (p < 0.01). Time to complete wound healing was 27 days (IQR 20-49) in the flap group and 62 days (IQR 41-75) in the VAC + STSG group (p < 0.01). Vancouver Scar Scale score was 6 (IQR 4-9) in the flap group and 11 (IQR 9-12) in the VAC + STSG group (p < 0.01). Protective sensory recovery was most satisfactory in the flap group (p < 0.01). Forty-four percent of patients of the VAC + STSG group demonstrated functional impairment of arm abduction. Time to return to work was less in group A with 42 days (IQR 27-57) needed as compared to group B with 48 days (IQR 34-55) needed (p = 0.32). The average cost saving was 25% higher for the flap group than for the VAC + STSG group. Conclusion: Despite an increased operation time, axillary reconstruction by the posterior arm flap yields a reduced length of stay, less time to complete wound healing along with restoration of a protective sensibility, and less axillary scarring avoiding functional deficits - eventually allowing earlier return to work.
C1 [Tereshenko, Vlad; Schweizer, Riccardo; Waldner, Matthias; Kim, Bong-Sung; Giovanoli, Pietro] Univ Zurich Hosp, Dept Plast Surg & Hand Surg, Zurich, Switzerland.
   [Tereshenko, Vlad] Med Univ Vienna, Dept Plast Reconstruct & Aesthet Surg, Clin Lab Bion Extrem Reconstruct, Vienna, Austria.
   [Klein, Holger Jan] Kantonsspital Aarau, Dept Plast Surg & Hand Surg, Aarau, Switzerland.
   [Klein, Holger Jan] Univ Zurich, Zurich, Switzerland.
C3 University of Zurich; University Zurich Hospital; Medical University of
   Vienna; Kantonsspital Aarau AG (KSA); University of Zurich
RP Klein, HJ (通讯作者)，Kantonsspital Aarau, Dept Plast Surg & Hand Surg, Aarau, Switzerland.; Klein, HJ (通讯作者)，Univ Zurich, Zurich, Switzerland.
EM holger.klein@ksa.ch
RI Kim, Bong-Sung/AAR-3802-2021; Tereshenko, Vlad/HLH-3336-2023
OI Kim, Bong-Sung/0000-0002-0493-3196; Tereshenko, Vlad/0000-0001-7761-5191
CR Aghdassi SJS, 2019, ANTIMICROB RESIST IN, V8, DOI 10.1186/s13756-019-0547-x
   ANGRIGIANI C, 1995, PLAST RECONSTR SURG, V96, P1608, DOI 10.1097/00006534-199512000-00014
   Besson, 2016, REKOLE BETRIEBLICHES
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   Clavien PA, 2009, ANN SURG, V250, P187, DOI 10.1097/SLA.0b013e3181b13ca2
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   Zouboulis CC, 2015, J EUR ACAD DERMATOL, V29, P619, DOI 10.1111/jdv.12966
NR 35
TC 8
Z9 9
U1 0
U2 2
PU KARGER
PI BASEL
PA ALLSCHWILERSTRASSE 10, CH-4009 BASEL, SWITZERLAND
SN 1018-8665
EI 1421-9832
J9 DERMATOLOGY
JI Dermatology
PD SEP
PY 2022
VL 238
IS 5
BP 851
EP 859
DI 10.1159/000521573
EA JAN 2022
PG 9
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 6M4PY
UT WOS:000750623900001
PM 35086097
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Pesonen, LO
   Halloran, BG
   Aziz, A
AF Pesonen, Luke O.
   Halloran, Brian G.
   Aziz, Abdulhameed
TI Prophylactic Groin Wound Vacuum-assisted Therapy in Vascular Surgery
   Patients at Enhanced Risk for Postoperative Wound Infection
SO ANNALS OF VASCULAR SURGERY
LA English
DT Article; Proceedings Paper
CT 27th Annual Winter Meeting of the
   Vascular-and-Endovascular-Surgery-Society (VESS)
CY FEB 02-05, 2017
CL Steamboat Springs, CO
SP Vasc & Endovascular Surg Soc
ID SURGICAL SITE INFECTION; PREVENTION; CLOSURE; MANAGEMENT
AB Background: Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified.
   Methods: A single institution, retrospective analysis was conducted from January 2013 to September 2016 utilizing procedure codes to identify patients with wound VACs placed in the operating room. Two distinct groups were identified. The first was a wound complication patient group with 15 limbs (13 patients) with a groin wound VAC placed within 45 days postoperatively for groin wound complications. Eleven of these limbs had the VAC placed at readmission. The second group was a prophylactic patient group that included 8 limbs (7 patients) who received a VAC prophylactically placed in the enhanced risk wounds. These wounds were determined to be enhanced risk based on clinical criteria judged by the operating surgeon such as a large overhanging panniculus and/or one of several ongoing medical issues. We calculated a Wiseman score for all patients, determined total cost of the readmissions, and determined 30-day postsurgical SSI incidence for the prophylactic VAC group.
   Results: Per the Wiseman scores, 9 limbs with postoperative complications were high risk and 3 limbs were moderate/high risk. Eleven limbs had a VAC placed at readmission with an average readmission cost of $8876.77. For the prophylactic group, 8 limbs were high risk with no observed postdischarge SSI in the first 30 days from surgery. The Wiseman scores showed close correlation between the retrospective high and moderate/high risk groups versus the prophylactic VAC group (31.5 +/- 7.3 vs. 32 +/- 5.5, P = 0.87).
   Conclusions: The Wiseman scores showed objective validation in the prognosis of anticipating groin wound breakdown. Our initial results suggest that prophylactic groin wound VAC placement for enhanced risk vascular surgery patients may proactively decrease wound morbidity, decrease readmission secondary to groin wound complications, and provide some cost benefit.
C1 [Pesonen, Luke O.; Halloran, Brian G.; Aziz, Abdulhameed] St Joseph Mercy Hosp, Dept Surg, Ann Arbor, MI 48104 USA.
C3 Saint Joseph Mercy Health System (SJMHS)
RP Aziz, A (通讯作者)，IHA Vasc & Endovasc Specialists, 5201 Elliot Dr,Suite 101, Ypsilanti, MI 48197 USA.
EM Abdulhameed_aziz@ihacares.com
CR Acosta S, 2017, BJS-BRIT J SURG, V104, pE75, DOI 10.1002/bjs.10403
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NR 10
TC 10
Z9 11
U1 0
U2 4
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0890-5096
EI 1615-5947
J9 ANN VASC SURG
JI Ann. Vasc. Surg.
PD JAN
PY 2018
VL 46
BP 127
EP 133
DI 10.1016/j.avsg.2017.07.009
PG 7
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery; Cardiovascular System & Cardiology
GA FQ3BZ
UT WOS:000418233100017
PM 28739464
DA 2026-07-24
ER

PT J
AU Wang, LW
   Han, XM
   Liu, M
   Ma, Y
   Li, B
   Pan, F
   Li, WC
   Wang, L
   Yang, X
   Chen, ZH
   Zeng, FQ
AF Wang, Longwang
   Han, Xiaomin
   Liu, Mei
   Ma, Yan
   Li, Bing
   Pan, Feng
   Li, Wencheng
   Wang, Liang
   Yang, Xiong
   Chen, Zhaohui
   Zeng, Fuqing
TI Experience in management of Fournier's gangrene: A report of 24 cases
SO JOURNAL OF HUAZHONG UNIVERSITY OF SCIENCE AND TECHNOLOGY-MEDICAL
   SCIENCES
LA English
DT Article
DE Fournier's gangrene; surgical debridement; Fournier's gangrene severity
   index
ID VACUUM-ASSISTED CLOSURE; PROGNOSTIC-FACTORS
AB Fournier's gangrene (FG) is an extremely aggressive and rapidly progressive polymicrobial soft tissue infection of the perineum, anal area or genitalial regions with a high mortality rate. The objectives of this study were to share our experience with the management of this serious infectious disease over the last 15 years. This retrospective study examined 24 patients diagnosed as having FG who were admitted to our hospital between March 1996 and December 2011. The gender, age, etiology, predisposing factors, laboratory findings, treatment modality, hospitalization time and spread of gangrene of the subjects were all recorded and analyzed. The results showed that the mean age of the patients was 48.33 years, the male-to-female ratio was 5:1 and the mortality rate was 20.8% (5/24). The most common predisposing factor was diabetes mellitus in 10 patients (41.6%), followed by alcohol abuse, obesity, neoplasms and immunosuppression. The most common etiology was peri-anal and peri-rectal abscesses (45.8%), followed by lesions of urogenital origin (33.3%) and cutaneous (8.3%) origin. No local pathologies could be identified in 3 (12.5%) patients. The most commonly isolated microorganisms were Escherichia coli (62.5%), followed by Enterococcus, Pseudomonas aeruginosa and Staphylococcus aureus. The median admission Fournier's gangrene severity index (FGSI) score for survivors was 5.63 +/- 1.89 against 13.6 +/- 3.64 for non-survivors which was designed for predicting the disease severity in the series. Early diagnosis and immediate extensive surgical debridement were significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive modalities for wound coverage were useful in that they repaired the tissue defect and improved the quality of life. We are led to conclude that Fournier's gangrene is a severe condition with a high mortality. The Fournier's gangrene severity index (FGSI) score at admission serves as a good predictor for the disease severity. Early diagnosis, surgical debridement and aggressive fluid therapy are significant prognostic factors in the management of Fournier gangrene. Individualized reconstructive surgery modalities for wound coverage are useful to correct the tissue defect and improve the quality of life.
C1 [Wang, Longwang; Han, Xiaomin; Ma, Yan; Li, Bing; Pan, Feng; Li, Wencheng; Wang, Liang; Yang, Xiong; Chen, Zhaohui; Zeng, Fuqing] Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Dept Urol, Wuhan 430022, Peoples R China.
   [Liu, Mei] Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Dept Anesthesiol, Wuhan 430022, Peoples R China.
C3 Huazhong University of Science & Technology; Huazhong University of
   Science & Technology
RP Han, XM (通讯作者)，Huazhong Univ Sci & Technol, Tongji Med Coll, Union Hosp, Dept Urol, Wuhan 430022, Peoples R China.
EM 252423414@qq.com; hanhanmin@126.com
RI PAN, Feng/HSH-1255-2023
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NR 27
TC 9
Z9 11
U1 0
U2 11
PU SPRINGER
PI NEW YORK
PA 233 SPRING ST, NEW YORK, NY 10013 USA
SN 1672-0733
J9 J HUAZHONG U SCI-MED
JI J. Huazhong Univ. Sci. Tech.-Med.
PD OCT
PY 2012
VL 32
IS 5
BP 719
EP 723
DI 10.1007/s11596-012-1024-4
PG 5
WC Biochemistry & Molecular Biology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Biochemistry & Molecular Biology
GA 023HN
UT WOS:000310023600015
PM 23073803
DA 2026-07-24
ER

PT J
AU Forsberg, JA
   Elster, EA
   Andersen, RC
   Nylen, E
   Brown, TS
   Rose, MW
   Stojadinovic, A
   Becker, KL
   McGuigan, FX
AF Forsberg, Jonathan Agner
   Elster, Eric A.
   Andersen, Romney C.
   Nylen, Eric
   Brown, Trevor S.
   Rose, Matthew W.
   Stojadinovic, Alexander
   Becker, Kenneth L.
   McGuigan, Francis Xavier
TI Correlation of procalcitonin and cytokine expression with dehiscence of
   wartime extremity wounds
SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
LA English
DT Article
ID OPERATION-IRAQI-FREEDOM; VACUUM-ASSISTED CLOSURE; ORTHOPEDIC INJURIES;
   DIAGNOSTIC-VALUE; PRESSURE ULCERS; TOTAL HIP; SEPSIS; INFECTION; SERUM;
   TRAUMA
AB Background: Despite technological advances in the treatment of severe extremity trauma, the timing of wound closure remains the subjective clinical decision of the treating surgeon. Traditional serum markers are poor predictors of wound-healing. The objective of this study was to evaluate the cytokine and chemokine profiles of severe extremity wounds prior to closure to determine if wound effluent markers can be used to predict healing.
   Methods: Serum and effluent (exudate) samples were collected prospectively from adult volunteers with multiple high-energy penetrating extremity wounds sustained during military combat. Samples were collected prior to definitive wound closure or flap coverage. Wounds were followed clinically for six weeks. The primary clinical outcome measures were wound-healing and dehiscence. Control serum samples were collected from normal age and sex-matched adult volunteers. All samples were analyzed for the following cytokines and chemokines: procalcitonin; eotaxin; granulocyte macrophage colony stimulating factor; interferon (IFN)-gamma; interieukin (IL)-1 through 8, 10, 12, 13, and 15; IFN-gamma inducible protein-10; monocyte chemotactic protein-1; macrophage inflammatory protein-la; the protein regulated on activation, normal T expressed and secreted (RANTES); and tumor necrosis factor (TNF)-alpha.
   Results: Fifty wounds were analyzed in twenty patients. Four of the fifty wounds dehisced. An increased rate of wound dehiscence was observed in patients with a concomitant closed head injury as well as in those with an associated arterial injury of the affected limb (p < 0.05). Among the serum chemokines and cytokines, only serum procalcitonin levels correlated with wound dehiscence (p < 0.05). Effluent analysis showed that, compared with wounds that healed, wounds that dehisced were associated with elevated procalcitonin, decreased RANTES protein, and decreased IL-13 concentrations (p < 0.05). No wound with an effluent procalcitonin concentration of < 220 pg/mL, an IL-13 concentration of > 12 pg/mL, or a RANTES protein concentration of > 1000 pg/mL failed to heal.
   Conclusions: Effluent procalcitonin, IL-13, and RANTES protein levels as well as serum procalcitonin levels correlate with wound dehiscence following closure of severe open extremity wounds. These preliminary results indicate that effluent biomarker analysis may be an objective means of determining the timing of traumatic wound closure.
C1 [Forsberg, Jonathan Agner; Elster, Eric A.; Andersen, Romney C.; Nylen, Eric; Brown, Trevor S.; Rose, Matthew W.; Stojadinovic, Alexander; Becker, Kenneth L.; McGuigan, Francis Xavier] Natl Naval Med Ctr, Dept Orthopaed Surg, Bethesda, MD 20889 USA.
C3 Walter Reed National Military Medical Center
RP Forsberg, JA (通讯作者)，Natl Naval Med Ctr, Dept Orthopaed Surg, 8901 Wisconsin Ave, Bethesda, MD 20889 USA.
EM onathan.forsberg@med.navy.mil
RI ; Forsberg, Jonathan/K-2116-2012; Brown, Trevor/F-7392-2015; Elster,
   Eric/G-2332-2010
OI Andersen, Romney/0009-0000-3507-7612; Forsberg,
   Jonathan/0000-0003-3835-0615; Brown, Trevor/0000-0001-7042-785X; Elster,
   Eric/0000-0002-0981-2748; Stojadinovic, Alexander/0000-0002-2829-8967
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NR 64
TC 59
Z9 65
U1 0
U2 4
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0021-9355
EI 1535-1386
J9 J BONE JOINT SURG AM
JI J. Bone Joint Surg.-Am. Vol.
PD MAR
PY 2008
VL 90A
IS 3
BP 580
EP 588
DI 10.2106/JBJS.G.00265
PG 9
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 273QJ
UT WOS:000253946500015
PM 18310708
DA 2026-07-24
ER

PT J
AU McGauran, N
   Wieseler, B
   Kreis, J
   Schüler, YB
   Kölsch, H
   Kaiser, T
AF McGauran, Natalie
   Wieseler, Beate
   Kreis, Julia
   Schueler, Yvonne-Beatrice
   Koelsch, Heike
   Kaiser, Thomas
TI Reporting bias in medical research - a narrative review
SO TRIALS
LA English
DT Review
ID CLINICAL-TRIAL REGISTRATION; ADVERSE DRUG-REACTIONS;
   CONFLICT-OF-INTEREST; NONSTEROIDAL ANTIINFLAMMATORY DRUGS; ACUTE
   MYOCARDIAL-INFARCTION; PUBLICATION BIAS; PHARMACEUTICAL-INDUSTRY;
   RANDOMIZED-TRIALS; CARDIOVASCULAR EVENTS; BREAST-CANCER
AB Reporting bias represents a major problem in the assessment of health care interventions. Several prominent cases have been described in the literature, for example, in the reporting of trials of antidepressants, Class I anti-arrhythmic drugs, and selective COX-2 inhibitors. The aim of this narrative review is to gain an overview of reporting bias in the medical literature, focussing on publication bias and selective outcome reporting. We explore whether these types of bias have been shown in areas beyond the well-known cases noted above, in order to gain an impression of how widespread the problem is. For this purpose, we screened relevant articles on reporting bias that had previously been obtained by the German Institute for Quality and Efficiency in Health Care in the context of its health technology assessment reports and other research work, together with the reference lists of these articles. We identified reporting bias in 40 indications comprising around 50 different pharmacological, surgical (e. g. vacuum-assisted closure therapy), diagnostic (e. g. ultrasound), and preventive (e. g. cancer vaccines) interventions. Regarding pharmacological interventions, cases of reporting bias were, for example, identified in the treatment of the following conditions: depression, bipolar disorder, schizophrenia, anxiety disorder, attention-deficit hyperactivity disorder, Alzheimer's disease, pain, migraine, cardiovascular disease, gastric ulcers, irritable bowel syndrome, urinary incontinence, atopic dermatitis, diabetes mellitus type 2, hypercholesterolaemia, thyroid disorders, menopausal symptoms, various types of cancer (e. g. ovarian cancer and melanoma), various types of infections (e. g. HIV, influenza and Hepatitis B), and acute trauma. Many cases involved the withholding of study data by manufacturers and regulatory agencies or the active attempt by manufacturers to suppress publication. The ascertained effects of reporting bias included the overestimation of efficacy and the underestimation of safety risks of interventions. In conclusion, reporting bias is a widespread phenomenon in the medical literature. Mandatory prospective registration of trials and public access to study data via results databases need to be introduced on a worldwide scale. This will allow for an independent review of research data, help fulfil ethical obligations towards patients, and ensure a basis for fully-informed decision making in the health care system.
C1 [McGauran, Natalie; Wieseler, Beate; Kreis, Julia; Schueler, Yvonne-Beatrice; Koelsch, Heike; Kaiser, Thomas] Inst Qual & Efficiency Hlth Care, D-51105 Cologne, Germany.
RP McGauran, N (通讯作者)，Inst Qual & Efficiency Hlth Care, Dillenburger Str 27, D-51105 Cologne, Germany.
EM n.mcgauran@iqwig.de
OI Wieseler, Beate/0000-0002-3519-754X; Kaiser, Thomas/0000-0003-0795-538X
FU German Institute for Quality and Efficiency in Health Care
FX This work was supported by the German Institute for Quality and
   Efficiency in Health Care. All authors are employees of the Institute.
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   MERCK SCHERING PLOUG
   2006, B WHO, V84, P10
NR 249
TC 332
Z9 361
U1 0
U2 54
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1745-6215
J9 TRIALS
JI Trials
PD APR 13
PY 2010
VL 11
AR 37
DI 10.1186/1745-6215-11-37
PG 15
WC Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Research & Experimental Medicine
GA 605FM
UT WOS:000278333100001
PM 20388211
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zhou, B
   Qin, HT
   Huang, YC
   Wang, QZ
   Zhang, J
   Xiao, YF
   Peng, YB
   Yu, F
AF Zhou, Bo
   Qin, Haotian
   Huang, Yicong
   Wang, Quanzhen
   Zhang, Jian
   Xiao, Yingfeng
   Peng, Yanbin
   Yu, Fei
TI Atrophie blanche complicated with lower limb infection and maggot
   growth: A case report
SO FRONTIERS IN SURGERY
LA English
DT Article
DE atrophie blanche; maggots; skin grafting; suppurative infection; surgery
ID LIVEDOID VASCULOPATHY; MYIASIS
AB BackgroundAtrophie blanche (AB) is a thrombotic vascular disease, also known as venous vasculitis or segmental hyaline vasculitis, characterized by chronic recurring painful ulcers on the lower legs, especially the ankles. AB is a clinically rare condition, affecting 1%-5% of the population, specifically middle-aged women with an average age of 45 years, and cases of AB in children are rare. Following recovery, ivory-white atrophy spots accompanied by pigmentation and telangiectasia remain in patients. One of the complications of AB is the parasitic growth of microorganisms infecting the ischemic soft tissue undergoing necrosis in the lower limbs. Furthermore, although infection combined with microbial parasitism is a type of surgical site infection, myiasis is particularly rare, which may warrant limb amputation or may even be life-threatening. Understanding the complications of AB may help in early and timely surgical debridement as well as wound repair. Summarizing the knowledge and treatment strategies of AB and formulating clinical strategies and guidelines for AB management with insights from relevant cases are important. Case summaryA 59-year-old woman was hospitalized due to repeated ulceration of the skin of the right lower leg for 3 years, aggravation, and maggot growth for 3 days. In the previous 3 years, the skin and soft tissue of the right calf had become ischemic, necrotic, and infected, but the patient did not seek any medical treatment. Subsequently, 2 years ago, she was diagnosed with AB at the dermatology department of our hospital. After hormone treatment, her right leg improved. However, 1 year ago, the skin and soft tissue of the right leg again became ischemic, necrotic, and infected. This time, the patient did not seek medical treatment and applied musk on her wound. The wound deepened, resulting in the exposure of the tendon and some bones. In addition, a large number of maggots and microorganisms grew in and infested the wound for 3 days before the patient came to our department for treatment. Debridement of the necrotizing infected site on the right lower leg combined with negative pressure vacuum sealing drainage were performed twice within 16 days after admission. Simultaneously, antibiotics were given systemically. On the 17th day after admission, the wound appeared clean, myiasis had resolved, and the growth and coverage of the granulation tissue on the wound were satisfactory. Subsequently, debridement of the infected site on the right leg, removal of skin of the right thigh, and autologous free skin grafting were performed. After 10 days, the wound was clean, all skin grafts had survived, and wound repair was satisfactory. Finally, the patient was discharged after 38 days of hospitalization. ConclusionAlthough AB is rare, leukodystrophy requires specialized treatment and regular follow-up. If lower limb infection and maggot growth occur simultaneously, self-treatment should be avoided and medical attention must be sought immediately. Early implementation of wound debridement and anti-infective treatment combined with wound repair, which should be performed after cleaning the wound, is advised.
C1 [Zhou, Bo; Wang, Quanzhen; Zhang, Jian; Xiao, Yingfeng; Peng, Yanbin] Peking Univ, Shenzhen Hosp, Dept Hand & Microsurg, Shenzhen, Peoples R China.
   [Qin, Haotian; Yu, Fei] Peking Univ, Shenzhen Hosp, Dept Bone & Joint Surg, Shenzhen, Peoples R China.
   [Qin, Haotian; Yu, Fei] Peking Univ, Shenzhen Hosp, Natl & Local Joint Engn Res Ctr Orthopaed Biomat, Shenzhen, Peoples R China.
   [Huang, Yicong] Southern Med Univ, Dongguan Peoples Hosp, Dept Orthoped Surg, Dongguan, Peoples R China.
C3 Peking University; Peking University; Peking University; Southern
   Medical University - China
RP Peng, YB (通讯作者)，Peking Univ, Shenzhen Hosp, Dept Hand & Microsurg, Shenzhen, Peoples R China.; Yu, F (通讯作者)，Peking Univ, Shenzhen Hosp, Dept Bone & Joint Surg, Shenzhen, Peoples R China.; Yu, F (通讯作者)，Peking Univ, Shenzhen Hosp, Natl & Local Joint Engn Res Ctr Orthopaed Biomat, Shenzhen, Peoples R China.
EM yufei89@pku.edu.cn; plybl@163.com
RI Yu, Fei/KIJ-8453-2024
OI Yu, Fei/0000-0002-5941-6452
FU National Natural Science Foundation of China [82102568, 82172432,
   82001319, 82102076]; National & Local Joint Engineering Research Center
   of Orthopaedic Biomaterials [XMHT20190204007]; Shenzhen High-level
   Hospital Construction Fund; Shenzhen Key Medical Discipline Construction
   Fund [SZXK023]; Shenzhen "San-Ming" Project of Medicine [SZSM201612092];
   Research and Development Projects of Shenzhen [Z2021N054]; Guangdong
   Basic and Applied Basic Research Foundation [2021A1515012586]; Bethune
   Charitable Foundation; CSPC Osteoporosis Research Foundation Project
   [G-X-2020-1107-21]; Scientific Research Foundation of PEKING UNIVERSITY
   SHENZHEN HOSPITAL [KYQD2021099]
FX This research was continuously funded by the National Natural Science
   Foundation of China (No. 82102568, 82172432, 82001319, and 82102076);
   the National & Local Joint Engineering Research Center of Orthopaedic
   Biomaterials (XMHT20190204007); Shenzhen High-level Hospital
   Construction Fund, Shenzhen Key Medical Discipline Construction Fund
   (No. SZXK023); Shenzhen "San-Ming" Project of Medicine (No.
   SZSM201612092); Research and Development Projects of Shenzhen (No.
   Z2021N054); Guangdong Basic and Applied Basic Research Foundation (No.
   2021A1515012586); Bethune Charitable Foundation and CSPC Osteoporosis
   Research Foundation Project (No. G-X-2020-1107-21); and Scientific
   Research Foundation of PEKING UNIVERSITY SHENZHEN HOSPITAL (No.
   KYQD2021099).
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NR 18
TC 1
Z9 1
U1 0
U2 12
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD NOV 7
PY 2022
VL 9
AR 941568
DI 10.3389/fsurg.2022.941568
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 6L9TD
UT WOS:000888520800001
PM 36420413
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Chen, Y
   Kuang, XC
   Zhou, J
   Zhen, PX
   Zeng, ZS
   Lin, ZX
   Gao, W
   He, LH
   Ding, Y
   Liu, GW
   Qiu, SH
   Qin, A
   Lu, W
   Lao, S
   Zhao, JM
   Hua, QK
AF Chen, Yan
   Kuang, Xiaocong
   Zhou, Jia
   Zhen, Puxiang
   Zeng, Zisan
   Lin, Zhenxun
   Gao, Wei
   He, Lihuan
   Ding, Yi
   Liu, Guangwei
   Qiu, Shaohua
   Qin, An
   Lu, William
   Lao, Shan
   Zhao, Jinmin
   Hua, Qikai
TI Proximal Tibial Cortex Transverse Distraction Facilitating Healing and
   Limb Salvage in Severe and Recalcitrant Diabetic Foot Ulcers
SO CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
LA English
DT Article
ID PERIPHERAL ARTERY-DISEASE; IWGDF GUIDANCE; BLOOD-FLOW; RISK; MANAGEMENT;
   AMPUTATION; BONE; MICROCIRCULATION; INTERVENTIONS; EPIDEMIOLOGY
AB Background The management of severe and recalcitrant diabetic foot ulcers is challenging. Distraction osteogenesis is accompanied by vascularization and regeneration of the surrounding tissues. Longitudinal distraction of the proximal tibia stimulates increased and prolonged blood flow to the distal tibia. However, the effects of transverse distraction of the proximal tibia cortex on severe and recalcitrant diabetic foot ulcers are largely unknown. Questions/purposes (1) Does tibial cortex transverse distraction increase healing and decrease major amputation and recurrence of severe and recalcitrant diabetic foot ulcers compared with routine management (which generally included debridement, revascularization, negative pressure wound therapy, local or free flaps, or skin grafts as indicated)? (2) Does neovascularization and perfusion increase at the foot after the procedure? (3) What are the complications of tibial cortex transverse distraction in patients with severe and recalcitrant diabetic foot ulcers? Methods Between July 2014 and March 2017, we treated 136 patients with diabetes mellitus and University of Texas Grade 2B to 3D ulcers (wound penetrating to the tendon, capsule, bone, or joint with infection and/or ischemia). The patients had failed to respond to treatment for at least 6 months, and their ulcers had a mean +/- SD area of 44 cm(2) +/- 10 cm(2). All 136 patients underwent tibial cortex transverse distraction (partial corticotomy of the upper tibia, which was in normal condition, followed by 4 weeks of transverse distraction medially then laterally). We compared these patients with the last 137 consecutive patients we treated with standard surgical treatment, consisting of debridement, revascularization, local or free flap or skin equivalent, or graft reconstruction along with negative-pressure wound therapy between May 2011 and June 2013; there was a 1-year period during which both treatments were in use, and we did not include patients whose procedures were performed during this time in either group. Patients in both groups received standard off-loading and wound care. The patients lost to follow-up by 2 years (0.7% of the treatment group [one of 137] and 1.4% of the control group [two of 139]; p = 0.57) were excluded. The patients in the treatment and control groups had a mean age of 61 years and 60 years, respectively, and they were predominantly men in both groups (70% [95 of 136] versus 64% [88 of 137]; p = 0.32). There were no differences with respect to parameters associated with the likelihood of ulcer healing, such as diabetes and ulcer duration, ulcer grades and area, smoking, and arterial status. We compared the groups with respect to ulcer healing (complete epithelialization without discharge, maintained for at least 2 weeks, which was determined by an assessor not involved with clinical care) in a 2-year follow-up, the proportion of ulcers that healed by 6 months, major amputation, recurrence, and complications in the 2-year follow-up. Foot arterial status and perfusion were assessed in the tibial cortex transverse distraction group using CT angiography and perfusion imaging. Results The tibial cortex transverse distraction group had a higher proportion of ulcers that healed in the 2-year follow-up than the control group (96% [131 of 136] versus 68% [98 of 137]; odds ratio 10.40 [95% confidence interval 3.96 to 27.43]; p < 0.001).
   By 6 months, a higher proportion of ulcers healed in the tibia cortex transverse distraction group than the control group (93% [126 of 136] versus 41% [56 of 137]; OR 18.2 [95% CI 8.80 to 37.
   76]; p < 0.001). Lower proportions of patients in the tibia cortex transverse distraction group underwent major amputation (2.9% [four of 136] versus 23% [31 of 137], OR 0.10 [95% CI 0.04 to 0.30]; p < 0.001) or had recurrences 2.9% (4 of 136) versus 17% (23 of 137), OR 0.20 [95% CI 0.05 to 0.45]; p < 0.001) than the control group in 2-year follow-up. In the feet of the patients in the tibial cortex transverse distraction group, there was a higher density of small vessels (19 +/- 2.1/mm(2) versus 9 +/- 1.9/mm(2); mean difference 10/mm(2); p = 0.010), higher blood flow (24 +/- 5 mL/100 g/min versus 8 +/- 2.4 mL/100 g/min, mean difference 16 mL/100 g/min; p = 0.004) and blood volume (2.5 +/- 0.29 mL/100 g versus 1.3 +/- 0.33 mL/100 g, mean difference 1.2 mL/100 g; p = 0.03) 12 weeks postoperatively than preoperatively. Complications included closed fractures at the corticotomy site (in 1.5% of patients; two of 136), which were treated with closed reduction and healed, as well as pin-site infections (in 2.2% of patients; three of 136), which were treated with dressing changes and they resolved without osteomyelitis. Conclusions Proximal tibial cortex transverse distraction substantially facilitated healing and limb salvage and decreased the recurrence of severe and recalcitrant diabetic foot ulcers. The surgical techniques were relatively straightforward although the treatment was unorthodox, and the complications were few and minor. These findings suggest that tibial cortex transverse distraction is an effective procedure to treat severe and recalcitrant diabetic foot ulcers compared with standard surgical therapy. Randomized controlled trials are required to confirm these findings.
C1 [Chen, Yan; Zhen, Puxiang; Lin, Zhenxun; Gao, Wei; He, Lihuan; Ding, Yi; Liu, Guangwei; Lao, Shan; Zhao, Jinmin; Hua, Qikai] Guangxi Med Univ, Dept Bone & Joint Surg, Affiliated Hosp 1, 6 Shuangyong Rd, Nanning 530021, Peoples R China.
   [Kuang, Xiaocong] Guangxi Med Univ, Preclin Sch, Dept Physiopathol, Nanning, Peoples R China.
   [Zhou, Jia] Guangxi Med Univ, Affiliated Hosp 1, Dept Endocrinol, Nanning, Peoples R China.
   [Zeng, Zisan; Qiu, Shaohua] Shanxi Med Univ, Affiliated Hosp 1, Dept Radiol, Taiyuan, Peoples R China.
   [Qin, An] Shanghai Jiao Tong Univ, Peoples Hosp 9, Dept Orthopaed, Shanghai Key Lab Orthopaed Implants,Sch Med, Shanghai, Peoples R China.
   [Lu, William] Univ Hong Kong, Dept Orthopaed & Traumatol, Hong Kong, Peoples R China.
C3 Guangxi Medical University; Guangxi Medical University; Guangxi Medical
   University; Shanxi Medical University; Shanghai Jiao Tong University;
   University of Hong Kong
RP Hua, QK (通讯作者)，Guangxi Med Univ, Dept Bone & Joint Surg, Affiliated Hosp 1, 6 Shuangyong Rd, Nanning 530021, Peoples R China.
EM hqk100@yeah.net
RI zhao, jin/LBH-0351-2024; Chen, Yan/MDS-5942-2025; /T-9081-2019
FU National Natural Science Foundation of China [81601930]; Natural Science
   Foundation of Guangxi [2017GXNSFAA198318, 2016GXNSFBA380007,
   2017GXNSFAA198293]; Postdoctoral Science Foundation of China [223363];
   Science Foundation for the Excellent Young Scholars of Guangxi
   Collaborative Innovation Center for Biomedicine [GCICB-TC-2017003]
FX The institution of the authors (YC, QH) has received, during the study
   period, funding from the National Natural Science Foundation of China
   (81601930), Natural Science Foundation of Guangxi (2017GXNSFAA198318,
   2016GXNSFBA380007, and 2017GXNSFAA198293), and Postdoctoral Science
   Foundation of China (223363), Science Foundation for the Excellent Young
   Scholars of Guangxi Collaborative Innovation Center for Biomedicine
   (GCICB-TC-2017003).
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NR 52
TC 79
Z9 124
U1 4
U2 57
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0009-921X
EI 1528-1132
J9 CLIN ORTHOP RELAT R
JI Clin. Orthop. Rel. Res.
PD APR
PY 2020
VL 478
IS 4
BP 836
EP 851
DI 10.1097/CORR.0000000000001075
PG 16
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA LD7WN
UT WOS:000526239700028
PM 31794478
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Alawi, SA
   Taqatqeh, F
   Matschke, J
   Bota, O
   Dragu, A
AF Alawi, Seyed Arash
   Taqatqeh, Feras
   Matschke, Jan
   Bota, Olimpiu
   Dragu, Adrian
TI Use of a collagen-elastin matrix with split-thickness skin graft for
   defect coverage in complex wounds
SO JOURNAL OF WOUND CARE
LA English
DT Article
DE collagen-elastin matrix; complicated wound; wound; wound care; wound
   dressing; wound healing; wound therapy; negative pressure wound therapy;
   soft tissue coverage; split-thickness skin graft
ID RECONSTRUCTIVE LADDER; FLAP
AB Objective: Severe soft tissue damage with destruction of the dermis requires plastic reconstructive treatment. For multimorbid patients or patients unable to undergo major reconstructive surgery, use of dermal substitutes, such as a collagen-elastin matrix (CEM) with a splitthickness skin graft (STSG), instead of local or free flap surgery, may be a valid and easy treatment option. We aimed to investigate and compare the outcomes and rate of successful defect reconstruction using CEM plus STSG, using either a one-step approach (simultaneous CEM and STSG) or a two-step approach (CEM and negative wound pressure therapy (NPWT), with secondary STSG transplantation). Method: A single-centre, retrospective follow-up study of patients who had received CEM was conducted. Wounds had been treated with an STSG transplantation covering a CEM (MatriDerm, MedSkin Solutions Dr. Suwelack AG, Germany). Previous attempts at wound closure with conventional methods had failed in the selected patient population, which would usually have resulted in flap surgery. Results: Overall, 46 patients were included (mean age 60.9 +/- 20.0 years), with a total of 49 wound sites. We analysed 38 patients with wounds that did not require flap coverage; 18 patients received the one-step approach and 20 patients received the two-step approach. The mean follow-up in these patients was 22 +/- 11.5 months, and one patient was lost to follow-up. Overall, 29 (78.4%) wounds remained comorbidities, such as diabetes, alcohol misuse and smoking. Using the one-step approach, long-term defect coverage was achieved in 13 (76.5%) wounds and 16 (80.0%) wounds were closed using the two-step approach. However, there was no statistically significant differences between the one- or two-step approaches regarding the rate of development of a wound healing disorder. Conclusion: Wound closure was achieved in 38 complex wounds using CEM plus STSG, while 11 wounds needed secondary flap coverage. In the flap-free wounds, there were no statistically significant differences between the one-step versus two-step approach. Using a simple defect reconstruction algorithm, we successfully used CEM plus STSG to treat complex wounds. Declaration of interest: Editorial assistance was provided by MedSkin Solutions Dr. Suwelack AG, Germany. The company had no influence on the content of the paper. The authors have no other conflicts of interest to declare
C1 [Alawi, Seyed Arash; Taqatqeh, Feras; Dragu, Adrian] Tech Univ Dresden, Univ Ctr Orthoped Trauma & Plast Surg, Univ Hosp Carl Gustav Carus, Dept Plast & Hand Surg, Dresden, Germany.
   [Matschke, Jan] Tech Univ Dresden, Dept Maxillofacial Surg, Univ Hosp Carl Gustav Carus, Dresden, Germany.
   [Bota, Olimpiu] Iuliu Hatieganu Univ Med, Emergency Cty Hosp Cluj Napoca, Dept Plast Surg, Surg Clin 1, Cluj Napoca, Romania.
C3 Technische Universitat Dresden; Carl Gustav Carus University Hospital;
   Technische Universitat Dresden; Carl Gustav Carus University Hospital;
   Iuliu Hatieganu University of Medicine & Pharmacy
RP Alawi, SA (通讯作者)，Tech Univ Dresden, Univ Ctr Orthoped Trauma & Plast Surg, Univ Hosp Carl Gustav Carus, Dept Plast & Hand Surg, Dresden, Germany.
EM seyed-arash.alawi@uniklinikum-dresden.de
RI Dragu, Adrian/AAH-3506-2019; Alawi, Seyed Arash/AFK-2242-2022; Bota,
   Olimpiu/AAN-4292-2021
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NR 20
TC 6
Z9 6
U1 0
U2 0
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2062-2916
J9 J WOUND CARE
JI J. Wound Care
PD JAN
PY 2024
VL 33
IS 1
PG 7
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA KG5F5
UT WOS:001178811300004
DA 2026-07-24
ER

PT J
AU Byun, SH
   Lee, J
   Kim, JH
AF Byun, Sung Hye
   Lee, Jonghoon
   Kim, Jong Hae
TI Ultrasound-guided bilateral combined inguinal femoral and subgluteal
   sciatic nerve blocks for simultaneous bilateral below-knee amputations
   due to bilateral diabetic foot gangrene unresponsive to peripheral
   arterial angioplasty and bypass surgery in a coagulopathic patient on
   antiplatelet therapy with a history of percutaneous coronary
   intervention for ischemic heart disease A case report
SO MEDICINE
LA English
DT Article
DE amputation; coronary artery disease; femoral nerve; nerve block; sciatic
   nerve
ID BRACHIAL-PLEXUS; REGIONAL ANESTHESIA; THYROID-SURGERY; MEPIVACAINE;
   ROPIVACAINE; INTERSCALENE; BUPIVACAINE; EPINEPHRINE; PRILOCAINE;
   ANALGESIA
AB Background: Patients on antiplatelet therapy following percutaneous coronary intervention can become coagulopathic due to infection. Performing regional anesthesia for bilateral surgery in such cases is challenging. We report a case of successful combined inguinal femoral and subgluteal sciatic nerve blocks (CFSNBs) for simultaneous bilateral below-knee amputations in a coagulopathic patient on antiplatelet therapy.
   Methods: A 70-year-old male patient presented with pain in both feet due to diabetic foot syndrome. The condition could not be managed by open amputations of the toes at the metatarsal bones and subsequent antibiotic therapy. Computed tomographic angiography showed significant stenosis in the arteries supplying the lower limbs, indicating atherosclerotic gangrene in both feet. Balloon angioplasty and bypass surgery with subsequent debridements with application of negative-pressure wound therapy and additional open amputations did not improve the patient's clinical condition: his leukocyte counts and C-reactive protein levels were above the normal range, and his prothrombin and activated partial thromboplastin times were increased.
   Results: Simultaneous bilateral below-knee amputations were performed under ultrasound-guided CFSNBs. Following left CFSNBs using 45mL of a local anesthetic mixture (1: 1 ratio of 1.0% mepivacaine and 0.75% ropivacaine), the left below-knee amputation was performed for 76 minutes. Subsequently, under right CFSNBs using 47mL of the local anesthetic mixture, the right below-knee amputation proceeded for 85 minutes. Throughout each surgery, dexmedetomidine was continuously administered, and a sensory blockade was well maintained in both limbs. The patient did not complain of pain due to regression of the first CFSNBs during the second surgery. The CFSNBs successfully prevented tourniquet pain. Local anesthetic systemic toxicity (LAST) and hemodynamic instability due to tourniquet deflation and administration of dexmedetomidine did not occur. No additional analgesic was required to supplement insufficient surgical anesthesia. Postoperatively, no neurologic complications related to the CFSNBs were reported.
   Conclusion: The timely placement of bilateral CFSNBs immediately before the corresponding limb surgery, which lasted for less than 2 hours, provided successful surgical anesthesia in both lower limbs without LAST or pain due to regression of the CFSNBs that were performed during the first surgery.
C1 [Byun, Sung Hye; Lee, Jonghoon; Kim, Jong Hae] Catholic Univ Daegu, Sch Med, Dept Anesthesiol & Pain Med, 33 Duryugongwon Ro 17 Gil, Daegu 42472, South Korea.
C3 Catholic University of Daegu
RP Kim, JH (通讯作者)，Catholic Univ Daegu, Sch Med, Dept Anesthesiol & Pain Med, 33 Duryugongwon Ro 17 Gil, Daegu 42472, South Korea.
EM usmed@cu.ac.kr
RI Byun, Sung-Hye/AEK-1234-2022; Kim, Jonghae/AAH-5310-2021
OI Byun, Sung-Hye/0000-0002-9287-5087; Kim, Jonghae/0000-0003-1222-0054
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NR 27
TC 6
Z9 10
U1 0
U2 12
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0025-7974
EI 1536-5964
J9 MEDICINE
JI Medicine (Baltimore)
PD JUL
PY 2016
VL 95
IS 29
AR e4324
DI 10.1097/MD.0000000000004324
PG 5
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA DS4RH
UT WOS:000380768000053
PM 27442683
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Chen, P
   Carville, K
   Swanson, T
   Lazzarini, PA
   Charles, J
   Cheney, J
   Prentice, J
AF Chen, Pamela
   Carville, Keryln
   Swanson, Terry
   Lazzarini, Peter A.
   Charles, James
   Cheney, Jane
   Prentice, Jenny
CA Australian Diabetes-Related Foot D
TI Australian guideline on wound healing interventions to enhance healing
   of foot ulcers: part of the 2021 Australian evidence-based guidelines
   for diabetes-related foot disease
SO JOURNAL OF FOOT AND ANKLE RESEARCH
LA English
DT Article
DE Diabetes-related foot ulcer; Diabetic foot; Foot ulcer; guideline;
   Recommendations; Treatment; Wound healing; Wound treatment
ID HYPERBARIC-OXYGEN THERAPY; LOWER-EXTREMITY ULCERS; DOUBLE-BLIND; SUCROSE
   OCTASULFATE; TOPICAL PHENYTOIN; CONTROLLED-TRIAL; MANAGEMENT;
   MULTICENTER; EFFICACY; PREVENTION
AB Background: Diabetes-related foot ulceration (DFU) has a substantial burden on both individuals and healthcare systems both globally and in Australia. There is a pressing need for updated guidelines on wound healing interventions to improve outcomes for people living with DFU. A national expert panel was convened to develop new Australian evidence-based guidelines on wound healing interventions for people with DFU by adapting suitable international guidelines to the Australian context
   Methods: The panel followed National Health and Medical Research Council (NHMRC) procedures to adapt suitable international guidelines by the International Working Group of the Diabetic Foot (IWGDF) to the Australian context. The panel systematically screened, assessed and judged all IWGDF wound healing recommendations using ADAPTE and GRADE frameworks for adapting guidelines to decide which recommendations should be adopted, adapted or excluded in the Australian context. Each recommendation had their wording, quality of evidence, and strength of recommendation re-evaluated, plus rationale, justifications and implementation considerations provided for the Australian context. This guideline underwent public consultation, further revision and approval by ten national peak bodies.
   Results: Thirteen IWGDF wound healing recommendations were evaluated in this process. After screening, nine recommendations were adopted and four were adapted after full assessment. Two recommendations had their strength of recommendations downgraded, one intervention was not currently approved for use in Australia, one intervention specified the need to obtain informed consent to be acceptable in Australia, and another was reworded to clarify best standard of care. Overall, five wound healing interventions have been recommended as having the evidence-based potential to improve wound healing in specific types of DFU when used in conjunction with other best standards of DFU care, including sucrose-octasulfate impregnated dressing, systemic hyperbaric oxygen therapy, negative pressure wound therapy, placental-derived products, and the autologous combined leucocyte, platelet and fibrin dressing. The six new guidelines and the full protocol can be found at https://diabetesfeetaustralia.org/new-guidelines/
   Conclusions: The IWGDF guideline for wound healing interventions has been adapted to suit the Australian context, and in particular for geographically remote and Aboriginal and Torres Strait Islander people. This new national wound healing guideline, endorsed by ten national peak bodies, also highlights important considerations for implementation, monitoring, and future research priorities in Australia.
C1 [Chen, Pamela] Univ Tasmania, Sch Med, Hobart, Tas, Australia.
   [Chen, Pamela] Univ Western Australia, Sch Allied Hlth, Podiatr Med & Surg, Perth, WA, Australia.
   [Chen, Pamela] Ramsay Healthcare Australia, Joondalup Hlth Campus, Perth, WA, Australia.
   [Carville, Keryln] Silver Chain Grp, Perth, WA, Australia.
   [Carville, Keryln] Curtin Univ, Perth, WA, Australia.
   [Lazzarini, Peter A.] Queensland Univ Technol, Sch Publ Hlth & Social Work, Brisbane, Qld, Australia.
   [Lazzarini, Peter A.] Prince Charles Hosp, Allied Hlth Res Collaborat, Brisbane, Qld, Australia.
   [Charles, James] Griffith Univ, Peoples Hlth Unit 1, Fac Hlth, Gold Coast, Qld, Australia.
   [Cheney, Jane] Diabet Victoria, Melbourne, Vic, Australia.
   [Prentice, Jenny] Hall & Prior Hlth & Aged Care Grp, Perth, WA, Australia.
   Diabet Feet Australia, Brisbane, Qld, Australia.
   [Australian Diabetes-Related Foot D] Australian Diabet Soc, Sydney, NSW, Australia.
C3 University of Tasmania; University of Western Australia; Curtin
   University; Queensland University of Technology (QUT); Prince Charles
   Hospital; Griffith University
RP Chen, P (通讯作者)，Univ Tasmania, Sch Med, Hobart, Tas, Australia.; Chen, P (通讯作者)，Univ Western Australia, Sch Allied Hlth, Podiatr Med & Surg, Perth, WA, Australia.; Chen, P (通讯作者)，Ramsay Healthcare Australia, Joondalup Hlth Campus, Perth, WA, Australia.
EM pamelachen@iinet.net.au
OI Lazzarini, Peter/0000-0002-8235-7964; Chen, Pamela/0000-0001-8082-5050
FU National Diabetes Services Scheme; Australian Diabetes Society
FX The Australian Diabetes-related Foot Disease Guidelines & Pathways
   Project received part funding from the National Diabetes Services Scheme
   and inkind secretariat support and oversight from Diabetic Foot
   Australia and the Australian Diabetes Society.
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NR 56
TC 20
Z9 25
U1 2
U2 15
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
EI 1757-1146
J9 J FOOT ANKLE RES
JI J. Foot Ankle Res.
PD MAY 25
PY 2022
VL 15
IS 1
AR 40
DI 10.1186/s13047-022-00544-5
PG 24
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA 1M2LC
UT WOS:000799804300001
PM 35610723
OA Green Submitted, Green Published, gold
DA 2026-07-24
ER

PT J
AU Peters, EJ
   Lipsky, BA
   Aragón-Sánchez, J
   Boyko, EJ
   Diggle, M
   Embil, JM
   Kono, S
   Lavery, LA
   Senneville, E
   Urbancic-Rovan, V
   Van Asten, SA
   Jeffcoate, WJ
AF Peters, E. J.
   Lipsky, B. A.
   Aragon-Sanchez, J.
   Boyko, E. J.
   Diggle, M.
   Embil, J. M.
   Kono, S.
   Lavery, L. A.
   Senneville, E.
   Urbancic-Rovan, V.
   Van Asten, S. A.
   Jeffcoate, W. J.
CA Int Working Grp Diabet Foot
TI Interventions in the management of infection in the foot in diabetes: a
   systematic review
SO DIABETES-METABOLISM RESEARCH AND REVIEWS
LA English
DT Article; Proceedings Paper
CT 2015 IWGDF Guidance on the Prevention and Management of Foot Problems in
   Diabetes
CY MAY 20-23, 2015
CL The Hague, NETHERLANDS
DE diabetes mellitus; diabetic foot infection; osteomyelitis; antibiotics;
   surgery; systematic review
ID COLONY-STIMULATING FACTOR; SKIN-STRUCTURE INFECTIONS; COMPLICATED SKIN;
   CONTROLLED-TRIAL; PIPERACILLIN-TAZOBACTAM; ANTIBIOTIC-THERAPY;
   OPEN-LABEL; ADJUNCTIVE THERAPY; MULTICENTER; ERTAPENEM
AB The expert panel on diabetic foot infection (DFI) of the International Working Group on the Diabetic Foot conducted a systematic review seeking all published reports relating to any type of treatment for infection of the foot in persons with diabetes published as of 30 June 2014. This review, conducted with both PubMed and EMBASE, was used to update an earlier one undertaken on 30 June 2010 using the same search string. Eligible publications included those that had outcome measures reported for both a treated and a control population that were managed either at the same time, or as part of a before-and-after case design. We did not include studies that contained only information related to definition or diagnosis, but not treatment, of DFI. The current search identified just seven new articles meeting our criteria that were published since the 33 identified with the previous search, making a total of 40 articles from the world literature. The identified articles included 37 randomised controlled trials (RCTs) and three cohort studies with concurrent controls, and included studies on the use of surgical procedures, topical antiseptics, negative pressure wound therapy and hyperbaric oxygen. Among the studies were 15 RCTs that compared outcomes of treatment with new antibiotic preparations compared with a conventional therapy in the management of skin and soft tissue infection. In addition, 10 RCTs and 1 cohort study compared different treatments for osteomyelitis in the diabetic foot. Results of comparisons of different antibiotic regimens generally demonstrated that newly introduced antibiotic regimens appeared to be as effective as conventional therapy (and also more cost-effective in one study), but one study failed to demonstrate non-inferiority of a new antibiotic compared with that of a standard agent. Overall, the available literature was both limited in both the number of studies and the quality of their design. Thus, our systematic review revealed little evidence upon which to make recommendations for treatment of DFIs. There is a great need for further well-designed trials that will provide robust data upon which to make decisions about the most appropriate treatment of both skin and soft tissue infection and osteomyelitis in diabetic patients. Copyright (c) 2016 John Wiley & Sons, Ltd.
C1 [Peters, E. J.; Van Asten, S. A.] Vrije Univ Amsterdam Med Ctr, Amsterdam, Netherlands.
   [Lipsky, B. A.] Univ Hosp Geneva, Geneva, Switzerland.
   [Lipsky, B. A.] Fac Med, Geneva, Switzerland.
   [Lipsky, B. A.] Univ Oxford, Oxford, England.
   [Aragon-Sanchez, J.] La Paloma Hosp, Las Palmas Gran Canaria, Spain.
   [Boyko, E. J.] Seattle Epidemiol Res & Informat Ctr, Dept Vet Affairs Puget Sound Hlth Care Syst, Seattle, WA USA.
   [Boyko, E. J.] Univ Washington, Seattle, WA 98195 USA.
   [Diggle, M.] Nottingham Univ Hosp Trust, Nottingham, England.
   [Embil, J. M.] Univ Manitoba, Winnipeg, MB, Canada.
   [Kono, S.] Kyoto Med Ctr, Natl Hosp Org, WHO Collaborating Ctr Diabet, Kyoto, Japan.
   [Lavery, L. A.; Van Asten, S. A.] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA.
   [Lavery, L. A.; Van Asten, S. A.] Parkland Hosp, Dallas, TX 75390 USA.
   [Senneville, E.] Gustave Dron Hosp, Tourcoing, France.
   [Urbancic-Rovan, V.] Univ Med Ctr, Ljubljana, Slovenia.
   [Jeffcoate, W. J.] Nottingham Univ Hosp Trust, Nottingham, England.
C3 Vrije Universiteit Amsterdam; Amsterdam University Medical Center;
   University of Geneva; University of Geneva; University of Oxford;
   University of Washington; University of Washington Seattle; University
   of Nottingham; Nottingham University Hospital NHS Trust; University of
   Manitoba; University of Texas System; University of Texas Southwestern
   Medical Center; University Medical Centre Ljubljana; University of
   Nottingham; Nottingham University Hospital NHS Trust
RP Peters, EJ (通讯作者)，Vrije Univ Amsterdam Med Ctr, Dept Internal Med, Room ZH-4A35,POB 7057, NL-1007 MB Amsterdam, Netherlands.
EM e.peters@vumc.nl
RI Aragón-Sánchez, Javier/AAR-9727-2021; Boyko, Edward/G-2484-2017; Diggle,
   Mathew/V-7678-2019; Lipsky, Benjamin A/IZE-0823-2023; Van Asten,
   Suzanne/OYE-3899-2025; Peters, Edgar/B-7790-2014
OI Aragón-Sánchez, Javier/0000-0001-6307-5040; Boyko,
   Edward/0000-0002-3695-192X; Diggle, Mathew/0000-0001-5773-0686; Lavery,
   Lawrence/0000-0002-7920-9952; van Asten, Suzanne/0000-0002-2753-4577;
   Lipsky, Benjamin A/0000-0001-9886-5114; Peters,
   Edgar/0000-0002-3410-1227
FU Innocoll; Osiris; MacroCure; ThermoTrek; Integra; GlaxoSmithKline; KCI;
   Cardinal; Dipexium
FX B. A. L.: Research funding from Innocoll; consulting for Innocoll,
   Merck, Pfizer, Dipexium, Cubist, Cerexa, KCI/Acelity; L. L. is on the
   speaker's bureau for Osiris, Integra, PamLabs, Smit & Nephew; consultant
   for KCI, PamLabs, Innovacyn; Stock ownership in Prizm Medical; received
   research grants from Osiris, MacroCure, ThermoTrek, Integra,
   GlaxoSmithKline, KCI, Cardinal, Dipexium.
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NR 56
TC 60
Z9 87
U1 0
U2 23
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1520-7552
EI 1520-7560
J9 DIABETES-METAB RES
JI Diabetes-Metab. Res. Rev.
PD JAN
PY 2016
VL 32
SU 1
BP 145
EP 153
DI 10.1002/dmrr.2706
PG 9
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Endocrinology & Metabolism
GA DC3QP
UT WOS:000369134100014
PM 26344844
OA Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Hultman, CS
   Friedstat, JS
AF Hultman, Charles Scott
   Friedstat, Jonathan S.
TI The ACAPS and SESPRS Surveys to Identify the Most Influential Innovators
   and Innovations in Plastic Surgery No Line on the Horizon
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE disruptive innovation; incremental change; strategy; marketing;
   competition; value-based health care
ID CREATIVITY
AB Introduction: Who and what have been the most influential innovators and innovations in plastic surgery? This historical paper attempts to determine our most important contributors and contributions.
   Methods: We conducted an anonymous, 7-question, web-based survey of all members of the American Council of Academic Plastic Surgeons (ACAPS) and the Southeastern Society of Plastic and Reconstructive Surgeons (SESPRS). We asked respondents to list their top 5 most influential surgeons, the most important publications or bodies of work, and the most important innovations in plastic surgery, past and present.
   Results: Of the 86 nominees from ACAPS, the 15 most influential surgeons of the past century were Tessier, Buncke, Murray, Millard, Gillies, Mathes, Jurkiewicz, Taylor, Converse, Blair, Kleinert, Edgerton, McCraw, Peacock, and Brown, in that order. The most 10 influential surgeons of the current era are Rohrich, McCarthy, Wei, Lee, Siemionow, Allen, Coleman, Guyuron, Serletti, and Nahai. Of the 112 nominees from SESPRS, the 15 most influential surgeons of the past century were Gillies, Millard, Tessier, Buncke, Murray, Jurkiewicz, Hartrampf, Mathes, Taylor, Bostwick, McCraw, Furlow, Converse, Peacock, and Blair, in that order. The 10 most influential surgeons of the current era are Rohrich, Nahai, Wei, McCarthy, Coleman, MacKinnon, McGrath, Rubin, Guyuron, and Hammond. Pooled from both lists, the 10 most influential publications or bodies of work were Hartrampf's TRAM flap, Millard's cleft lip repair, McCraw/Mathes/Nahai's myocutaneous flaps, Furlow's cleft palate repair, Tessier's cleft classification and craniofacial repairs, Ramirez's components separation, Buncke's replantation/toe-to-thumb transfer, McCarthy's mandibular distraction osteogenesis, Taylor's free flap and angiosome concepts, and Murray's kidney transplant. The top 10 innovations of the 20th century were myocutaneous flaps, microsurgery, craniofacial surgery, skin grafts, transplantation, liposuction, bioimplants, distraction osteogenesis, angiosome anatomy, and rigid fixation. The 10 most important, current innovations are hand/face transplantation, fat grafting, stem cells, neurotoxins and soft-tissue fillers, biologic scaffolds, information technology, tissue engineering and regenerative medicine, negative pressure wound therapy, perforator flaps, and noninvasive imaging.
   Conclusion: Plastic surgery includes a rich history of both incremental and disruptive innovation, which has endowed our discipline with a competitive advantage over other medical and surgical subspecialties. Based upon our past success in managing change, there may be no limit, or no line on the horizon, as to what is possible, provided that we pursue innovation in a systematic way that combines creativity and discipline.
C1 [Hultman, Charles Scott; Friedstat, Jonathan S.] Univ N Carolina, Div Plast Surg, Chapel Hill, NC 27599 USA.
C3 University of North Carolina; University of North Carolina Chapel Hill
RP Hultman, CS (通讯作者)，Univ N Carolina, Div Plast Surg, Suite 7038,CB 7195, Chapel Hill, NC 27599 USA.
EM cshult@med.unc.edu
FU Ethel and James Valone Plastic Surgery Research Endowment Alpha Omega
   Alpha Edward D. Harris Professionalism Grant
FX Conflicts of interest and sources of funding: Ethel and James Valone
   Plastic Surgery Research Endowment Alpha Omega Alpha Edward D. Harris
   Professionalism Grant.
CR [Anonymous], J PLAST SURG HAND SU
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   Waljee JF, 2013, CLIN PLAST SURG, V40, P271, DOI 10.1016/j.cps.2012.10.003
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   Zhang WJ, 2013, ANN PLAS SURG, V71, P103, DOI 10.1097/SAP.0b013e31824189ba
NR 18
TC 14
Z9 15
U1 1
U2 15
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD JUN
PY 2014
VL 72
IS 6
BP S202
EP S207
DI 10.1097/SAP.0000000000000089
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA AI3BY
UT WOS:000336734900026
PM 24835875
DA 2026-07-24
ER

PT J
AU Wei, DH
   Li, BY
   Wang, JN
   Gao, L
AF Wei, Dehua
   Li, Boya
   Wang, Jiangning
   Gao, Lei
TI Global Research Trends and Healthcare Innovations in Plantar Pressure
   Management for Diabetic Foot Ulcers: A 25-Year Bibliometric and Visual
   Analysis
SO HEALTHCARE
LA English
DT Article
DE diabetic foot ulcers; plantar pressure; bibliometric analysis;
   CiteSpace; VOSviewer; foot biomechanics; offloading; wound healing;
   research trends; co-citation analysis
ID OFF-LOADING DEVICES; OFFLOADING INTERVENTIONS; IWGDF GUIDANCE; WOUND
   THERAPY; HIGH-RISK; PREVENTION; ULCERATION; MULTICENTER; RECURRENCE;
   GUIDELINES
AB Background: Diabetic foot ulcers (DFUs) represent a major chronic complication of diabetes mellitus, often leading to severe infection, amputation, and reduced quality of life. Among various factors affecting DFUs, plantar pressure plays a pivotal role in ulcer formation and recurrence. Despite growing interest in this domain, few studies have comprehensively evaluated the research landscape concerning plantar pressure in the context of DFUs from a bibliometric perspective. Aim: To conduct a comprehensive bibliometric analysis and visualization of global research trends, hotspots, and collaborative networks in the field of plantar pressure-related diabetic foot studies from 2000 to 2024. Methods: A systematic search was conducted in the Web of Science Core Collection (WoSCC) on 16 February 2025, for articles published between 2000 and 2024 using terms related to "diabetic foot" and "plantar pressure". A total of 2518 records were retrieved, from which 2110 English-language articles and reviews were included. Bibliometric and visual analyses were performed using Microsoft Excel 2021, VOSviewer (v1.6.20), CiteSpace (v6.4.R1), Charticulator, and Scimago Graphica. Analyses included publication trends, country/institution/author collaborations, journal distributions, keyword co-occurrence and clustering, citation bursts, and reference co-citation networks. Results: A total of 2110 publications were identified, showing an overall increase in annual publication output from 2000 to 2024, with some year-to-year fluctuations. The United States led in publication volume (678 articles), citation frequency, and H-index, followed by the United Kingdom and China. Armstrong, David was the most prolific and also had the highest H-index among the listed authors, while the University of Amsterdam was the leading institution. "Journal of Wound Care" had the highest publication count, whereas "Diabetes Care" ranked first in citation frequency. Keyword analysis revealed major research clusters including "diabetic foot", "plantar pressure", "wound healing", "offloading", and "negative pressure wound therapy". Recent trends show an increased focus on microcirculation, regenerative medicine, customized footwear, and wound care technologies. Conclusions: The bibliometric analysis reveals research trends and current hotspots in plantar pressure management for diabetic foot ulcers, with a particular focus on managing plantar pressure through personalized offloading strategies and custom footwear. These findings highlight the practical value of tailoring interventions to individual patient needs, emphasizing the importance of biomechanical factors in ulcer prevention and healing.
C1 [Wei, Dehua; Li, Boya; Wang, Jiangning; Gao, Lei] Capital Med Univ, Affiliated Beijing Shijitan Hosp, Orthoped Dept, 10 Yangfangdian Tieyi Rd, Beijing 100038, Peoples R China.
C3 Capital Medical University
RP Gao, L (通讯作者)，Capital Med Univ, Affiliated Beijing Shijitan Hosp, Orthoped Dept, 10 Yangfangdian Tieyi Rd, Beijing 100038, Peoples R China.
EM weidehua6290@bjsjth.cn; liboya@bjsjth.cn; wangjn@bjsjth.cn;
   gaolei3337@bjsjth.cn
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NR 66
TC 0
Z9 0
U1 5
U2 5
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
EI 2227-9032
J9 HEALTHCARE-BASEL
JI Healthcare
PD MAR 19
PY 2026
VL 14
IS 6
AR 780
DI 10.3390/healthcare14060780
PG 31
WC Health Care Sciences & Services; Health Policy & Services
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Health Care Sciences & Services
GA FR3GM
UT WOS:001725545900001
PM 41897233
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Siebenbürger, G
   Grabein, B
   Schenck, T
   Kammerlander, C
   Böcker, W
   Zeckey, C
AF Siebenbuerger, G.
   Grabein, B.
   Schenck, T.
   Kammerlander, C.
   Boecker, W.
   Zeckey, C.
TI Eradication of Acinetobacter baumannii/Enterobacter
   cloacae complex in an open proximal tibial fracture and closed drop
   foot correction with a multidisciplinary approach using the Taylor
   Spatial Frame®: a case report
SO EUROPEAN JOURNAL OF MEDICAL RESEARCH
LA English
DT Article
DE Proximal tibial fracture; Locked plating; Open fracture; Acinetobacter
   baumannii; Complication; Outcome; Hexapod external fixation; Latissimus
   dorsi muscle flap; Antibiotics; Infection
ID ANTIBIOTIC-IMPREGNATED CEMENT; COLISTIN; CLASSIFICATION; OSTEOMYELITIS;
   MANAGEMENT; INFECTIONS; OUTCOMES; BEADS
AB BackgroundMulti-drug-resistant bacteria (e.g. Carbapenem-resistant Acinetobacter baumannii, extended-spectrum betalactamase or carbapenemase-producing enterobacteriaceae) are emerging in early-onset infections. So far, there is no report describing the eradication of these bacteria in a osseous infection of an open proximal tibial fracture in combination with the hexapod technology to address both osseous consolidation and closed drop foot correction.Case presentationAfter sustaining a proximal tibial fracture (Gustilo 3B), a 41-year-old man was primarily treated with open reduction and internal fixation by a locking plate and split-thickness skin graft in the home country. At the time of admission to our hospital there was a significant anterolateral soft tissue defect covered with an already-necrotic split-thickness graft and suspicious secretion. CAT and MRI scans revealed no signs of osseous healing, intramedullary distinctive osteomyelitis, as well as a large abscess zone in the dorsal compartment. Multiple wound smears showed multi-drug-resistant bacteria: Acinetobacter baumannii (Carbapenem resistant) as well as Enterobacter cloacae complex (AmpC overexpression). After implant removal, excessive osseous and intramedullary debridements using the Reamer Irrigator Aspirator (RIA((R))) as well as initial negative pressure wound therapy were performed. Colistin hand-modelled chains and sticks were applied topically as well as an adjusted systemic antibiotic scheme was applied. After repetitive surgical interventions, the smears showed bacterial eradication and the patient underwent soft tissue reconstruction with a free vascularized latissimus dorsi muscle flap. External fixation was converted to a hexapod fixator (TSF (R)) to correct primary varus displacement, axial assignment and secure osseous healing. A second ring was mounted to address the fixed drop foot in a closed fashion without further intervention. At final follow-up, 12months after trauma, the patient showed good functional recovery with osseous healing, intact soft tissue with satisfactory cosmetics and no signs of reinfection.ConclusionsA multidisciplinary approach with orthopaedic surgeons for debridement, planning and establishing osseous and joint correction and consolidation, plastic surgeons for microvascular muscle flaps for soft tissue defect coverage as well as clinical microbiologists for the optimized anti-infective treatment is essential in these challenging rare cases.Level of evidenceLevel IV.
C1 [Siebenbuerger, G.; Kammerlander, C.; Boecker, W.; Zeckey, C.] Ludwig Maximilians Univ Munchen, LMU Munich, Univ Hosp, Dept Gen Trauma & Reconstruct Surg, Marchioninistr 15, D-81377 Munich, Germany.
   [Grabein, B.] Ludwig Maximilians Univ Munchen, LMU Munich, Univ Hosp, Dept Clin Microbiol & Hosp Hyg, Marchioninistr 15, D-81377 Munich, Germany.
   [Schenck, T.] Ludwig Maximilians Univ Munchen, LMU Munich, Univ Hosp, Dept Hand Plast & Aesthet Surg, Nussbaumstr 20, D-80336 Munich, Germany.
C3 University of Munich; University of Munich; University of Munich
RP Zeckey, C (通讯作者)，Ludwig Maximilians Univ Munchen, LMU Munich, Univ Hosp, Dept Gen Trauma & Reconstruct Surg, Marchioninistr 15, D-81377 Munich, Germany.
EM Christian.Zeckey@med.uni-muenchen.de
RI Kammerlander, Christian/Z-2246-2019; /ADL-6367-2022
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NR 33
TC 8
Z9 12
U1 0
U2 7
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 0949-2321
EI 2047-783X
J9 EUR J MED RES
JI Eur. J. Med. Res.
PD JAN 19
PY 2019
VL 24
AR 2
DI 10.1186/s40001-019-0360-2
PG 8
WC Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Research & Experimental Medicine
GA HI1JW
UT WOS:000456202600001
PM 30660181
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Srinivas, S
   Coleman, JR
   Baselice, H
   Scarlet, S
   Tracy, BM
AF Srinivas, Shruthi
   Coleman, Julia R.
   Baselice, Holly
   Scarlet, Sara
   Tracy, Brett M.
TI Open or Closed? Management of Skin Incisions After Emergency General
   Surgery Laparotomies
SO JOURNAL OF SURGICAL RESEARCH
LA English
DT Article
DE Emergency general surgery; Hollow viscus perforation; Laparotomy; Skin
   management; Surgical site infection; Wound class
ID SURGICAL SITE INFECTION; PRESSURE WOUND THERAPY; RISK-FACTORS;
   COLORECTAL SURGERY; TRAUMA LAPAROTOMY; RANDOMIZED-TRIAL; CLOSURE
AB Introduction: We sought to determine if there was a relationship between skin management and surgical site infections (SSIs) among patients undergoing a laparotomy for emergency general surgery (EGS). We hypothesize that skin closure technique is not associated with SSI. Methods: We performed a retrospective review of adult patients (>18 y) who underwent an exploratory laparotomy for EGS conditions within 6 h of surgical consultation from 2015 to 2019. Patients whose fascia was not closed during the index operation were excluded. Patients were divided into groups: open skin (OS) and closed skin (CS). OS included negative pressure wound therapy or wet-to-dry gauze; CS included closure with staples or sutures. Our primary outcome was the rate of SSI. Results: The cohort comprised 388 patients: 42.3% OS (n = 164) and 57.7% CS (n = 224). The OS group had greater rates of systemic inflammatory response syndrome [SIRS] (54.9% versus 27.7%, P < 0.0001), hollow viscus perforation [HVP] (71.3% versus 20.5%, P < 0.0001), and peritoneal drains (51.2% versus 17.9%, P < 0.0001). Rates of OS management increased as wound class severity increased (0% [I] versus 12.2% [II] versus 15.9% [III] versus 72% [IV], P < 0.0001). The SSI rate for the cohort was 3.6% (n = 14); there was no difference in SSI rates (2.7% versus 4.9%, P = 0.3) between the CS or OS groups. Median length of stay was longer for the OS group (10 d versus 6.5 d, P < 0.0001). Independent predictors of OS management were SIRS (adjusted odds ratio [aOR] 1.72, 95% confidence interval [CI] 1.01-2.93, P = 0.04), HVP (aOR 2.03, 95% CI 1.09-3.8, P = 0.03), and class III/IV wounds (aOR 8.65, 95% CI 4.43-16.89, P < 0.0001). Conclusions: OS management occurs more often in patients with SIRS, HVP, and dirty wounds after EGS laparotomies. However, we found no difference in SSI between groups, suggesting that skin closure can be considered in contaminated or dirty wounds. (c) 2024 Elsevier Inc. All rights are reserved, including those for text and data mining, AI training, and similar technologies.
C1 [Srinivas, Shruthi; Coleman, Julia R.; Baselice, Holly; Scarlet, Sara; Tracy, Brett M.] Ohio State Univ, Wexner Med Ctr, Dept Surg, Columbus, OH USA.
C3 University System of Ohio; Ohio State University
RP Tracy, BM (通讯作者)，Ohio State Univ, Wexner Med Ctr, Dept Surg, Div Trauma Crit Care & Burn, 395 W 12th Ave, Columbus, OH 43210 USA.
EM brett.tracy@osumc.edu
OI Tracy, Brett/0000-0002-1469-3608; Srinivas, Shruthi/0000-0001-6246-7843
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NR 33
TC 2
Z9 2
U1 0
U2 0
PU ACADEMIC PRESS INC ELSEVIER SCIENCE
PI SAN DIEGO
PA 525 B ST, STE 1900, SAN DIEGO, CA 92101-4495 USA
SN 0022-4804
EI 1095-8673
J9 J SURG RES
JI J. Surg. Res.
PD DEC
PY 2024
VL 304
BP 190
EP 195
DI 10.1016/j.jss.2024.10.026
EA NOV 2024
PG 6
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA N0A2T
UT WOS:001361056500001
PM 39551013
DA 2026-07-24
ER

PT J
AU Kitano, D
   Takahashi, H
   Nomura, T
   Okada, K
   Terashi, H
   Sakakibara, S
AF Kitano, Daiki
   Takahashi, Hiroaki
   Nomura, Tadashi
   Okada, Kenji
   Terashi, Hiroto
   Sakakibara, Shunsuke
TI A new clinical classification and reconstructive strategy for
   post-sternotomy surgical site infection
SO REGENERATIVE THERAPY
LA English
DT Article
DE Surgical site infection; Cardiovascular surgery; Mediastinitis;
   Classification
ID MANAGEMENT; MEDIASTINITIS
AB Introduction: Post-sternotomy surgical site infection (SSI) is a serious complication of cardiovascular surgery. Here, we proposed a new clinical classification and reconstructive strategy for this condition. Methods: A retrospective study based on medical records was performed on 100 consecutive cases requiring wound management by plastic surgeons for post-sternotomy SSI at Kobe University Hospital between January 2009 and December 2021. We classified 100 cases into four categories according to the anatomical invasiveness of the infection (type 1, superficial SSI; type 2, sternal osteomyelitis; type 3, mediastinitis; and type 4, aortic graft infection). The standard treatment plan comprised initial debridement, negative pressure wound therapy with continuous irrigation, and reconstructive surgery. Reconstructive methods and their outcomes (in-hospital mortality rate, follow-up period, and infection recurrence rate) were investigated for each SSI category.Results: There were nine SSI cases in type 1, 28 in type 2, 25 in type 3, and 38 in type 4. The pectoralis major (PM) muscle advancement flap was mainly selected in types 1 and 2 (100 and 70.4%, respectively), while the omental flap or latissimus dorsi (LD) myocutaneous flaps were mainly selected in types 3 and 4 (77.3 and 81.8%, respectively) for reconstructive surgery. The in-hospital mortality rates for types 1, 2, 3, 4 were 44.4, 3.6, 12.0, and 15.8%, respectively. The mean follow-up periods for types 1, 2, 3, 4 were 542.8, 1514.5, 1154.5, and 831.1 days, respectively. Infection recurrence rates for types 1, 2, 3, 4 were 0,11.5, 13.3, and 19.2%, respectively. All of these recurrent cases, except for 4 cases of type 4 that required surgical intervention, were treated with conservative wound management.Conclusion: A volume-rich flap (omental or LD flap) was required to fill the dead space after debridement in mediastinitis (type 3) or aortic graft infection (type 4), whereas superficial SSI (type 1) or sternal osteomyelitis (type 2) received a less-invasive flap (PM muscle advancement flap). Our new classification method was based on the anatomical invasiveness of the infection, providing both a simple and easy diagnosis and definitive treatment strategy.(c) 2022, The Japanese Society for Regenerative Medicine. Production and hosting by Elsevier B.V. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/ 4.0/).
C1 [Kitano, Daiki; Nomura, Tadashi; Terashi, Hiroto; Sakakibara, Shunsuke] Kobe Univ, Grad Sch Med, Dept Plast Surg, Kobe, Japan.
   [Takahashi, Hiroaki; Okada, Kenji] Kobe Univ, Grad Sch Med, Dept Cardiovasc Surg, Kobe, Japan.
   [Kitano, Daiki] Kobe Univ, Grad Sch Med, Dept Plast Surg, 7-5-2,Kusunoki Cho,Chuo Ku, Kobe 6500017, Japan.
C3 Kobe University; Kobe University; Kobe University
RP Kitano, D (通讯作者)，Kobe Univ, Grad Sch Med, Dept Plast Surg, 7-5-2,Kusunoki Cho,Chuo Ku, Kobe 6500017, Japan.
EM dkitano.kobe.prs@gmail.com
RI Nomura, Tadashi/KYQ-6225-2024; Sakakibara, Shunsuke/JWP-3331-2024
OI Nomura, Tadashi/0000-0002-0321-0770; TERASHI,
   HIROTO/0000-0002-5939-6893; Takahashi, Hiroaki/0000-0002-0364-5598; 
FU Grants-in-Aid for Scientific Research [20K09864] Funding Source: KAKEN
CR Anger J, 2015, REV BRAS CIR CARDIOV, V30, P114, DOI 10.5935/1678-9741.20140033
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NR 19
TC 1
Z9 2
U1 0
U2 0
PU ELSEVIER
PI AMSTERDAM
PA RADARWEG 29, 1043 NX AMSTERDAM, NETHERLANDS
SN 2352-3204
J9 REGEN THER
JI Regen. Ther.
PD DEC
PY 2022
VL 21
BP 519
EP 526
DI 10.1016/j.reth.2022.10.007
EA OCT 2022
PG 8
WC Cell & Tissue Engineering; Engineering, Biomedical
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Engineering
GA 5Z6SH
UT WOS:000880100300007
PM 36382133
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Roberts, DJ
   Jenne, CN
   Ball, CG
   Tiruta, C
   Léger, C
   Xiao, ZW
   Faris, PD
   McBeth, PB
   Doig, CJ
   Skinner, CR
   Ruddell, SG
   Kubes, P
   Kirkpatrick, AW
AF Roberts, Derek J.
   Jenne, Craig N.
   Ball, Chad G.
   Tiruta, Corina
   Leger, Caroline
   Xiao, Zhengwen
   Faris, Peter D.
   McBeth, Paul B.
   Doig, Christopher J.
   Skinner, Christine R.
   Ruddell, Stacy G.
   Kubes, Paul
   Kirkpatrick, Andrew W.
TI Efficacy and safety of active negative pressure peritoneal therapy for
   reducing the systemic inflammatory response after damage control
   laparotomy (the Intra-peritoneal Vacuum Trial): study protocol for a
   randomized controlled trial
SO TRIALS
LA English
DT Article
DE Abdominal injuries; Damage control laparotomy; Inflammation; Negative
   pressure wound therapy; Randomized controlled trial; Sepsis; Temporary
   abdominal closure; Wounds and injuries
ID TEMPORARY ABDOMINAL CLOSURE; PLANNED RELAPAROTOMY; COMPARTMENT SYNDROME;
   ORGAN DYSFUNCTION; ASSISTED CLOSURE; CYTOKINE RELEASE; PACK TECHNIQUE;
   SEPTIC SHOCK; OPEN ABDOMEN; ON-DEMAND
AB Background: Damage control laparotomy, or abbreviated initial laparotomy followed by temporary abdominal closure (TAC), intensive care unit resuscitation, and planned re-laparotomy, is frequently used to manage intraabdominal bleeding and contamination among critically ill or injured adults. Animal data suggest that TAC techniques that employ negative pressure to the peritoneal cavity may reduce the systemic inflammatory response and associated organ injury. The primary objective of this study is to determine if use of a TAC dressing that affords active negative pressure peritoneal therapy, the ABThera Open Abdomen Negative Pressure Therapy System, reduces the extent of the systemic inflammatory response after damage control laparotomy for intra-abdominal sepsis or injury as compared to a commonly used TAC method that provides potentially less efficient peritoneal negative pressure, the Barker's vacuum pack.
   Methods/ Design: The Intra-peritoneal Vacuum Trial will be a single-center, randomized controlled trial. Adults will be intraoperatively allocated to TAC with either the ABThera or Barker's vacuum pack after the decision has been made by the attending surgeon to perform a damage control laparotomy. The study will use variable block size randomization. On study days 1, 2, 3, 7, and 28, blood will be collected. Whenever possible, peritoneal fluid will also be collected at these time points from the patient's abdomen or TAC device. Luminex technology will be used to quantify the concentrations of 65 mediators relevant to the inflammatory response in peritoneal fluid and plasma. The primary endpoint is the difference in the plasma concentration of the pro-inflammatory cytokine IL-6 at 24 and 48 h after TAC dressing application. Secondary endpoints include the differential effects of these dressings on the systemic concentration of other pro-inflammatory cytokines, collective peritoneal and systemic inflammatory mediator profiles, postoperative fluid balance, intra-abdominal pressure, and several patient-important outcomes, including organ dysfunction measures and mortality.
   Discussion: Results from this study will improve understanding of the effect of active negative pressure peritoneal therapy after damage control laparotomy on the inflammatory response. It will also gather necessary pilot information needed to inform design of a multicenter trial comparing clinical outcomes among patients randomized to TAC with the ABThera versus Barker's vacuum pack.
C1 [Roberts, Derek J.; Ball, Chad G.; Kirkpatrick, Andrew W.] Univ Calgary, Dept Surg, Calgary, AB T2N 2T9, Canada.
   [Roberts, Derek J.; Ball, Chad G.; Tiruta, Corina; Xiao, Zhengwen; Faris, Peter D.; Kirkpatrick, Andrew W.] Foothills Med Ctr, Calgary, AB T2N 2T9, Canada.
   [Roberts, Derek J.; Faris, Peter D.; Doig, Christopher J.] Univ Calgary, Dept Community Hlth Sci, Div Epidemiol, Calgary, AB T2N 4Z6, Canada.
   [Roberts, Derek J.; Faris, Peter D.; Doig, Christopher J.] Univ Calgary, Dept Community Hlth Sci, Div Biostat, Calgary, AB T2N 4Z6, Canada.
   [Jenne, Craig N.; Leger, Caroline; Doig, Christopher J.; Skinner, Christine R.; Ruddell, Stacy G.; Kubes, Paul; Kirkpatrick, Andrew W.] Univ Calgary, Dept Crit Care Med, Calgary, AB T2N 5A1, Canada.
   [Jenne, Craig N.; Leger, Caroline; Doig, Christopher J.; Skinner, Christine R.; Ruddell, Stacy G.; Kubes, Paul; Kirkpatrick, Andrew W.] Foothills Med Ctr, Calgary, AB T2N 5A1, Canada.
   [Ball, Chad G.] Univ Calgary, Dept Oncol, Calgary, AB T2N 2T9, Canada.
   [Ball, Chad G.; Tiruta, Corina; Xiao, Zhengwen; Kirkpatrick, Andrew W.] Univ Calgary, Reg Trauma Program, Calgary, AB T2N 2T9, Canada.
   [Faris, Peter D.] Univ Calgary, Alberta Hlth Serv, Res Excellence Support Team, Calgary, AB T2N 2T9, Canada.
   [Kubes, Paul] Univ Calgary, Hotchkiss Brain Inst, Calgary, AB T2N 4N1, Canada.
   [Jenne, Craig N.; Leger, Caroline; Kubes, Paul] Foothills Med Ctr, Hlth Res Innovat Ctr, Calgary, AB T2N 4N1, Canada.
   [Jenne, Craig N.; Leger, Caroline; Kubes, Paul] Univ Calgary, Calvin Phoebe & Joan Snyder Inst Chron Dis, Calgary, AB T2N 4N1, Canada.
   [McBeth, Paul B.] Univ British Columbia, Dept Med, Div Crit Care Med, Vancouver, BC V6Z 1Y6, Canada.
   [McBeth, Paul B.] St Pauls Hosp, Vancouver, BC V6Z 1Y6, Canada.
C3 University of Calgary; University of Calgary; University Calgary
   Hospital; University of Calgary; University of Calgary; University of
   Calgary; University of Calgary; University Calgary Hospital; University
   of Calgary; University of Calgary; Alberta Health Services (AHS);
   University of Calgary; University of Calgary; University of Calgary;
   University Calgary Hospital; University of Calgary; University of
   British Columbia; St. Paul's Hospital
RP Kirkpatrick, AW (通讯作者)，Univ Calgary, Dept Surg, North Tower 10th Floor,1403-29th St Northwest, Calgary, AB T2N 2T9, Canada.
EM Andrew.Kirkpatrick@albertahealthservices.ca
RI Doig, Christopher/AAC-7949-2020; Jenne, Craig/HCH-3413-2022; Faris,
   Peter/AAJ-3436-2020; Roberts, Derek/L-6229-2019
OI Faris, Peter/0000-0001-5208-817X; Roberts, Derek/0000-0001-6111-6291
FU Alberta Innovates - Health Solutions Clinician Fellowship Award;
   Knowledge Translation Canada Strategic Training in Health Research
   Fellowship; Clinician Investigator and Surgeon Scientist Programs at the
   University of Calgary; University of Calgary
FX DJR is supported by an Alberta Innovates - Health Solutions Clinician
   Fellowship Award, a Knowledge Translation Canada Strategic Training in
   Health Research Fellowship, and funding from the Clinician Investigator
   and Surgeon Scientist Programs at the University of Calgary. CL and CNJ
   are supported by the Calvin, Phoebe and Joan Snyder Chair in Critical
   Care Medicine based at the University of Calgary and awarded to PK. AWK
   has an investigator-initiated trial funding agreement with Kinetic
   Concepts Incorporated (KCI) USA and the Governors of the University of
   Calgary for the clinical and laboratory costs of conducting the study
   (KCI contract number: KCI
   Clinical/UniversityCalgaryAlbertaHealth/082611-000/7). KCI USA will have
   no role in the design or conduct of the study; collection, management,
   analysis, or interpretation of the data; or preparation, review, or
   approval of the manuscript. The remaining authors have no competing
   interests to declare. We would like to thank Anita Verdonk, RN, BScN,
   CEN, ET, who was formerly a clinical therapies specialist with KCI
   Medical Canada Inc., for providing technical information on the ABThera
   (TM) device. We would also like to thank Sandy Cochrane at Multimedia
   Services, University of Calgary for assistance with creation of the
   illustrations of the ABThera T and Barker's vacuum pack.
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NR 83
TC 22
Z9 31
U1 0
U2 12
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1745-6215
J9 TRIALS
JI Trials
PD MAY 16
PY 2013
VL 14
AR 141
DI 10.1186/1745-6215-14-141
PG 14
WC Medicine, Research & Experimental
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Research & Experimental Medicine
GA 150NT
UT WOS:000319398500001
PM 23680127
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zhou, CK
   Wang, L
   Gong, ZH
   Xiang, T
AF Zhou, Changkai
   Wang, Lu
   Gong, Zhenhua
   Xiang, Tie
TI Super-tension-reduction suture versus conventional closure for secondary
   closure of infected abdominal incisions
SO FRONTIERS IN SURGERY
LA English
DT Article
DE abdominal wound repair; complication; super-tension-reduction suture;
   surgical site infection; wound healing
ID BURIED VERTICAL MATTRESS
AB Background: Surgical site infection is a common complication after abdominal surgery and is associated with delayed wound healing, prolonged hospitalization, and increased healthcare costs. Secondary closure of infected abdominal incisions after debridement and negative pressure wound therapy remains challenging because tissue edema, inflammation, and skin retraction often lead to excessive wound tension. Super-tension-reduction suture has been proposed to redistribute wound tension and improve tissue perfusion, but its effectiveness in abdominal wound salvage remains unclear. Methods: We performed a retrospective cohort study of patients undergoing abdominal wound salvage for superficial/incisional surgical site infection between January 2020 and May 2024. Patients were categorized according to the final closure technique: standard interrupted suture or super-tension-reduction suture using a modified buried vertical mattress technique. Patient demographics, operative characteristics, and postoperative outcomes were collected. Primary outcomes included recurrent surgical site infection, wound breakdown, hematoma, seroma, fat necrosis, and reoperation. Secondary outcomes included operative duration, time to drain removal, time to suture removal, and length of hospitalization. Propensity score matching was used to mitigate the selection bias. Multivariable binary logistic regression identified significant predictors of complications. Results: We included 89 patients (standard interrupted suture group: 39; super-tension-reduction suture group: 50). In the unmatched cohort, super-tension-reduction suture was associated with lower rates of recurrent surgical site infection (6.0% vs. 23.1%, P = 0.028) and reoperation (4.0% vs. 17.9%, P = 0.039), alongside shorter hospitalization (17.5 vs. 21 days, P < 0.001), despite a modestly longer operative time (24 vs. 20 min, P < 0.001). After 1:1 propensity score matching (n = 58), super-tension-reduction suture group maintained a significantly lower overall complication rate (17.2% vs. 41.4%, P = 0.043). Crucially, multivariable logistic regression identified the super-tension-reduction suture as an independent protective factor against overall complications (aOR: 0.22, 95% CI: 0.08-0.59, P = 0.003) and recurrent surgical site infection (aOR: 0.21, 95% CI: 0.05-0.85, P = 0.028). Conclusion: The super-tension-reduction suture was associated with favorable clinical outcomes in abdominal wound salvage. Compared with conventional closure, it was associated with lower overall complication rates despite a modest increase in operative time. While clinically promising, these observational associations warrant further validation in prospective, randomized trials.
C1 [Zhou, Changkai; Wang, Lu; Gong, Zhenhua; Xiang, Tie] Nantong First Peoples Hosp, Dept Burn & Plast Surg, Nantong, Peoples R China.
C3 Southeast University - China
RP Xiang, T (通讯作者)，Nantong First Peoples Hosp, Dept Burn & Plast Surg, Nantong, Peoples R China.
EM ntyyxt@163.com
CR Allegranzi B, 2011, LANCET, V377, P228, DOI 10.1016/S0140-6736(10)61458-4
   Azoury SC, 2015, CHRONIC WOUND CARE M, V2, P137, DOI 10.2147/CWCMR.S62514
   CDC, 2026, NHSNS PATIENT SAFETY
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   Zhang X, 2009, AESTHET PLAST SURG, V33, P457, DOI 10.1007/s00266-009-9311-6
NR 20
TC 0
Z9 0
U1 0
U2 0
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD MAY 20
PY 2026
VL 13
AR 1829502
DI 10.3389/fsurg.2026.1829502
EA MAY 2026
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA IY1EM
UT WOS:001783080800001
PM 42245306
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kato, H
   Hamamoto, T
   Tahara, H
   Hattori, T
   Sato, Y
   Chikuie, N
   Taruya, T
   Ishino, T
   Nagamatsu, S
   Ueda, T
   Takeno, S
AF Kato, Hidenori
   Hamamoto, Takao
   Tahara, Hiroaki
   Hattori, Takayoshi
   Sato, Yuki
   Chikuie, Nobuyuki
   Taruya, Takayuki
   Ishino, Takashi
   Nagamatsu, Shogo
   Ueda, Tsutomu
   Takeno, Sachio
TI Seven cases of total laryngo-glossectomy combined with mandibulectomy: A
   retrospective case series from a single institution
SO AURIS NASUS LARYNX
LA English
DT Article
DE Laryngo-glossectomy; Mandibulectomy; Head and neck cancer; Surgery;
   Reconstruction
ID RECONSTRUCTION; FLAP
AB Objective: In cases of tongue, gingival, or base of tongue cancer with mandibular tumor invasion, total laryngoglossectomy and mandibulectomy may be necessary. However, since such cases are limited in number, very few cases have been reported. This study aimed to investigate the treatment strategy involving total laryngoglossectomy combined with mandibulectomy. Methods: This study included patients with head and neck cancer who underwent radical surgery involving total laryngo-glossectomy combined with partial mandibulectomy between January 2014 and December 2023. We investigated the sex, age, primary lesion location, tumor-node-metastasis classification, history of radiation exposure, preoperative/postoperative treatments, surgical methods for resection and reconstruction, extent of neck dissection, surgical duration, blood loss volume, perioperative complications, time to resume oral intake post-surgery, length of hospital stay, duration of follow-up observation, and outcomes. Results: Seven patients who underwent total laryngo-glossectomy combined with partial mandibulectomy were included in this study. The median age at the time of surgery was 57 years (six males and one female). Four patients had floor of the mouth cancer, two had gingival cancer, and one had dual primary cancer involving the tongue and hypopharynx. Two patients had a history of radiation therapy for other head and neck cancers. Five patients received induction chemotherapy with docetaxel, cisplatin, and fluorouracil, and four patients received postoperative chemoradiotherapy with cisplatin. Four patients had direct tumor invasion necessitating concurrent resection of the facial skin. Among the patients without prior radiation therapy to the head and neck region, five underwent bilateral neck dissection (I-IV), whereas the remaining patients underwent neck dissection on the affected side only. Reconstruction in all patients involved the free rectus abdominis musculocutaneous flap and a titanium mandibular reconstruction plate. Two patients experienced major leakage owing to suture rupture, and both recovered following negative pressure wound therapy. The median time to resumption of oral intake after surgery was 12.5 days, and the median hospital stay was 38 days. The median follow-up period was 26 months, with four patients remaining disease-free, one experiencing recurrence, and two succumbing to their primary disease. Conclusion: Long-term survival can be anticipated with appropriate treatment, even in cases of total laryngoglossectomy combined with partial mandibulectomy. In addition, to facilitate post-treatment oral intake, it is crucial to thoroughly evaluate the reconstruction methods, materials, and forms in a larger number of cases.
C1 [Kato, Hidenori] Miyoshi Cent Hosp, Dept Otorhinolaryngol, 10531 Higashisakaya Cho, Miyoshi, Hiroshima 7288502, Japan.
   [Hamamoto, Takao; Tahara, Hiroaki; Hattori, Takayoshi; Sato, Yuki; Chikuie, Nobuyuki; Taruya, Takayuki; Ishino, Takashi; Ueda, Tsutomu; Takeno, Sachio] Hiroshima Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, 1-2-3 Kasumi,Minami Ku, Hiroshima, Hiroshima 7348551, Japan.
   [Nagamatsu, Shogo] Hiroshima Univ Hosp, Dept Plast Surg, 1-2-3 Kasumi,Minami Ku, Hiroshima, Hiroshima 7348551, Japan.
C3 Hiroshima University; Hiroshima University
RP Hamamoto, T (通讯作者)，Hiroshima Univ Hosp, Dept Otorhinolaryngol Head & Neck Surg, 1-2-3 Kasumi,Minami Ku, Hiroshima, Hiroshima 7348551, Japan.
EM takao0320@hiroshima-u.ac.jp
RI ueda, tsutomu/JBJ-9555-2023; Taruya, Takayuki/MIU-5293-2025; Takeno,
   Sachio/AAX-9118-2021; Ishino, Takashi/AAB-2503-2020
OI Hattori, Takayoshi/0009-0008-6568-6855; 
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Basaran B, 2021, TURK ARCH OTORHINOL, V59, P103, DOI 10.4274/tao.2021.2021-1-9
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NR 13
TC 0
Z9 0
U1 1
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0385-8146
EI 1879-1476
J9 AURIS NASUS LARYNX
JI Auris Nasus Larynx
PD AUG
PY 2025
VL 52
IS 4
BP 327
EP 335
DI 10.1016/j.anl.2025.05.003
EA MAY 2025
PG 9
WC Otorhinolaryngology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Otorhinolaryngology
GA 3GK7A
UT WOS:001499730900001
PM 40413935
DA 2026-07-24
ER

PT J
AU Cheng, CY
   Cheng, MH
   Yang, CY
   Wang, CH
   Lim, J
   Huang, W
   Lin, CH
AF Cheng, Chun-Yu
   Cheng, Ming-Huei
   Yang, Chin-Yu
   Wang, Cheng-Han
   Lim, Joshua
   Huang, Wei
   Lin, Chih-Hsin
TI The Effects of Negative Pressure Therapy on Hair Growth of Mouse Models
SO TISSUE ENGINEERING PART A
LA English
DT Article
DE negative pressure therapy; external tissue expansion device; hair
   growth; angiogenesis; nude mice
ID VACUUM-ASSISTED CLOSURE; FOLLICLE; SOX9; LHX2; MECHANISMS; EXPRESSION;
   HYPOXIA; PATTERN; WOUNDS; CELLS
AB Negative pressure therapy (NPT) has been shown to facilitate wound healing and promote hair growth in a porcine model. However, there is a paucity of research on the impact of negative pressure on hair growth in murine models. Despite the ability of nude mice to develop hair follicles, the hair they produce is often flawed towing to genetically induced keratin disorders, rendering them a pertinent animal model for assessing hair regeneration. Therefore, this study aims to investigate the effects of negative pressure on hair follicle growth in a nude mouse model. To achieve this, a customized external tissue expansion device was developed to apply negative pressure to the dorsum of nude mice. The mice were subjected to several treatment courses consisting of 15 and 30 min of continuous negative pressure at 10 mmHg, which were repeated 5 and 10 times every other day until sacrifice. Dorsal skin samples were subsequently extracted from the suction and nonsuction areas. The sections were stained with various antibodies to assess the expression of SOX-9, LHX-2, Keratin-15, beta-catenin, CD31, and vascular endothelial growth factor-A, and a TUNEL assay was used to analyze cell apoptosis. The results showed that the number of hair follicles and angiogenesis were significantly higher in the suction area than in the nonsuction area in all groups. Moreover, mice that received NPT for 15 min for 10 times had a higher hair follicle density than the other three groups. Immunofluorescence staining for LHX-2 and Keratin 15 further validated the results of these findings. In conclusion, this study demonstrated that negative pressure effectively promotes hair follicle growth and angiogenesis in nude mice through SOX-9- and LHX-2-mediated follicular regeneration and beta-catenin-mediated hair follicle morphogenesis.
   Impact Statement The results of this study indicate that negative pressure therapy (NPT) is effective in promoting hair growth in nude mice, as evidenced by increased hair follicle density and angiogenesis in the treated areas. Using a custom external tissue expansion device (ETED) device, 15-min NPT treatment conducted over 10 sessions demonstrated the highest follicle density. This suggest that developing a regimen for NPT may offer to create innovative treatment approaches for hair loss, ultimately benefiting individuals suffering from hair loss disorders.
C1 [Cheng, Chun-Yu; Cheng, Ming-Huei; Yang, Chin-Yu; Wang, Cheng-Han] Chang Gung Mem Hosp, Ctr Tissue Engn, Taoyuan, Taiwan.
   [Cheng, Chun-Yu] Chang Gung Mem Hosp, Dept Dermatol, Taoyuan, Taiwan.
   [Cheng, Ming-Huei] Chang Gung Mem Hosp, Dept Plast & Reconstruct Surg, Div Reconstruct Microsurg, Taoyuan, Taiwan.
   [Cheng, Ming-Huei] Univ Michigan, Sect Plast Surg, Ann Arbor, MI USA.
   [Lim, Joshua; Lin, Chih-Hsin] Taipei Med Univ, Coll Biomed Engn, Grad Inst Nanomed & Med Engn, Taipei, Taiwan.
   [Huang, Wei] Rutgers Sch Dent Med, Dept Orthodont, Newark, NJ USA.
   [Lin, Chih-Hsin] Taipei Med Univ, Grad Inst Nanomed & Med Engn, 301 Yuantong Rd, New Taipei 235, Taiwan.
C3 Chang Gung Memorial Hospital; Chang Gung Memorial Hospital; Chang Gung
   Memorial Hospital; University of Michigan System; University of
   Michigan; Taipei Medical University; Rutgers University System; Rutgers
   University New Brunswick; Rutgers University Biomedical & Health
   Sciences
RP Lin, CH (通讯作者)，Taipei Med Univ, Grad Inst Nanomed & Med Engn, 301 Yuantong Rd, New Taipei 235, Taiwan.
EM melodylin@tmu.edu.tw
OI Lin, Chih-Hsin/0000-0001-7381-5938
FU Chang Gung Memorial Hospital [CMRPG3L0121]; Ministry of Science and
   Technology [MOST110-2222-E-038-001-MY3]
FX This project was supported by Chang Gung Memorial Hospital funding
   (CMRPG3L0121) and the Ministry of Science and Technology funding
   (MOST110-2222-E-038-001-MY3).
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NR 39
TC 0
Z9 0
U1 0
U2 8
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1937-3341
EI 1937-335X
J9 TISSUE ENG PT A
JI Tissue Eng. Part A
PD NOV 1
PY 2024
VL 30
IS 21-22
BP 712
EP 719
DI 10.1089/ten.tea.2024.0056
EA APR 2024
PG 8
WC Cell & Tissue Engineering; Cell Biology; Engineering, Biomedical;
   Materials Science, Biomaterials
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cell Biology; Engineering; Materials Science
GA L3W9L
UT WOS:001198729500001
PM 38534878
DA 2026-07-24
ER

PT J
AU Mayer, D
   Rancic, Z
   Meier, C
   Pfammatter, T
   Veith, FJ
   Lachat, M
AF Mayer, Dieter
   Rancic, Zoran
   Meier, Christoph
   Pfammatter, Thomas
   Veith, Frank J.
   Lachat, Mario
TI Open abdomen treatment following endovascular repair of ruptured
   abdominal aortic aneurysms
SO JOURNAL OF VASCULAR SURGERY
LA English
DT Article
AB Background: Open abdomen treatment (OAT) is considered a lifesaving procedure in patients with abdominal compartment syndrome (ACS) after endovascular or open intervention for ruptured abdominal aortic aneurysms (RAAA). Standardized treatment methods and algorithms for its use are still lacking. The high, published mortality rates may reflect difficulties in detecting and treating ACS, especially in patients treated by emergency endovascular aneurysm repair (eEVAR). Presented are standardized algorithms for OAT, including a new technique using the vacuum-assisted closure (VAC) system developed during 10 years of experience with eEVAR for RAAA.
   Methods. We retrospectively analyzed 102 patients with RAAA treated by eEVAR from January 1998 to April 2008. Abdominal decompression was done when intravesical pressure >20 mm Hg or when abdominal perfusion pressure was < 50 to 60 mm Hg and concomitant organ deterioration occurred. OAT was initially done with a subcutaneously sutured plastic bag or with a nonsutured zipper drape combined with a VAC device (VAC/ETHIZIP; KCI International Inc, Amstelveen, The Netherlands; Ethicon, Somerville, NJ). All patients were switched to VAC/ETHIZIP as soon as possible. Dressings were generally changed every 3 to 5 days. Intra-abdominal pressure was monitored until stability was observed after delayed direct abdominal closure.
   Results. Overall 30-day mortality for eEVAR was 13% (13 of 102); 8% (7 of 82) for patients without ACS and 30% (6 of 20) for those with ACS. Decompression for ACS was needed in 20 patients (20%) primarily during the intervention (n = 14) or secondarily in the intensive care unit (n = 6). Six of 20 (30%) patients requiring OAT died <= 30 days (4 primary, 2 secondary). A mean of 3.6 (range, 1-12) planned second-look interventions were done per patient at an interval of 3 to 5 days. No bowel lesions were observed. Four patients required antibiotic therapy for abdominal infection, and all infections resolved. Delayed abdominal wall closure (direct closure, 11; closure with polypropylene mesh, 3; bilateral anterior rectus abdominis sheath turnover flap, 1) was achieved after a median of 6 days (range, 1-47 days).
   Conclusion: The use of standardized novel techniques and a treatment Protocol and algorithm for OAT after eEVAR for RAAA were feasible and safe. It decreased the workload of the medical and nursing staff, enhanced patient comfort because the need for dressing changes was minimized, and likely contributed to lower overall mortality in RAAA patients. Delayed direct fascial closure was possible in most patients. (J Vasc Surg 2009;50:1-7.)
C1 [Mayer, Dieter; Rancic, Zoran; Lachat, Mario] Univ Zurich Hosp, Cardiovasc Surg Clin, CH-8091 Zurich, Switzerland.
   NYU, Med Ctr, New York, NY 10016 USA.
   Cleveland Clin, New York, NY USA.
C3 University of Zurich; University Zurich Hospital; New York University;
   Cleveland Clinic Foundation
RP Mayer, D (通讯作者)，Univ Zurich Hosp, Cardiovasc Surg Clin, Raemistr 100, CH-8091 Zurich, Switzerland.
EM dieter.mayer@usz.ch
RI Lachat, Mario/G-4826-2011; Mayer, Dieter/E-7617-2011
OI Lachat, Mario/0000-0001-7812-2110; Mayer, Dieter/0000-0001-5933-7749
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NR 41
TC 74
Z9 83
U1 0
U2 4
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0741-5214
J9 J VASC SURG
JI J. Vasc. Surg.
PD JUL
PY 2009
VL 50
IS 1
BP 1
EP 7
DI 10.1016/j.jvs.2008.12.030
PG 7
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA 464IL
UT WOS:000267498500001
PM 19563948
OA Green Accepted, Bronze
DA 2026-07-24
ER

PT J
AU Awad, SS
   Rao, RK
   Berger, DH
   Albo, D
   Bellows, CF
AF Awad, Samir S.
   Rao, Raghuram K.
   Berger, David H.
   Albo, Daniel
   Bellows, Charles F.
TI Microbiology of Infected Acellular Dermal Matrix (AlloDerm) in Patients
   Requiring Complex Abdominal Closure after Emergency Surgery
SO SURGICAL INFECTIONS
LA English
DT Article; Proceedings Paper
CT 26th Annual Meeting of the Surgical-Infection-Society
CY 2006
CL La Jolla, CA
SP Surg Infect Soc
ID SMALL-INTESTINAL SUBMUCOSA; REPAIR; MANAGEMENT; DEFECTS; HERNIA
AB Background: Acellular dermal matrix (AlloDerm) has recently been introduced as an option for complex abdominal closure for patients with loss of abdominal wall domain secondary to intra-abdominal sepsis or necrotizing fasciitis. AlloDerm has been touted as a promoter of neovascularization and collagen deposition. Currently, the rate of AlloDerm infection in contaminated cases is unknown. Our objective was to determine if the organisms cultured during source control would infect AlloDerm.
   Methods: The medical records of patients who required complex abdominal closure with AlloDerm in a tertiary-care hospital were reviewed from January to December, 2005. For each patient demographic, the reason for urgent surgery, American Society of Anesthesiologists (ASA) class, Acute Physiology and Chronic Health Evaluation (APACHE) II score, serum albumin concentration, culture results of purulent fluid obtained during surgery, and culture results of biopsies of infected-appearing AlloDerm (change of color, delayed granulation, odor) were collected. Data are presented as mean +/- standard error of the mean.
   Results: Seventeen patients required the use of AlloDerm for tension-free closure of the abdominal wall after surgery for source control in necrotizing fasciitis (13%) or intra-abdominal sepsis (87%). The mean age was 61 +/- 2 years; 73% of the patients were Caucasian, the remainder being African American. The mean APACHE II score was 23.7 +/- 2.0, and the median ASA class was 3. The mean preoperative albumin concentration was 2.27 +/- 0.26 g/dL. Most (76%) of the patients had a wound vacuum-assisted closure system placed over the AlloDerm. Four patients (24%) were noted to have an infection of the AlloDerm graft at 24 +/- 10 days postoperatively. The cultures obtained at operation and from infected AlloDerm show similar organisms (Pseudomonas in two, Escherichia coli and methicillin-resistant Staphylococcus aureus in one each). Infected AlloDerm was coated with silver sulfadiazene and moistened dressings, and all four patients had complete resolution of the Allo-Derm infection with an adequate bed of granulation tissue, allowing skin grafting.
   Conclusion: Patients with contaminated abdomens who require complex closure with AlloDerm are at risk of developing infection of their graft material with organisms similar to those present at the time of surgery. Once culture results are obtained, topical antimicrobials with activity against the cultured organisms may be employed as part of the AlloDerm dressings to prevent infection and promote healing.
C1 [Awad, Samir S.; Rao, Raghuram K.; Berger, David H.; Albo, Daniel; Bellows, Charles F.] Baylor Coll Med, Michael E DeBakey Dept Surg, MED VAMC, Houston, TX 77030 USA.
C3 Baylor College of Medicine
RP Awad, SS (通讯作者)，Baylor Coll Med, Michael E DeBakey Dept Surg, MED VAMC, OCL 112,RM 5A-344,2002 Holcombe Blvd, Houston, TX 77030 USA.
EM sawad@bcm.tmc.edu
CR Barker DE, 2000, J TRAUMA, V48, P201, DOI 10.1097/00005373-200002000-00001
   Buinewicz B, 2004, ANN PLAS SURG, V52, P188, DOI 10.1097/01.sap.0000100895.41198.27
   Butler CE, 2005, PLAST RECONSTR SURG, V116, P1263, DOI 10.1097/01.prs.0000181692.71901.bd
   Carbonell AM, 2005, SURG ENDOSC, V19, P430, DOI 10.1007/s00464-004-8810-4
   Edlich Richard F, 2005, J Long Term Eff Med Implants, V15, P57, DOI 10.1615/JLongTermEffMedImplants.v15.i1.70
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NR 16
TC 18
Z9 19
U1 0
U2 7
PU MARY ANN LIEBERT INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1096-2964
J9 SURG INFECT
JI Surg. Infect.
PD FEB
PY 2009
VL 10
IS 1
BP 79
EP 84
DI 10.1089/sur.2008.082
PG 6
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Infectious Diseases; Surgery
GA 612DM
UT WOS:000278877000011
PM 19298171
DA 2026-07-24
ER

PT J
AU Sweitzer, K
   Butterfield, J
   Hubert, J
   Park, W
   Tomtschik, J
   Carter, M
   Gosev, I
   Bell, D
AF Sweitzer, Keith
   Butterfield, James
   Hubert, Jessica
   Park, Won
   Tomtschik, Julia
   Carter, Mathew
   Gosev, Igor
   Bell, Derek
TI Flap Coverage of Infected Ventricular Assist Devices Influences Patient
   Outcomes
SO ANNALS OF PLASTIC SURGERY
LA English
DT Article
DE LVAD; infection; muscle flap; coverage
AB BackgroundThe use of left ventricular assist devices (LVADs) for patients with end-stage cardiac failure awaiting heart transplantation has become increasingly common. However, ventricular assist device-related infections remain a major problem complicating their long-term use. Poor data exist to determine how to manage these infections after operative debridement.MethodsPatients who underwent insertion of a ventricular assist device and had a subsequent readmission for LVAD infection at the University of Rochester Medical Center from 2012 to 2022 were identified through accessing the medical records archives of the hospital. Patients were followed retrospectively for an average of 3.2 years. Patient demographics, preoperative diagnosis/disease state, type of ventricular assist device inserted, postoperative day of ventricular assist device infection onset, infectious organism identified at initial washout, infectious organism identified at time of definitive device coverage, timing of coverage procedure after the initial washout for infection, type of flap used for coverage, 90-day complications after definitive coverage, and lifetime return to operating room for infection were reviewed. Comparison analysis with a & chi;(2) test was used to analyze outcomes.ResultsOf 568 patients admitted with an LVAD-related infection 117 underwent operative debridement. Of these, 34 underwent primary closure, 31 underwent closure with secondary intention (negative pressure wound therapy with split thickness skin grafting), and 52 were closed with a flap (pectoralis, omental, latissimus, or vertical rectus abdominus musculocutaneous flap). There was a statistically significant higher incidence of return to the operating room (RTOR) for infection over a lifetime with primary closure compared with secondary intention and flap reconstruction (P = 0.01, 0.02), but no difference in 90-day complications (P = 0.76, P = 0.58). Eighty-three patients had a positive culture upon definitive coverage with 24 having a postsurgical complication, 15 of which required lifetime RTOR for infection. Thirty four were closed with negative cultures with 9 having a complication and 4 requiring RTOR for infection. This was not statistically significant for complications or RTOR (P = 0.79, 0.40). Culture data were further substratified into bacterial cultures (n = 73) versus fungal cultures (n = 10), and there was no statistically significant difference between these compared with complications or RTOR (P = 0.40, 0.39).ConclusionsCoverage of infected LVADs with locoregional flaps or allowing to granulate using wound vac therapy has a decreased lifetime RTOR for future infections for these patients without increase in 90-day complications. Timing of RTOR should not be impacted by positive cultures provided there is healthy granulation tissue in the wound.
C1 [Sweitzer, Keith; Butterfield, James; Hubert, Jessica; Park, Won; Tomtschik, Julia; Carter, Mathew; Bell, Derek] Univ Rochester, Div Plast Surg, Rochester, NY USA.
   [Gosev, Igor] Univ Rochester, Dept Surg, Div Cardiothorac Surg, Rochester, NY USA.
   [Sweitzer, Keith] Univ Rochester, River Campus,601 Elmwood Ave, Rochester, NY 14642 USA.
C3 University of Rochester; University of Rochester; University of
   Rochester
RP Sweitzer, K (通讯作者)，Univ Rochester, River Campus,601 Elmwood Ave, Rochester, NY 14642 USA.
EM Keithsweitzer6@gmail.com; james_butterfield@URMC.rochester.edu;
   jessica_hubert@urmc.rochester.edu; won_park@urmc.rochester.edu;
   julia_tomtschik@URMC.rochester.edu; matthew_carter@urmc.rochester.edu;
   Igor_Gosev@URMC.rochester.edu; Derek_Bell@urmc.rochester.edu
OI Carter, Matthew Mason/0009-0001-3533-0195; Tomtschik,
   Julia/0000-0001-6982-7856
CR Aburjania N, 2021, ANN CARDIOTHORAC SUR, V10, P233, DOI 10.21037/acs-2020-cfmcs-26
   Bernhardt AM, 2020, J CRIT CARE, V56, P106, DOI 10.1016/j.jcrc.2019.12.014
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   Gordon RJ, 2013, CIRCULATION, V127, P691, DOI 10.1161/CIRCULATIONAHA.112.128132
   Han JJ, 2018, CIRCULATION, V138, P2841, DOI 10.1161/CIRCULATIONAHA.118.035566
   Hannan MM, 2019, J HEART LUNG TRANSPL, V38, P364, DOI 10.1016/j.healun.2019.01.007
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NR 15
TC 2
Z9 2
U1 0
U2 1
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0148-7043
EI 1536-3708
J9 ANN PLAS SURG
JI Ann. Plast. Surg.
PD JUN
PY 2023
VL 90
IS 6S
SU 5
BP S552
EP S555
DI 10.1097/SAP.0000000000003408
PG 4
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA L3MZ9
UT WOS:001022348000021
PM 36729072
DA 2026-07-24
ER

PT J
AU Alipouriani, A
   Erozkan, K
   Schabl, L
   Sancheti, H
   Sebastian, S
   Wong, SY
   Tozer, P
   Cohen, BL
   Holubar, SD
AF Alipouriani, Ali
   Erozkan, Kamil
   Schabl, Lucas
   Sancheti, Himani
   Sebastian, Shaji
   Wong, Serre-Yu
   Tozer, Phil
   Cohen, Benjamin L.
   Holubar, Stefan D.
TI TOpClass Class 4 Perineal Crohn's Disease: A Systematic Review and
   Meta-analysis of Perineal Wound Complication After Proctectomy in
   Crohn's Patients
SO INFLAMMATORY BOWEL DISEASES
LA English
DT Review
DE Crohn's disease; perianal wound; wound healing; TOpClass Consortium;
   perineal Crohn's disease
ID RISK REDUCTION STRATEGIES; SINUS; MANAGEMENT; PROCTOCOLECTOMY
AB Background Nonhealing perineal wounds have been reported to be common after proctectomy for Crohn's disease (CD). We performed a systematic review and meta-analysis of perineal wound healing after proctectomy for CD and assessed the risk factors for nonhealing.Methods A comprehensive literature search was conducted in PubMed, Embase, and Scopus databases from 2010 to 2023, and articles reporting perineal wound healing rates after proctectomy for CD were included. Data on study characteristics and proportion of healed wounds, and risk factors, were extracted. Random-effects meta-analysis was performed to estimate the pooled proportion and 95% CIs using the "meta" package in R. Heterogeneity was assessed using the I2 statistic.Results We identified 501 articles, of which 252 remained after de-duplication. After screening, 4 retrospective cohort studies involving 333 patients were included. Across the 4 studies, the pooled proportion of completely healed perineal wounds at 6 months was 65% (95% CI 52%-80%), and 70% (95% CI 60%-83%) at 12 months. Significant heterogeneity was found between studies (I2 = 86% at 6 months). Three studies examined risk factors for impaired healing after proctectomy. One study identified preoperative perineal sepsis as the only independent factor associated with impaired healing (P = .001) on multivariable analysis. In 1 study, male sex, shorter time from diversion to proctectomy, and higher preoperative C-reactive protein levels were all associated with delayed healing in univariate analysis. Another study found that close rectal dissection was associated with significantly lower healing rates than total mesorectal excision (P = .01). Prior use of tumor necrosis factor inhibitors was not associated with wound healing outcomes.Conclusions This meta-analysis revealed complete perineal healing in only 70% of patients 12 months after proctectomy for CD. This highlights knowledge gaps, including the identification of modifiable risk factors and methods for preventing or as rescue therapy, such as vacuum-assisted closure and flap reconstruction, for nonhealing perineal wounds after proctectomy for CD. Poor perineal wound healing outcomes are likely related to imperfectly understood underlying inflammatory dysregulation and systemically impaired wound healing in patients with CD.
   Meta-analysis of perineal healing after proctectomy for Crohn's revealed only 70% of patients at 12 months; the only independent risk factor was preoperative perineal sepsis; biologics did not affect healing. This highlights knowledge gaps, including best practices for prevention and treatment.
C1 [Alipouriani, Ali; Erozkan, Kamil; Schabl, Lucas; Sancheti, Himani; Holubar, Stefan D.] Cleveland Clin Fdn, Dept Colon & Rectal Surg, Cleveland, OH USA.
   [Sebastian, Shaji] Hull Univ Teaching Hosp, Dept Gastroenterol, IBD Unit, Kingston Upon Hull, England.
   [Wong, Serre-Yu] Icahn Sch Med Mt Sinai, Dept Med, Henry D Janowitz Div Gastroenterol, New York, NY USA.
   [Tozer, Phil] St Marks Hosp, Dept Colon & Rectal Surg, London, England.
   [Cohen, Benjamin L.] Cleveland Clin Fdn, Dept Gastroenterol & Hepatol, Cleveland, OH USA.
C3 Cleveland Clinic Foundation; Icahn School of Medicine at Mount Sinai;
   Imperial College London; Cleveland Clinic Foundation
RP Holubar, SD (通讯作者)，Cleveland Clin, Dept Colon & Rectal Surg, 9500 Euclid Ave,A30, Cleveland, OH 44122 USA.
EM holubas@ccf.org
RI Wong, Serre-Yu/JFK-7215-2023; Erözkan, Kamil/GVU-7136-2022; Holubar,
   FACS, FASCRS, Stefan D/I-3798-2019; Holubar, Stefan/I-3798-2019
OI Wong, Serre-Yu/0000-0002-2070-4123; Erözkan, Kamil/0000-0003-2193-9984;
   Holubar, FACS, FASCRS, Stefan D/0000-0002-2549-9042; 
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NR 50
TC 8
Z9 9
U1 0
U2 2
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1078-0998
EI 1536-4844
J9 INFLAMM BOWEL DIS
JI Inflamm. Bowel Dis.
PD APR
PY 2025
VL 31
IS 4
BP 1150
EP 1157
DI 10.1093/ibd/izae198
EA OCT 2024
PG 8
WC Gastroenterology & Hepatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology
GA 1XY8R
UT WOS:001333856800001
PM 39418126
DA 2026-07-24
ER

PT J
AU Herrera, FA
   Kohanzadeh, S
   Nasseri, Y
   Kansal, N
   Owens, EL
   Bodor, R
AF Herrera, Fernando A.
   Kohanzadeh, Som
   Nasseri, Yosef
   Kansal, Nikhil
   Owens, Eric L.
   Bodor, Richard
TI Management of Vascular Graft Infections with Soft Tissue Flap Coverage:
   Improving Limb Salvage Rates-A Veterans Affairs Experience
SO AMERICAN SURGEON
LA English
DT Article; Proceedings Paper
CT 20th Annual Scientific Meeting of the Southern California Chapter of the
   American-College-of-Surgeons
CY JAN 16-18, 2009
CL Santa Barbara, CA
SP Amer Coll Surg, So Calif Chapter
ID ROTATIONAL MUSCLE FLAPS; PROSTHETIC GRAFTS; RECONSTRUCTION;
   OSTEOMYELITIS; GROIN
AB Graft infections are one of the most challenging issues in surgery with an incidence of 0.7 to 7 per cent, with femoral site infections being the most common (13% incidence). The gold standard treatment has been graft removal, wide debridement, and extra-anatomical bypass. Routine excision of infected peripheral arterial grafts and vascular reconstruction with extraanatomic conduits are associated with mortality rates ranging from 10 to 30 per cent and amputation rates of up to 70 per cent. As a result of the high morbidity and mortality associated with this approach, selective graft preservation techniques have been developed. Newer treatment plans discuss preservation of the graft with debridement and coverage of the infected region. Better wound care, nutrition optimization, and robust flap coverage have led to significantly improved graft salvage, lower amputation rates, and improved outcomes. The objective of this study was to evaluate the Veterans Affairs (VA) experience with flap coverage for femoral vascular graft infections. A retrospective review was conducted of all VA data from 1997 to 2008 with inclusion criteria of patients with deep groin wound infections requiring flap coverage after femoral bypass surgery. Eleven such patients were identified with a mean age of 73 years and with multiple comorbidities (hypertension, malnutrition, diabetes mellitus, chronic obstructive pulmonary disease, coronary artery disease, chronic renal insufficiency). Patients presented with wound drainage, exposed graft, hematoma, perigraft fluid collection, and pseudoaneurysm. Treatment protocol included: 1) aggressive debridement of the wound bed; 2) early soft tissue (flap) coverage; 3) wound vacuum assisted closure device or frequent dressing changes; and 4) skin graft once the bed was prepared. Eighty-two per cent of wounds had positive cultures with equal numbers of patients with Staphylococcus epidermidis, Pseudomonas, Escherichia coli (22%), and higher methicillin-resistant Staphylococcus aureus (33%), whereas in the literature Staphylococcus is the most common (greater than 50%). Average hospital length of stay was 94 days with average follow up at 10 months. Fifty-five per cent graft salvage (one Dacron [50%], two polytetrafluoroethylene [33%], two saphenous vein graft [100%], one cryovein [100%]) was achieved with 91 per cent limb salvage. Complications included graft blowout (two) requiring partial flap loss (one), retroperitoneal hematoma (one), limb loss (one), sepsis (one), and death (one). Infected vascular grafts remain a challenging problem requiring multidisciplinary care. Careful debridement and aggressive wound care followed by selective flap coverage appears to decrease morbidity and increase graft and limb salvage.
C1 Vet Affairs Healthcare Syst, San Diego, CA USA.
   Univ Calif San Diego, San Diego, CA 92103 USA.
C3 University of California System; University of California San Diego
RP Kohanzadeh, S (通讯作者)，Cedars Sinai Med Ctr, Dept Surg, 8700 Beverly Blvd,Suite 8215, Los Angeles, CA 90048 USA.
EM somkohanzadeh@yahoo.com
RI ; Herrera, Fernando/OXB-2624-2025
OI Herrera, Fernando/0000-0001-6957-0413; 
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   Calligaro K D, 1996, Adv Surg, V29, P3
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NR 23
TC 56
Z9 58
U1 0
U2 0
PU SOUTHEASTERN SURGICAL CONGRESS
PI CUMMING
PA 115 SAMARITAN DR, #200, CUMMING, GA 30040-2354 USA
SN 0003-1348
EI 1555-9823
J9 AM SURGEON
JI Am. Surg.
PD OCT
PY 2009
VL 75
IS 10
BP 877
EP 881
PG 5
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 506SD
UT WOS:000270795300003
PM 19886126
DA 2026-07-24
ER

PT J
AU Seternes, A
   Fasting, S
   Klepstad, P
   Mo, S
   Dahl, T
   Bjorck, M
   Wibe, A
AF Seternes, Arne
   Fasting, Sigurd
   Klepstad, Pal
   Mo, Skule
   Dahl, Torbjorn
   Bjorck, Martin
   Wibe, Arne
TI Bedside dressing changes for open abdomen in the intensive care unit is
   safe and time and staff efficient
SO CRITICAL CARE
LA English
DT Article
DE Abdominal compartment syndrome; Open abdomen; Dressing changes;
   Infections; Intensive care; Resources; Health economy
ID CRITICALLY-ILL PATIENTS; ABDOMINAL COMPARTMENT SYNDROME; MEDIATED
   FASCIAL TRACTION; INTRAHOSPITAL TRANSPORT; OPERATING-ROOM;
   INTRAABDOMINAL HYPERTENSION; PERCUTANEOUS TRACHEOSTOMY; TRAUMA PATIENTS;
   LAPAROTOMY; MANAGEMENT
AB Background: Patients with an open abdomen (OA) treated with temporary abdominal closure (TAC) need multiple surgical procedures throughout the hospital stay with repeated changes of the vacuum-assisted closure device (VAC changes). The aim of this study was to examine if using the intensive care unit (ICU) for dressing changes in OA patients was safe regarding bloodstream infections (BSI) and survival. Secondary aims were to evaluate saved time, personnel, and costs.
   Methods: All patients treated with OA in the ICU from October 2006 to June 2014 were included. Data were retrospectively obtained from registered procedure codes, clinical and administrative patients' records and the OR, ICU, anesthesia and microbiology databases. Outcomes were 30-, 60- and 90-day survival, BSI, time used and saved personnel costs.
   Results: A total of 113 patients underwent 960 surgical procedures including 443 VAC changes as a single procedure, of which 165 (37 %) were performed in the ICU. Nine patients died before the first scheduled dressing change and six patients were closed at the first scheduled surgery after established OA, leaving 98 patients for further analysis. The mean duration for the surgical team performing a VAC change in the ICU was 63.4 (60.4-66.4) minutes and in the OR 98.2 (94.6-101.8) minutes (p < 0.001). The mean duration for the anesthesia team in the OR was 115.5 minutes, while this team was not used in the ICU. Personnel costs were reduced by (sic)682 per procedure when using the ICU. Forty-two patients had all the VAC changes done in the OR (VAC-OR), 22 in the ICU (VAC-ICU) and 34 in both OR and ICU (VAC-OR/ICU). BSI was diagnosed in eight (19 %) of the VAC-OR patients, seven (32 %) of the VAC-ICU and eight (24 %) of the VAC-OR/ICU (p = 0.509). Thirty-five patients (83 %) survived 30 days in the VAC-OR group, 17 in the VAC-ICU group (77 %) and 28 (82 %) in the VAC-OR/ICU group (p = 0.844).
   Conclusions: VAC change for OA in the ICU saved time for the OR team and the anesthesia team compared to using the OR, and it reduced personnel costs. Importantly, the use of ICU for OA dressing change seemed to be as safe as using the OR.
C1 [Seternes, Arne; Dahl, Torbjorn] Univ Trondheim Hosp, St Olavs Hosp, Dept Vasc Surg, Prinsesse Kristinas Gate 3, N-7030 Trondheim, Norway.
   [Seternes, Arne; Fasting, Sigurd; Klepstad, Pal; Dahl, Torbjorn] Norwegian Univ Sci & Technol NTNU, Dept Circulat & Med Imaging, Hogskoleringen 1, N-7491 Trondheim, Norway.
   [Fasting, Sigurd; Klepstad, Pal; Mo, Skule] Univ Trondheim Hosp, St Olavs Hosp, Dept Anesthesiol & Intens Care Med, Prinsesse Kristinas Gate 3, N-7030 Trondheim, Norway.
   [Wibe, Arne] Univ Trondheim Hosp, St Olavs Hosp, Dept Gastrointestinal Surg, Prinsesse Kristinas Gate 3, N-7030 Trondheim, Norway.
   [Bjorck, Martin] Uppsala Univ, Vasc Surg Sect, Dept Surg Sci, S-75185 Uppsala, Sweden.
   [Seternes, Arne; Wibe, Arne] Norwegian Univ Sci & Technol NTNU, Dept Canc Res & Mol Med, Hogskoleringen 1, N-7491 Trondheim, Norway.
C3 Norwegian University of Science & Technology (NTNU); Norwegian
   University of Science & Technology (NTNU); Norwegian University of
   Science & Technology (NTNU); Norwegian University of Science &
   Technology (NTNU); Uppsala University; Norwegian University of Science &
   Technology (NTNU)
RP Seternes, A (通讯作者)，Univ Trondheim Hosp, St Olavs Hosp, Dept Vasc Surg, Prinsesse Kristinas Gate 3, N-7030 Trondheim, Norway.; Seternes, A (通讯作者)，Norwegian Univ Sci & Technol NTNU, Dept Circulat & Med Imaging, Hogskoleringen 1, N-7491 Trondheim, Norway.; Seternes, A (通讯作者)，Norwegian Univ Sci & Technol NTNU, Dept Canc Res & Mol Med, Hogskoleringen 1, N-7491 Trondheim, Norway.
EM arne.seternes@stolav.no
FU St. Olavs Hospital, Trondheim University Hospital
FX Thanks to Toril Rendum for helping to calculate the personnel costs. The
   main investigator received unrestricted grants from St. Olavs Hospital,
   Trondheim University Hospital. Written informed consent was obtained
   from the patients and participants for publication of their individual
   details and any accompanying images. The consent forms are held by the
   authors and are available for review by the Editor-in-Chief.
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NR 34
TC 12
Z9 13
U1 0
U2 7
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
SN 1466-609X
EI 1364-8535
J9 CRIT CARE
JI Crit. Care
PD MAY 28
PY 2016
VL 20
AR 164
DI 10.1186/s13054-016-1337-y
PG 8
WC Critical Care Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA DN1UM
UT WOS:000376850900001
PM 27233244
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Bayer, J
   Zajonc, H
   Strohm, PC
   Vohrer, M
   Maier-Lenz, D
   Südkamp, NP
   Schwering, L
AF Bayer, J.
   Zajonc, H.
   Strohm, P. C.
   Vohrer, M.
   Maier-Lenz, D.
   Suedkamp, N. P.
   Schwering, L.
TI Stump Forming after Traumatic Foot Amputation of a Child - Description
   of a New Surgical Procedure and Literature Review of Lawnmower Accidents
SO ZEITSCHRIFT FUR ORTHOPADIE UND UNFALLCHIRURGIE
LA German
DT Article
DE amputation; child; operation
ID LAWN-MOWER INJURIES; VACUUM-ASSISTED CLOSURE; LOWER-EXTREMITY; LIMB
   LOSS; PREVENTION
AB Aim: Amputation injuries in children occur in motor vehicle, farming and, importantly, lawn mower accidents. Treatment of lawn mower related injuries is complicated by gross wound contamination, avascular tissue, soft tissue defects and exposed bone. Many treatment options exist and often an adequate prosthetic supply is needed for rehabilitation. We report on an 8-year old boy who got under a ride-on lawn mower and sustained a Subtotal amputation of his right foot. After initial surgery an amputation was subsequently necessary. For this, it had to be taken into account that the traumatic loss of the talus, calcaneus and parts of the cuboid bone would result in a length shortening of the right leg and so far not injured metatarsal and tarsal bones had to be sacrificed. Thus, we aimed to develop a new operation technique to optimize stump length as well as preserve tarsal bones and the possibility of limb growth.
   Method: In order to achieve this, we performed a new stump forming operation in which we integrated uninjured tarsal and metatarsal bones. First a Lisfranc's amputation was performed and a metatarsal bone was kept aside. The talus, calcaneus as well as the cuboid bone were either completely or almost completely destroyed and were removed. The remaining cuneiform bones were transfixed by a notched metatarsal bone, thus achieving a tarsal arthrodesis, and the cartilages of the proximal joint surfaces were removed. The cartilage of the cranial and caudal navicular as well as the distal tibial joint surface was also removed and an arthrodesis between the distal tibia and the navicular bone was achieved by crossed Kirschner wires. Finally the cuneiform bones were placed inferior to the navicular bone. Further stump coverage was managed by skin and muscle flaps as well as split skin graft.
   Result: Our patient was discharged on day 34. A fluent gait without crutches as well as sports activities were possible again as early as 61/2 months after the injury.
   Conclusion: Using our stump forming technique we hope to prevent some complications of amputation injuries. Because of the intact epiphysis a bone overgrowth is hopefully prevented and growth potential is preserved and by inclusion of tarsal and metatarsal bones in the stump formation a length discrepancy is minimized.
C1 [Bayer, J.; Strohm, P. C.; Vohrer, M.; Maier-Lenz, D.; Suedkamp, N. P.; Schwering, L.] Klinikum Albert Ludwigs Univ Freiburg, Dept Orthopad & Traumatol, D-79106 Freiburg, Germany.
   [Zajonc, H.] Univ Klin Freiburg, Abt Plast & Handchirurg, Freiburg, Germany.
C3 University of Freiburg; University of Freiburg
RP Bayer, J (通讯作者)，Klinikum Albert Ludwigs Univ Freiburg, Dept Orthopad & Traumatol, Hugstetter Str 55, D-79106 Freiburg, Germany.
EM joerg.bayer@uniklinik-freiburg.de
RI Suedkamp, Norbert/AAF-2931-2019
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NR 39
TC 1
Z9 1
U1 0
U2 5
PU THIEME MEDICAL PUBL INC
PI NEW YORK
PA 333 SEVENTH AVE, NEW YORK, NY 10001 USA
SN 1864-6697
EI 1864-6743
J9 Z ORTHOP UNFALLCHIR
JI Z. Orthop. Unfallchir.
PD JUL-AUG
PY 2009
VL 147
IS 4
BP 427
EP 432
DI 10.1055/s-0029-1185697
PG 6
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA 489BL
UT WOS:000269394400023
PM 19693738
DA 2026-07-24
ER

PT J
AU Kaláb, M
   Karkoska, J
   Kamínek, M
   Matejková, E
   Slameníková, Z
   Klvácek, A
   Santavy, P
AF Kalab, Martin
   Karkoska, Jan
   Kaminek, Milan
   Matejkova, Eva
   Slamenikova, Zuzana
   Klvacek, Ales
   Santavy, Petr
TI Reconstruction of massive post-sternotomy defects with allogeneic bone
   graft: four-year results and experience using the method
SO INTERACTIVE CARDIOVASCULAR AND THORACIC SURGERY
LA English
DT Article
DE Sternotomy; Deep sternal wound infection; Massive post-sternotomy
   defect; Allogeneic bone graft of sternum
ID STERNAL WOUND COMPLICATIONS; VACUUM-ASSISTED CLOSURE; NEGATIVE-PRESSURE;
   CARDIAC-SURGERY; HEART SURGERY; INFECTION; THERAPY; TRANSPLANTATION;
   MEDIASTINITIS; STERNECTOMY
AB OBJECTIVES: Deep sternal wound infection poses a serious problem in cardiac surgery, with an up to 40% risk of mortality. Massive loss of sternum bone tissue and adjacent ribs results in major chest wall instability causing respiratory insufficiency and defects of soft tissue healing. Proposals for managing the situation have been published but the complexity of the issue precludes unequivocal resolution. Capitalizing on orthopaedic experience, we used allogeneic bone graft of sternum as a viable option.
   METHODS: We performed the transplantation of allogeneic bone graft in 10 patients. In 9 cases, an allograft of sternum was used and in 1 case an allograft of calva bone. After the primary cardiac surgery, a massive post-sternotomy defect of the chest wall had developed in all 10 patients. Vacuum wound drainage was applied in the treatment of all patients. To stabilize the transverse, titanium plates were used. Bone allograft was prepared by the official Tissue Centre. Crushed allogeneic spongy bone was applied to reinforce the line of contact of the graft and the edges of residual skeleton. In 9 cases, the soft tissue was closed by direct suture of mobilized pectoral flaps. In 1 case, V-Y transposition of pectoral flap was performed.
   RESULTS: In 6 cases, healing of the reconstructed chest wall occurred without further complications. In 3 cases, additional re-suture of the soft tissues and skin in the lower pole of the wound was necessary. Excellent chest wall stability along with the adjustment of respiratory insufficiency and good cosmetic effect was achieved in all cases. In 1 case, severe concomitant complications and no healing of the wound resulted in death within 6 months after the reconstruction. Median follow-up of all patients in the series was 14.1 months (1-36 months). In 4 patients, scintigraphy of the chest wall was performed.
   CONCLUSIONS: Our existing results show that allogeneic bone graft transplantation is a promising and easily applied method in the management of serious tissue loss in sternal dehiscence with favourable functional and cosmetic effects. The relatively small number of patients with such severe healing complications of sternotomy however puts critical limits to a more detailed comparison with other practices and evaluation of long-term results.
C1 [Kalab, Martin; Slamenikova, Zuzana; Klvacek, Ales; Santavy, Petr] Palacky Univ Olomouc, Univ Hosp Olomouc, Dept Cardiosurg, IP Pavlova 6, Olomouc 77520, Czech Republic.
   [Kalab, Martin; Kaminek, Milan; Slamenikova, Zuzana; Klvacek, Ales; Santavy, Petr] Palacky Univ Olomouc, Fac Med, IP Pavlova 6, Olomouc 77520, Czech Republic.
   [Karkoska, Jan; Matejkova, Eva] Natl Cell & Tissue Ctr, Brno, Czech Republic.
   [Kaminek, Milan] Palacky Univ Olomouc, Univ Hosp Olomouc, Dept Nucl Med, Olomouc 77520, Czech Republic.
C3 University Hospital Olomouc; Palacky University Olomouc; Palacky
   University Olomouc; Palacky University Olomouc; University Hospital
   Olomouc
RP Kaláb, M (通讯作者)，Palacky Univ Olomouc, Univ Hosp Olomouc, Dept Cardiosurg, IP Pavlova 6, Olomouc 77520, Czech Republic.; Kaláb, M (通讯作者)，Palacky Univ Olomouc, Fac Med, IP Pavlova 6, Olomouc 77520, Czech Republic.
EM martin.kalab@email.cz
OI Klváček, Aleš/0000-0002-7431-2221
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NR 24
TC 13
Z9 17
U1 0
U2 10
PU OXFORD UNIV PRESS
PI OXFORD
PA GREAT CLARENDON ST, OXFORD OX2 6DP, ENGLAND
SN 1569-9293
EI 1569-9285
J9 INTERACT CARDIOV TH
JI Interact Cardiovasc. Thorac. Surg.
PD MAR
PY 2016
VL 22
IS 3
BP 305
EP 313
DI 10.1093/icvts/ivv322
PG 9
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA DH7OJ
UT WOS:000372983300012
PM 26621922
OA Bronze
DA 2026-07-24
ER

PT J
AU Hingorani, A
   LaMuraglia, GM
   Henke, P
   Meissner, MH
   Loretz, L
   Zinszer, KM
   Driver, VR
   Frykberg, R
   Carman, TL
   Marston, W
   Mills, JL
   Murad, MH
AF Hingorani, Anil
   LaMuraglia, Glenn M.
   Henke, Peter
   Meissner, Mark H.
   Loretz, Lorraine
   Zinszer, Kathya M.
   Driver, Vickie R.
   Frykberg, Robert
   Carman, Teresa L.
   Marston, William
   Mills, Joseph L., Sr.
   Murad, Mohammad Hassan
TI The management of diabetic foot: A clinical practice guideline by the
   Society for Vascular Surgery in collaboration with the American
   Podiatric Medical Association and the Society for Vascular Medicine
SO JOURNAL OF VASCULAR SURGERY
LA English
DT Article
ID PRESSURE WOUND THERAPY; PERIPHERAL ARTERIAL-DISEASE; VACUUM-ASSISTED
   CLOSURE; TRANSCUTANEOUS OXYGEN-TENSION; GLOBAL CONSENSUS GUIDELINES;
   RANDOMIZED CONTROLLED-TRIAL; LOWER-EXTREMITY AMPUTATION; CUSTOM-MADE
   FOOTWEAR; GROWTH FACTOR-BB; QUALITY-OF-LIFE
AB Background: Diabetes mellitus continues to grow in global prevalence and to consume an increasing amount of health care resources. One of the key areas of morbidity associated with diabetes is the diabetic foot. To improve the care of patients with diabetic foot and to provide an evidence-based multidisciplinary management approach, the Society for Vascular Surgery in collaboration with the American Podiatric Medical Association and the Society for Vascular Medicine developed this clinical practice guideline.
   Methods: The committee made specific practice recommendations using the Grades of Recommendation Assessment, Development, and Evaluation system. This was based on five systematic reviews of the literature. Specific areas of focus included (1) prevention of diabetic foot ulceration, (2) off-loading, (3) diagnosis of osteomyelitis, (4) wound care, and (5) peripheral arterial disease.
   Results: Although we identified only limited high-quality evidence for many of the critical questions, we used the best available evidence and considered the patients' values and preferences and the clinical context to develop these guidelines. We include preventive recommendations such as those for adequate glycemic control, periodic foot inspection, and patient and family education. We recommend using custom therapeutic footwear in high-risk diabetic patients, including those with significant neuropathy, foot deformities, or previous amputation. In patients with plantar diabetic foot ulcer (DFU), we recommend off-loading with a total contact cast or irremovable fixed ankle walking boot. In patients with a new DFU, we recommend probe to bone test and plain films to be followed by magnetic resonance imaging if a soft tissue abscess or osteomyelitis is suspected. We provide recommendations on comprehensive wound care and various debridement methods. For DFUs that fail to improve (>50% wound area reduction) after a minimum of 4 weeks of standard wound therapy, we recommend adjunctive wound therapy options. In patients with DFU who have peripheral arterial disease, we recommend revascularization by either surgical bypass or endovascular therapy.
   Conclusions: Whereas these guidelines have addressed five key areas in the care of DFUs, they do not cover all the aspects of this complex condition. Going forward as future evidence accumulates, we plan to update our recommendations accordingly.
C1 [Hingorani, Anil] NYU Lutheran Med Ctr, 150 55th St, Brooklyn, NY 11220 USA.
   [LaMuraglia, Glenn M.] Massachusetts Gen Hosp, Boston, MA 02114 USA.
   [LaMuraglia, Glenn M.] Harvard Univ, Sch Med, Boston, MA USA.
   [Henke, Peter] Univ Michigan, Ann Arbor, MI 48109 USA.
   [Meissner, Mark H.] Univ Washington, Seattle, WA 98195 USA.
   [Loretz, Lorraine] UMass Mem, Worcester, MA USA.
   [Zinszer, Kathya M.] Geisinger Hlth Syst, Danville, PA USA.
   [Driver, Vickie R.] Brown Univ, Alpert Med Sch, Providence, RI 02912 USA.
   [Frykberg, Robert] Carl T Hayden Vet Affairs Med Ctr, Phoenix, AZ USA.
   [Carman, Teresa L.] Univ Hosp Case Med Ctr, Cleveland, OH USA.
   [Marston, William] Univ N Carolina, Sch Med, Chapel Hill, NC USA.
   [Mills, Joseph L., Sr.] Baylor Coll Med, Houston, TX 77030 USA.
   [Murad, Mohammad Hassan] Mayo Clin, Rochester, MN USA.
C3 Harvard University; Harvard University Medical Affiliates; Massachusetts
   General Hospital; Harvard University; Harvard Medical School; University
   of Michigan System; University of Michigan; University of Washington;
   University of Washington Seattle; University of Massachusetts System;
   University of Massachusetts Worcester; Geisinger Health System; Brown
   University; University System of Ohio; Case Western Reserve University;
   Case Western Reserve University Hospital; University of North Carolina;
   University of North Carolina Chapel Hill; University of North Carolina
   School of Medicine; Baylor College of Medicine; Mayo Clinic
RP Hingorani, A (通讯作者)，NYU Lutheran Med Ctr, 150 55th St, Brooklyn, NY 11220 USA.
EM ahingorani67@gmail.com
RI Murad, Mohammad Hassan/AAW-4367-2020; hingorani, anil/O-2510-2019;
   Carman, Teresa/ADN-7358-2022; Mills, Joseph/L-2023-2019
OI Murad, Mohammad Hassan/0000-0001-5502-5975; Carman,
   Teresa/0009-0007-4496-2702; Mills, Joseph/0000-0002-4955-4384; Loretz,
   Lorraine/0009-0009-7774-6568
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NR 176
TC 433
Z9 563
U1 4
U2 136
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0741-5214
EI 1097-6809
J9 J VASC SURG
JI J. Vasc. Surg.
PD FEB
PY 2016
VL 63
IS 2
SU S
BP 3S
EP 21S
DI 10.1016/j.jvs.2015.10.003
PG 19
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA DE6XK
UT WOS:000370777900002
PM 26804367
HC Y
HP N
DA 2026-07-24
ER

PT J
AU van Wingerden, JJ
   Coret, MEH
   van Nieuwenhoven, CA
   Totté, ER
AF van Wingerden, Jan J.
   Coret, Matijn E. H.
   van Nieuwenhoven, Christianne A.
   Totte, Eric R.
TI The laparoscopically harvested omental flap for deep sternal wound
   infection
SO EUROPEAN JOURNAL OF CARDIO-THORACIC SURGERY
LA English
DT Article
DE Mediastinitis; Omentum; Laparoscopy; Hanuman syndrome; Sternal
   infection; Omental flap
ID VACUUM-ASSISTED CLOSURE; CHEST-WALL; GREATER OMENTUM; RECONSTRUCTION;
   MEDIASTINITIS; TRANSPOSITION; SURGERY; MOBILIZATION; THERAPY; DEFECT
AB Objective: To report our experience with the laparoscopically harvested omental flap in the treatment of deep sternal wound infection, and to present a modification and introduce two supportive techniques in the perioperative management. Methods: Between June 2005 and September 2007, six patients with grade IV (El Oakley-Wright classification) deep sternal wound infection following a median sternotomy for coronary artery bypass grafting underwent a reconstruction with a laparoscopically harvested omental flap. The median age of the cohort of six, consisting of one female and five males, was 67 years (range: 61-77 years). In five patients, an unilateral internal thoracic artery had been used. Considerable preoperative risk factors were present: one patient suffered from severe chronic obstructive pulmonary disease (COPD) Forced expiratory volume in 1 s (FEV1) 1L; two from moderate chronic obstructive airway disease, three from insulin-dependent diabetes mellitus and three were on glucocorticoid steroid therapy preoperatively. Abdominal surgery had previously been performed in four patients. In all cases, the mediastinal wound was prepared with vacuum-assisted (<= 125 mmHg) therapy following debridement and pulsed irrigation. White, small-pore foam was placed over the right ventricle when the risk of adhesion to the sternal remnants or secondary haemorrhage was a concern. In all cases, the position of the spread-out omental flap was maintained intrathoracically with autologous fibrin glue and in one case the split-skin graft covering the flap was also dealt with in this way. In the five other cases, the omental flap was covered by mobilising and advancing the local soft tissue and skin towards the midline. Portable sonography proved useful in monitoring the doubtful intrathoracic flap. Results: The 30-day perioperative mortality rate was zero, with a 2-year overall survival of 100%. One patient received a temporary colostomy due to a partial transverse colon necrosis. Follow-up ranged from 20 to 53 months (median: 39 months) for the group as a whole. Death occurred in one case 2.8 years after reconstruction due to reasons other than cardiac or mediastinal conditions. Conclusion: The laparoscopically harvested omental flap can contribute to a successful outcome following deep sternal wound infection and deserves serious consideration in type IV mediastinitis in particular, regardless of the co-morbidity or previous abdominal surgery. (C) 2009 European Association for Cardio-Thoracic Surgery. Published by Elsevier B.V. All rights reserved.
C1 [van Wingerden, Jan J.; Coret, Matijn E. H.; van Nieuwenhoven, Christianne A.] Med Ctr Leeuwarden, Dept Reconstruct Plast Surg, Leeuwarden, Netherlands.
   [Totte, Eric R.] Med Ctr Leeuwarden, Leeuwarden Inst Minimal Invas Surg, Leeuwarden, Netherlands.
C3 Medical Center Leeuwarden; Medical Center Leeuwarden
RP van Wingerden, JJ (通讯作者)，Beemdgras 14, NL-8935 BK Leeuwarden, Netherlands.
EM jjvw06@gmail.com
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NR 24
TC 30
Z9 35
U1 0
U2 4
PU OXFORD UNIV PRESS INC
PI CARY
PA JOURNALS DEPT, 2001 EVANS RD, CARY, NC 27513 USA
SN 1010-7940
EI 1873-734X
J9 EUR J CARDIO-THORAC
JI Eur. J. Cardio-Thorac. Surg.
PD JAN
PY 2010
VL 37
IS 1
BP 87
EP 92
DI 10.1016/j.ejcts.2009.06.020
PG 6
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 538PG
UT WOS:000273195800017
PM 19646890
DA 2026-07-24
ER

PT J
AU Bandol, G
   Cobzeanu, MD
   Moscalu, M
   Palade, OD
   Moisii, L
   Severin, F
   Patrascanu, E
   Mocanu, F
   Roman, AI
   Cobzeanu, BM
AF Bandol, Geanina
   Cobzeanu, Mihail Dan
   Moscalu, Mihaela
   Palade, Octavian Dragos
   Moisii, Liliana
   Severin, Florentina
   Patrascanu, Emilia
   Mocanu, Florin
   Roman, Andrei Ionut
   Cobzeanu, Bogdan Mihail
TI Deep Neck Infections: The Effectiveness of Therapeutic Management and
   Bacteriological Profile
SO MEDICINA-LITHUANIA
LA English
DT Article
DE deep neck infections; upper airway obstruction; length of hospital stay;
   pathogens; positive bacterial culture
ID VACUUM-ASSISTED CLOSURE; RISK-FACTORS; ABSCESSES; OUTCOMES
AB Background and Objectives: Deep neck infections (DNIs) are severe diagnoses that can cause serious complications. However, there are insufficient data to predict the evolution of this pathology. This study aims to review the microbiology of DNIs and to identify the factors that influence prolonged hospitalization. Materials and Methods: The present retrospective cohort observational analytical study analyzed 138 patients with DNIs who were diagnosed and received surgical treatment over a 8-year period. Results: Reduced lymphocyte percentages and increased neutrophil-to-lymphocyte ratios (NLRs) were significantly associated with complications (p < 0.001 and p = 0.0041, respectively). Laryngotracheal infections were significantly associated with complications (25.53%) (p = 0.0004). Diabetes mellitus (DM) and immunocompromised status were strongly associated with complications (p < 0.001 and p = 0.0056, respectively), establishing these conditions as significant risk factors. Patients with complications experienced substantially longer hospitalizations, with a mean duration of 24.9 days compared to 8.32 days in patients without complications (p < 0.001). Complications were observed in 47 patients (34.06%). The most common complications were airway obstruction, which occurred in 26 patients (18.84%), and mediastinitis, which was noted in 31 patients (22.46%). Patients requiring tracheotomy due to airway obstruction had 6.51 times higher odds of long-term hospitalization compared to those without airway obstruction (OR = 6.51; p < 0.001). Mediastinitis was associated with a 4.81-fold increase in the odds of prolonged hospitalization (OR = 4.81; p < 0.001). Monomicrobial infections were observed in 35.5% of cases, with no significant difference between the short-term (<2 weeks, 37.33%) and long-term (>= 2 weeks, 33.33%) hospitalization groups (p = 0.8472). Conversely, polymicrobial infections were significantly associated with prolonged hospitalization, occurring in 20.63% of the long-term cases compared to 6.66% of the short-term cases (p < 0.001). The most common aerobic bacteria observed were Staphylococcus aureus (14.28%), Streptococcus constellatus (12.69%) and Streptococcus viridans (7.93%) during long-term hospitalization. Comparative analysis of the Kaplan-Meier survival curves based on the presence of infection revealed a significantly lower survival in cases with a positive culture. Conclusions: Deep neck infection has a complex pathology, whose therapeutic management remains a challenge in order to reduce the length of hospitalization and mortality.
C1 [Bandol, Geanina; Palade, Octavian Dragos; Moisii, Liliana; Severin, Florentina] Grigore T Popa Univ Med & Pharm, Ears Nose Throat ENT Dept, Iasi 700115, Romania.
   [Cobzeanu, Mihail Dan; Mocanu, Florin; Roman, Andrei Ionut; Cobzeanu, Bogdan Mihail] Grigore T Popa Univ Med & Pharm, Surg Dept, Iasi 700115, Romania.
   [Moscalu, Mihaela] Grigore T Popa Univ Med & Pharm, Dept Prevent Med & Interdisciplinar, Iasi 700115, Romania.
   [Patrascanu, Emilia] Univ Med & Pharm Grigore T Popa Iasi, Dept Anesthesia & Intens Care, Iasi 700115, Romania.
C3 Grigore T Popa University of Medicine & Pharmacy; Grigore T Popa
   University of Medicine & Pharmacy; Grigore T Popa University of Medicine
   & Pharmacy; Grigore T Popa University of Medicine & Pharmacy
RP Cobzeanu, MD (通讯作者)，Grigore T Popa Univ Med & Pharm, Surg Dept, Iasi 700115, Romania.; Moscalu, M (通讯作者)，Grigore T Popa Univ Med & Pharm, Dept Prevent Med & Interdisciplinar, Iasi 700115, Romania.
EM geanina-bandol@umfiasi.ro; mihail.cobzeanu@umfiasi.ro;
   moscalu.mihaela@gmail.com; octavian.palade@umfiasi.ro;
   liliana.moisii@umfiasi.ro; florentina-s-severin@umfiasi.ro;
   patrascanu.emilia@umfiasi.ro; florin.mocanu@email.umfiasi.ro;
   roman.ionut-andrei@umfiasi.ro; bogdan-mihail.cobzeanu@umfiasi.ro
RI Mocanu, Florin/MTF-1861-2025; Cobzeanu, Bogdan Mihail/MSZ-4618-2025;
   Cobzeanu, Bogdan Mihail/AAN-1813-2020; Gheorghe, Liliana/AAB-9198-2021;
   Moscalu, Mihaela/ABA-9799-2020; Dan Mihail, Cobzeanu/AAN-1813-2020;
   Palade, Octavian Dragos/U-5755-2017; FLORENTINA, Severin/JOZ-9426-2023
OI Mocanu, Florin/0009-0005-2680-1572; Cobzeanu, Bogdan
   Mihail/0009-0001-3596-5617; Cobzeanu, Bogdan Mihail/0009-0001-3596-5617;
   Gheorghe, Liliana/0000-0002-8770-9340; Moscalu,
   Mihaela/0000-0002-8899-8594; Dan Mihail, Cobzeanu/0000-0003-3319-5564;
   Palade, Octavian Dragos/0000-0003-3002-7530; emilia,
   patrascanu/0000-0002-0646-985X; FLORENTINA, Severin/0000-0002-9362-2030
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NR 45
TC 5
Z9 6
U1 2
U2 8
PU MDPI
PI BASEL
PA MDPI AG, Grosspeteranlage 5, CH-4052 BASEL, SWITZERLAND
SN 1010-660X
EI 1648-9144
J9 MEDICINA-LITHUANIA
JI Med. Lith.
PD JAN
PY 2025
VL 61
IS 1
AR 129
DI 10.3390/medicina61010129
PG 17
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA T6E2O
UT WOS:001405905300001
PM 39859111
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Aust, MC
   Spies, M
   Guggenheim, M
   Gohritz, A
   Kall, S
   Rosenthal, H
   Pichlmaier, M
   Oehlert, G
   Vogt, PM
AF Aust, M. C.
   Spies, M.
   Guggenheim, M.
   Gohritz, A.
   Kall, S.
   Rosenthal, H.
   Pichlmaier, M.
   Oehlert, G.
   Vogt, P. M.
TI Lower limb revascularisation preceding surgical wound coverage - An
   interdisciplinary algorithm for chronic wound closure
SO JOURNAL OF PLASTIC RECONSTRUCTIVE AND AESTHETIC SURGERY
LA English
DT Article
DE chronic wounds; arterial occlusive disease; peripheral vascular
   recanalisation; plastic surgical wound closure
ID ANTERIOR THIGH FLAPS; FREE TISSUE TRANSFER; CHRONIC LEG ULCERS;
   LOWER-EXTREMITY; CHRONIC OSTEOMYELITIS; MUSCLE FLAP; PERFORATOR FLAPS;
   FOOT DEFECTS; BLOOD-FLOW; RECONSTRUCTION
AB Background: Chronic wounds may occur or persist due to arterial insufficiency. Despite the high prevalence of arterial occlusive disease, a search of the literature has yielded a paucity of data on the benefit of interventions to recanalise lower extremity arteries prior to surgical closure of chronic wounds.
   Objective: To investigate the correlation of simple clinical examinations and apparative diagnostics for the detection of arterial occlusive disease of the tower extremity in patients with chronic wounds, and to evaluate the benefit of vascular procedures to optimise wound perfusion before surgical closure.
   Patients and methods: During a 6-year period, 150 patients with chronic tower extremity wounds (no heating for more than 30 days) were included into this prospective study. All patients underwent palpation of foot pulses, Doppler sonography and measurement of occlusive pressures. Positive clinical findings were re-evaluated by angiography. All patients with peripheral extremity vessel occlusions underwent vascular interventions (percutaneous transluminal angioplasty with stenting, open thrombectomy or vascular bypass surgery) prior to surgical wound closure.
   Results: In all 34 patients (21%) with missing foot pulses, suspicious Doppler signals or pathological occlusive pressure measurements, the clinical diagnosis of arterial occlusion was confirmed by angiography. An arterial pathology had previously been diagnosed in merely two of those patients. Nineteen patients underwent percutaneous transluminal angioplasty and 21 stents were implanted; in 10 cases, open thrombectomy or vascular bypasses were performed. In all 34 patients, sufficient peripheral recanalisation and improved wound perfusion were successfully achieved.
   For definitive wound closure, microsurgical. tissue transplantation was performed in 15 patients. Angiography was performed prior to surgery. In 11 patients, regional or local flaps were used. Six patients received split skin grafting only; two wounds heated conservatively following vascular intervention. Vacuum-assisted closure (VAC) therapy was applied in 15 cases. Postoperatively, three cases of impaired wound heating and one infection occurred.
   Conclusions: Arterial insufficiency can be diagnosed safety by simple clinical examination. All clinically pathological results were successfully confirmed by angiography, allowing for a targeted peripheral vessel reopening to improve wound perfusion before surgery. This straightforward algorithm helped to improve the success of surgical therapy of chronic lower extremity wounds. (C) 2008 British Association of Plastic, Reconstructive and Aesthetic Surgeons. Published by Elsevier Ltd. All rights reserved.
C1 [Aust, M. C.; Spies, M.; Gohritz, A.; Kall, S.; Vogt, P. M.] Hannover Med Sch, Clin Plast Hand & Reconstruct Surg, D-30625 Hannover, Germany.
   [Guggenheim, M.] Univ Zurich Hosp, Dept Surg, Div Plast & Reconstruct Surg, Zurich, Switzerland.
   [Rosenthal, H.] Hannover Med Sch, Clin Diagnost Radiol, D-30625 Hannover, Germany.
   [Pichlmaier, M.] Hannover Med Sch, Clin Thorac Heart & Vasc Surg, D-30625 Hannover, Germany.
   [Oehlert, G.] Oststadt Hosp Hannover, Clin Radiol, Hannover, Germany.
C3 Hannover Medical School; University of Zurich; University Zurich
   Hospital; Hannover Medical School; Hannover Medical School
RP Aust, MC (通讯作者)，Hannover Med Sch, Clin Plast Hand & Reconstruct Surg, Carl Neubergstr 1, D-30625 Hannover, Germany.
EM aust_matthias@gmx.de
RI Vogt, Peter/AAL-1332-2020
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NR 47
TC 30
Z9 33
U1 1
U2 3
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 1748-6815
J9 J PLAST RECONSTR AES
JI J. Plast. Reconstr. Aesthet. Surg.
PY 2008
VL 61
IS 8
BP 925
EP 933
DI 10.1016/j.bjps.2007.09.060
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 354EA
UT WOS:000259620500018
PM 18407817
DA 2026-07-24
ER

PT J
AU Ioannidis, O
   Kitsikosta, L
   Tatsis, D
   Skandalos, I
   Cheva, A
   Gkioti, A
   Varnalidis, I
   Symeonidis, S
   Savvala, NA
   Parpoudi, S
   Paraskevas, GK
   Pramateftakis, MG
   Kotidis, E
   Mantzoros, I
   Tsalis, KG
AF Ioannidis, Orestis
   Kitsikosta, Loukiani
   Tatsis, Dimitris
   Skandalos, Ioannis
   Cheva, Aggeliki
   Gkioti, Aikaterini
   Varnalidis, Ioannis
   Symeonidis, Savvas
   Savvala, Natalia Antigoni
   Parpoudi, Styliani
   Paraskevas, George K.
   Pramateftakis, Manousos George
   Kotidis, Efstathios
   Mantzoros, Ioannis
   Tsalis, Konstantinos George
TI Fournier's gangrene: lessons learned from Multimodal and
   Multidisciplinary Management of Perineal necrotizing Fasciitis
SO FRONTIERS IN SURGERY
LA English
DT Article
DE necrosis; perianal; perineum; polymicrobial; scrotum; surgical
   debridement
ID VACUUM-ASSISTED CLOSURE; SEVERITY INDEX; EXPERIENCE; MORTALITY;
   COLOSTOMY; THERAPY; SCORE
AB Background: Fournier's gangrene (FG) is a rapidly evolving necrotizing fasciitis of the perineum and the genital area, the scrotum as it most commonly affects man in the vast majority of cases. It is polymicrobial in origin, due to the synergistic action of anaerobes and aerobes and has a very high mortality. There are many predisposing factors including diabetes mellitus, alcoholism, immunosuppression, renal, and hepatic disease. The prognosis of the disease depends on a lot of factors including but not limited to patient age, disease extent, and comorbidities. The purpose of the study is to describe the experience of a general surgery department in the management of FG, to present the multimodal and multidisciplinary treatment of the disease, to identify predictors of mortality, and to make general surgeons familiar with the disease.
   Methods: The current retrospective study is presenting the experience of our general surgery department in the management of FG during the last 20 years. The clinical presentation and demographics of the patients were recorded. Also we recorded the laboratory data, the comorbidities, the etiology, and microbiology and the therapeutic interventions performed, and we calculated the various severity indexes. Patients were divided to survivors and non- survivors, and all the collected data were statistically analyzed to assess mortality factors using univariate and then multivariate analysis.
   Results: In our series, we treated a total of 24 patients with a mean age 58.9 years including 20 males (83.4%) and 4 females (16.6%). In most patients, a delay between disease onset and seeking of medical help was noted. Comorbidities were present in almost all patients (87.5%). All patients were submitted to extensive surgical debridements and received broad-spectrum antibiotics until microbiological culture results were received. Regarding all the collected data, there was no statistically significant difference between survivors and non- survivors except the presence of malignancy in non-survivors (p = 0.036) and the lower hemoglobin (p < 0.001) and hematocrit (p = 0.002) in non-survivors. However, multivariate analysis did not reveal any predictor of mortality.
   Conclusion: Early diagnosis, aggressive thorough surgical treatment, and administration of the proper antibiotic treatment comprise the cornerstone for the outcome of this disease. In small populations like in the present study, it is difficult to recognize any predictors of mortality and even the severity indexes, which take into account a lot of data cannot predict mortality.
C1 [Ioannidis, Orestis; Kitsikosta, Loukiani; Tatsis, Dimitris; Symeonidis, Savvas; Savvala, Natalia Antigoni; Parpoudi, Styliani; Pramateftakis, Manousos George; Kotidis, Efstathios; Mantzoros, Ioannis; Tsalis, Konstantinos George] Aristotle Univ Thessaloniki, Sch Med, Surg Dept 4, Thessaloniki, Greece.
   [Skandalos, Ioannis] Gen Hosp Agios Pavlos, Dept Surg, Thessaloniki, Greece.
   [Cheva, Aggeliki] Gen Hosp G Papanikolaou, Dept Pathol, Thessaloniki, Greece.
   [Gkioti, Aikaterini] Gen Hosp G Papanikolaou, Dept Microbiol, Thessaloniki, Greece.
   [Varnalidis, Ioannis] Gen Hosp G Papanikolaou, Dept Plast Surg, Thessaloniki, Greece.
   [Paraskevas, George K.] Aristotle Univ Thessaloniki, Sch Med, Dept Anat, Thessaloniki, Greece.
C3 Aristotle University of Thessaloniki; Aristotle University of
   Thessaloniki
RP Ioannidis, O (通讯作者)，Aristotle Univ Thessaloniki, Sch Med, Surg Dept 4, Thessaloniki, Greece.
EM telonakos@hotmail.com
RI ; Tatsis, Dimitris/I-3648-2016; CHEVA, ANGELIKI/HGB-6685-2022
OI Ioannidis, Orestis/0000-0002-0861-8783; Tatsis,
   Dimitris/0000-0003-2508-0396; CHEVA, ANGELIKI/0000-0002-5374-1772
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NR 50
TC 36
Z9 46
U1 0
U2 4
PU FRONTIERS MEDIA SA
PI LAUSANNE
PA AVENUE DU TRIBUNAL FEDERAL 34, LAUSANNE, CH-1015, SWITZERLAND
SN 2296-875X
J9 FRONT SURG
JI Front. Surg.
PD JUL 10
PY 2017
VL 4
AR 36
DI 10.3389/fsurg.2017.00036
PG 12
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA FG2TQ
UT WOS:000409975300001
PM 28740847
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Kaplan, M
   Banwell, P
   Orgill, DP
   Ivatury, RR
   Demetriades, D
   Moore, FA
   Miller, P
   Nicholas, J
   Henry, S
AF Kaplan, M
   Banwell, P
   Orgill, DP
   Ivatury, RR
   Demetriades, D
   Moore, FA
   Miller, P
   Nicholas, J
   Henry, S
TI Guidelines for the management of the open abdomen
SO WOUNDS-A COMPENDIUM OF CLINICAL RESEARCH AND PRACTICE
LA English
DT Article
ID ABDOMINAL COMPARTMENT SYNDROME; MULTIPLE ORGAN FAILURE; ASSISTED FASCIAL
   CLOSURE; PLANNED VENTRAL HERNIA; VACUUM PACK TECHNIQUE;
   INTENSIVE-CARE-UNIT; WOUND CLOSURE; INTRAABDOMINAL HYPERTENSION;
   DAMAGE-CONTROL; TEMPORARY CLOSURE
AB The management of the open abdomen continues to pose a challenge for Surgeons. After Surgical exploration for abdominal trauma, operative misadventure, or relief of abdominal compartment syndrome, definitive closure of the abdominal fascia and abdominal wall immediately following laparotomy may be technically impossible. Alternatively, the abdomen may need to remain open to allow access for re-operation and time for decompression of the abdomen.
   Multiple techniques for temporary abdominal closure have been described in the literature. To better understand the current treatment of the open abdomen, an expert panel of surgeons convened to review the literature and current practices in managing the open abdomen. The panel reviewed the reasons for the increasing number of open abdomen procedures as well as each treatment method in the context of evidence-based medicine. In addition, panel members shared their experiences using various techniques for treating the open abdomen.
   The use of the open abdomen as a surgical option has increased in recent years. Benefits of maintaining an open abdomen include ease of re-exploration, control of abdominal contents, reduction of the risk of intra-abdominal hypertension and abdominal compartment syndrome, and fascial preservation for Closure of the abdominal wall. The prolonged exposure of abdominal viscera can result in high rates of complications, including infection, sepsis, and fistula formation.
   A number of techniques have been published, but no clear consensus on the best technique or device to manage an open abdomen exists. Recent intensive care unit advances, an awareness of intra-abdominal hypertension and abdominal compartment syndrome, and the increased usage of damage control laparotomy have resulted in a new class of challenging patients with open abdominal wounds.
   Temporary abdominal closure techniques, such as the Bogota bag or vacuum pack, have been described, along with other closure techniques, including allowing the wound to granulate through a biodegradable mesh and sequential closure using a Vacuum Assisted Closure (R) device (VA.C.(R) Therapy (TM), KCI, San Antonio, Tex). Each of these methods is reported to reduce complications compared to traditional gauze dressings. The V.A.C.(R) System allows surgeons to close most open abdomens without the use of skin grafts. Future studies and continued innovation will hopefully lead to better understanding of optimal treatment strategies for these devastating injuries.
RI Orgill, Dennis/H-7596-2019; Ivatury, Rao/H-2922-2019
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   Suliburk JW, 2003, J TRAUMA, V55, P1155, DOI 10.1097/01.TA.0000100218.03754.6A
   Wilkes MM, 2001, ANN INTERN MED, V135, P149, DOI 10.7326/0003-4819-135-3-200108070-00007
   2004, WORLD C ABD COMP SYN
NR 62
TC 38
Z9 58
U1 0
U2 6
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 1044-7946
EI 1943-2704
J9 WOUNDS
JI Wounds-Compend. Clin. Res. Pract.
PD OCT
PY 2005
SU S
BP 1
EP 24
PG 24
WC Dermatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology; Surgery
GA 982GI
UT WOS:000233145700001
DA 2026-07-24
ER

PT J
AU Ma, XW
   Wang, ZP
   Wang, JC
AF Ma, Xiaowei
   Wang, Zongpu
   Wang, Jianchuan
TI Clinical analysis of accelerated rehabilitation surgery for Gustilo type
   IIIA/B open tibio fibular fracture
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE ERAS; Open fracture of the tibia and fibula; Soft-tissue defect; Muscle
   flap transfer
ID EXTERNAL FIXATION; ENHANCED RECOVERY; RECONSTRUCTION; CONVERSION;
   INFECTION; SHAFT; BONE; NAIL
AB Purpose To investigate the clinical efficacy of accelerated rehabilitation surgery for the treatment of Gustilo type IIIA/B open tibiofibular fracture with emergency stage I debridement, internal fracture fixation, bone grafting, coverage of the wound surface with a muscle flap combined with vacuum sealing drainage (VSD), and internal and lateral leg reduction. Methods A retrospective analysis was performed on the clinical data of 15 patients with Gustilo type IIIA/B open tibiofibular fracture who were admitted to the Affiliated Zhongshan Hospital of Dalian University from January 2015 to December 2018. There were 12 males and 3 females. The patients ranged in age from 20 to 62 years, with an average of 39.5 years. After admission, the patients underwent stage I emergency debridement (including exploration and repair of nerves and tendons), open reduction and internal fixation of the tibia and fibula, iliac bone grafting, muscle flap and VSD coverage of the bone defect, complete tensioning of the calf inside and outside, tibia-sparing incision before healing, and stage II free skin grafting. Patients were followed up periodically to observe muscle flap survival, fracture healing time, length of hospitalization, wound healing time, delayed union, bone nonunion, osteomyelitis and other complications. At the last follow-up, the Johner-Wruhs criteria were used to evaluate the rate of good functional recovery from tibial shaft fracture, fracture healing quality was evaluated by the Merchant score, and limb function was evaluated by the LEFS. Results All 15 cases were followed up for 12-32 months, with an average of 22.8 months. All the fractures healed; the range of healing time was 14-30 weeks (mean 18.5 weeks). The length of hospitalization was 25.1 +/- 7.6 days, and wound healing took 12.2 +/- 2.0 days. None of the patients had complications such as osteomyelitis infection. When the Johner-Wruhs evaluation criteria for functional recovery from tibial shaft fracture were applied at the last follow-up, the outcomes were as follows: excellent in 13 cases, good in 1 case and fair in 1 case, for an excellent and good rate of 93.3%. When fracture healing was evaluated according to the Merchant scoring standard, the outcomes were as follows: excellent in 12 cases, good in 1 case, fair in 1 case, and poor in 1 case, for an excellent and good rate of 86.7%. The mean LEFS score of the affected limb at the last follow-up was 70 (59-80). Conclusion For Gustilo type IIIA/B open tibiofibular fractures, emergency stage I debridement, internal fixation of the fracture, bone grafting, coverage of the wound with a muscle flap, complete tensioning of the calf inside and outside, and application of VSD can improve the repair of leg soft-tissue defects, shorten hospitalization time, promote fracture healing, and effectively reduce infection and complications related to bone exposure. More importantly, this treatment protocol provides effective wound repair, guarantees the recovery of limb function, significantly speeds up recovery, and improve patients' quality of life.
C1 [Ma, Xiaowei; Wang, Zongpu; Wang, Jianchuan] Dalian Univ, Dept Orthoped, Affiliated Zhongshan Hosp, Dalian, Peoples R China.
C3 Dalian University
RP Wang, JC (通讯作者)，Dalian Univ, Dept Orthoped, Affiliated Zhongshan Hosp, Dalian, Peoples R China.
EM 422186196@qq.com
CR Al-Hourani K, 2021, INJURY, V52, P378, DOI 10.1016/j.injury.2021.01.021
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NR 28
TC 4
Z9 5
U1 0
U2 6
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD DEC
PY 2023
VL 49
IS 6
SI SI
BP 2355
EP 2362
DI 10.1007/s00068-022-02164-x
EA NOV 2022
PG 8
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA CS9L3
UT WOS:000884081400002
PM 36370184
DA 2026-07-24
ER

PT J
AU Reinisch, A
   Liese, J
   Woeste, G
   Bechstein, W
   Habbe, N
AF Reinisch, Alexander
   Liese, Juliane
   Woeste, Guido
   Bechstein, Wolf
   Habbe, Nils
TI A Retrospective, Observational Study of Enteral Nutrition in Patients
   with Enteroatmospheric Fistulas
SO OSTOMY WOUND MANAGEMENT
LA English
DT Article
DE case reports; postoperative complication; fistula; enteral feeding;
   nutritional status
ID HOME PARENTERAL-NUTRITION; SHORT-BOWEL SYNDROME; OPEN ABDOMEN;
   ENTEROCUTANEOUS FISTULAS; MANAGEMENT; TRAUMA; COMPLICATIONS; EXPERIENCE;
   OUTCOMES; SUPPORT
AB Enteroatmospheric fistulas (EAFs) represent a challenging problem in patients with an open abdomen (OA). A retrospective, descriptive study was conducted to evaluate the effects of enteral alimentation on wound status and management and nutrition. All patients with an EAF in an OA treated between October 2012 and December 2014 at a university hospital in Germany were included without criteria for exclusions. Demographic and morbidity-related data collected included age, gender, surgeries, OA grading, body mass index (BMI), serum albumin, and serum creatinin. Underlying diseases and time between the index operation and the formation of the OA and EAFs were analyzed in relation to the initiation of enteral nutrition (EN), which can aggravate and contaminate the OA due to intestinal secretions necessary for digestion. The OA was described in size and area of the fascia defect and classified according to the Bjrck Scale. The number and location of the fistulas and the duration of negative pressure wound therapy (NPWT) were documented. Outcome parameters included fistula volume, wound management (eg, dressing change frequency, need for wound revision), feeding tolerance, systemic impact of nutrition, nutrition status at discharge, and mortality. Data were analyzed using primary descriptive statistics. The Mann-Whitney test was used to evaluate changes in fistula volume and BMI; categorical data were compared using Fisher's exact test. A P value < 0.05 was considered significant. Ten (10) patients (8 women, median age of participants 55.4 [range 44-71] years) were treated during the study time period. Seven (7) patients had the first fistula orifice in the upper jejunum (UJF); 8 had more than 1 fistula. EN was initiated with high caloric liquid nutrition and gradually increased to a 25 kcal/kg/day liquid or solid nutrition. All patients were provided NPWT at 75 mm Hg to 100 mm Hg. EN was not followed by a significant increase of median daily fistula volume (1880 mL versus 2520 mL, P = 0.25) or the need for more frequent changes of NPWT dressings (days between changes 2.6 versus 2.9, P = 0.19). In 9 patients, the severity of wound complications such as inflammation or skin erosion decreased both in frequency and magnitude (eg, affected area). All patients achieved a sufficient oral intake, but only 3 were discharged from the hospital without parenteral nutrition. In this study, EN did not cause additional problems in wound management but did not provide sufficient alimentation in patients with a UJF. Prospective studies are needed to clarify associations between EN, nutrition, and wound management.
C1 [Reinisch, Alexander; Liese, Juliane; Woeste, Guido; Bechstein, Wolf; Habbe, Nils] Univ Hosp & Clin Frankfurt Main, Dept Gen & Visceral Surg, Frankfurt, Hassia, Germany.
RP Reinisch, A (通讯作者)，Univ Hosp & Clin Frankfurt Main, Gen & Visceral Surg, Theodor Stern Kai 7, D-60590 Frankfurt, Hassia, Germany.
EM alexander.reinisch@kgu.de
RI Reinisch, Alexander/AAP-6813-2021; Bechstein, Wolf/H-5457-2019; Liese,
   Juliane/J-6547-2017; /AAA-9828-2021
OI Reinisch, Alexander/0000-0002-5233-0648; Bechstein,
   Wolf/0000-0002-3267-8145; Liese, Juliane/0000-0003-1547-1334; 
CR Amiot A, 2013, CLIN NUTR, V32, P368, DOI 10.1016/j.clnu.2012.08.007
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NR 31
TC 9
Z9 11
U1 0
U2 5
PU H M P COMMUNICATIONS
PI MALVERN
PA 83 GENERAL WARREN BLVD, STE 100, MALVERN, PA 19355 USA
SN 0889-5899
EI 1943-2720
J9 OSTOMY WOUND MANAG
JI Ostomy Wound Manag.
PD JUL
PY 2016
VL 62
IS 7
PG 8
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA EL3DY
UT WOS:000394501000002
PM 27428564
DA 2026-07-24
ER

PT J
AU Tettelbach, WH
   Kelso, MR
AF Tettelbach, William H.
   Kelso, Martha R.
TI Establishing a shared framework for advanced wound care
SO JOURNAL OF WOUND CARE
LA English
DT Editorial Material
DE Full club 211 pound Digital club 153 pound; Medical Officer
AB As former Co-Vice Chairs of the 2025 Cellular, developments in this rapidly evolving field. Over the past decade, the field of advanced wound care has matured from offering promising adjuncts to a rigorously studied, standardsdriven pillar of wound repair and regeneration. The Journal of Wound Care (JWC) has been instrumental in that evolution, advancing both the language and the evidence base we rely on in a variety of settings: outpatient clinics, extended care facilities, assisted living, patient homes, as well as the operating theatre. In 2023, JWC, at the request of Dr William Tettelbach, codified the term 'CAMPs', replacing a patchwork of legacy labels ('skin substitutes', 'cellular/tissue products') with a unifying definition that reflects diverse mechanisms of action and a far broader set of indications than hard-to-heal ulcers alone. That consensus clarified what CAMPs are, and just as importantly, what they are for. Since then, the journal has continued to sharpen best practices. The most recent JWC position work reframes CAMPs not as a salvage manoeuvre but as an early, intentional component of comprehensive care, including acute surgical and traumatic wounds, when microenvironment, not just biomechanics, must be restored. These updates provide pragmatic guidance on patient selection, product choice across cellular, acellular and hybrid matrices, and the thoughtful use of adjuncts, such as negative pressure wound therapy, to stabilise grafts or matrices. The same work also maps the regulatory pathways clinicians navigate (Premarket Approval (PMA), 510(k), and 361 Human Cell and Tissue Product (HCT/P)), making it clear how the composition, scientific mechanism, clinical impact and regulatory status should inform how a given product is integrated into the plan of care. Across indications, the through-line in JWC's recent literature is earlier, smarter deployment. When CAMPs are introduced in step with integral debridement, infection control, oedema management, and offloading or compression, not after these foundations have failed, healing accelerates, complications fall, and quality of life improves. This isn't just biologically intuitive; it is economically credible. JWC has summarised growing datasets, such as real-world Medicare claims data, showing fewer amputations, readmissions, emergency visits and lower overall costs when CAMPs are applied judiciously and early. This message resonates with clinicians and payers alike. Equally important, the journal has not shied away from the remaining gaps. Authors have called for the design of better randomised trials in targeted populations, transparent reporting of product characteristics and application techniques, and registry-level surveillance to capture real-world standard of care, in addition to building the longitudinal datasets that turn promising case series into confident standards of care.
C1 [Tettelbach, William H.] RestorixHealth, Metairie, LA 70002 USA.
   [Kelso, Martha R.] Wound Care Plus LLC, Blue Springs, MO USA.
RP Tettelbach, WH (通讯作者)，RestorixHealth, Metairie, LA 70002 USA.
RI Tettelbach, William/T-8356-2019
OI Tettelbach, FACP, FIDSA, FUHM, MAPWCA, CWSP, William/0000-0001-5645-7577
NR 0
TC 0
Z9 0
U1 1
U2 1
PU MA HEALTHCARE LTD
PI LONDON
PA ST JUDES CHURCH, DULWICH ROAD, LONDON SE24 0PB, ENGLAND
SN 0969-0700
EI 2052-2916
J9 J WOUND CARE
JI J. Wound Care
PD NOV
PY 2025
VL 34
IS 11
SU A
DI 10.12968/jowc.2025.0505
PG 2
WC Dermatology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Dermatology
GA 9TM1J
UT WOS:001614636500001
PM 41205153
DA 2026-07-24
ER

PT J
AU Atherton, K
   SUNRRISE Trial Study Grp
   Brown, J
   Clouston, H
   Coe, P
   Duarte, R
   Dudi-Venkata, NN
   Duff, S
   Egoroff, N
   Fish, R
   Glasbey, J
   Ives, N
   Kaur, M
   Magill, L
   Mehta, S
   Pinkney, T
   Pockney, P
   Richards, T
   Sammour, T
   Sekhar, H
   Sinha, Y
   Stott, M
   Wilkin, R
AF Atherton, Kristy
   SUNRRISE Trial Study Group, James
   Brown, James
   Clouston, Hamish
   Coe, Pete
   Duarte, Rui
   Dudi-Venkata, Nagendra N.
   Duff, Sarah
   Egoroff, Natasha
   Fish, Rebecca
   Glasbey, James
   Ives, Natalie
   Kaur, Manjinder
   Magill, Laura
   Mehta, Samir
   Pinkney, Thomas
   Pockney, Peter
   Richards, Toby
   Sammour, Tarik
   Sekhar, Hema
   Sinha, Yash
   Stott, Martyn
   Wilkin, Richard
TI Negative Pressure Dressings to Prevent Surgical Site Infection After
   Emergency Laparotomy: The SUNRRISE Randomized Clinical Trial
SO JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION
LA English
DT Article
ID CESAREAN DELIVERY; IMPACT; CARE
AB Importance Patients undergoing unplanned abdominal surgical procedures are at increased risk of surgical site infection (SSI). It is not known if incisional negative pressure wound therapy (iNPWT) can reduce SSI rates in this setting. Objective To evaluate the effectiveness of iNPWT in reducing the rate of SSI in adults undergoing emergency laparotomy with primary skin closure. Design, Setting, and Participants SUNRRISE was an assessor-masked, pragmatic, phase 3, individual-participant, randomized clinical trial. Adult patients undergoing emergency laparotomy in 22 hospitals in the UK and 12 hospitals in Australia between December 18, 2018, and May 25, 2021, were recruited. Patients were followed up for 30 days postprocedure; database closure was on August 25, 2021. Interventions Participants were randomized 1:1 to receive iNPWT (n = 411), which involved a specialized dressing used to create negative pressure over the closed wound vs the surgeon's choice of wound dressing (n = 410). Randomization and dressing application occurred in the operating room at the end of the surgical procedure. Main Outcomes and MeasuresThe primary outcome measure was SSI up to 30 days postprocedure, evaluated by an assessor masked to the randomized allocation and using criteria from the US Centers for Disease Control and Prevention. There were 7 secondary outcomes, including length of hospital stay, postoperative complications up to 30 days, hospital readmission for wound-related complications within 30 days, wound pain, and quality of life. Results A total of 840 patients were randomized (536 from the UK; 304 from Australia). Overall, 52% were female; the mean age was 63.8 (range, 18.8 to 95.3) years. After postrandomization exclusions (N = 52), 394 participants per group were included in the primary analysis. The number of participants who had an SSI in the iNPWT group was 112 of 394 (28.4%), compared with 108 of 394 (27.4%) in the surgeon's preference group (relative risk, 1.03 [95% CI, 0.83-1.28]; P = .78). This finding was consistent across the preplanned subgroup analyses, including degree of contamination, presence of a stoma, participant body mass index, and skin preparation used, and across all preplanned sensitivity analyses. Of 7 secondary outcomes, 6 showed no significant difference, including hospital readmission, quality of life, and hospital stay (median [IQR], 8 [6-14] days in the iNPWT group and 9 [6-14.5] days in the surgeon's preference group [ratio of geometric means, 0.96 (95% CI, 0.88-1.06); P = .21]). Conclusions and Relevance Routine application of iNPWT to the closed surgical wound after emergency laparotomy did not prevent SSI more than other dressings. Trial Registrationisrctn.com Identifier: ISRCTN17599457; anzctr.org.au Identifier: ACTRN12619000496112
C1 [Atherton, Kristy; Egoroff, Natasha; Pockney, Peter] Univ Newcastle, Sydney, Australia.
   [Brown, James; Glasbey, James; Ives, Natalie; Kaur, Manjinder; Magill, Laura; Mehta, Samir; Pinkney, Thomas; Sinha, Yash] Univ Birmingham, Birmingham, England.
   [Clouston, Hamish; Fish, Rebecca; Sekhar, Hema] Christie NHS Fdn Trust, Manchester, England.
   [Coe, Pete] Leeds Teaching Hosp NHS Trust, Leeds, England.
   [Duarte, Rui; Stott, Martyn] Univ Liverpool, Liverpool, England.
   [Dudi-Venkata, Nagendra N.] Launceston Gen Hosp, Launceston, Tas, Australia.
   [Duff, Sarah] South Manchester Univ Hosp NHS Trust, Manchester, England.
   [Richards, Toby] UCL, London, England.
   [Sammour, Tarik] Univ Adelaide, Adelaide, Australia.
   [Wilkin, Richard] Worcestershire Royal Hosp, Worcester, England.
C3 University of Newcastle; University of Birmingham; Christie NHS
   Foundation Trust; University of Leeds; University of Liverpool;
   Launceston General Hospital; Wythenshawe Hospital NHS Foundation Trust;
   University of London; University College London; Adelaide University;
   University of Adelaide
RP Mehta, S (通讯作者)，Univ Birmingham, Coll Med & Hlth, Birmingham Clin Trials Unit, Birmingham B15 2TT, England.
EM s.mehta.1@bham.ac.uk
RI Sammour, Tarik/H-3467-2019; Dudi-Venkata, Nagendra/AAR-9204-2020;
   Duarte, Rui/C-9635-2012; Atherton, Kristy/JHU-9380-2023; Glasbey,
   James/I-2457-2019; Pinkney, Thomas/HGA-4022-2022; Stott,
   Martyn/ACR-2481-2022; Fish, Rebecca/L-2954-2019; Richards,
   Toby/K-6547-2013
OI Sammour, Tarik/0000-0002-4918-8871; Dudi-Venkata,
   Nagendra/0000-0002-9775-3599; Magill, Laura/0000-0003-2498-8407; Sekhar,
   Hema/0000-0002-6384-8872; Glasbey, James/0000-0001-7688-5018; Brown,
   James/0000-0003-4513-1509; Ives, Natalie/0000-0002-1664-7541; Pinkney,
   Thomas/0000-0001-7320-6673; Stott, Martyn/0000-0002-3536-8281; 
FU National Institute for Health and Care Research (NIHR) Research for
   Patient Benefit Programme in the UK [PB-PG-0416-20045]; Medical Research
   Future Fund (MRFF) International Clinical Trials Collaboration Program
   in Australia [2019/MRF1179938]; National Institutes of Health Research
   (NIHR) [PB-PG-0416-20045] Funding Source: National Institutes of Health
   Research (NIHR)
FX SUNRRISE was investigator initiated and led. It was funded by the
   National Institute for Health and Care Research (NIHR) Research for
   Patient Benefit Programme (PB-PG-0416-20045) in the UK and the Medical
   Research Future Fund (MRFF) International Clinical Trials Collaboration
   Program (2019/MRF1179938) in Australia. PICO 7 dressings were provided
   free of charge by Smith & Nephew.
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   Costa ML, 2020, HEALTH TECHNOL ASSES, V24, pI, DOI 10.3310/hta24380
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   National Institute for Health and Care Excellence, 2019, PICO NEGATIVE PRESSU
   NELA Project Team, 2019, Fifth Patient Report of the National Emergency Laparotomy Audit
   Nepogodiev D, 2020, BJS-BRIT J SURG, V107, P1440, DOI 10.1002/bjs.11746
   NIHR Global Res Hlth Unit, 2021, LANCET, V398, P1687, DOI 10.1016/S0140-6736(21)01548-8
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NR 23
TC 18
Z9 21
U1 5
U2 13
PU AMER MEDICAL ASSOC
PI CHICAGO
PA 330 N WABASH AVE, STE 39300, CHICAGO, IL 60611-5885 USA
SN 0098-7484
EI 1538-3598
J9 JAMA-J AM MED ASSOC
JI JAMA-J. Am. Med. Assoc.
PD MAR 11
PY 2025
VL 333
IS 10
BP 853
EP 863
DI 10.1001/jama.2024.24764
EA JAN 2025
PG 11
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 0DW5R
UT WOS:001411663500001
PM 39869330
OA Green Submitted, Green Accepted
DA 2026-07-24
ER

PT J
AU Bota, O
   Heinzinger, LM
   Herzog, B
   Disch, AC
   Amlang, M
   Flössel, P
   Dragu, A
   Taqatqeh, F
AF Bota, Olimpiu
   Heinzinger, Leona M.
   Herzog, Bianka
   Disch, Alexander C.
   Amlang, Michael
   Floessel, Philipp
   Dragu, Adrian
   Taqatqeh, Feras
TI Evaluation of the ankle function after Achilles tendon resection: a
   retrospective clinical study
SO ARCHIVES OF ORTHOPAEDIC AND TRAUMA SURGERY
LA English
DT Article
DE Achilles tendon infection; Achilles tendon reconstruction; Achilles
   tendon repair; Foot and ankle surgery; Reconstructive surgery; Negative
   pressure wound therapy
ID SOFT-TISSUE DEFECTS; RECONSTRUCTION; FLAP; COMPLICATIONS; MANAGEMENT;
   COVERAGE
AB IntroductionThe Achilles tendon is the strongest tendon in the human body and has the function of plantar ankle flexion. When the tendon is exposed, the peritendineum has been breached and the thick avascular tendon colonized with bacteria, a complete resection of the tendon may be indicated to achieve infection control and facilitate wound closure. The Achilles tendon reconstruction is not mandatory, as the plantar flexion of the ankle joint is assumed by the remaining flexor hallucis longus, flexor digitorum longus and tibialis posterior muscles. Our study aimed to evaluate the impact of Achilles tendon resection without reconstruction on leg function and quality of life.Material and methodsWe retrospectively evaluated all patients who were treated with an Achilles tendon resection between January 2017 and June 2022 in our quaternary institution. After evaluating the data, the patients who survived and were not amputated were contacted for re-evaluation, which included isokinetic strength measurement of both ankle joints, evaluation of the ankle range of motion and collection of several functional scores.ResultsThirty patients were included in the retrospective study, with a mean age of 70.3 years, including 11 women and 19 men. The most frequent cause of the infection was leg ulcer (43.3%), followed by open tendon suture (23.3%). No tendon reconstruction was performed. Fifteen patients could be gained for reevaluation. The average difference in ankle flexion torque on the injured side compared to the healthy side at 30 degrees/second was 57.49% (p = 0.003) and at 120 degrees/second was 53.13% (p = 0.050) while the difference in power was 45.77% (p = 0.025) at 30 degrees/second and 38.08% (p = 0.423) at 120 degrees/second. The follow-up time was between 4 and 49 months and a positive correlation could be determined between the time elapsed from surgery and the ankle joint strength. There was a significant loss of range of motion on the operated side compared to the healthy side: 37.30% for plantar flexion, 24.56% for dorsal extension, 27.79% for pronation and 24.99% for supination. The average Lepillhati Score was 68.33, while the average American Orthopedic Foot and Ankle Score was 74.53.ConclusionThe complete Achilles tendon resection leaves the patient with satisfactory leg function and an almost normal gait. Especially in elderly, multimorbid patients, straightforward tendon resection and wound closure provide fast infection control with acceptable long-term results. Further prospective studies should compare the ankle function and gait in patients with and without Achilles tendon reconstruction after complete resection.
C1 [Bota, Olimpiu; Heinzinger, Leona M.; Herzog, Bianka; Disch, Alexander C.; Amlang, Michael; Dragu, Adrian; Taqatqeh, Feras] Tech Univ Dresden, Univ Ctr Orthoped Trauma & Plast Surg, Fac Med Carl Gustav Carus, Fetscherstr 74, D-01307 Dresden, Germany.
   [Bota, Olimpiu] Iuliu Hatieganu Univ Med & Pharm, Emergency Cty Hosp Cluj Napoca, Dept Plast Surg, Surg Clin 1, Cluj Napoca, Romania.
   [Disch, Alexander C.; Floessel, Philipp] Tech Univ Dresden, Univ Ctr Orthoped Trauma & Plast Surg, Fac Med Carl Gustav Carus, Sect Sports Med & Rehabil, Dresden, Germany.
C3 Technische Universitat Dresden; Iuliu Hatieganu University of Medicine &
   Pharmacy; Technische Universitat Dresden
RP Bota, O (通讯作者)，Tech Univ Dresden, Univ Ctr Orthoped Trauma & Plast Surg, Fac Med Carl Gustav Carus, Fetscherstr 74, D-01307 Dresden, Germany.; Bota, O (通讯作者)，Iuliu Hatieganu Univ Med & Pharm, Emergency Cty Hosp Cluj Napoca, Dept Plast Surg, Surg Clin 1, Cluj Napoca, Romania.
EM drolimpiubota@gmail.com
RI Bota, Olimpiu/AAN-4292-2021; Dragu, Adrian/AAH-3506-2019
OI Bota, Olimpiu/0000-0002-5836-1269; Dragu, Adrian/0000-0003-4633-2695
FU Technische Universitt Dresden (1019)
FX No Statement Available
CR Bersotti FM, 2022, CLINICS, V77, DOI 10.1016/j.clinsp.2022.100125
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NR 31
TC 0
Z9 1
U1 0
U2 3
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0936-8051
EI 1434-3916
J9 ARCH ORTHOP TRAUM SU
JI Arch. Orthop. Trauma Surg.
PD MAR
PY 2024
VL 144
IS 3
BP 1243
EP 1257
DI 10.1007/s00402-023-05177-2
EA JAN 2024
PG 15
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA JG6H3
UT WOS:001144067500001
PM 38231207
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Kasten, K
   Yang, A
   Shaffer, L
   Kociola, S
   Holland, C
   Roche, FA
   Pilbeam, C
AF Kasten, Kody
   Yang, Andrew
   Shaffer, Lynn
   Kociola, Samuel
   Holland, Conor
   Roche, Faith Anne
   Pilbeam, Calvin
TI Managing incisional wounds with Prevena VAC therapy in lower-extremity
   vascular surgery: A comparative study
SO VASCULAR
LA English
DT Article
DE Prevena; vascular surgery; wound vac; lower-extremity wounds;
   lower-extremity; vascular
ID SURGICAL SITE INFECTION; PRESSURE; RISK; AMPUTATION
AB Background: Vascular surgical site infections have been reported with an overall incidence of 5-10% for patients undergoing arterial interventions and as high as 10-20% for lower-limb bypass grafting procedures. Given that vascular surgery patients are known to be at a higher risk of postoperative wound infections and other complications, our objective was to evaluate a potential method to reduce such complications. This study compares the rate of wound healing complications between incisional negative pressure wound therapy (NPWT) and conventional dressings in vascular surgery patients with infra-inguinal incisions. The primary endpoint is complete closure of the wound at the 2-week follow-up appointment. Secondary endpoints include frequency infections requiring antibiotics, need for wound revision, and wound dehiscence. Methods: A prospective cohort study with retrospective control group was performed following infra-inguinal vascular surgeries for peripheral arterial disease at the Mount Carmel Health System. The patients included in this study were those who underwent a lower-extremity vascular procedure with primary closure of an incision distal to the groin between January 2014 and July 2018. Patients that had received an infra-inguinal incision with primary closure were included. Patients in the experimental group who had a Prevena Wound VAC were compared with a retrospectively obtained control arm treated with conventional dressings. Data regarding wound healing and complications, specifically infections and wound dehiscence, were obtained. Results: A total of 201 patients were recruited in our study: 64 in the Prevena group and 137 in the control group. There was a significant reduction in the number of open wounds in the Prevena group compared to the control group at the 2-week follow-up (10.9% Prevena vs 33.6% control; p = .0005). When evaluated in aggregate, there was a statistically significant reduction in the number of patients who succumbed to any complication in the Prevena arm compared with traditional dressings (13 (20.3%) Prevena vs 72 (52.6%) control; p < .0001). Conclusion: The results of our study suggest there should be a significant consideration for the use of NPWT as a prophylactic measure to reduce the risk of wound complications of primarily closed infra-inguinal incisions in vascular surgery patients following common vascular procedures. Its use is particularly effective for patients at enhanced risk of infection, especially those with poor vascularization from BMI, smoking, and diabetes. This leads to decreased trends in antibiotic use, ED visits, readmissions, and surgical revisions, which translates to decreased utilization of hospital resources and economic burden.
C1 [Kasten, Kody; Yang, Andrew; Shaffer, Lynn; Kociola, Samuel; Holland, Conor; Roche, Faith Anne; Pilbeam, Calvin] Mt Carmel Hlth Syst, Vasc Surg Gen Surg, 5300 N Meadows Dr, Grove City, OH 43123 USA.
RP Kasten, K (通讯作者)，Mt Carmel Hlth Syst, Vasc Surg Gen Surg, 5300 N Meadows Dr, Grove City, OH 43123 USA.
EM kody.kasten001@mchs.com
OI Kasten, Kody/0009-0003-9631-2681
CR Armstrong DG, 2005, LANCET, V366, P1704, DOI 10.1016/S0140-6736(05)67695-7
   Bandyk DF, 2008, SEMIN VASC SURG, V21, P119, DOI 10.1053/j.semvascsurg.2008.05.008
   Colli A, 2011, J CARDIOTHORAC SURG, V6, DOI 10.1186/1749-8090-6-160
   Dormandy J, 1999, Semin Vasc Surg, V12, P154
   Martin ET, 2016, INFECT CONT HOSP EP, V37, P88, DOI 10.1017/ice.2015.249
   Pesonen LO, 2018, ANN VASC SURG, V46, P127, DOI 10.1016/j.avsg.2017.07.009
   Shiroky J, 2020, SURGERY, V167, P1001, DOI 10.1016/j.surg.2020.01.018
   Stannard JP, 2012, INT WOUND J, V9, P32, DOI 10.1111/j.1742-481X.2012.01017.x
   Suh H, 2016, ANN PLAS SURG, V76, P717, DOI 10.1097/SAP.0000000000000231
   Sumpio B, 2011, WOUNDS, V23, P301
   Svensson-Björk R, 2019, BJS-BRIT J SURG, V106, P310, DOI 10.1002/bjs.11100
   Turner MC, 2019, CLIN COLON RECT SURG, V32, P157, DOI 10.1055/s-0038-1677002
   Wee IJY, 2019, EUR J VASC ENDOVASC, V58, P446, DOI 10.1016/j.ejvs.2018.12.021
   Willy C, 2017, INT WOUND J, V14, P385, DOI 10.1111/iwj.12612
   Zhao MY, 2020, MEDICINE, V99, DOI 10.1097/MD.0000000000022164
NR 15
TC 2
Z9 2
U1 0
U2 2
PU SAGE PUBLICATIONS LTD
PI LONDON
PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND
SN 1708-5381
EI 1708-539X
J9 VASCULAR
JI Vascular
PD APR
PY 2025
VL 33
IS 2
BP 456
EP 461
DI 10.1177/17085381241247098
EA APR 2024
PG 6
WC Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA 0NY6M
UT WOS:001202015700001
PM 38607337
DA 2026-07-24
ER

PT J
AU MacKechnie, MC
   Flores, MJ
   Giordano, V
   Terry, MJ
   Garuz, M
   Lee, N
   Rojas, LGP
   MacKechnie, MA
   Bidolegui, F
   Brown, K
   Quintero, JE
   Ding, A
   Valenciano, CGS
   Neyra, HT
   Segovia, J
   Aguilar, D
   van Lieshout, EMM
   Verhofstad, MHJ
   Miclau, T
AF MacKechnie, Madeline C.
   Flores, Michael J.
   Giordano, Vincenzo
   Terry, Michael J.
   Garuz, Mario
   Lee, Nicolas
   Rojas, Luis G. Padilla
   MacKechnie, Michael A.
   Bidolegui, Fernando
   Brown, Kelsey
   Quintero, Jose Eduardo
   Ding, Anthony
   Valenciano, Carlos G. Sanchez
   Neyra, Horacio Tabares
   Segovia, Julio
   Aguilar, Dino
   van Lieshout, Esther M. M.
   Verhofstad, Michael H. J.
   Miclau, Theodore
TI Management of soft-tissue coverage of open tibia fractures in Latin
   America: Techniques, timing, and resources
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Flaps; Soft-tissue management; Wound coverage; Open tibia fractures;
   Latin America
ID TRAUMA-CARE; COST-EFFECTIVENESS; SMART COURSE; FLAP; RECONSTRUCTION;
   BURDEN; COUNTRIES; INJURIES; INCOME; FIX
AB Purpose: This study examined soft-tissue coverage techniques of open tibia fractures, described soft tissue treatment patterns across income groups, and determined resource accessibility and availability in Latin America.Methods: A 36-question survey was distributed to orthopaedic surgeons in Latin America through two networks: national orthopaedic societies and the Asociacion de Cirujanos Traumatologos de las Americas (ACTUAR). Demographic information was collected, and responses were stratified by income groups: high income countries (HICs) and middle-income countries (MICs). Results: The survey was completed by 469 orthopaedic surgeons, representing 19 countries in Latin America (2 HICs and 17 MICs). Most respondents were male (89%), completed residency training (96%), and were fellowship-trained (71%). Only 44% of the respondents had received soft-tissue training. Respondents (77%) reported a strong interest in attending a soft-tissue training course. Plastic surgeons were more commonly the primary providers for Gustilo Anderson (GA) Type IIIB injuries in HICs than in MICs (100% vs. 47%, p < 0.01) and plastic surgeons were more available ( < 24 h of patient presentation to the hospital) in HICs than MICs (63% vs. 26%, p = 0.05), demonstrating statistically significant differences. In addition, respondents in HICs performed free flaps more commonly than in MICs for proximal third (55% vs. 10%, p < 0.01), middle third (36% vs. 9%, p = 0.02), and distal third (55% vs. 10%, p < 0.01) lower extremity wounds. Negative Pressure Wound Therapy (NPWT or Wound VAC) was the only resource available to more than half of the respondents. Though not statistically significant, surgeons reported having more access to plastic surgeons at their institutions in HICs than MICs (91% vs. 62%, p = 0.12) and performed microsurgical flaps more commonly at their respective institutions (73% vs. 42%, p = 0.06).Conclusions: The study demonstrated that most orthopaedic surgeons in Latin America have received no soft-tissue training, HICs and MICs have differences in access to plastic surgeons and expectations for flap type and timing to definitive coverage, and most respondents had limited access to necessary soft-tissue surgical resources. Further investigation into differences in the clinical outcomes related to soft-tissue coverage methods and protocols can provide additional insight into the importance of timing and access to specialists.(c) 2022 The Author(s). Published by Elsevier Ltd. This is an open access article under the CC BY-NC-ND license ( http://creativecommons.org/licenses/by-nc-nd/4.0/ )
C1 [MacKechnie, Madeline C.; Flores, Michael J.; Terry, Michael J.; Lee, Nicolas; Brown, Kelsey; Ding, Anthony; Miclau, Theodore] Univ Calif San Francisco, Zuckerberg San Francisco Gen Hosp, Inst Global Orthopaed & Traumatol, Orthopaed Trauma Inst,Dept Orthopaed Surg, 2550 23rd St,Bldg 9,2nd Fl, San Francisco, CA 94110 USA.
   [Giordano, Vincenzo] Hosp Municipal Miguel Couto, Serv Ortopedia & Traumatol Prof Nova Monteiro, Ave Bartolomeu Mitre 1080, BR-22793260 Rio De Janeiro, Brazil.
   [Garuz, Mario] Hosp St Tomas, Calle 37 Este, Panama City, Panama.
   [Rojas, Luis G. Padilla] Puerta Hierro Hosp, Federac Mexicana Colegios Ortopedia & Traumatol A, Ave Empresarios 150, Zapopan 45116, Jalisco, Mexico.
   [MacKechnie, Michael A.] Cleveland Clin Martin Hlth, Dept Orthopaed Surg, Sports Med, 200 Hosp Ave, Stuart, FL 34994 USA.
   [Bidolegui, Fernando] Hosp Sirio Libanes, Serv Ortopedia & Traumatol, Campana 4658,C1419, Buenos Aires, DF, Argentina.
   [Quintero, Jose Eduardo] Fracturas & Fracturas, Carrera 12 Bis 9-22, Pereira Risaralda, Colombia.
   [Valenciano, Carlos G. Sanchez] Ctr Med Caracas, Ave Eraso,Plaza El Estanque Urb, Caracas, Venezuela.
   [Neyra, Horacio Tabares] Ctr Invest Longevidad Envejecimiento & Salud CITE, Soc Cubana Ortopedia & Traumatol, Calle G & 27, Vedado GP, Havana 10400, Cuba.
   [Segovia, Julio] Hosp Vivian Pellas, Cent Hosp, Inst Previs Social, Ave Sacramento & Dr Manuel Pena, Managua, Nicaragua.
   [Aguilar, Dino] Hosp Vivian Pellas, Ctr Ortopedia & Traumatol, POB 2261, Managua, Nicaragua.
   [van Lieshout, Esther M. M.; Verhofstad, Michael H. J.] Univ Med Ctr Rotterdam, Dept Surg, Trauma Res Unit, Erasmus MC, NL-3000 CA Rotterdam, Netherlands.
C3 University of California System; University of California San Francisco;
   Cleveland Clinic Foundation; University of Buenos Aires; University of
   Buenos Aires Hospital; Erasmus University Rotterdam; Erasmus MC
RP Miclau, T (通讯作者)，Univ Calif San Francisco, Zuckerberg San Francisco Gen Hosp, Inst Global Orthopaed & Traumatol, Orthopaed Trauma Inst,Dept Orthopaed Surg, 2550 23rd St,Bldg 9,2nd Fl, San Francisco, CA 94110 USA.
EM madeline.mackechnie@ucsf.edu; theodore.miclau@ucsf.edu
RI ; Giordano, Vincenzo/B-6285-2018
OI Verhofstad, Michael/0000-0001-8448-5903; Tabares Neyra, Horacio
   Inocencio/0000-0001-6599-4948; Flores, Michael/0000-0002-6842-3152;
   Brown, Kelsey/0000-0002-2811-6326; Garuz, Mario/0000-0002-7700-964X; 
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NR 46
TC 3
Z9 6
U1 0
U2 3
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD APR
PY 2022
VL 53
IS 4
BP 1422
EP 1429
DI 10.1016/j.injury.2022.01.027
EA MAR 2022
PG 8
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA 0P5JE
UT WOS:000784257900015
PM 35101259
OA Bronze
DA 2026-07-24
ER

PT J
AU Malizos, KN
   Gougoulias, NE
   Dailiana, ZH
   Varitimidis, S
   Bargiotas, KA
   Paridis, D
AF Malizos, Konstantinos N.
   Gougoulias, Nikolaos E.
   Dailiana, Zoe H.
   Varitimidis, Sokratis
   Bargiotas, Konstantinos A.
   Paridis, Dionysios
TI Ankle and foot osteomyelitis: Treatment protocol and clinical results
SO INJURY-INTERNATIONAL JOURNAL OF THE CARE OF THE INJURED
LA English
DT Article
DE Ankle; Foot; Osteomyelitis
ID BONE TRANSPORT; OPEN FRACTURES; LIMB SALVAGE; STAPHYLOCOCCUS-AUREUS;
   SKELETAL DEFECTS; MANAGEMENT; INFECTIONS; TIBIA; BEADS; RECONSTRUCTION
AB Introduction A management protocol for ankle and foot osteomyelitis and the outcome in 84 patients treated in a unit with special interest in musculoskeletal infection, is presented
   Patients and methods Patients' mean age was 507 +/- 165 years and mean follow-up 31 5 +/- 18 2 months Systemic antibiotics were administered initially empirically, and later according to cultures Surgical treatment included surgical debridement and bead-pouch technique, minor amputation (ray or toe), below knee amputation, and joint fusion "Second-look" procedures were per formed after 48-72 h Vascularised grafts or Ilizaiov's technique were used for bone defect reconstruction Soft tissues were managed according the 'reconstructive ladder' concept
   Results Host-type (Cierny's classification) was A in 25. B in 53 and C in 6 patients Seventy-six infections were chronic Causes were: open trauma without fracture (45/84), open fractures (9/84). ORIF of closed fractures (25/84) and elective surgery (5/84) Patients underwent 30 +/- 15 (range 1-10) operative procedures and spent 148 +/- 122 (range 3-60) days in hospital Two (host-C) patients died. Complications requiring reoperations occurred in 20/84 (2/25 host-A. 16/53 host-B, 2/6 host-C: significant difference between host-A versus host-B and -C patients, p < 0.001) Infection recurrence occurred in 12 (none host-A, significant difference between host-A versus host-B and -C patients. p < 0001) Multiple organisms were isolated in 39/84 Ankle arthrodesis using external fixation was performed in 9 (fusion rate 8/9) The free vascularised fibula graft was used in 2 and distraction osteogenesis in 8 patients with a mean bone defect of 5.4 cm (range 3-13) Below knee amputations were performed in 5/84 (3/53 host-B. 2/6 host-C) and foot ray amputations in 8/84(6/53 host-B, 2/6 host-C). Soft tissue coverage required free muscle flap transfer in 6/84, reverse soleus flap in 1/84. local fasciocutaneous flaps in 7/84, split thickness skin grafts in 5/84, and vacuum assisted closure in 5/84 patients Eighty-two surviving patients, including amputees. were able to mobilise independently and were satisfied with the result of treatment
   Conclusions Host-B and -C patients had more complications and infection recurrences and occasionally required amputations Reconstructive procedures were performed for limb salvage in patients with soft tissue and bone defects and restoration of a functional limb was achieved (C) 2009 Elsevier Ltd All rights reserved
C1 [Malizos, Konstantinos N.; Gougoulias, Nikolaos E.; Dailiana, Zoe H.; Varitimidis, Sokratis; Bargiotas, Konstantinos A.; Paridis, Dionysios] Univ Thessalia, Univ Hosp Larissa, Sch Hlth Sci, Dept Orthopaed Surg & Musculoskeletal Trauma,Fac, Mezouilo 41110, Larissa, Greece.
C3 General University Hospital of Larissa; University of Thessaly
RP Malizos, KN (通讯作者)，Univ Thessalia, Univ Hosp Larissa, Sch Hlth Sci, Dept Orthopaed Surg & Musculoskeletal Trauma,Fac, Mezouilo 41110, Larissa, Greece.
OI Gougoulias, Nikolaos/0000-0001-8455-0007
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NR 52
TC 31
Z9 39
U1 0
U2 9
PU ELSEVIER SCI LTD
PI OXFORD
PA THE BOULEVARD, LANGFORD LANE, KIDLINGTON, OXFORD OX5 1GB, OXON, ENGLAND
SN 0020-1383
EI 1879-0267
J9 INJURY
JI Injury-Int. J. Care Inj.
PD MAR
PY 2010
VL 41
IS 3
SI SI
BP 285
EP 293
DI 10.1016/j.injury.2009.09.010
PG 9
WC Critical Care Medicine; Emergency Medicine; Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Emergency Medicine; Orthopedics; Surgery
GA 576OZ
UT WOS:000276155600008
PM 20176168
DA 2026-07-24
ER

PT J
AU Chen, P
   Vilorio, NC
   Dhatariya, K
   Jeffcoate, W
   Lobmann, R
   McIntosh, C
   Piaggesi, A
   Steinberg, J
   Vas, P
   Viswanathan, V
   Wu, S
   Game, F
AF Chen, Pam
   Vilorio, Nalini Campillo
   Dhatariya, Ketan
   Jeffcoate, William
   Lobmann, Ralf
   McIntosh, Caroline
   Piaggesi, Alberto
   Steinberg, John
   Vas, Prash
   Viswanathan, Vijay
   Wu, Stephanie
   Game, Fran
TI Guidelines on interventions to enhance healing of foot ulcers in people
   with diabetes (IWGDF 2023 update)
SO DIABETES-METABOLISM RESEARCH AND REVIEWS
LA English
DT Article
DE amputation; diabetes-related foot ulcers; guideline; wound healing
ID HYPERBARIC-OXYGEN THERAPY; PRESSURE WOUND THERAPY; RANDOMIZED
   CONTROLLED-TRIAL; VACUUM-ASSISTED CLOSURE; PLATELET-RICH PLASMA;
   CONTROLLED CLINICAL-TRIAL; COLONY-STIMULATING FACTOR;
   EPIDERMAL-GROWTH-FACTOR; QUALITY-OF-LIFE; PLACEBO-CONTROLLED TRIAL
AB Aims: Principles of wound management, including debridement, wound bed preparation, and newer technologies involving alternation of wound physiology to facilitate healing, are of utmost importance when attempting to heal a chronic diabetes-related foot ulcer. However, the rising incidence and costs of diabetes-related foot ulcer management necessitate that interventions to enhance wound healing of chronic diabetes-related foot ulcers are supported by high-quality evidence of efficacy and cost effectiveness when used in conjunction with established aspects of gold-standard multidisciplinary care. This is the 2023 International Working Group on the Diabetic Foot (IWGDF) evidence-based guideline on wound healing interventions to promote healing of foot ulcers in persons with diabetes. It serves as an update of the 2019 IWGDF guideline.
   Materials and Methods: We followed the GRADE approach by devising clinical questions and important outcomes in the Patient-Intervention-Control-Outcome (PICO) format, undertaking a systematic review, developing summary of judgements tables, and writing recommendations and rationale for each question. Each recommendation is based on the evidence found in the systematic review and, using the GRADE summary of judgement items, including desirable and undesirable effects, certainty of evidence, patient values, resources required, cost effectiveness, equity, feasibility, and acceptability, we formulated recommendations that were agreed by the authors and reviewed by independent experts and stakeholders.
   Results: From the results of the systematic review and evidence-to-decision making process, we were able to make 29 separate recommendations. We made a number of conditional supportive recommendations for the use of interventions to improve healing of foot ulcers in people with diabetes. These include the use of sucrose octasulfate dressings, the use of negative pressure wound therapies for postoperative wounds, the use of placental-derived products, the use of the autologous leucocyte/platelet/fibrin patch, the use of topical oxygen therapy, and the use of hyperbaric oxygen. Although in all cases it was stressed that these should be used where best standard of care was not able to heal the wound alone and where resources were available for the interventions.
   Conclusions: These wound healing recommendations should support improved outcomes for people with diabetes and ulcers of the foot, and we hope that wide-scale implementation will follow. However, although the certainty of much of the evidence on which to base the recommendations is improving, it remains poor overall. We encourage not more, but better quality trials including those with a health economic analysis, into this area.
C1 [Chen, Pam] Ramsay Healthcare Australia, Joondalup Hlth Campus, Joondalup, WA, Australia.
   [Chen, Pam] Univ Tasmania, Fac Hlth, Hobart, Tas, Australia.
   [Vilorio, Nalini Campillo] Plaza Salud Gen Hosp, Dept Diabetol, Diabetic Foot Unit, Santo Domingo, Dominican Rep.
   [Dhatariya, Ketan] Norfolk & Norwich Univ Hosp NHS Fdn Trust, Elsie Bertram Diabet Ctr, Norwich, England.
   [Dhatariya, Ketan] Univ East Anglia, Norwich Med Sch, Norwich, England.
   [Lobmann, Ralf] Klinikum Stuttgart, Clin Endocrinol Diabetol & Geriatr, Stuttgart, Germany.
   [McIntosh, Caroline] Univ Galway, Sch Hlth Sci, Podiatr Med, Galway, Ireland.
   [Piaggesi, Alberto] Univ Pisa, Dept Med, Diabetic Foot Sect, Pisa, Italy.
   [Steinberg, John] Georgetown Univ, Sch Med, Georgetown, DC USA.
   [Vas, Prash] Kings Coll Hosp NHS Fdn Trust, London, England.
   [Viswanathan, Vijay] MV Hosp Diabetes, Chennai, India.
   [Viswanathan, Vijay] Prof M Viswanathan Diabet Res Ctr, Chennai, India.
   [Wu, Stephanie] Rosalind Franklin Univ Med & Sci, Dr William M Scholl Coll Podiatr Med, N Chicago, IL USA.
   [Game, Fran] Univ Hosp, Derby Burton NHS Fdn Trust, Derby, England.
C3 University of Tasmania; Norfolk & Norwich University Hospitals NHS
   Foundation Trust; University of East Anglia; University of Stuttgart;
   University Stuttgart Hospital; Ollscoil na Gaillimhe-University of
   Galway; University of Pisa; Georgetown University; King's College
   Hospital NHS Foundation Trust; Rosalind Franklin University of Medicine
   & Science
RP Chen, P (通讯作者)，Ramsay Healthcare Australia, Joondalup Hlth Campus, Joondalup, WA, Australia.; Chen, P (通讯作者)，Univ Tasmania, Fac Hlth, Hobart, Tas, Australia.
EM chenp@ramsayhealth.com.au
OI Campillo-Vilorio, Nalini/0009-0009-8521-4262; McIntosh,
   Caroline/0000-0003-1801-9554; Dhatariya, Ketan/0000-0003-3619-9579;
   Viswanathan, Vijay/0000-0001-9116-3937; Jeffcoate,
   William/0000-0002-1744-7576; Steinberg, John/0000-0003-3665-1481; Chen,
   Pamela/0000-0001-8082-5050; Game, Frances/0000-0002-5294-4789
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NR 265
TC 179
Z9 215
U1 17
U2 119
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1520-7552
EI 1520-7560
J9 DIABETES-METAB RES
JI Diabetes-Metab. Res. Rev.
PD MAR
PY 2024
VL 40
IS 3
AR e3644
DI 10.1002/dmrr.3644
EA MAY 2023
PG 28
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Endocrinology & Metabolism
GA PN9Z6
UT WOS:000995151700001
PM 37232034
OA hybrid
HC Y
HP N
DA 2026-07-24
ER

PT J
AU Rammelt, S
   Olbrich, A
   Zwipp, H
AF Rammelt, S.
   Olbrich, A.
   Zwipp, H.
TI Hindfoot amputations
SO OPERATIVE ORTHOPADIE UND TRAUMATOLOGIE
LA German
DT Article
DE Foot; Chopart amputation; Pirogoff amputation; Syme amputation;
   Disarticulation
ID ANKLE DISARTICULATION; SYME; PIROGOFF; FOOT
AB Obtaining a durable, weight-bearing stump with minimal or no loss of limb length, and stable soft tissue coverage with preservation of the original sensation of the sole of the foot at the heel.
   Complex trauma to the foot with devitalized or nonreconstructable forefoot and midfoot, deep bony and soft tissue infection, infected Charcot foot with threatening sepsis, necrosis or gangrene of the forefoot and midfoot with vasculopathy, malignant tumors, certain infections, gigantism of the forefoot.
   Possible reconstruction of the midfoot and forefoot beyond the midtarsal (Chopart) joint, loss or irreversible destruction of the sole of the foot or the distal tibial metaphysis.
   The skin incision is designed to retain a long plantar flap with a maximum amount of weight-bearing sole 5-7 cm below amputation level and a shorter anterior flap 1-2 cm below amputation level. Exarticulation or bone resection is performed from anterior to posterior, while preserving the posteromedial vessels to supply the heel flap. The Chopart stump is held in a neutral position avoiding equinus with a tibiotalar external fixator and additional tendon balancing with a noninfected posterior tibialis and one of the peronaeal tendons from medial and lateral through the talar head and Achilles tendon lengthening. Alternatively, a Pirogoff stump with minimal limb length loss (about 2 cm) is achieved with minimal resection at the anterior calcaneal process. The calcaneus is rotated 70-80A degrees and fused to the distal end of the tibia with lag screws or an external frame. Alternatively, a Syme stump is covered with the heel skin after resection of the malleoli flush to the tibial plafond. If anterior wound closure cannot be obtained without tension, temporary vacuum-assisted closure and later definitive coverage with skin grafts, local or free flaps is obtained. In cases of deep infection, the amputation is performed as a staged procedure.
   Nonweight bearing until stable scar formation, early mobilization in a total contact cast. Interim prosthesis after 2-4 weeks, fitting of the definitive prosthesis with special shoewear after 2-3 months.
   Over a 12-year period, 15 Chopart, 7 Pirogoff, and 2 Syme amputations were performed. A total of 15 patients had sustained a complex foot trauma, 9 had a deep infection, among them 7 in a diabetic Charcot foot. In 16 patients, among them all with deep infection, 1-4 planned revisions were performed. In 5 patients (20.8%), the stumps were revised subacutely to a more proximal amputation level. In 2 patients with Chopart amputation, a hindfoot fusion was performed to correct equinus, while 1 Chopart and 1 Pirogoff stump were subjected to resection of a prominent exostosis. Except for 2 patients with Charcot foot, all patients with hindfoot amputation could walk barefoot over short distances.
C1 [Rammelt, S.; Olbrich, A.; Zwipp, H.] Tech Univ Dresden, Univ Klinikum Carl Gustav Carus, Klin & Poliklin Unfall & Wiederherstellungsschiru, D-01307 Dresden, Germany.
C3 Technische Universitat Dresden; Carl Gustav Carus University Hospital
RP Rammelt, S (通讯作者)，Tech Univ Dresden, Univ Klinikum Carl Gustav Carus, Klin & Poliklin Unfall & Wiederherstellungsschiru, Fetscherstr 74, D-01307 Dresden, Germany.
EM stefan.rammelt@uniklinikum-dresden.de
RI Rammelt, Stefan/AAE-5863-2019
OI Rammelt, Stefan/0000-0003-1141-6493
CR [Anonymous], 1939, JBJS
   EILERT RE, 1976, J BONE JOINT SURG AM, V58, P1138, DOI 10.2106/00004623-197658080-00018
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   RAMMELT S, 2001, TRAUMA BERUFSKR S2, V3, P230
   SYME J, 1843, MONTH J MED SCI, V3, P93
   SYME J, 1831, TREATISE EXCISION DI
   Taniguchi A, 2003, CLIN ORTHOP RELAT R, P322, DOI 10.1097/01.blo.0000079444.64912.d6
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   Zwipp H, 1994, CHIRURG FUSSES
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
   [No title captured]
NR 25
TC 16
Z9 17
U1 0
U2 5
PU URBAN & VOGEL
PI MUNICH
PA NEUMARKTER STRASSE 43, D-81673 MUNICH, GERMANY
SN 0934-6694
J9 OPER ORTHOP TRAUMATO
JI Oper. Orthopade Traumatol.
PD OCT
PY 2011
VL 23
IS 4
BP 265
EP 279
DI 10.1007/s00064-011-0042-x
PG 15
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA 836AR
UT WOS:000296079200003
PM 21922229
DA 2026-07-24
ER

PT J
AU Draus, JM
   Huss, SA
   Harty, NJ
   Cheadle, WG
   Larson, GM
AF Draus, John M., Jr.
   Huss, Sara A.
   Harty, Niall J.
   Cheadle, William G.
   Larson, Gerald M.
TI Enterocutaneous fistula: Are treatments improving?
SO SURGERY
LA English
DT Article; Proceedings Paper
CT 63rd Annual Meeting of the Central-Surgical-Association
CY MAR 09-11, 2006
CL Louisville, KY
SP Cent Surg Assoc
ID ENDOSCOPIC TREATMENT; EXTERNAL FISTULAS; MANAGEMENT; EXPERIENCE; CLOSURE
AB Background. We studied the etiology, treatment, and outcome of enterocutaneous fistulas in 106 patients to evaluate our current practice and the impact of newer therapies'-octreotide, wound vacuum-assisted closure (VAC), and fibrin glue-on clinical outcomes. Review of the literature and our own 1990 study indicate a mortality rate of 5 % to 20 % for enterocutaneous fistula, and a healing rate of 75 % to 85 % after definitive surgery.
   Methods. We reviewed all cases of gastrointestinal-cutaneous fistula from 1997 to 2005 at 2 large teaching hospitals. We identified 106 patients with enterocutaneous fistula; patients with irritable bowel disease and anorectal fistulas were excluded.
   Results. The origin of the fistula was the small bowel in 67 patients, colon in 26, stomach in 8, and duodenum in 5. The etiology of the fistula was previous operation in 81 patients, trauma in 15, hernia mesh erosion in 6, diverticulitis in 2, and radiation in 2. Of the 106 patients in the study, 31 had a high output fistula (greater than 200 mL/day), 44 had a low output fistula, and, in 31 patients, the fistula output was low but there was no record of volume Initial treatment was nonoperative except for patients with an abscess who needed urgent drainage. In 24 patients, the effect of octreotide was monitored. in 8 patients, fistula output declined; in 16 patients, octreotide was of no benefit. Fibrin glue was used in 8 patients and was of benefit to 1. The wound VAC was used in 13 patients: 12 patients still required operative repair of the fistula, whereas the fistula was healed in] patient. The main benefit of the VAC system was improved wound care in all patients before definitive surgery. Total parenteral nutrition was used in most patients to provide nutritional support. Operative repair was performed in 77 patients and was successful in 69 (89 %), failing in 6 patients with persistent cancer or infection. Nonoperative treatment was wed in 29 patients and resulted in healing in 60 %. Of 106 patients, 7 (7 %) died of fistula complications. The cause of death was persistence or recurrence of cancer in 4 patients and persistent sepsis in 3.
   Conclusion. Enterocutaneous fistula continues to be a serious surgical problem. The wound VAC and fibrin glue had anecdotal successes (n = 2), and one-third of patients responded to octreotide. We believe that octreotide should be tried in most patients and that the wound VAC has a role in selected patients. Although 7 % overall mortality is lower than in previous studies, the number managed without operation (27 %) remains the same. In addition to early control of sepsis, nutritional support, and wound care, a well-timed operation was the most effective treatment.
C1 Univ Louisville, Hlth Sci Ctr, Sch Med, Dept Surg, Louisville, KY 40202 USA.
C3 University of Louisville
RP Larson, GM (通讯作者)，Univ Louisville, Hlth Sci Ctr, Sch Med, Dept Surg, 550 S Jackson St,2nd Fl ACB, Louisville, KY 40202 USA.
EM gmlars01@louisville.edu
RI ; Draus, John/JAO-5255-2023
OI aus, John/0009-0008-4932-5478; 
CR APOSTOLOS K, 1996, SURG CLIN NA, V76, P1175
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NR 17
TC 140
Z9 159
U1 0
U2 6
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0039-6060
J9 SURGERY
JI Surgery
PD OCT
PY 2006
VL 140
IS 4
BP 570
EP 576
DI 10.1016/j.surg.2006.07.003
PG 7
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA 093GD
UT WOS:000241155200020
PM 17011904
DA 2026-07-24
ER

PT J
AU Stone, PA
   Mousa, AY
   Hass, SM
   Dearing, D
   Campbell, JR
   Parker, A
   Thompson, S
   AbuRahma, AF
AF Stone, Patrick A.
   Mousa, Albeir Y.
   Hass, Stephen M.
   Dearing, Daniel
   Campbell, James R., II
   Parker, Ashley
   Thompson, Stephanie
   AbuRahma, Ali F.
TI Antibiotic-loaded polymethylmethacrylate beads for the treatment of
   extracavitary vascular surgical site infections
SO JOURNAL OF VASCULAR SURGERY
LA English
DT Article; Proceedings Paper
CT 25th Annual Meeting of the Eastern-Vascular-Society
CY SEP 22-24, 2011
CL Washington, DC
SP Eastern Vasc Soc
ID PROSTHETIC GRAFT INFECTIONS; STAPHYLOCOCCUS-AUREUS; CURRENT OPTIONS;
   MUSCLE FLAPS; MANAGEMENT; PREVENTION; REPLACEMENT; VANCOMYCIN; EFFICACY;
   BYPASS
AB Objective: This study assessed the efficacy of antibiotic-loaded polymethylmethacrylate (PMMA) beads in the treatment of lower extremity vascular surgical site infections (VSSIs).
   Methods: This was a retrospective review of all patients with a VSSI of a lower extremity bypass treated with antibiotic-loaded PMMA beads and culture-specific antibiotics during a 4.5-year period. Data collected included patient demographics, comorbidities, site of initial graft infection, symptoms and signs at presentation, initial and additional surgical debridement, wound culture results, type of antibiotic beads implanted, and graft treatment strategy, comprising conduit preservation or in situ replacement, with associated soft tissue management by muscle flap or vacuum-assisted closure. Primary outcome measures included death, recurrent infection, and limb salvage.
   Results: Forty patients developed 42 extracavitary lower extremity VSSIs (bilateral groin infections in two). Patients were treated according to our treatment algorithm with antibiotic-impregnated PMMA beads. Previous reconstructions included nine aortofemoral bypasses (groin infection only), 20 infrainguinal bypasses, five extra-anatomic bypasses, five femoral interpositions, two combined inflow-outflow bypass procedures, and one patch angioplasty with VSSI. Cultures isolated 59 pathogens (39 gram-positive, 18 gram-negative, 2 Candida spp). Methicillin-resistant Staphylococcus aureus was cultured from 10 VSSs (23.8%) overall and from 27.7% of those patients with attempted graft preservation or in situ reconstructions. Two patients (4.8%) had no growth despite clinical signs of infection. Repeat VSS exploration and culture results led to an average of 1.4 bead replacements before definitive treatment. Final treatment strategy included graft preservation of patent bypasses in 28, partial graft excision with in situ replacement in eight, graft removal only with residual graft remaining at implant site (ie, incorporated anastomotic conduit, 11.9%) in five, and extra-anatomic reconstruction in one. Sartorius muscle flap was performed in 14 groin infections (37.8%). The 30-day mortality was 0%, and limb loss was 7.1% (n = 3). At the median follow-up of 17 months, the limb loss was 21.4% and the recurrent infection rate was 19.4% (seven of 36) in those with attempted graft preservation or in situ replacement.
   Conclusions: Antibiotic-loaded PMMA beads may serve as an adjunct in the management of VSSIs and may also expand treatment options for graft preservation or in situ reconstruction, with expected recurrent infection rate approaching 20%. Further experience with this adjunct may help elucidate its role in the management of this complicated problem, including the need for bead exchanges, until perigraft cultures are free of microbes. (J Vasc Surg 2012;55:1706-11.)
C1 [Stone, Patrick A.; Mousa, Albeir Y.; Hass, Stephen M.; Dearing, Daniel; Campbell, James R., II; Parker, Ashley; Thompson, Stephanie; AbuRahma, Ali F.] W Virginia Univ, Dept Vasc Surg, Charleston, WV 25304 USA.
C3 West Virginia University
RP Stone, PA (通讯作者)，W Virginia Univ, Dept Vasc Surg, 3100 MacCorkle Ave, Charleston, WV 25304 USA.
EM pstone0627@yahoo.com
CR Armstrong PA, 2007, J VASC SURG, V46, P71, DOI 10.1016/j.jvs.2007.02.058
   Atahan E, 2007, EUR J VASC ENDOVASC, V34, P182, DOI 10.1016/j.ejvs.2007.03.002
   Bandyk DF, 2008, SEMIN VASC SURG, V21, P119, DOI 10.1053/j.semvascsurg.2008.05.008
   BUNT TJ, 1984, AM SURGEON, V50, P43
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   Dosluoglu HH, 2010, J VASC SURG, V51, P1160, DOI 10.1016/j.jvs.2009.11.053
   Edwards WH, 1998, AM SURGEON, V64, P45
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   Henke PK, 1998, AM SURGEON, V64, P39
   Herscu G, 2009, SURG CLIN N AM, V89, P391, DOI 10.1016/j.suc.2008.09.007
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NR 24
TC 39
Z9 43
U1 0
U2 7
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0741-5214
J9 J VASC SURG
JI J. Vasc. Surg.
PD JUN
PY 2012
VL 55
IS 6
BP 1706
EP 1711
DI 10.1016/j.jvs.2011.12.037
PG 6
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery; Cardiovascular System & Cardiology
GA 944MF
UT WOS:000304206000023
PM 22421462
OA Bronze
DA 2026-07-24
ER

PT J
AU Chen, P
   Wang, L
   Gao, SF
   Ji, JF
   Gong, ZH
AF Chen, Peng
   Wang, Lu
   Gao, ShengFeng
   Ji, JianFeng
   Gong, ZhenHua
TI Observational study on the therapeutic effects of two different negative
   pressure drainage devices on skin graft donor sites
SO JOURNAL OF TISSUE VIABILITY
LA English
DT Article
DE Intermediate-thickness skin graft; Donor site; VSD; VAC
ID VACUUM-ASSISTED CLOSURE; WOUND THERAPY; BLOOD-FLOW
AB Objective To conduct a retrospective analysis of patients who received treatment with two types of negative pressure materials for intermediate-thickness skin graft donor sites, comparing the clinical efficacy and exploring potential mechanisms. Methods According to the case inclusion criteria, a total of 55 patients hospitalized for surgery requiring autologous skin grafting between 2023 and 2024 were selected. Among them, 20 patients were treated with VAC (Group A), 20 with VSD (Group B), and another 15 patients (Group C) did not receive negative pressure device therapy; instead, their wounds were covered with sterile fine-mesh Vaseline gauze postoperatively, followed by sterile gauze and regular dressing changes. Data recorded included: drainage volume per square centimeter within the first 3 postoperative days for Groups A and B; occlusion of the external drainage tube; presence of active bleeding; skin itching and blisters in the film and negative pressure material coverage area; VAS scores of the donor sites on the first 3 postoperative days and at the time of negative pressure dressing removal for all three groups (A, B, C); and the total complete healing time. Original data were recorded. Results No cases of infection or active bleeding occurred before complete epithelialization healing in any of the three groups (A, B, C); 14 cases of occlusion occurred in the external drainage tubes of the VSD group, all of which were cleared by flushing with sterile water for injection within 3 h of occlusion; a small number of cases in both Groups A and B experienced varying degrees of blisters and itching; the mean time to complete epithelialization was shorter in the negative pressure groups compared to Group C (p < 0.05), but there was no significant difference between Groups A and B (p > 0.05); the drainage volume per square centimeter in the first 3 postoperative days showed no significant difference between the negative pressure groups (p > 0.05); regarding VAS scores for the donor sites in the first 3 days, the negative pressure groups showed significant differences on days 1 and 2 (p < 0.05), but no significant difference on day 3. The VAS scores of both Groups A and B were statistically significantly different from Group C (p < 0.05). Conclusion Both VAC (polyurethane) and VSD (polyvinyl alcohol) negative pressure drainage devices can shorten the healing time window for intermediate-thickness skin graft donor sites; within the limitations of this retrospective study, patients in the VAC group tolerated and cooperated better during the treatment of the donor site. These findings require validation in prospective randomized controlled trials.
C1 [Chen, Peng; Wang, Lu; Gao, ShengFeng; Ji, JianFeng; Gong, ZhenHua] Nantong Univ, Affiliated Hosp 2, Nantong Peoples Hosp 1, Nantong, Peoples R China.
C3 Nantong University; Southeast University - China
RP Gong, ZH (通讯作者)，Nantong Univ, Affiliated Hosp 2, Nantong Peoples Hosp 1, Nantong, Peoples R China.
EM 1543338532@qq.com
CR Argenta LC, 1997, ANN PLAS SURG, V38, P563, DOI 10.1097/00000637-199706000-00002
   Bai Wen-Bo, 2020, Zhongguo Gu Shang, V33, P873, DOI 10.12200/j.issn.1003-0034.2020.09.016
   Biermann N, 2020, J TISSUE VIABILITY, V29, P32, DOI 10.1016/j.jtv.2019.12.004
   Borgquist O, 2010, PLAST RECONSTR SURG, V125, P502, DOI 10.1097/PRS.0b013e3181c82e1f
   Chen XQ, 2019, ACS BIOMATER SCI ENG, V5, P1762, DOI 10.1021/acsbiomaterials.8b01554
   Cuomo R, 2021, J INVEST SURG, V34, P335, DOI 10.1080/08941939.2019.1616009
   Dumville JC, 2014, COCHRANE DB SYST REV, DOI 10.1002/14651858.CD006215.pub4
   FLEISCHMANN W, 1993, UNFALLCHIRURG, V96, P488
   Glass GE, 2012, J PLAST RECONSTR AES, V65, P989, DOI 10.1016/j.bjps.2011.12.012
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   Hosseini M, 2022, BURNS TRAUMA, V10, DOI 10.1093/burnst/tkac036
   Ibrahim ZM, 2019, J WOUND CARE, V28, P214, DOI 10.12968/jowc.2019.28.4.214
   Karmisholt KE, 2018, J EUR ACAD DERMATOL, V32, P1099, DOI 10.1111/jdv.14856
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   Sogorski A, 2018, J TISSUE VIABILITY, V27, P267, DOI 10.1016/j.jtv.2018.08.004
   Suissa D, 2011, PLAST RECONSTR SURG, V128, p498E, DOI 10.1097/PRS.0b013e31822b675c
   Tang SY, 2004, CHIN J CLIN REHABIL, V8, P7171
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   Wang Yang, 2015, Zhonghua Shao Shang Za Zhi, V31, P372
   Wang ZX, 2017, CHONGQING MED J, V46, P111
   Yane Y, 2021, BMC SURG, V21, DOI 10.1186/s12893-021-01109-2
   Yang H, 2021, THER CLIN RISK MANAG, V17, P65, DOI 10.2147/TCRM.S282840
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NR 30
TC 0
Z9 0
U1 0
U2 0
PU ELSEVIER SCI LTD
PI London
PA 125 London Wall, London, ENGLAND
SN 0965-206X
EI 1876-4746
J9 J TISSUE VIABILITY
JI J. Viab.
PD AUG
PY 2026
VL 35
IS 3
AR 101005
DI 10.1016/j.jtv.2026.101005
EA MAY 2026
PG 6
WC Dermatology; Nursing
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC Dermatology; Nursing
GA HT6UL
UT WOS:001762435500001
PM 42070549
OA hybrid
DA 2026-07-24
ER

PT J
AU Ploumis, A
   Mehbod, AA
   Dressel, TD
   Dykes, DC
   Transfeldt, EE
   Lonstein, JE
AF Ploumis, Avraam
   Mehbod, Amir A.
   Dressel, Thomas D.
   Dykes, Daryll C.
   Transfeldt, Ensor E.
   Lonstein, John E.
TI Therapy of spinal wound infections using vacuum-assisted wound closure:
   Risk factors leading to resistance to treatment
SO JOURNAL OF SPINAL DISORDERS & TECHNIQUES
LA English
DT Article
DE vacuum-assisted closure; spine; infection; instrumentation
ID POSTOPERATIVE INFECTIONS; INSTRUMENTATION; MANAGEMENT; SURGERY; FUSION;
   ADULTS; RECONSTRUCTION; SCOLIOSIS
AB Study Design: This study retrospectively reviewed spine surgical procedures complicated by wound infection and managed by a protocol including the use of vacuum-assisted wound closure (VAC).
   Objective: To define factors influencing the number of debridements needed before the final wound closure by applying VAC for patients with postoperative spinal wound infections.
   Summary of Background Data: VAC has been suggested as a safe and probably effective method for the treatment of spinal wound infections. The risk factors for infection resistance and need for debridement revisions after VAC placement are unknown.
   Methods: Seventy-three consecutive patients with 79 wound infections after undergoing spine surgery were studied (6 of them had recurrence of infection). All patients were taken to the operating room for irrigation and debridement under general anesthesia followed by placement of the VAC with subsequent delayed closure of the wound. Linear regression and t test were used to identify if the following variables were risk factors for the resistance of infection to VAC treatment: timing of clinical appearance of infection, depth of infection (deep or superficial), presence of instrumentation, positive culture for methicillin-resistant Staphylococcus aureus (MRSA) or more than 1 microorganism, age of the patient, and presence of other comorbidities.
   Results: There were 34 males and 39 females with an average age of 58.4 years (21 to 82). Once the VAC was initiated, there was an average of 1.4 procedures until and including closure of the wound. The wound was closed an average of 7 days (range 5 to 14) after the placement of the initial VAC on the wound. The average follow-up was 14 months (range 12 to 28). All of the patients but 2 achieved a clean, closed wound without removal of instrumentation at a minimum follow-up of I year. Sixty patients had implants (instrumentation or allograft) within the site of wound infection. Thirteen patients had a decompression with exposed dura. Sixty-four infections (81%) presented with a draining wound within the first 6 weeks postoperatively. Sixty-nine infections (87.3%) were deep below the fascia. There was no statistical significance (P > 0.05) of all tested risk factors for the resistance of infection to treatment with the VAC system. The parameter more related to repeat VAC procedures was the culture of MRSA or multiple bacteria.
   Conclusions: VAC therapy may be an effective adjunct in closing spinal wounds even after the repeat procedures. The MRSA or multibacterial infections seem to be most likely to need repeat debridements and VAC treatment before final wound closure.
C1 [Ploumis, Avraam; Mehbod, Amir A.; Dressel, Thomas D.; Dykes, Daryll C.; Transfeldt, Ensor E.; Lonstein, John E.] Twin Cities Spine Ctr, Minneapolis, MN 55414 USA.
RP Ploumis, A (通讯作者)，Twin Cities Spine Ctr, 913 E 26th St, Minneapolis, MN 55414 USA.
EM ploumis@med.auth.gr
RI ; /AAH-4169-2019
OI Ploumis, Avraam/0000-0002-6828-3196; 
CR Beiner John M, 2003, Neurosurg Focus, V15, pE14
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NR 20
TC 54
Z9 65
U1 0
U2 8
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 1536-0652
J9 J SPINAL DISORD TECH
JI J. Spinal Disord. Tech.
PD JUL
PY 2008
VL 21
IS 5
BP 320
EP 323
DI 10.1097/BSD.0b013e318141f99d
PG 4
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA 324UC
UT WOS:000257543900004
PM 18600140
DA 2026-07-24
ER

PT J
AU Chiang, N
   Rodda, OA
   Sleigh, J
   Vasudevan, T
AF Chiang, Nathaniel
   Rodda, Odette A.
   Sleigh, Jamie
   Vasudevan, Thodur
TI Effects of topical negative pressure therapy on tissue oxygenation and
   wound healing in vascular foot wounds
SO JOURNAL OF VASCULAR SURGERY
LA English
DT Article
ID MICROVASCULAR BLOOD-FLOW; VACUUM-ASSISTED CLOSURE; DIABETIC FOOT;
   RANDOMIZED-TRIAL; ULCERS; MANAGEMENT
AB Objective: Topical negative pressure (TNP) therapy is widely used in the treatment of acute wounds in vascular patients on the basis of proposed multifactorial benefits. However, numerous recent systematic reviews have concluded that there is inadequate evidence to support its benefits at a scientific level. This study evaluated the changes in wound volume, surface area, depth, collagen deposition, and tissue oxygenation when using TNP therapy compared with traditional dressings in patients with acute high-risk foot wounds.
   Methods: This study was performed with hospitalized vascular patients. Forty-eight patients were selected with an acute lower extremity wound after surgical debridement or minor amputation that had an adequate blood supply without requiring further surgical revascularization and were deemed suitable for TNP therapy. The 22 patients who completed the study were randomly allocated to a treatment group receiving TNP or to a control group receiving regular topical dressings. Wound volume and wound oxygenation were analyzed using a modern stereophotographic wound measurement system and a hyperspectral transcutaneous oxygenation measurement system, respectively. Laboratory analysis was conducted on wound biopsy samples to determine hydroxyproline levels, a surrogate marker to collagen.
   Results: Differences in clinical or demographic characteristics or in the location of the foot wounds were not significant between the two groups. All patients, with the exception of two, had diabetes. The two patients who did not have diabetes had end-stage renal failure. There was no significance in the primary outcome of wound volume reduction between TNP and control patients on day 14 (44.2% and 20.9%, respectively; P = .15). Analyses of secondary outcomes showed a significant result of better healing rates in the TNP group by demonstrating a reduction in maximum wound depth at day 14 (36.0% TNP vs 17.6% control; P = .03). No significant findings were found for the other outcomes of changes in hydroxyproline levels (58.0% TNP vs 94.5% control; P = .32) or tissue perfusion by tissue oxyhemoglobin saturation (19.4% TNP vs 12.0% control; P = .07) at day 14. At 1 year of follow-up, there were no significant outcomes in the analysis of wound failure, major amputation, and overall survival rates between the two groups.
   Conclusions: In this pilot study, applying TNP to acute high-risk foot wounds in patients with diabetes or end-stage renal failure improved the wound healing rate in reference to wound depth. This suggests that TNP may play a role in enhancing wound healing. This study sets the foundation for larger studies to evaluate the superiority of TNP over traditional dressings in high-risk foot wounds.
C1 [Chiang, Nathaniel; Sleigh, Jamie; Vasudevan, Thodur] Waikato Hosp, Dept Vasc Surg, Hamilton, New Zealand.
   [Rodda, Odette A.] St Vincents Hosp, Dept Vasc Surg, Melbourne, Vic, Australia.
C3 Waikato Hospital; St Vincent's Health; St Vincent's Hospital Melbourne;
   NSW Health; St Vincents Hospital Sydney
RP Rodda, OA (通讯作者)，St Vincents Hosp, Dept Vasc Surg, 41 Victoria Parade, Fitzroy, Vic 3065, Australia.
EM odette.rodda@svha.org.au
RI Vasudevan, Thodur/GRY-2923-2022
FU Waikato Medical Research Foundation; Faculty Research Development Fund;
   Braemar Charitable Trust Research Grant; Bayers Health Care Fund;
   Department Grant-in-aid, Performance-Based Research Fund Allocation,
   Postgraduate Student Fund; PReSS Fund
FX This work was supported by the Waikato Medical Research Foundation,
   Faculty Research Development Fund, Braemar Charitable Trust Research
   Grant, Bayers Health Care Fund, Department Grant-in-aid,
   Performance-Based Research Fund Allocation, Postgraduate Student Fund,
   and the PReSS Fund. There were no significant relationships with
   HyperMed Inc (developer of OxyVu), Intermed (manufacturer of VAC), and
   ARANZ (manufacturer of the FastScan and Silhouette Mobile). The devices
   were bought and leased using independent research funds. There were no
   conflicts of interest that were directly relevant to the content of this
   manuscript.
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NR 29
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U2 26
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0741-5214
J9 J VASC SURG
JI J. Vasc. Surg.
PD AUG
PY 2017
VL 66
IS 2
BP 564
EP 571
DI 10.1016/j.jvs.2017.02.050
PG 8
WC Surgery; Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery; Cardiovascular System & Cardiology
GA FE4YC
UT WOS:000408218200106
PM 28583732
OA Bronze
DA 2026-07-24
ER

PT J
AU Potter, BK
   Burns, TC
   Lacap, AP
   Granville, RR
   Gajewski, DA
AF Potter, Benjamin K.
   Burns, Travis C.
   Lacap, Anton P.
   Granville, Robert R.
   Gajewski, Donald A.
TI Heterotopic ossification following traumatic and combat-related
   amputations - Prevalence, risk factors, and preliminary results of
   excision
SO JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME
LA English
DT Article
ID TOTAL HIP-REPLACEMENT; VACUUM-ASSISTED CLOSURE; RADIATION-THERAPY;
   STAPHYLOCOCCUS-AUREUS; ACETABULAR FRACTURES; BONE-FORMATION; PREVENTION;
   INDOMETHACIN; IRRADIATION; ELBOW
AB Background: Although infrequently reported in amputees previously, heterotopic ossification has proven to be a common and problematic clinical entity in our recent experience in the treatment of traumatic and combat-related amputations related to Operation Enduring Freedom and Operation Iraqi Freedom. The purpose of the present study was to report the prevalence of and risk factors for heterotopic ossification following trauma-related amputation as well as the preliminary results of operative excision.
   Methods: We identified 330 patients with a total of 373 traumatic and combat-related amputations who had been managed at our centers between September 11, 2001 and November 30, 2005. We reviewed the medical records and radiographs of 187 patients with 213 amputations who had adequate radiographic follow-up. Additional analysis was performed for twenty-four patients with twenty-five limbs that required excision of symptomatic lesions. The mechanism and zone of injury, amputation level, timing of excision, use of prophylaxis against recurrence, and other confounding variables were examined. Outcomes were assessed by determining clinical and radiographic recurrence rates, perioperative complications, preoperative and follow-up pain medication requirements, and the ability to be fit with a functional prosthesis.
   Results: Heterotopic ossification was present in 134 (63%) of 213 residual limbs, with twenty-five lesions requiring excision. A final amputation level within the zone of injury was a risk factor for both the development and the grade of heterotopic ossification (p < 0.05). A blast mechanism was predictive of occurrence (p < 0.05) but did not correlate with grade. All patients who had been managed with excision were tolerating the prosthetic limb at an average of twelve months of follow-up. Twenty-three limbs demonstrated no evidence of recurrence, and two limbs had development of clinically asymptomatic, radiographically minimal recurrences. Six patients experienced wound-related complications that required reoperation, and two patients required subsequent minor revision surgery. There was a significant decrease in the use of pain medication following surgery (p < 0.05).
   Conclusions: Heterotopic ossification following trauma-related amputation is more common than the literature would suggest, particularly following amputations that are performed within the initial zone of injury and those that are due to blast injuries. Many patients are asymptomatic or can be successfully managed with modification of the prosthesis. For patients with refractory symptoms, surgical excision is associated with low recurrence rates and decreased medication requirements, with acceptable complication rates.
   Level of Evidence: Prognostic Level II. See Instructions to Authors for a complete description of levels of evidence.
C1 Walter Reed Army Med Ctr, Orthopaed Surg Serv, Dept Orthopaed & Rehabil, Washington, DC 20307 USA.
   Walter Reed Army Med Ctr, Amputee Serv, Dept Orthopaed & Rehabil, Washington, DC 20307 USA.
   Brooke Army Med Ctr, Orthopaed Surg Serv, Ft Sam Houston, TX 78234 USA.
   Brooke Army Med Ctr, Amputee Serv, Ft Sam Houston, TX 78234 USA.
C3 Walter Reed National Military Medical Center; United States Department
   of Defense; United States Army; Walter Reed National Military Medical
   Center; United States Department of Defense; United States Army; Brooke
   Army Medical Center; United States Department of Defense; United States
   Army; Brooke Army Medical Center; United States Department of Defense;
   United States Army
RP Potter, BK (通讯作者)，Walter Reed Army Med Ctr, Orthopaed Surg Serv, Dept Orthopaed & Rehabil, 6900 Georgia Ave NW,Bldg 2,Clin 5A, Washington, DC 20307 USA.
EM Beiijamin.Potter@na.amedd.army.mil
RI Potter,, Benjamin K/U-1769-2019
OI Potter,, Benjamin K/0000-0002-8771-0317
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NR 68
TC 257
Z9 289
U1 0
U2 23
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0021-9355
EI 1535-1386
J9 J BONE JOINT SURG AM
JI J. Bone Joint Surg.-Am. Vol.
PD MAR
PY 2007
VL 89A
IS 3
BP 476
EP 486
DI 10.2106/JBJS.F.00412
PG 11
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics; Surgery
GA 143OG
UT WOS:000244731400003
PM 17332095
DA 2026-07-24
ER

PT J
AU O'Connor, JV
   DuBose, JJ
   Scalea, TM
AF O'Connor, James V.
   DuBose, Joseph J.
   Scalea, Thomas M.
TI Damage-control thoracic surgery: Management and outcomes
SO JOURNAL OF TRAUMA AND ACUTE CARE SURGERY
LA English
DT Article; Proceedings Paper
CT 72nd Annual Meeting of the
   American-Association-for-the-Surgery-of-Trauma / Clinical Congress of
   Acute Care Surgery
CY SEP 18-23, 2013
CL San Francisco, CA
SP Amer Assoc Surg Trauma
DE Damage control; thoracic trauma; thoracotomy
ID LUNG RESECTION; ABBREVIATED THORACOTOMY; POSTTRAUMATIC EMPYEMA;
   PULMONARY TRACTOTOMY; TRAUMA; INJURY; MORTALITY; PACKING; CLOSURE
AB BACKGROUND: Damage-control surgery is successfully used for severe abdominal trauma. Although the damage-control surgery principles are applicable to thoracic trauma, there is a dearth of data on damage-control thoracic surgery.
   METHODS: This is an institutional review board-approved, retrospective trauma registry study, from January 2002 to December 2012, for thoracic injuries requiring emergency thoracotomy or sternotomy, with temporary closure. Demographics, physiologic and laboratory data, operative procedures, and outcomes were abstracted. Data are presented as mean and SD; Student's t test was used with p < 0.05 conferring statistically significance.
   RESULTS: Forty-four patients were identified, with a median age of 34 years and 86% males. Mean (SD) Injury Severity Score (ISS) was 33.2 (14.7), with 93% having a chest Abbreviated Injury Scale (AIS) score of 3 or greater, 61% having a chest AIS score of 4 or greater, and 32% having a chest AIS score of 5 or greater. Of the patients, 48% had gunshot wounds and 21% had stab wounds. Admission temperature, pH, base deficit, and international normalized ratio were 36 degrees C (1 degrees C), 7.07 (0.13), 11.1 (6.5), and 1.7, respectively. Incisions included anterolateral thoracotomy in 69% and sternotomy in 25%; 73% required pulmonary resection, 20% required cardiorraphy, and 9% had major vascular injuries; multiple procedures were common. Mean intraoperative transfusion was 13 U of packed red blood cells. Forty-two patients (95%) had thoracic packing with vacuum-assisted closure. The thorax was closed when physiology normalized, on a mean (SD) of 3 (1) days. When comparing physiologic parameters at initial operation and chest closure, temperature was 34.4 degrees C (1.3 degrees C) versus 37.4 degrees C (0.8 degrees C), pH was 7.13 (0.14) versus 7.38 (0.6), and international normalized ratio was 1.8 (0.9) versus 1.2 (0.3), respectively, all statistically significantly (p < 0.001). Complications included sepsis (36%), renal failure requiring continuous renal replacement therapy (30%), adult respiratory distress syndrome (25%), and empyema (23%). Six required salvage extracorporeal membrane oxygenation with one survivor. Mortality was 23%. Predictors included higher ISS, renal failure, continuous renal replacement therapy, and extracorporeal membrane oxygenation. All survivors were neurologically intact and dialysis free.
   CONCLUSION: Patients with severe chest trauma and marked physiologic derangement can benefit from damage-control thoracic surgery. Thoracic packing and temporary vacuum closure avoids thoracic compartment syndrome. Timing of thoracic closure is based on physiology. While complications were common, mortality is acceptable in this group of severely injured, metabolically depleted, challenging patients. Copyright (C) 2014 by Lippincott Williams & Wilkins
C1 [O'Connor, James V.] Univ Maryland, Sch Med, Med Ctr, R Adams Cowley Shock Trauma Ctr, Baltimore, MD 21201 USA.
C3 University System of Maryland; University of Maryland Baltimore
RP O'Connor, JV (通讯作者)，Univ Maryland, Sch Med, Med Ctr, R Adams Cowley Shock Trauma Ctr, 22 S Greene St, Baltimore, MD 21201 USA.
EM joconnor@umm.edu
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NR 30
TC 45
Z9 62
U1 0
U2 3
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA 530 WALNUT ST, PHILADELPHIA, PA 19106-3621 USA
SN 2163-0755
EI 2163-0763
J9 J TRAUMA ACUTE CARE
JI J. Trauma Acute Care Surg.
PD NOV
PY 2014
VL 77
IS 5
BP 660
EP 665
DI 10.1097/TA.0000000000000451
PG 6
WC Critical Care Medicine; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC General & Internal Medicine; Surgery
GA AT1OB
UT WOS:000344702300002
PM 25494414
DA 2026-07-24
ER

PT J
AU Zamani, N
   Sharath, SE
   Vo, E
   Awad, SS
   Kougias, P
   Barshes, NR
AF Zamani, Nader
   Sharath, Sherene E.
   Vo, Elaine
   Awad, Samir S.
   Kougias, Panos
   Barshes, Neal R.
TI A Multi-Component Strategy to Decrease Wound Complications after Open
   Infra-Inguinal Re-Vascularization
SO SURGICAL INFECTIONS
LA English
DT Article
DE decontamination; staples; surgical site infection; vascular surgery
ID SURGICAL SITE INFECTIONS; LOWER-EXTREMITY BYPASS; PERIPHERAL
   ARTERY-DISEASE; RISK-FACTORS; REVASCULARIZATION PROCEDURES; SUBCUTICULAR
   SUTURES; ORTHOPEDIC-SURGERY; AMERICAN-COLLEGE; POVIDONE-IODINE; SKIN
   CLOSURE
AB Background: Wound complications remain a significant source of morbidity for patients undergoing open infra-inguinal re-vascularization. The purpose of this study was to determine the impact of several infection-control strategies on post-operative wound complications after open infra-inguinal re-vascularization. Methods: A retrospective cohort study was conducted among all patients who underwent an open infra-inguinal re-vascularization procedure before and after 2014. Since 2014, we have implemented strategies to reduce post-operative wound complications, including: (1) Decreasing the use of incisional skin staples, (2) increasing the use of negative pressure wound therapy (NPWT) dressings, and (3) implementing an outpatient elective decontamination protocol for methicillin-resistant Staphylococcus aureus. Pre-era is defined as the period between January 2012 and December 2013, before the implementation of infection control strategies; Post-era is between January 2015 and August 2016, after implementation. The primary outcome of interest is 30-day wound complications (infection or dehiscence). Multi-variable logistic regression analysis was used to identify significant predictors of wound-related complications between the two cohorts. Propensity score adjustment controlled for baseline patient characteristics, peri-operative variables, and surgeon experience. Results: A total of 338 open infra-inguinal procedures were performed: 175 in the pre-era and 163 in the post-era. Chlorhexidine skin preparation was used in the majority (321 [95%]) of cases. Comparing the periods, the post-era is characterized by a significant decrease in the use of groin staples (118 [67%] vs. 51 [31%], p<0.001), and an increased application of NPWT dressings (6 [4%] vs. 66 [43%], p<0.001). Thirty-five (37%) outpatient elective cases received the pre-operative decontamination protocol in the post-era. Compared with the pre-era, there was a decrease in the 30-day rate of wound complications (68 [39%] to 42 [26%], p=0.011), and infection-related re-admissions (31 [17.7%] to 21 [12.9%], p=0.220). When adjusting for patient characteristics, operative variables, and surgeon experience, post-era had significantly lower wound complications (odds ratio [OR] 0.33, p=0.002) and re-operations (OR 0.16, p=0.007). Among outpatient elective cases, the decontamination protocol was also independently associated with these two outcomes (wound complications: OR 0.05, p=0.006; re-operations: 0.06, p=0.002). The use of groin staples was an independent predictor of deep groin infections (OR 248, p<0.001) and re-operations (OR 8.16, p=0.032). Conclusions: Wound complications after open infra-inguinal re-vascularization have decreased significantly after the implementation of several infection-control strategies. Findings suggest that skin staples should be avoided in groin wounds, and anti-staphylococcal decontamination protocols decrease wound complications and prevent re-operations.
C1 [Zamani, Nader; Kougias, Panos; Barshes, Neal R.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, 2002 Holcombe Blvd OCL 112, Houston, TX 77030 USA.
   [Sharath, Sherene E.] Michael E DeBakey VA Med Ctr, Hlth Serv & Res Dev, Houston, TX USA.
   [Vo, Elaine; Awad, Samir S.] Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Div Gen Surg, 2002 Holcombe Blvd OCL 112, Houston, TX 77030 USA.
C3 Baylor College of Medicine; US Department of Veterans Affairs; Veterans
   Health Administration (VHA); Michael E DeBakey VA Medical Center; Baylor
   College of Medicine; Baylor College Medical Hospital; US Department of
   Veterans Affairs; Veterans Health Administration (VHA); Michael E
   DeBakey VA Medical Center; Baylor College of Medicine
RP Barshes, NR (通讯作者)，Baylor Coll Med, Michael E DeBakey Vet Affairs Med Ctr, Michael E DeBakey Dept Surg, Div Vasc Surg & Endovasc Therapy, 2002 Holcombe Blvd OCL 112, Houston, TX 77030 USA.
EM nbarshes@bcm.edu
RI Sharath, Sherene/JYP-3673-2024
CR American College of Radiology, 2013, ACR BI RADS, P85
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NR 30
TC 9
Z9 10
U1 0
U2 5
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 1096-2964
EI 1557-8674
J9 SURG INFECT
JI Surg. Infect.
PD JAN
PY 2018
VL 19
IS 1
BP 87
EP 94
DI 10.1089/sur.2017.193
PG 8
WC Infectious Diseases; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Infectious Diseases; Surgery
GA FR9JV
UT WOS:000419390800014
PM 29303688
DA 2026-07-24
ER

PT J
AU Gombert, A
   Dillavou, E
   D'Agostino, R 
   Griffin, L
   Robertson, JM
   Eells, M
AF Gombert, Alexander
   Dillavou, Ellen
   D'Agostino, Ralph, Jr.
   Griffin, Leah
   Robertson, Julie M.
   Eells, Mark
TI A systematic review and meta-analysis of randomized controlled trials
   for the reduction of surgical site infection in closed incision
   management versus standard of care dressings over closed vascular groin
   incisions
SO VASCULAR
LA English
DT Review
DE Meta-analysis; vascular surgery; standard of care; negative pressure
   wound therapy
ID NEGATIVE-PRESSURE THERAPY; WOUND THERAPY; COMPLICATIONS
AB Objective Surgical site infection after groin incision is a common complication and a financial burden to patients and healthcare systems. Closed incision negative pressure therapy (ciNPT) has been associated with decreased surgical site infection rates in published literature. This meta-analysis examines the effect of ciNPT (PREVENA (TM) Incision Management System; KCI, San Antonio, TX) versus traditional postsurgical dressing use in reducing surgical site infection rates over closed groin incisions following vascular surgery. Methods A systematic literature search using PubMed, OVID, EMBASE, and QUOSA was performed on 3 January 2019, by two independent researchers and focused on publications between 1 January 2005 and 31 December 2018. The review conformed to the statement and reporting check list of the Preferred Reporting Items for Systematic Reviews and Meta Analyses. Inclusion criteria included abstract or manuscript written in English, published studies, conference abstracts, randomized controlled trials (RCTs), ciNPT usage over closed groin incisions in vascular surgery, comparison of ciNPT use and traditional dressings, study endpoint/outcome of surgical site infection, and study population of >10. Characteristics of study participants, surgical procedure, type of dressing used, duration of treatment, incidence of surgical site infection, and length of follow-up were extracted. Weighted odds ratios and 95% confidence intervals were calculated to pool study and control groups in each publication for analysis. Treatment effects were combined using Mantel-Haenszel risk ratios, and the Chi-Square test was used to assess heterogeneity. Overall, high-risk patients, normal-risk patients, and Szilagyi I, II, III outcomes were assessed between ciNPT and control groups. The Cochrane Collaboration tool was utilized to assess the risk of bias for all studies included in the analysis. Results A total of 615 articles were identified from the literature search. After removal of excluded studies and duplicates, six RCT studies were available for analysis. In these studies, a total of 362 patients received ciNPT, and 371 patients received traditional dressings (control). Surgical site infection events occurred in 41 ciNPT patients and 107 control patients. The heterogeneity test was nonsignificant (p > 0.05). The overall RCT meta-analysis showed a highly significant effect in favor of ciNPT (OR = 3.06, 95% CI [2.05, 4.58], p < 0.05). High-risk, normal-risk, Szilagyi I, and Szilagyi II meta-analyses were also statistically significant in favor of ciNPT use (p < 0.05). The varying RCT inclusion/exclusion criteria, such as differences in procedure types, and patient populations form the major limitations of this study. Conclusions A statistically significant reduction in the incidence of surgical site infection was seen following ciNPT usage in patients undergoing vascular surgery with groin incisions.
C1 [Gombert, Alexander] Univ Hosp RWTH Aachen, Vasc Ctr Aachen Maastricht, Vasc Surg, Aachen, Germany.
   [Dillavou, Ellen] Duke Univ, Med Ctr, Duke Reg Hosp, Vasc Surg, Durham, NC USA.
   [D'Agostino, Ralph, Jr.] Wake Forest Sch Med, Biostat Sci, Winston Salem, NC 27101 USA.
   [Griffin, Leah; Robertson, Julie M.; Eells, Mark] KCI, San Antonio, TX USA.
C3 RWTH Aachen University; RWTH Aachen University Hospital; Duke
   University; Wake Forest University
RP Gombert, A (通讯作者)，Univ Hosp RWTH Aachen, Dept Vasc Surg, European Vasc Ctr Aachen Maastricht, Pauwelsstr 30, D-52074 Aachen, Germany.
EM agombert@ukaachen.de
RI ; Dagostino, Ralph/C-4060-2017
OI Gombert, Alexander/0000-0002-8451-2913; Dagostino,
   Ralph/0000-0002-3550-8395
CR Arnaoutakis DJ, 2017, J VASC SURG, V65, P1713, DOI 10.1016/j.jvs.2016.12.116
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NR 21
TC 42
Z9 45
U1 1
U2 4
PU SAGE PUBLICATIONS LTD
PI LONDON
PA 1 OLIVERS YARD, 55 CITY ROAD, LONDON EC1Y 1SP, ENGLAND
SN 1708-5381
EI 1708-539X
J9 VASCULAR
JI Vascular
PD JUN
PY 2020
VL 28
IS 3
BP 274
EP 284
AR 1708538119890960
DI 10.1177/1708538119890960
EA JAN 2020
PG 11
WC Peripheral Vascular Disease
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA ME1AK
UT WOS:000508519900001
PM 31955666
OA Green Submitted, hybrid
DA 2026-07-24
ER

PT J
AU Markakis, K
   Bowling, FL
   Boulton, AJM
AF Markakis, K.
   Bowling, F. L.
   Boulton, A. J. M.
TI The diabetic foot in 2015: an overview
SO DIABETES-METABOLISM RESEARCH AND REVIEWS
LA English
DT Article; Proceedings Paper
CT 7th International Symposium on the Diabetic Foot
CY MAY 20-23, 2015
CL The Hague, NETHERLANDS
DE diabetes; foot; overview
ID ENDOTHELIAL PROGENITOR CELLS; PERIPHERAL ARTERIAL-DISEASE;
   HYPERBARIC-OXYGEN THERAPY; CRITICAL LIMB ISCHEMIA; PRESSURE WOUND
   THERAPY; ACUTE CHARCOT FOOT; INTERNATIONAL WORKING GROUP; DOUBLE-BLIND;
   RISK-FACTORS; STEM-CELL
AB In 2015, it can be said that the diabetic foot is no longer the Cinderella of diabetic complications. Thirty years ago there was little evidence-based research taking place on the diabetic foot, and there were no international meetings addressing this topic. Since then, the biennial Malvern Diabetic Foot meetings started in 1986, the American Diabetes Association founded their Foot Council in 1987, and the European Association for the Study of Diabetes established a Foot Study Group in 1998. The first International Symposium on the Diabetic Foot in The Netherlands was convened in 1991, and this was soon followed by the establishment of the International Working Group on the Diabetic Foot that has produced useful guidelines in several areas of investigation and the management of diabetic foot problems. There has been an exponential rise in publications on diabetic foot problems in high impact factor journals, and a comprehensive evidence-base now exists for many areas of treatment. Despite the extensive evidence available, it, unfortunately, remains difficult to demonstrate that most types of education are efficient in reducing the incidence of foot ulcers. However, there is evidence that education as part of a multi-disciplinary approach to diabetic foot ulceration plays a pivotal role in incidence reduction. With respect to treatment, strong evidence exists that offloading is the best modality for healing plantar neuropathic foot ulcers, and there is also evidence from two randomized controlled trials to support the use of negative-pressure wound therapy in complex post-surgical diabetic foot wounds. Hyperbaric oxygen therapy exhibits the same evidence level and strength of recommendation. International guidelines exist on the management of infection in the diabetic foot. Many randomized trials have been performed, and these have shown that the agents studied generally produced comparable results, with the exception of one study in which tigecycline was shown to be clinically inferior to ertapenem +/- vancomycin. Similarly, there are numerous types of wound dressings that might be used in treatment and which have shown efficacy, but no single type (or brand) has shown superiority over others. Peripheral artery disease is another major contributory factor in the development of ulceration, and its presence is a strong predictor of non-healing and amputation. Despite the proliferation of endovascular procedures in addition to open revascularization, many patients continue to suffer from severely impaired perfusion and exhaust all treatment options. Finally, the question of the true aetiopathogenesis of Charcot neuroarthropathy remains enigmatic, although much work is currently being undertaken in this area. In this area, it is most important to remember that a clinically uninfected, warm, insensate foot in a diabetic patient should be considered as a Charcot foot until proven otherwise, and, as such, treated with offloading, preferably in a cast. Copyright (c) 2016 John Wiley & Sons, Ltd.
C1 [Markakis, K.; Bowling, F. L.; Boulton, A. J. M.] Manchester Royal Infirm, Oxford Rd, Manchester M13 9WL, Lancs, England.
   [Bowling, F. L.; Boulton, A. J. M.] Univ Manchester, Manchester, Lancs, England.
C3 University of Manchester; University of Manchester
RP Boulton, AJM (通讯作者)，Manchester Diabet Ctr, 193 Hathersage Rd, Manchester M13 0JE, Lancs, England.
EM ABoulton@med.miami.edu
OI Boulton, Andrew/0000-0001-7856-1201
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NR 141
TC 93
Z9 113
U1 0
U2 43
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1520-7552
EI 1520-7560
J9 DIABETES-METAB RES
JI Diabetes-Metab. Res. Rev.
PD JAN
PY 2016
VL 32
SU 1
BP 169
EP 178
DI 10.1002/dmrr.2740
PG 10
WC Endocrinology & Metabolism
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Endocrinology & Metabolism
GA DC3QP
UT WOS:000369134100016
PM 26451519
OA Bronze
DA 2026-07-24
ER

PT J
AU Trevillyan, JM
   Johnson, PDR
AF Trevillyan, Janine M.
   Johnson, Paul D. R.
TI Steroids control paradoxical worsening of Mycobacterium ulcerans
   infection following initiation of antibiotic therapy
SO MEDICAL JOURNAL OF AUSTRALIA
LA English
DT Article
ID DIAGNOSIS
AB A 19-year-old man with a 3-month history of a non-healing ulcer of the right knee and indurated oedema involving the entire lower leg (Box 1) presented after not responding to multiple courses of antibiotics. A punch biopsy showed necrosis of the dermis and subcutaneous tissues, and extensive infiltration with extracellular acid-fast bacilli on auramine-rhodamine staining. Potymerase chain reaction (PCR) testing for the 152404 insertion sequence of Mycobacterium ulcerans was positive,(1) and M. ulcerans was isolated from culture at 6 weeks. The patient reported holidaying on the Bellarine Peninsula, an endemic area for M. ulcerans, 6 months before the development of the lesion. Surgical intervention was deferred due to the extensive area involved and World Health Organization guidelines suggesting antibiotics as first-line treatment for extensive oedematous disease.(2) He commenced oral daily rifampicin (600 mg) and moxifloxacin (400 mg) and, within a week, noted a marked decrease in. exudate and improvement in the painful oedematous disease of the lower leg. Therapy was well tolerated and the ulcer remained stable with only one small area of new skin loss lateral to the primary lesion.
   Four weeks later, there was a rapid deterioration in clinical condition, with fevers, sweats, anorexia and a recurrence of lower limb oedema and pain. Significant skin breakdown occurred around the ulcer and distally on the leg, with copious serous exudate (Box 2). Full blood examination showed a neutrophilia (neutrophil count, 14.9x10(9)/L [reference interval, 1.9-8.0x10(9)/L]) and a raised C-reactive protein level (69.8 mg/L [reference interval, <3 mg/L]). Prednisolone 50 mg daily and intravenous piperacillin tazobactam 4.5 g three times daily was commenced. An ultrasound of the Limb showed extensive liquefaction of the subcutaneous fat, and swabs were PCR-positive for M. ulcerans but culture-negative following prolonged incubation.
   Within 12 hours of commencing prednisolone therapy (combined with broad-spectrum antibiotics), the patient became afebrile, with neutrophil and C-reactive protein levels within reference intervals on full blood examination and an improvement in ulcer appearance. He was discharged on a 25 mg maintenance dose of prednisolone white continuing rifampicin and moxifloxacin. Increasing areas of skin loss and exudate,developed when prednisolone was decreased to 12.5 mg daily, and thus he underwent a limited debridement of the lateral knee and negative-pressure wound therapy (VAC GranuFoam dressing, KCI Medical), followed by successful split skin grafting., Heat therapy (Bair Hugger, 3M Arizant Healthcare) was used to maintain skin temperature at 39 degrees C.
   Prednisolone was continued for 2 weeks postoperatively (15 mg daily) and then stopped without further deterioration in the patient's condition. The patient completed a 3-month course of antimycobacterial antibiotics, at which time there was no sign of ongoing infection. Two skin sites subsequently discharged a small amount of culture-negative material but, at 12 months, there was no evidence of microbiological relapse.
C1 [Trevillyan, Janine M.; Johnson, Paul D. R.] Austin Hlth, Dept Infect Dis, Melbourne, Vic, Australia.
   [Johnson, Paul D. R.] Victorian Infect Dis Reference Lab, WHO Collaborating Ctr Mycobacterium Ulcerans West, Melbourne, Vic, Australia.
C3 Florey Institute of Neuroscience & Mental Health; Howard Florey
   Institute Affiliates; Austin Research Institute; Victorian Infectious
   Diseases Reference Laboratory
RP Trevillyan, JM (通讯作者)，Austin Hlth, Dept Infect Dis, Melbourne, Vic, Australia.
EM janine.trevillyan@monash.edu
RI Trevillyan, Janine/AAD-1631-2019
OI Trevillyan, Janine/0000-0002-8660-5558
CR Adusumilli S, 2005, CELL MICROBIOL, V7, P1295, DOI 10.1111/j.1462-5822.2005.00557.x
   [Anonymous], 2003, MORBIDITY MORTALITY, V52
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   World Health Organization, 2012, PROV GUID ROL SPEC A
NR 10
TC 13
Z9 15
U1 0
U2 8
PU AUSTRALASIAN MED PUBL CO LTD
PI PYRMONT
PA LEVEL 2, 26-32 PYRMONT BRIDGE RD, PYRMONT, NSW 2009, AUSTRALIA
SN 0025-729X
J9 MED J AUSTRALIA
JI Med. J. Aust.
PD MAY 6
PY 2013
VL 198
IS 8
BP 443
EP 444
DI 10.5694/mja12.11559
PG 2
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 153RR
UT WOS:000319620700020
PM 23641997
DA 2026-07-24
ER

PT J
AU Lodewijks, AJL
   Warin, MMR
   van der Broeck, LCA
   Fois, MG
   Lopez-Iglesias, C
   Blokhuis, TJ
   Van Griensven, M
   Poeze, M
AF Lodewijks, Anna J. L.
   Warin, Margot M. R.
   Van Der Broeck, Lotte C. A.
   Fois, Maria Gabriella
   Lopez-Iglesias, Carmen
   Blokhuis, Taco J.
   Van Griensven, Martijn
   Poeze, Martijn
TI Long-term follow-up of patients with large segmental bone defects
   treated with 3D-printed polycaprolactone/tricalcium phosphate scaffolds
SO EUROPEAN JOURNAL OF TRAUMA AND EMERGENCY SURGERY
LA English
DT Article
DE Induced membrane technique; Bone defects; 3D-printed PCL/TCP cages;
   Long-term outcomes; Posttraumatic segmental defects
ID TRICALCIUM PHOSPHATE; TCP SCAFFOLDS; IN-VITRO; DEGRADATION; POROSITY;
   REPAIR
AB IntroductionThe Induced Membrane Technique (IMT) combined with autologous bone grafting has proven effective in achieving union in many cases of non-healing bone defects. However, this treatment strategy remainschallenging in very large defects (>= 10 cm). Although the addition of a 3D-printed scaffold could enhance osteoconductivity and retention of cancellous bone, cells, and bioactive materials in the defect, the long-term outcomes of this innovative approach are not yet known. We therefore reviewed all patients with a very large posttraumatic segmental defect of a long bone treated with the IMT using a 3D-printed scaffold, cancellous bone, cells, and bioactive materials.MethodsFrom 2018 to 2024, all consecutive patients with a large segmental defect who received a 3D printed scaffold were identified. All patients were treated with the two-stage IMT procedure. The defects were filled in the second stage procedure with a 3D printed scaffold made from poly-epsilon-caprolactone and Tricalcium Phosphate (PCL/TCP), autologous bone graft (bone marrow aspirate concentrate and RIA-autograft), and biomaterials(P-15 +/- bioactive glass). In the event of complications, samples from the defect site with the PCL/TCP scaffold were collected for analysis using scanning electron microscopy and histology.ResultsA total of ten patients were treated for a segmental bone defect median of 10.5 cm (IQR 3.25) of the femur (n = 3) or tibia (n = 7). Follow-up of the patients ranges between one and four years. The median age of the patients is 46 (range 23-62). Complications occurred in seven patients (one femur, six tibia). All patients with complications required additional surgeries. One patient had a local osteomyelitis infection at the defect site with complete integration of the scaffold into the proximal and distal tibia; one required negative pressure wound therapy for a soft tissue infection; and five required a revision of the first stage procedure due to surgical site infection (n = 3) or failure of the fracture fixation material (n = 2). Remarkably, scanning electron microscopy and histology showed limited formation and incorporation of newly formed bone into the scaffold. After revision surgery, all patients are currently improving, and no amputations have been performed so far.ConclusionReconstructive treatment of large bone defects remains challenging. The short-term follow-up of this treatment strategy showed promising results with progress in clinical and radiological follow-up. However, in this small cohort a lack of bone growth at the defect site was found in some of the cases that were clinically performing well. The use of PCL/TCP scaffolds remains a valuable treatment strategy in very large bone defects for retention and extension of the autologous bone and cells, though improvements in fixation, composition or structural properties could enhance their feasibility.
C1 [Lodewijks, Anna J. L.; Van Der Broeck, Lotte C. A.; Blokhuis, Taco J.; Poeze, Martijn] Maastricht Univ Med Ctr MUMC, Dept Trauma Surg, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands.
   [Lodewijks, Anna J. L.; Van Der Broeck, Lotte C. A.; Blokhuis, Taco J.; Poeze, Martijn] Maastricht Univ, Inst Nutr & Translat Res Metab NUTRIM, Maastricht, Netherlands.
   [Warin, Margot M. R.; Van Griensven, Martijn] Maastricht Univ, MERLN Inst Technol Inspired Regenerat Med, Dept cBITE, Maastricht, Netherlands.
   [Fois, Maria Gabriella] Maastricht Univ, MERLN Inst Technol Inspired Regenerat Med, Dept Instructive Biomat Engn, Maastricht, Netherlands.
   [Fois, Maria Gabriella] Rhein Westfal TH Aachen, AME Inst Appl Med Engn, Helmholtz Inst, Dept Biohybrid & Med Text BioTex, D-52074 Aachen, Germany.
   [Lopez-Iglesias, Carmen] Maastricht Univ, Microscopy CORE Lab, Maastricht, Netherlands.
C3 Maastricht University; Maastricht University Medical Centre (MUMC);
   Maastricht University; Maastricht University; Maastricht University
   Medical Centre (MUMC); Maastricht University; Maastricht University
   Medical Centre (MUMC); Helmholtz Association; RWTH Aachen University;
   Maastricht University
RP Lodewijks, AJL (通讯作者)，Maastricht Univ Med Ctr MUMC, Dept Trauma Surg, P Debyelaan 25, NL-6229 HX Maastricht, Netherlands.; Lodewijks, AJL (通讯作者)，Maastricht Univ, Inst Nutr & Translat Res Metab NUTRIM, Maastricht, Netherlands.
EM Laureanne.lodewijks@maastrichtuniversity.nl
RI van Griensven, Martijn/F-5808-2012
OI van Griensven, Martijn/0000-0001-5104-9881; Poeze,
   Martijn/0000-0001-5005-1285; Fois, Maria Gabriella/0000-0001-9304-1554
FU Health~Holland [LSHM202206]
FX This study was supported by a PPP Allowance of Health ~ Holland, the
   Netherlands (LSHM202206).
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NR 40
TC 3
Z9 3
U1 1
U2 2
PU SPRINGER HEIDELBERG
PI HEIDELBERG
PA TIERGARTENSTRASSE 17, D-69121 HEIDELBERG, GERMANY
SN 1863-9933
EI 1863-9941
J9 EUR J TRAUMA EMERG S
JI Eur. J. Trauma Emerg. Surg.
PD NOV 14
PY 2025
VL 51
IS 1
AR 326
DI 10.1007/s00068-025-02982-9
PG 11
WC Emergency Medicine
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Emergency Medicine
GA 9WA3E
UT WOS:001616370600015
PM 41238943
OA Green Submitted, Green Published, hybrid
DA 2026-07-24
ER

PT J
AU Yalin, M
   Kazez, M
AF Yalin, Mustafa
   Kazez, Muhammed
TI Long-term recovery after fasciotomy for earthquake-related acute
   compartment syndrome: a comparative study of pediatric and adult
   patients
SO BMC SURGERY
LA English
DT Article
DE Fasciotomy; Acute Compartment Syndrome; Delayed Primary Closure;
   Earthquake; Skin Grafting
ID WOUND CLOSURE; CHILDREN DIAGNOSIS; EXTREMITY; LEG; MANAGEMENT; OUTCOMES;
   INJURY
AB Background Age-related differences after fasciotomy for earthquake-related acute compartment syndrome (ACS) remain incompletely defined. This study compared pediatric and adult patients with respect to definitive wound closure, baseline injury characteristics, wound-course complexity, and 12-month recovery. Methods This retrospective comparative cohort included 29 patients who underwent fasciotomy for earthquake-related ACS (9 pediatric, 20 adult). Baseline variables included time under rubble, time to hospital admission, number of fasciotomy incisions, affected extremity distribution, associated fracture, associated vascular injury, Injury Severity Score (ISS), and vacuum-assisted closure (VAC) duration. Wound-course variables included delayed primary closure (DPC), split-thickness skin grafting (SG), re-debridement count, wound infection, graft failure, and revision surgery. Long-term recovery was assessed at 6 and 12 months using full muscle strength, full joint range of motion (ROM), and joint stiffness. Unfavorable 12-month recovery was defined as failure to regain full ROM and/or full muscle strength, or persistence of clinically relevant stiffness. Results Time under rubble was comparable between pediatric and adult patients (16.7 +/- 11.3 vs. 14.8 +/- 7.8 h, p = 0.92), whereas time to hospital admission was longer in pediatric patients (65.5 +/- 29.5 vs. 40.1 +/- 15.6 h, p = 0.01). DPC was achieved in 88.9% versus 10.0% (p < 0.001), while SG was required in 11.1% versus 90.0% (p < 0.001). VAC duration was shorter in pediatric patients (12.4 +/- 2.3 vs. 22.6 +/- 8.2 days, p < 0.001), and re-debridement count was lower (0.7 +/- 0.5 vs. 2.1 +/- 1.0, p = 0.002). At 6 months, full muscle strength (88.9% vs. 45.0%, p = 0.043) and full ROM (77.8% vs. 35.0%, p = 0.050) favored the pediatric group. At 12 months, full ROM remained numerically higher in pediatric patients (77.8% vs. 50.0%, p = 0.23), while unfavorable 12-month recovery occurred in 11.1% versus 50.0% (p = 0.096). In exploratory multivariable analysis, SG, re-debridement count, and 6-month stiffness were associated with unfavorable recovery, whereas pediatric age group was protective. Associated fracture and ISS were not independently associated with unfavorable 12-month recovery. Conclusion Pediatric patients showed more favorable definitive closure profiles and less complex wound courses despite later presentation. They also showed signals of more favorable longer-term recovery, although between-group differences in 12-month functional outcomes did not reach conventional statistical significance. Wound-course factors and, to a lesser extent, baseline injury burden may partly explain age-related differences in recovery after fasciotomy for earthquake-related ACS.
C1 [Yalin, Mustafa] Yalova Univ, Fac Med, Dept Orthoped & Traumatol, TR-77200 Yalova, Turkiye.
   [Kazez, Muhammed] Elazig Fethi Sekin City Hosp, Dept Orthoped & Traumatol, Elazig, Turkiye.
C3 Yalova University
RP Yalin, M (通讯作者)，Yalova Univ, Fac Med, Dept Orthoped & Traumatol, TR-77200 Yalova, Turkiye.
EM mustiyalin1988@gmail.com; mkzz23@hotmail.com
RI yalın, mustafa/JOJ-5214-2023
CR Agarwal Pawan, 2019, J Clin Orthop Trauma, V10, P845, DOI [10.1016/j.jcot.2019.06.015, 10.1016/j.jcot.2019.06.015]
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NR 31
TC 0
Z9 0
U1 3
U2 3
PU BMC
PI LONDON
PA CAMPUS, 4 CRINAN ST, LONDON N1 9XW, ENGLAND
EI 1471-2482
J9 BMC SURG
JI BMC Surg.
PD APR 28
PY 2026
VL 26
IS 1
AR 409
DI 10.1186/s12893-026-03800-8
EA APR 2026
PG 9
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA JL5KU
UT WOS:001792188900002
PM 42050551
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Gao, X
   Fan, HY
   Huang, R
   Sui, YQ
   Li, F
   Yin, HL
AF Gao, Xu
   Fan, Hai-yu
   Huang, Rui
   Sui, Yong-qiang
   Li, Fei
   Yin, Hai-lei
TI Management of Open Calcaneal Fractures with Medial Wounds by One-Stage
   Sequential Reduction and Frame Structure Fixation Using Percutaneous
   Kirschner Wires
SO ORTHOPAEDIC SURGERY
LA English
DT Article
DE Calcaneal fractures; Kirschner wires; Open injury; Percutaneous fixation
ID INTRAARTICULAR FRACTURES; COMPLICATIONS
AB Objective To assess the clinical outcomes of open calcaneal fractures with medial wounds treated with one-stage management, including early modern wound care, sequential reduction, and frame structure fixation using percutaneous Kirschner wires.
   Methods A total of 19 patients with open calcaneal fractures admitted to our hospital from May 2016 to March 2019 were selected in this study. Twelve type-II and seven type-IIIA medial open injuries were identified according to the classification of Gustilo and Anderson. Fractures were stratified by Sanders classification, including nine type-II fractures, seven type-III fractures, and three type-IV fractures. All patients accepted one-stage irrigation and debridement, sequential reduction of calcaneal fractures through the open medial wound, percutaneous Kirschner wire fixation, and primary closure of wounds covered with vacuum-assisted closure (VAC) device. The Bohler angle, the Gissane angle, and the width of the calcaneus were compared before and after surgery. The functional results were evaluated according to the Paley and Hall score system, visual analogue scale (VAS), American Orthopaedic Foot and Ankle Society (AOFAS) ankle and hindfoot score, Maryland Foot Score, and related complications.
   Results The follow-up duration for all patients ranged from 14 to 28 months (mean, 22.7 months). The angle of Bohler and Giasane was increased from (-7.6 degrees +/- 15.0 degrees) and (96.6 degrees +/- 7.6 degrees) before surgery to (23.7 degrees +/- 6.1 degrees) and (124.1 degrees +/- 7.1 degrees) postoperatively (P < 0.05), respectively. Three cases of superficial infection and two cases of wound dehiscence were observed in our study, which were then successfully treated with wound debridement, VAC replacement, appropriate use of antibiotics, and delayed closure. The last follow-up revealed three cases of lateral wall expansion and six cases of mild-to-moderate subtalar arthritis based on the Paley and Hall scoring system. According to the AOFAS ankle and hindfoot score, one case showed excellent results, 14 cases exhibited good results, and four cases displayed fair results, with the mean of 80.7 +/- 6.7 points (range, 70-90). The Maryland Foot Score revealed one case of excellent outcomes, nine cases of good outcomes, and nine cases of fair outcomes with an average of 76.8 +/- 8.6 points (range, 62-90). The mean VAS for pain was 1.8 +/- 1.5 (range, 0-5), and a total of 14 patients complained of mild-to-moderate pain when walking for a more extended period. Severe complications, such as deep infection, osteomyelitis, and soft tissue necrosis, were not observed during follow-up.
   Conclusions Collectively, one-stage management allowed the direct restoration of calcaneal morphology with a minimal invasion of soft tissues in most open calcaneal fractures with medial wounds, and the functional outcomes were comparable to previous data.
C1 [Gao, Xu] Qingdao Univ, Dept Orthopaed Surg, Qingdao, Peoples R China.
   [Fan, Hai-yu] 971 Hosp Peoples Liberat Army PLA, Dept Burn & Plast Surg, Qingdao, Peoples R China.
   [Huang, Rui; Li, Fei; Yin, Hai-lei] 971 Hosp Peoples Liberat Army PLA, Orthopaed Surg 2, Qingdao, Peoples R China.
   [Sui, Yong-qiang] Luoyang Ship Mat Res Inst, Dept State Key Lab Marine Corros & Protect, Qingdao, Peoples R China.
C3 Qingdao University
RP Yin, HL (通讯作者)，971 Hosp Peoples Liberat Army PLA, Dept Orthopaed Surg 2, 22 Min Jiang Rd, Qingdao 266071, Peoples R China.
EM 1431951086@qq.com
RI ; yin, hailei/LGZ-3641-2024
OI Gao, X/0000-0002-5065-1077; 
CR Abdelgaid Sherif Mohamed, 2012, Foot Ankle Surg, V18, P164, DOI 10.1016/j.fas.2011.07.005
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NR 33
TC 4
Z9 10
U1 0
U2 12
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1757-7853
EI 1757-7861
J9 ORTHOP SURG
JI Orthop. Surg.
PD FEB
PY 2021
VL 13
IS 1
BP 225
EP 236
DI 10.1111/os.12902
EA JAN 2021
PG 12
WC Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Orthopedics
GA QC1ZF
UT WOS:000604862900001
PM 33403804
OA Green Submitted, gold
DA 2026-07-24
ER

PT J
AU Zheng, ZL
   Couture, D
   Adams, F
   Roberson, R
   Ma, R
   Argenta, L
   Morykwas, M
AF Zheng, Zhenlin
   Couture, Daniel
   Adams, Farren
   Roberson, Rebecca
   Ma, Rong
   Argenta, Louis
   Morykwas, Michael
TI Attenuated Tissue Damage With Mechanical Tissue Resuscitation in a Pig
   Model of Spinal Cord Injury
SO JOURNAL OF NEUROTRAUMA
LA English
DT Article
DE diffusion tensor imaging; mechanical tissue resuscitation; negative
   pressure treatment; nerve fiber tractography; spinal cord injury
ID VACUUM-ASSISTED CLOSURE; PORCINE MODEL; ANIMAL-MODEL; DIFFUSION;
   TRACTOGRAPHY; THERAPIES; SEVERITY; PRESSURE
AB Our previous studies on the treatment of spinal cord injuries with Mechanical Tissue Resuscitation (MTR) in rats have demonstrated that it can significantly improve the locomotor recovery and Basso Beattie Bresnahan scores. MTR treatment also reduced fluid accumulations by T2-imaging and improved the mean neural fiber number and fiber length in injured sites by fiber tractography. Myelin volume was also significantly preserved by MTR treatment. For further clinical application, a large animal model is necessary to assess this treatment. This study examined the effects of application of MTR on traumatic spinal cord injury in a swine model. Traumatic spinal cord contusion injuries in swine were created by controlled pneumatic impact device. Negative pressure at -75 mm Hg was continuously applied to the injured site through open cell silicone manifold for 7 days. In vivo magnetic resonance imaging for T2 and gradient echo (GRE) analysis employed a 3T machine, while a 7T machine was employed for diffusion tensor imaging (DTI) and fiber tractography. Histological hematoxylin and eosin (H&E) and Luxol fast blue staining were examined. MTR significantly reduced the mean injured volumes over 46% by T2-imaging in the injured sites from 477.34 +/- 146.31 mm(3) in non-treated group to 255.99 +/- 70.28 mm(3) in MTR treated group (p < 0.01). It also reduced fluid accumulations by relative T2 signal density in the epicenter of the spinal cord injury from 1.62 +/- 0.27 in non-treated group to 1.22 +/- 0.10 in the MTR treated group (p < 0.05). The mean injured tissue volume measured by H&E staining was 303.71 +/- 78.21 mm(3) in the non-treated group and decreased significantly to 162.16 +/- 33.0 mm(3) in the MTR treated group (p < 0.01). The myelin fiber bundles stained by Luxol blue were preserved much more in the MTR treated group (90 +/- 29.71 mm(3)) than in the non-treated group (33.68 +/- 24.99 mm(3), p < 0.01). The fractional anisotropy (FA) values processed by DTI analysis are increased from 0.203 +/- 0.027 in the untreated group to 0.238 +/- 0.029 in MTR treatment group (p < 0.05). Fiber tractography showings the mean fiber numbers across the impacted area were increased over 112% from 327.0 +/- 99.74 in the non-treated group to 694.83 +/- 297.86 in the MTR treated group (p < 0.05). These results indicate local application of MTR for 7 days to spinal cord injury in a swine model decreased tissue injury, reduced tissue edema, and preserved more myelin fibers as well as nerve fibers in the injured spinal cord.
C1 [Zheng, Zhenlin; Adams, Farren; Roberson, Rebecca; Ma, Rong; Argenta, Louis; Morykwas, Michael] Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Winston Salem, NC USA.
   [Couture, Daniel] Wake Forest Univ Hlth Sci, Dept Neurosurg, Winston Salem, NC USA.
   [Morykwas, Michael] Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, 1 Med Ctr Blvd, Winston Salem, NC 27157 USA.
C3 Wake Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine
RP Morykwas, M (通讯作者)，Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, 1 Med Ctr Blvd, Winston Salem, NC 27157 USA.
EM mmorykwa@wakehealth.edu
OI Morykwas, Michael/0009-0001-5547-5172
FU Department of Plastic and Reconstructive Surgery, Wake Forest University
   Health Science
FX This study was supported by the research endowment of the Department of
   Plastic and Reconstructive Surgery, Wake Forest University Health
   Science.
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NR 28
TC 1
Z9 1
U1 0
U2 2
PU MARY ANN LIEBERT, INC
PI NEW ROCHELLE
PA 140 HUGUENOT STREET, 3RD FL, NEW ROCHELLE, NY 10801 USA
SN 0897-7151
EI 1557-9042
J9 J NEUROTRAUM
JI J. Neurotrauma
PD MAY 1
PY 2024
VL 41
IS 9-10
BP 1020
EP 1029
DI 10.1089/neu.2023.0172
EA NOV 2023
PG 10
WC Critical Care Medicine; Clinical Neurology; Neurosciences
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine; Neurosciences & Neurology
GA SN0N7
UT WOS:001138185800001
PM 37830176
DA 2026-07-24
ER

PT J
AU Cirocchi, R
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AF Cirocchi, Roberto
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   Tellan, Guglielmo
   Mingoli, Andrea
   Zago, Mauro
   Chiarugi, Massimo
   Binda, Gian Andrea
   Kafka, Reinhold
   Anania, Gabriele
   Donini, Annibale
   Nascimbeni, Riccardo
   Edilbe, Mohammed
   Afshar, Sorena
TI The role of damage control surgery in the treatment of perforated
   colonic diverticulitis: a systematic review and meta-analysis
SO INTERNATIONAL JOURNAL OF COLORECTAL DISEASE
LA English
DT Review
DE Diverticular perforation; Diverticular peritonitis; Damage control
   surgery
ID HARTMANNS PROCEDURE; PRIMARY ANASTOMOSIS; GENERALIZED PERITONITIS;
   CONTROL STRATEGY; TRAUMA PATIENTS; MANAGEMENT; REVERSAL; MORTALITY;
   RESECTION; SURVIVAL
AB Introduction Damage control surgery (DCS) is the classic approach to manage severe trauma and has recently also been considered an appropriate approach to the treatment of critically ill patients with severe intra-abdominal sepsis. The purpose of the present review is to evaluate the outcomes following DCS for Hinchey II-IV complicated acute diverticulitis (CAD). Methods A comprehensive systematic search was undertaken to identify all randomized clinical trials (RCTs) and observational studies, irrespectively of their size, publication status, and language. Adults who have undergone DCS for CAD Hinchey II, III, or IV were included in this review. DCS is compared with the immediate and definitive surgical treatment in the form of HP, colonic resection, and primary anastomosis (RPA) with or without covering stoma or laparoscopic lavage. We searched the following electronic databases: PubMed MEDLINE, Scopus, and ISI Web of Knowledge. The protocol of this systematic review and meta-analysis was published on Prospero (CRD42020144953). Results Nine studies with 318 patients, undergoing DCS, were included. The presence of septic shock at the presentation in the emergency department was heterogeneous, and the weighted mean rate of septic shock across the studies was shown to be 35.1% [95% CI 8.4 to 78.6%]. The majority of the patients had Hinchey III (68.3%) disease. The remainder had either Hinchey IV (28.9%) or Hinchey II (2.8%). Phase I is similarly described in most of the studies as lavage, limited resection with closed blind colonic ends. In a few studies, resection and anastomosis (9.1%) or suture of the perforation site (0.9%) were performed in phase I of DCS. In those patients who underwent DCS, the most common method of temporary abdominal closure (TAC) was the negative pressure wound therapy (NPWT) (97.8%). The RPA was performed in 62.1% [95% CI 40.8 to 83.3%] and the 22.7% [95% CI 15.1 to 30.3%]: 12.8% during phase I and 87.2% during phase III. A covering ileostomy was performed in 6.9% [95% CI 1.5 to 12.2%]. In patients with RPA, the overall leak was 7.3% [95% CI 4.3 to 10.4%] and the major anastomotic leaks were 4.7% [95% CI 2.0 to 7.4%]; the rate of postoperative mortality was estimated to be 9.2% [95% CI 6.0 to 12.4%]. Conclusions The present meta-analysis revealed an approximately 62.1% weighted rate of achieving GI continuity with the DCS approach to generalized peritonitis in Hinchey III and IV with major leaks of 4.7% and overall mortality of 9.2%. Despite the promising results, we are aware of the limitations related to the significant heterogeneity of inclusion criteria. Importantly, the low rate of reported septic shock may point toward selection bias. Further studies are needed to evaluate the clinical advantages and cost-effectiveness of the DCS approach.
C1 [Cirocchi, Roberto; Donini, Annibale] Univ Perugia, Dept Gen Surg, I-06123 Perugia, Italy.
   [Popivanov, Georgi] Mil Med Acad, Dept Surg, Ul Sv Georgi Sofiyski 3, Sofia 1606, Bulgaria.
   [Konaktchieva, Marina] Mil Med Acad, Dept Gastroenterol & Hepatol, Ul Sv Georgi Sofiyski 3, Sofia 1606, Bulgaria.
   [Chipeva, Sonia] Univ Natl & World Econ, Dept Stat & Econometr, Sofia, Bulgaria.
   [Tellan, Guglielmo] Sapienza Univ Rome, Umberto I Univ Hosp, Dept Emergency & Acceptance, Crit Areas & Trauma, I-00161 Rome, Italy.
   [Mingoli, Andrea] Sapienza Univ Roma, Dipartimento Chirurg P Valdoni, Viale Policlin 155, I-00161 Rome, Italy.
   [Zago, Mauro] A Manzoni Hosp, Dept Emergency & Robot Surg, Lecce, Italy.
   [Chiarugi, Massimo] Cisanello Univ Hosp, Emergency Surg & Trauma Ctr, I-56124 Pisa, Italy.
   [Binda, Gian Andrea] Biomed Inst, Colorectal Surg, I-16157 Genoa, Italy.
   [Kafka, Reinhold] Med Univ Innsbruck, Dept Visceral Transplant & Thorac Surg, Innsbruck, Austria.
   [Anania, Gabriele] Univ Ferrara, Dept Med Sci, I-4121 Ferrara, Italy.
   [Nascimbeni, Riccardo] Univ Brescia, Dept Mol & Translat Med, I-25121 Brescia, Italy.
   [Edilbe, Mohammed; Afshar, Sorena] North Cumbria Integrated Care NHS Fdn Trust, Carlisle, England.
C3 University of Perugia; Military Medical Academy Sofia; Military Medical
   Academy Sofia; University of National & World Economics - Bulgaria;
   Sapienza University Rome; University Hospital Sapienza Rome; Sapienza
   University Rome; Medical University of Innsbruck; University of Ferrara;
   University of Brescia
RP Cirocchi, R (通讯作者)，Univ Perugia, Dept Gen Surg, I-06123 Perugia, Italy.
EM roberto.cirocchi@unipg.it; gerasimpopivanov@rocketmail.com;
   marina.konaktchieva@yahoo.com; sonia.chipeva@hotmail.com;
   guglielmo.tellan@uniroma1.it; andrea.mingoli@uniroma1.it;
   maurozago.md@gmail.com; massimo.chiarugi@med.unipi.it;
   gianbinda1@gmail.com; reinhold.kafka-ritsch@tirol-kliniken.at;
   g.anania@unife.it; annibale.donini@unipg.it;
   riccardo.nascimbeni@unibs.it; mwedilbe@outlook.com;
   s.afshar@doctors.org.uk
RI Mingoli, Andrea/A-2889-2010; Zago, Matteo/B-1481-2015; Popivanov,
   Georgi/IVH-4670-2023; Cirocchi, Roberto/I-1197-2014; Chiarugi,
   Massimo/ABQ-7280-2022
OI Chiarugi, Massimo/0000-0001-6905-2499; TELLAN,
   GUGLIELMO/0000-0002-4129-3300
FU Universita degli Studi di Perugia within the CRUI-CARE Agreement
FX Open access funding provided by Universita degli Studi di Perugia within
   the CRUI-CARE Agreement.
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NR 67
TC 31
Z9 32
U1 0
U2 4
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0179-1958
EI 1432-1262
J9 INT J COLORECTAL DIS
JI Int. J. Colorectal Dis.
PD MAY
PY 2021
VL 36
IS 5
BP 867
EP 879
DI 10.1007/s00384-020-03784-8
EA OCT 2020
PG 13
WC Gastroenterology & Hepatology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Gastroenterology & Hepatology; Surgery
GA RJ7VP
UT WOS:000581831900001
PM 33089382
OA Green Submitted, Green Published, hybrid
DA 2026-07-24
ER

PT J
AU Zheng, ZL
   Brown, T
   Adams, F
   Roberson, R
   Ma, R
   Wilson, JA
   Morykwas, M
   Argenta, L
AF Zheng, Zhenlin
   Brown, Theodore
   Adams, Farren
   Roberson, Rebecca
   Ma, Rong
   Wilson, John A.
   Morykwas, Michael
   Argenta, Louis
TI Novel treatment of intracerebral hemorrhage with mechanical tissue
   resuscitation
SO JOURNAL OF NEUROSURGERY
LA English
DT Article
DE intracerebral hemorrhage; subatmospheric pressure; mechanical tissue
   resuscitation; vascular disorders
ID VACUUM-ASSISTED CLOSURE; SUBSEQUENT FIBRINOLYTIC THERAPY; STEREOTACTIC
   HEMATOMA PUNCTURE; PLASMINOGEN-ACTIVATOR; DECOMPRESSIVE CRANIECTOMY;
   ASPIRATION; CLOT; EVACUATION; REDUCTION; INJURY
AB OBJECTIVE The previous laboratory and clinical experience of the authors had demonstrated that application of controlled subatmospheric pressure directly to injured soft tissue can result in increased survival of compromised tissues. Mechanical tissue resuscitation (MTR) is a new concept evolving from these discoveries. The authors' recent studies have demonstrated that traumatic brain injury tissue can also be salvaged. The aim of this study was to examine the effects of MTR application to injuries from intracerebral hemorrhages (ICHs) in a swine model. METHODS The ICHs in swine were simulated by infusion of autologous artery blood into the right frontal lobe. A specially designed silicone manifold device was introduced directly into the hematoma. Continuous negative pressure at -50 mm Hg was applied through this device. T2- and T2*-weighted MRI, histological H&E staining, and immunostaining were examined. RESULTS After 1 week of treatment, MTR significantly decreased gross hematoma volume by more than 60%, from 472.62 +/- 230.19 mm(3) in the nontreated group to 171.25 +/- 75.38 mm(3) in the MTR-treated group (p < 0.05). Total hypointense volumes measured on T2*-weighted MR images decreased from 791.99 +/- 360.47 mm(3) in the nontreated group to 371.16 +/- 105.75 mm(3) in the MTR-treated group (p < 0.05). The hyperintense area on the T2-weighted MR image decreased significantly from 2656.23 +/- 426.26 mm(3) in the nontreated group to 1816.66 +/- 525.26 mm(3) in the MTR-treated group (p < 0.05). When ICHs were treated with MTR for 2 weeks, the gross hematomas were reduced by 94%, from 112.23 +/- 66.21 mm(3) in the nontreated group to 6.12 +/- 10.99 mm(3) in the MTR-treated group (p = 0.003). MTR significantly decreased the total necrotic tissue volume in H&E staining from 120.42 +/- 48.35 mm(3) in the nontreated group to 60.94 +/- 38.99 mm(3) in the MTR-treated group (p < 0.05). The total hypointense volumes on T2*-weighted MR images were significantly reduced, from 385.54 +/- 93.85 mm(3) in the nontreated group to 220.54 +/- 104.28 mm(3) in the MTR-treated group (p < 0.05), while their mean T2 hyperintense volume decreased significantly from 2192.83 +/- 728.27 mm(3) in the nontreated group to 1366.97 +/- 463.36 mm(3) in the MTR-treated group (p < 0.05). Histology revealed that the capillary diameter in the reactive tissue rim adjacent to the hematoma increased in both the 1- and 2-week MTR-treated groups. Both von Willebrand factor and CD31 signals were detectable in endothelial cells within the hematoma cavity of both MTR-treated groups. CONCLUSIONS This study demonstrates that local continuous application of controlled subatmospheric pressure to an ICH can safely remove more than half of a clot in 1 week and more than 90% in 2 weeks.
C1 [Zheng, Zhenlin; Brown, Theodore; Adams, Farren; Roberson, Rebecca; Ma, Rong; Morykwas, Michael; Argenta, Louis] Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Winston Salem, NC 27109 USA.
   [Wilson, John A.] Wake Forest Univ Hlth Sci, Dept Neurosurg, Winston Salem, NC USA.
C3 Wake Forest University; Wake Forest University School of Medicine; Wake
   Forest University; Wake Forest University School of Medicine
RP Morykwas, M (通讯作者)，Wake Forest Univ Hlth Sci, Dept Plast & Reconstruct Surg, Winston Salem, NC 27109 USA.
EM mmorykwa@wakehealth.edu
OI Morykwas, Michael/0009-0001-5547-5172
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NR 38
TC 0
Z9 0
U1 0
U2 0
PU AMER ASSOC NEUROLOGICAL SURGEONS
PI ROLLING MEADOWS
PA 5550 MEADOWBROOK DRIVE, ROLLING MEADOWS, IL 60008 USA
SN 0022-3085
EI 1933-0693
J9 J NEUROSURG
JI J. Neurosurg.
PD JAN
PY 2024
VL 140
IS 1
BP 153
EP 163
DI 10.3171/2023.5.JNS2315
PG 11
WC Clinical Neurology; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Surgery
GA KC0M1
UT WOS:001177643500001
PM 37439483
DA 2026-07-24
ER

PT J
AU Graham, JS
   Stevenson, RS
   Mitcheltree, LW
   Hamilton, TA
   Deckert, RR
   Lee, RB
   Schiavetta, AM
AF Graham, John S.
   Stevenson, Robert S.
   Mitcheltree, Larry W.
   Hamilton, Tracey A.
   Deckert, Robin R.
   Lee, Robyn B.
   Schiavetta, Ann M.
TI Medical management of cutaneous sulfur mustard injuries
SO TOXICOLOGY
LA English
DT Article
DE Sulfur mustard; Wound healing; Pig; Skin; Treatment; Medical management
ID HUMAN EPIDERMAL-KERATINOCYTES; IRANIAN VETERANS; LATE COMPLICATIONS;
   LASER DEBRIDEMENT; RANDOMIZED-TRIAL; SKIN-LESIONS; FIBRIN-GLUE; BURNS;
   WOUNDS; GAS
AB Background: Sulfur mustard (2,2'-dichlorodiethyl sulfide; HD) is a potent vesicating chemical warfare agent that poses a continuing threat to both military and civilian populations. Significant cutaneous HD injuries can take several months to heal, necessitate lengthy hospitalizations, and result in long-term complications. There are currently no standardized or optimized methods of casualty management. New strategies are needed to provide for optimal and rapid wound healing.
   Objective: The primary aim of this research was to develop improved clinical strategies (treatment guidelines) for optimal treatment of superficial dermal (second degree) cutaneous HD injuries, with the goal of returning damaged skin to optimal appearance and normal function in the shortest period of time.
   Methods: Superficial dermal HD injuries were created on the ventral abdominal surface of weanling pigs. At 48 h post-exposure, lesions were laser debrided and a treatment adjunct applied. Cultured epithelial allografts and 11 commercial off-the-shelf (COTS) products were examined for their efficacy in improving wound healing of these injuries. Clinical evaluations and a variety of non-invasive bioengineering methods were used at 7 and 14 days post-surgery to follow the progress of wound healing and evaluate various cosmetic and functional properties of the wounds. Measurements included reflectance colorimetry to measure erythema: evaporimetry to examine transepidermal water loss as a method of evaluating barrier function; torsional ballistometry to evaluate the mechanical properties of skin firmness and elasticity; and two-dimensional high frequency ultrasonography (HFU) to monitor skin thickness (e.g., edema, scar tissue). Histopathology and immunohistochemistry were performed 14 days following surgery to examine structural integrity and quality of healing. Logical Decisions (R) for Windows was used to rank the 12 treatment adjuncts that were studied.
   Results: The most efficacious treatment adjuncts included (1) Vacuum Assisted Closure (TM), V.A.C.(R), involving application of topical negative pressure, (2) Amino-Plex (R) Spray (biO(2) Cosmeceuticals International, Inc., Beverly Hills, CA), a nutritive cosmeceutical product that is designed to increase oxygen in cells, stimulate ATP synthesis, improve glucose transportation, stimulate collagen formation, and promote angiogenesis, and (3) ReCell (R) Autologous Cell Harvesting Device (Clinical Cell Culture Americas LLC, Coral Springs. Florida), an innovative medical device that was developed to allow rapid harvesting of autologous cells from a thin split-thickness biopsy followed by spray application of a population of skin cells onto wounds within 30 min of collecting the biopsy, without the need of culturing the keratinocytes in a clinical laboratory.
   Conclusions: Complete re-epithelialization of debrided HD injuries in 7 days is possible. In general, shallow laser debridement through the basement membrane zone (100 mu m) appears to provide better results than deeper debridement (400 mu m) with respect to early re-epithelialization, cosmetic appearance, functional restoration, and structural integrity Of the 12 treatment adjuncts examined, the most promising included Vacuum Assisted Closur (TM), Amino-Plex (R) Spray, and ReCell (R) Autologous Cell Harvesting Device. Published by Elsevier Ireland Ltd.
C1 [Graham, John S.; Stevenson, Robert S.; Deckert, Robin R.] USA, Med Toxicol Branch, Analyt Toxicol Div, Med Res Inst Chem Def, Aberdeen Proving Ground, MD 21010 USA.
   [Mitcheltree, Larry W.; Hamilton, Tracey A.] USA, Comparat Pathol Branch, Div Comparat Med, Med Res Inst Chem Def, Aberdeen Proving Ground, MD 21010 USA.
   [Lee, Robyn B.] USA, Program S3, Strategies & Operat Off, Med Res Inst Chem Def, Aberdeen Proving Ground, MD 21010 USA.
   [Schiavetta, Ann M.] USA, Vet Med & Surg Branch, Div Comparat Med, Med Res Inst Chem Def, Aberdeen Proving Ground, MD 21010 USA.
C3 Research Institute of Chemical Defense - China; Research Institute of
   Chemical Defense - China; Research Institute of Chemical Defense -
   China; Research Institute of Chemical Defense - China
RP Graham, JS (通讯作者)，USA, Med Toxicol Branch, Analyt Toxicol Div, Med Res Inst Chem Def, 3100 Ricketts Point Rd, Aberdeen Proving Ground, MD 21010 USA.
EM john.s.graham1@us.army.mil; rob.stevenson1@us.army.mil;
   larry.mitcheltree@us.army.mil; tracey.hamilton@us.army.mil;
   robin.deckert@us.army.mil; robyn.lee2@us.army.mil;
   ann.schiavetta@us.army.mil
FU Plastic Surgery Associates of Northern Virginia, LTD, McLean, VA
FX The authors wish to thank MAJ Stephen Dalal, D.V.M. and MAJ Ann
   Schiavetta's staff for veterinary support; F. Steven Tucker and staff
   for clinical pathology support; Jamie Martin and staff for histology
   support; and Bruce Freedman, MD, FACS (Plastic Surgery Associates of
   Northern Virginia, LTD, McLean, VA) for guidance in use of the Sciton
   Profile laser.
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NR 49
TC 38
Z9 43
U1 0
U2 20
PU ELSEVIER IRELAND LTD
PI CLARE
PA ELSEVIER HOUSE, BROOKVALE PLAZA, EAST PARK SHANNON, CO, CLARE, 00000,
   IRELAND
SN 0300-483X
J9 TOXICOLOGY
JI Toxicology
PD SEP 1
PY 2009
VL 263
IS 1
SI SI
BP 47
EP 58
DI 10.1016/j.tox.2008.07.067
PG 12
WC Pharmacology & Pharmacy; Toxicology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Pharmacology & Pharmacy; Toxicology
GA 489HX
UT WOS:000269412200010
PM 18762227
DA 2026-07-24
ER

PT J
AU Aimaiti, A
   Wang, B
   Wang, YQ
   Xie, XB
   Zou, CY
   Huang, G
   Yin, JQ
   Shen, JN
   Zhao, ZQ
AF Aimaiti, Aierxiding
   Wang, Bo
   Wang, Yongqian
   Xie, Xianbiao
   Zou, Changye
   Huang, Gang
   Yin, Junqiang
   Shen, Jingnan
   Zhao, Zhiqiang
TI Modified spinopelvic fixation with a novel three-dimensional-printed
   element following total sacrectomy for patients with sacral tumours
SO EUROPEAN SPINE JOURNAL
LA English
DT Article; Early Access
DE Total sacrectomy; Spinopelvic reconstruction; Three-dimensional-printed
   element; Finite-element analysis; Mechanical failure
ID EN-BLOC SACRECTOMY; RECONSTRUCTION; RESECTION
AB ObjectiveTotal sacrectomy is now a standard curative procedure for primary malignant sacral tumours. Reconstruction, however, remains demanding because of the complex regional anatomy and unique biomechanical environment. Several spinopelvic reconstruction techniques have been reported, all yielding satisfactory functional outcomes. This study aims to evaluate both the clinical outcomes and the biomechanical behavior of a modified spinopelvic fixation construct, which incorporates a novel three-dimensional-printed component following total sacrectomy.MethodsWe conducted a retrospective cohort study of 12 consecutive patients (4 men, 8 women; mean age 38 years, range 17-61 years) treated between 2021 and 2024. Eleven patients with primary malignant sacral tumours underwent total en-bloc sacrectomy, and one patient with a giant-cell tumour (GCT) underwent piecemeal resection. All patients received modified spinopelvic reconstruction. Tumour extent was L5-S5 in two patients with recurrent malignant peripheral nerve sheath tumour (MPNST), S1-S5 in eight patients with primary malignancies, S1-S5 in the patient with GCT, and S1-S5 with extension into pelvic zones I/IV in one patient with osteosarcoma. Operative time, oncological outcomes, functional outcomes, complications, and implant status were all reviewed. A finite-element analysis was performed to evaluate the biomechanical behaviour of the novel construct and to compare it with previously described reconstruction models.ResultsAll 12 patients had a confirmed histological diagnosis before surgery. Three osteosarcoma and four malignant peripheral nerve sheath tumour (MPNST) patients received neoadjuvant and postoperative chemotherapy; one giant-cell tumour (GCT) patient was treated with denosumab. Mean operative time was 11.5 h (range 7.5-15 h) and mean intra-operative blood loss was 2,616 ml (range 1,200-4,000 ml). During follow-up, local recurrence was detected in two chordoma cases. Functionally, S1-S5 root transection caused sphincter disturbance in 11 patients; two of these also sacrificed a unilateral L5 root, yet none required colostomy or chronic catheterisation. Nine patients lost dorsiflexion strength. At the latest follow-up, 10 patients could walk independently, and 2 required assistive devices. No major perioperative complications were observed; three patients experienced wound healing complications, which were successfully managed with simple debridement, suturing, and negative pressure wound therapy. Only one overweight patient experienced unilateral iliac screw failure without further revision; the remaining 11 patients had no mechanical complications. Finite-element analysis suggested that the current reconstruction may have favorable load-bearing capacity and stability characteristics compared with previously described models.ConclusionThe modified spinopelvic fixation with the fifth rod and 3D-printing element represents a potential option for anterior column reconstruction after total sacrectomy, with preliminary evidence of satisfactory clinical outcomes in non-overweight patients. Finite-element analysis suggests that the construct may possess adequate stiffness and stability characteristics that could contribute to preventing pelvic-spinal collapse, though these biomechanical findings require further clinical validation.
   Stress values from the finite-element model indicate a theoretically low risk of implant fracture under static loading or fatigue conditions, but long-term follow-up is necessary to confirm implant durability and exclude late complications such as loosening or breakage.
C1 [Aimaiti, Aierxiding; Wang, Bo; Wang, Yongqian; Xie, Xianbiao; Zou, Changye; Huang, Gang; Yin, Junqiang; Shen, Jingnan; Zhao, Zhiqiang] Sun Yat Sen Univ, Affiliated Hosp 1, Dept Musculoskeletal Oncol Ctr, 58 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, Peoples R China.
C3 Sun Yat Sen University
RP Zhao, ZQ (通讯作者)，Sun Yat Sen Univ, Affiliated Hosp 1, Dept Musculoskeletal Oncol Ctr, 58 Zhongshan 2nd Rd, Guangzhou 510080, Guangdong, Peoples R China.
EM aimaiti@mail2.sysu.edu.cn; wangb45@mail.sysu.edu.cn;
   wyongq@mail.sysu.edu.cn; xiexbiao@mail.sysu.edu.cn;
   zouchy@mail.sysu.edu.cn; hgang@mail.sysu.edu.cn;
   yinjunq@mail.sysu.edu.cn; shenjn@mail.sysu.edu.cn;
   zhaozhq7@mail.sysu.edu.cn
FU National Natural Science Foundation of China [82173258]
FX This work was supported by the National Natural Science Foundation of
   China (Grant number 82173258). No other funds, grants, or financial
   support were received for the conduct or preparation of this manuscript.
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NR 30
TC 0
Z9 0
U1 1
U2 1
PU SPRINGER
PI NEW YORK
PA ONE NEW YORK PLAZA, SUITE 4600, NEW YORK, NY, UNITED STATES
SN 0940-6719
EI 1432-0932
J9 EUR SPINE J
JI Eur. Spine J.
PD 2026 JUN 9
PY 2026
DI 10.1007/s00586-026-10008-0
EA JUN 2026
PG 12
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA JD6HM
UT WOS:001786821700001
PM 42260154
DA 2026-07-24
ER

PT J
AU DiPaola, CP
   Saravanja, DD
   Boriani, L
   Zhang, HB
   Boyd, MC
   Kwon, BK
   Paquette, SJ
   Dvorak, MFS
   Fisher, CG
   Street, JT
AF DiPaola, Christian P.
   Saravanja, Davor D.
   Boriani, Luca
   Zhang, Hongbin
   Boyd, Michael C.
   Kwon, Brian K.
   Paquette, Scott J.
   Dvorak, Marcel F. S.
   Fisher, Charles G.
   Street, John T.
TI Postoperative Infection Treatment Score for the Spine (PITSS):
   construction and validation of a predictive model to define need for
   single versus multiple irrigation and debridement for spinal surgical
   site infection
SO SPINE JOURNAL
LA English
DT Article
DE Surgical site infection; Irrigation and debridement; Spinal wound
   management
ID RESISTANT STAPHYLOCOCCUS-AUREUS; RISK-FACTORS; WOUND-INFECTION; ELUTION
   CHARACTERISTICS; BONE-CEMENT; SURGERY; COMPLICATIONS; EPIDEMIOLOGY;
   TOBRAMYCIN; MANAGEMENT
AB BACKGROUND CONTEXT: There is very little evidence to guide treatment of patients with spinal surgical site infection (SSI) who require irrigation and debridement (I&D) in deciding need for single or multiple I&Ds or more complex wound management such as vacuum-assisted closure dressing or soft-tissue flaps.
   PURPOSE: The purpose of this study was to build a predictive model that stratifies patients with spinal SSI, allowing us to determine which patients will need single versus multiple I&D. The model will be validated and will serve as evidence to support a scoring system to guide treatment.
   STUDY DESIGN: A consecutive series of 128 patients from a tertiary spine center (collected from 1999 to 2005) who required I&D for spinal SSI were studied based on data from a prospectively collected outcomes database.
   METHODS: More than 30 variables were identified by extensive literature review as possible risk factors for SSI and tested as possible predictors of risk for multiple I&D. Logistic regression was conducted to assess each variable's predictability by a "bootstrap" statistical method. A prediction model was built in which single or multiple I&D was treated as the "response" and risk factors as "predictors." Next, a second series of 34 different patients meeting the same criteria as the first population were studied. External validation of the predictive model was performed by applying the model to the second data set, and predicted probabilities were generated for each patient. Receiver operating characteristic curves were constructed, and the area under the curve (AUC) was calculated.
   RESULTS: Twenty-four of one hundred twenty-eight patients with spinal SSI required multiple I&D. Six predictors: anatomical location, medical comorbidities, specific microbiology of the SSI, the presence of distant site infection (ie, urinary tract infection or bacteremia), the presence of instrumentation, and the bone graft type proved to be the most reliable predictors of need for multiple I&D. Internal validation of the predictive model yielded an AUC of 0.84. External validation analysis yielded AUC of 0.70 and 95% confidence interval of 0.51 to 0.89. By setting a probability cutoff of .24, the negative predictive value (NPV) for multiple I&D was 0.77 and positive predictive value (PPV) was 0.57. A probability cutoff of .53 yielded a PPV of 0.85 and NPV of 0.46.
   CONCLUSIONS: Patients with positive methicillin-resistant Staphylococcus aureus culture or those with distant site infection such as bacteremia were strong predictors of need for multiple I&D. Presence of instrumentation, location of surgery in the posterior lumbar spine, and use of non-autograft bone graft material predicted multiple I&D. Diabetes also proved to be the most significant medical comorbidity for multiple I&D. The validation of this predictive model revealed excellent PPV and good NPV with appropriately chosen probability cutoff points. This study forms the basis for an evidence-based classification system, the Postoperative Infection Treatment Score for the Spine that stratifies patients who require surgery for SSI, based on specific spine, patient, infection, and surgical factors to assess a low, indeterminate, and high risk for the need for multiple I&D. (C) 2012 Elsevier Inc. All rights reserved.
C1 [DiPaola, Christian P.] Univ Massachusetts, Med Ctr, Dept Orthopaed, Worcester, MA 01605 USA.
   [Saravanja, Davor D.] Sydney Childrens Hosp, Dept Orthopaed, Randwick, NSW 2031, Australia.
   [Zhang, Hongbin; Boyd, Michael C.; Kwon, Brian K.; Paquette, Scott J.; Dvorak, Marcel F. S.; Fisher, Charles G.; Street, John T.] Univ British Columbia, Dept Orthopaed, Combined Neurosurgery & Orthopaed Spine Program, Vancouver, BC V5Z 1M9, Canada.
   [Boriani, Luca] Dept Orthopaed, I-41026 Pavullo Nel Frignano Mod, Italy.
C3 University of Massachusetts System; University of Massachusetts
   Worcester; NSW Health; Sydney Childrens Hospitals Network; University of
   British Columbia
RP DiPaola, CP (通讯作者)，Univ Massachusetts, Med Ctr, Dept Orthopaed, 119 Belmont St, Worcester, MA 01605 USA.
EM Christian.dipaola@umassmemorial.org
RI ; Boriani, Luca/AAB-2696-2019
OI Dvorak, Marcel/0000-0002-9404-8448; Boriani, Luca/0000-0002-7069-7638
FU Medtronic; University of British Columbia; Depuy Spine; Rick Hansen
   Institute; Synthes; Depuy
FX Author disclosures: CPD: Consulting: Depuy Spine (B), Allen Medical (B);
   Speaking/Teaching Arrangements: Medtronic (B); Research Support
   (Staff/Materials): Medtronic (B). DDS: Trips/Travel: K2M-Depuy
   (Nonfinancial, Paid directly to institution/employer). LB: Nothing to
   disclose. HZ: Nothing to disclose. MCB: Nothing to disclose. BKK:
   Consulting: Medtronic (D); Fellowship Support: Medtronic (D, Paid
   directly to institution/employer). SJP: Nothing to disclose. MFSD:
   Royalties: Medtronic (D); Stock Ownership: Medtronic (10 shares);
   Consulting: Medtronic (F); Speaking/Teaching Arrangements: Medtronic
   (Financial); Trips/Travel: Medtronic (Financial); Scientific Advisory
   Board: Medtronic (Financial); Endowments: University of British Columbia
   (B); Research Support (Staff/Materials): Medtronic (E); Grants:
   Medtronic (D), Depuy Spine (G), Rick Hansen Institute (H); Fellowship
   Support: Medtronic (E), Synthes (E), Depuy (E). CGF: Royalties:
   Medtronic (D); Consulting: Medtronic (F, Paid directly to
   institution/employer); Speaking/Teaching Arrangements: Medtronic, Depuy,
   AO (Nonfinancial, Paid directly to institution/employer); Trips/Travel:
   Medtronic (Nonfinancial), AO (Nonfinancial), Depuy (Nonfinancial);
   Research Support (Staff/Materials): Medtronic, Depuy (E, Paid directly
   to institution/employer); Fellowship Support: Medtronic, Synthes (F,
   Paid directly to institution/employer). JTS: Nothing to disclose.
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NR 47
TC 47
Z9 62
U1 0
U2 14
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 1529-9430
EI 1878-1632
J9 SPINE J
JI Spine Journal
PD MAR
PY 2012
VL 12
IS 3
BP 218
EP 230
DI 10.1016/j.spinee.2012.02.004
PG 13
WC Clinical Neurology; Orthopedics
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Neurosciences & Neurology; Orthopedics
GA 919US
UT WOS:000302355600009
PM 22386957
DA 2026-07-24
ER

PT J
AU Wöhler, A
   Schwab, R
   Güsgen, C
   Schaaf, S
   Weitzel, C
   Jänig, C
   Willms, A
AF Woehler, Aliona
   Schwab, Robert
   Guesgen, Christoph
   Schaaf, Sebastian
   Weitzel, Carolin
   Jaenig, Christoph
   Willms, Arnulf
TI Diagnosis and Treatment of Severe Fournier's Gangrene: Introduction of a
   Surgical Approach, Evaluation of Risk Factors, Microbiological
   Characteristics and Review of the Literature
SO ZENTRALBLATT FUR CHIRURGIE
LA German
DT Review
DE Fournier&#700; s gangrene; Fournier&#700; s Gangrene Severity Index
   (FGSI); mortality; surgery
AB Zusammenfassung
   Hintergrund Die Fournier-Gangran ist eine nekrotisierende Fasziitis Typ I der genitalen und perinealen Regionen, die insbesondere bei schweren Verlaufen und systemischer Sepsis mit einer hohen Letalitat vergesellschaftet ist. Der Schwerpunkt wurde auf die Evaluation der Risikofaktoren und Komorbiditaten, auf das bakteriologische Spektrum, laborchemische Analysen, Mortalitat und den Verlauf nach dem algorithmischen Vorgehen gelegt.
   Material und Methoden Es wurden 10 Patienten am Bundeswehrzentralkrankenhaus Koblenz im Zeitraum von 2010 bis 2019 mit einer Fournier-Gangran und Sepsis sowie einer mindestens 48-stundigen Intensivtherapie erfasst und deskriptiv analysiert.
   Ergebnisse Die Patientenkohorte bestand aus 6 mannlichen und 4 weiblichen Patienten mit einem Durchschnittsalter von 62 Jahren (Range 42-78 Jahre). Der durchschnittliche Zeitpunkt zwischen Auftreten der Beschwerden und der Krankenhausaufnahme betrug 4 Tage (Range 3-5). Die haufigste Genese war ein Bagatelltrauma bei bestehender entgleister Diabeteserkrankung (30%). Diabetes mellitus (60%) und Adipositas (80% mit BMI>25) waren fuhrende Risikofaktoren. Bei 90% der Patienten bestand eine polymikrobielle Besiedlung. Alle Patienten wiesen eine Multiorgandysfunktion auf und hatten einen SOFA-Score zwischen 3 und 17 Punkten. Die Mortalitatsrate betrug in unserem Patientenkollektiv 40%. Signifikante Unterschiede zwischen uberlebenden und verstorbenen Patienten zeigten PCT, INR und aPTT (p<0,05).
   Schlussfolgerung Die Fournier-Gangran ist insbesondere bei septischem Verlauf nach wie vor eine Erkrankung mit hoher Letalitatsrate. Bei foudroyantem Verlauf bedarf es einer unmittelbaren Diagnosestellung sowie eines aggressiven operativen Vorgehens, um die Letalitat so gering wie moglich zu halten. Nach initialem radikalem Debridement sowie stabilisierenden intensivmedizinischen Ma<ss>nahmen folgen weitere operative Eingriffe. In der postakuten Phase hat sich die Anwendung der Vakuumtherapie zur Defektverkleinerung bewahrt.
   Abstract
   Background Fourniers gangrene is a necrotising fasciitis type I occurring in the perineal and genital region. The disease expands progressively and still has poor outcome, especially in critical ill patients. This studys focus was placed on the evaluation of risk factors and comorbidities, on the bacteriological spectrum, laboratory analyses, mortality and the course according to the algorithmic approach.
   Method The medical records were reviewed of 10 patients with severe Fourniers gangrene from 2010 to 2019 who underwent intensive care therapy for at least 48 hours. Ten patients with Fourniers gangrene and sepsis and intensive therapy lasting at least 48 hours were recorded and analysed descriptively.
   Results The patient cohort consisted of six men and four women with a median age of 62 years (range 42-78 years). The median time between the onset of symptoms and hospitalisation was four days (range 3-5 days). The commonest aetiological event was a minor trauma. Predisposing factors included diabetes mellitus (30%) and overweight (80% BMI>25). 90% of patients exhibited polymicrobial infection. All patients had systemic sepsis with SOFA-Score between 3 and 17 points. The mortality rate was 40%. Significant differences between surviving and deceased patients were shown by PCT, INR and aPTT (p<0.05).
   Conclusion Severe Fourniers gangrene continues to be a major challenge with a high mortality rate. Only rapid diagnosis, urgent extensive surgical debridement and intensive care therapy can lead to a favourable outcome in these critically ill patients. Vacuum-assisted closure can be successfully used in the management of soft-tissue defects.
C1 [Woehler, Aliona; Schwab, Robert; Guesgen, Christoph; Schaaf, Sebastian; Weitzel, Carolin; Willms, Arnulf] Bundeswehrzentralkrankenhaus Koblenz, Klin Allgemein Viszeral & Thoraxchirurg, Rubenacher Str 170, D-56064 Koblenz, Germany.
   [Jaenig, Christoph] Bundeswehrzentralkrankenhaus Koblenz, Klin Anasthesie Intensivmed & Notfallmed, Koblenz, Germany.
RP Willms, A (通讯作者)，Bundeswehrzentralkrankenhaus Koblenz, Klin Allgemein Viszeral & Thoraxchirurg, Rubenacher Str 170, D-56064 Koblenz, Germany.
EM ArnulfWillms@gmx.de
RI ; /AFN-0812-2022
OI Aliona, Woehler/0000-0002-0225-5950; 
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NR 51
TC 1
Z9 2
U1 0
U2 4
PU GEORG THIEME VERLAG KG
PI STUTTGART
PA Oswald-Hesse-Strasse 50, D-70469 STUTTGART, GERMANY
SN 0044-409X
EI 1438-9592
J9 ZBL CHIR
JI Zent.bl. Chir.
PD OCT
PY 2022
VL 147
IS 05
BP 480
EP 491
DI 10.1055/a-1319-1734
EA FEB 2021
PG 12
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Surgery
GA 5E7WH
UT WOS:000615971500003
PM 33556981
DA 2026-07-24
ER

PT J
AU Bedi, M
   King, DM
   DeVries, J
   Hackbarth, DA
   Neilson, JC
AF Bedi, Meena
   King, David M.
   DeVries, John
   Hackbarth, Donald A.
   Neilson, John C.
TI Does Vacuum-assisted Closure Reduce the Risk of Wound Complications in
   Patients With Lower Extremity Sarcomas Treated With Preoperative
   Radiation?
SO CLINICAL ORTHOPAEDICS AND RELATED RESEARCH
LA English
DT Article; Proceedings Paper
CT Annual Meeting of the Musculoskeletal-Tumor-Society (MSTS)
CY SEP 27-29, 2017
CL Denver, CO
SP Musculoskeletal Tumor Soc
ID SOFT-TISSUE SARCOMA; SURGICAL SITE INFECTIONS; THERAPY; RADIOTHERAPY;
   IRRADIATION; PARADOX; SURGERY
AB Background Although preoperative radiation followed by wide local excision yields excellent local control in soft tissue sarcomas, the risk of wound complications is reported to be higher compared with the incidence in patients who were administered postoperative radiation therapy. Vacuum (vac)-assisted closure may improve wound healing, but it is unknown whether vac-assisted closure during soft tissue sarcoma resection may reduce the risk of wound complications or impair local disease control.
   Questions/purposes (1) Does the use of a wound vac application at the time of soft tissue sarcoma resection reduce the risk of developing wound complications after lower extremity sarcoma resection? (2) Is vac-assisted closure associated with an increased risk of local relapse?
   Methods From 2000 to 2016, 312 patients with stage I to III soft tissue sarcomas were treated. Of these, 123 were treated with preoperative radiation +/- chemotherapy followed by limb-sparing resection based on tumor location, size, grade, histology, and patient age. There was a minimum followup of 12 months. Radiation was delivered generally based on tumor size, grade, superficial versus deep nature, and proximity to neurovascular structures. Chemotherapy was administered in patients < 70 years old with high-grade tumors and tumors > 5 cm. Patient, demographic, and treatment variables, including incisional vac application and wound outcomes, were retrospectively evaluated. Incisional vac-assisted closure took place at the time of primary resection in 32% (46 of 123) of patients. Vac-assisted closure was considered when there was a concern for risk of external contamination such as instances in which fixation of adhesives would be difficult or regions where there was a high risk of contamination. Vac-assisted closure may have also been used in instances with increased wound tension at closure or with heightened concern for shearing on the wound such as buttock wounds. Ten patients were lost to followup, two in the vac group and eight in the non-vac group. Potential factors associated with wound complications were evaluated using Fisher's exact test for univariate analysis and logistic regression for multivariate analysis. Local recurrence-free survival was evaluated using the Kaplan-Meier estimate.
   Results After taking into consideration factors such as tumor size, location, age, and patient comorbidities, it was shown that patients who underwent vac-assisted closure were less likely to experience wound complications compared with patients who did not undergo vac-assisted closure (odds ratio, 0.129; 95% confidence interval [CI], 0.041-0.398; p = 0.004). The local control incidence in the entire cohort was 98%. With the numbers available, Kaplan-Meier survivorship free from local recurrence did not differ between patients treated with or without the vac (100% [95% CI, 154.09-154.09] versus 96% [95% CI, 152.21-169.16]; p = 0.211), respectively.
   Conclusions Vac-assisted closure at the time of resection of proximal lower extremity soft tissue sarcomas is associated with a lower risk of wound complications, and its use apparently did not compromise local control. We show that the use of vac-assisted closure may be worth considering in surgeons' attempts to reduce the risk of wound complications among patients with soft tissue sarcomas of the proximal lower extremities.
   Level of Evidence Level III, therapeutic study.
C1 [Bedi, Meena] Med Coll Wisconsin, Dept Radiat Oncol, Milwaukee, WI 53226 USA.
   [King, David M.; DeVries, John; Hackbarth, Donald A.; Neilson, John C.] Med Coll Wisconsin, Dept Orthopaed Surg, 8700 W Wisconsin Ave, Milwaukee, WI 53226 USA.
   [Bedi, Meena] Med Coll Wisconsin, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA.
C3 Medical College of Wisconsin; Medical College of Wisconsin; Medical
   College of Wisconsin
RP Bedi, M (通讯作者)，Med Coll Wisconsin, 9200 West Wisconsin Ave, Milwaukee, WI 53226 USA.
EM mbedi@mcw.edu
RI Neilson, John/HJP-9461-2023
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NR 21
TC 36
Z9 41
U1 0
U2 1
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0009-921X
EI 1528-1132
J9 CLIN ORTHOP RELAT R
JI Clin. Orthop. Rel. Res.
PD APR
PY 2019
VL 477
IS 4
BP 768
EP 774
DI 10.1097/CORR.0000000000000371
PG 7
WC Orthopedics; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Orthopedics; Surgery
GA IE8FI
UT WOS:000472608900020
PM 30811365
DA 2026-07-24
ER

PT J
AU Zoghbi, V
   Caskey, RC
   Dumon, KR
   Ballester, JMS
   Brooks, AD
   Morris, JB
   Dempsey, DT
AF Zoghbi, Veronica
   Caskey, Robert C.
   Dumon, Kristoffel R.
   Ballester, Jacqueline M. Soegaard
   Brooks, Ari D.
   Morris, Jon B.
   Dempsey, Daniel T.
TI "How To" Videos Improve Residents Performance of Essential Perioperative
   Electronic Medical Records and Clinical Tasks
SO JOURNAL OF SURGICAL EDUCATION
LA English
DT Article
DE electronic medical records; instructional films and videos; mobile
   applications; medical simulation; internship and residency
ID DECISION-SUPPORT; PRIMARY-CARE; INFORMATION; TECHNOLOGY; EDUCATION;
   IMPACT
AB OBJECTIVE: The ability to use electronic medical records (EMR) is an essential skill for surgical residents. However, frustration and anxiety surrounding EMR tasks may detract from clinical performance. We created a series of brief, 1-3 minutes "how to" videos demonstrating 7 key perioperative EMR tasks: booking OR cases, placing preprocedure orders, ordering negative-pressure wound dressing supplies, updating day-of-surgery history and physical notes, writing brief operative notes, discharging patients from the postanesthesia care unit, and checking vital signs. Additionally, we used "Cutting Insights"-a locally developed responsive mobile application for surgical trainee education-as a platform for providing interns with easy access to these videos. We hypothesized that exposure to these videos would lead to increased resident efficiency and confidence in performing essential perioperative tasks, ultimately leading to improved clinical performance.& para;& para;METHODS: Eleven surgery interns participated in this initiative. Before watching the "how to" videos, each intern was timed performing the aforementioned 7 key perioperative EMR tasks. They also underwent a simulated perioperative emergency requiring the performance of 3 of these EMR tasks in conjunction with 5 other required interventions (including notifying the chief resident, the anesthesia team, and the OR coordinator; and ordering fluid boluses, appropriate laboratories, and blood products). These simulations were scored on a scale from 0 to 8. The interns were then directed to watch the videos. Two days later, their times for performing the 7 tasks and their scores for a similar perioperative emergency simulation were once again recorded. Before and after watching the videos, participants were surveyed to assess their confidence in performing each EMR task using a 5-point Likert scale. We also elicited their opinions of the videos and web-based mobile application using a 5-point scale. Statistical analyses to assess for statistical significance (p <= 0.05) were conducted using paired t-test for parametric variables and a Wilcoxon matched-pair test for nonparametric variables.& para;& para;SETTING: Hospital of the University of Pennsylvania, Philadelphia, PA (a quaternary teaching hospital within the University of Pennsylvania Health System).
   & para;& para;PARTICIPANTS: Eleven out of 15 interns (12 entered and 11 completed the study) from our categorical and preliminary general surgery residency programs during the 2016 academic year.& para;& para;RESULTS: Before exposure to the brief "how to" videos, 6 of 11 interns were unable to complete all 7 EMR tasks; after exposure, all 11 interns were able to complete all 7 EMR tasks. Moreover, interns' times for each task improved following exposure. Interns self-reported improved confidence in booking an OR case (4 +/- 0.9 vs. 4.7 +/- 0.6, p = 0.05), ordering negative-pressure wound therapy supplies (3.1 +/- 1.6 vs. 4.5 +/- 0.7, p < 0.05), writing a brief operative note (3.7 +/- 1.2 vs. 4.6 +/- 0.7, p = 0.05), discharging patients from the postanesthesia care unit (3.3 +/- 1.0 vs. 4.4 +/- 0.8, p < 0.05), checking vital signs (2.5 +/- 1.4 vs. 4.5 +/- 0.8, p <= 0.01), and performing necessary EMR tasks during an emergency situation (2.4 +/- 0.8 vs. 4.6 +/- 0.7, p <= 0.0001). Participants also demonstrated a significant improvement in average clinical score on the emergency simulations (5.2 +/- 1.7 vs. 6.6 +/- 0.9, p < 0.05). Interns' opinions of the videos and the mobile phone application were favorable.& para;& para;CONCLUSIONS: In our group of 11 surgery interns, exposure to a series of short "how to" videos led to increased confidence and shortened times in performing 7 essential EMR tasks. Additionally, during a simulated perioperative emergency, EMR tasks were performed significantly faster. Clinical performance also improved significantly following exposure to the videos. This just-in-time educational intervention could improve workflow efficiency and clinical performance, both of which may ultimately enhance perioperative patient safety. (C) 2017 Published by Elsevier Inc. on behalf of the Association of Program Directors in Surgery
C1 [Zoghbi, Veronica; Dempsey, Daniel T.] Hosp Univ Penn, Dept Perioperat Serv, 3400 Spruce St, Philadelphia, PA 19104 USA.
   [Caskey, Robert C.; Dumon, Kristoffel R.] Univ Penn, Perelman Sch Med, Penn Med Simulat Ctr, Philadelphia, PA 19104 USA.
   [Dumon, Kristoffel R.; Brooks, Ari D.; Morris, Jon B.] Univ Penn, Dept Surg, Perelman Sch Med, Div Surg Educ, 3400 Spruce St,Silverstein Bldg,4th Floor, Philadelphia, PA 19104 USA.
   [Ballester, Jacqueline M. Soegaard; Dempsey, Daniel T.] Univ Penn, Dept Surg, Perelman Sch Med, Philadelphia, PA 19104 USA.
C3 University of Pennsylvania; University of Pennsylvania; University of
   Pennsylvania; University of Pennsylvania
RP Dumon, KR (通讯作者)，Univ Penn, Dept Surg, Perelman Sch Med, Div Surg Educ, 3400 Spruce St,Silverstein Bldg,4th Floor, Philadelphia, PA 19104 USA.
EM Kristoffel.Dumon@uphs.upenn.edu
OI Caskey, Robert/0009-0009-3143-5262; Brooks, Ari/0000-0003-4328-7307
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NR 20
TC 11
Z9 14
U1 0
U2 5
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA 360 PARK AVE SOUTH, NEW YORK, NY 10010-1710 USA
SN 1931-7204
EI 1878-7452
J9 J SURG EDUC
JI J. Surg. Educ.
PD MAR-APR
PY 2018
VL 75
IS 2
BP 489
EP 496
DI 10.1016/j.jsurg.2017.07.009
PG 8
WC Education, Scientific Disciplines; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Education & Educational Research; Surgery
GA GC9RP
UT WOS:000430136800033
PM 28801082
DA 2026-07-24
ER

PT J
AU Jacobs, AK
AF Jacobs, Alice K.
CA Amer Assoc Thoracic Surg
   Soc Cardiovasc Anesthesiologists
   Soc Thoracic Surg
TI 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery:
   Executive Summary A Report of the American College of Cardiology
   Foundation/American Heart Association Task Force on Practice Guidelines
SO ANESTHESIA AND ANALGESIA
LA English
DT Article
ID ACUTE MYOCARDIAL-INFARCTION; LONG-TERM SURVIVAL; VACUUM-ASSISTED
   CLOSURE; PREOPERATIVE STATIN THERAPY; ACUTE-RENAL-FAILURE;
   TRANSMYOCARDIAL LASER REVASCULARIZATION; DRUG-ELUTING STENTS; HIGH-RISK
   PATIENTS; INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY; MODERATE
   AORTIC-STENOSIS
AB The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.
   The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly produced guidelines in the area of cardiovascular disease since 1980. The ACCF/AHA Task Force on Practice Guidelines (Task Force), charged with developing, updating, and revising practice guidelines for cardiovascular diseases and procedures, directs and oversees this effort. Writing committees are charged with regularly reviewing and evaluating all available evidence to develop balanced, patient-centric recommendations for clinical practice.
   Experts in the subject under consideration are selected by the ACCF and AHA to examine subject-specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a formal literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include
   [GRAPHICS]
   estimates of expected outcomes where such data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered. When available, information from studies on cost is considered, but data on efficacy and outcomes constitute the primary basis for the recommendations contained herein.
   In analyzing the data and developing recommendations and supporting text, the writing committee uses evidence-based methodologies developed by the Task Force. 1 The Class of Recommendation (COR) is an estimate of the size of the treatment effect considering risks versus benefits in addition to evidence and/or agreement that a given treatment or procedure is or is not useful/effective or in some situations may cause harm. The Level of Evidence (LOE) is an estimate of the certainty or precision of the treatment effect. The writing committee reviews and ranks evidence supporting each recommendation with the weight of evidence ranked as LOE A, B, or C according to specific definitions that are included in Table 1. Studies are identified as observational, retrospective, prospective, or randomized where appropriate. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C. When recommendations at LOE C are supported by historical clinical data, appropriate references (including clinical reviews) are cited if available. For issues for which sparse data are available, a survey of current practice among the clinicians on the writing committee is the basis for LOE C recommendations, and no references are cited. The schema for COR and LOE is summarized in Table 1, which also provides suggested phrases for writing recommendations within each COR. A new addition to this methodology is separation of the Class III recommendations to delineate if the recommendation is determined to be of "no benefit" or is associated with "harm" to the patient. In addition, in view of the increasing number of comparative effectiveness studies, comparator verbs and suggested phrases for writing recommendations for the comparative effectiveness of one treatment or strategy versus another have been added for COR I and IIa, LOE A or B only.
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NR 504
TC 0
Z9 0
U1 0
U2 11
PU LIPPINCOTT WILLIAMS & WILKINS
PI PHILADELPHIA
PA TWO COMMERCE SQ, 2001 MARKET ST, PHILADELPHIA, PA 19103 USA
SN 0003-2999
J9 ANESTH ANALG
JI Anesth. Analg.
PD JAN
PY 2012
VL 114
IS 1
BP 11
EP 45
DI 10.1213/ANE.0b013e3182407c25
PG 35
WC Anesthesiology
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Anesthesiology
GA 866UM
UT WOS:000298410400004
DA 2026-07-24
ER

PT J
AU Gross, JL
   Goldman, MP
   Farrah, JP
   Miller, PR
AF Gross, Jessica L.
   Goldman, Matthew P.
   Farrah, Jason P.
   Miller, Preston R.
TI The Wandering Bullet
SO AMERICAN SURGEON
LA English
DT Article; Proceedings Paper
CT Annual Scientific Meeting and Postgraduate Course Program of the
   Southeastern-Surgical-Congress
CY FEB 22-25, 2014
CL Savannah, GA
SP SE Surg Congress
AB Bullet emboli are an uncommon complication of penetrating trauma. Bullet embolism has been reported from both arterial and venous circulation. Many agree that arterial emboli should be extracted, but reports in the literature suggest that venous embolisms can either be observed or removed through an open or endovascular technique. 1, (2)Bullet extraction is recommended when the bullet enters the gastrointestinal tract. (2)We present a case of bullet embolism leading to pulmonary necrosis and need for lobectomy. Both endovascular and open attempts at removal of the bullet embolism were unsuccessful. The initial open procedure was complicated by bulletmigration into the right pulmonary artery leading to additional pulmonary necrosis necessitating an additional pulmonary resection. The bullet was ultimately removed at the time of the second thoracotomy.
   The patient was a 23-year-old woman who was shot in the right chest right below the inframammary crease. Chest radiography in the trauma bay showed a bullet near the left hilum without hemopneumothorax (Fig. 1A). Ultrasonography to evaluate the pericardium revealed absence of pericardial fluid. Soon after ultrasonography, the patient became hypotensive and tachycardic and was taken emergently to the operating room for exploration. Laparotomy was performed and revealed missile injury to the right lobe of the liver, a small injury to the anterior wall of the second portion of the duodenum, a through-and-through injury to the head of the pancreas, and a through-and-through injury of the vena cava. The inferior vena cava injury was repaired with a 3-0 Prolene suture. A primary repair of the anterior duodenal wall was performed and drains were placed around the pancreatic injury. As a result ofthe patient's hemodynamic instability, the decision was made to pack the abdomen and leave the peritoneal cavity open with a vacuum-assisted closure device. It was determined that the bullet had embolized to the left lung vasculature through the inferior vena cava and no attempt was made to retrieve the bullet at the time of the damage control laparotomy. The patient was taken to the trauma intensive care unit for further resuscitation; however, soon after, the patient was taken emergently back to the operating room for bleeding. The abdomen was again packed and left open.
   Two weeks after admission, imaging showed an infarction of her left lower lobe and the patient underwent a left thoracotomy with left lower lobectomy and attempt at bullet removal. Unfortunately, a postoperative chest radiograph showed the bullet had migrated into her right pulmonary artery (Fig. 1B). The next day (hospital Day 15; Fig. 2A), the patient went to the interventional radiology suite and despite multiple attempts with various wires, catheters, snares, and a Fogarty balloon, efforts to retrieve the retained bullet were unsuccessful. A month later (hospital Day 41; Fig. 2B), the patient went back to interventional radiology for another attempt at endovascular removal of the bullet. A guidewire was positioned distal to the bullet; however, attempts to remove the bullet with either a snare or a balloon were unsuccessful. The next week, cardiothoracic surgery and interventional cardiology performed a combined procedure, which included venovenous bypass with suctioning, but they too were unable to remove the bullet. Ultimately, the patient was taken to the operating room eight weeks after admission for a right thoracotomy with right lower lobectomy. The operative specimen included the retained bullet (Fig. 2C). The patient was eventually discharged to a rehabilitation center one week later.
   Bullet embolization should be suspected when the number of entry wounds does not match the number of exit wounds or the radiographic evidence does not correspond with the suspected pathway of the bullet. Embolization is an infrequent complication of penetrating injuries caused by gunshot wounds; thus, thereare no management guidelines in the literature. It is generally accepted that bullets with arterial embolization should be extracted as a result of risk of ischemia. Venous bullet embolisms have been managed both through extraction and observation. In considering bullets that have embolized in the pulmonary vasculature, both observation and bullet extraction have been reported in the literature; however, the bullet should be removed either through an endovascular or open technique if complications arise. (1, 2)
   In the present case, the bullet embolized from the inferior vena cava to the left pulmonary artery. The presence of the bullet in the left pulmonary artery ultimately resulted in infarction of the left lower lobe and the patient underwent a left lower lobectomy. Unfortunately for the patient, the bullet migrated into the right pulmonary artery during the surgery. Multiple endovascular attempts were performed to remove the bullet so not to subject the patient to a second thoracotomy; however, these attempts were unsuccessful and the patient ultimately infarcted her right lower lobe and underwent a right thoracotomy with right lowerlobectomy. The bullet was successfully removed during this procedure.
   Bullet embolisms can be successfully managed with observation unless complications arise. Physicians should be aware that the bullets may migrate from their current position weeks after the primary insult.
C1 [Gross, Jessica L.; Goldman, Matthew P.; Farrah, Jason P.; Miller, Preston R.] Wake Forest Baptist Med Ctr, Dept Surg, Winston Salem, NC 27157 USA.
C3 Wake Forest University; Wake Forest Baptist Medical Center
RP Gross, JL (通讯作者)，Wake Forest Baptist Med Ctr, Med Ctr Blvd, Winston Salem, NC 27157 USA.
EM jgross@wakehealth.edu
CR Bertoldo U, 2004, J TRAUMA, V57, P187, DOI 10.1097/01.TA.0000135490.10227.5C
   Miller KR, 2011, INJURY, V42, P441, DOI 10.1016/j.injury.2010.08.006
NR 2
TC 6
Z9 6
U1 0
U2 5
PU SOUTHEASTERN SURGICAL CONGRESS
PI CUMMING
PA 115 SAMARITAN DR, #200, CUMMING, GA 30040-2354 USA
SN 0003-1348
EI 1555-9823
J9 AM SURGEON
JI Am. Surg.
PD JUL
PY 2014
VL 80
IS 7
BP E196
EP E197
PG 2
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA AK2WX
UT WOS:000338282000006
PM 24987883
DA 2026-07-24
ER

PT J
AU Cristino, MAB
   Nakano, LCU
   Vasconcelos, V
   Correia, RM
   Flumignan, RLG
AF Cristino, Mateus A. B.
   Nakano, Luis C. U.
   Vasconcelos, Vladimir
   Correia, Rebeca M.
   Flumignan, Ronald L. G.
TI Prevention of infection in aortic or aortoiliac peripheral arterial
   reconstruction
SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS
LA English
DT Review
DE Anti-Bacterial Agents [therapeutic use]; Aorta [surgery]; Aortic
   Aneurysm [surgery]; Bias; Iliac Artery [surgery]; Peripheral Arterial
   Disease [surgery]; Randomized Controlled Trials as Topic; Surgical Wound
   Infection [prevention & control]; Vascular Surgical Procedures [adverse
   effects]; Aged; Humans
ID PERIOPERATIVE ANTIBIOTIC-PROPHYLAXIS; NEGATIVE-PRESSURE THERAPY;
   RANDOMIZED CLINICAL-TRIAL; SURGICAL SITE INFECTIONS; VASCULAR-SURGERY;
   DOUBLE-BLIND; ANTIMICROBIAL PROPHYLAXIS; WOUND-INFECTION;
   COST-EFFECTIVENESS; HEALTH-CARE
AB Background
   Peripheral arterial disease (PAD) results from the narrowing of arteries. Aortic aneurysms abnormal dilatations in artery walls are a related concern. For severe cases, arterial reconstruction surgery is the treatment option. Surgical site infections (SSIs) are a feared and common complication of vascular surgery. These infections have a significant global healthcare impact. Evaluating the effectiveness of preventive measures is essential.
   Objectives
   To assess the effects of pharmacological and non-pharmacological interventions, including antimicrobial therapy, antisepsis, and wound management, for the prevention of infection in people undergoing any open or hybrid aortic or aortoiliac peripheral arterial reconstruction.
   Search methods
   The Cochrane Vascular Information Specialist searched the Cochrane Vascular Specialised Register, CENTRAL, MEDLINE, Embase, and CINAHL databases, and the World Health Organization International Clinical Trials Registry Platform, LILACS, and ClinicalTrials.gov up to 11 November 2024.
   Selection criteria
   We included all randomised controlled trials (RCTs) with a parallel (e.g. cluster or individual) or split-body design, and quasi-RCTs, which assessed any intervention to reduce or prevent infection following aortic or aortoiliac procedures for the treatment of aneurysm or PAD. There were no limitations regarding age and sex.
   Data collection and analysis
   We used standard Cochrane methodological procedures. Two review authors independently extracted the data and assessed the risk of bias of the trials. A third review author resolved disagreements when necessary. We assessed the evidence certainty for key outcomes using GRADE.
   Main results
   We included 21 RCTs with 4952 participants. Fifteen studies were assessed as having a high risk of bias in at least one domain, and 19 studies had an unclear risk of bias in at least one domain. We analysed 10 different comparisons for eight different outcomes. The comparisons were antibiotic versus placebo or no treatment; short-duration antibiotics (= 24 hours) versus long-duration antibiotics (> 24 hours); different types of systemic antibiotics (one versus another); antibiotic-bonded implant versus standard implant; Dacron graft versus stretch polytetrafluoroethylene graft; prophylactic closed suction drainage versus undrained wound; individualised goal-directed therapy (IGDT) versus fluid therapy based on losses, standard haemodynamic parameters and arterial blood gas values (standard care); comprehensive geriatric assessment versus standard preoperative care; percutaneous versus open-access technique; and negative pressure wound therapy (NPWT) versus standard dressing. The primary outcomes were graft infection rate and SSI rate. The secondary outcomes included all-cause mortality, arterial reconstruction failure rate, re-intervention rate, amputation rate, pain resulting from the intervention, and adverse events resulting from the interventions to prevent infection. We did not assess all the outcomes across the different comparisons. The main findings are presented below.
   Antibiotic versus placebo or no treatment (five studies)
   Very low-certainty evidence from five included studies suggests that antibiotic prophylaxis reduces SSI (risk ratio (RR) 0.33, 95% confidence interval (CI) 0.15 to 0.71; 5 studies, 583 participants; number needed to treat for an additional beneficial outcome (NNT) 9). With very low- to low-certainty evidence, there was little or no difference between the groups in the other assessed outcomes (graft infection rate, all-cause mortality, re-intervention rate, and amputation rate). We did not quantitatively assess other outcomes in this comparison.
   Short duration antibiotics (<= 24 hours) versus long duration antibiotics (> 24 hours) (three studies)
   Very low-certainty evidence from three included studies suggests that there is little or no difference in graft infection rate (RR 2.74, 95% CI 0.11 to 65.59; 1 study, 88 participants) or SSI rate (RR 3.65, 95% CI 0.59 to 7.71; 1 study, 88 participants) between short- and long-duration antibiotic prophylaxis. We did not quantitatively assess other outcomes in this comparison.
   Different types of systemic antibiotics (one versus another) (seven studies)
   We grouped seven studies comparing one antibiotic to another into three subgroups that compared different classes of antibiotics amongst themselves. We found little or no difference between the groups analysed. Graft infection rate: beta-lactams versus cephalosporins (RR 0.36, 95% CI 0.02 to 8.71; 1 study, 88 participants; very low-certainty evidence); glycopeptides versus cephalosporins (RR 5.00, 95% CI 0.24 to 103.05; 1 study, 238 participants; low-certainty evidence); one cephalosporin versus another (RR not estimable, CI not estimable; 1 study; 69 participants; very low-certainty evidence); SSI rate: beta-lactams and cephalosporins (RR 0.27, 95% CI 0.03 to 2.53; 2 studies, 229 participants; very low-certainty evidence); glycopeptides versus cephalosporins (RR 2.17, 95% CI 0.65 to 7.23; 2 studies, 312 participants; very low-certainty evidence); and one cephalosporin versus another (RR 1.26, 95% CI 0.21 to 7.45; 3 studies, 625 participants; very low-certainty evidence). We could extract all-cause mortality data for the glycopeptide versus cephalosporin comparison; there was little or no difference between groups (RR 1.33, 95% CI 0.30 to 5.83; 1 study, 238 participants; low-certainty evidence). We did not quantitatively assess other outcomes in this comparison.
   Authors' conclusions
   Very low-certainty evidence suggests that the use of prophylactic antibiotics may prevent SSIs in aortic or aortoiliac peripheral arterial reconstruction. We found no superiority amongst specific antibiotics or differences in extended antibiotic use (over 24 hours) compared with shorter use (up to 24 hours), with low-certainty evidence. For other interventions, very low- to moderate-certainty evidence showed little or no difference across various outcomes. We advise interpreting these conclusions with caution due to the limited number of events in all groups and comparisons.
C1 [Cristino, Mateus A. B.; Nakano, Luis C. U.; Vasconcelos, Vladimir; Correia, Rebeca M.; Flumignan, Ronald L. G.] Univ Fed Sao Paulo, Div Vasc & Endovasc Surg, Dept Surg, Sao Paulo, Brazil.
   [Nakano, Luis C. U.; Vasconcelos, Vladimir; Flumignan, Ronald L. G.] Univ Fed Sao Paulo, Cochrane Brazil, Sao Paulo, Brazil.
C3 Universidade Federal de Sao Paulo (UNIFESP); Universidade Federal de Sao
   Paulo (UNIFESP)
RP Nakano, LCU (通讯作者)，Univ Fed Sao Paulo, Div Vasc & Endovasc Surg, Dept Surg, Sao Paulo, Brazil.
EM luis.nakano1@gmail.com
RI Vasconcelos, Vladimir/H-8028-2015; Flumignan, Ronald/P-6653-2016
FU Division of Vascular and Endovascular Surgery, Universidade Federal de
   Sao Paulo, Brazil Technical collaboration; Chief Scientist OFice,
   Scottish Government Health Directorates; Scottish Government; Chief
   Scientist Office
FX Internal sources Division of Vascular and Endovascular Surgery,
   Universidade Federal de Sao Paulo, Brazil Technical collaboration;
   non-financial support Source of funding, Other No financial support
   External sources Chief Scientist OFice, Scottish Government Health
   Directorates, The Scottish Government, UK The Cochrane Vascular
   editorial base is supported by the Chief Scientist Office.
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NR 169
TC 2
Z9 2
U1 0
U2 1
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1469-493X
EI 1361-6137
J9 COCHRANE DB SYST REV
JI Cochrane Database Syst Rev.
PY 2025
IS 4
AR CD015192
DI 10.1002/14651858.CD015192.pub2
PG 174
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 7AW4J
UT WOS:001566656900002
PM 40260835
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Herrod, PJ
   Doleman, B
   Hardy, EJ
   Hardy, P
   Maloney, T
   Williams, JP
   Lund, JN
AF Herrod, Philip J.
   Doleman, Brett
   Hardy, Edward J.
   Hardy, Paul
   Maloney, Trevor
   Williams, John P.
   Lund, Jon N.
TI Dressings and topical agents for the management of open wounds after
   surgical treatment for sacrococcygeal pilonidal sinus
SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS
LA English
DT Review
ID SECONDARY INTENTION; EXCISION; DISEASE; SURGERY; TRIAL; COMPLICATIONS;
   METAANALYSIS; DURATION; COLLAGEN; THERAPY
AB Background
   Sacrococcygeal pilonidal sinus disease is a common debilitating condition that predominantly affects young adults, with a profound impact on their activities of daily living. The condition is treated surgically, and in some cases the wound in the natal cleft is left open to heal by itself. Many dressings and topical agents are available to aid healing of these wounds.
   Objectives
   To assess the effects of dressings and topical agents for the management of open wounds following surgical treatment for sacrococcygeal pilonidal sinus in any care setting.
   Search methods
   In March 2021, we searched the Cochrane Wounds Specialised Register, CENTRAL, MEDLINE, Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and we scanned reference lists of included studies, reviews, meta-analyses and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting.
   Selection criteria
   We included parallel-group randomised controlled trials (RCTs) only. We included studies with participants who had undergone any type of sacrococcygeal pilonidal sinus disease surgery and were left with an open wound.
   Data collection and analysis
   We used the standard methodological procedures expected by Cochrane. We used GRADE to assess the certainty of the evidence for each outcome.
   Main results
   We included 11 RCTs comprising 932 participants. Two studies compared topical negative pressure wound therapy (TNPWT) with conventional open wound healing, two studies compared platelet-rich plasma with sterile absorbent gauze, and the other seven studies compared various dressings and topical agents. All studies were at high risk of bias in at least one domain, whilst one study was judged to be at low risk of bias in all but one domain. All studies were conducted in secondary care. Mean participant ages were between 20 and 30 years, and nearly 80% of participants were male. No studies provided data on quality of life, cost-effectiveness, pain at first dressing change or proportion of wounds healed at 6 or 12 months, and very few adverse effects were recorded in any study.
   It is unclear whether TNPWT reduces time to wound healing compared with conventional open wound healing (comparison 1), as the certainty of evidence is very low. The two studies provided conflicting results, with one study showing benefit (mean difference (MD) -24.01 days, 95% confidence interval (CI) -35.65 to -12.37; 19 participants), whilst the other reported no difference. It is also unclear whether TNPWT has any effect on the proportion of wounds healed by 30 days (risk ratio (RR) 3.60, 95% CI 0.49 to 26.54; 19 participants, 1 study; very low-certainty evidence). Limited data were available for our secondary outcomes time to return to normal daily activities and recurrence rate; we do not know whether TNPWT has any effect on these outcomes.
   Lietofix cream may increase the proportion of wounds that heal by 30 days compared with an iodine dressing (comparison 4; RR 8.06, 95% CI 1.05 to 61.68; 205 participants, 1 study; low-certainty evidence). The study did not provide data on time to wound healing.
   We do not know whether hydrogel dressings reduce time to wound healing compared with wound cleaning with 10% povidone iodine (comparison 5; MD -24.54 days, 95% CI -47.72 to -1.36; 31 participants, 1 study; very low-certainty evidence). The study did not provide data on the proportion of wounds healed. It is unclear whether hydrogel dressings have any effect on adverse effects as the certainty of the evidence is very low.
   Platelet-rich plasma may reduce time to wound healing compared with sterile absorbent gauze (comparison 6; MD -19.63 days, 95% CI -34.69 to -4.57; 210 participants, 2 studies; low-certainty evidence). No studies provided data on the proportion of wounds healed. Plateletrich plasma may reduce time to return to normal daily activities (MD -15.49, 95% CI -28.95 to -2.02; 210 participants, 2 studies; low-certainty evidence).
   Zinc oxide mesh may make little or no difference to time to wound heating compared with placebo (comparison 2; median 54 days in the zinc oxide mesh group versus 62 days in the placebo mesh group; low-certainty evidence). We do not know whether zinc oxide mesh has an effect on the proportion of wounds healed by 30 days as the certainty of the evidence is very low (RR 2.35, 95% CI 0.49 to 11.23).
   It is unclear whether gentamicin-impregnated collagen sponge reduces time to wound healing compared with no dressing (comparison 7; MD -1.40 days, 95% CI -5.05 to 2.25; 50 participants, 1 study; very tow-certainty evidence). The study did not provide data on the proportion of wounds healed.
   Dialkylcarbamoyl chloride (DACC)-coated dressings may make little or no difference to time to wound healing compared with alginate dressings (comparison 8; median 69 (95% CI 62 to 72) days in the DACC group versus 71 (95% CI 69 to 85) days in the alginate group; 1 study, 246 participants; low-certainty evidence).
   One study compared a polyurethane foam hydrophilic dressing with an alginate dressing (comparison 3) whilst another study compared a hydrocolloid dressing with an iodine dressing (comparison 9). It is unclear whether either intervention has any effect on time to wound healing as the certainty of evidence is very low.
   Authors' conclusions
   At present, the evidence that any of the dressings or topical agents contained in this review have a benefit on time to wound heating, the proportion of wounds that heal at a specific time point or on any of the secondary outcomes of our review ranges from low certainty to very low certainty. There is low-certainty evidence on the benefit on wound healing of platelet-rich plasma from two studies and of Lietofix cream and hydrogel dressings from single studies. Further studies are required to investigate these interventions further.
C1 [Herrod, Philip J.; Hardy, Edward J.] Royal Derby Hosp, Dept Surg, Derby, England.
   [Doleman, Brett; Williams, John P.] Univ Nottingham, Sch Med, Dept Surg & Anaesthesia, Div Med Sci & Grad Entry Med, Derby, England.
   [Hardy, Paul; Maloney, Trevor] Royal Derby Hosp, Dept Tissue Viabil, Derby, England.
   [Lund, Jon N.] Univ Nottingham, Sch Med, Div Hlth Sci, Derby, England.
C3 University of Nottingham; University of Nottingham; University of
   Nottingham; University of Nottingham
RP Herrod, PJ (通讯作者)，Royal Derby Hosp, Dept Surg, Derby, England.
EM pherrod@nhs.net
RI Lund, Jonathan/K-6631-2019
OI Lund, Jonathan/0000-0001-5195-2181; Doleman, Brett/0000-0003-4707-4755;
   Herrod, Philip/0000-0002-6839-3897
FU National Institute for Health Research (NIHR), UK; National Institute
   for Health Research, via Cochrane Infrastructure funding; National
   Institute for Health Research [ACF-2020-12-004] Funding Source:
   researchfish
FX National Institute for Health Research (NIHR), UK This project was
   supported by the National Institute for Health Research, via Cochrane
   Infrastructure funding to Cochrane Wounds. The views and opinions
   expressed are those of the authors and not necessarily those of the
   NIHR, NHS or the Department of Health and Social Care.
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NR 56
TC 18
Z9 19
U1 0
U2 16
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1469-493X
EI 1361-6137
J9 COCHRANE DB SYST REV
JI Cochrane Database Syst Rev.
PY 2022
IS 5
AR CD013439
DI 10.1002/14651858.CD013439.pub2
PG 72
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED)
SC General & Internal Medicine
GA 1S5YF
UT WOS:000804126100021
PM 35593897
OA Green Submitted
DA 2026-07-24
ER

PT J
AU Westby, MJ
   Dumville, JC
   Soares, MO
   Stubbs, N
   Norman, G
AF Westby, Maggie J.
   Dumville, Jo C.
   Soares, Marta O.
   Stubbs, Nikki
   Norman, Gill
TI Dressings and topical agents for treating pressure ulcers
SO COCHRANE DATABASE OF SYSTEMATIC REVIEWS
LA English
DT Review
ID RANDOMIZED CONTROLLED-TRIAL; VACUUM-ASSISTED CLOSURE; GROWTH FACTOR-BB;
   PLATELET-RICH PLASMA; DOUBLE-BLIND; NETWORK METAANALYSIS;
   COST-EFFECTIVENESS; DECUBITUS ULCERS; WOUND THERAPY; COLLAGENASE
   OINTMENT
AB Background
   Pressure ulcers, also known as bedsores, decubitus ulcers and pressure injuries, are localised areas of injury to the skin or the underlying tissue, or both. Dressings are widely used to treat pressure ulcers and promote healing, and there are many options to choose from including alginate, hydrocolloid and protease-modulating dressings. Topical agents have also been used as alternatives to dressings in order to promote healing.
   A clear and current overview of all the evidence is required to facilitate decision-making regarding the use of dressings or topical agents for the treatment of pressure ulcers. Such a review would ideally help people with pressure ulcers and health professionals assess the best treatment options. This review is a network meta-analysis (NMA) which assesses the probability of complete ulcer healing associated with alternative dressings and topical agents.
   Objectives
   To assess the effects of dressings and topical agents for healing pressure ulcers in any care setting. We aimed to examine this evidence base as a whole, determining probabilities that each treatment is the best, with full assessment of uncertainty and evidence quality.
   Search methods
   In July 2016 we searched the CochraneWounds Specialised Register; the Cochrane Central Register of Controlled Trials (CENTRAL); OvidMEDLINE; OvidMEDLINE (In-Process & OtherNon-Indexed Citations); Ovid Embase and EBSCO CINAHL Plus. We also searched clinical trials registries for ongoing and unpublished studies, and scanned reference lists of relevant included studies as well as reviews, meta-analyses, guidelines and health technology reports to identify additional studies. There were no restrictions with respect to language, date of publication or study setting.
   Selection criteria
   Published or unpublished randomised controlled trials (RCTs) comparing the effects of at least one of the following interventions with any other intervention in the treatment of pressure ulcers (Stage 2 or above): any dressing, or any topical agent applied directly to an open pressure ulcer and left in situ. We excluded from this review dressings attached to external devices such as negative pressure wound therapies, skin grafts, growth factor treatments, platelet gels and larval therapy.
   Data collection and analysis
   Two review authors independently performed study selection, risk of bias assessment and data extraction. We conducted network metaanalysis using frequentist mega-regression methods for the efficacy outcome, probability of complete healing. We modelled the relative effectiveness of any two treatments as a function of each treatment relative to the reference treatment (saline gauze). We assumed that treatment effects were similar within dressings classes (e.g. hydrocolloid, foam). We present estimates of effect with their 95% confidence intervals for individual treatments compared with every other, and we report ranking probabilities for each intervention (probability of being the best, second best, etc treatment). We assessed the certainty (quality) of the body of evidence using GRADE for each network comparison and for the network as whole.
   Main results
   We included 51 studies (2947 participants) in this review and carried out NMA in a network of linked interventions for the sole outcome of probability of complete healing. The network included 21 different interventions (13 dressings, 6 topical agents and 2 supplementary linking interventions) and was informed by 39 studies in 2127 participants, of whom 783 had completely healed wounds.
   We judged the network to be sparse: overall, there were relatively few participants, with few events, both for the number of interventions and the number of mixed treatment contrasts; most studies were small or very small. The consequence of this sparseness is high imprecision in the evidence, and this, coupled with the (mainly) high risk of bias in the studies informing the network, means that we judged the vast majority of the evidence to be of low or very low certainty. We have no confidence in the findings regarding the rank order of interventions in this review (very low-certainty evidence), but we report here a summary of results for some comparisons of interventions compared with saline gauze. We present here only the findings from evidence which we did not consider to be very low certainty, but these reported results should still be interpreted in the context of the very low certainty of the network as a whole.
   It is not clear whether regimens involving protease-modulating dressings increase the probability of pressure ulcer healing compared with saline gauze (risk ratio (RR) 1.65, 95% confidence interval (CI) 0.92 to 2.94) (moderate-certainty evidence: low risk of bias, downgraded for imprecision). This risk ratio of 1.65 corresponds to an absolute difference of 102 more people healed with protease modulating dressings per 1000 people treated than with saline gauze alone (95% CI 13 fewer to 302 more). It is unclear whether the following interventions increase the probability of healing compared with saline gauze (low-certainty evidence): collagenase ointment (RR 2.12, 95% CI 1.06 to 4.22); foamdressings (RR 1.52, 95% CI 1.03 to 2.26); basic wound contact dressings (RR 1.30, 95% CI 0.65 to 2.58) and polyvinylpyrrolidone plus zinc oxide (RR 1.31, 95% CI 0.37 to 4.62); the latter two interventions both had confidence intervals consistent with both a clinically important benefit and a clinically important harm, and the former two interventions each had high risk of bias as well as imprecision.
   Authors' conclusions
   A network meta-analysis (NMA) of data from 39 studies (evaluating 21 dressings and topical agents for pressure ulcers) is sparse and the evidence is of low or very low certainty (due mainly to risk of bias and imprecision). Consequently we are unable to determine which dressings or topical agents are the most likely to heal pressure ulcers, and it is generally unclear whether the treatments examined are more effective than saline gauze.
   More research is needed to determine whether particular dressings or topical agents improve the probability of healing of pressure ulcers. The NMA is uninformative regarding which interventions might best be included in a large trial, and it may be that research is directed towards prevention, leaving clinicians to decide which treatment to use on the basis of wound symptoms, clinical experience, patient preference and cost.
C1 [Westby, Maggie J.; Dumville, Jo C.; Norman, Gill] Univ Manchester, Div Nursing Midwifery & Social Work, Fac Biol Med & Hlth, Sch Hlth Sci,Manchester Acad Hlth Sci Ctr, JeanMcFarlane Bldg,Oxford Rd, Manchester M13 9PL, Lancs, England.
   [Soares, Marta O.] Univ York, Ctr Hlth Econ, York, N Yorkshire, England.
   [Stubbs, Nikki] Leeds Community Healthcare NHS Trust, St Marys Hosp, Wound Prevent & Management Serv, Leeds, W Yorkshire, England.
C3 University of Manchester; University of York - UK
RP Westby, MJ (通讯作者)，Univ Manchester, Div Nursing Midwifery & Social Work, Fac Biol Med & Hlth, Sch Hlth Sci,Manchester Acad Hlth Sci Ctr, JeanMcFarlane Bldg,Oxford Rd, Manchester M13 9PL, Lancs, England.
EM maggie.westby@manchester.ac.uk
RI Westby, Maggie/O-8794-2014; Norman, Gill/O-7029-2014; Soares, Marta
   Ferreira Oliveira/HJH-3434-2023; Dumville, Jo/O-7867-2014
OI Westby, Maggie/0000-0003-4273-3942; Norman, Gill/0000-0002-3972-5733;
   Soares, Marta Ferreira Oliveira/0000-0003-1579-8513; Dumville,
   Jo/0000-0002-6546-3685
FU Division of Nursing, Midwifery and Social Work, School of Health
   Sciences, University of Manchester, UK; National Institute for Health
   Research, UK; National Institute for Health Research [13/89/08];
   National Institute for Health Research Collaboration for Leadership in
   Applied Health Research and Care (NIHR CLAHRC) Greater Manchester, UK;
   National Institute for Health Research Collaboration for Leadership in
   Applied Health Research and Care (NIHR CLAHRC) Greater Manchester;
   National Institute for Health Research [13/89/08] Funding Source:
   researchfish
FX Internal sourcesr Division of Nursing, Midwifery and Social Work, School
   of Health Sciences, University of Manchester, UK.r External sourcesr
   National Institute for Health Research, UK. This project was supported
   by the National Institute for Health Research, via Cochrane
   Infrastructure and Cochrane Programme Grant funding (NIHR Cochrane
   Programme Grant 13/89/08 - High Priority Cochrane Reviews in Wound
   Prevention and Treatment) to Cochrane Wounds. The views and opinions
   expressed therein are those of the authors and do not necessarily
   reflect those of the Systematic Reviews Programme, NIHR, NHS or the
   Department of Health.r National Institute for Health Research
   Collaboration for Leadership in Applied Health Research and Care (NIHR
   CLAHRC) Greater Manchester, UK. Jo Dumville was partly funded by the
   National Institute for Health Research Collaboration for Leadership in
   Applied Health Research and Care (NIHR CLAHRC) Greater Manchester. The
   funder had no role in the design of the studies, data collection and
   analysis, decision to publish, or preparation of the manuscript.
   However, the review may be considered to be affiliated to the work of
   the NIHR CLAHRC Greater Manchester. The views expressed herein are those
   of the authors and not necessarily those of the NHS, NIHR or the
   Department of Health.
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NR 452
TC 97
Z9 114
U1 1
U2 73
PU WILEY
PI HOBOKEN
PA 111 RIVER ST, HOBOKEN 07030-5774, NJ USA
SN 1469-493X
EI 1361-6137
J9 COCHRANE DB SYST REV
JI Cochrane Database Syst Rev.
PY 2017
IS 6
AR UNSP CD011947
DI 10.1002/14651858.CD011947.pub2
PG 200
WC Medicine, General & Internal
WE Science Citation Index Expanded (SCI-EXPANDED); Social Science Citation Index (SSCI)
SC General & Internal Medicine
GA FF3SV
UT WOS:000408840400031
PM 28639707
OA Green Published, Green Submitted, Bronze
DA 2026-07-24
ER

PT J
AU Raza, A
   Cuenca, AG
   Tan, S
   Singhal, D
AF Raza, Ahsan
   Cuenca, Alex G.
   Tan, Sanda
   Singhal, Dhruv
TI Omental Flaps for Coverage of Sacral or Gluteal Defects: A Useful and
   Potentially Underused Tool
SO AMERICAN SURGEON
LA English
DT Article; Proceedings Paper
CT Annual Scientific Meeting and Postgraduate Course Program of the
   Southeastern-Surgical-Congress
CY FEB 22-25, 2014
CL Savannah, GA
SP SE Surg Congress
ID RECONSTRUCTION
AB A 51-year-old man presented with a slowly growing mass arising from his left gluteus maximus muscle that measured 12 cm in its greatest dimension (Fig. 1A). Imaging demonstrated that the mass extended into the dorsal aspect of the sacrum. Preoperative staging of the neoplasm was T2bN0M0. The patient underwent preoperative radiation therapy before undergoing extirpation of the lesion including partial sacrectomy, partial iliac bone resection, and pelvic floor reconstruction. AGore-tex (TM) mesh was used to span the sacral defect and the wound was closed primarily. Unfortunately, a fall three weeks postprocedure resulted in wound dehiscence, exposing the underlying mesh. Negative pressure wound therapy was initially used as a temporizing approach given the performance status of the patient at that time. After improvement in the patient's nutritional and performance status, and the formation of a healthy wound bed, the decision was made for wound de bridement, colonic diversion, and omental flap coverage.
   The procedure began with the patient prone by incising the remaining intact prior inferolateral incision. The resulting wound was over 15 cm in size tracking inferomedially (Fig. 1A). The wound was debrided to healthy bleeding tissue. The preoperative plan was to pedicle the omental flap through Petit's triangle so as to avoid dissection around the rectum (Fig. 1B). We then dissected a subcutaneous tunnel from the right edge of the wound up to Petit's triangle on the right side (marked out with medial border being marked by the latissimus and inferior border being marked by thepossible immunocompromised conditions such as diabetes, poor nutrition, history of radiation to the affected area, and wound infections. Flap options include local flaps including muscle, fasciocutaneous skin flaps from the gluteal, back, or posterior thigh region. Other options include VRAM flap and pedicled omental flaps. Paraspinal muscles have been used with greater success for flat wounds but omentum is ideal for deep wounds as a result of its ability to be readily contoured. However, the approach taken for this patient is often not considered. In our case, the patient had radiotherapy to the gluteal region; therefore, local flap options were very limited. He also had a history of wound infection and debridement and needed reconstruction with well-vascularized tissue with the ability to overcome resistant bacterial infection. In such patients, transpelvic vertical rectus abdominis muscle flaps have been advocated. 1 The flap is detached from the pubis and the pelvis inset isiliac crest). The patient was then turned supine. The abdomen was opened with the midline incision proceeding to the left of the umbilicus to preserve the possibility of a left vertical rectus abdominis myocutaneous (VRAM) flap. Laparoscopy was also not performed in case a VRAM flap was needed. The omentum was freed from the distal transverse colon and greater curvature of the stomach and the flap was mobilized inferolaterally with vascular supply based on the right gastroepiploic artery. The cecum was mobilized medially to expose the region of Petit's triangle from the abdominal approach. The omentum was placed near the triangle for easy access in second part of the surgery. An end colostomy through the left rectus muscle was created and the abdominal fascia was closed. The patient was then turned prone.
   A 5-cm counterincision over the previously marked Petit's triangle was made and the omentum was delivered through the previously dissected space. As demonstrated in Figure 2A, complete coverage of the sacral defect was achieved. We then secured the omentum to the sacral wound using polydioxanone suture. The remainder of the omentum was used to fill the void of the left gluteal region. A superiorly oriented incision was then performed from the lateral edge of the initial incision thereby developing a superiorly based rotation advancement fasciocutaneous flap (18 5 cm). The fasciocutaneous flap was then advanced over the omentum and the wound was closed primarily. The patient was seen in clinic postoperatively six weeks after the operation (Fig. 2C). He was ambulating well. At three months, the sacral wound had healed well. The colostomy was reversed.
   Soft tissue reconstruction of the pelvis with vascularized tissue flaps is becoming an increasingly common procedure. The primary goal of such an operation is to restore form and function, obliterate dead space, and create an environment favorable to wound healing. Resections of tumors from the pelvis and presacral areas often leave deep and extensive defects, which are challenging for the surgeon to reconstruct. Other obstacles that hamper wound healing also include possible immunocompromised conditions such as diabetes, poor nutrition, history of radiation to the affected area, and wound infections. Flap options include local flaps including muscle, fasciocutaneous skin flaps from the gluteal, back, or posterior thigh region. Other options include VRAM flap and pedicled omental flaps. Paraspinal muscles have been used with greater success for flat wounds but omentum is ideal for deep wounds as a result of its ability to be readily contoured. However, the approach taken for this patient is often not considered.
   In our case, the patient had radiotherapy to the gluteal region; therefore, local flap options were very limited. He also had a history of wound infection and debridement and needed reconstruction with well-vascularized tissue with the ability to overcome resistant bacterial infection. In such patients, transpelvic vertical rectus abdominis muscle flaps have been advocated. (1)The flap is detached from the pubis and the pelvis inset isadvanced into the sacral defect. Because the operative plan included colonic diversion and colostomy creation, this approach was not considered ideal. Another flap that has been widely used in intraperitoneal and extraperitoneal defects because of its generous blood supply, large surface area, and angiogenic potential is an omental flap. It successfully fills dead spaces, induces angiogenesis, and is known to have immunological function. (2)These properties make it an effective option in treating infected, irradiated, or ischemic wounds.
   Anatomically, the omentum can be divided into greater and lesser omentum, gastrohepatic, and hepatoduodenal ligaments. For an omental pedicle flap, greater omentum is used with the vascular supply being from either the right or left gastroepiploic artery. Omental pedicle flap length can be varied depending on the volume needed at the recipient site. It is dissected from the transverse colon and greater curvatureof the stomach and tunneled laterally along the left or right colic gutter to the pelvic floor. (2)Petit's triangle is formed by the iliac crest, latissimus dorsi, and external oblique muscles. This can be used as a tunnel to bring the omentum posteriorly to cover sacral defects. Contraindications for the use of omental flaps include adhesions, prior surgeries, malignancies with peritoneal metastasis, or other concomitant abdominal disease. (3)The main disadvantage of using the omental flap is the combined anterior and posterior approach, which increases morbidity and creates problems with positioning. (4)Other complications may include small bowel obstruction, herniation, and fluid and electrolyte disturbances. The omental flap has also been used successfully in chest wall, scrotal, and penile reconstruction. Reconstructive options for large sacral defects, which have been previously irradiated and infected, are very limited. The possibilities that have been explored in this report include local flap options like gluteal, thigh, or back flaps as well as vertical rectus abdominis and pedicled omental flaps. When the surgeon cannot use local flaps or free tissue transfers, the omental flap with its rich vascular supply, contourability, and ability to fight infections can be used successfully through the Petit triangle to cover such defects. This is a safe option with good wound closure and healing and provides better results than the use of local flaps. It may be a particularly attractive option when colostomy is also indicated.
C1 [Raza, Ahsan; Cuenca, Alex G.; Tan, Sanda] Univ Florida, Coll Med, Dept Surg, Div Gen Surg, Gainesville, FL 32610 USA.
   [Singhal, Dhruv] Univ Florida, Coll Med, Dept Surg, Div Plast & Reconstruct Surg, Gainesville, FL 32610 USA.
C3 State University System of Florida; University of Florida; State
   University System of Florida; University of Florida
RP Tan, S (通讯作者)，Univ Florida, Coll Med, Dept Surg, Box 100019, Gainesville, FL 32610 USA.
EM sanda.tan@surgery.ufl.edu
CR GIORDANO PA, 1994, PLAST RECONSTR SURG, V93, P1508, DOI 10.1097/00006534-199406000-00030
   Hultman CS, 2010, ANN PLAS SURG, V64, P559, DOI 10.1097/SAP.0b013e3181ce3947
   Hultman CS, 2001, ANN PLAS SURG, V46, P242, DOI 10.1097/00000637-200103000-00007
   Miles WK, 2000, PLAST RECONSTR SURG, V105, P2387, DOI 10.1097/00006534-200006000-00012
NR 4
TC 2
Z9 2
U1 0
U2 4
PU SOUTHEASTERN SURGICAL CONGRESS
PI CUMMING
PA 115 SAMARITAN DR, #200, CUMMING, GA 30040-2354 USA
SN 0003-1348
EI 1555-9823
J9 AM SURGEON
JI Am. Surg.
PD JUL
PY 2014
VL 80
IS 7
BP E202
EP E204
PG 3
WC Surgery
WE Science Citation Index Expanded (SCI-EXPANDED); Conference Proceedings Citation Index - Science (CPCI-S)
SC Surgery
GA AK2WX
UT WOS:000338282000009
PM 24987886
DA 2026-07-24
ER

PT J
AU Hillis, LD
   Smith, PK
   Anderson, JL
   Bittl, JA
   Bridges, CR
   Byrne, JG
   Cigarroa, JE
   DiSesa, VJ
   Hiratzka, LF
   Hutter, AM
   Jessen, ME
   Keeley, EC
   Lahey, SJ
   Lange, RA
   London, MJ
   Mack, MJ
   Patel, MR
   Puskas, JD
   Sabik, JF
   Selnes, O
   Shahian, DM
   Trost, JC
   Winniford, MD
   Jacobs, AK
   Anderson, JL
   Albert, N
   Creager, MA
   Ettinger, SM
   Guyton, RA
   Halperin, JL
   Hochman, JS
   Kushner, FG
   Ohman, EM
   Stevenson, W
   Yancy, CW
AF Hillis, L. David
   Smith, Peter K.
   Anderson, Jeffrey L.
   Bittl, John A.
   Bridges, Charles R.
   Byrne, John G.
   Cigarroa, Joaquin E.
   DiSesa, Verdi J.
   Hiratzka, Loren F.
   Hutter, Adolph M., Jr.
   Jessen, Michael E.
   Keeley, Ellen C.
   Lahey, Stephen J.
   Lange, Richard A.
   London, Martin J.
   Mack, Michael J.
   Patel, Manesh R.
   Puskas, John D.
   Sabik, Joseph F.
   Selnes, Ola
   Shahian, David M.
   Trost, Jeffrey C.
   Winniford, Michael D.
   Jacobs, Alice K.
   Anderson, Jeffrey L.
   Albert, Nancy
   Creager, Mark A.
   Ettinger, Steven M.
   Guyton, Robert A.
   Halperin, Jonathan L.
   Hochman, Judith S.
   Kushner, Frederick G.
   Ohman, E. Magnus
   Stevenson, William
   Yancy, Clyde W.
CA Writing Comm Members
   ACCF AHA Task Force Members
TI 2011 ACCF/AHA guideline for coronary artery bypass graft surgery:
   Executive summary
SO JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY
LA English
DT Article
ID ACUTE MYOCARDIAL-INFARCTION; LONG-TERM SURVIVAL; VACUUM-ASSISTED
   CLOSURE; QUALITY-OF-LIFE; PREOPERATIVE STATIN THERAPY;
   ACUTE-RENAL-FAILURE; TRANSMYOCARDIAL LASER REVASCULARIZATION;
   DRUG-ELUTING STENTS; HIGH-RISK PATIENTS; INTRAOPERATIVE TRANSESOPHAGEAL
   ECHOCARDIOGRAPHY
AB The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.
   The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly produced guidelines in the area of cardiovascular disease since 1980. The ACCF/AHATask Force on Practice Guidelines (Task Force), charged with developing, updating, and revising practice guidelines for cardiovascular diseases and procedures, directs and oversees this effort. Writing committees are charged with regularly reviewing and evaluating all available evidence to develop balanced, patient-centric recommendations for clinical practice.
   Experts in the subject under consideration are selected by the ACCF and AHA to examine subject-specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a formal literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include estimates of expected outcomes where such data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered. When available, information from studies on cost is considered, but data on efficacy and outcomes constitute the primary basis for the recommendations contained herein.
   In analyzing the data and developing recommendations and supporting text, the writing committee uses evidence-based methodologies developed by the Task Force. 1 The Class of Recommendation (COR) is an estimate of the size of the treatment effect considering risks versus benefits in addition to evidence and/or agreement that a given treatment or procedure is or is not useful/effective or in some situations may cause harm. The Level of Evidence (LOE) is an estimate of the certainty or precision of the treatment effect. The writing committee reviews and ranks evidence supporting each recommendation with the weight of evidence ranked as LOE A, B, or C according to specific definitions that are included in Table 1. Studies are identified as observational, retrospective, prospective, or randomized where appropriate. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C. When recommendations at LOE C are supported by historical clinical data, appropriate references (including clinical reviews) are cited if available. For issues for which sparse data are available, a survey of current practice among the clinicians on the writing committee is the basis for LOE C recommendations, and no references are cited. The schema for COR and LOE is summarized in Table 1, which also provides suggested phrases for writing recommendations within each COR. A new addition to this methodology is separation of the Class III recommendations to delineate if the recommendation is determined to be of "no benefit" or is associated with "harm" to the patient. In addition, in view of the increasing number of comparative effectiveness studies, comparator verbs and suggested phrases for writing recommendations for the comparative effectiveness of one treatment or strategy versus another have been added for COR I and IIa, LOE A or B only.
   In view of the advances in medical therapy across the spectrum of cardiovascular diseases, the Task Force has designated the term guideline-directed medical therapy (GDMT) to represent optimal medical therapy as defined by ACCF/AHA guideline-recommended therapies (primarily Class I). This new term, GDMT, will be used herein and throughout all future guidelines.
   Because the ACCF/AHA practice guidelines address patient populations (and healthcare providers) residing in North America, drugs that are not currently available in North America are discussed in the text without a specific COR. For studies performed in large numbers of subjects outside North America, each writing committee reviews the potential influence of different practice patterns and patient populations on the treatment effect and relevance to the ACCF/AHA target population to determine whether the findings should inform a specific recommendation.
   The ACCF/AHA practice guidelines are intended to assist healthcare providers in clinical decision making by describing a range of generally acceptable approaches to the diagnosis, management, and prevention of specific diseases or conditions. The guidelines attempt to define practices that meet the needs of most patients in most circumstances. The ultimate judgment regarding the care of a particular patient must be made by the healthcare provider and patient in light of all the circumstances presented by that patient. As a result, situations may arise for which deviations from these guidelines may be appropriate. Clinical decision making should involve consideration of the quality and availability of expertise in the area where care is provided. When these guidelines are used as the basis for regulatory or payer decisions, the goal should be improvement in quality of care. The Task Force recognizes that situations arise in which additional data are needed to inform patient care more effectively; these areas will be identified within each respective guideline when appropriate.
   Prescribed courses of treatment in accordance with these recommendations are effective only if followed. Because lack of patient understanding and adherence may adversely affect outcomes, physicians and other healthcare providers should make every effort to engage the patient's active participation in prescribed medical regimens and lifestyles. In addition, patients should be informed of the risks, benefits, and alternatives to a particular treatment and be involved in shared decision making whenever feasible, particularly for COR IIa and IIb, where the benefit-to-risk ratio may be lower.
   The Task Force makes every effort to avoid actual, potential, or perceived conflicts of interest that may arise as a result of industry relationships or personal interests among the members of the writing committee. All writing committee members and peer reviewers of the guideline are required to disclose all such current relationships, as well as those existing 12 months previously. In December 2009, the ACCF and AHA implemented a new policy for relationships with industry and other entities (RWI) that requires the writing committee chair plus a minimum of 50% of the writing committee to have no relevant RWI (Appendix 1 for the ACCF/AHA definition of relevance). These statements are reviewed by the Task Force and all members during each conference call and meeting of the writing committee and are updated as changes occur. All guideline recommendations require a confidential vote by the writing committee and must be approved by a consensus of the voting members. Members are not permitted to write, and must rescue themselves from voting on, any recommendation or section to which their RWI apply. Members who recused themselves from voting are indicated in the list of writing committee members, and section recusals are noted in Appendix 1. Authors' and peer reviewers' RWI pertinent to this guideline are disclosed in Appendixes 1 and 2, respectively. Additionally, to ensure complete transparency, writing committee members' comprehensive disclosure information-including RWI not pertinent to this document-is available as an online supplement. Comprehensive disclosure information for the Task Force is also available online at www.cardiosource.org/ACC/About-ACC/Leadership/Guide lines-and-Documents-Task-Forces. aspx. The work of the writing committee was supported exclusively by the ACCF and AHA without commercial support. Writing committee members volunteered their time for this activity.
   In an effort to maintain relevance at the point of care for practicing physicians, the Task Force continues to oversee an ongoing process improvement initiative. As a result, in response to pilot projects, evidence tables (with references linked to abstracts in PubMed) have been added.
   In April 2011, the Institute of Medicine released 2 reports: Finding What Works in Health Care: Standards for Systematic Reviews and Clinical Practice Guidelines We Can Trust. 2,3 It is noteworthy that the ACCF/AHA guidelines are cited as being compliant with many of the proposed standards. A thorough review of these reports and of our current methodology is under way, with further enhancements anticipated.
   The recommendations in this guideline are considered current until they are superseded by a focused update or the full-text guideline is revised. Guidelines are official policy of both the ACCF and AHA.
C1 [Jacobs, Alice K.] ACCF AHA Task Force Practice Guidelines, New York, NY USA.
RI ; Stevenson, William/GXG-0403-2022; Yancy, Clyde/HCI-3948-2022; Patel,
   Manesh/AAC-5385-2019; Halperin, Jonathan/AAJ-4721-2020; Albert,
   Nancy/ACQ-4895-2022; Ohman, Erik/AFU-8541-2022; Lange,
   Richard/AAM-9594-2021; Kushner, Frederick/J-1937-2019
OI Jacobs, Alice/0000-0002-2428-2458; Hochman, Judith/0000-0002-5889-5981; 
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NR 491
TC 242
Z9 292
U1 0
U2 35
PU MOSBY-ELSEVIER
PI NEW YORK
PA 360 PARK AVENUE SOUTH, NEW YORK, NY 10010-1710 USA
SN 0022-5223
EI 1097-685X
J9 J THORAC CARDIOV SUR
JI J. Thorac. Cardiovasc. Surg.
PD JAN
PY 2012
VL 143
IS 1
BP 4
EP 34
DI 10.1016/j.jtcvs.2011.10.015
PG 31
WC Cardiac & Cardiovascular Systems; Respiratory System; Surgery
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology; Respiratory System; Surgery
GA 863GW
UT WOS:000298151800006
PM 22172748
OA Bronze
DA 2026-07-24
ER

PT J
AU Hillis, LD
   Smith, PK
   Anderson, JL
   Bittl, JA
   Bridges, CR
   Byrne, JG
   Cigarroa, JE
   DiSesa, VJ
   Hiratzka, LF
   Hutter, AM
   Jessen, ME
   Keeley, EC
   Lahey, SJ
   Lange, RA
   London, MJ
   Mack, MJ
   Patel, MR
   Puskas, JD
   Sabik, JF
   Selnes, O
   Shahian, DM
   Trost, JC
   Winniford, MD
AF Hillis, L. David
   Smith, Peter K.
   Anderson, Jeffrey L.
   Bittl, John A.
   Bridges, Charles R.
   Byrne, John G.
   Cigarroa, Joaquin E.
   DiSesa, Verdi J.
   Hiratzka, Loren F.
   Hutter, Adolph M., Jr.
   Jessen, Michael E.
   Keeley, Ellen C.
   Lahey, Stephen J.
   Lange, Richard A.
   London, Martin J.
   Mack, Michael J.
   Patel, Manesh R.
   Puskas, John D.
   Sabik, Joseph F.
   Selnes, Ola
   Shahian, David M.
   Trost, Jeffrey C.
   Winniford, Michael D.
TI 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery:
   Executive Summary A Report of the American College of Cardiology
   Foundation/American Heart Association Task Force on Practice Guidelines
   Developed in Collaboration With the American Association for Thoracic
   Surgery, Society of Cardiovascular Anesthesiologists, and
   Society of Thoracic Surgeons
SO JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
LA English
DT Article
DE ACCF/AHA Practice Guidelines; acute coronary syndromes; anticoagulants;
   antiplatelet agents; arrhythmias, cardiac; coronary angiography;
   coronary artery revascularization interventions: stents; drug therapy;
   heart diseases; myocardial revasularization; platelet aggregation
   inhibitor; ultrasound
ID ACUTE MYOCARDIAL-INFARCTION; LONG-TERM SURVIVAL; VACUUM-ASSISTED
   CLOSURE; PREOPERATIVE STATIN THERAPY; ACUTE-RENAL-FAILURE;
   TRANSMYOCARDIAL LASER REVASCULARIZATION; DRUG-ELUTING STENTS; HIGH-RISK
   PATIENTS; INTRAOPERATIVE TRANSESOPHAGEAL ECHOCARDIOGRAPHY; MODERATE
   AORTIC-STENOSIS
AB The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.
   The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly produced guidelines in the area of cardiovascular disease since 1980. The ACCF/AHA Task Force on Practice Guidelines (Task Force), charged with developing, updating, and revising practice guidelines for cardiovascular diseases and procedures, directs and oversees this effort. Writing committees are charged with regularly reviewing and evaluating all available evidence to develop balanced, patient-centric recommendations for clinical practice.
   Experts in the subject under consideration are selected by the ACCF and AHA to examine subject-specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a formal literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include estimates of expected outcomes where such data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered. When available, information from studies on cost is considered, but data on efficacy and outcomes constitute the primary basis for the recommendations contained herein.
   In analyzing the data and developing recommendations and supporting text, the writing committee uses evidence-based methodologies developed by the Task Force (1). The Class of Recommendation (COR) is an estimate of the size of the treatment effect considering risks versus benefits in addition to evidence and/or agreement that a given treatment or procedure is or is not useful/effective or in some situations may cause harm. The Level of Evidence (LOE) is an estimate of the certainty or precision of the treatment effect. The writing committee reviews and ranks evidence supporting each recommendation with the weight of evidence ranked as LOE A, B, or C according to specific definitions that are included in Table 1. Studies are identified as observational, retrospective, prospective, or randomized where appropriate. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C. When recommendations at LOE C are supported by historical clinical data, appropriate references (including clinical reviews) are cited if available. For issues for which sparse data are available, a survey of current practice among the clinicians on the writing committee is the basis for LOE C recommendations, and no references are cited. The schema for COR and LOE is summarized in Table 1, which also provides suggested phrases for writing recommendations within each COR. A new addition to this methodology is separation of the Class III recommendations to delineate if the recommendation is determined to be of "no benefit" or is associated with "harm" to the patient. In addition, in view of the increasing number of comparative effectiveness studies, comparator verbs and suggested phrases for writing recommendations for the comparative effectiveness of one treatment or strategy versus another have been added for COR I and IIa, LOE A or B only.
   In view of the advances in medical therapy across the spectrum of cardiovascular diseases, the Task Force has designated the term guideline-directed medical therapy (GDMT) to represent optimal medical therapy as defined by ACCF/AHA guideline-recommended therapies (primarily Class I). This new term, GDMT, will be used herein and throughout all future guidelines.
   Because the ACCF/AHA practice guidelines address patient populations (and healthcare providers) residing in North America, drugs that are not currently available in North America are discussed in the text without a specific COR. For studies performed in large numbers of subjects outside North America, each writing committee reviews the potential influence of different practice patterns and patient populations on the treatment effect and relevance to the ACCF/AHA target population to determine whether the findings should inform a specific recommendation.
   The ACCF/AHA practice guidelines are intended to assist healthcare providers in clinical decision making by describing a range of generally acceptable approaches to the diagnosis, management, and prevention of specific diseases or conditions. The guidelines attempt to define practices that meet the needs of most patients in most circumstances. The ultimate judgment regarding the care of a particular patient must be made by the healthcare provider and patient in light of all the circumstances presented by that patient. As a result, situations may arise for which deviations from these guidelines may be appropriate. Clinical decision making should involve consideration of the quality and availability of expertise in the area where care is provided. When these guidelines are used as the basis for regulatory or payer decisions, the goal should be improvement in quality of care. The Task Force recognizes that situations arise in which additional data are needed to inform patient care more effectively; these areas will be identified within each respective guideline when appropriate.
   Prescribed courses of treatment in accordance with these recommendations are effective only if followed. Because lack of patient understanding and adherence may adversely affect outcomes, physicians and other healthcare providers should make every effort to engage the patient's active participation in prescribed medical regimens and lifestyles. In addition, patients should be informed of the risks, benefits, and alternatives to a particular treatment and be involved in shared decision making whenever feasible, particularly for COR IIa and IIb, where the benefit-to-risk ratio may be lower.
   The Task Force makes every effort to avoid actual, potential, or perceived conflicts of interest that may arise as a result of industry relationships or personal interests among the members of the writing committee. All writing committee members and peer reviewers of the guideline are required to disclose all such current relationships, as well as those existing 12 months previously. In December 2009, the ACCF and AHA implemented a new policy for relationships with industry and other entities (RWI) that requires the writing committee chair plus a minimum of 50% of the writing committee to have no relevant RWI (Appendix 1 for the ACCF/AHA definition of relevance). These statements are reviewed by the Task Force and all members during each conference call and meeting of the writing committee and are updated as changes occur. All guideline recommendations require a confidential vote by the writing committee
   [GRAPHICS]
   and must be approved by a consensus of the voting members. Members are not permitted to write, and must rescue themselves from voting on, any recommendation or section to which their RWI apply. Members who recused themselves from voting are indicated in the list of writing committee members, and section recusals are noted in Appendix 1. Authors' and peer reviewers' RWI pertinent to this guideline are disclosed in Appendixes 1 and 2, respectively. Additionally, to ensure complete transparency, writing committee members' comprehensive disclosure information-including RWI not pertinent to this document-is available as an online supplement. Comprehensive disclosure information for the Task Force is also available online at www. cardiosource. org/ACC/About-ACC/Leadership/Guidelines-and-Documents-Task-Forces.aspx. The work of the writing committee was supported exclusively by the ACCF and AHA without commercial support. Writing committee members volunteered their time for this activity.
   In an effort to maintain relevance at the point of care for practicing physicians, the Task Force continues to oversee an ongoing process improvement initiative. As a result, in response to pilot projects, evidence tables (with references linked to abstracts in PubMed) have been added.
   In April 2011, the Institute of Medicine released 2 reports: Finding What Works in Health Care: Standards for Systematic Reviews and Clinical Practice Guidelines We Can Trust (2,3). It is noteworthy that the ACCF/AHA guidelines are cited as being compliant with many of the proposed standards. A thorough review of these reports and of our current methodology is under way, with further enhancements anticipated.
   The recommendations in this guideline are considered current until they are superseded by a focused update or the full-text guideline is revised. Guidelines are official policy of both the ACCF and AHA.
C1 [Hillis, L. David; Lange, Richard A.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.
   [Smith, Peter K.; Patel, Manesh R.] Duke Univ, Med Ctr, Durham, NC 27706 USA.
   [Bridges, Charles R.] Univ Penn, Med Ctr, Philadelphia, PA 19104 USA.
   [Byrne, John G.] Vanderbilt Univ, Med Ctr, Div Cardiac Surg, Nashville, TN USA.
   [Cigarroa, Joaquin E.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA.
   [DiSesa, Verdi J.] Johns Hopkins Univ Hosp, Div Cardiac Surg, Baltimore, MD 21287 USA.
   [Hutter, Adolph M., Jr.; Shahian, David M.] Massachusetts Gen Hosp, Boston, MA 02114 USA.
   [Keeley, Ellen C.] Univ Virginia, Charlottesville, VA 22903 USA.
   [Lahey, Stephen J.] Univ Connecticut, Storrs, CT USA.
   [London, Martin J.] Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94143 USA.
   [Puskas, John D.] Emory Univ Emory Healthcare, Atlanta, GA USA.
   [Sabik, Joseph F.] Cleveland Clin Fdn, Cleveland, OH USA.
   [Selnes, Ola] Johns Hopkins Univ Hosp, Dept Neurol, Baltimore, MD 21287 USA.
   [Winniford, Michael D.] Univ Mississippi, Med Ctr, University, MS 38677 USA.
C3 University of Texas System; University of Texas at San Antonio; Duke
   University; University of Pennsylvania; Vanderbilt University; Oregon
   Health & Science University; Johns Hopkins University; Johns Hopkins
   Medicine; Harvard University; Harvard University Medical Affiliates;
   Massachusetts General Hospital; University of Virginia; University of
   Connecticut; US Department of Veterans Affairs; Veterans Health
   Administration (VHA); University of California System; University of
   California San Francisco; Cleveland Clinic Foundation; Johns Hopkins
   University; Johns Hopkins Medicine; University of Mississippi Medical
   Center; University of Mississippi
RP Hillis, LD (通讯作者)，Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.
RI Lange, Richard/AAM-9594-2021; Patel, Manesh/AAC-5385-2019
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TC 45
Z9 59
U1 0
U2 21
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 0735-1097
EI 1558-3597
J9 J AM COLL CARDIOL
JI J. Am. Coll. Cardiol.
PD DEC
PY 2011
VL 58
IS 24
BP 2584
EP 2614
DI 10.1016/j.jacc.2011.08.008
PG 31
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA 862ZJ
UT WOS:000298132300025
DA 2026-07-24
ER

PT J
AU Hillis, LD
   Smith, PK
   Anderson, JL
   Bittl, JA
   Bridges, CR
   Byrne, JG
   Cigarroa, JE
   DiSesa, VJ
   Hiratzka, LF
   Hutter, AM Jr
   Jessen, ME
   Keeley, EC
   Lahey, SJ
   Lange, RA
   London, MJ
   Mack, MJ
   Patel, MR
   Puskas, JD
   Sabik, JF
   Selnes, O
   Shahian, DM
   Trost, JC
   Winniford, MD
AF Hillis, L. David
   Smith, Peter K.
   Anderson, Jeffrey L.
   Bittl, John A.
   Bridges, Charles R.
   Byrne, John G.
   Cigarroa, Joaquin E.
   DiSesa, Verdi J.
   Hiratzka, Loren F.
   Hutter, Adolph M., Jr.
   Jessen, Michael E.
   Keeley, Ellen C.
   Lahey, Stephen J.
   Lange, Richard A.
   London, Martin J.
   Mack, Michael J.
   Patel, Manesh R.
   Puskas, John D.
   Sabik, Joseph F.
   Selnes, Ola
   Shahian, David M.
   Trost, Jeffrey C.
   Winniford, Michael D.
TI 2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery A
   Report of the American College of Cardiology Foundation/American Heart
   Association Task Force on Practice Guidelines Developed in
   Collaboration With the American Association for Thoracic Surgery,
   Society of Cardiovascular Anesthesiologists, and Society of
   Thoracic Surgeons
SO JACC-JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
LA English
DT Article
DE ACCF/AHA Practice Guidelines; acute coronary syndromes; anticoagulants;
   antiplatelet agents; arrhythmias, cardiac; coronary angiography;
   coronary artery revascularization interventions: stents; drug therapy;
   heart diseases; myocardial revasularization; platelet aggregation
   inhibitor; ultrasound
ID INTERNAL-MAMMARY-ARTERY; LONG-TERM SURVIVAL; ACUTE
   MYOCARDIAL-INFARCTION; ACUTE-RENAL-FAILURE; DRUG-ELUTING STENTS;
   HIGH-RISK PATIENTS; VACUUM-ASSISTED CLOSURE; NEW-YORK-STATE;
   RECOMBINANT-HUMAN-ERYTHROPOIETIN; AUTOLOGOUS BLOOD-DONATION
AB The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease. When properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can improve the quality of care, optimize patient outcomes, and favorably affect costs by focusing resources on the most effective strategies. An organized and directed approach to a thorough review of evidence has resulted in the production of clinical practice guidelines that assist physicians in selecting the best management strategy for an individual patient. Moreover, clinical practice guidelines can provide a foundation for other applications, such as performance measures, appropriate use criteria, and both quality improvement and clinical decision support tools.
   The American College of Cardiology Foundation (ACCF) and the American Heart Association (AHA) have jointly produced guidelines in the area of cardiovascular disease since 1980. The ACCF/AHA Task Force on Practice Guidelines (Task Force), charged with developing, updating, and revising practice guidelines for cardiovascular diseases and procedures, directs and oversees this effort. Writing committees are charged with regularly reviewing and evaluating all available evidence to develop balanced, patient-centric recommendations for clinical practice.
   Experts in the subject under consideration are selected by the ACCF and AHA to examine subject-specific data and write guidelines in partnership with representatives from other medical organizations and specialty groups. Writing committees are asked to perform a formal literature review; weigh the strength of evidence for or against particular tests, treatments, or procedures; and include estimates of expected outcomes where such data exist. Patient-specific modifiers, comorbidities, and issues of patient preference that may influence the choice of tests or therapies are considered. When available, information from studies on cost is considered, but data on efficacy and outcomes constitute the primary basis for the recommendations contained herein.
   In analyzing the data and developing recommendations and supporting text, the writing committee uses evidence-based methodologies developed by the Task Force (1). The Class of Recommendation (COR) is an estimate of the size of the treatment effect considering risks versus benefits in addition to evidence and/or agreement that a given treatment or procedure is or is not useful/effective or in some situations may cause harm. The Level of Evidence (LOE) is an estimate of the certainty or precision of the treatment effect. The writing committee reviews and ranks evidence supporting each recommendation with the weight of evidence ranked as LOE A, B, or C according to specific definitions that are included in Table 1. Studies are identified as observational, retrospective, prospective, or randomized where appropriate. For certain conditions for which inadequate data are available, recommendations are based on expert consensus and clinical experience and are ranked as LOE C. When recommendations at LOE C are supported by historical clinical data, appropriate references (including clinical reviews) are cited if available. For issues for which sparse data are available, a survey of current
   [GRAPHICS]
   practice among the clinicians on the writing committee is the basis for LOE C recommendations, and no references are cited. The schema for COR and LOE is summarized in Table 1, which also provides suggested phrases for writing recommendations within each COR. A new addition to this methodology is separation of the Class III recommendations to delineate if the recommendation is determined to be of "no benefit" or is associated with "harm" to the patient. In addition, in view of the increasing number of comparative effectiveness studies, comparator verbs and suggested phrases for writing recommendations for the comparative effectiveness of one treatment or strategy versus another have been added for COR I and IIa, LOE A or B only.
   In view of the advances in medical therapy across the spectrum of cardiovascular diseases, the Task Force has designated the term guideline-directed medical therapy (GDMT) to represent optimal medical therapy as defined by ACCF/AHA guideline-recommended therapies (primarily Class I). This new term, GDMT, will be used herein and throughout all future guidelines.
   Because the ACCF/AHA practice guidelines address patient populations (and healthcare providers) residing in North America, drugs that are not currently available in North America are discussed in the text without a specific COR. For studies performed in large numbers of subjects outside North America, each writing committee reviews the potential influence of different practice patterns and patient populations on the treatment effect and relevance to the ACCF/AHA target population to determine whether the findings should inform a specific recommendation.
   The ACCF/AHA practice guidelines are intended to assist healthcare providers in clinical decision making by describing a range of generally acceptable approaches to the diagnosis, management, and prevention of specific diseases or conditions. The guidelines attempt to define practices that meet the needs of most patients in most circumstances. The ultimate judgment regarding the care of a particular patient must be made by the healthcare provider and patient in light of all the circumstances presented by that patient. As a result, situations may arise for which deviations from these guidelines may be appropriate. Clinical decision making should involve consideration of the quality and availability of expertise in the area where care is provided. When these guidelines are used as the basis for regulatory or payer decisions, the goal should be improvement in quality of care. The Task Force recognizes that situations arise in which additional data are needed to inform patient care more effectively; these areas will be identified within each respective guideline when appropriate.
   Prescribed courses of treatment in accordance with these recommendations are effective only if followed. Because lack of patient understanding and adherence may adversely affect outcomes, physicians and other healthcare providers should make every effort to engage the patient's active participation in prescribed medical regimens and lifestyles. In addition, patients should be informed of the risks, benefits, and alternatives to a particular treatment and be involved in shared decision making whenever feasible, particularly for COR IIa and IIb, where the benefit-to-risk ratio may be lower.
   The Task Force makes every effort to avoid actual, potential, or perceived conflicts of interest that may arise as a result of industry relationships or personal interests among the members of the writing committee. All writing committee members and peer reviewers of the guideline are required to disclose all such current relationships, as well as those existing 12 months previously. In December 2009, the ACCF and AHA implemented a new policy for relationships with industry and other entities (RWI) that requires the writing committee chair plus a minimum of 50% of the writing committee to have no relevant RWI (Appendix 1 for the ACCF/AHA definition of relevance). These statements are reviewed by the Task Force and all members during each conference call and meeting of the writing committee and are updated as changes occur. All guideline recommendations require a confidential vote by the writing committee and must be approved by a consensus of the voting members. Members are not permitted to write, and must recuse themselves from voting on, any recommendation or section to which their RWI apply. Members who recused themselves from voting are indicated in the list of writing committee members, and section recusals are noted in Appendix 1. Authors' and peer reviewers' RWI pertinent to this guideline are disclosed in Appendixes 1 and 2, respectively. Additionally, to ensure complete transparency, writing committee members' comprehensive disclosure information-including RWI not pertinent to this document-is available as an online supplement. Comprehensive disclosure information for the Task Force is also available online at www.cardiosource.org/ACC/About-ACC/Leadership/Guidelinesand-Documents-Task-Forces.aspx. The work of the writing committee was supported exclusively by the ACCF and AHA without commercial support. Writing committee members volunteered their time for this activity.
   In an effort to maintain relevance at the point of care for practicing physicians, the Task Force continues to oversee an ongoing process improvement initiative. As a result, in response to pilot projects, evidence tables (with references linked to abstracts in PubMed) have been added.
   In April 2011, the Institute of Medicine released 2 reports: Finding What Works in Health Care: Standards for Systematic Reviews and Clinical Practice Guidelines We Can Trust (2,3). It is noteworthy that the ACCF/AHA guidelines are cited as being compliant with many of the proposed standards. A thorough review of these reports and of our current methodology is under way, with further enhancements anticipated.
   The recommendations in this guideline are considered current until they are superseded by a focused update or the full-text guideline is revised. Guidelines are official policy of both the ACCF and AHA.
C1 [Hillis, L. David; Lange, Richard A.] Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.
   [Smith, Peter K.] Duke Univ, Med Ctr, Private Diagnost Clin, Durham, NC 27706 USA.
   [Bridges, Charles R.] Univ Penn, Med Ctr, Philadelphia, PA 19104 USA.
   [Byrne, John G.] Vanderbilt Univ, Med Ctr, Div Cardiac Surg, Nashville, TN 37203 USA.
   [Cigarroa, Joaquin E.] Oregon Hlth & Sci Univ, Portland, OR 97201 USA.
   [DiSesa, Verdi J.] Johns Hopkins Univ Hosp, Div Cardiac Surg, Baltimore, MD 21287 USA.
   [Hutter, Adolph M., Jr.; Shahian, David M.] Massachusetts Gen Hosp, Boston, MA 02114 USA.
   [Jessen, Michael E.] UT SW Med Ctr, Dallas, TX 75390 USA.
   [Keeley, Ellen C.] Univ Virginia, Charlottesville, VA 22903 USA.
   [Lahey, Stephen J.] Univ Connecticut, Storrs, CT 06269 USA.
   [London, Martin J.] Univ Calif San Francisco, Vet Affairs Med Ctr, San Francisco, CA 94143 USA.
   [Puskas, John D.] Emory Univ, Atlanta, GA 30322 USA.
   [Sabik, Joseph F.] Cleveland Clin Fdn, Cleveland, OH USA.
   [Selnes, Ola] Johns Hopkins Univ Hosp, Dept Neurol, Baltimore, MD 21287 USA.
   [Winniford, Michael D.] Univ Mississippi, Med Ctr, University, MS 38677 USA.
C3 University of Texas System; University of Texas at San Antonio; Duke
   University; University of Pennsylvania; Vanderbilt University; Oregon
   Health & Science University; Johns Hopkins University; Johns Hopkins
   Medicine; Harvard University; Harvard University Medical Affiliates;
   Massachusetts General Hospital; University of Texas System; University
   of Texas Southwestern Medical Center; University of Virginia; University
   of Connecticut; US Department of Veterans Affairs; Veterans Health
   Administration (VHA); University of California System; University of
   California San Francisco; Emory University; Cleveland Clinic Foundation;
   Johns Hopkins University; Johns Hopkins Medicine; University of
   Mississippi; University of Mississippi Medical Center
RP Hillis, LD (通讯作者)，Univ Texas Hlth Sci Ctr San Antonio, San Antonio, TX 78229 USA.
RI Lange, Richard/AAM-9594-2021; Patel, Manesh/AAC-5385-2019
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NR 1257
TC 808
Z9 925
U1 0
U2 100
PU ELSEVIER SCIENCE INC
PI NEW YORK
PA STE 800, 230 PARK AVE, NEW YORK, NY 10169 USA
SN 0735-1097
EI 1558-3597
J9 J AM COLL CARDIOL
JI J. Am. Coll. Cardiol.
PD DEC
PY 2011
VL 58
IS 24
BP E123
EP E210
DI 10.1016/j.jacc.2011.08.009
PG 88
WC Cardiac & Cardiovascular Systems
WE Science Citation Index Expanded (SCI-EXPANDED)
SC Cardiovascular System & Cardiology
GA 862ZJ
UT WOS:000298132300003
PM 22070836
DA 2026-07-24
ER

EF