-
Animals : An Open Access Journal From... Jun 2024We aimed to compare surgical time, bleeding level, patient pain level, healing period, scar tissue, relapse of the initial process and complications in patients with...
We aimed to compare surgical time, bleeding level, patient pain level, healing period, scar tissue, relapse of the initial process and complications in patients with nasopharyngeal oncological masses undergoing surgery using a scalpel blade versus a CO surgical laser. This is a clinical prospective study comprising surgical work in the nasopharynx area. A sample of 12 inpatients dogs (N = 12) of both genders underwent a surgical excision of nasopharyngeal masses with a scalpel blade (GS = 6) and CO surgical laser (GL = 6). An Aesculigth CO surgical laser-Vetscalpel model with a superpulse mode, 12 W of power, and a multi-focus pen was used. Statistically significant differences were registered for a -value of < 0.05. Variations were noted between both groups (GS and GL) concerning surgery time ( = 0.038), first meal time ( = 0.013), pain level ( 0.003), and healing time ( 0.014), with the GL group presenting lower values. GL exhibited only one relapse case, with the elapsed time being more than double that of the GS group. Surgical and healing times were shorter in the GL group, and pain levels were lower, with the GL group also demonstrating less scar tissue than the GS group, along with a lower relapse rate. Nasopharynx surgical exposure with precision via the soft palate using the CO laser has facilitated successful treatment of regional masses without discomfort and complications, compared to conventional blade scalpel procedures.
PubMed: 38929352
DOI: 10.3390/ani14121733 -
Journal of Cardiothoracic and Vascular... May 2024To test the effectiveness of a novel wire-guided scalpel (Guideblade) to create a precise dermatotomy incision for central venous catheter (CVC) insertion.
OBJECTIVE
To test the effectiveness of a novel wire-guided scalpel (Guideblade) to create a precise dermatotomy incision for central venous catheter (CVC) insertion.
DESIGN
Prospective, nonrandomized interventional study.
SETTING
Stanford University, single-center teaching hospital.
PARTICIPANTS
Cardiac and vascular surgical patients (n = 100) with planned CVC insertion for operation.
INTERVENTIONS
A wire-guided scalpel was used during CVC insertion.
RESULTS
A total of 188 CVCs were performed successfully with a wire-guided scalpel without the need for additional equipment in 100 patients, and 94% of CVCs were accomplished with only a single dermatotomy attempt. "No bleeding" or "minimal bleeding" at the insertion site was observed in 90% of patients 30 minutes after insertion and 80.7% at the conclusion of surgery.
CONCLUSION
The wire-guided scalpel was effective in performing dermatotomy for CVC with a 100% success rate and a very high first-attempt rate. The wire-guided scalpel may decrease bleeding at the CVC insertion site.
PubMed: 38908939
DOI: 10.1053/j.jvca.2024.04.003 -
Arthroscopy : the Journal of... Jun 2024Articular cartilage defects in the knee are common and possess limited ability to inherently heal. Many of the surgical management options for cartilage repair that...
Articular cartilage defects in the knee are common and possess limited ability to inherently heal. Many of the surgical management options for cartilage repair that result in a hyaline or hyaline-like chondral surface have donor site morbidity, are resource intensive, are costly, and may require multiple surgeries. Autologous minced cartilage implantation is an encouraging, single-stage technique that can be safely and efficiently performed arthroscopically to address focal chondral defects in the knee. The limited morbidity and cost-effective nature of using autograft tissue has clear advantages, including an ability to treat patients at the time a clinically relevant defect is identified, increased availability of tissue, reduced patient morbidity with the use of an arthroscopic harvest technique, and the production of a hyaline cartilage repair product with active chondrocytes. Clinically, it has been demonstrated to be superior to microfracture. However, mincing technique may compromise cell viability. A recent porcine model investigation demonstrated that arthroscopic cartilage harvest using a shaver, contains a significantly lower median number of viable chondrocytes compared to open scalpel harvest, resulting in reduced proteoglycans, glycosaminoglycans, aggrecan, and COL2A1 expression, a result of fewer viable chondrocytes. The authors suggest that traditional open scalpel harvest results in a superior single-stage autologous minced cartilage transplantation product with more hyaline-like tissue compared to arthroscopic mincing techniques. However, the findings of the study regarding cell viability after arthroscopic harvest are in stark contrast to previous findings, including our prior work. Pending future research, it is our view that an arthroscopic single-stage autologous cartilage transplant is more reproducible, efficient, and of lower morbidity than open harvest, and we and others have shown the arthroscopic technique to be both safe and effective.
PubMed: 38908489
DOI: 10.1016/j.arthro.2024.06.025 -
Journal of Plastic, Reconstructive &... Jun 2024
PubMed: 38901079
DOI: 10.1016/j.bjps.2024.06.011 -
BMC Infectious Diseases Jun 2024Acinetobacter baumannii resistant strains lead to increased mortality, treatment costs, and an increase in the length of hospitalization. Nowadays, nanoparticles are...
Study of MIC of silver and zinc oxide nanoparticles, strong and cost-effective antibacterial against biofilm-producing Acinetobacter baumannii in Shiraz, Southwest of Iran.
BACKGROUND
Acinetobacter baumannii resistant strains lead to increased mortality, treatment costs, and an increase in the length of hospitalization. Nowadays, nanoparticles are considered a substitute for antibiotics. This study aimed to determine the MIC of Silver (Ag) and Zinc Oxide (ZnO) Nanoparticles (NPs) on Biofilm-Producing Acinetobacter baumannii and determine the relationship between MIC and frequency of efflux pump genes in cutaneous specimens in Shiraz, Southwest Iran in 2021-2022.
METHODS
In this study, specimens were collected from April 2021 to June 2022 at Namazi and Faqihi Hospitals in Shiraz. Investigation of biofilm production in multidrug resistance (MDR) isolates was done by the microtiter plate method. Synthesized nanoparticles were characterized by UV-vis spectrum, X-ray diffraction (XRD), and electron microscopy. The MIC of AgNPs and ZnONPs for isolates was done using the method described in the CLSI guideline (2018). The antibacterial effect of MIC of NPs on inanimate objects was done by colony counts. The prevalence of efflux pump genes (adeR, adeC, adeA, abeM, adeK, adeI) was also investigated by PCR technique.
RESULTS
The highest ceftriaxone resistance (68%) and lowest colistin resistance (7%) were identified. 57% of isolates were MDR. In addition, 71.9% could produce biofilm and 28.1% of isolates could not produce biofilm. The average size of AgNPs and ZnONPs in the present study is 48 and < 70 nm, respectively. The nanoparticles were spherical. The MIC and the MBC of the ZnONPs were in the range of 125 to 250 µg/mL respectively. Also, for AgNPs, the MIC and the MBC were in the range of 62.5 to 250 µg/ml, respectively. AbeM gene had the highest frequency and the AdeK gene had the lowest frequency. Statistical analysis showed that there is a relationship between the frequency of adeA, adeC, and adeM genes with the MIC of AgNPs and ZnONPs.
CONCLUSION
According to the results of the present study, inanimate objects such as scalpels in contact with AgNPs (6000 µg/ml for 240 min) or ZnONPs (5000 µg/ml for 120 min) can be free of biofilm producing Acinetobacter baumannii with efflux pump genes.
Topics: Acinetobacter baumannii; Biofilms; Iran; Microbial Sensitivity Tests; Anti-Bacterial Agents; Silver; Zinc Oxide; Humans; Acinetobacter Infections; Metal Nanoparticles; Drug Resistance, Multiple, Bacterial; Adult; Male; Female; Middle Aged; Adolescent; Young Adult; Child; Aged; Child, Preschool; Nanoparticles
PubMed: 38886629
DOI: 10.1186/s12879-024-09471-1 -
Aesthetic Plastic Surgery Jun 2024Abdominoplasty, an emerging surgical procedure worldwide, associated with complications, as seroma, infection, and hematoma. This systematic review and meta-analysis... (Review)
Review
BACKGROUND
Abdominoplasty, an emerging surgical procedure worldwide, associated with complications, as seroma, infection, and hematoma. This systematic review and meta-analysis compare the outcomes of abdominoplasty procedures performed using a scalpel versus a diathermocoagulation device (diathermy monopolar electrocautery), aiming to find a safer approach with fewer complications.
METHODS
We conducted a systematic search in November 2023 using PubMed, Ovid Medline, and Ovid Chocrane databases. The methodological index for nonrandomized studies and the Revised Cochrane Risk of Bias assessment tools were used to assess risk of bias for observational studies and randomized controlled trials, respectively. The data were analyzed using RevMan software.
RESULTS
Six articles (1135 patients) were included, 521 patients were operated using a scalpel and 614 using electrocautery. Our analysis suggests that both seroma and drain output were seen more among the electrocautery group, with an odds ratio (OR) of 0.62 (95% CI [0.39, 0.97], p = 0.04) and - 103.63 (95% CI [- 205.67, - 1.59], p = 0.05), respectively. It is important to note the high heterogeneity seen among the studies discussing the total drain output. Additionally, we did not find any statistical significance between both techniques in terms of the rate of hematoma, wound infection, operation time, and hospital stay length.
CONCLUSION
When comparing the use of scalpel and electrocautery dissection in abdominoplasty, higher rates of seroma and total drain output are significantly associated with electrocautery dissection.
LEVEL OF EVIDENCE II
This 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 .
PubMed: 38886194
DOI: 10.1007/s00266-024-04156-1 -
Cureus May 2024Frenum aberrations in the maxillary and mandibular regions are pivotal concerns, particularly regarding midline diastema and gingival health. The frenum is...
Frenum aberrations in the maxillary and mandibular regions are pivotal concerns, particularly regarding midline diastema and gingival health. The frenum is composed predominantly of collagenous and elastic fibers. There are various frenal attachment anomalies that may result in gingival recession. Amidst treatment options, conventional scalpel frenectomy emerges as a viable solution, showcasing its efficacy in addressing deviant frena. Ultimately, our findings underscore the imperative for personalized interventions to alleviate aesthetic apprehensions and uphold periodontal integrity in adult populations.
PubMed: 38872694
DOI: 10.7759/cureus.60252 -
Surgical Innovation Jun 2024Endoscopic surgery is an effective technique for preserving the nipple and areola, as well as for sentinel lymph node biopsy and breast implant reconstruction. However,...
OBJECTIVE
Endoscopic surgery is an effective technique for preserving the nipple and areola, as well as for sentinel lymph node biopsy and breast implant reconstruction. However, the technical challenges associated with endoscopic surgery have limited its widespread adoption.
METHODS
In the normal single-port endoscopic surgery, the ultrasonic knife was accessed through the retractor. In our modified procedure, a tiny 5 mm incision was made at the lateral margin underneath the breast, serving as the second entry port for the ultrasonic scalpel, which was referred to as the "Haigui-1 hole". Preoperative and postoperative indicators such as blood loss, operative time, and postoperative drainage volume were collected. Differences between parameters were compared using Student's test.
RESULTS
Endoscopic surgery with the assistance of the "Haigui-1 hole" led to preserved breast aesthetics with minimal scarring. Moreover, "Haigui-1 hole" surgery significantly reduced the operation time, intraoperative bleeding, and postoperative drainage volume compared to normal single-port endoscopic surgery.
CONCLUSION
The "Haigui-1 hole" procedure, which involves the addition of a second entrance to improve the maneuverability of the ultrasonic knife, is worthy of further promotion.
PubMed: 38867678
DOI: 10.1177/15533506241262563 -
Journal of Stomatology, Oral and... Jun 2024A constant search for methods to limit blood loss, especially the vascular lesions of the tongue, has led to the acceptance of ultrasonic harmonic scalpels.The harmonic...
A constant search for methods to limit blood loss, especially the vascular lesions of the tongue, has led to the acceptance of ultrasonic harmonic scalpels.The harmonic scalpel's reliability exists in its ability for lasting hemostasis with minimal heat dispersion to the surrounding structures.Surgical removal of the vascular pathology in a restricted area of the oral cavity and oropharynx dictates a bloodless surgical field, further allowing increased visibility of the lesion and the surrounding anatomical structures, subsequently narrowing the surgical time frame.We report a rare case of haemangioma of the lateral border of the tongue managed with complete resection of the tumor achieved using the harmonic scalpel with reduced intraoperative blood loss, increased visibility, evidently reduced post-operative necrosis and highly preserved tissue for the histopathological examination.
PubMed: 38852621
DOI: 10.1016/j.jormas.2024.101943 -
The Annals of Thoracic Surgery Jun 2024We evaluated the prevalence and outcomes of competitive flow in the terminal right coronary artery (RCA) graft after coronary artery bypass grafting (CABG) with left...
BACKGROUND
We evaluated the prevalence and outcomes of competitive flow in the terminal right coronary artery (RCA) graft after coronary artery bypass grafting (CABG) with left internal thoracic artery-based Y-composite grafting at 1 year after CABG.
METHODS
We enrolled 642 patients who underwent Y-composite graft-based off-pump CABG with in situ left internal thoracic artery between 2014 and 2022. All patients underwent early postoperative angiography, and 1-year postoperative angiography was performed in 81.2% (522/642) of patients.
RESULTS
The early occlusion rate of distal anastomoses with Y-composite graft was 2.1%. Competitive flow was observed in 69 of 642 anastomoses (10.7%). Multivariate analysis showed that the maximal degree of target vessel stenosis (odds ratio [OR], 0.909; 95% CI, 0.886-0.931; P < .001), maximal degree of non-terminal target vessel in Y-arm grafts (OR, 1.103; 95% CI, 1.047-1.172; P < .001), and diabetes mellitus (OR, 0.535; 95% CI, 0.303-0.934; P = .029) were factors associated with competitive flow to the RCA territory. The optimal cutoff value for the degree of terminal target vessel stenosis predicting competitive flow to the RCA territory was 92.5%. The 1-year graft failure rate of anastomoses with competitive flow of the terminal anastomosis was 30.9% (17/55). The presence of competitive flow on early angiography was the only factor associated with graft occlusion of the terminal anastomosis at 1 year (OR, 2.339; 95% CI, 1.165-4.481; P = .013).
CONCLUSIONS
For terminal anastomosis to the RCA territory in Y-composite graft-based CABG, the presence of competitive flow on early angiography was associated with graft occlusion of the terminal anastomosis at 1 year. Notably, 30.9% of these grafts demonstrated failure on 1-year follow-up angiography.
PubMed: 38851416
DOI: 10.1016/j.athoracsur.2024.05.026