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Anaesthesiology Intensive Therapy 2017The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed... (Review)
Review
BACKGROUND
The aim of this paper was to review the literature on vacuum-assisted wound closure and mesh-mediated fascial traction (VAWCM) in open abdomen therapy. It was designed as systematic review of observational studies.
METHODS
A Pub Med, EMBASE and Cochrane search from 2007/01-2016/07 was performed combining the Medical Subject Headings "vacuum", "mesh-mediated fascial traction", "temporary abdominal closure", "delayed abdominal closure", "open abdomen", "abdominal compartment syndrome", "negative pressure wound therapy" or "vacuum assisted wound closure".
RESULTS
Eleven original studies were found including patients numbering from 7 to 111. Six studies were prospective and five were retrospective. Nine studies were on mixed surgical (n = 9), vascular (n = 6) and trauma (n = 6) patients, while two were exclusively on vascular patients. The primary fascial closure rate per protocol varied from 80-100%. The time to closure of the open abdomen varied between 9-32 days. The entero-atmospheric fistula rate varied from 0-10.0%. The in-hospital survival rate varied from 57-100%. In the largest prospective study, the incisional hernia rate among survivors at 63 months of median follow-up was 54% (27/50), and 16 (33%) repairs out of 48 incisional hernias were performed throughout the study period. The study patients reported lower short form health survey (SF-36) scores than the mean reference population, mainly dependent on the prevalence of major co-morbidities. There was no difference in SF-36 scores or a modified ventral hernia pain questionnaire (VHPQ) at 5 years of follow up between those with versus those without incisional hernias.
CONCLUSIONS
A high primary fascial closure rate can be achieved with the vacuum-assisted wound closure and meshmediated fascial traction technique in elderly, mainly non-trauma patients, in need of prolonged open abdomen therapy.
Topics: Abdomen; Abdominal Wound Closure Techniques; Aged; Humans; Surgical Mesh; Time Factors; Traction; Vacuum; Wound Healing
PubMed: 28502075
DOI: 10.5603/AIT.a2017.0023 -
Eye (London, England) Jul 2016
Topics: Myopia; Myopia, Degenerative; Retinal Diseases; Tomography, Optical Coherence; Traction; Visual Acuity
PubMed: 26965013
DOI: 10.1038/eye.2016.38 -
Anaesthesia, Critical Care & Pain... Feb 2023Mesenteric traction syndrome (MTS) is commonly seen during major abdominal surgery and is characterised by facial flushing, hypotension, and tachycardia 15 min into... (Review)
Review
BACKGROUND
Mesenteric traction syndrome (MTS) is commonly seen during major abdominal surgery and is characterised by facial flushing, hypotension, and tachycardia 15 min into surgery. MTS also impacts the postoperative course, as severe MTS has been associated with increased postoperative morbidity. However, despite MTS being common and severe MTS causing increased postoperative morbidity, the gaps in the literature are not clearly defined. We aimed to examine the diagnostic criteria, incidence, intraoperative and postoperative impact, and potential preventative measures of MTS while highlighting potential gaps in the literature.
METHODS
We followed the Prisma guidelines and performed a systematic literature search. We included only human studies examining MTS. All hits were screened for title and abstract, followed by a full-text review by at least two authors for determining eligibility for inclusion. Data were extracted and risk of bias was assessed by two independent reviewers.
RESULTS
A total of 37 studies, comprising 1102 patients were included in the review. The combined incidence of MTS during open abdominal surgery was found to be 76%, with 35% developing severe MTS. It was found that the development of MTS was associated with marked haemodynamic changes. It was also found that several different subjective diagnostic criteria exist and that severe MTS was associated with increased postoperative morbidity. Furthermore, several preventative measures for protecting against MTS have been examined, but only on the incidence of MTS and not on the postoperative course.
CONCLUSION
MTS occurs in 76% of patients undergoing major abdominal surgery and is associated with deleterious haemodynamic effects, which are more pronounced in patients developing severe MTS. Severe MTS is also associated with a worse postoperative outcome. However, gaps are still present in the current literature on MTS.
Topics: Humans; Incidence; Traction; Hypotension; Hemodynamics; Flushing
PubMed: 36162787
DOI: 10.1016/j.accpm.2022.101162 -
BMC Surgery Mar 2023In order to improve the clinical medical technology, enhance the clinical effect and improve the disease detection rate, the clinical incidence rate of atlantoaxial... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
In order to improve the clinical medical technology, enhance the clinical effect and improve the disease detection rate, the clinical incidence rate of atlantoaxial dislocation and vertebral body malformation that are difficult to summarize is increasing year by year.
METHODS
A total of 80 patients with atlantoaxial dislocation deformity treated in our hospital from January 2017 to May 2021 are selected for this study. According to the number table method, 80 patients are randomly divided into the auxiliary group and the traditional group, with 40 cases in each group. The traditional group is treated with posterior atlantoaxial pedicle screw system internal fixation and intervertebral fusion, and the auxiliary implementation and application of a new head and neck fixation and traction device through nasal cannula and oral release decompression fixation for posterior fusion. The patients in the two groups are compared changes and differences in efficacy, spinal cord function index, pain score, surgery, and quality of life.
RESULTS
Compared with the traditional group, the total clinical effective rate, cervical spine extension and flexion range of motion, physical function, physical function, psychological function, and social function in the auxiliary group are significantly improved. The operation time, intraoperative blood loss, and VAS score are significantly reduced (P < 0.05).
CONCLUSION
The new head and neck fixation traction device can improve the surgical efficacy and quality of life of patients with irreversible atlantoaxial dislocation, enhance spinal cord function, reduce pain symptoms and surgical risks, and is worthy of clinical application.
Topics: Humans; Traction; Quality of Life; Joint Dislocations; Cervical Vertebrae; Fracture Fixation, Internal; Treatment Outcome; Spinal Fusion
PubMed: 36997968
DOI: 10.1186/s12893-023-01957-0 -
The Cochrane Database of Systematic... Aug 2013Traction has been used to treat low-back pain (LBP), often in combination with other treatments. We included both manual and machine-delivered traction in this review.... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Traction has been used to treat low-back pain (LBP), often in combination with other treatments. We included both manual and machine-delivered traction in this review. This is an update of a Cochrane review first published in 1995, and previously updated in 2006.
OBJECTIVES
To assess the effects of traction compared to placebo, sham traction, reference treatments and no treatment in people with LBP.
SEARCH METHODS
We searched the Cochrane Back Review Group Specialized Register, the Cochrane Central Register of Controlled Trials (2012, Issue 8), MEDLINE (January 2006 to August 2012), EMBASE (January 2006 to August 2012), CINAHL (January 2006 to August 2012), and reference lists of articles and personal files. The review authors are not aware of any important new randomized controlled trial (RCTs) on this topic since the date of the last search.
SELECTION CRITERIA
RCTs involving traction to treat acute (less than four weeks' duration), subacute (four to 12 weeks' duration) or chronic (more than 12 weeks' duration) non-specific LBP with or without sciatica.
DATA COLLECTION AND ANALYSIS
Two review authors independently performed study selection, risk of bias assessment and data extraction. As there were insufficient data for statistical pooling, we performed a descriptive analysis. We did not find any case series that identified adverse effects, therefore we evaluated adverse effects that were reported in the included studies.
MAIN RESULTS
We included 32 RCTs involving 2762 participants in this review. We considered 16 trials, representing 57% of all participants, to have a low risk of bias based on the Cochrane Back Review Group's 'Risk of bias' tool.For people with mixed symptom patterns (acute, subacute and chronic LBP with and without sciatica), there was low- to moderate-quality evidence that traction may make little or no difference in pain intensity, functional status, global improvement or return to work when compared to placebo, sham traction or no treatment. Similarly, when comparing the combination of physiotherapy plus traction with physiotherapy alone or when comparing traction with other treatments, there was very-low- to moderate-quality evidence that traction may make little or no difference in pain intensity, functional status or global improvement.For people with LBP with sciatica and acute, subacute or chronic pain, there was low- to moderate-quality evidence that traction probably has no impact on pain intensity, functional status or global improvement. This was true when traction was compared with controls and other treatments, as well as when the combination of traction plus physiotherapy was compared with physiotherapy alone. No studies reported the effect of traction on return to work.For chronic LBP without sciatica, there was moderate-quality evidence that traction probably makes little or no difference in pain intensity when compared with sham treatment. No studies reported on the effect of traction on functional status, global improvement or return to work.Adverse effects were reported in seven of the 32 studies. These included increased pain, aggravation of neurological signs and subsequent surgery. Four studies reported that there were no adverse effects. The remaining studies did not mention adverse effects.
AUTHORS' CONCLUSIONS
These findings indicate that traction, either alone or in combination with other treatments, has little or no impact on pain intensity, functional status, global improvement and return to work among people with LBP. There is only limited-quality evidence from studies with small sample sizes and moderate to high risk of bias. The effects shown by these studies are small and are not clinically relevant. Implications for practice To date, the use of traction as treatment for non-specific LBP cannot be motivated by the best available evidence. These conclusions are applicable to both manual and mechanical traction. Implications for research Only new, large, high-quality studies may change the point estimate and its accuracy, but it should be noted that such change may not necessarily favour traction. Therefore, little priority should be given to new studies on the effect of traction treatment alone or as part of a package.
Topics: Acute Pain; Chronic Pain; Humans; Low Back Pain; Pain Measurement; Randomized Controlled Trials as Topic; Sciatica; Traction
PubMed: 23959683
DOI: 10.1002/14651858.CD003010.pub5 -
British Medical Journal Jul 1960
Topics: Alopecia; Female; Humans; Traction; Women
PubMed: 14424109
DOI: 10.1136/bmj.2.5192.115 -
Nano Letters Jul 2019Quantification of mechanical forces is a major challenge across biomedical sciences. Yet such measurements are essential to understanding the role of biomechanics in...
Quantification of mechanical forces is a major challenge across biomedical sciences. Yet such measurements are essential to understanding the role of biomechanics in cell regulation and function. Traction force microscopy remains the most broadly applied force probing technology but typically restricts itself to single-plane two-dimensional quantifications with limited spatiotemporal resolution. Here, we introduce an enhanced force measurement technique combining 3D super-resolution fluorescence structural illumination microscopy and traction force microscopy (3D-SIM-TFM) offering increased spatiotemporal resolution, opening-up unprecedented insights into physiological three-dimensional force production in living cells.
Topics: Computer Simulation; Microscopy, Atomic Force; Traction
PubMed: 31199151
DOI: 10.1021/acs.nanolett.9b01196 -
Journal of Rehabilitation Medicine May 2006To assess whether mechanical traction, either alone or in combination with other treatments, improves pain, function/disability, patient satisfaction and global... (Comparative Study)
Comparative Study Review
OBJECTIVE
To assess whether mechanical traction, either alone or in combination with other treatments, improves pain, function/disability, patient satisfaction and global perceived effect in adults with mechanical neck disorders.
METHODS
We conducted a systematic review up to September 2004 of randomized controlled trials and used pre-defined levels of evidence for qualitative analysis. Two independent reviewers conducted study selection, data abstraction and methodological quality assessment. Using a random effects model, relative risk and standardized mean differences were calculated. The reasonableness of combining studies was assessed on clinical and statistical grounds. In the absence of heterogeneity, pooled effect measures were calculated.
RESULTS
Of the 10 selected trials, one study was of high quality. Our review revealed low-quality trials for mechanical neck disorders, showing evidence of benefit favouring intermittent traction for pain reduction. Continuous traction showed no significant difference for defined outcomes.
CONCLUSION
Inconclusive evidence for continuous and intermittent traction exists due to trial methodological quality. Two clinical conclusions may be drawn, one favouring the use of intermittent traction and the other not supporting the use of continuous traction. Attention to research design flaws and description of traction characteristics is needed.
Topics: Adult; Cervical Vertebrae; Disability Evaluation; Humans; Neck Injuries; Neck Pain; Physical Therapy Modalities; Recovery of Function; Traction; Treatment Outcome; Whiplash Injuries
PubMed: 16702080
DOI: 10.1080/16501970600583029 -
Indian Journal of Ophthalmology Jul 2022Vitreomacular traction (VMT) is a commonly encountered entity in our routine practice. The key question is whether to observe or operate by clinical and imaging based...
BACKGROUND
Vitreomacular traction (VMT) is a commonly encountered entity in our routine practice. The key question is whether to observe or operate by clinical and imaging based judgement of the visual prognosis in every case.
PURPOSE
This video encapsulates diagnostics, surgical method, and prognosis in a case of VMT released with vitrectomy.
SYNOPSIS
A 56-year-old businessman was diagnosed with VMT in the OPD and was advised surgical release of the same. The patient was extremely keen to know the visual prognosis, where the OCT imaging helped. The surgical method demonstrates the method to find the edge of the PVD to release the traction. Also, a simple ILM peel procedure has been described to reduce recurrences in cases like these.
HIGHLIGHTS
1. Judging the prognosis in VMT cases on basis of imaging. 2.Finding the edge (FTE) method of inducing the PVD. 3. ILM peeling simplified.
ONLINE VIDEO LINK
https://youtu.be/oSZQGQgYmQ8.
Topics: Humans; Middle Aged; Retina; Tomography, Optical Coherence; Traction; Vision Disorders; Visual Acuity; Vitrectomy
PubMed: 35791254
DOI: 10.4103/ijo.IJO_1430_22 -
Biophysical Journal Aug 2021Cells interact mechanically with their surroundings by exerting and sensing forces. Traction force microscopy (TFM), purported to map cell-generated forces or stresses,...
Cells interact mechanically with their surroundings by exerting and sensing forces. Traction force microscopy (TFM), purported to map cell-generated forces or stresses, represents an important tool that has powered the rapid advances in mechanobiology. However, to solve the ill-posed mathematical problem, conventional TFM involved compromises in accuracy and/or resolution. Here, we applied neural network-based deep learning as an alternative approach for TFM. We modified a neural network designed for image processing to predict the vector field of stress from displacements. Furthermore, we adapted a mathematical model for cell migration to generate large sets of simulated stresses and displacements for training and testing the neural network. We found that deep learning-based TFM yielded results that resemble those using conventional TFM but at a higher accuracy than several conventional implementations tested. In addition, a trained neural network is appliable to a wide range of conditions, including cell size, shape, substrate stiffness, and traction output. The performance of deep learning-based TFM makes it an appealing alternative to conventional methods for characterizing mechanical interactions between adherent cells and the environment.
Topics: Computer Simulation; Deep Learning; Microscopy, Atomic Force; Models, Theoretical; Traction
PubMed: 34214526
DOI: 10.1016/j.bpj.2021.06.011