Aneurysm in a double velour knitted Dacron graft

Double velour knitted Dacron grafts are currently used for aorto-iliac arterial reconstructions to increase encapsulation and enable rapid intimization of the grafts. Reports of an aneurysm arising in the body of a double velour knitted Dacron graft are rare. We experienced a case of aneurysm arising in the body of an innominate-abdominal aortic bypass graft four years after implantation. Microscopically, this focal aneurysm seemed to be related to a structural defect in the manufacturing process. We wish to stress that patients with implanted commercial Dacron prostheses should be carefully and regularly followed.     

Mechanism of primary graft non‐function in a rat model for fatty liver transplantation

Abstract We established a fatty liver model in rat suitable for the model of human liver with steatosis by cholesterol enriched chow, and investigated the mechanism of primary graft non‐function in fatty liver transplantation (LTx) using this model. Grafts with steatosis caused primary graft dysfunction after LTx following even short cold preservation; however, no significant difference was recognized in mitochondrial function of the graft during preservation. Morphological findings were not different at 1 h after reperfusion between non‐steatotic and steatotic livers. Focal necrosis of hepatocytes was seen and the sinusoidal endothelial cells were injured 24 h after reperfusion. In addition, the fluidity of the plasma membrane decreased in fatty liver. Our results indicate that deterioration of sinusoidal endothelial cells after reperfusion causes graft dysfunction in LTx of steatotic liver.     

Evaluation of Hyphecan (1‐4,2‐acetamide‐deoxy‐B‐D‐glucan polymer) on wound healing in a rodent model

Objective: To evaluate the effect of an artificial skin Hyphecan (1‐4,2‐acetamide‐deoxy‐B ‐D ‐glucan polymer) on wound healing in a rodent model. Materials and Method: The prospective study was conducted at a basic science laboratory at a tertiary teaching hospital. Two 4 cm × 4 cm full‐thickness wounds were created on the dorsal surface of 10 Spraque–Dawley rats and covered with Hyphecan and Kaltostat, respectively. Wounds were examined and measured on days 4, 10, 21 and 28, and would continue after day 28 until healed up completely. Punch biopsies (3 mm) were taken on days 4, 10 and 28 for histological examination of the response of healing and repair. Results: Despite the fact that the wound healing rate was similar for both groups on days 4, 10, 21 and 28, the average healing time for the Hyphecan group (29.1 ± 1.7 days) was significantly shorter statistically (P = 0.03) than the Kaltostat group (30.7 ± 2.8 days). Conversely, the marked healing response elicited by Hyphecan on day 4 persisted on days 10 and 28 in contrast to Kaltostat, which had only a mild degree of healing response on days 10 and 28. The study suggests that wounds treated by Hyphecan heal faster than Kaltostat. Conclusion: The findings provide basic scientific evidence supporting the clinical use of Hyphecan in different wounds and might also reduce the cost of wound management as Hyphecan is cheaper than Kaltostat and requires a shorter treatment time.      

70 vs 120 W thulium:yttrium‐aluminium‐garnet 2 µm continuous‐wave laser for the treatment of benign prostatic hyperplasia: a systematic ex‐vivo evaluation

Study Type – Aetiology (case series)
Level of Evidence 4

OBJECTIVE

To evaluate the ablative and haemostatic properties of the recently introduced 120‐W thulium:yttrium‐aluminium‐garnet (Tm‐YAG) laser and to assess these results against those of the previously introduced 70‐W Tm‐YAG laser.

MATERIALS AND METHODS

The ex‐vivo model of the isolated blood‐perfused porcine kidney was used to determine the ablation capacity, haemostatic properties and coagulation depth of a 2 µm continuous‐wave Tm‐YAG laser. The energy was delivered using a 550‐µm and an 800‐µm bare‐ended fibre. The results of the recently introduced 120‐W Tm‐YAG were compared to the established 70‐W device. Kidney tissue was embedded for histological evaluation. After staining (haematoxylin and eosin, H&E; and NADH) of the specimen, the coagulation zone and depth of the necrotic tissue layer were measured.

RESULTS

With increased power output, the mean (sd ) rate of vaporization of tissue increased, from 9.80 (3.03) g/10 min at 70 W to 16.41 (5.2) g/10 min at 120 W using the 550 µm fibre. The total amount of ablated tissue using the 800 µm fibre was lower than with the 550 µm fibre. With increasing power output the bleeding rate remained stable in either group. Tissue penetration remained shallow, even with increasing power output. In contrast to H&E staining, where the coagulation zone was measured, NADH staining showed an inner zone of necrotic tissue, again with no difference between the 70‐ and the 120‐W Tm‐YAG.

CONCLUSION

The 120‐W Tm‐YAG offers significantly higher ablation rates than the 70‐W device, and despite the increased rate of ablation with the 120‐W Tm‐YAG, the bleeding rate and depth of tissue penetration were comparable to those using the 70‐W device.     

Minimizing the risk of non‐vertical,non‐sexual HIV infection in children – beyond mother to child transmission

After witnessing an episode of poor injection safety in large numbers of children in a rural under‐resourced hospital in Uganda, we briefly review our own experience and that of others in investigating HIV infection in children considered unlikely to be through commonly identified routes such as vertical transmission, sexual abuse or blood transfusion. In the majority of cases, parents are HIV uninfected. The cumulative experience suggests that the problem is real, but with relatively low frequency. Vertical transmission is the major route for HIV to children. However, factors such as poor injection safety, undocumented surrogate breast feeding, an HIV‐infected adult feeding premasticated food to a weaning toddler, poor hygienic practice in the home and using unsterilised equipment for minor surgical or traditional procedures are of cumulative concern.     

Attenuated and non‐haemadsorbing (non‐HAD) genotype II African swine fever virus (ASFV) isolated in Europe,Latvia 2017

A non‐haemadsorbing (non‐HAD) ASF virus (ASFV) genotype II, namely Lv17/WB/Rie1, was isolated from a hunted wild boar in Latvia in 2017. Domestic pigs experimentally infected with the non‐HAD ASFV developed a nonspecific or subclinical form of the disease. Two months later, these animals were fully protected when exposed to other domestic pigs infected with a related virulent HAD genotype II ASFV.     

Associated use of silicone–vitamin E gauzes and α‐tocopherol acetate oil in healing of skin graft donor sites

Split‐thickness skin graft is one of the most used procedures in plastic surgery. This procedure involves numerous painful dressings at the donor site. α‐Tocopherol acetate has anti‐oxidative and anti‐inflammatory properties and it can reduce the local bacterial growth, thereby promoting wound healing. We designed a prospective study to evaluate the effects of two different kinds of dressings at skin graft donor sites. A total of 30 patients were subjected to daily dressings with α‐tocopherol acetate oil and traditional moist gauzes (group 1). Another 30 patients were subjected to dressings every 4 days with α‐tocopherol acetate oil and silicone–vitamin E gauzes (group 2). Healing time, infection rate, patient's pain perception and costs were evaluated in both the groups. No statistically significant difference was found in terms of healing time. The infection rate was slightly different in the two groups. Significant reduction of pain perception was detected in group 2. In the same group, significant reduction in the total cost of the treatment was also observed. α‐Tocopherol acetate oil and silicone–vitamin E gauzes may represent a safe, simple, painless and inexpensive method for improving skin graft donor site healing.