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Isabelle Mermet MD ; Nathalie Pottier MSc ; Jean Marie Sainthillier MSc ; Carole Malugani MSc ; Sandrive Cairey-Remonnay MD ; Stéphane Maddens PhD ; Didier Riethmuller MD PhD ; Pierre Tiberghien MD PhD ; Philippe Humbert MD PhD ; François Aubin MD PhD 《Wound repair and regeneration》2007,15(4):459-464
Amniotic membrane (AM), the most internal placental membrane, has unique properties including antiadhesive effects, bacteriostatic, wound protection and pain-reduction properties, as well as epithelialization initialization capacities. Furthermore, AM is widely available and less costly than other bioengineered skin substitutes. In a prospective pilot study, we evaluated the safety, feasibility, and the effects on healing of AM graft in 15 patients with chronic venous leg ulcers. AM grafts were prepared from placentas harvested during cesarean section. All grafted AM had adhered to the wound bed 7 days after being applied with a 100% engraftment rate. The percentage of granulation tissue increased significantly (from 17% on day 0 to 69% on day 14, p<0.0001), along with a significant decrease of fibrinous slough (from 36% at day 0 to 16% at day 14, p<0.001). A significant clinical response occurred in 12 patients (80%) including complete healing (20%) in three during the 3-month follow-up period. The ulcer surface area decreased significantly from a mean value (+/- standard deviation) of 4.59 +/- 2.49 cm(2) at baseline to 2.91+/-2.01 cm(2) on day 30 (p<0.001). All patients experienced a significant reduction of ulcer-related pain rapidly after AM transplantation. No adverse events were recorded. AM transplantation seems to function as a safe substrate, promoting proper epithelialization while suppressing excessive fibrosis. Further advantages of biotherapy with AM are its easy and low-cost production, and that it can be applied as an ambulatory treatment without immobilization. AM transplantation may thus be considered to be an alternative method for treating chronic leg ulcers. 相似文献
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Nicolas Borenstein Valérie Chetboul Patrick Bruneval Mehrak Hekmati Renaud Tissier Luc Behr Geneviève Derumeaux Didier Montarras 《European journal of cardio-thoracic surgery》2007,31(3):444-451
OBJECTIVE: Cell therapy may be a promising alternative or adjunct to current treatment modalities for ischemic heart failure. But little is known on the impact of myogenic cell transplantation in large animal models of non-ischemic cardiomyopathy. The aim of the present study was to explore whether an ovine model of toxin-induced heart disease could benefit from non-cultured skeletal muscle cell transplantation. METHODS: Sequential intracoronary injections of doxorubicin (0.75 mg/kg) were carried out every 2 weeks until echocardiographic detection of myocardial dysfunction. Sheep were then randomly assigned to either non-cultured cell transplantation (n=8) or placebo injection (n=5). For the cell therapy group, a skeletal muscle biopsy (about 10 g) was explanted from each animal approximately 3h before grafting. After thoracotomy, 20 epicardial injections were carried out. The animals were assessed one last time before sacrifice, 2 months after the thoracotomy. Cells were tracked with cmDiI (red fluorescence) and characterized with immunohistochemistry with monoclonal antibodies to a fast skeletal isoform of myosin heavy chain. RESULTS: Two months after intramyocardial grafting, tissue Doppler imaging and conventional echocardiographic assessment of the groups showed a marked improvement in the non-cultured cell therapy group. Ejection fraction (EF) (p<0.05) as well as systolic endocardial velocities (p<0.01) improved versus the placebo group. CmDiI and skeletal myosin heavy chain expression was detected in all animals at 2 months after implantation confirming engraftment of skeletal muscle cells. CONCLUSIONS: In conclusion, our data indicate that non-cultured muscle cell transplantation is feasible and may translate into a functional benefit in an ovine model of dilated heart failure. 相似文献
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François Lavigne P. Culpan T. Judet P. Piriou 《European journal of orthopaedic surgery & traumatology : orthopedie traumatologie》2009,19(5):321-325
Objective Stiffness and severe deformity pose a major challenge in total knee arthroplasty. Numerous techniques have been described
to gain exposure and improve knee flexion. Tibial tubercle osteotomy provides excellent and safe exposure of the joint, although
mechanical and wound complications have been reported.
Materials and methods We present a series of 32 consecutive complex primary total replacements where an osteotomy of the tibial tubercle was utilised.
Results The patients had a mean follow-up of 2 years and 11 months. Following the procedure, with the exception of one case complicated
with deep infection, all of the patients had improved clinically. The mean postoperative range of motion had increased to
102° (give P value < 0.005) and there were no cases of delayed union or non-union. A mechanical complication related to technique occurred
in one patient; there were no other cases with a postoperative extension lag.
Conclusion In this challenging population group, we have found a tibial tubercle tuberosity osteotomy to greatly facilitate exposure
without compromising the clinical and radiographic outcome. 相似文献
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Carmem Lúcia Pessoa-Silva Sasi Dharan Stéphane Hugonnet Sylvie Touveneau Klara Posfay-Barbe Riccardo Pfister Didier Pittet 《Infection control and hospital epidemiology》2004,25(3):192-197
OBJECTIVE: To evaluate the dynamics of bacterial contamination of healthcare workers' (HCWs) hands during neonatal care. SETTING: The 20-bed neonatal unit of a large acute care teaching hospital in Geneva, Switzerland. METHODS: Structured observation sessions were conducted. A sequence of care began when the HCW performed hand hygiene and ended when the activity changed or hand hygiene was performed again. Alcohol-based handrub was the standard procedure for hand hygiene. An imprint of the five fingertips of the dominant hand was obtained before and after hand hygiene and at the end of a sequence of care. Regression methods were used to model the final bacterial count according to the type and duration of care and the use of gloves. RESULTS: One hundred forty-nine sequences of care were observed. Commensal skin flora comprised 72.4% of all culture-positive specimens (n = 360). Other microorganisms identified were Enterobacteriaceae (n = 55, 13.8%); Staphylococcus aureus (n = 10, 2.5%); and fungi (n = 7, 1.8%). Skin contact, respiratory care, and diaper change were independently associated with an increased bacterial count; the use of gloves did not fully protect HCWs' hands from bacterial contamination. CONCLUSIONS: These data confirm that hands become progressively contaminated with commensal flora and potential pathogens during neonatal care, and identify activities at higher risk for hand contamination. They also reinforce the need for hand hygiene after a sequence of care, before starting a different task, and after glove removal. 相似文献
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