“Gunsight” Skin Incision and Closure Technique for Stoma Reversal

2010 ◽  
Vol 53 (11) ◽  
pp. 1569-1575 ◽  
Author(s):  
James T. Lim ◽  
Susan M. Shedda ◽  
Ian P. Hayes
Keyword(s):  
Skin Incision ◽  
Closure Technique ◽  
Stoma Reversal

Minimally Invasive Repair of Pectus Excavatum (MIRPE) - The Basel Experience

Swiss Surgery ◽  
2003 ◽  
Vol 9 (6) ◽  
pp. 289-295 ◽  
Author(s):  
Haecker ◽  
Bielek ◽  
von Schweinitz
Keyword(s):  
Minimally Invasive ◽  
Pectus Excavatum ◽  
Pulmonary Function Tests ◽  
Preoperative Evaluation ◽  
Skin Incision ◽  
Original Method ◽  
Restrictive Lung Disease ◽  
Cardiac Compression ◽  
Cardiac Evaluation ◽  
Indications For Operation

Purpose: Minimally invasive repair of pectus excavatum (MIRPE) was first reported in 1998 by D. Nuss. This technique has gained wide acceptance during the last 4-5 years. In the meantime, some modifications of the technique have been introduced by different authors. Our retrospective study reports our own experience over the last 36 months and modifications introduced due to a number of complications. Methods: From 3/2000 to 3/2003, 22 patients underwent MIRPE. Patients median age was 15.5 years (10.7 to 20.3 years). Standardised preoperative evaluation included 3D computerised tomography (CT) scan, pulmonary function tests, cardiac evaluation with electrocardiogram and echocardiography, and photo documentation. Indications for operation included at least two of the following: Haller CT index > 3.2, restrictive lung disease, cardiac compression, progression of the deformity and severe psychological alterations. Results: In 22 patients (2 girls, 20 boys) undergoing MIRPE procedure, a single bar was used in 21 patients and two bars in one boy. Lateral stabilisers were fixed with non resorbable sutures on both sides. Overall, postoperative complications occurred in six patients (27.3%). In two patients (9.1%) a redo-procedure was necessary due to bar displacement. An additional median skin incision was performed in two patients to elevate the sternum. Pneumothorax or hematothorax in two patients resulted in routine use of a chest tube on both sides. Long-term favourable results were noted in all patients. Conclusions: The MIRPE procedure is an effective method with elegant cosmetic results. Modifications of the original method help to decrease the complication rate and to accelerate acquirement of expertise.

Influence of sternal closure technique on the incidence of sternal dehiscence and sternal wound infection

2009 ◽  
Vol 56 (S 01) ◽  
Author(s):  
C Schimmer ◽  
C Yildirim ◽  
K Hamouda ◽  
SP Sommer ◽  
M Bensch ◽  
...  
Keyword(s):  
Wound Infection ◽  
Sternal Wound Infection ◽  
Closure Technique ◽  
Sternal Dehiscence ◽  
Sternal Closure

Thrombin Generation Measured Ex Vivo Following Microvasculor Injury Is Increased in SLE Patients with Antiphospholipid-protein Antibodies

1997 ◽  
Vol 78 (04) ◽  
pp. 1173-1177 ◽  
Author(s):  
Jacek Musiał ◽  
Jakub Swadźba ◽  
Miłosz Jankowski ◽  
Marek Grzywacz ◽  
Stanisława Bazan-Socha ◽  
...  
Keyword(s):  
Lupus Erythematosus ◽  
Thrombin Generation ◽  
Ex Vivo ◽  
Skin Incision ◽  
Anticardiolipin Antibodies ◽  
Small Blood Vessel ◽  
Anionic Phospholipids ◽  
Increased Risk ◽  
High Concentrations

SummaryAntiphospholipid-protein antibodies (APA) include lupus-type anticoagulant (LA) and antibodies recognizing complexes of anionic phospholipids (e.g. cardiolipin) and proteins (e.g. prothrombin and (β2-glycoprotein I). The presence of APA is associated with an increased risk of both arterial and venous thrombosis. However, the pathogenic mechanism leading to thrombosis in patients with APA remains unclear. We studied 32 patients with systemic lupus erythematosus (SLE) who were divided into two groups depending on the presence (n = 19) or absence (n = 13) of APA. Healthy volunteers (n = 12) matched by age and sex served as controls. In all subjects LA and IgG class anticardiolipin antibodies (ACA) were determined. Thrombin generation was monitored ex vivo measuring fibrinopeptide A (FPA) and prothrombin fragment F1 + 2 (F1 + 2) in blood emerging from a skin microvasculature injury, collected at 30 second intervals. In subjects with antiphospholipid antibodies mean FPA and F1 + 2 concentrations were signiF1cantly higher at most blood sampling times than in controls. In some SLE patients with APA the process of thrombin generation was clearly disturbed and very high concentrations of F1brinopeptide A were detected already in the F1rst samples collected. Two minutes after skin incision SLE patients without APA produced slightly more FPA, but not F1 + 2, as compared to healthy subjects. Mathematical model applied to analyze the thrombin generation kinetics revealed that APA patients generated signiF1cantly greater amounts of thrombin than healthy controls (p = 0.02 for either marker). In contrast, in the same patients generation of thrombin in recalciF1ed plasma in vitro was delayed pointing to the role of endothelium in the phenomenon studied. In summary, these data show for the F1rst time that in SLE patients with antiphospholipid-protein antibodies thrombin generation after small blood vessel injury is markedly increased. Enhanced thrombin generation might explain thrombotic tendency observed in these patients.

Prompt Return to Work after Bilateral Transforaminal Full-endoscopic Lateral Recess Decompression under Local Anesthesia: A Case Report

2020 ◽  
Author(s):  
Kosuke Sugiura ◽  
Kazuta Yamashita ◽  
Hiroaki Manabe ◽  
Yoshihiro Ishihama ◽  
Fumitake Tezuka ◽  
...  
Keyword(s):  
Return To Work ◽  
Local Anesthesia ◽  
Skin Incision ◽  
Leg Pain ◽  
Lateral Recess ◽  
Canal Stenosis ◽  
Transforaminal Approach ◽  
Lateral Recess Stenosis ◽  
Lumbar Spinal ◽  
Herniated Nucleus Pulposus

AbstractTransforaminal full-endoscopic lumbar diskectomy became established early in the 21st century. It can be performed under local anesthesia and requires only an 8-mm skin incision, making it the least invasive disk surgery method available. The full-endoscopic technique has recently been used to treat lumbar spinal canal stenosis. Here, we describe the outcome of simultaneous bilateral decompression of lumbar lateral recess stenosis via a transforaminal approach under local anesthesia in a 60-year-old man. The patient presented with a complaint of bilateral leg pain that was preventing him from standing and walking, and he had been able to continue his work as a dentist by treating patients while seated. Imaging studies revealed bilateral lumbar lateral recess stenosis with central herniated nucleus pulposus at L4/5. We performed simultaneous bilateral transforaminal full-endoscopic lumbar lateral recess decompression (TE-LRD) under local anesthesia. Both decompression and diskectomy were successfully completed without complications. Five days after TE-LRD, he was able to return to work, and 3 months after the surgery, he resumed playing golf. Full-endoscopic surgery under local anesthesia can be very effective in patients who need to return to work as soon as possible after surgery.

Calculating Energy Release Rate as a Function of Crack Length Using a Multiple-Step Crack Closure Technique in Tire Finite Element Models

2018 ◽  
Vol 46 (3) ◽  
pp. 130-152
Author(s):  
Dennis S. Kelliher
Keyword(s):  
Finite Element ◽  
Energy Release Rate ◽  
Crack Length ◽  
Energy Release ◽  
Crack Closure ◽  
Release Rate ◽  
Fatigue Behavior ◽  
Three Dimensions ◽  
Quantitative Prediction ◽  
Closure Technique

ABSTRACT When performing predictive durability analyses on tires using finite element methods, it is generally recognized that energy release rate (ERR) is the best measure by which to characterize the fatigue behavior of rubber. By addressing actual cracks in a simulation geometry, ERR provides a more appropriate durability criterion than the strain energy density (SED) of geometries without cracks. If determined as a function of crack length and loading history, and augmented with material crack growth properties, ERR allows for a quantitative prediction of fatigue life. Complications arise, however, from extra steps required to implement the calculation of ERR within the analysis process. This article presents an overview and some details of a method to perform such analyses. The method involves a preprocessing step that automates the creation of a ribbon crack within an axisymmetric-geometry finite element model at a predetermined location. After inflating and expanding to three dimensions to fully load the tire against a surface, full ribbon sections of the crack are then incrementally closed through multiple solution steps, finally achieving complete closure. A postprocessing step is developed to determine ERR as a function of crack length from this enforced crack closure technique. This includes an innovative approach to calculating ERR as the crack length approaches zero.

Improving patient care after stoma reversal

2011 ◽  
Vol 20 (Sup9) ◽  
pp. S19-S22 ◽  
Author(s):  
Claire Taylor
Keyword(s):  
Patient Care ◽  
Stoma Reversal ◽  
Improving Patient Care

Impact of C-shaped skin incision on surgical operability in the retrosigmoid approach: when a good start is half of the job

2021 ◽  
Author(s):  
Filippo Gagliardi ◽  
Martina Piloni ◽  
Silvia Snider ◽  
Francesca Roncelli ◽  
Edoardo Pompeo ◽  
...  
Keyword(s):  
Skin Incision ◽  
Retrosigmoid Approach
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