scholarly journals Autotransplantation of Flaps in the Treatment of Peri-Implant Infection After Osteosynthesis (Analysis of Clinical Observations)

2021 ◽  
Vol 10 (3) ◽  
pp. 575-581
Author(s):  
R. R. Ganiyev ◽  
A. V. Nevedrov ◽  
R. I. Valiyeva ◽  
N. N. Zadneprovsky ◽  
P. A. Ivanov ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Soft Tissue Defect ◽  
Successful Outcome ◽  
Composite Grafts ◽  
Clinical Observations ◽  
Multi Stage ◽  
Focus Of Infection ◽  
Surgical Tactics ◽  
The Moment

Unfortunately, suppuration of a postoperative wound remains the most frequent complication of surgical intervention. If suppuration is located superficially, within the subcutaneous fat, it can be successfully managed with minimal functional losses. The clinical course is significantly complicated if the focus of infection is located under the skin, in the thickness of the muscles, in the fracture zone. In the case of suppuration in the area of osteosynthesis, the complication may become critical.Such a complication is a serious condition that requires multi-stage complex and sometimes multidisciplinary treatment.The conditions for a successful outcome in this pathology are the minimum period from the moment of suppuration, active surgical tactics, stability of the implant, and good vascularization of the surrounding soft tissues.Active surgical tactics involves the opening and sanitation of purulent foci, leaks, recesses. Staged necrectomies are inevitable companions of surgical treatment and can cause the formation of defects in the skin, subcutaneous tissue, and muscles.The resulting soft tissue defect leads to exposure of the bone and plate. Removal of the metal fixator becomes inevitable.Only the closure of the defect with a complex of tissues based on free vascularized composite grafts can radically solve the problem.The article presents two clinical observations of deep wound infection after bone osteosynthesis, where autotransplantation of a vascularized flap was used. The use of this technique made it possible to achieve suppression of infection, wound healing by primary intention, to create conditions for consolidation of the fracture, restoration of function and preservation of the limb as a whole.

Sex difference in insulin-stimulated glucose transport in rat and human adipocytes

1984 ◽  
Vol 246 (3) ◽  
pp. E211-E215 ◽  
Author(s):  
J. E. Foley ◽  
A. Kashiwagi ◽  
H. Chang ◽  
T. P. Huecksteadt ◽  
S. Lillioja ◽  
...  
Keyword(s):  
Adipose Tissue ◽  
Glucose Transport ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Transport Rate ◽  
Female Rats ◽  
Fat Tissue ◽  
Male And Female ◽  
Male And Female Rats ◽  
Female Subjects

In an effort to determine whether differences in basal and maximum insulin-stimulated glucose transport by isolated adipocytes are a function of donor sex, we measured glucose transport rates in the absence and presence of 8 nM insulin in adipocytes isolated from the abdominal subcutaneous fat tissue of nine male and ten female subjects with varying degrees of obesity and in adipocytes isolated from the abdominal subcutaneous and retroperitoneal fat tissue of (180-220 g) male and female rats. Because maximal insulin-stimulated glucose transport rate per cell of adipocytes isolated from subcutaneous abdominal tissue of male and female subjects was constant in each sex, the data have been normalized on the basis of transport per cell. The results demonstrated that basal and maximal insulin-stimulated glucose transport per cell was 53-75% higher per cell in the females versus males in adipocytes from human subcutaneous abdominal adipose tissue (P less than 0.01). A similar difference in glucose transport rate between males and females (P less than 0.001) was also found in rat abdominal subcutaneous adipose tissue. Adipocytes isolated from rat retroperitoneal adipose tissue had higher transport rates (approximately three-fold) and smaller sex differences (35% higher in females) than found in adipocytes from rat and human subcutaneous tissue. These results indicate that basal and maximum insulin-stimulated glucose transport is higher by adipocytes isolated from females and that this difference is independent of adipose cell size and species.

Effect of Subcutaneous Tissue on Changes in Thigh Circumference Following Anterior Cruciate Ligament Reconstruction

2019 ◽  
Vol 40 (08) ◽  
pp. 544-550
Author(s):  
Ryo Yoshii ◽  
Yu Konishi ◽  
Daisuke Ando ◽  
Satoshi Ochiai ◽  
Tetsuo Hagino ◽  
...  
Keyword(s):  
Subcutaneous Tissue ◽  
Cruciate Ligament ◽  
Subcutaneous Fat ◽  
Quadriceps Muscle ◽  
Thigh Circumference ◽  
Cross Sectional ◽  
Short Period ◽  
Anterior Cruciate ◽  
Muscle Cross Sectional Area ◽  
The Relationship

AbstractCircumference measurements have been used to estimate muscle cross-sectional area (CSA) in clinical settings. Measurements of thigh circumference are affected by muscle and subcutaneous fat (SF). In fact, SF could increase over a short period. Therefore, clarifying the relationship between thigh circumference and muscle and SF following ACL reconstruction is important. This study’s primary purpose was to examine pre- and post-operative changes in thigh circumference, thigh muscles and SF CSAs in both legs. Secondary, the relationship between thigh circumference and muscle and SF CSAs was examined to demonstrate that circumference measurements could be used to detect atrophy. Quadriceps, hamstrings, and SF CSAs at 15, 10, and 5 cm proximal to the patella were measured by MRI pre- and 4 weeks postoperatively to examine how reconstruction affected those tissues in the thighs. The results showed increases in SF CSA (r=0.72 at 10 cm, r=0.67 at 15 cm) greatly affected thigh circumference in females on the surgical side. In males, increases in SF CSA (r=0.83) at 15- and 5-cm and decreases in quadriceps muscle CSA (r=0.73) at 5 cm affected thigh circumference on the surgical side. Thigh circumference measurements might not reflect actual muscle CSA in ACL patients.

Comparative studies of meat. VIII. The percentage of fat in the fatty and muscular tissues of steers and the iodine number of the extracted fat, as affected by breed and level of nutrition

1962 ◽  
Vol 58 (3) ◽  
pp. 295-307 ◽  
Author(s):  
E. H. Callow
Keyword(s):  
Iodine Number ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Local Temperature ◽  
Reverse Direction ◽  
Muscular Tissue ◽  
Fatty Tissue ◽  
Average Percentage ◽  
Best Fit ◽  
Muscular Tissues

1. An investigation has been carried out concerning the percentage of fat in the subcutaneous and intermuscular fatty tissues and in the muscular tissues, and the iodine number of the extracted fat from eight anatomical joints (foreshin, neck, shoulder, thorax, loin, pelvis, leg and hindshin) and from the perinephric fatty tissue and psoas muscles of the carcasses from twenty-four animals. The animals were from three breeds (Hereford, Dairy Shorthorn and Friesian) and were on four levels of nutrition—high-high and medium-high, and high-medium and medium-medium. The first two groups—finished on concentrates—were younger than the second two groups—finished on grass.2. Using an analysis of variance for the resultant data for percentage of fat and iodine number, it was found that breed had affected the percentage of fat in the tissues of the various joints significantly—on the average the order was Shorthorn (highest), Hereford and Friesian (lowest). This result could be predicted from the fact that this was the order of fatness of the carcasses (as measured by the percentage of fatty tissue in the carcass—see Callow, 1961).3. The data for iodine number showed no significant effect for breed in either the subcutaneous or intermuscular tissues. The significant effect of breed in the case of muscle could be attributed to significant differences in the overall level of fatness (see Callow, 1961) of the carcasses of the three breeds.4. A good correlation existed between the average percentage of fat in a joint and the average iodine number of fat extracted when the data for various joints was used to calculate straight lines of best fit. (In the case of muscular tissue, it was necessary to use the inverse of the percentage of fat to calculate the average—because the relation between the percentage of fat in muscular tissue and its iodine number is a rectangular hyperbola.)5. Using such lines of best fit, it was possible to show that certain joints had tissues which gave abnormal values for iodine number. Thus, deepseated tissues, like psoas muscle and kidney fat, had unexpectedly low values, whilst tissues from the hindshin had unexpectedly high values. This was attributed to the effect of local temperature—a high local temperature in the body giving a lower iodine number and a low temperature a higher iodine number than would otherwise be expected. The special case of subcutaneous fat from the thorax—with a higher iodine number than expected—is explained by the presence of brisket fat (which has a high iodine number).6. The data were used graphically to show the effect of growth gradients, thus the average percentage of fat in all the tissues is lowest in fore- and hindshins and highest in thorax (muscular and intermuscular tissues) and in the pelvis (subcutaneous tissue). Similar effects, but in the reverse direction, were shown by average values for iodine numbers.7. There were systematic differences in the percentage of fat in the subcutaneous and intermuscular tissues of joints and in the iodine number of the extracted fat. These too showed marked growth gradients. Although the percentage of fat in the intermuscular tissue was greater than that in the subcutaneous tissue in the fore- and hindshins, it was less in the thorax, loin, pelvis and leg. In spite of this, the iodine number of the subcutaneous fat was always higher than that of the intermuscular fat. This is attributed to the former being a colder tissue than the latter.8. It was shown that the relation between iodine number and percentage of fat in the various joints was different for the animals finished on grass (highmoderate and moderate-moderate levels of nutrition) as compared with those finished on concentrates (high-high and moderate-high levels). This was attributed to the rate of fattening being greater in the second case and to this giving rise to lower iodine numbers.9. Beyond this effect of rate of fattening, no reason could be found for the fact that the general level of iodine numbers showed variation from animal to animal.10. The extreme variation in percentage of fat in the tissues was (a) muscular tissue from 1·3 to 14·5%, (b) intermuscular tissue from 29·5 to 82·7%, and (c) subcutaneous tissue from 25·2 to 89·8%. For iodine number the variation was (a) 50·0 to 73·9, (b) 42·9 to 67·9 and (c) 46·3 to 67·9 It is thus clear that beef can be a very variable foodstuff.

scholarly journals Comparison of Muscle and Subcutaneous Tissue Fatty Acid Composition of Bangladeshi Nondescript Deshi Bulls Finished on Pasture Diet

2017 ◽  
Vol 2017 ◽  
pp. 1-6 ◽  
Author(s):  
Mohammad Khairul Alam ◽  
Ziaul Hasan Rana ◽  
Mohammad Akhtaruzzaman
Keyword(s):  
Fatty Acids ◽  
Fatty Acid ◽  
Subcutaneous Tissue ◽  
Saturated Fatty Acids ◽  
Subcutaneous Fat ◽  
Monounsaturated Fatty Acids ◽  
Intramuscular Fat ◽  
Human Consumption ◽  
Average Chemical Composition ◽  
Total N

The objective of this study was to characterize and compare the tissue-associated differences in the fatty acid profiles of intramuscular and subcutaneous fat from pasture fed nondescript deshi breed bulls of Bangladesh. The average chemical composition of thelongissimusmuscle was as follows: moisture74.65±0.48%, protein21.55±0.83%, intramuscular fat2.78±0.28%, and ash1.02±0.03%. There was significant evidence that the lipids oflongissimusmuscle from the nondescript deshi bulls had a lower content of saturated fatty acids (SFA), monounsaturated fatty acids (MUFA), and conjugated linoleic acid (CLA) and a higher content of polyunsaturated fatty acids (PUFA) compared to subcutaneous fat. Intramuscular fat also showed the highest PUFA/SFA and∑n-6/∑n-3fatty acids ratios and total n-3 and n-6 PUFAs compared to subcutaneous tissue depots. Overall findings suggest that the meat from pasture fed nondescript deshi breed can be considered as lean meat and healthy for human consumption.

Staged Scalp Soft Tissue Expansion Before Delayed Allograft Cranioplasty

2011 ◽  
Vol 71 (suppl_1) ◽  
pp. ons15-ons21 ◽  
Author(s):  
Ekkehard M. Kasper ◽  
Emily B. Ridgway ◽  
Amr Rabie ◽  
Bernard T. Lee ◽  
Clark Chen ◽  
...  
Keyword(s):  
Soft Tissue ◽  
Tissue Expansion ◽  
Soft Tissue Defect ◽  
Successful Outcome ◽  
Skull Defect ◽  
Neurosurgical Procedure ◽  
Decompressive Hemicraniectomy ◽  
Second Stage ◽  
Cranial Defect ◽  
Complex Cases

Abstract BACKGROUND: Hemicraniectomy is an established neurosurgical procedure. However, before cranial vault reconstruction, it is imperative that sufficient scalp soft tissue is available for coverage of the reconstructed skull. OBJECTIVE: To present 2 complex cases of posttraumatic patients requiring soft tissue expansion of the scalp before definite cranioplasty with use of a synthetic polyethylene graft. METHODS: Two patients underwent decompressive hemicraniectomy for trauma and required delayed cranioplasty. Both patients had developed significant scalp contraction and presented with a paucity of soft tissue. These patients underwent a staged cranioplasty in which we first achieved scalp-tissue expansion adjacent to the craniectomy site over a prolonged interval. In a second stage, the patient underwent definite reconstructive surgery in which the subgaleal expanders were removed and polyethylene allograft cranioplasty was performed. RESULTS: Cutaneous coverage of the underlying defect could be achieved in this setting without causing tension on the incision line secondary to the now available excess scalp tissue. CONCLUSION: Repair of a cranial defect requires detailed attention to the available scalp and its size relationship to the skull defect to achieve a successful outcome with an aesthetically pleasing, reliable, and lasting result. Preoperative scalp tissue expansion is a valuable step in taking care of patients presenting with scalp soft tissue defect. This technique reduces the morbidity associated with conventional rotational and free-flap techniques.

Necrotizing Fasciitis in a Patient with Type 2 Diabetes Mellitus

2006 ◽  
Vol 96 (1) ◽  
pp. 67-72 ◽  
Author(s):  
David M. Kanuck ◽  
Thomas Zgonis ◽  
Gary Peter Jolly
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Necrotizing Fasciitis ◽  
Subcutaneous Fat ◽  
Disease Process ◽  
Treatment Modalities ◽  
Successful Outcome ◽  
High Morbidity

Necrotizing fasciitis is a soft-tissue infection characterized by extensive necrosis of subcutaneous fat, neurovascular structures, and fascia. In general, fascial necrosis precedes muscle and skin involvement, hence its namesake. Initially, this uncommon and rapidly progressive disease process can present as a form of cellulitis or superficial abscess. However, the high morbidity and mortality rates associated with necrotizing fasciitis suggest a more serious, ominous condition. A delay in diagnosis can result in progressive advancement highlighted by widespread infection, multiple-organ involvement, and, ultimately, death. We present a case of limb salvage in a 52-year-old patient with type 2 diabetes mellitus and progressive fascial necrosis. A detailed review of the literature is presented, and current treatment modalities are described. Aggressive surgical debridement, comprehensive medical management of the sepsis and comorbidities, and timely closure of the resultant wound or wounds are essential for a successful outcome. (J Am Podiatr Med Assoc 96(1): 67–72, 2006)

scholarly journals Clinical significance of lipohypertrophy without visual and palpable changes detected by ultrasonography of subcutaneous fat

2019 ◽  
Vol 91 (4) ◽  
pp. 62-66 ◽  
Author(s):  
N I Volkova ◽  
I Yu Davidenko
Keyword(s):  
Body Mass Index ◽  
Clinical Significance ◽  
Hba1c Level ◽  
Fasting Glucose ◽  
Subcutaneous Fat ◽  
Postprandial Glucose ◽  
Diabetic Patients ◽  
Clinically Significant ◽  
The Moment ◽  
Basal Bolus

Aim. To estimate clinical significance of lipohypertrophy (LH) without visual and palpable changes, detected by ultrasonography of subcutaneous fat. Materials and methods. This study included 140 diabetic patients who received insulin in basal-bolus regimen. Ultrasonography of subcutaneous fat was performed for LH diagnostics in these diabetic patients. Than clinical significance of LH without visual and palpable changes was estimated. HbA1c level, fasting and postprandial glucose, episodes of hypoglycemia, body mass index (BMI) and scheme of insulinotherapy were evaluated at the moment of LH, after 3 and 6 months in all patients. Results and discussion. After changing injection sites, good results were demonstrated by measuring glucose and HbA1c level. Thus fasting glucose decreased from 9.03±1.98 mmol/l to 7.11±0.95 mmol/l (p=0.023). Postprandial glucose reduced from 10.27±2.72 mmol/l to 9.34±1.21 mmol/l (p=0.011). HbA1c level reduced from 9.27±1.75% to 7.43±1.02% (p=0.002). Also BMI decreased from 33.75±3.49 kg/m2 to 30.5±2.96 kg/m2 (p=0.018). Conclusion. LH without visual and palpable changes could worsen compensation of glycemic control and leads to hypoglycemia and chronic Somogyi rebound. So, LH without visual and palpable is as important and clinically significant as classic LH.

scholarly journals Effect of caffeine gel and caffeine gel associated with iontophoresis in women gynoidlipodystrophy: A pilot randomized trial

2021 ◽  
Vol 10 (4) ◽  
pp. e25710413813
Author(s):  
Alana Roberta Forti Quessada ◽  
Karina Couto Furlanetto ◽  
Thainá Bessa Alves ◽  
Ovídia Ignez Pires ◽  
André Lucino Pinto ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Subcutaneous Tissue ◽  
Subcutaneous Fat ◽  
Ultrasound Image ◽  
Life Questionnaire ◽  
Severity Scale ◽  
Tissue Thickness ◽  
Quality Of Life Questionnaire ◽  
Single Blind

Caffeine has been widely used to treat gynoid lipodystrophy (GLD). Despite caffeine has been considered as a promise treatment, there is a lack of scientific evidences regarding its effect on GLD when associated with iontophoresis or others equipment. We aimed to evaluate the effects of a caffeine gel alone and associated with iontophoresis in GLD treatment. In a single-blind randomized clinical trial, women with mild/moderate GLD in the buttocks were randomized to topical caffeine gel group (CG; n=10); caffeine gel plus iontophoresis group (CIG; n=11) or iontophoresis group (IG; n=10). The groups were treated with 10 sessions, two times/week, 20 min/session. The subjects were evaluated pre and post treatment by photonumeric GLD severity scale, ultrasound image, thermography and quality of life questionnaire with a blind evaluator. There were statistical reduction in subcutaneous tissue thickness (P≤0.046) as well as in subcutaneous tissue plus dermis thickness (P≤0.044) in buttocks both in CG and CIG. GLD reduction was similar between CG and CIG, and these reductions were more pronounced than in IG (P<0.0001). Furthermore, quality of life improved in all groups (P<0.017). We concluded that caffeine alone and associated with iontophoresis were effective for decreasing the subcutaneous fat layer in women with GLD.

scholarly journals Overgrowth Syndrome and Multi-Stage Reconstruction of Hand and Feet Deformations

2021 ◽  
Vol 1 (1) ◽  
Author(s):  
Erik Vrabič
Keyword(s):  
Diagnostic Criteria ◽  
Soft Tissues ◽  
Subcutaneous Tissue ◽  
Surgical Reconstruction ◽  
Histological Investigation ◽  
Hypertrophic Growth ◽  
Multi Stage ◽  
Inner Organs ◽  
Hands And Feet ◽  
Overgrowth Syndromes

A case of asymmetric overgrowth of feet, fingers and toes is presented and the performed diagnostic and multi-stage surgical reconstruction described. The condition in hands and feet was already present at birth. The hypertrophic growth advanced progressively, and histological investigation of the affected tissues revealed no pathology. The examination of inner organs, skin, subcutaneous tissue, nerves and vessels showed no deviations, the girl's karyotype was normal, 46 xx, no mosaicism was confirmed. In view of the new diagnostic criteria, this case cannot be assigned to any of the overgrowth syndromes. The most suitable classification would be in the group of Proteus-like syndrome. At this time only isolated hypertrophy of soft tissues and skeleton is present. According to the data from the literature, later development of anomalies is possible, so Proteus-like syndrome cannot be completely excluded.

scholarly journals Necrotizing Fasciitis in Neonate and Use of Allograft

2019 ◽  
Vol 8 (1) ◽  
pp. 8
Author(s):  
Nitinkumar Borkar ◽  
Phalguni Padhi ◽  
Jiten Kumar Mishra ◽  
Shamendra Anand Sahu ◽  
Debajyoti Mohanty ◽  
...  
Keyword(s):  
Early Diagnosis ◽  
Necrotizing Fasciitis ◽  
Skin Graft ◽  
Subcutaneous Tissue ◽  
Donor Site ◽  
Subcutaneous Fat ◽  
Surgical Debridement ◽  
Split Thickness Skin Graft ◽  
Superficial Fascia ◽  
Thickness Skin

Necrotising fasciitis is a fulminant and rapidly progressive infection of the superficial fascia and subcutaneous tissue. It is rare in newborn. Trunk is the commonest site of involvement in newborns. Early diagnosis and prompt surgical debridement is the preferred treatment. Debridement in NF leads to a large raw area which may not heal by primary intention and may a split thickness skin graft for healing. Presence of minimum subcutaneous fat, loose skin and large raw area at donor site like back in some neonate poses difficulty for harvesting of skin graft. In such neonates allograft make a valuable option temporarily. Herein we report a case of a neonate with NF in whom post debridement raw area was covered with allograft from mother.

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