A standardized model for in vitro testing of sutures and patches for watertight dural closure

2021 ◽  
pp. 1-10
Author(s):  
Florian Ebel ◽  
Stefan Wanderer ◽  
C. Marvin Jesse ◽  
Ralph T. Schär ◽  
Irena Zubak ◽  
...  
Keyword(s):  
Double Layer ◽  
In Vitro Model ◽  
Infusion Pump ◽  
Suture Technique ◽  
Suture Techniques ◽  
Interrupted Suture ◽  
Dural Closure ◽  
Significant Difference ◽  
Vitro Model

OBJECTIVE CSF leaks are common complications of spinal and cranial surgeries. Several dural grafts and suture techniques are available to achieve watertight dural closure, but the effectiveness of these techniques remains unclear. The authors developed a standardized in vitro model to test available grafts and suture techniques alone or in combination to find the technique with the most watertight dural closure. METHODS A fluid chamber with a dural fixation device, infusion pump, pressure gauge, and porcine pericardium as a dural equivalent was assembled to provide the reusable device for testing. The authors performed dural closure in 4 different fashions, as follows: A) using running versus simple interrupted suture technique and different suture materials to close a 3-cm incision; B) selecting commonly used sealants and dural patches in combination with a running suture; C) performing duraplasty (1.5 × 1.5–cm square defect) with different dural substitutes in a stand-alone fashion; and D) performing duraplasty with different dural substitutes in a double-layer fashion. Each technique was tested 6 times. The hydrostatic burst pressure (BP) was measured and compared using the Kruskal-Wallis test or the Mann-Whitney U-test. Values are reported as mean ± SD. RESULTS There was no significant difference between the running and simple interrupted suture technique (p = 0.79). Adding a patch or sealant to a suture resulted in a 1.7- to 14-fold higher BP compared to solitary suture closure (36.2 ± 24.27 cm H2O and 4.58 ± 1.41 cm H2O, respectively; p < 0.001). The highest BP was achieved by adding DuraSeal or TachoSil (82.33 ± 12.72 cm H2O and 74.17 ± 12.64 cm H2O, respectively). For closing a square defect, using a double-layer duraplasty significantly increased BP by a factor of 4–12 compared to a single-layer duraplasty (31.71 ± 12.62 cm H2O vs 4.19 ± 0.88 cm H2O, respectively; p < 0.001). The highest BP was achieved with the combination of Lyomesh and TachoSil (43.67 ± 11.45 cm H2O). CONCLUSIONS A standardized in vitro model helps to objectify the watertightness of dural closure. It allows testing of sutures and dural grafts alone or in combination. In the authors’ testing, a running 6-0 monofilament polypropylene suture combined with DuraSeal or TachoSil was the technique achieving the highest BP. For the duraplasty of square defects, the double-layer technique showed the highest efficacy.

Performance changes of venous valves following tissue treatment with novel in vitro system

2018 ◽  
Vol 34 (5) ◽  
pp. 347-354
Author(s):  
Garrett Easson ◽  
Megan Laughlin ◽  
Hanna Jensen ◽  
Kevin Haney ◽  
Marc Girardot ◽  
...  
Keyword(s):  
High Speed ◽  
In Vitro Model ◽  
Closing Time ◽  
Venous Valve ◽  
Orifice Area ◽  
Treatment Methods ◽  
Venous Valves ◽  
Significant Difference ◽  
Vitro Model

Objectives The purpose of this study is to test venous valve performance and identify differences between native tissue and replacement devices developed with traditional tissue treatment methods using a new in vitro model with synchronized hemodynamic parameters and high-speed valve image acquisition. Methods An in vitro model mimicking the venous circulation to test valve performance was developed using hydrostatic pressure driven flow. Fresh and glutaraldehyde-treated vein segments were placed in the setup and opening/closing of the valves was captured by a high-speed camera. Hemodynamic data were obtained using synchronized hardware and virtual instrumentation. Results Geometric orifice area and opening/closing time of the valves was evaluated at the same hemodynamic conditions. A reduction in geometric orifice area of 27.2  ± 14.8% (p < 0.05) was observed following glutaraldehyde fixation. No significant difference in opening/closing time following chemical fixation was observed. Conclusions The developed in vitro model was shown to be an effective method for measuring the performance of venous valves. The observed decrease in geometric orifice area following glutaraldehyde treatment indicates a decrease in flow through the valve, demonstrating the consequences of traditional tissue treatment methods.

Gelatin sponge insertion into tympanostomy tubes: An in-vitro study to evaluate postoperative obstruction

2009 ◽  
Vol 140 (5) ◽  
pp. 661-664
Author(s):  
Chad P. Secor ◽  
Robert E. Wilson ◽  
Paul M. Spring ◽  
Richard C. Haydon
Keyword(s):  
In Vitro Model ◽  
In Vitro Study ◽  
The Other ◽  
Gelatin Sponge ◽  
Pressure Equalization ◽  
Significant Difference ◽  
Tympanostomy Tubes ◽  
Ventilation Tubes ◽  
Vitro Model

Objective: To analyze the efficacy of gelatin sponge insertion into lumens of tympanostomy tubes to prevent obstruction in the presence of blood. Study Design: In vitro model. Methods: Absorbable gelatin sponge wicks were placed in the lumen of Ultrasil Collar Button ventilation tubes and Shepherd Grommet ventilation tubes. One half of each group was covered with blood, the other left untreated. Each tube was treated with ofloxacin solution three times daily for seven days. After treatment, the tubes were inspected. Reinspection was performed after brief suctioning. Numerical scores were given based on degree of obstruction. Results: A statistically significant difference in degree of obstruction ( P < 0.0001) was seen between all tubes with wicks alone versus those with blood added. After re-evaluation, there remained a statistically significant difference between tubes with wicks alone and tubes with wicks and blood ( P < 0.0001). Conclusions: Gelatin sponge insertion does not prevent, and may in fact, enhance, obstruction of pressure equalization tube lumens in the presence of blood.

Usefulness of Sealants for Dural Closure: Evaluation in an In Vitro Model

2017 ◽  
Vol 15 (4) ◽  
pp. 425-432 ◽  
Author(s):  
Tristan van Doormaal ◽  
Ahmet Kinaci ◽  
Sander van Thoor ◽  
Saskia Redegeld ◽  
Wilhelmina Bergmann ◽  
...  
Keyword(s):  
North Carolina ◽  
Intracranial Pressure ◽  
Pressure Wave ◽  
In Vitro Model ◽  
Burst Pressure ◽  
Dural Closure ◽  
Csf Leakage ◽  
Vitro Model ◽  
Patient Burden

Abstract BACKGROUND Cerebrospinal fluid (CSF) leakage occurs in 4% to 32% of cranial surgeries and is associated with significant patient burden and expense. The use of sealant as an adjunct to primary dural closure is assumed to help prevent CSF leakage. OBJECTIVE To examine the utility of different sealants for dural closure using an in Vitro model. METHODS We evaluated 9 commonly used dural sealants, including Tachosil (Takeda Inc, Osaka, Japan), Adherus (Hyperbranch Inc, Durham, North Carolina), Duraform (Codman, Raynham, Massachusetts), Tissudura (Baxter, Deerfield, Illinois), Hemopatch (Baxter), TissuePatchDural (Tissuemed, Leeds, United Kingdom), Tisseel (Baxter), Duragen Secure (Integra, Plainsboro, New Jersey), and Duraseal, (Integra). Sealants were tested in 2 novel in Vitro setups using fresh porcine dura: the first tested the acute burst pressure of a sealed 3-mm gap, while the second examined resistance to a pressure wave mimicking intracranial pressure for 72 h. RESULTS Adherus showed the highest mean burst pressure (87 ± 47 mmHg) followed by Tachosil (71 ± 16 mmHg) and Duraseal (51 ± 42 mmHg); these were the only 3 sealants showing burst pressures above normal physiological intracranial pressure. In the 72-h setup, only Adherus and Duraseal maintained appropriate sealing for the duration of the experiment. Tachosil released from the dura after 1.4 h (95% confidence interval, −1.8-4.7). CONCLUSION Given the high cost of sealants and the results of this study, we advocate a critical attitude toward sealant application as an adjunct to classic dural closure.

Suture techniques and patch materials using an in-vitro model for watertight closure of in-utero spina bifida repair

2020 ◽  
Vol 55 (4) ◽  
pp. 726-731 ◽  
Author(s):  
Thai Vu ◽  
Lovepreet K. Mann ◽  
Stephen A. Fletcher ◽  
Ranu Jain ◽  
Jeannine Garnett ◽  
...  
Keyword(s):  
Spina Bifida ◽  
In Vitro Model ◽  
In Utero ◽  
Suture Techniques ◽  
Watertight Closure ◽  
Vitro Model

Examination of sclerotial germination in Sclerotinia minor with an in vitro model

1996 ◽  
Vol 74 (3) ◽  
pp. 450-455 ◽  
Author(s):  
D. R. Burgess ◽  
G. Hepworth
Keyword(s):  
In Vitro Model ◽  
Prolonged Exposure ◽  
Soil Microflora ◽  
Acid Mixture ◽  
Sclerotinia Minor ◽  
Germination Response ◽  
Significant Difference ◽  
Vitro Model ◽  
Sclerotial Germination

An in vitro model was developed to examine the effect of surface microflora and exogenous nutrient on sclerotial germination of Sclerotinia minor. Germinated sclerotia were identified by the presence of appressoria on the plastic Petri dish. Surface sterilised field sclerotia germinated at maximum rates on water agar, but unsterilised sclerotia failed to germinate, even after drying and rewetting, indicating that sclerotia of S. minor are unlikely to germinate spontaneously in the presence of soil microflora. Partial surface sterilisation gave intermediate germination rates, which were enhanced two- to four-fold by treatment with sunflower root sap. There was no significant difference in the germination response to root sap from susceptible and resistant sunflower lines, but germination rates were highest with root nutrient obtained from plants during vegetative growth. A positive germination response to peptone and an amino acid mixture implicated amino acids as germination stimuli. Germination of field sclerotia required incubation with root sap for more than 3 days, suggesting that prolonged exposure of sclerotia to root exudates may be required for the onset of stem rot in sunflowers. This is discussed in relation to the dynamics of root growth. Keywords: exogenous nutrient, field sclerotia, germination stimulus.

The In Vitro Evaluation of Preosteoblast Migration From 3-D-printed Scaffolds to Decontaminated Smooth and Minimally Rough Titanium Surfaces: A Pilot Study

2021 ◽  
pp. 026119292110221
Author(s):  
Vitor de Toledo Stuani ◽  
David Minjoon Kim ◽  
Masazumi Nagai ◽  
Chia-Yu Chen ◽  
Adriana Campos Passanezi Sant’Ana
Keyword(s):  
Cell Migration ◽  
Pilot Study ◽  
In Vitro Model ◽  
Cellular Migration ◽  
Bone Implant ◽  
Significant Difference ◽  
Animal Use ◽  
Titanium Surfaces ◽  
Vitro Model

In vitro evaluations are essential to gaining a better understanding of re-osseointegration, while reducing animal use and the overall costs of peri-implantitis studies. This pilot study evaluated preosteoblast migration from 3-D-printed scaffolds to decontaminated titanium microimplants, creating a system that tries to mimic the bone–implant interface. Smooth (S) and minimally rough (R) titanium microimplants were incubated in Escherichia coli cultures and divided into six groups according to the decontamination protocol applied: EDTA gel (EDTA); chlorhexidine (CHL); chlorhexidine-soaked gauze (GCHL); scaling (SC); titanium brush (TiB); and implantoplasty (IP). Pristine S and R microimplants were used as the controls (C). After the decontamination procedures, the microimplants were inserted in 3-D-printed polyurethane-based scaffolds previously inoculated with preosteoblast cell cultures. Cellular migration was assessed after 24, 72 and 120 hours by ATP quantification. At the 120-hour time point, there was no statistically significant difference between S-C, S-EDTA, S-CHL, S-GCHL and S-SC ( p > 0.05), and between R-C, R-EDTA and R-GCHL ( p > 0.05). The in vitro model developed in this pilot study successfully demonstrated cell migration on the different decontaminated surfaces. This methodology suggests that on smooth microimplants, EDTA, GCHL, SC and TiB decontamination may have a reduced impact on preosteoblast migration, while on minimally rough microimplants, EDTA and GCHL decontamination affected cell migration the least. However, when selecting a decontamination protocol, the effectiveness of the decontamination per se must also be considered.

An in vitro model for investigation of vitamin A effects on wound healing

2021 ◽  
pp. 1-6
Author(s):  
Hoda Keshmiri Neghab ◽  
Mohammad Hasan Soheilifar ◽  
Gholamreza Esmaeeli Djavid
Keyword(s):  
Wound Healing ◽  
Endothelial Cell ◽  
Vitamin A ◽  
In Vitro Model ◽  
Cellular Proliferation ◽  
Endothelial Cell Migration ◽  
Normal Fibroblast ◽  
Anti Inflammatory ◽  
Vitro Model

Abstract. Wound healing consists of a series of highly orderly overlapping processes characterized by hemostasis, inflammation, proliferation, and remodeling. Prolongation or interruption in each phase can lead to delayed wound healing or a non-healing chronic wound. Vitamin A is a crucial nutrient that is most beneficial for the health of the skin. The present study was undertaken to determine the effect of vitamin A on regeneration, angiogenesis, and inflammation characteristics in an in vitro model system during wound healing. For this purpose, mouse skin normal fibroblast (L929), human umbilical vein endothelial cell (HUVEC), and monocyte/macrophage-like cell line (RAW 264.7) were considered to evaluate proliferation, angiogenesis, and anti-inflammatory responses, respectively. Vitamin A (0.1–5 μM) increased cellular proliferation of L929 and HUVEC (p < 0.05). Similarly, it stimulated angiogenesis by promoting endothelial cell migration up to approximately 4 fold and interestingly tube formation up to 8.5 fold (p < 0.01). Furthermore, vitamin A treatment was shown to decrease the level of nitric oxide production in a dose-dependent effect (p < 0.05), exhibiting the anti-inflammatory property of vitamin A in accelerating wound healing. These results may reveal the therapeutic potential of vitamin A in diabetic wound healing by stimulating regeneration, angiogenesis, and anti-inflammation responses.

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