A room-temperature self-healing elastomer with ultra-high strength and toughness fabricated via optimized hierarchical hydrogen-bonding interactions

The preparation of room-temperature self-healing polymeric materials with good healing efficiency and high mechanical strength is challenging. Two processes are essential to realise the room-temperature self-healing of materials: (a) a...

Management of intercondylar fractures of the distal humerus in adults using bi-columnar plating through trans-olecranon approach

<p class="abstract"><strong>Background: </strong>Inter-condylar fractures of the distal humerus are uncommon injuries and present the most difficult challenge among fractures of the lower end of the humerus. The principle involves anatomical reduction and fixation with stabilization of extra-osseous implants. The functional outcome has been greatly influenced by the early graduated rehabilitative exercise. We aimed to evaluate the functional outcome of inter-condylar fractures of the distal humerus in adults using bi-columnar plating through a trans-olecranon approach.</p><p class="abstract"><strong>Methods:</strong> A prospective study with 40 adult patients with inter-condylar fracture of the distal humerus were managed with bi-columnar plating through a trans-olecranon approach and were followed up for 12 months. The functional outcome was analysed by Mayo’s Elbow Performance Score (MEPS) at the end of 12 months follow up.</p><p class="abstract"><strong>Results: </strong>The average age of study participants were 50.8 years. A total of 24 cases were due to RTA and 16 cases were due to direct falls. Out of 40 cases, 6 (15%) were of B1 type, 2 (5%) were of type B2, 12 (30%) were of C1, 10 (25%) of C2, and 10 (25%) were of the type of C3 according to AO classification. According to MEPS at the end of the 12th-month follow-up, excellent results were seen in 24 (60%), good in 8 (20%), fair in 6 (15%), and poor results in 2 (5%) cases.</p><p class="abstract"><strong>Conclusions: </strong>Anatomically, bi-columnar plating for distal humerus is useful in providing stable fixation for complex distal articular fractured by trans-olecranon approach and facilitating early postoperative rehabilitation. Clinical and radiological results showed a good healing rate with a good range of motion. </p>

Bowel Anastomoses: Manual or Mechanical

An anastomosis is a connection between two tubular anatomical structures. Anastomoses have been a great surgical challenge from antiquities to modern times. Main research on the manual techniques and healing processes of digestive anastomoses took place during the 19th century. They were later improved by the advent of mechanical devices in the early 20th century. For both types of anastomoses, local and general conditions required for a good healing are the same. Many devices, both for manual and mechanical anastomoses have been developed. The devices’ uses depend on their availability, surgeons usual practice and the relative difficulty of the anastomosis. The debate is still lively about the advantages and the potential inconveniences of one technique versus the other in regards to many parameters such as operating time and the incidence of anastomotic leakage.

Novel Anti-Inflammatory and Wound Healing Controlled Released LDH-Curcumin Nanocomposite Via Intramuscular Implantation, In-Vivo Study

One of the most common problems in wounds is delayed healing and complications such as infection. Therefore, the need for novel materials accelerates the healing of wounds especially abdominal wounds after surgery besides high efficiency and safety is mandatory. The rate of wound healing, anti-inflammatory and biocompatibility of Zn-Al LDH alone and loaded with Curcumin was screened via in-vivo assays through intramuscular implantation in rat abdominal wall with intact peritoneum cavity. The implanted drugs were formed through Curcumin loaded into LDH of Zn-Al with drug release of 56.78 ±1.51% within 24 h. The synthesized nanocomposite was characterized by thermal analysis, X-ray diffraction, Field emission scanning microscopy, high resolution transmission electron microscope and BET surface area. The integrity of blood circulation, inflammatory signs, wound healing rate, capacity of tissue integration, antigenicity and composite biocompatibility, auto fluorescence ability of collagen bundles and the tensile strength of the muscle were assessed histopathologically after 7 and 30 days post-implantation. Excellent wound healing ability was achieved with shortest length between the wound gap edges and higher tensile strength of the muscle. Besides emit florescence very well followed by good healing and tensile muscles strength in Curcumin while very low strength with scar formation in Curcumin-Zn/Al-LDH in both acute and chronic wound. No signs of inflammation in Curcumin & Zn-Al LDH. No vessels obstruction or bleeding observed in both Zn/Al-LDH and Curcumin more than nanocurcumin and control which examined through candling. Good healing & infiltrated immune cells in same groups through histopathological examination. This work supports the anti-inflammatory, wound healing and biocompatibility of both LDH and Curcumin with living matter, increasing their biomedical applications in this era with safety and increasing efficacy with prolonged drug release.

Case Report: Treatment of Penile Intraepithelial Neoplasia in an Asian Male With Reconstructive Plastic Surgery

Intraepithelial neoplasia is a special type of squamous cell carcinoma occurring in the skin epidermis. The incidence of penile intraepithelial neoplasia in Asian males is rare. We report the clinical characteristics and treatment process of a case of penile intraepithelial neoplasia in a Chinese man. We treated the disease of this patient by surgical excision of the penile lesion and scrotal flap plastic surgery. After surgery, the shape of the penis was satisfactory, and there was no adverse effect on erection. The pathological results confirmed the diagnosis of penile intraepithelial neoplasia. The pathological features showed that the lesion tissue was covered with squamous epithelium and that there was severe atypical hyperplasia of the lesion epithelium, disordered arrangement of polarity, and an intact basement membrane. The removal of the lesions of penile intraepithelial neoplasia through a wider surgical resection range, combined with the stretchability of a scrotal flap, can achieve a good healing effect of the surgical wound and reduce the possibility of recurrence of penile intraepithelial neoplasia.

Orthodontic Pre Grafting Closure of Large Alveolar Bony and Soft Tissue Gaps: A Novel Nonsurgical Protraction of the Lesser Segments in Growing Patients With Cleft Lip and Palate

Background: Closure of wide alveolar clefts with large soft tissue gaps and reconstruction of the dentoalveolar defect are challenging for the surgeon. Some authors successfully used interdental segmental distraction, which requires an additional surgical procedure. Objective: This study evaluates the effectiveness of tooth borne devices utilized to orthopedically advance the lesser segments, with a complete approximation of the soft tissue of the alveolar stumps, allowing traditional simultaneous soft tissue closure and bone grafting, and avoiding the need for supplementary surgery. Methods: Eight growing patients, 2 with unilateral complete cleft lip and palate (UCLP) and 6 with bilateral complete cleft lip and palate (BCLP), with large soft tissue and bony alveolar defects prior to bone grafting were prospectively selected. A banded rapid palatal expander (RPE) in BCLP and a modified RPE in UCLP combined with protraction face mask in younger patients or a modified Alt-Ramec in patients older than 12 years were applied. Radiographic and photographic records were available at T0, at the end of protraction (T1) and at least 1 year after bone grafting (T2). Results: Patients with large gaps showed a significant reduction in the bony cleft area and approximation of the soft tissues at T1. All patients received bone grafting with good healing and ossification at T2. Conclusion: In growing patients with UCLP and BCLP with large gaps, presurgical orthodontic protraction seems to be an efficient method to reduce the cleft defect, minimizing the risk of post grafting fistulas, reducing the need for supplementary surgical procedures.

A Case Report of Osteomyelitis of Lower End of Tibia and Fibula as a Complication of Elastic Rubber Band Syndrome (Dhaga Syndrome)

Introduction: Rubber band syndrome is a rare acquired condition poorly discussed in literature, when neglected can lead to devastating complications of compartment syndrome and infection of soft tissue and bone as seen in the present case. Rubber band or Dhaga (sacred thread) when worn for prolonged duration can bury into the skin and soft tissue. Case Report: A 12-month-old girl developed osteomyelitis of tibia and fibula as sequelae of misdiagnosis and treatment for this syndrome. Assuming it to be a simple constriction band, incisions were given on medial and lateral aspect of the ankle, later she developed osteomyelitis of the tibia and fibula with in buried rubber band, which was removed and thorough curettage done and achieved good healing of the bones. Conclusion: Rubber band syndrome in not an uncommon condition, but when neglected or misdiagnosed can lead to complications such as compartment syndrome and osteomyelitis of the bones in involved limb as seen in this case. In suspected cases, imaging with sonography and X-ray of involved helps in diagnosis. Keywords: Osteomyelitis, rubber band syndrome, Dhaga syndrome, compartment syndrome.

Preliminary Biocompatibility Tests of Poly-ε-Caprolactone/Silver Nanofibers in Wistar Rats

Currently, nanotechnology is perceived as a promising science that produces materials with diverse unique properties at a nanometric scale. Biocompatibility tests of poly-ε-caprolactone nanofibers, embedded with silver nanoparticles manufactured by means of the electrospinning technique, were carried out in Wistar rats to be used as oral dressings for the eradication of bacteria. Solutions of 12.5, 25, 50 and 100 mM of silver nitrate were made using N-dimethylformamide (DMF) and tetrahydrofuran (THF) as reducing solvents with 8% of poly-ε-caprolactone (PCL) polymer. The solutions were electrospun, and the nanofibers obtained in the process were characterized by infrared spectroscopy, Raman spectroscopy, dark field optical microscopy, scanning electron microscopy and X-ray scattering spectroscopy. The nanofibers had an average diameter of 400 ± 100 nm. Once the characterization of the material was done, three implants of each concentration of the nanofibers were formed and placed in the subcutaneous tissue of the rats. Three experimental subjects were used, leaving the material in them for a length of two, four and six weeks, respectively. The rats showed good healing, with the lesions completely healed at four weeks after implantation. After that time, biopsies were taken, and histopathological sections were made to evaluate the inflammatory infiltrate. The tissues of the rats presented chronic inflammatory infiltrate composed mainly of lymphocytes and giant multinucleated cells. The material was rejected by the rats when a layer of collagen and fibroblasts was produced, coating the material, a process characteristic of a foreign body reaction.

Efficacy comparative characteristics of antiseptic DECASAN Yuria-Pharm and CUTASEPT G in the treatment of purulent inflammatory diseases of various localization

Background: High mortality because of various infectious complications (immediate cause in 42.5 % of cases), the ever-increasing frequency of purulent inflammatory diseases, as well as the growth of microbial resistance to anti-bacterial drugs, force to seek a solution to the problem among local antiseptics. Aim: to compare the effectiveness of antiseptics DECASAN Yuria-Pharm and CUTASEPT G in the treatment of puru-lent inflammatory diseases of different localization.Materials and methods: The study involved 30 patients with purulent inflammatory diseases of various localiza-tions. Patients were divided into two groups, according to the chosen tactics of local antiseptic therapy, in patients of the first study group (n = 15; mean age – 49.73 ± 6.35 years) antiseptic treatment was performed with a drug based on 0.02 % decamethoxine (Decasan). In the second group (n = 15; mean age – 51.4 ± 5.14 years) treatment was performed with a disinfectant (skin antiseptic) “Cutasept G”. Collection of material for microbiological examination (bacteriological culture) was performed before treatment, 3 and 5 days after treatment. Probability analysis was performed according to Student’s t-test. A statistically significant difference between the indicators was considered when the probability of validity of the null hypothesis was less than 5 % (p <0.05).Results: Analyzing the results of bacteriological examination of both groups, in the first, where Decasan was used and in the second, with the use of Cutasept G, it was found that at the beginning of treatment there was a pronounced microbial colonization of wounds, not significantly different among patients in both groups (p <0.05). Microbio-logical observation of the course of purulent-inflammatory process in the dynamics showed a significantly slowed down process of microbial purification in the second group (Cutasept G), the condition for 5 days was lg (8.8 ± 0.4) CFU/ml. At that time for patients of the first comparison group the number of microorganisms in 1 ml of wound contents, expressed in lg, was (4.8 ± 0.4) CFU/ml, which does not exceed the critical level. The obtained values were significantly higher than with Cutasept G (p <0.05), which was twice higher than the level of microbial colonization compared to the treatment of wounds with 0.02 % decamethoxine solution (p <0.001).Conclusions: The use of antiseptic 0.02 % decamethoxine for 5 days provides a reduction in the number of oppor-tunistic pathogens lg (4.8 ± 0.4) CFU/ml, which is 1.9 times lower (p <0.05) compared with the use of Cutasept G, creating conditions for the settlement of normal microbiotic skin (Corynebacterium spp., S. epidermidis). Antiseptic Dekasan is characterized by good healing properties due to its high antimicrobial activity, isotonicity, which makes it possible to use it successfully in patients with purulent inflammatory diseases of various localizations. In addition, the use of Dekasan promotes rapid cleansing of wounds from purulent-necrotic contents and formation of granula-tion tissue in them.