Friction Trauma Research Articles

Relationship between transforming growth factor beta 1 (TGF-ß1) level and skin tag

Background: Skin tag, also known as acrochordons, are benign neoplasms that look like a protrusion skin growth. Multifactorial causes of skin tags such as aging, obesity, metabolic and hormonal disorders. One of the mechanisms for the occurrence of skin tags by repeated scratching or friction trauma and continuously triggers an inflammatory response. During inflammation, TGF-ß1 has been activating to prevent the adhesion of neutrophils and T cells to endothelial cells, then limiting the recruitment of inflammatory cells. In addition, TGF-β1 expression is the main promoter in fibroblast proliferation and collagen synthesis as a response to cell repair function. This study aims to determine the relationship between TGF-ß1 level and skin tags. Methods: This observational study has a cross-sectional design of 39 skin tag patients and 40 non-skin tags. Each patient underwent history taking, dermatological examination, then took the blood sampling to analyze the TGF-ß1 level using the ELISA test. These data were statistically analyzed with the Mann-Whitney analytic test. Results: The average TGF-β1 level on skin tags group was 549.05±173.52 ng/ml. Most subjects with skin tags had 1–5 lesions, were 24 people (61.5%). The most common type of skin tag was pedunculated in 9 people (23.1%), followed by the drop form in 6 people (15.3%) and the spherical in 6 people (15.3%). The majority shows that 16 people (41%) have more than one type of skin tag in one region. The results of this study reveal that there is a relationship between TGF-β1 low level and skin tags. Conclusion: There is a significant relationship between TGF-β1 and skin tags.

Silicone Breast Implant Injector: A Retooled Breast Augmentation Device.

Silicone breast implants are used worldwide for breast augmentation. After an axillary, periareolar or inframmary incision has been made to create an adequately sized pocket; the surgeon usually uses his or her fingers to insert the implant. The use of fingers makes the insertion process time-consuming, a few minutes or more. There are some complications, including need to ensure that the incision is long enough for the implant to be inserted, scar hypertrophy caused by implant insertion friction damage to the edge of incision, and the occasional need to ask the surgical assistant to lend more fingers to facilitate satisfactory insertion and placement. In addition, the use of gloved fingers to repeatedly push on the implant can increase the risk of contamination, postoperative silicone microleakage, and capsular contracture. To resolve these problems, we developed an improved silicone breast implant injector (reusable stainless steel 2007; single use polypropylene 2018) that can be used more easily than fingers and other "no touch" devices. From 2013 to 2017, the first author, a plastic surgeon at our clinic, used the 2007 reusable stainless steel injector to perform breast augmentations in 53 patients (Ave. age 23.8years; range 19-67years), 5 (8.8%) receiving 250-ml implants, 41 (77.4%) 251-300-ml implants, and 7 (13.8%) 301-400-ml implants. Overall, results were satisfactory except for two patients (3.7%) in whom capsular contracture occurred. There were no ruptures. Use of the injector made it possible to shorten the length of the incisions from the traditional 4-7 to 3-4cm and expedited insertion time from a few minutes to a few seconds. This "no touch" insertion technique reduced implant damage caused by finger pushing, leading to a decrease in silicone microleakage and capsular contracture rate. It was performed with no friction trauma to the incision edge or harm to the surgeon's fingers. It was found to be an effective alternative operative tool for the insertion of silicone breast implants.Level of evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Epidermolysis Bullosa - An anaesthetic challenge

Epidermolysis bullosa (EB) is a rare genetic disorder characterized by blisters of skin and mucosa as a result of friction or minor trauma. EB can be of three forms: Epidermolysis Simplex (EBS), Junctional Epidermolysis Bullosa (JEB) and Dystrophic (DEB). Management of EB poses a challenge to the anesthetist. We report a case of 4-year-old girl who had been diagnosed with DEB since birth. At present, she was diagnosed to have esophageal stricture and was posted for balloon dilatation of esophagus. Airway examination revealed mouth opening of 1.5-2 fingers breadth with adequate neck movements. Difficult airway was anticipated. General anesthesia was administered and intubation was achieved using Airtraq video laryngoscope. Care was taken not to cause further trauma to the skin and mucosa in the perioperative period.

Influence of different lubricating fluids on friction trauma of small intestine during enteroscopy

Abstract Given the increasing attention to abdominal pain problem caused by small intestine damage during enteroscopy, the development of lubricating fluids for injury prevention has become an urgent task. In this study, in vivo friction experiments were conducted by using rabbit small intestine tissue under natural condition and lubricated conditions of Normal Saline, Calf Serum and Hyaluronic Acid, respectively. A quantitative grading system was designed to assess the friction trauma of the small intestine tissue. Results showed that the Calf Serum or Hyaluronic Acid lubricant could relieve the traumas and reduce the friction at the probe-small intestine mucosa interface. These results can be useful to identify the suitable lubricating fluids for the safe operation of enteroscopy.

Rehabilitation and adaptation of lower limb skin to friction trauma during friction contact

Most amputees usually use prostheses to retain upright mobility capabilities and restore appearance. A prosthetic socket is a fitting between the prosthesis and the trans-tibial stump, which is the critical component for prosthetic performance and the only way of load transfer between the prosthesis and the stump. However, the skin of an amputated limb is not adapted to bearing load. The interaction between the stump and the prosthetic socket usually causes dermatologic problems. A total of 34% of amputees experienced skin problems, such as pressure ulcers, blister, cysts, edema, skin irritation, dermatitis, etc, which result from friction, pressure, heat and humidity. This would affect the wear of the prosthesis. In this paper, skin self-rehabilitation and self-adaptation to friction trauma were studied by means of friction testing, skin surface characterization, skin trauma and skin sensation evaluation. The human limb skin was investigated in vivo under the simulated friction conditions of mobility capability training of amputees who preliminarily wear prosthesis. Results showed that in the 30 days׳ friction trauma and rehabilitation process, the trauma degree of skin surface was from severe to slight, the skin surface roughness values increased first and decreased later, and then increased again. Keratinization gradually formed on the skin surface, and correspondingly, the coefficient of friction decreased first and then increased. The differences of skin temperature from friction test start to end gradually decreased with increasing friction days. The EEG signal examinations suggested that the discomfort sensations gradually weakened with increasing friction days. These results demonstrated that the limb skin went through the tribological behavior from friction trauma to gradual self-adaptation under a long period of reciprocal sliding friction condition. The results would be useful for the new amputee to arrange the best policy of capability training, and would also guide the correct use of labor and sporting goods.

Investigation on Friction Trauma of Small Intestine In Vivo Under Reciprocal Sliding Conditions

In the process of surgery, operation equipments or materials inevitably rub against the internal organs or tissues of patient, which often causes a series of frictional trauma problems. However, research work on the tribological factors at the interface and subsequent friction trauma is still very limited. In this paper, the friction trauma mechanism of small intestine caused by the surgeon’s fingers in the process of grasping and pulling operation was investigated in vivo by means of reciprocal sliding friction testing. The rabbit small intestine was used to simulate human small intestine. An UMT-II tribometer was used to measure tribological parameters of the rabbit small intestine under different normal force of 1.0, 2.0 and 3.0 N to simulate the grip strength of surgeon’s hands. Histological analysis was used to evaluate the degree of tissue damage. Results showed that the ratio of tangential force to normal force of rabbit small intestine decreased with the normal force increasing. The frictional behavior under the three normal forces was all in the tissue damage range of intermediate regime from sticking to relative sliding. With the normal force and friction time increasing, the total friction energy dissipation on the small intestine increased, which induced the damage degree of the small intestine aggravation. The damage of rabbit small intestine extended gradually from outside to inside: serosa layer tearing and falling, muscularis bleeding, longitudinal muscularis and circular muscularis division and mucosal bleeding and necrosis.

What Factors Impact Referral of Patients by Radiation Therapists at the Princess Margaret Cancer Centre to the Electronic Living Laboratory for Interdisciplinary Cancer Survivorship Research (ELLICSR) Kitchen?

based on a modified RTOG visual assessment scale. On day 1 of treatment, baseline photos are taken and patients complete a Quality of Life Questionnaire (QLQ). 7-10 days post-treatment, patients return for photos, STAT, 2 QLQ, and Global Questionnaire (GQ) completion. Preliminary Results: Currently, 19 patients have completed treatment (8/19 medial BF; 11/19 lateral BF); preliminary results are based on data collected from these cases. In the control arm, 8/19 patients had > grade (G) 1 dermatitis vs. 7/19 using BF (42% vs. 37%). In the control arm, 3/19 patients had G2 dermatitis vs. 4/19 using BF (16% vs. 21%). Of the 4 BF arm patients that experienced G2 scores, 3/4 of these reactions occurred in the lateral half of the breast. Of the 7 BF patients that had > G1, 5/7 of the reactions occurred laterally, suggesting an increased susceptibility/sensitivity of the lateral aspect of the intact breast. Of the 4 occurrences of G2, 3/4 occurred bilaterally; 1 case occurred unilaterally in the lateral BF arm. GQ responses indicate that patients would use the BF again and thought it made a meaningful difference to their skin care (67% would use again; 20% would not; 0.07% did not respond or were undecided. QLQ and pain/pruritus scores have not been analyzed at this point. Conclusion: BFs protect skin from external trauma and help maintain integrity while allowing skin to breathe. By protecting irradiated skin from excess friction trauma, the severity of radiation skin toxicity and/or pain/pruritus scores in post-lumpectomy breast cancer patients may be reduced, or the time of onset delayed. Though preliminary results are marginally suggestive of benefit, continuation of our current study will provide more definitive data.

Skin self-adaptation to friction trauma under reciprocal sliding conditions

In this study, skin self-rehabilitation and self-adaptation to friction trauma were investigated in vivo by means of friction testing, histological analysis and animal experiments under the simulated prosthetic socket rubbing condition. The denuded dorsal skin of rabbits was used to simulate stump skin. Results showed that after the skin went through several alternations of trauma and rehabilitation process, a keratinization appeared on the skin surface, which decreased the friction coefficient of skin and reduced the skin traumas. These results suggested that during the reciprocal sliding friction process, the rabbit skin suffered from friction trauma, rehabilitation and self-adaptation in turn.

Blistering Skin Conditions

Blisters are fluid-filled eruptions on the skin or mucous membranes. They are commonly seen in general practice in patients with herpes infection, insect bites, burns and friction trauma. Primary blistering disorders, for example bullous pemphigoid (BP) and pemphigus vulgaris (PV) are rare in comparison. These are immune or inherited disorders of proteins that bind the skin together. Blistering conditions may present alone or in association with other diseases, for example dermatitis herpetiformis and gluten-sensitive enteropathy. Blistering may be trivial or life threatening and therefore requires a logical approach to assessment, management and referral in the primary care setting.

Spinal Anesthesia for Cesarean Section in a Case of Pemphigus Foliaceous

Spinal Anesthesia for Cesarean Section in a Case of Pemphigus Foliaceous