Mattress Method Research Articles

Prospective Observational Study Of Surgical Site Infections In Obstetrics And Gynaecological Operations In Teaching Hospital

Background: Surgical site infections (SSI) are defined as infections occurring upto 30 days after surgery or (upto one year in patients receiving implants) and affecting either the incision or deep tissue at the operative site. SSIs are potential complications associated with any type of surgical procedure. Even though SSIs are among the most preventable hospital acquired infections, they still symbolize a significant burden in terms of patient’s morbidity and mortality leading to prolonged hospital stay and increase the patient susceptibility to other nosocomial infections affecting the financial condition of patients. Risk factors for SSIs are grouped as patient related, preoperative or pre pregnancy, intraoperative or intrapartum, and postoperative. SSI causes a substantial risk to patients and financial loses for health system because the multi-factorial causes achieving a measurable and sustained reduction in SSIs. In this context it becomes important to determine the prevalence of SSI, assess the magnitude of problem and provide a rationale to set priorities in infection control in the hospitals. Materials and Methods: The present prospective observational study was conducted on 200 patients in the Department of Obstetrics and gynaecology, at Dr B R Ambedkar Medical College and Hospital for a period of 12 months. Prior to the initiation of the study, Ethical and Research Committee clearance was obtained from Institutional Ethical Committee. Results: There was a significant statistical difference in the incidence of SSIs basing on the body mass index of subjects (pvalue:<0.001). SSI incidence was high in morbidly obese subjects. There was a highly significant statistical difference in the incidence of SSIs basing on the history of previous surgeries of subjects (p-value: <0.0001). SSI incidence was low in subjects with no history of previous surgeries. There was a highly significant statistical difference in the incidence of SSIs basing on the type of surgery (p-value: 0.48). SSI incidence was high in caesarean and low in tubectomy surgeries. There was a significant no statistical difference in the incidence of SSIs basing on the type of incision (p-value: 0.70). There was a highly significant statistical difference in the incidence of SSIs basing on the methods of skin closure (p-value: 0.002). SSI incidence was high in mattress method of skin closure and low in subcuticular method of skin closure. There was a highly significant statistical difference in the incidence of SSIs basing on the class of wound (p-value: 0.00001). SSI incidence was high in dirty wounds and low in clean wounds of skin closure. Conclusion: Although several preoperative risk factors (e.g., age, morbid obesity, ability to pursue a minimally invasive approach, type of gynaecologic surgery, type of incision, methods of skin closure, class of wound) may not be within the surgeon’s control, several evidence based interventions can limit the incidence of SSIs.

Hypertrophic cardiomyopathy-linked mutation in troponin T causes myofibrillar disarray and pro-arrhythmic action potential changes in human iPSC cardiomyocytes

BackgroundMutations in cardiac troponin T (TnT) are linked to increased risk of ventricular arrhythmia and sudden death despite causing little to no cardiac hypertrophy. Studies in mice suggest that the hypertrophic cardiomyopathy (HCM)-associated TnT-I79N mutation increases myofilament Ca sensitivity and is arrhythmogenic, but whether findings from mice translate to human cardiomyocyte electrophysiology is not known. ObjectivesTo study the effects of the TnT-I79N mutation in human cardiomyocytes. MethodsUsing CRISPR/Cas9, the TnT-I79N mutation was introduced into human induced pluripotent stem cells (hiPSCs). We then used the matrigel mattress method to generate single rod-shaped cardiomyocytes (CMs) and studied contractility, Ca handling and electrophysiology. ResultsCompared to isogenic control hiPSC-CMs, TnT-I79N hiPSC-CMs exhibited sarcomere disorganization, increased systolic function and impaired relaxation. The Ca-dependence of contractility was leftward shifted in mutation containing cardiomyocytes, demonstrating increased myofilament Ca sensitivity. In voltage-clamped hiPSC-CMs, TnT-I79N reduced intracellular Ca transients by enhancing cytosolic Ca buffering. These changes in Ca handling resulted in beat-to-beat instability and triangulation of the cardiac action potential, which are predictors of arrhythmia risk. The myofilament Ca sensitizer EMD57033 produced similar action potential triangulation in control hiPSC-CMs. ConclusionsThe TnT-I79N hiPSC-CM model not only reproduces key cellular features of TnT-linked HCM such as myofilament disarray, hypercontractility and diastolic dysfunction, but also suggests that this TnT mutation causes pro-arrhythmic changes of the human ventricular action potential.

Production of Single Contracting Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes: Matrigel Mattress Technique.

This unit describes the published Matrigel mattress method. Briefly, we describe the preparation of the mattress, replating of the human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CM) on the Matrigel mattress, and hiPSC-CM mattress maintenance. Adherence to this protocol will yield individual, robustly shortening hiPSC-CMs, which can be used for downstream applications. © 2017 by John Wiley & Sons, Inc.

Easy Placement of Annular Sutures During Minimally Invasive Aortic Valve Replacement.

Placing annular sutures at the right coronary cusp is difficult during minimally invasive aortic valve replacement. We propose the partial everting mattress method, whereby a prosthetic valve is implanted in a supra-annular position at the left coronary and noncoronary cusps, with pledgets on the left ventricular side, but in an intra-annular position at the right coronary cusp, with pledgets on the aortic side. Needles can be grasped in forehand pass at all three coronary cusps. Our method enables easy placement of annular stitches even in the small surgical field, without adversely influencing the hemodynamic performance of the prosthesis.

Electrophysiological Properties of Human Induced Pluripotent Stem Cell-Derived Cardiomyocytes Cultured on a Flexible Matrigel Substrate

Human-induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs) provide a unique tool to evaluate cellular properties in disease models, investigate underlying mechanisms and optimize cell-based therapies. We recently reported that after plating 30 day old single hiPSC-CMs on undiluted Matrigel “Mattress” (thickness ∼0.5 mm) for 5 days, mattress hiPSC-CMs developed a rod-like cell shape, aligned myofilament structure, increased sarcomere length and exhibited robust cell shortening. Here, we compared the electrophysiological properties of mattress hiPSC-CMs to hiPSC-CMs cultured on standard substrates (control) and acutely-isolated adult rabbit CMs. The action potentials of mattress hiPSC-CMs were comparable to rabbit CMs. Compared to control, mattress hiPSC-CMs had significantly increased the action potential upstroke velocity due to two-fold increase in sodium current (INa) (−68.61±11.63 pA·pF-1 in mattress vs. −29.66±7.50 pA·pF-1 in control at −30mV). The inward rectifier current (IK1) is responsible for the maintenance of resting membrane potential and contributes to phase 3 of the action potential. Although resting potential and action potential duration was not different from rabbit CMs, IK1 density in mattress hiPSC-CMs was nine-time smaller than in rabbit CMs, but there was no difference between mattress and control hiPSC-CMs (−4.86±0.66 pA·pF-1 in mattress vs. −43.75±4.13 pA·pF-1 in rabbit vs. −3.98±0.83 pA·pF-1 in control at −120 mV). The funny current (If) is an inward current activating at hyperpolarized membrane potential, which is detectable in the developing heart but absent in the adult ventricle and contributes to the spontaneous beating of hiPSC-CMs. Mattress hiPSC-CMs exhibit robust If that was not significantly different from control (−6.22±1.31 pA·pF-1 in mattress vs.-5.60±1.43 pA·pF-1 in control at −120 mV). In summary, the matrigel mattress method enables the rapid generation of robustly contracting single hiPSC-CMs and increases INa, with negligible effect on IK1 or If.

Matrigel Mattress: A Method for the Generation of Single Contracting Human-Induced Pluripotent Stem Cell-Derived Cardiomyocytes.

The lack of measurable single-cell contractility of human-induced pluripotent stem cell-derived cardiac myocytes (hiPSC-CMs) currently limits the utility of hiPSC-CMs for evaluating contractile performance for both basic research and drug discovery. To develop a culture method that rapidly generates contracting single hiPSC-CMs and allows quantification of cell shortening with standard equipment used for studying adult CMs. Single hiPSC-CMs were cultured for 5 to 7 days on a 0.4- to 0.8-mm thick mattress of undiluted Matrigel (mattress hiPSC-CMs) and compared with hiPSC-CMs maintained on a control substrate (<0.1-mm thick 1:60 diluted Matrigel, control hiPSC-CMs). Compared with control hiPSC-CMs, mattress hiPSC-CMs had more rod-shape morphology and significantly increased sarcomere length. Contractile parameters of mattress hiPSC-CMs measured with video-based edge detection were comparable with those of freshly isolated adult rabbit ventricular CMs. Morphological and contractile properties of mattress hiPSC-CMs were consistent across cryopreserved hiPSC-CMs generated independently at another institution. Unlike control hiPSC-CMs, mattress hiPSC-CMs display robust contractile responses to positive inotropic agents, such as myofilament calcium sensitizers. Mattress hiPSC-CMs exhibit molecular changes that include increased expression of the maturation marker cardiac troponin I and significantly increased action potential upstroke velocity because of a 2-fold increase in sodium current (INa). The Matrigel mattress method enables the rapid generation of robustly contracting hiPSC-CMs and enhances maturation. This new method allows quantification of contractile performance at the single-cell level, which should be valuable to disease modeling, drug discovery, and preclinical cardiotoxicity testing.

Cryptosporidiosis and Colorectal Cancer

Background Suturing quality and reducing its complications and resulting infection have always been a major concern of surgeons. Many of them have prohibited applying polyfilament and absorbable suturing materials. Objectives In this study, we compared skin wound infection rate and other complications in two groups of post appendectomy patients whom were treated with two types of suturing materials - conventionally used Nylon and absorbable braided polyglactin (Vicryl) - and wound healing, existence of complication and recovery course of treated patients were surveyed. Patients and Methods A total of 130 patients who underwent appendectomy were divided into two groups of 645 members, each. Patients in group A had their incisions closed by separate sutures (mattress method) by vicryl, while patients in group B had their surgical incisions were closed in the same method, by nylon sutures. Any signs and symptoms of surgical site wound infection like inappropriate pain, redness, discharge, bulging, and unhealing wound were checked during hospital stay and on the 7th - 9th day postoperatively. Results The postsurgical complication and infections rates were similar between the two groups. Conclusions Vicryl sutures can safely be used for skin and subcutaneous wound suturing even when our surgery site is not ideally clean.

Melilotus officinalis L. Protects Ulcerative Colitis in Rats

Background Suturing quality and reducing its complications and resulting infection have always been a major concern of surgeons. Many of them have prohibited applying polyfilament and absorbable suturing materials. Objectives In this study, we compared skin wound infection rate and other complications in two groups of post appendectomy patients whom were treated with two types of suturing materials - conventionally used Nylon and absorbable braided polyglactin (Vicryl) - and wound healing, existence of complication and recovery course of treated patients were surveyed. Patients and Methods A total of 130 patients who underwent appendectomy were divided into two groups of 645 members, each. Patients in group A had their incisions closed by separate sutures (mattress method) by vicryl, while patients in group B had their surgical incisions were closed in the same method, by nylon sutures. Any signs and symptoms of surgical site wound infection like inappropriate pain, redness, discharge, bulging, and unhealing wound were checked during hospital stay and on the 7th - 9th day postoperatively. Results The postsurgical complication and infections rates were similar between the two groups. Conclusions Vicryl sutures can safely be used for skin and subcutaneous wound suturing even when our surgery site is not ideally clean.

Conservative Management of Anterior Abdominal Stab Wounds

Background Suturing quality and reducing its complications and resulting infection have always been a major concern of surgeons. Many of them have prohibited applying polyfilament and absorbable suturing materials. Objectives In this study, we compared skin wound infection rate and other complications in two groups of post appendectomy patients whom were treated with two types of suturing materials - conventionally used Nylon and absorbable braided polyglactin (Vicryl) - and wound healing, existence of complication and recovery course of treated patients were surveyed. Patients and Methods A total of 130 patients who underwent appendectomy were divided into two groups of 645 members, each. Patients in group A had their incisions closed by separate sutures (mattress method) by vicryl, while patients in group B had their surgical incisions were closed in the same method, by nylon sutures. Any signs and symptoms of surgical site wound infection like inappropriate pain, redness, discharge, bulging, and unhealing wound were checked during hospital stay and on the 7th - 9th day postoperatively. Results The postsurgical complication and infections rates were similar between the two groups. Conclusions Vicryl sutures can safely be used for skin and subcutaneous wound suturing even when our surgery site is not ideally clean.

Comparison of Infection Incidence Between Appendectomy Skin Incisions Sutured by Nylon and Polyglactin (Vicryl)

Background: Suturing quality and reducing its complications and resulting infection have always been a major concern of surgeons. Many of them have prohibited applying polyfilament and absorbable suturing materials. Objectives: In this study, we compared skin wound infection rate and other complications in two groups of post appendectomy patients whom were treated with two types of suturing materials - conventionally used Nylon and absorbable braided polyglactin (Vicryl) - and wound healing, existence of complication and recovery course of treated patients were surveyed. Patients and Methods: A total of 130 patients who underwent appendectomy were divided into two groups of 645 members, each. Patients in group A had their incisions closed by separate sutures (mattress method) by vicryl, while patients in group B had their surgical incisions were closed in the same method, by nylon sutures. Any signs and symptoms of surgical site wound infection like inappropriate pain, redness, discharge, bulging, and unhealing wound were checked during hospital stay and on the 7 th - 9 th day postoperatively. Results: The postsurgical complication and infections rates were similar between the two groups. Conclusions: Vicryl sutures can safely be used for skin and subcutaneous wound suturing even when our surgery site is not ideally clean.

Tendon Repair: Zone I and II Flexor Tendons and Extensor Tendons

Tendon injuries in the hand are common, yet represent some of the most challenging problems in the hand to both patient and surgeon. The goal is for a repair or reconstruction to be strong enough to allow for early active range of motion, yet to retain its anatomic morphology to allow for smooth gliding. This review will discuss optimal repair characteristics and will offer a suggestion of techniques that are effective and applicable to the daily practicing hand surgeon. The focus will be on zones I and II flexor tendon repairs and reconstruction and extensor tendon repair. The anchor button technique for zone I injuries and reconstruction, cross-locked cruciate–interlocking horizontal mattress repair method for zone II injuries, and the running-interlocking horizontal mattress method for extensor tendon repair provide excellent biomechanical characteristics that allow for early active range of motion. Rationale for these techniques with specific descriptions will be presented.

Development of the Transplantation Method of Subtropical Seagrass which Expands by its Roots

New type of transplantation technique with the use of mattresses to create a seagrass community has been developed recently in Japan. This technique suits the wide-space transplantation because of its efficiently for the seagrass like Zostera marina that expands by its seeds. The authors developed and reformed this technique to make it applicable for the subtropical seagrass like Halodule uninervis that expands by its rhizomes in Dubai, U. A. E. A field-test was performed to check the applicability of newly developed mattress method for transplantation. The test result revealed that the new mattress method showed high performance in transplantation.

Field experiment of Zostera japonica transplanting using mattress method in Ago Bay

On environmental restoration of coastal zone, it should be developed conservation and transplantation techniques of seagrass. Transplanting shoot is applied for seagarss which propagates by growth of own root. However, since the method takes heavy diving works, simple and convenient method is required practically. In this study, Zostera japonica is focused as typical seagrass that propagates by root. New transplanting method, which uses mattress, was developed. And, the applicability was researched in Ago Bay. Advantage of the method is that big transplanting is possible at one time without much diving works. Efficient knowledge from field experiment are Zostera japonica can propagate on palm mattress or biodegradability sheet set on sea bed, it can grow after transplanting on the mattress or sheet.

Simulation of wear in a rolling–sliding contact by a semi-Winkler model and the Archard’s wear law

The purpose of this work is to develop a method of controlling the friction and wear affecting the contact pair in rolling–sliding contact. The scope is in small-scale tribology by which mechanism of wear would be clarified on first hand by Archard’s law. The prerequisite for using Archard’s wear law in a simulation is proper piecewise linear modelling of contact at the substructural level, including prediction of deformations and relative motions for every part of the contact. The deformation level at the real contact depends on such parameters as normal forces, relative motions, geometry, surface tractions, etc. There is a need for a simulation tool that explains the role of these parameters. The present work simulates the well-known disc-on-disc test for dry wear. The deformation field due to normal load is solved by the Winkler mattress method. The tangential stress field is subsequently calculated knowing the normal pressure field, the penetration and the general rigid body movement for every subregion. The influence functions from potential theory are used to model the tangential traction and displacement field in the contact. The special computing excludes the need for the creep constants that depend on the Poisson’s ratio and the result is not dependent on the shape of the contact area. Every rectangular cell is tested whether it is subject to sliding. The sliding distance is calculated by subtracting elastic displacements from the relative motion of the rigid body. The elastic deflections are reversible and exist both under the sticking region in contact and also in the sliding region. A comparison of the results of a simulation and a disc-on-disc test is presented. Good agreement was found for both wear and rolling friction at different load and creep levels.

The changes in main pulmonary artery pressure after bilateral lung autotransplantation in dogs.

In the Respiratory Center, Yongdong Severance Hospital, Yonsei University, we performed 10 cases of bilateral lung autotransplantation in mongrel dogs from July 1994 to June 1996, and we have analyzed the hemodynamic changes. Autotransplantation was performed in order to avoid postoperative rejection. The lung was flushed with an Euro-Collins(E-C) solution containing PGE1 which passed through a 10 French catheter inserted into an incision on the anterior half of the pulmonary artery to pulmonary parenchyme, and the vertical incision was made on the anterior half of the left atrium near the proximal part of the pulmonary vein. However, the bronchus was totally divided after clamping both sides. The lung was kept cold (4 degrees C) in the thoracic cavity for an hour by using slushed ice made from an E-C solution. After an hour of cold ischemia, the pulmonary artery was sutured with Prolene 5-0. The pulmonary vein was sutured with Prolene 6-0 by using the continuous everting mattress method. The main bronchus was anastomosed using the telescope method. The arterial oxygen concentration and the pressures in the femoral and pulmonary arteries were measured both preoperatively and postoperatively. There were no significant hemodynamic differences between the preoperative and postoperative mean pulmonary artery pressure (MPAP) (paired t-test, P = 0.05). Lung preservation using a cold (4 degrees C) E-C solution containing PGE1 may be an acceptable method for short-term storage of a lung (for about an hour) in bilateral lung autotransplantation in dogs.