Sandwich Technique Research Articles

Interfacial Phenomena in Multiwalled Carbon Nanotube-Reinforced Magnesium Nanocomposite Synthesized by the Sandwich Technique

Interfacial Phenomena in Multiwalled Carbon Nanotube-Reinforced Magnesium Nanocomposite Synthesized by the Sandwich Technique

Diffusion of Magnesium in Czochralski Silicon

The diffusion of magnesium in monocrystalline dislocation‐free Czochralski silicon (Cz–Si) with an oxygen concentration of (3–4) × 1017 cm−3 is studied. Initial silicon wafers are doped with Mg by using the sandwich technique. The impurity diffusion profiles are investigated in n‐Si samples by the differential conductivity method. The diffusivity of electrically active magnesium in the temperature range of 1,100–1,250 °C is two to three orders of magnitude lower than the values observed at doping high‐purity silicon crystals grown by the float‐zone method (Fz–Si). The diffusion in Cz–Si is retarded through the trapping of diffusing Mg atoms by oxygen‐related traps. The observed high value of the activation energy of Mg diffusion in investigated samples (4.1 eV) is due—along with the migration energy of interstitial magnesium in the crystal lattice (1.83 eV) —to the significant binding energy of Mg atoms with traps (2.27 eV). A study of the temperature dependence of the Hall effect in bulk‐doped samples reveals two types of deep double donors: interstitial Mg atoms and MgO complexes.

Evaluation of the Outcome of Modified Open Sandwich Technique and Conventional Composite Resin Restoration: For Managing Class II Cavity of Primary Molars Among 4- 8 years Old Children

Background: Dental caries is the most prevalent disease in humans, especially during early childhood. The restoration of such an extensive carious lesion should be done properly to reestablish their anatomy and hence their masticatory, phonetic, esthetic, and space-maintainer functions in the dental arches. Composite resins are the most commonly used tooth-colored restorative material, but many difficulties occur particularly when used directly in posterior restorations. The objective of the study was to compare the clinical effectiveness of the Modified Open Sandwich Technique and Conventional Composite Resin Restoration for managing class II caries on primary molars. Material & Methods: This was a randomized control trial and was conducted in the Department of Pedodontics, Faculty of Dentistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period from October, 2021 to September, 2022. In our study we included 68 patients with proximal dental caries of primary molars with reversible pulpitis. The patients were divided by using random sampling technique into two groups – Group A (The modified open sandwich technique, n=34) and Group B (The conventional composite resin restoration, n=34). Results: In total 68 patients from both the groups completed the study. In our study we found mean±SD of age was 5.37±1.24 years. 76.5% of cases of the modified open sandwich technique restorations were & 82.4% of the conventional composite resin restoration were < 6 years. Mandibular primary molars were 64.7% and 53% for the modified open sandwich technique and conventional composite resin restoration respectively. Conventional composite resin restorations showed 32.4% postoperative sensitivity and the modified open sandwich technique restorations showed 11.8%. After 12 months of follow-up, no secondary caries developed. Good marginal adaptation in 100% of cases were found in the modified open sandwich technique and 88.2% for conventional composite restorations. Conclusion: In our study we found that postoperative sensitivity developed more in conventional composite restorations in comparison to the modified open sandwich technique. Initially marginal adaptation showed better in the modified open sandwich method technique. So, conventional and modified open sandwich composite resin techniques were acceptable for primary molar teeth considering secondary caries and marginal adaptation.

Intelligent Materials for Labeling Dentures in Forensic Dental Identification—A Pilot Study

(1) Background: the present study continues previous research on new marking techniques by using intelligent materials, NFC-tags (Near Field Communication tags) and Aerogel. They prevent the loss of information over time for cadavers of unknown identities in various stages of destruction or unknown living victims, as well as missing persons who have lost or are concealing their identity. (2) Methods: this study consisted of a technological and an experimental stage. In the technological stage, two different sizes were used: round (Ø 1 cm, 0.1 mm thickness, 0.1 g weight) and square (5/5/0.1 mm), both with a 140 byte memory and high-temperature resistance (at max. 200 °C), (by the classical producing technology). After loading the identification information on the NFC-tags, they were embedded (either alone or protected by Aerogel) in the sample dentures using a new “sandwich technique” method, before the polymerization process. In the experimental stage, the sample dentures with the new materials were exposed to various damaging environments such as liquid media (sea water, fresh water, alcohol 40%, and HCl 0.2%) in order to test the time resistance of the identification elements. The samples were monitored and tested over four years. (3) Results: the information stored on the NFC tags was retrieved unaltered at the end of the monitoring period, regardless of the damage caused by the liquid media to the sample denture material and will provide an innovative solution as compared to other labeling methods. (4) Conclusion: the use of intelligent materials for labeling acrylic dentures provides additional reliability by preserving the identification information over time.

The Impact of Dental Adhesives on the Shear Bond Strength between Restorations in Sandwich Technique: A Systematic Review and Meta-analysis

The Impact of Dental Adhesives on the Shear Bond Strength between Restorations in Sandwich Technique: A Systematic Review and Meta-analysis

Introduction of Mini Clinical Evaluation Exercise as an Assessment Tool for M.B.B.S. Interns in the Department of Orthopaedics.

Mini-CEX helps in judicious use of competencies in authentic settings by simultaneously assessing clinical skills of trainees and providing feedback on their performance. As assessment of M.B.B.S. Interns for their competency in clinical examination skills in Department of Orthopaedics is lacking, this study is taken up to introduce Mini-CEX for M.B.B.S. Interns, by sensitising faculty and interns. A Quasi-experimental study was conducted during June to December 2020, among 60 interns posted in the Department of Orthopaedics. After obtaining IEC Clearance and written informed consent from the study participants, they were sensitised and exposed to five Mini-CEX clinical encounters involving examination of a patient with knee/other joint disorder in the Outpatient/Inpatient clinical setting, with eight faculty. The study tool used was Mini-CEX questionnaire developed by American Board of Internal Medicine (ABIM). Case specific feedback was provided to interns using sandwich technique. The reflections and perceptions of interns and faculty were obtained after completion of all Mini-CEX encounters. 96.7% encounters were conducted in OPD during first encounter. On an average, one Mini-CEX encounter lasted for 17min. Interns had an overall score for the various domains ranging from 5.38 to 5.58. Comparison of mean scores showed a statistically significant improvement (p value < 0.0001). All the assessors were satisfied with Mini-CEX as an assessment tool. Interns and faculty opined that Mini-CEX improves clinical examination skills and professional development as focus is on the outcome and learning process, with multiple sampling in a longitudinal manner.

Assessment of microleakage and interfacial adaptation following simultaneous activation technique in primary molars

Simultaneous Activation Technique is a newer method of co-curing resin modified glass ionomer (RMGI) and self-etch adhesive. Assessment of microleakage and interfacial adaptation following simultaneous activation technique in primary molars. Standardized Class I cavities were prepared in 66 non-carious primary molars and randomly allocated to Group I – Simultaneous activation of RMGI and self-etch adhesive (SAT); Group II – SAT with enamel etching (SAT + EE); Group III – Conventional Sandwich Technique (ST) and restored with bulk fill composite. Time taken was calculated using stopwatch. Microleakage was assessed using dye penetration method under stereomicroscope. Seven samples per group were sent for Scanning Electron Microscopy (SEM) analysis. One-Way Analysis of Variance and Post- Hoc Tukey's test were applied at P < 0.05. Mean microleakage of group I, II and III were 1.23, 1.41 and 1.59 respectively. Time taken was least for SAT followed by SAT + EE and ST group. Statistically significant difference was seen between SAT and ST group (p < 0.0001) and SAT + EE and ST group (p < 0.0001). SEM analysis showed better mean interfacial adaptation in SAT + EE (1.00) followed by ST (2.14) and SAT (3.57) group. Difference between SAT + EE and SAT group was significant (p = 0.005). Simultaneous activation technique with selective enamel etching resulted in less microleakage and better interfacial adaptation.

V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY

You have accessJournal of UrologyCME1 Apr 2023V11-09 PENILE VIBRATORY STIMULATION (PVS): THE METHOD OF CHOICE FOR ANEJACULATION AFTER SPINAL CORD INJURY Emad Ibrahim Emad IbrahimEmad Ibrahim More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000003337.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Spinal cord injury (SCI) is the leading cause of anejaculation in young men. After SCI 90% of men with SCI will need a method of assisted ejaculation to achieve biological fatherhood. Penile vibratory stimulation (PVS) was popularized in 1994 after the production of the first vibrator specifically designed for semen retrieval in men with SCI. The success of this device was based on a calculated amplitude of 2.5 mm which was proven to be optimal for successfully producing an ejaculate. PVS is safe, reliable, can be performed by the male partner at home after an initial evaluation by a health care provider and yields the best sperm quality.A newly designed vibrator was produced in 2019 and was tested by a group of international experts for safety and efficacy. The study concluded the device was safe and effective in inducing ejaculation in men suffering from anejaculation after SCI. METHODS: Initial encounter: standard history, physical exam and level of injury determination using the International Standards for Neurological Classification of Spinal Cord Injury were performed. In addition, assessment of Hip Flexor Reflex and Bulbocavernosus Reflex was performed. Procedure: Patients with a level of injury at or rostral to T6 were pretreated with 10-40 mg of sublingual nifedipine to mange autonomic dysreflexia. The patient lied supine on the exam table and the vibrator was applied to the dorsum or frenulum of the glans penis. Stimulation was delivered in 2-minute increments to a maximum of 10 minutes per visit. Stimulation using 2 vibrators (Sandwich technique) or with abdominal electrical stimulation can be performed in select patients. Semen: Ejaculated semen was collected in a sterile cup and a semen analysis was performed after liquefaction. Bladder preparation using sperm wash medium was performed in patients suspected of having retrograde ejaculation. RESULTS: PVS was successful in 86% of men whose level of injury was T10 or rostral. A total of 3,698 PVS procedures were successfully performed by our group. The total motile sperm count in antegrade ejaculates produced by PVS was >5 million (lower limit considered for IUI) in 71% of ejaculates. CONCLUSIONS: PVS is a safe and effective method to manage anejaculation in men with SCI. Sperm can be obtained non surgically from most men with SCI. Sufficient sperm are available for simple insemination procedures. PVS should be considered as the method of choice for semen retrieval in this patient population. Source of Funding: Paralyzed Veterans of America (PVA) Educational Grant #877 © 2023 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 209Issue Supplement 4April 2023Page: e1001 Advertisement Copyright & Permissions© 2023 by American Urological Association Education and Research, Inc.MetricsAuthor Information Emad Ibrahim More articles by this author Expand All Advertisement PDF downloadLoading ...

‘Flip-flap’ hernia sac sandwich mesh hernioplasty for giant incisional hernia

Purpose: The treatment of giant ventral hernia (GVH) with domain loss is a challenge for surgeons. This modified and simplified form of sandwich technique in a form of flip-flap repair was done to assess the outcomes of GVH repair by using the hernia sac taking into account the late complications in terms of recurrence, mesh explantation and early: SSO (surgical site occurrence). Material and method: A total of 21 patients of GVH were treated with flip-flap repair technique in the department of surgery in a teaching hospital in the central India between December 16 to June 21. In flip-flap technique the hernia sac is tailored in the best possible way, by making multiple layered flaps encasing the Polypropylene mesh in between, separating it from intraperitoneal contents and subcutaneous tissue. Results: In this prospective and interventional study, the collected data revealed the mean follow up period of 22.3 months (7months to 48months). Mean age was 44.2years (27-65 years). SSO was seen in 38% of cases mainly in the form of SSI. No explantation of mesh and recurrence was seen in any patient. Conclusion: The flip-flap repair technique is safe and effective surgical technique that can be used for the treatment of GVH regardless of the size, BMI or position of hernia.

Abstract Number ‐ 117: Sandwich technique as rescue therapy. (Stent retriever)

Introduction system to extract foreign bodies in the cerebral circulation with 2 stent retrievers (solitare) Methods We present 2 cases in which we have had to withdraw devices. (Flow diverter due to poor opening and coil due to distal migration.) Results 2 cases are presented, in which we used the technique developed by angioteam. In the first case we rescued a flow diverter stent that was exchanged for another stent. In the second case, we the rescued the coils that migrated from the internal carotid artery to the medium cerebral artery. Conclusions It is a rescue technique in which a distal stent retriever and a second proximal device are pulled between them to catch the device that is going to be removed Both cases were successfull in removing the flow diverter stent and coil.

Vertical ridge augmentation of atrophic posterior mandible with corticocancellous onlay symphysis graft versus sandwich technique: clinical and radiographic analysis.

Alveolar ridge augmentation of atrophic posterior mandibular ridge represents a challenge in oral and maxillofacial surgery to restore aesthetic and function. The aim of the study was to compare the clinical and radiographic outcomes of bone formation in atrophic posterior mandibles augmented using onlay symphysis cortico-cancellous bone block with that augmented using sandwich bone augmentation technique (Inlay). Twelve patients were selected with missing mandibular posterior teeth. CBCT were done for all patients preoperatively to assess the residual bone height, ranged between 5 and 7mm from the inferior alveolar nerve with adequate sufficient alveolar ridge width more than 4mm. Patients required bone augmentation procedure with autologous onlay chin graft (group I) versus those used as inlay sandwich technique (group II). Clinical and radiographic analysis were done to analyses the newly formed bone and bone height. Percent of change in bone height was also calculated and revealed that group I was higher than group II, however, statistically insignificant differences between the two groups were found regarding the percentage of newly formed bone. Vertical ridge augmentation procedures using onlay chin graft took lesser time than the interpositional grafting with fixation technique, however, both techniques are promising for vertical ridge augmentation.

Лабораторне дослідження мікропроникності між стоматологічними відновлювальними матеріалами

The purpose of the work was to study the micropermeability between portions of restorative materials under different surface preparation in laboratory conditions. Materials and methods. The study used 50 samples of cylindrical restorative materials with a diameter of 5.0 mm and a height of 4.0 mm, divided into five groups 10 samples each. The samples of group 1 consisted of two portions of photocomposite without preliminary preparation. The samples of group 2 were produced from two portions, between which the V generation adhesive system was applied. In the samples of group 3, the vertical surface of the first portion of the photocomposite was moistened, adhesive preparation was performed, and the second portion was added. In the samples of group 4, the vertical surface of the portion was polished and similar measures were taken. Group 5 samples consisted of glass ionomer cement and photocomposite. The surfaces of the samples, except for the border, were isolated, the samples were immersed for a day in the dye, sprayed and the depth of its penetration was estimated through the border on vertical cuts in points and by a computer program in millimeters. Results and discussion. Micropermeability in the samples of group 1 was 1.3 ± 0.15 points and was significantly (p&lt;0.05) the lowest among all groups except group 2. The indicator in the samples of group 2 was 1.7 ± 0.15 points with an unreliable (p&gt;0.05) difference from the given indicator, in the samples of group 3 – 1.9 ± 0.18 points with a significant (p&lt;0.05) difference, the last two indicators had an unreliable difference (p&gt;0.05) between them. Significantly (p&lt;0.05) the highest micropermeability was in the samples of group 4 – 4.1 ± 0.18 points. In samples of group 5, the indicator was equal to 2.6 ± 0.16 points (p&lt;0.05). According to the computer analysis of the image in the samples of group 1, the dye deepened by 0.55 ± 0.15 mm, which is reliably (p&lt;0.05) the lowest indicator. In the samples of group 2, it was 1.20 ± 0.18 mm, in the samples of group 3 – 1.31 ± 0.12 mm (the difference was not significant, p&gt;0.05). The indicator was significantly (p&lt;0.05) higher in the samples of group 5 – 2.13 ± 0.16 mm, in the samples of group 4 it was 3.65 ± 0.19 mm and was significantly (p&lt;0.05) the highest, exaggerating by 6.6 times the indicator of the samples of group 1. A significantly high indicator of micropermeability was found in the samples consisting of glass ionomer cement and photocomposite, and this should be a certain warning, however, in clinical conditions, when using an open “sandwich technique”, as a rule, photocomposite material overlaps a certain area of glass ionomer cement without marking a clear border between materials. Nevertheless, it is necessary to pay special attention to the formation of this border during the direct restoration of teeth with damage to their contact and occlusal surfaces in the “sandwich technique” and to ensure the tightest adhesion of the photocomposite to the glass ionomer with somewhat limited visual control. Conclusion. The lowest indicators of micropermeability according to two estimates were established between portions of the photocomposite material without any preparation of their surfaces. The highest micropermeability was found in the case of applying the photocomposite to the polished surface of the material

Synergism of silver/CEM drug on novel proteinaceous silk fibroin/mesoporous silica based sandwich-layered nanofibrous scaffolds for osteoregenerative applications

Osteoregeneration and bacterial infection remains a major challenge in current clinical practice despite, many advanced strategies significantly developed so far. The combination of bioactive molecules and nano topology design can favour osteoinducivity that holds a greater potential as a bone substitute and minimize implant failure due to burst antibacterial effect. Here, we have reported a novel design of sandwich-like layered silver doped mesoporous silica nanofibers stuffed with an antibiotic drug combined with silk fibroin to boost the synergistic effect. We have investigated the physiochemical property of CEM incorporated sandwiched scaffolds by in vitro biomineralization, tensile strength, antibacterial efficacy against Escherichia coli and Staphylococcus aureus bacterial strains, in vitro degradation, osteogenic effects (MTT assay using MG63 cell line and ARS staining). In conclusion, the faster degradation of monolayered nanofibrous scaffold by incorporating the sandwich technique was minimized. The combination of CEM/SF embedded Ag@mesoporous silica sandwich layered nanofibers showed a synergistic antibacterial effect due to the sustained release of drug from the middle layer with no burst release. The development of sandwich technique for the nanofibrous scaffolds could be a viable candidate for bone regeneration and defect repair.

Establishment of matrix metalloproteinase 3 time-resolved immunoassay and some potential clinical applications

AimTo develop a highly sensitive time-resolved fluorescence immunoassay (TRFIA) for the detection of serum matrix metalloproteinase-3 (MMP-3) and to assess MMP-3's clinical value in patients with colorectal cancer (CRC).st. MethodsMMP-3 levels were established using the double antibody sandwich technique. The MMP-3 TRFIA technique was developed and optimized, and its linearity, sensitivity, accuracy, specificity, and recovery were assessed. Then, serum concentrations in healthy individuals and patients with CRC were determined by MMP-3 TRFIA. ResultsThe linear range of MMP-3 TRFIA was 0.73–500 ng/mL. MMP-3 TRFIA had an intra-batch precision range of 2.16%–7.10% percent and an inter-batch precision range of 3.99%–11.21%. MMP-3, tumor-associated trypsinogen 2, and AFP had no cross reaction.The recovery is between 90% and 110%, and had no serum interference. Patients with CRC had serum MMP-3 levels (73.95 ± 78.43 ng/mL) that were considerably higher than those of healthy individuals (21.45 ± 11.12 ng/mL), and those with metastasis had serum MMP-3 levels (95.89 ± 76.21 ng/mL) that were considerably higher than those of patients without metastasis (52.74 ± 47.25 ng/mL). ConclusionsA highly sensitive MMP-3 TRFIA assay was successfully developed, and serum MMP-3 may be associated with CRC invasion and metastasis. Therefore, MMP-3 can be used in the auxiliary diagnosis of CRC.

The efficacy of lining materials in the reduction of microleakage in class II composite resin restoration using the sandwich technique: A stereomicroscopic study.

The sealing ability of different liners under composite restorations in the reduction of microleakage. To evaluate the effects of three different liners in sandwich techniques on gingival microleakage of class II composite restorations. Standardized Class II box cavities were prepared on forty premolar teeth and randomly divided into four groups, n = 10: Group A, no liner (control); Group B, Polofil NHT Flow; Group C, Ionolux; and Group D, Fuji VII. The etching, bonding, and process for restoring the whole remaining mass of the cavities with G-aenial composite were the same, with the sandwich material expectations. Dye penetration was evaluated using a stereomicroscope. Duncan's Post hoc analysis and Friedman's test. Group A showed the highest microleakage followed by Group D, Group C, and Group B. Polofil NHT Flow seems to be a promising liner for gingivally deep class II cavities.

Investigation of Charged Small Molecule-Aptamer Interactions with Surface Plasmon Resonance.

Investigating the interactions between small, charged molecules and aptamers using surface plasmon resonance (SPR) is limited by the inherent low response of small molecules and difficulties with nonspecific electrostatic interactions between the aptamer, analyte, and sensor surface. However, aptamers are increasingly being used in sensors for small molecule detection in critical areas like healthcare and environmental safety. The ability to probe these interactions through simple, direct SPR assays would be greatly beneficial and allow for the development of improved sensors without the need for complicated signal enhancement. However, these assays are nearly nonexistent in the current literature and are instead surpassed by sandwich or competitive binding techniques, which require additional sample preparation and reagents. In this work, we develop a method to characterize the interaction between the charged small molecule serotonin (176 Da) and an aptamer with SPR using streptavidin-biotin capture and a high-ionic-strength buffer. Additionally, other methods, such as serotonin immobilization and thiol-coupling of the aptamer, were investigated for comparison. These techniques give insight into working with small molecules and allow for quickly adapting a binding affinity assay into a direct SPR sensor.

Sandwich Composite Panel from Spent Mushroom Substrate Fiber and Empty Fruit Bunch Fiber for Potential Green Thermal Insulation

Massive generation of natural waste fiber from agricultural industries followed by improper disposal management might result in a detrimental effect on our ecosystem contributing to various types of environmental pollution. With the growing significance of climate change, an effort is being undertaken by utilizing natural waste fiber into eco-friendly insulation panels to reduce the environmental impact of buildings. In this research, a composite panel was developed from spent mushroom substrate (SMS) and empty fruit bunch (EFB) fibers via a sandwich technique. Five samples were made, each with a different fiber ratio (100 SMS: 0 EFB, 80 SMS: 20 EFB, 60 SMS: 40 EFB, 40 SMS: 60 EFB, and 0 SMS: 100 EFB) at density 0.8 g/cm3. Fourier transformation infrared (FTIR) Soxhlet extraction followed by thermogravimetric analysis (TGA) indicated that the SMS and EFB fibers were relevant for fabrication into a composite panel for thermal insulation. Thermal conductivity, thermal resistance, and thermal diffusivity values for these five composite samples were 0.231 to 0.31 W/(mK), 0.0194 to 0.0260 m2K/W, and 0.2665 to 0.3855 mm2/s, respectively. The flexural strength of the composite was at the range 15.61 to 23.62 MPa. These research findings suggest that the fabrication of a sandwich composite panel from SMS and EFB fiber is a promising alternative way to utilize natural waste fiber.

Biogenic carbon dot-based fluorescence-mediated immunosensor for the detection of disease biomarker

The dynamic interplay of nanotechnology and immunoassay has unlocked an arena for developing next-generation techniques to contribute to detecting disease biomarkers. Herein, the work establishes the strategic fabrication of an immunosensor by sandwich technique based on the fluorescence phenomenon of carbon dots for the detection of the disease biomarker VEGF (Vascular Endothelial Growth Factor). VEGF, a biomarker for angiogenesis, is considered cancerous if found in elevated levels in the blood, and so is paramount for early detection of disease. Carbon dots derived from a biogenic source were synthesized employing a green microwave-assisted method followed by conjugating with a detection antibody, human immunoglobulin G (IgG), via EDC-NHS amidation reaction. On the other hand, the VEGF biomarker was immobilized onto the capture antibody. The detection antibody tagged with the fluorescent probe is employed as a bridge to connect with the VEGF biomarkers bound to the capture antibody. The response to different concentrations of VEGF biomarkers was recorded in terms of the fluorescence intensity of the carbon dots. The fluorescence immunosensor could exhibit a wide linear range of 0.1 fg/mL to 10 pg/mL with a low detection limit of 5.65 pg/mL towards VEGF. The potentiality of this designed immunosensor was qualitatively assessed with human blood plasma samples, showing promising results, thereby upholding the applicability of carbon dots as fluorescent labels in immunoassay techniques.

Perspectives of prevention and treatment of parastomal hernia-what do we really know and where should we go?

Parastomal hernia is a frequent complication after ostomy formation, causing a significant reduction of the quality of life of patients. In contrast to surgical dogmas dealing with the surgical technique of ostomy formation, mesh-based prophylaxis of parastomal hernia seemed to be effective, leading to the strong recommendation in the European Hernia Society(EHS) guidelines. More recent studies do not favor prophylaxis of parastomal hernia anymore, mainly due to the lack of clearly differentiating the techniques. The mostly used keyhole technique (flat mesh) cannot be equated with the “chimney technique” (3-dimensional mesh) that can be easily performed laparoscopically. Very recent results of the Finnish Randomized Study showed a dramatic reduction of parastomal hernia using the chimney technique. Concerning therapy of parastomal hernia, the chimney technique was also revealed to be effective. The laparoscopic “sandwich technique” should also be used therapeutically with very promising mid- and long-term results and seems to be superior to any other approaches. In a conclusion, investigating the prevention of parastomal hernia should clearly differentiate between the keyhole and chimney techniques and adopt strict technical standardization. Therapy of parastomal hernia should be based on the most effective sandwich or the chimney technique in specialized centers, according to recent registry results. Both techniques are based on the intraperitoneal placement of meshes requiring 3-dimensionality or the possibility of overlapping two meshes. Up to now, these requirements are only fulfilled by meshes made by polyvinylidene fluoride.

The Sandwich Technique for Quick and Efficient Application of Negative Pressure Wound Therapy to the Feet and Hands: A Case Report

Introduction. NPWT is a surgical dressing that combines polyurethane foam with the subsequent application of continuous or intermittent negative pressure. NPWT facilitates granulation tissue production by macrostrain, microstrain and, if desired, fluid instillation. Sealing the polyurethane foam over the wound bed is achieved using acrylic drapes; however, this can be difficult to use in some anatomic sites. Failure to achieve an effective seal can necessitate additional supplies, which has led to increased innovation in developing a more effective NPWT seal over the target wound bed. Obtaining an effective pressure seal on the feet or hands can be difficult because these anatomic sites have distinct curvature for each digit, with multiple interdigital web spaces and independent mobility. In this case report, the authors propose a technique to apply either an acrylic drape or combination acrylic and soft silicone drape utilizing the “sandwich technique” to seal NPWT foam quickly and efficiently to the feet or hands.