Suture Removal Research Articles

Avacopan in the treatment of refractory scleritis secondary to granulomatosis with polyangiitis: A case report.

Avacopan is a novel C5a receptor inhibitor which was recently licensed for treatment of severe granulomatosis with polyangiitis (GPA) in the European Union and the United Kingdom. To the best of our knowledge, this is the first described case on initial ophthalmic outcomes in a patient with severe GPA and concurrent refractory scleritis treated with avacopan. We present a case of de novo scleritis in a 77-year-old male with a background of retinitis pigmentosa with Argus II implant in situ. Severe scleral inflammation occurred following a suture removal from the implant site. Remission was not maintained despite orbital floor injections and high dose oral prednisolone. The diagnostic work-up revealed GPA which quickly progressed to involve vital organs. In view of his systemic deterioration, he was started on avacopan alongside rituximab, cyclophosphamide and high dose oral prednisolone. Sustained remission of scleritis was noted after 7 months of treatment with avacopan and low dose oral prednisolone with no other maintenance immunosuppression. We observed a sustained benefit of avacopan in allowing for successful taper of systemic steroids. We report that avacopan used alongside other immunosuppressants may be a viable option in patients with GPA and concurrent refractory scleritis. Further studies are needed to establish the longer term impact of this agent on the control of scleral inflammation.

Catheter Exchange With Elongation of Tunnel (CEET) Procedure-A Novel Technique for Cuff Extrusion of Tunneled Dialysis Catheter: Surgical Experience and Early Outcomes.

Cuff extrusion of tunneled dialysis catheter (TDC) leads to catheter dysfunction, leading to loss of vascular access and the need for new catheter. Definitive management is to remove TDC and reinsert new catheter by new venous puncture and tunnel, which may not be possible in all cases. The study evaluated the surgical experience and early outcomes of a novel "Catheter Exchange with Elongation of Tunnel (CEET)" procedure for cuff extrusion. The retrospective study included all cases of hemodialysis with TDC with partial or complete cuff extrusion and excluded complete catheter dislodgement, tunnel infection, or any catheter related infection. All patients also underwent the CEET procedure under fluoroscopy guidance, and the clinical details and outcomes were analyzed. Eleven cases of TDC cuff extrusion underwent the CEET procedure of which three (27.2%) had previous and four (36.4%) had partial cuff extrusion, and seven cases (63.6%) had short tunnel length, which likely predisposed to cuff extrusion. CEET procedure was successful in 10 cases (success rate 90.1%) with desired position of catheter tip and good blood flow. Study population was divided into early and late cuff extrusion (≥1 month). Short tunnel length was associated with late extrusion (p = 0.05), whereas premature removal of TDC anchor sutures was associated with early cuff extrusion (p = 0.04). CEET procedure is a successful alternative technique for correction of cuff extrusion of TDC with good success rate. Premature removal of anchor sutures was associated with early cuff extrusion, whereas short tunnel length was associated with late cuff extrusion.

Excimer Laser-Assisted Deep Anterior Lamellar Keratoplasty Versus Penetrating Keratoplasty for Patients With Keratoconus: A Retrospective Analysis From the Homburg Keratoconus Center.

To evaluate the outcome of excimer laser-assisted deep anterior lamellar keratoplasty (Exc-DALK) and penetrating keratoplasty (Exc-PKP) for keratoconus (KC). We included 123 eyes and compared the outcome of 30 eyes undergoing big-bubble Exc-DALK after stromal debulking (G1) against a matched group of 83 eyes undergoing Exc-PKP (G2) in our department. G2 was created after performing a pseudorandom stratified bootstrapping of our PKP database starting with 2802 surgeries with removal of any bias. Main outcomes included best corrected visual acuity (BCVA), spherical equivalent (SE), tomographic changes, and endothelial cell density (ECD). Data were compared preoperatively, postoperatively with 2 double-running cross-stitch sutures according to Hoffmann [2 and 10 months postoperatively (T1 and T2)], after first suture removal [15 months postoperatively (T3)], and after final suture removal [26 months postoperatively (T4)]. Preoperatively, all parameters were comparable without significant differences. At T1, G1 showed significantly better BCVA (P = 0.01), lower SE (P = 0.04), lower anterior and posterior topographic astigmatism (ATA and PTA, P < 0.01), lower maximal keratometry (P = 0.02), and lower central corneal thickness (P < 0.01). At T2, G1 showed significantly better BCVA (P = 0.04), lower PTA (P < 0.01), and higher ECD (P < 0.01). At T3, G1 showed significantly lower ATA (P = 0.01) and PTA (P < 0.01) and higher ECD (P = 0.02). At T4, G1 showed significantly lower PTA and higher ECD (P < 0.01) but no significant difference in BCVA (P = 0.07). Exc-DALK provided faster visual rehabilitation and represented an endothelial cell-sparing method compared with Exc-PKP. After final suture removal, Exc-DALK showed noninferior outcomes compared with Exc-PKP if the graft was placed on naked Descemet membrane.

How to remove non-absorbable sutures.

Skin sutures are commonly used to bring together the edges of a wound, assisting it to heal. Depending on the location of the wound, the sutures used may be absorbable or non-absorbable. Non-absorbable sutures will need to be removed once the wound has sufficiently healed. Timely, safe and effective removal of non-absorbable sutures is crucial to avoid complications and ensure optimal cosmetic results. Nurses undertaking suture removal must have the knowledge and skills to undertake the procedure safely and effectively and work within the limits of their competence. • Before suture removal, the wound must be checked for signs of infection and indications of dehiscence. • Removing sutures at the recommended time assists in preventing new skin growth from covering the sutures and in reducing scarring. • Aseptic non-touch technique (ANTT) is recommended for suture removal, but local policy should always be followed. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when removing non-absorbable sutures. • How you could use this information to educate nursing students or your colleagues about the procedure for removing non-absorbable sutures.

Aesthetic Surgical Treatment of Large Xanthelasma palpebrarum.

Xanthelasma palpebrarum (XP) is a common eyelid condition. Various treatment modalities exist, each with its own merits and drawbacks. Managing larger lesions poses increased challenges. This study aims to explore the aesthetic surgical management of large xanthelasma palpebrarum. Patients with xanthelasma palpebrarum presenting to our department underwent partial excision of the lesion and debridement of the medullary nucleus under local anesthesia for lesions with a diameter of 6mm or more. Microsurgical scissors were utilized to remove residual subcutaneous lesions. Postoperatively, tie-over bolster dressings were applied. Patients with lipid and glucose abnormalities received corresponding therapy. Bolster dressings were removed on the third postoperative day, with suture removal seven days later. All flaps subjected to subcutaneous medullary debridement exhibited complete viability, with minimal localized eyelid depression early postoperatively and inconspicuous scarring three months post-surgery. No instances of lid ectropion were observed. The eyelid maintained a natural appearance, with a low recurrence rate of xanthelasma palpebrarum. Surgical intervention involving partial excision of the lesion and medullary nucleus debridement offers a satisfactory approach for managing large xanthelasma palpebrarum. 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 Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Comparison of the effectiveness of 0.5% and 0.25% proparacaine hydrochloride eye drops as topical anesthetics in routine ocular investigations and procedures.

To compare the effectiveness of 0.5% and 0.25% proparacaine eye drops in providing topical anesthesia for routine ocular procedures. 137 patients (274 eyes) were included in this study. They were categorized into two groups. Group A patients received 0.5% and Group B received 0.25% proparacaine drops. A single surgeon performed all the procedures. Intraprocedural and postprocedural pain scores, surgeon comfort, supplemental anesthesia, and vital parameters, were noted. The mean age of the participants was 69.42 years (±12.05). An equal number of procedures were performed (n = 30) for applanation tonometry, lacrimal sac syringing, and A-scan biometry. The other procedures performed were removal of the conjunctiva (n = 5) and corneal foreign bodies (n = 16 per group), corneal scraping (n = 8 per group), and corneal suture removal (n = 18 per group).The mean visual analog pain score during the procedure was 6.9663 in Group A and 8.0803 in Group B (P = 0.66). The mean postprocedural pain score was not significant (P = 0.21). None of the patients required any additional anesthesia during or after the procedure. The average surgeon's experience was 0.152±0.507 in Group A and 0.111±0.402 in Group B (P = 0.07).In Group A, 133 of 137 patients (97.08%), and in Group B, 132 out of 137 patients (96.35%) preferred to use the same anesthetic for future procedures. None of the patients experienced a vasovagal attack or any change in vital parameters. The present study aimed to establish equivalence between two concentrations of proparacaine hydrochloride in which false positive and false negative errors were expected. This is the inherent challenge in the equivalence and inferiority trials. To mitigate these risks, the present study was carefully designed with specific statistical methods, sample size calculation, and rigorous methodology. Nevertheless, it is crucial to recognize that the risk of false positive errors remains, and the results should be interpreted with this in mind. These findings indicated that 0.25% proparacaine is a viable alternative to the standard 0.5% concentration in routine ophthalmic procedures, with the potential for improved patient comfort.

Iatrogenic Common Peroneal Nerve Injuries From Inside-out Lateral Meniscus Repair: A Report of 2 Cases.

We report 2 cases of common peroneal nerve (CPN) palsy after inside-out lateral meniscus (LM) repair with very different presentations, occurring despite the standard surgical precautions (open counter incision and proper retraction between the biceps femoris tendon, lateral gastrocnemius, and capsule). On exploration, needle was found to have penetrated the nerve in one case and the nerve sheath in the other case. Patient 1 had near-complete neurological recovery, while patient 2 had partial neurological recovery after suture removal and neurolysis. CPN palsy can occur despite following all precautions during LM repair and should be managed as an iatrogenic injury unless proven otherwise.

Managing Complicated Nontuberculous Mycobacteria Infections in Plastic Surgery.

Nontuberculous mycobacteria (NTM) infections after cosmetic surgery have become an increasing concern. These infections are often initially misdiagnosed and treated with standard antibiotic regimens, which fail to resolve the underlying infection, leading to prolonged patient suffering. In this case study, we describe a chronic wound infection caused by Mycobacterium abscessus subsp. bolletii after a muscle-repair abdominoplasty. This case illustrates the diagnostic and therapeutic challenges plastic surgeons face in successfully treating such infections. Initial obstacles included the isolation of co-contaminating bacteria that masked the NTM infection, the use of antibiotics ineffective against the specific NTM species, and the failure to identify the infection source. In this instance, contaminated skin marker ink used to mark the rectus muscle, combined with a nonabsorbable (permanent) suture for muscle repair, led to the development of a biofilm that acted as a persistent reservoir for the infection, resistant to antibiotic treatments. Complete resolution was achieved only after evaluation by a plastic surgeon experienced in treating NTM infections and the subsequent removal of the permanent suture. The delayed suture removal contributed to a 15-month recovery period. This case underscores the importance of early recognition of NTM infections after cosmetic procedures. By sharing this case, we aim to raise awareness of NTM infections and help prevent future cases of misdiagnosis and prolonged antibiotic treatments. Key points regarding the diagnosis, sources of infection, and treatment options for NTM infections are highlighted in this article using "text boxes" to emphasize the most important information and provide concise summaries of critical insights.

Sewing: A New Quilting Suture Method for Nasal Septum Repair

A deviated nasal septum leads to congestion and headaches. Surgery is the primary treatment, requiring careful postoperative septum positioning to prevent bleeding and hematoma. The study compared this method with nasal packing and traditional nasal septum suturing regarding surgical time, patient pain, nasal obstruction, and bleeding after septoplasty. The surgical time for nasal packing was significantly shorter than that for the other 2 suturing methods (P &lt; 0.0001), but there was no statistically significant difference between the two suture methods (P = 0.1358). The Visual Analog Scale scores showed that the pain in the packing group was significantly higher than that in the other 2 groups within 2 days after surgery (P &lt; 0.0001). The pain during suture removal was significantly higher in the packing group than in the “sewing group” (P &lt; 0.0001). The number of injuries to the outer wall of the nasal cavity by continuous suturing was significantly higher than that by sewing (P &lt; 0.0001). Tearing within 2 days after surgery was significantly higher in the packing group than in the other 2 groups (P &lt; 0.0001). Compared with nasal packing, nasal septum suturing can significantly reduce postoperative pain and tearing, improve comfort, and do not increase bleeding. The newly described nasal septum sewing method in this study has no difference in surgical time compared with the traditional suturing method and can reduce injuries to the outer wall of the nasal cavity. In addition, it is painless and easy to remove during suture removal.

Ultrasound-assisted minimally invasive technique for tissue collection from bovine mammary glands.

The objective of this case report was to describe an ultrasound-guided, minimally invasive method for longitudinal mammary gland tissue collection from the bovine species. Biopsies were performed on 14 8-week-old calves and 113 10-week-old calves. A subset of 36 animals had repeated mammary gland biopsies through the first lactation. Mammary gland biopsies were performed using a disposable biopsy punch. The technique was also performed on multiparous cows on other independent research trials. One-hundred and thirteen animals healed from the 10-week biopsies with no complications. Of the 36 animals that received repeated biopsies, one developed mastitis due to premature suture removal and one had recurring mastitis in all quarters. Thirty-three animals underwent all biopsies during gestation. Thirty of the original 36 are currently in lactation and still undergoing repeated biopsies. The method has also been successfully replicated on multiparous cows in separate studies. The described technique is a safe, reliable method for cattle mammary gland biopsies beginning at eight weeks of age and can be utilized to obtain repeated tissue collection from individual animals. The technique is also straightforward to perform and utilizes simple tools while providing acceptable amounts of tissue for most applications, with low risk for infection and long-term tissue damage.

Orthopedic Skin Closure in South India: Sutures Versus Staples and Their Postoperative Outcomes.

Introduction Skin closure is an essential step in deciding the success of a surgery. Despite this, the choice of skin closure material is frequently overlooked when making surgical decisions. Skin closure plays an important role in promoting rapid wound healing and decreasing the length of hospital stay, especially in orthopedic surgeries. Our study focused on comparing the outcome of wound closure in orthopedic surgeries with sutures and staples in a South Indian population. Materials and methods We enrolled 120 patients undergoing orthopedic procedures at Chettinad Hospital and Research Institute from July 2023 to February 2024. Patients were randomly assigned to skin closure with either staples or sutures. Wound inspection was done on the 2nd, 5th, 7th and 12th post-operative days. The patients were evaluated at six months using the Visual Analog Scale (VAS) and Hollander Wound Evaluation Score (HWES). Results Staple closure significantly reduced mean closure time (5.2 ± 0.9 minutes) compared to sutures (12.6 ± 1.5 minutes, p < 0.0001). Pain during staple removal was less (VAS score 1.41 ± 0.15) than with suture removal (VAS score 1.57 ± 0.2, p = 0.024). Although patient satisfaction was similar between the groups (Staples: 8.35 ± 0.45 vs. Sutures: 8.0 ± 0.5, p = 0.062), staples provided superior cosmetic outcomes (HWES: 4.1 ± 0.7) compared to sutures (HWES: 3.3 ± 0.6, p = 0.003). Complication rates, including infection, discharge, and hypertrophic scar formation, were comparable between the two methods. Conclusion Staple closure in orthopedic surgeries offers several advantages over sutures, including reduced operative time, less pain during removal, and superior cosmetic results. These benefits occur without an increased risk of wound complications. This study suggests that staples may be a preferable option for skin closure in orthopedic procedures, though further research with extended follow-up is needed to fully assess long-term outcomes.

WP8.5 - Operative Documentation of Laparoscopic Appendicectomies at FVRH based on GIRFT - An Audit

Abstract Introduction Laparoscopic appendicectomy (LA) is the most performed abdominal surgery in the UK. Clear documentation is required to ensure safe and effective patient care. Aims To assess compliance with LA operative documentation at Forth Valley Royal Hospital using Getting It Right First Time (GIRFT) guidelines. Methods 27 data points selected from GIRFT Guidelines were examined retrospectively for 172 LA procedures between 01/08/2022 and 29/09/2023. Completed numbers and percentages for each data point were calculated. Results Most consistently documented data points were intra-operative findings 168 (98%), details of closure 168 (98%) and method to secure appendix stump 161 (94%). Least consistently documented were drain insertion 7 (4%), estimated blood loss 5 (3%) and instructions for suture removal 6 (3%). 6 (37%) operative notes explicitly confirmed whether the appendix was removed in those with a macroscopically normal appendix. Conclusion Many data points had a high completion rate, whilst others had a low completion rate. We have highlighted discrepancies in documentation between surgeons which the department is hoping to streamline to avoid any gaps that could have patient care, legal or cost implications in the future.

P.548: The effect of early selective suture removal on post-penetrating keratoplasty keratometry and refraction.

P.548: The effect of early selective suture removal on post-penetrating keratoplasty keratometry and refraction.

The use of a novel nitric oxide wound dressing in acute traumatic wounds in dogs.

To describe the use of a novel wound dressing that delivers nitric oxide (NO) to naturally occurring traumatic wounds in dogs. 24 client-owned dogs with 30 wounds. Dogs were presented with acute traumatic wounds requiring open wound management. Wounds were bandaged with a novel NO wound dressing and reassessed as needed for continued open wound management until wounds healed by second intention or wound closure was recommended. Dogs could be removed from the study at any point at the clinician's discretion. All wounds had the novel NO wound dressing used during open wound management until wound closure was recommended. Median time to wound closure was 6 days (range, 2 to 42). There were no complications directly attributed to the use of the novel wound dressing that clinically affected the dogs. Three wounds dehisced following wound closure. Wound healing was confirmed in 19 dogs with 25 wounds, with 3 dogs lost to follow-up prior to suture removal. Only 7.1% of wounds had clinical signs consistent with wound infection following wound closure. The novel NO wound dressing was easy to use and well tolerated in dogs with naturally occurring traumatic wounds. It can be used throughout all phases of wound healing, simplifying open wound management.

Comparison of clinical efficacy between autologous partially demineralized dentin matrix and deproteinized bovine bone mineral for bone augmentation in orthodontic patients with alveolar bone deficiency: a randomized controlled clinical trial

BackgroundIt is common to see patients who need orthodontic treatment but with insufficient alveolar bone volume. However, safe and effective tooth movement requires sufficient alveolar bone width and height. The aim of this study is to compare the bone augmentation efficacy of Autologous Partially Demineralized Dentin Matrix (APDDM) and Deproteinized Bovine Bone Mineral (DBBM) in orthodontic patients with insufficient bone by using a randomized controlled clinical trial approach.Materials and methodsTwenty-seven orthodontic patients involving 40 posterior teeth alveolar sites (n = 40) with insufficient alveolar bone volume were randomly divided into a control group (n = 20) and an experimental group (n = 20). The patients in the experimental group were treated with APDDM, and those in the control group were treated with DBBM. After surgery, the adjacent teeth are moved toward the bone grafting sites according to the orthodontic treatment plan. Patients completed a postoperative response questionnaire by the Visual Analogue Scale (VAS) score to indicate pain and swelling in the bone grafted area at the time of suture removal; and CBCT scans were conducted before surgery, 6 months and 2 years after surgery to assess changes in buccal and central alveolar heights, as well as widths at the alveolar ridge apex and 3 mm, 5 mm below the apex, respectively. The CBCT image sequences were imported into Mimics 21.0 software in DICOM format. The data of the patients in both groups were collected and analyzed by SPSS 25.0.ResultsThe VAS scores were significantly lower in the APDDM group than in the DBBM group (p < 0.05). Significant increases were observed in alveolar bone height and width at 6 months and 2 years postoperative (p < 0.05); At 2 years, the APDDM group exhibited a reduction in buccal crest height and in 3 mm, 5 mm width below alveolar ridge apex, relative to 6 months (p < 0.05), while the DBBM group showed a decrease only in the central height of the alveolar bone (p < 0.05). There was a significant bone augmentation increase found only 3 mm below the alveolar ridge apex in the APDDM group compared with the DBBM group among all 6 months group comparison (p < 0.05). At 2 years, the augmentation effects were similar across both groups (p > 0.05).ConclusionRadiomics analysis indicates that APDDM serves as a viable bone augmentation material for orthodontic patients with insufficient alveolar bone volume, achieving comparable clinical efficacy to DBBM. Additionally, APDDM is associated with a milder postoperative response than DBBM.The registration number (TRN)ChiCTR2400084607.

Early Bone and Suture Reformations in Different Cranial Regions After Cranial Vault Remodeling for Sagittal Craniosynostosis.

Cranial vault remodeling (CVR) is a common procedure for correcting sagittal craniosynostosis. Some approaches leave significant craniectomy defects. The authors investigated the reosteogenesis in different cranial defect areas after CVR. A cross-sectional study was conducted in nonsyndromic sagittal craniosynostosis. Available early postoperative computed tomography (CT) scans were analyzed. The segmentation of three-dimensional reconstructed images was performed. Different cranial defect areas, including coronal, vertex, and occipital regions, were further investigated using an automated three-dimensional analysis software for reosteogenesis percentage. Forty-four CT scans were included. The average age at CVR was 8.8 months. The median time of postoperative CT scans was 6.1 weeks. The median bone reformation percentage of the entire cranial defect was 56.7%. Given the similar postoperative CT timing, the median bone reformation at the coronal, vertex, and occipital areas demonstrated 44.21%, 41.13%, and 77.75%, respectively (P < 0.001). In the simultaneously removed coronal and lambdoid sutures, there were 45% with coronal and lambdoid sutures reformation, followed by lambdoid suture reformation alone, no suture reformation and coronal reformation alone in 35%, 20%, and 0%, respectively (P = 0.013). There was no coronal reformation in the removed coronal suture group. However, 40% demonstrated lambdoid suture reformation after the isolated lambdoid suture removal. The occipital region has the highest reosteogenesis compared with the other cranial defects after CVR in nonsyndromic sagittal craniosynostosis. Within the removed previous patent sutures, the lambdoid suture reformation showed a higher rate than the coronal suture.

Single-stage reconstruction of severe question mark ear with the absence of large portions of the lobule using affected cartilage graft and 3 flaps

BackgroundQuestion mark ear is a congenital abnormality characterized by a prominent curve within the helix that resembles a question mark. Several surgical reconstruction techniques have been proposed to treat this deformity. In this study, we aimed to evaluate the cosmetic outcomes of a new cartilage and postauricular flap surgical reconstruction technique for patients diagnosed with severe QME. MethodFrom 2017 to 2023, 33 patients with severe QMEs were treated with a new reconstruction surgical technique at the Plastic Surgery Hospital of Peking Union Medical College. The perimeter, width, length, and auriculocephalic angles of both ears were measured and compared to assess the symmetry. The patient’s satisfaction with the surgical outcomes and the incidence of postoperative complications were also evaluated. The average follow-up duration was 15.48 months. ResultsThe auricular perimeter, width, and length changed significantly after surgery. The dimensions between the left and right ear did not vary significantly in both patients with unilateral or bilateral severe QME after surgery and at the end of one-year follow-up. The majority of patients (87.88%) or carers were satisfied with cosmetic outcomes after surgery. All patients underwent suture removal 14 days after surgery and exhibited excellent wound healing without any complications such as hematoma, infection, and flap necrosis. ConclusionOur new surgical reconstruction technique for severe QME resulted in good cosmetic outcomes, high patient satisfaction, fast recovery, and no post-operative complications.

Abstract Tu053: Activin Signaling Inhibition Enhances Cardiac Functional Recovery After Aortic Debanding

Background: Human aortic stenosis (AS) induces adverse cardiac remodeling and heart failure by pressure overload. Reducing pressure overload (e.g., Trans-catheter aortic valve replacement (TAVR) mitigates or reverses adverse remodeling but these benefits are limited in many TAVR patients. Here we established a murine transverse-aortic-constriction (TAC)-debanding model to mimic TAVR and identify ways to enhance reverse remodeling. Methods: 10-week-old wild-type C57BL/6 mice were subjected to TAC surgery and debanding by suture removal, or sham-debanding, between 4 (short duration) and 10 weeks (long duration) after TAC. Echocardiography was performed to assess cardiac function. RNA sequencing (RNAseq) of TAC and debanded hearts demonstrated activation of activin signaling with TAC that was relieved by debanding. Based on this, TAC-debanded animals were treated with an investigational modified activin receptor type IIB ligand trap, RKER-012 (10 mg/kg IP, bi-weekly), to inhibit signaling downstream of activin and related ligands. Results: Serial echocardiography of TAC-debanded animals showed greater dysfunction with longer duration TAC (Fractional shortening [FS]=39.2±3.84 for 4 weeks-TAC vs Sham: 61.2±0.94, p&lt;0.05; FS=18.2±1.80 for 10 weeks-TAC vs Sham-TAC: 64.7±0.43, p&lt;0.05). Cardiac functional recovery was slower and less complete in animals with longer duration TAC (10 weeks after debanding with TAC for 4 weeks, FS=57.8±1.41 vs 46.6±3.4 TAC for 10 weeks). RNAseq analysis of hearts post-debanding (10 weeks TAC+10 weeks debanding) showed a 5.73-fold decrease (p=2.57x10 -16 ) in FSTL3 expression, a biomarker of activin pathway signaling, suggesting a decrease in activin signaling accompanied functional recovery. To assess functional contribution of activin signaling to incomplete recovery and therapeutic potential of pathway inhibitors, we treated debanded animals (debanded 8 weeks post-TAC) with RKER-012 or placebo (TBS) for 4 weeks. RKER-012-treated mice showed significantly increased ejection fraction (54.12±1.50 vs placebo control 42.88±3.21; p=0.001) and reduced heart weight (p=0.01). Conclusions: Debanding after TAC mitigates adverse remodeling that is slower and less complete with longer duration TAC. A ligand trap (RKER-012) that was designed to inhibit signaling downstream of activin enhanced recovery after debanding and warrants further study as a potential therapeutic intervention in patients with incomplete functional recovery after TAVR.

Current situation of knowledge, practice skill of nurses on wound care and some related factors according to Vietnamese nursing competency standards: A study in a hospital in Hanoi

Background: The introduction of Vietnamese Nursing Competency Standards in 2012 has urged the needs for re-assessment of nursing skills, with the aim to improve the quality of the training on wound care in country. Purposes: The study aimed to describe knowledge and practice of nurses on wound care and identify some the related factors in order to make the recommendation for improvement of the nursing care competency. Methods: This a cross-sectional descriptive prospective study was conducted in Ha Dong General Hospital from July 2023 to October 2023. Results: 76 clinical nurses were enrolled with the mean age was 35.6±6.8 years, female nurses most commonly accounted for 89.5%. Notably, the lowest average score in terms of knowledge was observed in suture removal (9.74±3.21) and pressure ulcer wound care (6.93±1.63). In terms of practice, the lowest average score was recorded for pain assessment and bleeding control (7.91±1.33). Furthermore, the study revealed a statistically significant correlation between knowledge and working experience (p&lt;0.05). Nurses with a good level of knowledge were found to have a 4.66 times higher likelihood of demonstrating good practice (OR=4.66). Conclusions and recommendations: The factors related to the competency of wound care of nurses were found in the study strongly suggest the need for improvement of quality of training in order to align with the established standards.

Comparison of the Cosmetic Efficacy of Extractum Cepae and Silicone-Based Gel in Upper Blepharoplasty.

Upper eyelid blepharoplasty is one of the most common surgeries performed worldwide. However, an important problem after surgery is scar formation. The authors aimed to compare the efficacy of extractum cepae and silicone-based gels on postoperative scar appearance in patients undergoing upper eyelid blepharoplasty. After suture removal, patients were divided into 3 groups: group 1 [n=82, extractum cepae, sodium heparin, and allantoin mixture, Contractubex Gel (Merz Pharmaceuticals, Frankfurt, Germany)], group 2 [n=81, silicone-based gel (Dermatix Ultra Silicone Gel, Menarini, Singapore)], and group 3 (n=77, no additional treatment). Patients used the topical gels twice daily. All evaluations were performed on color photographs by 2 physicians during the postoperative first and third months. The mean visual analog scale scores were significantly higher in all 3 groups in the postoperative first month (4.39±2.03, 4.41±2.57, and 4.33±2.46, respectively) compared with the postoperative third month (2.22±1.24, 2.15±1.38, and 2.29±1.47, respectively) ( P =0.014, 0.037, and 0.026, respectively). The "Is the scar more stiff" score was higher in the postoperative first month compared with the third month. In conclusion, blepharoplasty scars improved up to the postoperative third month, but the topical gels used did not significantly improve the cosmetic appearance of blepharoplasty scars compared with the control group.