Figure 8 - available via license: Creative Commons Attribution 4.0 International
Content may be subject to copyright.
Vein illuminator images, showing patterns of superficial veins, captured by a digital camera at t0 (0') (left), t1 (30') (middle), and t6 (60') (right).
Source publication
The effects of topical negative pressure therapy (TNP) have been a subject of research for many years. In this study, we investigated new imaging devices to detect clinical changes that TNP causes on healthy tissue and identified differences in microcirculation created by different pressure levels. We used near-infrared spectroscopy (NIS), thermogr...
Context in source publication
Context 1
... instrument creates live images, which were then captured using another digital camera. Comparing the images of the vein finder captured throughout the examination time, no significant differences could be detected between t0, t1, and t6 in the venous pattern, but the veins seemed to vary slightly in terms of thickness or vessel diameter, as shown in Figure 8. ...
Similar publications
At present, perforator flaps are a very popular technique in reconstructive surgery. However, in spite of the fact that perforator flaps provide favourable aesthetic results, their use is often related to complications in the form of transplanted tissue perfusion disorders. Objective — to investigate the possibility of optimising the blood supply a...
Citations
... Other authors have also confirmed the possibility of cutaneous NP influence on skin microcirculation. There are reports of experimental studies [2,11]. In a report of preoperative external NP therapy, Morykwas et al. found a 21 % increase in flap survival in random pattern flaps that were treated with external NP in a pig model [10]. ...
At present, perforator flaps are a very popular technique in reconstructive surgery. However, in spite of the fact that perforator flaps provide favourable aesthetic results, their use is often related to complications in the form of transplanted tissue perfusion disorders. Objective — to investigate the possibility of optimising the blood supply at the flap donor site through the application of cutaneous negative pressure (NP). Materials and methods. The study was carried out from 2019 to 2021. A single‑arm clinical trial consisted of 20 individuals who presented with deep wound defects requiring flap coverage. A dynamic thermography study was conducted to examine the chosen donor site before and after dressing with NP. Results. The temperature measurements obtained from the two selected warm perforator points and the point in the cool area between perforators prior to the application of NP showed a steady downward trend in temperature. Specifically, the temperature in the cool area was observed to be lower by an average of –1.89 °С and –2.12 °С as compared to warm points. The application of local NP had an impact on trend analysis of skin temperature, which demonstrated a significant decrease in the differences between values seen in the cool and warm areas. This effect was already noted after the first day of the NP system application, as evidenced by the everyday data collection. The «levelling» of temperature curves was associated with temperature rises both in the cool area and at the perforator exit points. Conclusions. The findings obtained from thermography analysis suggest that the application of NP has the potential to enhance blood circulation in the intended donor area. Therefore, it is plausible to discuss the possibility of improved microcirculation in the skin and the beneficial effect of local cutaneous NP application on the state of anastomoses between perforators.
... New modalities of perfusion measurements such as hyperspectral imaging, thermography or Indocyanin green near infrared angiography might be a valuable extension to manugraphy to further delineate the potential effects of microcirculation after operative inventions as has been shown for other hand and plastic surgical entities [34][35][36][37][38][39][40][41]. ...
Background
Carpal tunnel syndrome, A1 annular pulley stenosis and Dupuytren’s contracture are among the most common conditions of the hand. In this study, we investigated the impact of surgical procedure on hand grip strength and high-resolution spatial load distribution in individuals suffering from those diseases over a follow-up period of one year.
Materials and methods
In this prospective study, data of 9 patients with carpal tunnel syndrome, 12 patients with A1 annular pulley stenosis and 7 patients with Dupuytren’s contracture were evaluated. Only patients with unilateral disease were included providing the contralateral hand as an intra-individual control. Grip strength was measured with cylindrical instruments in two different sizes with respect to the hand size of the patients. Maximum and average values of grip strength as well as spatial load distribution in each finger, thenar, hypothenar and palm were analyzed. Data of the affected patients were collected preoperatively and 6 weeks, 6 months and 1 year postoperatively. Grip strength and spatial load distribution were compared preoperatively to postoperatively. In addition, DASH score, Levine score, 2-point discrimination and degree of flexion contracture were assessed.
Results
The patients with A1 annular pulley stenosis showed a significant increase in grip strength 6 months and one year postoperatively. Patients with carpal tunnel syndrome and Dupuytren’s contracture showed no significant difference in grip strength over the course of time. An increase in the percentual grip strength of the thenar in patients with carpal tunnel disease and within the affected finger in A1 annular pulley stenosis was observed over the course of time. The DASH score was significantly lower in all patient cohorts one year postoperatively.
Conclusion
Surgical procedure in carpal tunnel syndrome, A1 annular ligament stenosis and Dupuytren’s contracture improves the functionality of the hand in everyday life. Some areas of the hand seem to compensate other weaker areas in grip strength.
... Due to worldwide increasing expertise today, by means of microsurgery and perforator flaps, almost every reconstructive issue can be addressed somehow utilizing individually tailored techniques. Flaps can by their very nature comprise different tissues and can be custom designed using new imaging technologies [1][2][3] in order to increase the safety of the procedures and to retain the form and function of the reconstructed area in accordance with the donor site morbidity [4], as well as to reduce complications [5]. Automated devices-such as topical negative pressure application-to clean and precondition complex wounds and make them suitable for flap or skin graft coverage have found their way into daily clinical practice [2]. ...
... Flaps can by their very nature comprise different tissues and can be custom designed using new imaging technologies [1][2][3] in order to increase the safety of the procedures and to retain the form and function of the reconstructed area in accordance with the donor site morbidity [4], as well as to reduce complications [5]. Automated devices-such as topical negative pressure application-to clean and precondition complex wounds and make them suitable for flap or skin graft coverage have found their way into daily clinical practice [2]. As with other developments of the specialty, the ingenuity of plastic surgeons leads to a continuous further evolution, and improvements of such technical tools are subject to sustained improvement and new indications. ...
With an ever-growing knowledge in various disciplines of medicine and with rapidly evolving new techniques and operative methods in plastic surgery, it is obvious that it becomes more and more difficult to keep up with all the developments in this field at any time [...]
... Blood vessels are responsible for the supply of oxygen and nutrients as well as the removal of waste from the tissues [4,5]. Physical influences such as pressure, torque, or periods of ischemia are other factors known from clinical practice to interact with vasculogenesis and perfusion [7,23]. However, providing microvasculature to thick tissues (>100-200 microns) is one of the main obstacles in the field of tissue engineering [4]. ...
Due to the limitations of current in vivo experimental designs, our comprehensive knowledge of vascular development and its implications for the development of large-scale engineered tissue constructs is very limited. Therefore, the purpose of this study was to develop unique in vivo imaging chambers that allow the live visualization of cellular processes in the arteriovenous (AV) loop model in rats. We have developed two different types of chambers. Chamber A is installed in the skin using the purse sting fixing method, while chamber B is installed subcutaneously under the skin. Both chambers are filled with modified gelatin hydrogel as a matrix. Intravital microscopy (IVM) was performed after the injection of fluorescein isothiocyanate (FITC)-labeled dextran and rhodamine 6G dye. The AV loop was functional for two weeks in chamber A and allowed visualization of the leukocyte trafficking. In chamber B, microvascular development in the AV loop could be examined for 21 days. Quantification of the microvascular outgrowth was performed using Fiji-ImageJ. Overall, by combining these two IVM chambers, we can comprehensively understand vascular development in the AV loop tissue engineering model¯.
... However, little is known about the use of NPWT in breast infections following breast implantation. It has been demonstrated that topical negative pressure used as closed incisional NPWT on closed operation wounds improves local blood circulation and reduces edema as well [18][19][20][21][22][23][24][25]. ...
... Another issue is microperfusion of the skin and soft tissue in PPBI, which is essential for proper healing and hence the use of alloplastic material for reimplantation. There are currently several tools that can provide sufficient oxygenation and microperfusion to ensure adequate vascular supply to the affected tissue [2,3,18,19,33,38]. The use of noninvasive tools to validate tissue perfusion can be a helpful aid in optimizing reoperations. ...
Peri-prosthetic breast infections pose a risk of severe complications after breast implant surgery. The need to remove the breast implant, control the infection and perform additional surgical procedures are the consequences. Reimplantation of an alloplastic implant is only appropriate after an infection-free interval. In this retrospective cohort study, we investigated the effectiveness of negative pressure wound treatment with instillation and dwell time (NPWTi-d) on peri-prosthetic breast infections in combination with implant removal and antibiotic therapy. Twelve patients treated with NPWTi-d due to breast implant infection were included in the study. The bacterial burden was analyzed using wound swabs before and after NPWTi-d. Additionally, laboratory values were determined before NPWTi-d and immediately before wound closure. A total of 13 peri-prosthetic breast infections in 12 patients were treated using implant removal and NPWTi-d. In 76.9% (n = 10) of the cases, the patients had undergone alloplastic breast reconstruction following cancer-related mastectomy, whereas 23.1% (n = 3) of the patients had undergone breast augmentation for cosmetic reasons. The bacterial burden in the breast pocket decreased statistically significant after implant removal and NPWTi-d. No shift from Gram-positive to Gram-negative bacteria was observed. Inflammatory markers rapidly decreased following treatment. NPWTi-d had a positive impact on the healing process after peri-prosthetic breast infections, leading to a decrease in bacterial burden within the wounds and contributing to uneventful healing. Therefore, secondary reimplantation of breast prostheses might be positively influenced when compared to conventional implant removal and simple secondary closure. Further studies are required to conclusively establish the beneficial long-term effects of using NPWTi-d for the treatment of peri-prosthetic breast infections.
... Blood vessels are responsible for the supply of oxygen and nutrients as well as the removal of waste from the tissues [4,5]. Physical influences such as pressure, torque, or periods of ischemia are other factors known from clinical practice to interact with vasculogenesis and perfusion [7,23]. However, providing microvasculature to thick tissues (>100-200 microns) is one of the main obstacles in the field of tissue engineering [4]. ...
Tissue engineering in reconstructive surgery seeks to generate bioartificial tissue substitutes. The Arterio-Venous (AV)-loop allows the generation of axially vascularized tissue constructs. Cellular mechanisms of this vascularization process are largely unclear. In this study, we developed two different chamber models for intravital microscopy and imaging of the AV-loop in the rat. Multiple design variations were implanted and the stability of the chamber and AV-loop patency was tested in vivo. Our novel chamber facilitates repetitive observation of the AV-loop using fluorescence-enhanced intravital microscopy. This technique can be used for daily evaluation of leukocyte-endothelial cell interactions, vascularization and tissue formation in the AV-loop model on 14 consecutive days. Therefore, our newly developed model for intravital microscopy will provide better understanding of cellular and molecular processes in tissue engineering in the AV-loop. Moreover, it supports initiation of the novel approaches for therapeutic applications.
Background:
Compression of the ulnar nerve at the elbow within the cubital tunnel is related to the anatomical structures and is generally believed to be caused by Osborne's ligament (also known as the cubital retinaculum). However, in rare cases an anatomical variation of the developmental peculiarity of a remaining anconeus epitrochlearis muscle may be responsible for the disease.
Methods:
We present a series of five cases in which an anconeus epitrochlearis muscle was found as the cause of illness.
Results:
All patients presented with typical symptoms of numbness and tingling in the hand and ulnar fingers, and recurring pain as well as weakness of the ulnar innervated muscles. With neurophysiologically confirmed diminished nerve conduction velocity and unsuccessful conservative treatment, surgical decompression revealed an anconeus epitrochlearis muscle as the reason of compression. Full symptom relief was achieved immediately after the procedure in all cases.
Conclusions:
This article strives to call attention to this entity when diagnosing ulnar nerve compression. Myectomy and medial epicondylectomy is the preferred treatment option in such cases.
