Langenbeck's archives of surgery
-
Langenbecks Arch Surg · Aug 2001
Randomized Controlled Trial Comparative Study Clinical TrialChanges in p(i)CO(2) reflect splanchnic mucosal ischaemia more reliably than changes in pH(i) during haemorrhagic shock.
Gastric tonometry is intended to reveal alterations in splanchnic perfusion and oxygenation. Based on the tonometric measurement of gastric mucosal partial pressure of carbon dioxide (pCO(2)) and the simultaneous determination of arterial blood gas parameters (bicarbonate concentration [HCO(3-)], pH and pCO(2)), several parameters can be calculated. ⋯ pH(i), pCO(2) gap and [H+] gap are considerably influenced by changes of systemic arterial blood gas values. This is demonstrated by lower P values of the corresponding arterial blood gas values in comparison with p(i)CO(2). Therefore pH(i), pCO(2) gap and [H+] gap seem to indicate more likely systemic changes, whereas p(i)CO(2) appears to reflect disturbances of regional gastric tissue perfusion and oxygenation more reliably than any other derived tonometric parameter.
-
Intraosseous lipoma of the calcaneus is thought to be a rare tumour. As most of the articles have been single case reports, we performed a meta-analysis to evaluate diagnostic and therapeutic procedures. ⋯ Continued observation in asymptomatic cases is a reasonable clinical approach. We propose surgical treatment with curettage and bone grafting only in symptomatic cases.
-
Langenbecks Arch Surg · Aug 2001
Organotypical engineering of differentiated composite-skin equivalents of human keratinocytes in a collagen-GAG matrix (INTEGRA Artificial Skin) in a perfusion culture system.
The production of autologous composite skin equivalents for the treatment of full-thickness skin defects in burns is time consuming and costly because of laboratory procedures which have to be performed manually. In the present study keratinocytes were seeded into INTEGRA Artificial Skin and placed in a perfusion culture system in order to evaluate the possibility of producing composite grafts in an automated system with the aim of establishing a cost-effective method of industrial production. ⋯ Engineering of differentiated composite skin equivalents is possible in a perfusion culture system, which offers technical and procedural and possibly even biological advantages compared to standard stagnant culture methods. The development of automated perfusion culture systems for the production of composite grafts in sizes required clinically (scale-up) will be the next step in the cost-effective engineering of large-scale composite skin equivalents.
-
Langenbecks Arch Surg · Jul 2001
Acute ischemia of the upper extremity: long-term results following thrombembolectomy with the Fogarty catheter.
In 1962, the procedure of arterial thrombembolectomy with the Fogarty catheter was established. Numerous studies have been published studying thrombembolectomies of the lower extremities. Limited information, however, is available following thrombembolectomy of the upper extremity after arterial occlusion. The aim of the present study, therefore, was to determine long-term results (3-5 years after thrombembolectomy) following thrombembolectomy of the upper extremity with the Fogarty catheter in a large retrospective clinical study. ⋯ The results of the present study indicate that, in most cases, thrombembolectomy with the Fogarty catheter represents a successful surgical method for the acute treatment of arterial occlusion of the upper extremity.
-
Langenbecks Arch Surg · Apr 2001
Intraperitoneal capsaicin treatment reduces postoperative gastric ileus in awake rats.
Postoperative gastric ileus interferes with postoperative recovery of the patients. Previous studies suggest that capsaicin-sensitive afferent neurons are involved in the mediation of postoperative gastric ileus. ⋯ Intraperitoneal capsaicin treatment 2 days prior to abdominal surgery resulted in immediate recovery of postoperative gastric motility, indicating an important role for serosal visceral afferent nerve fibers in the mediation of postoperative gastric ileus. Possibly, capsaicin or vanilloid (capsaicin) receptor agonists can be used to treat postoperative ileus in the future.