Journal of investigative surgery : the official journal of the Academy of Surgical Research最新文献

{"title":"Post-Operative Day Zero Discharge after Laparoscopic Appendectomy Does Not Worsen High-Yield Outcomes: A NSQIP Database Observational Study.","authors":"Farheen A Qurashi,&nbsp;Alana C Keegan,&nbsp;Christopher R D'Adamo,&nbsp;Joshua H Wolf","doi":"10.1080/08941939.2022.2119493","DOIUrl":"https://doi.org/10.1080/08941939.2022.2119493","url":null,"abstract":"Abstract Background: Post-operative day zero (POD-0) discharge after laparoscopic appendectomy for uncomplicated appendicitis has been studied primarily in single-center or pediatric studies. A larger study from a national sample addressing high-yield outcomes can update and supplement current literature and evaluate early discharge rates. Methods: This is a retrospective, observational National Surgical Quality Improvement (NSQIP) database study of laparoscopic appendectomies for uncomplicated appendicitis performed 2016–2019, with discharge POD-0 or post-operative day one (POD-1). Study outcomes included any or serious complication, unplanned readmission, and unplanned return to operating room (OR). Unadjusted outcomes comparisons were estimated via chi-square tests. Multivariate logistic regression models were constructed to adjust for potential confounders (sex, ethnicity, frailty, ASA score, tobacco use and diabetes). Results: A total of 25,629 patients were included in this analysis. More patients were discharged POD-1 (n = 15,229) than POD-0 (n = 10,440). Rate of any or serious complication was lower in patients discharged POD-0 than POD-1 (any complication: 2.0 vs. 2.8, p = 0.0002, serious complication: 1.4 vs. 2.1, p < 0.0001). Unplanned return to OR and unplanned readmission rates were not different between POD-0 and POD-1 discharged groups (p = 0.9 and p = 0.6, respectively). These findings were robust to adjustment for covariates in logistic regression modeling. Conclusions: This study found that unplanned readmission and other outcomes do not appear to be adversely affected by early discharge after laparoscopic appendectomy for uncomplicated appendicitis, confirming prior evidence on the topic in a large, national sample. It also found that early discharge does not appear to be used in most of these patients. Media Summary Post-operative day 0 discharge after laparoscopic appendectomy for uncomplicated appendicitis does not increase readmission or return to OR – but is it happening in practice?","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1767-1771"},"PeriodicalIF":1.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"33450560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effects of Driving Pressure-Guided Ventilation on Postoperative Pulmonary Complications in Prone-Positioned Patients Undergoing Spinal Surgery: A Randomized Controlled Clinical Trial.","authors":"Di Jin,&nbsp;Huayue Liu,&nbsp;Xiaoqi Kong,&nbsp;Guangle Wei,&nbsp;Ke Peng,&nbsp;Hao Cheng,&nbsp;Fuhai Ji","doi":"10.1080/08941939.2022.2107250","DOIUrl":"https://doi.org/10.1080/08941939.2022.2107250","url":null,"abstract":"<p><strong>Background: </strong>Prolonged spinal surgery in the prone position may lead to postoperative pulmonary complications (PPCs). We aimed to compare the effects of driving pressure-guided ventilation versus conventional protective ventilation on postoperative pulmonary complications in patients undergoing spinal surgery in the prone position. We hypothesized that driving pressure-guided ventilation would be associated with a decreased incidence of PPC.</p><p><strong>Methods: </strong>We enrolled 78 patients into this single-center, double-blind, randomized controlled trial. The driving pressure (DP) group (n = 40) received a tidal volume of 6 ml/kg of predicted body weight, individualized positive end-expiratory pressure (PEEP) which produced the lowest driving pressure (plateau pressure-PEEP), and a recruitment maneuver. The protective ventilation (PV) group (n = 38) received the same tidal volume and recruitment maneuver but with a fixed PEEP of 5 cm H₂O. Our primary outcome was postoperative pulmonary complications based on Lung Ultrasound Scores (LUS) at the end of the surgery and the simplified Clinical Pulmonary Infection Score (sCPIS) on postoperative days (POD) 1 and 3.</p><p><strong>Results: </strong>DP patients had lower LUS and POD1 sCPIS than the PV group (<i>p</i> < 0.01). DP patients had lower driving pressure during the surgery than PV patients (<i>p</i> < 0.01). Perioperative arterial blood gases and hemodynamic parameters were comparable between the two groups (<i>p</i> > 0.05). The visual pain score (VAS) in postoperative days, drainage, and lengths of stay (LOS) were also similar between the two groups (<i>p</i> > 0.05).</p><p><strong>Conclusions: </strong>Driving pressure-guided ventilation during spinal surgery with a prolonged prone patient position may reduce the incidence of early postoperative pulmonary complications, compared with conventional protective ventilation.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1754-1760"},"PeriodicalIF":1.9,"publicationDate":"2022-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40574016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Collagen Deposition and Inflammatory Response Associated with Macroporous Mesh Shrinkage in Incisional Hernia Repair: A Rat Model.","authors":"Peticha Tanprasert,&nbsp;Kanokkan Tepmalai,&nbsp;Bandhuphat Chakrabandhu,&nbsp;Supachai Yodkeeree,&nbsp;Wirawit Piyamongkol,&nbsp;Sirikan Limpakan Yamada","doi":"10.1080/08941939.2022.2087240","DOIUrl":"https://doi.org/10.1080/08941939.2022.2087240","url":null,"abstract":"<p><p><b>Background:</b> Mesh repair is the current recommendation for the treatment of incisional hernia; however, the best mesh has yet to be determined. The objective of this study was to compare the inflammatory response and collagen deposition in primary incisional hernia repair (P) and different macroporous mesh materials, including polypropylene with poliglecaprone (PP-PG), polyvinylidene fluoride (PVDF), and polyester (PE), using quantitative methods. <b>Methods:</b> Sixty male rats were divided into four groups. Anterior abdominal wall defects were created and either suture or mesh repair was done. Rats were euthanized on days 14, 90, and 180, and the gross findings were recorded. The inflammatory and collagen levels in the abdominal wall tissues were measured using enzyme-linked immunosorbent assay (ELISA). <b>Results:</b> The PE group demonstrated significant mesh shrinkage at 180 days. The extent of PE mesh shrinkage ranged from 22-42% (mean = 30.49%). At 14 days, the PVDF group had higher interleukin-6 (IL-6) levels than the PP-PG (<i>P</i> = .004) and PE groups (<i>P</i> = .019). At 90 days, the collagen type I (Col I) levels in the PE group were significantly lower than those in the others, and the collagen type I/III (Col I/III) ratios in the PE group were lower than those in the <i>P</i> group (<i>P</i> = .006). <b>Conclusions:</b> The persistently high IL-6 levels until 180 days and the decrease in Col I levels and Col I/III ratio at 90 days seem to predict mesh shrinkage at 180 days. The mesh induces high Col I levels, but those associated with low Col III levels should be preferred.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1635-1647"},"PeriodicalIF":1.9,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40402359","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"PPARγ Mediates Protective Effect against Hepatic Ischemia/Reperfusion Injury via NF-κB Pathway.","authors":"Xinyu Liu,&nbsp;Ping Zhang,&nbsp;Xianqing Song,&nbsp;Hengguan Cui,&nbsp;Weixing Shen","doi":"10.1080/08941939.2022.2090033","DOIUrl":"https://doi.org/10.1080/08941939.2022.2090033","url":null,"abstract":"<p><strong>Background: </strong>Hepatic ischemia/reperfusion injury (HIRI) is an unavoidable complication in liver surgery, however its pathological process is still unclear. Therefore, in this study, the role and mechanism of peroxisome proliferator-activated receptor gamma (PPARγ) was investigated in HIRI.</p><p><strong>Materials and methods: </strong>We constructed mice models with HIRI and L02 cell models insulted hypoxia/re-oxygenation (H/R). PPARγ agonist rosiglitazone was administered prior to HIRI in mice and PPARγ-siRNA was to H/R treatment in L02 cells. Liver injury was measured by serum ALT, AST and LDH levels and performing H&E staining; the inflammatory injury was reflected by inflammatory markers IL-1β, IL-6 and TNF-α, which were assayed by Real-time PCR and Western blotting, MPO activity was determined using commercial kits; oxidative stress injury was evaluated by iNOS, MDA, SOD and GSH-PX levels; apoptosis was detected by cleaved-Caspase-3, TUNEL staining and flow cytometry; NF-κB signaling activation was reflected by phosphorylation of IκBα (p-IκBα) and nuclear translocation of NF-κB p65.</p><p><strong>Results: </strong>The level of PPARγ expression was obviously down-regulated both in mice liver subjected to IRI and in L02 cells to H/R. Overexpression of PPARγ presented protective effect on HIRI by reducing serum levels of aminotransferase and hepatic necrosis, inhibiting inflammation and apoptosis and alleviating oxidative stress in vivo. But PPARγ-siRNA aggravate H/R insult by promoting inflammation and apoptosis in vitro. Mechanistically, the NF-κB pathway activity was increased with PPARγ down-regulation by PPARγ-siRNA. Importantly, inhibition of NF-κB signaling abolished PPARγ knockdown-mediated hepatic injury.</p><p><strong>Conclusions: </strong>PPARγ present protective effects on HIRI by attenuating liver injury, inflammatory response, oxidative stress and apoptosis in vivo and in vitro, and its mechanism may be related to down-regulation of NF-κB signaling.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1648-1659"},"PeriodicalIF":1.9,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40194792","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Combined HIF-1α and SHH Up-Regulation Is a Potential Biomarker to Predict Poor Prognosis in Postoperative Hepatocellular Carcinoma.","authors":"Jiali Zhao,&nbsp;Guifang Zeng,&nbsp;En Lin,&nbsp;Chaonong Cai,&nbsp;Peiping Li,&nbsp;Baojia Zou,&nbsp;Jian Li","doi":"10.1080/08941939.2022.2090034","DOIUrl":"https://doi.org/10.1080/08941939.2022.2090034","url":null,"abstract":"<p><strong>Background: </strong>Hypoxia-inducible factor-1α (HIF-1α) or sonic hedgehog (SHH) is associated with hepatocellular carcinoma (HCC) progression. Hypoxia inhibits ferroptosis, which induces cancer cell death. However, the correlation between the combined HIF-1α and SHH up-regulation with prognosis, and the association between SHH and ferroptosis remain unclear. This study aimed to investigate them.</p><p><strong>Methods: </strong>We detected the expression of HIF-1α and SHH in HCC. Cox regression, clinical data, and Kaplan-Meier analyses were performed. In vitro cell experiments verified the relationship between HIF-1α and SHH, and observed the invasion of hypoxic HCC cells. The correlation between SHH and ferroptosis was also analyzed.</p><p><strong>Results: </strong>HIF-1α and SHH expression levels were significantly correlated with HCC (<i>p</i> < 0.0001). HIF-1α and SHH expression levels were found to be associated with TNM stage (<i>p</i> = 0.0121, <i>p</i> = 0.0078, respectively), vascular invasion (<i>p</i> < 0.0001, <i>p</i> < 0.0001, respectively), and recurrence (<i>p</i> = 0.0212, <i>p</i> = 0.0392, respectively). The combined upregulation of HIF-1α and SHH was an independent factor for predicting the overall survival (OS) of patients with HCC (<i>p</i> = 0.003), who had the shortest OS (<i>p</i> = 0.0009). SHH paralleled the increase in HIF-1α expression, which promotes cancer cell invasion. The upregulation of SHH was related to the inhibition of the expression of ferroptosis-related factors (FANCD2, <i>p</i> < 0.0001 and FTH1, <i>p</i> = 0.0009) in HCC.</p><p><strong>Conclusion: </strong>Combined HIF-1α and SHH upregulation is a potentially poor prognosis indicator in patients with HCC because the upregulation of SHH inhibits ferroptosis in hypoxic cancer cells.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1660-1667"},"PeriodicalIF":1.9,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40408974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Could Penile Mondor's Disease Worsen Symptoms in Patients with Erectile Dysfunction?","authors":"Emrullah Durmus,&nbsp;Fesih Ok","doi":"10.1080/08941939.2022.2092664","DOIUrl":"https://doi.org/10.1080/08941939.2022.2092664","url":null,"abstract":"<p><strong>Background: </strong>To determine the impact of Penile Mondor's disease (PMD) in patients with erectile dysfunction (ED).</p><p><strong>Methods: </strong>Forty-seven patients diagnosed with PMD were included in the study and analyzed prospectively. The patients were divided into two groups according to the presence of ED at admission. The patients with ED were named Group 1, and those without ED were named Group 2. The International Index of Erectile Function (IIEF-5) and Beck Anxiety Inventory (BAI) forms at admission, 3rd, and 6th months were compared.</p><p><strong>Results: </strong>There were 21 (44.6%) patients in Group 1 and 26 (55.4%) patients in Group 2. The mean patient ages in Group 1 and Group 2 were 38.1 ± 7.5 and 26.9 ± 10.3 years, respectively (<i>p</i> < 0.001). The mean admission IIEF-5 score was 19.52 ± 1.21 in Group 1 and 22.92 ± 1.23 in Group 2. After treatment, the mean IIEF-5 scores in Group 1 were 19.24 ± 1.14 and 19.09 ± 1.09 at the 3rd and 6th months, respectively. The mean IIEF-5 scores in Group 2 was 22.77 ± 0.99 and 22.96 ± 1.08 at 3rd and 6th months, respectively. In Group 1, the 6th-month IIEF-5 score was lower than the initial score (<i>p</i> = 0.026). In Group 1, the mean BAI score at 6 months increased compared to admission (6.0 ± 1.27 vs 5.43 ± 1.43^, <i>p</i> = 0.015).</p><p><strong>Conclusion: </strong>PMD can worsen symptoms in men with ED who have a low IIEF5 score. The anxiety of recurrence of PMD during sexual intercourse may have caused this situation, or this may also be due to the natural progression of ED.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1668-1672"},"PeriodicalIF":1.9,"publicationDate":"2022-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40606886","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Protective Effects of Hydrogen-Rich Saline on Experimental Intestinal Volvulus in Rats.","authors":"Hayrunnisa Oral,&nbsp;Zafer Türkyılmaz,&nbsp;Ramazan Karabulut,&nbsp;Cem Kaya,&nbsp;Duygu Dayanır,&nbsp;Cengiz Karakaya,&nbsp;Kaan Sonmez","doi":"10.1080/08941939.2022.2056273","DOIUrl":"https://doi.org/10.1080/08941939.2022.2056273","url":null,"abstract":"<p><strong>Background: </strong>Intestinal volvulus can cause morbidity and mortality. Surgical reduction, on the other hand, could result in ischemia-reperfusion (I/R) injury. Hydrogen rich saline solution (HRSS neutralizes free radicals in the body. This study aimed to investigate the effects of HRSS in I/R injury in experimental intestinal volvulus in rats.</p><p><strong>Methods: </strong>Thirty rats were randomly allocated into 5 groups. All procedures were done under general anesthesia and sterile conditions in each animal. Five ml/kg of saline and HRSS were administered intraperitoneally (ip) in Sham (Group 1) and HRSS (Group 2) groups, respectively. Groups 3, 4, and 5 constituted the study groups in which volvulus was created in a 5-cm- long ileal segment 2 cm proximal to the ileocecal valve. After 2 hours the volvuli were reduced and following 2 hours of reperfusion, these segments were removed. In volvulus-I/R group (Group 3) no additional procedure was done. HRSS was administered shortly before reperfusion (reduction of the volvulus) in Treatment I (Group 4) and 1 h before experimental volvulus in Treatment II (Group 5) groups. Blood and intestinal tissue samples were obtained from all rats at the 4th hour. Both tissue and blood total oxidant (TOS) and antioxidant status (TAS) levels were determined and tissue histomorphologies were studied. Oxidative stress indices (TOS ÷ TAS) (OSI) were calculated.</p><p><strong>Results: </strong>Tissue TOS and OSI levels and histomorphological injury scores were statistically lower in treatment groups than I/R group, whereas blood TOS and OSI levels were similar between the groups.</p><p><strong>Conclusions: </strong>This study provides biochemical and histomorphological evidence that HRSS prevents intestinal damage in I/R injury caused by volvulus.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1427-1433"},"PeriodicalIF":1.9,"publicationDate":"2022-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40324302","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Surgical Education Today.","authors":"Georgios Tsoulfas","doi":"10.1080/08941939.2022.2053253","DOIUrl":"https://doi.org/10.1080/08941939.2022.2053253","url":null,"abstract":"In the paper “A standardized workshop for Peer-Teaching simple interrupted sutures to medical students: Analysis of the student factors that affect outcomes.” the authors demon-strate and assess the implementation of standardized Peer Assisted Learning (PAL) suturing workshops in helping medical students attain technical competence in surgical suturing [1]. They were able to show in an elegant manner that surgical peer teaching is an effective method, with factors such as previous workshop experience and recent completion of a general surgery rotation being a factor in achieving better results [1]. These findings underscore the importance of active learning methods in surgical education, thus benefiting both the trainees and the trainers.","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1385"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40312469","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Comparative Effects of Inulin and <i>Bacillus clausii</i> on LPS-Induced Endotoxemic Rat Liver.","authors":"Ibrahim Sogut,&nbsp;Fatih Kar,&nbsp;Sevda Tanrikulu-Kucuk,&nbsp;Tarık Talha Gozden,&nbsp;Sumeyye Asena Can,&nbsp;Aslı Kandil","doi":"10.1080/08941939.2022.2052210","DOIUrl":"https://doi.org/10.1080/08941939.2022.2052210","url":null,"abstract":"<p><strong>Background: </strong>This paper sought to investigate the modifies of inulin and Bacillus clausii on the lipopolysaccharides (LPS) inducing oxidative stress signaling pathway in the endotoxemic rat model.</p><p><strong>Methods: </strong>Wistar albino male rats (n = 36), divided into six groups, were formed randomly in the following stages: the control group; the prebiotic group (Inulin; 500 mg/kg); the probiotic group (<i>Bacillus clausii</i>; 1x10⁹ CFU); the LPS group (1.5 mg/kg) as the endotoxemic model; the prebiotic group + LPS; and the probiotic group + LPS as treatment groups.</p><p><strong>Results: </strong>The reactive oxygen species (ROS), advanced oxidation products of protein (AOPP), thiobarbituric acid reactive substances (TBARS), total oxidant status (TOS), oxidative stress index (OSI), and myeloperoxidase activity (MPO) levels increased in LPS-induced toxicity. Prebiotic treatment decreased LPS-induced hepatotoxicity on rat liver as observed in the decrease in the levels of oxidative stress parameters, such as ROS, TBARS, TOS, and OSI. The effect of the probiotic treatment on the ROS, AOPP, TOS, OSI levels was not statistically significant. However, it was determined that probiotic application was effective in the TBARS, TAS, and GSH levels. When the biochemical results of the prebiotic and probiotic treatment applications were compared, it was found that the prebiotic treatment was more effective on oxidative stress parameters (ROS, TBARS, TOS, and OSI). In addition, the histological damage score and MPO-staining results of the prebiotic treatment group were found to be more effective than the probiotic group.</p><p><strong>Conclusion: </strong>In this first study, where inulin and <i>Bacillus clausii</i> spores are used against liver damage caused by LPS, inulin provides much more effective protection than <i>Bacillus clausii</i> spores.</p>","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1322-1328"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40310996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Tissue Adhesive: Current Uses and Strengths.","authors":"Francesca Allegra Waldner,&nbsp;Payam Sadeghi,&nbsp;Luca Grimaldi,&nbsp;Giuseppe Nisi,&nbsp;Natale Calomino,&nbsp;Roberto Cuomo","doi":"10.1080/08941939.2022.2052211","DOIUrl":"https://doi.org/10.1080/08941939.2022.2052211","url":null,"abstract":"Tissue adhesives are increasingly important elements in modern medicine, with rapid development over the past 30 years. They enable the innate wound healing processes to occur through the adhesion of tissue to the tissue on-site or tissue to non-tissue surfaces on-site, thus exhibiting some attractive characteristics in the clinic, such as less traumatic closure and suffering, easy application, no stitches required after surgery, excellent cosmetic results, and localized drug release [1]. These tissue adhesives are extensively used for different tissues, including skin, breast, cardiac, gastrointestinal, head and neck, hepatic, orthopedic, pediatric, thoracic, bone, neurological and vascular surgery [2]. After several decades of intensive research activities, a wide variety of tissue adhesives have been developed to increase the ability of tissue adhesives to meet different clinic requirements. The current clinical tissue adhesives could be divided into three groups: natural tissue adhesives, synthetic and semisynthetic tissue adhesive, and biomimetic tissue adhesives. The advantages of tissue adhesives include easy and rapid use with no follow-ups for removal of any residual components as is the case with sutures or staples. Until now, many tissue adhesives synthetic and semi-synthetic in origin with biomimetic characteristics and good biocompatibility have been developed and applied into clinical setting [3]. However, some challenges in the form of poor mechanical strength, swelling, and low stability limited their further applications in the field [4]. Polyurethanes are polymers formed through poly-addition reactions of isocyanates. The medical use of polyurethane was previously limited due to carcinogenicity and toxicity of intermediate chemicals and catalysts. However, after improvement in biosafety by modifying isocyanates from aromatic to lysine-derived, polyurethane adhesives have been introduced for surgical application. A novel lysine-derived urethane adhesive (TissuGlu® Surgical Adhesive, Cohera Medical, Inc., Pittsburgh, PA) has recently been developed which adheres large tissue flaps to the underlying tissue during surgical procedures. TissuGlu is the only FDA-approved polyurethane adhesive for intracorporeal use and it was studied for large flap surgeries such as abdominoplasty [5]. TissuGlu was utilized on patients undergoing abdominoplastic surgery and the results showed that it effectively binds tissue layers together in comparison to standard surgical closure techniques. Thereby reducing dead spaces where seroma can occur, while it also reduces post-surgery wound drainage [6, 7]. Recently, a long-term evaluation of TissuGlu showed that it can prevent the formation of seroma in a canine abdominoplasty model [8, 9]. This glue is described as resorbable and nontoxic; it forms a strong bond between tissue layers, and it eliminates or reduces fluid accumulation and the need for postsurgical drains. The use of the adhesive may provide","PeriodicalId":284931,"journal":{"name":"Journal of investigative surgery : the official journal of the Academy of Surgical Research","volume":" ","pages":"1415-1416"},"PeriodicalIF":1.9,"publicationDate":"2022-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"40324305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}