RESUMEN
Efforts are ongoing to enhance the functionality of human acellular dermal matrices (hADMs), which are extensively utilized in reconstructive surgeries. Among these efforts, plasma treatments, particularly vacuum plasma treatments, have recently emerged in the medical field. This study aims to investigate the efficacy of a vacuum plasma treatment in enhancing the biocompatibility and biointegration of hADMs. Utilizing a plasma activator (ACTILINK reborn, Plasmapp Co., Ltd., Daejeon, Republic of Korea), hADMs were treated and evaluated through in vitro and in vivo analyses. Hydrophilicity changes were gauged by the blood absorption times, while SEM imaging was used to analyze physical surface deformation. Protein adsorption was measured with fluorescently labeled bovine serum albumin and fibronectin. For the in vivo study, mice were implanted with plasma-treated and untreated hADMs, and the post-implantation effects were analyzed through histological and immunofluorescence microscopy. The plasma-treated hADMs demonstrated a significantly enhanced hydrophilicity compared to the untreated samples. SEM imaging confirmed the maintenance of the microroughness after the treatment. The treated hADMs showed a significant reduction in fibronectin adsorption, a critical factor for cellular adhesion. In vivo, the plasma-treated hADMs exhibited reduced capsule formation and enhanced fibroblast infiltration, indicating improved biocompatibility and integration. These findings highlight the potential of a plasma treatment to enhance the performance of hADMs in clinical settings, offering a promising avenue for improving reconstructive surgery outcomes.
RESUMEN
PURPOSE: Urine output (UO) is an important intraoperative parameter that is not yet electronically monitored. We compared an automatic urinometer (AU) based on a smart scale with a manual urinometer (MU). PATIENTS AND METHODS: This prospective study investigated the hourly UO of 35 preoperative patients with an indwelling urinary catheter using AU, MU, and cylinder measurements. Data were analyzed using the Bland-Altman method. A questionnaire related to the use of the AU was completed by medical staff (n=25). RESULTS: Compared to the cylinder measurements, the differences in measurements by the AU and the MU were -6.31 â± â15.03 âmL/h (p=0.018) and 20.26 â± â26.81 âmL/h (p=0.001), respectively. The r values for the comparison of cylinder measurements with AU and MU values were 0.985 (p<0.001) and 0.968 (p<0.001), respectively. Bland-Altman analyses showed that cylinder measurements had better agreement with the AU measurements than with the MU measurements. Also, the medical staff reported that the use of the AU was easier to learn than the use of the MU (p<0.001). CONCLUSIONS: Compared to the MU values, AU values were noninferior; they had significantly less bias and temporal deviation. Additionally, the medical staff reported that the use of the AU was easier to learn than the use of the MU.
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Quirófanos , Humanos , Estudios ProspectivosRESUMEN
BACKGROUND: Human acellular dermal matrix (hADM) has found applications in a variety of settings, particularly in breast surgery. The most common hADM is a sheet. Recently, an injectable hADM has been introduced; we compared the biocompatibility and long-term structural integrity of, an injectable hADM and a sheet-type hADM in mice. METHODS: An injectable hADM (experimental group) and a sheet-type hADM (control group) were implanted into sub-panniculus pockets on the backs of 50 mice. The animals were sacrificed 2, 4, 8, 12, or 24 weeks later and the hADMs and surrounding tissues were recovered and stained for histopathological analyses. The microscopic endpoints included the thickness of the hADM and capsule around the hADM, and the extents of fibroblast proliferation and neovascularization. RESULTS: No animal developed a complication or infection. The capsule was significantly thinner in the experimental than the control group. There were no significant differences between groups in the hADM thickness. Microscopically, the fibroblast density inside the hADM was significantly higher in the experimental group. The fibroblasts inside of the hADM lay significantly deeper in the experimental group. Similarly, the experimental group exhibited significantly deeper microvessels inside the hADM. CONCLUSIONS: The injectable hADM had a thinner capsule thickness (more biocompatible), than the sheet-type hADM. It maintained its thickness as well as the sheet-type hADM and had a more fibroblast proliferation and neovascularization. This means the tissue incorporation and long-term structural integrity of the injectable hADM may be as good as or better than that of the sheet-type hADM. NO LEVEL ASSIGNED: This journal requires that authors assign a level of evidence to each submission to which Evidence-Based Medicine rankings are applicable. This excludes Review Articles, Book Reviews, and manuscripts that concern Basic Science, Animal Studies, Cadaver Studies, and Experimental Studies. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .