|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Thursday, 03 January 2008 19:00 |
 Ann Arbor, MI, USA. There is at least one thing all HBS patients have in common when they enter a hospital for surgical correction: they will have a catheter inserted into their uretha.
Urinary catheters are used to relieve urinary retention, monitor urine output, and diagnose  pathology in the lower urinary tract. However, their near-universal availability and ease of insertion too often leads to indiscreet and prolonged use.
In fact, whether HBS or not, one in four Americans in the hospital right now has a catheter. One percent of those patients will get a urinary tract infection (UTI) and all of those will require antibiotics. A few may suffer life-threatening complications. And with every new case, UTIs will retain their title of “most common hospital-acquired infection,” responsible for 40 percent of infections related to hospitalization.
Preventing Hospital–Acquired Urinary Tract Infection in the United States: A National Study. Sanjay Saint, Christine P. Kowalski, Samuel R. Kaufman, Timothy P. Hofer, Carol A. Kauffman, Russell N. Olmsted, Jane Forman, Jane Banaszak‐Holl, Laura Damschroder, and Sarah L. Krein. Clinical Infectious Diseases 2008;46:243–250. 1058-4838/2008/4602-0013. DOI: 10.1086/524662.
But despite all this, a new study finds American hospitals don’t seem to have a consistent strategy for preventing catheter-related UTIs. In fact, the study shows, most hospitals aren’t using basic tactics that have been proven to keep patients from getting catheter-related UTIs in the first place.
 “Until now, we haven’t had national data to tell us what hospitals are doing to prevent this common and costly patient-safety problem,” says lead author Sanjay Saint, M.D., MPH, the director of the U-M/VA Patient Safety Enhancement Program, and leader of several other studies on catheter-related issues.
“Now that we have these data, it’s clear that there’s no one dominant practice that’s being used, including physician reminders, which have proven benefit and make a lot of common sense.”
The picture that develops from this snapshot is chaotic, with nearly half of hospitals lacking a system that tells them which patients currently have a catheter, and three-quarters lacking a system that can tell them how long a patient has had a catheter or whether one has been removed. Nearly one-third of hospitals didn’t even track the UTI rates in their patient populations.
Meanwhile, less than 10 percent of hospitals used an approach that has been shown to reduce UTI rates and decrease the time patients spend on catheters: a simple reminder that asks doctors every day whether a patient’s catheter is necessary, or even makes catheter removal the default action unless a physician says otherwise.
Continues Saint, who is also a U-M professor of internal medicine and a research scientist at VA Ann Arbor, “The bottom line for hospitalized patients and their families is, if you have a catheter, ask the doctor or nurse every day if you really still need it.”
 For hospitals, the authors say they hope the study puts needed focus on the opportunities for improvement.
“This issue is especially important now that hospitals will not be reimbursed as part of the Medicare system for the cost of caring for hospital-acquired urinary tract infections,” says senior author Sarah Krein, Ph.D., R.N.
Krein is a research assistant professor of internal medicine and research investigator at the Ann Arbor VA.
The researchers designed a survey that they sent to all 119 VA hospitals in the Unites States, and to a random sample of 600 non-federal hospitals that have an intensive care unit and 50 or more hospital beds. This sample was designed to represent the 2,671 hospitals of that type in the United States.
The survey asked about a range of practices that can be used to prevent hospital-acquired UTIs, including the use of catheters coated with antimicrobial agents that inhibit bacterial growth, the use of condom-style and suprapubic catheters that reduce the risk of bacteria entering the urethra, the use of antimicrobial agents in the drainage bags that collect urine, and the use of portable ultrasound bladder scanners to see of patients’ bladders were truly being emptied without a catheter.
It also asked about system-related measures that can be used, including reminders, stop orders, monitoring systems, feedback on UTIs to patient care providers, and urinary catheter teams to focus on preventing infections.
The survey also collected information about a hospital’s location, nurse staffing levels, availability of a hospital epidemiologist and hospitalist physicians who practice solely in the hospital, teaching hospital status, participation in a broader infection-prevention collaborative effort, and overall safety culture.
The surveys were completed by infection control specialists or hospital epidemiologists, and the response rate was excellent — 70 percent for non-VA hospitals and 80 percent for VA hospitals.
In all, the researchers found, less than a third of hospitals used either of the two most common tactics: bladder scanners and antimicrobial catheters. VA hospitals were more likely than non-VA hospitals to use bladder scanners, condom catheters and suprapubic catheters, but less likely to use the antimicrobial catheters, which cost about $5 more apiece than regular catheters.
The authors note that the VA hospitals were no more likely than non-VA hospitals to use a reminder system to prompt doctors to remove or maintain a patient’s catheter — despite the fact that the VA system uses a standard computerized medical-order entry system in all its hospitals, which makes such reminders easier to implement than at hospitals without computerized order-entry.
Interestingly, hospitals that were participating in a collaborative effort to reduce hospital-acquired infections were no more likely to use any of the UTI-preventions strategies than the other hospitals in the study. This finding, the authors say, may be attributed to the fact that at the time they sent the survey out in 2005, UTIs were not a major focus of such collaboratives, which tended to start with bloodstream infections and central venous catheters as a target for infection prevention. But today, efforts such as the Keystone Center for Patient Safety & Quality Initiative in Michigan are including UTI prevention in their efforts.
As this issue continues to gain attention, the authors say, patients should not be afraid to speak up about catheters that might have been put in place when they had surgery or an emergency, were treated for a bladder obstruction, or needed close monitoring of their urine output. Previous studies have shown that up to a third of the days that patients use catheters are medically unnecessary, and that doctors don’t know whether their hospitalized patients have catheters about a third of the time.
Preventing Hospital‐Acquired Urinary Tract Infection in the United States: A National Study. Sanjay Saint, Christine P. Kowalski, Samuel R. Kaufman, Timothy P. Hofer, Carol A. Kauffman, Russell N. Olmsted, Jane Forman, Jane Banaszak‐Holl, Laura Damschroder, and Sarah L. Krein. Clinical Infectious Diseases 2008;46:243–250. 1058-4838/2008/4602-0013. DOI: 10.1086/524662.
Abstract
Background. Although urinary tract infection (UTI) is the most common hospital‐acquired infection in the United States, to our knowledge, no national data exist describing what hospitals in the United States are doing to prevent this patient safety problem. We conducted a national study to examine the current practices used by hospitals to prevent hospital‐acquired UTI.
Methods. We mailed written surveys to infection control coordinators at a national random sample of nonfederal US hospitals with an intensive care unit and 50 hospital beds () and to all Veterans Affairs (VA) hospitals (). The survey asked about practices to prevent hospital‐acquired UTI and other device‐associated infections.
Results. The response rate was 72%. Overall, 56% of hospitals did not have a system for monitoring which patients had urinary catheters placed, and 74% did not monitor catheter duration. Thirty percent of hospitals reported regularly using antimicrobial urinary catheters and portable bladder scanners; 14% used condom catheters, and 9% used catheter reminders. VA hospitals were more likely than non‐VA hospitals to use portable bladder scanners (49% vs. 29%; ), condom catheters (46% vs. 12%; ), and suprapubic catheters (22% vs. 9%; ); non‐VA hospitals were more likely to use antimicrobial urinary catheters (30% vs. 14%; ).
Conclusions. Despite the strong link between urinary catheters and subsequent UTI, we found no strategy that appeared to be widely used to prevent hospital‐acquired UTI. The most commonly used practices — bladder ultrasound and antimicrobial catheters — were each used in fewer than one‐third of hospitals, and urinary catheter reminders, which have proven benefits, were used in ‹10% of US hospitals.
|
|
Last Updated on Friday, 04 January 2008 06:22 |
|
|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Thursday, 03 January 2008 19:00 |
 Alicante, Spain and Ankara, Turkey. Laser surgery has been used to correct vision problems since the early 1990s. There are two main types of surgery. Photorefractive Keratotomy (PRK) is often used to correct low to moderate myopia. In-situ keratomileusis (LASIK) is preferred for high myopia corrections. Although over 18 million LASIK procedures have been performed worldwide, controversy remains regarding the maximum correction possible and efficacy with this technique.
Researchers from Miguel Hernandez University, Medical School (Alicante, Spain) and Ankara University School of Medicine (Ankara, Turkey) report on a study of high myopia patients ten years after LASIK surgery. Researchers found the treatment was safe and effective for myopia over -10 D in the long term, with a retreatment rate of under 30 per cent. The study is published in the American Journal of Ophthalmology.
Ten-year Follow-up of Laser In Situ Keratomileusis for High Myopia. Jorge L. Alio, Orkun Muftuoglu , Dolores Ortiz , Juan Jose Perez-Santonja , Alberto Artola , Maria Jose Ayala , Maria Jose Garcia , Gracia Castro de Luna. American Journal of Ophthalmology, 2008 January, Vol. 145, Issue 1, Pages 55-64.e1. PII: S0002-9394(07)00781-7. doi: 10.1016/j.ajo.2007.08.035.
196 high myopic eyes of 118 patients, preoperatively needing at least 10 diopter (10 D) corrections to achieve 20/20 vision, were evaluated ten years following surgery.
- Uncorrected vision was 77% of best-corrected vision (BSCVA) before surgery.
- BSCVA improved 1 line. Only 5% of eyes lost more than 2 lines of BSCVA and 40% avoided the use of glasses.
- 119 (61 %) of eyes were within ± 2.00 Diopters at 10 years.
- Only 2 eyes (1%) developed corneal ectasia. The retreatment rate was 27%.
According to lead investigator Jorge L. Alió, "These results are extremely encouraging considering that this refractive correction implies the maximum limit of application of this technique. This study has allowed us to demonstrate that, in spite of the prejudices about the limits of LASIK technique, the results regarding predictability, efficacy and safety for high myopic patients are very good in the long term. The optimum limit of predictability for this technique is around 10 D of myopia. This reference study, with a long time perspective, allows us to know the safety, precision and limits of LASIK in highly myopic eyes."
The researchers concluded that "LASIK for myopia over -10 D is a safe procedure with myopic regression that slows down with time and a high rate of BSCVA increase in the long term."
Lead investigator, Jorge L. Alio, said "These results are extremely encouraging considering that this refractive correction implies the maximum limit of application of this technique."
"This study has allowed us to demonstrate that, in spite of the prejudices about the limits of LASIK technique, the results regarding predictability, efficacy and safety for high myopic patients are very good in the long term," he added.
He stressed that the optimum limit of predicatability for this type of surgery appears to be around 10 D of myopia.
In an editorial in the same issue of the journal, Dr George O Waring, of Emory University and Inview in Atlanta, generally supported the findings, and said that LASIK and other vision correction procedures have improved significantly in the last ten years, with some recent studies on LASIK reporting correction to plus or minus 0.5 D in more than 90 per cent of eyes.
Ten-year Follow-up of Laser In Situ Keratomileusis for High Myopia. Jorge L. Alio, Orkun Muftuoglu , Dolores Ortiz , Juan Jose Perez-Santonja , Alberto Artola , Maria Jose Ayala , Maria Jose Garcia , Gracia Castro de Luna. American Journal of Ophthalmology, 2008 January, Vol. 145, Issue 1, Pages 55-64.e1. PII: S0002-9394(07)00781-7. doi: 10.1016/j.ajo.2007.08.035.
Abstract
Purpose. To evaluate the long-term outcomes of laser in situ keratomileusis (LASIK) for high myopia.
Design. A long-term (10 years) follow-up retrospective interventional case series study.
Methods. The study included 196 myopic eyes of 118 patients with a mean preoperative spherical equivalent of −13.95 ± 2.79 diopter (D) treated with myopic LASIK at the Instituto Oftalmológico de Alicante, Spain using the VISX 20/20 excimer laser (VISX Inc, Santa Monica, California, USA) and the Automated Corneal Shaper microkeratome (Chiron Vision, Irvine, California, USA). All patients were evaluated three months, one year, two years, five years, and 10 years postoperatively. The main outcome measures were refractive predictability and stability, mean corneal keratometry, topographical cylinder, safety, efficacy, stability of visual acuity, and postoperative complications.
Results. At 10 years, 82 (42%) of 196 eyes were within ±1.00 D and 119 (61%) were within ±2.00 D. Fifty-four (27.5%) eyes underwent retreatments attributable to under correction and/or regression. The myopic regression decreases with time in eyes that did not undergo retreatment with a mean rate of −0.25 ± 0.18 D per year. Eleven eyes (5%) lost more than 2 lines of best spectacle-corrected visual acuity (BSCVA) and 78 eyes (40%) showed a postoperatively uncorrected visual acuity of 20/40 or better. Two eyes (1%) with more than 15 D myopic correction developed corneal ectasia.
Conclusions. LASIK for myopia over −10 D is a safe procedure with myopic regression that slows down with time and a high rate of BSCVA increase in the long-term.
|
|
Last Updated on Friday, 04 January 2008 01:28 |
|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Tuesday, 01 January 2008 19:00 |
 Los Angeles, CA, USA. For women, marital distress means less relief from stress. That is a finding from a UCLA study that tracked levels of cortisol, a key stress hormone. Cortisol is widely considered a reliable marker for an individual's response to — and recovery from — stress.
The subjects were 30 heterosexual married couples that became involved in one of our age's trickiest juggling acts — raising kids when both parents work full time.
Marital Satisfaction, Recovery from Work, and Diurnal Cortisol Among Men and Women. Saxbe, D. E., Repetti, R. L, & Nishina, A. Health Psychology (ISSN: 0278-6133), Vol. 27, Issue 1 (January 2007).
Released by the adrenal glands under stressful conditions, cortisol levels start high in the morning and steadily decline over the course of the day, with intermittent rises as stressors arouse the adrenal gland. The slope of the hormone's daily decline is believed to be correlated with well-being, with steeper declines reflective of better health and shallower declines predictive of health problems.
 "This is the first study to show that daily cortisol patterns are linked to marital satisfaction for women but not men," said co-author Rena Repetti (pictured at left), a UCLA professor in the department of psychology.
"At least as far as women are concerned, being happily married appears to bolster physiological recovery from work," said Darby E. Saxbe (pictured at right), the study's lead author and a UCLA graduate student in clinical psychology.
"After a tough day at the office, cortisol levels dropped further among happily married women than less happily married ones. Less happily married women also showed a flatter daily pattern of cortisol release, suggesting that they are rebounding less well from everyday stress."
CELF researchers asked the study's 60 middle-class parents to complete a standardized test of marital satisfaction. Twice during each of the three days over which the study was conducted, the parents also filled out a questionnaire while they were at work that asked how their workday was going and how busy they felt. At four intervals — early morning, late morning, afternoon and evening — the UCLA team collected saliva samples, which were then analyzed for cortisol concentrations.
Long-term elevated cortisol levels have been associated with a host of maladies, including depression, burnout, chronic fatigue syndrome, relationship problems, poor social adjustment and possibly even cancer. " Cortisol may by one of the routes by which repeated everyday stress translates into long-term mental and physical health problems," Repetti said.
Overall, women in happy marriages enjoyed stronger cortisol declines than their counterparts in less blissful unions, the UCLA team found. Men, no matter the quality of their marriage, showed an exaggerated cortisol decrease after busier days. However, only happily married women appeared to enjoy this benefit; unhappily married women did not show the exaggerated drop-off in cortisol after a busy day.
The investigators said additional research is needed to understand precisely how marital satisfaction influences the body's stress response process. But they believe that a natural tendency to socially withdraw after a stressful day may help explain why men and happily married women showed the exaggerated decline in cortisol after busier days at work while unhappily married women did not.
"They're coming home from a busy day and instead of having some time to unwind and relax and have a spouse picking up the load of setting the table, getting dinner going, signing forms for the kids, these women may have to immediately to launch back into another stressful routine," Repetti said.
"Perhaps in happily married couples the demands of domestic life are being shared more equitably between men and women, or at least that may be the case when wives return home from a demanding day at work."
Past research has looked at the effects of marital satisfaction on cortisol levels, but the CELF study is the first to look at the relationship outside of the laboratory separately in men and women. Most researchers in the past have aroused cortisol responses by subjecting participants to such stressors as public speaking or electric shock. The CELF study, on the other hand, tracked real-life families as they went through their actual daily routines.
"Past research has found that men appear to get a health and longevity boost from marriage, while for women, being married is only beneficial insofar as the marriage is high-quality," Repetti said. "This study is the first to point to daily cortisol fluctuations as a specific pathway through which marital quality affects health for women but not men."
"It may be that a chronically unhappy marriage creates multiple occasions everyday when the wife needs to mount a stress response, putting her cortisol levels on a kind of roller coaster ride," Repetti said. "The system is under more wear and tear. It's like driving a car in traffic conditions that are constantly stop and go. You need to repeatedly step on the gas and apply the brakes, step on the gas, apply the breaks. Over time, you create a less reliable system. You don't stop and re-accelerate as quickly. You don't recover as quickly."
The CELF study launched in 2001, and concluded data collection early 2005. Elinor Ochs, a 1998 MacArthur Fellowship winner, directed the project. It was funded by $11 million in grants from the Alfred P. Sloan Foundation's Dual Career, Working Middle-Class Families program,
The project received attention for its unique data collection methods — which included videotaping the families at various times throughout the day, from waking up in the morning to the children's bedtime at night — and findings on such diverse topics as clutter management and reliance on convenience foods.
Marital Satisfaction, Recovery from Work, and Diurnal Cortisol Among Men and Women. Saxbe, D. E., Repetti, R. L, & Nishina, A. Health Psychology (ISSN: 0278-6133), Vol. 27, Issue 1 (January 2007).
Abstract. Despite documented links between chronic stress, relationship quality, and health outcomes in married men and women, naturalistic cortisol research focusing on this population has been inconclusive. In a sample of sixty married, employed adults (30 men, 30 women) who sampled saliva over three days, multilevel modeling was used to explore relationships between marital satisfaction, daily work experiences, and two possible indicators of allostatic load, diurnal cortisol rhythm and evening cortisol levels. Among women but not men, marital satisfaction was significantly associated with a stronger basal cortisol cycle, with higher morning values and a steeper decline across the day. For women but not men, marital satisfaction appeared to moderate the within-subjects association between afternoon and evening cortisol level, suggesting that marital quality may be implicated in women’s physiological recovery from work. For both men and women, evening cortisol was lower than usual on higher-workload days, and marital satisfaction appeared to augment this association among women. Men showed higher evening cortisol after more distressing social experiences at work, an association that was strongest among men with higher marital satisfaction.
|
|
Last Updated on Monday, 07 January 2008 02:07 |
|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Thursday, 27 December 2007 19:00 |
 San Diego, CA, USA. Surgery is inherently painful. For most operations, going under the surgical knife means going under first with anesthesia. Given the possible side effects, some people choose a more direct approach to block the pain. As an alternative, anesthesiologists can use ultrasound to locate peripheral nerves, then inject a nerve numbing medication into the area.
A single injection leaves a limb numb for several hours or a day.
The medication is a local anesthetic, but the precise point of administration allows pain-free surgery without losing consciousness and allowing patients to breathe without assistance. The patient doesn't feel anyhting because of the nerve block.
 “I like to compare it to an injection a dentist gives you before you have a cavity filled,” Edward Mariano, M.D., director of regional anesthesia at University of California San Diego.
The term, regional anesthesia, refers to the set of medical techniques used to abolish painful impulses from any region or regions of the body. They are used to temporarily interrupt sensory nerve conductivity without altering patient consciousness.
For this application, the anesthesiologist first uses ultrasound to locate the peripheral nerve near the surgical site. Through a catheter, a nerve numbing medication is injected into the area, and minutes later the patient undergoes surgery without general anesthesia.
“You can breath on your own; you don’t require a breathing tube like you do with general anesthesia and after surgery your pain relief is very specific to the sight,” Dr. Mariano said.
For Paul Tomasini, this surgery has been a long time coming. After years of dealing with crippling arthritis in his feet, Mr. Tomasini is finally getting some relief. The pain was so bad he had trouble staying on his feet. This was a serious impediment, since he owns his own contracting business. The only shoes he could wear were torn out, worn out sneakers. “I’m on my feet most of the time. I need protective foot wear.”
Patients can stay awake for their surgery. In Paul's case, he caught up on some rest and returned home within a few hours. A small pump was attached to his catheter, giving him the control to add more or less pain medication directly to his foot. “If I needed an extra dose of medicine, I would just pump this blue button," Tomasini said.
"What this allows patients to do is enjoy a better recovery in terms of having less mental confusion, less nausea, less itching," Dr. Mariano said.
Paul was up and around ready to get back to work the day after surgery.
The UCSD division designs and implements extramurally-funded clinical
research, involving both human subjects as well as laboratory-based projects. Current extramural activities include 7-10 active protocols (in effect at any one time), including several multi-center randomized clinical trials. The topics under current study include:
- Effect of infraorbital nerve blocks on immediate and long-term recovery following outpatient nasal surgery
- Optimizing local anesthetic concentration for continuous peripheral nerve block local anesthetic infusions
- Optimizing perineural catheter location for continuous brachial plexus nerve block local anesthetic infusions
- Continuous femoral nerve blocks following total knee arthroplasty and their effects on readiness-for-discharge and quality-of-life
- Continuous psoas compartment nerve blocks following total hip arthroplasty and their effects on readiness-for-discharge and quality-of-life
- Optimizing perineural catheter placement with the use of ultrasound, nerve-stimulation, and a combination of the two modalities.
|
|
Last Updated on Friday, 28 December 2007 07:49 |
|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Thursday, 27 December 2007 19:00 |
|
Can be produced with less time and effort
 Daegu, Gyeongsangbuk-do, Korea. Skin substitutes can improve wound healing in the early-stages and reduce the time between preparation and patient use. However, expense has deterred their use in recent years. As part of a widespread search for solutions to this problem, a new study tested the effects of a wound dressing created with hair follicular cells.
The findings reveal that skin substitutes using living hair cells can increase the rate of wound healing and do so with reduced effort.
Effect of Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Nanofiber Matrices Cocultured With Hair Follicular Epithelial and Dermal Cells for Biological Wound Dressing. Insook Han, Kyung Jin Shim, Jung Yong Kim, Sang Uk Im, Young Kwan Sung, Moonkyu Kim, Inn-Kyu Kang, Jung Chul Kim. Artificial Organs 31 (11), 801–808. doi:10.1111/j.1525-1594.2007.00466.x
The technique not only provides the proper environment for cell attachment and growth, but also serves as an effective biodressing to keep wounds moist and maintain structural strength during healing.
Researchers applied the technique to wound surfaces on mice. Subjects that were administered this biological dressing produced two times better wound closure than the control set.
“This technique shows promise as a biological dressing that is not only efficient and strong but also can be produced with less time and effort,” says Jung Chul Kim, lead author of the study.
Effect of Poly(3-hydroxybutyrate-co-3-hydroxyvalerate) Nanofiber Matrices Cocultured With Hair Follicular Epithelial and Dermal Cells for Biological Wound Dressing. Insook Han, Kyung Jin Shim, Jung Yong Kim, Sang Uk Im, Young Kwan Sung, Moonkyu Kim, Inn-Kyu Kang, Jung Chul Kim. Artificial Organs 31 (11), 801–808. doi:10.1111/j.1525-1594.2007.00466.x
Abstract. We tested the effects on the early-stage wound healing of poly(3-hydroxybutyrate-co-3-hydroxyvalerate) (PHBV) nanofiber matrices cultured with hair follicular cells. PHBV only, PHBV/collagen, and PHBV/gelatin at a 7/3 weight ratio were produced by electrospinning, and their in vitro cell culture and in vivo wound healing as biological dressings were examined. In cell attachment and growth on matrices, dermal sheath (DS) cells attached to hydrophilic PHBV/collagen and PHBV/gelatin faster than hydrophobic PHBV at the early incubation stage (up to 6 h). From 6- to 24-h incubation, PHBV/collagen showed the best results in cell culture. Furthermore, PHBV/collagen cocultured for 3–5 days with DS and epithelial outer root sheath (ORS) cells expressed more extracellular materials, such as type I collagen, elastin, and α-smooth muscle actin, than cocultured PHBV with the same cells. However, there was no significant difference between PHBV and PHBV/collagen in the amounts of cytokeratin 8 expressed. Grafting of PHBV and PHBV/collagen matrices cocultured with ORS/DS cells for 3–5 days showed that PHBV promoted wound closure and re-epithelization more obviously than PHBV/collagen in both cocultured matrices and matrices alone. Cocultured matrices would heal wounds better than the corresponding matrices alone. Thus, PHBV cocultured with ORS/DS cells could be used as a cell-seeded biological dressing, thereby reducing preparation time as well as regenerating the epidermis efficiently during the early stage of wound healing.
|
|
Last Updated on Thursday, 27 December 2007 19:10 |
|
SciMed -
Healthcare
|
|
TS-Si News Service
|
|
Thursday, 27 December 2007 19:00 |
|
Could make sutures a medical relic of medical history
Measuring just 50 microns thick, a thin polymer bio-film is placed on a surgical wound and exposed to an infrared laser.
The film heats just enough to meld it and the tissue, thus perfectly sealing the wound.
Known as Surgilux, the device’s raw material is extracted from crab shells and could make sutures a relic of medical history.
 “Others have tried surgical glues but these are mainly gel-like so bonding to the tissue is uneven often resulting in leakages and they’re not easy to use. The strongest surgical glue is so toxic that it’s limited to external applications,” says Dr. Foster.
Early test results indicate that Surgilux has strongest potential for use in brain and nerve surgery. Up to 11% of brain surgery patients have to return for repeat surgery due to leakage of cerebro-spinal fluid (CSF) and other complications arising from sutures. It is thought the new product can avoid the numerous disadvantages of invasive stictches/sutures, which fail to seal and can act as a source of infection.
“Other devices use ultra-violet light to effect rather poor sealing, but UV rays are damaging to living cells." Foster is one of the device’s inventors and leader of the UNSW Biopolymer Research Group.
“The beauty of this is that infra-red laser doesn’t cause any tissue damage. Better still, Surgilux has anti-microbial properties, which deters post-operative infections.”
Foster and his team are working with micro-surgeon Marcus Stoodley who specialises in nerve repair. Based at the Prince of Wales Hospital Stoodley is excited about early test results. “Surgilux is well suited to repairing damaged nerves because the gold standard — sutures — inevitably cause damage to nerves and there is always some permanent loss of function.
“Our test results with rats have shown some degree of permanent nerve recovery within six weeks of operating.”
Surgilux has US Food and Drug Administration approval and could be a viable candidate for clinical trials. The researchers are looking for commercial backing to initiate the trials. They plan a second generation version that incorporates growth factors and perhaps stem cells to regenerate nerves.
John Foster focuses on the production, characterization and potential applications of medical and environmental biopolymers. He researches the development and degradation of biopolymer-based materials, and their applications as bioplastics, anti-fouling coatings and proactive scaffolds for tissue engineering.
|
|
Last Updated on Wednesday, 12 March 2008 07:24 |
|
|
Sydney, NSW, Australia. Surgical sutures date back some 4,000 years, so a new approach is long overdue, says John Foster of the 
The TS-Si News Service
and the TS-Si Research Service are collaborations of TS-Si officials, staff, contributors, and corresponding institutions. The contents do not necessarily convey official positions of TS-Si or its owners, participants, partners, or affiliates.