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Tracheostomy
Published in Raymond W Clarke, Diseases of the Ear, Nose & Throat in Children, 2023
Tubes have improved greatly in recent years. Silastic tubes are flexible yet strong, cause less tissue reaction than older rubber tubes, and are easily inserted by parents and carers provided they are well trained. Children’s tubes typically have no inner tube due to the narrow calibre of the airway, and fenestrated tubes are very rarely used due to the risk of excessive granulation tissue. Cuffed tubes may be needed to help ventilation but, in general, are best avoided for long-term use.
Common head and neck viva topics
Published in Joseph Manjaly, Peter Kullar, Advanced ENT Training, 2019
Open medialisation (type 1 Isshiki thyroplasty). This should be ideally done under LA with or without sedation. This will allow intraoperative voice feedback. Implant position can be confirmed with flexible nasendoscopy. Implant options are silastic block carved to measure, prefabricated Montgomery implants, titanium plate and Gore-Tex®.
Internal Fistulas in the Rat
Published in Waldemar L. Olszewski, CRC Handbook of Microsurgery, 2019
The animal receives 1 mℓ of Intra-lipid® (Vitrum, Stockholm) orally by means of a gastric tube 1 hr before the operation. After opening the abdomen by a midline incision a right nephrectomy is carried out. Using microsurgical instruments, the cannulation sites are carefully dissected under a Zeiss® OP-MI 6 operation microscope with a magnification of approximately 4 ×. Silastic® tubing (Dow Corning, internal diameter 0.30 mm, external diameter 0.64 mm) filled with heparin in saline (50 U/mℓ) is inserted first into the ureter and fixed with 8/0 nylon. The ureter is flushed with heparin/saline solution via the cannula until the bladder is filled. This is to prevent clotting in the early stage of the cannulation procedure. In the ensuing period a regular flow prevents clotting of the chyli. The mesenteric lymph duct is tied close to its outflow point into the thoracic duct with 8/0 nylon. Because the mesenteric lymph duct is very intimately connected to the mesenteric artery it is of great help to use atraumatic suture material (8/0 nylon connected to a BV 2 needle, Ethicon, Germany). Using this, it is not necessary to separate both structures; with a small needle it is rather easy to slip through the layer of connective tissue between the duct and the artery. A cut is made distally from this ligature. The cannula is inserted and fixed with the same suture material. Uniformly, immediately after cannulation, the milky fluid is seen entering the cannula. The intestines are brought back into the abdomen and the wound is closed. To help recover from anesthesia the animals are put for some time under an IR lamp.
The interplay between PCOS pathology and diet on gut microbiota in a mouse model
Published in Gut Microbes, 2022
Valentina Rodriguez Paris, Xin Yi Denise Wong, Samantha M Solon-Biet, Melissa C Edwards, Ali Aflatounian, Robert B Gilchrist, Stephen J Simpson, David J Handelsman, Nadeem O Kaakoush, Kirsty A Walters
PCOS-like mice were generated by postnatal exposure to DHT. Female mice were implanted subcutaneously with either a blank or a DHT-filled implant at 3–4 weeks of age. Implants were made using a 1-cm SILASTIC brand tubing with an inner diameter of 1.47 mm and an outer diameter of 1.95 mm made of medical grade–grade silicon (Dow Corning Corp, catalog no. 508–006). Implants were filled with ~10 mg DHT before being sealed. DHT-filled implants provide a continuous release of DHT over 90 days and induce a PCOS-like phenotype in mice.29,30 This PCOS mouse model was chosen for this study to reproduce both metabolic and reproductive features of PCOS, which more closely resembles the ‘obese’ PCOS phenotype that affects most women with PCOS. Blank implants were empty 1-cm sized SILASTIC tubing.
Navigation-Assisted Isolated Medial Orbital Wall Fracture Reconstruction Using an U-HA/PLLA Sheet via a Transcaruncular Approach
Published in Journal of Investigative Surgery, 2020
Quang Ngoc Dong, Masaaki Karino, Takashi Koike, Taichi Ide, Satoe Okuma, Ichiro Kaneko, Rie Osako, Takahiro Kanno
With regard to the choice of reconstructive materials, some of the most common implant types are autogenous bone graft, titanium mesh, silastic, and porous polyethylene. Autogenous bone is the most compatible material but its resorption is unpredictable and it is difficult to match its shape to the defect [24]. Sometimes, a second surgery is required, and the choice of donor site depends on the surgeon’s preference. Titanium mesh and porous polyethylene provide acceptable results and have been widely used for many years. However, titanium mesh is very difficult to remove if required [24]. The sharp edge of the mesh may cause trauma to the patient and there is a risk of orbital adherence syndrome [11,33]. A new type of titanium mesh has been developed but is still used infrequently [5]. Porous polyethylene has a low complication rate, but cannot be detected on CT and is also expensive [34]. Both titanium mesh and porous polyethylene will become permanent foreign bodies in the patient; this will become problematic if the patient suffers a second trauma in the same orbit. Silastic is often used with the endonasal approach and can be removed if necessary.
A case of total scaphoid titanium custom-made 3D-printed prostheses with one-year follow-up
Published in Case Reports in Plastic Surgery and Hand Surgery, 2020
The first scaphoid prosthesis was constructed from vitallium in 1945 [10], followed by the acrylic implant which was designed in 1950 [11]. However, in 1962, a truly revolutionary implant – the Silastic™ (Dow Corning Corporation, Midland, MI, USA) prosthesis – was introduced by Swanson [7,12–15]. The implant was increasingly used globally until severe problems of silicone synovitis were observed on long-term follow-up. However, biomechanical or anatomical problems were not reported for this implant [16]. The only disadvantages cited were silicone synovitis and severe wrist destruction caused by particulate implant debris [17]. Subsequently, Swanson developed the titanium implant in 1989. This prosthesis averted siliconitis while maintaining the good biomechanical and anatomic results of the silicone scaphoid implant [16]. However, the titanium implant did not attain the popularity of the silastic implant.