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Comparative Immunology
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Hagfish kept under good conditions in a warm environment can reject skin allografts. First-set grafts take about seventy-two days at 18°C to be rejected; second-set grafts are rejected in about twenty-eight days. This suggests that immunologic memory has developed. Lampreys also reject skin allografts slowly, and their lymphocytes will divide in the presence of cells from a second lamprey and phytohemagglutinin. Elasmobranchs reject scale allografts slowly as do lampreys but bony fish reject them rapidly. Repeated grafting leads to accelerated graft rejection. The rejected allografts are infiltrated by lymphocytes and show destruction of blood vessels and pigment cells. As in all ectotherms, graft rejection is slower at lower temperatures.
Resource-Limited Environment Plastic Surgery
Published in Mansoor Khan, David Nott, Fundamentals of Frontline Surgery, 2021
Johann A. Jeevaratnam, Charles Anton Fries, Dimitrios Kanakopoulos, Paul J. H. Drake, Lorraine Harry
Skin grafting is a surgical procedure that involves removing skin from one area of the body and moving it – or transplanting it – to a different area of the body. It is completely detached from its vascular supply and relies on the blood supply of the recipient wound bed to survive.
Complications of upper extremity bypass grafting for occlusive and aneurysmal disease
Published in Sachinder Singh Hans, Mark F. Conrad, Vascular and Endovascular Complications, 2021
Graft infection is a rare complication of upper extremity bypass grafting, but it can have devastating consequences. In the available literature regarding upper extremity bypass grafting for both occlusive and aneurysmal disease pathologies, noted infections have been limited to the incision sites, with no graft infections reported.24–26,28,29 Rhodes et al. describe increased incisional infection rates in patients with radiation arteritis and atherosclerosis obliterans.29 One explanation for the paucity of infections in upper extremity bypasses could be that the vast majority of patients are treated with autologous conduits, which can be infection resistant.25–26
Utilization of Perifascial Loose Areolar Tissue Grafting as an Autologous Dermal Substitute in Extremity Burns
Published in Journal of Investigative Surgery, 2023
Burak Özkan, Burak Ergün Tatar, Abbas Albayati, Cagri Ahmet Uysal
In this study, we demonstrated the usefulness of PAT grafting in upper and lower extremity burns with exposed tendon/bone. In these patients, we observed several advantages of PAT grafting. First, the donor site did not constitute a problem in our series. The PAT lies over the deep muscle fascia such as the rectus abdominis and tensor fascia lata, which are generally not affected even in third-degree burn traumas. These donor sites can provide sufficient PAT grafts. The commonly preferred route for PAT graft harvesting is through a transverse incision over the inguinal crease [17]. However, this incision carries a risk of damage to superior circumflex iliac artery (SCIA)-based workhorse free flaps, which might be needed in burn treatments such as contracture release or defect reconstruction [18, 19]. We modified the traditional harvest site to a more superior and medial position from the inguinal crease to protect the SCIA and its branches (Figure 11). Second, PAT graft harvesting has a short learning curve. Third, the grafting procedure did not require microvascular anastomosis or frequent postoperative follow-up. As a consequence, the operation time was shorter than that required for microvascular tissue transfers. Fourth, we successfully reconstructed the extremity defects of the patients with poor vascular conditions who were not candidates for free microvascular transfers. The main drawbacks of PAT grafting are the unpredictable intake rate of the skin graft applied simultaneously and donor site-related complications.
Modeling of the PHEMA-gelatin scaffold enriched with graphene oxide utilizing finite element method for bone tissue engineering
Published in Computer Methods in Biomechanics and Biomedical Engineering, 2023
Sara Tabatabaee, Mehran Hatami, Hossein Mostajeran, Nafiseh Baheiraei
Bone defects cause a remarkable economic impact on the healthcare system of the countries (Perez et al. 2018; Haghighizadeh et al. 2019). At least, 4 million operations are performed utilizing bone grafts annually all over the world (Brydone et al. 2010). Only in the United States, the expenses of these therapies and their follow up have been estimated to reach about $5 billion per year (Perez et al. 2018). Despite the fact that autografting is considered the gold standard for healing bone fractures, muscle weakness, post-surgical morbidity, and infection could be noted as its drawbacks (Younger and Chapman 1989). Furthermore, allografting (grafting from a different donor) carries the risk of disease transmission, immune responses, nonunion fatigue fracture, and rejection (Hollister 2005; Baheiraei et al. 2018).
Strategies for extremity reconstruction with exposed bones and tendons using acellular dermal matrices: concept of sequential vascularization
Published in Case Reports in Plastic Surgery and Hand Surgery, 2022
A 34-year-old male was hit by a motorcycle while riding a bicycle. He was admitted to the hospital and presented a soft tissue injury on the right foot; on the dorsal side lateral to the ankle with exposed bone and joint (Figure 1(A,B)). Patient was a smoker with no medical history. The wound was contaminated with significant amount of gravel and road rash. The patient was administered antibiotics upon admission, and the wound underwent 2 operative debridement procedures (Figure 1(C)). Following debridement, the resulting defects measured 15 × 8 cm with exposed underlying joint. IMBWM was applied to the wound in the operating room (OR) under general anesthesia, and was fixed in place using staples. The immediate post-operative dressing was a wound VAC, with black foam sponge, set at negative pressure of 125 mm Hg. The patient was discharged 2 days after placement of the matrix, with the outpatient wound VAC. Vascularization of the dermal matrix occurred sequentially (Figure 1(D)) and was achieved 9 weeks after placement (Figure 1(E)), at which time the silicone layer was removed. Matrix take was 100%. A STSG of 12/1000″ was applied to the neodermis, under general anesthesia. The patient was discharged the same day after grafting, with 5 days of outpatient wound VAC treatment. STSG take was 100%, 1 week after grafting (Figure 1(F)). There was no postoperative complication, and the reconstruction covered the exposed joint without flap treatment.