elastin and Postoperative-Complications

Supravalvar aortic stenosis (SVAS) is a rare anomaly of the aortic root caused by a genetically based deficiency in elastin production. Concomitant primary and secondary cardiovascular lesions complicate surgical management and impact early and late outcomes. Because SVAS is a rare lesion, surgical series are relatively small and span lengthy time periods. Consequently, risk factors that influence early and late outcomes are not well defined. Patients who come to surgery during infancy are particularly challenging, but little attention has been directed as to whether or not young age influences outcomes. This review suggests that complicating associated features of elastin arteriopathy are more prevalent in patients who require relief of SVAS during infancy, and that concomitant lesions significantly increase the difficulty and risk of treating younger patients with SVAS.

Topics: Angiography; Aortic Stenosis, Supravalvular; Cardiac Surgical Procedures; Coronary Stenosis; Elastin; Female; Follow-Up Studies; Humans; Infant; Infant, Newborn; Male; Postoperative Complications; Rare Diseases; Risk Assessment; Severity of Illness Index; Survival Rate; Treatment Outcome

Patients with postgastric bypass and diet-induced weight loss present to the plastic surgeon for various body contouring procedures. Gross differences in skin dermal elasticity may exist between these populations; however, studies evaluating histologic differences are lacking. This prospective study aims to evaluate histomorphologic differences in morbidly obese patients following surgical versus diet-induced (nonsurgical) weight loss. Further, we aim to elicit if postoperative complications are correlated with the mechanism of weight loss and potential histomorphologic differences.. Defined infraumbilical skin specimens were collected during abdominal contouring procedures following weight loss achieved through surgical or nonsurgical means. Specimens were stained for elastic fiber content and morphology, collagen deposition, and inflammation. All sections underwent evaluation for quality and quantity of elastic fibers, collagen architecture, and presence of inflammation in the context of age-matched controls. Histomorphological results were compared between the 2 groups and subanalyzed according to clinical variables and postbody contouring wound complications.. Between July 2008 and December 2010, 30 consecutive patients with significant weight loss (17 surgical, 13 nonsurgical) underwent a panniculectomy (n = 15), abdominoplasty (n = 13), and lower body lift (n = 2), with an average age of 48.3 ± 11.10 years and a body mass index of 39.23 ± 13.65 kg/m. Demographic and clinical variables were not statistically significant between the 2 groups. Blinded histologic evaluation revealed a trend toward normal elastic fiber appearance (P = 0.255), increased wound complications (P = 0.546), and mild inflammation (P = 0.462) in the surgical group. Analysis of dermal histomorphology correlating with wound complications was not statistically significant at follow-up (4.76 ± 5.55 months). Interestingly, there was a persistent inflammatory component in both groups when compared with age-matched controls.. Although the differences in histomorphology between the surgical and nonsurgical weight loss groups did not reach statistical significance, the results demonstrated an existence of weight loss-induced histomorphological skin changes that may impact future studies. The study did not demonstrate a relationship between dermal histomorphology and postoperative wound complications, suggesting that aberrant healing in body contouring procedures involves a multifactorial process.

Topics: Adult; Aged; Collagen; Cosmetic Techniques; Dermatologic Surgical Procedures; Elastin; Female; Follow-Up Studies; Gastric Bypass; Humans; Male; Middle Aged; Obesity, Morbid; Postoperative Complications; Prospective Studies; Skin; Treatment Outcome; Weight Loss; Weight Reduction Programs; Wound Healing

The advent of dermal regeneration templates has fostered major advances in the treatment of acute burns and their sequelae, in the last three decades. Both data on morphological aspects of the newly-formed tissue, and clinical trials comparing different templates, are few. The goal of this study was to prospectively analyze the outcome of randomized patients treated with two of the existing templates, followed by thin skin autograft. They are both 2 mm-thick bovine collagen templates (Matriderm® and Integra®), the latter includes a superficial silicone layer. Surgery was performed on patients with impaired mobility resulting from burn sequelae (n = 12 per template) in a two-step procedure. Negative pressure therapy was applied after surgery; patients were monitored for 12 months. No intra or postoperative complications were observed. Data on scar skin quality (Vancouver scar scale), rate of mobility recovery, and graft contraction were recorded; as well as morphological analyses at light microscopical level. Improvement in mobility and skin quality were demonstrated along with graft contraction, in all patients. The double layer template showed the best performance in retraction rate, skin quality and mobility recovery. The subepidermal newly-formed connective tissue showed no histoarchitectural differences between the templates. The double layer template was not absorbed up to 12 months after placement.

Topics: Adolescent; Adult; Burns; Chondroitin Sulfates; Cicatrix; Collagen; Contracture; Elastin; Female; Guided Tissue Regeneration; Humans; Longitudinal Studies; Male; Middle Aged; Negative-Pressure Wound Therapy; Plastic Surgery Procedures; Postoperative Complications; Skin; Skin Transplantation; Transplantation, Autologous; Young Adult

Management of encephaloceles is challenging when massive brain herniation is present. In such instances, an expansile cranioplasty may be attempted so as to preserve some herniated brain tissue. Complications such as wound dehiscence, cerebrospinal fluid leak, and scalp necrosis are postoperative concerns. The treatment of scalp necrosis with dural and brain exposure is certainly a challenge due to the complexity of flap techniques in such a young age. Herein we describe the use of a novel technique for the management of a scalp necrosis and dehiscence in an infant.. A patient with a giant parietal encephalocele and massive brain herniation underwent an expansile cranioplasty. A large scalp necrosis ensued as a complication and later progressed to a suture dehiscence despite a new surgical intervention, with resultant brain exposure. A scalp reconstruction was subsequently performed using an artificial dermal substitute, laid directly onto the brain, followed by a split-thickness skin graft. We observed a rapid engraftment, without any further complications, with an acceptable cosmetic result in the long-term follow-up.. A simple technique, such as the use of an artificial dermal matrix with simultaneous split-thickness skin graft, may be an effective treatment for the repair of scalp defects, even when coverage of exposed brain tissue is necessary, when no other techniques are found to be suitable.

Topics: Collagen; Elastin; Encephalocele; Female; Humans; Infant; Magnetic Resonance Angiography; Magnetic Resonance Imaging; Necrosis; Plastic Surgery Procedures; Postoperative Complications; Prenatal Diagnosis; Scalp

The hands are involved in more than 80% of severe (grade IIb-III) burn accidents. Even if appropriate initial surgical care is provided in a timely manner, this does not necessarily guarantee a satisfactory outcome in terms of function and aesthetics if interdisciplinary postoperative care and patient compliance are inadequate. In the following case, a grade IIb-III burn, this led to unstable scars on the back of both hands and an intrinsic-minus hand position, bilaterally. Our case study demonstrates that even a delayed reconstruction with a collagen- elastin-based dermal substitute and split-skin graft combined with appropriate interdisciplinary postoperative care may lead to an excellent result comparable with the function and aesthetics of healthy hands, albeit with a significant effort.. Im Fall von schweren (IIb-III gradigen) Verbrennungen sind die Hände in über 80% mitbeteiligt. Auch die schnellstmögliche und richtige initiale chirurgische Versorgung sichert nicht zwingend ein funktionell und ästhetisch zufriedenstellendes Ergebnis, wenn die interdisziplinäre Nachsorge und Patientencompliance mangelhaft sind. In dem vorliegenden Fall führte dies bei einer IIb-III gradigen Verbrennung beider Hände zu instabilen Narbenverhältnisse im Bereich beider Handrücken sowie einer Intrinsic-minus-Handstellung beidseits. Wir zeigen, dass auch eine sekundäre Versorgung einer Verbrennungsnarbe im Bereich der Hände mit einem Collagen-Elastin-basierten Dermisersatz und nochmaliger Spalthauttransplantation mit dem richtigen interdisziplinären postoperativen Regime zu einem Ergebnis führen kann, das funktionell und ästhetisch einer gesunden Hand entspricht, jedoch mit einem deutlich erhöhtem Aufwand.

Topics: Cicatrix; Collagen; Elastin; Female; Follow-Up Studies; Hand Deformities, Acquired; Hand Injuries; Humans; Plastic Surgery Procedures; Postoperative Complications; Reoperation; Skin Transplantation; Wound Healing; Young Adult

To date, clinically available expanded polytetrafluoro-ethylene (ePTFE) vascular grafts are suboptimal for reconstructing small caliber (D < 6 mm) arteries, owing to thrombosis in early and restenosis in late stage. Our aim in this preliminary study was to fabricate a nano-fibrous vascular graft which was biofunctionalized with VEGF. Four-mm caliber grafts were prepared by the coaxial-elctrospun technique, which consisted of poly(l-lactide-co-caprolactone) [P(LLA-CL)] collagen and elastin. Heparin and endothelial cell growth factor-165 (VEGF. Biofunctionalized electrospun graft showed surgical properties, hemocompatibility and higher short-term patency compared with the ePTFE grafts. Despite good early performances, profound study should be designed for long-term evaluation.

Topics: Animals; Anticoagulants; Aorta, Abdominal; Biocompatible Materials; Blood Vessel Prosthesis; Collagen; Elastin; Endothelial Cells; Heparin; Polyesters; Postoperative Complications; Rabbits; Thrombosis; Vascular Endothelial Growth Factor A; Vascular Grafting

Children with elastin arteriopathy (EA), the majority of whom have Williams-Beuren syndrome, are at high risk for sudden death. Case reports suggest that the risk of perioperative cardiac arrest and death is high, but none have reported the frequency or risk factors for morbidity and mortality in an entire cohort of children with EA undergoing anesthesia.. The aim of this study was to present one institution's rate of morbidity and mortality in all children with EA undergoing anesthesia and to examine patient characteristics that pose the greatest risk.. We reviewed medical records of children with EA who underwent anesthesia or sedation for any procedure at our institution from 1990 to 2013. Cardiovascular hemodynamic indices from recent cardiac catheterization or echocardiography were tabulated for each child. The incidence, type, and associated factors of complications occurring intraoperatively through 48 h postoperatively were examined.. Forty-eight patients with confirmed EA underwent a total of 141 anesthetics. There were seven cardiac arrests (15% of patients, 5% of anesthetics) and nine additional intraoperative cardiovascular complications (15% of patients, 6% of anesthetics). Extracorporeal life support was initiated in five cases. There were no perioperative deaths. All children having a cardiac arrest or complication were <3 years old and had biventricular outflow tract obstruction (BVOTO). Subgroup analysis demonstrated high rates of cardiac arrest in two groups: children with BVOTO (44%) and age <3 years old (21%).. We have confirmed that the rate of cardiac arrest and complications is significantly elevated in children with EA undergoing anesthesia. Children <3 years old and with BVOTO were at the greatest risk in our population.

Topics: Anesthesia; Child, Preschool; Comorbidity; Elastin; Female; Heart Arrest; Humans; Infant; Intraoperative Complications; Male; Postoperative Complications; Retrospective Studies; Risk Factors; Williams Syndrome

Implantable long-term central venous port systems (CVPS) are widely used as a permanent means of accessing the vascular system for intravenous delivery of drugs, parenteral nutrition, blood transfusion, and blood sampling. These systems allow easy and repetitive puncture without causing much damage to the vessels. However, the body foreign surface of CVPS induces an inflammatory response with varying intensity (depending on the implant materials) that leads to formation of a fibrous tissue capsule around the implant. This study was designed to investigate the influence of bacterial infection on the tissue reaction induced by implanted CVPS in adult patients. 20 patients (9 women, 11 men, 58 ± 14 yrs of age) were included in this study. These patients received explantation of a polysulfone based CVPS (ChemoSite™, Covidien, Mansfield, USA) due to port related infections (patients with bacterial infections at the implantation site: group A, 5 men, 1 women) or to other reasons such as termination of treatment, thrombosis, or CVPS dysfunction (patients without bacterial infections, group B, 6 men, 8 women) 299.9 ± 261.2 days after CVPS implantation. A sample of the encapsulating tissue covering the CVPS together with surrounding tissue (at least 1 × 1 cm2) was placed in a small container with fixing agent, a buffered neutral 4% formalin solution (pH 7). Histological sections of the samples were prepared for light microscopic analysis after paraffin embedding. Sections of 3 μm were cut and stained with haematoxylin and eosin, Weigert's elastic stain, and Heidenhain's azan stain. There was no difference in thickness, collagen and elastin content, or cell and capillary density of the fibrous capsule between both groups. Due to the wound healing reaction involving angiogenesis and fibroblast activation cell density and number of capillaries in the capsule tissue of all patients showed a positive correlation (r = 0.45, p < 0.05). However, the study demonstrated that at the end of the foreign body reaction the artificial tissue layer which covers the CVPS after implantation due to foreign body reaction shows only low reactivity towards infections.

Topics: Adult; Aged; Bacterial Infections; Biocompatible Materials; Blood Pressure; Capillaries; Catheterization, Central Venous; Central Venous Catheters; Collagen; Elasticity; Elastin; Female; Fibroblasts; Foreign-Body Reaction; Humans; Infusions, Intravenous; Male; Middle Aged; Neovascularization, Pathologic; Postoperative Complications; Surgical Wound Infection; Wound Healing

Skin grafts with an artificial dermis have been widely used as a part of the efforts to minimize contractures and reduce donor-site scars. We conducted a prospective randomized clinical trial to study the effect of a dermal substitute by measuring the size of the graft after surgery for months.. The artificial dermis (Matriderm, Dr. Suwelack Skin and Health Care AG, Billerbeck, Germany) was applied in combination with a split-thickness autograft in 40 patients with acute burn wounds or scar reconstruction. Demographic and medical data were collected on each patient. We directly measured the graft size by using a transparent two-ply film (Visitrak Grid, Smith & Nephew Wound Management, Inc, Largo, FL, USA) intraoperatively and 1, 2, 3, and 6 months postoperatively. For effective data comparison, the size of the graft at the time of surgery was taken to be "100%." Then, the size in each phase was estimated in percentage (%).. During the 1st month, the average size was 89%. The figure decreased to 86% and 82% in the 2nd and 3rd months, respectively. In the 6th month, it slightly rebounded to 85% but failed to return to the original state. The size of patients with acute burns was smaller than the size of scar patients as follows: 85-91% in the 2nd month, 81-87% in the 3rd month, and 85-96% in the 6th month.. This study examined the progress of skin grafts through the measurement of graft size in the human body. The grafted skin underwent contracture and remodeling for 3-6 months. In terms of skin contraction, an acute burn was more serious than scar reconstruction. The use of an artificial dermis that contains elastin is very effective from the functional and esthetic perspective by minimizing contractures and enhancing skin elasticity.

Topics: Adolescent; Adult; Burns; Child; Child, Preschool; Cicatrix; Collagen; Contracture; Elastin; Female; Humans; Infant; Male; Middle Aged; Organ Size; Postoperative Complications; Skin; Skin Transplantation; Skin, Artificial; Treatment Outcome; Young Adult

Adherent scars on the hand often lead to a major functional impairment and an aesthetic deformity. The rate of recurrence after scar correction is usually very high. A 57-year-old woman with an adherent scar on the back of her hand and major functional impairment was successfully treated with Matriderm. Using Matriderm as an additional layer between the atrophic skin and the tendons adherency of the scar could be prevented. One year after surgery the patient is free of pain. There is normal mobility between the skin and the underlying tissue. Complete wrist flexion and extension could be achieved. To the best of our knowledge this is the first case reported of using Matriderm for the correction of a scar that was caused by the paravasal injection of cytostatic drugs.

Topics: Absorbable Implants; Antineoplastic Agents; Breast Neoplasms; Cicatrix; Collagen; Dermatologic Surgical Procedures; Drug Eruptions; Elastin; Extravasation of Diagnostic and Therapeutic Materials; Female; Hand; Hand Deformities, Acquired; Humans; Infusions, Intravenous; Middle Aged; Postoperative Complications; Reoperation; Skin; Skin, Artificial; Suture Techniques; Tissue Adhesions

The major morbidity of colorectal anastomoses is leaks. The concept of staple-line reinforcement is a growing area of interest. In this study, we evaluated the feasibility and effect of utilizing AlloDerm to bolster end-to-end stapled rectal anastomoses in a porcine model.. A total of 30 female 45-kg domestic pigs were studied, and each served as its own control by creating a bolstered and unbolstered anastomosis in each animal. All anastomoses were created with a 29-mm end-to-end stapling device. Bolstered anastomoses were randomized to proximal and distal positions along the rectum, and each rectorectal anastomosis was separated by an average of 10 cm. In 20 pigs, an unmeshed bolster of a 0.5-0.7-mm thickness was used. The remaining 10 pigs had a 1:1 meshed bolster that was 0.34-0.51 mm thick. The animals were survived for 14 days. Barium enemas were then performed and the two anastomotic sites harvested, and each anastomosis underwent burst testing. The internal diameter of each anastomosis was measured and a biochemical analysis was performed for matrix metalloproteinase (MMP), elastin and collagen content.. The unmeshed bolstered anastomoses burst fewer times than the unbolstered anastomoses (P=0.004) and had higher burst pressures (P=0.023), though their anastomotic circumferences were smaller (P=0.007). Meshed bolsters offered no strength advantage to anastomoses and were significantly (P=0.009) smaller than unbolstered anastomoses in the same animal. No difference in elastin, collagen, or MMP content was observed between bolstered and unbolstered groups. No animals had clinical or radiographic leaks.. The routine use of unmeshed and 1:1 meshed AlloDerm bolsters is safe and does not appear to inhibit healing in elective colorectal surgery on healthy subjects. AlloDerm may have a role as a tissue bolster in select patients who are more prone to develop anastomotic leaks.

Topics: Anastomosis, Surgical; Animals; Collagen; Elastin; Female; Matrix Metalloproteinases; Postoperative Complications; Prosthesis Design; Random Allocation; Rectum; Skin, Artificial; Sutures; Swine

To study the feasibility of urethral reconstruction with two urethroplasty techniques using an elastin and collagen heterograft in rabbits.. Fifty-two male rabbits were studied. Two types of injury, (1) a 1.5 x 0.6 cm2 semicircumferential defect; (2) a 1.5 cm segmental defect of the penile urethra, were created and repaired using size-matched elastin and collagen patches or tubed conduits. Urethral repair by primary closure for the type 1 injury and a tubularized autologous bladder mucosal graft for the type 2 injury served as controls. At 3 months, urethral diameter was measured with retrograde urethrography. The animals were then euthanized for histological examination.. The postoperative complication rate was significantly higher in the urethral reconstructions using tubed collagen (83%) and elastin (50%) grafts compared to the patch onlay grafts (p = 0.001 for collagen and p = 0.01 for elastin) and tubularized ABM (10%, p = 0.003 and 0.05, respectively). At the type 2 injury site, a dense circumferential fibrosis developed after all repairs. Only minimal ventral fibrosis presented in the type 1 injury repair. The intensity of chronic inflammation and fibrosis was greatest when collagen was used for the urethral repair. In the elastin urethral repairs the urethral diameter decreased significantly for the tubed repair compared to the patch onlay (p = 0.02).. Urethral injury repair using elastin and collagen biomaterials is feasible in the rabbit model. The results of onlay urethroplasty using the elastin and collagen patches are significantly superior to those using the elastin and collagen tubed conduits.

Topics: Animals; Biocompatible Materials; Collagen; Elastin; Fibrosis; Male; Plastic Surgery Procedures; Postoperative Complications; Rabbits; Urethra; Urethral Diseases; Urologic Surgical Procedures

Bioprosthetic heart valves fabricated from glutaraldehyde crosslinked porcine aortic valves often fail because of calcific degeneration. Calcification occurs in both cusp and aortic wall portions of bioprosthetic heart valves. The purpose of this study was to discern the role of different aortic wall components in the calcification process. Thus, we selectively extracted cells and other extracellular matrix proteins from porcine aorta using trypsin/DNase/RNase, cyanogen bromide (CNBr), and sodium hydroxide (NaOH) treatments and subdermally implanted these pretreated aortas in young rats. Total DNA and phospholipid data showed complete removal of cells by CNBr and NaOH treatments, whereas trypsin/DNase/RNase treatment was effective in removing DNA but not phospholipids. As shown by amino acid data and Masson's trichrome staining, collagen was removed in CNBr and NaOH treatments. Control fresh porcine aorta calcified significantly after 21 days of implantation (Ca 26.4 +/- 2.4 microg/mg). Removal of cells and collagen from the aorta by CNBr treatment did not lead to a statistically significant reduction in aortic calcification (Ca 20.8 +/- 3.0 microg/mg). Moreover, partial degradation of elastin fibers caused by NaOH (during extraction) and trypsin treatment (after implantation) of the aorta significantly increased elastin-oriented calcification (Ca 94.4 +/- 9.3 and 58.4 +/- 4.6 microg/mg, respectively). Our results indicate that the elastin component of the aorta may undergo independent calcification irrespective of devitalized cell-mediated calcification observed in glutaraldehyde crosslinked aortas. Our results also demonstrate the importance of studying elastin-oriented calcification in decellularized elastin-rich aortic matrices currently used in tissue-engineering applications.

Topics: Amino Acids; Animals; Aorta; Aortic Diseases; Bioprosthesis; Calcinosis; Cross-Linking Reagents; Cyanogen Bromide; Dermis; DNA; Elastic Tissue; Elastin; Extracellular Matrix; Glutaral; Heart Valve Prosthesis; Male; Phospholipids; Postoperative Complications; Rats; Sodium Hydroxide; Swine; Transplantation, Heterologous; Transplantation, Heterotopic; Trypsin

Endopatch E-F is a new product elaborated with natural human and animal proteins. Its synthesis originates in a covalent link between elastin and fibrin monomers. Numerous experimental studies carried out in animal have previously shown its ability to reinforce healing process of digestive wall. The results reported herein have been obtained in very selected patients in whom a digestive anastomosis had to be done in spite of unfavorable circumstances, such as intra-abdominal infection, radiated bowel or ascitis. From October 1990 to October 1992, 21 digestive anastomosis have been performed in 18 patients. All were reinforced by Endopatch E-F. Two deaths have been observed (mortality: 11.1%), which do not look like a consequence of the use of the product (One myocardial infarction and one cirrhotic failure). There were 2 post-operative fistulas (9.5% of the whole anastomosis). No patients had any reaction of intolerance. These preliminary results confirm experimental data, and suggest that Endopatch EF can be used in order to reinforce digestive sutures when performed under unfavorable circumstances.

Topics: Adult; Aged; Aged, 80 and over; Biocompatible Materials; Elastin; Female; Fibrin; Humans; Male; Middle Aged; Postoperative Complications; Sepsis; Sutures; Wound Healing

In experimental piglets after heterotopic heart transplant, we observed an immune/inflammatory response in the coronary arteries with increased expression of interleukin-1 beta and accumulation of fibronectin and smooth muscle cells in the subendothelium (N. Clausell, S. Molossi, M. Rabinovitch, Am J Pathol 1993, 142, 1772-1786). Proteolytic enzymes including elastases regulate cytokine activity and are associated with the development of neointimal proliferation. We now report ultrastructural evidence of elastolytic activity in the donor compared to host coronary arteries judged by a fivefold increase in the breaks in the internal elastic lamina, (P < 0.01) correlating with a 10-fold increase in elastase activity per mg tissue (P < 0.01). The enzyme activity is serine elastase, i.e., inhibited by phenylmethyl sulfonyl fluoride, and elafin but not EDTA. Using a novel strategy that greatly increases the activity extractable from the tissue, we resolved the enzyme on an elastin substrate gel as a protein of approximately 23 kd. Ours is the first report and characterization of increased elastase activity associated with the development of the post-cardiac transplant coronary arteriopathy. The source may be inflammatory or smooth muscle cells, and elastase may play a pathophysiological role in neointimal proliferation by activating cytokines and growth factors and by release of chemotactic peptides.

Topics: Animals; Coronary Disease; Elastin; Heart Transplantation; Microscopy, Electron; Pancreatic Elastase; Postoperative Complications; Serine; Swine

We investigated the use of a sheet of polypentapeptide of elastin as a physical barrier to adhesion formation in a contaminated peritoneal wound model. A total of 88 rats were studied with random assignment of animals to three study groups; control (29), polypentapeptide steam sterilized (30), and polypentapeptide gas sterilized (29). Animals were anesthetized and a laparotomy was conducted to reveal the cranial portion of the ileum. The abdominal wall muscle peritoneum was excoriated until hemorrhage was noted. In sham animals, there was no physical barrier placed between bowel loop and the abdominal wall. In two of the study groups, the polypentapeptide sheet was placed directly over the excoriated area. The intestinal loop was then loosely secured to excoriated area with 2-O nylon (stay suture) which was tied subcutaneously in all groups. Four puncture wounds were made with a 20-gauge hypodermic needle in the bowel that was apposed to the excoriated peritoneal musculature which allowed leakage of intestinal contents and contamination. On Day 7 postsurgery, the animals were anesthetized and the stay suture was removed. On Day 14, all animals were sacrificed and adhesions were graded. The incidence of significant adhesions was 28% for the barrier group versus 90% for control animals (P < 0.05). The results of this study indicate that the polypentapeptide of elastin sheet is an effective physical barrier in this surgically induced contaminated wound model.

Topics: Animals; Elastin; Gastrointestinal Hemorrhage; Intestinal Diseases; Intestines; Peritoneum; Polymers; Postoperative Complications; Prostheses and Implants; Punctures; Rats; Tissue Adhesions

Topics: Adult; Animals; Bronchoscopy; Elastin; Granulation Tissue; Humans; Infant; Male; Methods; Polymers; Postoperative Complications; Prostheses and Implants; Radiography; Sheep; Silicones; Sutures; Trachea; Tracheal Stenosis