Abstract

Capsular contracture (CC) is one of the most common complications of implant-based breast reconstruction or augmentation surgery. Common risk factors of CC include biofilm, surgical site infections, history of prior CC or fibrosis, history of radiation therapy, and implant characteristics. Though bacterial contamination of breast protheses is associated with adverse sequelae, there are not universally accepted guidelines and limited best practice recommendations for antimicrobial breast pocket irrigation. Despite advanced molecular biology, the exact mechanism of this complication is not fully understood. Interventions that decrease the rate of CC include antibiotic prophylaxis or irrigation, acellular dermal matrix, leukotriene inhibitors, surgical techniques, and others. However, there is inconsistent evidence supporting these risk factors, and the current data was based on broad heterogeneous studies. The objective of this review was to provide a summary of the current data of contributing risk factors as  well as preventative and treatment measures for CC.

Abstract

Burn injuries present a persistent health challenge, particularly in Indonesia. In extensive burns, xenografts are valuable for temporary wound coverage. However, accessibility to certain xenografts is limited due to cultural, financial, and religious considerations or aesthetic drawbacks, such as the scaly appearance of tilapia fish skin. Striped catfish (*Pangasius hypophthalmus*), a scaleless fish rich in type 1 collagen, may offer a promising alternative. This study aimed to evaluate the suitability of striped catfish skin as a xenograft by comparing its characteristics to those of commonly used Nile tilapia and porcine skin xenografts.

Methods: In this experimental study, nine different skin samples from striped catfish, Nile tilapia, and porcine sources were prepared and examined histologically using hematoxylin-eosin staining. Macroscopic and microscopic features of each sample were documented and analyzed.

Abstract

Acute peritonitis is a relatively common intra-abdominal infection that a general surgeon will have to manage many times in his surgical carrier. Usually it is a secondary peritonitis caused either by direct peritoneal invasion from an inflamed infected viscera or by gastrointestinal tract integrity loss. The mainstay of treatment is source control of the infection which is in most cases surgical. In the physiologically deranged patient there is indication for source control surgery in order to restore the patient’s physiology and not the patient anatomy utilizing a step approach and allowing the patient to resuscitate in the intensive care unit. In such cases there is a clear indication for relaparotomy and the most common strategy applied is open abdomen. In the open abdomen technique the fascial edges are not approximated and a temporarily closure technique is used. In such cases the negative pressure wound therapy seems to be the most favourable technique, as especially in combination with fascial traction either by sutures or by mesh gives the best results regarding delayed definite fascial closure, and morbidity and mortality. In our surgical practice we utilize in most cases the use of negative pressure wound therapy with a temporary mesh placement. In the initial laparotomy the mesh is placed to approximate the fascial edges as much as possible without whoever causing abdominal hypertension and in every relaparotomy the mesh is divided in the middle and, after the end of the relaparotomy and dressing change, is approximated as much as possible in order for the fascial edges to be further approximated. In every relaparotomy the mesh is further reduced to finally allow definite closure of the aponeurosis. In the presence of ostomies the negative pressure wound therapy can be applied as usual taking care just to place the dressing around the stoma and the negative pressure can be the standard of -125 mmHg. However, in the presence of anastomosis the available date are scarce and the possible strategies are to differ the anastomosis for the relaparotomy with definitive closure and no further need of negative pressure wound therapy, to low the pressure to -25 mmHg in order to protect the anastomosis and to place the anastomosis with omentum in order to avoid direct contact to the dressing. The objective should be early closure, within 7 days, of the open abdomen to reduce mortality and complications.

Abstract

Urban green spaces play a dual role in both enhancing city environments and acting as reservoirs
for dust particles that carry hazardous microorganisms. These microorganisms, accumulated on
plant surfaces, pose significant risks to human health, particularly by affecting skin integrity and
increasing susceptibility to infections. My research delves into how these environmental
microorganisms can contribute to health complications on environemnt and human health, by
understanding the role of microorganisms in urban green spaces and their impact on pollution and
public health. Specifically, to investigates how dust particles on plant leaves accumulate
microorganisms and influence environmental quality and human well-being. By understanding
these environmental hazards, we can develop targeted interventions to minimize their impact on
human being. The findings will help to mitigate infection risks by recognizing external
environmental factors that may compromise skin health and other complications. The research
emphasizes the need for integrating environmental awareness into clinical practices, offering a new
perspective on protecting allergic patients from harmful microbial exposures in urban settings.