Deep sternal wound infection following cardiac surgery. A comparison of the monolateral with the bilateral pectoralis major flaps

Deep sternal wound infections are a serious complication following sternotomy for cardiothoracic surgery. “Conventional” treatment provides debridement and secondary closure or closed catheter irrigation. The combination of the Negative Pressure Therapy with flap coverages is an accepted technique and one or both Pectoralis Major muscles could be chosen. A multistep protocol was adopted. One hundred and sixty seven patients were treated with the combination of Negative Pressure Therapy with the Pectoralis Major muscle flap: 86 monolateral flap and 81 bilateral flap reconstruction. The main complications (hematoma, seroma, dehiscence, and re-infection), the need for re-intervention, mortality rates, Intensive Care Unit, and hospitalisation time were assessed. The mono-pectoralis group had fewer complications and need for revision, with a shorter hospital stay. A statistically significant difference emerged for the hematoma rate (P =.0079). Monolateral flap should to be preferred because with the same coverage effectiveness, it guarantees the saving of controlateral muscle with its functionality and the possibility of its use in case of failure. Furthermore, as the technique is less invasive, it can be reserved for more fragile patients

Ascending aorta disruption after thoracic blunt trauma

Blunt traumatic aortic injury is the second leading cause of death after motor vehicle accident. The most frequent localisation of aortic lesion is the isthmus, especially in those patients who survive the accident. Here we report a case of blunt traumatic aortic injury with unusual localisation and modality. A 31 years old man sustained a motorcycle accident, being run over by a car. Computed tomography scan showed an atypical ascending aorta lesion, confirmed by intraoperative finding. The patient underwent emergency ascending aorta replacement with Dacron tubular graft. The patient was discharged well on 35th postoperative day, after multiple maxillofacial surgeries for concomitant injuries

The dimensional stability of a CFRP structure probed with sub-micrometer accuracy in varying external condition

The paper presents the thermal deformations of a CFRP High Dimensional Stability Structure. With an experimental facility designed and tested to undergo negligible deformations, ten points of the UV-spectrometer' support (Test Article, TA) have been monitored with triaxial capacitive transducers, both in vacuum and in dry nitrogen atmosphere, with temperature variations in the range 253÷333K. The measured deformations differ from point to point: +4.05±0.01μm/K has been the largest dimensional variation measured in one point of TA and in one direction, whereas -0.05±0.02μm/K has been the smallest one, in another point and in a different direction. All the obtained results agree within ±2μm/K with the computer simulated tests accomplished in the design of TA. A complete analysis of the sources of uncertainty assures the displacement' measurements' accuracy has been ≤0.1μm, whatever the experimental conditions. The dimensional stability of the TA has been verified finally with a series of hygro-thermal cycles The results show that permanent deformations not larger than ±2μm occurred in a limited number of point

The dimensional stability of a CFRP structure probed with sub-micrometer accuracy in varying external condition

The paper presents the thermal deformations of a CFRP High Dimensional Stability Structure. With an experimental facility designed and tested to undergo negligible deformations, ten points of the UV-spectrometer' support (Test Article, TA) have been monitored with triaxial capacitive transducers, both in vacuum and in dry nitrogen atmosphere, with temperature variations in the range 253÷333K. The measured deformations differ from point to point: +4.05±0.01μm/K has been the largest dimensional variation measured in one point of TA and in one direction, whereas -0.05±0.02μm/K has been the smallest one, in another point and in a different direction. All the obtained results agree within ±2μm/K with the computer simulated tests accomplished in the design of TA. A complete analysis of the sources of uncertainty assures the displacement' measurements' accuracy has been ≤0.1μm, whatever the experimental conditions. The dimensional stability of the TA has been verified finally with a series of hygro-thermal cycles The results show that permanent deformations not larger than ±2μm occurred in a limited number of points

Sars-cov-2 and atherosclerosis. should covid-19 be recognized as a new predisposing cardiovascular risk factor

At the beginning of the COVID-19 pandemic, the lung was recognized as the main target organ; now, new evidence suggests that SARS-CoV-2 infection leads to vascular disease. In a previous review, we supposed a bidirectional link between endothelial dysfunction and COVID-19, identifying atherosclerosis as having a crucial role in its pathogenesis. Atherosclerosis with an existing endothelial dysfunction may worsen COVID-19 manifestations, leading to adverse outcomes, as largely reported. However, COVID-19 may be the trigger factor in the progression of the atherosclerotic process up to making it clinically manifest. The thrombotic complications can involve not only the atherosclerotic plaque, but also the durability of the surgical device implanted to treat a pre-existing coronary artery disease as recently reported. The burden of the disease makes necessary a long-term stratification of patients, revising drastically targeted therapy among others