Skin thickness of the anterior, anteromedial, and anterolateral thigh: a cadaveric study for split-skin graft donor sites

Background: The depth of graft harvest and the residual dermis available for reepithelization primarily influence the healing of split-skin graft donor sites. When the thigh region is chosen, the authors hypothesize based on thickness measurements that the anterolateral region is the optimal donor site. Methods: Full-thickness skin specimens were sampled from the anteromedial, anterior, and anterolateral regions of human cadavers. Skin specimens were cut perpendicularly with a custom-made precision apparatus to avoid the overestimation of thickness measurements. The combined epidermal and dermal thicknesses (overall skin thickness) were measured using a digital calliper. The specimens were histologically stained to visualize their basement membrane, and microscopy images were captured. Since the epidermal thickness varies across the specimen, a stereological method was used to eliminate observer bias. Results: Epidermal thickness represented 2.5% to 9.9% of the overall skin thickness. There was a significant difference in epidermal thickness from one region to another (P<0.05). The anterolateral thigh region had the most consistent and highest mean epidermal thickness (60±3.2 µm). We observed that overall skin thickness increased laterally from the anteromedial region to the anterior and anterolateral regions of the thigh. The overall skin thickness measured 1,032±435 µm in the anteromedial region compared to 1,220±257 µm in the anterolateral region. Conclusions: Based on skin thickness measurements, the anterolateral thigh had the thickest epidermal and dermal layers. We suggest that the anterolateral thigh region is the optimal donor site for split-skin graft harvests from the thigh

Evaluating the Educational Use of Ultrasound and Custom-Made Imaging Phantoms in Anatomy Teaching

The use of ultrasound as a teaching adjunct is growing quickly, as it allows learners to visualise structures from an integrated perspective enhancing understanding of topographic anatomy. Ultrasound also allows vocational learners to practise important skills (e.g. central venous catheterisation on imaging phantoms). The perceived educational usefulness of hands-on ultrasound and imaging phantoms was assessed using a 0-5 Likert scale. The custom-made phantom was designed in-house using gelatine and penne pasta simulating the echogenicity of neck vessels with and without atherosclerotic plaques. Undergraduate honours science students, from a clinically applied anatomy course, were invited to complete a fully anonymous questionnaire in January 2019 at the University of Glasgow, UK. The teaching session focused on cerebrovascular disease and the students actively scanned the phantoms in the context of carotid disease. As these data were collected anonymously for teaching evaluation to inform future practice, ethical approval was not sought. Data were analysed in SPSS version 24 using non-parametric tests. Twenty-eight out of forty-seven students returned the questionnaires (60% response rate). Based on their experience, 100% of respondents would recommend the use of ultrasound for anatomy learning. The mean score for the perceived usefulness of the ultrasound and imaging phantom as teaching adjuncts in learning the content was 4.96 (SD: 0.189; min-max range: 4-5) and 4.82 (SD: 0.390; min-max range: 4-5) respectively. The mean score for the interaction with the ultrasound aiding understanding of the content was 4.79 (SD: 0.499; min-max range: 3-5). There was a statistically significant correlation between the perceived ultrasound usefulness and the interaction aiding understanding (r=0.394; p=0.038). These data not only highlight the usefulness of hands-on ultrasound within educational settings, but also the potential applications of custom-made imaging phantoms. This area is evolving quickly and more research will allow educationalists to better delineate the role of ultrasound and phantoms

Renal pathology in a mouse model of severe Spinal Muscular Atrophy is associated with downregulation of Glial Cell-Line Derived Neurotrophic Factor (GDNF)

Acknowledgements: We would like to acknowledge the Microscopy and Histology Core Facility members; Kevin Mackenzie, Debbie Wilkinson, Gillian Milne and Lucy Wight at the University of Aberdeen, and Margaret Mullin at the Glasgow Imaging Facility, University of Glasgow, for their support, assistance and use of the facilities. Funding: SMA Europe and an Anatomical Society PhD Studentship to S.H.P. and H.A.; the Deutsche Muskelstiftung (E-2019-01 to P.C.)Peer reviewedPostprin

COVID-19 and anatomy: Stimulus and initial response.

The outbreak of COVID-19, resulting from widespread transmission of the SARS-CoV-2 virus, represents one of the foremost current challenges to societies across the globe, with few areas of life remaining untouched. Here, we detail the immediate impact that COVID-19 has had on the teaching and practice of anatomy, providing specific examples of the varied responses from several UK, Irish and German universities and medical schools. Alongside significant issues for, and suspension of, body donation programmes, the widespread closure of university campuses has led to challenges in delivering anatomy education via online methods, a particular problem for a practical, experience-based subject such as anatomy. We discuss the short-term consequences of COVID-19 for body donation programmes and anatomical education, and highlight issues and challenges that will need to be addressed in the medium to long term in order to restore anatomy education and practice throughout the world

Neutralisation of SARS-CoV-2 by anatomical embalming solutions.

Teaching and learning anatomy by using human cadaveric specimens has been a foundation of medical and biomedical teaching for hundreds of years. Therefore, the majority of institutions that teach topographical anatomy rely on body donation programmes to provide specimens for both undergraduate and postgraduate teaching of gross anatomy. The COVID-19 pandemic has posed an unprecedented challenge to anatomy teaching because of the suspension of donor acceptance at most institutions. This was largely due to concerns about the potential transmissibility of the SARS-CoV-2 virus and the absence of data about the ability of embalming solutions to neutralise the virus. Twenty embalming solutions commonly used in institutions in the United Kingdom and Ireland were tested for their ability to neutralise SARS-CoV-2, using an established cytotoxicity assay. All embalming solutions tested neutralised SARS-CoV-2, with the majority of solutions being effective at high-working dilutions. These results suggest that successful embalming with the tested solutions can neutralise the SARS-CoV-2 virus, thereby facilitating the safe resumption of body donation programmes and cadaveric anatomy teaching

The Legal and Ethical Framework Governing Body Donation in Europe - 2nd update on Current Practice.

BACKGROUND In 2008, members of the TEPARG provided first insights into the legal and ethical framework governing body donation in Europe. In 2012, a first update followed. This paper is now the second update on this topic and tries to extend the available information to many mor European contries. METHODS For this second update, we have asked authors from all European countries to contribute their national perspectives. By this inquiry, we got many contributions compiled in this paper. When we did not get a personal contribution, one of us (EB) searched the internet for relevant information. RESULTS Perspectives on the legal and ethical framework governing body donation in Europe. CONCLUSIONS We still see that a clear and rigorous legal framework is still unavailable in several countries. We found national regulations in 18 out of 39 countries; two others have at least federal laws. Several countries accept not only donated bodies but also utilise unclaimed bodies. These findings can guide policymakers in reviewing and updating existing laws and regulations related to body donation and anatomical studies

Skin and diabetes mellitus: what do we know?

Diabetes mellitus (DM) is becoming increasingly prevalent worldwide. Although major complications of this condition involve kidney, retina and peripheral nerves, the skin of diabetic patients is also frequently injured. Hence, interest is mounting in the definition of the structural and molecular profile of non-complicated diabetic skin, i.e., before injuries occur. Most of the available knowledge in this area has been obtained relatively recently and, in part, derives from various diabetic animal models. These include both insulin-dependent and insulin-resistant models. Structural work in human diabetic skin has also been carried out by means of tissue samples or of non-invasive methods. Indications have indeed been found for molecular/structural changes in diabetic skin. However, the overall picture that emerges is heterogeneous, incomplete and often contradictory and many questions remain unanswered. This review aims to detail, as much as possible, the various pieces of current knowledge in a systematic and synoptic manner. This should aid the identification of areas in which key questions are still open and more research is needed. A comprehensive understanding of this field could help in determining molecular targets for the prevention and treatment of skin injuries in DM and markers for the monitoring of cutaneous and systemic aspects of the disease. Additionally, with the increasing development of non-invasive optics-based deep-tissue-imaging diagnostic technologies, precise knowledge of cutaneous texture and molecular structure becomes an important pre-requisite for the use of such methods in diabetic patients

The role of basement membranes in cardiac biology and disease

Basement membranes are highly specialised extracellular matrix structures that within the heart underlie endothelial cells and surround cardiomyocytes and vascular smooth muscle cells. They generate a dynamic and structurally supportive environment throughout cardiac development and maturation by providing physical anchorage to the underlying interstitium, structural support to the tissue, and by influencing cell behaviour and signalling. While this provides a strong link between basement membrane dysfunction and cardiac disease, the role of the basement membrane in cardiac biology remains under-researched and our understanding regarding the mechanistic interplay between basement membrane defects and their morphological and functional consequences remain important knowledge-gaps. In this review we bring together emerging understanding of basement membrane defects within the heart including in common cardiovascular pathologies such as contractile dysfunction and highlight some key questions that are now ready to be addressed

The cutting edge of cardiovascular anatomy

No abstract available