@article{BalakirskiKotliarPaulyetal.2018, author = {Balakirski, Galina and Kotliar, Konstantin and Pauly, Karolin J. and Krings, Laura K. and R{\"u}bben, Albert and Baron, Jens M. and Schmitt, Laurenz}, title = {Surgical Site Infections After Dermatologic Surgery in Immunocompromised Patients: A Single-Center Experience}, series = {Dermatologic Surgery}, journal = {Dermatologic Surgery}, number = {44 (12)}, publisher = {Wolters Kluwer}, doi = {10.1097/DSS.0000000000001615}, pages = {1525 -- 1536}, year = {2018}, abstract = {BACKGROUND Immunosuppression is often considered as an indication for antibiotic prophylaxis to prevent surgical site infections (SSI) while performing skin surgery. However, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. PATIENTS AND METHODS All patients of the Department of Dermatology and Allergology at the University Hospital of RWTH Aachen in Aachen, Germany, who underwent hospitalization for a dermatologic surgery between June 2016 and January 2017 (6 months), were followed up after surgery until completion of the wound healing process. The follow-up addressed the occurrence of SSI and the need for systemic antibiotics after the operative procedure. Immunocompromised patients were compared with immunocompetent patients. The investigation was conducted as a retrospective analysis of patient records. RESULTS The authors performed 284 dermatologic surgeries in 177 patients. Nineteen percent (54/284) of the skin surgery was performed on immunocompromised patients. The most common indications for surgical treatment were nonmelanoma skin cancer and malignant melanomas. Surgical site infections occurred in 6.7\% (19/284) of the cases. In 95\% (18/19), systemic antibiotic treatment was needed. Twenty-one percent of all SSI (4/19) were seen in immunosuppressed patients. CONCLUSION According to the authors' data, immunosuppression does not represent a significant risk factor for SSI after dermatologic surgery. However, larger prospective studies are needed to make specific recommendations on the use of antibiotic prophylaxis while performing skin surgery in these patients. The available data on complications after dermatologic surgery have improved over the past years. Particularly, additional risk factors have been identified for surgical site infections (SSI). Purulent surgical sites, older age, involvement of head, neck, and acral regions, and also the involvement of less experienced surgeons have been reported to increase the risk of the SSI after dermatologic surgeries.1 In general, the incidence of SSI after skin surgery is considered to be low.1,2 However, antibiotics in dermatologic surgeries, especially in the perioperative setting, seem to be overused,3,4 particularly regarding developing antibiotic resistances and side effects. Immunosuppression has been recommended to be taken into consideration as an additional indication for antibiotic prophylaxis to prevent SSI after skin surgery in special cases.5,6 However, these recommendations do not specify the exact dermatologic surgeries, and were not specifically developed for dermatologic surgery patients and treatments, but adopted from other surgical fields.6 According to the survey conducted on American College of Mohs Surgery members in 2012, 13\% to 29\% of the surgeons administered antibiotic prophylaxis to immunocompromised patients to prevent SSI while performing dermatologic surgery on noninfected skin,3 although this was not recommended by Journal of the American Academy of Dermatology Advisory Statement. Indeed, the data on the risk of developing SSI after dermatologic surgery in immunosuppressed patients are limited. However, it is possible that due to the insufficient evidence on the risk of SSI occurrence in this patient group, dermatologic surgeons tend to overuse perioperative antibiotic prophylaxis. To make specific recommendations on the use of antibiotic prophylaxis in immunosuppressed patients in the field of skin surgery, more information about the incidence of SSI after dermatologic surgery in these patients is needed. The aim of this study was to fill this data gap by investigating whether there is an increased risk of SSI after skin surgery in immunocompromised patients compared with immunocompetent patients.}, language = {en} } @article{RittwegerAlbrachtFluecketal.2018, author = {Rittweger, J{\"o}rn and Albracht, Kirsten and Fl{\"u}ck, Martin and Ruoss, Severin and Brocca, Lorenza and Longa, Emanuela and Moriggi, Manuela and Seynnes, Olivier and Di Giulio, Irene and Tenori, Leonardo and Vignoli, Alessia and Capri, Miriam and Gelfi, Cecilia and Luchinat, Claudio and Franceschi, Claudio and Bottinelli, Roberto and Cerretelli, Paolo and Narici, Marco}, title = {Sarcolab pilot study into skeletal muscle's adaptation to longterm spaceflight}, series = {npj Microgravity}, volume = {4}, journal = {npj Microgravity}, number = {1}, publisher = {Nature Portfolio}, issn = {2373-8065}, doi = {10.1038/s41526-018-0052-1}, pages = {1 -- 9}, year = {2018}, language = {en} } @article{CiritsisHorbachStaatetal.2018, author = {Ciritsis, Alexander and Horbach, Andreas and Staat, Manfred and Kuhl, Christiane K. and Kraemer, Nils Andreas}, title = {Porosity and tissue integration of elastic mesh implants evaluated in vitro and in vivo}, series = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials}, volume = {106}, journal = {Journal of Biomedical Materials Research: Part B: Applied Biomaterials}, number = {2}, publisher = {Wiley}, address = {New York, NY}, issn = {1552-4981}, doi = {10.1002/jbm.b.33877}, pages = {827 -- 833}, year = {2018}, abstract = {Purpose In vivo, a loss of mesh porosity triggers scar tissue formation and restricts functionality. The purpose of this study was to evaluate the properties and configuration changes as mesh deformation and mesh shrinkage of a soft mesh implant compared with a conventional stiff mesh implant in vitro and in a porcine model. Material and Methods Tensile tests and digital image correlation were used to determine the textile porosity for both mesh types in vitro. A group of three pigs each were treated with magnetic resonance imaging (MRI) visible conventional stiff polyvinylidene fluoride meshes (PVDF) or with soft thermoplastic polyurethane meshes (TPU) (FEG Textiltechnik mbH, Aachen, Germany), respectively. MRI was performed with a pneumoperitoneum at a pressure of 0 and 15 mmHg, which resulted in bulging of the abdomen. The mesh-induced signal voids were semiautomatically segmented and the mesh areas were determined. With the deformations assessed in both mesh types at both pressure conditions, the porosity change of the meshes after 8 weeks of ingrowth was calculated as an indicator of preserved elastic properties. The explanted specimens were examined histologically for the maturity of the scar (collagen I/III ratio). Results In TPU, the in vitro porosity increased constantly, in PVDF, a loss of porosity was observed under mild stresses. In vivo, the mean mesh areas of TPU were 206.8 cm2 (± 5.7 cm2) at 0 mmHg pneumoperitoneum and 274.6 cm2 (± 5.2 cm2) at 15 mmHg; for PVDF the mean areas were 205.5 cm2 (± 8.8 cm2) and 221.5 cm2 (± 11.8 cm2), respectively. The pneumoperitoneum-induced pressure increase resulted in a calculated porosity increase of 8.4\% for TPU and of 1.2\% for PVDF. The mean collagen I/III ratio was 8.7 (± 0.5) for TPU and 4.7 (± 0.7) for PVDF. Conclusion The elastic properties of TPU mesh implants result in improved tissue integration compared to conventional PVDF meshes, and they adapt more efficiently to the abdominal wall. © 2017 Wiley Periodicals, Inc. J Biomed Mater Res Part B: Appl Biomater, 106B: 827-833, 2018.}, language = {en} } @article{HorbachStaat2018, author = {Horbach, Andreas and Staat, Manfred}, title = {Optical strain measurement for the modeling of surgical meshes and their porosity}, series = {Current Directions in Biomedical Engineering}, volume = {Band 4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, issn = {2364-5504}, doi = {10.1515/cdbme-2018-0045}, pages = {181 -- 184}, year = {2018}, abstract = {The porosity of surgical meshes makes them flexible for large elastic deformation and establishes the healing conditions of good tissue in growth. The biomechanic modeling of orthotropic and compressible materials requires new materials models and simulstaneoaus fit of deformation in the load direction as well as trannsversely to to load. This nonlinear modeling can be achieved by an optical deformation measurement. At the same time the full field deformation measurement allows the dermination of the change of porosity with deformation. Also the socalled effective porosity, which has been defined to asses the tisssue interatcion with the mesh implants, can be determined from the global deformation of the surgical meshes.}, language = {en} } @article{BhattaraiStaat2018, author = {Bhattarai, Aroj and Staat, Manfred}, title = {Computational comparison of different textile implants to correct apical prolapse in females}, series = {Current Directions in Biomedical Engineering}, volume = {4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, doi = {10.1515/cdbme-2018-0159}, pages = {661 -- 664}, year = {2018}, abstract = {Prosthetic textile implants of different shapes, sizes and polymers are used to correct the apical prolapse after hysterectomy (removal of the uterus). The selection of the implant before or during minimally invasive surgery depends on the patient's anatomical defect, intended function after reconstruction and most importantly the surgeon's preference. Weakness or damage of the supporting tissues during childbirth, menopause or previous pelvic surgeries may put females in higher risk of prolapse. Numerical simulations of reconstructed pelvic floor with weakened tissues and organ supported by textile product models: DynaMesh®-PRS soft, DynaMesh®-PRP soft and DynaMesh®-CESA from FEG Textiletechnik mbH, Germany are compared.}, language = {en} } @article{KetelhutGoellBraunsteinetal.2018, author = {Ketelhut, Maike and G{\"o}ll, Fabian and Braunstein, Bj{\"o}rn and Albracht, Kirsten and Abel, Dirk}, title = {Comparison of different training algorithms for the leg extension training with an industrial robot}, series = {Current Directions in Biomedical Engineering}, volume = {4}, journal = {Current Directions in Biomedical Engineering}, number = {1}, publisher = {De Gruyter}, address = {Berlin}, issn = {2364-5504}, doi = {10.1515/cdbme-2018-0005}, pages = {17 -- 20}, year = {2018}, abstract = {In the past, different training scenarios have been developed and implemented on robotic research platforms, but no systematic analysis and comparison have been done so far. This paper deals with the comparison of an isokinematic (motion with constant velocity) and an isotonic (motion against constant weight) training algorithm. Both algorithms are designed for a robotic research platform consisting of a 3D force plate and a high payload industrial robot, which allows leg extension training with arbitrary six-dimensional motion trajectories. In the isokinematic as well as the isotonic training algorithm, individual paths are defined i n C artesian s pace by sufficient s upport p oses. I n t he i sotonic t raining s cenario, the trajectory is adapted to the measured force as the robot should only move along the trajectory as long as the force applied by the user exceeds a minimum threshold. In the isotonic training scenario however, the robot's acceleration is a function of the force applied by the user. To validate these findings, a simulative experiment with a simple linear trajectory is performed. For this purpose, the same force path is applied in both training scenarios. The results illustrate that the algorithms differ in the force dependent trajectory adaption.}, language = {en} } @article{WerkhausenAlbrachtCroninetal.2018, author = {Werkhausen, Amelie and Albracht, Kirsten and Cronin, Neil J and Paulsen, G{\o}ran and Bojsen-M{\o}ller, Jens and Seynnes, Olivier R}, title = {Effect of training-induced changes in achilles tendon stiffness on muscle-tendon behavior during landing}, series = {Frontiers in physiology}, journal = {Frontiers in physiology}, number = {9}, publisher = {Frontiers Research Foundation}, address = {Lausanne}, issn = {1664-042X}, doi = {10.3389/fphys.2018.00794}, pages = {11 Seiten}, year = {2018}, abstract = {During rapid deceleration of the body, tendons buffer part of the elongation of the muscle-tendon unit (MTU), enabling safe energy dissipation via eccentric muscle contraction. Yet, the influence of changes in tendon stiffness within the physiological range upon these lengthening contractions is unknown. This study aimed to examine the effect of training-induced stiffening of the Achilles tendon on triceps surae muscle-tendon behavior during a landing task. Twenty-one male subjects were assigned to either a 10-week resistance-training program consisting of single-leg isometric plantarflexion (n = 11) or to a non-training control group (n = 10). Before and after the training period, plantarflexion force, peak Achilles tendon strain and stiffness were measured during isometric contractions, using a combination of dynamometry, ultrasound and kinematics data. Additionally, testing included a step-landing task, during which joint mechanics and lengths of gastrocnemius and soleus fascicles, Achilles tendon, and MTU were determined using synchronized ultrasound, kinematics and kinetics data collection. After training, plantarflexion strength and Achilles tendon stiffness increased (15 and 18\%, respectively), and tendon strain during landing remained similar. Likewise, lengthening and negative work produced by the gastrocnemius MTU did not change detectably. However, in the training group, gastrocnemius fascicle length was offset (8\%) to a longer length at touch down and, surprisingly, fascicle lengthening and velocity were reduced by 27 and 21\%, respectively. These changes were not observed for soleus fascicles when accounting for variation in task execution between tests. These results indicate that a training-induced increase in tendon stiffness does not noticeably affect the buffering action of the tendon when the MTU is rapidly stretched. Reductions in gastrocnemius fascicle lengthening and lengthening velocity during landing occurred independently from tendon strain. Future studies are required to provide insight into the mechanisms underpinning these observations and their influence on energy dissipation.}, language = {en} }