Is there anybody out there: what do senior surgeons expect of their youngsters?

Surgery is indeed one of the most fascinating medical professions. However, it is also a stressful field of work with a high workload, and often leaves little time for personal and family needs. Within the last decade, a noticeable decline occurred in the willingness of medical students to enter a surgical residency.

Vascular anatomy of the small intestine-a comparative anatomic study on humans and pigs.

Background: Porcine models are well established for studying intestinal anastomotic healing. In this study, we aimed to clarify the anatomic differences between human and porcine small intestines. Additionally, we investigated the influences of longitudinal and circular sutures on human small intestine perfusion.

Comparison of intestinal microcirculation and wound healing in a rat model.

Purpose: If a colonic or small bowel lesion is not accessible for endoscopic mucosal resection, enterotomy is a possible although rarely performed surgical technique. It has never been compared to circular anastomosis regarding leakage rate, bowel wall perfusion, and wound healing. Thus, the aim of this basic experimental scientific study was to investigate perianastomotic microcirculation and wound healing.

Balancing zinc deficiency leads to an improved healing of colon anastomosis in rats.

Background: In colorectal surgery, anastomotic leakage is a relevant complication. The aim of this study was to investigate whether intraperitoneally (i.p.

Zinc deficiency impairs wound healing of colon anastomosis in rats.

Background: Anastomotic leakage is a relevant surgical complication. The aim of the study was to investigate the influence of a controlled preoperative zinc deficiency on the extracellular matrix composition of colon anastomosis.

Materials And Methods: Forty male Wistar rats were randomized to either a zinc deficiency group (n = 20) or a control group (n = 20).

Intraperitoneally applied gentamicin increases collagen content and mechanical stability of colon anastomosis in rats.

Background: Anastomotic leakage remains a serious complication in colorectal surgery, and is being caused by a multitude of factors. Recent reports reveal changes of the extracellular matrix as risk factors as well as gentamicin as a potential agent to influence wound healing. This experimental study was initiated to investigate the influence of intraperitoneally applied gentamicin on colonic anastomotic wound healing and in particular on mechanical stability, overall collagen content and collagen type I/III ratio.

Collagen in colon disease.

The pathophysiology of wound healing in the bowel wall suggests that collagen and matrix metalloproteinases (MMPs) have an important role in the changes of the bowel wall seen in several colonic diseases. Several recent studies suggest that disturbances of the collagen texture and the extracellular matrix (ECM) metabolism are major factors leading to the onset of diverticular disease. Changes of the ECM also play a role in the development of inflammatory bowel diseases.

Incisional hernia: challenge of re-operations after mesh repair.

Background And Aims: The widespread use of meshes for the repair of incisional hernia is currently followed by an increasing number of re-operations. The incidence of incisional hernia recurrence after mesh repair varies between 3 and 32%. The problem of mesh failure and options for another surgical intervention seem rather unattended.

Missing effects of zinc in a porcine model of recurrent endotoxemia.

Background: Chronic human sepsis often is characterised by the compensatory anti-inflammatory response syndrome (CARS). During CARS, anti-inflammatory cytokines depress the inflammatory response leading to secondary and opportunistic infections. Proved in vitro as well as in vivo, zinc's pro-inflammatory effect might overcome this depression.

Incisional hernia: open techniques.

Even with the routine use of mesh, repairing an incisional hernia is a challenge. Increasing evidence of impaired wound healing in these patients supports routine use of an open prefascial, retromuscular mesh repair. Basic pathophysiologic principles dictate that for a successful long-term outcome and prevention of recurrence a wide overlap underneath healthy tissue is required.

Reduced expression of collagen type I and increased expression of matrix metalloproteinases 1 in patients with Crohn's disease.

Crohn's disease (CD) is a chronic inflammatory bowel disease of still unknown etiology. The aim of our study was to find out whether there are any changes in the colonic wall of CD patients that could give hints for a predisposing disorder concerning the extracellular matrix, especially the collagen metabolism. Eight samples of colonic tissue from patients with Crohn's disease were compared to 14 specimens from patients without Crohn's disease.

Effect of zinc pretreatment on pulmonary endothelial cells in vitro and pulmonary function in a porcine model of endotoxemia.

Background: During endotoxemia, the systemic inflammatory response often leads to severe pulmonary damages. Destruction of endothelial cells, interstitial edema, and interstitial alveolitis depress pulmonary circulation and raise extravascular lung water and intrapulmonary shunt. As protective effects of zinc are described in vitro as well as in vivo, this study investigates its impact on septic porcine pulmonary endothelial monolayers as well as on the pulmonary function of endotoxemic pigs.