A standardized treatment protocol for pilonidal disease can influence the health mindset of adolescents.

Purpose: Pilonidal disease (PD) significantly impacts patients' quality of life and requires regular maintenance behaviors to achieve cure. Health mindset is a psychological construct which can influence health behaviors and outcomes, with a growth mindset being associated with better outcomes than a fixed. We propose that participation in a standardized treatment protocol can affect the health mindset for adolescents with pilonidal disease.

Comorbidities are not associated with pain symptom or recurrence in patients with pilonidal disease.

Background: Comorbidities can potentially impact the presentation or outcome of patients with pilonidal disease (PD) due to poor wound healing or increased inflammatory response. We hypothesized that certain comorbidities could lead to worse pain or higher recurrence rate.

Methods: A retrospective study was performed on all PD patients treated with standardized minimally invasive protocol at our clinic 2019-2022.

Regular epilation alone is an acceptable treatment for symptom-free pilonidal patients.

Introduction: Patients with mild pilonidal disease often experience symptom resolution without excision. We hypothesized that treating symptom-free/asymptomatic pilonidal patients with regular epilation alone had similar recurrence rate as patients who were also treated surgically.

Method: Patient data were prospectively collected 2/2019-11/2022 at our Pilonidal Clinic.

Lessons Learned From the First-In-Human Compassionate Use of Connect-EA™ in Ten Patients With Esophageal Atresia.

Introduction: Delayed primary repair of esophageal atresia in patients with high-risk physiologic and anatomic comorbidities remains a daunting challenge with an increased risk for peri-operative morbidity and mortality via conventional repair. The Connect-EA device facilitates the endoscopic creation of a secure esophageal anastomosis. This follow-up study reports our long-term outcomes with the novel esophageal magnetic compression anastomosis (EMCA) Connect-EA device for EA repair, as well as lessons learned from the ten first-in-human cases.

Increasing Amount of Hair Reduction using Laser Correlates with Lower Probability of Recurrence in Patients with Pilonidal Disease.

Background: Hair at the gluteal cleft plays a key role in the development and recurrence of pilonidal disease (PD). We hypothesized that more hair reduction achieved using laser could correlate with lower chance of PD recurrence.

Methods: PD patients who underwent laser epilation (LE) were categorized by Fitzpatrick skin type, hair color, and hair thickness.

Adoption of a standardized treatment protocol for pilonidal disease leads to low recurrence.

Background: Pilonidal disease may present as acute abscesses or chronic draining sinuses. There is no standardized treatment and recurrence rates can be as high as 30%. Within our five-hospital network we have established a standardized treatment protocol including minimally invasive surgical trephination and aggressive epilation.

Burden of pilonidal disease and improvement in quality of life after treatment in adolescents.

Purpose: Pilonidal Disease (PD) affects adolescents in different aspects. We hypothesized that patients with different gender, ethnicity, and age have different quality of life (QOL) measurements which could improve with minimally invasive treatment (MIT).

Methods: 131 PD patients underwent MIT (laser epilation ± trephination) from 2019 to 2021.

The novel application of an emerging device for salvage of primary repair in high-risk complex esophageal atresia.

Introduction: Preservation of native esophagus is a tenet of esophageal atresia (EA) repair. However, techniques for delayed primary anastomosis are severely limited for surgically and medically complex patients at high-risk for operative repair. We report our initial experience with the novel application of the Connect-EA, an esophageal magnetic compression anastomosis device, for salvage of primary repair in 2 high-risk complex EA patients.

Serial Reduction of an Extremely Large Gastroschisis using Vacuum-Assisted Closure.

We herein describe a case of serial reduction of an extremely large and complex gastroschisis using vacuum-assisted closure (VAC) therapy in a boy born at 35 weeks' gestation. A spring-loaded silicone silo was placed at birth. By day of life (DOL) 22, minimal visceral contents had been reduced, and the silo was difficult to maintain due to the size of the fascial defect and loss of abdominal domain.

A comparison of accidental and nonaccidental trauma: it is worse than you think.

Background: Child abuse, or nonaccidental trauma (NAT), is a major cause of pediatric morbidity and mortality, and is often unrecognized. Our hypothesis was that injuries due to accidental trauma (AT) and NAT are significantly different in incidence, injury, severity, and outcome, and are often unrecognized.

Objective: Our aim was to carry out an examination of the differences between pediatric injuries due to AT and NAT regarding incidence, demographics, injury severity, and outcomes.

Use of an omega-3 fatty acid-based emulsion in the treatment of parenteral nutrition-induced cholestasis in patients with microvillous inclusion disease.

Microvillous inclusion disease is a congenital intestinal epithelial cell disorder leading to lifelong intestinal failure. In this report, we discuss the use of a fish oil-based lipid emulsion in the treatment of 3 patients with microvillous inclusion disease who developed parenteral nutrition-associated liver disease.

Impact of surgical approach on outcome in 622 consecutive pyloromyotomies at a pediatric teaching institution.

Purpose: The aim of this study is to compare the outcome of 3 different approaches to pyloromyotomy in a large single institution series.

Methods: Records of consecutive patients undergoing pyloromyotomy for an 8-year period were reviewed. Patients' age, sex, weight, operating time, length of stay, number of emeses, and complications were recorded.

Complete colonic duplication--a case report.

Duplications of the entire colon are very rare. An 18-month-old boy presented with symptoms of chronic constipation and was noted with a complete colonic duplication. The presentation and management are discussed.

A comparative analysis of cartilage engineered from different perinatal mesenchymal progenitor cells.

We sought to compare engineered cartilaginous constructs derived from different perinatal mesenchymal progenitor cell (MPC) sources. Ovine MPCs isolated from amniotic fluid (AF, n = 8), neonatal bone marrow (BM, n = 6), and preterm umbilical cord blood (CB, n = 12) were expanded and comparably seeded onto synthetic scaffolds. Constructs were maintained in chondrogenic media containing transforming growth factor-beta.

Survey of pediatric surgeons on current practices of bowel preparation for elective colorectal surgery in children.

Background: Guidelines regarding bowel preparation exist for the adult but not the pediatric population. Our aim was to evaluate the bowel preparation practices, including antibiotic usage for elective colorectal operations in children.

Methods: A survey was designed and administered to a nationwide group of pediatric surgeons to ascertain current practices of bowel preparation.

Postnatal myocardial augmentation with skeletal myoblast-based fetal tissue engineering.

Background: Cardiac anomalies constitute the most common birth defects, many of which involve variable myocardial deficiencies. Therapeutic options for structural myocardial repair remain limited in the neonatal population. This study was aimed at determining whether engineered fetal muscle constructs undergo milieu-dependent transdifferentiation after cardiac implantation, thus becoming a potential means to increase/support myocardial mass after birth.

Fetal hepatic haematopoiesis is modulated by arterial blood flow to the liver.

We describe an as yet unrecognised relationship between fetal hepatic haematopoiesis and arterial blood flow to the liver. To increase hepatic arterial flow, the common bile duct (CBD) was ligated in fetal lambs. Reduction of hepatic arterial flow was accomplished in age-matched animals by hepatic artery (HA) ligation.

Diaphragmatic repair through fetal tissue engineering: a comparison between mesenchymal amniocyte- and myoblast-based constructs.

Purpose: We have previously shown that fetal tissue engineering is a preferred alternative to diaphragmatic repair in a large animal model. This study was aimed at comparing diaphragmatic constructs seeded with mesenchymal amniocytes and fetal myoblasts in this model.

Methods: Neonatal lambs (n = 14) underwent repair of an experimental diaphragmatic defect with identical scaffolds, either seeded with labeled autologous cells (mesenchymal amniocytes in group 1 and fetal myoblasts in group 2) or as an acellular graft (group 3).

Hydrogel optimization for cultured elastic chondrocytes seeded onto a polyglycolic acid scaffold.

The purpose of this study was to compare the effect of different hydrogels on the production of tissue-engineered cartilage based on polyglycolic acid (PGA). Chondrocytes were isolated from adult sheep auricles. Alginate, Type I collagen, methylcellulose, and pluronic F127 hydrogels were evaluated, as were controls prepared without hydrogels.

Cartilage engineering from ovine umbilical cord blood mesenchymal progenitor cells.

We aimed to determine whether three-dimensional (3D) cartilage could be engineered from umbilical cord blood (CB) cells and compare it with both engineered fetal cartilage and native tissue. Ovine mesenchymal progenitor cells were isolated from CB samples (n=4) harvested at 80-120 days of gestation by low-density fractionation, expanded, and seeded onto polyglycolic acid scaffolds. Constructs (n=28) were maintained in a rotating bioreactor with serum-free medium supplemented with transforming growth factor-beta1 for 4-12 weeks.

In vitro cartilage regeneration from proliferated adult elastic chondrocytes.

The purpose of this study was to investigate cellular feasibility in the proliferation and differentiation status of adult chondrocytes for cartilage regeneration in comparison to fetal chondrocytes. Primary cells were isolated from adult (n = 6) and fetal (n = 6) sheep ear cartilages and expanded in 10% fetal bovine serum (FBS) containing Ham's F12 medium, in which adult and fetal cell proliferation rates were compared using a WST-1 assay kit. Approximately 4 million cells were seeded onto each 1 x 1 x 0.

Cost considerations and applicant characteristics for the Pediatric Surgery Match.

Background/purpose: Formal training in pediatric surgery is highly competitive. The limited number of accredited positions has historically favored applicants with basic science experience, numerous publications, national presentations, and exposure to well-known pediatric surgeons. This review analyzes characteristics of successful applicants and cost associated with the Match.

Intratracheal pulmonary ventilation improves gas exchange during laparoscopy in a pediatric lung injury model.

Background/purpose: This study was aimed at determining whether intraoperative intratracheal pulmonary ventilation (ITPV) could prevent/treat respiratory complications of laparoscopy in a model of pediatric pulmonary insufficiency.

Methods: Severe lung injury was induced in 0- to 2-month-old lambs (n = 5) by endotracheal saline lavage. Animals then underwent establishment of CO2 pneumoperitoneum.

Diaphragmatic reconstruction with autologous tendon engineered from mesenchymal amniocytes.

Purpose: This study examined the effects of amniocyte-based engineered tendons on partial diaphragmatic replacement.

Methods: Ovine mesenchymal amniocytes were labeled with green fluorescent protein (GFP), expanded, and seeded into a collagen hydrogel. Composite grafts (20 to 25 cm2) based on acellular dermis (group I), or acellular small intestinal submucosa (group II) received either a cell-seeded or an acellular hydrogel within their layers.