Impact of Needle Design and Suture Gauge on Tissue Tearing During Skin Suturing: A Comparative Analysis.

Background: Surgeons face numerous choices in selecting sutures for skin closure, with potential adverse effects such as tissue tearing.

Objective: To investigate the influence of needle design and suture gauge on tissue tearing during suturing procedures.

Materials And Methods: The authors tested the tear-through force in Newtons for 3 needle types and 3 suture gauges using an artificial skin model and a professional-grade tensiometer.

Comparative Analysis of Taper Point and Reverse Cutting Needles on Skin Puncture Force.

Background: Reverse cutting needles are commonly used in cutaneous surgery due to their perceived ease of use. Despite this, there is limited research evaluating the force required to puncture skin using contemporary needles.

Objective: This study aims to compare the puncture forces required for two different needle geometries across various gauge sizes.

The Effect of Preoperative Chlorhexidine Gluconate Cleanse on Lower Extremity Surgical Site Infections: A Retrospective Cohort Study.

Background: Lower extremity surgical sites are at an increased risk of wound infection following Mohs micrographic surgery.

Objective: To evaluate the rate of lower extremity surgical site infections following a 14-day regimen of preoperative 4% chlorhexidine gluconate (CHG) rinses and postoperative wound occlusion for 14 days.

Materials And Methods: Retrospective data were collected from procedures performed by the senior author from January 2022 through June 2023.

Reconstruction of High-Tension Scalp Defects by the Twizzler Technique: A Retrospective Case Series.

Background: Scalp wounds are difficult to close primarily because of the inelasticity of the galea, often requiring adjacent tissue transfer or grafting. It is still debated whether intraoperative tissue expansion can occur on the scalp.

Objective: We report our experience with the Twizzler technique, a form of intraoperative tissue expansion and load cycling, to achieve primary closure of high-tension scalp wounds.

Superior Antihelix Composite Graft for Repair of Nasal Ala and Lateral Nasal Tip Defects: A Retrospective Case Series.

Background: Deep defects on the nasal ala and lateral nasal tip may result in nasal valve insufficiency or alar notching and are often repaired with a 2-stage reconstruction. Previous literature has demonstrated high failure rates of composite grafts.

Objective: Identify survival rates and cosmetic outcomes of nasal composite grafts harvested from the antihelix.

Complement 1q/Tumor Necrosis Factor-Related Proteins (CTRPs): Structure, Receptors and Signaling.

Adiponectin and the other 15 members of the complement 1q (C1q)/tumor necrosis factor (TNF)-related protein (CTRP) family are secreted proteins composed of an N-terminal variable domain followed by a stalk region and a characteristic C-terminal trimerizing globular C1q (gC1q) domain originally identified in the subunits of the complement protein C1q. We performed a basic PubMed literature search for articles mentioning the various CTRPs or their receptors in the abstract or title. In this narrative review, we briefly summarize the biology of CTRPs and focus then on the structure, receptors and major signaling pathways of CTRPs.

Plume Generated by Different Electrosurgical Techniques: An In Vitro Experiment on Human Skin.

Background: Plume generated by electrosurgical techniques is a health hazard to patients and dermatologists.

Objective: To compare the particle concentration generated by various energy devices used in dermatologic surgery.

Materials And Methods: Five surgical techniques were tested on human tissue samples in a closed chamber.

The Twizzler: a modified primary closure for distal lower extremity wound reconstruction utilizing a dynamic winch stitch.

Management of lower extremity wounds following successful tumor excision presents multiple challenges. Distal lower extremity integument is highly prone to edema often lacks adequate skin laxity for standard primary closures. The closure must be resilient enough to withstand mobility.

ERK1/2 Activity Is Critical for the Outcome of Ischemic Stroke.

Ischemic disorders are the leading cause of death worldwide. The extracellular signal-regulated kinases 1 and 2 (ERK1/2) are thought to affect the outcome of ischemic stroke. However, it is under debate whether activation or inhibition of ERK1/2 is beneficial.

Interference with ERK-dimerization at the nucleocytosolic interface targets pathological ERK1/2 signaling without cardiotoxic side-effects.

Dysregulation of extracellular signal-regulated kinases (ERK1/2) is linked to several diseases including heart failure, genetic syndromes and cancer. Inhibition of ERK1/2, however, can cause severe cardiac side-effects, precluding its wide therapeutic application. ERK-autophosphorylation was identified to cause pathological cardiac hypertrophy.

Nature of Large Temporal Fluctuations of Hydrogen Transfer Rates in Single Molecules.

Double hydrogen transfer was monitored in single molecules of parent porphycene and its tetra- t-butyl derivative using confocal fluorescence microscopy. The molecules have been embedded in a polymer matrix. Under such conditions, a significant fraction of the population reveals a huge decrease of the tautomerization rate with respect to the value obtained from ensemble studies in solution.

Phosphodiesterase 2 Protects Against Catecholamine-Induced Arrhythmia and Preserves Contractile Function After Myocardial Infarction.

Rationale: Phosphodiesterase 2 is a dual substrate esterase, which has the unique property to be stimulated by cGMP, but primarily hydrolyzes cAMP. Myocardial phosphodiesterase 2 is upregulated in human heart failure, but its role in the heart is unknown.

Objective: To explore the role of phosphodiesterase 2 in cardiac function, propensity to arrhythmia, and myocardial infarction.

Tumor-specific T cells in human Merkel cell carcinomas: a possible role for Tregs and T-cell exhaustion in reducing T-cell responses.

Merkel cell carcinomas (MCCs) are rare but highly malignant skin cancers associated with a recently described polyomavirus. MCC tumors were infiltrated by T cells, including effector, central memory, and regulatory T cells. Infiltrating T cells showed markedly reduced activation as evidenced by reduced expression of CD69 and CD25.

Imiquimod enhances IFN-gamma production and effector function of T cells infiltrating human squamous cell carcinomas of the skin.

Squamous cell carcinomas (SCCs) are sun-induced skin cancers that are particularly numerous and aggressive in patients taking T-cell immunosuppressant medications. Imiquimod is a topical immune response modifier and Toll-like receptor 7 (TLR7) agonist that induces the immunological destruction of SCC and other skin cancers. TLR7 activation by imiquimod has pleiotropic effects on innate immune cells, but its effects on T cells remain largely uncharacterized.

Human squamous cell carcinomas evade the immune response by down-regulation of vascular E-selectin and recruitment of regulatory T cells.

Squamous cell carcinomas (SCCs) of the skin are sun-induced skin cancers that are particularly numerous in patients on T cell immunosuppression. We found that blood vessels in SCCs did not express E-selectin, and tumors contained few cutaneous lymphocyte antigen (CLA)(+) T cells, the cell type thought to provide cutaneous immunosurveillance. Tumors treated with the Toll-like receptor (TLR)7 agonist imiquimod before excision showed induction of E-selectin on tumor vessels, recruitment of CLA(+) CD8(+) T cells, and histological evidence of tumor regression.

Blood exposure risk during procedural dermatology.

Background: Dermatologists are at risk of body-fluid contamination during procedures.

Objective: We sought to determine the frequency of blood splash during procedural dermatology.

Methods: In all, 500 consecutive excisions were performed.