“P>Background: Two stage reconstructions of deep scalp

“P>Background: Two stage reconstructions of deep scalp wounds with exposed calvarial bone require a vital granulation tissue. By evaluating different surgical approaches functional and

cosmetic results as well as economic aspects have to be taken into account.

Patients and Methods: 52 patients undergoing three different surgical procedures for soft tissue reconstruction of complex scalp wounds with exposed bone were included into a retrospective study. All patients underwent a two stage procedure with 3D histologic control, soft tissue reconstruction and final split thickness skin grafting. Soft tissue reconstruction was carried out using allogenic fascia lata, an artificial Selleck BAY 57-1293 skin MS-275 substitute or a negative pressure wound therapy (NPWT). The costs

for all used materials as well as personnel and infrastructure were calculated.

Results: Comparing the costs for the different treatments, the fascia lata group was least costly (4,475 euro) followed by the artificial skin substitute group (4,557 euro). The highest expenses occurred in the NPWT group (7,.521 euro). The artificial skin substitute group had the fewest dressing changes and the shortest treatment time.

Conclusions: Although dermal regeneration templates are expensive, their use may be economic. NPWT causes high

treatment costs due to high daily rental rates and frequent and time-consuming dressing changes.”
“Background: Obstructive PD-1/PD-L1 targets sleep apnea has been associated with impaired endothelial function; however, the mechanisms underlying this association are not completely understood. Cell-derived microparticles may provide a link between obstructive sleep apnea and endothelial dysfunction. Objectives: This randomized controlled trial aimed to examine the effect of a 2-week withdrawal of continuous positive airway pressure (CPAP) therapy on levels of circulating microparticles. Methods: Forty-one obstructive sleep apnea patients established on CPAP treatment were randomized to either CPAP withdrawal (subtherapeutic CPAP) or continuing therapeutic CPAP, for 2 weeks. Polysomnography was performed and circulating levels of microparticles were analyzed by flow cytometry at baseline and 2 weeks. Results: CPAP withdrawal led to a recurrence of obstructive sleep apnea. Levels of CD62E+ endothelium-derived microparticles increased significantly in the CPAP withdrawal group compared to the continuing therapeutic CPAP group (median difference in change +32.4 per mu l; 95% CI + 7.3 to + 64.1 per mu l, p = 0.010).

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