Delayed development of toxic shock syndrome following abdominal tissue expansion in a pediatric reconstruction patient: case report.

Toxic shock syndrome (TSS) is a potentially fatal postoperative complication, and even more so if the diagnosis is delayed. We present the case of a 7-month-old male infant who developed TSS as a complication of tissue expansion using an external port device. There have been 5 documented cases of TSS after tissue expander or breast prosthesis placement occurring in the adult population, however, there has not been a reported case of TSS in an infant. The long interval to development of TSS like symptoms, 4 months in this case, should not exclude TSS from the differential diagnosis. In a pediatric patient, a diffuse macular rash without the severe systemic symptoms on initial presentation can present as a diagnostic challenge. New diagnosis techniques are discussed that can shorten the time to a diagnosis of TSS. In this case, because the local bacterial count was low, the expanded tissue was transferred without complication.

Nanofiber applications for burn care.

Nanotechnology is a growing field of manufactured materials with sizes less than 1 mum, and it is particularly useful in the field of medicine because these applications replicate components of a cell's in vivo environment. Nanofibers, which mimic collagen fibrils in the extracellular matrix (ECM), can be created from a host of natural and synthetic compounds and have multiple properties that may be beneficial to burn wound care. These properties include a large surface-area-to-volume ratio, high porosity, improved cell adherence, proliferation and migration, and controlled in vivo degradation rates. The large surface area of nanofiber mats allows for increased interaction with compounds and provides a mechanism for sustained release of antibiotics, analgesics, or growth factors into burn wounds; high porosity allows diffusion of nutrients and waste. Improved cell function on these scaffolds will promote healing. Controlled degradation rates of these scaffolds will promote scaffold absorption after its function is no longer required. The objective of this article is to review the current literature describing nanofibers and their potential application to burn care.

Cellular incorporation into electrospun nanofibers: retained viability, proliferation, and function in fibroblasts.

Nanofibers are an emerging scaffold for tissue engineering. To date no one has reported cell incorporation into nanofibers. Human foreskin fibroblasts and human adipose-derived adult stem cells (hADAS) were grown to confluence, resuspended in phosphate-buffered saline, and then solubilized in polyvinyl alcohol (PVA). Nanofibers were created using an electrospinning technique across an electric potential of 20 kV. Cell interaction with nanofibers was assessed with optical microscopic imaging and scanning electron microscopy. PVA nanofibers with incorporated cells were then solubilized in phosphate-buffered saline; cell viability was assessed by trypan blue exclusion. Viable cells were allowed to proliferate. Chondrogenesis in fibroblasts was induced with TGF-beta1. Both fibroblasts and hADAS survived the electrospinning process and were incorporated into PVA nanofibers. hADAS cell proliferation was negligible; however, fibroblasts proliferated and showed retained ability to undergo chondrogenesis. Cells can be incorporated into nanofibers, with maintained viability, proliferation, and function.