Gastrointestinal fistula with thigh extension and intractable pain.

Spontaneous enterocutaneous fistulae are a rare complication in patients with cancer, especially following irradiation, chemotherapy or cytoreductive operations. They are associated with worse prognosis, higher costs of treatment and impaired quality of life. Proper recognition of the problem and fast implementation of selective therapy including water electrolyte resuscitation, infection control, nutritional support, control of output volume, proper wound care and, ultimately, surgical treatment in selected patients may result in better symptom relief and improved quality of life of patients. We describe a case of a patient with advanced rectal cancer and acute pain in the lateral aspect of thigh caused by the presumptive presence of an enterocutaneous fistula, in whom therapy with antibiotics and surgical incision enabled rapid pain relief and comfort of dying.

Development of tantalum with highly hydrophilic surface and antimicrobial properties obtained by micro-arc oxidation process.

Tantalum (Ta) and its application in biomaterials has been attracting more and more attention recently. It can be considered as a material for hard tissue implants. This study focuses on antimicrobial and surface characterization of micro-arc oxidized (MAO) nanocrystalline Ta compared with its microcrystalline equivalent. For the purposes of the investigation, x-ray diffractometry (XRD), scanning electron microscopy (SEM), atomic force microscopy (AFM), wetting analysis, optical profilometry, corrosion resistance measurement, and antimicrobial tests were performed. Nanocrystalline Ta was fabricated using high-energy ball milling (HEBM) and pulse plasma sintering (PPS). The MAO process done at 250 V results in the formation of a porous oxide surface. An XRD analysis confirmed the presence of a Ta2 O5 oxide layer. Based on the SEM pictures, the obtained oxide layer was approximately 3-4 µm thick for nanocrystalline Ta substrate. For microcrystalline Ta, the oxide layer was thinner, in the range of 0.3-0.6 µm. The analysis of polarization curves showed a significant improvement of corrosion resistance for MAO nanocrystalline Ta (2.62 × 10-8 A/cm2 ) versus not oxidized nanocrystalline Ta (1.20 × 10-5 A/cm2 ). The surface roughness of MAO nanocrystalline Ta proved to be several times higher than that of unoxidized Ta. Wetting analysis showed that the oxide layer on the nanocrystalline substrate is hydrophilic. This research provides detailed information about MAO microcrystalline and MAO nanocrystalline Ta antimicrobial activity against Staphylococcus aureus and Pseudomonas aeruginosa. A significant decrease of S. aureus for MAO nanocrystalline Ta (control 10,435 ± 981 vs. sample 3,453 ± 130) was noticed. No significant difference was noticed for MAO microcrystalline and nanocrystalline Ta tested for P. aeruginosa.

Scanning electron microscopic examination of absorption potency of various fibrous dressings.

OBJECTIVE: There is a lack of literature on the characteristics and properties of fibre dressings available on the market. This study analysed the structure and absorption properties of different fibrous dressings used in wound treatment. METHOD: This in vitro experiment was performed using scanning electron microscopy (SEM) and absorption test. Dressings were compared before and after the gelling process which was then compared with the results of the absorption test. RESULTS: A total of five samples were analysed. The SEM analysis demonstrated that there are differences in the gelling processes for each. In some cases, a formation of dead spaces was noticed. Despite a similar structure and mode of action, the dressings have different properties. Results were correlated with absorption measurements. There was a considerable difference in absorption capacity of individual dressings, which may further affect the capacity of the dressing to manage exudate. CONCLUSION: Absorption of excess exudate and maintaining moisture balance in the wound environment are among the most important conditions of successful healing. Various fibrous dressings have different properties and clinicians should use this information to select the most appropriate dressing for the type of wound.