A Systemic Review of Spinal Needles Broken During Neuraxial Anesthesia.

Needle breakage during spinal anesthesia occurs infrequently and represents a serious complication with potentially adverse effects. The objective of this systemic review was to look at the incidence, risk factors, and preventative measures for broken spinal needles. A search of the literature on PubMed, Web of Science, and Embase databases and a manual web search was performed, with no filters and up to April 2023 from inception. Out of the 43 potential studies, 23 were included. The search terms for the full article reading were broken needle, spinal anesthesia, humans, and post-operative, and the exclusion criteria were systematic reviews, conference presentations, and non-full articles. A review of the 23 studies (24 cases) suggests an association between specific risk factors such as obesity and needle size and breaks. Identifying the risks and complications of needle breaks could help physicians modify their practice and inform their patients of any increased risks applicable to them.

Development of wound healing scaffolds with precisely-triggered sequential release of therapeutic nanoparticles.

Natural bioactive cue profiles are generally transient with cues switching on/off to coordinate successful outcomes. Dysregulation of these sequences typically leads to disease. Successful wound healing, for example, should progress sequentially through hemostasis, inflammation, granulation tissue formation, and maturation. Chronic wounds, such as diabetic foot ulcers, suffer from uncoordinated signaling, and arrest and cycle between the inflammation and granulation stages. Traditionally, therapeutic delivery in tissue engineering has focused on sustaining delivery of key signaling factors; however, temporal and sequential delivery have increasingly come into focus. To fully take advantage of these signaling systems, a scaffold or matrix material that can house the delivery system is desirable. In this work, we functionalized a collagen-based scaffold - which has proven regenerative potential in wounds - with on-demand delivery of nanoparticles. Building on our previous work with ultrasound-responsive alginate that shows near-zero baseline release and a rapid release in response to an ultrasound trigger, we developed two novel scaffolds. In the first version, homogeneously-distributed microparticles of alginate were incorporated within the collagen-glycosaminoglycan (GAG) scaffold; ultrasound-triggered release of platelet derived growth factor (PDGF) loaded gold nanoparticles was demonstrated; and their maintained bioactivity confirmed. In the second version, pockets of alginate that can be individually loaded and triggered with ultrasound, were incorporated. The ability to sequentially release multiple therapeutics within these scaffolds using ultrasound was successfully confirmed. These platforms offer a precise and versatile way to deliver therapeutic nanoparticles within a proven regenerative template, and can be used to deliver and probe timed therapeutic delivery in wound healing and other tissue engineering applications.

Correction: Development of wound healing scaffolds with precisely-triggered sequential release of therapeutic nanoparticles.

Correction for 'Development of wound healing scaffolds with precisely-triggered sequential release of therapeutic nanoparticles' by Tauseef Ahmad et al., Biomater. Sci., 2020, DOI: 10.1039/d0bm01277g.