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Your search keyword '"Brunotte, Maximilian"' showing total 2 results
Start Over Author "Brunotte, Maximilian" Publisher elsevier
2 results on '"Brunotte, Maximilian"'

1. Hyperspectral Imaging (HSI) in anatomic left liver resection

Author

Sucher, Robert, Athanasios, Alvanos, Köhler, Hannes, Wagner, Tristan, Brunotte, Maximilian, Lederer, Andri, Gockel, Ines, and Seehofer, Daniel

Subjects
Liver resection, Hyperspectral imaging, Intraoperative visualization, Surgical guidance, Article
Abstract

Highlights • Hyperspectral Imaging (HSI) is non-contact, non-ionizing and non-invasive. • HSI detects tissue pathology based on spectral characteristics of different tissues. • HSI is well suited for counter perfusion staining in anatomic liver resection. • HSI can be used for future image guided liver surgery., Introduction Anatomic liver resection is based on the description of functional segments, which rely on the organs arterial and portal venous blood supply. Vascular inflow control of the left liver is performed by occlusion of the left hepatic artery (LHA) and left portal vein (LPV). Depending on the quality of the parenchyma a sharp demarcation line (Cantlie Line) between segments IV and V/VIII can hence be detected. Material and Methods TIVITA® is a novel contact free tool which facilitates non-invasive hyperspectral imaging (HSI) and near infrared spectroscopy (NIRS) for the assessment of tissue- oxygenation (StO2) and perfusion (NIR Perfusion). We hypothesized that this imaging modality might be practicable to identify the future resection plane after left vascular inflow occlusion in anatomic liver resection. Presentation of Case TIVITA ® is a viable tool for the identification of segments with reduced StO2 (inflow occlusion: 0.23 ± 0.03 vs normal: 0.50 ± 0.06) and NIR Perfusion (inflow occlusion: 0.02 ± 0.04 vs normal: 0.47 ± 0.06) and allows for a visual differentiation of well oxygenated, perfused (green) and low oxygenated, poorly perfused (blue) liver tissue in a patient undergoing left hemihepatectomy for hepatocellular carcinoma. Conclusion Hyperspectral Imaging is an emerging optical technique with the potential to identify exact resection planes for anatomic liver resection based on the optically determined perfusion and oxygenation status of liver segments lined up for resection. This novel Hyperspectral Demarcation Technique (HSI DT) is non- contact, non-ionizing and non-invasive.

Published
2019

2. A new small animal model for simulating a two-stage-revision procedure in implant-related methicillin-resistant Staphylococcus aureus bone infection.

Author

Brunotte M, Rupp M, Stötzel S, Sommer U, Mohammed W, Thormann U, Heiss C, Lips KS, Domann E, and Alt V

Subjects
Animals, Anti-Bacterial Agents pharmacology, Disease Models, Animal, Fracture Fixation, Osteomyelitis drug therapy, Osteomyelitis microbiology, Prosthesis-Related Infections drug therapy, Prosthesis-Related Infections microbiology, Rabbits, Staphylococcal Infections drug therapy, Staphylococcal Infections microbiology, Tibial Fractures microbiology, Vancomycin pharmacology, Methicillin-Resistant Staphylococcus aureus, Osteomyelitis pathology, Prosthesis-Related Infections pathology, Staphylococcal Infections pathology, Tibial Fractures pathology
Abstract

Background: Implant-related bone infections with methicillin-resistant Staphylococcus aureus (MRSA) remain a challenge for orthopedic surgeons. This devasting complication may lead to functional impairment and loss of the affected limbs. High failure rates in treatment make improvement of surgical treatment necessary. Beside an already established demanding and costly large animal model, a small animal model of a two-stage revision does not exist, yet. Thus, the purpose of this study was to establish a preclinical small animal model to simulate a two-stage revision in implant-related MRSA infection., Materials and Methods: In twelve rabbits Steel K-wires were implanted into the intramedullary canal of the left tibia, followed by inoculation with MRSA. Two different clinical isolates of MRSA-strains were used in two different concentrations (CFUs; 10 5 and 10 7 colony forming units (CFUs). This led to four groups of three rabbits each. Eleven rabbits survived the whole study period. After four weeks the inoculated K-wires were removed and replaced with vancomycin loaded PMMA-spacers (stage 1). Twenty-eight days later new K-wire implants were placed intramedullary (stage 2). After 84 days all animals were sacrificed. Tibiae were analyzed microbiologically, radiologically and histologically., Results: In every rabbit K-wire associated infection could be established within the first four weeks. After irrigation and debridement at revision one (stage 1), infection could be eradicated in 67% of group I, in 50% of group II and in 33% of group III and IV. Recurrence of the infection could be determined in all animals of group I and IV at day 84. X-ray analysis and histology both demonstrated clear signs of osteomyelitis after twelve weeks. Survival, clinical observations and weight assessment confirmed the ethical justifiable stress of the animals during the experiment., Conclusion: The presented small animal model of a two-stage revision in implant-related infection is a promising preclinical set-up for assessment of new treatment strategies of implant-related infections. Both high survival as well as reinfection rates were possible by simulating the clinical gold standard of two-stage revision surgery in an MRSA implant-related infection model. Therefore, the model can be deemed suitable for further preclinical in vivo testing., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Published
2019
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