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Biomedical subjects

G H Engelhardt

Publications and source records attributed to G H Engelhardt.

At least 19 recordsLinked to original sources
PubMed1995

The abdominal lift: is there any advantage for the critically ill patient?

The use of carbon dioxide to create a cavity for the operation of laparoscopic cholecystectomy leads to serious complications of the cardiovascular system; consequently, patients with ischaemic heart disease can be put at greater risk. For example, on reaching an intra-abdominal pressure of 15mmHg, a fall of about 35% of the static compliance was observed. Upon using the Laparolift, these influences on the respiratory system were not detected, and the rise in systemic vascular resistance usually seen with the CO2-pneumoperitoneum did not occur. From the anaesthetist's viewpoint the Laparolift was helpful in the treatment of patients with serious limitations of cardiac function.

Abdominal Muscles↗
PubMed1992

Reversal of gelatin-impaired wound healing in rats by exogenous fibronectin.

Animal experiments have shown that administration of gelatin results in a deprivation of plasma fibronectin (FN) and impaired wound healing. For further elucidation of these findings a therapy study with purified human FN was performed in rats. Fifty animals received a standard burn injury of 1% body surface and were divided into five experimental groups. Positive controls given no further treatment or treated with solvent only served for estimation of normal healing. For a negative control, 10 animals received three intraperitoneal injections of gelatin (58 mg/kg body wt) on Days 0, 1, and 2 after injury. They exhibited a striking lack of plasma FN (Day 1) and a significant delay of wound contraction (Days 7 and 14). In the therapy groups each administration of gelatin was followed by an intraperitoneal or intracardiac injection of FN (58 mg/kg body wt) 1 hr later. In these animals the negative effect of gelatin upon plasma FN and wound contraction was prevented. According to this study wound healing is menaced by FN deficiency and can be optimized by substitution of exogenous FN.

Animals↗
PubMed1991

[Priorities in polytrauma].

Principles of medical action in cases of polytrauma: Immediate concentrated introduction of all measures; simultaneous diagnosis and therapy; ideal management; inspection and palpitation initially adequate; systematic examination from head to foot; choice of a suitable hospital; appropriate scoring. Priority of action (in the hospital): disturbances in vital functions first; puncture/drain valvular pneumothorax and cardiac tamponade; laparatomize intraabdominal bleeding; emergency thoracotomy if severe bleeding persists; laboratory and X-rays; relieve intracranial bleeding; surgery to save vital organs; intensive-care ward.

Emergencies↗
PubMed1989

[Action and biocompatibility of two collagen-based hemostatics in animal experiments].

Efficacy and biocompatibility of two collagen hemostatic wound dressings (usual agent: Collastypt, fluid-stabilised agent: Lyostypt) were compared. In a prospective randomized study the local hemostatic effect (bleeding time and blood loss) of the two agents were investigated after liver trauma of 45 rats. Liver wounds which remained untreated served as controls. Both preparations significantly reduced bleeding. The fluid-stabilised agent was significantly superior to the second collagen agent of different manufacturing.

Animals↗
PubMed1987

The effect of fibronectin therapy and fibronectin deficiency on healing of rat burns and excision wounds.

Rats with standardized burns and skin excision wounds were treated i.p. with human fibronectin or swine skin gelatin. Controls received bovine albumin, solvent, or no treatment. Wound healing was assessed by planimetry, additionally plasma fibronectin was determined. Solvent or albumin did not influence the healing process, neither did fibronectin. However, when opsonizing fibronectin was additionally consumed by application of gelatin, a significant retardation of wound healing was observed. The results support the opinion that fibronectin is of essential importance for posttraumatic opsonization of gelatin-like material originating from the damaged tissue.

Animals↗
PubMed1987

Effect of fibronectin therapy and fibronectin deficiency on wound healing: a study in rats.

Rats with standardized 3rd-degree burns of 1% body surface were treated intraperitoneally with different doses of human fibronectin or swine gelatin immediately after injury and on the following days. Controls received bovine albumin or no further treatment. Wound healing was assessed by planimetry (days 0, 2, and 7); additionally, plasma fibronectin was determined (days 3 and 7). On day 3 fibronectin levels were significantly elevated after albumin and the highest dosage of fibronectin (3 X 16 mg) and decreased after gelatin and the lowest dosage of fibronectin (3 X 4 mg). Wound healing was neither affected by albumin nor by human fibronectin, but it was significantly impaired by gelatin-induced lack of fibronectin. The data support the opinion that fibronectin is an essential factor for the post-traumatic clearance of gelatin-like tissue debris via the reticuloendothelial system (RES). Overload by gelatin results in fibronectin deficiency and RES dysfunction with risks of infection and poor wound healing.

Animals↗
PubMed1983

[Age-related problems of wound healing].

A study on wound failures after surgical operations performed at the Dep. of Surgery, Köln-Merheim, revealed an overall rate of 10,8%. 40,3% of all complications were observed in patients aged more than 60 years, which gives a rate of 19,1% for those people. To date this significant increase of wound failures in older individuals is preferently explained by the reduced resistance of the old organism to infections. Our trials with rats as well as numerous publications of other authors on the topic of age-related changes of metabolism prove that the wound healing process is delayed in older individuals. This fact does not consequently lead to complications but the prolonged healing in connection with the repeated change of wound dressing gives an enhanced risk for infections. If special precautions are observed the age of a patient is not a principal contraindication to a great surgical operation today.

Adolescent↗
PubMed1980

[Diagnosis and management of abdominal injuries (author's transl)].

Prognosis and mortality rate of abdominal injuries are substantially influenced by early diagnosis and thereby early definite operative treatment. Especially in cases of multiple traumata a subtle search for intraabdominal lesions in needed. 242 patients with abdominal traumata were analysed. 142 (= 58%) of them had contusions of the abdominal wall only, 83 (= 36%) had blunt and 17 (= 6%) had perforating abdominal injuries. In two-third of blunt traumata with organ lesions the operation was indicated only by clinical symptoms. The preoperative radiological examinations revealed organ lesions in 23,7% of cases. In addition to clinical and radiological examinations peritoneal lavage is an important diagnosis test of abdominal organ lesions. A laparotomy for diagnostic reasons should never be done before peritoneal lavage which can be used even in smaller hospitals.

Abdominal Injuries↗
PubMed1978

[Treatment of burns. Experimental and clinical studies].

Burn disease is a severe complication of all extensive deep burns. Therefore, the destroyed skin must be removed and the open wounds closed as soon as possible. Until now only the early surgical necrectomy and grafting can meet these essentials. Our studies on "chemical débridement" by various enzyme preparations showed that collagenase hastened the removal of dead tissue without any complications. The subsequent application of soluble collagen to the would area caused significant acceleration of wound closure in rats as well as in pigs without immunological reactions. Finally, evidence of anti-collagen antibodies may be important for the treatment of burn disease if a direct effect can be proved.

Animals↗