The Rise of Surgery

Wangensteen, Owen H.; Wangensteen, S. D.; Freshwater, M. Felix

doi:10.1097/00006534-198004000-00029

Cited by 8 publications

(9 citation statements)

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“…Evidence for the use of artificial, synthetic or natural substitutes, however, predates this in the form of gold and silver plates and pieces of coconut shell found in cranial defects within prehistoric skulls (Sanan & Haines 1997). Furthermore, archaeological studies of the skeletons of ancient Egyptian mummies have demonstrated the successful practice of external fracture fixation using splints made of bamboo, reeds, wood or bark, padded with linen (Wangensteen & Wangensteen 1978). In modern medicine, autografting is regarded as the 'gold standard'; however, the amount of bone that can be safely harvested is limited, while the additional surgical procedure may be complicated by donor-site pain and morbidity.…”

Section: Introductionmentioning

confidence: 99%

Bone repair in the twenty–first century: biology, chemistry or engineering?

Hing

2004

Philosophical Transactions of the Royal Society of London. Seri

356

244

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Increases in reconstructive orthopaedic surgery, such as total hip replacement and spinal fusion, resulting from advances in surgical practice and the ageing population, have lead to a demand for bone graft that far exceeds supply. Consequently, a number of synthetic bone-graft substitutes (BGSs) have been developed with mixed success and surgical acceptance. Skeletal tissue regeneration requires the interaction of three basic elements: cells, growth factors (GFs) and a permissive scaffold. This can be achieved by pre-loading a synthetic scaffold with GFs or pre-expanded cells; however, a 'simpler' approach is to design intrinsic 'osteoinductivity' into your BGS, i.e. the capability to recruit and stimulate the patient's own GFs and stem cells. Through investigation of the mechanisms controlling bone repair in BGSs, linking interactions between the local chemical and physical environment, scientists are currently developing osteoinductive materials that can stimulate bone regeneration through control of the scaffold chemistry and structure. Moreover, this body of research is providing the foundations for future generations of BGSs and bone-repair therapies and may ultimately contribute towards improving the quality of life through maintenance of the skeleton and reversal of disease states, as opposed to the mending of broken bones that we currently practice. Will we be able to grow our own bones in a bioreactor for use as autologous graft materials in the future? Could surgery be limited to accidental trauma cases, with greater restoration of function through biochemical or gene therapies? The technology and research probes necessary to this task are currently being developed with the advent of nanotechnology, genomics and proteomics: are we about to embark on a chemical revolution in medicine? This paper aims to discuss some of the current thinking on the mechanisms behind bioactivity and biocompatibility in bone and how a fuller understanding of the interactions between cells and the materials used today could bring about completely new approaches for the treatment of bone fracture and disease tomorrow.

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Section: Introductionmentioning

confidence: 99%

Bone repair in the twenty–first century: biology, chemistry or engineering?

Hing

2004

Philosophical Transactions of the Royal Society of London. Seri

356

244

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“…Later, when statistical analysis demonstrating the benefit of infection control practices was applied to an outbreak of typhus, it showed that a 10-fold reduction in nosocomial cases and a 42-fold decrease in associated deaths resulted from adherence to specific practices for contagious patients (16). Microbiologists began to play an important role in infection control, documenting microbial contamination of the operating room environment that resulted from surgeons' carrying on normal conversations, leading to the standard practice of wearing masks during surgery (28). Modern hospital epidemiology only began in the mid1960s (15), and since that time the clinical microbiology laboratory has progressively demonstrated the critical roles it can serve for ongoing management and control of health careassociated infectious diseases.…”

Section: Introductionmentioning

confidence: 99%

Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance

Peterson

Brossette

2002

J Clin Microbiol

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“…If general surgery can maintain its creative and innovative spirit, perhaps, the spawning of new disciplines will become its most important function." 32 In summary, in this nation, trauma will always be the cornerstone of acute care surgery, but the specialty that has emerged to help address a void and a need is acute care surgery. There are 3 issues or challenges (Table 6) that have not been effectively and definitively addressed: quality outcomes, access, and branding.…”

mentioning

confidence: 99%

Trauma: Still the Cornerstone of Acute Care Surgery Specialty

Britt

2018

Journal of the American College of Surgeons

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The Rise of Surgery

Cited by 8 publications

References 0 publications

Bone repair in the twenty–first century: biology, chemistry or engineering?

Bone repair in the twenty–first century: biology, chemistry or engineering?

Hunting Health Care-Associated Infections from the Clinical Microbiology Laboratory: Passive, Active, and Virtual Surveillance

Trauma: Still the Cornerstone of Acute Care Surgery Specialty

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