Eric J. Culbertson | UCLA David Geffen School of Medicine (original) (raw)
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Papers by Eric J. Culbertson
ABSTRACT The invention consists of three parts made to work together to ensure safe, fast and eff... more ABSTRACT The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards equipment goggles, visors and shields, defensive protective armors and high impact vision wear, high performance athletic equipment, and avionics surfaces. The three parts are the anti-fog coating materials composition, their methods of preparation and processing in large, medium or small scale manufacturing, and a single unit delivery device with the coating materials to apply on any existing surface, lens, scope, tools or dials, as a wet or quickly drying coating.
Obesity Surgery, 2011
Obesity increases the risk of laparotomy dehiscence and incisional hernia. The aim of this study ... more Obesity increases the risk of laparotomy dehiscence and incisional hernia. The aim of this study was to measure the biological effect of obesity on laparotomy wound healing and the formation of incisional hernias. Normal-weight Sprague-Dawley (SD) and obese Zucker rats were used in an established laparotomy wound healing and incisional ventral hernia model. Mechanical testing was performed on abdominal wall strips collected from laparotomy wounds. Hernia size was measured by digital imaging. Picrosirius staining for collagen isoforms was observed with polarized microscopy. Abdominal wall fibroblasts were cultured to measure collagen matrix remodeling and proliferation. Laparotomy wound healing was significantly impaired in obese rats. Mechanical strength was lower than in normal-weight rats. Yield load was reduced in the obese group at all time points. Picrosirius red staining showed increased immature type III collagen content and disorganized type I collagen fibers within laparotomy wounds of obese rats. Wound size was significantly larger in the obese group. Collagen matrix remodeling was impaired with fibroblasts from obese rats, but there was no difference in fibroblast proliferation between the obese and normal-weight groups. We observed for the first time that laparotomy wound healing is impaired in obese rats. The recovery of laparotomy wound strength is delayed due to abnormal collagen maturation and remodeling, possibly due to a defect in fibroblast function. Strategies to improve outcomes for laparotomy wound healing in obese patients should include correcting the wound healing defect, possibly with growth factor or cell therapy.
Journal of Surgical Research, 2011
Journal of Surgical Research, 2013
Incisional hernia is the most common complication of abdominal surgery leading to reoperation. In... more Incisional hernia is the most common complication of abdominal surgery leading to reoperation. In the United States, 200,000 incisional hernia repairs are performed annually, often with significant morbidity. Obesity is increasing the risk of laparotomy wound failure. We used a validated animal model of incisional hernia formation. We intentionally induced laparotomy wound failure in otherwise normal adult, male Sprague-Dawley rats. Radio-opaque, metal surgical clips served as markers for the use of x-ray images to follow the progress of laparotomy wound failure. We confirmed radiographic findings of the time course for mechanical laparotomy wound failure by necropsy. Noninvasive radiographic imaging predicts early laparotomy wound failure and incisional hernia formation. We confirmed both transverse and craniocaudad migration of radio-opaque markers at necropsy after 28 d that was uniformly associated with the clinical development of incisional hernias. Early laparotomy wound failure is a primary mechanism for incisional hernia formation. A noninvasive radiographic method for studying laparotomy wound healing may help design clinical trials to prevent and treat this common general surgical complication.
Annals of Surgery, 2013
To determine whether primary or mesh herniorrhaphy reverses abdominal wall atrophy and fibrosis a... more To determine whether primary or mesh herniorrhaphy reverses abdominal wall atrophy and fibrosis associated with hernia formation. We previously demonstrated that hernia formation is associated with abdominal wall atrophy and fibrosis after 5 weeks in an animal model. A rat model of chronic incisional hernia was used. Groups consisted of uninjured control (UC, n = 8), sham repair (SR, n = 8), unrepaired hernia (UR, n = 8), and 2 repair groups: primary repair (PR, n = 8) or tension-free polypropylene mesh repair (MR, n = 8) hernia repair on postoperative day (POD) 35. All rats were killed on POD 70. Intact abdominal wall strips were cut perpendicular to the wound for tensiometric analysis. Internal oblique muscles were harvested for fiber type and size determination. No hernia recurrences occurred after PR or MR. Unrepaired abdominal walls significantly demonstrated greater stiffness, increased breaking and tensile strengths, yield load and yield energy, a shift to increased type IIa muscle fibers than SR (15.9% vs 9.13%; P < 0.001), and smaller fiber cross-sectional area (CSA, 1792 vs 2669 μm(2); P < 0.001). PR failed to reverse any mechanical changes but partially restored type IIa fiber (12.9% vs 9.13% SR; P < 0.001 vs 15.9% UR; P < 0.01) and CSA (2354 vs 2669 μm(2) SR; P < 0.001 vs 1792 μm(2) UR; P < 0.001). Mesh-repaired abdominal walls demonstrated a trend toward an intermediate mechanical phenotype but fully restored type IIa muscle fiber (9.19% vs 9.13% SR; P > 0.05 vs 15.9% UR; P < 0.001) and nearly restored CSA (2530 vs 2669 μm(2) SR; P < 0.05 vs 1792 μm(2) UR; P < 0.001). Mesh herniorrhaphy more completely reverses atrophic abdominal wall changes than primary herniorrhaphy, despite failing to restore normal anatomic muscle position. Techniques for hernia repair and mesh design should take into account abdominal wall muscle length and tension relationships and total abdominal wall compliance.
US Patent Office/International PCT, Nov 19, 2014
The invention consists of three parts made to work together to ensure safe, fast and effective de... more The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards equipment goggles, visors and shields, defensive protective armors and high impact vision wear, high performance athletic equipment, and avionics surfaces. The three parts are the anti-fog coating materials composition, their methods of preparation and processing in large, medium or small scale manufacturing, and a single unit delivery device with the coating materials to apply on any existing surface, lens, scope, tools or dials, as a wet or quickly drying coating.
ABSTRACT The invention consists of three parts made to work together to ensure safe, fast and eff... more ABSTRACT The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards equipment goggles, visors and shields, defensive protective armors and high impact vision wear, high performance athletic equipment, and avionics surfaces. The three parts are the anti-fog coating materials composition, their methods of preparation and processing in large, medium or small scale manufacturing, and a single unit delivery device with the coating materials to apply on any existing surface, lens, scope, tools or dials, as a wet or quickly drying coating.
Obesity Surgery, 2011
Obesity increases the risk of laparotomy dehiscence and incisional hernia. The aim of this study ... more Obesity increases the risk of laparotomy dehiscence and incisional hernia. The aim of this study was to measure the biological effect of obesity on laparotomy wound healing and the formation of incisional hernias. Normal-weight Sprague-Dawley (SD) and obese Zucker rats were used in an established laparotomy wound healing and incisional ventral hernia model. Mechanical testing was performed on abdominal wall strips collected from laparotomy wounds. Hernia size was measured by digital imaging. Picrosirius staining for collagen isoforms was observed with polarized microscopy. Abdominal wall fibroblasts were cultured to measure collagen matrix remodeling and proliferation. Laparotomy wound healing was significantly impaired in obese rats. Mechanical strength was lower than in normal-weight rats. Yield load was reduced in the obese group at all time points. Picrosirius red staining showed increased immature type III collagen content and disorganized type I collagen fibers within laparotomy wounds of obese rats. Wound size was significantly larger in the obese group. Collagen matrix remodeling was impaired with fibroblasts from obese rats, but there was no difference in fibroblast proliferation between the obese and normal-weight groups. We observed for the first time that laparotomy wound healing is impaired in obese rats. The recovery of laparotomy wound strength is delayed due to abnormal collagen maturation and remodeling, possibly due to a defect in fibroblast function. Strategies to improve outcomes for laparotomy wound healing in obese patients should include correcting the wound healing defect, possibly with growth factor or cell therapy.
Journal of Surgical Research, 2011
Journal of Surgical Research, 2013
Incisional hernia is the most common complication of abdominal surgery leading to reoperation. In... more Incisional hernia is the most common complication of abdominal surgery leading to reoperation. In the United States, 200,000 incisional hernia repairs are performed annually, often with significant morbidity. Obesity is increasing the risk of laparotomy wound failure. We used a validated animal model of incisional hernia formation. We intentionally induced laparotomy wound failure in otherwise normal adult, male Sprague-Dawley rats. Radio-opaque, metal surgical clips served as markers for the use of x-ray images to follow the progress of laparotomy wound failure. We confirmed radiographic findings of the time course for mechanical laparotomy wound failure by necropsy. Noninvasive radiographic imaging predicts early laparotomy wound failure and incisional hernia formation. We confirmed both transverse and craniocaudad migration of radio-opaque markers at necropsy after 28 d that was uniformly associated with the clinical development of incisional hernias. Early laparotomy wound failure is a primary mechanism for incisional hernia formation. A noninvasive radiographic method for studying laparotomy wound healing may help design clinical trials to prevent and treat this common general surgical complication.
Annals of Surgery, 2013
To determine whether primary or mesh herniorrhaphy reverses abdominal wall atrophy and fibrosis a... more To determine whether primary or mesh herniorrhaphy reverses abdominal wall atrophy and fibrosis associated with hernia formation. We previously demonstrated that hernia formation is associated with abdominal wall atrophy and fibrosis after 5 weeks in an animal model. A rat model of chronic incisional hernia was used. Groups consisted of uninjured control (UC, n = 8), sham repair (SR, n = 8), unrepaired hernia (UR, n = 8), and 2 repair groups: primary repair (PR, n = 8) or tension-free polypropylene mesh repair (MR, n = 8) hernia repair on postoperative day (POD) 35. All rats were killed on POD 70. Intact abdominal wall strips were cut perpendicular to the wound for tensiometric analysis. Internal oblique muscles were harvested for fiber type and size determination. No hernia recurrences occurred after PR or MR. Unrepaired abdominal walls significantly demonstrated greater stiffness, increased breaking and tensile strengths, yield load and yield energy, a shift to increased type IIa muscle fibers than SR (15.9% vs 9.13%; P < 0.001), and smaller fiber cross-sectional area (CSA, 1792 vs 2669 μm(2); P < 0.001). PR failed to reverse any mechanical changes but partially restored type IIa fiber (12.9% vs 9.13% SR; P < 0.001 vs 15.9% UR; P < 0.01) and CSA (2354 vs 2669 μm(2) SR; P < 0.001 vs 1792 μm(2) UR; P < 0.001). Mesh-repaired abdominal walls demonstrated a trend toward an intermediate mechanical phenotype but fully restored type IIa muscle fiber (9.19% vs 9.13% SR; P > 0.05 vs 15.9% UR; P < 0.001) and nearly restored CSA (2530 vs 2669 μm(2) SR; P < 0.05 vs 1792 μm(2) UR; P < 0.001). Mesh herniorrhaphy more completely reverses atrophic abdominal wall changes than primary herniorrhaphy, despite failing to restore normal anatomic muscle position. Techniques for hernia repair and mesh design should take into account abdominal wall muscle length and tension relationships and total abdominal wall compliance.
US Patent Office/International PCT, Nov 19, 2014
The invention consists of three parts made to work together to ensure safe, fast and effective de... more The invention consists of three parts made to work together to ensure safe, fast and effective deployment to the end users, which include but are not limited to surgeons and doctors in emergency and operating rooms, occupational hazards equipment goggles, visors and shields, defensive protective armors and high impact vision wear, high performance athletic equipment, and avionics surfaces. The three parts are the anti-fog coating materials composition, their methods of preparation and processing in large, medium or small scale manufacturing, and a single unit delivery device with the coating materials to apply on any existing surface, lens, scope, tools or dials, as a wet or quickly drying coating.