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Abstract. The biliary system consists of the biliary tree, gallbladder and major duodenal papilla. Soft tissues compliance plays important role in the bio-fluids transport. Particularly, bile flow disturbances due to bile duct wall motor function changes in the extra-hepatic ducts, from medicine point of view are called dyscinesia of biliary tract. Fluid motion in the elastic and compliant ducts can be described by different models (for example, Windkessel model, peristaltic fluid motion, FSI algorithm). Our approach is decomposition of the biliary system into three compartments (extra-hepatic biliary tree, gallbladder, major duodenal papilla). Bile flow in the extra-hepatic ducts is simulated using FSI algorithm. Bile flow in the gallbladder can be described as flow in the reservoir with compliant ducts using Windkessel model. Bile flow in the major duodenal papilla is considered as peristaltic fluid motion, because the wall contraction is really important factor of fluid motion in that segment. The coupling of these compartments is performed by boundary conditions. The biliary system geometry was obtained using MRI patient-specific data. It was confirmed that normal bile can be modeled as Newtonian fluid and lithogenic bile can be modeled as non-Newtonian fluid (Carreau fluid). Bile ducts were modeled as hyperelastic material.

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Background and Objectives: To propose a new classification of diabetic foot syndrome adapted for inclusion in the ICD-10 (the ICD-10 is the 10th revision of the International Statistical Classification of Diseases) and providing more reliable data on the number of clinical cases. Materials and Methods: A randomized controlled trial was performed. A total of 180 patients (36.6%) discharged from the hospital after surgical treatment and 312 patients (63.4%) who applied independently were observed and analysed. All patients had type 2 diabetes and were comparable in gender, age, duration of diabetes, area and nature of the wound defect. Results: We proposed to add the following to the existing ICD-10 and the emerging ICD-11 codes: Edf10.0—insulin-dependent diabetes mellitus with diabetic foot syndrome and Edf11.0—non-insulin-dependent diabetes mellitus with diabetic foot syndrome, where “df” is an acronym for diabetic foot. The new classification designates the seven most frequent areas of the lesion and five degrees of depth of soft tissue lesions. Conclusions: The proposed classification adapted for ICD-10 will enable the standardisation of diagnosis, providing a complete picture of this complication of diabetes mellitus, determining the number of amputations and their validity. Accurate statistics will allow for objective funding and timely preventive measures.

AbstractThe aim of this study is to improve treatment results and SSI prevention by differential usage of the contemporary suture materials and choice of proper suturing technique. To simulate suturing process and compared two suturing techniques, two FE models were developed. Finite-element analysis (FEA) was based on experimental data of contemporary commercial sutures and soft tissue properties. We applied obtained results for abdominal wall closure in rats and compared non-absorbable suture (capron) with absorbable suture (PDS Plus) for chosen technique. Cross-sections were examined by lighting electron microscope. Afterwards, the results of patients’ treatment are also presented. It was shown that running sew was more appropriate for aponeurosis suturing compared to interrupted sew. The optimal parameters of suturing techniques were computed. Single-row running sew by PDS Plus was proved to hold wound edges for 90 days with less inflammatory response compared to other suture in the result of histological analysis. Application of contemporary synthetic absorbable suture materials with antibacterial coating for laparotomic wounds closure and anastomosis decreases local inflammatory reaction and provides the successful tissue regeneration. Application of advanced SSI prophylactics algorithm was shown to decrease risk of post-operative suppurative complications from 14.2 to 1.6 %.