Host Response to Sepsis
Sepsis constitutes a spectrum of clinical conditions brought on by a systemic inflammatory immune response to infection. In the surgical setting, sepsis is a potentially lethal and difficult to treat complication with 750,000 cases each year, and at an annual cost of over $16 billion, it is a significant burden on the healthcare system. The pathogenesis of sepsis has remained a confounding issue. Numerous clinical trials for novel treatments of sepsis have failed and current treatment is largely limited to administration of antibiotics and fluids. Our lab is vigorously investigating the noncanonical role of the body’s lipoproteins in modulating the immune response to infection. We have identified several important immunomodulatory effects of lipoproteins during sepsis and are seeking to elucidate the mechanisms underlying the interplay between lipoproteins and immune cells. With an understanding of the role of lipoproteins in the inflammatory response following infection, we aspire to contribute a novel therapeutic solution to sepsis.
Complex Ventral Hernia Repair
Ventral hernia repair is one of the most common procedures for a general surgeon. Prosthetic mesh-reinforced repair is generally thought to result in superior outcomes compared to primary repair. However, the quality of data with respects to the use of prosthetic mesh in the setting of surgical wound contamination is quite poor. To date, there exists no high-level data on ventral hernia repair with mesh, in the setting of wound contamination. Our prospective, randomized controlled trial will compare the clinical efficacy and overall costs of two types of prosthetic meshes (a biologic and a synthetic) in the repair of complex ventral hernias. Study participants will have their hernias repaired with one of the prosthetic meshes and will be followed for 24 months post-operatively. The primary outcome variable is hernia recurrence. Secondary outcome variables include surgical site infections, pain, activity, quality-of-life, and overall costs. We hope that the data produced by the study will provide guidance to general surgeons as they approach these complex cases.
Complex Ventral Hernia Repair (NIH 1R21DK093006-01A1)