Self Inflicted Injuries among Children in United States - estimates from a nationwide emergency department sample.

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Naseem Sulyman

Full Text Available OBJECTIVE: The objectives of the current study are to provide nationally representative estimates of hospital based emergency department visits (ED attributed to self inflicted injuries and attempted suicides among children in United States; and to identify potential methods of such intentional self inflicted injuries and attempted suicides. METHODS: The Nationwide Emergency Department Sample (year 2007 was used. All ED visits occurring among children (aged ≤18 years with an External Cause of Injury for any of self inflicted injuries were selected. Outcomes examined include hospital ED charges and hospitalization charges. All estimates were projected to national levels. RESULTS: 77,420 visits to hospital based emergency departments were attributed to self inflicted injuries among children (26,045 males and 51,370 females. The average age of the ED visits was 15.7 years. 134 patients died in ED's (106 males and 28 females and 93 died in hospitals following in-patient admission (75 males and 18 females. A greater proportion of male ED visits were discharged routinely as opposed to female ED visits (51.1% versus 44%. A greater proportion of male ED visits also died in the emergency departments compared to female visits (0.4% versus 0.05%. 17,965 ED visits necessitated admission into same hospital. The mean charge for each ED visit was $1,874. Self inflicted injuries by poisoning were the most frequently reported sources accounting for close to 70% of all ED visits. CONCLUSIONS: Females comprise a greater proportion of ED visits attributed to self inflicted injuries. 227 children died either in the ED's or in hospitals. The current study results highlight the burden associated with such injuries among children.

[The death of Kaspar Hauser (17 Dec 1833)--assassination, suicide or self-inflicted injury?].

Science.gov (United States)

Risse, Manfred; Bartsch, Christine; Dreyer, Thomas; Weiler, Günter

2005-01-01

The death of Kaspar Hauser is described taking present medicolegal and criminological knowledge into account, the main question being whether the injury was self-inflicted, homicidal or suicidal. In spite of a critical retrospective analysis this question cannot be answered with sufficient certainty even from our modern perspective. It seems unlikely that the stab to the chest was inflicted exclusively for the purpose of self-damage, but both a suicidal stab and a homicidal act (assassination) cannot be definitely ruled out.

Feminist therapy with people who self-inflict violence.

Science.gov (United States)

Brown, Laura S; Bryan, Tracy C

2007-11-01

In this article, the authors describe how a feminist therapist approaches work with clients who practice self-inflicted violence (SIV). They begin by discussing feminist therapy, with its focus on empowerment of clients and the use of noncoercive strategies. The feminist perspective on understanding SIV behaviors is described, with SIV being defined as a coping strategy used by survivors of complex trauma as a means of self-care. Feminist therapy is illustrated with a case example of a woman who used SIV, and the challenges to a therapist wishing to promote client safety while empowering the client. Practice recommendations and cautions are advanced.

Suicide and self-inflicted injury hospitalizations in Canada (1979 to 2014/15

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R. Skinner

2016-11-01

Full Text Available Introduction: The purpose of this paper is to describe the trends and patterns of self-inflicted injuries, available from Canadian administrative data between 1979 and 2014/15, in order to inform and improve suicide prevention efforts. Methods: Suicide mortality and hospital separation data were retrieved from the Public Health Agency of Canada (PHAC holdings of Statistics Canada's Canadian Vital Statistics: Death Database (CVS:D (1979 to 2012; Canadian Socio-Economic Information Management System (CANSIM 2011, 2012; the Hospital Morbidity Database (HMDB (1994/95 to 2010/11; and the Discharge Abstract Database (2011/12 to 2014/15. Mortality and hospitalization counts and rates were reported by sex, 5-year age groups and method. Results: The Canadian suicide rate (males and fe­males combined, all ages, age-sex standardized rate has decreased from 14.4/100 000 (n = 3355 in 1979 to 10.4/100 000 (n = 3926 in 2012, with an annual percent change (APC of ­ 1.2% (95% CI: ­1.3 to ­1.0. However, this trend was not observed in both sexes: female suicide rates stabilized around 1990, while male rates continued declining over time—yet males still accounted for 75.7% of all suicides in 2012. Suffocation (hanging and strangulation was the primary method of suicide (46.9% among Canadians of all ages in 2012, followed by poisoning at 23.3%. In the 2014/15 fiscal year, there were 13 438 hospitalizations in Canada (excluding Quebec associated with self-in­flicted injuries—over 3 times the number of suicides. Over time females have displayed con­sistently higher rates of hospitalization for self-inflicted injury than males, with 63% of the total. Poisoning was reported as the most frequent means of self-inflicted harm in the fiscal year 2014/15, at 86% of all hospitalizations. Conclusion: Suicides and self-inflicted injuries continue to be a serious—but preventable—public health problem that requires ongoing surveillance.

Self-Inflicted Needle Injuries to the Eye: A Curing Pain

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Shahrokh Amiri

2015-01-01

Full Text Available There are few reports of severe self-injury to eyes in patients with schizophrenia. We report on a 41-year-old woman, primarily visiting for symptoms of endophthalmitis resulting from self-inflicted needles. Further evaluations established the diagnosis of schizophrenia because of arguing and commenting on auditory hallucinations and negative symptoms including social isolation, decreased self-care, blunt affect, and a monotone voice. The patient had been suffering from auditory hallucinations for several years and found relief in bodily pain caused by needles. The patient received 6 mg of risperidone. Hallucinations were resolved and self-injury behaviour was not repeated.

Post-dexamethasone Cortisol, Self-inflicted Injury, and Suicidal Ideation among Depressed Adolescent Girls

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Beauchaine, Theodore P.; Crowell, Sheila E.; Hsiao, Ray C.

2014-01-01

Although the dexamethasone suppression test (DST) has limited use as a marker of depression given inadequate sensitivity and specificity, it marks prospective risk for suicide among adults. However, few studies have examined associations between the DST, suicidal ideation, and self-inflicted injury (SII) among adolescents, even though SII is the single best predictor of eventual suicide. We evaluated the DST as a correlate of suicidal ideation and retrospective reports of self-inflicted injury (SII) among adolescent girls, ages 13–17, with histories of depression (n=28) or depression/self-harm (n=29). Lower post-DST cortisol was associated with suicidal ideation and SII, over-and-above parent-reports and combined parent-/self-reports of internalizing and externalizing behavior. These findings are consistent with recent acquired capacity models of stress-related psychopathology in which hypothalamic-pituitary adrenal (HPA) axis function is altered through epigenetic/allostatic mechanisms among vulnerable individuals who incur adversity early in life. PMID:25208812

Retroperitoneal migration of a self-inflicted ballpoint pen via the urethra

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Jose Cury

2006-04-01

Full Text Available Numerous accounts documenting the introduction of foreign bodies into the urinary bladder have been reported. These foreign bodies are typically self-inserted via urethral but migration from adjacent organs by an ulcerative process and penetrating injuries are also reported. However, "contrary" migration of a self-inflicted vesical foreign body to the retroperitoneum was not previously reported in literature. We report here a case of a ballpoint pen self-inserted via urethral by a female patient, which was identified in retroperitoneal position years later.

The burden and management of self-inflicted injuries at a tertiary ...

African Journals Online (AJOL)

The mortality rate was 22.8%. Late presentation (>24 hour), severe injuries (KTS II ≤ 6) and presence of surgical site infections were the main predictors of mortality (p<0.001). Conclusion: Self-inflicted injuries are an emerging but neglected public health problem in Mwanza, Tanzania and contribute to unacceptably high ...

A Retrospective Study of Blade Wound Characteristics in Suicide and Homicide.

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Krywanczyk, Alison; Shapiro, Steven

2015-12-01

The distinction between self-inflicted blade wounds and blade wounds inflicted by another can be difficult in situations where there is little available history or context. We reviewed homicides and suicides in the past 10 years at the Vermont Office of the Chief Medical Examiner to define the characteristics of homicidal and suicidal blade wounds. All homicides and suicides involving blade wounds, not just those in which blade wounds were the cause of death, were included. Information regarding victim demographics, location and type of injuries, toxicology, and evidence of suicidality was gathered. Blade wounds were the cause of death in 85.7% of homicides but only in 36% of suicides. Hanging and gunshot wounds were the cause of death in 28% and 24% of suicides, respectively. Multiple stab wounds were found in 10% of homicides and in 0% of suicides, whereas multiple incised wounds were found in 60% of suicides and only 10% of homicides. However, several unusual instances of suicide were found, including suicides with clothing damage or bone or cartilage injury from blade wounds. No characteristics of blade wounds were definitive for homicide or suicide. History and circumstances of the scene are thus crucial in determining the manner of death.

Income inequality, social capital and self-inflicted injury and violence-related mortality

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Huisman, M.; Oldehinkel, A. J.

Background: The objective of the study was to investigate the relation of income inequality and indicators of social capital to self-inflicted injury mortality (suicide) and violence-related mortality, and to the share of total mortality that is due to these two causes of death in 35 developed

Using human-centered design to improve the assault rifle.

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Kuo, Cheng-Lang; Yuan, Cheng-Kang; Liu, Bor-Shong

2012-11-01

The objective of the present study was to interview infantry soldiers to determine their preferences with respect to rifle design and to examine the effect of buttstocks on shooting performance. Factor analysis showed that seven main factors should be considered in rifle redesign including tactics necessary, interface design, saving weight, bullpup configuration, sight design, other devices, and bayonet lug. For the shooting experiment, a total of four shooting trials were performed with the T-91 rifle, with buttstock lengths of 26 mm, 34 mm, self-adjusting stock, and bullpup stock. The analysis revealed that buttstock length had a significant effect on shooting performance. The redesigned rifle weight and total length should be reduced to 3.2 kg and 750 mm, respectively. The rifle buttstock should be a non-adjustable bullpup style. The buttstock shape should be curved and the hand-guard type should be more deeply and density seams, while the trigger handle shape should be slanted. Copyright © 2012 Elsevier Ltd and The Ergonomics Society. All rights reserved.

Antidepressant treatment and suicide attempts and self-inflicted injury in children and adolescents.

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Gibbons, Robert D; Coca Perraillon, Marcelo; Hur, Kwan; Conti, Rena M; Valuck, Robert J; Brent, David A

2015-02-01

In the 2004, FDA placed a black box warning on antidepressants for risk of suicidal thoughts and behavior in children and adolescents. The purpose of this paper is to examine the risk of suicide attempt and self-inflicted injury in depressed children ages 5-17 treated with antidepressants in two large observational datasets taking account time-varying confounding. We analyzed two large US medical claims databases (MarketScan and LifeLink) containing 221,028 youth (ages 5-17) with new episodes of depression, with and without antidepressant treatment during the period of 2004-2009. Subjects were followed for up to 180 days. Marginal structural models were used to adjust for time-dependent confounding. For both datasets, significantly increased risk of suicide attempts and self-inflicted injury were seen during antidepressant treatment episodes in the unadjusted and simple covariate adjusted analyses. Marginal structural models revealed that the majority of the association is produced by dynamic confounding in the treatment selection process; estimated odds ratios were close to 1.0 consistent with the unadjusted and simple covariate adjusted association being a product of chance alone. Our analysis suggests antidepressant treatment selection is a product of both static and dynamic patient characteristics. Lack of adjustment for treatment selection based on dynamic patient characteristics can lead to the appearance of an association between antidepressant treatment and suicide attempts and self-inflicted injury among youths in unadjusted and simple covariate adjusted analyses. Marginal structural models can be used to adjust for static and dynamic treatment selection processes such as that likely encountered in observational studies of associations between antidepressant treatment selection, suicide and related behaviors in youth. Copyright © 2014 John Wiley & Sons, Ltd.

An unusual case of self-inflicted multiple needles injuries to eye

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Shweta Gaur

2013-01-01

Full Text Available Self-inflicted eye injuries among psychiatric patients are rare but important group of ophthalmic conditions that require close cooperation between different medical specialties to ensure optimum care of the severely disturbed patient. They have been associated with a variety of disorders, including paranoid schizophrenia, drug-induced psychosis, obsessive-compulsive disorder, depression, mental retardation, and ritualistic behavior. It has been described in both adults and children, but occurs most commonly in young adults with acute or chronic psychoses.

Parent–Child Interactions, Peripheral Serotonin, and Self-Inflicted Injury in Adolescents

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Crowell, Sheila E.; Beauchaine, Theodore P.; McCauley, Elizabeth; Smith, Cindy J.; Vasilev, Christina A.; Stevens, Adrianne L.

2009-01-01

Self-inflicted injury in adolescence indicates significant emotional and psychological suffering. Although data on the etiology of self-injury are limited, current theories suggest that the emotional lability observed among self-injuring adolescents results from complex interactions between individual biological vulnerabilities and environmental risk. For example, deficiencies in serotonergic functioning, in conjunction with certain family interaction patterns, may contribute to the development of emotional lability and risk for self-injury. The authors explored the relation between peripheral serotonin levels and mother–child interaction patterns among typical (n = 21) and self-injuring (n = 20) adolescents. Findings revealed higher levels of negative affect and lower levels of both positive affect and cohesiveness among families of self-injuring participants. Peripheral serotonin was also correlated with the expression of positive affect within dyads. Furthermore, adolescents’ serotonin levels interacted with negativity and conflict within dyads to explain 64% of the variance in self-injury. These findings underscore the importance of considering both biological and environmental risk factors in understanding and treating self-injuring adolescents. PMID:18229978

Therapy of infections in mice irradiated in mixed neutron/photon fields and inflicted with wound trauma: a review of current work.

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Ledney, G D; Madonna, G S; Elliott, T B; Moore, M M; Jackson, W E

1991-10-01

When host antimicrobial defenses are severely compromised by radiation or trauma in conjunction with radiation, death from sepsis results. To evaluate therapies for sepsis in radiation casualties, we developed models of acquired and induced bacterial infections in irradiated and irradiated-wounded mice. Animals were exposed to either a mixed radiation field of equal proportions of neutrons and gamma rays (n/gamma = 1) from a TRIGA reactor or pure gamma rays from 60[Co sources. Skin wounds (15% of total body surface area) were inflicted under methoxyflurane anesthesia 1 h after irradiation. In all mice, wounding after irradiation decreased resistance to infection. Treatments with the immunomodulator synthetic trehalose dicorynomycolate (S-TDCM) before or after mixed neutron-gamma irradiation or gamma irradiation increased survival. Therapy with S-TDCM for mice irradiated with either a mixed field or gamma rays increased resistance to Klebsiella pneumoniae-induced infections. Combined therapy with S-TDCM and ceftriaxone for K. pneumoniae infections in mice exposed to a mixed radiation field or to gamma rays was more effective than single-agent therapy. In all irradiated-wounded mice, single therapy of acquired infections with an antibiotic or S-TDCM did not increase survival. Survival of irradiated-wounded mice after topical application of gentamicin sulfate cream suggested that bacteria colonizing the wound disseminated systemically in untreated irradiated mice, resulting in death from sepsis. In lethal models of acquired infections in irradiated-wounded mice, significant increases in survival were achieved when systemic treatments with S-TDCM or gentamicin were combined with topical treatments of gentamicin cream. Therapies for sepsis in all mice exposed to a mixed field were less effective than in mice exposed to gamma rays. Nonetheless, the data show a principle by which successful therapy may be provided to individuals receiving tissue trauma in conjunction with

Attachment-Focused Psychotherapy and the Wounded Self.

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Spiegel, Eric B

2016-07-01

The concept of the "wounded self" (Wolfe, 2005) offers an integrative theoretical framework for self-wounds and their developmental origins. Alladin (2013, 2014, 2016) integrated hypnotherapy into this model to comprehensively address the unconscious protective mechanisms and maladaptive conscious cognitive strategies of the wounded self. The purpose of this article is to propose how an attachment-focused psychotherapy could be utilized in working with the wounded self. With its emphasis on developmental maturation through the frame of the attachment relationship, attachment theory is well-positioned to offer conceptual and treatment insights in treating the wounded self. E. B. Spiegel's (2016) attunement, representation, and mentalization approach to attachment-focused psychotherapy described how hypnosis can be utilized across attachment processes of attunement, representation, and mentalization toward structural maturation and developmental repair of patients with histories of complex relational trauma. In this article, the attunement, representation, and mentalization attachment approach and associated interventions are further explicated in the treatment of self-wounds in the borderline and narcissistic spectrums of personality organization. These principles of conceptualization and treatment interventions are then applied in a case example.

Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

OpenAIRE

Dimitre Dimitrov; Radomir Reszke; Jacek Szepietowski

2016-01-01

Introduction . Patients with self-inflicted skin lesions (SISL) are most often referred to dermatologists. Since psychological and psychiatric conditions might be the underlying reasons for the behavior of these patients, the psychology-associated component should always be kept in mind when approaching such individuals. Objective. To discuss distinctive aspects of the approach towards patients with SISL and emphasize the most relevant issues concerning the management of psychodermatose...

Self-mutilations in private-accident-insurance cases.

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Dotzauer, G; Iffland, R

1976-04-21

Self-inflicted injuries can be classified in groups. One group deals with the simulation of illness, another with the occurrence itself and the application of chemical, thermic or mechanical methods. One sector concerns self-mutilation, which, from a psychiatrist's point of view, is interesting. At this time we are more concerned with the problems of proving it. In wartime and even during military service in peace-time soldiers inflict mutilating injuries on themselves. They are motivated by the notion that they will gain benefit from their action. Economic gain plays a role in the case of people who have taken out private accident insurance: self mutilation to simulate the result of an accident. Our investigation into self-mutilation started with an analysis under the following aspects of 123 cases: age, sex, occupation, place of residence, place and time of deed, method employed (weapon used), localisation, single or multiple wound, direction of injury, position of fingers, nature of edges of wound. Whether or not an injury was suffered voluntarily or involuntarily can only be determined with the help of auxiliary facts. It must be clarified whether or not the information given by the injured person ties in with facts concerning the place where the injury was sustained, its position and its direction. The medico-legal expert should not interpret medical findings without relating them to the facts of the case. Indeed, he should start by examining the claimant's account of the accident. To some extent it almost requires the work of a general staff to compare the findings of a careful medical investigation with the injuries themselves. If the injury was inflicted by a certain tool information must be available regarding, for example, the "accident with the saw" together with an assessment of the wounds sustained (utilization of clinical material). Sometimes tests on corpses need to be carried out because these can provide information on mechanical and physical

Profiling wound healing with wound effluent: Raman spectroscopic indicators of infection

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Crane, Nicole J.; Elster, Eric A.

2012-01-01

The care of modern traumatic war wounds remains a significant challenge for clinicians. Many of the extremity wounds inflicted during Operation Enduring Freedom and Operation Iraqi Freedom are colonized or infected with multi-drug resistant organisms, particularly Acinetobacter baumannii. Biofilm formation and resistance to current treatments can significantly confound the wound healing process. Accurate strain identification and targeted drug administration for the treatment of wound bioburden has become a priority for combat casualty care. In this study, we use vibrational spectroscopy to examine wound exudates for bacterial load. Inherent chemical differences in different bacterial species and strains make possible the high specificity of vibrational spectroscopy.

Effect of auto-skin grafting on bacterial infection of wound in rats inflicted with combined radiation-burn injury

International Nuclear Information System (INIS)

Ran Xinze; Yan Yongtang; Wei Shuqing

1992-01-01

Rats were exposed to 6 Gy whole body γ-ray irradiation from a 60 Co source followed by light radiation burn (15% TBSA, full thickness burn) from a 5 kw bromo-tungsten lamp. The effect of auto-skin grafting on invasive bacterial infection of wound in the rats with combined radiation-burn injury was studied, In the control group inflicted with combined radiation-burn injury but without skin grafting, bacteria were found on and in the eschars at 24th hour after injury, and in the subeschar tissue on 3rd day. Tremendous bacterial multiplication occurred from 7th to 15th day, and the amount of bacteria in the internal organs increased along with the increase of subeschar infection. At the same time, no bacterial infection was found in internal organs in auto-skin grafted group at 24th hour after injury. The results show that skin grafting can decrease or prevent bacterial infection in both subeschar tissue and internal organs

Private well/spring position paper, Rifle, Colorado, sites

International Nuclear Information System (INIS)

1995-05-01

This report describes the hydrogeochemical relationship between the New and Old Rifle processing sites and 15 domestic wells in their vicinity. The relationship of the domestic wells to the Old and New Rifle tailings sites requires clarification due to recent advances in understanding of Rifle site conceptual models. In order to form a bridge from the Rifle remedial action plan (RAP) and the recent baseline risk assessment to this position paper, several issues require discussion. First, through analysis of long-term ground water level data, the hydraulic gradient between the former tailings and private wells and springs was assessed. Second, in the Rifle RAP there was not a strong emphasis placed on describing regional influences on water quality in the vicinity of the processing sites. This document uses available information coupled with theory of regional ground water flow to describe regional flow systems north of Rifle. Third, the definition of background water quality from the RAP has been refined in several ways. Also, for the recent baseline risk assessment, all alluvial wells used to define background for the sites were located east of Old Rifle. In the RAP, alluvial background wells were also placed between the sites (downgradient of Old Rifle). Two additional wells were installed for the recent baseline risk assessment upgradient of Old Rifle which verified that several of the older wells (RFO-01-0597 and -0598) were in locations representative of background

Characteristics of Bone Injuries Resulting from Knife Wounds Incised with Different Forces.

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Humphrey, Caitlin; Kumaratilake, Jaliya; Henneberg, Maciej

2017-11-01

The aim of this research was to experimentally determine the characteristics of incised bone wounds, which are commonly found in defense injuries. A specially constructed pivoting arm device was used to inflict wounds with controlled forces and direction. Five knives were selected to inflict the wounds on porcine forelimbs. Eight incised wounds were made per knife per force. A larger knife and a greater force caused longer and wider bone wounds. Comparisons of individual knives at the two forces produced varying results in the bone wounds. A correlation was seen between the force and the length (r = 0.69), width (r = 0.63), and depth (r = 0.57) of bone wounds. Serrated-edge and nonserrated knives can be distinguished from the appearance of the wound. The outcomes may be applicable in forensic investigations to ascertain the forces associated with incised wounds and identify the specific knife used. © 2017 American Academy of Forensic Sciences.

Experimental closure of gunshot wounds by fibrin glue with antibiotics in pigs

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Đenić Nebojša

2015-01-01

Full Text Available Background/Aim. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a local hemostatic and as a matrix for the local dosed release of antibiotics. Antibiotics addition to fibrin glue resulted in continuous diffusion into the surrounding next 4 to 7 days. The aim of this study was to create the preconditions for gunshot wounds closing without complications by the application of fibrin glue with antibiotics 24 h after primary surgical treatment. Methods. A total of 14 pigs were wounded in the gluteofemoral region by the bullet M67, initial velocity of 720 m/s. All wounded animals were surgically treated according to the principles of the warsurgery doctrine. Seven wounds were closed with primary delayed suture four days after the primary surgical treatment (traditional approach. Fibrin glue with antibiotics was introduced in seven wounds during the primary surgical treatment and primary delayed suture was done after 24 h. The macroscopic appearance and the clinical assessment of the wound were done during the primary surgical treatment and during its revision after 24 h, as well as histopathological findings at the days 4 and 7 after wounding. Results. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47 7.62 mm, and treated with fibrin glue with antibiotics after primary surgical management, were closed with primary delayed suture after 24 h. In further wound evolution there were no complications. Conclusion. Uncomplicated soft-tissue wounds caused by an automatic M70AB2 rifle may be closed primarily with delayed suture without the risk of developing complications if on revision, 24 h after primary surgery, there were no present necrotic tissues, hematoma, and any signs of infection when fibrin glue with antibiotics

The Mechanisms of Centalla asiatica's Wound Healing Molecule ...

African Journals Online (AJOL)

Asiaticoside is a triterpene obtained from Centella asiatica and demonstrated to have healing potential against various wound models. Wounds are inflicted for constructive reasons even though more often they are results of accidents. This work aims at identifying molecular targets which account for the therapeutic results ...

Clinical outcome of patients with self-inflicted burns.

Science.gov (United States)

Cornet, P A; Niemeijer, A S; Figaroa, G D; van Daalen, M A; Broersma, T W; van Baar, M E; Beerthuizen, G I J M; Nieuwenhuis, M K

2017-06-01

Patients with self-inflicted burns (SIB) are thought to have a longer length of stay compared to patients with accidental burns. However, other predictors for a longer length of stay are often not taken into account, e.g. percentage of the body surface area burned, age or comorbidities. Therefore, we wanted to study the outcome of patients with SIB at our burn center. A retrospective, observational study was conducted. All adult patients with acute burns admitted to the burn center of the Martini Hospital Groningen, between January 1, 2009 and December 31, 2013 were included. Data on characteristics of the patient, injury, and outcome (LOS, mortality, discharge destination) were collected. In patients with SIB, suicide attempts (SA) were distinguished from self-harm without the intention to die (non-suicidal self-injury, NSSI). To evaluate differences in outcome, each patient with SIB was matched on variables and total score of the Abbreviated Burn Severity Index (ABSI) to a patient with accidental burns (AB). In total 29 admissions (21 SA and 8 NSSI) were due to SIB and 528 due to accidents. Overall, when compared to AB, there were significant differences with respect to mortality and LOS for SA and/or NSSI. Mortality was higher in the SA group, while the LOS was higher in both the SA and NSSI groups compared to the AB group. However, after matching on ABSI, no statistical significant differences between the SA and SA-match or the NSSI and NSSI-match group were found. With the right and timely treatment, differences in mortality rate or length of stay in hospital could all be explained by the severity of the burn and the intention of the patient. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

Complex experimental analysis of rifle-shooter interaction

Directory of Open Access Journals (Sweden)

Michał Taraszewski, M.ScEng, PhD. candidate

2017-10-01

Full Text Available In this study, a complex analysis of a man-weapon interaction based on experimental effort is presented. The attention is focused on how a shooter can influence on a rifle, opposite to generally considered in literature rifle's impact on a shooter. It is shown, based on the kbk AKM weapon, that each support point of the rifle has an substantial impact on the system. It is said that identifying human reactions on weapon may let to describe gun movement and thus may be applied to weapon accuracy determination.

Variations in Wounding by Relationship Intimacy in Homicide Cases

Science.gov (United States)

Trojan, Carrie; Krull, Amy C.

2012-01-01

There are numerous examples in the homicide literature of a presumed connection between the victim-offender relationship and the manner, extent, and body location of wounds inflicted in homicides. The current study examined variations in wounding patterns according to the intimacy of the victim-offender relationship in a sample of urban homicides…

Bee Pollen as a Promising Agent in the Burn Wounds Treatment

Directory of Open Access Journals (Sweden)

Paweł Olczyk

2016-01-01

Full Text Available The aim of the present study was to visualize the benefits and advantages derived from preparations based on extracts of bee pollen as compared to pharmaceuticals commonly used in the treatment of burns. The bee pollen ointment was applied for the first time in topical burn treatment. Experimental burn wounds were inflicted on two white, domestic pigs. Clinical, histopathological, and microbiological assessment of specimens from burn wounds, inflicted on polish domestic pigs, treated with silver sulfadiazine or bee pollen ointment, was done. The comparative material was constituted by either tissues obtained from wounds treated with physiological saline or tissues obtained from wounds which were untreated. Clinical and histopathological evaluation showed that applied apitherapeutic agent reduces the healing time of burn wounds and positively affects the general condition of the animals. Moreover the used natural preparation proved to be highly effective antimicrobial agent, which was reflected in a reduction of the number of microorganisms in quantitative research and bactericidal activity of isolated strains. On the basis of the obtained bacteriological analysis, it may be concluded that the applied bee pollen ointment may affect the wound healing process of burn wounds, preventing infection of the newly formed tissue.

Self-Inflicted Lesions in Dermatology: A Management and Therapeutic Approach - A Position Paper From the European Society for Dermatology and Psychiatry

NARCIS (Netherlands)

Tomas-Aragones, Lucia; Consoli, Silla M.; Consoli, Sylvie G.; Poot, Francoise; Taube, Klaus-Michael; Linder, M. Dennis; Jemec, Gregor B. E.; Szepietowski, Jacek C.; de Korte, John; Lvov, Andrey; Gieler, Uwe

2017-01-01

The classification of self-inflicted skin lesions proposed by the European Society for Dermatology and Psychiatry (ESDaP) group generated questions with regard to specific treatments that could be recommended for such cases. The therapeutic guidelines in the current paper integrate new

Self-inflicted lesions in dermatology: terminology and classification--a position paper from the European Society for Dermatology and Psychiatry (ESDaP)

NARCIS (Netherlands)

Gieler, Uwe; Consoli, Sylvie G.; Tomás-Aragones, Lucía; Linder, Dennis M.; Jemec, Gregor B. E.; Poot, Francoise; Szepietowski, Jacek C.; de Korte, John; Taube, Klaus-Michael; Lvov, Andrey; Consoli, Silla M.

2013-01-01

The terminology, classification, diagnosis and treatment of self-inflicted dermatological lesions are subjects of open debate. The present study is the result of various meetings of a task force of dermatologists, psychiatrists and psychologists, all active in the field of psychodermatology, aimed

[The morphological characteristic of the skin lesions inflicted by plastic knives with four cutting edges].

Science.gov (United States)

Leonov, S V; Finkel'shtein, V T

2015-01-01

The objective of the present work was to study the morphological features of the skin lesions inflicted by the blades of the Fgx Boot Blade I knives having four cutting edges. The study revealed the signs that can be used to distinguish between morphological characteristics of the stab and lacerated wounds having the primary and secondary incisions made by the four-edge blade.

Work plan for preliminary investigation of organic constituents in ground water at the New Rifle site, Rifle, Colorado. Revision 2

International Nuclear Information System (INIS)

1996-01-01

A special study screening for Appendix 9 (40 CFR Part 264) analytes identified the New Rifle site as a target for additional screening for organic constituents. Because of this recommendation and the findings in a recent independent technical review, the US Department of Energy (DOE) has requested that the Technical Assistance Contractor (TAC) perform a preliminary investigation of the potential presence of organic compounds in the ground water at the New Rifle Uranium Mill Tailings Remedial Action (UMTRA) Project site, Rifle, Colorado. From 1958 to 1972, organic chemicals were used in large quantities during ore processing at the New Rifle site, and it is possible that some fraction was released to the environment. Therefore, the primary objective of this investigation is to determine whether organic chemicals used at the milling facility are present in the ground water. The purpose of this document is to describe the work that will be performed and the procedures that will be followed during installation of ground water well points at the New Rifle site. The selection of analytes and the procedures for collecting ground water samples for analysis of organic constituents are also described

Clinical process in an integrative psychotherapy for self-wounds.

Science.gov (United States)

Wolfe, Barry E

2013-09-01

In this article, I will briefly describe the clinical process of an integrative psychotherapy for the healing of self-wounds, including its intended interventions and the variability of their application and outcome. Four specific strategies will be considered, including (a) the role of empathy throughout the course of therapy; (b) exposure therapy as a paradigmatic treatment for the treatment of feared thoughts, behavior, and emotions; (c) focusing and other experiential interventions for eliciting self-wounds; and (d) modification and healing of self-wounds with an individualized array of psychodynamic, experiential, and cognitive-behavioral strategies. In addition, we will briefly consider the impact of transference and countertransference on the trajectory of therapy. 2013 APA, all rights reserved

Marine Corps Expeditionary Rifle Platoon Energy Burden

Science.gov (United States)

2014-12-01

26  a.  Step 1: The Flight to MRP AOR ............................................26  b...Terrain and Troops MEU Marine Expeditionary Unit MRP Marine Rifle Platoon NVG Night Vision Goggles SAW Squad automatic weapon SPOD Seaport...rifle platoon ( MRP ). The MRP is an infantry unit, which is the core component of the GCE. Each MRP consists of 40–45 Marines and requires energy

Experimental closure of gunshot wounds by fibrin glue with antibiotics in pigs

OpenAIRE

Đenić Nebojša; Višnjić Milan; Dragović Saša; Bojanić Vladmila; Bojanić Zoran; Đurđević Dragan; Đinđić Boris; Kostov Miloš

2015-01-01

Background/Aim. Gunshot wounds caused by the automatic rifle M70AB2 (AK-47) 7.62 mm, after the primary surgical management, were closed with delayed primary suture during the next four to seven days. This period coincides with the fibroblastic phase of wound healing. Fibrin glue is used as a local hemostatic and as a matrix for the local dosed release of antibiotics. Antibiotics addition to fibrin glue resulted in continuous diffusion into the surrounding n...

A novel investigation of heat transfer characteristics in rifled tubes

Science.gov (United States)

Jegan, C. Dhayananth; Azhagesan, N.

2018-05-01

The experimental investigation of heat transfer of water flowing in a rifled tube was explored at different pressures and at various operating conditions in a rifled tube heat exchanger. The specifications for the inner and outer diameters of the inner tube are 25.8 and 50.6 mm, respectively. The working fluids used in shell side and tube side are cold and hot water. The rifled tube was made of the stainless steel with 4 ribs, 50.6 mm outer diameter, 0.775 mm rib height, 58o helix angle and the length 1500 mm. The effect of pressure, wall heat flux and friction factor were discussed. The results confirm that even at low pressures the rifled tubes has an obvious enhancement in heat transfer compared with smooth tube. Results depicts that the Nusselt number increases with Reynolds number and the friction factor decreases with increase in Reynolds number and the heat transfer rate is higher for the rifled tube when compared to smooth tube, because of strong swirl flow due to centrifugal action. It also confirms that, the friction factor obtained from the rifled tube is significantly higher than that of smooth tube.

Work plan for ground water elevation data recorder/monitor well installation at the New Rifle Site, Rifle, Colorado

International Nuclear Information System (INIS)

1994-01-01

The purpose of this document is to describe the work that will be performed and the procedures that will be followed during installation of ground water monitor wells and ground water elevation data recorders (data loggers) at the New Rifle Uranium Mill Tailings Remedial Action (UMTRA) Project site, Rifle, Colorado. The monitor wells and data loggers will be used to gather required time-dependent data to investigate the interaction between the shallow aquifer and the Colorado River

Neurolaena lobata L. promotes wound healing in Sprague Dawley rats

OpenAIRE

Nayak, Bijoor Shivananda; Ramlogan, Surrin; Chalapathi Rao, AV; Maharaj, Sandeep

2014-01-01

Background: The leaves of the Neurolaena lobata (Asteraceae) plant are used to control diabetes and heal wounds and infections. Aim: The ethanolic extract of N. lobata leaf was evaluated for its ability to heal inflicted wounds in rats using the excision wound model. Materials and Methods: Animals were divided into three groups of six each. Test group animals were treated topically with an ethanolic extract of N. lobata (1:1 with petroleum jelly, 100 mg/kg/day). Standard and control group ani...

Creation of Consistent Burn Wounds: A Rat Model

Directory of Open Access Journals (Sweden)

Elijah Zhengyang Cai

2014-07-01

Full Text Available Background Burn infliction techniques are poorly described in rat models. An accurate study can only be achieved with wounds that are uniform in size and depth. We describe a simple reproducible method for creating consistent burn wounds in rats. Methods Ten male Sprague-Dawley rats were anesthetized and dorsum shaved. A 100 g cylindrical stainless-steel rod (1 cm diameter was heated to 100℃ in boiling water. Temperature was monitored using a thermocouple. We performed two consecutive toe-pinch tests on different limbs to assess the depth of sedation. Burn infliction was limited to the loin. The skin was pulled upwards, away from the underlying viscera, creating a flat surface. The rod rested on its own weight for 5, 10, and 20 seconds at three different sites on each rat. Wounds were evaluated for size, morphology and depth. Results Average wound size was 0.9957 cm2 (standard deviation [SD] 0.1845 (n=30. Wounds created with duration of 5 seconds were pale, with an indistinct margin of erythema. Wounds of 10 and 20 seconds were well-defined, uniformly brown with a rim of erythema. Average depths of tissue damage were 1.30 mm (SD 0.424, 2.35 mm (SD 0.071, and 2.60 mm (SD 0.283 for duration of 5, 10, 20 seconds respectively. Burn duration of 5 seconds resulted in full-thickness damage. Burn duration of 10 seconds and 20 seconds resulted in full-thickness damage, involving subjacent skeletal muscle. Conclusions This is a simple reproducible method for creating burn wounds consistent in size and depth in a rat burn model.

Development of self-inflicted injury: Comorbidities and continuities with borderline and antisocial personality traits.

Science.gov (United States)

Crowell, Sheila E; Kaufman, Erin A

2016-11-01

Self-inflicted injury (SII) is a continuum of intentionally self-destructive behaviors, including nonsuicidal self-injuries, suicide attempts, and death by suicide. These behaviors are among the most pressing yet perplexing clinical problems, affecting males and females of every race, ethnicity, culture, socioeconomic status, and nearly every age. The complexity of these behaviors has spurred an immense literature documenting risk and vulnerability factors ranging from individual to societal levels of analysis. However, there have been relatively few attempts to articulate a life span developmental model that integrates ontogenenic processes across these diverse systems. The objective of this review is to outline such a model with a focus on how observed patterns of comorbidity and continuity can inform developmental theories, early prevention efforts, and intervention across traditional diagnostic boundaries. Specifically, when SII is viewed through the developmental psychopathology lens, it becomes apparent that early temperamental risk factors are associated with risk for SII and a range of highly comorbid conditions, such as borderline and antisocial personality disorders. Prevention efforts focused on early-emerging biological and temperamental contributors to psychopathology have great potential to reduce risk for many presumably distinct clinical problems. Such work requires identification of early biological vulnerabilities, behaviorally conditioned social mechanisms, as well as societal inequities that contribute to self-injury and underlie intergenerational transmission of risk.

To reiterate the concept of self-aid and buddy-aid for combat wounded

Directory of Open Access Journals (Sweden)

Zhong-jie HE

2015-11-01

Full Text Available Explore new concept of self-aid and buddy-aid for combat wounded based on the emergency timeliness and the challenges we are going to face in the future combats, the importance of self-aid, buddy-aid and rescue are discussed. The concept and characteristics of self-aid and buddy-aid in our army are reviewed, and the care of the wounded in foreign armies were reviewed. Based on the experiences gained from previous combats, and the results of "Medical Service Mission-2014 Drill", it was believed that the emergency rescue of battle wounded should follow the timeliness rule and the principle of self-aid and buddy-aid technology. It might be beneficial to use cell protective agent, urgent relief of life-threatening conditions such as profuse bleeding from extremities, suffocation, pneumothorax, and traumatic shock etc., in order to stabilize the general condition of the wounded, according to the regime of "Platinum 10 minutes" and "golden 1 hour", self-aid and buddy-aid might play an important role in preventing early death and late morbidity of the wounded, thus helps reduce the mortality rate or the victims of combat wounds. DOI: 10.11855/j.issn.0577-7402.2015.11.01

Effects of topical topiramate in wound healing in mice.

Science.gov (United States)

Jara, Carlos Poblete; Bóbbo, Vanessa Cristina Dias; Carraro, Rodrigo Scarpari; de Araujo, Thiago Matos Ferreira; Lima, Maria H M; Velloso, Licio A; Araújo, Eliana P

2018-02-23

Recent studies have indicated that systemic topiramate can induce an improvement on the aesthetic appearance of skin scars. Here, we evaluated topical topiramate as an agent to improve wound healing in C57/BL6 mice. Mice were inflicted with a 6.0 mm punch to create two wounds in the skin of the dorsal region. Thereafter, mice were randomly assigned to either vehicle or topical topiramate (20 µl of 2% cream) once a day for 14 days, beginning on the same day as wound generation. We analyzed the wound samples over real-time PCR, Western blotting, and microscopy. There was no effect of the topiramate treatment on the time for complete reepithelization of the wound. However, on microscopic analysis, topiramate treatment resulted in increased granulation tissue, thicker epidermal repair, and improved deposition of type I collagen fibers. During wound healing, there were increased expressions of anti-inflammatory markers, such as IL-10, TGF-β1, and reduced expression of the active form of JNK. In addition, topiramate treatment increased the expression of active forms of two intermediaries in the insulin-signaling pathway, IRS-1 and Akt. Finally, at the end of the wound-healing process, topiramate treatment resulted in increased expression of SOX-2, a transcription factor that is essential to maintain cell self-renewal of undifferentiated embryonic stem cells. We conclude that topical topiramate can improve the overall quality of wound healing in the healthy skin of mice. This improvement is accompanied by reduced expression of markers involved in inflammation and increased expression of proteins of the insulin-signaling pathway.

Penetrating Bihemispheric Traumatic Brain Injury: A Collective Review of Gunshot Wounds to the Head.

Science.gov (United States)

Turco, Lauren; Cornell, David L; Phillips, Bradley

2017-08-01

Head injuries that cross midline structures of the brain are bihemispheric. Other terms have been used to describe such injuries, but bihemispheric is the most accurate and should be standard nomenclature. Bihemispheric head injuries are associated with greater mortality and morbidity than other penetrating traumatic brain injuries (TBIs). Currently, there is a tendency to manage severe gunshot wounds (GSWs) to the head nonoperatively, despite reports of improved outcome in military patients treated aggressively. Thus, controversy exists in the management of civilian TBI. PubMed was searched for query terms, and PRISMA guidelines were used. Studies were selected by relevance and inclusion of data regarding etiology, diagnosis, and management of bihemispheric TBI. Case reports, studies not in English, and records lacking information on mechanism or bihemispheric injuries were excluded. Thirteen studies were included and most contained level IV evidence. The mean mortality rate of all head GSWs was 62% in adults and 32% in children. Bihemispheric GSWs had greater mortality rates of 82% in adults and 60% in children. There was a larger proportion of self-inflicted injury in studies with greater rates of bihemispheric injuries. Bihemispheric injuries have greater mortality rates than other penetrating TBI. Violation of midline brain structures such as the diencephalon and mesencephalon, increased rate of self-inflicted wounds, and lack of a standard management algorithm may increase the lethality of these injuries. Although bihemispheric injuries historically have been considered nonsalvageable, an aggressive surgical approach has been shown to improve outcomes, particularly in the military population. Copyright © 2017 Elsevier Inc. All rights reserved.

Investigation of background radiation and associated anomalies in Rifle, Colorado

International Nuclear Information System (INIS)

Smuin, D.R.; Wilson, M.J.; Crutcher, J.W.

1988-02-01

In addition to examining anomalies and establishing the background gamma exposure rate range, the study presents a formula to convert thousand counts per minute (kcpm) from a gamma scintillator to microroentgen per hour (μRh) for the Rifle region. Also, a method is presented to identify contaminated areas containing excess 226 Ra, by using a GR-410 gamma spectrometer. This method is suggested to be applied to all property surveys in the Rifle area. The Wasatch Formation, which outcrops extensively in the Rifle area, was found to have a major influence on the background radiation. Varying potassium concentrations and naturally occurring uranium in this rock unit reveal varying gamma exposure rates. Examining RaTh ratios from laboratory analysis of soil samples or use of RaTh ratios from GR-410 gamma spectrometer readings on site allows discrimination between mill related contamination and naturally occuring radioactivity. Radioactive coal clinkers were found used as fill material throughout the Rifle region and have been determined to be a product of the mill and subject to remediation. Finally, windblown mill tailings contamination is addressed in some detail. Mill tailings redistributed from the Rifle uranium mill tailings piles by prevailing winds were detected extensively on vicinity properties in Rifle. Some radioactive components of the windblown tailings were found to have leached into the subsurface soil. The combination of Wasatch Formation, radioactive coal clinkers, and windblown tailings accounts for many of the anomalous gamma exposure rates observed by the radiological survey teams. 11 refs., 10 figs., 3 tabs

[Injury patterns and roentgen findings in gunshot wounds with rare flint ammunition].

Science.gov (United States)

Pollak, S; Lindermann, A

1990-01-01

Smoothbore shotgun barrels can fire cartridges with common pellet loads as well as shotgun slugs and rubber bullets. Other than conventional shot, the cylindrical Brenneke-type rifled shotgun slugs sometimes cause perforating wounds. The shotgun ammunition for use in self-defence can have a single projectile or several rubber pellets. Where the propellant is black powder, short range shots will probably leave searing marks and intensive soot deposits. Fired at close range, rubber bullets can penetrate through the skin into the body, fired at greater distance they cause contusions. A case of homicide (repeated firing with a 12-ga. pump gun) is used to present and discuss the injury patterns and X-ray findings after impact of Brenneke-type slugs and rubber bullets as well as of "classical" shot pellets.

Self-inflicted skin lesions: the importance of a proper diagnostic and therapeutic approach

Directory of Open Access Journals (Sweden)

Dimitre Dimitrov

2016-12-01

Full Text Available Introduction . Patients with self-inflicted skin lesions (SISL are most often referred to dermatologists. Since psychological and psychiatric conditions might be the underlying reasons for the behavior of these patients, the psychology-associated component should always be kept in mind when approaching such individuals. Objective. To discuss distinctive aspects of the approach towards patients with SISL and emphasize the most relevant issues concerning the management of psychodermatoses. Case report. We present a case of a 13-year-old girl with a 6-month history of skin lesions misdiagnosed as allergic contact dermatitis. Conscientious history taking and physical examination enabled the diagnosis of SISL. Conclusions. The proper approach to patients presenting with psychodermatoses differs from that for other dermatological patients and requires considering several additional aspects. We would like to emphasize the distinguishing aspects and importance of the proper approach to patients with SISL that might aid clinicians in diagnosing and treating these individuals in the future.

Acute Ultraviolet Radiation Perturbs Epithelialization but not the Biomechanical Strength of Full-thickness Cutaneous Wounds

DEFF Research Database (Denmark)

Danielsen, Patricia L; Lerche, Catharina M; Wulf, Hans Christian

2016-01-01

SED, 3 SED and 5 SED. Twenty-four hours after UV irradiation, inflammation was quantified by skin reflectance (erythema) and myeloperoxidase (MPO) tissue levels, and two 6 mm full-thickness excisional wounds and one 3 cm incisional wound were inflicted. Epidermal hyperplasia was assessed...... (P epithelial coverage decreased (P = 0.024) by increasing the UVR dose, whereas there was no significant difference (P = 0.765) in wound MPO levels. Neither wound width (P = 0.850) nor breaking strength (P...... = 0.320) differed among the groups. Solar-simulated UVR 24 h before wounding impaired epithelialization but was not detrimental for surgical incisional wound healing....

Characteristics of Firearm Brain Injury Survivors in the Traumatic Brain Injury Model Systems (TBIMS) National Database: A Comparison of Assault and Self-Inflicted Injury Survivors.

Science.gov (United States)

Bertisch, Hilary; Krellman, Jason W; Bergquist, Thomas F; Dreer, Laura E; Ellois, Valerie; Bushnik, Tamara

2017-11-01

To characterize and compare subgroups of survivors with assault-related versus self-inflicted traumatic brain injuries (TBIs) via firearms at the time of inpatient rehabilitation and at 1-, 2-, and 5-year follow-up. Secondary analysis of data from the Traumatic Brain Injury Model Systems National Database (TBIMS NDB), a multicenter, longitudinal cohort study. Retrospective analyses of a subset of individuals enrolled in the TBIMS NDB. Individuals 16 years and older (N=399; 310 via assault, 89 via self-inflicted injury) with a primary diagnosis of TBI caused by firearm injury enrolled in the TBIMS NDB. Not applicable. Disability Rating Scale, Glasgow Outcome Scale-Extended, sociodemographic variables (sex, age, race, marital status), injury-related/acute care information (posttraumatic amnesia, loss of consciousness, time from injury to acute hospital discharge), and mental health variables (substance use history, psychiatric hospitalizations, suicide history, incarcerations). Individuals who survived TBI secondary to a firearm injury differed by injury mechanism (assault vs self-inflicted) on critical demographic, injury-related/acute care, and mental health variables at inpatient rehabilitation and across long-term recovery. Groups differed in terms of geographic area, age, ethnicity, education, marital status, admission Glasgow Coma Scale score, and alcohol abuse, suicide attempts, and psychiatric hospitalizations at various time points. These findings have implications for prevention (eg, mental health programming and access to firearms in targeted areas) and for rehabilitation planning (eg, by incorporating training with coping strategies and implementation of addictions-related services) for firearm-related TBI, based on subtype of injury. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

Muscle wound healing in rainbow trout (Oncorhynchus mykiss).

Science.gov (United States)

Schmidt, J G; Andersen, E W; Ersbøll, B K; Nielsen, M E

2016-01-01

We followed the progression of healing of deep excisional biopsy punch wounds over the course of 365 days in rainbow trout (Oncorhynchus mykiss) by monitoring visual wound healing and gene expression in the healing muscle at regular intervals (1, 3, 7, 14, 38 and 100 days post-wounding). In addition, we performed muscle texture analysis one year after wound infliction. The selected genes have all previously been investigated in relation to vertebrate wound healing, but only few specifically in fish. The selected genes were interleukin (IL)-1β, IL-6, transforming growth factor (TGF)-β1 and -β3, matrix metalloproteinase (MMP) -9 and -13, inducible nitric oxide synthase (iNOS), fibronectin (FN), tenascin-C (TN-C), prolyl 4-hydroxylase α1-chain (P4Hα1), lysyl oxidase (LOX), collagen type I α1-chain (ColIα1), CD41 and CD163. Wound healing progressed slowly in the presented study, which is at least partially due to the low temperature of about 8.5 °C during the first 100 days. The inflammation phase lasted more than 14 days, and the genes relating to production and remodeling of new extracellular matrix (ECM) exhibited a delayed but prolonged upregulation starting 1-2 weeks post-wounding and lasting until at least 100 days post-wounding. The gene expression patterns and histology reveal limited capacity for muscle regeneration in rainbow trout, and muscle texture analyses one year after wound infliction confirm that wounds heal with fibrosis. At 100 dpw epidermis had fully regenerated, and dermis partially regenerated. Scales had not regenerated even after one year. CD163 is a marker of "wound healing"-type M2c macrophages in mammals. M2 macrophage markers are as yet poorly described in fish. The pattern of CD163 expression in the present study is consistent with the expected timing of presence of M2c macrophages in the wound. CD163 may thus potentially prove a valuable marker of M2 macrophages - or a subset hereof - in fish. We subjected a group of fish to

UMTRA project water sampling and analysis plan, Old and New Rifle, Colorado

International Nuclear Information System (INIS)

1994-07-01

Surface remedial action at the Rifle, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project site began in the spring of 1992. Results of water sampling at the Old and New Rifle processing sites for recent years indicate that ground water contamination occurs in the shallow unconfined alluvial aquifer (the uppermost aquifer) and less extensively in the underlying Wasatch Formation. Uranium and sulfate continue to exceed background ground water concentrations and/or maximum concentration limits at and downgradient from the former processing sites. These constituents provide the best indication of changes in contaminant distribution. Contamination in the uppermost (alluvial) aquifer at New Rifle extends a minimum of approximately 5000 feet (ft) (1,524 meters [m]) downgradient. At Old Rifle, the extent of contamination in the alluvial aquifer is much less (a minimum of approximately 1,000 ft [305 m]), partially due to differences in hydrologic regime. For example, the Old Rifle site lies in a relatively narrow alluvial floodplain; the New Rifle site lies in a broad floodplain. Data gathering for the Rifle baseline risk assessment is under way. The purpose of this effort is to determine with greater precision the background ground water quality and extent of ground water contamination at the processing sites. Historical surface water quality indicates that the Colorado River has not been affected by uranium processing activities. No compliance monitoring of the Estes Gulch disposal cell has been proposed, because ground water in the underlying Wasatch Formation is limited use (Class 111) ground water and because the disposal cell is hydrogeologically isolated from the uppermost aquifer

Intractable Postoperative Wounds Caused by Self-Inflicted Trauma in a Patient with Cutaneous Munchausen Syndrome Presenting as a Pyoderma Gangrenosum-Like Lesion

OpenAIRE

Inui, Keiko; Hanafusa, Takaaki; Namiki, Takeshi; Ueno, Makiko; Igawa, Ken; Yokozeki, Hiroo

2016-01-01

A 50-year-old Japanese woman consulted the emergency department of our hospital for bleeding due to an intractable postoperative wound on the lower abdomen; the postoperative wound was owing to a laparoscopic cholecystectomy performed 1 year previously for acute cholecystitis. She presented with a painful ulcer on her right lower abdomen. She also presented with multiple scars, skin grafts on the extremities, and a missing left lower leg, the causes for all of which were unexplained. The resu...

Wound healing activity of Sida cordifolia Linn. in rats.

Science.gov (United States)

Pawar, Rajesh S; Chaurasiya, Pradeep K; Rajak, Harish; Singour, Pradeep K; Toppo, Fedelic Ashish; Jain, Ankit

2013-01-01

The present study provides a scientific evaluation for the wound healing potential of ethanolic (EtOH) extract of Sida cordifolia Linn. (SCL) plant. Excision, incision and burn wounds were inflicted upon three groups of six rats each. Group I was assigned as control (ointment base). Group II was treated with 10% EtOH extract ointment. Group III was treated with standard silver sulfadiazine (0.01%) cream. The parameters observed were percentage of wound contraction, epithelialization period, hydroxyproline content, tensile strength including histopathological studies. It was noted that the effect produced by the ethanolic extract of SCL ointment showed significant (P < 0.01) healing in all wound models when compared with the control group. All parameters such as wound contraction, epithelialization period, hydroxyproline content, tensile strength and histopathological studies showed significant (P < 0.01) changes when compared with the control. The ethanolic extract ointment of SCL effectively stimulates wound contraction; increases tensile strength of excision, incision and burn wounds.

Picturesque Wounds: A Multimodal Analysis of Self-Injury Photographs on Flickr

Directory of Open Access Journals (Sweden)

Yukari Seko

2013-05-01

Full Text Available The advancement of Web 2.0 technologies has drastically extended the realm of self-expression, to the extent that personal and potentially controversial photographs are widely shared with public viewers. This study examined user-generated photographs of self-injury (SI uploaded on a popular photo-sharing site Flickr.com, to explore how the photo uploaders represent their wounded bodies, whether there are any emergent discursive and visual conventions that (redefine "photographs of SI," and whether these emergent conventions affirm or resist dominant cultural discourses of SI. 516 photographs of SI uploaded by 146 Flickr members were analyzed using methods of visual content analysis and discourse analysis. The findings indicate that while dominant discourses largely determine the shaping of SI photographs, some uploaders subversively frame their wounds as a narrative of resilience, thereby transforming their wounds into an authentic source of self-expression. URN: http://nbn-resolving.de/urn:nbn:de:0114-fqs1302229

Expression of immune system-related genes during ontogeny in experimentally wounded common carp (Cyprinus carpio) larvae and juveniles

DEFF Research Database (Denmark)

Schmidt, Jacob; Nielsen, Michael Engelbrecht

2014-01-01

We investigated the effect of full-thickness incisional wounding on expression of genes related to the immune system in larvae and juveniles of common carp (Cyprinus carpio). The wounds were inflicted by needle puncture immediately below the anterior part of the dorsal fin on days 7, 14, 28 and 49...

Are There Ways out of the Self-inflicted Irrelevance of the Qualitative Off-stream?

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Norbert Groeben

2006-09-01

Full Text Available The qualitative paradigm is relatively irrelevant in psychological research and teaching, which is not only due to the hegemony of the quantitative paradigm. This irrelevance also arises from the fragmentation within the qualitative research paradigm, which is a result of the principle of a close interdependence of research object and method; this fragmentation is evident in the lack of a systematic approach to the concept of method. The conviction to conduct a superior psychological approach leads to destructive competition both within the qualitative paradigm and in relation to the quantitative paradigm. Instead, I recommend the pursuit of approaches that attempt to integrate qualitative and quantitative research methods on the basis of the idea of ontological layers, clearly distinct from esoteric approaches. Above all, the development of sophisticated and complex methods of statistical analysis appears a promising way to overcome the self-inflicted irrelevance of the qualitative research paradigm. URN: urn:nbn:de:0114-fqs0604347

Correlation between incidences of self-inflicted burns and means of inbreeding coefficients, an ecologic study.

Science.gov (United States)

Saadat, Mostafa; Zendeh-Boodi, Zahra

2006-09-01

The aim of the study is to obtain more insight into the possible association between consanguinity and the incidence of deliberate self-burning. Data were obtained by analysis of medical records of patients hospitalized in two referral burn centers: Chormy Burn Center (Bushehr Province, south of Iran) from March 21, 1998, through March 20, 2004, and Shahid Sadoqi Center of Burns and Injuries (Yazd Province, center of Iran) from March 21, 2000, through March 20, 2004. The incidence of suicidal burns was 6.51 and 2.32/100,000 person-years for Bushehr and Yazd Provinces, respectively. The observed sex ratio of patients in both centers indicated there was a female predominance in patients with self-inflicted burns. Using patients' home addresses, patients were sorted into 16 cities. The incidence of suicide by self-burning ranged from 0.80 (for Tabas, located in Yazd Province) to 12.60/100,000 person-years (for Dilam, located in Bushehr Province). The coefficient of inbreeding defines the probability that an individual received both alleles of a pair from an identical ancestral source. There was a significant correlation between incidences of suicidal burns and mean coefficient of inbreeding (r = 0.782, df = 14, p < 0.001). In addition to other factors, consanguineous marriage may be a risk factor that influences the incidence of suicidal burns in a population.

SELF WOUND MANAGEMENT PRACTICES BEFORE ATTENDING ANTIRABIES VACCINE CLINIC

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Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda

2015-07-01

Full Text Available Introduction: In INDIA almost 20000 people die (40% of world death each year from rabies. Most of these deaths could be prevented by post exposure prophylaxis with wound washing, rabies immunoglobulin & vaccination. Local wound management alone can reduce viral load by up to 80%. Objective: To study self-wound management practices in animal exposure patients before attending a tertiary level ARV clinic. Methodology: Data regarding wound management was collected by individual interview of patients attending the ARV clinic during OCT 2011 to MAR 2012. The data collected in the form of a questionnaire. Analysis of data was done in the Department Of Community Medicine, V.S.S. Medical College, Burla. Results: Total 493 cases of animal exposure were attended during the study period. Most common biting animal was dog (94.5%. 31% of cases were under the age of 10 years & 23% belongs to the age of 10-19 years. Male to female ratio was 3:1. Most of the cases (91% were of category III exposure. Immediate management of wound was practiced by 63-77% of cases before visiting ARV clinic; only 2% wash the wound with running water & soap for 15 minutes. 39% of cases applied Dettol/savlon at the wound side & other 38% applied turmeric, red chilli, kerosene, Band-Aid & ghee locally. Most cases (61% reported to ARV clinic within 24hours.

Wound repair and anti-inflammatory potential of Lonicera japonica in excision wound-induced rats.

Science.gov (United States)

Chen, Wei-Cheng; Liou, Shorong-Shii; Tzeng, Thing-Fong; Lee, Shiow-Ling; Liu, I-Min

2012-11-23

Lonicera japonica Thunb. (Caprifoliaceae), a widely used traditional Chinese medicinal plant, is used to treat some infectious diseases and it may have uses as a healthy food and applications in cosmetics and as an ornamental groundcover. The ethanol extract of the flowering aerial parts of L. japonica (LJEE) was investigated for its healing efficiency in a rat excision wound model. Excision wounds were inflicted upon three groups of eight rats each. Healing was assessed by the rate of wound contraction in skin wound sites in rats treated with simple ointment base, 10% (w/w) LJEE ointment, or the reference standard drug, 0.2% (w/w) nitrofurazone ointment. The effects of LJEE on the contents of hydroxyproline and hexosamine during healing were estimated. The antimicrobial activity of LJEE against microorganisms was also assessed. The in vivo anti-inflammatory activity of LJEE was investigated to understand the mechanism of wound healing. LJEE exhibited significant antimicrobial activity against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Candida albicans, and Candida tropicalis. The ointment formulation prepared with 10% (w/w) LJEE exhibited potent wound healing capacity as evidenced by the wound contraction in the excision wound model. The contents of hydroxyproline and hexosamine also correlated with the observed healing pattern. These findings were supported by the histopathological characteristics of healed wound sections, as greater tissue regeneration, more fibroblasts, and angiogenesis were observed in the 10% (w/w) LJEE ointment-treated group. The results also indicated that LJEE possesses potent anti-inflammatory activity, as it enhanced the production of anti-inflammatory cytokines that suppress proinflammatory cytokine production. The results suggest that the antimicrobial and anti-inflammatory activities of LJEE act synergistically to accelerate wound repair.

Intensity and direction of competitive state anxiety as interpreted by rugby players and rifle shooters.

Science.gov (United States)

Hanton, S; Jones, G; Mullen, R

2000-04-01

This study reports the findings of part of an ongoing research program examining sports performers' interpretations of competitive anxiety prior to competition. The notion of 'directional perceptions' has questioned the limited utility of examining only the intensity of competitive anxiety responses as has Jones. The purpose of this study was to examine intensity and direction, i.e., interpretation of intensity as facilitative or debilitative, of anxiety symptoms as a function of two types of sport. The types of sport were explosive (rugby league) versus fine motor skills (target rifle shooting). The sample comprised 50 male rugby league participants and 50 target rifle shooters who completed a modified version of the Competitive State Anxiety Inventory-2 prior to competition. Contingency analysis yielded a significant difference in the number of rugby players who reported somatic anxiety as facilitative and the number of rifle shooters who reported somatic states as debilitative. No such differences were evident for cognitive anxiety. Analysis of variance indicated no differences between the two groups on the intensity of cognitive and somatic anxiety, but the performers competing in rugby league interpreted both states as being more facilitative to performance; the rugby league players also had higher scores on self-confidence than the shooters. These findings provide continuing support for the measurement of directional perceptions of competitive anxiety and highlight the importance of examining individual sports.

Muscle wound healing in rainbow trout (Oncorhynchus mykiss)

DEFF Research Database (Denmark)

Schmidt, Jacob Günther; Andersen, Elisabeth Wreford; Ersbøll, Bjarne Kjær

2016-01-01

We followed the progression of healing of deep excisional biopsy punch wounds over the course of 365 days in rainbow trout (Oncorhynchus mykiss) by monitoring visual wound healing and gene expression in the healing muscle at regular intervals (1, 3, 7, 14, 38 and 100 days post-wounding). In addit......We followed the progression of healing of deep excisional biopsy punch wounds over the course of 365 days in rainbow trout (Oncorhynchus mykiss) by monitoring visual wound healing and gene expression in the healing muscle at regular intervals (1, 3, 7, 14, 38 and 100 days post......-wounding). In addition, we performed muscle texture analysis one year after wound infliction. The selected genes have all previously been investigated in relation to vertebrate wound healing, but only few specifically in fish. The selected genes were interleukin (IL)-1β, IL-6, transforming growth factor (TGF)-β1 and -β3......, matrix metalloproteinase (MMP) -9 and -13, inducible nitric oxide synthase (iNOS), fibronectin (FN), tenascin-C (TN-C), prolyl 4-hydroxylase α1-chain (P4Hα1), lysyl oxidase (LOX), collagen type I α1-chain (ColIα1), CD41 and CD163. Wound healing progressed slowly in the presented study, which is at least...

Engineering assessment of inactive uranium mill tailings, Rifle Site, Rifle, Colorado. Summary of the Phase II, Title I

International Nuclear Information System (INIS)

1977-10-01

Ford, Bacon and Davis Utah Inc. has performed an engineering assessment of the problems resulting from the existence of radioactive uranium mill tailings at Rifle, Colorado. The Phase II - Title I services include the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 3.1 million tons of tailings at the two Rifle sites, constitutes the most significant environmental impact. Windblown tailings, external gamma radiation and localized contamination of surface waters are other environmental effects. The 15 alternative remedial action options presented range from millsite decomtamination and off-site remedial action (Options I and IV), to adding various depths of stabilization cover material (Options II, V, VI, and VII), to removal of the tailings to long-term storage sites and decontamination of the present sites (Options III and VIII through XV). Cost estimates for the first 14 options range from $224,000 to $20,300,000. Option XV, estimated at $32,200,000, includes the cost for moving both Rifle tailings piles and the Grand Junction tailings pile to DeBeque for long-term storage and site decontamination after removal of the piles. Reprocessing of the tailings for uranium appears to be economically attractive at present

Engineering assessment of inactive uranium mill tailings new and old Rifle site, Rifle, Colorado. Phase II, Title I

International Nuclear Information System (INIS)

1977-10-01

Ford, Bacon and Davis Utah Inc. has performed an engineering assessment of the problems resulting from the existence of radioactive uranium mill tailings at Rifle, Colorado. The Phase II--Title I services include the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 3.1 million tons of tailings at the two Rifle sites, constitutes the most significant environmental impact. Windblown tailings, external gamma radiation and localized contamination of surface waters are other environmental effects. The 15 alternative remedial action options presented range from millsite decontamination and off-site remedial action (Options I and IV), to adding various depths of stabilization cover material (Options II, V, VI and VII), to removal of the tailings to long-term storage sites and decontamination of the present sites (Options III and VIII through XV). Cost estimates for the first 14 options range from $224,000 to $20,300,000. Option XV, estimated at $32,200,000, includes the cost for moving both Rifle tailings piles and the Grand Junction tailings pile to DeBeque for long-term storage and site decontamination after removal of the piles. Reprocessing of the tailings for uranium appears to be economically attractive at present

Engineering assessment of inactive uranium mill tailings new and old Rifle site, Rifle, Colorado. Phase II, Title I

Energy Technology Data Exchange (ETDEWEB)

None

1977-10-01

Ford, Bacon and Davis Utah Inc. has performed an engineering assessment of the problems resulting from the existence of radioactive uranium mill tailings at Rifle, Colorado. The Phase II--Title I services include the preparation of topographic maps, the performance of core drillings and radiometric measurements sufficient to determine areas and volumes of tailings and other radium-contaminated materials, the evaluation of resulting radiation exposures of individuals and nearby populations, the investigation of site hydrology and meteorology and the evaluation and costing of alternative corrective actions. Radon gas release from the 3.1 million tons of tailings at the two Rifle sites, constitutes the most significant environmental impact. Windblown tailings, external gamma radiation and localized contamination of surface waters are other environmental effects. The 15 alternative remedial action options presented range from millsite decontamination and off-site remedial action (Options I and IV), to adding various depths of stabilization cover material (Options II, V, VI and VII), to removal of the tailings to long-term storage sites and decontamination of the present sites (Options III and VIII through XV). Cost estimates for the first 14 options range from $224,000 to $20,300,000. Option XV, estimated at $32,200,000, includes the cost for moving both Rifle tailings piles and the Grand Junction tailings pile to DeBeque for long-term storage and site decontamination after removal of the piles. Reprocessing of the tailings for uranium appears to be economically attractive at present.

Neurolaena lobata L. promotes wound healing in Sprague Dawley rats.

Science.gov (United States)

Nayak, Bijoor Shivananda; Ramlogan, Surrin; Chalapathi Rao, Av; Maharaj, Sandeep

2014-07-01

The leaves of the Neurolaena lobata (Asteraceae) plant are used to control diabetes and heal wounds and infections. The ethanolic extract of N. lobata leaf was evaluated for its ability to heal inflicted wounds in rats using the excision wound model. Animals were divided into three groups of six each. Test group animals were treated topically with an ethanolic extract of N. lobata (1:1 with petroleum jelly, 100 mg/kg/day). Standard and control group animals were treated with mupirocin and petroleum jelly, respectively. Treatment was given for 13 days and the wound area was measured on alternate days. Parameters of healing assessed were the rate of wound contraction, period of epithelialization and hydroxyproline content. Antimicrobial activity of the extract was observed against Pseudomonas aeruginosa, Staphylococcus aureus and Escherichia coli. Phytochemical analysis of the extract showed the presence of saponins, tannins, alkaloids and flavanoids. Extract-treated animals exhibited 87% reduction in the wound area over 13 days when compared with the control (78%) and standard (83%) groups (P lobata as a pharmacotherapy for wound healing.

Extrafloral nectar secretion from wounds of Solanum dulcamara.

Science.gov (United States)

Lortzing, Tobias; Calf, Onno W; Böhlke, Marlene; Schwachtje, Jens; Kopka, Joachim; Geuß, Daniel; Kosanke, Susanne; van Dam, Nicole M; Steppuhn, Anke

2016-04-25

Plants usually close wounds rapidly to prevent infections and the loss of valuable resources such as assimilates(1). However, herbivore-inflicted wounds on the bittersweet nightshade Solanum dulcamara appear not to close completely and produce sugary wound secretions visible as droplets. Many plants across the plant kingdom secrete sugary nectar from extrafloral nectaries(2) to attract natural enemies of herbivores for indirect defence(3,4). As ants forage on wound edges of S. dulcamara in the field, we hypothesized that wound secretions are a form of extrafloral nectar (EFN). We show that, unlike EFN from known nectaries, wound secretions are neither associated with any specific structure nor restricted to certain locations. However, similar to EFN, they are jasmonate-inducible and the plant controls their chemical composition. Wound secretions are attractive for ants, and application of wound secretion mimics increases ant attraction and reduces herbivory on S. dulcamara plants in a natural population. In greenhouse experiments, we reveal that ants can defend S. dulcamara from two of its native herbivores, slugs and flea beetle larvae. Since nectar is defined by its ecological function as a sugary secretion involved in interactions with animals(5), such 'plant bleeding' could be a primitive mode of nectar secretion exemplifying an evolutionary origin of structured extrafloral nectaries.

Radiological survey of the inactive uranium-mill tailings at Rifle, Colorado

International Nuclear Information System (INIS)

Haywood, F.F.; Jacobs, D.J.; Ellis, B.S.; Hubbard, H.M. Jr.; Shinpaugh, W.H.

1980-06-01

Results of radiological surveys of two inactive uranium-mill sites near Rifle, Colorado, in May 1976 are presented. These sites are referred to as Old Rifle and New Rifle. The calculated 226 Ra inventory of the latter site is much higher than at the older mill location. Data on above-ground measurements of gamma exposure rates, surface and near-surface concentration of 226 Ra in soil and sediment samples, concentration of 226 Ra in water, calculated subsurface distribution of 226 Ra, and particulate radionuclide concentrations in air samples are given. The data serve to define the extent of contamination in the vicinity of the mill sites and their immediate surrounding areas with tailings particles. Results of these measurements were utilized as technical input for an engineering assessment of these two sites

Healing the wounded self: combining hypnotherapy with ego state therapy.

Science.gov (United States)

Alladin, Assen

2013-07-01

The purpose of this article is to formulate a theoretical conceptualization for utilizing ego state therapy (EST) as an adjunct with cognitive hypnotherapy (CH) for depression. As the relationship between life events and onset of depression is very complex, it is not clear from current literature how stressors cause depressive symptoms. The notion of "wounded self," derived from the work of Wolfe (2005, 2006), is examined as a potential unifying concept for binding the role of risk factors in the precipitation of depression. By incorporating wounded self, the circular feedback model of depression, on which CH for depression is based, is expanded. This revised version provides conceptual and empirical underpinnings for integrating EST with CH in the management of depression.

Acute renal failure according to the RIFLE and AKIN criteria: a multicenter study.

Science.gov (United States)

Salgado, G; Landa, M; Masevicius, D; Gianassi, S; San-Román, J E; Silva, L; Gimenez, M; Tejerina, O; Díaz-Cisneros, P; Ciccioli, F; do Pico, J L

2014-01-01

To determine the incidence of acute renal failure (ARF) in critically ill patients using the RIFLE and AKIN criteria. A prospective, multicenter observational study with a duration of one year from February 2010 was carried out. RIFLE and AKIN were employed using the urinary (UC) and creatinine criteria (CC) jointly and separately. Nine polyvalent Critical Care Units (CCUs) in Argentina. A total of 627 critical patients over 18 years of age were admitted to the CCU for more than 48h. inability to quantify diuresis, surgical instrumentation of the urinary tract, and need for renal support therapy (RST). Calculated hourly diuresis (CHD) was used to apply the UC. The incidence of ARF was 69.4% and 51.8% according to RIFLE and AKIN, respectively. UC detected ARF in 59.5% of cases, while CC identified ARF in 34.7% (RIFLE) and 25.3% (AKIN). The mortality rate was 40.9% and 44.6% according to RIFLE and AKIN respectively, was significantly higher than in patients without ARF, and increased with disease severity (Data processing: Excel, SQL and SPSS. Levene test, comparison of means with Student t and chi-squared, with 95% confidence interval). RIFLE identified more cases of ARF. UC proved more effective than CC. The presence of ARF and severity levels were correlated to mortality but not to days of stay in the CCU. Implementation of the unified CHD was useful for implementing UC and achieving comparable results. Copyright © 2012 Elsevier España, S.L. and SEMICYUC. All rights reserved.

Strategies to promote self-esteem, autonomy and self-care practices for people with chronic wounds

Directory of Open Access Journals (Sweden)

Liarine Fernandes Bedin

Full Text Available This is a qualitative study of an exploratory nature that aims to identify the strategies used by nurses in primary care, in situations involving nursing care, to promote self-esteem, autonomy and self-care practices for people with chronic wounds. The study included eight nurses. Data were collected by means of a focus group in July 2012. The thematic analysis technique was used to identify the following categories: Nursing care from the perspective of comprehensiveness; Recovering support networks: family and social movements; Multidisciplinary work; Autonomy and nurses. It was concluded that the presented strategies value, above all, the social environment of these individuals, the family, religion and the nurse's approximation to the realities of people with chronic wounds.

Made up by makeup--A case report about an exceptional kind of self-inflicted "injuries".

Science.gov (United States)

Mauf, Sabrina; Martinez, Rosa M; Thali, Michael J; Bartsch, Christine

2015-12-01

Self-inflicted injuries are a known, but challenging topic in the healthcare sector and the judicial system. Therefore, differentiation of these injuries from a third-party-interference is crucial in the field of forensic medicine. However, self-painted injuries with makeup, which entail misleading of medical staff and the administration of justice, have apparently not been described in the literature so far. A case of a rare kind of victim role staging in a 26-year-old Caucasian woman in the field of forensic medicine is presented. She supposedly had been robbed and harmed by two unknown men. The forensic examination revealed subjective symptoms and objective findings, such as skin discolorations appearing as fresh bruises. However, a closer look revealed makeup. After removal, no injuries were seen. Awareness of the existence of exceptional cases of victim role staging is essential in the daily routine of healthcare, judicial and forensic professionals. Therefore, a questioning attitude within the physical examination as well as proper assessment of objective findings is crucial. Furthermore, the importance of an interdisciplinary approach of possible factitious disorders is demonstrated. The sensitization may exclude a third-party-interference, prevent damages to the health care system, avoid misleading of the administration of justice, and, therefore, reduce socioeconomic costs. Moreover, the recognition may enable adequate interventions and provide patients with professional help. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Summary of the engineering assessment of inactive uranium mill tailings: New and Old Rifle sites, Rifle, Colorado

International Nuclear Information System (INIS)

1981-08-01

This report is a summary of a parent report DOE/UMT--0108. These reports have become necessary as a result of changes that have occurred since 1977 which pertain to the Rifle sites and vicinity, as well as changes in remedial action criteria. The new data reflecting these changes are summarized in this report

Environmental Audit, Rifle, Gunnison and Grand Junction UMTRA Project Sites

International Nuclear Information System (INIS)

1991-08-01

This report documents the results of the comprehensive baseline Environmental Audit completed for the Uranium Mill Tailings Remedial Action (UMTRA) sites at Grand Junction, Rifle, and Gunnison, Colorado. Included in the Audit were the actual abandoned mill sites, associated transportation and disposal cell facilities, and representative examples of the more than 4,000 known vicinity properties. Sites investigated include: Climax Mill Site, Truck/Train Haul Route, Cotter Transfer Station, Cheney Disposal Cell, Rifle Mill Sites (Old and New Rifle), Gunnison Mill Site, Vicinity Properties, and Estes Gulch and Proposed Landfill Site No. 1 Disposal Cells. The UMTRA Audit was a comprehensive baseline audit which considered all environmental programs and the activities associated with ongoing and planned remediation at the UMTRA sites listed above. Compliance with the National Environmental Policy Act (NEPA) was not considered during this investigation. The Audit Team looked at the following technical disciplines: air, surface water/drinking water, groundwater, soil/sediment/biota, waste management, toxic and chemical materials, quality assurance, radiation, inactive waste sites, and environmental management. 6 figs., 12 tabs

Environmental Audit, Rifle, Gunnison and Grand Junction UMTRA Project Sites

Energy Technology Data Exchange (ETDEWEB)

None

1991-08-01

This report documents the results of the comprehensive baseline Environmental Audit completed for the Uranium Mill Tailings Remedial Action (UMTRA) sites at Grand Junction, Rifle, and Gunnison, Colorado. Included in the Audit were the actual abandoned mill sites, associated transportation and disposal cell facilities, and representative examples of the more than 4,000 known vicinity properties. Sites investigated include: Climax Mill Site, Truck/Train Haul Route, Cotter Transfer Station, Cheney Disposal Cell, Rifle Mill Sites (Old and New Rifle), Gunnison Mill Site, Vicinity Properties, and Estes Gulch and Proposed Landfill Site No. 1 Disposal Cells. The UMTRA Audit was a comprehensive baseline audit which considered all environmental programs and the activities associated with ongoing and planned remediation at the UMTRA sites listed above. Compliance with the National Environmental Policy Act (NEPA) was not considered during this investigation. The Audit Team looked at the following technical disciplines: air, surface water/drinking water, groundwater, soil/sediment/biota, waste management, toxic and chemical materials, quality assurance, radiation, inactive waste sites, and environmental management. 6 figs., 12 tabs.

Influence of Organizational Culture on the Acquisition of the M16 Rifle

Science.gov (United States)

2006-12-15

positiv outcome from early attempts at auto loading rifle development was to establish desired specifications for future designs. Though the Armories...The development of the atomic bomb was the most significant example, however, science took on additional significance in o Quantitative analysis and...performance reported in both the ARPA and Comptroller’s evaluation of the rifle. McNamara’s request to be provided a quantitative 63 comparison of the

Simulations and experiments of laminar heat transfer for Therminol heat transfer fluids in a rifled tube

International Nuclear Information System (INIS)

Xu, Weiguo; Ren, Depeng; Ye, Qing; Liu, Guodong; Lu, Huilin; Wang, Shuai

2016-01-01

Graphical abstract: Predicted laminar Nusselt number using regression correlation of Therminol-55 heat transfer fluid is in agreement with experiments in the rifled tube. - Highlights: • Heat transfer coefficient and friction factor are measured and predicted in the rifled tube. • Correlations for Nusselt number and friction factor are proposed. • The roughness height of 0.425 mm in transition SST model is suggested as an input parameter. • k–kl–ω transition and transition SST models are recommended for laminar–turbulent transition. • Thermal enhancement factor and synergy angle are predicted in the rifled tube. - Abstract: Simulations and experiments of flow and heat transfer behavior of Therminol-55 heat transfer fluid have been conducted in a horizontal rifled tube with outer diameter and inner diameter 25.0 and 20.0 mm, pitch and rib height of 12.0 and 1.0 mm, respectively. Numerical simulations of three-dimensional flow behavior of Therminol-55 heat transfer fluid are carried out using FLUENT code in the rifled tube. Experimental results show that the heat transfer and thermal performance of Therminol-55 heat transfer fluid in the rifled tube are considerably improved compared to those of the smooth tube. The Nusselt number increases with the increase of Reynolds number, and is from 3.5 to 5.1 times over the smooth tube. Also, the pressure drop results reveal that the average friction factor of the ribbed tube is in a range of 2.2 and 4.2 times over the smooth tube. Predictive Nusselt number and friction factor correlations have been presented. The numerical results show that the laminar flow model is valid only at lower Reynolds number in the developed laminar flow of rifled tube. The k–kl–ω transition model and transition SST model with roughness of 0.425 mm are recommended for the predictions of transition process from laminar to turbulent flow in the rifled tube.

Data Validation Package June 2016 Groundwater and Surface Water Sampling at the Old and New Rifle, Colorado, Processing Sites September 2016

Energy Technology Data Exchange (ETDEWEB)

Bush, Richard [USDOE Office of Legacy Management (LM), Washington, DC (United States); Lemke, Peter [Navarro Research and Engineering, Inc., Oak Ridge, TN (United States)

2016-10-17

Sampling Period: June 14–17 and July 7, 2016. Water samples were collected from 36 locations at New Rifle and Old Rifle, Colorado, Disposal/Processing Sites. Planned monitoring locations are shown in Attachment 1, Sampling and Analysis Work Order. Duplicate samples were collected from New Rifle locations 0216 and 0855, and Old Rifle location 0655. One equipment blank was collected after decontamination of non-dedicated equipment used to collect one surface water sample. See Attachment 2, Trip Report for additional details. Sampling and analyses were conducted as specified in the Sampling and Analysis Plan for U.S. Department of Energy Office of Legacy Management Sites (LMS/PRO/S04351, continually updated, http://energy.gov/lm/downloads/sampling-and- analysis-plan-us-department-energy-office-legacy-management-sites). New Rifle Site Samples were collected at the New Rifle site from 16 monitoring wells and 7 surface locations in compliance with the December 2008 Groundwater Compliance Action Plan [GCAP] for the New Rifle, Colorado, Processing Site (LMS/RFN/S01920). Monitoring well 0216 could not be sampled in June because it was surrounded by standing water due to the high river stage from spring runoff, it was later sampled in July. Monitoring well 0635 and surface location 0322 could not be sampled because access through the elk fence along Interstate 70 has not been completed at this time. Old Rifle Site Samples were collected at the Old Rifle site from eight monitoring wells and five surface locations in compliance with the December 2001 Ground Water Compliance Action Plan for the Old Rifle, Colorado, UMTRA Project Site (GJ0-2000-177-TAR).

The U.S. M-16 rifle versus the Russian AK-47 rifle. A comparison of terminal ballistics.

Science.gov (United States)

Swan, K G; Swan, R C; Levine, M G; Rocko, J M

1983-09-01

The standard U.S. military rifle (M-16) is substantially more destructive than its Russian counterpart (AK-47) when fired at short range into clay blocks, despite the fact that the AK-47 is of larger caliber and fires a much heavier bullet with a kinetic energy (muzzle) 25% greater when compared to the M-16. The decisive factor is the 40% greater muzzle velocity of the M-16.

An assessment of potential hydrologic and ecologic impacts of constructing mitigation wetlands, Rifle, Colorado, UMTRA project sites

International Nuclear Information System (INIS)

1995-04-01

This-assessment examines the consequences and risks that could result from the proposed construction of mitigation wetlands at the New and Old Rifle Uranium Mill Tailings Remedial Action (UMTRA) Project sites near Rifle, Colorado. Remediation of surface contamination at those sites is now under way. Preexisting wetlands at or near the Old and New Rifle sites have been cleaned up, resulting in the loss of 0.7 and 10.5 wetland acres (ac) (0.28 and 4.2 hectares [ha]) respectively. Another 9.9 ac (4.0 ha) of wetlands are in the area of windblown contamination west of the New Rifle site. The US Army Corps of Engineers (USACE) has jurisdiction over the remediated wetlands. Before remedial action began, and before any wetlands were eliminated, the USACE issued a Section 404 Permit that included a mitigation plan for the wetlands to be lost. The mitigation plan calls for 34.2 ac (1 3.8 ha) of wetlands to be constructed at the south end and to the west of the New Rifle site. The mitigation wetlands would be constructed over and in the contaminated alluvial aquifer at the New Rifle site. As a result of the hydrologic characteristics of this aquifer, contaminated ground water would be expected to enter the environment through the proposed wetlands. A preliminary assessment was therefore required to assess any potential ecological risks associated with constructing the mitigation wetlands at the proposed location

[Gunshot wounds caused by non-lethal ammunition on the porcine model post-mortem].

Science.gov (United States)

Jabrocký, Peter; Pivko, Juraj; Vondráková, Mária; Tažký, Boris

2013-10-01

In this article we focus on the effects of so called non-lethal ammunition. We studied possible mechanism of firearm injury formation as a consequence of using firearm on the body, to present a more comprehensive material in wound ballistics. We pointed out possible actions of a projectile causes on human, respectively other animal organisms, as well as to a manner in which an injury is caused by rifles or shotguns using non-lethal ammunition with rubber projectiles. In the experiment, we have focused on macroscopic analysis of the tissue penetrated by a rubber projectile fired from a long firearm and pump-action shotgun while focusing on the anatomical-morphological analysis of entry wounds to determine the effectiveness respectively, the wounding potential of the projectile. The results of the experiment based on the macroscopic analysis of entry wounds, cavities and exit wounds, show that when a rubber projectile penetrates the body it causes loss of the tissue (i.e. the minus effect) and mechanical disruption of the tissue similar to lethal projectile. Based on the measures and ballistic computations we concluded that in specific cases, like for example in a close range hit, a penetration of vital organs can cause serious or even lethal injuries.

[Suicide by double bolt gunshot wound to the head: case report and review of the literature].

Science.gov (United States)

Grellner, W; Buhmann, D; Wilske, J

2000-01-01

Suicidal gunshot wounds from a livestock stunner with infliction of two shots against the head are extremely rare events. A case with these characteristics is presented and the corresponding literature is reviewed. A 61-year-old butcher was found dead with two entry wounds of the forehead on the right side and in the centre being typical for captive bolt pistols (symmetrically localized powder burns). The issues of the sequence of shots and the capacity of action are discussed on the basis of morphological findings and pathophysiological considerations. A literature review revealed only 4 case reports with double gunshot wounds of the skull caused by "humane killers" (Tovo 1956, Wolff and Laufer 1965, Schiermeyer 1973, Pollak 1977).

Spatial distribution of an uranium-respiring betaproteobacterium at the Rifle, CO field research site.

Directory of Open Access Journals (Sweden)

Nicole M Koribanics

Full Text Available The Department of Energy's Integrated Field-Scale Subsurface Research Challenge Site (IFRC at Rifle, Colorado was created to address the gaps in knowledge on the mechanisms and rates of U(VI bioreduction in alluvial sediments. Previous studies at the Rifle IFRC have linked microbial processes to uranium immobilization during acetate amendment. Several key bacteria believed to be involved in radionuclide containment have been described; however, most of the evidence implicating uranium reduction with specific microbiota has been indirect. Here, we report on the cultivation of a microorganism from the Rifle IFRC that reduces uranium and appears to utilize it as a terminal electron acceptor for respiration with acetate as electron donor. Furthermore, this bacterium constitutes a significant proportion of the subsurface sediment community prior to biostimulation based on TRFLP profiling of 16S rRNA genes. 16S rRNA gene sequence analysis indicates that the microorganism is a betaproteobacterium with a high similarity to Burkholderia fungorum. This is, to our knowledge, the first report of a betaproteobacterium capable of uranium respiration. Our results indicate that this microorganism occurs commonly in alluvial sediments located between 3-6 m below ground surface at Rifle and may play a role in the initial reduction of uranium at the site.

Remedial action plan and site design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado

International Nuclear Information System (INIS)

1990-02-01

This volume contains appendices D6 through D8 containing laboratory test data: from MK-F investigation, 1987, Old Rifle and New Rifle sites; on bentonite amended radon barrier material; and from MK-F investigation, 1987, riprap tests

The effect of wounds on desiccation of prey: implications for a predator with extra-oral digestion.

Science.gov (United States)

Morse, Douglass H

1998-06-01

Predators that inject prey with proteolytic enzymes, thereby breaking down their tissues for subsequent ingestion, run the risk that desiccation will hinder eventual retrieval of resources from these prey. Wounds made in capture might exacerbate this problem. However, desiccation rates of small syrphid flies Toxomerusmarginatus (Diptera: Syrphidae) killed by juvenile crab spiders Misumena vatia (Araneae: Thomisidae) and intact dead syrphid flies did not differ over the normal period of feeding, though desiccation rates in shade and sun differed several-fold. Neither the size of the spider (and presumably the size of the wounds it inflicted) nor the location of the wounds on the flies' bodies affected desiccation rates. Thus, this tactic of prey handling does not exact an added processing cost on Misumena.

Remedial Action Plan and site design for stabilization of the inactive uranium mill tailings site at Rifle, Colorado

International Nuclear Information System (INIS)

1990-02-01

This document has been structured to provide a comprehensive understanding of the remedial action proposed for the Rifle sites. That remedial action consists of removing approximately 4,185,000 cubic yards (cy) of tailings and contaminated materials from their current locations, transporting, and stabilizing the tailings material at the Estes Gulch disposal site, approximately six miles north of Rifle. The tailings and contaminated materials are comprised of approximately 597,000 cy from Old Rifle, 3,232,000 cy from New Rifle, and 322,000 cy from vicinity properties and about 34,000 cy from demolition. The remedial action plan includes specific design requirements for the detailed design and construction of the remedial action. An extensive amount of data and supporting information have been generated for this remedial action and cannot all be incorporated into this document. Pertinent information and data are included with reference given to the supporting documents

Engineering Design Handbook: Recoilless Rifle Weapon Systems.

Science.gov (United States)

1976-01-15

rifles also creates danger of physiological damage also exists. psychological factors which may be signifi- The extent and nature of the damage caused...the intensity of the bla&st, its disruption often cause psychological effects impulse, the position of the subject with of extreme lethargy and...General. 6. AD 3S 1 905, Capt. L. R. Creelman , A 2. David E. Walters and Edith F. Reilly, Parameiric Study of the Probability of Hit Hitting

Epidemiology, demographics, and outcomes of craniomaxillofacial gunshot wounds in a level I trauma center.

Science.gov (United States)

Tholpady, Sunil S; DeMoss, Patrick; Murage, Kariuki P; Havlik, Robert J; Flores, Roberto L

2014-07-01

Gunshot injuries to the craniomaxillofacial region are a challenge to the trauma and reconstructive surgeon. Although management of these injuries has been standardized and early rather than late intervention is advocated, the patient characteristics before, during, and after have been poorly elucidated. A prospectively maintained Level I trauma center database was queried as to gunshot wounds of the craniomaxillofacial skeleton. Over a five-year period (2007-2011), 168 patients were identified with these injuries. Charts were reviewed as to demographics, presentations, and outcomes and these were tested for significant relationships with hospital length of stay, numbers and types of procedures, morbidity, and mortality. Gunshot wounds to the craniofacial skeleton resulted in 71 deaths in this patient population. Those that died were significantly older, presented with a lower GCS, had a shorter LOS, and a higher INR than those that lived. Subgroup analysis of mechanism demonstrated mortality was more likely to occur as a result of self-inflicted injury in whites and due to assault in the African-American population. Data gathered from this study disputes some commonly held beliefs regarding the epidemiology of gunshot injuries and should allow for better characterization of which outcomes are consistent with which presentations. Published by Elsevier Ltd.

Sphere-forming cells from peripheral cornea demonstrate a wound-healing response to injury.

Science.gov (United States)

Huang, Stephanie U; Yoon, Jinny J; Ismail, Salim; McGhee, Jennifer J; Sherwin, Trevor

2015-11-01

The cornea is the initial refractive interface of the eye. Its transparency is critical for clear vision and is maintained by stem cells which also act to repair injury inflicted by external insults, such as chemical and thermal burns. Damage to the epithelium compromises its clarity and can reduce or eliminate the stem cell population, diminishing the ability for self-repair. This condition has been termed "limbal stem cell deficiency"; severe cases can lead to corneal blindness. Sphere-forming cells isolated from peripheral cornea are a potential source of stem and progenitor cells for corneal repair. When provided with appropriate substrate, these spheres have the ability to adhere and for cells to migrate outwards akin to that of their natural environment. Direct compression injury and remote scratch injury experiments were conducted on the sphere cells to gauge their wound healing capacity. Measures of proliferation, differentiation, and migration were assessed by immunohistochemical detection of EdU incorporation, α-smooth muscle actin expression and confocal image analysis, respectively. Both modes of injury were observed to draw responses from the spheres indicating wound healing processes. Direct wounding induced a rapid, but transient increase in expression of α-SMA, a marker of corneal myofibroblasts, followed by a proliferative and increasing migratory response. The spheres were observed to respond to remote injury as entire units, with no directional response seen for targeted repair over the scratch injury area. These results give strength to the future use of these peripheral corneal spheres as transplantable units for the regeneration of corneal tissue. © 2015 International Federation for Cell Biology.

Gross and histopathological evaluation of human inflicted bruises in Danish slaughter pigs

DEFF Research Database (Denmark)

Barington, Kristiane; Agger, Jens Frederik Gramstrup; Nielsen, Søren Saxmose

2016-01-01

Background: Human inflicted bruises in slaughter pigs are hampering animal welfare, are an infringement of the animal protection act, and are a focus of public attention. The aim of the present study was to evaluate the gross appearance of human inflicted bruises in slaughter pigs and to compare ...

The Influence of Cognitive and Non-Cognitive Factors on the Development of Rifle Marksmanship Skills. CRESST Report 753

Science.gov (United States)

Chung, Gregory K. W. K.; Nagashima, Sam O.; Espinosa, Paul D.; Berka, Chris; Baker, Eva L.

2009-01-01

In this report, researchers examined rifle marksmanship development within a skill development framework outlined by Chung, Delacruz, de Vries, Bewley, and Baker (2006). Thirty-three novice shooters used an M4 rifle training simulator system to learn to shoot an 8-inch target at a simulated distance of 200 yards. Cognitive, psychomotor, and…

Radiological, health, and safety, and occurrence reporting system audit report, Rifle, Colorado

International Nuclear Information System (INIS)

1993-11-01

This paper describes an audit dated September 14--16, 1993. The performance of the contractors and subcontractors responsible for remedial action work at the former uranium ore processing site at Rifle, Colorado, and the uranium tailings disposal cell at Estes Gulch (Colorado) was reviewed during an audit conducted September 14 through 16, 1993. MK-Ferguson Company (MK-F) is the Remedial Action Contractor (RAC) responsible for engineering and construction management of the Rifle operations. The audit focused on radiological issues, occupational safety and health (OS ampersand H) issues, and the Occurrence Reporting and Processing System (ORPS). The close-out meeting was held on September 16, 1993, which was attended by representatives of MK-F, the US Department of Energy (DOE), and the Technical Assistance Contractor (TAC)

Micro-CT features of intermediate gunshot wounds severely damaged by fire.

Science.gov (United States)

Fais, Paolo; Giraudo, Chiara; Boscolo-Berto, Rafael; Amagliani, Alessandro; Miotto, Diego; Feltrin, Giampietro; Viel, Guido; Ferrara, S Davide; Cecchetto, Giovanni

2013-03-01

Incineration or extensive burning of the body, causing changes in the content and distribution of fluids, fixation and shrinking processes of tissues, can alter the typical macroscopic and microscopic characteristics of firearm wounds, hampering or at least complicating the reconstruction of gunshot fatalities. The present study aims at evaluating the potential role of micro-computed tomography (micro-CT) for detecting and quantifying gunshot residue (GSR) particles in experimentally produced intermediate-range gunshot wounds severely damaged by fire. Eighteen experimental shootings were performed on 18 sections of human calves surgically amputated for medical reasons at three different firing distances (5, 15 and 30 cm). Six stab wounds produced with an ice pick were used as controls. Each calf section underwent a charring cycle, being placed in a wood-burning stove for 4 min at a temperature of 400 °C. At visual inspection, the charred entrance wounds could not be differentiated from the exit lesions and the stab wounds. On the contrary, micro-CT analysis showed the presence of GSR particles in all burnt entrance gunshot wounds, while GSR was absent in the exit and stab wounds. The GSR deposits of the firearm lesions inflicted at very close distance (5 cm) were mainly constituted of huge particles (diameter >150 μm) with an irregular shape and well-delineated edges; at greater distances (15 and 30 cm), agglomerates of tiny radiopaque particles scattered in the epidermis and dermis layers were evident. Statistical analysis demonstrated that also in charred firearm wounds the amount of GSR roughly correlates with the distance from which the gun was fired. The obtained results suggest that micro-CT analysis can be a valid screening tool for identifying entrance gunshot wounds and for differentiating firearm wounds from sharp-force injuries in bodies severely damaged by fire.

Remedial actions at the former Union Carbide Corporation uranium mill sites, Rifle, Garfield County, Colorado

International Nuclear Information System (INIS)

1990-03-01

This appendix provides the information needed to understand the conceptual designs for the remedial action alternatives addressed in this environmental impact statement (EIS). It is intended to provide sufficient details for the reader to evaluate the feasibility and assess the impacts of each remedial action alternative. It is not intended to provide the detailed engineering necessary to implement the alternatives. Details of the preferred remedial action will be presented in the remedial action plan (RAP). The remedial action alternatives addressed in this EIS include no action, stabilization at the New Rifle site, disposal at the Estes Gulch site, and disposal at the Lucas Mesa site. All alternatives include interim actions to remediate existing health and safety hazards to the Rifle community that presently exist at the Old and New Rifle processing sites. It should be noted that the borrow sites included in this EIS were selected as the sources of the necessary borrow materials for impacts analyses purposes only. The borrow sites to be used for the remedial action will be selected during the final design. 21 figs., 18 tabs

Wound healing activity of the ethanol root extract and polyphenolic rich fraction from Potentilla fulgens.

Science.gov (United States)

Kundu, Anindita; Ghosh, Arka; Singh, Narendra K; Singh, Gireesh K; Seth, Ankit; Maurya, Santosh K; Hemalatha, Siva; Laloo, Damiki

2016-11-01

Potentilla fulgens Wall. ex Hook (Rosaceae) is a potent medicinal plant of the Western Himalayas, where its roots are traditionally used by the local people of Uttaranchal (India) to treat wounds and tiger bites. The present study scientifically evaluates the wound healing activity of P. fulgens ethanol root extract (EPF) and its ethyl acetate fraction (PFEA) on experimental rats. Wounds were inflicted on animals by using both excision and incision models. The wounded animals were treated for 16 days with EPF (oral: 200-400 mg/kg and topical: 5-10% w/w) and PFEA (oral: 75 mg/kg; topical: 1.75% w/w). Various physical (wound contraction, epithelialization rate, tensile strength) and biochemical parameters (hydroxyproline, hexosamine, proteins, DNA) were examined during the study. Oxidant product (lipidperoxidase), antioxidant enzymes (catalase, superoxide-dismutase) and reduced glutathione were determined. Morphological and histopathological studies of the skin tissues were monitored. A significant (p EPF (10% w/w) and PFEA (1.75% w/w). A significantly (p EPF and PFEA also showed significant (p < 0.05) antioxidant activity. The present study provided the scientific evidence, where P. fulgens rich in polyphenolic components possess remarkable wound healing activities, thereby supporting the traditional claims.

Data Validation Package November 2015 Groundwater and Surface Water Sampling at the Old and New Rifle, Colorado, Processing Sites February 2016

Energy Technology Data Exchange (ETDEWEB)

Bush, Richard [USDOE Office of Legacy Management, Washington, DC (United States); Lemke, Peter [Navarro Research and Engineering, Inc., Oak Ridge, TN (United States)

2016-02-01

Water samples were collected from 36 locations at New Rifle and Old Rifle, Colorado, Processing Sites. Duplicate samples were collected from New Rifle locations 0659 and 0855, and Old Rifle location 0304. One equipment blank was collected after decontamination of non-dedicated equipment used to collect one surface water sample. Sampling and analyses were conducted as specified in the Sampling and Analysis Plan for U.S. Department of Energy Office of Legacy Management Sites (LMS/PRO/S04351, continually updated). New Rifle Site Samples were collected at the New Rifle site from 16 monitoring wells and 7 surface locations in compliance with the December 2008 Groundwater Compliance Action Plan [GCAP] for the New Rifle, Colorado, Processing Site (LMS/RFN/S01920), with one exception: New Rifle location 0635 could not be sampled because it was inaccessible; a fence installed by the Colorado Department of Transportation prevents access to this location. DOE is currently negotiating access with the Colorado Department of Transportation. Analytes measured at the New Rifle site included contaminants of concern (COCs) (arsenic, molybdenum, nitrate + nitrite as nitrogen, selenium, uranium, and vanadium) ammonia as nitrogen, major cations, and major anions. Field measurements of total alkalinity, oxidation- reduction potential, pH, specific conductance, turbidity, and temperature were made at each location, and the water level was measured at each sampled well. A proposed alternate concentration limit (ACL) for vanadium of 50 milligrams per liter (mg/L), specific to the compliance (POC) wells (RFN-0217, -0659, -0664, and -0669) is included in the New Rifle GCAP. Vanadium concentrations in the POC wells were below the proposed ACL as shown in the time-concentration graphs in the Data Presentation section (Attachment 2). Time-concentration graphs from all other locations sampled are also included in Attachment 2. Sampling location RFN-0195 was misidentified for the June/August 2014

Immune Modulating Topical S100A8/A9 Inhibits Growth of Pseudomonas aeruginosa and Mitigates Biofilm Infection in Chronic Wounds

DEFF Research Database (Denmark)

Trøstrup, Hannah; Lerche, Christian Johann; Christophersen, Lars

2017-01-01

in a murine model and P. aeruginosa growth in vitro. Seventy-six mice, inflicted with a full-thickness burn wound were challenged subcutaneously (s.c.) by 10⁶ colony-forming units (CFUs) of P. aeruginosa biofilm. Mice were subsequently randomized into two treatment groups, one group receiving recombinant...... murine S100A8/A9 and a group of vehicle controls (phosphate-buffered saline, PBS) all treated with s.c. injections daily for up to five days. Wounds were analyzed for quantitative bacteriology and contents of key inflammatory markers. Count of blood polymorphonuclear leukocytes was included. S100A8/A9...

Serine Proteolytic Pathway Activation Reveals an Expanded Ensemble of Wound Response Genes in Drosophila

Science.gov (United States)

Patterson, Rachel A.; Juarez, Michelle T.; Hermann, Anita; Sasik, Roman; Hardiman, Gary; McGinnis, William

2013-01-01

After injury to the animal epidermis, a variety of genes are transcriptionally activated in nearby cells to regenerate the missing cells and facilitate barrier repair. The range and types of diffusible wound signals that are produced by damaged epidermis and function to activate repair genes during epidermal regeneration remains a subject of very active study in many animals. In Drosophila embryos, we have discovered that serine protease function is locally activated around wound sites, and is also required for localized activation of epidermal repair genes. The serine protease trypsin is sufficient to induce a striking global epidermal wound response without inflicting cell death or compromising the integrity of the epithelial barrier. We developed a trypsin wounding treatment as an amplification tool to more fully understand the changes in the Drosophila transcriptome that occur after epidermal injury. By comparing our array results with similar results on mammalian skin wounding we can see which evolutionarily conserved pathways are activated after epidermal wounding in very diverse animals. Our innovative serine protease-mediated wounding protocol allowed us to identify 8 additional genes that are activated in epidermal cells in the immediate vicinity of puncture wounds, and the functions of many of these genes suggest novel genetic pathways that may control epidermal wound repair. Additionally, our data augments the evidence that clean puncture wounding can mount a powerful innate immune transcriptional response, with different innate immune genes being activated in an interesting variety of ways. These include puncture-induced activation only in epidermal cells in the immediate vicinity of wounds, or in all epidermal cells, or specifically in the fat body, or in multiple tissues. PMID:23637905

Elevated lactate as an early marker of brain injury in inflicted traumatic brain injury

International Nuclear Information System (INIS)

Makoroff, Kathi L.; Cecil, Kim M.; Ball, William S.; Care, Marguerite

2005-01-01

Patients with inflicted traumatic brain injury and evidence of hypoxic-ischemic injury as indicated by elevated lactate on MRS tend to have worse early neurological status and early outcome scores. Lactate levels as sampled by MRS might predict early clinical outcome in inflicted traumatic brain injury. (orig.)

[Child-pedestrian injuries inflicted in the road traffic accidents as a forensic medical problem].

Science.gov (United States)

Savenkova, E N; Efimov, A A

The road traffic accidents are known to make the greatest contribution to the overall structure of pediatric traumatism with the fatal outcome. The problem of pediatric traumatism remains on top of its relevancy despite numerous administrative, legal, technical, and financial measures taken at the government level in an attempt to reduce the mortality rate associated with the child-pedestrian injuries inflicted in the road traffic accidents. The objective of the present study was to summarize and interpret the results published in the scientific literature concerning child-pedestrian injuries inflicted in the road traffic accidents with special reference to the age of the victims and the type of the injury. The analysis of the publications of the domestic and foreign authors has demonstrated that the available data of interest remain to be systematized and that the forensic medical aspects of the problem in question are poorly represented in these materials. It was shown that forensic medical expertises of child-pedestrian injuries inflicted in the road traffic accidents are frequently carried out without taking into consideration the peculiar anatomical and physiological features of the child's organism. The available data concerning the mechanisms and evaluation of severe injuries inflicted to the children in the road traffic accidents are insufficient for the development of the algorithms for the relevant adequate forensic medical expertise. In the light of these findings, the problem of the child-pedestrian injuries inflicted in the road traffic accidents takes on new significance when considered in the context of pediatric traumatism. There is evidently the growing necessity to formulate the universal database containing systematized objective information for the development of new methods of forensic medical expertise for the elucidation of the mechanisms of road traffic injuries inflicted to the children of different age groups depending on the type of the

Impact of real-time electronic alerting of acute kidney injury on therapeutic intervention and progression of RIFLE class.

Science.gov (United States)

Colpaert, Kirsten; Hoste, Eric A; Steurbaut, Kristof; Benoit, Dominique; Van Hoecke, Sofie; De Turck, Filip; Decruyenaere, Johan

2012-04-01

To evaluate whether a real-time electronic alert system or "AKI sniffer," which is based on the RIFLE classification criteria (Risk, Injury and Failure), would have an impact on therapeutic interventions and acute kidney injury progression. Prospective intervention study. Surgical and medical intensive care unit in a tertiary care hospital. A total of 951 patients having in total 1,079 admission episodes were admitted during the study period (prealert control group: 227, alert group: 616, and postalert control group: 236). Three study phases were compared: A 1.5-month prealert control phase in which physicians were blinded for the acute kidney injury sniffer and a 3-month intervention phase with real-time alerting of worsening RIFLE class through the Digital Enhanced Cordless Technology telephone system followed by a second 1.5-month postalert control phase. A total of 2593 acute kidney injury alerts were recorded with a balanced distribution over all study phases. Most acute kidney injury alerts were RIFLE class risk (59.8%) followed by RIFLE class injury (34.1%) and failure (6.1%). A higher percentage of patients in the alert group received therapeutic intervention within 60 mins after the acute kidney injury alert (28.7% in alert group vs. 7.9% and 10.4% in the pre- and postalert control groups, respectively, p μ .001). In the alert group, more patients received fluid therapy (23.0% vs. 4.9% and 9.2%, p μ .01), diuretics (4.2% vs. 2.6% and 0.8%, p μ .001), or vasopressors (3.9% vs. 1.1% and 0.8%, p μ .001). Furthermore, these patients had a shorter time to intervention (p μ .001). A higher proportion of patients in the alert group showed return to a baseline kidney function within 8 hrs after an acute kidney injury alert "from normal to risk" compared with patients in the control group (p = .048). The real-time alerting of every worsening RIFLE class by the acute kidney injury sniffer increased the number and timeliness of early therapeutic interventions

Remedial actions at the former Union Carbide Corporation uranium mill sites, Rifle, Garfield County, Colorado: Final environmental impact statement

International Nuclear Information System (INIS)

1990-03-01

This appendix provides the information needed to understand the conceptual designs for the remedial action alternatives addressed in this environmental impact statement (EIS). It is intended to provide sufficient details for the reader to evaluate the feasibility and assess the impacts of each remedial action alternative. It is not intended to provide the detailed engineering necessary to implement the alternatives. Details of the preferred remedial action will be presented in the remedial action plan (RAP). The remedial action alternatives addressed in this EIS include no action, stabilization at the New Rifle site, disposal at the Estes Gulch site, and disposal at the Lucas Mesa site. All alternatives include interim actions to remediate existing health and safety hazards to the Rifle community that presently exist at the Old and New Rifle processing sites. 21 figs., 18 tabs

Remedial action plan and site design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado

Energy Technology Data Exchange (ETDEWEB)

1992-02-01

This appendix assesses the present conditions and data gathered about the two inactive uranium mill tailings sites near Rifle, Colorado, and the designated disposal site six miles north of Rifle in the area of Estes Gulch. It consolidates available engineering, radiological, geotechnical, hydrological, meteorological, and other information pertinent to the design of the Remedial Action Plan (RAP). The data characterize conditions at the mill, tailings, and disposal site so that the Remedial Action Contractor (RAC) may complete final designs for the remedial actions.

[Automutilation with indistinct underlying disease--difficulties of care in the community].

Science.gov (United States)

Gehb, Iris; Reuhl, Joachim; Volk, Stephan; Urban, Reinhard

2009-11-01

Self-mutilation is well-known in various psychiatric diseases and represents a challenge for forensic pathologists as regards the differentiation of accidental versus self-inflicted injuries, especially when a criminal charge is likely to emerge. A case of extraordinarily severe self-inflicted injuries is presented as well as the related implications concerning clinical and ambulatory care for patients, whose underlying motivation remains unknown. A 60 year-old worker exhibited an open scull fracture and 14 abdominal wounds with protrusion of small intestine, from which a part of 160 cm length was completely removed beforehand. The patient claimed the wounds having been caused accidentally. When examined by a psychiatrist, disturbances in orientation, unrest and ill concentration were found, but no symptoms related to psychosis, depression or suicidal behaviour. Although the need for more detailed examination seemed to be clearly evident, the medical authorities did not take action. Consequently, no further psychiatric treatment was initiated. The implications of this case on the background of the literature are discussed. Georg Thieme Verlag KG Stuttgart.New York.

Prevention of noise damages causes by shooting fire of Kalashnikov (AK-47) rifle by regulation of suitable distance

OpenAIRE

Gholamhossein Pourtaghi; Hamidreza Mokarami; Firouz Valipour; Mohammad Ghasemi

2014-01-01

The aims of this study were control of rifle shooting noise by regulation of suitable distance and investigation of frequency characteristic of the noise caused by single Kalashnikov rifle (AK-47) in an open shooting field. Due to the condition of the trainees and other people in the shooting fields, the measurements were done in 2 stages of individual and groups of 20 individuals and at 1, 30 and 50 meters distance, respectively. At each stage of the experiment the sound pressure level and p...

[Forensic medical expertise of the stab wounds: the current state-of-the art].

Science.gov (United States)

Sarkisian, B A; Karpov, D A

2014-01-01

This review of special literature encompasses the publications on the injuries inflicted by piercing objects. The results of analysis of these materials indicate that both the mechanisms of formation and the morphological features of stab wounds and damages to the clothes are studied perfectly well. Their shape and morphological patterns are shown to be dependent on the size, shape, and cross-section area of the great variety of the piercing objects. However, investigations carried out thus far did not take into consideration the formation of the signs of skin plastic deformation, such as edge portions of borderline thickening, stretching of epidermis over the walls, transformation of the epidermal network pattern into longitudinal folding, etc. It is concluded that further studies are necessary to better characterize injuries inflicted by piercing objects differing in the sharpness and the shape of cross section and thereby to obtain a deeper insight in the morphological features. It can be expected that such studies will provide a basis for the development of criteria for the individual and intra-group expert identification of the traumatic agents.

Repetitive urges to inflict burns: An unusual presentation of impulse control disorder.

Science.gov (United States)

Pal, Arghya; Parmar, Arpit; Pattanayak, Raman Deep

2016-01-01

Impulse control disorders (ICDs) are characterized by an inability to resist an intense impulse or drive to perform a particular act that is excessive and/or harmful to self/others. Till date, there is no published report of an ICD presenting with repetitive urges to inflict burns. We describe the case of an adult male in regular follow-up for 6 months who presented with intense, irresistible, and repetitive urges and acts of causing burns on his skin for past 1 year. The phenomenology shared the core qualities described for ICDs and patient showed adequate response to treatment. The case report describes an unusual type of ICD classifiable as not otherwise specified. More clinical and research attention is warranted toward ICDs in general, with implications for ICD-11.

Repetitive urges to inflict burns: An unusual presentation of impulse control disorder

Directory of Open Access Journals (Sweden)

Arghya Pal

2016-01-01

Full Text Available Impulse control disorders (ICDs are characterized by an inability to resist an intense impulse or drive to perform a particular act that is excessive and/or harmful to self/others. Till date, there is no published report of an ICD presenting with repetitive urges to inflict burns. We describe the case of an adult male in regular follow-up for 6 months who presented with intense, irresistible, and repetitive urges and acts of causing burns on his skin for past 1 year. The phenomenology shared the core qualities described for ICDs and patient showed adequate response to treatment. The case report describes an unusual type of ICD classifiable as not otherwise specified. More clinical and research attention is warranted toward ICDs in general, with implications for ICD-11.

Wound Geometry as it Relates to Tunnel Valvular Competence in ...

African Journals Online (AJOL)

tulyasys

Second, for a wound to be self-sealing, Ernest et al.[1] had proposed “square incisional geometry.” This concept states that an ideal self-sealing wound has a length equal to its width. In reality, however, the length is usually smaller because of the need to have expanded wound to allow the exiting nucleus. As a compromise,.

Assessment of a Hydroxyapatite Permeable Reactive Barrier to Remediate Uranium at the Old Rifle Site Colorado

International Nuclear Information System (INIS)

Moore, Robert C.; Szecsody, James; Rigali, Mark J.; Vermuel, Vince; Leullen, Jon

2016-01-01

We have performed an initial evaluation and testing program to assess the effectiveness of a hydroxyapatite (Ca10(PO4)6(OH)2) permeable reactive barrier and source area treatment to decrease uranium mobility at the Department of Energy (DOE) former Old Rifle uranium mill processing site in Rifle, western Colorado. Uranium ore was processed at the site from the 1940s to the 1970s. The mill facilities at the site as well as the uranium mill tailings previously stored there have all been removed. Groundwater in the alluvial aquifer beneath the site still contains elevated concentrations of uranium, and is currently used for field tests to study uranium behavior in groundwater and investigate potential uranium remediation technologies. The technology investigated in this work is based on in situ formation of apatite in sediment to create a subsurface apatite PRB and also for source area treatment. The process is based on injecting a solution containing calcium citrate and sodium into the subsurface for constructing the PRB within the uranium plume. As the indigenous sediment micro-organisms biodegrade the injected citrate, the calcium is released and reacts with the phosphate to form hydroxyapatite (precipitate). This paper reports on proof-of-principle column tests with Old Rifle sediment and synthetic groundwater.

Assessment of a Hydroxyapatite Permeable Reactive Barrier to Remediate Uranium at the Old Rifle Site Colorado.

Energy Technology Data Exchange (ETDEWEB)

Moore, Robert C.; Szecsody, James (PNNL); Rigali, Mark J.; Vermuel, Vince (PNNL); Leullen, Jon (AECOM)

2016-02-01

We have performed an initial evaluation and testing program to assess the effectiveness of a hydroxyapatite (Ca10(PO4)6(OH)2) permeable reactive barrier and source area treatment to decrease uranium mobility at the Department of Energy (DOE) former Old Rifle uranium mill processing site in Rifle, western Colorado. Uranium ore was processed at the site from the 1940s to the 1970s. The mill facilities at the site as well as the uranium mill tailings previously stored there have all been removed. Groundwater in the alluvial aquifer beneath the site still contains elevated concentrations of uranium, and is currently used for field tests to study uranium behavior in groundwater and investigate potential uranium remediation technologies. The technology investigated in this work is based on in situ formation of apatite in sediment to create a subsurface apatite PRB and also for source area treatment. The process is based on injecting a solution containing calcium citrate and sodium into the subsurface for constructing the PRB within the uranium plume. As the indigenous sediment micro-organisms biodegrade the injected citrate, the calcium is released and reacts with the phosphate to form hydroxyapatite (precipitate). This paper reports on proof-of-principle column tests with Old Rifle sediment and synthetic groundwater.

Clinical effects of pranayama on performance of rifle shooters

Directory of Open Access Journals (Sweden)

Amte Snehal Shekhar, Mistry Hetal M

2014-07-01

Full Text Available Background: Yoga has an enormous scientifically proven effect on man’s physical and psychological functioning. Pranayama constitute the most vital aspects of yoga. Various methods of pranayama have a sound scientific basis and are traditionally believed to produce equilibrium between psychic and somatic aspects of bodily functions. The link between body and mind is obligatory for the better performance of sports persons. Aim: The aim of the study is to find out the effect of pranayama on the performance of Rifle shooters by measuring the parameters like-breath holding time, lung functional capacity and shooting performance. Method: 52 state level shooters subjects were chosen from 2 centres between the age group of 15-30years. Out of them, 26 shooters were given training in the techniques of pranayama for 3weeks.The other 26 subjects served as control i.e. with out Pranayama training. Variables like shooting performance, breath holding time (BHT, peak expiratory flow rate (PEFR, respiratory rate (RR and pulse rate (PR were measured in both the groups. Results: The study showed highly significant improvement in all the five variables shooting performance (in mm, BHT, PEFR, RR and PR with p value of 3.62E-05, 2.78E-07, 1.31E-09, 0.013, 3.40E-04respectively. Conclusion: So it can be concluded that pranayama is efficacious for better performance of Rifle shooters and should be included in their training practice.

Self-injury, converting emotional distress into physical pain

DEFF Research Database (Denmark)

Møhl, Bo; Rubæk, Lotte

2017-01-01

Self-inflicted pain by cutting, hitting or burning oneself has become a common way to regulate emotions and to serve as coping strategy. 21.5-32% of adolescents in non-clinical populations have a history of non-suicidal self-injury. Non-suicidal self-injury has a momentarily relieving effect and ...... and is an important predictor of suicidal behaviour; even superficial self-injury should be taken seriously. There is an urgent need for organized treatment programmes for young people who self-harm.......Self-inflicted pain by cutting, hitting or burning oneself has become a common way to regulate emotions and to serve as coping strategy. 21.5-32% of adolescents in non-clinical populations have a history of non-suicidal self-injury. Non-suicidal self-injury has a momentarily relieving effect...

Remedial action plan and site design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado: Final report

International Nuclear Information System (INIS)

1990-02-01

This radiologic characterization of tho two inactive uranium millsites at Rifle, Colorado, was conducted by Bendix Field Engineering Corporation (Bendix) for the US Department of Energy (DOE), Grand Junction Projects Office, in accord with a Statement of Work prepared by the DOE Uranium Mill Tailings Remedial Action (UMTRA) Project Technical Assistance Contractor, Jacobs Engineering Group, Inc. (Jacobs). The purpose of this project is to define the extent of radioactive contamination at the Rifle sites that exceeds US Environmental Protection Agency, (EPA) standards for UMTRA sites. The data presented in this report are required for characterization of the areas adjacent to the tailings piles and for the subsequent design of cleanup activities. An orientation visit to the study area was conducted on 31 July--1 August 1984, in conjunction with Jacobs, to determine the approximate extent of contaminated area surrounding tho piles. During that visit, survey control points were located and baselines were defined from which survey grids would later be established; drilling requirements were assessed; and radiologic and geochemical data were collected for use in planning the radiologic fieldwork. The information gained from this visit was used by Jacobs, with cooperation by Bendix, to determine the scope of work required for the radiologic characterization of the Rifle sites. Fieldwork at Rifle was conducted from 1 October through 16 November 1984

Use of a Ca-Citrate-Phosphate Solution to Form Hydroxyapatite for Uranium Stabilization of Old Rifle Sediments: Laboratory Proof of Principle Studies

Energy Technology Data Exchange (ETDEWEB)

Szescody, James E. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Moore, Robert C. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rigali, Mark J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Vermeul, Vincent R. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Luellen, Jon [AECOM, Denver, CO (United States)

2016-03-01

The Old Rifle Site is a former vanadium and uranium ore-processing facility located adjacent to the Colorado River and approximately 0.3 miles east of the city of Rifle, CO. The former processing facilities have been removed and the site uranium mill tailings are interned at a disposal cell north of the city of Rifle. However, some low level remnant uranium contamination still exists at the Old Rifle site. In 2002, the United States Nuclear Regulatory Commission (US NRC) concurred with United States Department of Energy (US DOE) on a groundwater compliance strategy of natural flushing with institutional controls to decrease contaminant concentrations in the aquifer. In addition to active monitoring of contaminant concentrations, the site is also used for DOE Legacy Management (LM) and other DOE-funded small-scale field tests of remediation technologies. The purpose of this laboratory scale study was to evaluate the effectiveness of a hydroxyapatite (Ca₁₀(PO₄)₆(OH)₂) permeable reactive barrier and source area treatment in Old Rifle sediments. Phosphate treatment impact was evaluated by comparing uranium leaching and surface phase changes in untreated to PO₄-treated sediments. The impact of the amount of phosphate precipitation in the sediment on uranium mobility was evaluated with three different phosphate loadings. A range of flow velocity and uranium concentration conditions (i.e., uranium flux through the phosphate-treated sediment) was also evaluated to quantify the uranium uptake mass and rate by the phosphate precipitate.

Negative Pressure Wound Therapy in Infected Wound following Posterior Spinal Instrumentation using Simple Self-assembled System: A Case Report

Directory of Open Access Journals (Sweden)

CW Chang

2014-07-01

Full Text Available Postoperative wound infection in an instrumented spine patient is often disastrous. Management includes implant removal leading to spine instability. Negative pressure wound therapy (NPWT applied to the spine surgical wound is one of the wound care technique with successful results. We report a case of a man who sustained Chance fracture of Lumbar 1 (L1 vertebra treated with long segment posterior instrumentation, who unfortunately developed Extended-spectrum beta-lactamase (ESBL positive E. coli infection one month after the operation. After careful debridement of the wound, the implant became exposed. Three cycles of NPWT were applied and the wound healed with granulation tissue completely covering the implant, and thus negating the need to remove the implant. In conclusion, the NPWT is a good alternative in postoperative wound management especially in an instrumented spine patient.

Impact of glycemic control on the incidence of acute kidney injury in critically ill patients: a comparison of two strategies using the RIFLE criteria

Directory of Open Access Journals (Sweden)

José Raimundo Araújo de Azevedo

2010-06-01

Full Text Available OBJECTIVE: To compare the renal outcome in patients submitted to two different regimens of glycemic control, using the RIFLE criteria to define acute kidney injury. INTRODUCTION: The impact of intensive insulin therapy on renal function outcome is controversial. The lack of a criterion for AKI definition may play a role on that. METHODS: Included as the subjects were 228 randomly selected, critically ill patients engaged in intensive insulin therapyor in a carbohydrate-restrictive strategy. Renal outcome was evaluated through the comparison of the last RIFLE score obtained during the ICU stay and the RIFLE score at admission; the outcome was classified as favorable, stable or unfavorable. RESULTS: The two groups were comparable regarding demographic data. AKI developed in 52% of the patients and was associated with a higher mortality (39.4% compared with those who did not have AKI (8.2% (p60, acute kidney injury and hypoglycemia were risk factors for mortality. CONCLUSION: Intensive insulin therapy and a carbohydrate-restrictive strategy were comparable regarding the incidence of acute kidney injury evaluated using RIFLE criteria.

[Association between violence against women inflicted by the partner and chronic malnutrition in their children under five years old in Peru].

Science.gov (United States)

Ruiz-Grosso, Paulo; Loret de Mola, Christian; Miranda, J Jaime

2014-01-01

To assess the association between violence against women inflicted by their partner and the prevalence of chronic malnutrition in their children less than five years old. A secondary cross-sectional analysis of the 2001 Peru Demographic and Health Survey performed in Peru, with national representativeness. The dependent variable was chronic malnutrition in the youngest child under five years old. The independent variables were emotional violence, physical violence (mild or severe) and sexual violence self-report; the violence was inflicted by the mother's last partner or spouse in the last 12 months. Univariate and multivariate analysis was performed, generalized linear models (log-binomial regression) were used, and the nature of the sample was taken into account. Models for socio-demographic and mother-son health variables were adjusted. Prevalence ratios (PR) and confidence intervals were calculated. Data from 5,154 mothers and children were analyzed. The prevalence of chronic malnutrition was 19.8% (CI 95%: 18.1-21.6). In the multivariate analysis, a higher prevalence of chronic malnutrition was found in the children whose mothers had a history of severe physical violence history: PR=1.27% (IC 95%: 1.09-1.48). There was no evidence of association between the prevalence of chronic malnutrition and other kinds of violence inflicted by a partner. The mothers' report of physical violence in the last year was associated with an increased prevalence of chronic malnutrition in children under five years old.

Preclinical advantages of intramuscularly administered peptide A3-APO over existing therapies in Acinetobacter baumannii wound infections.

Science.gov (United States)

Ostorhazi, Eszter; Rozgonyi, Ferenc; Sztodola, Andras; Harmos, Ferenc; Kovalszky, Ilona; Szabo, Dora; Knappe, Daniel; Hoffmann, Ralf; Cassone, Marco; Wade, John D; Bonomo, Robert A; Otvos, Laszlo

2010-11-01

The designer antibacterial peptide A3-APO is efficacious in mouse models of Escherichia coli and Acinetobacter baumannii systemic infections. Here we compare the efficacy of the peptide with that of imipenem and colistin in A. baumannii wound infections after burn injury. CD-1 mice were inflicted with burn wounds and different inocula of A. baumannii, isolated from an injured soldier, were placed into the wound sites. The antibiotics were given intramuscularly (im) one to five times. Available free peptide in the blood and the systemic toxicity of colistin and A3-APO were studied in healthy mice. While toxicity of colistin was observed at 25 mg/kg bolus drug administration, the lowest toxic dose of A3-APO was 75 mg/kg. In the A. baumannii blast injury models, 5 mg/kg A3-APO improved survival and reduced bacterial counts in the blood as well as in the wounds and improved wound appearance significantly better than any other antibiotic treatment. The free peptide concentration in the blood did not reach 1 µg/mL. Peptide A3-APO, with an intramuscular therapeutic index of 15, is more efficacious and less toxic than any existing burn injury infection therapy modality against multidrug-resistant Gram-negative pathogens. A3-APO administered by the im route probably binds to a biopolymer that promotes the peptide's biodistribution.

Change in muzzle velocity due to freezing and water immersion of .22, long rifle, K.F. cartridges.

Science.gov (United States)

Jauhari, M; Chatterjee, S M; Ghosh, P K

1975-01-01

A study of change in muzzle velocity due to freezing and water immersion of .22, long rifle, K. F. cartridges has been presented. A statistical criterion has been formulated to ascertain whether or not a cartridge undergoes a change in muzzle velocity due to a particular treatment. The muzzle velocity data of .22, long rifle, K. F. cartridges, obtained by an electronic timer before and after the various treatments, have been analyzed in the light of this criterion. These cartridges have generally been found to suffer considerable loss in muzzle velocity when immersed in water for three weeks and also when immersed in water for three days and simultaneously cooled to 0 degrees C. The forensic significance of this loss in muzzle velocity has been discussed.

Socio-Demographic and Mental Health Profile of Admitted Cases of Self-Inflicted Harm in the US Population

Directory of Open Access Journals (Sweden)

Chris Hanuscin

2018-01-01

Full Text Available Self-inflicted harm (SIH has a substantial lifetime prevalence, it is associated with tremendous costs, and its rate is increasing on a national scale. To examine the characteristics of those admitted for SIH in the US and to investigate the factors that potentially modify the methods used for SIH. This was a retrospective analysis of admitted cases of SIH including suicide attempts between 2007 and 2012 using the National Trauma Data Bank. We included a total of 204,633 cases admitted for SIH. Our participants were 75.1% males. Those aged 15–24 (21%, 25–34 (22%, 35–44 (19%, 45–54 (19%, and 55–64 (10% years comprised the largest age groups among our cases—70.8%, 11.5%, 11.1%, and 6.6% were, respectively, Caucasians, Hispanics, Blacks, and Asian/Others. Analyses of the SIH methods revealed that Blacks were less likely to self-poison [Odds Ratio (OR: 0.78] compared to Whites, whereas individuals with psychiatric disorders or substance abuse carried 2.5 and 2.0-fold higher risk, respectively. Blacks were also less likely to use anoxic methods (OR: 0.69, whereas patients with psychiatric disorders or substance abuse carried 1.5-fold higher risk. Being Black, Hispanic, and Asian (OR: 0.58, 0.55, and 0.55, respectively as well as having psychiatric disorders (OR: 0.80 were associated with lower risks of using firearms, whereas its risk was increased with increasing age. Blacks (OR: 0.77 were less likely to cut or pierce in contrast to Hispanics (OR: 1.4, Asians/Others (OR: 1.29, and those with psychiatric disorders (2.5-fold higher risk or drug abuse (2-fold higher risk. Blacks (OR: 1.11, Hispanics (OR: 1.13, and Asians/Others (OR: 1.57 were more likely to jump from high places, whereas those with substance abuse were less likely (OR: 0.77. Among patients admitted for SIH, males, those aged 15–64 years, and Whites comprised the largest sex, age, and racial/ethnic groups, respectively. We also found that several factors including race

Mitigation action plan for remedial action at the Uranium Mill Tailing Sites and Disposal Site, Rifle, Colorado

International Nuclear Information System (INIS)

1992-07-01

The Estes Gulch disposal site is approximately 10 kilometers (6 miles) north of the town of Rifle, off State Highway 13 on Federal land administered by the Bureau of Land Management. The Department of Energy (DOE) will transport the residual radioactive materials (RRM) by truck to the Estes Gulch disposal site via State Highway 13 and place it in a partially below-grade disposal cell. The RRM will be covered by an earthen radon barrier, frost protection layers, and a rock erosion protection layer. A toe ditch and other features will also be constructed to control erosion at the disposal site. After removal of the RRM and disposal at the Estes Gulch site, the disturbed areas at all three sites will be backfilled with clean soils, contoured to facilitate surface drainage, and revegetated. Wetlands areas destroyed at the former Rifle processing sites will be compensated for by the incorporation of now wetlands into the revegetation plan at the New Rifle site. The UMTRA Project Office, supported by the Remedial Action Contractor (RAC) and the Technical Assistance Contractor (TAC), oversees the implementation of the MAP. The RAC executes mitigation measures in the field. The TAC provides monitoring of the mitigation actions in cases where mitigation measures are associated with design features. Site closeout and inspection compliance will be documented in the site completion report

The seductive superego: the trauma of self-betrayal.

Science.gov (United States)

Josephs, L

2001-08-01

The author describes a pathological manifestation of the approving superego that functions as a perversely seductive superego. In this process, the seductive superego rationalises and makes ego-syntonic a gratification of forbidden wishes that will result in unconscious punishment. The author argues that the seductive superego torments the self by teasing it with the presence of a tantalising but forbidden object of desire and then by inflicting shame on the self for its timidity, which prevents it from pursuing the object in spite of the dangers. He suggests that the seductive superego inflicts a betrayal trauma upon the self by unconsciously actualising a sado-masochistic fantasy of seduction, surrender and betrayal, along with a humiliating punishment for surrendering.

Self-inflicted transparietal intraventricular nail: case report and ...

African Journals Online (AJOL)

Background Deliberate self-harm with stone- or hammer-driven nail through the cranium is unusual. The need is stressed for comprehensive radiological evaluation with computed tomography (CT) scan, with or without angiography, and removal through an open cranial procedure under general anaesthesia, rather than ...

High-velocity facial gunshot wounds: multidisciplinary care from prehospital to discharge.

Science.gov (United States)

Sinnott, J D; Morris, G; Medland, P J; Porter, K

2016-01-28

A case is presented in which a high velocity rifle (shotgun) was fired into the inferior part of a patient's face in an attempted suicide causing widespread trauma to the inferior and left side of the patient's face. He presented to his general practitioner where an ambulance was called. The patient is followed from prehospital care (air ambulance) to resuscitation in accident and emergency and through the first stages of reconstructive surgery. The article focuses on the multidisciplinary approach to the patient's prehospital care and initial resuscitation at a major trauma centre. CT reconstruction images of the patient's skull allow visualisation of the extent of bone damage at presentation. Medical photography allows visualisation of the extent of the initial damage and shows how reconstructive surgery was undertaken early and in progressive stages. A literature review was performed allowing discussion of the current evidence and best practice in the management of facial gunshot wounds. 2016 BMJ Publishing Group Ltd.

An epidemiology of homicidal deaths due to rifled firearms in Peshawar Pakistan.

Science.gov (United States)

Marri, Murad Zafar; Bashir, Muhammad Zahid

2010-02-01

To determine the pattern of homicidal deaths caused by rifled weapons in Peshawar as regards the parameters of age, gender, place of occurrence and the number and location of injuries on the body. Descriptive study. The study was conducted at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar, from June 2005 to February 2006. The subjects were selected from victims presenting for autopsy at the Department of Forensic Medicine and Toxicology, Khyber Medical College, Peshawar. One hundred cases were selected where the weapon of offence was a rifled weapon and the manner of death was homicide on the basis of the police inquest, the autopsy and an interview with the relatives of the victim. After the autopsy, the findings were tabulated and analyzed. Homicides predominantly occurred in young males residing in a rural locality. The peak incidence was between 20-29 years in males and in females the age group most prone was 30-39 years. Male to female ratio was 6:1. The chest (33.8%) followed by the head and abdomen were the areas primarily targeted. High velocity automatic weapons are primarily being used to kill young people in rural areas. Prevention can be through strict gun control laws coupled with education and awareness.

Self-injurious behavior as a habit and its treatment.

Science.gov (United States)

Orian, C

1989-10-01

The definition of self-injurious behavior applies to persons who hurt or harm themselves without the motive of suicide or of sexual deviation. The different aspects of self-injurious behavior and the theories explaining them are reviewed. For 5 years a young, intelligent woman had inflicted injuries upon herself with sharp instruments while ostensibly caring for her face and legs. The short-term hypnobehavioral treatment included keeping daily reports of her self-inflicted injuries and of her thoughts while executing them, finding alternative activities to replace her habit, and practicing self-hypnosis once a day. Increasing the level of understanding of her inner conflict and accenting ways of breaking the habit by means of positive autosuggestion proved very effective. The treatment was successful after 13 sessions.

Colour-the-INSight : Combining a direct view rifle sight with fused intensified and thermal imagery

NARCIS (Netherlands)

Hogervorst, M.A.; Jansen, C.; Toet, A.; Bijl, P.; Bakker, P.J.; Hiddema, A.C.; Vliet, S.F. van

2012-01-01

We present the design and evaluation of a new demonstrator rifle sight viewing system containing direct view, red aim point and fusion of an (uncooled, LWIR) thermal sensor with a digital image intensifier. Our goal is to create a system that performs well under a wide variety of (weather)

The transition to non-lead rifle ammunition in Denmark: national obligations and policy considerations

DEFF Research Database (Denmark)

Kanstrup, Niels; Thomas, Vernon G.; Krone, Oliver

2016-01-01

The issue of Denmark regulating use of lead-free rifle ammunition because of potential risks of lead exposure in wildlife and humans was examined from a scientific and objective policy perspective. The consequences of adopting or rejecting such regulation were identified. Denmark is obliged to ex......-contaminated wild game meat. Opposition from hunting organizations would be expected....

Acute stress reduces wound-induced activation of microbicidal potential of ex vivo isolated human monocyte-derived macrophages.

Directory of Open Access Journals (Sweden)

Ulrike Kuebler

Full Text Available BACKGROUND: Psychological stress delays wound healing but the precise underlying mechanisms are unclear. Macrophages play an important role in wound healing, in particular by killing microbes. We hypothesized that (a acute psychological stress reduces wound-induced activation of microbicidal potential of human monocyte-derived macrophages (HMDM, and (b that these reductions are modulated by stress hormone release. METHODS: Fourty-one healthy men (mean age 35 ± 13 years were randomly assigned to either a stress or stress-control group. While the stress group underwent a standardized short-term psychological stress task after catheter-induced wound infliction, stress-controls did not. Catheter insertion was controlled. Assessing the microbicidal potential, we investigated PMA-activated superoxide anion production by HMDM immediately before and 1, 10 and 60 min after stress/rest. Moreover, plasma norepinephrine and epinephrine and salivary cortisol were repeatedly measured. In subsequent in vitro studies, whole blood was incubated with norepinephrine in the presence or absence of phentolamine (norepinephrine blocker before assessing HMDM microbicidal potential. RESULTS: Compared with stress-controls, HMDM of the stressed subjects displayed decreased superoxide anion-responses after stress (p's <.05. Higher plasma norepinephrine levels statistically mediated lower amounts of superoxide anion-responses (indirect effect 95% CI: 4.14-44.72. Norepinephrine-treated HMDM showed reduced superoxide anion-production (p<.001. This effect was blocked by prior incubation with phentolamine. CONCLUSIONS: Our results suggest that acute psychological stress reduces wound-induced activation of microbicidal potential of HMDM and that this reduction is mediated by norepinephrine. This might have implications for stress-induced impairment in wound healing.

Baseline risk assessment of ground water contamination at the uranium mill tailings sites near Rifle, Colorado. Revision 1

International Nuclear Information System (INIS)

1995-08-01

The US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project consists of the Surface Project (Phase 1) and the Ground Water Project (Phase 2). Under the UMTRA Surface Project, tailings, radioactive contaminated soil, equipment, and materials associated with the former uranium ore processing sites are placed into disposal cells. The cells are designed to reduce radon and other radiation emissions and to prevent further ground water contamination. The Ground Water Project evaluates the nature and extent of ground water contamination resulting from the uranium ore processing activities. Two UMTRA Project sites are near Rifle, Colorado: the Old Rifle site and the New Rifle site. Surface cleanup at the two sites is under way and is scheduled for completion in 1996. The Ground Water Project is in its beginning stages. A risk assessment identifies a source of contamination, how that contamination reaches people and the environment, the amount of contamination to which people or the environment may be exposed, and the health or environmental effects that could result from that exposure. This report is a site-specific document that will be used to evaluate current and future impacts to the public and the environment from exposure to contaminated ground water. This evaluation and further site characterization will be used to determine if action is needed to protect human health or the environment

Baseline risk assessment of ground water contamination at the uranium mill tailings sites near Rifle, Colorado. Revision 1

Energy Technology Data Exchange (ETDEWEB)

NONE

1995-08-01

The US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project consists of the Surface Project (Phase 1) and the Ground Water Project (Phase 2). Under the UMTRA Surface Project, tailings, radioactive contaminated soil, equipment, and materials associated with the former uranium ore processing sites are placed into disposal cells. The cells are designed to reduce radon and other radiation emissions and to prevent further ground water contamination. The Ground Water Project evaluates the nature and extent of ground water contamination resulting from the uranium ore processing activities. Two UMTRA Project sites are near Rifle, Colorado: the Old Rifle site and the New Rifle site. Surface cleanup at the two sites is under way and is scheduled for completion in 1996. The Ground Water Project is in its beginning stages. A risk assessment identifies a source of contamination, how that contamination reaches people and the environment, the amount of contamination to which people or the environment may be exposed, and the health or environmental effects that could result from that exposure. This report is a site-specific document that will be used to evaluate current and future impacts to the public and the environment from exposure to contaminated ground water. This evaluation and further site characterization will be used to determine if action is needed to protect human health or the environment.

Microbiological, Geochemical and Hydrologic Processes Controlling Uranium Mobility: An Integrated Field-Scale Subsurface Research Challenge Site at Rifle, Colorado, Quality Assurance Project Plan

International Nuclear Information System (INIS)

Fix, N. J.

2008-01-01

The U.S. Department of Energy (DOE) is cleaning up and/or monitoring large, dilute plumes contaminated by metals, such as uranium and chromium, whose mobility and solubility change with redox status. Field-scale experiments with acetate as the electron donor have stimulated metal-reducing bacteria to effectively remove uranium [U(VI)] from groundwater at the Uranium Mill Tailings Site in Rifle, Colorado. The Pacific Northwest National Laboratory and a multidisciplinary team of national laboratory and academic collaborators has embarked on a research proposed for the Rifle site, the object of which is to gain a comprehensive and mechanistic understanding of the microbial factors and associated geochemistry controlling uranium mobility so that DOE can confidently remediate uranium plumes as well as support stewardship of uranium-contaminated sites. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by the Rifle Integrated Field-Scale Subsurface Research Challenge Project

Microbiological, Geochemical and Hydrologic Processes Controlling Uranium Mobility: An Integrated Field-Scale Subsurface Research Challenge Site at Rifle, Colorado, Quality Assurance Project Plan

Energy Technology Data Exchange (ETDEWEB)

Fix, N. J.

2008-01-07

The U.S. Department of Energy (DOE) is cleaning up and/or monitoring large, dilute plumes contaminated by metals, such as uranium and chromium, whose mobility and solubility change with redox status. Field-scale experiments with acetate as the electron donor have stimulated metal-reducing bacteria to effectively remove uranium [U(VI)] from groundwater at the Uranium Mill Tailings Site in Rifle, Colorado. The Pacific Northwest National Laboratory and a multidisciplinary team of national laboratory and academic collaborators has embarked on a research proposed for the Rifle site, the object of which is to gain a comprehensive and mechanistic understanding of the microbial factors and associated geochemistry controlling uranium mobility so that DOE can confidently remediate uranium plumes as well as support stewardship of uranium-contaminated sites. This Quality Assurance Project Plan provides the quality assurance requirements and processes that will be followed by the Rifle Integrated Field-Scale Subsurface Research Challenge Project.

Remedial action plan and site conceptual design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado. Appendix D, Final report

International Nuclear Information System (INIS)

1992-02-01

This appendix assesses the present conditions and data gathered about the two designated inactive uranium mill tailings sites near Rifle, Colorado, and the proposed disposal site six miles north of Rifle in the area of Estes Gulch. It consolidates available engineering, radiological, geotechnical, hydrological, meteorological, and other information pertinent to the design of the Remedial Action Plan (RAP). The data characterize conditions at the mill, tailings, and disposal site so that the Remedial Action Contractor (RAC) may complete final designs for the remedial actions

Remedial action plan and site conceptual design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado. Appendix D, Final report

Energy Technology Data Exchange (ETDEWEB)

NONE

1992-02-01

This appendix assesses the present conditions and data gathered about the two designated inactive uranium mill tailings sites near Rifle, Colorado, and the proposed disposal site six miles north of Rifle in the area of Estes Gulch. It consolidates available engineering, radiological, geotechnical, hydrological, meteorological, and other information pertinent to the design of the Remedial Action Plan (RAP). The data characterize conditions at the mill, tailings, and disposal site so that the Remedial Action Contractor (RAC) may complete final designs for the remedial actions.

Self-injury, converting emotional distress into physical pain

DEFF Research Database (Denmark)

Møhl, Bo; Rubæk, Lotte

2017-01-01

Self-inflicted pain by cutting, hitting or burning oneself has become a common way to regulate emotions and to serve as coping strategy. 21.5-32% of adolescents in non-clinical populations have a history of non-suicidal self-injury. Non-suicidal self-injury has a momentarily relieving effect...

The destabilizing effect of body armour on military rifle bullets.

Science.gov (United States)

Knudsen, P J; Sørensen, O H

1997-01-01

Soft body armour is designed to give protection against fragments and some low velocity bullets but is not designed to stop high velocity rifle bullets. Reports have claimed that soft body armour might disturb the stability of bullets that penetrate it, and that this might increase the size of the lesions. The reason for such an effect might be early yaw of the bullet, so we studied the behaviour of bullets which had passed through soft body armour. A 7.62 x 39 mm AK-47 rifle was fired from a permanent stand using full metal jacketed lead core bullets at a range of 30 m. Soft body armour composed for 14 and 28 layers of aramid fibres (Kevlar) was placed at 90 degrees and 60 degrees to the line of fire. Yaw was measured by the shadowgraph technique and a TERMA Doppler radar. A total of ten shots without body armour, and ten shots with each of the two types of body armour at the two angles were used. The results of the shadowgraph and Doppler radar measurements showed a proportional correlation between the two methods of determining the bullet yaw. The semiquantitative approach of the Doppler radar measurement was in agreement with the more concise measurement using the photographic technique. Velocity loss and loss of spin rate from penetrating 14 or 28 ply Kevlar was negligible. We observed induced instability after penetration of 14 and particularly 28 ply Kevlar, dependence of yaw with respect to the number of layers of Kevlar as well as to the angle of the body armour with respect to the line of fire.

Axial-Symmetry Numerical Approaches for Noise Predicting and Attenuating of Rifle Shooting with Suppressors

Directory of Open Access Journals (Sweden)

Shi-Wei Lo

2011-01-01

Full Text Available The moving bullet out of a rifle barrel is propelled by a fired explosive charge. Subsequently, a disturbed muzzle blast wave is initiated which lasts several milliseconds. In this study, axially symmetric, unsteady, Large Eddy Simulation (LES, and Ffowcs Williams and Hawkins (FWH equations were solved by the implicit-time formulation. For the spatial discretization, second order upwind scheme was employed. In addition, dynamic mesh model was used to where the ballistic domain changed with time due to the motion of bullet. Results obtained for muzzle flow field and for noise recorded were compared with those obtained from experimental data; these two batches of results were in agreement. Five cases of gunshot including one model of an unsuppressed rifle and four models of suppressors were simulated. Besides, serial images of species distributions and velocity vectors-pressure contours in suppressors and near muzzle field were displayed. The sound pressure levels (dB in far field that were post-processed by the fast Fourier transform (FFT were compared. The proposed physical model and the numerical simulations used in the present work are expected to be extended to solve other shooting weapon problems with three-dimensional and complex geometries.

[Bullet and shrapnel injuries in the face and neck regions. Current aspects of wound ballistics].

Science.gov (United States)

Hauer, T; Huschitt, N; Kulla, M; Kneubuehl, B; Willy, C

2011-08-01

A basic understanding of the ballistic behaviour of projectiles or fragments after entering the human body is essential for the head and neck surgeon in the military environment in order to anticipate the diagnostic and therapeutic consequences of this type of injury. Although a large number of factors influence the missile in flight and after penetration of the body, the most important factor is the amount of energy transmitted to the tissue. Long guns (rifles or shotguns) have a much higher muzzle energy compared to handguns, explaining why the remote effects beyond the bullet track play a major role. While most full metal jacket bullets release their energy after 12-20 cm (depending on the calibre), soft point bullets release their energy immediately after entry into the human body. This results in a major difference in extremity wounds, but not so much in injuries with long bullet paths (e.g. diagonal shots). Shrapnel wounds are usually produced with similarly high kinetic energy to those caused by hand- and long guns. However, fragments tend to dissipate the entire amount of energy within the body, which increases the degree of tissue disruption. Of all relevant injuries in the head and neck region, soft tissue injuries make up the largest proportion (60%), while injuries to the face are seen three times more often than injuries to the neck. Concomitant intracranial or spinal injury is seen in 30% of cases. Due to high levels of wound contamination, the infection rate is approximately 15%, often associated with a complicated and/or multiresistant spectrum of germs.

Non-lead rifle hunting ammunition: issues of availability and performance in Europe

DEFF Research Database (Denmark)

Thomas, Vernon G.; Gremse, Carl; Kanstrup, Niels

2016-01-01

companies make non-lead bullets for traditional, rare, and novel rifle calibres. Local retail availability is now a function of consumer demand which relates, directly, to legal requirements for use. Costs of non-lead and equivalent lead-core hunting bullets are similar in Europe and pose no barrier to use......, but there is no advice to hunters yet given on the use of these two bullet types. The non-toxicity of ingested metallic copper, the principal component of non-lead bullets, is scientifically well-established....

Atypical gunshot injury to the right side of the face with the bullet lodged in the carotid sheath: a case report.

Science.gov (United States)

Ongom, Peter A; Kijjambu, Stephen C; Jombwe, Josephat

2014-01-27

Gunshot injuries of the head and neck from the AK-47 rifle (a common assault rifle, submachine gun type) are a significant contributor to morbidity and mortality among civilians in Sub-Saharan Africa. They may cause significant damage to the closely arranged structures in this region, and the bullet's trajectory can be very difficult to determine. We present an unusual case of gunshot injury with an atypical bullet entry wound, profound injury to the face, lodgment in the right carotid sheath, and 'wandering'; a first of its kind in East Africa. A 27-year-old African-Ugandan woman of Nilotic ethnicity was referred to the Accident and Emergency Department of a tertiary hospital in Uganda, having sustained complex injuries due to an inadvertent AK-47 rifle gunshot injury. The gunshot injury was to the right side of her face with a large ragged entry wound and no exit wound. Prior basic wound care and radiological imaging showed a comminuted fracture of her mandible with lodgment of the bullet in her neck, anterior to her sixth and seventh cervical vertebrae. Standard debridement of her wound was done. A computed tomography scan showed an apparent cephalad shift ('wandering') of the bullet, leaving it lying partially anterior to her fifth cervical vertebra as well as within her carotid sheath. Other injuries were to her facial and trigeminal nerves, and her middle ear. The 'wandering' bullet was successfully removed surgically. It had caused no damage to any part of her neck structure. AK-47 rifle bullet injuries may present with uncharacteristically large entry wounds and cause complex structural injuries at the area of impact. The consequent trajectory is difficult to predict making regional examination and radiological investigations essential in management. Bullets may be retained, leaving no exit wound. Securing the airway, controlling hemorrhage and identifying other injuries are the first vital steps. This case illustrates all these interventions and the

Design of Vibration Absorber using Spring and Rubber for Armored Vehicle 5.56 mm Caliber Rifle

Directory of Open Access Journals (Sweden)

Aditya Sukma Nugraha

2014-12-01

Full Text Available This paper presents a design of vibration absorber using spring and rubber for 5.56 mm caliber rifle armored vehicle. Such a rifle is used in a Remote-Controlled Weapon System (RCWS or a turret where it is fixed using a two degree of freedom pan-tilt mechanism. A half car lumped mass dynamic model of armored vehicles was derived. Numerical simulation was conducted using fourth order Runge Kutta method. Various types of vibration absorbers using spring and rubber with different configurations are installed in the elevation element. Vibration effects on horizontal direction, vertical direction and angular deviation of the elevation element was investigated. Three modes of fire were applied i.e. single fire, semi-automatic fire and automatic fire. From simulation results, it was concluded that the parallel configuration of damping rubber type 3, which has stiffness of 980,356.04 (N/m2 and damping coefficient of 107.37 (N.s/m, and Carbon steel spring whose stiffness coefficient is 5.547 x 106 (N/m2 provides the best vibration absorption. 

Bear-inflicted injuries - a report from Nepal.

Science.gov (United States)

Atreya, Alok; Kanchan, Tanuj; Nepal, Samata; Acharya, Jenash

2016-06-01

Upper Mustang in the Northern Himalayan range of Nepal is the home of brown bears (Ursusarctos). Low-plant biomass as a result of scanty rainfall in Upper Mustang is a reason for habitat overlap of humans and wild animals. Humans who enter into the wild to collect firewood and graze cattle are liable to wild animal attacks. Such attacks, especially by brown bears, are readily identified by the type of injuries. These are more commonly confined to head and neck regions. Cutting, gnawing and tearing by sharp teeth and claws produces specific pattern of injuries, which are devastating but seldom fatal. This article reports a rare case of brown bear injury inflicted upon a man from the Upper Mustang region in Nepal. © The Author(s) 2016.

Remedial action plan and site design for stabilization of the inactive uranium mill tailings sites at Rifle, Colorado. Volume 2, Appendices D and E: Final report

Energy Technology Data Exchange (ETDEWEB)

1992-02-01

This appendix assesses the present conditions and data gathered about the two inactive uranium mill tailings sites near Rifle, Colorado, and the designated disposal site six miles north of Rifle in the area of Estes Gulch. It consolidates available engineering, radiological, geotechnical, hydrological, meteorological, and other information pertinent to the design of the Remedial Action Plan (RAP). The data characterize conditions at the mill, tailings, and disposal site so that the Remedial Action Contractor (RAC) may complete final designs for the remedial actions.

[Surgical peculiarities of gunshot injuries to arteries of the extremities caused by modern small arms and light weapons].

Science.gov (United States)

Samokhvalov, I M; Reva, V A; Denisov, A V; Ozeretskovskiĭ, L B; Pronchenko, A A

2014-10-01

The aim of the given study was development of surgical tactics in case of femoral artery injury, caused by medium-calibre bullet, on the basis acute experiment on large biological objects. Experimental animals were shot into mid third of the femora by a rifle cartridge in 7,62-mm calibre (AK-47 made in 1943). The analysis of microstructure, made in 5 cross-sections performed every 1-centimetre way from the wound canal, showed that there were no any damages of arterial wall. Authors came to conclusion that the surgical debridement of the gunshot wound, made by a rifle cartridge in 7,62-mm calibre of AK-47, should consist of exsection of devitalized section of artery.

Rogue-Elephant-Inflicted Panfacial Injuries: A Rare Case Report

Directory of Open Access Journals (Sweden)

Santosh Kumar Yadav

2012-01-01

Full Text Available Attacks by elephants, the largest of the “large animals,” produce many fatalities a year. Most attacks are provoked, although rogue elephants are occasionally responsible. Trampling, goring, tossing the individual with the trunk, or crushing with the knees produces the injuries. Injuries from encounters with large animals represent a significant health risk for rural communities. Wild-animal-inflicted maxillofacial injuries are rare, and limited literature is available describing their management. We present a case of severe maxillofacial injuries caused by the attack of a rogue elephant.

Differentiating Adolescent Self-Injury from Adolescent Depression: Possible Implications for Borderline Personality Development

Science.gov (United States)

Crowell, Sheila E.; Beauchaine, Theodore P.; Hsiao, Ray C.; Vasilev, Christina A.; Yaptangco, Mona; Linehan, Marsha M.; McCauley, Elizabeth

2012-01-01

Self-inflicted injury (SII) in adolescence marks heightened risk for suicide attempts, completed suicide, and adult psychopathology. Although several studies have revealed elevated rates of depression among adolescents who self injure, no one has compared adolescent self injury with adolescent depression on biological, self-, and informant-report…

Can Wound Exudate from Venous Leg Ulcers Measure Wound Pain Status?: A Pilot Study.

Directory of Open Access Journals (Sweden)

Taichi Goto

Full Text Available We investigated the associations between the self-evaluated pain status and two pain biomarker candidates, nerve growth factor and S100A8/A9, in exudate from venous leg ulcer to finally develop an objective pain evaluation method. Patients with venous leg ulcer participated in this cross-sectional observational study conducted between April and October 2014 at two medical facilities. During routine wound care, each participant self-evaluated their pain status at each examination using the 10-point numerical rating scale (present pain intensity and the short-form McGill Pain Questionnaire 2 (continuous pain, intermittent pain, neuropathic pain, affective descriptors, and total score. Venous leg ulcer exudate sample was collected after wound cleansing. The nerve growth factor and S100A8/A9 concentrations in the venous leg ulcer exudate were measured by enzyme-linked immunosorbent assay and standardized according to the wound area. The association between each pain status and the two standardized protein concentrations was evaluated using Spearman's correlation coefficient. In 30 sample collected from 13 participants, the standardized nerve growth factor concentration was negatively correlated with continuous pain (ρ = -0.47, P = 0.01, intermittent pain (ρ = -0.48, P = 0.01, neuropathic pain (ρ = -0.51, P = 0.01, and total score (ρ = -0.46, P = 0.01. The standardized S100A8/A9 concentration was positively correlated with present pain intensity (ρ = 0.46, P = 0.03 and continuous pain (ρ = 0.48, P = 0.03. Thus, these two proteins may be useful for objective evaluation of wound pain in venous leg ulcer patients.

Mystery of the First Russian Rifle Naval Guns

Directory of Open Access Journals (Sweden)

Nicholas W. Mitiukov

2015-09-01

Full Text Available In 1859 France completed the first ocean-going ironclad warship, «La Gloire», and changed the definition of naval power completely. Russia, as all the other Powers, found that her most powerful naval gun, the 60-pdr, was insufficient for modern warfare, and realized the future naval armament relied on heavy rifled artillery. Both the Army and Navy began purchasing such cannon from foreign providers until a suitable domestic weapon could be produced. The relationship between the Russian military and Krupp is well known. But there was another provided, the Blakely Ordnance Company in England sold many guns to the Army and Navy, beginning with 8-inch MLR in early 1863 to a large number of 9- and 11-inch guns. Deliveries began in November 1863 and continued until mid-1866. But no sources on the armament of Russian ships and fortresses mentions these guns. What happened to them is a mystery.

Final audit report of remedial action construction at the UMTRA project site Rifle, Colorado. Rev. 1

International Nuclear Information System (INIS)

1997-01-01

This final audit report summarizes the assessments performed by the U.S. Department of Energy (DOE) Environmental Restoration Division (ERD) and its Technical Assistance Contractor (TAC) of remedial action compliance with approved plans, specifications, standards, and 40 CFR Part 192 at the Rifle, Colorado, Uranium Mill Tailings Remedial Action (UMTRA) Project site. Remedial action construction was directed by the Remedial Action Contractor (RAC)

Self-Inflicted Wounds: Debates and Divisions within al-Qa’ida and its Periphery

Science.gov (United States)

2010-12-16

Genetics : The Afghan Origins  Al‐Qa’ida’s current efforts to unify disparate Islamist groups and struggles into a global  conflict against the so‐called...upon.    The Tawhed.ws site has a special page dedicated to the Shi’a under the  rubric  of “sects  and  schools,”  a  section  that  is modeled  on

Exercise accelerates wound healing among healthy older adults: a preliminary investigation.

Science.gov (United States)

Emery, Charles F; Kiecolt-Glaser, Janice K; Glaser, Ronald; Malarkey, William B; Frid, David J

2005-11-01

Older adults are likely to experience delayed rates of wound healing, impaired neuroendocrine responsiveness, and increased daily stress. Exercise activity has been shown to have a positive effect on physiological functioning and psychological functioning among older adults. This study evaluated the effect of a 3-month exercise program on wound healing, neuroendocrine function, and perceived stress among healthy older adults. Twenty-eight healthy older adults (mean age 61.0 +/- 5.5 years) were assigned randomly to an exercise activity group (n = 13) or to a nonexercise control group (n = 15). One month following baseline randomization, after exercise participants had acclimated to the exercise routine, all participants underwent an experimental wound procedure. Wounds were measured 3 times per week until healed to calculate rate of wound healing. All participants completed assessments of exercise endurance, salivary cortisol, and self-reported stress prior to randomization and at the conclusion of the intervention. Exercise participants achieved significant improvements in cardiorespiratory fitness, as reflected by increased oxygen consumption (VO(2)max) and exercise duration. Wound healing occurred at a significantly faster rate in the exercise group [mean = 29.2 (9.0) days] than in the nonexercise group [38.9 (7.4) days; p =.012]. Exercise participants also experienced increased cortisol secretion during stress testing following the intervention. Group differences in wound healing and neuroendocrine responsiveness were found despite low levels of self-reported stress. A relatively short-term exercise intervention is associated with enhanced rates of wound healing among healthy older adults. Thus, exercise activity may be an important component of health care to promote wound healing.

Baseline risk assessment of ground water contamination at the Uranium Mill Tailings Sites near Rifle, Colorado. Revision 2

International Nuclear Information System (INIS)

1996-02-01

The U.S. Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project consists of the Surface Project (Phase I) and the Ground Water Project (Phase II). Under the UMTRA Surface Project, tailings, radioactive contaminated soil, equipment, and materials associated with the former uranium ore processing sites are placed into disposal cells. The cells are designed to reduce radon and other radiation emissions and to prevent further ground water contamination. The Ground Water Project evaluates the nature and extent of ground water contamination resulting from the uranium ore processing activities. Two UMTRA Project sites are near Rifle, Colorado: the Old Rifle site and the New Rifle site. Surface cleanup at the two sites is under way and is scheduled for completion in 1996. The Ground Water Project is in its beginning stages. A risk assessment identifies a source of contamination, how that contamination reaches people and the environment, the amount of contamination to which people or the environment may be exposed, and the health or environmental effects that could result from that exposure. This report is a site-specific document that will be used to evaluate current and future impacts to the public and the environment from exposure to contaminated ground water. This evaluation and further site characterization will be used to determine if action is needed to protect human health or the environment. Human health risk may result from exposure to ground water contaminated from uranium ore processing. Exposure could occur from drinking water obtained from a well placed in the areas of contamination. Furthermore, environmental risk may result from plant or animal exposure to surface water and sediment that have received contaminated ground water

Baseline risk assessment of ground water contamination at the Uranium Mill Tailings Sites near Rifle, Colorado. Revision 2

Energy Technology Data Exchange (ETDEWEB)

NONE

1996-02-01

The U.S. Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project consists of the Surface Project (Phase I) and the Ground Water Project (Phase II). Under the UMTRA Surface Project, tailings, radioactive contaminated soil, equipment, and materials associated with the former uranium ore processing sites are placed into disposal cells. The cells are designed to reduce radon and other radiation emissions and to prevent further ground water contamination. The Ground Water Project evaluates the nature and extent of ground water contamination resulting from the uranium ore processing activities. Two UMTRA Project sites are near Rifle, Colorado: the Old Rifle site and the New Rifle site. Surface cleanup at the two sites is under way and is scheduled for completion in 1996. The Ground Water Project is in its beginning stages. A risk assessment identifies a source of contamination, how that contamination reaches people and the environment, the amount of contamination to which people or the environment may be exposed, and the health or environmental effects that could result from that exposure. This report is a site-specific document that will be used to evaluate current and future impacts to the public and the environment from exposure to contaminated ground water. This evaluation and further site characterization will be used to determine if action is needed to protect human health or the environment. Human health risk may result from exposure to ground water contaminated from uranium ore processing. Exposure could occur from drinking water obtained from a well placed in the areas of contamination. Furthermore, environmental risk may result from plant or animal exposure to surface water and sediment that have received contaminated ground water.

Red Maca (Lepidium meyenii), a Plant from the Peruvian Highlands, Promotes Skin Wound Healing at Sea Level and at High Altitude in Adult Male Mice.

Science.gov (United States)

Nuñez, Denisse; Olavegoya, Paola; Gonzales, Gustavo F; Gonzales-Castañeda, Cynthia

2017-12-01

Nuñez, Denisse, Paola Olavegoya, Gustavo F. Gonzales, and Cynthia Gonzales-Castañeda. Red maca (Lepidium meyenii), a plant from the Peruvian highlands, promotes skin wound healing at sea level and at high altitude in adult male mice. High Alt Med Biol 18:373-383, 2017.-Wound healing consists of three simultaneous phases: inflammation, proliferation, and remodeling. Previous studies suggest that there is a delay in the healing process in high altitude, mainly due to alterations in the inflammatory phase. Maca (Lepidium meyenii) is a Peruvian plant with diverse biological properties, such as the ability to protect the skin from inflammatory lesions caused by ultraviolet radiation, as well as its antioxidant and immunomodulatory properties. The aim of this study was to determine the effect of high altitude on tissue repair and the effect of the topical administration of the spray-dried extract of red maca (RM) in tissue repair. Studies were conducted in male Balb/c mice at sea level and high altitude. Lesions were inflicted through a 10 mm-diameter excisional wound in the skin dorsal surface. Treatments consisted of either (1) spray-dried RM extract or (2) vehicle (VH). Animals wounded at high altitude had a delayed healing rate and an increased wound width compared with those at sea level. Moreover, wounding at high altitude was associated with an increase in inflammatory cells. Treatment with RM accelerated wound closure, decreased the level of epidermal hyperplasia, and decreased the number of inflammatory cells at the wound site. In conclusion, RM at high altitude generate a positive effect on wound healing, decreasing the number of neutrophils and increasing the number of macrophages in the wound healing at day 7 postwounding. This phenomenon is not observed at sea level.

[The forensic medical characteristics of the entrance bullet holes created by the shots from pneumatic rifles].

Science.gov (United States)

Legin, G A; Bondarchuk, A O; Perebetjuk, A N

2015-01-01

The objective of the present study was to compare the injurious action of three types of the bullets for the pneumatic weapons shot from different distances using the Gamo pump air pistol and the BAM B22-1 pneumatic rifle. The following four kinds of the bullets were tested: "the fireball", "Luman cap 0.3", "Luman Field Target 0.68" and "DIABOLO". It was experimentally shown that the injurious action of the bullets fired from the same distance from the pneumatic weapons depends on the type of both the bullet and the weapon, as well as the properties of the target material. Specifically, the action of bullets fired from the piston pneumatic rifle remained stable whereas that of the bullets shot from the gas-balloon air pistol decreased as the gas was exhausted. The studies by the contact-diffusion method have demonstrated that the entrance bullet holes created by the shots from pneumatic weapons are surrounded by dispersed metal particles which makes it possible to estimate the shooting distance. Moreover, the bullets fired from the pneumatic weapons leave the muzzle face imprint on certain target materials.

Self-Inflicted Trauma Secondary to Local Anaesthesia in Children

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Srikrishna Vempaty

2017-01-01

Full Text Available Long acting local anaesthetics and inferior alveolar nerve block in children can cause loss of sensation and proprioception in a large area supplied by that particular nerve. Similar to the maxilla in mandible also, adequate level of anaesthesia can be achieved in the desired site of treatment by using a short acting local anaesthetic. Early return of normal sensory feedback after using short acting anaesthetics can be helpful in preventing self-harm.

Anaesthetic Bodies and the Absence of Feeling: Pain and Self-Mutilation in Later Nineteenth-Century Psychiatry

Directory of Open Access Journals (Sweden)

Sarah Chaney

2012-12-01

Full Text Available This paper addresses the overlapping ways in which self-inflicted injury was understood in relation to an absence of pain during the long nineteenth century, arguing that a clear distinction between bodily and mental suffering cannot be made in this period. The medical view that self-infliction of injury must necessarily be pathological is shown to have emerged from earlier philosophical approaches to pain. This was cemented by the formation of a somatic model of self-mutilation, based on the concept of cutaneous anaesthesia, particularly in the work of Wilhelm Griesinger in Germany. In contrast, the words of asylum patients provide a much broader spectrum of ways in which injuries might have been understood. Nonetheless, the meanings attributed generally emphasize self-mutilation as a response to physical, rather than emotional, pain, indicating the widespread nature of physical aetiologies of insanity. Such a somatic approach also permeated psychological models of self-inflicted injury in the late nineteenth and early twentieth centuries, as shown through examination of Richard von Krafft-Ebing’s concept of ‘sexual anaesthesia’, William James’s association of anaesthesia with the absence of emotion, and self-mutilation and fixed ideas in the work of Pierre Janet. The study of self-mutilation thus provides an interesting angle from which to explore the complexity of notions of body and mind, in relation to concepts of pain.

Patients' experiences of negative pressure wound therapy for the treatment of wounds: a review.

Science.gov (United States)

Upton, D; Stephens, D; Andrews, A

2013-01-01

To review the research on patients' experiences of undergoing negative pressure wound therapy (NPWT). A literature search was carried out using the following databases: Academic Search Complete, CINAHL, PsychINFO, MEDLINE, PubMed and PsyARTICLES. The search covered the period from 2001 to 2012, using the key words: ['negative pressure wound therapy' OR 'vacuum-assisted closure' OR 'topical negative therapy'] AND ['patients' experiences' OR 'psychological' OR 'stress' OR 'anxiety' OR 'wellbeing' OR 'pain' OR 'quality of life' OR 'physical']. Twenty-five relevant articles were included. NPWT is generally considered to be successful in reducing wound depth and facilitating healing. However, studies have highlighted a number of issues that need to be considered. For example, the type of dressing used during treatment can have a significant effect on patients' experience of pain. Furthermore, the NPWT system can cause patients to feel anxious due to both the patient and the health professional being unfamiliar with this form of treatment. It can also restrict patients' daily care and wider social life, which may result in a negative self-image and low self-esteem. Despite this, some studies have reported positive improvements to patients' quality of life. Additionally, since NPWT can lead to faster healing, any detrimental impact upon patients' wellbeing may be short-term and less prolonged than that of other treatments. Compared with other treatments, there is evidence to show that NPWT can lead to faster wound healing, and a reduced frequency of dressing changes and other treatments. However, there are a number of challenges with the use of NPWT, which need to be explored further so that improvements can be made. Specifically, certain aspects of NPWT may impact negatively on patients' wellbeing, albeit short-term. Therefore, research needs to explore patients' experience of NPWT throughout the treatment process and to consider how this can be improved to minimise any

A comparison of observed versus estimated baseline creatinine for determination of RIFLE class in patients with acute kidney injury

NARCIS (Netherlands)

Bagshaw, Sean M.; Uchino, Shigehiko; Cruz, Dinna; Bellomo, Rinaldo; Morimatsu, Hiroshi; Morgera, Stanislao; Schetz, Miet; Tan, Ian; Bouman, Catherine; Macedo, Etienne; Gibney, Noel; Tolwani, Ashita; Oudemans-van Straaten, Heleen M.; Ronco, Claudio; Kellum, John A.; French, Craig; Mulder, John; Pinder, Mary; Roberts, Brigit; Botha, John; Mudholkar, Pradeen; Holt, Andrew; Hunt, Tamara; Honoré, Patrick Maurice; Clerbaux, Gaetan; Schetz, Miet Maria; Wilmer, Alexander; Yu, Luis; Macedo, Ettiene V.; Laranja, Sandra Maria; Rodrigues, Cassio José; Suassuna, José Hermógenes Rocco; Ruzany, Frederico; Campos, Bruno; Leblanc, Martine; Senécal, Lynne; Gibney, R. T. Noel; Johnston, Curtis; Brindley, Peter; Tan, Ian K. S.; Chen, Hui De; Wan, Li; Rokyta, Richard; Krouzecky, Ales; Neumayer, Hans-Helmut; Detlef, Kindgen-Milles; Mueller, Eckhard; Tsiora, Vicky; Sombolos, Kostas; Mustafa, Iqbal; Suranadi, Iwayan; Bar-Lavie, Yaron; Nakhoul, Farid; Ceriani, Roberto; Bortone, Franco; Zamperetti, Nereo; Pappalardo, Federico; Marino, Giovanni; Calabrese, Prospero; Monaco, Francesco; Liverani, Chiara; Clementi, Stefano; Coltrinari, Rosanna; Marini, Benedetto; Fuke, Nobuo; Miyazawa, Masaaki; Katayama, Hiroshi; Kurasako, Toshiaki; Hirasawa, Hiroyuki; Oda, Shigeto; Tanigawa, Koichi; Tanaka, Keiichi; Oudemans-van Straaten, Helena Maria; de Pont, Anne-Cornelie J. M.; Bugge, Jan Frederik; Riddervold, Fridtjov; Nilsen, Paul Age; Julsrud, Joar; Teixeira e Costa, Fernando; Marcelino, Paulo; Serra, Isabel Maria; Yaroustovsky, Mike; Grigoriyanc, Rachik; Lee, Kang Hoe; Loo, Shi; Singh, Kulgit; Barrachina, Ferran; Llorens, Julio; Sanchez-Izquierdo-Riera, Jose Angel; Toral-Vazquez, Darío; Wizelius, Ivar; Hermansson, Dan; Gaspert, Tomislav; Maggiorini, Marco; Davenport, Andrew; Lombardi, Raúl; Llopart, Teresita; Venkataraman, Ramesh; Kellum, John; Murray, Patrick; Trevino, Sharon; Benjamin, Ernest; Hufanda, Jerry; Paganini, Emil; Warnock, David; Guirguis, Nabil

2009-01-01

The RIFLE classification scheme for acute kidney injury (AKI) is based on relative changes in serum creatinine (SCr) and on urine output. The SCr criteria, therefore, require a pre-morbid baseline value. When unknown, current recommendations are to estimate a baseline SCr by the MDRD equation.

Nanofibrillar cellulose wound dressing in skin graft donor site treatment.

Science.gov (United States)

Hakkarainen, T; Koivuniemi, R; Kosonen, M; Escobedo-Lucea, C; Sanz-Garcia, A; Vuola, J; Valtonen, J; Tammela, P; Mäkitie, A; Luukko, K; Yliperttula, M; Kavola, H

2016-12-28

Although new therapeutic approaches for burn treatment have made progress, there is still need for better methods to enhance wound healing and recovery especially in severely burned patients. Nanofibrillar cellulose (NFC) has gained attention due to its renewable nature, good biocompatibility and excellent physical properties that are of importance for a range of applications in pharmaceutical and biomedical fields. In the present study, we investigated the potential of a wood based NFC wound dressing in a clinical trial on burn patients. Previously, we have investigated NFC as a topical functionalized wound dressing that contributes to improve wound healing in mice. Wood based NFC wound dressing was tested in split-thickness skin graft donor site treatment for nine burn patients in clinical trials at Helsinki Burn Centre. NFC dressing was applied to split thickness skin graft donor sites. The dressing gradually dehydrated and attached to donor site during the first days. During the clinical trials, physical and mechanical properties of NFC wound dressing were optimized by changing its composition. From patient 5 forward, NFC dressing was compared to commercial lactocapromer dressing, Suprathel® (PMI Polymedics, Germany). Epithelialization of the NFC dressing-covered donor site was faster in comparison to Suprathel®. Healthy epithelialized skin was revealed under the detached NFC dressing. NFC dressing self-detached after 11-21days for patients 1-9, while Suprathel® self-detached after 16-28days for patients 5-9. In comparison studies with patients 5-9, NFC dressing self-detached on average 4days earlier compared with Suprathel®. Lower NFC content in the material was evaluated to influence the enhanced pliability of the dressing and attachment to the wound bed. No allergic reaction or inflammatory response to NFC was observed. NFC dressing did not cause more pain for patients than the traditional methods to treat the skin graft donor sites. Based on the

Self-Burns in Fars Province, Southern Iran

OpenAIRE

Mohammadi, Ali Akbar; Tohidinik, Hamid Reza; Zardosht, Mitra; Seyed Jafari, Seyed Morteza

2016-01-01

BACKGROUND The alarming incidence of self- burning provoked to set up a multidisciplinary preventive program to decrease the incidence and complications of this harmful issue. This study investigated the incidence and the preventive measures in self-burn in Fars Province, southern Iran. METHODS This study was a longitudinal prospective design on trend of self-inflicted burn injuries in Fars province after setting up a regional multidisciplinary preventive plan (2009-2012). RESULTS From 18862 ...

The financial and quality-of-life cost to patients living with a chronic wound in the community.

Science.gov (United States)

Kapp, Suzanne; Santamaria, Nick

2017-12-01

Chronic wounds are associated with financial and personal costs. The system level expense associated with chronic wounds has been established, however, the out-of-pocket cost incurred by individuals who self-fund has not been the focus of extensive investigation. Recently, there has been renewed interest in evaluating quality of life, in line with the shift to patient enablement and self-care in chronic disease management. The objectives of this research were to describe the out-of-pocket wound treatment costs and the quality of life of people who have chronic wounds. A questionnaire incorporating the Cardiff Wound Impact Schedule and purpose-designed instruments was completed by a non-probability, convenience sample of 113 people in Australia and Wales. Data was analysed using descriptive statistics. The sample was on average 63·6 years of age and had wounds that were on an average 109 weeks duration. Participants had spent on average AU$2475 on wound dressing products since the wound started, and AU$121·82 in the most recent 28 days which represented 10% of their disposable income. Health-related quality of life was sub-optimal, 6/10 (ave) according to the Cardiff Wound Impact Schedule. Younger participants reported significantly poorer quality of life on all CWIS sub-scales when compared to older participants. This study found that chronic wounds present a significant financial cost to individuals who must self-fund their wound dressings and other wound treatment related expenses. Participants who had access to wound product subsidisation also experienced personal financial costs. People who have chronic wounds experience sub-optimal quality of life therefore this condition is also costly to the individual's well-being. The quality of life of younger people has not received adequate attention and requires further consideration given the many years that younger people may have to live with this debilitating and often recurrent condition. Continued action is

Specific Characteristics of Injuries Inflicted by Claw Hammer.

Science.gov (United States)

Buchaillet, Céline; Gaudin, Arnaud; Rougé-Maillart, Clotilde; Jousset, Nathalie

2016-09-01

Claw hammers have the specific characteristic of having two distinct ends: one a flat head of variable form, the other bifurcated. So the use of this tool as a blunt instrument will cause varying injuries. The authors present two clinical cases of assault with a claw hammer. Examinations revealed two types of wound. A first injury composed of integumentary lacerations and underlying bone injuries in terms of "shape" suggested the use of a blunt instrument. A second injury made up of damage showing two parallel wounds or two wounds located one in the extension of the other suggested the use of an object with a bifurcated end. The combination of both types of injury should alert examiners to the possibility of the use of a claw hammer in causing the injuries in order to help direct investigators in their investigations and in the search for the weapon used. © 2016 American Academy of Forensic Sciences.

“It's Just a Matter of Time:” Lessons from Agency and Community Responses to Polar Bear-inflicted Human Injury

OpenAIRE

Aimee L Schmidt; Douglas A Clark

2018-01-01

Bear-inflicted human injuries or deaths are often widely publicised, controversial, and evoke substantial social responses that articulate public expectations about bear management. In this paper, we examine how local people and management agencies (i.e. Manitoba Conservation, Parks Canada, and the Town of Churchill) responded to a polar bear-inflicted human injury in Churchill, Manitoba, Canada. On November 1st, 2013, two people in Churchill were badly mauled by a polar bear. The incident sh...

Waste minimization opportunities at the U.S. Uranium Mill Tailings Remedial Action (UMTRA) Project, Rifle, Colorado, site

International Nuclear Information System (INIS)

Hartmann, G.L.; Arp, S.; Hempill, H.

1993-01-01

At two uranium mill sites in Rifle, Colorado, the US Department of Energy (DOE) Uranium Mill Tailings Remedial Action (UMTRA) Project is removing uranium mill tailings and contaminated subgrade soils. This remediation activity will result in the production of groundwater contaminated with uranium, heavy metals, ammonia, sulfates, and total dissolved solids (TDS). The initial remediation plan called for a wastewater treatment plant for removal of the uranium, heavy metals, and ammonia, with disposal of the treated water, which still includes the sulfates and TDSS, to the Colorado River. The National Pollutant Discharge Elimination (NPDES) permit issued by the Colorado Department of Health for the two Rifle sites contained more restrictive discharge limits than originally anticipated. During the detailed review of alternate treatment systems to meet these more restrictive limits, the proposed construction procedures were reviewed emphasizing the methods to minimize groundwater production to reduce the size of the water treatment facility, or to eliminate it entirely. It was determined that with changes to the excavation procedures and use of the contaminated groundwater for use in dust suppression at the disposal site, discharge to the river could be eliminated completely

Long-term surveillance plan for the Estes Gulch disposal site near Rifle, Colorado

International Nuclear Information System (INIS)

1997-07-01

This long-term surveillance plan (LTSP) describes the U.S. Department of Energy's (DOE) long-term care program for the Uranium Mill Tailings Remedial Action (UMTRA) Project Estes Gulch disposal site near Rifle, Colorado. This LSTP describes the long-term surveillance program the DOE will implement to ensure the Estes Gulch disposal site performs as designed and is cared for in a manner that protects the public health and safety and the environment. Before each disposal site is licensed for custody and long-term care, the Nuclear Regulatory Commission (NRC) requires the DOE to submit such a site-specific LTSP

The Level of Vision Necessary for Competitive Performance in Rifle Shooting: Setting the Standards for Paralympic Shooting with Vision Impairment

NARCIS (Netherlands)

Allen, P.M.; Latham, K.; Mann, D.L.; Ravensbergen, H.J.C.; Myint, J.

2016-01-01

The aim of this study was to investigate the level of vision impairment (VI) that would reduce performance in shooting; to guide development of entry criteria to visually impaired (VI) shooting. Nineteen international-level shooters without VI took part in the study. Participants shot an air rifle,

Differential effects of suppressors on hazardous sound pressure levels generated by AR-15 rifles: Considerations for recreational shooters, law enforcement, and the military.

Science.gov (United States)

Lobarinas, Edward; Scott, Ryan; Spankovich, Christopher; Le Prell, Colleen G

2016-01-01

Firearm discharges produce hazardous levels of impulse noise that can lead to permanent hearing loss. In the present study, we evaluated the effects of suppression, ammunition, and barrel length on AR-15 rifles. Sound levels were measured left/right of a user's head, and 1-m left of the muzzle, per MIL-STD-1474-D, under both unsuppressed and suppressed conditions. Nine commercially available AR-15 rifles and 14 suppressors were used. Suppressors significantly decreased peak dB SPL at the 1-m location and the left ear location. However, under most rifle/ammunition conditions, levels remained above 140 dB peak SPL near a user's right ear. In a subset of conditions, subsonic ammunition produced values near or below 140 dB peak SPL. Overall suppression ranged from 7-32 dB across conditions. These data indicate that (1) suppressors reduce discharge levels to 140 dB peak SPL or below in only a subset of AR-15 conditions, (2) shorter barrel length and use of muzzle brake devices can substantially increase exposure level for the user, and (3) there are significant left/right ear sound pressure differences under suppressed conditions as a function of the AR-15 direct impingement design that must be considered during sound measurements to fully evaluate overall efficacy.

Hypoperfusion and Wound Healing: Another Dimension of Wound Assessment.

Science.gov (United States)

Smollock, Wendy; Montenegro, Paul; Czenis, Amy; He, Yuan

2018-02-01

To examine the correlation between mean arterial pressure (MAP) and wound healing indices and describe an analytical process that can be used accurately and prospectively when evaluating all types of skin ulcerations. A correlational study in a long-term-care facility.Participants (N = 230) were adults residing in a long-term-care facility with an average age of 77.8 years (range, 35-105). Assessment through both an index of wound healing and wound surface area. Signs of wound healing included a reduction of surface area and surface necrosis and increased granulation or epithelialization. Aggregate analyses for all wound locations revealed a positive correlation between the MAP and index of wound healing (r = 0.86, n = 501, P wound healing was noted for all wound locations in this data set when MAP values were 80 mm Hg or less (r = 0.95, n = 141, P wounds and MAP of less than 80 mm Hg yielded a very strong positive correlation. The data indicated that as perfusion decreased, wounds within the sample population declined (r = 0.93, n = 102, P wound healing or worsened wounds. A predictability of wounds stalling or declining related to the MAP was observed, regardless of topical treatment or standard-of-care interventions. Therefore, the data also suggest that remediating states of low perfusion should take precedence in making treatment decisions.

Atypical gunshot injury to the right side of the face with the bullet lodged in the carotid sheath: a case report

OpenAIRE

Ongom, Peter A; Kijjambu, Stephen C; Jombwe, Josephat

2014-01-01

Introduction Gunshot injuries of the head and neck from the AK-47 rifle (a common assault rifle, submachine gun type) are a significant contributor to morbidity and mortality among civilians in Sub-Saharan Africa. They may cause significant damage to the closely arranged structures in this region, and the bullet’s trajectory can be very difficult to determine. We present an unusual case of gunshot injury with an atypical bullet entry wound, profound injury to the face, lodgment in the right c...

Case Study: Severe Self-Injurious Behavior in Comorbid Tourette's Disorder and OCD

Science.gov (United States)

Hood, Korey K.; Baptista-Neto, Lourival; Beasley, Pamela J.; Lobis, Robert; Pravdova, Iva

2004-01-01

This case report describes the successful treatment of severe self-injurious behavior in a 16-year-old adolescent with Tourette's disorder and obsessive-compulsive disorder. Treatment is described from initial presentation to the emergency department for severe self-inflicted oral lacerations through discharge from the inpatient psychiatric…

Wound care centers

Science.gov (United States)

Pressure ulcer - wound care center; Decubitus ulcer - wound care center; Diabetic ulcer - wound care center; Surgical wound - wound ... Common types of non-healing wounds include: Pressure sores Surgical ... flow, or swollen legs Certain wounds may not heal well due to: ...

Medicolegal aspects of atypical firearm injuries: a case report.

Science.gov (United States)

Gürses, Murat Serdar; Akan, Okan; Eren, Bülent; Durak, Dilek; Türkmen, Nursel; Cetin, Selçuk

2014-01-01

Our case was a twenty year-old man, who was injured during the military duty with G3 infantry rifle in the training area. An atypical firearm entry wound on the left side of sternum which was 4.5 cm in diameter, and was surrounded by six irregular skin burn wounds by a flash-suppressor and a 0.7 cm diameter firearm exit wound at space on the left midscapular line. Our case emphasizes that the interpretation of properties of these atypical firearm entry wounds need to be carefully assessed by physicians.

Application of Three - dimensional Wound Analyzer in the Small Wound Area Measurement during the Process of Wound Healing.

Science.gov (United States)

Sheng, Jiajun; Li, Haihang; Jin, Jian; Liu, Tong; Ma, Bing; Liu, Gongcheng; Zhu, Shihui

2018-02-20

The objective of this study was to determinate the reliability of 3-dimensional wound analyzer (3-DWMD) in the wound area measurement for animal small area in the process of wound healing. Seven Sprague-Dawley rats were used to establish the skin defect model. And the wound area and time consumption were measured on days 0, 5, 10, 15 using 3-DWMD, investigators, and planimetry method. The measurement results using 3-DWMD and investigators were analyzed comparative with that using planimetry method separately. A total 46 wounds, including 32 irregular wounds and regular 14 wounds, were measured. No matter calculating the irregular wounds or the regular wounds, there was no significant difference between 3-DWMD group and planimetry group in measuring wound area (P > 0.05). However, a statistically significant difference was found in time-consuming for measuring wound area between 3-DWMD group and planimetry group (P area, and its measurement results were consistent with planimetry method. Therefore, such measuring equipment has clinical reference value for measuring precision area of the wound in the process of wound healing.

Stunning effect of different rifle-bullets for slaughter of outdoor cattle

Directory of Open Access Journals (Sweden)

Stefanie Retz

2014-12-01

Full Text Available The slaughter method via gunshot implies a stunning of cattle by means of a targeted shot from a rifle and is as an alternative to regular slaughter at abattoirs. This method is only permitted under restricted circumstances and if the cattle is held on a pasture all the year. However, there is a considerable lack of specifications regulated by law concerning calibre and bullet-type. In this study, four different calibres, two bullet-types and two different shot placements were investigated with respect to their stunning efficiency. All of the calibres exhibited an entry-energy over 400 J and provided sufficient stunning potential. Yet, only calibre .22 Magnum caused no exit of the bullet out of the scull, which provides higher safety conditions for man and cattle.

The molecular biology in wound healing & non-healing wound.

Science.gov (United States)

Qing, Chun

2017-08-01

The development of molecular biology and other new biotechnologies helps us to recognize the wound healing and non-healing wound of skin in the past 30 years. This review mainly focuses on the molecular biology of many cytokines (including growth factors) and other molecular factors such as extracellular matrix (ECM) on wound healing. The molecular biology in cell movement such as epidermal cells in wound healing was also discussed. Moreover many common chronic wounds such as pressure ulcers, leg ulcers, diabetic foot wounds, venous stasis ulcers, etc. usually deteriorate into non-healing wounds. Therefore the molecular biology such as advanced glycation end products (AGEs) and other molecular factors in diabetes non-healing wounds were also reviewed. Copyright © 2017 Daping Hospital and the Research Institute of Surgery of the Third Military Medical University. Production and hosting by Elsevier B.V. All rights reserved.

Tracking, aiming, and hitting the UAV with ordinary assault rifle

Science.gov (United States)

Racek, František; Baláž, Teodor; Krejčí, Jaroslav; Procházka, Stanislav; Macko, Martin

2017-10-01

The usage small-unmanned aerial vehicles (UAVs) is significantly increasing nowadays. They are being used as a carrier of military spy and reconnaissance devices (taking photos, live video streaming and so on), or as a carrier of potentially dangerous cargo (intended for destruction and killing). Both ways of utilizing the UAV cause the necessity to disable it. From the military point of view, to disable the UAV means to bring it down by a weapon of an ordinary soldier that is the assault rifle. This task can be challenging for the soldier because he needs visually detect and identify the target, track the target visually and aim on the target. The final success of the soldier's mission depends not only on the said visual tasks, but also on the properties of the weapon and ammunition. The paper deals with possible methods of prediction of probability of hitting the UAV targets.

Does Lycoperscon Esculentum (Tomato) Accelerate or Retard ...

African Journals Online (AJOL)

The study aimed at determining the effects of Lycoperscon esculentum on the wound healing processes of wistar rats. Excisional wounds were inflicted on the upper dorsolateral trunk of 20 adult male wistar rats. The wounds were dressed every three days (experimental with methanol extract of Lycoperscon esculentum and ...

Aging influences wound healing in patients with chronic lower extremity wounds treated in a specialized Wound Care Center.

Science.gov (United States)

Wicke, Corinna; Bachinger, Andreas; Coerper, Stephan; Beckert, Stefan; Witte, Maria B; Königsrainer, Alfred

2009-01-01

With the dramatic increase in the aging population, the study and care of wounds in the elderly have become priority topics for both researchers and clinicians. The effects of aging on wound healing in humans have remained controversial. The study was a 5-year epidemiological evaluation of standardized data collected regularly during patients' visits at a specialized Wound Care Center with the aim to determine the key factors influencing the healing of chronic lower extremity wounds. In this analysis of 1,158 chronic wounds, the frequency of wound closure was statistically significantly lower in older patients compared with younger patients. The share of closed wounds decreased by nearly 25% in the elderly patients (>or=70 years). The relationship between the patient's age and the proportion of wound closure was nonlinear. The effect of aging on the frequency of wound closure of chronic wounds became clinically apparent after age 60. The chronicity of the wounds was illustrated by their recurrent nature, their long duration, the presence of multiple wounds, and the frequency of concurrent infection. Comorbidity was documented by the coprevalence of up to three underlying diseases related to impaired wound healing. The present study clearly showed that aging affects chronic wound healing negatively.

The burden and management of self-inflicted injuries at a tertiary ...

African Journals Online (AJOL)

Praveen Sravanam

unemployment, financial difficulties, substance abuse, a difficult childhood, poor physical ... include extremes of heat or cold, electrocution and suicidal behaviour .... Self-poisoning (mainly drug overdose and other chemical agents unknown to.

Late neurologic and cognitive sequelae of inflicted traumatic brain injury in infancy.

Science.gov (United States)

Barlow, Karen M; Thomson, Elaine; Johnson, David; Minns, Robert A

2005-08-01

There is limited information regarding the long-term outcome of inflicted traumatic brain injury (TBI), including shaken infant syndrome. The purpose of this study was to describe the long-term neurologic, behavioral, and cognitive sequelae seen in this population. A cross-sectional and prospective longitudinal study was conducted of 25 children with inflicted TBI in Scotland between 1980 and 1999. After consent was obtained, neurologic and cognitive examinations were performed on all participants and sequentially in the prospective cohort. Two global outcome measures were used: Glasgow Outcome Score (GOS) and Seshia's outcome score. Cognitive outcome was assessed using the Bayley Scales of Infant Development, British Ability Scales, and the Vineland Adaptive Behavior Scales. The mean length of follow-up was 59 months. A total of 68% of survivors were abnormal on follow-up, 36% had severe difficulties and were totally dependant, 16% had moderate difficulties, and 16% had mild difficulties on follow-up. A wide range of neurologic sequelae were seen, including motor deficits (60%), visual deficits (48%), epilepsy (20%), speech and language abnormalities (64%), and behavioral problems (52%). There was a wide range of cognitive abilities: the mean psychomotor index, 69.9 (SD: +/-25.73); and mean mental development index, 74.53 (SD: +/-28.55). Adaptive functioning showed a wide range of difficulties across all domains: communication domain (mean: 76.1; SD: +/-25.4), Daily living skills domain (mean: 76.9; SD: +/-24.3), and socialization domain (mean: 79.1; SD: +/-23.1). Outcome was found to correlate with the Pediatric Trauma Score and the Glasgow Coma Score but did not correlate with age at injury or mechanism of injury. Inflicted TBI has a very poor prognosis and correlates with severity of injury. Extended follow-up is necessary so as not to underestimate problems such as specific learning difficulties and attentional and memory problems that may become apparent only

Vellykket konservativ behandling efter knivtraume mod hjertet

DEFF Research Database (Denmark)

Wærsted, Stian; Schou-Jensen, Katrine; Jensen, Tim

2012-01-01

A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained haemodynam......A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained...

Three-dimensional wound measurements for monitoring wound healing

DEFF Research Database (Denmark)

Bisgaard Jørgensen, Line; Møller Jeppesen, Sune; Halekoh, Ulrich

Telemedicine is increasingly used for monitoring wound healing. Three-dimensional (3D) measurement methods enable clinicians to assess wound healing with respect to all dimensions. However, the currently available methods are inaccurate, costly or complicated to use. To address these issues, a 3D......-WAM camera was developed. This camera is able to measure wound size (2D area, 3D area, perimeter and volume) and to assess wound characteristics....

Triterpenes for Well-Balanced Scar Formation in Superficial Wounds

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Stefan Kindler

2016-08-01

Full Text Available Triterpenes are demonstrably effective for accelerating re-epithelialisation of wounds and known to improve scar formation for superficial lesions. Among the variety of triterpenes, betuline is of particular medical interest. Topical betuline gel (TBG received drug approval in 2016 from the European Commission as the first topical therapeutic agent with the proven clinical benefit of accelerating wound healing. Two self-conducted randomized intra-individual comparison clinical studies with a total of 220 patients involved in TBG treatment of skin graft surgical wounds have been screened for data concerning the aesthetic aspect of wound healing. Three months after surgery wound treatment with TBG resulted in about 30% of cases with more discreet scars, and standard of care in about 10%. Patients themselves appreciate the results of TBG after 3 months even more (about 50% compared to standard of care (about 10%. One year after surgery, the superiority of TBG counts for about 25% in comparison with about 10%, and from the patients’ point of view, for 25% compared to 4% under standard of care. In the majority of wound treatment cases, there is no difference visible between TBG treatment and standard of care after 1 year of scar formation. However, in comparison, TBG still offers a better chance for discreet scars and therefore happens to be superior in good care of wounds.

Self-inflicted skin lesions

DEFF Research Database (Denmark)

Ring, Hans Christian; Smith, Matthias Nybro; Jemec, Gregor B E

2014-01-01

professionals, the European Society for Dermatology and Psychiatry (ESDaP) recently proposed a classification of psychodermatological terms in order to establish a coherent use of terms across the medical fields involved. We reviewed current and previous psychodermatological diagnoses in order to clarify how...

Comparacao dos criterios RIFLE, AKIN e KDIGO quanto a capacidade de predicao de mortalidade em pacientes graves

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Talita Machado Levi

2013-12-01

Full Text Available Objetivo: A lesão renal aguda é uma complicação comum em pacientes gravemente enfermos, sendo os critérios RIFLE, AKIN e KDIGO utilizados para sua classificação. Esse trabalho teve como objetivo a comparação dos critérios citados quanto à capacidade de predição de mortalidade em pacientes gravemente enfermos. Métodos: Estudo de coorte prospectiva, utilizando como fonte de dados prontuários médicos. Foram incluídos todos os pacientes admitidos na unidade de terapia intensiva. Os critérios de exclusão foram tempo de internamento menor que 24 horas e doença renal crônica dialítica. Os pacientes foram acompanhados até a alta ou óbito Para análise dos dados, foram utilizados os testes t de Student, qui-quadrado, regressão logística multivariada e curva ROC. Resultados: A média de idade foi de 64 anos, com mulheres e afrodescendentes representando maioria. Segundo o RIFLE, a taxa de mortalidade foi de 17,74%, 22,58%, 24,19% e 35,48% para pacientes sem lesão renal aguda e em estágios Risk, Injury e Failure, respectivamente. Quanto ao AKIN, a taxa de mortalidade foi de 17,74%, 29,03%, 12,90% e 40,32% para pacientes sem lesão renal aguda, estágio I, estágio II e estágio III, respectivamente. Considerando o KDIGO 2012, a taxa de mortalidade foi de 17,74%, 29,03%, 11,29% e 41,94% para pacientes sem lesão renal aguda, estágio I, estágio II e estágio III, respectivamente. As três classificações apresentaram resultados de curvas ROC para mortalidade semelhantes. Conclusão: Os critérios RIFLE, AKIN e KDIGO apresentaram-se como boas ferramentas para predição de mortalidade em pacientes graves, não havendo diferença relevante entre os mesmos.

Analysis of cobbly soils for cobbles-to-fines corrections to radionuclide concentrations at the New Rifle, Colorado, processing site

International Nuclear Information System (INIS)

1994-05-01

A contamination depth and cobbly soil characterization study was performed in November and December 1993 at the Uranium Mill Tailings Remedial Action (UMTRA) Projects's New Rifle, Colorado, processing site. This study was initiated due to a concurrence by the US Nuclear Regulatory Commission (NRC) clarifying that the allowable residual contamination in soil should be averaged over the total mass of the soil volume, including cobbles and gravels (i.e., bulk concentration). The New Rifle processing site has a high percentage of cobbles and gravels underlying the pile and other contaminated areas, which preliminary excavation designs have identified for removal and disposal. The main purpose of this study was to evaluate the relative mass percentage and radionuclide concentrations of cobbles and gravels in order to determine the bulk contamination concentrations, revise the underlying excavation design depths, and improve verification methods. Another important goal of the study was to acquire more accurate contamination depth data (profile) for the subpile material. In summary, this recharacterization study will probably reduce the volume of material for excavation/disposal by several hundred thousand cubic yards and significantly reduce the amount of ground water expected to be pumped out of the excavation during cleanup

Development of a wound healing index for patients with chronic wounds.

Science.gov (United States)

Horn, Susan D; Fife, Caroline E; Smout, Randall J; Barrett, Ryan S; Thomson, Brett

2013-01-01

Randomized controlled trials in wound care generalize poorly because they exclude patients with significant comorbid conditions. Research using real-world wound care patients is hindered by lack of validated methods to stratify patients according to severity of underlying illnesses. We developed a comprehensive stratification system for patients with wounds that predicts healing likelihood. Complete medical record data on 50,967 wounds from the United States Wound Registry were assigned a clear outcome (healed, amputated, etc.). Factors known to be associated with healing were evaluated using logistic regression models. Significant variables (p healing for each wound type. Some variables predicted significantly in nearly all models: wound size, wound age, number of wounds, evidence of bioburden, tissue type exposed (Wagner grade or stage), being nonambulatory, and requiring hospitalization during the course of care. Variables significant in some models included renal failure, renal transplant, malnutrition, autoimmune disease, and cardiovascular disease. All models validated well when applied to the holdout sample. The "Wound Healing Index" can validly predict likelihood of wound healing among real-world patients and can facilitate comparative effectiveness research to identify patients needing advanced therapeutics. © 2013 by the Wound Healing Society.

Linguistic Factors Associated with Self-Inflicted Injury in Borderline Personality Disorder

Science.gov (United States)

Birdwell, Benjamin Park

2009-01-01

The present study builds on previous research, which demonstrated higher levels of depressive and interpersonal conflict language in first-person narrative accounts of nonsuicidal self-injury (NSSI) and suicide attempt (SA) in borderline personality disorder. The present study was designed to examine the semantic similarity of time-sequences…

THE HUNTER OF MAN

African Journals Online (AJOL)

as 1755, in which year the British Government, licking their wounds after an ... were adept at sniping from behind rocks and any .... ing rifles in the world, incredibly had no effective .... awarded third prize for the above contribution to the Military.

Managing painful chronic wounds: the Wound Pain Management Model

DEFF Research Database (Denmark)

Price, Patricia; Fogh, Karsten; Glynn, Chris

2007-01-01

of the pain experience: location, duration, intensity, quality, onset and impact on activities of daily living. Holistic management must be based on a safe and effective mix of psychosocial approaches together with local and systemic pain management. It is no longer acceptable to ignore or inadequately...... to the wound should be handled as one of the main priorities in chronic wound management together with addressing the cause. Management of pain in chronic wounds depends on proper assessment, reporting and documenting patient experiences of pain. Assessment should be based on six critical dimensions...... document persistent wound pain and not to develop a treatment and monitoring strategy to improve the lives of persons with chronic wounds. Unless wound pain is optimally managed, patient suffering and costs to health care systems will increase. Udgivelsesdato: 2007-Apr...

Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs

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Ayesha Bhatia

2016-01-01

Full Text Available Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5–treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.

Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs.

Science.gov (United States)

Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T; Li, Wei

2016-01-01

Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for burns should show dual abilities to prevent the burn wound progression and thereafter promote burn wound healing. Herein we report that topically applied F-5 fragment of heat shock protein-90α is a dual functional agent to promote burn wound healing in pigs. First, F-5 prevents burn wound progression by protecting the surrounding cells from undergoing heat-induced caspase 3 activation and apoptosis with increased Akt activation. Accordingly, F-5-treated burn and excision wounds show a marked decline in inflammation. Thereafter, F-5 accelerates burn wound healing by stimulating the keratinocyte migration-led reepithelialization, leading to wound closure. This study addresses a topical agent that is capable of preventing burn wound progression and accelerating burn wound healing.

The unmourned wound: Reflections on the psychology of Adolf Hitler.

Science.gov (United States)

Ferrell, D R

1995-09-01

Fifty years after his death by suicide, Adolf Hitler continues to arouse profound feelings of revulsion and attraction. This paper is an exploration of Hitler's psyche from the perspective of a depth psychology. After examining analyses of Hilter's personality by Richard Rubenstein and Alice Miller, the argument is made that we need C.G. Jung's concept of psychic inflation to understand more fully Hitler's impact upon the world. Hitler is seen as inflated by the compensating energies of the Self in response to his deeply wounded ego, a wound he could not mourn. Consequently, he became identified with the dark and destructive energies of the Self which inflated and then usurped his ego. Hitler's demonic and destructive career resulted from that inflation, which he was not able to neutralize. The paper concludes with reflections on the role of mourning in protecting us from the experience of psychic inflation, especially by the Self in its dark and destructive aspects.

The persistence to slaughter age of scars resulting from damage ...

African Journals Online (AJOL)

Cut wounds were persistent to slaughter as were scratch marks, with only a small percentage of scratch wounds incurred at a young age not persisting to slaughter age. Mean scar size at slaughter became smaller with an increase in age at which the wounds were inflicted, except at 13 months of age where it was assumed ...

Die predikant wat houe uitdeel – die gemeente as teiken

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C.J.H. Venter

2004-08-01

Full Text Available A minister inflicting wounds – a congregation as target In subject-related literature in the field of Practical Theology a certain emphasis is placed on studying the actions, spirituality and conduct of a minister. This article links up with this trend and attempts a closer investigation of the attitude and actions of a minister who unintentionally or intentionally wounds members of a congregation. In the article basis-theoretical perspectives from the Pastoral Epistles on the calling, requirements and spirituality of a minister are indicated. The metatheoretical research in this article is directed at investigating possible trends in contemporary society, the way in which a minister reacts to and copes with these trends and how his reaction may contribute to a situation where he hurts members of the congregation. This part of the investigation is followed by findings of established research on certain possible personality disorders that may contribute to a minister’s acts and attitudes of wounding a congregation. Special focus is placed on narcissistic, histrionic and obsessive-compulsive personality disorders. Finally, practice-theoretical perspectives on guiding future pastors are provided – especially as a means of sensitising them to the possibility of their own approach and behaviour being experienced as negative and that of someone inflicting wounds. In the final instance, the congregant experiencing the wounds as well as the minister inflicting the wounds should still be regarded as objects of God’s saving grace and the pastoral care of the community of faith.

The Role of Heart Team Approach in Penetrating Cardiac Trauma: Case Report and Review of the Literature

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Marzia Cottini

Full Text Available Abstract Penetrating cardiac trauma has been increasing in clinical experience and is joined to important morbidity and mortality. A case of a 38-year-old female with history of postpartum depression was reported, admitted to our department for cardiac tamponade due to penetrating self-inflicted multiple stab wound of the chest complicated by rupture of anterior left ventricular wall and traumatic ventricular septal defect. Following the unstable hemodynamic instability, a combined therapeutic strategy was chosen: surgery and transcatheter implantation to correct free wall ventricle damage and traumatic ventricular septal defect, respectively.

A Clinicoepidemiological Profile of Chronic Wounds in Wound Healing Department in Shanghai.

Science.gov (United States)

Sun, Xiaofang; Ni, Pengwen; Wu, Minjie; Huang, Yao; Ye, Junna; Xie, Ting

2017-03-01

The aim of the study was to update the clinical database of chronic wounds in order to derive an evidence based understanding of the condition and hence to guide future clinical management in China. A total of 241 patients from January 1, 2011 to April 30, 2016 with chronic wounds of more than 2 weeks' duration were studied in wound healing department in Shanghai. Results revealed that among all the patients the mean age was 52.5 ± 20.2 years (range 2-92 years). The mean initial area of wounds was 30.3 ± 63.0 cm 2 (range 0.25-468 cm 2 ). The mean duration of wounds was 68.5 ± 175.2 months (range 0.5-840 months). The previously reported causes of chronic wounds were traumatic or surgical wounds (n = 82, 34.0%), followed by pressure ulcers (n = 59, 24.5%). To study the effects of age, patients were divided into 2 groups: less than 60 years (wounds etiology between the 2 age groups was analyzed, and there was significant statistical difference ( P wounds, chi-square test was used. There were significant differences in the factor of wound infection. ( P = .035, 95% CI = 0.031-0.038) Regarding therapies, 72.6% (n = 175) of the patients were treated with negative pressure wound therapy. Among all the patients, 29.9% (n = 72) of them were completely healed when discharged while 62.7% (n = 150) of them improved. The mean treatment cost was 12055.4 ± 9206.3 Chinese Yuan (range 891-63626 Chinese Yuan). In conclusion, traumatic or surgical wounds have recently become the leading cause of chronic wounds in Shanghai, China. Etiology of the 2 age groups was different. Infection could significantly influence the wound outcome.

Physicochemical properties of radiation-sterilized honey alginate wound dressing for exudating wounds

International Nuclear Information System (INIS)

Asa, Anie Day DC.; De Guzman, Zenaida M.; Baldos, Davison T.; Asaad, Celia O.

2013-01-01

Honey is a well-known natural cure in promoting healing of wounds. Alginate, on the other hand, is a polysaccharide with pharmaceutical applications such as wound dressing and control release drugs. Calcium-alginate wound dressings have a gel-forming capability. in that, upon ion exchange between calcium ions in the dressing, and sodium ions in wound fluid, the dressing transforms into a gel. Cross-linked alginate gels can absorb would fluid, and also maintain a moist environment to the wound area. Combined with anti-microbial properties of honey and absorption and gelling properties of alginate, a honey alginate wound dressing is developed and irradiated for sterility. Its physicochemical properties are then analyzed. The honey-alginate wound dressing has lower pH (4.40±0.02) than alginate alone dressings (5.40±0.04) which is more favorable for wound healing. The dressing also has low moisture content (10.25±1.11%). Analysis of moisture vapour transmission rate shows a general increase with time for 48 hours. The wound dressing also has an absorbency of 19.00±1.80 g/100 cm 2 with a gel fraction of 18.44±0.63%. The rate of absorption analysis, meanwhile, shows a very rapid absorption rate upon exposure to wound fluid. After some time, a decrease in rate is observed which is accounted to the release of honey to the wound environment. For tensile strength, irradiation causes an effect in tensile strength in machine direction but is insignificant for cross machine direction. Physicochemical properties of the radiation-sterilized honey alginate wound dressing e.g. acidic pH, absorbency, moisture vapor permeability and absorption rate ascertain its characteristic as a good wound dressing for exudating wounds. Its low moisture content, meanwhile, allows for longer shelf-life of the developed product. (author)

Image acquisition and planimetry systems to develop wounding techniques in 3D wound model

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Kiefer Ann-Kathrin

2017-09-01

Full Text Available Wound healing represents a complex biological repair process. Established 2D monolayers and wounding techniques investigate cell migration, but do not represent coordinated multi-cellular systems. We aim to use wound surface area measurements obtained from image acquisition and planimetry systems to establish our wounding technique and in vitro organotypic tissue. These systems will be used in our future wound healing treatment studies to assess the rate of wound closure in response to wound healing treatment with light therapy (photobiomodulation. The image acquisition and planimetry systems were developed, calibrated, and verified to measure wound surface area in vitro. The system consists of a recording system (Sony DSC HX60, 20.4 M Pixel, 1/2.3″ CMOS sensor and calibrated with 1mm scale paper. Macro photography with an optical zoom magnification of 2:1 achieves sufficient resolution to evaluate the 3mm wound size and healing growth. The camera system was leveled with an aluminum construction to ensure constant distance and orientation of the images. The JPG-format images were processed with a planimetry system in MATLAB. Edge detection enables definition of the wounded area. Wound area can be calculated with surface integrals. To separate the wounded area from the background, the image was filtered in several steps. Agar models, injured through several test persons with different levels of experience, were used as pilot data to test the planimetry software. These image acquisition and planimetry systems support the development of our wound healing research. The reproducibility of our wounding technique can be assessed by the variability in initial wound surface area. Also, wound healing treatment effects can be assessed by the change in rate of wound closure. These techniques represent the foundations of our wound model, wounding technique, and analysis systems in our ongoing studies in wound healing and therapy.

Hesitation Wounds and Sharp Force Injuries in Forensic Pathology and Psychiatry: Multidisciplinary Review of the Literature and Study of Two Cases.

Science.gov (United States)

Karakasi, Maria-Valeria; Nastoulis, Evangelos; Kapetanakis, Stylianos; Vasilikos, Epameinondas; Kyropoulos, Grigorios; Pavlidis, Pavlos

2016-11-01

The aim of this paper was to showcase the significant diagnostic value of hesitation wounds in terms of forensic, psychiatric, and medicolegal interest. A number of studies were reviewed to update and summarize the relevant literature on the incidence, distribution, character, and function of hesitation wounds as well as the sociodemographic variables and psychopathology of the inducers. This study also investigates their importance as a forensic criterion in the distinction between suicide and homicide as well as a psychiatric diagnostic tool in suicide prevention. In addition, the paper reports two new cases. Results conclude that there is equal incidence, but different distribution of hesitation wounds between genders. Furthermore, the low dispersion of hesitation wounds contrasts with the high dispersion of defense wounds. The inducers' psychopathology lies principally in Axis I disorders. Finally, there is a comprehensive analysis of non-suicidal self-injury and the role of self-wounding in suicide prevention. © 2016 American Academy of Forensic Sciences.

Wounding in the plant tissue: the defense of a dangerous passage

Directory of Open Access Journals (Sweden)

Daniel Valentin Savatin

2014-09-01

Full Text Available Plants are continuously exposed to agents such as herbivores and environmental mechanical stresses that cause wounding and open the way to the invasion by microbial pathogens. Wounding provides nutrients to pathogens and facilitates their entry into the tissue and subsequent infection. Plants have evolved constitutive and induced defense mechanisms to properly respond to wounding and prevent infection. The constitutive defenses are represented by physical barriers, i.e. the presence of cuticle or lignin, or by metabolites that act as toxins or deterrents for herbivores. Plants are also able to sense the injured tissue as an altered self and induce responses similar to those activated by pathogen infection. Endogenous molecules released from wounded tissue may act as Damage-Associated Molecular Patterns (DAMPs that activate the plant innate immunity. Wound-induced responses are both rapid, such as the oxidative burst and the expression of defense-related genes, and late, such as the callose deposition, the accumulation of proteinase inhibitors and of hydrolytic enzymes (i.e. chitinases and gluganases. Typical examples of DAMPs involved in the response to wounding are the peptide systemin and the oligogalacturonides, which are oligosaccharides released from the pectic component of the cell wall. Responses to wounding take place both at the site of damage (local response and systemically (systemic response and are mediated by hormones such as jasmonic acid, ethylene, salicylic acid and abscisic acid.

[Biomechanical-clinical interpretation of firearm wounds. General problems. VIII. Propedeutic ABC of terminal ballistics].

Science.gov (United States)

Marini, F; Dagradi, V; Radin, S; Mangiante, G; Carolo, F; Giarolli, M; Prati, G; Tenci, A; Della Giacoma, C; Massari, S

1993-01-01

The Authors, consistent with their aim to compare and contrast the two protagonists of bullet wounds, namely the bullet and its soft human target, delineating their respective profiles, strengths and weaknesses, feel obliged to dwell at some length on the most frequently pathogenetic regulation firearms. Up until the early twentieth century bullet wounds could be generically classified among the forms of open traumatism, but with the advent of high-speed bullets they have come to take on a unique profile of their own, setting against the old permanent cavity due to mechanical insult a new type of transitory ghost, the definition of which as a cavity would merely be an oversimplification in theoretical terms. Can we really attribute this somewhat privileged dimension to bullet wounds today or must we relegate them once again to the sphere of mechanical traumatisms, albeit with a new inflammatory key to their interpretation, making the most in this sense of the contribution provided by the speed of the bullet? The literature is abundant, but uncertain; we intend to attempt an answer to this tricky question in the following pages, devoted more properly to terminal ballistics. Undoubtedly, the new speeds have had a substantial impact on the wounds inflicted upon the soft target, but the streamlining of the jacket has modified and even offset the results, giving rise to the unexpectedly humanitarian bullet, later subject to reappraisal in military quarters as tactically more efficient, because it obliges the enemy to employ greater resources for recovering, assisting and healing the wounded. We can safely claim that ballistic science in the field of light or portable firearms is experiencing a contradiction between the speed of the bullet and the streamlining of the jacket which makes this speed possible, but which undermines the efficacy of the often unconfessable results. Short-barrelled firearms, which on account of their defensive role, the alibi of their

Teaching wound care to family medicine residents on a wound care service

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Little SH

2013-08-01

Full Text Available Sahoko H Little,1,2 Sunil S Menawat,1,3 Michael Worzniak,1 Michael D Fetters2 1Oakwood Annapolis Family Medicine Residency, Wayne, Michigan, USA; 2University of Michigan, Department of Family Medicine, Ann Arbor, Michigan, USA; 3Ghent Family Medicine Residency, Eastern Virginia Medical School, Norfolk, Virginia, USA Abstract: Primary care physicians often care for patients with chronic wounds, and they can best serve patients if they have knowledge and proficient skills in chronic wound care, including sharp debridement. The Oakwood Annapolis Family Medicine Residency in Michigan, USA developed a Wound Care Service, incorporating wound care training during the surgical rotation. Effectiveness of the wound care training was evaluated through pre- and posttesting of residents, to assess changes in knowledge and comfort in treating chronic wounds. The results demonstrate significant improvement in residents’ knowledge and comfort in wound care. This innovation demonstrates the feasibility of educating residents in chronic wound care through hands-on experience. Keywords: wound care education, primary care, residency education, surgery rotation, curriculum development

Revised preliminary geologic map of the Rifle Quadrangle, Garfield County, Colorado

Science.gov (United States)

Shroba, R.R.; Scott, R.B.

1997-01-01

The Rifle quadrangle extends from the Grand Hogback monocline into the southeastern part of the Piceance basin. In the northeastern part of the map area, the Wasatch Formation is nearly vertical, and over a distance of about 1 km, the dip decreases sharply from about 70-85o to about 15-30o toward the southwest. No evidence of a fault in this zone of sharp change in dip is observed but exposures in the Shire Member of the Wasatch Formation are poor, and few marker horizons that might demonstrate offset are distinct. In the central part of the map area, the Shire Member is essentially flat lying. In the south and southwest part of the map area, the dominant dip is slightly to the north, forming an open syncline that plunges gently to the northwest. Evidence for this fold also exists in the subsurface from drill-hole data. According to Tweto (1975), folding of the early Eocene to Paleocene Wasatch Formation along the Grand Hogback reqired an early Eocene age for the last phase of Laramide compression. We find the attitude of the Wasatch Formation to be nearly horizontal, essentially parallel to the overlying Anvil Points Member of the Eocene Green River Formation; therefore, we have no information that either confirms or disputes that early Eocene was the time of the last Laramide event. Near Rifle Gap in the northeast part of the map area, the Mesaverde Group locally dips about 10o less steeply than the overlying Wasatch Formation, indicating that not only had the formation of the Hogback monocline not begun by the time the Wasatch was deposited at this locality, but the underlying Mesaverde Group was locally tilted slightly toward the present White River uplift. Also the basal part of the Atwell Gulch Member of the Wasatch Formation consists of fine-grained mudstones and siltstones containing sparse sandstone and rare conglomerates, indicating that the source of sediment was not from erosion of the adjacent Upper Cretaceous Mesaverde Group. The most likely source of

Diabetic foot wounds: the value of negative pressure wound therapy with instillation.

Science.gov (United States)

Dalla Paola, Luca

2013-12-01

Chronic wounds such as diabetic foot wounds are a tremendous burden to the health care system and often require a multidisciplinary approach to prevent amputations. Advanced technologies such as negative pressure wound therapy (NPWT) and bioengineered tissues have been successfully used in the treatment of these types of complex wounds. However, the introduction of NPWT with instillation (NPWTi) has provided an alternative treatment for treating complex and difficult-to-heal wounds. This article provides an overview of NPWT and the new NPWTi system and describes preliminary experience using NPWTi on patients with complicated infected diabetic foot wounds after surgical debridement and in a multidisciplinary setting. © 2013 The Author. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Biofilms in wounds

DEFF Research Database (Denmark)

Cooper, R A; Bjarnsholt, Thomas; Alhede, M

2014-01-01

Following confirmation of the presence of biofilms in chronic wounds, the term biofilm became a buzzword within the wound healing community. For more than a century pathogens have been successfully isolated and identified from wound specimens using techniques that were devised in the nineteenth...... extracellular polymeric substances (EPS). Cells within such aggregations (or biofilms) display varying physiological and metabolic properties that are distinct from those of planktonic cells, and which contribute to their persistence. There are many factors that influence healing in wounds and the discovery...... of biofilms in chronic wounds has provided new insight into the reasons why. Increased tolerance of biofilms to antimicrobial agents explains the limited efficacy of antimicrobial agents in chronic wounds and illustrates the need to develop new management strategies. This review aims to explain the nature...

A prospective randomized evaluation of negative-pressure wound dressings for diabetic foot wounds.

Science.gov (United States)

Eginton, Mark T; Brown, Kellie R; Seabrook, Gary R; Towne, Jonathan B; Cambria, Robert A

2003-11-01

Optimal treatment for large diabetic foot wounds is ill defined. The purpose of this study was to compare the rate of wound healing with the Vacuum Assisted Closure device trade mark (VAC) to conventional moist dressings in the treatment of large diabetic foot wounds. Diabetics with significant soft tissue defects of the foot were considered for enrollment. Patients were randomized to receive either moist gauze dressings or VAC treatments for 2 weeks, after which they were treated with the alternative dressing for an additional 2 weeks. Wounds were photographed weekly and wound dimensions calculated in a blinded fashion with spatial analysis software. Percent change in wound dimensions were calculated and compared for each weekly assessment and over 2 weeks of therapy with each dressing type. Ten patients were enrolled in the trial, but two were lost to follow-up and two were withdrawn. Complete data were available for analysis on seven wounds in six patients. Average length, width, and depth of the wounds at initiation of the trial was 7.7, 3.5, and 3.1 cm, respectively. Only the wound depth was significantly decreased over the weeks of the trial to 1.2 cm ( p VAC dressings decreased the wound volume and depth significantly more than moist gauze dressings (59% vs. 0% and 49% vs. 8%, respectively). VAC dressings were associated with a decrease in all wound dimensions while wound length and width increased with moist dressings. In summary, over the first several weeks of therapy, VAC dressings decreased wound depth and volume more effectively than moist gauze dressings. Negative-pressure wound treatment may accelerate closure of large foot wounds in the diabetic patient.

Innate defense regulator peptide 1018 in wound healing and wound infection.

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Lars Steinstraesser

Full Text Available Innate defense regulators (IDRs are synthetic immunomodulatory versions of natural host defense peptides (HDP. IDRs mediate protection against bacterial challenge in the absence of direct antimicrobial activity, representing a novel approach to anti-infective and anti-inflammatory therapy. Previously, we reported that IDR-1018 selectively induced chemokine responses and suppressed pro-inflammatory responses. As there has been an increasing appreciation for the ability of HDPs to modulate complex immune processes, including wound healing, we characterized the wound healing activities of IDR-1018 in vitro. Further, we investigated the efficacy of IDR-1018 in diabetic and non-diabetic wound healing models. In all experiments, IDR-1018 was compared to the human HDP LL-37 and HDP-derived wound healing peptide HB-107. IDR-1018 was significantly less cytotoxic in vitro as compared to either LL-37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However, no significant differences in bacterial colonization were observed. Our investigation demonstrates that in addition to previously reported immunomodulatory activities IDR-1018 promotes wound healing independent of direct antibacterial activity. Interestingly, these effects were not observed in diabetic wounds. It is anticipated that the wound healing activities of IDR-1018 can be attributed to modulation of host immune pathways that are suppressed in diabetic wounds and provide further evidence of the multiple immunomodulatory activities of IDR-1018.

Modern and Convensional Wound Dressing to Interleukin 1 and Interleukin 6 in Diabetic wound

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Werna Nontji

2015-04-01

Full Text Available Introduction:Holistic wound care is one of the ways to prevent gangrene and amputation, modern wound dressing is more effective than convensional with increasing transforming growth factor and cytokine, especially interleukin. This study aims to identify the effectiveness of Modern and Convensional Wound Dressing to Interleukin 1 (IL-1 and Interleukin 6 (IL-6 in Diabetic wound. Method:A Quasi eksperimental pre-post with control group design was used. The intervention given was modern wound dressing and Control group by convensional wound dressing, This study was conducted in Makassar with 32 samples (16 in intervention group and 16 in control group. Result: The result of Pooled T- test showed that p = 0.00 (p < 0.05, it means that there was signifi cant correlation between modern wound dressing to IL-6 and IL-1 than Convensional wound dressing. Discussion: Process of wound healing was produced growth factor and cytokine (IL-1 and IL-6, it will stimulated by wound dressing, modern wound dressing (Calcium alginat can absorb wound drainage, non oklusive, non adhesif, and autolytic debridement. Keywords: Modern wound dressing, Interleukin 1 (IL-1, Interleukin 6 (IL-6

Neutron activation and the JFK assassination. Part 2. Extended benefits

International Nuclear Information System (INIS)

Sturdivan, L.M.; Rahn, K.A.

2004-01-01

The NAA of the bullets and fragments from the JFK assassination not only demonstrated that U.S. President John F. Kennedy and Texas Governor John B. Connally were hit by two and only two bullets, both from Lee Harvey Oswald's rifle, but offered a considerable number of extended benefits for understanding the assassination as well. The NAA eliminated all conspiracy theories that involved additional shooters or planted bullets. The NAA proved that none of the fragments were planted, that the rifle was fired that day (not planted), and that the locations of Kennedy's head wounds and back wound were not needed in order to get the right answer for the assassination. It supported the single-bullet theory and thus helped to provide the best-documented shooting scenario to date. It knits together the core physical evidence into an airtight case against Lee Oswald. It is, thus, the key to resolving the major controversies in the JFK assassination and putting the matter to rest. (author)

[Errors in wound management].

Science.gov (United States)

Filipović, Marinko; Novinscak, Tomislav

2014-10-01

Chronic ulcers have adverse effects on the patient quality of life and productivity, thus posing financial burden upon the healthcare system. Chronic wound healing is a complex process resulting from the interaction of the patient general health status, wound related factors, medical personnel skill and competence, and therapy related products. In clinical practice, considerable improvement has been made in the treatment of chronic wounds, which is evident in the reduced rate of the severe forms of chronic wounds in outpatient clinics. However, in spite of all the modern approaches, efforts invested by medical personnel and agents available for wound care, numerous problems are still encountered in daily practice. Most frequently, the problems arise from inappropriate education, of young personnel in particular, absence of multidisciplinary approach, and inadequate communication among the personnel directly involved in wound treatment. To perceive them more clearly, the potential problems or complications in the management of chronic wounds can be classified into the following groups: problems mostly related to the use of wound coverage and other etiology related specificities of wound treatment; problems related to incompatibility of the agents used in wound treatment; and problems arising from failure to ensure aseptic and antiseptic performance conditions.

Research Article Special Issue

African Journals Online (AJOL)

2017-09-10

Sep 10, 2017 ... include revolvers, self-loading pistols, rifles, carbines, assault rifles, submachine .... This section provides related theory on spring that was modelled in the .... Zhong-Xian L. Development and experimental verification of a.

 Ischemic Stroke Secondary to Aortic Dissection Following Rifle Butt Recoil Chest Injury: A Case Report

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John Valiath

2011-11-01

Full Text Available  Ischemic stroke secondary to aortic dissection is not uncommon. We present a patient with left hemiplegia secondary to Stanford type A aortic dissection extending to the supra-aortic vessels, which was precipitated by rifle butt recoil chest injury. The diagnosis of aortic dissection was delayed due to various factors. Finally, the patient underwent successful Bentall procedure with complete resolution of symptoms. This case emphasizes the need for caution in the use of firearms for recreation and to take precautions in preventing such incidents. In addition, this case illustrates the need for prompt cardiovascular physical examination in patients presenting with stroke.

[The peculiar features of conducting comprehensive expertises of the injuries inflicted inside the passenger car compartment].

Science.gov (United States)

Fetisov, V A; Gusarov, A A; Smirenin, S A

2016-01-01

The present article deals with the problem of forensic medical diagnostics of the injuries inflicted inside the passenger car compartment during motor vehicle accidents. The authors place special emphasis on the fact of a significant increase in the number of road traffic accidents (RTA) with such consequences throughout the world. The modern automobile industry pays much attention to the enhancement of the car safety features by significantly improving the design of passenger compartments. It accounts for a change in the traditional character of the injuries to both the driver and the passengers resulting from motor vehicle accidents. This, in turn, creates difficulties for the forensic medical experts as regards personality identification of the subjects who happened to be inside the car at the moment of the collision especially in the case of unascertainable circumstances of the accident and/or the involvement of several victims. The authors describe peculiarities of the injuries inflicted inside the passenger car compartment during road traffic accidents including such that result from bringing the driver and the passengers closer to the construction elements of the car (stage I), their direct contact with these elements (stage II), and subsequent displacement (stage III).

Chitosan preparations for wounds and burns: antimicrobial and wound-healing effects

Science.gov (United States)

Dai, Tianhong; Tanaka, Masamitsu; Huang, Ying-Ying; Hamblin, Michael R

2011-01-01

Since its discovery approximately 200 years ago, chitosan, as a cationic natural polymer, has been widely used as a topical dressing in wound management owing to its hemostatic, stimulation of healing, antimicrobial, nontoxic, biocompatible and biodegradable properties. This article covers the antimicrobial and wound-healing effects of chitosan, as well as its derivatives and complexes, and its use as a vehicle to deliver biopharmaceuticals, antimicrobials and growth factors into tissue. Studies covering applications of chitosan in wounds and burns can be classified into in vitro, animal and clinical studies. Chitosan preparations are classified into native chitosan, chitosan formulations, complexes and derivatives with other substances. Chitosan can be used to prevent or treat wound and burn infections not only because of its intrinsic antimicrobial properties, but also by virtue of its ability to deliver extrinsic antimicrobial agents to wounds and burns. It can also be used as a slow-release drug-delivery vehicle for growth factors to improve wound healing. The large number of publications in this area suggests that chitosan will continue to be an important agent in the management of wounds and burns. PMID:21810057

Saliva and wound healing.

Science.gov (United States)

Brand, Henk S; Ligtenberg, Antoon J M; Veerman, Enno C I

2014-01-01

Oral wounds heal faster and with less scar formation than skin wounds. One of the key factors involved is saliva, which promotes wound healing in several ways. Saliva creates a humid environment, thus improving the survival and functioning of inflammatory cells that are crucial for wound healing. In addition, saliva contains several proteins which play a role in the different stages of wound healing. Saliva contains substantial amounts of tissue factor, which dramatically accelerates blood clotting. Subsequently, epidermal growth factor in saliva promotes the proliferation of epithelial cells. Secretory leucocyte protease inhibitor inhibits the tissue-degrading activity of enzymes like elastase and trypsin. Absence of this protease inhibitor delays oral wound healing. Salivary histatins in vitro promote wound closure by enhancing cell spreading and cell migration, but do not stimulate cell proliferation. A synthetic cyclic variant of histatin exhibits a 1,000-fold higher activity than linear histatin, which makes this cyclic variant a promising agent for the development of a new wound healing medication. Conclusively, recognition of the many roles salivary proteins play in wound healing makes saliva a promising source for the development of new drugs involved in tissue regeneration.

Telemedicine for wound management

Directory of Open Access Journals (Sweden)

Ravi K Chittoria

2012-01-01

Full Text Available The escalating physiological, psychological, social and financial burdens of wounds and wound care on patients, families and society demand the immediate attention of the health care sector. Many forces are affecting the changes in health care provision for patients with chronic wounds, including managed care, the limited number of wound care therapists, an increasingly ageing and disabled population, regulatory and malpractice issues, and compromised care. The physician is also faced with a number of difficult issues when caring for chronic wound patients because their conditions are time consuming and high risk, represent an unprofitable part of care practice and raise issues of liability. Telemedicine enhances communication with the surgical wound care specialist. Digital image for skin lesions is a safe, accurate and cost-effective referral pathway. The two basic modes of telemedicine applications, store and forward (asynchronous transfer and real-time transmission (synchronous transfer, e.g. video conference, are utilized in the wound care setting. Telemedicine technology in the hands of an experienced physician can streamline management of a problem wound. Although there is always an element of anxiety related to technical change, the evolution of wound care telemedicine technology has demonstrated a predictable maturation process.

Microbiological, Geochemical and Hydrologic Processes Controlling Uranium Mobility: An Integrated Field Scale Subsurface Research Challenge Site at Rifle, Colorado, February 2011 to January 2012

Energy Technology Data Exchange (ETDEWEB)

Long, Philip E. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Banfield, Jill [Univ. of California, Berkeley, CA (United States); Chandler, Darrell P. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Davis, James A. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Hettich, Bob [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); VerBerkmoes, Nathan [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Jaffe, Peter R. [Princeton Univ., NJ (United States); Kerkhof, Lee J. [Rutgers Univ., New Brunswick, NJ (United States); Kukkadapu, Ravi K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Lipton, Mary [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Peacock, Aaron [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Williams, Kenneth H. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States); Yabusaki, Steven B. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

2012-02-15

The Rifle IFRC continued to make excellent progress during the last 12 months. As noted above, a key field experiment (Best Western) was performed during 2011 as a logical follow-on to the Super 8 field experiment preformed in 2010. In the Super 8 experiment, we successfully combined desorption and bioreduction and deployed a number of novel tracer techniques to enhance our ability to interpret the biogeochemistry of the experiment. In the Best Western experiment, we used the same experimental plot (Plot C) as was used for Super 8. The overarching objective of the Best Western field experiment was to compared the impacts of abiotic vs. biotic increases in alkalinity and to assess the mass of the sorbed pool of U(VI) at Rifle at the field scale. Both of these objectives were met. Preliminary analysis of the data indicate that the underlying biogeochemical data sets were obtained that will support a mechanistic understanding of the underlying processes, including remarkable insight into previously unrecognized microbial processes taking place during acetate amendment of the subsurface for a second time.

CHARACTERISTICS OF GETTING INJURED AND WOUNDED IN THE NATO AGGRESSION VICTIMS ON THE TERRITORY OF BELGRADE

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Tatjana Atanasijevic

2001-07-01

Full Text Available During the NATO aggression against Yugoslavia in the period from March toJune, 1999, at the Institute for Forensic Medicine in Belgrade there were 34 victimsregistered, namely, 22 of male and 12 of male sex. The greatest number of the killedwas of younger age, namely, of 31 to 40 years of age (l O persons and from 21 to 30years of age (8 persons while three victims were children up to 10 years of age. Onlyin one čaše the person on duty was wounded while all the other victims were civilianswho got fatal injuries out of the military objects. The wounds were in most casesinflicted by the NATO aviation actions at night, from midnight to 6 o'clock a. m. (28.In the inner city zone 26 persons were hurt; 6 were hurt in the villages aroundBelgrade and two in the suburban settlements. Half of them were killed at their jobs;16 of them were killed in the building of the Radio Television of Serbia; 9 were killedin their homes; 3 were killed in the hospital just like in the embassy and 2 in the street.Most of the persons (33 got injured due to a direct mechanical and/or thermal effectof explosive weapons. The forensic-medical autopsy was done on 31 victims. In 30cases the death occurred at the place where in the injury was inflicted.

Surgical support of Operation Sea Signal: adaptability of the 59th Air Transportable Hospital in Cuba.

Science.gov (United States)

Pelton, Jeffrey J; Buehrer, Jeffrey L; Cull, David L

2003-12-01

The attempted migration of approximately 50,000 Cubans in the summer of 1994 created a large patient population detained at Guantanamo Bay, Cuba. This study examined the roles and results of the 59th Air Transportable Hospital (ATH) in treating surgical problems within that population during Operation Sea Signal. The surgical case log of the 59th ATH was used to identify all patients operated on at the 59th ATH during the interval of August 1994 to April 1995. These case records and the individual records of the three 59th ATH surgeons were used to determine the types of cases performed, complications, and outcomes. A total of 333 operations were performed at the 59th ATH in three types of surgery: (1) elective (267); (2) emergency for nonself-inflicted conditions (46); and (3) emergency for self-inflicted conditions (20). The total perioperative complication rate was 2.4% (8/333), and the wound infection rate for clean surgical cases was 0.87% (2/229). Elective surgery may be performed in a field environment with acceptable complication and wound infection rates. Humanitarian missions will be faced with considerable pathology from pre-existing conditions within the population cared for. The humanitarian mission may be complicated by political situations that may encourage malingering and self-injurious behavior within the population cared for. The latter events have not been previously encountered in humanitarian missions involving the U.S. military and must be considered by policy makers and mission planners in planning future humanitarian missions.

Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing

Energy Technology Data Exchange (ETDEWEB)

Liu, Xiangyu; Niu, Yuqing [College of Materials Science and Engineering, Shenzhen University, Shenzhen 518060 (China); Nanshan District Key lab for Biopolymers and Safety Evaluation, Shenzhen 518060 (China); Shenzhen Key Laboratory of Polymer Science and Technology, Shenzhen 518060 (China); Guangdong Research Center for Interfacial Engineering of Functional Materials, Shenzhen 518060 (China); Chen, Kevin C. [Multidisciplinary Research Center, Shantou University, Shantou, Guangdong 515063 (China); Chen, Shiguo, E-mail: csg@szu.edu.cn [College of Materials Science and Engineering, Shenzhen University, Shenzhen 518060 (China); Nanshan District Key lab for Biopolymers and Safety Evaluation, Shenzhen 518060 (China); Shenzhen Key Laboratory of Polymer Science and Technology, Shenzhen 518060 (China); Guangdong Research Center for Interfacial Engineering of Functional Materials, Shenzhen 518060 (China)

2017-02-01

A novel rapid hemostatic and mild polyurethane-urea foam (PUUF) wound dressing was prepared by the particle leaching method and vacuum freeze-drying method using 4, 4-Methylenebis(cyclohexyl isocyanate), 4,4-diaminodicyclohexylmethane and poly (ethylene glycol) as raw materials. And X-ray diffraction (XRD), tensile test, differential scanning calorimetry (DSC) and thermogravimetry (TG) were used to its crystallinity, stress and strain behavior, and thermal properties, respectively. Platelet adhesion, fibrinogen adhesion and blood clotting were performed to evaluate its hemostatic effect. And H&E staining and Masson Trichrome staining were used to its wound healing efficacy. The results revealed the pore size of PUUF is 50–130 μm, and its porosity is 71.01%. Porous PUUF exhibited good water uptake that was benefit to adsorb abundant wound exudates to build a regional moist environment beneficial for wound healing. The PUUF wound dressing exhibit better blood coagulation effect than commercial polyurethane dressing (CaduMedi). Though both PUUF and CaduMedi facilitated wound healing generating full re-epithelialization within 13 days, PUUF was milder and lead to more slight inflammatory response than CaduMedi. In addition, PUUF wound dressing exhibited lower cytotoxicity than CaduMedi against NIH3T3 cells. Overall, porous PUUF represents a novel mild wound dressing with excellent water uptake, hemostatic effect and low toxicity, and it can promote wound healing and enhance re-epithelialization. - Highlights: • Rapid hemostatic and mild PUUF wound dressing was fabricated. • Low-toxic PUUF exhibited good water uptake that could build a regional moist environment beneficial for wound healing. • PUUF could promote wound healing and enhance re-epithelialization.

Protein matrices for wound dressings =

Science.gov (United States)

Vasconcelos, Andreia Joana Costa

Fibrous proteins such as silk fibroin (SF), keratin (K) and elastin (EL) are able to mimic the extracellular matrix (ECM) that allows their recognition under physiological conditions. The impressive mechanical properties, the environmental stability, in combination with their biocompatibility and control of morphology, provide an important basis to use these proteins in biomedical applications like protein-based wound dressings. Along time the concept of wound dressings has changed from the traditional dressings such as honey or natural fibres, used just to protect the wound from external factors, to the interactive dressings of the present. Wounds can be classified in acute that heal in the expected time frame, and chronic, which fail to heal because the orderly sequence of events is disrupted at one or more stages of the healing process. Moreover, chronic wound exudates contain high levels of tissue destructive proteolytic enzymes such as human neutrophil elastase (HNE) that need to be controlled for a proper healing. The aim of this work is to exploit the self-assemble properties of silk fibroin, keratin and elastin for the development of new protein materials to be used as wound dressings: i) evaluation of the blending effect on the physical and chemical properties of the materials; ii) development of materials with different morphologies; iii) assessment of the cytocompatibility of the protein matrices; iv) ultimately, study the ability of the developed protein matrices as wound dressings through the use of human chronic wound exudate; v) use of innovative short peptide sequences that allow to target the control of high levels of HNE found on chronic wounds. Chapter III reports the preparation of silk fibroin/keratin (SF/K) blend films by solvent casting evaporation. Two solvent systems, aqueous and acidic, were used for the preparation of films from fibroin and keratin extracted from the respective silk and wool fibres. The effect of solvent system used was

A multi-centre clinical evaluation of reactive oxygen topical wound gel in 114 wounds.

Science.gov (United States)

Dryden, M; Dickinson, A; Brooks, J; Hudgell, L; Saeed, K; Cutting, K F

2016-03-01

This article reports the outcomes of the use of Surgihoney RO (SHRO), topical wound dressing in a multi-centre, international setting. The aims were to explore the clinical effects of SHRO, including a reduction in bacterial load and biofilm and improvement in healing in a variety of challenging non-healing and clinically infected wounds. This was a non-comparative evaluation, where both acute and chronic wounds with established delayed healing were treated with the dressing. Clinicians prospectively recorded wound improvement or deterioration, level of wound exudate, presence of pain, and presence of slough and necrosis. Analysis of this data provided information on clinical performance of the dressing. Semi-quantitative culture to assess bacterial bioburden was performed where possible. We recruited 104 patients, mean age 61 years old, with 114 wounds. The mean duration of wounds before treatment was 3.7 months and the mean duration of treatment was 25.7 days. During treatment 24 wounds (21%) healed and the remaining 90 (79%) wounds improved following application of the dressing. No deterioration in any wound was observed. A reduction in patient pain, level of wound exudate and in devitalised tissue were consistently reported. These positive improvements in wound progress were reflected in the wound cultures that showed a reduction in bacterial load in 39 out of the 40 swabs taken. There were two adverse events recorded: a stinging sensation following application of the dressing was experienced by 2 patients, and 2 elderly patients died of causes unrelated to the dressing or to the chronic wound. These patients' wounds and their response to SHRO have been included in the analysis. SHRO was well tolerated and shows great promise as an effective potent topical antimicrobial in the healing of challenging wounds. Matthew Dryden has become a shareholder in Matoke Holdings, the manufacturer of Surgihoney RO, since the completion of this study. Keith Cutting is a

Wound healing and all-cause mortality in 958 wound patients treated in home care

DEFF Research Database (Denmark)

Zarchi, Kian; Martinussen, Torben; Jemec, Gregor B. E.

2015-01-01

to investigate wound healing and all-cause mortality associated with different types of skin wounds. Consecutive skin wound patients who received wound care by home-care nurses from January 2010 to December 2011 in a district in Eastern Denmark were included in this study. Patients were followed until wound...... healing, death, or the end of follow-up on December 2012. In total, 958 consecutive patients received wound care by home-care nurses, corresponding to a 1-year prevalence of 1.2% of the total population in the district. During the study, wound healing was achieved in 511 (53.3%), whereas 90 (9.4%) died...

[Experimental studies on the wounding capacity of recently developed shuriken/throwing stars and their legal categorization--an interdisciplinary view].

Science.gov (United States)

Kettner, Mattias; Gade, Gunther; Ramsthaler, Frank; Shah, Sanjai; Pape, Andreas; Theisen, Alf; Schmidt, Peter

2010-01-01

Shuriken/throwing stars are traditional Japanese weapons for close combat situations. They vary greatly in shape and mode of action. Due to their wounding capacity traditional shuriken made of steel were prohibited in Germany in the 1980's. In the present study three recently developed types of shuriken were examined to determine their wounding capacity. Type 1 was made of plastic, whereas type 2 was a so-called cyclone shuriken equipped with three knives protruding from a discoidal center due to centrifugal force during the flight. Type 3 consisted of three traditional metal shuriken with blunt edges and peaks produced for decorative purposes. Experiments using pig carcasses were carried out for types 1 and 2. An experiment using human skin was performed with type 3 shuriken. An experienced thrower performed throws from a distance of 1, 2, 3, and 4 m with the shuriken made of plastic. For the cyclone shuriken a distance of 4 m was chosen to ensure the unfolding of the shuriken during flight. Type 3 shuriken were tested using a distance of 2 m. Penetration depths of the shuriken made of plastic reached up to 8 mm in pig skin. The experiment with the cyclone shuriken revealed a penetration depth of up to 2.5 cm cutting through the entire abdominal tissue and opening up an intestinal loop whereas type 3 shuriken yielded maximal penetration depths between 0.9 and 2.3 cm. This study indicates that all three types of shuriken may inflict lethal wounds upon opponents in close combat. The findings of this study should promote a public discussion whether the ban on traditional shuriken should be extended to the recently developed types.

Surface complexation modeling of U(VI) adsorption by aquifer sediments from a former mill tailings site at Rifle, Colorado

Science.gov (United States)

Hyun, S.P.; Fox, P.M.; Davis, J.A.; Campbell, K.M.; Hayes, K.F.; Long, P.E.

2009-01-01

A study of U(VI) adsorption by aquifer sediment samples from a former uranium mill tailings site at Rifle, Colorado, was conducted under oxic conditions as a function of pH, U(VI), Ca, and dissolved carbonate concentration. Batch adsorption experiments were performed using tailings site at Naturita, Colorado, indicated that possible calcite nonequilibrium of dissolved calcium concentration should be evaluated. The modeling results also illustrate the importance of the range of data used in deriving the best fit model parameters. ?? 2009 American Chemical Society.

Psoriasis and wound healing outcomes: A retrospective cohort study examining wound complications and antibiotic use.

Science.gov (United States)

Young, Paulina M; Parsi, Kory K; Schupp, Clayton W; Armstrong, April W

2017-11-15

Little is known about wound healing in psoriasis. We performed a cohort study examining differences in wound healing complications between patients with and without psoriasis. Psoriasis patients with traumatic wounds were matched 1:3 to non-psoriasis patients with traumatic wounds based on age, gender, and body mass index (BMI). We examined theincidence of wound complications including infection, necrosis, and hematoma as well as incident antibiotic use within three months following diagnosis of a traumatic wound. The study included 164 patients with traumatic wounds, comprised of 41 patients with psoriasis matched to 123 patients without psoriasis. No statistically significant differences were detected in the incidence of overall wound complications between wound patients with psoriasis and wound patients without psoriasis (14.6% versus. 13.0%, HR 1.18, CI 0.39-3.56). After adjustment for diabetes, peripheral vascular disease, and smoking, no statistically significant differences were detected in the incidence of overall wound complications between patients with and without psoriasis (HR 1.11, CI 0.34-3.58). Specifically, the adjusted rates of antibiotic use were not significantly different between those with and without psoriasis (HR 0.65, CI 0.29-1.46). The incidence of wound complications following traumatic wounds of the skin was found to be similar between patients with and without psoriasis.

Clay Mineralogy of AN Alluvial Aquifer in a Mountainous, Semiarid Terrain, AN Example from Rifle, Colorado

Science.gov (United States)

Elliott, W. C.; Lim, D.; Zaunbrecher, L. K.; Pickering, R. A.; Williams, K. H.; Navarre-Sitchler, A.; Long, P. E.; Noel, V.; Bargar, J.; Qafoku, N. P.

2015-12-01

Alluvial sediments deposited along the Colorado River corridor in the semi-arid regions of central to western Colorado can be important hosts for legacy contamination including U, V, As and Se. These alluvial sediments host aquifers which are thought to provide important "hot spots" and "hot moments" for microbiological activity controlling organic carbon processing and fluxes in the subsurface. Relatively little is known about the clay mineralogy of these alluvial aquifers and the parent alluvial sediments in spite of the fact that they commonly include lenses of silt-clay materials. These lenses are typically more reduced than coarser grained materials, but zones of reduced and more oxidized materials are present in these alluvial aquifer sediments. The clay mineralogy of the non-reduced parent alluvial sediments of the alluvial aquifer located in Rifle, CO (USA) is composed of chlorite, smectite, illite, kaolinite and quartz. The clay mineralogy of non-reduced fine-grained materials at Rifle are composed of the same suite of minerals found in the sediments plus a vermiculite-smectite intergrade that occurs near the bottom of the aquifer near the top of the Wasatch Formation. The clay mineral assemblages of the system reflect the mineralogically immature character of the source sediments. These assemblages are consistent with sediments and soils that formed in a moderately low rainfall climate and suggestive of minimal transport of the alluvial sediments from their source areas. Chlorite, smectite, smectite-vermiculite intergrade, and illite are the likely phases involved in the sorption of organic carbon and related microbial redox transformations of metals in these sediments. Both the occurrence and abundance of chlorite, smectite-vermiculite, illite and smectite can therefore exert an important control on the contaminant fluxes and are important determinants of biogeofacies in mountainous, semiarid terrains.

Molecular pathology of wound healing.

Science.gov (United States)

Kondo, Toshikazu; Ishida, Yuko

2010-12-15

Skin-wound healing is an orchestrated biological phenomena consisting of three sequential phases, inflammation, proliferation, and maturation. Many biological substances are involved in the process of wound repair, and this short and simplified overview of wound healing can be adopted to determine wound vitality or wound age in forensic medicine. With the development of genetically engineered animals, essential molecules for skin-wound healing have been identified. Especially, cytokines, and growth factors are useful candidates and markers for the determination of wound vitality or age. Moreover, bone marrow-derived progenitor cells would give significant information to wound age determination. In this review article, some interesting observations are presented, possibly contributing to the future practice of forensic pathologists. Copyright © 2010. Published by Elsevier Ireland Ltd.

Proposed diagnosis criteria for inflicted head injury of children younger than two years of age

International Nuclear Information System (INIS)

Fujiwara, Takeo; Okuyama, Makiko; Matsumoto, Tsutomu; Aritaki, Kentarou; Yotani, Nobuyuki; Miyasaka, Mikiko; Nishina, Sachiko

2008-01-01

It is difficult to distinguish whether children's head injuries are due to physical abuse or unintentional accidents. However, in the literature, medical findings specific to infant physical abuse were identified. Thus, we developed diagnostic criteria for inflicted head injury (IHI) and assessed its validity. Subjects were collected from all patients who were less than two years old when they visited National Center for Child Health (NCCHD) and Development and underwent head CT scan to assess head trauma from March 1, 2002 to December 31, 2005. Diagnostic criteria for IHI were developed based on definitions of Duhaime et al (1992) and Reece et al (2001). Validity of diagnosis criteria was assessed by comparing the official report to the Child Guidance Center (CGC) from NCCHD to the disposition decided by the CGC. Two-hundred and sixty cases were collected and diagnosed. There was a 86.5% match of the number of cases which were diagnosed as IHI or non-IHI using the IHI diagnostic criteria with official reports to CGC from NCCHD. Among the cases which were diagnosed as presumptive IHI and also reported to the CGC, 20 cases (83.3%) were regarded as abused cases by the CGC. The diagnostic criteria for IHI were valid and would be useful for pediatricians not to condone inflicted head injury. (author)

Comparison of conventional gauze therapy with vacuum assisted closure wound therapy in acute traumatic wounds

International Nuclear Information System (INIS)

Naqvi, S.H.; Jalil, M.; Butt, Q.; Malik, Z.U

2013-01-01

Objective: To compare the Vacuum Assisted Closure (Vac) wound therapy with Conventional Gauze Therapy (CGT) in management of acute traumatic wounds on the basis of time taken to achieve a vital red wound ready for definitive surgical closure. Study Design: Randomized control trial. Place and Duration of Study: Department of Surgery Combined Military Hospital Rawalpindi from Mar 2009 to Sep 2009. Patients and Methods: This study included 82 patients of acute traumatic wounds. Patients were randomly allotted to group A, in which wound was treated with new method of vacuum assisted closure (VAC) wound therapy and to group B, in which wound was managed by conventional gauze therapy (CGT). Outcomes were measured by the presence of vital red wound ready to be closed by surgical intervention. Patients with concomitant systemic pathology were not included in study. Results: Comparison between the two groups revealed mean time for wound healing 13 days in group A and 16.9 days in group B with significant difference (p value =0.029). Conclusion: Vacuum assisted closure wound therapy is an effective method in reducing time of wound healing for definitive surgical closure. (author)

Factors Affecting Wound Healing

Science.gov (United States)

Guo, S.; DiPietro, L.A.

2010-01-01

Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutaneous wound healing and the potential cellular and/or molecular mechanisms involved. The factors discussed include oxygenation, infection, age and sex hormones, stress, diabetes, obesity, medications, alcoholism, smoking, and nutrition. A better understanding of the influence of these factors on repair may lead to therapeutics that improve wound healing and resolve impaired wounds. PMID:20139336

Wound Disruption Following Colorectal Operations.

Science.gov (United States)

Moghadamyeghaneh, Zhobin; Hanna, Mark H; Carmichael, Joseph C; Mills, Steven; Pigazzi, Alessio; Nguyen, Ninh T; Stamos, Michael J

2015-12-01

Postoperative wound disruption is associated with high morbidity and mortality. We sought to identify the risk factors and outcomes of wound disruption following colorectal resection. The American College of Surgeons National Surgical Quality Improvement Program (NSQIP) database was used to examine the clinical data of patients who underwent colorectal resection from 2005 to 2013. Multivariate regression analysis was performed to identify risk factors of wound disruption. We sampled a total of 164,297 patients who underwent colorectal resection. Of these, 2073 (1.3 %) had wound disruption. Patients with wound disruption had significantly higher mortality (5.1 vs. 1.9 %, AOR: 1.46, P = 0.01). The highest risk of wound disruption was seen in patients with wound infection (4.8 vs. 0.9 %, AOR: 4.11, P disruption such as chronic steroid use (AOR: 1.71, P disruption compared to open surgery (AOR: 0.61, P disruption occurs in 1.3 % of colorectal resections, and it correlates with mortality of patients. Wound infection is the strongest predictor of wound disruption. Chronic steroid use, obesity, severe COPD, prolonged operation, non-elective admission, and serum albumin level are strongly associated with wound disruption. Utilization of the laparoscopic approach may decrease the risk of wound disruption when possible.

Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study.

Science.gov (United States)

Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

2015-10-01

It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we determined which patient- and wound-related characteristics best predict time to complete wound healing and derived a prediction formula to estimate how long this may take. We selected 563 patients with acute wounds, documented in the WEC registry between 2007 and 2012. Wounds had existed for a median of 19 days (range 6-46 days). The majority of these were located on the leg (52%). Five significant independent predictors of prolonged wound healing were identified: wound location on the trunk [hazard ratio (HR) 0·565, 95% confidence interval (CI) 0·405-0·788; P = 0·001], wound infection (HR 0·728, 95% CI 0·534-0·991; P = 0·044), wound size (HR 0·993, 95% CI 0·988-0·997; P = 0·001), wound duration (HR 0·998, 95% CI 0·996-0·999; P = 0·005) and patient's age (HR 1·009, 95% CI 1·001-1·018; P = 0·020), but not diabetes. Awareness of the five factors predicting the healing of complex acute wounds, particularly wound infection and location on the trunk, may help caregivers to predict wound healing time and to detect, refer and focus on patients who need additional attention. © 2013 The Authors. International Wound Journal © 2013 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Humidity-dependent wound sealing in succulent leaves of Delosperma cooperi - An adaptation to seasonal drought stress.

Science.gov (United States)

Speck, Olga; Schlechtendahl, Mark; Borm, Florian; Kampowski, Tim; Speck, Thomas

2018-01-01

During evolution, plants evolved various reactions to wounding. Fast wound sealing and subsequent healing represent a selective advantage of particular importance for plants growing in arid habitats. An effective self-sealing function by internal deformation has been found in the succulent leaves of Delosperma cooperi. After a transversal incision, the entire leaf bends until the wound is closed. Our results indicate that the underlying sealing principle is a combination of hydraulic shrinking and swelling as the main driving forces and growth-induced mechanical pre-stresses in the tissues. Hydraulic effects were measured in terms of the relative bending angle over 55 minutes under various humidity conditions. The higher the relative air humidity, the lower the bending angle. Negative bending angles were found when a droplet of liquid water was applied to the wound. The statistical analysis revealed highly significant differences of the single main effects such as "humidity conditions in the wound region" and "time after wounding" and their interaction effect. The centripetal arrangement of five tissue layers with various thicknesses and significantly different mechanical properties might play an additional role with regard to mechanically driven effects. Injury disturbs the mechanical equilibrium, with pre-stresses leading to internal deformation until a new equilibrium is reached. In the context of self-sealing by internal deformation, the highly flexible wide-band tracheids, which form a net of vascular bundles, are regarded as paedomorphic tracheids, which are specialised to prevent cell collapse under drought stress and allow for building growth-induced mechanical pre-stresses.

Bioinspired porous membranes containing polymer nanoparticles for wound healing.

Science.gov (United States)

Ferreira, Ana M; Mattu, Clara; Ranzato, Elia; Ciardelli, Gianluca

2014-12-01

Skin damages covering a surface larger than 4 cm(2) require a regenerative strategy based on the use of appropriate wound dressing supports to facilitate the rapid tissue replacement and efficient self-healing of the lost or damaged tissue. In the present work, A novel biomimetic approach is proposed for the design of a therapeutic porous construct made of poly(L-lactic acid) (PLLA) fabricated by thermally induced phase separation (TIPS). Biomimicry of ECM was achieved by immobilization of type I collagen through a two-step plasma treatment for wound healing. Anti-inflammatory (indomethacin)-containing polymeric nanoparticles (nps) were loaded within the porous membranes in order to minimize undesired cell response caused by post-operative inflammation. The biological response to the scaffold was analyzed by using human keratinocytes cell cultures. In this work, a promising biomimetic construct for wound healing and soft tissue regeneration with drug-release properties was fabricated since it shows (i) proper porosity, pore size, and mechanical properties, (ii) biomimicry of ECM, and (iii) therapeutic potential. © 2014 Wiley Periodicals, Inc.

Fabrication of wound capacitors using flexible alkali-free glass

International Nuclear Information System (INIS)

Wilke, Rudeger H. T.; Baker, Amanda; Brown-Shaklee, Harlan; Johnson-Wilke, Raegan; Hettler, Chad

2016-01-01

Here, alkali-free glasses, which exhibit high energy storage densities (~35 J/cc), present a unique opportunity to couple high temperature stability with high breakdown strength, and thus provide an avenue for capacitor applications with stringent temperature and power requirements. Realizing the potential of these materials in kilovolt class capacitors with >1 J/cc recoverable energy density requires novel packaging strategies that incorporate these extremely fragile dielectrics. In this paper, we demonstrate the feasibility of fabricating wound capacitors using 50-μm-thick glass. Two capacitors were fabricated from 2.8-m-long ribbons of thin (50 μm) glass wound into 125-140-mm-diameter spools. The capacitors exhibit a capacitance of 70-75 nF with loss tangents below 1%. The wound capacitors can operate up to 1 kV and show excellent temperature stability to 150 °C. By improving the end terminations, the self-resonance can be shifted to above 1 MHz, indicating that these materials may be useful for pulsed power applications with microsecond discharge times.

Recent advances in topical wound care

Directory of Open Access Journals (Sweden)

Sujata Sarabahi

2012-01-01

Full Text Available There are a wide variety of dressing techniques and materials available for management of both acute wounds and chronic non-healing wounds. The primary objective in both the cases is to achieve a healed closed wound. However, in a chronic wound the dressing may be required for preparing the wound bed for further operative procedures such as skin grafting. An ideal dressing material should not only accelerate wound healing but also reduce loss of protein, electrolytes and fluid from the wound, and help to minimize pain and infection. The present dictum is to promote the concept of moist wound healing. This is in sharp contrast to the earlier practice of exposure method of wound management wherein the wound was allowed to dry. It can be quite a challenge for any physician to choose an appropriate dressing material when faced with a wound. Since wound care is undergoing a constant change and new products are being introduced into the market frequently, one needs to keep abreast of their effect on wound healing. This article emphasizes on the importance of assessment of the wound bed, the amount of drainage, depth of damage, presence of infection and location of wound. These characteristics will help any clinician decide on which product to use and where,in order to get optimal wound healing. However, there are no ′magical dressings′. Dressings are one important aspect that promotes wound healing apart from treating the underlying cause and other supportive measures like nutrition and systemic antibiotics need to be given equal attention.

Teaching advanced wound closure techniques using cattle digits.

Science.gov (United States)

Khalil, Philipe N; Kanz, Karl-Georg; Siebeck, Matthias; Mutschler, Wolf

2011-03-01

To evaluate a model used to impart advanced wound closure skills because available models do not meet the necessary requirements to a substantial degree. Seventy-one residents were asked to evaluate a 75-minute-long skills course using cadaveric cattle digits to learn Z-plasty, V-Y-plasty, and oval-shaped rotational flaps. A short film and the course instructor demonstrated each technique first. A Likert rating scale ranging from 1 to 6 was used for questions in the survey given to the residents. There was strong agreement among residents (1.65 ± 1.17 years of experience) that advanced wound closure training courses are necessary (5.73 ± 0.73), which corresponded to the residents' low level of knowledge and self-assessment of practical skills and present experience (2.84 ± 1.01). The course was evaluated with high acceptance, even though it was found to be demanding for the trainees (5.84 ± 0.40). This might also be related to the high rating of the model itself, which was found to be a suitable method for teaching advanced wound closure techniques (5.50 ± 0.71) that was easily comprehensible (5.73 ± 0.53). Skills training courses for young trainees are warranted to impart advanced wound closure techniques. The curriculum using cattle digits presented here is recommended. The authors have indicated no significant interest with commercial supporters. © 2011 by the American Society for Dermatologic Surgery, Inc.

[The historical aspects of the notion of "self-striking" in the Russian- and foreign-language literature].

Science.gov (United States)

Ivanov, I N

2015-01-01

This article was designed to illustrate specific features of the injuries inflicted by the sharp objects as a result of the so-called self-striking based on the examples from the historical and literary works. The forensic medical characteristics of such cases are provided.

Recombinant human erythropoietin improves angiogenesis and wound healing in experimental burn wounds.

Science.gov (United States)

Galeano, Mariarosaria; Altavilla, Domenica; Bitto, Alessandra; Minutoli, Letteria; Calò, Margherita; Lo Cascio, Patrizia; Polito, Francesca; Giugliano, Giovanni; Squadrito, Giovanni; Mioni, Chiara; Giuliani, Daniela; Venuti, Francesco S; Squadrito, Francesco

2006-04-01

Erythropoietin interacts with vascular endothelial growth factor (VEGF) and stimulates endothelial cell mitosis and motility; thus it may be of importance in the complex phenomenon of wound healing. The purpose of this study was to investigate the effect of recombinant human erythropoietin (rHuEPO) on experimental burn wounds. Randomized experiment. Research laboratory. C57BL/6 male mice weighing 25-30 g. Mice were immersed in 80 degrees C water for 10 secs to achieve a deep-dermal second degree burn. Animals were randomized to receive either rHuEPO (400 units/kg/day for 14 days in 100 microL subcutaneously) or its vehicle alone (100 microl/day distilled water for 14 days subcutaneously). On day 14 the animals were killed. Burn areas were used for histologic examination, evaluation of neoangiogenesis by immunohistochemistry, and expression (Western blot) of the specific endothelial marker CD31 as well as quantification of microvessel density, measurement of VEGF wound content (enzyme-linked immunosorbent assay), expression (Western blot) of endothelial and inducible nitric oxide synthases, and determination of wound nitric oxide (NO) products. rHuEPO increased burn wound reepithelialization and reduced the time to final wound closure. These effects were completely abated by a passive immunization with specific antibodies against erythropoietin. rHuEPO improved healing of burn wound through increased epithelial proliferation, maturation of the extracellular matrix, and angiogenesis. The hematopoietic factor augmented neoangiogenesis as suggested by the marked increase in microvessel density and by the robust expression of the specific endothelial marker CD31. Furthermore, rHuEPO enhanced the wound content of VEGF caused a marked expression of endothelial and inducible nitric oxide synthases and increased wound content of nitric oxide products. Our study suggests that rHuEPO may be an effective therapeutic approach to improve clinical outcomes after thermal injury.

Geologic map of the Rifle Falls quadrangle, Garfield County, Colorado

Science.gov (United States)

Scott, Robert B.; Shroba, Ralph R.; Egger, Anne

2001-01-01

New 1:24,000-scale geologic map of the Rifle Falls 7.5' quadrangle, in support of the USGS Western Colorado I-70 Corridor Cooperative Geologic Mapping Project, provides new interpretations of the stratigraphy, structure, and geologic hazards in the area of the southwest flank of the White River uplift. Bedrock strata include the Upper Cretaceous Iles Formation through Ordovician and Cambrian units. The Iles Formation includes the Cozzette Sandstone and Corcoran Sandstone Members, which are undivided. The Mancos Shale is divided into three members, an upper member, the Niobrara Member, and a lower member. The Lower Cretaceous Dakota Sandstone, the Upper Jurassic Morrison Formation, and the Entrada Sandstone are present. Below the Upper Jurassic Entrada Sandstone, the easternmost limit of the Lower Jurassic and Upper Triassic Glen Canyon Sandstone is recognized. Both the Upper Triassic Chinle Formation and the Lower Triassic(?) and Permian State Bridge Formation are present. The Pennsylvanian and Permian Maroon Formation is divided into two members, the Schoolhouse Member and a lower member. All the exposures of the Middle Pennsylvanian Eagle Evaporite intruded into the Middle Pennsylvanian Eagle Valley Formation, which includes locally mappable limestone beds. The Middle and Lower Pennsylvanian Belden Formation and the Lower Mississippian Leadville Limestone are present. The Upper Devonian Chaffee Group is divided into the Dyer Dolomite, which is broken into the Coffee Pot Member and the Broken Rib Member, and the Parting Formation. Ordovician through Cambrian units are undivided. The southwest flank of the White River uplift is a late Laramide structure that is represented by the steeply southwest-dipping Grand Hogback, which is only present in the southwestern corner of the map area, and less steeply southwest-dipping older strata that flatten to nearly horizontal attitudes in the northern part of the map area. Between these two is a large-offset, mid

Topical sucralfate treatment of anal fistulotomy wounds: a randomized placebo-controlled trial.

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Gupta, Pravin J; Heda, Purushottam S; Shrirao, Subhash A; Kalaskar, Surekha S

2011-06-01

Sucralfate is a cytoprotective agent which adheres to mucoproteins and forms a protective barrier at wound sites. In oral form it is a common ulcer medication, and as a topical preparation it has been used to treat a wide variety of wounds. The present study was designed to evaluate the effectiveness and safety of topical sucralfate in wound healing after anal fistulotomy. Double-blind, randomized controlled study comparing topical application of sucralfate or placebo. Private outpatient clinic specializing in anorectal disease in Nagpur, India. Patients with a wound length of at least 5 cm after low anal fistulotomy were eligible for the study. Patients were randomly assigned to receive ointment containing 7% sucralfate or a placebo ointment consisting of petroleum jelly. Patients were instructed to apply approximately 3 g of ointment to the wound twice daily after a sitz bath for 6 weeks or until the wound had healed. The wounds were examined by a blinded independent observer at 2, 4, and 6 weeks after the operation. The primary end point was the proportion of patients with wounds that had completely healed. Secondary end points included amount of mucosal covering (scored by the observer), adverse events, and postoperative pain (self-rated on a visual analog scale). Of 80 participants (29 women, 51 men; median age, 23 (range, 17-49) years), 76 participants completed the trial (sucralfate, 39; placebo, 37). At 6-week follow-up, complete wound healing was achieved in 37 patients (95%) in the sucralfate group and 27 patients (73%) in the placebo group (P = .009). Mucosal coverage of the wound was significantly greater with sucralfate than with placebo at each measurement point (P = .01). No adverse events were observed. Postoperative pain scores were significantly lower for sucralfate than for placebo at 2 and 4 weeks after the start of treatment. Wound tissue specimens were not available for morphological and ultrastructural analysis. The results of this study add

Silver nanoparticle/bacterial cellulose gel membranes for antibacterial wound dressing: investigation in vitro and in vivo

International Nuclear Information System (INIS)

Wu, Jian; Zheng, Yudong; Wen, Xiaoxiao; Lin, Qinghua; Chen, Xiaohua; Wu, Zhigu

2014-01-01

Bacterial cellulose (BC) has attracted increasing attention as a novel wound dressing material, but its antimicrobial activity, which is one of the critical skin-barrier functions in wound healing, is not sufficient for use in practical applications. To overcome such a deficiency, silver nanoparticles were generated and self-assembled on the surface of BC nanofibers, forming a stable and evenly distributed Ag nanoparticle coated BC nanofiber (AgNP-BC). The performance of AgNP-BC was systematically studied in terms of antibacterial activities, cytocompatibility and effects on wound healing. The results showed that AgNP-BC exhibited significant antibacterial activity against Staphylococcus aureus. Moreover, AgNP-BC allowed attachment, and growth of rat fibroblasts with low cytotoxicity emerged. Based on these advantages, AgNP-BC samples were applied in a second-degree rat wound model. Wound flora showed a significant reduction during the healing. The fresh epidermal and dermis thicknesses with AgNP-BC samples were 111 and 855 µm respectively, higher than 74 and 619 µm for BC groups and 57 and 473 µm for untreated control wounds. The results demonstrated that AgNP-BC could reduce inflammation and promote scald wound healing. (paper)

Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study

OpenAIRE

Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

2015-01-01

It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We developed a model to detect which factors can predict (prolonged) healing of complex acute wounds in patients treated in a large wound expertise centre (WEC). Using Cox and linear regression analyses, we ...

Negative pressure wound therapy for the treatment of infected wounds with exposed knee joint after patellar fracture.

Science.gov (United States)

Lee, Sang Yang; Niikura, Takahiro; Miwa, Masahiko; Sakai, Yoshitada; Oe, Keisuke; Fukazawa, Takahiro; Kawakami, Yohei; Kurosaka, Masahiro

2011-06-14

Treatment of soft tissue defects with exposed bones and joints, resulting from trauma, infection, and surgical complications, represents a major challenge. The introduction of negative pressure wound therapy has changed many wound management practices. Negative pressure wound therapy has recently been used in the orthopedic field for management of traumatic or open wounds with exposed bone, nerve, tendon, and orthopedic implants. This article describes a case of a patient with a large soft tissue defect and exposed knee joint, in which negative pressure wound therapy markedly improved wound healing. A 50-year-old man presented with an ulceration of his left knee with exposed joint, caused by severe wound infections after open reduction and internal fixation of a patellar fracture. After 20 days of negative pressure wound therapy, a granulated wound bed covered the exposed bones and joint.To our knowledge, this is the first report of negative pressure wound therapy used in a patient with a large soft tissue defect with exposed knee joint. Despite the chronic wound secondary to infection, healing was achieved through the use of the negative pressure wound therapy, thus promoting granulation tissue formation and closing the joint. We suggest negative pressure wound therapy as an alternative option for patients with lower limb wounds containing exposed bones and joints when free flap transfer is contraindicated. Our result added to the growing evidence that negative pressure wound therapy is a useful adjunctive treatment for open wounds around the knee joint. Copyright 2011, SLACK Incorporated.

Polymeric hydrogels for burn wound care: Advanced skin wound dressings and regenerative templates.

Science.gov (United States)

Madaghiele, Marta; Demitri, Christian; Sannino, Alessandro; Ambrosio, Luigi

2014-01-01

Wound closure represents a primary goal in the treatment of very deep and/or large wounds, for which the mortality rate is particularly high. However, the spontaneous healing of adult skin eventually results in the formation of epithelialized scar and scar contracture (repair), which might distort the tissues and cause lifelong deformities and disabilities. This clinical evidence suggests that wound closure attained by means of skin regeneration, instead of repair, should be the true goal of burn wound management. The traditional concept of temporary wound dressings, able to stimulate skin healing by repair, is thus being increasingly replaced by the idea of temporary scaffolds, or regenerative templates, able to promote healing by regeneration. As wound dressings, polymeric hydrogels provide an ideal moisture environment for healing while protecting the wound, with the additional advantage of being comfortable to the patient, due to their cooling effect and non-adhesiveness to the wound tissue. More importantly, recent advances in regenerative medicine demonstrate that bioactive hydrogels can be properly designed to induce at least partial skin regeneration in vivo. The aim of this review is to provide a concise insight on the key properties of hydrogels for skin healing and regeneration, particularly highlighting the emerging role of hydrogels as next generation skin substitutes for the treatment of full-thickness burns.

Polymeric hydrogels for burn wound care: Advanced skin wound dressings and regenerative templates

Directory of Open Access Journals (Sweden)

Marta Madaghiele

2014-10-01

Full Text Available Wound closure represents a primary goal in the treatment of very deep and/or large wounds, for which the mortality rate is particularly high. However, the spontaneous healing of adult skin eventually results in the formation of epithelialized scar and scar contracture (repair, which might distort the tissues and cause lifelong deformities and disabilities. This clinical evidence suggests that wound closure attained by means of skin regeneration, instead of repair, should be the true goal of burn wound management. The traditional concept of temporary wound dressings, able to stimulate skin healing by repair, is thus being increasingly replaced by the idea of temporary scaffolds, or regenerative templates, able to promote healing by regeneration. As wound dressings, polymeric hydrogels provide an ideal moisture environment for healing while protecting the wound, with the additional advantage of being comfortable to the patient, due to their cooling effect and non-adhesiveness to the wound tissue. More importantly, recent advances in regenerative medicine demonstrate that bioactive hydrogels can be properly designed to induce at least partial skin regeneration in vivo. The aim of this review is to provide a concise insight on the key properties of hydrogels for skin healing and regeneration, particularly highlighting the emerging role of hydrogels as next generation skin substitutes for the treatment of full-thickness burns.

Military nurses and combat-wounded patients: a qualitative analysis of psychosocial care.

Science.gov (United States)

Hagerty, Bonnie M; Williams, Reg Arthur; Bingham, Mona; Richard, Maggie

2011-04-01

The aims were to explore the lived experience of combat-wounded patients and the military nurses who care for them. The study was a qualitative phenomenological design, and focus groups were conducted with 20 nurses and 8 combat-wounded patients. Themes common to nurses and patients were coping, shared experiences, finding meaning, psychosocial nursing care, families, and bureaucratic structure. Thematic differences were the patients' perspectives "changed self" while nurses described "professional boundaries." The importance of finding meaning presents ideas that could help nurses and patients cope better with stressful situations regardless of the setting. © 2010 Wiley Periodicals, Inc.

[Wound information management system: a standardized scheme for acquisition, storage and management of wound information].

Science.gov (United States)

Liu, Hu; Su, Rong-jia; Wu, Min-jie; Zhang, Yi; Qiu, Xiang-jun; Feng, Jian-gang; Xie, Ting; Lu, Shu-liang

2012-06-01

To form a wound information management scheme with objectivity, standardization, and convenience by means of wound information management system. A wound information management system was set up with the acquisition terminal, the defined wound description, the data bank, and related softwares. The efficacy of this system was evaluated in clinical practice. The acquisition terminal was composed of the third generation mobile phone and the software. It was feasible to get access to the wound information, including description, image, and therapeutic plan from the data bank by mobile phone. During 4 months, a collection of a total of 232 wound treatment information was entered, and accordingly standardized data of 38 patients were formed automatically. This system can provide standardized wound information management by standardized techniques of acquisition, transmission, and storage of wound information. It can be used widely in hospitals, especially primary medical institutions. Data resource of the system makes it possible for epidemiological study with large sample size in future.

Improved wound care product

DEFF Research Database (Denmark)

2012-01-01

The present invention pertains to use of sodium diacetate (NaHAc 2) as an antimicrobial agent against bacteria growing in biofilms. The aspects of the invention include a wound care product comprising sodium diacetate, a kit comprising a wound care product,and a methodof treating an infected wound....

How wounds heal

Science.gov (United States)

... How puncture wounds heal; How burns heal; How pressure sores heal; How lacerations heal ... bleed. For example, burns, some puncture wounds, and pressure sores do not bleed. Once the scab forms, your ...

Topical Medical Cannabis: A New Treatment for Wound Pain-Three Cases of Pyoderma Gangrenosum.

Science.gov (United States)

Maida, Vincent; Corban, Jason

2017-11-01

Pain associated with integumentary wounds is highly prevalent, yet it remains an area of significant unmet need within health care. Currently, systemically administered opioids are the mainstay of treatment. However, recent publications are casting opioids in a negative light given their high side effect profile, inhibition of wound healing, and association with accidental overdose, incidents that are frequently fatal. Thus, novel analgesic strategies for wound-related pain need to be investigated. The ideal methods of pain relief for wound patients are modalities that are topical, lack systemic side effects, noninvasive, self-administered, and display rapid onset of analgesia. Extracts derived from the cannabis plant have been applied to wounds for thousands of years. The discovery of the human endocannabinoid system and its dominant presence throughout the integumentary system provides a valid and logical scientific platform to consider the use of topical cannabinoids for wounds. We are reporting a prospective case series of three patients with pyoderma gangrenosum that were treated with topical medical cannabis compounded in nongenetically modified organic sunflower oil. Clinically significant analgesia that was associated with reduced opioid utilization was noted in all three cases. Topical medical cannabis has the potential to improve pain management in patients suffering from wounds of all classes. Copyright © 2017 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

Filament wound structure and method

International Nuclear Information System (INIS)

Dritt, W.S.; Gerth, H.L.; Knight, C.E. Jr.; Pardue, R.M.

1977-01-01

A filament wound spherical structure is described comprising a plurality of filament band sets disposed about the surface of a mandrel with each band of each set formed of a continuous filament circumferentially wound about the mandrel a selected number of circuits and with each circuit of filament being wound parallel to and contiguous with an immediate previously wound circuit. Each filament band in each band set is wound at the same helix angle from the axis of revolution of the mandrel and all of the bands of each set are uniformly distributed about the mandrel circumference. The pole-to-equator wall thickness taper associated with each band set, as several contiguous band sets are wound about the mandrel starting at the poles, is accumulative as the band sets are nested to provide a complete filament wound sphere of essentially uniform thickness

[Effects of arnebia root oil on wound healing of rats with full-thickness skin defect and the related mechanism].

Science.gov (United States)

Shen, J Y; Ma, Q; Yang, Z B; Gong, J J; Wu, Y S

2017-09-20

Objective: To observe the effects of arnebia root oil on wound healing of rats with full-thickness skin defect, and to explore the related mechanism. Methods: Eighty SD rats were divided into arnebia root oil group and control group according to the random number table, with 40 rats in each group, then full-thickness skin wounds with area of 3 cm×3 cm were inflicted on the back of each rat. Wounds of rats in arnebia root oil group and control group were treated with sterile medical gauze and bandage package infiltrated with arnebia root oil gauze or Vaseline gauze, respectively, with dressing change of once every two days. On post injury day (PID) 3, 7, 14, and 21, 10 rats in each group were sacrificed respectively for general observation and calculation of wound healing rate. The tissue samples of unhealed wound were collected for observation of histomorphological change with HE staining, observation of expressions of vascular endothelial growth factor (VEGF) and basic fibroblast growth factor (bFGF) with immunohistochemical staining, and determination of mRNA expressions of VEGF and bFGF with real time fluorescent quantitive reverse transcription polymerase chain reaction. Data were processed with analysis of variance of factorial design, t test, and Bonferroni correction. Results: (1) On PID 3, there were a few secretions in wounds of rats in the two groups. On PID 7, there were fewer secretions and more granulation tissue in wounds of rats in arnebia root oil group, while there were more secretions and less granulation tissue in wounds of rats in control group. On PID 14, most of the wounds of rats in arnebia root oil group were healed and there was much red granulation tissue in unhealed wounds, while part of wounds of rats in control group was healed and there were a few secretions and less granulation tissue in unhealed wounds. On PID 21, wounds of rats in arnebia root oil group were basically healed, while there were still some unhealed wounds of rats in

Consequences of age on ischemic wound healing in rats: altered antioxidant activity and delayed wound closure.

Science.gov (United States)

Moor, Andrea N; Tummel, Evan; Prather, Jamie L; Jung, Michelle; Lopez, Jonathan J; Connors, Sarah; Gould, Lisa J

2014-04-01

Advertisements targeted at the elderly population suggest that antioxidant therapy will reduce free radicals and promote wound healing, yet few scientific studies substantiate these claims. To better understand the potential utility of supplemental antioxidant therapy for wound healing, we tested the hypothesis that age and tissue ischemia alter the balance of endogenous antioxidant enzymes. Using a bipedicled skin flap model, ischemic and non-ischemic wounds were created on young and aged rats. Wound closure and the balance of the critical antioxidants superoxide dismutase and glutathione in the wound bed were determined. Ischemia delayed wound closure significantly more in aged rats. Lower superoxide dismutase 2 and glutathione in non-ischemic wounds of aged rats indicate a basal deficit due to age alone. Ischemic wounds from aged rats had lower superoxide dismutase 2 protein and activity initially, coupled with decreased ratios of reduced/oxidized glutathione and lower glutathione peroxidase activity. De novo glutathione synthesis, to restore redox balance in aged ischemic wounds, was initiated as evidenced by increased glutamate cysteine ligase. Results demonstrate deficiencies in two antioxidant pathways in aged rats that become exaggerated in ischemic tissue, culminating in profoundly impaired wound healing and prolonged inflammation.

Combat Wound Initiative program.

Science.gov (United States)

Stojadinovic, Alexander; Elster, Eric; Potter, Benjamin K; Davis, Thomas A; Tadaki, Doug K; Brown, Trevor S; Ahlers, Stephen; Attinger, Christopher E; Andersen, Romney C; Burris, David; Centeno, Jose; Champion, Hunter; Crumbley, David R; Denobile, John; Duga, Michael; Dunne, James R; Eberhardt, John; Ennis, William J; Forsberg, Jonathan A; Hawksworth, Jason; Helling, Thomas S; Lazarus, Gerald S; Milner, Stephen M; Mullick, Florabel G; Owner, Christopher R; Pasquina, Paul F; Patel, Chirag R; Peoples, George E; Nissan, Aviram; Ring, Michael; Sandberg, Glenn D; Schaden, Wolfgang; Schultz, Gregory S; Scofield, Tom; Shawen, Scott B; Sheppard, Forest R; Stannard, James P; Weina, Peter J; Zenilman, Jonathan M

2010-07-01

The Combat Wound Initiative (CWI) program is a collaborative, multidisciplinary, and interservice public-private partnership that provides personalized, state-of-the-art, and complex wound care via targeted clinical and translational research. The CWI uses a bench-to-bedside approach to translational research, including the rapid development of a human extracorporeal shock wave therapy (ESWT) study in complex wounds after establishing the potential efficacy, biologic mechanisms, and safety of this treatment modality in a murine model. Additional clinical trials include the prospective use of clinical data, serum and wound biomarkers, and wound gene expression profiles to predict wound healing/failure and additional clinical patient outcomes following combat-related trauma. These clinical research data are analyzed using machine-based learning algorithms to develop predictive treatment models to guide clinical decision-making. Future CWI directions include additional clinical trials and study centers and the refinement and deployment of our genetically driven, personalized medicine initiative to provide patient-specific care across multiple medical disciplines, with an emphasis on combat casualty care.

Wound Healing in Older Adults.

Science.gov (United States)

Gould, Lisa J; Fulton, Ana Tuya

2016-02-01

Impaired wound healing in the elderly represents a major clinical problem that is growing as our population ages. Wound healing is affected by age and by co-morbid conditions, particularly diabetes and obesity. This is particularly important in Rhode Island as the state has a very high percentage of vulnerable older adults. A multi- disciplinary approach that incorporates the skills of a comprehensive wound center with specialized nursing, geriatric medicine and palliative care will facilitate rapid wound healing, reduce costs and improve outcomes for our older adults that suffer from 'problem wounds'.

Apitherapeutics and phage-loaded nanofibers as wound dressings with enhanced wound healing and antibacterial activity.

Science.gov (United States)

Sarhan, Wessam A; Azzazy, Hassan Me

2017-09-01

Develop green wound dressings which exhibit enhanced wound-healing ability and potent antibacterial effects. Honey, polyvinyl alcohol, chitosan nanofibers were electrospun and loaded with bee venom, propolis and/or bacteriophage against the multidrug-resistant Pseudomonas aeruginosa and examined for their antibacterial, wound-healing ability and cytotoxicity. Among different formulations of nanofibers, honey, polyvinyl alcohol, chitosan-bee venom/bacteriophage exhibited the most potent antibacterial activity against all tested bacterial strains (Gram-positive and -negative strains) and achieved nearly complete killing of multidrug-resistant P. aeruginosa. In vivo testing revealed enhanced wound-healing results and cytotoxicity testing proved improved biocompatibility. The developed biocompatible nanofibers represent competitive wound-healing dressings with potent antibacterial and wound-healing activity.

The management of perineal wounds

Directory of Open Access Journals (Sweden)

Ramesh k Sharma

2012-01-01

Full Text Available Management of perineal wounds can be very frustrating as these invariably get contaminated from the ano-genital tracts. Moreover, the apparent skin defect may be associated with a significant three dimensional dead space in the pelvic region. Such wounds are likely to become chronic and recalcitrant if appropriate wound management is not instituted in a timely manner. These wounds usually result after tumor excision, following trauma or as a result of infective pathologies like hideradenitis suppurativa or following thermal burns. Many options are available for management of perineal wounds and these have been discussed with illustrative case examples. A review of literature has been done for listing commonly instituted options for management of the wounds in perineum.

Negative pressure wound therapy via vacuum-assisted closure following partial foot amputation: what is the role of wound chronicity?

Science.gov (United States)

Armstrong, David G; Lavery, Lawrence A; Boulton, Andrew J M

2007-03-01

Randomised clinical trials (RCTs) to evaluate diabetic foot wound therapies have systematically eliminated large acute wounds from evaluation, focusing only on smaller chronic wounds. The purpose of this study was to evaluate the proportion and rate of wound healing in acute and chronic wounds after partial foot amputation in individuals with diabetes treated with negative pressure wound therapy (NPWT) delivered by the vacuum-assisted closure (VAC) device or with standard wound therapy (SWT). This study constitutes a secondary analysis of patients enrolled in a 16-week RCT of NPWT: 162 open foot amputation wounds (mean wound size = 20.7 cm(2)) were included. Acute wounds were defined as the wounds less than 30 days after amputation, whereas chronic wounds as the wounds greater than 30 days. Inclusion criteria consisted of individuals older than 18 years, presence of a diabetic foot amputation wound up to the transmetatarsal level and adequate perfusion. Wound size and healing were confirmed by independent, blinded wound evaluators. Analyses were done on an intent-to-treat basis. There was a significantly higher proportion of acute wounds (SWT = 59; NPWT = 63) than chronic wounds (SWT = 26; NPWT = 14), evaluated in this clinical trial (P = 0.001). There was no significant difference in the proportion of acute and chronic wounds achieving complete wound closure in either treatment group. Despite this finding, the Kaplan-Meier curves demonstrated statistically significantly faster healing in the NPWT group in both acute (P = 0.030) and chronic wounds (P = 0.033). Among the patients treated with NPWT via the VAC, there was not a significant difference in healing as a function of chronicity. In both the acute and the chronic wound groups, results for patients treated with NPWT were superior to those for the patients treated with SWT. These results appear to indicate that wound duration should not deter the clinician from using this modality to treat complex wounds.

Exploring the concept of a team approach to wound care: Managing wounds as a team.

Science.gov (United States)

Moore, Zena; Butcher, Gillian; Corbett, Lisa Q; McGuiness, William; Snyder, Robert J; van Acker, Kristien

2014-05-01

Background - The growing prevalence and incidence of nonhealing acute and chronic wounds is a worrying concern. A major challenge is the lack of united services aimed at addressing the complex needs of individuals with wounds. However, the WHO argues that interprofessional collaboration in education and practice is key to providing the best patient care, enhancing clinical and health-related outcomes and strengthening the health system. It is based on this background that the team approach to wound care project was conceptualised. The project was jointly initiated and realised by the Association for the Advancement of Wound Care (AAWC-USA), the Australian Wound Management Association (AWMA) and the European Wound Management Association (EWMA). Aim - The aim of this project was to develop a universal model for the adoption of a team approach to wound care. Objective The overarching objective of this project was to provide recommendations for implementing a team approach to wound care within all clinical settings and through this to develop a model for advocating the team approach toward decision makers in national government levels. Method An integrative literature review was conducted. Using this knowledge, the authors arrived at a consensus on the most appropriate model to adopt and realise a team approach to wound care. Results - Eighty four articles met the inclusion criteria. Following data extraction, it was evident that none of the articles provided a definition for the terms multidisciplinary, interdisciplinary or transdisciplinary in the context of wound care. Given this lack of clarity within the wound care literature, the authors have here developed a Universal Model for the Team Approach to Wound Care to fill this gap in our current understanding. Conclusion - We advocate that the patient should be at the heart of all decision-making, as working with the Universal Model for the Team Approach to Wound Care begins with the needs of the patient. To

Images of God used by self-injurious burn patients.

Science.gov (United States)

Grossoehme, D H; Springer, L S

1999-08-01

Suicide by burning and other forms of self-injurious behaviors which involve burning are sometimes considered to have religious overtones. The ritual death of widows upon their husband's funeral pyre is closely associated with Hindu beliefs. Buddhists have used self-immolation as a form of protest. The Judaeo-Christian traditions have imagery of fire as cleansing and purifying; there is also secular imagery associating fire with images of condemnation and evil. Previous studies have described religiosity as a common theme among survivors. The present study describes the ways in which persons who inflicted self-injurious behaviors through burning, including attempted suicide, imagine the Divinity and use religious language to give meaning to their experience.

The use of negative pressure wound therapy in the treatment of infected wounds. Case studies

Directory of Open Access Journals (Sweden)

Daniel de Alcântara Jones

Full Text Available ABSTRACT OBJECTIVE: To evaluate the results and benefits obtained from the topical use of negative pressure wound therapy (NPWT in patients with infected wounds. METHODS: This was a retrospective study of 20 patients (17 males and three females, mean age 42 years with infected wounds treated using NPWT. The infected wounds were caused by trauma. The treatment system used was VAC.(r (Vacuum Assisted Closure, KCI, San Antonio, United States applied to the wound in continuous mode from 100 to 125 mmHg. The parameters related to the wounds (location, number of VAC changes, the size of the defects in the soft parts, and the evolution of the state of the wound, length of hospital stay, length of intravenous antibiotic therapy, and complications related to the use of this therapy were evaluated. RESULTS: The mean length of the hospital stay, use of NPWT, and antibacterial therapy were 41 days, 22.5 days, and 20 days respectively. The use of the VAC led to a mean reduction of 29% in the wound area (95.65-68.1 cm2; p < 0.05. Only one patient did not show any improvement in the final appearance of the wound with complete eradication of the infection. No complication directly caused by NPWT was observed. CONCLUSION: NPWT stimulates infection-free scar tissue formation in a short time, and is a quick and comfortable alternative to conventional infected wounds treatment methods.

Lower limb revascularisation preceding surgical wound coverage - an interdisciplinary algorithm for chronic wound closure.

Science.gov (United States)

Aust, M C; Spies, M; Guggenheim, M; Gohritz, A; Kall, S; Rosenthal, H; Pichlmaier, M; Oehlert, G; Vogt, P M

2008-08-01

Chronic wounds may occur or persist due to arterial insufficiency. Despite the high prevalence of arterial occlusive disease, a search of the literature has yielded a paucity of data on the benefit of interventions to recanalise lower extremity arteries prior to surgical closure of chronic wounds. To investigate the correlation of simple clinical examinations and apparative diagnostics for the detection of arterial occlusive disease of the lower extremity in patients with chronic wounds, and to evaluate the benefit of vascular procedures to optimise wound perfusion before surgical closure. During a 6-year period, 150 patients with chronic lower extremity wounds (no healing for more than 30 days) were included into this prospective study. All patients underwent palpation of foot pulses, Doppler sonography and measurement of occlusive pressures. Positive clinical findings were re-evaluated by angiography. All patients with peripheral extremity vessel occlusions underwent vascular interventions (percutaneous transluminal angioplasty with stenting, open thrombectomy or vascular bypass surgery) prior to surgical wound closure. In all 34 patients (21%) with missing foot pulses, suspicious Doppler signals or pathological occlusive pressure measurements, the clinical diagnosis of arterial occlusion was confirmed by angiography. An arterial pathology had previously been diagnosed in merely two of those patients. Nineteen patients underwent percutaneous transluminal angioplasty and 21 stents were implanted; in 10 cases, open thrombectomy or vascular bypasses were performed. In all 34 patients, sufficient peripheral recanalisation and improved wound perfusion were successfully achieved. For definitive wound closure, microsurgical tissue transplantation was performed in 15 patients. Angiography was performed prior to surgery. In 11 patients, regional or local flaps were used. Six patients received split skin grafting only; two wounds healed conservatively following vascular

Riflery: A Specialty Opportunity for Camp.

Science.gov (United States)

Pulliam, Richard

1997-01-01

Campers at the Virginia 4-H Shooting Education Camp receive intensive training from certified range coaches in shotgun, rifle, air rifle, air pistol, and archery. Such programs teach campers responsibility; develop character and self-concept; and promote safety, sportsmanship, and ethical behavior. Includes resources for developing a shooting…

Wound Healing Effects of Rose Placenta in a Mouse Model of Full-Thickness Wounds

Directory of Open Access Journals (Sweden)

Yang Woo Kim

2015-11-01

Full Text Available BackgroundRosa damascena, a type of herb, has been used for wound healing in Eastern folk medicine. The goal of this study was to evaluate the effectiveness of rose placenta from R. damascena in a full-thickness wound model in mice.MethodsSixty six-week-old C57BL/6N mice were used. Full-thickness wounds were made with an 8-mm diameter punch. Two wounds were made on each side of the back, and wounds were assigned randomly to the control and experimental groups. Rose placenta (250 µg was injected in the experimental group, and normal saline was injected in the control group. Wound sizes were measured with digital photography, and specimens were harvested. Immunohistochemical staining was performed to assess the expression of epidermal growth factor (EGF, vascular endothelial growth factor (VEGF, transforming growth factor-β1 (TGF-β1, and CD31. Vessel density was measured. Quantitative analysis using an enzyme-linked immunosorbent assay (ELISA for EGF was performed. All evaluations were performed on postoperative days 0, 2, 4, 7, and 10. Statistical analyses were performed using the paired t-test.Results On days 4, 7, and 10, the wounds treated with rose placenta were significantly smaller. On day 2, VEGF and EGF expression increased in the experimental group. On days 7 and 10, TGF-β1 expression decreased in the experimental group. On day 10, vessel density increased in the experimental group. The increase in EGF on day 2 was confirmed with ELISA.ConclusionsRose placenta was found to be associated with improved wound healing in a mouse full-thickness wound model via increased EGF release. Rose placenta may potentially be a novel drug candidate for enhancing wound healing.

Validation of a laser-assisted wound measurement device in a wound healing model.

Science.gov (United States)

Constantine, Ryan S; Bills, Jessica D; Lavery, Lawrence A; Davis, Kathryn E

2016-10-01

In the treatment and monitoring of a diabetic or chronic wound, accurate and repeatable measurement of the wound provides indispensable data for the patient's medical record. This study aims to measure the accuracy of the laser-assisted wound measurement (LAWM) device against traditional methods in the measurement of area, depth and volume. We measured four 'healing' wounds in a Play-Doh(®) -based model over five subsequent states of wound healing progression in which the model was irregularly filled in to replicate the healing process. We evaluated the LAWM device against traditional methods including digital photograph assessment with National Institutes of Health ImageJ software, measurements of depth with a ruler and weight-to-volume assessment with dental paste. Statistical analyses included analysis of variance (ANOVA) and paired t-tests. We demonstrate that there are significantly different and nearly statistically significant differences between traditional ruler depth measurement and LAWM device measurement, but there are no statistically significant differences in area measurement. Volume measurements were found to be significantly different in two of the wounds. Rate of percentage change was analysed for volume and depth in the wound healing model, and the LAWM device was not significantly different than the traditional measurement technique. While occasionally inaccurate in its absolute measurement, the LAWM device is a useful tool in the clinician's arsenal as it reliably measures rate of percentage change in depth and volume and offers a potentially aseptic alternative to traditional measurement techniques. © 2014 The Authors. International Wound Journal © 2014 Medicalhelplines.com Inc and John Wiley & Sons Ltd.

Predicting complex acute wound healing in patients from a wound expertise centre registry: a prognostic study

NARCIS (Netherlands)

Ubbink, Dirk T.; Lindeboom, Robert; Eskes, Anne M.; Brull, Huub; Legemate, Dink A.; Vermeulen, Hester

2015-01-01

It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We

Predicting complex acute wound healing in patients from a wound expertise centre registry : a prognostic study

NARCIS (Netherlands)

Ubbink, Dirk T; Lindeboom, Robert; Eskes, Anne M; Brull, Huub; Legemate, Dink A; Vermeulen, Hester

2015-01-01

It is important for caregivers and patients to know which wounds are at risk of prolonged wound healing to enable timely communication and treatment. Available prognostic models predict wound healing in chronic ulcers, but not in acute wounds, that is, originating after trauma or surgery. We

Sinonasal Epithelial Wound Resealing in an In Vitro Model: Inhibition of Wound Closure with IL-4 Exposure

Science.gov (United States)

Wise, Sarah K.; Den Beste, Kyle A.; Hoddeson, Elizabeth K.; Parkos, Charles A.; Nusrat, Asma

2013-01-01

Background Prolonged healing and persistent inflammation following surgery for rhinosinusitis impacts patient satisfaction and healthcare resources. Cytokines interleukin (IL)-4, 5, and 13 are important mediators in Th2 inflammatory rhinosinusitis. Decreased wound healing has been demonstrated with Th2 cytokine exposure, but this has not been extensively studied in sinonasal epithelium. We hypothesized that in vitro exposure of primary sinonasal epithelial cell cultures to Th2 inflammatory cytokine IL-4 and IL-13 would impair wound resealing and decrease expression of annexin A2 at the wound edge. Methods Following 24-hour exposure to IL-4, 5, or 13 versus controls, sterile linear mechanical wounds were created in primary sinonasal epithelial cultures (n = 12 wounds per condition). Wounds were followed for 36 hours or until complete closure and residual wound areas were calculated by image analysis. Group differences in annexin A2 were assessed by immunofluorescence labeling, confocal microscopy, and Western blots. Results Significant wound closure differences were identified across cytokine exposure groups (pprotein levels were decreased in IL-4 treated wounds when compared to control wounds (p<0.01). Conclusions Th2 cytokine IL-4 decreases sinonasal epithelial wound closure in vitro. Annexin A2 is also diminished with IL-4 exposure. This supports the hypothesis that IL-4 exposure impairs sinonasal epithelial wound healing and may contribute to prolonged healing in Th2 inflammatory rhinosinusitis. PMID:23468432

In vivo performance of chitosan/soy-based membranes as wound-dressing devices for acute skin wounds.

Science.gov (United States)

Santos, Tírcia C; Höring, Bernhard; Reise, Kathrin; Marques, Alexandra P; Silva, Simone S; Oliveira, Joaquim M; Mano, João F; Castro, António G; Reis, Rui L; van Griensven, Martijn

2013-04-01

Wound management represents a major clinical challenge on what concerns healing enhancement and pain control. The selection of an appropriate dressing plays an important role in both recovery and esthetic appearance of the regenerated tissue. Despite the wide range of available dressings, the progress in the wound care market relies on the increasing interest in using natural-based biomedical products. Herein, a rat wound-dressing model of partial-thickness skin wounds was used to study newly developed chitosan/soy (cht/soy)-based membranes as wound-dressing materials. Healing and repair of nondressed, cht/soy membrane-dressed, and Epigard(®)-dressed wounds were followed macroscopically and histologically for 1 and 2 weeks. cht/soy membranes performed better than the controls, promoting a faster wound repair. Re-epithelialization, observed 1 week after wounding, was followed by cornification of the outermost epidermal layer at the second week of dressing, indicating repair of the wounded tissue. The use of this rodent model, although in impaired healing conditions, may enclose some drawbacks regarding the inevitable wound contraction. Moreover, being the main purpose the evaluation of cht/soy-based membranes' performance in the absence of growth factors, the choice of a clinically relevant positive control was limited to a polymeric mesh, without any growth factor influencing skin healing/repair, Epigard. These new cht/soy membranes possess the desired features regarding healing/repair stimulation, ease of handling, and final esthetic appearance-thus, valuable properties for wound dressings.

Venous ulcers -- self-care

Science.gov (United States)

... surgery to improve blood flow through your veins. Prevention If you are at risk for venous ulcers, take the steps listed above under Wound Care. ... weight if you are overweight. Manage your blood pressure and cholesterol levels. ... Venous leg ulcers - self-care; Venous insufficiency ulcers - self-care; Stasis ...

Aloe vera and Vitis vinifera improve wound healing in an in vivo rat burn wound model.

Science.gov (United States)

Lin, Li-Xin; Wang, Peng; Wang, Yu-Ting; Huang, Yong; Jiang, Lei; Wang, Xue-Ming

2016-02-01

Aloe vera and Vitis vinifera have been traditionally used as wound healing agents. The present study aimed to investigate the effects of aloe emodin and resveratrol in the burn wound healing procedure. Burn wounds are common in developed and developing countries, however, in developing countries, the incidence of severe complications is higher and financial resources are limited. The results of the present study demonstrated that neither aloe emodin or resveratrol were cytotoxic to THP-1 macrophages at concentrations of 1, 100 and 500 ng/ml. A significant increase in wound-healing activity was observed in mice treated with the aloe emodin and resveratrol, compared with those which received control treatments. The levels of IL-1β in the exudates of the burn wound area of the treated mice increased in a time-dependent manner over 7 days following burn wound injury. At 10 days post-injury, steady and progressive wound healing was observed in the control animals. The present study confirmed that increased wound healing occurs following treatment with aloe emodin,, compared with resveratrol, providing support for the use of Aloe vera plants to improve burn wound healing.

Negative Pressure Wound Therapy in Maxillofacial Applications

Directory of Open Access Journals (Sweden)

Adam J. Mellott

2016-09-01

Full Text Available Negative pressure wound therapy has greatly advanced the field of wound healing for nearly two decades, by providing a robust surgical adjunct technique for accelerating wound closure in acute and chronic wounds. However, the application of negative pressure wound therapy in maxillofacial applications has been relatively under utilized as a result of the physical articulations and contours of the head and neck that make it challenging to obtain an airtight seal for different negative pressure wound therapy systems. Adapting negative pressure wound therapies for maxillofacial applications could yield significant enhancement of wound closure in maxillofacial applications. The current review summarizes the basic science underlying negative pressure wound therapy, as well as specific maxillofacial procedures that could benefit from negative pressure wound therapy.

Guanidine hydrochloride embedded polyurethanes as antimicrobial and absorptive wound dressing membranes with promising cytocompatibility

Energy Technology Data Exchange (ETDEWEB)

Sahraro, Maryam; Yeganeh, Hamid, E-mail: h.yeganeh@ippi.ac.ir; Sorayya, Marziyeh

2016-02-01

Preparation and assessments of novel absorptive wound dressing materials with efficient antimicrobial activity as well as very good cytocompatibility were described in this work. An amine terminated poly(hexamethylene guanidine hydrochloride) was prepared and used as curing agent of different epoxy-terminated polyurethane prepolymers. The structures of prepared materials were elucidated by evaluation of their {sup 1}H NMR and FTIR spectra. The recorded tensile strength of membranes confirmed the excellent dimensional stability of the film type dressings even at fully hydrated conditions. Therefore, these dressings could protect the wound bed from external forces during the healing period. The structurally optimized dressing membranes could preserve the desired moist environment over the wounded area, as a result of their balanced equilibrium, water absorption and water vapor transmission rate. Therefore, a very good condition for stimulation of self-healing of wound bed was attained. Also, owing to the presence of guanidine hydrochloride moieties embedded into the structure of dressings, efficient antimicrobial activity against Staphylococcus aureus, Pseudomonas aeruginosa and Candida albicans were detected. In vitro cytotoxicity assay of the prepared dressings revealed cytocompatibility of these materials against fibroblast cells. Therefore, they could support cell growth and proliferation at the wounded area. - Highlights: • New polyurethane wound dressings with guanidine hydrochloride based antimicrobials • Maintaining moist and warm wound environment for accelerating healing • Proper tensile strength of dressings even at fully hydrated state • Excellent biocompatibility index due to proper selection of starting materials.

Scalp Wound Closure with K wires: An alternative easier method to scalp wound closure.

Science.gov (United States)

Ramesh, S; Ajik, S

2012-12-01

Scalp defects and lacerations present a reconstructive challenge to plastic surgeons. Many methods have been described from the use of skin grafting to rotation flaps. Here we present a method of closure of a contaminated scalp wound with the use of Kirschner wires. In our case, closure of scalp laceration was made possible with the use of 1.4 Kirschner wires and cable tie/ zip tie fasteners. The duration to closure of wound was 10 days. In reconstructing the scalp defect, this method was found to adhere to principles of scalp reconstruction. There were no post operative complications found from the procedure. On initial application on the edge of the wound, tension applied caused the K wires to cut through the wound edge. On replacement of K wires 1cm away from wound edge the procedure was not plagued by any further complication. In conclusion we find scalp closure with Kirschner wires are a simple and effective method for scalp wound closure.

Bacterial Contribution in Chronicity of Wounds.

Science.gov (United States)

Rahim, Kashif; Saleha, Shamim; Zhu, Xudong; Huo, Liang; Basit, Abdul; Franco, Octavio Luiz

2017-04-01

A wound is damage of a tissue usually caused by laceration of a membrane, generally the skin. Wound healing is accomplished in three stages in healthy individuals, including inflammatory, proliferative, and remodeling stages. Healing of wounds normally starts from the inflammatory phase and ends up in the remodeling phase, but chronic wounds remain in an inflammatory stage and do not show progression due to some specific reasons. Chronic wounds are classified in different categories, such as diabetic foot ulcer (DFU), venous leg ulcers (VLU) and pressure ulcer (PU), surgical site infection (SSI), abscess, or trauma ulcers. Globally, the incidence rate of DFU is 1-4 % and prevalence rate is 5.3-10.5 %. However, colonization of pathogenic bacteria at the wound site is associated with wound chronicity. Most chronic wounds contain more than one bacterial species and produce a synergetic effect that results in previously non-virulent bacterial species becoming virulent and causing damage to the host. While investigating bacterial diversity in chronic wounds, Staphylococcus, Pseudomonas, Peptoniphilus, Enterobacter, Stenotrophomonas, Finegoldia, and Serratia were found most frequently in chronic wounds. Recently, it has been observed that bacteria in chronic wounds develop biofilms that contribute to a delay in healing. In a mature biofilm, bacteria grow slowly due to deficiency of nutrients that results in the resistance of bacteria to antibiotics. The present review reflects the reasons why acute wounds become chronic. Interesting findings include the bacterial load, which forms biofilms and shows high-level resistance toward antibiotics, which is a threat to human health in general and particularly to some patients who have acute wounds.

risk factors for wound dehiscence

African Journals Online (AJOL)

group B included 17 patients (minor wound dehiscence,. 26.98%), and group C ... Conclusion With regard to the wound complications following the repair of .... appear to add extra protection for wound healing. (Table 1). Median time to ...

Modeling of anisotropic wound healing

Science.gov (United States)

Valero, C.; Javierre, E.; García-Aznar, J. M.; Gómez-Benito, M. J.; Menzel, A.

2015-06-01

Biological soft tissues exhibit non-linear complex properties, the quantification of which presents a challenge. Nevertheless, these properties, such as skin anisotropy, highly influence different processes that occur in soft tissues, for instance wound healing, and thus its correct identification and quantification is crucial to understand them. Experimental and computational works are required in order to find the most precise model to replicate the tissues' properties. In this work, we present a wound healing model focused on the proliferative stage that includes angiogenesis and wound contraction in three dimensions and which relies on the accurate representation of the mechanical behavior of the skin. Thus, an anisotropic hyperelastic model has been considered to analyze the effect of collagen fibers on the healing evolution of an ellipsoidal wound. The implemented model accounts for the contribution of the ground matrix and two mechanically equivalent families of fibers. Simulation results show the evolution of the cellular and chemical species in the wound and the wound volume evolution. Moreover, the local strain directions depend on the relative wound orientation with respect to the fibers.

Smoking synthetic marijuana leads to self-mutilation requiring bilateral amputations.

Science.gov (United States)

Meijer, Karim A; Russo, Russell R; Adhvaryu, Dhaval V

2014-04-01

Synthetic cannabinoids have become a worldwide epidemic because they provide a sometimes legal, easily accessible, and presumably safe alternative to marijuana. Recently published reports have linked acute psychosis, myocardial infarctions, convulsions, self-harm, and even terrorist organizations to these designer substances. This case report outlines the first reported case of Black Diamond, a synthetic cannabis, leading to a self-inflicted burn to the bilateral upper extremities requiring a transradial amputation of the right arm and a toe transfer procedure of the left hand after loss of all digits. The patient presented to the emergency department with self-inflicted fourth-degree burns to the bilateral hands and forearms with second-degree burns of the face, for a total body surface area of 14.5%. The patient was found by firefighters with his hands aflame on his kitchen stove. With no previous medical or psychiatric history and collateral information to confirm the patient's mental status prior to use of Black Diamond, the patient's acute psychotic episode was attributed to Black Diamond. After multiple procedures and a lengthy recovery, the patient completed his post-graduate education and entered the professional world. As orthopedic surgeons, we should be involved in educating the public on the harm of these designer drugs, including self-mutilation. The popularity of synthetic drugs in the United States will continue to present a major challenge to all health care providers. Orthopedists are on the front lines of this epidemic because these drugs push patients into risky, traumatic behavior. Copyright 2014, SLACK Incorporated.

Enzymatic wound debridement; role of papaya in the management of post cesarean gaped wounds

International Nuclear Information System (INIS)

Nisa, M.U.

2012-01-01

Background: Enzymatic wound debridement is an emerging concept in facilitating the wound healing process. Papaya has de-sloughing, antibacterial and wound healing properties. It has been used in African countries since centuries for different medicinal pur-poses. Apart from anecdotal reports and few studies on chronic ulcers and burns, no planned studies are available to support its action in postoperative wound infection.Objectives: To compare efficacy and safety of papaya dressing with conventional wound dressing with povidone iodine in post cesarean section gaped wounds. Setting: Gynecology Unit 3, Sir Ganga Ram Hospital Lahore - Pakistan, over a period of six months(June 2012 to Nov 2012). Study Design: Randomized, quasi experimental stu-dy. Materials and Methods: The study sample included 60 patients with post cesarean section gaped wounds. The sample was divided into two groups; thirty patients as Group A or the study group received Papaya dressing and rest of thirty patients as Group B or the control group received Povidone iodine dressing. Wounds were thoroughly washed with saline and then mashed unripe papaya was spread over the whole area of wound in the study group and povidone iodine in the control group. Wounds were covered with sterile bandage for at least 48 hours in study group and 24 hours in the control group. The process was repeated till a clean base of wound with healthy granulation tis-sue was achieved suitable for secondary suture. The efficacy parameters studied were the duration of time needed to develop healthy granulation tissue and total duration of hospital stay which were compared bet-ween the two groups. Safety factors studied were the adverse effects of medications used in the study. Results: Out of 1200 cesarean sections done during study period, sixty (5%) were gaped in the post-operative period. Out of 60, 55 (90%) were emergency and only 5 (10%) were elective cesarean sections. All the sixty patients with postoperative gaped

Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

Directory of Open Access Journals (Sweden)

Moris Topaz

2012-01-01

Full Text Available Regulated negative pressure-assisted wound therapy (RNPT should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

Preclinical Evaluation of Tegaderm™ Supported Nanofibrous Wound Matrix Dressing on Porcine Wound Healing Model.

Science.gov (United States)

Ong, Chee Tian; Zhang, Yanzhong; Lim, Raymond; Samsonraj, Rebekah; Masilamani, Jeyakumar; Phan, Tran Hong Ha; Ramakrishna, Seeram; Lim, Ivor; Kee, Irene; Fahamy, Mohammad; Templonuevo, Vilma; Lim, Chwee Teck; Phan, Toan Thang

2015-02-01

Objective: Nanofibers for tissue scaffolding and wound dressings hold great potential in realizing enhanced healing of wounds in comparison with conventional counterparts. Previously, we demonstrated good fibroblast adherence and growth on a newly developed scaffold, Tegaderm™-Nanofiber (TG-NF), made from poly ɛ-caprolactone (PCL)/gelatin nanofibers electrospun onto Tegaderm (TG). The purpose of this study is to evaluate the performance and safety of TG-NF dressings in partial-thickness wound in a pig healing model. Approach: To evaluate the rate of reepithelialization, control TG, human dermal fibroblast-seeded TG-NF(+) and -unseeded TG-NF(-) were randomly dressed onto 80 partial-thickness burns created on four female and four male pigs. Wound inspections and dressings were done after burns on day 7, 14, 21, and 28. On day 28, full-thickness biopsies were taken for histopathological evaluation by Masson-Trichrome staining for collagen and hematoxylin-eosin staining for cell counting. Results: No infection and severe inflammation were recorded. Wounds treated with TG-NF(+) reepithelialized significantly faster than TG-NF(-) and control. Wound site inflammatory responses to study groups were similar as total cell counts on granulation tissues show no significant differences. Most of the wounds completely reepithelialized by day 28, except for two wounds in control and TG-NF(-). A higher collagen coverage was also recorded in the granulation tissues treated with TG-NF(+). Innovation and Conclusion: With better reepithelialization achieved by TG-NF(+) and similar rates of wound closure by TG-NF(-) and control, and the absence of elevated inflammatory responses to TG-NF constructs, TG-NF constructs are safe and demonstrated good healing potentials that are comparable to Tegaderm.

Morphological analysis of three wound-cleaning processes on potentially contamined wounds in rats

Directory of Open Access Journals (Sweden)

d'Acampora Armando José

2006-01-01

Full Text Available PURPOSE: To evaluate the inflammatory response of potentially infected wounds treated with isotonic saline solution, chlorhexidine and PVP-I, seven days after surgery. METHODS: Thirty-two male rats were used, divided into 4 groups. All animals had their surgical wounds infected with a standard bacterial inoculum. Control group (A: animals had their surgical wounds sutured without any kind of cleaning. Saline solution group (B: animals had their wounds cleaned with saline solution. Chlorhexidine group (C: animals had their wounds cleaned with chlorhexidine. PVP-I group (D: animals had their wounds cleaned with PVP-I. Seven days after surgery, all the animals had their skin submitted to microscopic and macroscopic evaluation. RESULTS: Edema was found on all histological slices analyzed, as well as vascular proliferation and congestion. Groups A and D showed presence of mild neutrophilic infiltrate, and moderate lymphocytic and macrophage infiltrate. Group B showed severe neutrophilic, macrophage, and lymphocytic infiltrate. Group C showed moderate neutrophilic, macrophage, and lymphocytic infiltrate. CONCLUSION: Group D was the group which showed inflammatory infiltrate most similar to the group that was not submitted to treatment.

Innate Defense Regulator Peptide 1018 in Wound Healing and Wound Infection

DEFF Research Database (Denmark)

Steinstraesser, Lars; Hirsch, Tobias; Schulte, Matthias

2012-01-01

-37 or HB-107. Furthermore, administration of IDR-1018 resulted in a dose-dependent increase in fibroblast cellular respiration. In vivo, IDR-1018 demonstrated significantly accelerated wound healing in S. aureus infected porcine and non-diabetic but not in diabetic murine wounds. However...

Assessment of Severe Extremity Wound Bioburden at the Time of Definitive Wound Closure or Coverage: Correlation With Subsequent Postclosure Deep Wound Infection (Bioburden Study).

Science.gov (United States)

Bosse, Michael J; Murray, Clinton K; Carlini, Anthony R; Firoozabadi, Reza; Manson, Theodore; Scharfstein, Daniel O; Wenke, Joseph C; Zadnik, Mary; Castillo, Renan C

2017-04-01

Infection remains the most common and significant complication after high-energy fractures. The Bioburden Study is a multicenter, prospective, observational cohort study of wound bacterial bioburden and antibiotic care in severe open lower extremity fractures. The aims of this study are to (1) characterize the contemporary extremity wound "bioburden" at the time of definitive wound closure; (2) determine the concordance between polymerase chain reaction results and hospital microbiology; (3) determine, among those who develop deep infections, the concordance between the pathogens at wound closure and at deep infection; and (4) compare the probability of deep infection between those who did and did not receive an appropriate course of antibiotics based on bioburden at the time of wound closure. To address these aims, sites collected tissue samples from severe lower extremity injuries at the time of wound closure and at first surgery for treatment of a deep infection, nonunion, flap failure, amputation, or other complications (because these surgeries may be due to undetected infection). Otherwise, if no further surgical treatment occurred, participants were followed for 12 months. The study was conducted at 38 US trauma centers and has enrolled 655 participants aged 18-64 years. This is the first large multi-institutional study evaluating the wound bioburden of severe open tibia fractures and correlating this bioburden with the risk of wound complications after definitive soft tissue closure.

Mineral transformation and biomass accumulation associated with uranium bioremediation at Rifle, Colorado.

Science.gov (United States)

Li, Li; Steefel, Carl I; Williams, Kenneth H; Wilkins, Michael J; Hubbard, Susan S

2009-07-15

Injection of organic carbon into the subsurface as an electron donor for bioremediation of redox-sensitive contaminants like uranium often leads to mineral transformation and biomass accumulation, both of which can alter the flow field and potentially bioremediation efficacy. This work combines reactive transport modeling with a column experiment and field measurements to understand the biogeochemical processes and to quantify the biomass and mineral transformation/accumulation during a bioremediation experiment at a uranium contaminated site near Rifle, Colorado. We use the reactive transport model CrunchFlow to explicitly simulate microbial community dynamics of iron and sulfate reducers, and their impacts on reaction rates. The column experiment shows clear evidence of mineral precipitation, primarily in the form of calcite and iron monosulfide. At the field scale, reactive transport simulations suggest that the biogeochemical reactions occur mostly close to the injection wells where acetate concentrations are highest, with mineral precipitate and biomass accumulation reaching as high as 1.5% of the pore space. This work shows that reactive transport modeling coupled with field data can bean effective tool for quantitative estimation of mineral transformation and biomass accumulation, thus improving the design of bioremediation strategies.

Antibiofilm Efficacy of DispersinB Wound Spray Used in Combination with a Silver Wound Dressing

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Purushottam V. Gawande

2014-01-01

Full Text Available Chronic wounds including diabetic foot ulcers, pressure ulcers, and venous leg ulcers are a worldwide health problem. As the traditional methods of treatment have proven ineffective against chronic wounds involving biofilms, there is an unmet clinical need for developing products with an antibiofilm component that inhibits and/or disrupts biofilms and thus make the biofilm-embedded bacteria more susceptible to antimicrobial therapy. We developed a DispersinB® antibiofilm enzyme-based wound spray for treating chronic wounds in conjunction with an antimicrobial. Under in vitro conditions, the DispersinB® and Acticoat™ combination performed significantly better ( P < 0.05 than Acticoat™ alone, indicating the synergy between the two compounds because of DispersinB® enhancing the antimicrobial activity of Acticoat™. Furthermore, DispersinB® wound spray enhanced the antimicrobial activity of Acticoat™ in a chronic wound mouse model of methicillin-resistant Staphylococcus aureus (MRSA infection. Thus, this novel combination of DispersinB® and Acticoat™, an antimicrobial dressing, prompts clinical evaluation for potential applications in biofilm-based chronic wound management.

Initial Management of Traumatic Wounds.

Science.gov (United States)

Devriendt, Nausikaa; de Rooster, Hilde

2017-11-01

When traumatic wounds are quickly and accurately treated, morbidity and costs can be significantly decreased. Several factors, such as time delay between injury and treatment, the degree of contamination, extension and depth of the wound, and the mechanism of injury, influence the treatment and prognosis and stress the importance of a patient-specific approach. Although all traumatic wounds are contaminated, antibiotic therapy is seldom required if correct wound management is installed. Copyright © 2017 Elsevier Inc. All rights reserved.

Mechanical states in wound capacitors

International Nuclear Information System (INIS)

Allen, J.J.; Reuter, R.C. Jr.

1989-01-01

The winding process is encountered frequently in manufacturing, such as winding of polymer films and paper, laminated pressure vessel construction, and the manufacture of wound capacitors. The winding of capacitors will typically involve hundreds of plies of conductor and dielectric wound over a core. Due to the large number of layers, the calculation of the mechanical studies within a wound capacitor is a significant computational task. The focus of Part II of this paper is the formulation and application of optimization techniques for the design of wound capacitors. The design criteria to be achieved is a specified uniform wound tension in a capacitor. The paper will formulate an optimization statement of the wound capacitor design problem, develop a technique for reducing the numerical calculation required to repeatedly analyze the capacitor as required by the optimization algorithm, and apply the technique to an example. 4 refs., 13 figs., 4 tabs

Incisional Negative Pressure Wound Therapy

DEFF Research Database (Denmark)

Hyldig, Nana

the rate of surgical wound infection and wound exudate post-caesarean and that wound infection had a negative impact on quality of life one month after surgery. Alongside the clinical trial, a trial-based cost-effectiveness analysis demonstrated that the treatment is cost-effective in a high......Women with a pre-gestational body mass index (BMI) above 30 kg/m2 giving birth by caesarean section are at high risk of surgical wound infection compared with women with a BMI below 30 kg/m2. Incisional Negative Pressure Wound Therapy (iNPWT) is one strategy to reduce the rate of surgical wound...... a randomised controlled trial in two tertiary and three teaching hospitals in three regions of Denmark, the Happy Belly Study, investigating the effectiveness of iNPWT in a population of obese women after caesarean section. The Happy Belly Study has demonstrated that prophylactic iNPWT significantly reduced...

Wound healing in animal models: review article

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Fariba Jaffary

2017-10-01

Full Text Available Wound healing and reduction of its recovery time is one of the most important issues in medicine. Wound is defined as disruption of anatomy and function of normal skin. This injury could be the result of physical elements such as  surgical incision, hit or pressure cut of the skin and gunshot wound. Chemical or caustic burn is another category of wound causes that can be induced by acid or base contact irritation. Healing is a process of cellular and extracellular matrix interactions that occur in the damaged tissue. Wound healing consists of several stages including hemostasis, inflammatory phase, proliferative phase and new tissue formation which reconstructs by new collagen formation. Wounds are divided into acute and chronic types based on their healing time. Acute wounds have sudden onset and in normal individuals usually have healing process of less than 4 weeks without any residual side effects. In contrast, chronic wounds have gradual onset. Their inflammatory phase is prolonged and the healing process is stopped due to some background factors like diabetes, ischemia or local pressure. If the healing process lasts more than 4 weeks it will be classified as chronic wound. Despite major advances in the treatment of wounds, still finding effective modalities for healing wounds in the shortest possible time with the fewest side effects is a current challenge. In this review different phases of wound healing and clinical types of wound such as venous leg ulcer, diabetic foot ulcer and pressure ulcer are discussed. Also acute wound models (i.e burn wounds or incisional wound and chronic wound models (such as venous leg ulcers, diabetic foot ulcer, pressure ulcers or bedsore in laboratory animals are presented. This summary can be considered as a preliminary step to facilitate designing of more targeted and applied research in this area.

The electric field near human skin wounds declines with age and provides a noninvasive indicator of wound healing.

Science.gov (United States)

Nuccitelli, Richard; Nuccitelli, Pamela; Li, Changyi; Narsing, Suman; Pariser, David M; Lui, Kaying

2011-01-01

Due to the transepidermal potential of 15-50 mV, inside positive, an injury current is driven out of all human skin wounds. The flow of this current generates a lateral electric field within the epidermis that is more negative at the wound edge than at regions more lateral from the wound edge. Electric fields in this region could be as large as 40 mV/mm, and electric fields of this magnitude have been shown to stimulate human keratinocyte migration toward the wounded region. After flowing out of the wound, the current returns through the space between the epidermis and stratum corneum, generating a lateral field above the epidermis in the opposite direction. Here, we report the results from the first clinical trial designed to measure this lateral electric field adjacent to human skin wounds noninvasively. Using a new instrument, the Dermacorder®, we found that the mean lateral electric field in the space between the epidermis and stratum corneum adjacent to a lancet wound in 18-25-year-olds is 107-148 mV/mm, 48% larger on average than that in 65-80-year-olds. We also conducted extensive measurements of the lateral electric field adjacent to mouse wounds as they healed and compared this field with histological sections through the wound to determine the correlation between the electric field and the rate of epithelial wound closure. Immediately after wounding, the average lateral electric field was 122 ± 9 mV/mm. When the wound is filled in with a thick, disorganized epidermal layer, the mean field falls to 79 ± 4 mV/mm. Once this epidermis forms a compact structure with only three cell layers, the mean field is 59 ± 5 mV/mm. Thus, the peak-to-peak spatial variation in surface potential is largest in fresh wounds and slowly declines as the wound closes. The rate of wound healing is slightly greater when wounds are kept moist as expected, but we could find no correlation between the amplitude of the electric field and the rate of wound

Effects of topical negative pressure therapy on tissue oxygenation and wound healing in vascular foot wounds.

Science.gov (United States)

Chiang, Nathaniel; Rodda, Odette A; Sleigh, Jamie; Vasudevan, Thodur

2017-08-01

Topical negative pressure (TNP) therapy is widely used in the treatment of acute wounds in vascular patients on the basis of proposed multifactorial benefits. However, numerous recent systematic reviews have concluded that there is inadequate evidence to support its benefits at a scientific level. This study evaluated the changes in wound volume, surface area, depth, collagen deposition, and tissue oxygenation when using TNP therapy compared with traditional dressings in patients with acute high-risk foot wounds. This study was performed with hospitalized vascular patients. Forty-eight patients were selected with an acute lower extremity wound after surgical débridement or minor amputation that had an adequate blood supply without requiring further surgical revascularization and were deemed suitable for TNP therapy. The 22 patients who completed the study were randomly allocated to a treatment group receiving TNP or to a control group receiving regular topical dressings. Wound volume and wound oxygenation were analyzed using a modern stereophotographic wound measurement system and a hyperspectral transcutaneous oxygenation measurement system, respectively. Laboratory analysis was conducted on wound biopsy samples to determine hydroxyproline levels, a surrogate marker to collagen. Differences in clinical or demographic characteristics or in the location of the foot wounds were not significant between the two groups. All patients, with the exception of two, had diabetes. The two patients who did not have diabetes had end-stage renal failure. There was no significance in the primary outcome of wound volume reduction between TNP and control patients on day 14 (44.2% and 20.9%, respectively; P = .15). Analyses of secondary outcomes showed a significant result of better healing rates in the TNP group by demonstrating a reduction in maximum wound depth at day 14 (36.0% TNP vs 17.6% control; P = .03). No significant findings were found for the other outcomes of changes

The external microenvironment of healing skin wounds

DEFF Research Database (Denmark)

Kruse, Carla R; Nuutila, Kristo; Lee, Cameron Cy

2015-01-01

The skin wound microenvironment can be divided into two main components that influence healing: the external wound microenvironment, which is outside the wound surface; and the internal wound microenvironment, underneath the surface, to which the cells within the wound are exposed. Treatment...

New techniques for wound debridement.

Science.gov (United States)

Madhok, Brijesh M; Vowden, Kathryn; Vowden, Peter

2013-06-01

Debridement is a crucial component of wound management. Traditionally, several types of wound debridement techniques have been used in clinical practice such as autolytic, enzymatic, biodebridement, mechanical, conservative sharp and surgical. Various factors determine the method of choice for debridement for a particular wound such as suitability to the patient, the type of wound, its anatomical location and the extent of debridement required. Recently developed products are beginning to challenge traditional techniques that are currently used in wound bed preparation. The purpose of this review was to critically evaluate the current evidence behind the use of these newer techniques in clinical practice. There is some evidence to suggest that low frequency ultrasound therapy may improve healing rates in patients with venous ulcers and diabetic foot ulcers. Hydrosurgery debridement is quick and precise, but the current evidence is limited and further studies are underway. Debridement using a monofilament polyester fibre pad and plasma-mediated bipolar radiofrequency ablation are both very new techniques. The initial evidence is limited, and further studies are warranted to confirm their role in management of chronic wounds. © 2013 The Authors. International Wound Journal © 2013 John Wiley & Sons Ltd and Medicalhelplines.com Inc.

Wound Documentation by Using 3G Mobile as Acquisition Terminal: An Appropriate Proposal for Community Wound Care.

Science.gov (United States)

Ge, Kui; Wu, Minjie; Liu, Hu; Gong, Jiahong; Zhang, Yi; Hu, Qiang; Fang, Min; Tao, Yanping; Cai, Minqiang; Chen, Hua; Wang, Jianbo; Xie, Ting; Lu, Shuliang

2015-06-01

The increasing numbers of cases of wound disease are now posing a big challenge in China. For more convenience of wound patients, wound management in community health care centers under the supervision of a specialist at general hospitals is an ideal solution. To ensure an accurate diagnosis in community health clinics, it is important that "the same language" for wound description, which may be composed of unified format description, including wound image, must be achieved. We developed a wound information management system that was built up by acquisition terminal, wound description, data bank, and related software. In this system, a 3G mobile phone was applied as acquisition terminal, which could be used to access to the data bank. This documentation system was thought to be an appropriate proposal for community wound care because of its objectivity, uniformity, and facilitation. It also provides possibility for epidemiological study in the future. © The Author(s) 2014.

Bioimpedance measurement based evaluation of wound healing.

Science.gov (United States)

Kekonen, Atte; Bergelin, Mikael; Eriksson, Jan-Erik; Vaalasti, Annikki; Ylänen, Heimo; Viik, Jari

2017-06-22

Our group has developed a bipolar bioimpedance measurement-based method for determining the state of wound healing. The objective of this study was to assess the capability of the method. To assess the performance of the method, we arranged a follow-up study of four acute wounds. The wounds were measured using the method and photographed throughout the healing process. Initially the bioimpedance of the wounds was significantly lower than the impedance of the undamaged skin, used as a baseline. Gradually, as healing progressed, the wound impedance increased and finally reached the impedance of the undamaged skin. The clinical appearance of the wounds examined in this study corresponded well with the parameters derived from the bioimpedance data. Hard-to-heal wounds are a significant and growing socioeconomic burden, especially in the developed countries, due to aging populations and to the increasing prevalence of various lifestyle related diseases. The assessment and the monitoring of chronic wounds are mainly based on visual inspection by medical professionals. The dressings covering the wound must be removed before assessment; this may disturb the wound healing process and significantly increases the work effort of the medical staff. There is a need for an objective and quantitative method for determining the status of a wound without removing the wound dressings. This study provided evidence of the capability of the bioimpedance based method for assessing the wound status. In the future measurements with the method should be extended to concern hard-to-heal wounds.

The scarifications as regulation of the relationship to the world

Directory of Open Access Journals (Sweden)

David Le Breton

2016-08-01

Full Text Available The adolescence  imposes physical changes raising the question of the others’ look on the young man or on the young woman becoming, of the opening to the desire and to the genital. His/her body escapes from his/her control, at the same time his/her status is now situated in the social link. By changing his/her appearance, the young makes the skin as a scene where he/she projects a temporary or permanent identity searching for his/her character. It is a tool of self-experimentation, of exploration of the characters. The skin is a scraped border if the symbolic boundaries, between the self and the others, between the inner world and the social reality, are struggling to establish, because it encloses into an unbearable identity which he/she wishes to escape, whose self-inflicted bodily wounds are testimony.

The Wound CARE Instrument: the process for developing standards for wound management education and programming.

Science.gov (United States)

Orsted, Heather L; Woodbury, M Gail; Stevenson, Kimberly

2012-06-01

This article describes the collaborative process undertaken by the Canadian Association for Enterostomal Therapy and the Canadian Association of Wound Care in an effort to improve the quality of wound prevention and management education and programming. The end result of this process is the Wound CARE Instrument which promotes an interprofessional, collaborative appraisal process to support the development, adoption or adaption of wound management educational events and programs. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

The bile acids, deoxycholic acid and ursodeoxycholic acid, regulate colonic epithelial wound healing.

Science.gov (United States)

Mroz, Magdalena S; Lajczak, Natalia K; Goggins, Bridie J; Keely, Simon; Keely, Stephen J

2018-03-01

The intestinal epithelium constitutes an innate barrier which, upon injury, undergoes self-repair processes known as restitution. Although bile acids are known as important regulators of epithelial function in health and disease, their effects on wound healing processes are not yet clear. Here we set out to investigate the effects of the colonic bile acids, deoxycholic acid (DCA) and ursodeoxycholic acid (UDCA), on epithelial restitution. Wound healing in T 84 cell monolayers grown on transparent, permeable supports was assessed over 48 h with or without bile acids. Cell migration was measured in Boyden chambers. mRNA and protein expression were measured by RT-PCR and Western blotting. DCA (50-150 µM) significantly inhibited wound closure in cultured epithelial monolayers and attenuated cell migration in Boyden chamber assays. DCA also induced nuclear accumulation of the farnesoid X receptor (FXR), whereas an FXR agonist, GW4064 (10 µM), inhibited wound closure. Both DCA and GW4064 attenuated the expression of CFTR Cl - channels, whereas inhibition of CFTR activity with either CFTR- inh -172 (10 µM) or GlyH-101 (25 µM) also prevented wound healing. Promoter/reporter assays revealed that FXR-induced downregulation of CFTR is mediated at the transcriptional level. In contrast, UDCA (50-150 µM) enhanced wound healing in vitro and prevented the effects of DCA. Finally, DCA inhibited and UDCA promoted mucosal healing in an in vivo mouse model. In conclusion, these studies suggest bile acids are important regulators of epithelial wound healing and are therefore good targets for development of new drugs to modulate intestinal barrier function in disease treatment. NEW & NOTEWORTHY The secondary bile acid, deoxycholic acid, inhibits colonic epithelial wound healing, an effect which appears to be mediated by activation of the nuclear bile acid receptor, FXR, with subsequent downregulation of CFTR expression and activity. In contrast, ursodeoxycholic acid promotes

Modern collagen wound dressings: function and purpose.

Science.gov (United States)

Fleck, Cynthia Ann; Simman, Richard

2010-09-01

Collagen, which is produced by fibroblasts, is the most abundant protein in the human body. A natural structural protein, collagen is involved in all 3 phases of the wound-healing cascade. It stimulates cellular migration and contributes to new tissue development. Because of their chemotactic properties on wound fibroblasts, collagen dressings encourage the deposition and organization of newly formed collagen, creating an environment that fosters healing. Collagen-based biomaterials stimulate and recruit specific cells, such as macrophages and fibroblasts, along the healing cascade to enhance and influence wound healing. These biomaterials can provide moisture or absorption, depending on the delivery system. Collagen dressings are easy to apply and remove and are conformable. Collagen dressings are usually formulated with bovine, avian, or porcine collagen. Oxidized regenerated cellulose, a plant-based material, has been combined with collagen to produce a dressing capable of binding to and protecting growth factors by binding and inactivating matrix metalloproteinases in the wound environment. The increased understanding of the biochemical processes involved in chronic wound healing allows the design of wound care products aimed at correcting imbalances in the wound microenvironment. Traditional advanced wound care products tend to address the wound's macroenvironment, including moist wound environment control, fluid management, and controlled transpiration of wound fluids. The newer class of biomaterials and wound-healing agents, such as collagen and growth factors, targets specific defects in the chronic wound environment. In vitro laboratory data point to the possibility that these agents benefit the wound healing process at a biochemical level. Considerable evidence has indicated that collagen-based dressings may be capable of stimulating healing by manipulating wound biochemistry.

Histomorphological evaluation of wound healing - Comparison ...

African Journals Online (AJOL)

Wound size was measured using a digital camera (Canon Powershot 5.0MP, Canon, Tokyo, Japan) and Adobe photoshop CS5 software. Wound tissues were removed on days 3, 5, 7 and 10 post wounding for histomorphological examinations. Average time for complete wound closure in honey (11.00 ± 0.00 days) and ...

Tetanus with multiple wedge vertebral collapses

African Journals Online (AJOL)

owner

2012-07-06

Jul 6, 2012 ... associated with traumatic injury, often a penetrating wound inflicted by dirty ... multiple vertebral collapses and the management chal- .... back pains and swelling as in our patient.9 There are usually no ... The cervical and.

Factors Affecting Wound Healing

OpenAIRE

Guo, S.; DiPietro, L.A.

2010-01-01

Wound healing, as a normal biological process in the human body, is achieved through four precisely and highly programmed phases: hemostasis, inflammation, proliferation, and remodeling. For a wound to heal successfully, all four phases must occur in the proper sequence and time frame. Many factors can interfere with one or more phases of this process, thus causing improper or impaired wound healing. This article reviews the recent literature on the most significant factors that affect cutane...

The effect of mesenchymal stem cells combined with platelet-rich plasma on skin wound healing.

Science.gov (United States)

Mahmoudian-Sani, Mohammad-Reza; Rafeei, Fatemeh; Amini, Razieh; Saidijam, Massoud

2018-03-04

Mesenchymal stem cells (MSCs) are multipotent stem cells that have the potential of proliferation, high self-renewal, and the potential of multilineage differentiation. The differentiation potential of the MSCs in vivo and in vitro has caused these cells to be regarded as potentially appropriate tools for wound healing. After the burn, trauma or removal of the tumor of wide wounds is developed. Although standard treatment for skin wounds is primary healing or skin grafting, they are not always practical mainly because of limited autologous skin grafting. Directory of Open Access Journals (DOAJ), Google Scholar, PubMed (NLM), LISTA (EBSCO), and Web of Science have been searched. For clinical use of the MSCs in wound healing, two key issues should be taken into account: First, engineering biocompatible scaffolds clinical use of which leads to the least amount of side effects without any immunologic response and secondly, use of stem cells secretions with the least amount of clinical complications despite their high capability of healing damage. In light of the MSCs' high capability of proliferation and multilineage differentiation as well as their significant role in modulating immunity, these cells can be used in combination with tissue engineering techniques. Moreover, the MSCs' secretions can be used in cell therapy to heal many types of wounds. The combination of MSCs and PRP aids wound healing which could potentially be used to promote wound healing. © 2018 Wiley Periodicals, Inc.

[Wound Ballistics – a Brief Overview].

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Bolliger, Stephan A; Eggert, Sebastian; Thali, Michael J

2016-02-03

Wound ballistics examines the specific effect, namely the wound profile, of bullets on the body by firing at synthetic models made of ordnance gelatine, glycerin soap and synthetic bones, validated with real cases from (battlefield) surgery and forensic pathology. Wound profile refers to the penetration depth, the bullet deformation/ fragmentation, the diameter of the permanent and the temporary wound cavity. Knowing these features and the used ammunition a surgeon can rapidly assess the amount damage within a patient. The forensic pathologist can draw conclusions as to the used ammunition based on the wound profile. By measuring of the destructive capability of different ammunition types, wound ballistics lays the foundation for guidelines concerning the maximum effect of military ammunition.

Designing cellulosic and nanocellulosic sensors for interface with a protease sequestrant wound-dressing prototype: implications of material selection for dressing and protease sensor design

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An intelligent dressing is a self-adjusting material with multifunctional properties and/or a biosensor-interface designed to treat specific pathological issues of wounds at a molecular or cellular level. The ability to detect and treat excessive protease levels in wounds, one indicator of chronic w...

General concept of wound healing, revisited

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Theddeus O.H. Prasetyono

2009-09-01

Full Text Available Wound healing is a transition of processes which is also recognized as one of the most complex processes in human physiology. Complex series of reactions and interactions among cells and mediators take place in the healing process of wound involving cellular and molecular events. The inflammatory phase is naturally intended to remove devitalized tissue and prevent invasive infection. The proliferative phase is characterized by the formation of granulation tissue within the wound bed, composed of new capillary network, fibroblast, and macrophages in a loose arrangement of supporting structure. This second phase lasts from day 8 to 21 after the injury is also the phase for epithelialisation. The natural period of proliferative phase is a reflection for us in treating wound to reach the goal which ultimately defines as closed wound. The final maturation phase is also characterized by the balancing between deposition of collagen and its degradation. There are at least three prerequisites which are ideal local conditions for the nature of wound to go on a normal process of healing i.e. 1 all tissue involved in the wound and surrounding should be vital, 2 no foreign bodies in the wound, and 3 free from excessive contamination/infection. The author formulated a step ladder of thinking in regards of healing intentions covering all acute and chronic wounds. Regarding the “hierarchy” of healing intention, the fi rst and ideal choice to heal wounds is by primary intention followed by tertiary intention and lastly the secondary intention. (Med J Indones 2009;18:206-14Key words: inflammatory mediator, epithelialisation, growth factor, wound healing

Cutaneous wound healing: Current concepts and advances in wound care

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Kenneth C Klein

2014-01-01

Full Text Available A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care. [1] It is a snapshot of a patient′s total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors. [2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT, as used at our institution (CAMC, and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society may vary widely from country to country and payment system. [3] In the USA, CMS (Centers for Medicare and Medicaid Services approved indications for HBOT vary from that of the UHMS for logistical reasons. [1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise.

Cutaneous wound healing: Current concepts and advances in wound care

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Klein, Kenneth C; Guha, Somes Chandra

2014-01-01

A non-healing wound is defined as showing no measurable signs of healing for at least 30 consecutive treatments with standard wound care.[1] It is a snapshot of a patient's total health as well as the ongoing battle between noxious factors and the restoration of optimal macro and micro circulation, oxygenation and nutrition. In practice, standard therapies for non-healing cutaneous wounds include application of appropriate dressings, periodic debridement and eliminating causative factors.[2] The vast majority of wounds would heal by such approach with variable degrees of residual morbidity, disability and even mortality. Globally, beyond the above therapies, newer tools of healing are selectively accessible to caregivers, for various logistical or financial reasons. Our review will focus on the use of hyperbaric oxygen therapy (HBOT), as used at our institution (CAMC), and some other modalities that are relatively accessible to patients. HBOT is a relatively safe and technologically simpler way to deliver care worldwide. However, the expense for including HBOT as standard of care for recognized indications per UHMS(Undersea and Hyperbaric Medical Society) may vary widely from country to country and payment system.[3] In the USA, CMS (Centers for Medicare and Medicaid Services) approved indications for HBOT vary from that of the UHMS for logistical reasons.[1] We shall also briefly look into other newer therapies per current clinical usage and general acceptance by the medical community. Admittedly, there would be other novel tools with variable success in wound healing worldwide, but it would be difficult to include all in this treatise. PMID:25593414

Combat Wound Initiative Program

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2010-07-01

Government as part of that person’s official duties. Deliver~~ by Publishing Technology to: Waiter Reed Army Institute of R~l!il>~~vTP:11~1~:S6;!4!B1...develop a predictive model, which could serve as a clinical decision support tool in the management of complex war wounds. Bayesian belief networks...decisions regarding the surgical management of wounds and estimate overall out- come of patients on the basis of casualty-specific factors in wounded

Influence of hydrophilic polymers on functional properties and wound healing efficacy of hydrocolloid based wound dressings.

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Jin, Sung Giu; Yousaf, Abid Mehmood; Kim, Kyeong Soo; Kim, Dong Wuk; Kim, Dong Shik; Kim, Jin Ki; Yong, Chul Soon; Youn, Yu Seok; Kim, Jong Oh; Choi, Han-Gon

2016-03-30

The purpose of this study was to investigate the influence of different hydrophilic polymers on the swelling, bioadhesion and mechanical strength of hydrocolloid wound dressings (HCDs) in order to provide an appropriate composition for a hydrocolloid wound dressing system. In this study, the HCDs were prepared with styrene-isoprene-styrene copolymer (SIS) and polyisobutylene (PIB) as the base using a hot melting method. Additionally, numerous SIS/PIB-based HCDs were prepared with six hydrophilic polymers, and their wound dressing properties were assessed. Finally, the wound healing efficacy of the selected formulations was compared to a commercial wound dressing. The swelling ratio, bioadhesive force and mechanical strengths of HCDs were increased in the order of sodium alginate>sodium CMC=poloxamer=HPMC>PVA=PVP, sodium alginate>sodium CMC=poloxamer>PVA>HPMC=PVP and sodium alginate≥PVA>PVP=HPMC=sodium CMC>poloxamer, respectively. Among the hydrophilic polymers tested, sodium alginate most enhanced the swelling capacity, bioadhesive force and mechanical strengths. Thus, the hydrophilic polymers played great role in the swelling, bioadhesion and mechanical strength of SIS/PIB-based HCDs. The HCD formulation composed of PIB, SIS, liquid paraffin and sodium alginate at the weight ratio of 20/25/12/43 gave better wound dressing properties and more excellent wound healing efficacy than the commercial wound dressing. Therefore, the novel HCD formulation could be a promising hydrocolloid system for wound dressings. Copyright © 2016 Elsevier B.V. All rights reserved.

Debridement and wound bed preparation.

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Falabella, Anna F

2006-01-01

Debridement can play a vital role in wound bed preparation and the removal of barriers that impair wound healing. In accordance with the TIME principles, debridement can help remove nonviable tissue, control inflammation or infection, decrease excess moisture, and stimulate a nonadvancing wound edge. There are many types of debridement, each with a set of advantages and disadvantages that must be clearly understood by the healthcare team. Failure to use the correct debridement method for a given type of wound may lead to further delays in healing, increase patient suffering, and unnecessarily increase the cost of care. This review article discusses the various methods of debridement, describes currently available debriding agents, evaluates the clinical data regarding their efficacy and safety, and describes strategies for the management of problematic nonhealing wounds.

Wound Care Center of Excellence: A Process for Continuous Monitoring and Improvement of Wound Care Quality.

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Howell, Raelina S; Kohan, Lauren S; Woods, Jon S; Criscitelli, Theresa; Gillette, Brian M; Donovan, Virginia; Gorenstein, Scott

2018-05-01

To provide information about a study using a new process for continuous monitoring to improve chronic wound care quality.This continuing education activity is intended for physicians, physician assistants, nurse practitioners, and nurses with an interest in skin and wound care.After completing this continuing education activity, you should be better able to:1. Recognize problems associated with chronic wound care.2. Identify methods used in this project to improve care.3. Illustrate the findings from this and similar projects and implications for providing improved wound care.Patients with chronic wounds require complex care because of comorbidities that can affect healing. Therefore, the goal of this project was to develop a system of reviewing all hospitalized patients seen by the study authors' wound care service on a weekly basis to decrease readmissions, morbidity, and mortality. Weekly multidisciplinary conferences were conducted to evaluate patient data and systematically assess for adherence to wound care protocols, as well as to create and modify patient care plans. This review of pathology and the performance of root-cause analyses often led to improved patient care.

CLINICAL STUDY OF POST LAPAROTOMY WOUND DEHISCENCE

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Chanda Ramanachalam

2017-04-01

Full Text Available BACKGROUND The aim of the study is to- 1. Assess the association and prevalence of risk factors involved in causing post laparotomy wound dehiscence. 2. Identify the type of disease involved in causing abdominal wound dehiscence. 3. Effectively manage cases of wound dehiscence. MATERIALS AND METHODS Total 50 cases clinically presenting as gaping of abdominal wound and discharge from the site during the period of October 2014 to April 2016 were taken for study. Patients presenting with abdominal wound dehiscence after undergoing elective or emergency operation Each case was examined clinically and properly in systematic manner and an elaborative study of history based on chief complaints, significant risk factors, investigations, time and type of surgery performed and postoperative events and day of onset of wound dehiscence. RESULTS Males outnumbered females with 64% males and 36% females. Patients in the age group of 41-50 years and 51-60 years found to have highest incidence of abdominal wound dehiscence. Mean age of the patients affected was 48.02 years. Incidence of abdominal wound dehiscence is more common in patients with peritonitis due to duodenal and appendicular perforation than in case of intestinal obstruction. Incidence of abdominal wound dehiscence is more common in patients who are operated in emergency than elective (35:15. Surgical procedures, which included perforation closure carried higher incidence of wound dehiscence. Patients operated with midline incision carried higher risk for wound dehiscence than those operated with paramedian incisions. Incidence of abdominal wound dehiscence is more common in patients having their BMI >25 and anaemia (Hb% <10 g%. Average stay was 22 days, which increased both economic burden on patient and hospital. Out of 50 cases, 48 survivals and 2 were mortals. Partial wound dehiscence was conservative management, i.e. healing by secondary intention was observed in 32 patients and 8 patients had

The mechanical fingerprint of murine excisional wounds.

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Pensalfini, Marco; Haertel, Eric; Hopf, Raoul; Wietecha, Mateusz; Werner, Sabine; Mazza, Edoardo

2018-01-01

A multiscale mechanics approach to the characterization of murine excisional wounds subjected to uniaxial tensile loading is presented. Local strain analysis at a physiological level of tension uncovers the presence of two distinct regions within the wound: i) a very compliant peripheral cushion and ii) a core area undergoing modest deformation. Microstructural visualizations of stretched wound specimens show negligible engagement of the collagen located in the center of a 7-day old wound; fibers remain coiled despite the applied tension, confirming the existence of a mechanically isolated wound core. The compliant cushion located at the wound periphery appears to protect the newly-formed tissue from excessive deformation during the phase of new tissue formation. The early remodeling phase (day 14) is characterized by a restored mechanical connection between far field and wound center. The latter remains less deformable, a characteristic possibly required for cell activities during tissue remodeling. The distribution of fibrillary collagens at these two time points corresponds well to the identified heterogeneity of mechanical properties of the wound region. This novel approach provides new insight into the mechanical properties of wounded skin and will be applicable to the analysis of compound-treated wounds or wounds in genetically modified tissue. Biophysical characterization of healing wounds is crucial to assess the recovery of the skin barrier function and the associated mechanobiological processes. For the first time, we performed highly resolved local deformation analysis to identify mechanical characteristics of the wound and its periphery. Our results reveal the presence of a compliant cushion surrounding a stiffer wound core; we refer to this heterogeneous mechanical behavior as "mechanical fingerprint" of the wound. The mechanical response is shown to progress towards that of the intact skin as healing takes place. Histology and multiphoton microscopy

Hyperbaric oxygen and wound healing

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Sourabh Bhutani

2012-01-01

Full Text Available Hyperbaric oxygen therapy (HBOT is the use of 100% oxygen at pressures greater than atmospheric pressure. Today several approved applications and indications exist for HBOT. HBOT has been successfully used as adjunctive therapy for wound healing. Non-healing wounds such as diabetic and vascular insufficiency ulcers have been one major area of study for hyperbaric physicians where use of HBOT as an adjunct has been approved for use by way of various studies and trials. HBOT is also indicated for infected wounds like clostridial myonecrosis, necrotising soft tissue infections, Fournier′s gangrene, as also for traumatic wounds, crush injury, compartment syndrome, compromised skin grafts and flaps and thermal burns. Another major area of application of HBOT is radiation-induced wounds, specifically osteoradionecrosis of mandible, radiation cystitis and radiation proctitis. With the increase in availability of chambers across the country, and with increasing number of studies proving the benefits of adjunctive use for various kinds of wounds and other indications, HBOT should be considered in these situations as an essential part of the overall management strategy for the treating surgeon.

Ballistic Puncture Self-Healing Polymeric Materials

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Gordon, Keith L.; Siochi, Emilie J.; Yost, William T.; Bogert, Phil B.; Howell, Patricia A.; Cramer, K. Elliott; Burke, Eric R.

2017-01-01

Space exploration launch costs on the order of $10,000 per pound provide an incentive to seek ways to reduce structural mass while maintaining structural function to assure safety and reliability. Damage-tolerant structural systems provide a route to avoiding weight penalty while enhancing vehicle safety and reliability. Self-healing polymers capable of spontaneous puncture repair show promise to mitigate potentially catastrophic damage from events such as micrometeoroid penetration. Effective self-repair requires these materials to quickly heal following projectile penetration while retaining some structural function during the healing processes. Although there are materials known to possess this capability, they are typically not considered for structural applications. Current efforts use inexpensive experimental methods to inflict damage, after which analytical procedures are identified to verify that function is restored. Two candidate self-healing polymer materials for structural engineering systems are used to test these experimental methods.

Dynamic Reciprocity in the Wound Microenvironment

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Schultz, Gregory S.; Davidson, Jeffrey M.; Kirsner, Robert S.; Bornstein, Paul; Herman, Ira M.

2011-01-01

Here, we define dynamic reciprocity (DR) as an ongoing, bidirectional interaction amongst cells and their surrounding microenvironment. In the review, we posit that DR is especially meaningful during wound healing as the DR-driven biochemical, biophysical and cellular responses to injury play pivotal roles in regulating tissue regenerative responses. Such cell-extracellular matrix interactions not only guide and regulate cellular morphology, but cellular differentiation, migration, proliferation, and survival during tissue development, including e.g. embryogenesis, angiogenesis, as well as during pathologic processes including cancer diabetes, hypertension and chronic wound healing. Herein, we examine DR within the wound microenvironment while considering specific examples across acute and chronic wound healing. This review also considers how a number of hypotheses that attempt to explain chronic wound pathophysiology, which may be understood within the DR framework. The implications of applying the principles of dynamic reciprocity to optimize wound care practice and future development of innovative wound healing therapeutics are also briefly considered. PMID:21362080

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

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Das, Subhamoy; Baker, Aaron B.

2016-01-01

Wound healing is an intricate process that requires complex coordination between many cell types and an appropriate extracellular microenvironment. Chronic wounds often suffer from high protease activity, persistent infection, excess inflammation, and hypoxia. While there has been intense investigation to find new methods to improve cutaneous wound care, the management of chronic wounds, burns, and skin wound infection remain challenging clinical problems. Ideally, advanced wound dressings can provide enhanced healing and bridge the gaps in the healing processes that prevent chronic wounds from healing. These technologies have great potential for improving outcomes in patients with poorly healing wounds but face significant barriers in addressing the heterogeneity and clinical complexity of chronic or severe wounds. Active wound dressings aim to enhance the natural healing process and work to counter many aspects that plague poorly healing wounds, including excessive inflammation, ischemia, scarring, and wound infection. This review paper discusses recent advances in the development of biomaterials and nanoparticle therapeutics to enhance wound healing. In particular, this review focuses on the novel cutaneous wound treatments that have undergone significant preclinical development or are currently used in clinical practice. PMID:27843895

Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

Directory of Open Access Journals (Sweden)

Subhamoy Das

2016-10-01

Full Text Available Wound healing is an intricate process that requires complex coordination between many cells and an appropriate extracellular microenvironment. Chronic wounds often suffer from high protease activity, persistent infection, excess inflammation, and hypoxia. While there has been intense investigation to find new methods to improve cutaneous wound care; the management of chronic wounds, burns, and skin wound infection remain challenging clinical problems. Ideally, advanced wound dressings can provide enhanced healing and bridge the gaps in the healing processes that prevent chronic wounds from healing. These technologies have great potential for improving outcomes in patients with poorly healing wounds but face significant barriers in addressing the heterogeneity and clinical complexity of chronic or severe wounds. Active wound dressings aim to enhance the natural healing process and work to counter many aspects that plague poorly healing wounds including excessive inflammation, ischemia, scarring and wound infection. This review paper discusses recent advances in the development of biomaterials and nanoparticle therapeutics to enhance wound healing. In particular, this review focuses on the novel cutaneous wound treatments that have undergone significant preclinical development or currently used in clinical practice.

Wound healing efficacy of a 660-nm diode laser in a rat incisional wound model.

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Suzuki, Ryoichi; Takakuda, Kazuo

2016-11-01

This study aimed to elucidate the optimum usage parameters of low reactive-level laser therapy (LLLT) in a rat incisional wound model. In Sprague-Dawley rats, surgical wounds of 15-mm length were made in the dorsal thoracic region. They were divided into groups to receive 660-nm diode laser irradiation 24 h after surgery at an energy density of 0 (control), 1, 5, or 10 J/cm 2 . Tissue sections collected on postoperative day 3 were stained with hematoxylin-eosin and an antibody for ED1 to determine the number of macrophages around the wound. Samples collected on day 7 were stained with hematoxylin-eosin and observed via polarized light microscopy to measure the area occupied by collagen fibers around the wound; day 7 skin specimens were also subjected to mechanical testing to evaluate tensile strength. On postoperative day 3, the numbers of macrophages around the wound were significantly lower in the groups receiving 1 and 5 J/cm 2 irradiation, compared to the control and 10 J/cm 2 irradiation groups (p diode laser with energy density of 1 and 5 J/cm 2 enhanced wound healing in a rat incisional wound model. However, a higher radiation energy density yielded no significant enhancement.

Myofibroblasts in palatal wound healing: prospects for the reduction of wound contraction after cleft palate repair.

NARCIS (Netherlands)

Beurden, H.E. van; Hoff, J.W. Von den; Torensma, R.; Maltha, J.C.; Kuijpers-Jagtman, A.M.

2005-01-01

The surgical closure of orofacial clefts is considered to impair maxillary growth and dento-alveolar development. Wound contraction and subsequent scar tissue formation, during healing of these surgical wounds, contribute largely to these growth disturbances. The potential to minimize wound

Surgical pathology to describe the clinical margin of debridement of chronic wounds using a wound electronic medical record.

Science.gov (United States)

Golinko, Michael S; Joffe, Renata; de Vinck, David; Chandrasekaran, Eashwar; Stojadinovic, Olivera; Barrientos, Stephan; Vukelic, Sasa; Tomic-Canic, Marjana; Brem, Harold

2009-08-01

Chronic wounds, including diabetic foot ulcers (DFU), pressure ulcers (PU), and venous ulcers (VU) result from multiple physiologic impairments. Operative debridement is a mainstay of treatment to remove nonviable tissue and to stimulate wound healing. Unlike tumor resection, however, operative wound specimens are not routinely sent for pathology. The objective of this study was to describe the pathology present in chronic wounds. Pathology reports of the skin edge and wound base from 397 initial debridements in 336 consecutive patients with chronic wounds were retrospectively reviewed. All data were entered and stored in a Wound Electronic Medical Record. Pathology data were extracted from the Wound Electronic Medical Record, coded, and quantified. Up to 15 distinct histopathologic findings across 7 tissue types were observed after review of pathology reports from chronic wounds. Specifically, the pathology of epidermis revealed hyperkeratosis: 66% in DFUs, 31% in PUs, and 29% in VUs. Dermal pathology revealed fibrosis in 49% of DFUs, 30% of PUs, and 15% of VUs. Wound bed pathology revealed necrosis in the subcutaneous tissue in 67% of DFUs, 55% of PUs, and 19% of VUs. Fibrosis was reported in between 19% and 52% of all wound types. Acute osteomyelitis was present in 39% of DFUs, 33% of PUs, and 29% of VUs. This observational study of the histopathology of initial surgical debridement of chronic wounds revealed a wide range of findings across multiple tissue levels. Although certain findings such as osteomyelitis and gangrene have been shown to directly relate to impaired wound healing and amputation, other findings require additional investigation. To rigorously define a margin of debridement, a prospective study relating histopathology and clinical outcomes such as healing rates and amputation is needed.

Honey: an immunomodulator in wound healing.

Science.gov (United States)

Majtan, Juraj

2014-01-01

Honey is a popular natural product that is used in the treatment of burns and a broad spectrum of injuries, in particular chronic wounds. The antibacterial potential of honey has been considered the exclusive criterion for its wound healing properties. The antibacterial activity of honey has recently been fully characterized in medical-grade honeys. Recently, the multifunctional immunomodulatory properties of honey have attracted much attention. The aim of this review is to provide closer insight into the potential immunomodulatory effects of honey in wound healing. Honey and its components are able to either stimulate or inhibit the release of certain cytokines (tumor necrosis factor-α, interleukin-1β, interleukin-6) from human monocytes and macrophages, depending on wound condition. Similarly, honey seems to either reduce or activate the production of reactive oxygen species from neutrophils, also depending on the wound microenvironment. The honey-induced activation of both types of immune cells could promote debridement of a wound and speed up the repair process. Similarly, human keratinocytes, fibroblasts, and endothelial cell responses (e.g., cell migration and proliferation, collagen matrix production, chemotaxis) are positively affected in the presence of honey; thus, honey may accelerate reepithelization and wound closure. The immunomodulatory activity of honey is highly complex because of the involvement of multiple quantitatively variable compounds among honeys of different origins. The identification of these individual compounds and their contributions to wound healing is crucial for a better understanding of the mechanisms behind honey-mediated healing of chronic wounds. © 2014 by the Wound Healing Society.

The Use of a Magnetic Port Finder in the Retrieval of Air Rifle BBs to the Upper Extremity.

Science.gov (United States)

Kiwanuka, Elizabeth; Hsieh, Sun; Roussel, Lauren Ouellet; Jehle, Charles Christopher; Mehrzad, Raman; Schmidt, Scott

2018-04-03

Air-powered rifles shoot ball bearings with enough kinetic energy to penetrate skin and fracture underlying bones. In addition, there are reports of these ball bearings embolizing within the vascular network, causing serious injuries such as ischemic stroke with resultant blindness. The severity of these complications warrants occasional removal of these foreign bodies; however, they can be difficult to localize. In this case report, we describe the use of a magnetic port finder, a sterilizable tool used in breast reconstruction, to localize the foreign body in situ. We believe that this tool is effective at locating ferrous foreign bodies precisely, allowing for surgical retrieval while minimizing damage to surrounding tissue. Copyright © 2018 American Society for Surgery of the Hand. Published by Elsevier Inc. All rights reserved.

Komodo dragon-inspired synthetic peptide DRGN-1 promotes wound-healing of a mixed-biofilm infected wound.

Science.gov (United States)

M C Chung, Ezra; Dean, Scott N; Propst, Crystal N; Bishop, Barney M; van Hoek, Monique L

2017-01-01

Cationic antimicrobial peptides are multifunctional molecules that have a high potential as therapeutic agents. We have identified a histone H1-derived peptide from the Komodo dragon ( Varanus komodoensis) , called VK25. Using this peptide as inspiration, we designed a synthetic peptide called DRGN-1. We evaluated the antimicrobial and anti-biofilm activity of both peptides against Pseudomonas aeruginosa and Staphylococcus aureus . DRGN-1, more than VK25, exhibited potent antimicrobial and anti-biofilm activity, and permeabilized bacterial membranes. Wound healing was significantly enhanced by DRGN-1 in both uninfected and mixed biofilm ( Pseudomonas aeruginosa and Staphylococcus aureus )-infected murine wounds. In a scratch wound closure assay used to elucidate the wound healing mechanism, the peptide promoted the migration of HEKa keratinocyte cells, which was inhibited by mitomycin C (proliferation inhibitor) and AG1478 (epidermal growth factor receptor inhibitor). DRGN-1 also activated the EGFR-STAT1/3 pathway. Thus, DRGN-1 is a candidate for use as a topical wound treatment. Wound infections are a major concern; made increasingly complicated by the emerging, rapid spread of bacterial resistance. The novel synthetic peptide DRGN-1 (inspired by a peptide identified from Komodo dragon) exhibits pathogen-directed and host-directed activities in promoting the clearance and healing of polymicrobial ( Pseudomonas aeruginosa & Staphylococcus aureus ) biofilm infected wounds. The effectiveness of this peptide cannot be attributed solely to its ability to act upon the bacteria and disrupt the biofilm, but also reflects the peptide's ability to promsote keratinocyte migration. When applied in a murine model, infected wounds treated with DRGN-1 healed significantly faster than did untreated wounds, or wounds treated with other peptides. The host-directed mechanism of action was determined to be via the EGFR-STAT1/3 pathway. The pathogen-directed mechanism of action was

Wound Healing and Care

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... Safe Videos for Educators Search English Español Wound Healing and Care KidsHealth / For Teens / Wound Healing and ... open to heal through natural scar formation. The Healing Process Before healing begins, the body gears up ...

Scar-free wound healing and regeneration following tail loss in the leopard gecko, Eublepharis macularius.

Science.gov (United States)

Delorme, Stephanie Lynn; Lungu, Ilinca Mihaela; Vickaryous, Matthew Kenneth

2012-10-01

Many lizards are able to undergo scar-free wound healing and regeneration following loss of the tail. In most instances, lizard tail loss is facilitated by autotomy, an evolved mechanism that permits the tail to be self-detached at pre-existing fracture planes. However, it has also been reported that the tail can regenerate following surgical amputation outside the fracture plane. In this study, we used the leopard gecko, Eublepharis macularius, to investigate and compare wound healing and regeneration following autotomy at a fracture plane and amputation outside the fracture plane. Both forms of tail loss undergo a nearly identical sequence of events leading to scar-free wound healing and regeneration. Early wound healing is characterized by transient myofibroblasts and the formation of a highly proliferative wound epithelium immunoreactive for the wound keratin marker WE6. The new tail forms from what is commonly referred to as a blastema, a mass of proliferating mesenchymal-like cells. Blastema cells express the protease matrix metalloproteinase-9. Apoptosis (demonstrated by activated caspase 3 immunostaining) is largely restricted to isolated cells of the original and regenerating tail tissues, although cell death also occurs within dermal structures at the original-regenerated tissue interface and among clusters of newly formed myocytes. Furthermore, the autotomized tail is unique in demonstrating apoptosis among cells adjacent to the fracture planes. Unlike mammals, transforming growth factor-β3 is not involved in wound healing. We demonstrate that scar-free wound healing and regeneration are intrinsic properties of the tail, unrelated to the location or mode of tail detachment. Copyright © 2012 Wiley Periodicals, Inc.

Injectable Polyurethane Composite Scaffolds Delay Wound Contraction and Support Cellular Infiltration and Remodeling in Rat Excisional Wounds

Science.gov (United States)

Adolph, Elizabeth J.; Hafeman, Andrea E.; Davidson, Jeffrey M.; Nanney, Lillian B.; Guelcher, Scott A.

2011-01-01

Injectable scaffolds present compelling opportunities for wound repair and regeneration due to their ability to fill irregularly shaped defects and deliver biologics such as growth factors. In this study, we investigated the properties of injectable polyurethane biocomposite scaffolds and their application in cutaneous wound repair using a rat excisional model. The scaffolds have a minimal reaction exotherm and clinically relevant working and setting times. Moreover, the biocomposites have mechanical and thermal properties consistent with rubbery elastomers. In the rat excisional wound model, injection of settable biocomposite scaffolds stented the wounds at early time points, resulting in a regenerative rather than a scarring phenotype at later time points. Measurements of wound width and thickness revealed that the treated wounds were less contracted at day 7 compared to blank wounds. Analysis of cell proliferation and apoptosis showed that the scaffolds were biocompatible and supported tissue ingrowth. Myofibroblast formation and collagen fiber organization provided evidence that the scaffolds have a positive effect on extracellular matrix remodeling by disrupting the formation of an aligned matrix under elevated tension. In summary, we have developed an injectable biodegradable polyurethane biocomposite scaffold that enhances cutaneous wound healing in a rat model. PMID:22105887

“It's Just a Matter of Time:” Lessons from Agency and Community Responses to Polar Bear-inflicted Human Injury

Directory of Open Access Journals (Sweden)

Aimee L Schmidt

2018-01-01

Full Text Available Bear-inflicted human injuries or deaths are often widely publicised, controversial, and evoke substantial social responses that articulate public expectations about bear management. In this paper, we examine how local people and management agencies (i.e. Manitoba Conservation, Parks Canada, and the Town of Churchill responded to a polar bear-inflicted human injury in Churchill, Manitoba, Canada. On November 1st, 2013, two people in Churchill were badly mauled by a polar bear. The incident shocked the community, highlighted problems such as a lack of bear safety education, and led to reviews of institutional policies for preventing polar bear-human conflicts. We used qualitative analysis methods to describe what is said (about polar bears, about people, and about management and what is done (changes in behaviours and changes in policies/practices when someone is attacked by a polar bear in Churchill. Results show that polar bear management agencies in Churchill respond remarkably well to errors in procedure, but are often unable to address the many underlying systematic drivers of polar bear-human conflict. Hence, managerial reactions to bear-human conflicts are successful at addressing the proximate cause of the problem, but offer few long-term solutions.

Reaching for the bottle of pesticide--a cry for help. Self-inflicted poisonings in Sri Lanka

DEFF Research Database (Denmark)

Konradsen, Flemming; Hoek, Wim van der; Peiris, Pushpalatha

2005-01-01

, as it is likely to reduce death from pesticides although unlikely to impact on the number of episodes. Support to families plagued by domestic violence and male alcohol misuse is essential to improve the quality of life for the most vulnerable and to reduce the number of self-harm episodes in the long-term....... in general, conveying misgiving, anger, sadness, hopelessness, frustration, or simply a way to manipulate a situation to one's own advantage. The effects of alcohol misuse are especially important in understanding self-harm at the community level in terms of the impact they have on the domestic environment....... Also, issues around "love affairs," arranged marriages and domestic physical, sexual or psychological abuse in the domestic environment are referred to by many self-harmers or their relatives as a reason for ingesting poison. Clearly, easy access to lethal pesticides by impulsive individuals often...

[Chronic wounds as a public health problem].

Science.gov (United States)

Situm, Mirna; Kolić, Maja; Redzepi, Gzim; Antolić, Slavko

2014-10-01

Chronic wounds represent a significant burden to patients, health care professionals and the entire health care system. Regarding the healing process, wounds can be classified as acute or chronic wounds. A wound is considered chronic if healing does not occur within the expected period according to the wound etiology and localization. Chronic wounds can be classified as typical and atypical. The majority of wounds (95 percent) are typical ones, which include ischemic, neurotrophic and hypostatic ulcers and two separate entities: diabetic foot and decubital ulcers. Eighty percent of chronic wounds localized on lower leg are the result of chronic venous insufficiency, in 5-10 percent the cause is of arterial etiology, whereas the rest are mostly neuropathic ulcers. Chronic wounds significantly decrease the quality of life of patients by requiring continuous topical treatment, causing immobility and pain in a high percentage of patients. Chronic wounds affect elderly population. Chronic leg ulcers affect 0.6-3 percent of those aged over 60, increasing to over 5 percent of those aged over 80. Emergence of chronic wounds is a substantial socioeconomic problem as 1-2 percent of western population will suffer from it. This estimate is expected to rise due to the increasing proportion of elderly population along with the diabetic and obesity epidemic. It has been proved that chronic wounds account for the large proportion of costs in the health care system, even in rich societies. Socioeconomically, the management of chronic wounds reaches a total of 2-4 percent of the health budget in western countries. Treatment costs for some other diseases are not irrelevant, nor are the method and materials used for treating these wounds. Considering etiologic factors, a chronic wound demands a multidisciplinary approach with great efforts of health care professionals to treat it more efficiently, more simply and more painlessly for the patient, as well as more inexpensively for

Transparent crosslinked ultrashort peptide hydrogel dressing with high shape-fidelity accelerates healing of full-thickness excision wounds

KAUST Repository

Seow, Wei Yang; Salgado, Giorgiana; Lane, E. Birgitte; Hauser, Charlotte

2016-01-01

Wound healing is a major burden of healthcare systems worldwide and hydrogel dressings offer a moist environment conducive to healing. We describe cysteine-containing ultrashort peptides that self-assemble spontaneously into hydrogels. After

Vacuum therapy for chronic wounds

Directory of Open Access Journals (Sweden)

Ekaterina Leonidovna Zaytseva

2012-09-01

Full Text Available Chronic wound in patients with diabetes mellitus (DM is one of the most urgent problems of modern diabetology and surgery. Numberof patients suffering from different types of chronic wounds follows increase in DM incidence. Vacuum therapy is a novel perspectivemethod of topical treatment for non-healing chronic wounds of various etiology. Current review addresses experimental and clinicalevidence for this method.

The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds

OpenAIRE

Hiebert, John?M.; Robson, Martin?C.

2016-01-01

Introduction: Wound debridement is considered essential in chronic wound management. Hypochlorous acid has been shown to be an effective agent in reducing wound bacterial counts in open wounds. Ultrasound-enabled wound debridement is an effective and efficient method of debridement. This study compared ultrasound irrigation with hypochlorous acid versus saline irrigation for wound debridement on pre- and postoperative wounds and determined regrowth of bacteria over 1 week period of time. Fina...

Therapy of spinal wound infections using vacuum-assisted wound closure: risk factors leading to resistance to treatment.

Science.gov (United States)

Ploumis, Avraam; Mehbod, Amir A; Dressel, Thomas D; Dykes, Daryll C; Transfeldt, Ensor E; Lonstein, John E

2008-07-01

This study retrospectively reviewed spine surgical procedures complicated by wound infection and managed by a protocol including the use of vacuum-assisted wound closure (VAC). To define factors influencing the number of debridements needed before the final wound closure by applying VAC for patients with postoperative spinal wound infections. VAC has been suggested as a safe and probably effective method for the treatment of spinal wound infections. The risk factors for infection resistance and need for debridement revisions after VAC placement are unknown. Seventy-three consecutive patients with 79 wound infections after undergoing spine surgery were studied (6 of them had recurrence of infection). All patients were taken to the operating room for irrigation and debridement under general anesthesia followed by placement of the VAC with subsequent delayed closure of the wound. Linear regression and t test were used to identify if the following variables were risk factors for the resistance of infection to VAC treatment: timing of clinical appearance of infection, depth of infection (deep or superficial), presence of instrumentation, positive culture for methicillin-resistant Staphylococcus aureus (MRSA) or more than 1 microorganism, age of the patient, and presence of other comorbidities. There were 34 males and 39 females with an average age of 58.4 years (21 to 82). Once the VAC was initiated, there was an average of 1.4 procedures until and including closure of the wound. The wound was closed an average of 7 days (range 5 to 14) after the placement of the initial VAC on the wound. The average follow-up was 14 months (range 12 to 28). All of the patients but 2 achieved a clean, closed wound without removal of instrumentation at a minimum follow-up of 1 year. Sixty patients had implants (instrumentation or allograft) within the site of wound infection. Thirteen patients had a decompression with exposed dura. Sixty-four infections (81%) presented with a draining

Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

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Lenka Vinklárková

2015-01-01

Full Text Available Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT. To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds.

Formulation of Novel Layered Sodium Carboxymethylcellulose Film Wound Dressings with Ibuprofen for Alleviating Wound Pain

Science.gov (United States)

Vinklárková, Lenka; Vetchý, David; Bernatonienė, Jurga

2015-01-01

Effective assessment and management of wound pain can facilitate both improvements in healing rates and overall quality of life. From a pharmacological perspective, topical application of nonsteroidal anti-inflammatory drugs in the form of film wound dressings may be a good choice. Thus, the aim of this work was to develop novel layered film wound dressings containing ibuprofen based on partially substituted fibrous sodium carboxymethylcellulose (nonwoven textile Hcel NaT). To this end, an innovative solvent casting method using a sequential coating technique has been applied. The concentration of ibuprofen which was incorporated as an acetone solution or as a suspension in a sodium carboxymethylcellulose dispersion was 0.5 mg/cm2 and 1.0 mg/cm2 of film. Results showed that developed films had adequate mechanical and swelling properties and an advantageous acidic surface pH for wound application. An in vitro drug release study implied that layered films retained the drug for a longer period of time and thus could minimize the frequency of changing the dressing. Films with suspended ibuprofen demonstrated higher drug content uniformity and superior in vitro drug release characteristics in comparison with ibuprofen incorporation as an acetone solution. Prepared films could be potential wound dressings for the effective treatment of wound pain in low exuding wounds. PMID:26090454

The Immediate and Delayed Post-Debridement Effects on Tissue Bacterial Wound Counts of Hypochlorous Acid Versus Saline Irrigation in Chronic Wounds.

Science.gov (United States)

Hiebert, John M; Robson, Martin C

2016-01-01

Introduction: Wound debridement is considered essential in chronic wound management. Hypochlorous acid has been shown to be an effective agent in reducing wound bacterial counts in open wounds. Ultrasound-enabled wound debridement is an effective and efficient method of debridement. This study compared ultrasound irrigation with hypochlorous acid versus saline irrigation for wound debridement on pre- and postoperative wounds and determined regrowth of bacteria over 1 week period of time. Finally, the outcome of definitive wound closure of the clinically clean-appearing wounds was recorded. Methods: Seventeen consenting adult patients with chronic open wounds were randomly selected for study. The patients were randomly divided into the hypochlorous acid irrigation or saline irrigation group. All patients provided pre- and postoperative tissue samples for qualitative and quantitative bacteriology. For the time (7 days) between the debridement procedure and the definitive closure procedure, the wounds were dressed with a silver-impregnated dressing and a hydroconductive dressing. Results : Both types of irrigation in the ultrasonic system initially lowered the bacterial counts by 4 to 6 logs. However, by the time of definitive closure, the saline-irrigated wounds had bacterial counts back up to 10 5 whereas the hypochlorous acid-irrigated wounds remained at 10 2 or fewer. More than 80% of patients in the saline group had postoperative closure failure compared with 25% of patients in the hypochlorous acid group. Conclusions: Hypochlorous acid irrigation with ultrasound debridement reduced bacterial growth in chronic open wounds more efficiently than saline alone. Postoperative wound closure outcomes suggest a remarkable reduction in wound complications after wound debridement using hypochlorous acid irrigation with ultrasound versus saline alone.

The Fire Challenge: A Case Report and Analysis of Self-Inflicted Flame Injury Posted on Social Media.

Science.gov (United States)

Avery, Andrew H; Rae, Lisa; Summitt, J Blair; Kahn, Steven Alexander

2016-01-01

With the advent of social media platforms such as Facebook and YouTube, online dissemination of exhibitionist videos has gained popularity. One recent disturbing trend is the "fire challenge" wherein a participant douses his or herself in a household accelerant such as isopropyl alcohol or acetone, sets him or herself ablaze, and attempts to extinguish the flames before serious burns are incurred. As expected, participants in the "fire challenge" often accidentally suffer serious burns. A 17-year-old white male was recently treated at our burn center after participating in the "fire challenge." He suffered 15% TBSA full and partial thickness burns requiring split thickness skin grafting to his abdomen. He reported lighting himself on fire because he had seen this stunt performed on the internet. A search for "fire challenge" and similar terms was conducted on YouTube (www.youtube.com). Gender and ethnicity of each participant were documented. Burn size, burn depth, and age of video participant were estimated by two attending burn surgeons evaluating YouTube videos. Results were reported with descriptive statistics. The search yielded thousands of hits, mostly home videos, compilations of stunts, and commentaries. After omitting duplicate and irrelevant videos, 50 videos were selected for the study. Of these, 13 videos included postburn footage demonstrating burn wounds of various location, size, and severity. Of these burns, the median TBSA burned was 4 ± 2.7% with a maximum size of 10%. Superficial and partial thickness burns were sustained on the torso (10/13, 77%), face (4/13, 31%), and extremities (2/13, 15%). Full thickness burns were seen in 2/13 videos. Some burn wounds were obscured by dressings. Of the 50 videos reviewed, 45/50 participants (90%) were male and 32/50 (64%) were African American with 29/50 participants (58%) estimated to be under age 20. The "fire challenge" is a popular social media phenomenon, but it can result in severe injury as seen

Expression of the SOCS family in human chronic wound tissues: Potential implications for SOCS in chronic wound healing

Science.gov (United States)

Feng, Yi; Sanders, Andrew J.; Ruge, Fiona; Morris, Ceri-Ann; Harding, Keith G.; Jiang, Wen G.

2016-01-01

Cytokines play important roles in the wound healing process through various signalling pathways. The JAK-STAT pathway is utilised by most cytokines for signal transduction and is regulated by a variety of molecules, including suppressor of cytokine signalling (SOCS) proteins. SOCS are associated with inflammatory diseases and have an impact on cytokines, growth factors and key cell types involved in the wound-healing process. SOCS, a negative regulator of cytokine signalling, may hold the potential to regulate cytokine-induced signalling in the chronic wound-healing process. Wound edge tissues were collected from chronic venous leg ulcer patients and classified as non-healing and healing wounds. The expression pattern of seven SOCSs members, at the transcript and protein level, were examined in these tissues using qPCR and immunohistochemistry. Significantly higher levels of SOCS3 (P=0.0284) and SOCS4 (P=0.0376) in non-healing chronic wounds compared to the healing/healed chronic wounds were observed at the transcript level. Relocalisation of SOCS3 protein in the non-healing wound environment was evident in the investigated chronic biopsies. Thus, the results show that the expression of SOCS transcript indicated that SOCS members may act as a prognostic biomarker of chronic wounds. PMID:27635428

ANALYSIS OF TREATMENT OF WOUNDS IN PATIENTS WITH GRADE IIIB COMPOUND FRACTURE WITH VACUUM-ASSISTED WOUND MANAGEMENT

Directory of Open Access Journals (Sweden)

Ashish R. Agarwal

2017-08-01

Full Text Available BACKGROUND Delayed wound healing is a significant health problem, particularly in patients with compound fractures. It still remains a challenging task in orthopaedic surgery, which in addition to the pain and suffering, failure of the wound to heal, also imposes social and financial burdens. The aim of the study is to evaluate the results of vacuum-assisted wound therapy in patients with open musculoskeletal injuries. MATERIALS AND METHODS 30 patients of open musculoskeletal injuries underwent randomised trial of vacuum-assisted closure therapy versus standard wound therapy around the upper limb and lower limb. Mean patient age was 39 ± 18 years necrotic tissues were debrided before applying VAC therapy. Dressings were changed every 3 or 4 days. For standard wound therapy, debridement followed by daily dressings was done. Data Management and Statistical Analysis- The results obtained were subjected to statistical analysis. RESULTS Granulation tissue status and skin healing is better in patients undergoing VAC therapy. Hospital stay of patients undergoing VAC therapy was also less. CONCLUSION Vacuum-assisted wound therapy was better method of wound management.

Topical silver for preventing wound infection

NARCIS (Netherlands)

Storm-Versloot, Marja N.; Vos, Cornelis G.; Ubbink, Dirk T.; Vermeulen, Hester

2010-01-01

BACKGROUND: Silver-containing treatments are popular and used in wound treatments to combat a broad spectrum of pathogens, but evidence of their effectiveness in preventing wound infection or promoting healing is lacking. OBJECTIVES: To establish the effects of silver-containing wound dressings and

Transparent crosslinked ultrashort peptide hydrogel dressing with high shape-fidelity accelerates healing of full-thickness excision wounds

KAUST Repository

Seow, Wei Yang

2016-09-07

Wound healing is a major burden of healthcare systems worldwide and hydrogel dressings offer a moist environment conducive to healing. We describe cysteine-containing ultrashort peptides that self-assemble spontaneously into hydrogels. After disulfide crosslinking, the optically-transparent hydrogels became significantly stiffer and exhibited high shape fidelity. The peptide sequence (LIVAGKC or LK6C) was then chosen for evaluation on mice with full-thickness excision wounds. Crosslinked LK6C hydrogels are handled easily with forceps during surgical procedures and offer an improvement over our earlier study of a non-crosslinked peptide hydrogel for burn wounds. LK6C showed low allergenic potential and failed to provoke any sensitivity when administered to guinea pigs in the Magnusson-Kligman maximization test. When applied topically as a dressing, the medium-infused LK6C hydrogel accelerated re-epithelialization compared to controls. The peptide hydrogel is thus safe for topical application and promotes a superior rate and quality of wound healing.

Effect of astaxanthin on cutaneous wound healing.

Science.gov (United States)

Meephansan, Jitlada; Rungjang, Atiya; Yingmema, Werayut; Deenonpoe, Raksawan; Ponnikorn, Saranyoo

2017-01-01

Wound healing consists of a complex series of convoluted processes which involve renewal of the skin after injury. ROS are involved in all phases of wound healing. A balance between oxidative and antioxidative forces is necessary for a favorable healing outcome. Astaxanthin, a member of the xanthophyll group, is considered a powerful antioxidant. In this study, we investigated the effect of topical astaxanthin on cutaneous wound healing. Full-thickness dermal wounds were created in 36 healthy female mice, which were divided into a control group and a group receiving 78.9 µM topical astaxanthin treatment twice daily for 15 days. Astaxanthin-treated wounds showed noticeable contraction by day 3 of treatment and complete wound closure by day 9, whereas the wounds of control mice revealed only partial epithelialization and still carried scabs. Wound healing biological markers including Col1A1 and bFGF were significantly increased in the astaxanthin-treated group since day 1. Interestingly, the oxidative stress marker iNOS showed a significantly lower expression in the study. The results indicate that astaxanthin is an effective compound for accelerating wound healing.

Metalloproteinase Expression is Associated with Traumatic Wound Failure

Science.gov (United States)

2010-04-01

Traumatic amputation- no.(%) 15 Size of wound (cm3 )* Associated vascular injury- no.(%) 7 Wound closure method no.(%) Suture 29 Skin graft 9 Number...definitive closure or coverage with skin graft . Im- paired wound healing included delayed wound closure or wound dehiscence after closure or coverage...closure time period of 10 d. Dehiscence was defined as spontaneous partial or com- plete wound disruption after primary closure or > 90% skin graft loss

Prophylactic Groin Wound Vacuum-assisted Therapy in Vascular Surgery Patients at Enhanced Risk for Postoperative Wound Infection.

Science.gov (United States)

Pesonen, Luke O; Halloran, Brian G; Aziz, Abdulhameed

2018-01-01

Vascular groin wounds have higher than expected surgical site infection (SSI) rates and some patients are at enhanced risk. The Wiseman et al. paper suggests an objective scoring system that identifies patients at enhanced risk of postdischarge SSI. We hypothesize that prophylactic groin wound vacuum-assisted closure (VAC) therapy in enhanced risk patients will decrease SSI and readmission and the Wiseman model provides potential evidence that enhanced risk patients can be objectively identified. A single institution, retrospective analysis was conducted from January 2013 to September 2016 utilizing procedure codes to identify patients with wound VACs placed in the operating room. Two distinct groups were identified. The first was a wound complication patient group with 15 limbs (13 patients) with a groin wound VAC placed within 45 days postoperatively for groin wound complications. Eleven of these limbs had the VAC placed at readmission. The second group was a prophylactic patient group that included 8 limbs (7 patients) who received a VAC prophylactically placed in the enhanced risk wounds. These wounds were determined to be enhanced risk based on clinical criteria judged by the operating surgeon such as a large overhanging panniculus and/or one of several ongoing medical issues. We calculated a Wiseman score for all patients, determined total cost of the readmissions, and determined 30-day postsurgical SSI incidence for the prophylactic VAC group. Per the Wiseman scores, 9 limbs with postoperative complications were high risk and 3 limbs were moderate/high risk. Eleven limbs had a VAC placed at readmission with an average readmission cost of $8876.77. For the prophylactic group, 8 limbs were high risk with no observed postdischarge SSI in the first 30 days from surgery. The Wiseman scores showed close correlation between the retrospective high and moderate/high risk groups versus the prophylactic VAC group (31.5 ± 7.3 vs. 32 ± 5.5, P = 0.87). The Wiseman

An mHealth App for Decision-Making Support in Wound Dressing Selection (WounDS): Protocol for a User-Centered Feasibility Study.

Science.gov (United States)

Jordan, Scott; McSwiggan, Jane; Parker, Joanne; Halas, Gayle A; Friesen, Marcia

2018-04-24

Primary care health professionals, especially family physicians, see a variety of wounds, and yet-despite the frequency of providing wound care-many family physicians do not feel confident in wound care management. This is partly due to a lack of formal wound education in Family Medicine programs. While there are numerous electronic wound care resources available in the UK and North America, none were identified that address the specific need in supporting clinical decision-making in wound dressing selection. At the same time, healthcare providers are increasingly using technology in personal and professional contexts, and a logical extension is to use technology for knowledge translation strategies. This work developed a prototype mobile health software application named WounDS, designed to support clinical decision-making in selecting wound dressings. This article presents the development and evaluation plan for the WounDS app. WounDS has been developed on the iOS platform. The primary specification included ease of use, in that one of the primary influences in user adoption would be the ability to receive a wound dressing recommendation in under 30 seconds and under 5 taps on the screen. The WounDS app guides users through a series of binary decisions for assessing the wound and provides a wound dressing recommendation. The selection algorithm is based in best practices using the Wound Bed Preparation Paradigm. Current work is underway to examine the implementation needs for WounDS to be most effectively utilized and to pilot test its feasibility and use in clinical care. Data will be collected through user trials, focus groups, and user metadata will be collected within the app. Optimizing these preconditions will enable a subsequent phase of study to determine effects on clinical decision-making and clinical outcomes. WounDS is designed for knowledge translation, use of technology in clinical decision-making, and continuity of care. The benefits of WounDS

Jasmonic acid/methyl jasmonate accumulate in wounded soybean hypocotyls and modulate wound gene expression.

Science.gov (United States)

Creelman, R A; Tierney, M L; Mullet, J E

1992-06-01

Jasmonic acid (JA) and its methyl ester, methyl jasmonate (MeJA), are plant lipid derivatives that resemble mammalian eicosanoids in structure and biosynthesis. These compounds are proposed to play a role in plant wound and pathogen responses. Here we report the quantitative determination of JA/MeJA in planta by a procedure based on the use of [13C,2H3]MeJA as an internal standard. Wounded soybean (Glycine max [L] Merr. cv. Williams) stems rapidly accumulated MeJA and JA. Addition of MeJA to soybean suspension cultures also increased mRNA levels for three wound-responsive genes (chalcone synthase, vegetative storage protein, and proline-rich cell wall protein) suggesting a role for MeJA/JA in the mediation of several changes in gene expression associated with the plants' response to wounding.

Anterior gradient 2 is induced in cutaneous wound and promotes wound healing through its adhesion domain.

Science.gov (United States)

Zhu, Qi; Mangukiya, Hitesh Bhagavanbhai; Mashausi, Dhahiri Saidi; Guo, Hao; Negi, Hema; Merugu, Siva Bharath; Wu, Zhenghua; Li, Dawei

2017-09-01

Anterior gradient 2 (AGR2), a member of protein disulfide isomerase (PDI) family, is both located in cytoplasm and secreted into extracellular matrix. The orthologs of AGR2 have been linked to limb regeneration in newt and wound healing in zebrafish. In mammals, AGR2 influences multiple cell signaling pathways in tumor formation and in normal cell functions related to new tissue formation like angiogenesis. However, the function of AGR2 in mammalian wound healing remains unknown. This study aimed to investigate AGR2 expression and its function during skin wound healing and the possible application of external AGR2 in cutaneous wound to accelerate the healing process. Our results showed that AGR2 expression was induced in the migrating epidermal tongue and hyperplastic epidermis after skin excision. Topical application of recombinant AGR2 significantly accelerated wound-healing process by increasing the migration of keratinocytes (Kera.) and the recruitment of fibroblasts (Fibro.) near the wounded area. External AGR2 also promoted the migration of Kera. and Fibro. in vitro in a dose-dependent manner. The adhesion domain of AGR2 was required for the formation of focal adhesions in migrating Fibro., leading to the directional migration along AGR2 gradient. These results indicate that recombinant AGR2 accelerates skin wound healing through regulation of Kera. and Fibro. migration, thus demonstrating its potential utility as an alternative strategy of the therapeutics to accelerate the healing of acute or chronic skin wounds. © 2017 Federation of European Biochemical Societies.

Cell kinetics during regeneration in the sponge Halisarca caerulea: how local is the response to tissue damage?

NARCIS (Netherlands)

Alexander, B.E.; Achlatis, M.; Osinga, R.; van der Geest, H.G.; Cleutjens, J.P.M.; Schutte, B.; de Goeij, J.M.

2015-01-01

Sponges have a remarkable capacity to rapidly regenerate in response to wound infliction. In addition, sponges rapidly renew their filter systems (choanocytes) to maintain a healthy population of cells. This study describes the cell kinetics of choanocytes in the encrusting reef sponge Halisarca

Sex hormones and mucosal wound healing.

Science.gov (United States)

Engeland, Christopher G; Sabzehei, Bahareh; Marucha, Phillip T

2009-07-01

Wound healing studies, which have chiefly examined dermal tissues, have reported a female advantage in healing rates. In contrast, our laboratory recently demonstrated women heal mucosal wounds more slowly than men. We hypothesized sex hormones influence wound healing rates, possibly through their modulating effects on inflammation. This study involved 329 younger subjects aged 18-43 (165 women, 164 men) and 93 older subjects aged 50-88 (60 women, 33 men). A 3.5mm diameter wound was created on the hard oral palate and videographed daily to assess wound closure. Blood collected at the time of wounding was used to assess circulating testosterone, progesterone and estradiol levels, and in vitro cytokine production in response to LPS. No strong associations were observed between healing times and estradiol or progesterone levels. However, in younger subjects, lower testosterone levels related to faster wound closure. Conversely, in older women higher testosterone levels related to (1) lower inflammatory responses; and (2) faster healing times. No such relationships were seen in older men, or in women taking oral contraceptives or hormone replacement therapy [HRT]. Older women (50-54 years) not yet experiencing menopause healed similarly to younger women and dissimilarly from age-matched post-menopausal women. This suggests that the deleterious effects of aging on wound healing occur secondary to the effects of menopause. Supporting this, there was evidence in post-menopausal women that HRT augmented wound closure. Overall, this study suggests that human mucosal healing rates are modulated by testosterone levels. Based upon when between-group differences were observed, testosterone may impact upon the proliferative phase of healing which involves immune processes such as re-epithelialization and angiogenesis.

Effect of astaxanthin on cutaneous wound healing

Directory of Open Access Journals (Sweden)

Meephansan J

2017-07-01

Full Text Available Jitlada Meephansan,1 Atiya Rungjang,1 Werayut Yingmema,2 Raksawan Deenonpoe,3 Saranyoo Ponnikorn3 1Division of Dermatology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand; 2Laboratory Animal Centers, Thammasat University, Pathum Thani, Thailand; 3Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand Abstract: Wound healing consists of a complex series of convoluted processes which involve renewal of the skin after injury. ROS are involved in all phases of wound healing. A balance between oxidative and antioxidative forces is necessary for a favorable healing outcome. Astaxanthin, a member of the xanthophyll group, is considered a powerful antioxidant. In this study, we investigated the effect of topical astaxanthin on cutaneous wound healing. Full-thickness dermal wounds were created in 36 healthy female mice, which were divided into a control group and a group receiving 78.9 µM topical astaxanthin treatment twice daily for 15 days. Astaxanthin-treated wounds showed noticeable contraction by day 3 of treatment and complete wound closure by day 9, whereas the wounds of control mice revealed only partial epithelialization and still carried scabs. Wound healing biological markers including Col1A1 and bFGF were significantly increased in the astaxanthin-treated group since day 1. Interestingly, the oxidative stress marker iNOS showed a significantly lower expression in the study. The results indicate that astaxanthin is an effective compound for accelerating wound healing. Keywords: astaxanthin, wound healing, reactive oxygen species, antioxidant 

[Aesthetic effect of wound repair with flaps].

Science.gov (United States)

Tan, Qian; Zhou, Hong-Reng; Wang, Shu-Qin; Zheng, Dong-Feng; Xu, Peng; Wu, Jie; Ge, Hua-Qiang; Lin, Yue; Yan, Xin

2012-08-01

To investigate the aesthetic effect of wound repair with flaps. One thousand nine hundred and ninety-six patients with 2082 wounds hospitalized from January 2004 to December 2011. These wounds included 503 deep burn wounds, 268 pressure sores, 392 soft tissue defects caused by trauma, 479 soft tissue defects due to resection of skin cancer and mole removal, 314 soft tissue defects caused by scar excision, and 126 other wounds. Wound area ranged from 1.5 cm x 1.0 cm to 30.0 cm x 22.0 cm. Sliding flaps, expanded flaps, pedicle flaps, and free flaps were used to repair the wounds in accordance with the principle and timing of wound repair with flaps. Five flaps showed venous congestion within 48 hours post-operation, 2 flaps of them improved after local massage. One flap survived after local heparin wet packing and venous bloodletting. One flap survived after emergency surgical embolectomy and bridging with saphenous vein graft. One flap showed partial necrosis and healed after skin grafting. The other flaps survived well. One thousand three hundred and twenty-one patients were followed up for 3 months to 2 years, and flaps of them were satisfactory in shape, color, and elasticity, similar to that of normal skin. Some patients underwent scar revision later with good results. Application of suitable flaps in wound repair will result in quick wound healing, good function recovery, and satisfactory aesthetic effect.

Effects of plasma treatment on wounds

NARCIS (Netherlands)

Tipa, R.S.; Stoffels - Adamowicz, E.; Lim, C.T.; Goh, J.C.H.

2009-01-01

Cold plasma treatment of wounds is gaining much interest, because it will offer a non-contact, painless and harmless therapy to manage large-area lesions (burn wounds, chronic ulcerations). One of the important issues in plasma wound healing is the safety of the method. In this work we study in

Evaluation of Borrago topical effects on wound healing of cutting wounds in mice

Directory of Open Access Journals (Sweden)

Hossein kaboli

2017-07-01

Conclusion: The results show the positive effect of Borrago Officinalis extract on wound healing. In comparison, this effect is less than the phenytoin and more than iodine. More studies are needed on different doses of this plant and its comparative effect with other common treatments for wound healing.

Why your housecat's trite little bite could cause you quite a fright: a study of domestic felines on the occurrence and antibiotic susceptibility of Pasteurella multocida.

Science.gov (United States)

Freshwater, A

2008-10-01

Approximately four to five million animal bite wounds are reported in the USA each year. Domestic companion animals inflict the majority of these wounds. Although canine bites far outnumber feline bites, unlike the dog, the cat's bite is worse than its bark; 20-80% of all cat bites will become infected, compared with only 3-18% of dog bite wounds. Pasteurella multocida is the most commonly cultured bacterium from infected cat bite wounds. Anyone seeking medical attention for a cat-inflicted bite wound is given prophylactic/empiric penicillin or a derivative to prevent Pasteurella infection (provided they are not allergic to penicillins). In an effort to establish a carriage rate of P. multocida in the domestic feline, bacterial samples from the gingival margins of domestic northern Ohio cats (n=409) were cultured. Isolates were tested for antibiotic sensitivity as prophylactic/empiric use of penicillin and its derivatives could potentially give rise to antibiotic resistance in P. multocida. The high carriage rate (approximately 90%) of P. multocida observed was found to be independent of physiological and behavioural variables including age, breed, food type, gingival scale, lifestyle and sex. High antibiotic susceptibility percentages were observed for benzylpenicillin, amoxicillin-clavulanate, cefazolin, and azithromycin (100%, 100%, 98.37% and 94.02%, respectively) in P. multocida isolates. The high prevalence of P. multocida in the feline oral cavity indicates that prophylactic/empiric antibiotic therapy is still an appropriate response to cat bite wounds. Additionally, the susceptibility of P. multocida to penicillin and its derivatives indicates that they remain reliable choices for preventing and treating P. multocida infections.

Topical erythropoietin promotes wound repair in diabetic rats.

Science.gov (United States)

Hamed, Saher; Ullmann, Yehuda; Masoud, Muhannad; Hellou, Elias; Khamaysi, Ziad; Teot, Luc

2010-01-01

Wound healing in diabetic patients is slower than in healthy individuals. Erythropoietin (EPO) has non-hemopoietic targets in the skin, and systemically administered EPO promotes wound healing in experimental animals. This study investigated the effect of topical EPO treatment on defective wound repair in the skin of diabetic rats. Full-thickness excisional skin wounds were made in 38 rats, of which 30 had diabetes. The wounds were then treated topically with a cream that contained either vehicle, 600 IU ml(-1) EPO (low dose), or 3,000 IU ml(-1) (high dose) EPO. We assessed the rate of wound closure during the 12-day treatment period, and microvascular density (MVD), vascular endothelial growth factor (VEGF), and hydroxyproline (HP) contents, and the extent of apoptosis in wound tissues at the end of the 12-day treatment period. Topical EPO treatment significantly reduced the time to final wound closure. This increased rate of closure of the two EPO-treated wounds in diabetic rats was associated with increased MVD, VEGF, and HP contents, and a reduced extent of apoptosis. In light of our finding that topical EPO treatment promotes skin wound repair in diabetic rats, we propose that topical EPO treatment is a therapeutically beneficial method of treating chronic diabetic wounds.

Cellular inhibitor of apoptosis protein 2 (cIAP2) controls human colonic epithelial restitution, migration and Rac1 activation

DEFF Research Database (Denmark)

Seidelin, JB; Larsen, Sylvester; Linnemann, D

2015-01-01

epithelial cells (IECs) was increased at the wound edge after 24 h (P 2 was induced in vitro in regenerating Caco2 IECs after wound infliction (P ...Identification of pathways involved in wound healing is important for understanding the pathogenesis of various intestinal diseases. Cellular inhibitor of apoptosis protein 2 (cIAP2) regulates proliferation and migration in nonepithelial cells and is expressed in human colonocytes. The aim...... of the study was to investigate the role of cIAP2 for wound healing in the normal human colon. Wound tissue was generated by taking rectosigmoidal biopsies across an experimental ulcer in healthy subjects after 5, 24, and 48 h. In experimental ulcers, the expression of cIAP2 in regenerating intestinal...

Impedance spectroscopy applied to the fast wounding dynamics of an electrical wound-healing assay in mammalian cells

Science.gov (United States)

Bellotti, Mariela I.; Giana, Fabián E.; Bonetto, Fabián J.

2015-08-01

Electrical wound-healing assays are often used as a means to study in vitro cell migration and proliferation. In such analysis, a cell monolayer that sits on a small electrode is electrically wounded and its spectral impedance is then continuously measured in order to monitor the healing process. The relatively slow dynamics of the cell healing have been extensively studied, while those of the much faster wounding phase have not yet been investigated. An analysis of the electrical properties of a particular cell type during this phase could give extra information about the changes in the cell membrane due to the application of the wounding current, and could also be useful to optimize the wounding regime for different cell types. The main issue when trying to register information about these dynamics is that the traditional measurement scheme employed in typical wound-healing assays doesn’t allow the simultaneous application of the wounding signal and measurement of the system’s impedance. In this paper, we overcome this limitation by implementing a measurement strategy consisting of cycles of fast alternating low- and high-voltage signals applied on electrodes covered with mammalian cells. This approach is capable of registering the fast impedance changes during the transient regime corresponding to the cell wounding process. Furthermore, these quasi-simultaneous high- and low-voltage measurements can be compared in order to obtain an empirical correlation between both quantities.

Impedance spectroscopy applied to the fast wounding dynamics of an electrical wound-healing assay in mammalian cells

International Nuclear Information System (INIS)

Bellotti, Mariela I; Giana, Fabián E; Bonetto, Fabián J

2015-01-01

Electrical wound-healing assays are often used as a means to study in vitro cell migration and proliferation. In such analysis, a cell monolayer that sits on a small electrode is electrically wounded and its spectral impedance is then continuously measured in order to monitor the healing process. The relatively slow dynamics of the cell healing have been extensively studied, while those of the much faster wounding phase have not yet been investigated. An analysis of the electrical properties of a particular cell type during this phase could give extra information about the changes in the cell membrane due to the application of the wounding current, and could also be useful to optimize the wounding regime for different cell types. The main issue when trying to register information about these dynamics is that the traditional measurement scheme employed in typical wound-healing assays doesn’t allow the simultaneous application of the wounding signal and measurement of the system’s impedance. In this paper, we overcome this limitation by implementing a measurement strategy consisting of cycles of fast alternating low- and high-voltage signals applied on electrodes covered with mammalian cells. This approach is capable of registering the fast impedance changes during the transient regime corresponding to the cell wounding process. Furthermore, these quasi-simultaneous high- and low-voltage measurements can be compared in order to obtain an empirical correlation between both quantities. (paper)

Microfluidic wound-healing assay to assess the regenerative effect of HGF on wounded alveolar epithelium.

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Felder, Marcel; Sallin, Pauline; Barbe, Laurent; Haenni, Beat; Gazdhar, Amiq; Geiser, Thomas; Guenat, Olivier

2012-02-07

We present a microfluidic epithelial wound-healing assay that allows characterization of the effect of hepatocyte growth factor (HGF) on the regeneration of alveolar epithelium using a flow-focusing technique to create a regular wound in the epithelial monolayer. The phenotype of the epithelial cell was characterized using immunostaining for tight junction (TJ) proteins and transmission electron micrographs (TEMs) of cells cultured in the microfluidic system, a technique that is reported here for the first time. We demonstrate that alveolar epithelial cells cultured in a microfluidic environment preserve their phenotype before and after wounding. In addition, we report a wound-healing benefit induced by addition of HGF to the cell culture medium (19.2 vs. 13.5 μm h(-1) healing rate).

Multispectral imaging of acute wound tissue oxygenation

Directory of Open Access Journals (Sweden)

Audrey Huong

2017-05-01

Full Text Available This paper investigates the appropriate range of values for the transcutaneous blood oxygen saturation (StO2 of granulating tissues and the surrounding tissue that can ensure timely wound recovery. This work has used a multispectral imaging system to collect wound images at wavelengths ranging between 520nm and 600nm with a resolution of 10nm. As part of this research, a pilot study was conducted on three injured individuals with superficial wounds of different wound ages at different skin locations. The StO2 value predicted for the examined wounds using the Extended Modified Lambert–Beer model revealed a mean StO2 of 61±10.3% compared to 41.6±6.2% at the surrounding tissues, and 50.1±1.53% for control sites. These preliminary results contribute to the existing knowledge on the possible range and variation of wound bed StO2 that are to be used as indicators of the functioning of the vasomotion system and wound health. This study has concluded that a high StO2 of approximately 60% and a large fluctuation in this value should precede a good progression in wound healing.

Trauma and the transference-countertransference: working with the bad object and the wounded self.

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West, Marcus

2013-02-01

This paper focuses on the transference-countertransference dynamics that manifest in work with those individuals who experienced severe early relational trauma and, in particular, childhood sexual abuse. The literature is surveyed from Davies and Frawley's (1992a) seminal paper through to more current trauma-related and sensorimotor approaches, which deepen our understanding greatly. The rapidly shifting, powerful, conflicting and kaleidoscopic transference-countertransference dynamics are explored in the light of these views and in relation to a lengthy clinical example. The author elucidates the dual-aspect of the traumatic complex, whereby the abuser figure, which is disavowed by the patient, becomes manifest in prosecuting the analyst for the 'wounds' that the analysis evokes. The paper also explores the particular nature of the splitting processes, whereby pressure is put on the analyst to adopt an idealized role, in particular to act as a self-object, in order to enable the patient to safely express and 'be' themselves in an attempt to make up for what was not possible in childhood; the analyst will necessarily fail in this task. In the context of powerful masochisto-sadistic dynamics, the analyst's masochism is likely to be called up in the spirit of caring 'humanity' (another inevitable enactment), which can impede the progress of the analysis if not addressed. The extreme woundedness, intense affect and moral outrage associated with these dynamics are characteristic and compelling. Issues relating to disclosure, enactment and analytic attitude are also discussed. © 2013, The Society of Analytical Psychology.

Stem Cells for Cutaneous Wound Healing.

Science.gov (United States)

Kirby, Giles T S; Mills, Stuart J; Cowin, Allison J; Smith, Louise E

2015-01-01

Optimum healing of a cutaneous wound involves a well-orchestrated cascade of biological and molecular processes involving cell migration, proliferation, extracellular matrix deposition, and remodelling. When the normal biological process fails for any reason, this healing process can stall resulting in chronic wounds. Wounds are a growing clinical burden on healthcare systems and with an aging population as well as increasing incidences of obesity and diabetes, this problem is set to increase. Cell therapies may be the solution. A range of cell based approaches have begun to cross the rift from bench to bedside and the supporting data suggests that the appropriate administration of stem cells can accelerate wound healing. This review examines the main cell types explored for cutaneous wound healing with a focus on clinical use. The literature overwhelmingly suggests that cell therapies can help to heal cutaneous wounds when used appropriately but we are at risk of clinical use outpacing the evidence. There is a need, now more than ever, for standardised methods of cell characterisation and delivery, as well as randomised clinical trials.

Stem Cells for Cutaneous Wound Healing

Directory of Open Access Journals (Sweden)

Giles T. S. Kirby

2015-01-01

Full Text Available Optimum healing of a cutaneous wound involves a well-orchestrated cascade of biological and molecular processes involving cell migration, proliferation, extracellular matrix deposition, and remodelling. When the normal biological process fails for any reason, this healing process can stall resulting in chronic wounds. Wounds are a growing clinical burden on healthcare systems and with an aging population as well as increasing incidences of obesity and diabetes, this problem is set to increase. Cell therapies may be the solution. A range of cell based approaches have begun to cross the rift from bench to bedside and the supporting data suggests that the appropriate administration of stem cells can accelerate wound healing. This review examines the main cell types explored for cutaneous wound healing with a focus on clinical use. The literature overwhelmingly suggests that cell therapies can help to heal cutaneous wounds when used appropriately but we are at risk of clinical use outpacing the evidence. There is a need, now more than ever, for standardised methods of cell characterisation and delivery, as well as randomised clinical trials.

Antimicrobial stewardship in wound care

DEFF Research Database (Denmark)

Lipsky, Benjamin A; Dryden, Matthew; Gottrup, Finn

2016-01-01

BACKGROUND: With the growing global problem of antibiotic resistance it is crucial that clinicians use antibiotics wisely, which largely means following the principles of antimicrobial stewardship (AMS). Treatment of various types of wounds is one of the more common reasons for prescribing...... of experts in infectious diseases/clinical microbiology (from the British Society for Antimicrobial Chemotherapy) and wound management (from the European Wound Management Association) who, after thoroughly reviewing the available literature and holding teleconferences, jointly produced this guidance document...

Dual therapeutic functions of F-5 fragment in burn wounds: preventing wound progression and promoting wound healing in pigs

OpenAIRE

Bhatia, Ayesha; O'Brien, Kathryn; Chen, Mei; Wong, Alex; Garner, Warren; Woodley, David T.; Li, Wei

2016-01-01

Burn injuries are a leading cause of morbidity including prolonged hospitalization, disfigurement, and disability. Currently there is no Food and Drug Administration-approved burn therapeutics. A clinical distinction of burn injuries from other acute wounds is the event of the so-called secondary burn wound progression within the first week of the injury, in which a burn expands horizontally and vertically from its initial boundary to a larger area. Therefore, an effective therapeutics for bu...

A guide to wound managment in palliative care.

Science.gov (United States)

Naylor, Wayne A

2005-11-01

Wound management in palliative patients is often a very challenging area of care. There are many unique issues that can combine to produce complicated wound management scenarios, including the types of wounds and wound symptoms most commonly affecting palliative care patients, as well as the presence of concurrent disease and associated treatment. Problems exist with the availability of suitable dressings and balancing life expectancy with the goals of wound care. A significant, and possibly under-recognized, issue is the emotional and social distress experienced by these patients, which can be directly attributed to their wound. These problems must all be recognized and addressed in order to manage wounds effectively in this patient population. This article aims to explore these issues and offer advice on the management of wound-related symptoms, with the ultimate goal of improving patients' quality of life.

Self-Expanding, Tough Biodegradable Elastomers for Wound Stasis

Science.gov (United States)

2015-08-06

the civilian setting, with no effective therapies available at point of injury. We previously reported that a self- expanding polyurethane foam...setting, with no effective therapies available at point of injury. We previously reported that a self-expanding polyurethane foam significantly...care in accor- dance with the Guide of the Care and Use of Laboratory Ani- mals (Health, 2011 #17). 2.2. Instrumentation and monitoring All swine (n

Enhancement of Wound Healing by Non-Thermal N2/Ar Micro-Plasma Exposure in Mice with Fractional-CO2-Laser-Induced Wounds

Science.gov (United States)

Shao, Pei-Lin; Liao, Jiunn-Der; Wong, Tak-Wah; Wang, Yi-Cheng; Leu, Steve; Yip, Hon-Kan

2016-01-01

Micro-plasma is a possible alternative treatment for wound management. The effect of micro-plasma on wound healing depends on its composition and temperature. The authors previously developed a capillary-tube-based micro-plasma system that can generate micro-plasma with a high nitric oxide-containing species composition and mild working temperature. Here, the efficacy of micro-plasma treatment on wound healing in a laser-induced skin wound mouse model was investigated. A partial thickness wound was created in the back skin of each mouse and then treated with micro-plasma. Non-invasive methods, namely wound closure kinetics, optical coherence tomography (OCT), and laser Doppler scanning, were used to measure the healing efficiency in the wound area. Neo-tissue growth and the expressions of matrix metallopeptidase-3 (MMP-3) and laminin in the wound area were assessed using histological and immunohistochemistry (IHC) analysis. The results show that micro-plasma treatment promoted wound healing. Micro-plasma treatment significantly reduced the wound bed region. The OCT images and histological analysis indicates more pronounced tissue regrowth in the wound bed region after micro-plasma treatment. The laser Doppler images shows that micro-plasma treatment promoted blood flow in the wound bed region. The IHC results show that the level of laminin increased in the wound bed region after micro-plasma treatment, whereas the level of MMP-3 decreased. Based on these results, micro-plasma has potential to be used to promote the healing of skin wounds clinically. PMID:27248979

Animal bites - self-care

Science.gov (United States)

Bites - animals - self-care ... Most animal bites come from pets. Dog bites are common and most often happen to children. Cat bites are ... which can cause deeper puncture wounds. Most other animal bites are caused by stray or wild animals, ...

Cottoning on

Science.gov (United States)

Non-healing or chronic wounds are an often unacknowledged burden to healthcare sectors worldwide. When left unresolved they can inflict untold suffering, result in high mortality and contribute to burgeoning health service expenditure. In the US, for example, more than 6 million people currently suf...

Honey improves healing of circumscribed excision injury to the paniculus adiposus in albino rats.

Science.gov (United States)

Osuegbu, O I; Yama, O E; Edibamode, E I; Awolola, N A; Clement, A B; Amah, C I

2012-01-01

Honey promoteswound healing. In this study, we described the anatomical perspective of honey on wound healing in male rats. The twenty-four male rats used were randomly divided equally into treated Experimental (E) and Control (C) groups. Infliction of wound done under anaesthesia; honey was used for wound dressing in E, distilled water firmly held by plaster in C. Monitoring of wound contraction were carried out at the interval of three days till the wound healed. The histology of granulation tissue excised from the wounds of rats was also done. Mean wound contraction (%) of rats in E on days 3, 6, and 9 were: 35.32 +/- 5.5; 57.56 +/- 0.7 and 82.30 +/- 0.9% compared to 26.50 +/- 1.2; 46.69 +/- 0.4 and 61.24 +/- 1.0% of rats in C. Honey treated groups showed significant increase (p honey accelerates the wound healing process.

Cost-effectiveness of negative pressure wound therapy in patients with many comorbidities and severe wounds of various etiology.

Science.gov (United States)

Driver, Vickie R; Eckert, Kristen A; Carter, Marissa J; French, Michael A

2016-11-01

This study analyzed a cross-section of patients with severe chronic wounds and multiple comorbidities at an outpatient wound clinic, with regard to the cost-effectiveness and cost-benefit of negative pressure wound therapy (intervention) vs. no negative pressure wound therapy (control) at 1 and 2 years. Medicare reimbursement charges for wound care were used to calculate costs. Amputation charges were assessed using diagnosis-related groups. Cost-benefit analysis was based on ulcer-free months and cost-effectiveness on quality-adjusted life-years. Undiscounted costs, benefits, quality-adjusted life-years, undiscounted and discounted incremental net health benefits, and incremental cost-effectiveness ratios were calculated for unmatched and matched cohorts. There were 150 subjects in the intervention group and 154 controls before matching and 103 subjects in each of the matched cohorts. Time to heal for the intervention cohort was significantly shorter compared to the controls (270 vs. 635 days, p = 1.0 × 10 -7 , matched cohorts). The intervention cohort had higher benefits and quality-adjusted life-year gains compared to the control cohort at years 1 and 2; by year 2, the gains were 68-73% higher. In the unmatched cohorts, the incremental net health benefit was $9,933 per ulcer-free month at year 2 for the intervention; the incremental cost-effectiveness ratio was -825,271 per quality-adjusted life-year gained (undiscounted costs and benefits). For the matched cohorts, the incremental net health benefits was only $1,371 per ulcer-free month for the intervention, but the incremental cost-effectiveness ratio was $366,683 per quality-adjusted life-year gained for year 2 (discounted costs and benefits). In a patient population with severe chronic wounds and serious comorbidities, negative pressure wound therapy resulted in faster healing wounds and was more cost-effective with greater cost-benefits than not using negative pressure wound therapy. Regarding overall

21 CFR 882.4800 - Self-retaining retractor for neurosurgery.

Science.gov (United States)

2010-04-01

... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Self-retaining retractor for neurosurgery. 882...-retaining retractor for neurosurgery. (a) Identification. A self-retaining retractor for neurosurgery is a self-locking device used to hold the edges of a wound open during neurosurgery. (b) Classification...

Wound Drainage Culture (For Parents)

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... Fitness Diseases & Conditions Infections Drugs & Alcohol School & Jobs Sports Expert Answers (Q&A) Staying Safe Videos for Educators Search English Español Wound Drainage Culture KidsHealth / For Parents / Wound Drainage Culture What's in ...

Differential expression of myofibroblasts on CO2 laser wounds and scalpel wounds: an experimental model

Science.gov (United States)

Machado, R. M.; Oliveira, C. R. B.; Vitória, L. A.; Xavier, F. C. A.; Pinheiro, A. L. B.; Freitas, A. C.; Ramalho, L. M. P.

2018-04-01

Wound contraction of both traumatic and surgical origin may reduce or limit the function of the tissue. Myofibroblasts are cells involved on the process of wound contraction, which is smaller on CO2 Laser wounds. The aims of this study were to quantitative and statistically assess the presence of myofibroblasts on both conventional and CO2 Laser wounds. Thirty-two animals (rattus norvegicus) were divided into four groups and operated using either the CO2 Laser (groups A1 and A2) or conventional scalpel (groups B1 and B2). The animals were sacrificed eight days post-operatively (groups: A1 and B1) and 14th days after surgery (groups: A2 and B2). The spec imens we re routinely processed to wax and stained with a-Smooth Muscle Actin (aSMA) and analyzed under light microscopy (40X). Two standard areas around the wound of each slide were selected and used to count the number of myofribroblasts present using a calibrated eyepiece and a graticule. The number of myofibroblasts at day eight was significantly higher than at day 14th. Comparison of the two techniques at day eight showed significant differences between the two groups (Laser, p=0.007 and scalpel, p=0.001). The number of cells present on group B1 was significantly higher than group A1 (p=0.001). However at the 14th day there was no such difference (p=0,072). It is concluded that the small number of myofibroblasts at day eight after wounding with the CO2 Lasermay be the reason why contraction on this wound is smaller than the one observed in conventional surgery.

Investigation of inflicted injury in a young girl reveals mild haemophilia A and Turner's syndrome.

Science.gov (United States)

Williams, V K; Suppiah, R; Coppin, B; Nicholls, C M; Simsek, A; McGregor, L K

2012-02-01

A 2-year-old girl presented to casualty with a right knee effusion after apparently minor trauma. Inflicted injury was suspected and full forensic coagulation studies were performed which revealed a mild deficiency of factor VIII. Screening of the exons and intron/exon boundaries of F8 gene indicated that the child appeared to be homozygous for the missense mutation c.5123G>A (p.Arg1708His) in exon 14 of the F8 gene. This mutation has been reported to be associated with mild haemophilia A. The possibility of hemizygosity had been masked by the test kit employed but referral to the genetics service and subsequent array CGH resulted in a diagnosis of Turner syndrome. © 2011 Blackwell Publishing Ltd.

Wound-Related Allergic/Irritant Contact Dermatitis.

Science.gov (United States)

Alavi, Afsaneh; Sibbald, R Gary; Ladizinski, Barry; Saraiya, Ami; Lee, Kachiu C; Skotnicki-Grant, Sandy; Maibach, Howard

2016-06-01

To provide information from a literature review about the prevention, recognition, and treatment for contact dermatitis. This continuing education activity is intended for physicians and nurses with an interest in skin and wound care. After participating in this educational activity, the participant should be better able to:1. Identify signs and symptoms of and diagnostic measures for contact dermatitis.2. Identify causes and risks for contact dermatitis.3. Select appropriate treatment for contact dermatitis and its prevention. Contact dermatitis to wound care products is a common, often neglected problem. A review was conducted to identify articles relevant to contact dermatitis.A PubMed English-language literature review was conducted for appropriate articles published between January 2000 and December 2015.Contact dermatitis is both irritant (80% of cases) or allergic (20% of cases). Frequent use of potential contact allergens and impaired barrier function of the skin can lead to rising sensitization in patients with chronic wounds. Common known allergens to avoid in wound care patients include fragrances, colophony, lanolin, and topical antibiotics.Clinicians should be cognizant of the allergens in wound care products and the potential for sensitization. All medical devices, including wound dressings, adhesives, and bandages, should be labeled with their complete ingredients, and manufacturers should be encouraged to remove common allergens from wound care products, including topical creams, ointments, and dressings.

The Role of Macrophages in Acute and Chronic Wound Healing and Interventions to Promote Pro-wound Healing Phenotypes

Directory of Open Access Journals (Sweden)

Paulina Krzyszczyk

2018-05-01

Full Text Available Macrophages play key roles in all phases of adult wound healing, which are inflammation, proliferation, and remodeling. As wounds heal, the local macrophage population transitions from predominantly pro-inflammatory (M1-like phenotypes to anti-inflammatory (M2-like phenotypes. Non-healing chronic wounds, such as pressure, arterial, venous, and diabetic ulcers indefinitely remain in inflammation—the first stage of wound healing. Thus, local macrophages retain pro-inflammatory characteristics. This review discusses the physiology of monocytes and macrophages in acute wound healing and the different phenotypes described in the literature for both in vitro and in vivo models. We also discuss aberrations that occur in macrophage populations in chronic wounds, and attempts to restore macrophage function by therapeutic approaches. These include endogenous M1 attenuation, exogenous M2 supplementation and endogenous macrophage modulation/M2 promotion via mesenchymal stem cells, growth factors, biomaterials, heme oxygenase-1 (HO-1 expression, and oxygen therapy. We recognize the challenges and controversies that exist in this field, such as standardization of macrophage phenotype nomenclature, definition of their distinct roles and understanding which phenotype is optimal in order to promote healing in chronic wounds.

The Role of Macrophages in Acute and Chronic Wound Healing and Interventions to Promote Pro-wound Healing Phenotypes

Science.gov (United States)

Krzyszczyk, Paulina; Schloss, Rene; Palmer, Andre; Berthiaume, François

2018-01-01

Macrophages play key roles in all phases of adult wound healing, which are inflammation, proliferation, and remodeling. As wounds heal, the local macrophage population transitions from predominantly pro-inflammatory (M1-like phenotypes) to anti-inflammatory (M2-like phenotypes). Non-healing chronic wounds, such as pressure, arterial, venous, and diabetic ulcers indefinitely remain in inflammation—the first stage of wound healing. Thus, local macrophages retain pro-inflammatory characteristics. This review discusses the physiology of monocytes and macrophages in acute wound healing and the different phenotypes described in the literature for both in vitro and in vivo models. We also discuss aberrations that occur in macrophage populations in chronic wounds, and attempts to restore macrophage function by therapeutic approaches. These include endogenous M1 attenuation, exogenous M2 supplementation and endogenous macrophage modulation/M2 promotion via mesenchymal stem cells, growth factors, biomaterials, heme oxygenase-1 (HO-1) expression, and oxygen therapy. We recognize the challenges and controversies that exist in this field, such as standardization of macrophage phenotype nomenclature, definition of their distinct roles and understanding which phenotype is optimal in order to promote healing in chronic wounds. PMID:29765329

Lumican as a multivalent effector in wound healing.

Science.gov (United States)

Karamanou, Konstantina; Perrot, Gwenn; Maquart, Francois-Xavier; Brézillon, Stéphane

2018-03-01

Wound healing, a complex physiological process, is responsible for tissue repair after exposure to destructive stimuli, without resulting in complete functional regeneration. Injuries can be stromal or epithelial, and most cases of wound repair have been studied in the skin and cornea. Lumican, a small leucine-rich proteoglycan, is expressed in the extracellular matrices of several tissues, such as the cornea, cartilage, and skin. This molecule has been shown to regulate collagen fibrillogenesis, keratinocyte phenotypes, and corneal transparency modulation. Lumican is also involved in the extravasation of inflammatory cells and angiogenesis, which are both critical in stromal wound healing. Lumican is the only member of the small leucine-rich proteoglycan family expressed by the epithelia during wound healing. This review summarizes the importance of lumican in wound healing and potential methods of lumican drug delivery to target wound repair are discussed. The involvement of lumican in corneal wound healing is described based on in vitro and in vivo models, with critical emphasis on its underlying mechanisms of action. Similarly, the expression and role of lumican in the healing of other tissues are presented, with emphasis on skin wound healing. Overall, lumican promotes normal wound repair and broadens new therapeutic perspectives for impaired wound healing. Copyright © 2018. Published by Elsevier B.V.

Self-inflicted finger injury in individuals with spinal cord injury: an analysis of 5 cases.

Science.gov (United States)

Frost, Frederick S; Mukkamala, Sridevi; Covington, Edward

2008-01-01

To describe the occurrence of finger autophagia in 5 persons with traumatic spinal cord injury and to present a discussion of putative causes and potential treatments. Minor self-mutilating actions, such as nail biting and hair pulling, are common in humans and usually benign. In some circumstances, these behaviors are associated with obsessive-compulsive personality traits. In humans, self-injurious biting behaviors are well described in the setting of mental retardation and psychosis and in persons with Lesch-Nyhan syndrome. Rare cases of human autophagia in persons with intact cognition have been reported, most commonly in the setting of acquired nervous system lesions. After spinal cord injury, it has been suggested that this behavior constitutes a human variant of animal autotomy and a response to neuropathic pain. Case presentation narrative. Photographic and radiological study, administration of Yale-Brown Obsessive-Compulsive Scale (YBOCS). In 5 patients with complete tetraplegia, pain in the hands was present in only one instance. The severity of autoamputation varied from minor to extreme. In all cases, damage was confined to analgesic body parts. In 3 cases, autophagia behavior was discovered in progress. Treatments included pharmacotherapy, counseling, and behavioral therapy, with mixed results. All patients were intelligent, willing to discuss their issues, and able to identify conditions of stress and isolation in their lives. Mild preinjury obsessive-compulsive behaviors, such as nail biting, were universal. On the YBOCS, only 1 patient scored in a range indicative of mild obsessive-compulsive symptomatology. This group exhibited heterogeneous medical, social, and cultural characteristics. A link between pain and self-injurious behavior could not be demonstrated. This behavior may be viewed as an extreme variant of nail biting, with potential ominous complications. Treatment strategies have been employed with mixed results.

The effects of Fe-oxidizing microorganisms on post-biostimulation permeability reduction and oxidative processes at the Rifle IFRC site

Energy Technology Data Exchange (ETDEWEB)

Chan, Clara Sze-Yue [Univ. of Delaware, Newark, DE (United States)

2015-07-02

Fe oxidation and biomineral formation is important in aquifers because the highly-reactive oxides can control the mobility of nutrients (e.g. phosphate, C) and metals (e.g. arsenic, uranium). Mineral formation also has the potential to affect hydrology, depending on the volume and distribution in pore spaces. In this exploratory study, we sought to understand how microbial Fe-oxidizers and their biominerals affect, and are affected by groundwater flow. As part of work at the Rifle aquifer in Colorado, we initially hypothesized that Fe-oxidizers were contributing to aquifer clogging problems associated with enhanced bioremediation. To demonstrate the presence of Fe-oxidizers in the Rifle aquifer, we enriched FeOM from groundwater samples, and isolated two novel chemolithotrophic, microaerophilic Fe-oxidizing Betaproteobacteria, Hydrogenophaga sp. P101 and Curvibacter sp. CD03. To image cells and biominerals in the context of pores, we developed a “micro-aquifer,” a sand-filled flow-through culture chamber that allows for imaging of sediment pore space with multiphoton confocal microscopy. Fe oxide biofilms formed on sand grains, demonstrating that FeOM produce Fe oxide sand coatings. Fe coatings are common on aquifer sands, and tend to sequester contaminants; however, it has never previously been shown that microbes are responsible for their formation. In contrast to our original hypothesis, the biominerals did not clog the mini-aquifer. Instead, Fe biofilm distribution was dynamic: they grew as coatings, then periodically sloughed off sand grains, with some flocs later caught in pore throats. This has implications for physical hydrology, including pore scale architecture, and element transport. The sloughing of coatings likely prevents the biominerals from clogging wells and aquifers, at least initially. Although attached biomineral coatings sequester Fe-associated elements (e.g. P, As, C, U), when biominerals detach, these elements are transported as particles

Implementation of the NCRP wound model for interpretation of bioassay data for intake of radionuclides through contaminated wounds

International Nuclear Information System (INIS)

Ishigure, Nobuhito

2009-01-01

Emergency response preparedness for radiological accidents involving wound contamination has become more important, considering the current extending tendency in the nuclear industry related to the nuclear fuel cycle. The US National Council on Radiation Protection and Measurements (NCRP) proposed a biokinetic and dosimetric model for the intake of radionuclides through contaminated wounds in 2007. The present paper describes the implementation of this NCRP wound model for the prediction of systemic behaviour of some important radioactive elements encountered in workplaces related to the nuclear industry. The NCRP wound model was linked to the current ICRP systemic model at each blood compartment and simultaneous differential equations for the content of radioactivity in each compartment and excreta were solved with the Runge-Kutta method. The results of the calculation of wound, whole-body or specific organ retention and daily urinary or faecal excretion rate of some selected elements will be useful for the interpretation of bioassay data and dose assessment for cases of wound contamination. (author)

Significant Differences in Nurses’ Knowledge of Basic Wound Management

DEFF Research Database (Denmark)

Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B

2014-01-01

Wounds represent a growing healthcare problem due to an aging population. Nurses play a key role in wound management and their theoretical understanding of basic wound management may be expected to influence the quality of wound therapy fundamentally. In this study, we evaluated the level...... of knowledge of wound management in 136 Danish nurses working in 3 different settings: advanced wound care clinics, home care and general hospital departments. We found that hospital nurses had less theoretical knowledge than home care nurses and nurses working at advanced wound care clinics. We also found...... of wound management in Denmark and suggests how improvements might be achieved....

In situ synthesis of silver-nanoparticles/bacterial cellulose composites for slow-released antimicrobial wound dressing.

Science.gov (United States)

Wu, Jian; Zheng, Yudong; Song, Wenhui; Luan, Jiabin; Wen, Xiaoxiao; Wu, Zhigu; Chen, Xiaohua; Wang, Qi; Guo, Shaolin

2014-02-15

Bacterial cellulose has attracted increasing attention as a novel wound dressing material, but it has no antimicrobial activity, which is one of critical skin-barrier functions in wound healing. To overcome such deficiency, we developed a novel method to synthesize and impregnate silver nanoparticles on to bacterial cellulose nanofibres (AgNP-BC). Uniform spherical silver nano-particles (10-30 nm) were generated and self-assembled on the surface of BC nano-fibers, forming a stable and evenly distributed Ag nanoparticles coated BC nanofiber. Such hybrid nanostructure prevented Ag nanoparticles from dropping off BC network and thus minimized the toxicity of nanoparticles. Regardless the slow Ag(+) release, AgNP-BC still exhibited significant antibacterial activities with more than 99% reductions in Escherichia coli, Staphylococcus aureus and Pseudomonas aeruginosa. Moreover, AgNP-BC allowed attachment and growth of epidermal cells with no cytotoxicity emerged. The results demonstrated that AgNP-BC could reduce inflammation and promote wound healing. Copyright © 2013 Elsevier Ltd. All rights reserved.

Copaiba oil in experimental wound healing in horses

Directory of Open Access Journals (Sweden)

Flavia de Almeida Lucas

Full Text Available ABSTRACT: The aim of this study was to evaluate the effects of 10% copaiba oil in experimentally induced wounds in horses. Four wounds were made in the lumbar and metacarpal regions of eight adult horses. In the treatment group, the wounds received 10% copaiba oil and in the control group 0.9% sodium chloride, in the daily dressing for 21 days. The wounds were evaluated three, 7, 14, and 21 days postoperatively. No significant differences were observed between the groups. The mean lumbar wound contraction rates were 80.54% and 69.64%, for the control and treated groups, respectively. For the wounds in the metacarpal region, these averages were 44.15% and 52.48%, respectively. Under the experimental conditions of the present study, it is concluded that 10% copaiba oil has beneficial in wound healing in the equine species and suggest that copaiba oil can be used as a therapeutic possibility in equine wound therapy.

Adenosine Receptors and Wound Healing

Directory of Open Access Journals (Sweden)

Bruce N. Cronstein

2004-01-01

Full Text Available Recent studies have demonstrated that application of topical adenosine A2A receptor agonists promotes more rapid wound closure and clinical studies are currently underway to determine the utility of topical A2A adenosine receptor agonists in the therapy of diabetic foot ulcers. The effects of adenosine A2A receptors on the cells and tissues of healing wounds have only recently been explored. We review here the known effects of adenosine A2A receptor occupancy on the cells involved in wound healing.

Wound healing in pre-tibial injuries--an observation study.

Science.gov (United States)

McClelland, Heather M; Stephenson, John; Ousey, Karen J; Gillibrand, Warren P; Underwood, Paul

2012-06-01

Pre-tibial lacerations are complex wounds affecting a primarily aged population, with poor healing and a potentially significant impact on social well-being. Management of these wounds has changed little in 20 years, despite significant advances in wound care. A retrospective observational study was undertaken to observe current wound care practice and to assess the effect of various medical factors on wound healing time on 24 elderly patients throughout their wound journey. Wound length was found to be substantively and significantly associated with wound healing time, with a reduction in instantaneous healing rate of about 30% for every increase of 1 cm in wound length. Hence, longer wounds are associated with longer wound healing times. Prescription of several categories of drugs, including those for ischaemic heart disease (IHD), hypertension, respiratory disease or asthma; and the age of the patient were not significantly associated with wound healing times, although substantive significance could be inferred in the case of prescription for IHD and asthma. Despite the small sample size, this study identified a clear association between healing and length of wound. Neither the comorbidities nor prescriptions explored showed any significant association although some seem to be more prevalent in this patient group. The study also highlighted other issues that require further exploration including the social and economic impact of these wounds. © 2011 The Authors. © 2011 Blackwell Publishing Ltd and Medicalhelplines.com Inc.

Occurrence of Wounds in Nigerian Horses.

Science.gov (United States)

Agina, Onyinyechukwu A; Ihedioha, John I

2017-01-01

This study investigated the occurrence of wounds in Nigerian horses. The study population was 1,621 horses sold at the Obollo Afor horse lairage in Enugu State, Nigeria, during a 6-month period: 3 months of dry season and 3 months of rainy season (February-April and June-August 2012). A total of 207 horses were systematically sampled and subjected to a comprehensive physical examination. Those with wounds were marked, recorded, and clinically examined. Of the 207 horses sampled, 21 (10.1%) had wounds. The body distribution of the wounds was 9.5% head, 9.5% forelimbs, 19.1% hind limbs, 4.8% tail, 14.3% flank, 9.5% loin, 19.1% hip, 9.5% barrel, and 4.8% croup. The occurrence of the wounds was not significantly associated with sex or season, but the occurrence in adults was significantly (p horses. It was concluded that the occurrence of wounds is relatively high (10.1%), and mainly the hind limbs, hip, and flank of adult horses are affected. It was recommended that horse guardians and handlers should be properly educated on the care of horses.

Electrofabrication of functional materials: Chloramine-based antimicrobial film for infectious wound treatment.

Science.gov (United States)

Qu, Xue; Liu, Huan; Zhang, Chuchu; Lei, Yu; Lei, Miao; Xu, Miao; Jin, Dawei; Li, Peng; Yin, Meng; Payne, Gregory F; Liu, Changsheng

2018-06-01

Electrical signals can be imposed with exquisite spatiotemporal control and provide exciting opportunities to create structure and confer function. Here, we report the use of electrical signals to program the fabrication of a chloramine wound dressing with high antimicrobial activity. This method involves two electrofabrication steps: (i) a cathodic electrodeposition of an aminopolysaccharide chitosan triggered by a localized region of high pH; and (ii) an anodic chlorination of the deposited film in the presence of chloride. This electrofabrication process is completed within several minutes and the chlorinated chitosan can be peeled from the electrode to yield a free-standing film. The presence of active NCl species in this electrofabricated film was confirmed with chlorination occurring first on the amine groups and then on the amide groups when large anodic charges were used. Electrofabrication is quantitatively controllable as the cathodic input controls film growth during deposition and the anodic input controls film chlorination. In vitro studies demonstrate that the chlorinated chitosan film has antimicrobial activities that depend on the chlorination degree. In vivo studies with a MRSA infected wound healing model indicate that the chlorinated chitosan film inhibited bacterial growth, induced less inflammation, developed reorganized epithelial and dermis structures, and thus promoted wound healing compared to a bare wound or wound treated with unmodified chitosan. These results demonstrate the fabrication of advanced functional materials (i.e., antimicrobial wound dressings) using controllable electrical signals to both organize structure through non-covalent interactions (i.e., induce chitosan's reversible self-assembly) and to initiate function-conferring covalent modifications (i.e., generate chloramine bonds). Potentially, electrofabrication may provide a simple, low cost and sustainable alternative for materials fabrication. We believe this work is

Wound healing properties of ointment formulations of Ocimum ...

African Journals Online (AJOL)

present work evaluated the phyto-constituents and wound healing properties of ointments formulated with the n-hexane crude bark extract of a plant used folklorically in wound healing, Ocimum gratissimum. The excision wound model was employed in the wound healing studies. The air-dried, size-reduced barks were ...

Elements affecting wound healing time: An evidence based analysis.

Science.gov (United States)

Khalil, Hanan; Cullen, Marianne; Chambers, Helen; Carroll, Matthew; Walker, Judi

2015-01-01

The purpose of this study was to identify the predominant client factors and comorbidities that affected the time taken for wounds to heal. A prospective study design used the Mobile Wound Care (MWC) database to capture and collate detailed medical histories, comorbidities, healing times and consumable costs for clients with wounds in Gippsland, Victoria. There were 3,726 wounds documented from 2,350 clients, so an average of 1.6 wounds per client. Half (49.6%) of all clients were females, indicating that there were no gender differences in terms of wound prevalence. The clients were primarily older people, with an average age of 64.3 years (ranging between 0.7 and 102.9 years). The majority of the wounds (56%) were acute and described as surgical, crush and trauma. The MWC database categorized the elements that influenced wound healing into 3 groups--factors affecting healing (FAH), comorbidities, and medications known to affect wound healing. While there were a multitude of significant associations, multiple linear regression identified the following key elements: age over 65 years, obesity, nonadherence to treatment plan, peripheral vascular disease, specific wounds associated with pressure/friction/shear, confirmed infection, and cerebrovascular accident (stroke). Wound healing is a complex process that requires a thorough understanding of influencing elements to improve healing times.© 2015 by the Wound Healing Society. © 2015 by the Wound Healing Society.

Negative pressure wound therapy versus standard wound care on quality of life: a systematic review.

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Janssen, A H J; Mommers, E H H; Notter, J; de Vries Reilingh, T S; Wegdam, J A

2016-03-01

Negative pressure wound therapy (NPWT) is a widely accepted treatment modality for open or infected wounds. Premature ending of NPWT occasionally occurs due to negative effects on the quality of life (QoL), however, the actual impact on QoL is unknown. The aim of this review is to analyse the effect of NPWT versus standard wound care (SWC) on QoL when used for the treatment of open or infected wounds. A systematic literature search in a range of databases (PubMed, CINAHL, Medline, Web of Science, Science Direct Freedom Collection, SwetsWise, PSYCArticles and Infrotrac Custom Journals) using the following search terms; 'standard wound care', 'wound dressing', 'dressing', 'treatment', OR 'negative pressure wound therapy [MESH]', OR 'vacuum assisted closure' AND 'quality of life [MESH]', 'patient-satisfaction', OR 'experiences' was performed. Methodological quality was assessed using the methodological index for non-randomised studies (MINORS) checklist. There were 42 studies identified, five matched the inclusion criteria: two randomised clinical trials (RCTs), one clinical comparative study, one exploratory prospective cohort study and one quasi experimental pilot study. Median MINORS-score was 75% (58%-96%). There were seven different questionnaires used to measure QoL or a subsidiary outcome. QoL in the NPWT group was lower in the first week, though no difference in QoL was observed thereafter. This systematic review observed that QoL improved at the end of therapy independent of which therapy was used. NPWT led to a lower QoL during the first week of treatment, possible due to aniexty, after which a similar or better QoL was reported when compared with SWC. It could be suggested that NPWT might be associated with increased anxiety. All authors of this publication have received no financial support or have personal interests conflicting with the objectivity of this manuscript.

The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

Directory of Open Access Journals (Sweden)

Kaundinya Kiran Bharatam

2015-01-01

Conclusion: Uterine scar dehiscence with infection requires high index of suspicion as rare cause for post partum localized/generalized peritonitis with sepsis. Severe abdominal wound infection after caesarean section may be associated with uterine wound dehiscence, which poses a grave risk to the mother in a future pregnancy.

Vellykket konservativ behandling efter knivtraume mod hjertet

DEFF Research Database (Denmark)

Wærsted, Stian; Schou-Jensen, Katrine; Jensen, Tim

2012-01-01

A five year-old girl was admitted to hospital following an accidental stab wound to the chest, inflicted by a knife placed in a dishwasher's cutlery tray. Investigations revealed a traumatic ventricular septum defect of the heart, with a pericardial effusion. Since the patient remained haemodynam...

Wound Healing in Patients With Impaired Kidney Function.

Science.gov (United States)

Maroz, Natallia; Simman, Richard

2013-04-01

Renal impairment has long been known to affect wound healing. However, information on differences in the spectrum of wound healing depending on the type of renal insufficiency is limited. Acute kidney injury (AKI) may be observed with different wound types. On one hand, it follows acute traumatic conditions such as crush injury, burns, and post-surgical wounds, and on the other hand, it arises as simultaneous targeting of skin and kidneys by autoimmune-mediated vasculitis. Chronic kidney disease (CKD) and end-stage renal disease (ESRD) often occur in older people, who have limited physical mobility and predisposition for developing pressure-related wounds. The common risk factors for poor wound healing, generally observed in patients with CKD and ESRD, include poorly controlled diabetes mellitus, neuropathy, peripheral vascular disease, chronic venous insufficiency, and aging. ESRD patients have a unique spectrum of wounds related to impaired calcium-phosphorus metabolism, including calciphylaxis, in addition to having the risk factors presented by CKD patients. Overall, there is a wide range of uremic toxins: they may affect local mechanisms of wound healing and also adversely affect the functioning of multiple systems. In the present literature review, we discuss the association between different types of renal impairments and their effects on wound healing and examine this association from different aspects related to the management of wounds in renal impairment patients.

The effect of pH on cell viability, cell migration, cell proliferation, wound closure, and wound reepithelialization

DEFF Research Database (Denmark)

Kruse, Carla R; Singh, Mansher; Targosinski, Stefan

2017-01-01

primary keratinocyte and fibroblast function in vitro and on wound healing in vivo. In vitro, primary human keratinocytes and fibroblasts were cultured in different levels of pH (5.5-12.5) and the effect on cell viability, proliferation, and migration was studied. A rat full-thickness wound model was used...... to investigate the effect of pH (5.5-9.5) on wound healing in vivo. The effect of pH on inflammation was monitored by measuring IL-1 α concentrations from wounds and cell cultures exposed to different pH environments. Our results showed that both skin cell types tolerated wide range of pH very well. They further...... demonstrated that both acidic and alkaline environments decelerated cell migration in comparison to neutral environments and interestingly alkaline conditions significantly enhanced cell proliferation. Results from the in vivo experiments indicated that a prolonged, strongly acidic wound environment prevents...

Effects of Aloe Vera and Chitosan Nanoparticle Thin-Film Membranes on Wound Healing in Full Thickness Infected Wounds with Methicillin Resistant Staphylococcus Aureus.

Science.gov (United States)

Ranjbar, Reza; Yousefi, Alireza

2018-01-01

To assess effect of Aleo vera with chitosan nanoparticle biofilm on wound healing in full thickness infected wounds with antibiotic resistant gram positive bacteria. Thirty rats were randomized into five groups of six rats each. Group I: Animals with uninfected wounds treated with 0.9% saline solution. Group II: Animals with infected wounds treated with saline. Group III: Animals with infected wounds were dressed with chitosan nanoparticle thin-film membranes. Group IV: Animals with infected wounds were treated topically with Aloe vera and Group V: Animals with infected wounds were treated topically with Aloe vera and dressed with chitosan nanoparticle thin-film membranes. Wound size was measured on 6, 9, 12, 15, 18 and 21days after surgery. Microbiology, reduction in wound area and hydroxyproline contents indicated that there was significant difference ( p vera with chitosan nanoparticle thin-film membranes had a reproducible wound healing potential and hereby justified its use in practice.

ROLE OF VACUUM ASSISTED CLOSURE (VAC - IN WOUND HEALING

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L. Lokanadha Rao

2016-09-01

Full Text Available BACKGROUND Large, complicated wounds pose a significant surgical problem. Negative pressure wound therapy is one of several methods enabling to obtain better treatment results in case of open infected wounds.1,2 The use of negative pressure therapy enables to obtain a reduction in the number of bacteria which significantly reduces the number of complications.3,4,5 AIMS AND OBJECTIVES: To review the Role of VAC in wound healing in Orthopaedics. MATERIALS AND METHODS The cases presented in this study are those who were admitted in King George Hospital in the time period from January 2014 to August 2015. This is a prospective interventional study. In this study, 15 patients were assigned to the study group (Negative Pressure Wound Therapy- NPWT based on their willingness for undergoing treatment. OBSERVATIONS AND RESULTS 12 males and 3 females are involved in the study. There is decrease in the mean wound area from 64 cm2 to 38 cm2 . There is decrease in the duration of hospital stay. Finally, wound is closed by SSG or secondary suturing. DISCUSSION NPWT is known to reduce bacterial counts, although they remain colonised with organisms. Wounds covered with NPW dressing are completely isolated from the environment, thereby reduces cross infection. In our series, we had 73.3% (11 cases excellent results and 26.7% (4 cases good results and no poor results. As interpretation with results, VAC therapy is effective mode of adjuvant therapy for the management of infected wounds. CONCLUSION VAC has been proven to be a reliable method of treating a variety of infected wounds. It greatly increases the rate of granulation tissue formation and lowers bacterial counts to accelerate wound healing. It can be used as a temporary dressing to prepare wounds optimally prior to closure or as a definitive treatment for nonsurgical and surgical wounds. VAC is now being used in a multitude of clinical settings, including the treatment of surgical wounds, infected wounds

Production of hydrogel wound dressing by radiation

International Nuclear Information System (INIS)

Isobe, Kazuki

2008-01-01

It has been thought that making a dry scab helps to cure a wound faster. However, recently a treatment of a wound according to moist healing theory which cure a wound without making a scab is becoming popular. Accordingly, we prepared a highly stable sheet type hydrogel in a short period by radiating electron beam to an aqueous solution of a polymer. The hydrogel is not soluble in water and keeps suitable moist environment for wound healing. Therefore, a hydrogel a wound dressing, Viewgel R in which represents a registered trademark and is referred to Viewgel hereinafter, is developed and released from July of 2004. In this paper we report the process of the development of Viewgel. (author)

Epithelial self-healing is recapitulated by a 3D biomimetic E-cadherin junction

NARCIS (Netherlands)

Cohen, Daniel J.; Gloerich, Martijn; Nelson, W. James

2016-01-01

Epithelial monolayers undergo self-healing when wounded. During healing, cells collectively migrate into the wound site, and the converging tissue fronts collide and form a stable interface. To heal, migrating tissues must form cell-cell adhesions and reorganize from the front-rear polarity

Trends in Surgical Wound Healing

DEFF Research Database (Denmark)

Gottrup, F.

2008-01-01

The understanding of acute and chronic wound pathophysiology has progressed considerably over the past decades. Unfortunately, improvement in clinical practice has not followed suit, although new trends and developments have improved the outcome of wound treatment in many ways. This review focuse...

Leptin promotes wound healing in the skin.

Directory of Open Access Journals (Sweden)

Susumu Tadokoro

Full Text Available Leptin, a 16 kDa anti-obesity hormone, exhibits various physiological properties. Interestingly, skin wound healing was proven to delay in leptin-deficient ob/ob mice. However, little is known on the mechanisms of this phenomenon. In this study, we attempted to elucidate a role of leptin in wound healing of skin.Immunohistochemical analysis was performed to confirm the expression of the leptin receptor (Ob-R in human and mouse skin. Leptin was topically administered to chemical wounds created in mouse back skin along with sustained-release absorbable hydrogel. The process of wound repair was histologically observed and the area of ulceration was measured over time. The effect of leptin on the proliferation, differentiation and migration of human epidermal keratinocytes was investigated.Ob-R was expressed in epidermal cells of human and mouse skin. Topical administration of leptin significantly promoted wound healing. Histological analysis showed more blood vessels in the dermal connective tissues in the leptin-treated group. The proliferation, differentiation/function and migration of human epidermal keratinocytes were enhanced by exogenous leptin.Topically administered leptin was proven to promote wound healing in the skin by accelerating proliferation, differentiation/function and migration of epidermal keratinocytes and enhancing angiogenesis around the wounded area. These results strongly suggest that topical administration of leptin may be useful as a treatment to promote wound healing in the skin.

Low level diode laser accelerates wound healing.

Science.gov (United States)

Dawood, Munqith S; Salman, Saif Dawood

2013-05-01

The effect of wound illumination time by pulsed diode laser on the wound healing process was studied in this paper. For this purpose, the original electronic drive circuit of a 650-nm wavelength CW diode laser was reconstructed to give pulsed output laser of 50 % duty cycle and 1 MHz pulse repetition frequency. Twenty male mice, 3 months old were used to follow up the laser photobiostimulation effect on the wound healing progress. They were subdivided into two groups and then the wounds were made on the bilateral back sides of each mouse. Two sessions of pulsed laser therapy were carried along 15 days. Each mice group wounds were illuminated by this pulsed laser for 12 or 18 min per session during these 12 days. The results of this study were compared with the results of our previous wound healing therapy study by using the same type of laser. The mice wounds in that study received only 5 min of illumination time therapy in the first and second days of healing process. In this study, we found that the wounds, which were illuminated for 12 min/session healed in about 3 days earlier than those which were illuminated for 18 min/session. Both of them were healed earlier in about 10-11 days than the control group did.

The Society for Vascular Surgery Wound, Ischemia, and foot Infection (WIfI) classification independently predicts wound healing in diabetic foot ulcers.

Science.gov (United States)

Hicks, Caitlin W; Canner, Joseph K; Mathioudakis, Nestoras; Sherman, Ronald; Malas, Mahmoud B; Black, James H; Abularrage, Christopher J

2018-04-02

Previous studies have reported correlation between the Wound, Ischemia, and foot Infection (WIfI) classification system and wound healing time on unadjusted analyses. However, in the only multivariable analysis to date, WIfI stage was not predictive of wound healing. Our aim was to examine the association between WIfI classification and wound healing after risk adjustment in patients with diabetic foot ulcers (DFUs) treated in a multidisciplinary setting. All patients presenting to our multidisciplinary DFU clinic from June 2012 to July 2017 were enrolled in a prospective database. A Cox proportional hazards model accounting for patients' sociodemographics, comorbidities, medication profiles, and wound characteristics was used to assess the association between WIfI classification and likelihood of wound healing at 1 year. There were 310 DFU patients enrolled (mean age, 59.0 ± 0.7 years; 60.3% male; 60.0% black) with 709 wounds, including 32.4% WIfI stage 1, 19.9% stage 2, 25.2% stage 3, and 22.4% stage 4. Mean wound healing time increased with increasing WIfI stage (stage 1, 96.9 ± 8.3 days; stage 4, 195.1 ± 10.6 days; P healing at 1 year was 94.1% ± 2.0% for stage 1 wounds vs 67.4% ± 4.4% for stage 4 (P healing (stage 4 vs stage 1: hazard ratio, [HR] 0.44; 95% confidence interval, 0.33-0.59). Peripheral artery disease (HR, 0.73), increasing wound area (HR, 0.99 per square centimeter), and longer time from wound onset to first assessment (HR, 0.97 per month) also decreased the likelihood of wound healing, whereas use of clopidogrel was protective (HR, 1.39; all, P ≤ .04). The top three predictors of poor wound healing were WIfI stage 4 (z score, -5.40), increasing wound area (z score, -3.14), and WIfI stage 3 (z score, -3.11), respectively. Among patients with DFU, the WIfI classification system predicts wound healing at 1 year in both crude and risk-adjusted analyses. This is the first study to validate the WIfI score as an independent

[Medicine behind bars. Illness is usual not grounds for modifying imprisonment].

Science.gov (United States)

Schwarzkopf, A; Zenker, M

2002-05-16

The article describes the possibilities of medical care in prison as exemplified by the Kassel 1 prison with its attached central hospital facility. The main areas of medical care covered there are the treatment of wounds, conservative treatment of fractures, ophthalmology, ENT, urology, dentistry and, via external consultant physicians, also internal medicine, pneumology, dermatology and gynecology. Such infections as hepatitis B and C, syphilis, and tuberculosis have a greater prevalence among prisoners--in contrast to other infections afflicting people housed under similar living conditions, such as in communal living facilities, which show no such increased prevalence. Furthermore, there is a relatively high percentage of injuries, including those that are self-inflicted. The problem of certifying a prisoner medically unfit to tolerate imprisonment is discussed.

Wound bed preparation: A novel approach using HydroTherapy.

Science.gov (United States)

Atkin, Leanne; Ousey, Karen

2016-12-01

Wounds that fail to heal quickly are often encountered by community nursing staff. An important step in assisting these chronic or stalled wounds progress through healing is debridement to remove devitalised tissue, including slough and eschar, that can prevent the wound from healing. A unique wound treatment called HydroTherapy aims to provide an optimal healing environment. The first step of HydroTherapy involves HydroClean plus™, this dressing enables removal of devitalised tissue through autolytic debridement and absorption of wound fluid. Irrigation and cleansing provided by Ringer's solution from the dressing further removes any necrotic tissue or eschar. Once effective wound bed preparation has been achieved a second dressing, HydroTac™, provides an ongoing hydrated wound environment that enables re-epithelialisation to occur in an unrestricted fashion. This paper presents 3 case studies of slow healing wounds treated with HydroClean plus™ which demonstrates effective wound debridement.

[Relationship between FoxO1 Expression and Wound Age during Skin Incised Wound Healing].

Science.gov (United States)

Chen, Y; Ji, X Y; Fan, Y Y; Yu, L S

2018-02-01

To investigate FoxO1 expression and its time-dependent changes during the skin incised wound healing. After the establishment of the skin incised wound model in mice, the FoxO1 expression of skin in different time periods was detected by immunohistochemistry and Western blotting. Immunohistochemistry staining showed that FoxO1 was weakly expressed in a few fibroblasts of epidermis, hair follicles, sebaceous glands, vessel endothelium and dermis in the control group. The FoxO1 expression was enhanced in the epidermis and skin appendages around the wound during 6-12 h after injury, which could be detected in the infiltrating neutrophils and a small number of monocytes. FoxO1 was mainly expressed in monocytes during 1-3 d after injury, and in neovascular endothelial cells and fibroblasts during 5-10 d. On the 14th day after injury, the FoxO1 expression still could be detected in a few fibroblasts. The Western blotting results showed that the FoxO1 expression quantity of the tissue samples in injury group was higher than in control group. The FoxO1 expression peaked at 12 h and 7 d after injury. FoxO1 is time-dependently expressed in skin wound healing, which can be a useful marker for wound age determination. Copyright© by the Editorial Department of Journal of Forensic Medicine.

Chitosan: A potential biopolymer for wound management.

Science.gov (United States)

Bano, Ijaz; Arshad, Muhammad; Yasin, Tariq; Ghauri, Muhammad Afzal; Younus, Muhammad

2017-09-01

It has been seen that slow healing and non-healing wounds conditions are treatable but still challenging to humans. Wound dressing usually seeks for biocompatible and biodegradable recipe. Natural polysaccharides like chitosan have been examined for its antimicrobial and healing properties on the basis of its variation in molecular weight and degree of deacetylation. Chitosan adopts some vital characteristics for treatment of various kinds of wounds which include its bonding nature, antifungal, bactericidal and permeability to oxygen. Chitosan therefore has been modified into various forms for the treatment of wounds and burns. The purpose of this review article is to understand the exploitation of chitosan and its derivatives as wound dressings. This article will also provide a concise insight on the properties of chitosan necessary for skin healing and regeneration, particularly highlighting the emerging role of chitosan films as next generation skin substitutes for the treatment of full thickness wounds. Copyright © 2017 Elsevier B.V. All rights reserved.

Self-Burns in Fars Province, Southern Iran

Science.gov (United States)

Mohammadi, Ali Akbar; Tohidinik, Hamid Reza; Zardosht, Mitra; Seyed Jafari, Seyed Morteza

2016-01-01

BACKGROUND The alarming incidence of self- burning provoked to set up a multidisciplinary preventive program to decrease the incidence and complications of this harmful issue. This study investigated the incidence and the preventive measures in self-burn in Fars Province, southern Iran. METHODS This study was a longitudinal prospective design on trend of self-inflicted burn injuries in Fars province after setting up a regional multidisciplinary preventive plan (2009-2012). RESULTS From 18862 admitted patients, 388 (2%) committed self-burning. While the incidence showed a constant decrease in proportion of suicidal cases among all admitted patients (2.5% to 1.6%). The mean age of self-burning victims ranged from 28.3±10.8 to 30.3±11.7 years. The female victims comprised 67.4% of all suicidal burn patients (Female to male ratio: 2.18). The leading causes of suicide commitment were familial conflicts (75.6%) and psychological problems (16.7%) CONCLUSION It is crucial to continue the regional preventive programs and pave the way to set up national, and even international collaborations to alleviate relevant financial, social, cultural and infrastructural difficulties in order to have lower incidence for this dramatic issue. PMID:27308238

[Wound healing in the elderly].

Science.gov (United States)

Eming, S A; Wlaschek, M; Scharffetter-Kochanek, K

2016-02-01

Restoration of tissue integrity is essential for host defense and protection of the organism. The efficacy and quality of skin repair varies significantly over a person's lifetime. Whereas prenatal wound healing is characterized by regeneration and scarless healing, scarring, fibrosis, and loss of function are features of postnatal repair. In fact, aging is the prominent risk factor for chronic wounds, skin fragility, infections, comorbidities, and decreased quality of life. Current strategies for restoration of tissue integrity and wound therapy are not sufficient and require further investigation of the underlying pathomechanisms and the development of causal-based concepts.

[Role of debridement in treatment of chronic wounds].

Science.gov (United States)

Huljev, Dubravko; Gajić, Aleksandar; Triller, Ciril; Leskovec, Nada Kecelj

2012-10-01

Debridement is the process of removing dead tissue from the wound bed. Since devitalized tissue can obstruct or completely stop healing of the wound, it is indicated to debride wound bed as part of the treatment process. The aim of debridement is to transform a chronic wound into an acute wound and to initiate the process of healing. Debridement is the foundation of each wound treatment and it has to be repeated, depending on the necrotic tissue formation. There are several types of debridement: surgical, autolytic, chemical, enzymatic, mechanical, and biological. Using previous knowledge and advances in technology, new types of debridement have been introduced. Besides standard methods, methods of pulsed lavage debridement (hydro-surgery, water-jet) and ultrasound-assisted wound treatment (UAW) are ever more widely introduced. The method of debridement the clinician will choose depends on the amount of necrotic (devitalized) tissue in the wound bed, the size and depth of the wound, the underlying disease, the possible comorbidity, as well as on the general condition of the patient. Frequently, the methods of debridement are combined in order to achieve better removal of devitalized tissue. Debridement in addition significantly reduces bacterial burden. Regardless of the method of debridement, it is essential to take pain to the lowest point.

Negative pressure wound therapy in complex cranio-maxillofacial and cervical wounds.

Science.gov (United States)

Novelli, Giorgio; Daleffe, Francesco; Birra, Gisella; Canzi, Gabriele; Mazzoleni, Fabio; Boni, Pietro; Maino, Clara; Giussani, Carlo; Sozzi, Davide; Bozzetti, Alberto

2018-02-01

The care and the management of the healing of difficult wounds at the level of the skull-facial face many problems related to patient compliance and the need to perform multiple dressings, with long periods of healing and, occasionally, a very long hospitalisation period. The introduction and evolution of negative pressure wound therapy (NPWT) in the treatment of difficult wounds has resulted in better healing, with a drastic reduction in terms of time and biological costs to the patient and cost to the health care system. The main aim of this study is to describe and discuss, using out our experience, the usefulness of NPWT in the cranial-facial-cervical region. We studied 16 patients with complex wounds of the cranial-facial-cervical region treated with NPWT. We divided clinical cases in four groups: cervicofacial infectious disease, healing complications in oncological-reconstructive surgery, healing complications of injury with exposure of bone and/or internal fixations and healing complications in traumatic injury with loss of substance. We evaluated complete or incomplete wound healing; application time, related also to hospitalisation time; days of intensive care unit (ICU) stay; management of the upper airways; timing of medication renewal; and patient comfort and compliance (on a scale of 1-5). Depression values were always between -75 and -125 mmHg in a continuous aspiration pattern. For every patient, we used the ActiVAC Therapy Unit, derived from the vacuum-assisted closure system (Kinetic Concepts Inc., San Antonio, TX). Medication renewals were performed every 48-72 hours. The NPWT application time ranged from 4 to 22 days (mean of 11·57 day). Therapy was effective to gain a complete restitutio ad integrum in every patient included in the group of cervicofacial infectious disease. Therapy has, however, been well tolerated in our series; this is probably due to the decreased number of applications, the ease of use and the comfort of the system