Sample records for wound post hemorroidectomy


    Directory of Open Access Journals (Sweden)

    Ah. Yusuf


    Full Text Available Introduction: Decision for cesarean section may lead to the stress for women in delivery. Stress response requires longer recovery time in post cesarean section patients. Most of patients who experience stress before and after surgical is associated with wound healing delay. When this condition continues, the wound will have a higher risk of infection. The objective of this study was to analyze correlation between stress and wound healing phase in post cesarean section patients. Method: A cross sectional design was used in this study. The population were women with cesarean section, both elective or emergency, in Delivery Room I RSU Dr. Soetomo Surabaya. Samples were recruited by using purposive sampling, with 28 samples who met to the inclusion criterias. The observed variables were stress and wound healing phase in post cesarean section patient. Stress data were collected by interview and wound healing measurement done by observation on the 3rd day post cesarean section. Result: The result showed that women with stress experience wound healing delay. The characteristic of wound healing delay was prolonged on inflammation phase, nevertheless there was presence of granulation tissue. Spearman’s rho correlation showed that correlation value r=0.675 with p=0.000. Discussion: It can be concluded that there was strong significant correlation between stress and wound healing phase in post cesarean section patients. It is important to give this information to the patients with cesarean section in order to prevent stress and delay in wound healing phase.

  2. Bacteriology of Post Caesarean Wound Infection in a Specialist ...

    African Journals Online (AJOL)

    Post caesarean wound infection is a common cause of maternal morbidity and mortality especially in developing countries where strict adherence to infection control procedures is low. The aim of the present study is to establish the spectrum of microbes causing post caesarean wound infection and antibiotic sensitivity ...

  3. Post-operative wound infection in developing country - A ...

    African Journals Online (AJOL)

    A prospective survey of post-operative wound infection rates was undertaken at the Queen Elizabeth Central Hospital, Blantyre, Malawi over a three-month period from April to June, 1985. The methods whereby wound sepsis data were obtained are presented. The results show an overall infection rate of 25.8% and that for ...

  4. Pseudomonas aeruginosa in Post-operative Wound Infections in ...

    African Journals Online (AJOL)

    The occurrence of post-operative wound infections was studied over a period of five months in the University College Hospital, Ibadan between February to July, 2003. Two hundred Surgical wounds were collected and routinely processed by Gram staining and culture in the Microbiology Laboratory. Of the 200 samples ...

  5. Knowledge and Practice of Post-Operative Wound Infection ...

    African Journals Online (AJOL)

    Application of sterile dressings to the surgical wound and strict adherence to asepsis were the most occurring precautionary measures adopted by nurses in the prevention of post operative wound infection. Excess work load and poor attitude featured most frequently among the respondents as factors that militate against ...

  6. The tip of the iceberg: Post caesarean wound dehiscence presenting as abdominal wound sepsis

    Directory of Open Access Journals (Sweden)

    Kaundinya Kiran Bharatam


    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.

  7. Microbiology of post-operative wound infection in implant surgery ...

    African Journals Online (AJOL)

    Background: Open reduction and internal fixation (ORIF) of fractures with implants and prosthesis has become the first line in the management of fractures in most trauma centres. Incidentally, this is associated with post-operative wound infection which is accompanied by significant morbidity, cost and mortality.

  8. Early Post-Operative Wound Infection in Austin Moore ...

    African Journals Online (AJOL)

    Background: Early post operative wound infection is usually seen within four weeks of orthopaedic operations 1.Use of foreign implants, operating on the elderly, the obese, diabetic or patients with other chronic diseases increase the risk further 2.This study reveals the incidence of early infection and associated factors ...


    African Journals Online (AJOL)

    Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections in the patients developing ...

  10. Citric acid treatment of post operative wound infections in HIV/AIDS patients. (United States)

    Nagoba, Basavraj; Patil Dawale, Chandrakala; Raju, Reena; Wadher, Bharat; Chidrawar, Shruti; Selkar, Sohan; Suryawanshi, Namdev


    The normal cellular immunity is required for normal wound healing. The HIV infection affects wound healing adversely. Wound infections in HIV/AIDS patients are difficult to manage because of compromised immunity. The result is delayed wound healing and increased susceptibility to wound infection. Here we report two cases of HIV positive patients who had developed the post operative wound gape, not responding to the conventional treatment, treated simply by local application of three percent citric acid ointment. Copyright © 2013 Tissue Viability Society. Published by Elsevier Ltd. All rights reserved.

  11. Study of Bacteriology of Post-Operative Wound Infection

    Directory of Open Access Journals (Sweden)

    Neelam Abdulrauf Bagwan


    Full Text Available Background: While many patients are admitted to hospital for treatment of infections, some acquire infection during their stay in the hospital. These infections are called as nosocomial infections. Surgical site infection or post operative wound infection is one of them. It is defined as infection of previously sterile tissue incised to gain exposure for operating deeper spaces operatively exposed or organs manipulated by a surgeon. It is one of the feared complications of surgery as it increases morbidity as well as cost of medical care. Aims and Objectives: Study was conducted to find out incidence of surgical site infection rate in surgical ward, evaluate various factors contributing to infection and to identify causative pathogens and their antibiogram patterns. Material and Methods: All clean and clean contaminated operative cases admitted in surgery ward in study period of 18 months were included. Preoperative, operative and postoperative management protocols of the cases were recorded in detail. Results: A total of 1082 operated cases were studied among which 59 infected cases were found. Surgical Site Infection (SSI rate was 5.45%. E. coli and Staphylococcus aureus were the commonest pathogen isolated from the infected wound. 50 % were Methicillin Resistant Staphylococcus Aureus (MRSA among them and 50% of rd Enterobacteriaceae group were resistant to 3 generation Cephalosporins. Conclusion: Surgical site infection rate of a hospital can be reduced easily by following proper pre-operative protocol for the patients. Those patients with surgical site infection can be treated effectively by following the antibiotic policy as provided by the Department of Microbiology.

  12. Results of open wound technique in the treatment of post ...

    African Journals Online (AJOL)

    Background and method. Severe chronic osteomyelitis with variable outcomes is still common among children in developing nations. There has been no consensus on the optimal method of treatment. We therefore prospectively evaluated the rates of wound healing and recurrence following open wound treatment of ...

  13. Wound infiltration with local anesthetics for post-operative pain relief in lumbar spine surgery

    DEFF Research Database (Denmark)

    Kjærgaard, M; Møiniche, S; Olsen, K S


    In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery.......In this systematic review, we evaluated double-blind, randomized and controlled trials on the effect of wound infiltration with local anesthetics compared with the effect of placebo on post-operative pain after lumbar spine surgery....

  14. Microbiology and management of post-surgical wounds infection in children. (United States)

    Brook, Itzhak


    The recent increased recovery of anaerobic bacteria from children has led to greater appreciation of their role in paediatric infections at all body sites, including post-surgical wounds (PSW). In studies that employed adequate method for recovery of aerobic and anaerobic bacteria polymicrobial, aerobic and anaerobes were isolated from over half of the patients with PSW. The wounds studied were those that developed following these surgical procedures: head and neck surgery for malignancies, post-thoracotomy, spinal fusion and gastrostomy tube insertion. Staphylococcus aureus and aerobic gram-negative bacilli were found at all sites. However, a correlation was generally found between the site of the wounds and microbial flora recovered from the wound. Organisms that resided in the mucous membranes close to the surgical site predominated in the wound next to these areas. Enteric Gram-negative rods, Group D enterococcus and Bacteroides fragilis group predominated in wounds relating to the gut flora, while Streptococcus spp., pigmented Prevotella and Porphyromonas spp. and Fusobacterium spp. were most frequently recovered in wounds proximal to the oral area. Management of PSW should include administration of antimicrobials effective against the polymicrobial bacterial flora adjacent to the anatomic site of the wound.

  15. Prevention of post-operative pediatric tracheotomy wounds: A multidisciplinary team approach. (United States)

    McEvoy, Timothy P; Seim, Nolan B; Aljasser, Abdullah; Elmaraghy, Charles A; Ruth, Brenda; Justice, Leslie; Begue, Sarah; Jatana, Kris R


    Tracheotomy-related pressure wounds have been reported as high as 29%. All advanced stage (stage 3 or 4) wounds are reported by hospitals, and CMS will no longer reimburse healthcare costs to manage them. We present the results of an intensive, multidisciplinary wound prevention strategy starting in the operating room at the time of tracheotomy placement. Prospective analysis of a tracheostomy wound care protocol at an academic, tertiary-care pediatric hospital from September 2012 to February 2016. Participants include all patients having undergone tracheostomy placement followed by protocoled daily dressing changes until the first tracheostomy tube change by team consisting a senior level otolaryngology resident or pediatric otolaryngology fellow, certified wound care specialist, respiratory therapist, and bedside nurse. Post-operative tracheostomy-related wound data from 3 years prior to clinical intervention was obtained and compared to the intervention cohort. From March 2010-August 2012, 161 tracheotomy procedures were performed with 36 (22.4%) subsequent pressure wounds; 31% of these were stage 3 or 4 wounds. After multidisciplinary protocol implementation, there have been 121 additional tracheotomy procedures with reduction to 12 (9.9%) total tracheotomy-related wounds (p = 0.0064) and none (0%) were stage 3 or 4 (p = 0.0014). All stage 1 and 2 wounds were identified early, underwent appropriate intervention, and avoided further progression. This protocol was successful in the elimination of all tracheostomy-related advanced stage, hospital-acquired pressure injuries and led to prompt identification of early stage wounds post-operatively. Copyright © 2017 Elsevier B.V. All rights reserved.

  16. Betadine irrigation and post-craniotomy wound infection (United States)

    Patel, Kunal S.; Goldenberg, Brandon; Schwartz, Theodore H.


    Object The purpose of this study is to evaluate the efficacy of betadine irrigation in preventing postoperative wound infection in cranial neurosurgical procedures. Methods A total of 473 consecutive cranial neurosurgical procedures, including craniotomies and burr hole procedures were retrospectively reviewed. Patients had either antibiotic irrigation or dilute betadine plus antibiotic irrigation prior to skin closure. Infection was determined by purulence noted on reoperation and confirmed with bacterial growth culture. One and three month postoperative infection rates were calculated. Statistical analysis was performed using chi-squared tests. Results This study included 404 patients. Betadine was used in 117 (29.0%). At 1 month after surgery, there was no difference in the rate of wound infection between the two groups (1.7% each). However, at 90 days, the betadine group had a 2.6% infection rate compared with 3.8% in the antibiotic group, indicating a 33% decrease in infection rates with the addition of betadine (p=.527). The small sample size of the study produced a low power and high beta error. Conclusions In this small preliminary study, betadine decreased postoperative infection rates compared with antibiotic prophylaxis alone at 90 days but not 30 days. This was not statistically significant, but a larger sample size would lower the beta error and decrease confounding bias associated with group heterogeneity. The potential for betadine, a cheap, low toxicity antimicrobial, to decrease infection rates and reoperations for infection warrants a larger multicenter trial. PMID:24529229

  17. Post-thoracotomy wound separation (DEHISCENCE: a disturbing complication

    Directory of Open Access Journals (Sweden)

    Aydin Nadir


    Full Text Available OBJECTIVES: We described the treatment of dehiscence of thoracotomy incisions in patients who underwent thoracic surgery in the present study. METHODS: Twenty-four patients with either partial or complete dehiscence of their thoracotomy incisions were included in the study from 2005 to 2010. The patients were evaluated regarding their age, sex, indication for thoracotomy, and surgical approaches. We also described our method of re-closure. RESULTS: The male/female ratio was 17/7. The youngest and oldest patients were 15 and 75 years old, respectively, and the mean age was 43 years. Among the indications for thoracotomy, empyema was the most common reason (determined in eight [33%] patients, followed by vertebral surgery (determined in six [25%] patients. Bacterial growth was detected in the wound site cultures from 13 (54% patients. For the patients with dehiscence of their thoracotomy incisions, an en block approximation technique with debridement was performed under general or local anesthesia in 16 (66% and eight (33% of the cases, respectively. Three patients exhibited an open thorax with dehiscence of the thoracotomy incision. Thoracoplasty was required in two patients. Using this method, successful closure was obtained in 91.7% (n = 22 of the patients with dehiscence of their thoracotomy incisions. CONCLUSION: Dehiscence of the thoracotomy incision is an important complication that causes concern in patients and their thoracic surgeons and strongly affects the success of the surgery. An en block approximation technique with significant debridement that enables removal of the necrotic tissues from the wound site can successfully be applied to patients with dehiscence of their thoracotomy incisions.

  18. Nosocomial Wound Infection amongst Post Operative Patients and ...

    African Journals Online (AJOL)

    Nosocomial infection constitutes a major public health problem worldwide. Increasing antibiotic resistance of pathogens associated with nosocomial infections also becomes a major therapeutic challenge for physicians. Thus, the aim of this study was to identify post operative bacterial infections in the patients developing ...

  19. Results of open wound technique in the treatment of post-sequestrectomy dead space. (United States)

    Onuminya, J E; Onuminya, D S


    Severe chronic osteomyelitis with variable outcomes is still common among children in developing nations. There has been no consensus on the optimal method of treatment. We therefore prospectively evaluated the rates of wound healing and recurrence following open wound treatment of post-sequestrectomy dead spaces in 30 patients with haematogenous chronic osteomyelitis of the tibial shaft at the King Orthopaedic Clinic, Ekpoma, Edo State, Nigeria, between January 2001 and December 2005. Thirty similar patients whose post-sequestrectomy dead spaces were treated by closed wound technique formed the control group. Both groups were subjected to standard methods of perioperative management. Saucerisation, sequestrectomy and curettage were the cornerstones of surgical therapy. The wounds were primarily either left open (study group) or closed (control group). The rates of wound healing and recurrence were used to assess the outcome of treatment. The chi-square test was used for statistical analysis. The median age was 13 years, with a range of 6 - 60 years. Staphylococcus aureus was the organism most commonly associated with chronic osteomyelitis. Rates of wound healing and recurrence in the study group were significantly better than in the control group (p<0.05), even though it took a relatively longer period to achieve healing with the open method of treatment. The follow-up period ranged from 1 to 5 years, with a median of 2 years. We observed that the results of the open method of treating post-sequestrectomy dead spaces were good, and we advocate its use in resource-poor settings.

  20. Early versus delayed post-operative bathing or showering to prevent wound complications. (United States)

    Toon, Clare D; Sinha, Sidhartha; Davidson, Brian R; Gurusamy, Kurinchi Selvan


    Many people undergo surgical operations during their life-time, which result in surgical wounds. After an operation the incision is closed using stiches, staples, steri-strips or an adhesive glue. Usually, towards the end of the surgical procedure and before the patient leaves the operating theatre, the surgeon covers the closed surgical wound using gauze and adhesive tape or an adhesive tape containing a pad (a wound dressing) that covers the surgical wound. There is currently no guidance about when the wound can be made wet by post-operative bathing or showering. Early bathing may encourage early mobilisation of the patient, which is good after most types of operation. Avoiding post-operative bathing or showering for two to three days may result in accumulation of sweat and dirt on the body. Conversely, early washing of the surgical wound may have an adverse effect on healing, for example by irritating or macerating the wound, and disturbing the healing environment. To compare the benefits (such as potential improvements to quality of life) and harms (potentially increased wound-related morbidity) of early post-operative bathing or showering (i.e. within 48 hours after surgery, the period during which epithelialisation of the wound occurs) compared with delayed post-operative bathing or showering (i.e. no bathing or showering for over 48 hours after surgery) in patients with closed surgical wounds. We searched The Cochrane Wounds Group Specialised Register (30th June 2015); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library); The Database of Abstracts of Reviews of Effects (DARE) (The Cochrane Library); Ovid MEDLINE; Ovid MEDLINE (In-Process & Other Non-Indexed Citations); Ovid EMBASE; EBSCO CINAHL; the metaRegister of Controlled Trials (mRCT) and the International Clinical Trials Registry Platform (ICTRP). We considered all randomised trials conducted in patients who had undergone any surgical procedure and had surgical closure of

  1. Fabrication and characterization of cefazolin-loaded nanofibrous mats for the recovery of post-surgical wound. (United States)

    Rath, Goutam; Hussain, Taqadus; Chauhan, Gaurav; Garg, Tarun; Kumar Goyal, Amit


    The aim of the present study was to evaluate the wound healing performance of cefazolin-loaded gelatin nanofiber mats in post-operative wound. The obtained nanofibers were smooth, non-beaded and having diameter ranging from 620-680 nm. Nanofiber mats that are prepared exhibit high drug entrapment, excellent oxygen permeability and sustained drug release behavior. Further, medicated nanofiber mats showed an accelerated wound healing as compared to plain cefazolin. Macroscopical and histological evaluations demonstrated that cefazolin-loaded gelatin nanofiber showed increased epithelialization rate and collagen deposition. The results indicated that therapeutic strategies offer new prospects in the management of post-operative wound repair.

  2. Post mortem computed tomography: useful or unnecessary in gunshot wounds deaths? Two case reports. (United States)

    Maiese, Aniello; Gitto, Lorenzo; De Matteis, Alessandra; Panebianco, Valeria; Bolino, Giorgio


    Post-mortem computer tomography (PMCT) is currently an useful procedure that can elucidate patterns of injuries, providing strong medical evidence that is very useful during litigation and at trial. This technique is especially useful in gunshot wounds cases, allowing an easier location and retrieval of the bullet and/or its fragments inside the body. In such cases, the use of 3D rendering can be very useful in order to obtain essential information, such as: accurate depict of the wound track, discerning between entrance and exit wounds, show bone's fracture and its fragments course inside the body. The authors performed analysis on two cases of death by gunshot wounds, and a PMCT before the postmortem examination was made. The obtained CT scans were evaluated using the open-source software OsiriX on a Mac OS X computer, performing 3D rendering of the DICOM images. The crime scene reconstruction was performed using the software Poser Debut® on a Mac OS X computer. In both cases, PMCT showed multiple advantages: objectivity, reproducibility, ease visualization of the wound paths, easy localization of bullet and their fragments, allowing us to clarify the cause of death before the traditional autopsy. PMCT should became a standard in forensic practice as an aid to the tradition postmortem examination to obtain as much information as possible in order to clarify the cause and manner of death. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  3. Forensic aspects of incised wounds and bruises in pigs established post-mortem. (United States)

    Barington, Kristiane; Jensen, Henrik Elvang


    Recognizing post-mortem (PM) changes is of crucial importance in veterinary forensic pathology. In porcine wounds established PM contradicting observations regarding infiltration of leukocytes have been described. In the present study, skin, subcutis and muscle tissue sampled from experimental pigs with PM incised wounds (n=8), PM bruises (n=8) and no lesions, i.e. controls (n=4), were examined for signs of vitality over time. All tissue samples were subjected to gross and histopathological evaluation. Hemorrhages were present along the edges of PM incised wounds but deposits of fibrin were never observed. PM bruise led to hemorrhage in the subcutis visible on cross section of the skin in 3 out of 8 pigs. Histologically, hemorrhages in the subcutaneous tissue and disrupted muscle fibers were observed in PM bruises and could not be differentiated from similar lesions in ante-mortem (AM) bruises. Vital reactions, i.e. infiltrating leukocytes, hyper-leukocytosis and pavement of leukocytes, were absent in all incised wounds and bruises regardless of the time of sampling after traumatization. In conclusion, a vital reaction was not present in PM incised wounds, regardless of the time of sampling. Moreover, it was found that AM bruises free of leukocyte infiltration cannot be distinguished from PM bruises, an observation which is of crucial importance when timing bruises in forensic cases. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Can medical hypnosis accelerate post-surgical wound healing? Results of a clinical trial. (United States)

    Ginandes, Carol; Brooks, Patricia; Sando, William; Jones, Christopher; Aker, John


    Although medical hypnosis has a long history of myriad functional applications (pain reduction, procedural preparation etc.), it has been little tested for site-specific effects on physical healing per se. In this randomized controlled trial, we compared the relative efficacy of an adjunctive hypnotic intervention, supportive attention, and usual care only on early post-surgical wound healing. Eighteen healthy women presenting consecutively for medically recommended reduction mammaplasty at an ambulatory surgery practice underwent the same surgical protocol and postoperative care following preoperative randomization (n = 6 each) to one of the three treatment conditions: usual care, 8 adjunctive supportive attention sessions, or 8 adjunctive hypnosis sessions targeting accelerated wound healing. The primary outcome data of interest were objective, observational measures of incision healing made at 1,7 weeks postoperatively by medical staff blind to the participants' group assignments. Data included clinical exams and digitized photographs that were scored using a wound assessment inventory (WAI). Secondary outcome measures included the participants' subjectively rated pain, perceived incision healing (VAS Scales), and baseline and post-surgical functional health status (SF-36). Analysis of variance showed the hypnosis group's objectively observed wound healing to be significantly greater than the other two groups', p post-surgical observation intervals, one-way analyses showed the hypnosis group to be significantly more healed than the usual care controls, p recovery trended similarly. Results of this preliminary trial indicate that use of a targeted hypnotic intervention can accelerate postoperative wound healing and suggest that further tests of using hypnosis to augment physical healing are warranted.



    Rajesh; Dinesh


    ABSTRACT: INTRODUCTION: Bone infections after implant surgery leading to non union and implant failure is one of the most challenging Ortho paedic complications. This study is done to find out relation of type of pathogens causing postope rative infection with that of fracture nonunion, chronic osteomylities and implant failure. METHODOLOGY: This is a retrograde study of 20 cases, in which post operative wound infe ction occurred after implant surgery from ...

  6. Effect of wound healing period and temperature, irradiation and post irradiation storage temperature on the keeping quality of potatoes

    NARCIS (Netherlands)

    Langerak, D.I.; Wolters, T.C.; Jong, de W.J.H.J.; Hollman, P.C.; Cramwinckel, A.B.; Oortwijn, H.; Vroomen, L.H.M.


    The effect of irradiation doses, wound healing temperature, post harvest irradiation time (wound healing period) and storage temperature on a number of quality parameters such as loss of weight, sprout inhibition and rot incidence, chemical parameters such as sugar and vitamin e content, sensory

  7. Implications for better nursing practice: psychological aspects of patients undergoing post-operative wound care. (United States)

    Murakami, Reiko; Shiromaru, Mizue; Yamane, Reiko; Hikoyama, Hiroko; Sato, Mikiyo; Takahashi, Natsuko; Yoshida, Sumie; Nakamura, Misuzu; Kojima, Yoshikazu


    To understand the psychological aspects in patients undergoing post-operative wound care and to gain insights for improving nursing practice. Very few studies have examined education on or practice of wound care with a view towards the patient's psychology. Descriptive exploratory qualitative study. Four patients who had undergone open surgery of the upper gastrointestinal tract were interviewed using a semi-structured format to gain an understanding of their feelings and opinions with regard to wound care. Interview transcripts were analysed using an inductive coding approach. Fifteen categories of responses were finally identified from the data. Patients wanted nursing staff to observe their wound more often so that patients could recognise improvement, to have better knowledge of the patient's disease and condition, to explain the patient's situation more completely and to appropriately answer questions. Patients also said that they felt more comfortable in posing questions or concerns regarding their condition to nursing staff than to their surgeons and did so while the wounds were being taken care of by nurses. These findings suggested the importance of nursing staff to fully understand and to be ready to share feelings regarding a patient's postoperative condition and to have skills in properly explaining the importance of each procedure or steps in treatments that a patient must undergo. The present study also indicates that it is imperative for nursing staff to learn methods to build relationships with patients so that they can express their feelings of fear or anxiety freely to nurses. It is not possible to develop nursing practice without understanding psychological aspects of patients undergoing postoperative wound care. © 2012 Blackwell Publishing Ltd.

  8. Treatment of Non-healing, Post-traumatic Wound with High Frequency Ultrasound of 10 MHz: A Case Report


    Gohla, Thomas; Kruglikova, Ekaterina; Kruglikov, Ilja L.


    We present a case of a non-healing, post-traumatic wound, which as an alternative to reconstructive surgical intervention, was successfully treated with a non-invasive, highfrequency ultrasound of 10 MHz.

  9. Prevalence of Post-operative Wound Infections in Rural area of Latur District

    Directory of Open Access Journals (Sweden)

    Vikram Rajput


    Full Text Available Background: Surgical site infection (SSI continues to be a major source of morbidity following operative procedures. The modern surgeon cannot escape the responsibility of dealing with infections, having the knowledge for the appropriate use of aseptic and antiseptic technique, proper use of prophylactic and therapeutic antibiotics, and adequate monitoring and support with novel surgical and pharmacologic as well as nonpharmacologic aids. Objective: To study the most common organisms encountered in postoperative wound infections and to find out the most effective Antibiotics in case of Post Operative Wound Infections. Methodology: It is an Observational study done on 50 operated cases of post operative wounds. Results: Most common microorganism encountered in present series was E. coli in 13 cases (26%. Least common micro organism was Proteus (2%. E. coli was also encountered in mixed culture with Kleibsiella, Pseudomonas and Citrobacter. Most effective antibiotic in present series was Imipenem. Other common effective antibiotics were Amikacin, Netillin, Piperacillin, Tetracycline and Gentamycin. Least effective antibiotics were Penicillin, Cefotaxime, Cefuroxime and Cefoxitin. Conclusion: E. coli was the most common organism cultured. Imipenem and Amikacin were the most effective antibiotics.

  10. Effect of a baking soda-peroxide dentifrice on post-surgical wound healing. (United States)

    Dentino, A R; Ciancio, S G; Bessinger, M; Mather, M A; Cancro, L; Fischman, S


    To investigate the effect of a baking soda-hydrogen peroxide (0.75%) dentifrice on wound healing, plaque formation, gingival inflammation, patient comfort, probing depth, and clinical attachment level following gingival flap surgery. A randomized, double-blind crossover study involving 25 patients requiring bilateral maxillary gingival flap surgery was completed. The effects of twice daily brushing with a baking soda-hydrogen peroxide dentifrice (Mentadent) or a placebo dentifrice (Crest) were observed over a 28-day post-surgical period. Gingival Index (GI), plaque index (PI), probing depth (PD), clinical attachment level (CAL) and gingival bleeding index (BI) were recorded pre-surgically and at day 28 for each surgical sextant. At days 7 and 14, soft tissue appearance/wound healing (STA) was assessed based on color and edema, PIs were determined and patient comfort was ascertained by report. Post-surgical wound healing was statistically significantly improved at day 7 with the trend continuing to day 14 when Mentadent dentifrice was used as compared to Crest dentifrice. However, there was no statistical difference in the PI values between the test and control dentifrice throughout the study. Use of Mentadent may be an effective aid in the early phase of healing following gingival flap surgery.

  11. Post-Surgical Clinical Monitoring of Soft Tissue Wound Healing in Periodontal and Implant Surgery


    Pippi, Roberto


    Clinical features of surgical soft tissue wound healing in dentistry have been rarely discussed in the international literature. The aim of the present paper is to highlight both the main clinical findings of surgical wound healing, especially in periodontal and implant dentistry, and the wound healing monitoring procedures which should be followed. Wound inspection after careful food and plaque debridement is the essential part of wound healing monitoring. Periodontal and peri-implant probin...

  12. Nasal Methicillin Resistant Staphylococcus aureus Associated Post-surgical Wounds Infections

    Directory of Open Access Journals (Sweden)

    Ikpeme, E. M.


    Full Text Available Aims: Staphylococcus aureus nasal colonization is an important risk factor for developing a wide range of infections in clinical setting. This study was aimed at determining the extent of staphylococcal carriages including methicillin resistant Staphylococcus aureus (MRSA in post-surgical patients and employees in a tertiary health facility. Methodology and Results: Between April and July 2010, 240 post-surgical patients and 80 hospital personnel at the University of Calabar Teaching Hospital, Calabar were enrolled in the present study. All subjects consented to participation in the study and those who had previous medical history or treatment on antibiotic in the last six months prior to enrolment were noted. Nasal specimens collected from carrier and post-surgical sites in individuals (15-63 years who were hospitalized for at least 21 days were immediately placed in Staurts’ transport medium and kept at 4 °C before being analyzed accordingly and screened for methicillin resistant Staphylococcus aureus. Out of a total number of 320 subjects examined within a period of 4 months 144 (45% were carriers of Staphylococcus aureus and 55 (38% of these were MRSA. Demographic and clinical data of subjects indicated more male carriers (60.7% confined to older age groups above 35 years. There was a significant difference (p> 0.05 in Staphylococcus aureus carriage for subjects with recent medical history of hospitalization or treatment with antibiotics. There also appears to be a considerable association (50.9% between nasal carriage status and autoinfection of post-surgical wounds. A good proportion of all strains tested were resistant to commonly used antibiotics. Approximately 89% of MRSA were resistant to penicillin. Resistant rate against other antibiotics was largely below 30%. Conclusion, significance and impact of study: An improved understanding of nasal carriage is needed to foster development of new strategies to reduce colonization and

  13. Post-surgical wound management of pilonidal cysts with a haemoglobin spray: a case series. (United States)

    Mustafi, N; Engels, P


    Painful acute cysts in the natal cleft or lower back, known as pilonidal sinus disease, are a severe burden to many younger patients. Although surgical intervention is the preferred first line treatment, postsurgical wound healing disturbances are frequently reported due to infection or other complications. Different treatment options of pilonidal cysts have been discussed in the literature, however, no standardised guideline for the postsurgical wound treatment is available. After surgery, a common recommended treatment to patients is rinsing the wound with clean water and dressing with a sterile compress. We present a case series of seven patients with wounds healing by secondary intention after surgical intervention of a pilonidal cyst. The average age of the patients was 40 years old. Of the seven patients, three had developed a wound healing disturbance, one wound had started to develop a fibrin coating and three were in a good condition. The applied wound care regimens comprised appropriate mechanical or autolytic debridement, rinsing with an antimicrobial solution, haemoglobin application, and primary and secondary dressings. In all seven cases a complete wound closure was achieved within an average of 76 days with six out of seven wounds achieving wound closure within 23-98 days. Aesthetic appearance was deemed excellent in five out of seven cases excellent and acceptable in one. Treatment of one case with a sustained healing disturbance did result in wound closure but with a poor aesthetic outcome and an extensive cicatrisation of the new tissue. Based on these results we recommend that to avoid healing disturbances of wounds healing by secondary intention after surgical pilonidal cyst intervention, an adequate wound care regime comprising appropriate wound debridement, rinsing, topically applied haemoglobin and adequate wound dressing is recommendable as early as possible after surgery.

  14. A Study of Post-Caesarean Section Wound Infections in a Regional Referral Hospital, Oman

    Directory of Open Access Journals (Sweden)

    Hansa Dhar


    Full Text Available Objectives: The aim of this study was to determine the incidence of surgical site infections (SSI in patients undergoing a Caesarean section (CS and to identify risk factors, common bacterial pathogens and antibiotic sensitivity. SSI significantly affect the patient’s quality of life by increasing morbidity and extending hospital stays. Methods: A retrospective cross-sectional study was conducted in Nizwa Hospital, Oman, to determine the incidence of post-Caesarean (PCS SSI from 2001 to 2012. This was followed by a case-control study of 211 PCS cases with SSI. Controls (220 were randomly selected cases, at the same hospital in the same time period, who had undergone CS without any SSI. Data was collected on CS type, risk factors, demographic profile, type of organism, drug sensitivity and date of infection. Results: The total number of PCS wound infections was 211 (2.66%. There was a four-fold higher incidence of premature rupture of the membranes (37, 17.53% and a three-fold higher incidence of diabetes (32, 15.16% in the PCS cases compared with controls. The most common organisms responsible for SSI were Staphylococcus aureus (66, 31.27% and the Gram-negative Escherichia coli group (40, 18.95%. The most sensitive antibiotics were aminoglycoside and cephalosporin. Polymicrobial infections were noted in 42 (19.90%, while 47 (22.27% yielded no growth. A high incidence of associated risk factors like obesity, hypertension, anaemia and wound haematoma was noted. Conclusion: Measures are recommended to reduce the incidence of SSI, including the implementation of infection prevention practices and the administration of antibiotic prophylaxis with rigorous surgical techniques.

  15. Post-Surgical Clinical Monitoring of Soft Tissue Wound Healing in Periodontal and Implant Surgery. (United States)

    Pippi, Roberto


    Clinical features of surgical soft tissue wound healing in dentistry have been rarely discussed in the international literature. The aim of the present paper is to highlight both the main clinical findings of surgical wound healing, especially in periodontal and implant dentistry, and the wound healing monitoring procedures which should be followed. Wound inspection after careful food and plaque debridement is the essential part of wound healing monitoring. Periodontal and peri-implant probing should be performed only after tissue healing has been completed and not on a weekly basis in peri-implant tissue monitoring. Telephone follow-up and patient self-assessment scales can also be used the days following surgery to monitor the most common surgical complications such as pain, swelling, bleeding, and bruising. Wound healing monitoring is an important concern in all surgical procedures since it allows to identify signs or/and symptoms possibly related to surgical complications.

  16. Forensic aspects of incised wounds and bruises in pigs established post-mortem

    DEFF Research Database (Denmark)

    Barington, Kristiane; Jensen, Henrik Elvang


    ) bruises. Vital reactions, i.e. infiltrating leukocytes, hyper-leukocytosis and pavement of leukocytes, were absent in all incised wounds and bruises regardless of the time of sampling after traumatization. In conclusion, a vital reaction was not present in PM incised wounds, regardless of the time...

  17. Biodegradable urethral stent in the treatment of post-traumatic urethral strictures in a war wound rabbit urethral model

    Energy Technology Data Exchange (ETDEWEB)

    Fu Weijun [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Binghong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Gao Jiangping [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Hong Baofa [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Zhang Lei [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Yang Yong [Department of Urology, Chinese People' s Liberation Army General Hospital, Military Postgraduate Medical College, No.28 Fuxing Road, Hai dian District, Beijing 100853 (China); Meng Bo [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Zhu Ning [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China); Cui Fuzhai [Biomaterials Lab, School of Materials Science and Engineering, Tsinghua University, Beijing (China)


    To prevent terrorism during anti-terror war, we developed a reproducible animal model for the induction of a urethral stricture in a war wound rabbit, and to evaluate the feasibility and effect of using a biodegradable urethral stent in the prophylaxis and treatment of urethral strictures in a war wound (or traumatic) rabbit urethral model. The urethral stricture rabbit model was successfully performed by a self-control explosion destructor. New biodegradable urethral stents were placed in the urethras of 20 war wound (traumatic) rabbits, but no stent was used in the 8 rabbits which formed the control group. Follow-up investigation included assessment of procedure success, stent changes, urethrascopy and retrograde urethrography, and histological findings were obtained after sacrifice at 4, 6, 8 and 12 weeks after stent placement. The urethral stricture model owing to a war wound (trauma) was tested by tissue reactions and urethroscopy. The length of the urethral strictures was 5-10 mm; the coarctatetion of the urethral lumen was more than 50%. Biodegradable stent placement was technically successful in 20 rabbits. Urethral specimens obtained from the 4 week stent placement group showed diminished inflammatory cell infiltration and decreased thickness of the papillary projections of the epithelium. There was a strong tendency towards regression of the papillary projections and regeneration of urethral mucosa epithelium in the 8 week group. In particular, the injured urethra has recovered completely in the biodegradable stent groups compared with the control group at 12 weeks. The biodegradable urethral stent seems feasible for treating and preventing urethral strictures owing to a war wound (or traumatic) urethra. There are distinct advantages in terms of safe, effective and less-invasive treatment for the reconstruction of post-traumatic urethral strictures.

  18. Improper wound treatment and delay of rabies post-exposure prophylaxis of animal bite victims in China: Prevalence and determinants. (United States)

    Liu, Qiaoyan; Wang, Xiaojun; Liu, Bing; Gong, Yanhong; Mkandawire, Naomie; Li, Wenzhen; Fu, Wenning; Li, Liqing; Gan, Yong; Shi, Jun; Shi, Bin; Liu, Junan; Cao, Shiyi; Lu, Zuxun


    Rabies is invariably a fatal disease. Appropriate wound treatment and prompt rabies post-exposure prophylaxis (PEP) are of great importance to rabies prevention. The objective of this study was to investigate the prevalence and influencing factors of improper wound treatment and delay of rabies PEP after an animal bite in Wuhan, China. This cross-sectional study was conducted among animal bite victims visiting rabies prevention clinics (RPCs). We selected respondents by a multistage sampling technique. A face-to-face interview was conducted to investigate whether the wound was treated properly and the time disparity between injury and attendance to the RPCs. Determinants of improper wound treatment and delay of rabies PEP were identified by a stepwise multivariate logistic regression analysis. In total, 1,015 animal bite victims (564 women and 451 men) responded to the questionnaire, and the response rate was 93.98%. Overall, 81.2% of animal bite victims treated their wounds improperly after suspected rabies exposure, and 35.3% of animal bite victims delayed the initiation of PEP. Males (OR = 1.871, 95% CI: 1.318-2.656), residents without college education (OR = 1.698, 95% CI: 1.203-2.396), participants liking to play with animals (OR = 1.554, 95% CI: 1.089-2.216), and people who knew the fatality of rabies (OR = 1.577, 95% CI: 1.096-2.270), were more likely to treat wounds improperly after an animal bite. Patients aged 15-44 years (OR = 2.324, 95% CI: 1.457-3.707), who were bitten or scratched by a domestic animal (OR = 1.696, 95% CI: 1.103-2.608) and people who knew the incubation period of rabies (OR = 1.844, 95% CI: 1.279-2.659) were inclined to delay the initiation of PEP. Our investigation shows that improper wound treatment and delayed PEP is common among animal bite victims, although RPCs is in close proximity and PEP is affordable. The lack of knowledge and poor awareness might be the main reason for improper PEP. Educational programs and awareness raising

  19. The Simple Urine Bag as Wound Drain Post-Craniotomy in a Low ...

    African Journals Online (AJOL)

    Background: In the face of the practical non-availability of custom-made surgical wound drain materials, many other substitutes are used in developing countries. ... Data analyzed include the patients' brief demographics; the types of cranial surgery in which drain was used; the drain performance, and any associated ...

  20. Antioxidant response system in the short-term post-wounding effect in Mesembryanthemum crystallinum leaves. (United States)

    Slesak, Ireneusz; Slesak, Halina; Libik, Marta; Miszalski, Zbigniew


    Mechanical wounding of Mesembryanthemum crystallinum leaves in planta induced a fast decrease in stomatal conductance, which was related to accumulation of hydrogen peroxide (H(2)O(2)). Higher levels of H(2)O(2) were accompanied by an increase in total activity of superoxide dismutase (SOD) and a decrease in catalase (CAT) activity. Among SOD forms, manganese SOD (MnSOD) and copper/zinc SOD (Cu/ZnSOD) seem to be especially important sources of H(2)O(2) at early stages of wounding response. Moreover, NADP-malic enzyme (NADP-ME), one of the key enzymes of primary carbon metabolism, which is also involved in stress responses, showed a strong increase in activity in wounded leaves. All these symptoms: high accumulation of H(2)O(2), high activities of Cu/ZnSOD and NADP-ME, together with the decrease of CAT activity, were also observed in the major veins of unwounded leaves. The potential role of veinal tissues as an important source of H(2)O(2) during wounding response is discussed.


    African Journals Online (AJOL)

    NEGATIVE PRESSURE WOUND THERAPY (NPWT) FOR THE MANAGEMENT OF LAPAROSTOMY WOUNDS: ... Negative pressure wound therapy (NPWT) is one of the new additions to the armamentarium of laparostomy wound management to achieve the above (8). ... However, second day post operatively she.

  2. Prospective randomised controlled trial of nanocrystalline silver dressing versus plain gauze as the initial post-debridement management of military wounds on wound microbiology and healing. (United States)

    Fries, C A; Ayalew, Y; Penn-Barwell, J G; Porter, K; Jeffery, S L A; Midwinter, M J


    Recent conflicts have been characterised by the use of improvised explosive devices causing devastating injuries, including heavily contaminated wounds requiring meticulous surgical debridement. After being rendered surgical clean, these wounds are dressed and the patient transferred back to the UK for on-going treatment. A dressing that would prevent wounds from becoming colonised during transit would be desirable. The aim of this study was to establish whether using nanocrystalline silver dressings, as an adjunct to the initial debridement, would positively affect wound microbiology and wound healing compared to standard plain gauze dressings. Patients were prospectively randomised to receive either silver dressings, in a nanocrystalline preparation (Acticoat™), or standard of care dressings (plain gauze) following their initial debridement in the field hospital. On repatriation to the UK microbiological swabs were taken from the dressing and the wound, and an odour score recorded. Wounds were followed prospectively and time to wound healing was recorded. Additionally, patient demographic data were recorded, as well as the mechanism of injury and Injury Severity Score. 76 patients were recruited to the trial between February 2010 and February 2012. 39 received current dressings and 37 received the trial dressings. Eleven patients were not swabbed. There was no difference (p=0.1384, Fishers) in the primary outcome measure of wound colonisation between the treatment arm (14/33) and the control arm (20/32). Similarly time to wound healing was not statistically different (p=0.5009, Mann-Whitney). Wounds in the control group were scored as being significantly more malodorous (p=0.002, Mann-Whitney) than those in the treatment arm. This is the first randomised controlled trial to report results from an active theatre of war. Performing research under these conditions poses additional challenges to military clinicians. Meticulous debridement of wounds remains the

  3. The effect of post traumatic stress disorders on rehabilitation among combat-wounded veterans. (United States)

    Siddharthan, Kris


    In June 2008 the Congressionally Directed Medical Research Program provided a grant to the Research Foundation at the James A Haley Veterans Hospital in Tampa, Florida to provide care for wounded veterans from Operation Enduring Freedom (Afghanistan) and Operation Iraqi Freedom (OEF/OIF). The telerehabilitation for OEF/OIF returnees with mild or moderate combat related Traumatic Brain Injury (TBI) has as its objectives 1) care coordination for wounded veterans using distance technology via the internet and 2) monitoring of physical and mental health outcomes using a variety of instruments. A total of 75 veterans were enrolled in the study. Our initial findings indicate that 1) Functional capabilities measured by locomotion and mobility appear to have stabilized among our cohort of veterans while deficiencies in cognition (memory, problem solving), psychosocial adjustment (anger, emotional status) and problems in integrating into society pose challenges 2) Those with comorbid PTSD appear to linger in employability and ultimate integration into society as compared to those without the diagnosis 3) Individualized treatment pathways are needed for rehabilitation and ultimate integration into society.

  4. Biobased silver nanocolloid coating on silk fibers for prevention of post-surgical wound infections. (United States)

    Dhas, Sindhu Priya; Anbarasan, Suruthi; Mukherjee, Amitava; Chandrasekaran, Natarajan


    Bombyx mori silk fibers are an important biomaterial and are used in surgical sutures due to their remarkable biocompatibility. The major drawback to the application of biomaterials is the risk of bacterial invasion, leading to clinical complications. We have developed an easy and cost-effective method for fabrication of antibacterial silk fibers loaded with silver nanoparticles (AgNPs) by an in situ and ex situ process using an aqueous extract of Rhizophora apiculata leaf. Scanning electron microscopy revealed that well dispersed nanoparticles impregnated the silk fibers both in situ and ex situ. The crystalline nature of the AgNPs in the silk fibers was demonstrated by X-ray diffraction. The thermal and mechanical properties of the silk fibers were enhanced after they were impregnated with AgNPs. The silver-coated silk fibers fabricated by the in situ and ex situ method exhibited more than 90% inhibition against Pseudomonas aeruginosa and Staphylococcus aureus. Silk fibers doped with AgNPs were found to be biocompatible with 3T3 fibroblasts. The results obtained represent an important advance towards the clinical application of biocompatible AgNP-loaded silk fibers for prevention of surgical wound infections.

  5. Combination of negative pressure wound therapy and acoustic pressure wound therapy for treatment of infected surgical wounds: a case series. (United States)

    Liguori, Paul A; Peters, Kim L; Bowers, Jolene M


    The optimal wound therapy for healing infected wounds post surgery or surgical debridement has not been established. Negative pressure wound therapy and acoustic pressure wound therapy are advanced wound-healing modalities that apply forms of mechanical pressure to wound tissue in an effort to promote healing by stimulating cellular proliferation. Using a combination of negative pressure wound therapy and acoustic pressure wound therapy was evaluated in a series of six patients with large, infected surgical wounds presenting with moderate to large amounts of serosanguineous drainage. After concurrent treatment with both modalities (range: 4 to 12 weeks), wound volume was reduced by 99% to 100% in all wounds except one wound for which depth at end of treatment was not measurable due to hypergranulation. Similarly, wound surface area was reduced by 82% to 100%, with the exception of the hypergranular wound, which decreased in size by 60%. Serosanguineous wound drainage was reduced in four wounds and remained unchanged in two wounds.

  6. Hemostasis and Post-operative Care of Oral Surgical Wounds by Hemcon Dental Dressing in Patients on Oral Anticoagulant Therapy: A Split Mouth Randomized Controlled Clinical Trial. (United States)

    Kumar, K R Ashok; Kumar, Jambukeshwar; Sarvagna, Jagadesh; Gadde, Praveen; Chikkaboriah, Shwetha


    Hemostasis is a fundamental management issue post-operatively in minor oral surgical procedures. To ensure safety and therapeutic efficacy in patients, under oral anti coagulant therapy, is complicated by necessity for frequent determination of prothrombin time or international normalised ratio. The aim of the study was to determine whether early hemostasis achieved by using Hemcon Dental Dressing (HDD) will affect post-operative care and surgical healing outcome in minor oral surgical procedures. A total of 30 patients, aged 18 years to 90 years, except those allergic to seafood, who consented to participate, were enrolled into this study. Patients were required to have two or more surgical sites so that they would have both surgical and control sites. All patients taking Oral Anticoagulation Therapy (OAT) were included for treatment in the study without altering the anticoagulant regimens. Institutional Review Board approval was obtained for the same. The collected data was subjected to statistical analysis using unpaired t-test. All HDD surgically treated sites achieved hemostasis in 1.49 minutes and control wounds in 4.06 minutes (p wounds achieved statistically significant improved healing both at 1(st) and 3(rd) post-operative days (p surgical procedures under local anaesthesia, including those patients taking OAT. Patients receiving the HDD had improved surgical wound healing as compared to controls.

  7. Virtopsy: fatal stab wounds to the skull--the relevance of ante-mortem and post-mortem radiological data in case reconstructions. (United States)

    Oesterhelweg, L; Ross, S; Spendlove, D; Schoen, C A; Christe, A; Thali, M J; Bolliger, S A


    Homicides with a survival of several days are not uncommon in forensic routine work. Reconstructions of these cases by autopsy alone are very difficult and may occasionally lead to unsatisfying results. For the medico-legal reconstruction of these cases, ante-mortem and post-mortem radiological imaging should always be included in the expertise. We report on a case of fatal penetrating stab wounds to the skull in which a case reconstruction was only possible by combining the radiological ante- and post-mortem data with the autopsy findings.

  8. Functional genomics unique to week 20 post wounding in the deep cone/fat dome of the Duroc/Yorkshire porcine model of fibroproliferative scarring.

    Directory of Open Access Journals (Sweden)

    Loren H Engrav

    Full Text Available BACKGROUND: Hypertrophic scar was first described over 100 years ago; PubMed has more than 1,000 references on the topic. Nevertheless prevention and treatment remains poor, because 1 there has been no validated animal model; 2 human scar tissue, which is impossible to obtain in a controlled manner, has been the only source for study; 3 tissues typically have been homogenized, mixing cell populations; and 4 gene-by-gene studies are incomplete. METHODOLOGY/PRINCIPAL FINDINGS: We have assembled a system that overcomes these barriers and permits the study of genome-wide gene expression in microanatomical locations, in shallow and deep partial-thickness wounds, and pigmented and non-pigmented skin, using the Duroc(pigmented fibroproliferative/Yorkshire(non-pigmented non-fibroproliferative porcine model. We used this system to obtain the differential transcriptome at 1, 2, 3, 12 and 20 weeks post wounding. It is not clear when fibroproliferation begins, but it is fully developed in humans and the Duroc breed at 20 weeks. Therefore we obtained the derivative functional genomics unique to 20 weeks post wounding. We also obtained long-term, forty-six week follow-up with the model. CONCLUSIONS/SIGNIFICANCE: 1 The scars are still thick at forty-six weeks post wounding further validating the model. 2 The differential transcriptome provides new insights into the fibroproliferative process as several genes thought fundamental to fibroproliferation are absent and others differentially expressed are newly implicated. 3 The findings in the derivative functional genomics support old concepts, which further validates the model, and suggests new avenues for reductionist exploration. In the future, these findings will be searched for directed networks likely involved in cutaneous fibroproliferation. These clues may lead to a better understanding of the systems biology of cutaneous fibroproliferation, and ultimately prevention and treatment of hypertrophic scarring.

  9. The Effect of Channa striatus (Haruan Extract on Pain and Wound Healing of Post-Lower Segment Caesarean Section Women

    Directory of Open Access Journals (Sweden)

    Siti Zubaidah Ab Wahab


    Full Text Available Channa striatus has been consumed for decades as a remedy to promote wound healing by women during postpartum period. The objectives of this study were to compare postoperative pain, wound healing based on wound evaluation scale (WES, wound cosmetic appearance based on visual analogue scale (VAS scores and patient satisfaction score (PSS, and safety profiles between C. striatus group and placebo group after six weeks of lower segment caesarean section (LSCS delivery. A randomised, double-blind, placebo-controlled study was conducted. Subjects were randomised in a ratio of 1 : 1 into either the C. striatus group (500 mg daily or placebo group (500 mg of maltodextrin daily. 76 subjects were successfully randomised, with 38 in the C. striatus group and 35 in the placebo group. There were no significant differences in postoperative pain p=0.814 and WES p=0.160 between the C. striatus and placebo groups. However, VAS and PSS in the C. striatus group were significantly better compared with the placebo group (p=0.014 and p<0.001, resp.. The safety profiles showed no significant differences between the groups. In conclusion, six-week supplementation of 500 mg of C. striatus extract showed marked differences in wound cosmetic appearance and patient’s satisfaction and is safe for human consumption.

  10. Psychological status, real pain and antioxidant capacity of plasma, could make the prediction about the post-trauma wound healing. (United States)

    Marcoci, Diana; Bran, B; Ciurea, M; Pârvănescu, H; Vrabete, Maria


    Patients submitted to a trauma followed by a surgical intervention, experience pain and discomfort. Exogenous (surgical intervention, anesthesia) postoperative care, and endogenous factors, belonging to patient, especially neuro-psychological disturbances are synergic and participate together, to induce and to amplify the imbalance between oxidants/antioxidants, sustaining the appearance of oxidative injury, and worsening the wound healing. The morphological aspects are not correlated with the pain expression, but the discomfort and agitation have a great influence upon the bad evolution of organism and of wound healing.

  11. Does Wound-Induced Xylem Peroxide Contribute to the Post-Harvest Loss of Hydraulic Conductivity in Stems?

    NARCIS (Netherlands)

    Etalo, D.W.; Harbinson, J.; Meeteren, van U.


    The hydraulic conductivity of cut flower stems decreases 4-8 h after cutting, possibly because of up-regulation of L-phenylalanine ammonia-lyase (PAL). To get more insight into the processes linking wounding with the increase in enzyme activity we explored the movement of reactive oxygen species

  12. A patient-centered system in a provider-centered world: challenges of incorporating post-discharge wound data into practice. (United States)

    Sanger, Patrick C; Hartzler, Andrea; Lordon, Ross J; Armstrong, Cheryl Al; Lober, William B; Evans, Heather L; Pratt, Wanda


    The proposed Meaningful Use Stage 3 recommendations require healthcare providers to accept patient-generated health data (PGHD) by 2017. Yet, we know little about the tensions that arise in supporting the needs of both patients and providers in this context. We sought to examine these tensions when designing a novel, patient-centered technology - mobile Post-Operative Wound Evaluator (mPOWEr) - that uses PGHD for post-discharge surgical wound monitoring. As part of the iterative design process of mPOWEr, we conducted semistructured interviews and think-aloud sessions using mockups with surgical patients and providers. We asked participants how mPOWEr could enhance the current post-discharge process for surgical patients, then used grounded theory to develop themes related to conflicts and agreements between patients and providers. We identified four areas of agreement: providing contextual metadata, accessible and actionable data presentation, building on existing sociotechnical systems, and process transparency. We identified six areas of conflict, with patients preferring: more flexibility in data input, frequent data transfer, text-based communication, patient input in provider response prioritization, timely and reliable provider responses, and definitive diagnoses. We present design implications and potential solutions to the identified conflicts for each theme, illustrated using our work on mPOWEr. Our experience highlights the importance of bringing a variety of stakeholders, including patients, into the design process for PGHD applications. We have identified critical barriers to integrating PGHD into clinical care and describe design implications to help address these barriers. Our work informs future efforts to ensure the smooth integration of essential PGHD into clinical practice. © The Author 2016. Published by Oxford University Press on behalf of the American Medical Informatics Association. All rights reserved. For Permissions, please email:

  13. Effects of the nephrilin peptide on post-burn glycemic control, renal function, fat and lean body mass, and wound healing. (United States)

    Mascarenhas, Desmond D; Ayadi, Amina El; Wetzel, Michael; Prasai, Anesh; Mifflin, Randy; Jay, Jayson; Herndon, David N; Finnerty, Celeste C


    The mechanisms underlying the effects of severe burn trauma are not well understood. We previously demonstrated the ability of nephrilin peptide (an iron-binding peptide believed to enter cells through iron-uptake pathways) to suppress aspects of the neuroinflammatory response in a rat scald model, as well as sepsis mortality in a mouse model. This study explores the effect of nephrilin on other clinically relevant outcomes in the rat scald model. In a rat scald model, animals were treated with nephrilin either in week 1 or week 2 post-burn. Measurements were made of serum glucose and creatinine as well as wound area by planimetry and body composition by DEXA. Given the potential role of iron, results were analyzed both for the entire cohort of animals and for the normoferremic (>100 ug/dL serum iron) subset of animals. Nephrilin improved body composition, wound healing, kidney function, and glycemic control. The first two effects were significant in normoferremic but not in hypoferremic animals suggesting an effect of iron status on burn injury outcomes. Nephrilin treatment modulates a number of relevant variables in the rat scald model.

  14. Can immunohistochemistry quantification of Cathepsin-D be useful in the differential diagnosis between vital and post-mortem wounds in humans? (United States)

    Montisci, Massimo; Corradin, Matteo; Giacomelli, Luciano; Viel, Guido; Cecchetto, Giovanni; Ferrara, Santo Davide


    Markers of skin wound vitality and the research methodology used for their determination are still matters of debate in forensic pathology. Cathepsin-D, a lysosomal enzyme, is the most expressed cathepsin in human skin, and although it seems to have the necessary requirements to be utilized as a vitality marker, past research has provided no definitive and clear response on its potential usefulness. Immunohistochemistry with monoclonal antibodies and image analysis has been employed to detect and quantify the expression of Cathepsin-D in human skin wounds. We analyzed skin fragments obtained from 20 living individuals (group A) and 20 persons deceased from natural causes (group B). For each case, five skin fragments were withdrawn at 0', 5', 10', 30', and 90' after abdominal incision. Once the samples were formalin-fixed and paraffin-embedded, we analyzed the expression of Cathepsin-D through the quantification of the immunohistochemistry signal by image analysis. Immunoreactivity was displayed in Pixels of positive area measured by image analysis and converted in micrometer squares. The average levels of Cathepsin-D were higher in group B than in group A, except in three cases which showed a lower expression, with a statistically significant difference of Cathepsin-D expression between the two groups (p vital and post-mortem injuries.

  15. Wound care centers (United States)

    ... wound care center; Diabetic ulcer - wound care center; Surgical wound - wound center; Ischemic ulcer - wound center ... types of non-healing wounds include: Pressure sores Surgical wounds Radiation sores Foot ulcers due to diabetes , poor ...

  16. 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...... infection. However, the treatment is relatively costly compared to standard postoperative dressings and thus it was important to consider the rationale for using iNPWT before introducing the treatment in a clinical setting. This thesis assesses the current evidence of whether iNPWT reduces post...

  17. Puncture Wounds (United States)

    ... particles of which can get trapped in the wound. Treatment A puncture wound must be cleaned properly and ... play a crucial role in preventing them. Puncture Wounds: What You Should Do Seek treatment right away. Get a tetanus shot if needed ( ...

  18. MiR-1908 promotes scar formation post-burn wound healing by suppressing Ski-mediated inflammation and fibroblast proliferation. (United States)

    Xie, Chunhui; Shi, Kai; Zhang, Xi; Zhao, Jingchun; Yu, Jiaao


    The cell biological basis for scar formation is mainly via excessive fibroblast proliferation accompanied by hypernomic Col I accumulation and inflammation. The role of miR-1908 in scar formation has not been investigated. In this study, we found that miR-1908 expression was inversely associated with the scar suppressor Ski in normal, burn-wounded, healing and scar dermal tissues in humans. Bioinformatics and luciferase reporter gene assays confirmed that miR-1908 targeted the 3'UTR region of Ski mRNA and suppressed Ski expression. Next, human scar epidermal fibroblasts were isolated and the miR-1908 oligonucleotide mimic and inhibitor were respectively transfected into the cells. Western blot analysis proved that Ski expression was sharply reduced by the miR-1908 mimic. MTT and Cell Counting Kit-8 analyses showed that miR-1908 mimic transfection promoted cell proliferation. Simultaneously, data on real-time qPCR analysis indicated that expression of the fibrotic master gene TGF-β1, Ski-suppressing gene Meox2, Col I and proinflammatory markers IL-1α and TNF-α, were all significantly upregulated. In contrast, the miR-1908 inhibitor had a completely opposite effect on cell proliferation and gene expression. The mimic and inhibitor were locally injected into rats with abdominal burn-wounded scars during a 180-day, post-healing experiment. The miR-1908 mimic injection significantly reduced Ski expression, as well as the area, volume and fibrosis of scars in vivo. And, in contrast, the miR-1908 inhibitor injection had an opposite effect to that of the miR-1908 mimic injection. In conclusion, miR-1908 had a positive role in scar formation by suppressing Ski-mediated inflammation and fibroblast proliferation in vitro and in vivo.

  19. Ultrasound-guided Transversus Abdominis plane block versus continuous wound infusion for post-caesarean analgesia: a randomized trial.

    Directory of Open Access Journals (Sweden)

    Michel Chandon

    Full Text Available To compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane (TAP block versus Continuous Wound Infusion (CWI with levobupivacaine after caesarean delivery.We recruited parturients undergoing elective caesareans for this multicenter study. Following written informed consent, they received a spinal anaesthetic without intrathecal morphine for their caesarean section. The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block (levobupivicaine = 150 mg or a CWI through an elastomeric pump for 48 hours (levobupivacaine = 150 mg the first day and 12.5 mg/h thereafter. Every woman received regular analgesics along with oral morphine if required. The primary outcome was comparison of the 48-hour area under the curve (AUC pain scores. Secondary outcomes included morphine consumption, adverse events, and persistent pain one month postoperatively.Recruitment of 120 women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group. By then, 36 patients with TAP and 29 with CWI had completed the study. AUC of pain at rest and during mobilization were not significantly different: 50 [22.5-80] in TAP versus 50 [27.5-130] in CWI (P = 0.4 and 190 [130-240] versus 160 [112.5-247.5] (P = 0.5, respectively. Morphine consumption (0 [0-20] mg in the TAP group and 10 [0-32.5] mg in the CWI group (P = 0.09 and persistent pain at one month were similar in both groups (respectively 29.6% and 26.6% (P = 0.73.In cases of morphine-free spinal anesthesia for cesarean delivery, no difference between TAP block and CWI for postoperative analgesia was suggested. TAP block may induce seizures in this specific context. Consequently, such a technique after a caesarean section cannot be NCT01151943.

  20. Reiki: Application as a Modality of Integrative Therapy for Treating Post-Traumatic Stress Disorder and Other Wounded Warrior Issues (United States)


    patients undergoing heart surgery, patients had shorter lengths of hospital stay, less time in the intensive care unit, required blood transfusion ...innumerable topics at any given time. These case studies are often the stimulus for trying new techniques and procedures. There have been many case...PTSD),” National Institutes of Health, topics /post-traumatic-stress-disorder- ptsd/index.shtml (accessed 11 February

  1. Ultrasound-Guided Transversus Abdominis Plane Block versus Continuous Wound Infusion for Post-Caesarean Analgesia: A Randomized Trial (United States)

    Chandon, Michel; Bonnet, Agnès; Burg, Yannick; Barnichon, Carole; DesMesnards-Smaja, Véronique; Sitbon, Brigitte; Foiret, Christine; Dreyfus, Jean-François; Rahmani, Jamil; Laloë, Pierre-Antoine; Fischler, Marc; Le Guen, Morgan


    Objective To compare the analgesic effect of ultrasound-guided Transversus Abdominis Plane (TAP) block versus Continuous Wound Infusion (CWI) with levobupivacaine after caesarean delivery. Methods We recruited parturients undergoing elective caesareans for this multicenter study. Following written informed consent, they received a spinal anaesthetic without intrathecal morphine for their caesarean section. The postoperative analgesia was randomized to either a bilateral ultrasound guided TAP block (levobupivicaine = 150 mg) or a CWI through an elastomeric pump for 48 hours (levobupivacaine = 150 mg the first day and 12.5 mg/h thereafter). Every woman received regular analgesics along with oral morphine if required. The primary outcome was comparison of the 48-hour area under the curve (AUC) pain scores. Secondary outcomes included morphine consumption, adverse events, and persistent pain one month postoperatively. Results Recruitment of 120 women was planned but the study was prematurely terminated due to the occurrence of generalized seizures in one patient of the TAP group. By then, 36 patients with TAP and 29 with CWI had completed the study. AUC of pain at rest and during mobilization were not significantly different: 50 [22.5–80] in TAP versus 50 [27.5–130] in CWI (P = 0.4) and 190 [130–240] versus 160 [112.5–247.5] (P = 0.5), respectively. Morphine consumption (0 [0–20] mg in the TAP group and 10 [0–32.5] mg in the CWI group (P = 0.09)) and persistent pain at one month were similar in both groups (respectively 29.6% and 26.6% (P = 0.73)). Conclusion In cases of morphine-free spinal anesthesia for cesarean delivery, no difference between TAP block and CWI for postoperative analgesia was suggested. TAP block may induce seizures in this specific context. Consequently, such a technique after a caesarean section cannot be recommended. Trial Registration NCT01151943 PMID:25093663

  2. Post-qualitative mo(vements: Concluding remarks on methodological response-abilities and being wounded by thought

    Directory of Open Access Journals (Sweden)

    Marc Higgins


    Full Text Available Post-qualitative research methodologies require us to work within, against, and beyond our methodological inheritance to respond to the world’s ongoing becoming. It is our responsibility; yet do we have the ability to respond to that which is beyond and yet-to-come? This article begins by asking this question of the process it engages in: concluding. Following an exploration entangled practices of textual closure, (foreclosure, and the clôture of metaphysics, the article expands outward through the relation between closure and responsibility. Specifically, the lived concept of response-ability as an engaged practice of (reopening the lines of closure (beyond knowledge already known to respond to and enact responsibility for that which is not-yet and/or to-come. Drawing from Kuokkanen, Spivak, and Barad, response-ability is explored respectively as necessary homework, as (not hearing the call of the other, and as account-ability toward co-constitutive relationality. The article concludes with further lines of questioning as to what it might mean to responsibly inherit (post-qualitative methodological pasts and futurities.

  3. Open-label clinical trial comparing the clinical and economic effectiveness of using a polyurethane film surgical dressing with gauze surgical dressings in the care of post-operative surgical wounds. (United States)

    Arroyo, Ana Abejón; Casanova, Pabló López; Soriano, José Verdú; Torra I Bou, Joan-Enric


    Surgical site infection (SSI) is a common postoperative complication and can cause avoidable morbidity and excessive costs for the health service. Novel dressings, designed specifically for postoperative wounds, can help to reduce the risk of SSI and other complications such as blistering. This study compared the use of a new polyurethane film surgical dressing (Opsite Post-Op Visible, Smith & Nephew, Hull, UK) with gauze and tape in the management of postoperative wounds. The results show that the polyurethane film dressing results in a significant reduction in SSI (1·4% versus 6·6%, P = 0·006) as well as a reduction in other postoperative wound complications (e.g. blistering and erythema). Economic analysis conducted alongside the study suggests that these improved outcomes can be achieved at a lower treatment cost than gauze and tape dressings. The modest incremental cost of the polyurethane film surgical dressing is easily offset by the reduction in the costs related to treating SSI and other wound complications associated with gauze and tape dressings. © 2013 The Authors. International Wound Journal © 2013 Inc and John Wiley & Sons Ltd.

  4. Aseptic surgical preparation for upper eyelid blepharoplasty via full-face octenidine antiseptic without antibiotic medication shows effective prophylaxis against post-surgical wound infection. (United States)

    Matiasek, Johannes; Kienzl, Philip; Otti, Gerlinde R; Turk, Bela R; Djedovic, Gabriel; Rieger, Ulrich M


    Blepharoplasty is the third most common plastic surgical procedure in the USA. Due to the emergence of multiresistant bacteria, optimising the antiseptic procedure is crucial. Choice of antiseptics plays an important role as they may cause skin irritation and colouring of disinfected areas. In this study, the use of the aqueous antiseptic octenisept® (octenidine) was evaluated in the outcome of blepharoplasties: incidence of wound dehiscence; haematoma; and infection in correlation with gender, medication, smoking habits and time of year. This retrospective surveillance study included 352 patients (median age 58·3 years). Skin disinfection was performed thrice prior to blepharoplasty. Sutures were removed on day 6. None of the patients suffered from wound infection. The total rate of wound dehiscence was 6·3%, with a higher ratio among male patients. Smokers and patients on anticoagulant medication showed a significantly higher incidence of wound dehiscence. Throughout the year, rates of wound dehiscence were highest in summer. Aseptic surgical preparation for blepharoplasty via full-face scrub with octenisept® without oral antibiotic prophylaxis is well tolerated, with no report of wound infection, which may improve antibiotic stewardship as well as patient comfort. Elective upper eyelid blepharoplasty may ideally be performed in winter. © 2017 Inc and John Wiley & Sons Ltd.

  5. Our initial learning curve in the enzymatic debridement of severely burned hands-Management and pit falls of initial treatments and our development of a post debridement wound treatment algorithm. (United States)

    Schulz, A; Perbix, W; Shoham, Y; Daali, S; Charalampaki, C; Fuchs, P C; Schiefer, J


    Excisional surgical debridement (SD) is still the gold standard in the treatment of deeply burned hands, though the intricate anatomy is easily damaged. Previous studies demonstrated that enzymatic debridement with the bromelain debriding agent NexoBrid(®) (EDNX) is more selective and thus can preserve viable tissue with excellent outcome results. So far no method paper has been published presenting different treatment algorithms in this new field. Therefore our aim was to close this gap by presenting our detailed learning curve in EDNX of deeply burned hands. We conducted a single-center prospective observational clinical trial treating 20 patients with deeply burned hands with EDNX. Different anaesthetic procedures, debridement and wound treatment algorithms were compared and main pitfalls described. EDNX was efficient in 90% of the treatments though correct wound bed evaluation was challenging and found unusual compared to SD. Post EDNX surprisingly the majority of the burn surface area was found overestimated (18 wounds). Finally we simplified our process and reduced treatment costs by following a modified treatment algorithm and treating under plexus anaesthesia bedside through a single nurse and one burn surgeon solely. Suprathel(®) could be shown to be an appropriate dressing for wound treatment after EDNX. Complete healing (less 5% rest defect) was achieved at an average of day 28. EDNX in deep burned hands is promising regarding handling and duration of the treatment, efficiency and selectivity of debridement, healing potential and early rehabilitation. Following our treatment algorithm EDNX can be performed easily and even without special knowledge in burn wound depth evaluation. Copyright © 2016 Elsevier Ltd and ISBI. All rights reserved.

  6. Broad-Spectrum Inhibition of the CC-Chemokine Class Improves Wound Healing and Wound Angiogenesis. (United States)

    Ridiandries, Anisyah; Bursill, Christina; Tan, Joanne


    Angiogenesis is involved in the inflammation and proliferation stages of wound healing, to bring inflammatory cells to the wound and provide a microvascular network to maintain new tissue formation. An excess of inflammation, however, leads to prolonged wound healing and scar formation, often resulting in unfavourable outcomes such as amputation. CC-chemokines play key roles in the promotion of inflammation and inflammatory-driven angiogenesis. Therefore, inhibition of the CC-chemokine class may improve wound healing. We aimed to determine if the broad-spectrum CC-chemokine inhibitor "35K" could accelerate wound healing in vivo in mice. In a murine wound healing model, 35K protein or phosphate buffered saline (PBS, control) were added topically daily to wounds. Cohorts of mice were assessed in the early stages (four days post-wounding) and in the later stages of wound repair (10 and 21 days post-wounding). Topical application of the 35K protein inhibited CC-chemokine expression (CCL5, CCL2) in wounds and caused enhanced blood flow recovery and wound closure in early-mid stage wounds. In addition, 35K promoted neovascularisation in the early stages of wound repair. Furthermore, 35K treated wounds had significantly lower expression of the p65 subunit of NF-κB, a key inflammatory transcription factor, and augmented wound expression of the pro-angiogenic and pro-repair cytokine TGF-β. These findings show that broad-spectrum CC-chemokine inhibition may be beneficial for the promotion of wound healing.

  7. Bacterial Wound Culture (United States)

    ... and services. Advertising & Sponsorship: Policy | Opportunities Bacterial Wound Culture Share this page: Was this page helpful? Also known as: Aerobic Wound Culture; Anaerobic Wound Culture Formal name: Culture, wound Related ...

  8. Wound Healing and Care (United States)

    ... Arrhythmias Abuse Love and Romance Understanding Other People Wound Healing and Care KidsHealth > For Teens > Wound Healing ... stitches or a hospital stay? Different Types of Wounds Most of us think of wounds happening because ...

  9. A unique presentation of renal cell transformation into renal cell carcinoma in subcutaneous fatty tissue post twenty year old healing gun-shot wound: A case report

    Directory of Open Access Journals (Sweden)

    Awadh R. Alqahtani


    Conclusion: The authors have reported an interesting case of an RCC presenting in a healed gun-shot wound in a previously nephrectomized patient. To the best of authors’ knowledge, such a case hasn’t been reported in the literature before, with it being unique in its time course, preceding events, and absence of primary lesions.

  10. Effects of two different post-surgical protocols including either 0.05 % chlorhexidine herbal extract or 0.1 % chlorhexidine on post-surgical plaque control, early wound healing and patient acceptance following standard periodontal surgery and implant placement. (United States)

    Laugisch, Oliver; Ramseier, Christoph A; Salvi, Giovanni E; Hägi, Tobias T; Bürgin, Walter; Eick, Sigrun; Sculean, Anton


    The aim of this study was to compare early wound healing, tooth staining and patient acceptance with two different post-surgical maintenance protocols. Forty patients scheduled for flap surgery to treat periodontal pockets or accommodate dental implants were randomly assigned to receive the following two different post-surgical maintenance protocols: (a) 2 weeks rinsing with a 0.05 % chlorhexidine digluconate (CHX)/herbal extract combination (test) or (b) a 0.1 % CHX solution (control). Early wound healing was evaluated clinically and immunologically. Tooth staining and patient acceptance were assessed by means of visual analogue scale (VAS). Both groups presented with comparable wound healing profiles. No statistically significant differences were observed between the two protocols regarding early wound healing and plaque index (p > 0.05). However, in the control group, statistically significantly more patients felt discomfort due to tooth staining (p = 0.0467). Compared with patients from the test group, patients in the control group reported statistically significant more irritation of taste at week 1 (p = 0.0359) and at week 2 (p = 0.0042). The present findings indicate that the two CHX protocols resulted in comparable healing and inhibition of plaque formation. Tooth staining and subjective discomfort related to irritation of taste were more frequent in the control group. A post-operative protocol including 0.05 % CHX/herbal extract may have the potential to improve patient compliance during post-operative maintenance.

  11. Collecting and measuring wound exudate biochemical mediators in surgical wounds. (United States)

    Carvalho, Brendan; Clark, David J; Yeomans, David; Angst, Martin S


    We describe a methodology by which we are able to collect and measure biochemical inflammatory and nociceptive mediators at the surgical wound site. Collecting site-specific biochemical markers is important to understand the relationship between levels in serum and surgical wound, determine any associations between mediator release, pain, analgesic use and other outcomes of interest, and evaluate the effect of systemic and peripheral drug administration on surgical wound biochemistry. This methodology has been applied to healthy women undergoing elective cesarean delivery with spinal anesthesia. We have measured wound exudate and serum mediators at the same time intervals as patient's pain scores and analgesics consumption for up to 48 hours post-cesarean delivery. Using this methodology we have been able to detect various biochemical mediators including nerve growth factor (NGF), prostaglandin E2 (PG-E2) substance P, IL-1β, IL-2, IL-4, IL-6, IL-7, IL-8, IL-10, IL-12, IL-13, IL-17, TNFα, INFγ, G-CSF, GM-CSF, MCP-1 and MIP-1β. Studies applying this human surgical wound bioassay have found no correlations between wound and serum cytokine concentrations or their time-release profile (J Pain. 2008; 9(7):650-7).(1) We also documented the utility of the technique to identify drug-mediated changes in wound cytokine content.

  12. Potential of pomegranate fruit extract (Punica granatum Linn. to increase vascular endothelial growth factor and platelet-derived growth factor expressions on the post-tooth extraction wound of Cavia cobaya

    Directory of Open Access Journals (Sweden)

    Intan Nirwana


    Full Text Available Background: Pomegranates fruit extracts have several activities, among others, anti-inflammatory, antibacterial, and antioxidants that have the main content punicalagin and ellagic acid. Pomegranate has the ability of various therapies through different mechanisms. Vascular endothelial growth factor (VEGF function was to form new blood vessels produced by various cells one of them was macrophages. Platelet-derived growth factor (PDGF was a growth factor proven chemotactic, increased fibroblast proliferation and collagen matrix production. In addition, VEGF and PDGF synergize in their ability to vascularize tissues. The PDGF function was to stabilize and regulate maturation of new blood vessels. Activities of pomegranate fruit extract were observed by measuring the increased of VEGF and PDGF expression as a marker of wound healing process. Aim: To investigate the potential of pomegranate extracts on the tooth extraction wound to increase the expression of VEGF and PDGF on the 4th day of wound healing process. Materials and Methods: This study used 12 Cavia cobaya, which were divided into two groups, namely, the provision of 3% sodium carboxymethyl cellulose and pomegranate extract. The 12 C. cobaya would be executed on the 4th day, the lower jaw of experimental animals was taken, decalcified about 30 days. The expression of VEGF and PDGF was examined using immunohistochemical techniques. The differences of VEGF and PDGF expression were evaluated statistically using t-test. Results: Statistically analysis showed that there were significant differences between control and treatment groups (p<0.05. Conclusion: Pomegranate fruit extract administration increased VEGF and PDGF expression on post-tooth extraction wound.

  13. Wound healing properties of Artocarpus heterophyllus Lam. (United States)

    Gupta, Nilesh; Jain, U K; Pathak, A K


    The studies on excision wound healing model reveals significant wound healing activity of the methanolic leaf extract (simple ointment 5%) of "Artocarpus heterophyllus" ham which is comparable with standard (Betadine). In the excision model, the period of epithelization, of the extract treated group was found to be higher than the controlgroup and slightly lesser than standard treated group of animals on the up to 16(th) post wounding day.

  14. Poste.

    Directory of Open Access Journals (Sweden)

    Saskia Cousin


    Full Text Available Poste à moustache. Le 27 février a été publié au journal officiel l ‘arrêté du 16 février 2007 portant déclaration de vacance d’emplois du supérieur pour la rentrée 2007. La chasse aux postes est donc ouverte. Petit rappel pour le lecteur non averti. En France, le parcours d’un docteur aspirant chercheur ou enseignant-chercheur est celui d’un marathonien, qui dure, en cas de recrutement immédiat, un an, mais peut se poursuivre de nombreuses années. Pour concourir, il ...

  15. Bromelain ameliorates the wound microenvironment and improves the healing of firearm wounds. (United States)

    Wu, Si-Yu; Hu, Wei; Zhang, Bo; Liu, Shuai; Wang, Jian-Min; Wang, Ai-Min


    In a previous study, we proposed a new therapy using topical bromelain as a supplement to simple wound-track incision for the debridement of firearm wounds. This enzymatic debridement greatly simplified the management of high-velocity gunshot wounds in a pig model, and bromelain was confirmed to improve wound healing. The purpose of the present study was to investigate the effect of bromelain on the microenvironment of firearm wounds. Sixteen Chinese landrace pigs wounded by high-velocity projectiles were divided randomly into four groups: wound incision (group I), incision + bromelain (group IB), wound excision (group E), and control. Blood perfusion, oxygen partial pressure (pO(2)), and the content of tumor necrosis factor (TNF)-α and transforming growth factor (TGF)-β in wound-track tissue were measured. Wound healing was also noted. The recovery of blood perfusion in tissue and pO(2) in wound tracks was significantly more rapid in group IB and group E than in group I and control. The tissue level of TNF-α was significantly lower in group IB than in group I and control 48 h and 72 h post-wounding, and was lower than in group E 48 h post-wounding. The tissue level of TGF-β in group IB was sustained at a significantly higher level than in the other three groups. Wound healing time was also shorter in group IB. Enzymatic debridement using topical bromelain in incised wound tracks accelerates the recovery of blood perfusion, pO(2) in wound tissue, controls the expression of TNF-α and raises the expression of TGF-β. Copyright © 2012 Elsevier Inc. All rights reserved.

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

    Directory of Open Access Journals (Sweden)

    Werna Nontji


    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

  17. Complex wounds Feridas complexas

    Directory of Open Access Journals (Sweden)

    Marcus Castro Ferreira


    Full Text Available Complex wound is the term used more recently to group those well-known difficult wounds, either chronic or acute, that challenge medical and nursing teams. They defy cure using conventional and simple "dressings" therapy and currently have a major socioeconomic impact. The purpose of this review is to bring these wounds to the attention of the health-care community, suggesting that they should be treated by multidisciplinary teams in specialized hospital centers. In most cases, surgical treatment is unavoidable, because the extent of skin and subcutaneous tissue loss requires reconstruction with grafts and flaps. New technologies, such as the negative pressure device, should be introduced. A brief review is provided of the major groups of complex wounds-diabetic wounds, pressure sores, chronic venous ulcers, post-infection soft-tissue gangrenes, and ulcers resulting from vasculitis.Ferida complexa é uma nova definição para identificar aquelas feridas crônicas e algumas agudas já bem conhecidas e que desafiam equipes médicas e de enfermagem. São difíceis de serem resolvidas usando tratamentos convencionais e simples curativos. Têm atualmente grande impacto sócio-econômico. Esta revisão procura atrair atenção da comunidade de profissionais de saúde para estas feridas, sugerindo que devam ser tratadas por equipe multidisciplinar em centro hospitalar especializado. Na maioria dos casos o tratamento cirúrgico deve ser indicado, uma vez que a perda de pele e tecido subcutâneo é extensa, necessitando de reconstrução com enxertos e retalhos. Nova tecnologia, como uso da terapia por pressão negativa foi introduzido. Breves comentários sobre os principais grupos de feridas complexas: pé diabético, úlceras por pressão, úlceras venosas, síndrome de Fournier e vasculites.

  18. Novel use of a flowable collagen-glycosaminoglycan matrix (Integra™ Flowable Wound Matrix) combined with percutaneous cannula scar tissue release in treatment of post-burn malfunction of the hand--A preliminary 6 month follow-up. (United States)

    Hirche, C; Senghaas, A; Fischer, S; Hollenbeck, S T; Kremer, T; Kneser, U


    Long-term function following severe burns to the hand may be poor secondary to scar adhesions to the underlying tendons, webspaces, and joints. In this pilot study, we report the feasibility of applying a pasty dermal matrix combined with percutaneous cannula teno- and adhesiolysis. In this 6 month follow-up pilot study, we included eight hands in five patients with hand burns undergoing minimal-invasive, percutaneous cannula adhesiolysis and injection of INTEGRA™ Flowable Wound Matrix for a pilot study of this new concept. The flowable collagen-glycosaminoglycan wound matrix (FCGWM) was applied with a buttoned 2mm cannula to induce formation of a neo-gliding plane. Post treatment follow-up was performed to assess active range of motion (AROM), grip strength, Disabilities of the Arm, Shoulder and Hand (DASH) score, Vancouver Scar Scale (VSS) and quality of life Short-Form (SF)-36 questionnaire. No complications were detected associated with the treatment of FCGWM injection. The mean improvement (AROM) at 6 months was 30.6° for digits 2-5. The improvement in the DASH score was a mean of 9 points out of 100. The VSS improved by a mean of 2 points out of 14. The study demonstrates the feasibility and safety of percutaneous FCGWM for dermal augmentation after burn. Results from this pilot study show improvements in AROM for digits 2-5, functional scores from the patient's perspective (DASH) and scar quality (VSS). The flowable form of established INTEGRA™ wound matrix offers the advantage of minimal-invasive injection after scar release in the post-burned hand with a reduction in the risk of postsurgical re-scarring. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  19. [Wound prevention in the surgical intensive care unit]. (United States)

    Le Moel, Carole; Mounier, Roman; Ardic-Pulas, Taline


    Literature reports a high prevalence of wounds in the hospital environment. A study devoted to wounds encountered in post-surgical intensive care has been carried out in a university hospital. This work highlighted the diversity of acute wounds mainly observed in intensive care and the difficulties nurses have in managing them.

  20. Bacterial Aggregates Establish at the Edges of Acute Epidermal Wounds

    DEFF Research Database (Denmark)

    Bay, Lene; Kragh, Kasper N.; Eickhardt, Steffen R.


    : On the buttock of 26 healthy volunteers, 28 suction blisters were made and de-roofed. Four wounds were biopsied immediately after wounding, whereas the remaining 24 wounds were treated daily with sterile deionized water and covered with a moisture-retaining dressing. On day 4 post-wounding, swabs were obtained...... for culturing from the wounds and adjacent skin, and the wounds including adjacent skin were excised. Tissue sections were stained with peptide nucleic acid (PNA) fluorescence in situ hybridization (FISH) probes, counterstained by 4′,6-diamidino-2-phenylindole, and evaluated by confocal laser scanning...

  1. Microbial profile of canine persistent wound infections

    Directory of Open Access Journals (Sweden)

    A. Padhy


    Full Text Available Aim: To analyse the microbial profile of canine persistent wound infections. Materials and Methods: The total wound samples (n=172 taken from both traumatic (140 and post-surgical (32 persistent wounds in canines were processed for routine microbial isolation and identification during a period of 15 months. Results: Staphylococcus intermedius was found to be the predominant isolate from all types of wounds under study. It was followed by Staphylococcus aureus, Pseudomonas aeruginosa, E. coli, Pasteurella spp., Corynaebacterium spp. and Bacillus spp. From different traumatic wounds of dogs, S. intermedius (92/140=65.7% and from surgical wounds, P. aeruginosa (24/32=75% were found to be the predominant isolates recovered whereas the most commonly isolated bacterial genus in both traumatic and surgical wounds of dogs was Staphylococcus spp. Conclusion: Canine wounds are polymicrobial in nature. Hence proper microbial laboratory diagnosis and presence of multiple organisms in a wound are to be taken into consideration for effective treatment of persistent wound infections in dogs.

  2. Dermal wound transcriptomic responses to Infection with Pseudomonas aeruginosa versus Klebsiella pneumoniae in a rabbit ear wound model


    Leung, Kai P.; D’Arpa, Peter; Seth, Akhil K; Geringer, Matthew R.; Jett, Marti; Xu, Wei; Hong, Seok J; Galiano, Robert D.; Chen, Tsute; Mustoe, Thomas A.


    Background Bacterial infections of wounds impair healing and worsen scarring. We hypothesized that transcriptome analysis of wounds infected with Klebsiella pneumoniae (K.p.) or Pseudomonas aeruginosa (P.a.) would indicate host-responses associated with the worse healing of P.a.- than K.p.-infected wounds. Methods Wounds created on post-operative day (POD) 0 were infected during the inflammatory phase of healing on POD3 and were harvested on POD4 for microarray and transcriptome analysis. Oth...

  3. Acticoat™ stimulates inflammation, but does not delay healing, in acute full-thickness excisional wounds. (United States)

    Hartmann, Carol A; Rode, Heinz; Kramer, Beverley


    Acticoat™ has antimicrobial and anti-inflammatory effects which aid wound healing. However, in vitro studies indicate that Acticoat™ is cytotoxic and clinical and in vivo studies suggest that it may delay healing in acute wounds. Therefore, this study investigated the effects of Acticoat™ on healing in acute full-thickness excisional wounds. Using a porcine model, healing was assessed on days 3, 6, 9 and 15 post-wounding. Five wounds dressed with Acticoat™ and five wounds dressed with polyurethane film (control) were assessed per day (n = 40 wounds). The rate of healing, inflammatory response, restoration of the epithelium and blood vessel and collagen formation were evaluated. No difference was found in the rate of healing between wounds treated with Acticoat™ and the control wounds. Inflammation was increased in Acticoat™-treated wounds on day 3 post-wounding compared to the control wounds. However, by day 15 post-wounding, the epithelium of the Acticoat™-treated wounds closely resembled normal epithelium. Acticoat™-treated wounds also contained a higher proportion of mature blood vessels, and differences in collagen deposition were apparent. Despite inducing an inflammatory response, Acticoat™ did not delay healing in acute wounds. Conversely, the improved quality of the epithelium and blood vessels within Acticoat™-treated wounds indicates that Acticoat™ has a beneficial effect on healing. © 2015 Inc and John Wiley & Sons Ltd.

  4. Irradiation at 660 nm modulates different genes central to wound healing in wounded and diabetic wounded cell models (United States)

    Houreld, Nicolette N.


    Wound healing is a highly orchestrated process and involves a wide variety of cellular components, chemokines and growth factors. Laser irradiation has influenced gene expression and release of various growth factors, cytokines and extracellular matrix proteins involved in wound healing. This study aimed to determine the expression profile of genes involved in wound healing in wounded and diabetic wounded fibroblast cells in response to irradiation at a wavelength of 660 nm. Human skin fibroblast cells (WS1) were irradiated with a diode laser (wavelength 660 nm; fluence 5 J/cm2; power output 100 mW; power density 11 mW/cm2; spot size 9.1 cm2; exposure duration 7 min 35 s). Total RNA was isolated and 1 μg reverse transcribed into cDNA which was used as a template in real-time qualitative polymerase chain reaction (qPCR). Eighty four genes involved in wound healing (extracellular matrix and cell adhesion; inflammatory cytokines and chemokines; growth factors; and signal transduction) were evaluated in wounded and diabetic wounded cell models. Forty eight hours post-irradiation, 6 genes were significantly upregulated and 8 genes were down-regulated in irradiated wounded cells, whereas 1 gene was up-regulated and 33 genes down-regulated in irradiated diabetic wounded cells. Irradiation of stressed fibroblast cells to a wavelength of 660 nm and a fluence of 5 J/cm2 modulated the expression of different genes involved in wound healing in different cell models. Modulation of these genes leads to the effects of laser irradiation seen both in vivo and in vitro, and facilitates the wound healing process.

  5. A retrospective study of ketamine administration and the development of acute or post-traumatic stress disorder in 274 war-wounded soldiers. (United States)

    Mion, G; Le Masson, J; Granier, C; Hoffmann, C


    The objective of this study was to explore whether ketamine prevents or exacerbates acute or post-traumatic stress disorders in military trauma patients. We conducted a retrospective study of a database from the French Military Health Service, including all soldiers surviving a war injury in Afghanistan (2010-2012). The diagnosis of post-traumatic stress disorder was made by a psychiatrist and patients were analysed according to the presence or absence of this condition. Analysis included the following covariables: age; sex; acute stress disorder; blast injury; associated fatality; brain injury; traumatic amputation; Glasgow coma scale; injury severity score; administered drugs; number of surgical procedures; physical, neurosensory or aesthetic sequelae; and the development chronic pain. Covariables related to post-traumatic and acute stress disorders with a p ≤ 0.10 were included in a multivariable logistic regression model. The data from 450 soldiers were identified; 399 survived, of which 274 were analysed. Among these, 98 (36%) suffered from post-traumatic stress disorder and 89 (32%) had received ketamine. Fifty-four patients (55%) in the post-traumatic stress disorder group received ketamine vs. 35 (20%) in the no PTSD group (p stress disorder and total number of surgical procedures were independently associated with the development of post-traumatic stress disorder. In this retrospective study, ketamine administration was not a risk factor for the development of post-traumatic stress disorder in the military trauma setting. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

  6. A Skin Fixation Method for Decreasing the Influence of Wound Contraction on Wound Healing in a Rat Model

    Directory of Open Access Journals (Sweden)

    Seong Hwan Bae


    Full Text Available BackgroundThe elasticity of the back skin of the rat reduced the tension around wounds during the wound healing process in that region, and thus activates wound contraction. The authors proposed two skin fixation methods using readily available materials to decrease the influence of wound contraction on wound healing and designed an experiment to determine their effects.MethodsThe authors made 36 skin wounds on the backs of 18 rats, and they divided them into three groups. Each group was treated with three different kinds of dressing materials, each with different skin fixing characteristics. Group A was a control group. Group B and group C were dressed by the first and the second skin fixation method. We measured the areas of the wounds post-surgically and calculated the wound area reduction rates.ResultsThe two skin fixation methods both reduced the effect of wound contraction compared to the control group. Each of the two methods had different outcomes in reducing wound contraction.ConclusionsThe experiment demonstrated significant differences among the wound areas and the wound area reduction rates of the three groups as a result of differences in the degree of wound contraction. To obtain accurate results from wound healing experiments, appropriate skin fixation methods must be adopted.

  7. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Ligtenberg, A.J.M.; Veerman, E.C.I.; Ligtenberg, A.J.M.; Veerman, E.C.I.


    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

  8. Wound debridement optimisation

    DEFF Research Database (Denmark)

    Ågren, Sven Per Magnus


    Wound debridement, the removal of contaminated tissue and senescent cells, is the cornerstone in the care of patients with chronic wounds.......Wound debridement, the removal of contaminated tissue and senescent cells, is the cornerstone in the care of patients with chronic wounds....

  9. Comparison of stab wound probing versus radiological stab wound channel depiction with contrast medium. (United States)

    Bolliger, Stephan A; Ruder, Thomas D; Ketterer, Thomas; Gläser, Nadine; Thali, Michael J; Ampanozi, Garyfalia


    Instillation of contrast medium into stab wounds has shown promising results regarding visibility and assessment of general stab direction with computed tomography. However, the accuracy of this method--and, incidentally also probing of stab wounds--has to our knowledge not previously been examined. Also the effect of bluntness of different stabbing objects on the examination of stab wounds was not considered before this study. Using a pocket-knife, a steak-knife, and a Phillips screwdriver, nine stab wounds each were inflicted to three pork haunches. The depths of the stab wounds were determined by probing and multislice computed tomography (MSCT) after instillation of a contrast medium (CM) and then compared to those observed by dissection, our internal "gold standard". In stab wounds inflicted by knives, MSCT-CM and probing provided results which differed by roughly 10-11% from the dissection results. In screwdriver stabs MSCT-CM showed a deviation of almost 30%, probing over 33%. MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. MSCT-CM is a possible alternative to layer-by-layer dissection in autopsy cases of knife stab wounds. Probing, although obsolete in post-mortem examinations, is sufficiently accurate in determining the length of a stab wound of a living person. In cases of stab wounds with blunt objects such as screwdrivers, neither MSCT-CM nor probing proved to be sufficiently accurate. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  10. Armpits, Belly Buttons and Chronic Wounds: The ABCs of Our Body Bacteria (United States)

    ... and Chronic Wounds: The ABCs of Our Body Bacteria By Alisa Machalek and Allison MacLachlan Posted April ... treating skin and other conditions. Chronic Wounds and Bacteria Bacteria from human skin grown on agar in ...

  11. Aloe vera and Vitis vinifera improve wound healing in an in vivo rat burn wound model. (United States)

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


    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.

  12. Rabbit Achilles tendon full transection model – wound healing, adhesion formation and biomechanics at 3, 6 and 12 weeks post-surgery

    Directory of Open Access Journals (Sweden)

    Gabriella Meier Bürgisser


    Full Text Available After tendon rupture repair, two main problems may occur: re-rupture and adhesion formation. Suitable non-murine animal models are needed to study the healing tendon in terms of biomechanical properties and extent of adhesion formation. In this study 24 New Zealand White rabbits received a full transection of the Achilles tendon 2 cm above the calcaneus, sutured with a 4-strand Becker suture. Post-surgical analysis was performed at 3, 6 and 12 weeks. In the 6-week group, animals received a cast either in a 180 deg stretched position during 6 weeks (adhesion provoking immobilization, or were re-casted with a 150 deg position after 3 weeks (adhesion inhibiting immobilization, while in the other groups (3 and 12 weeks a 180 deg position cast was applied for 3 weeks. Adhesion extent was analyzed by histology and ultrasound. Histopathological scoring was performed according to a method by Stoll et al. (2011, and the main biomechanical properties were assessed. Histopathological scores increased as a function of time, but did not reach values of healthy tendons after 12 weeks (only around 15 out of 20 points. Adhesion provoking immobilization led to an adhesion extent of 82.7±9.7%, while adhesion inhibiting immobilization led to 31.9±9.8% after 6 weeks. Biomechanical properties increased over time, however, they did not reach full strength nor elastic modulus at 12 weeks post-operation. Furthermore, the rabbit Achilles tendon model can be modulated in terms of adhesion formation to the surrounding tissue. It clearly shows the different healing stages in terms of histopathology and offers a suitable model regarding biomechanics because it exhibits similar biomechanics as the human flexor tendons of the hand.

  13. Rabbit Achilles tendon full transection model – wound healing, adhesion formation and biomechanics at 3, 6 and 12 weeks post-surgery (United States)

    Meier Bürgisser, Gabriella; Calcagni, Maurizio; Bachmann, Elias; Fessel, Gion; Snedeker, Jess G.; Giovanoli, Pietro


    ABSTRACT After tendon rupture repair, two main problems may occur: re-rupture and adhesion formation. Suitable non-murine animal models are needed to study the healing tendon in terms of biomechanical properties and extent of adhesion formation. In this study 24 New Zealand White rabbits received a full transection of the Achilles tendon 2 cm above the calcaneus, sutured with a 4-strand Becker suture. Post-surgical analysis was performed at 3, 6 and 12 weeks. In the 6-week group, animals received a cast either in a 180 deg stretched position during 6 weeks (adhesion provoking immobilization), or were re-casted with a 150 deg position after 3 weeks (adhesion inhibiting immobilization), while in the other groups (3 and 12 weeks) a 180 deg position cast was applied for 3 weeks. Adhesion extent was analyzed by histology and ultrasound. Histopathological scoring was performed according to a method by Stoll et al. (2011), and the main biomechanical properties were assessed. Histopathological scores increased as a function of time, but did not reach values of healthy tendons after 12 weeks (only around 15 out of 20 points). Adhesion provoking immobilization led to an adhesion extent of 82.7±9.7%, while adhesion inhibiting immobilization led to 31.9±9.8% after 6 weeks. Biomechanical properties increased over time, however, they did not reach full strength nor elastic modulus at 12 weeks post-operation. Furthermore, the rabbit Achilles tendon model can be modulated in terms of adhesion formation to the surrounding tissue. It clearly shows the different healing stages in terms of histopathology and offers a suitable model regarding biomechanics because it exhibits similar biomechanics as the human flexor tendons of the hand. PMID:27635037

  14. How wounds heal (United States)

    How cuts heal; How scrapes heal; How puncture wounds heal; How burns heal; How pressure sores heal; How lacerations heal ... For major wounds, follow your doctor's instructions on how to care for your injury. Avoid picking at ...

  15. Surgical wound care (United States)

    ... closing before the wound underneath fills in. Proper Handwashing It is important to clean your hands before ... 5°F (38°C) or higher. Alternative Names Surgical incision care; Open wound care Images Proper hand ...

  16. Surgical wound care -- closed (United States)

    ... this page: // Surgical wound care - closed To use the sharing features on ... made during surgery. It is also called a "surgical wound." Some incisions are small. Others are very long. ...


    Directory of Open Access Journals (Sweden)

    Mahendra Ram


    Full Text Available Forty apparently healthy male Wister rats were used in this study and full thickness cutaneous wounds were created under pentobarbitone anesthesia. All the rats were divided into two groups, of which one (control was treated with ointment base and other with DFO ointment (0.1%. Wound size measurement and tissue collection were done on days 3, 7, 11 and 14 post-wounding. Histopathological changes were assessed by H&E staining. The percent wound healing was significantly higher on days 7, 11 and 14 in DFO-treated rats as compared to control. DFO markedly facilitated cutaneous wound healing in rats by recruitment of inflammatory cells, deposition of fibroblasts, formation of new blood vessels and epithelialization to the wound site. Therefore, topical application of DFO ointment might be of great use in cutaneous wound healing in rats.


    African Journals Online (AJOL)

    Going hand in hand with training personnel is the need to establish wound care protocols which are totally lacking in developing countries. Negative- pressure wound therapy. This is also known as vacuum dressing, Negative. Pressure Wound Therapy (NPWT). It has turned out to be very useful in burn and extensive skin ...

  19. Saliva and wound healing

    NARCIS (Netherlands)

    Brand, H.S.; Veerman, E.C.I.


    Wounds in the oral cavity heal faster and with less scarring than wounds in other parts of the body. One of the factors implicated in this phenomenon is the presence of saliva, which promotes the healing of oral wounds in several ways. Saliva creates a humid environment, which improves the survival

  20. Improved wound care product

    DEFF Research Database (Denmark)


    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....

  1. [Safety of a multiperforated catheter implanted in the surgical wound for the continuous infusion of local anaesthetics in post-operative analgesia]. (United States)

    Lluis, Félix; Romero Simó, Manuel; Márquez Peiró, Juan Francisco; Selva Otaolaurruchi, Juan; Zarco, Antonio


    To evaluate the incidence of infection at the surgical site in patients who have a multiperforated catheter implant for continuous infusion of a local anaesthetic as a local analgesic. An observational, descriptive and prospective study, of one month duration. It included 50 patients subjected to selective laparotomy in whom a multiperforated pre-peritoneal catheter was implanted for analgesia purposes (Painfusor®. Baxter). Patients with a surgical incision of less than 15 cm and/or ASA>III, were excluded from the study. The catheter was removed from all patients at 48 hours. An infection at the surgical site was present in 6% of the patients who had the catheter implanted, which was similar to the incidence in clean-contaminated surgery (5.5%; 95% CI: 3.4-8.7%). Colonisation of the catheter was observed in two patients, causing only one infection of the surgical site. The use of an in-situ pre-peritoneal catheter for post-surgical anaesthesia does not increase the risk of surgical site infection. Copyright © 2011 AEC. Published by Elsevier Espana. All rights reserved.

  2. The use of wound healing assessment methods in psychological studies: a review and recommendations. (United States)

    Koschwanez, Heidi E; Broadbent, Elizabeth


    To provide a critical review of methods used to assess human wound healing in psychological research and related disciplines, in order to guide future research into psychological influences on wound healing. Acute wound models (skin blister, tape stripping, skin biopsy, oral palate biopsy, expanded polytetrafluoroethylene tubing), surgical wound healing assessment methods (wound drains, wound scoring), and chronic wound assessment techniques (surface area, volumetric measurements, wound composition, and assessment tools/scoring systems) are summarized, including merits, limitations, and recommendations. Several dermal and mucosal tissue acute wound models have been established to assess the effects of psychological stress on the inflammatory, proliferative, and repair phases of wound healing in humans, including material-based models developed to evaluate factors influencing post-surgical recovery. There is a paucity of research published on psychological factors influencing chronic wound healing. There are many assessment techniques available to study the progression of chronic wound healing but many difficulties inherent to long-term clinical studies. Researchers need to consider several design-related issues when conducting studies into the effects of psychological stress on wound healing, including the study aims, type of wound, tissue type, setting, sample characteristics and accessibility, costs, timeframe, and facilities available. Researchers should consider combining multiple wound assessment methods to increase the reliability and validity of results and to further understand mechanisms that link stress and wound healing. ©2010 The British Psychological Society.

  3. Wound care in horses. (United States)

    Caston, Stephanie S


    Care of equine wounds in the field can be a challenging endeavor. Many times, wound care is complicated by chronicity or by prior inappropriate care in addition to the great degree of tissue trauma that occurred when the horse was wounded. Recognizing involvement of synovial structures, loss of skin, and damage to bone are critical in the initial examination of wounds and will guide future care. Education of clients is also important in that preparing them for possible outcomes during healing may help improve compliance and proper treatment of wound. Owners and trainers often perform much of the daily care and monitoring of equine wounds and thus can greatly assist or impede the progress. Bandaging is important to management of equine wounds-especially on the limbs-and is sometimes overlooked because of its labor-intensive nature and the desire for a spray, ointment, or salve that will heal the wound. The practitioner that improves and utilizes his or her understanding of the wound-healing process in concert with his or her knowledge of local anatomy will be the one who is best equipped to care for wounds in ambulatory practice.

  4. Muscle wound healing in rainbow trout (Oncorhynchus mykiss)

    DEFF Research Database (Denmark)

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


    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......-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...

  5. A modified collagen gel dressing promotes angiogenesis in a preclinical swine model of chronic ischemic wounds. (United States)

    Elgharably, Haytham; Ganesh, Kasturi; Dickerson, Jennifer; Khanna, Savita; Abas, Motaz; Ghatak, Piya Das; Dixit, Sriteja; Bergdall, Valerie; Roy, Sashwati; Sen, Chandan K


    We recently performed proteomic characterization of a modified collagen gel (MCG) dressing and reported promising effects of the gel in healing full-thickness excisional wounds. In this work, we test the translational relevance of our aforesaid findings by testing the dressing in a swine model of chronic ischemic wounds recently reported by our laboratory. Full-thickness excisional wounds were established in the center of bipedicle ischemic skin flaps on the backs of animals. Ischemia was verified by laser Doppler imaging, and MCG was applied to the test group of wounds. Seven days post wounding, macrophage recruitment to the wound was significantly higher in MCG-treated ischemic wounds. In vitro, MCG up-regulated expression of Mrc-1 (a reparative M2 macrophage marker) and induced the expression of anti-inflammatory cytokine interleukin (IL)-10 and of fibroblast growth factor-basic (β-FGF). An increased expression of CCR2, an M2 macrophage marker, was noted in the macrophages from MCG treated wounds. Furthermore, analyses of wound tissues 7 days post wounding showed up-regulation of transforming growth factor-β, vascular endothelial growth factor, von Willebrand's factor, and collagen type I expression in MCG-treated ischemic wounds. At 21 days post wounding, MCG-treated ischemic wounds displayed higher abundance of proliferating endothelial cells that formed mature vascular structures and increased blood flow to the wound. Fibroblast count was markedly higher in MCG-treated ischemic wound-edge tissue. In addition, MCG-treated wound-edge tissues displayed higher abundance of mature collagen with increased collagen type I : III deposition. Taken together, MCG helped mount a more robust inflammatory response that resolved in a timely manner, followed by an enhanced proliferative phase, angiogenic outcome, and postwound tissue remodeling. Findings of the current study warrant clinical testing of MCG in a setting of ischemic chronic wounds. © 2014 by the Wound

  6. characterisation of bacterial isolates from patients wounds and ...

    African Journals Online (AJOL)


    Dec 12, 2013 ... CHARACTERISATION OF BACTERIAL ISOLATES FROM PATIENTS WOUNDS AND ENVIRONMENTAL FACTORS. PREDICTIVE OF POST-SURGICAL .... as: mannitol salt agar (MSA) tryptone soy agar (TSA) supplemented with nystatin, blood agar ... by sugar fermentation (7). Gram negative rods were.

  7. Diabetes and Wound Angiogenesis

    Directory of Open Access Journals (Sweden)

    Uzoagu A. Okonkwo


    Full Text Available Diabetes Mellitus Type II (DM2 is a growing international health concern with no end in sight. Complications of DM2 involve a myriad of comorbidities including the serious complications of poor wound healing, chronic ulceration, and resultant limb amputation. In skin wound healing, which has definite, orderly phases, diabetes leads to improper function at all stages. While the etiology of chronic, non-healing diabetic wounds is multi-faceted, the progression to a non-healing phenotype is closely linked to poor vascular networks. This review focuses on diabetic wound healing, paying special attention to the aberrations that have been described in the proliferative, remodeling, and maturation phases of wound angiogenesis. Additionally, this review considers therapeutics that may offer promise to better wound healing outcomes.

  8. Biofilms in wounds

    DEFF Research Database (Denmark)

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


    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...

  9. Factors Affecting Wound Healing (United States)

    Guo, S.; DiPietro, L.A.


    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

  10. Wound Assessment: Made Easy


    Ousey, Karen; Cook, Leanne


    A structured approach to wound assessment is required to maintain a good standard of care. This involves a thorough patient assessment, which should be carried out by skilled and competent practitioners, adhering to local and national guidelines (Harding et al, 2008). Inappropriate or inaccurate assessment can lead to delayed wound healing, pain, increased risk of infection, inappropriate use of wound dressings and a reduction in the quality of life for patients.

  11. Innovation and wound healing. (United States)

    Harding, Keith


    Innovation in medicine requires unique partnerships between academic research, biotech or pharmaceutical companies, and health-care providers. While innovation in medicine has greatly increased over the past 100 years, innovation in wound care has been slow, despite the fact that chronic wounds are a global health challenge where there is a need for technical, process and social innovation. While novel partnerships between research and the health-care system have been created, we still have much to learn about wound care and the wound-healing processes.

  12. Telemedicine for wound management

    Directory of Open Access Journals (Sweden)

    Ravi K Chittoria


    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.

  13. Inflammation in Chronic Wounds. (United States)

    Zhao, Ruilong; Liang, Helena; Clarke, Elizabeth; Jackson, Christopher; Xue, Meilang


    Non-healing chronic wounds present a major biological, psychological, social, and financial burden on both individual patients and the broader health system. Pathologically extensive inflammation plays a major role in the disruption of the normal healing cascade. The causes of chronic wounds (venous, arterial, pressure, and diabetic ulcers) can be examined through a juxtaposition of normal healing and the rogue inflammatory response created by the common components within chronic wounds (ageing, hypoxia, ischaemia-reperfusion injury, and bacterial colonisation). Wound bed care through debridement, dressings, and antibiotics currently form the basic mode of treatment. Despite recent setbacks, pharmaceutical adjuncts form an interesting area of research.

  14. Feasibility of speckle variance OCT for imaging cutaneous microvasculature regeneration during healing of wounds in diabetic mice (United States)

    Sharma, P.; Kumawat, J.; Kumar, S.; Sahu, K.; Verma, Y.; Gupta, P. K.; Rao, K. D.


    We report on a study to assess the feasibility of a swept source-based speckle variance optical coherence tomography setup for monitoring cutaneous microvasculature. Punch wounds created in the ear pinnae of diabetic mice were monitored at different times post wounding to assess the structural and vascular changes. It was observed that the epithelium thickness increases post wounding and continues to be thick even after healing. Also, the wound size assessed by vascular images is larger than the physical wound size. The results show that the developed speckle variance optical coherence tomography system can be used to monitor vascular regeneration during wound healing in diabetic mice.

  15. Wound healing potential of Pañcavalkala formulations in a postfistulectomy wound. (United States)

    Meena, Rakesh Kumar; Dudhamal, Tukaram; Gupta, Sanjay Kumar; Mahanta, Vyasadeva


    Sushruta mentioned sixty measures for management of wounds. Panchavalkal is the combination of five herbs having properties like Shodhana (cleaning) and Ropana (healing) of wounds. Individual drugs and in combination have Kashaya rasa (astringent) dominant and useful in the management of Vrana (wounds) as well as Shotha (inflammations). A 35 years old male patient consulted in Shalya OPD with complaints like discharge per anum, induration and intermittent pain at perianal region since last five years. On inspection external opening was observed at anterior portion 1 O' clock position which was four centimeter away from anal verge. That case was diagnosed as Bhagandara (fistula-in-ano) and was treated with partial fistulectomy and application of Guggulu based Ksharasutra in the remaining tract. The big fistulectomy wound was treated with local application of Panchavalkal ointment daily and simultaneous change of Ksharasutra. The wound was assessed daily for pain, swelling, discharge, size, and shape. The wound healed completely within two and half month with normal scar having good tissue strength. This case demonstrated that post fistulectomy wound can be treated with Panchavalkal ointment.

  16. Sugar for wounds. (United States)

    Topham, J


    Sugar in its pure form, or incorporated into a paste containing an adhesive hydropolymer (gum), is a non-toxic treatment for a variety of wounds. Not only does it provide a suitable clean environment for angiogenesis to take place, but it will debride the wound surface and reduce odour. The presence of an adhesive hydropolymer seems to prevent hypergranulation, scarring and contraction.

  17. Surgical wound infection - treatment (United States)

    ... page: // Surgical wound infection - treatment To use the sharing features on this page, ... the organ and space where you had surgery Treatment Antibiotics are used to treat most wound infections. Sometimes, you also may need surgery to ...

  18. Outpatient wound care. (United States)

    Kravitz, M


    As patients are discharged from the acute care setting to the home care setting at a much earlier time in their recovery, surgical wound care will be delivered by patients, family members, and home health care providers rather than by the hospital nurse in a traditional in-patient setting. This trend, which began in the mid-1980s, is expanding to include not just surgical wounds but also surgical complications such as wound dehiscence and traumatic wounds healing by secondary intention. Intensive care nurses are involved in discharge planning from the time the patient is admitted to the ICU. Early planning and teaching regarding wound care, universal precautions, and medical waste disposal have become a vital component of preparing the patient for optimal continuity of care as the transition is made into the community.

  19. Vegetative deviation in patients with slow-repair processes in the post-operative wound and effect of the combined use of low-intensity laser therapy and pantovegin electrophoresis

    Directory of Open Access Journals (Sweden)

    Dugieva M.Z.


    Full Text Available Aim of this study was to evaluate the influence of combined use of low-intensity infrared laser therapy when exposed area of the thymus and electrophoresis of pantovegin on vegetative status of patients with the slowdown in the wound recovery reparative processes. Material study were 190 patients after gynecological laparotomy. Result. The article presents data on changes in vegetative status in postoperative gynecological patients with a slowdown in the wound recovery reparative processes. In this group of patients in the postoperative period parasimpatikotony prevails. By combination of low-intensity infrared laser therapy when exposed area of the thymus and pantovegin electrophoresis achieved more rapid normalization of available changes with the transition to the use of combination eitony. It is recommended to use physiotherapy method for slowing reparative processes in the wound.

  20. Enhanced wound contraction in fresh wounds dressed with honey in ...

    African Journals Online (AJOL)

    Background: Due to reports that honey accelerates wound healing, an investigation on its role in wound contraction in fresh wounds inflicted on wistar rats was carried out. Method: Twenty adult male wistar rats had 2cm by 2cm square wound inflicted on their right dorsolateral trunk. They were divided into two groups.

  1. Wound drains in non-complex lumbar surgery: a systematic review

    NARCIS (Netherlands)

    Zijlmans, J. L.; Buis, D. R.; Verbaan, D.; Vandertop, W. P.


    Our aim was to perform a systematic review of the literature to assess the incidence of post-operative epidural haematomas and wound infections after one-, or two-level, non-complex, lumbar surgery for degenerative disease in patients with, or without post-operative wound drainage. Studies were



    Novida Rizani


    When the tissue of skin is break means a wound is happens. To seal it, many choices of wound healing are available. Moist wound dressing can be better optional than the conservative ones. A bioactive agent that being added at the dressing in fact can increase healing rate of wound, moreover can subjugate wound infection caused by the pathogens, and also capable to prevent it. In this review, there are summary of modern moist wound healing, the wound pathogens, and some of sturdy bioactive age...

  3. Management of complicated wounds. (United States)

    Hendrix, Sam M; Baxter, Gary M


    Most injuries, including those with significant tissue loss, can be successfully managed with proper therapy. With delayed healing, potential causes for the delay, such as sequestra, foreign bodies, and excessive motion,should be determined and treated to permit complete wound resolution. Horses have the innate ability to heal rapidly; however, minor injuries can quickly turn into complicated wounds, given the severity of the inciting trauma and the less than ideal environment in which the horses are housed. Wound management must focus on a combination of timely surgical and medical intervention to ensure the best potential outcome.

  4. Wording the Wound Man

    Directory of Open Access Journals (Sweden)

    Jack Hartnell


    Full Text Available Little is known about the image of the Wound Man, a graphic drawing of a violently wounded figure repeated across a series of European surgical treatises from 1400 onwards. Focusing on the only known English example, preserved in the back of a late fifteenth-century medical miscellany now in the Wellcome Collection, London, this article seeks to unravel the origins and scope of this picture. Considering both the image’s diagrammatic and metaphorical qualities, it presents the Wound Man as a particularly potent site not just of surgical knowledge but of a broader medico-artistic entanglement.

  5. Histopathological assessment of OASIS Ultra on critical-sized wound healing: a pilot study. (United States)

    Yeh, Daniel Dante; Nazarian, Rosalynn M; Demetri, Leah; Mesar, Tomaz; Dijkink, Suzan; Larentzakis, Andreas; Velmahos, George; Sadik, Karim Walid


    Dermatopathologists assess wounds secondary to trauma, infection, or oncologic resection that can be challenging to reconstruct. OASIS Ultra, an extracellular matrix, has been described for use in chronic and burn wounds. The aim of this pilot study is to assess wound healing in post-traumatic and infective wounds treated with OASIS using histological markers of repair. Adults with traumatic, infective or iatrogenic wound defects with size precluding primary closure were eligible. Half the wound was randomly assigned to receive OASIS plus standard therapy; the other half received standard of care (SOC) therapy. During dressing changes, standardized-scale photographs were taken and biopsies obtained. Histologic sections were reviewed for degree of acute inflammation and extent of tissue repair. Neutrophils, edema, hemorrhage, necrosis, fibroblasts, collagen density and neovascularization were semi-quantitatively assessed. Forty-four skin biopsies from 7 patients with 10 acute wounds met eligibility criteria. Histologically, OASIS samples demonstrated improved acute inflammation scores compared to SOC. No patients experienced OASIS-related complications. OASIS-treated wound halves trended toward more wound contraction and improved tissue repair. Our scoring system aids histopathological wound assessment. Treatment of critical-sized, post-traumatic, acute wounds with OASIS resulted in decreased inflammation, and potentially more advanced wound healing, compared to SOC. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  6. The occurrence of biofilm in an equine experimental wound model of healing by secondary intention

    DEFF Research Database (Denmark)

    Jørgensen, Elin Lisby Kastbjerg; Bay, Lene; Bjarnsholt, Thomas


    In humans, biofilm is a well-known cause of delayed healing and low-grade inflammation of chronic wounds. In horses, biofilm formation in wounds has been studied to a very limited degree. The objective of this study was thus to investigate the occurrence of biofilm in equine experimental wounds...... healing by secondary intention. Tissue biopsies from non-contaminated, experimental excisional shoulder and limb wounds were obtained on day 1–2, day 7–10 and day 14–15 post-wounding. Limb wounds were either un-bandaged or bandaged to induce exuberant granulation tissue (EGT) formation and thereby...... impaired healing. Presence of biofilm in tissue biopsies was assessed by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) and confocal laser scanning microscopy (CLSM). Bandaged limb wounds developed EGT and displayed delayed healing, while shoulder and un-bandaged limb wounds healed...

  7. Pseudomonas aeruginosa biofilm hampers murine central wound healing by suppression of vascular epithelial growth factor

    DEFF Research Database (Denmark)

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


    Biofilm-infected wounds are clinically challenging. Vascular endothelial growth factor and host defence S100A8/A9 are crucial for wound healing but may be suppressed by biofilms. The natural course of Pseudomonas aeruginosa biofilm infection was compared in central and peripheral zones of burn......-wounded, infection-susceptible BALB/c mice, which display delayed wound closure compared to C3H/HeN mice. Wounds were evaluated histopathologically 4, 7 or 10 days post-infection. Photoplanimetry evaluated necrotic areas. P. aeruginosa biofilm suppressed vascular endothelial growth factor levels centrally in BALB......100A8/A9 in BALB/c and centrally and peripherally later on in C3H/HeN wounds as compared to uninfected mice. Peripheral polymorphonuclear-dominated inflammation and larger necrosis were observed in BALB/c wounds. In conclusion, P. aeruginosa biofilm modulates wounds by suppressing central...

  8. Cuts and puncture wounds (United States)

    ... 2009:chap 39. Simon BC, Hern HG. Wound management principles. In: Marx JA, Hockberger RS, Walls RM, et al., eds. Rosen's Emergency Medicine: Concepts and Clinical Practice . 8th ed. Philadelphia, PA: Elsevier Saunders; 2014:chap ...

  9. Prevent Bite Wounds (United States)

    ... Issues Listen Español Text Size Email Print Share Prevent Bite Wounds Page Content Article Body Each year, ... bite Swollen glands that occur above the bite Prevention of Bites and Infections To prevent bites and ...

  10. Ferrets: wound healing and therapy. (United States)

    Pilny, Anthony A; Hess, Laurie


    In all species of mammals, the stages of wound healing are the same, and both host factors and wound characteristics affect how wounds heal. The basic principles of wound care in ferrets, such as lavage, bandaging, and surgical closure, are similar to those in other species; however, knowledge of ferrets' anatomy and pathophysiology, as well as skin conditions commonly seen in ferrets, will help ensure proper wound healing.

  11. Role of Negative-Pressure Wound Therapy in Deep Sternal Wound Infection After Open Heart Surgery

    Directory of Open Access Journals (Sweden)

    Cemalettin Aydın


    Full Text Available Introduction: Mediastinitis is a devastating complication in open heart surgery. The most common treatments after debridement are rewiring with antibiotic irrigation. Vacuum assisted closure therapy is a recently introduced technique that promotes the healing of difficult wounds, including post-sternotomy mediastinitis.Patients and Methods: Forty one patients with deep sternal wound infection were divided into two groups based on the treatment method used. Twenty two patients with post-cardio to my deep sternal wound infection were treated primarily by vacuum assisted closure method (group A and 19 patients with deep sternal wound infection who received closed mediastinal irrigation were treated with antibiotics (group B between January 2006 and January 2010.Results: The two groups were compared. Three patients died during treatment in group B. The median healing time was significantly shorter in group A (mean, 13.5 ± 3.2 days compared to 18 days (mean, 21.2 ± 16.4 days in group B (p< 0.001. Deep sternal wound infection showed no recurrences after the vacuum treatment, while 7 (24% patients in group B suffered recurrences. Hospital stay was significantly shorter in group A (median, 30.5 days; mean, 32.2 ± 11.3 days vs. median, 45 days; mean, 49.2 ± 19.3 days (p= 0.001.Conclusion: A significantly shorter healing time was confirmed with vacuum assisted closure. Hospital stay remained significantly shorter in group A (35 vs. 46 days.

  12. Combat Wound Initiative program. (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


    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.

  13. Managing painful chronic wounds: the Wound Pain Management Model

    DEFF Research Database (Denmark)

    Price, Patricia; Fogh, Karsten; Glynn, Chris


    Chronic wound pain is not well understood and the literature is limited. Six of 10 patients venous leg ulcer experience pain with their ulcer, and similar trends are observed for other chronic wounds. Chronic wound pain can lead to depression and the feeling of constant tiredness. Pain related...... 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...

  14. Wound pH depends on actual wound size

    CERN Document Server

    Sirkka, T; Apell, S P


    Wound healing is an intricate process that involves many types of cells, reaction pathways as well as chemical, physical and electrical cues. Since biochemical reactions and physiological events are pH-dependent we study here pH as an important major characteristic of the wound healing process in the presence of endogenous and exogenous electric fields. Our model gives the spatial pH distribution in a wound. In particular we isolate a number of dimensionless quantities which sets the length, energy and time scales governing the wound healing process and which can be experimentally tested. Most interesting finding is that wound pH depends on actual wound size.

  15. Rigenera protocol in the treatment of surgical wound dehiscence. (United States)

    Marcarelli, Marco; Trovato, Letizia; Novarese, Elvio; Riccio, Michele; Graziano, Antonio


    The effective management of post-operative wounds is important to prevent potential complications such as surgical-site infections and wound dehiscence. The purpose of this study was to treat wound dehiscence in elderly patients who were subjected to orthopaedic surgical interventions. The dehisced wounds were treated with autologous micro-grafts obtained using a promising CE-certified medical device called Rigeneracons. This instrument is a biological disruptor of human tissues able to specifically select progenitor cells that, as already reported in previous studies, maintain high cell viability but mainly have a high regenerative potential, allowing the repair of damaged tissues. Autologous micro-grafts obtained by Rigeneracons are ready to use and can be applied alone or in combination with biological scaffolds directly on the injured area. We observed in our patients a complete remission of dehisced wounds, on average, after 30 days from micro-grafts application and a total wound re-epithelialisation after 1 year from the surgical intervention. In conclusion, although we reported only three patients, autologous micro-grafts can be considered a promising approach for the treatment of dehisced wounds, improving the wound-healing process and in general the patient's quality of life without using other dressings. © 2016 Inc and John Wiley & Sons Ltd.

  16. The effect of Mindfulness-Based Stress Reduction on wound healing: a preliminary study. (United States)

    Meesters, Astrid; den Bosch-Meevissen, Yvo M C In; Weijzen, Chantal A H; Buurman, Wim A; Losen, Mario; Schepers, Jan; Thissen, Monique R T M; Alberts, Hugo J E M; Schalkwijk, Casper G; Peters, Madelon L


    Psychological factors have been shown to influence the process of wound healing. This study examined the effect of Mindfulness-Based Stress Reduction (MBSR) on the speed of wound healing. The local production of pro-inflammatory cytokines and growth factors was studied as potential underlying mechanism. Forty-nine adults were randomly allocated to a waiting-list control group (n = 26) or an 8-week MBSR group (n = 23). Pre- and post-intervention/waiting period assessment for both groups consisted of questionnaires. Standardized skin wounds were induced on the forearm using a suction blister method. Primary outcomes were skin permeability and reduction in wound size monitored once a day at day 3, 4, 5, 6, 7, and 10 after injury. Secondary outcomes were cytokines and growth factors and were measured in wound exudates obtained at 3, 6, and 22 h after wounding. Although there was no overall condition effect on skin permeability or wound size, post hoc analyses indicated that larger increases in mindfulness were related to greater reductions in skin permeability 3 and 4 days after wound induction. In addition, MBSR was associated with lower levels of interleukin (IL)-8 and placental growth factor in the wound fluid 22 h after wound induction. These outcomes suggest that increasing mindfulness by MBSR might have beneficial effects on early stages of wound healing. Trial Registration NTR3652,

  17. Tissue and cellular biomechanics during corneal wound injury and repair. (United States)

    Raghunathan, Vijay Krishna; Thomasy, Sara M; Strøm, Peter; Yañez-Soto, Bernardo; Garland, Shaun P; Sermeno, Jasmyne; Reilly, Christopher M; Murphy, Christopher J


    Corneal wound healing is an enormously complex process that requires the simultaneous cellular integration of multiple soluble biochemical cues, as well as cellular responses to the intrinsic chemistry and biophysical attributes associated with the matrix of the wound space. Here, we document how the biomechanics of the corneal stroma are altered through the course of wound repair following keratoablative procedures in rabbits. Further we documented the influence that substrate stiffness has on stromal cell mechanics. Following corneal epithelial debridement, New Zealand white rabbits underwent phototherapeutic keratectomy (PTK) on the right eye (OD). Wound healing was monitored using advanced imaging modalities. Rabbits were euthanized and corneas were harvested at various time points following PTK. Tissues were characterized for biomechanics with atomic force microscopy and with histology to assess inflammation and fibrosis. Factor analysis was performed to determine any discernable patterns in wound healing parameters. The matrix associated with the wound space was stiffest at 7days post PTK. The greatest number of inflammatory cells were observed 3days after wounding. The highest number of myofibroblasts and the greatest degree of fibrosis occurred 21days after wounding. While all clinical parameters returned to normal values 400days after wounding, the elastic modulus remained greater than pre-surgical values. Factor analysis demonstrated dynamic remodeling of stroma occurs between days 10 and 42 during corneal stromal wound repair. Elastic modulus of the anterior corneal stroma is dramatically altered following PTK and its changes coincide initially with the development of edema and inflammation, and later with formation of stromal haze and population of the wound space with myofibroblasts. Factor analysis demonstrates strongest correlation between elastic modulus, myofibroblasts, fibrosis and stromal haze thickness, and between edema and central corneal

  18. The molecular biology in wound healing & non-healing wound. (United States)

    Qing, Chun


    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.

  19. Wound healing and treating wounds: Differential diagnosis and evaluation of chronic wounds. (United States)

    Morton, Laurel M; Phillips, Tania J


    Wounds are an excellent example of how the field of dermatology represents a cross-section of many medical disciplines. For instance, wounds may be caused by trauma, vascular insufficiency, and underlying medical conditions, such as diabetes, hypertension, and rheumatologic and inflammatory disease. This continuing medical education article provides an overview of wound healing and the pathophysiology of chronic wounds and reviews the broad differential diagnosis of chronic wounds. It also describes the initial steps necessary in evaluating a chronic wound and determining its underlying etiology. Copyright © 2015 American Academy of Dermatology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Burn wound: How it differs from other wounds?

    Directory of Open Access Journals (Sweden)

    V K Tiwari


    Full Text Available Management of burn injury has always been the domain of burn specialists. Since ancient time, local and systemic remedies have been advised for burn wound dressing and burn scar prevention. Management of burn wound inflicted by the different physical and chemical agents require different regimes which are poles apart from the regimes used for any of the other traumatic wounds. In extensive burn, because of increased capillary permeability, there is extensive loss of plasma leading to shock while whole blood loss is the cause of shock in other acute wounds. Even though the burn wounds are sterile in the beginning in comparison to most of other wounds, yet, the death in extensive burns is mainly because of wound infection and septicemia, because of the immunocompromised status of the burn patients. Eschar and blister are specific for burn wounds requiring a specific treatment protocol. Antimicrobial creams and other dressing agents used for traumatic wounds are ineffective in deep burns with eschar. The subeschar plane harbours the micro-organisms and many of these agents are not able to penetrate the eschar. Even after complete epithelisation of burn wound, remodelling phase is prolonged. It may take years for scar maturation in burns. This article emphasizes on how the pathophysiology, healing and management of a burn wound is different from that of other wounds.

  1. The wound/burn guidelines - 1: Wounds in general. (United States)

    Inoue, Yuji; Hasegawa, Minoru; Maekawa, Takeo; Le Pavoux, Andres; Asano, Yoshihide; Abe, Masatoshi; Ishii, Takayuki; Ito, Takaaki; Isei, Taiki; Imafuku, Shinichi; Irisawa, Ryokichi; Ohtsuka, Masaki; Ohtsuka, Mikio; Ogawa, Fumihide; Kadono, Takafumi; Kodera, Masanari; Kawakami, Tamihiro; Kawaguchi, Masakazu; Kukino, Ryuichi; Kono, Takeshi; Sakai, Keisuke; Takahara, Masakazu; Tanioka, Miki; Nakanishi, Takeshi; Nakamura, Yasuhiro; Hashimoto, Akira; Hayashi, Masahiro; Fujimoto, Manabu; Fujiwara, Hiroshi; Matsuo, Koma; Madokoro, Naoki; Yamasaki, Osamu; Yoshino, Yuichiro; Tachibana, Takao; Ihn, Hironobu


    The Japanese Dermatological Association determined to prepare the Wound/Burn Guidelines focusing on treatments, catering to needs for the clinical practice of dermatology. Among these guidelines, "Wounds in General" was intended to explain knowledge necessary "to heal wounds" without specifying particular disorders. © 2016 Japanese Dermatological Association.

  2. Wound morbidity after kidney transplant

    NARCIS (Netherlands)

    Fockens, M. Matthijs; Alberts, Victor P.; Bemelman, Frederike J.; van der Pant, Karlijn A. M. I.; Idu, Mirza M.


    Wound morbidity is an important surgical complication after kidney transplant. To assess risk factors for postoperative wound complications and the impact of such complications on outcomes of kidney transplant. Retrospectively, 108 consecutive kidney transplant patients between January 2010 and

  3. Initial Management of Traumatic Wounds. (United States)

    Devriendt, Nausikaa; de Rooster, Hilde


    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.

  4. Effects of platelet-rich plasma gel on skin healing in surgical wound in horses. (United States)

    DeRossi, Rafael; Coelho, Anna Carolina Anciliero de Oliveira; Mello, Gisele Silveira de; Frazílio, Fabrício Oliveira; Leal, Cássia Rejane Brito; Facco, Gilberto Gonçalves; Brum, Karine Bonucielli


    To establish a low-cost method to prepare platelet-rich plasma (PRP) and evaluates the potential of platelet derived factors to enhance wound healing in the surgical wounds in equine. To obtain a PRP gel, calcium gluconate and autologous thrombin were added to platelet-rich plasma. For the tests six saddle horses were used and two surgical incisions were made in each animal. Wounds were treated with PRP gel or untreated. Sequential wound biopsies collected at Treatment 1: at days 5 and 30 and Treatment 2: at days 15 and 45 post wounding permitted comparison of differentiation markers and wound repair. The optimal platelets enrichment over 4.0 time's baseline values was obtained using 300 g for 10 min on the first centrifugation and 640 g for 10 min on the second centrifugation. Wounds treated with PRP gel exhibit more rapid epithelial differentiation and enhanced organization of dermal collagen compared to controls in equine.

  5. Wound Drainage Culture (For Parents) (United States)

    ... a Voice in Health Care Decisions Wound Drainage Culture KidsHealth > For Parents > Wound Drainage Culture Print A A A What's in this article? ... Have Questions What It Is A wound drainage culture is a test to detect germs such as ...

  6. Trends in Surgical Wound Healing

    DEFF Research Database (Denmark)

    Gottrup, F.


    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 focuses...... on promising clinical development in major wound problems in general and on postoperative infections in particular Udgivelsesdato: 2008...

  7. Gunshot wounds -- aftercare (United States)

    ... clean towel. Let the wound air dry. After Effects Being shot by a gun is traumatic. You may feel shock, fear for your safety, depression, or anger as a result. These are completely normal feelings for someone who has been through a traumatic event . These feelings are not signs of weakness. You ...

  8. Healing Invisible Wounds (United States)

    Adams, Erica J.


    As many as 9 in 10 justice-involved youth are affected by traumatic childhood experiences. According to "Healing Invisible Wounds: Why Investing in Trauma-Informed Care for Children Makes Sense," between 75 and 93 percent of youth currently incarcerated in the justice system have had at least one traumatic experience, including sexual…

  9. Wound Infections PSA (:30)

    Centers for Disease Control (CDC) Podcasts


    This 30 second public service announcement is about how to avoid a wound infection after a disaster.  Created: 10/25/2017 by Centers for Disease Control and Prevention (CDC).   Date Released: 10/25/2017.

  10. Fungal Wound Infection

    Centers for Disease Control (CDC) Podcasts


    Dr. David Tribble, acting director of the infectious disease clinical research program at Uniformed Services University of the Health Sciences, discusses fungal wound infections after combat trauma.  Created: 1/28/2016 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 1/28/2016.

  11. A pilot study exploring quality of life experienced by patients undergoing negative-pressure wound therapy as part of their wound care treatment compared to patients receiving standard wound care. (United States)

    Ousey, Karen J; Milne, Jeanette; Cook, Leanne; Stephenson, John; Gillibrand, Warren


    The use of negative pressure wound therapy (NPWT) has been widely documented as a technique to help heal complex wounds. This article presents the findings of a preliminary study which aimed to explore quality of life (QoL) experienced by patients undergoing NPWT as part of their wound care treatment in comparison to that of patients with a wound using traditional (standard) wound care therapies. A quasi-experimental study was undertaken, with patients treated in wound care/vascular clinics with chronic/acute wounds. QoL impact was measured using the Cardiff Wound Impact Schedule and administered post-consent at timed intervals. Our results identified that there were no real differences in QoL scores recorded by patients over the 12-week period. Although there was no overall interaction between the therapies used for wound healing, NPWT did have an effect on social life: during the first 2 weeks of the application of therapy, patients in the NPWT group reported an increase in the social life domain. The authors conclude that true QoL can only be elicited if an accurate baseline is established or if data is collected over a long enough period to allow comparison of scores over time. © 2012 The Authors. International Wound Journal © 2012 Inc and John Wiley & Sons Ltd.

  12. Differential effects of Losartan and Atorvastatin in partial and full thickness burn wounds. (United States)

    Akershoek, Johanneke J; Brouwer, Katrien M; Vlig, Marcel; Boekema, Bouke K H L; Beelen, Rob H J; Middelkoop, Esther; Ulrich, Magda M W


    Healing of burn wounds is often associated with scar formation due to excessive inflammation and delayed wound closure. To date, no effective treatment is available to prevent the fibrotic process. The Renin Angiotensin System (RAS) was shown to be involved in fibrosis in various organs. Statins (e.g. Atorvastatin), Angiotensin receptor antagonists (e.g. Losartan) and the combination of these drugs are able to reduce the local RAS activation, and reduced fibrosis in other organs. We investigated whether inhibition of the RAS could improve healing of burn wounds by treatment with Atorvastatin, Losartan or the combination of both drugs. Therefore, full and partial thickness burn wounds were inflicted on both flanks of Yorkshire pigs. Oral administration of Atorvastatin, Losartan or the combination was started at post-burn day 1 and continued for 28 days. Full thickness wounds were excised and transplanted with an autologous meshed split-thickness skin graft at post-burn day 14. Partial thickness wounds received conservative treatment. Atorvastatin treatment resulted in enhanced graft take and wound closure of the full thickness wounds, faster resolution of neutrophils compared to all treatments and reduced alpha-smooth muscle actin positive cells compared to control treatment. Treatment with Losartan and to a lesser extent the combination therapy resulted in diminished graft take, increased wound contraction and poorer scar outcome. In contrast, Losartan treatment in partial thickness wounds decreased the alpha-smooth muscle actin+ fibroblasts and contraction. In conclusion, we showed differential effects of Losartan and Atorvastatin in full and partial thickness wounds. The extensive graft loss seen in Losartan treated wounds is most likely responsible for the poor clinical outcome of these full thickness burn wounds. Therefore, Losartan treatment should not be started before transplantation in order to prevent graft loss. Atorvastatin seems to accelerate the

  13. The modified Meek technique as a novel method for skin grafting in horses: evaluation of acceptance, wound contraction and closure in chronic wounds. (United States)

    Wilmink, J M; van den Boom, R; van Weeren, P R; Barneveld, A


    The acceptance of skin grafts in horses is unpredictable and the final cosmetic result can be disappointing. Besides movement and infection, graft failure is often caused by chronic inflammation, inherently present during second intention healing of limb wounds in horses. In human burns affected by infection and inflammation, the acceptance of the island skin grafts of the modified Meek technique appeared to be better than meshed sheet skin grafts. The percentage take of Meek micrografts is higher than of other techniques; and rates of both wound contraction and epithelialisation are increased. Large traumatic limb wounds of 13 horses healing by second intention were grafted using the modified Meek technique. Photographs of the wounds were taken at set intervals. Wound areas, and areas of acceptance and rejection were determined using a digital image post processor (Scion Image). The percentages of take, wound contraction and epithelialisation were calculated. The initial mean wound area was 7500 mm2. Graft acceptance was mean +/- s.d. 93.7 +/- 5.9%. Wound closure was due to contraction (55.2 +/- 11.1%) and epithelialisation (44.8 +/- 11.1%) and resulted in a 96.7 +/- 3.6% reduction of the initial wound area 29.1 +/- 6 days after grafting. All wounds showed functional and cosmetic healing. The method for skin grafting in horses achieved higher percentages of take than reported previously and consistent cosmetic and functional results. The grafts increased not only the rate of epithelialisation but also had a strong positive effect on wound contraction, resulting in rapid closure and smaller scars. The modified Meek technique proved to be a novel technique for skin grafting equine wounds in clinical practice, which can be performed easily. The molecular background of the increase of wound contraction by the grafts may provide a clue in the search for medicinal stimulation of wound contraction during second intention healing.

  14. Mechanism of Action of Topical Garlic on Wound Healing. (United States)

    Alhashim, Minhal; Lombardo, Jamie


    Allicin, the active component of garlic, has been shown to have antimicrobial and anti-inflammatory properties. Garlic has also been used historically by many cultures to heal wounds. Several animal studies have shown that garlic extracts increase the rate of wound healing and decrease the rate of infection. Fibroblasts play a key role in wound healing. Here we hypothesize that fibroblasts are being activated by allicin, leading to more organized and rapid wound repair. Six rats were each given 2 surgical wounds. One side was treated with a 30% garlic ointment while the other was treated with Vaseline for two weeks. A biopsy was taken from each scar site and histopathology with Immunohistochemistry was performed to quantify the number of fibroblasts and proliferating fibroblasts in each site. The wound biopsies had more proliferating fibroblasts in the scars treated with the 30% garlic ointment than in the scars treated with Vaseline with a p-value of 0.0175 at two weeks post op and 0.081 at 6 week post op. This data tells us that allicin is acting on fibroblasts as there were more proliferating fibroblasts in the garlic treated sites than in the other sites.


    Directory of Open Access Journals (Sweden)

    Amit Kumar Mishra, Smita Panda, Prakash Chandra Panda


    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.

  16. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Birke-Sorensen, Hanne; Kruse, Marie

    Aim: Postoperative wound complications make many surgical procedures unnecessarily complex, particularly in high-risk patients. Negative Pressure Wound Therapy is well recognized in the management of open wounds. In recent years, it has been introduced as well in the management of closed surgical...... incisions to reduce postoperative wound complications, though the evidence base to support this intervention is limited. The aim of this study was to assess if Negative Pressure Wound Therapy (NPWT) reduces postoperative complications when applied on closed surgical incisions. Method: A systematic review...

  17. Scientific production on the applicability of phenytoin in wound healing

    Directory of Open Access Journals (Sweden)

    Flávia Firmino


    Full Text Available Phenytoin is an anticonvulsant that has been used in wound healing. The objectives of this study were to describe how the scientific production presents the use ofphenytoinas a healing agent and to discuss its applicability in wounds. A literature review and hierarchy analysis of evidence-based practices was performed. Eighteen articles were analyzed that tested the intervention in wounds such as leprosy ulcers, leg ulcers, diabetic foot ulcers, pressure ulcers, trophic ulcers, war wounds, burns, preparation of recipient graft area, radiodermatitis and post-extraction of melanocytic nevi. Systemic use ofphenytoinin the treatment of fistulas and the hypothesis of topical use in the treatment of vitiligo were found. In conclusion, topical use ofphenytoinis scientifically evidenced. However robust research is needed that supports a protocol for the use ofphenytoinas another option of a healing agent in clinical practice.

  18. The occurrence of biofilm in an equine experimental wound model of healing by secondary intention. (United States)

    Jørgensen, E; Bay, L; Bjarnsholt, T; Bundgaard, L; Sørensen, M A; Jacobsen, S


    In humans, biofilm is a well-known cause of delayed healing and low-grade inflammation of chronic wounds. In horses, biofilm formation in wounds has been studied to a very limited degree. The objective of this study was thus to investigate the occurrence of biofilm in equine experimental wounds healing by secondary intention. Tissue biopsies from non-contaminated, experimental excisional shoulder and limb wounds were obtained on day 1-2, day 7-10 and day 14-15 post-wounding. Limb wounds were either un-bandaged or bandaged to induce exuberant granulation tissue (EGT) formation and thereby impaired healing. Presence of biofilm in tissue biopsies was assessed by peptide nucleic acid fluorescence in situ hybridization (PNA FISH) and confocal laser scanning microscopy (CLSM). Bandaged limb wounds developed EGT and displayed delayed healing, while shoulder and un-bandaged limb wounds healed normally. Biofilm was detected in limb wounds only. At day 14-15 biofilm was significantly more prevalent in bandaged limb wounds than in un-bandaged limb wounds (P=0.003). Further, bandaged limb wounds had a statistically significant increase in biofilm burden from day 7-10 to day 14-15 (P=0.009). The finding that biofilm was most prevalent in bandaged limb wounds with EGT formation suggests that biofilm may be linked to delayed wound healing in horses, as has been observed in humans. The inability to clear bacteria could be related to hypoxia and low-grade inflammation in the EGT, but the interaction between biofilm forming bacteria and wound healing in horses needs further elucidation. Copyright © 2017 Elsevier B.V. All rights reserved.

  19. The effect of color type on early wound healing in farmed mink (Neovison vison). (United States)

    Jespersen, A; Jensen, H E; Agger, J F; Heegaard, P M H; Damborg, P; Aalbæk, B; Hammer, A S


    Individual differences of mink, including color type, are speculated to affect the course of wound healing, thereby impacting wound assessment and management on the farms, as well as the assessment of wounds in forensic cases. In this study, we examined the effect of color type on early wound healing in farmed mink. Full thickness excisional wounds (2 × 2 cm) were made on the back in 18 mink of the color types Brown, Silverblue and Blue Iris. Gross and microscopic pathology of the wounds was evaluated 2 days post-wounding together with degree of wound size reduction, presence of bacteria and blood analyses. Pathological examination on day 2 showed the greatest mean wound size reduction in Brown mink (11.0%) followed by Blue Iris (7.9%) and Silverblue (1.6%). Bacteria were cultured from all wounds, and predominantly Staphylococcus species were recovered in mixed or pure culture. Histopathology from day 2 wounds showed a scab overlying necrotic wound edges, which were separated from underlying vital tissue by a demarcation zone rich in polymorphonuclear leukocytes. Fibroblasts and plump endothelial cells were more numerous in the deeper tissues. Complete blood count parameters were within normal ranges in most cases, however, the mink showed mildly to markedly decreased hematocrit and six mink of the color types Silverblue and Blue Iris showed moderately elevated numbers of circulating segmented neutrophils on day 2. There was a marked increase in concentration of serum amyloid A from day 0 to day 2 in all color types. We have described differences in early wound healing between mink of the color types Brown, Silverblue and Blue Iris by use of an experimental wound model in farmed mink. The most pronounced difference pertained to the degree of wound size reduction which was greatest in Brown mink, followed by Blue Iris and Silverblue, respectively.

  20. Comparative efficacy of two polyherbal creams with framycetin sulfate on diabetic wound model in rats. (United States)

    Nehete, Minakshi N; Nipanikar, Sanjay; Kanjilal, Anisha S; Kanjilal, Sanjivan; Tatke, Pratima A


    Diabetes mellitus is one of the metabolic disorders that impede normal steps of wound healing process. Worldwide, 15% of the 200 million diabetics suffer from diabetic wounds. Diabetic complications, such as foot ulcer, impose major public health burdens worldwide. The present study was carried out to evaluate comparative efficacy of polyherbal creams with framycetin sulfate cream on diabetic rats using incision and excision wound models. Alloxan (120 mg/kg, intraperitoneal) induced diabetic rat models (incision and excision models) were used to evaluate wound healing effect of cream A, B, and framycetin sulfate. Cream A and B were applied for a period of 10 and 20 days for incision and excision wound models, respectively. Incision wound model was used to assess the effect on breaking strength. Wound contraction and epithelialization period were measured using excision wound model. The data were analyzed by one-way ANOVA followed by Bonferroni post-test. Tensile strength of the animals treated with cream B (941.66 ± 15.36) was found to be significantly greater (P cream A (825 ± 22.36). Wound treated with cream B was found to heal significantly (P Cream B was found to be more effective wound healing agent than cream A and framycetin sulfate cream in treating diabetic wounds. Copyright © 2016 Transdisciplinary University, Bangalore and World Ayurveda Foundation. Published by Elsevier B.V. All rights reserved.

  1. Ascorbic acid deficiency impairs wound healing in surgical patients: Four case reports

    Directory of Open Access Journals (Sweden)

    A. Bikker


    Conclusion: AA deficiency is not uncommon in the hospital population, especially in those at risk. Treating deficient patients with AA leads to swift improvement of the wound healing process post-surgery, thereby reducing the costs of extensive wound treatment and extended stay in hospital.

  2. Treating Fasciotomy Wounds with Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d)


    Lee, Priscilla


    Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* ...

  3. Silver nanoparticles enhance wound healing in zebrafish (Danio rerio). (United States)

    Seo, Seung Beom; Dananjaya, S H S; Nikapitiya, Chamilani; Park, Bae Keun; Gooneratne, Ravi; Kim, Tae-Yoon; Lee, Jehee; Kim, Cheol-Hee; De Zoysa, Mahanama


    Silver nanoparticles (AgNPs) were successfully synthesized by a chemical reduction method, physico-chemically characterized and their effect on wound-healing activity in zebrafish was investigated. The prepared AgNPs were circular-shaped, water soluble with average diameter and zeta potential of 72.66 nm and -0.45 mv, respectively. Following the creation of a laser skin wound on zebrafish, the effect of AgNPs on wound-healing activity was tested by two methods, direct skin application (2 μg/wound) and immersion in a solution of AgNPs and water (50 μg/L). The zebrafish were followed for 20 days post-wounding (dpw) by visual observation of wound size, calculating wound healing percentage (WHP), and histological examination. Visually, both direct skin application and immersion AgNPs treatments displayed clear and faster wound closure at 5, 10 and 20 dpw compared to the controls, which was confirmed by 5 dpw histology data. At 5 dpw, WHP was highest in the AgNPs immersion group (36.6%) > AgNPs direct application group (23.7%) > controls (18.2%), showing that WHP was most effective in fish immersed in AgNPs solution. In general, exposure to AgNPs induced gene expression of selected wound-healing-related genes, namely, transforming growth factor (TGF-β), matrix metalloproteinase (MMP) -9 and -13, pro-inflammatory cytokines (IL-1β and TNF-α) and antioxidant enzymes (superoxide dismutase and catalase), which observed differentiation at 12 and 24 h against the control; but the results were not consistently significant, and many either reached basal levels or were down regulated at 5 dpw in the wounded muscle. These results suggest that AgNPs are effective in acceleration of wound healing and altered the expression of some wound-healing-related genes. However, the detailed mechanism of enhanced wound healing remains to be investigated in fish. Copyright © 2017 Elsevier Ltd. All rights reserved.

  4. Melting graft wound syndrome

    Directory of Open Access Journals (Sweden)

    Shiou-Mei Chen


    Full Text Available Melting graft wound syndrome is characterized by progressive epidermal loss from a previously well-taken skin graft, healed burn, or donor site. It may result in considerable morbidity and require prolonged treatment. We report a 23-year-old flame-burned patient with second- to third-degree burns involving more than 70% of the total body surface area, whose condition was complicated with septic shock. The patient presented with erosions and ulcers occurring on previously well-taken skin graft recipient sites over both legs and progressive epidermal loss on donor sites over the back. The patient's presentation was compatible with the diagnosis of melting graft wound syndrome, and we successfully treated the patient with debridement and supportive treatment.

  5. Burn Wound Infection (United States)


    generalized. Clinically, the like- controlled Pseudomonas burn wound infection in most lihood of septicemia appears to increase as the area of patients (2,4...31 patients, dida, Coccidiodes, Phycomyces, and Rhizopus . In 69 of pneumonia was the primary septic process in 27 (20 of these 75 patients (92%), the...carried out as described above and appropriate systemic anti- to which the invading organisms were sensitive and fungal agents are employed to control

  6. Fungal Burn Wound Infection (United States)


    Aspergillus), Blasto- T he use of effective topical chemotherapeutic agents to myces (Candida), and Zygomycetes (Mucor, Rhizopus ).6 reduce...below the infected burn wound . If the infection was controlled by these measures and the patient’s condition permit- ted, the involved area was...species, 18%; Mucor species and Rhizopus species, acetate in the morning and silver sulfadiazine in the evening. Prophy- 9.1%; and Microspora species and

  7. Telemedicine in wound care. (United States)

    Chanussot-Deprez, Caroline; Contreras-Ruiz, José


    Telemedical wound care is one of the applications of teledermatology. We present our experience using telemedicine in the successful assessment and treatment of three patients with hard-to-heal ulcers. Three patients were seen at the PEMEX General Hospital in Veracruz, Mexico. The first patient was a 53-year-old man with hypertension, morbid obesity, chronic venous insufficiency, recurrent erysipelas, leg ulcers and lymphoedema. There was one ulcer on his left lower leg (20 x 10 cm) and one on his right leg (9 x 7 cm). The second patient was a 73-year-old woman with class III obesity and ulcers in her right leg, secondary to surgical debridement of bullous erysipelas. The third patient was a 51-year-old female with rheumatoid arthritis with one ulcer on each leg and chronic lymphostasis. Photographs with a digital camera were taken and sent weekly via email to a wound care specialist in Mexico City. The photographs allowed the expert to diagnose and evaluate the chronic wounds periodically. In the present cases, telemedicine allowed us to have a rapid evaluation, diagnosis and treatment. The images were of enough quality to be useful and small enough to be sent via regular email to the remote physician who immediately gave his feedback. The expert was confident to give therapeutic recommendations in this way, and we considered this method to be very cost-effective, saving the patient and the health care system, especially in transportation.

  8. Honey as a topical treatment for wounds. (United States)

    Jull, Andrew B; Cullum, Nicky; Dumville, Jo C; Westby, Maggie J; Deshpande, Sohan; Walker, Natalie


    Honey is a viscous, supersaturated sugar solution derived from nectar gathered and modified by the honeybee, Apis mellifera. Honey has been used since ancient times as a remedy in wound care. Evidence from animal studies and some trials has suggested that honey may accelerate wound healing. The objective of this review was to assess the effects of honey compared with alternative wound dressings and topical treatments on the of healing of acute (e.g. burns, lacerations) and/or chronic (e.g. venous ulcers) wounds. For this update of the review we searched the Cochrane Wounds Group Specialised Register (searched 15 October 2014); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2014, Issue 9); Ovid MEDLINE (1946 to October Week 1 2014); Ovid MEDLINE (In-Process & Other Non-Indexed Citations 13 October 2014); Ovid EMBASE (1974 to 13 October 2014); and EBSCO CINAHL (1982 to 15 October 2014). Randomised and quasi-randomised trials that evaluated honey as a treatment for any sort of acute or chronic wound were sought. There was no restriction in terms of source, date of publication or language. Wound healing was the primary endpoint. Data from eligible trials were extracted and summarised by one review author, using a data extraction sheet, and independently verified by a second review author. All data have been subsequently checked by two more authors. We identified 26 eligible trials (total of 3011 participants). Three trials evaluated the effects of honey in minor acute wounds, 11 trials evaluated honey in burns, 10 trials recruited people with different chronic wounds including two in people with venous leg ulcers, two trials in people with diabetic foot ulcers and single trials in infected post-operative wounds, pressure injuries, cutaneous Leishmaniasis and Fournier's gangrene. Two trials recruited a mixed population of people with acute and chronic wounds. The quality of the evidence varied between different comparisons and

  9. The analgesic effect of wound infiltration with local anaesthetics after breast surgery

    DEFF Research Database (Denmark)

    Byager, N; Hansen, Mads; Mathiesen, Ole


    BACKGROUND: Wound infiltration with local anaesthetics is commonly used during breast surgery in an attempt to reduce post-operative pain and opioid consumption. The aim of this review was to evaluate the effect of wound infiltration with local anaesthetics compared with a control group on post......-operative pain after breast surgery. METHODS: A systematic review was performed by searching PubMed, Google Scholar, the Cochrane database and Embase for randomised, blinded, controlled trials of wound infiltration with local anaesthetics for post-operative pain relief in female adults undergoing breast surgery...... significant reduction in post-operative, supplemental opioid consumption that was, however, of limited clinical relevance. CONCLUSION: Wound infiltration with local anaesthetics may have a modest analgesic effect in the first few hours after surgery. Pain after breast surgery is, however, generally mild...

  10. p38 MAPK inhibition reduces diabetes-induced impairment of wound healing

    Directory of Open Access Journals (Sweden)

    Satyanarayana Medicherla


    Full Text Available Satyanarayana Medicherla1, Scott Wadsworth2, Breda Cullen3, Derek Silcock3, Jing Y Ma1, Ruban Mangadu1, Irene Kerr1, Sarvajit Chakravarty1, Gregory L Luedtke1, Sundeep Dugar1, Andrew A Protter1, Linda S Higgins11Scios Inc., Fremont, CA, USA; 2Center for Biomaterials and Advanced Technologies, Somerville, NJ, USA; 3Johnson & Johnson Wound Management, Gargrave, UKAbstract: In healthy tissue, a wound initiates an inflammatory response characterized by the presence of a hematoma, infiltration of inflammatory cells into the wound and, eventually, wound healing. In pathological conditions like diabetes mellitus, wound healing is impaired by the presence of chronic nonresolving inflammation. p38 mitogen-activated protein kinase (MAPK inhibitors have demonstrated anti-inflammatory effects, primarily by inhibiting the expression of inflammatory cytokines and regulating cellular traffic into wounds. The db/db mouse model of type 2 diabetes was used to characterize the time course of expression of activated p38 during impaired wound healing. The p38α-selective inhibitor, SCIO-469, was applied topically and effects on p38 activation and on wound healing were evaluated. A topical dressing used clinically, PromogranTM, was used as a comparator. In this study, we established that p38 is phosphorylated on Days 1 to 7 post-wounding in db/db mice. Further, we demonstrated that SCIO-469, at a dose of 10 µg/wound, had a positive effect on wound contraction, granulation tissue formation, and re-epithelialization, and also increased wound maturity during healing. These effects were similar to or greater than those observed with PromogranTM. These results suggest a novel approach to prophylactic and therapeutic management of chronic wounds associated with diabetes or other conditions in which healing is impaired.Keywords: p38 MAPK ihibition, diabetic wound healing, db/db mouse, nonresolving healing, PromogranTM

  11. The effects of psychological interventions on wound healing: A systematic review of randomized trials. (United States)

    Robinson, Hayley; Norton, Sam; Jarrett, Paul; Broadbent, Elizabeth


    Psychological stress has been shown to delay wound healing. Several trials have investigated whether psychological interventions can improve wound healing, but to date, this evidence base has not been systematically synthesized. The objective was to conduct a systematic review of randomized controlled trials in humans investigating whether psychological interventions can enhance wound healing. A systematic review was performed using PsychINFO, CINAHL, Web of Science, and MEDLINE. The searches included all papers published in English up until September 2016. The reference lists of relevant papers were screened manually to identify further review articles or relevant studies. Nineteen studies met inclusion criteria and were included in the review. Fifteen of nineteen studies were of high methodological quality. Six studies were conducted with acute experimentally created wounds, five studies with surgical patients, two studies with burn wounds, two studies with fracture wounds, and four studies were conducted with ulcer wounds. Post-intervention standardized mean differences (SMD) between groups across all intervention types ranged from 0.13 to 3.21, favouring improved healing, particularly for surgical patients and for relaxation interventions. However, there was some evidence for publication bias suggesting negative studies may not have been reported. Due to the heterogeneity of wound types, population types, and intervention types, it is difficult to pool effect sizes across studies. Current evidence suggests that psychological interventions may aid wound healing. Although promising, more research is needed to assess the efficacy of each intervention on different wound types. Statement of contribution What is already known on this subject? Psychological stress negatively affects wound healing. A number of studies have investigated whether psychological interventions can improve healing. However, no systematic reviews have been conducted. What does this study add

  12. The management of perineal wounds

    Directory of Open Access Journals (Sweden)

    Ramesh k Sharma


    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.

  13. Risk Factors For Wound Infections After Implant Surgery | Onche ...

    African Journals Online (AJOL)

    OBJECTIVE: Post-operative wound infection (POWI) rates for implant surgery are in the range of 0.08 to 13% in spite of the many advances in surgery in the past decades. It is therefore imperative that we develop a system of predicting the occurrence of POWI as a key to effective prevention. One approach is for each ...

  14. Identification of Biomarkers Associated with the Healing of Chronic Wounds (United States)


    at the June 23, 2009 Blood and Blood Safety PLR meeting. • Herr M, Fries KM, Upton GL, Edsberg LE. Potential biomarkers of temporomandibular joint ...painted with tissue adhesive, and all treated wounds were covered with a dressing. Pain medication and post-operative antibiotics were administered as


    Sinožić, T; Katić, M; Kovačević, J


    It can be said that the occurrence and development of wounds, healing, delayed healing, and the notion of chronic wound are some of the basic characteristics of all living beings. When it comes to people, there are a number of processes that take place during wound healing, and even under ideal circumstances, they create a functionally less valuable skin tissue, along with structural and functional changes. Fibrosis in the form of hypertrophic scars and keloids, contractures and adhesions are examples of excessive healing. Microcirculation is significantly different from healthy skin circulation with consequential formation of local hypoxia and stagnation in lymph flow with edema. Poor functionality of the scar tissue, particularly in the areas exposed to stronger forces, can cause forming of wounds. Such wounds are hard to heal despite the inexistence of other possible reasons for delayed healing, precisely because of their poor functionality and placement. The presence of wound requiring long-term treatment affects all areas of patient life and leads to decline in the quality of life. Exemplified by case presentation of a patient with post-traumatic wound in the scar area, in our office we showed a model of care based on the principle of overall personalized care with the biopsychosocial approach. Diagnostic and therapeutic procedures included wound assessment, biofilm and lymphedema detection, assessment of the patient’s psychosocial status, risk factors for wound healing, vascular ultrasound diagnostics, carboxytherapy as specialized adjuvant therapy, use of modern wound dressings, and compression therapy. Supportive psychotherapy was conducted in positive communication environment during treatment. In this way, in an atmosphere of cooperation with the patient, it was possible not only to influence the process of wound healing as the primary objective, but also to improve the quality of the patient’s life, as well as to influence our professional

  16. Reconstructive challenges in war wounds


    Bhandari, Prem Singh; Maurya, Sanjay; Mukherjee, Mrinal Kanti


    War wounds are devastating with extensive soft tissue and osseous destruction and heavy contamination. War casualties generally reach the reconstructive surgery centre after a delayed period due to additional injuries to the vital organs. This delay in their transfer to a tertiary care centre is responsible for progressive deterioration in wound conditions. In the prevailing circumstances, a majority of war wounds undergo delayed reconstruction, after a series of debridements. In the recent m...

  17. [Interobserver variation in wound assessments]. (United States)

    Lorentzen, H F; Gottrup, F


    Agreement in describing a chronic leg ulcer is pivotal in identifying and treating impediments to the healing process. Six nurses and one doctor without special experience with wound healing registered wound related diagnoses for a five month period. On average each patient was seen by three observers yielding 270 registrations. Agreement beyond chance (global kappa) showed poor to moderate agreement. Agreement was best for the yellow or malodorous wound and lowest for cellulitis, hypergranulation and peripheral pulses. This emphasizes the importance of allocating wound treatment to specialist departments with access to paraclinical investigations.

  18. Treating Fasciotomy Wounds with Negative Pressure Wound Therapy with Instillation and Dwell Time (NPWTi-d). (United States)

    Lee, Priscilla


    Acute compartment syndrome (ACS) is a serious complication of lower-extremity trauma caused by accidents or post-procedure complications. ACS is characterized by increased pressure within the compartment, resulting in reduced blood flow, tissue hypoxia, and tissue necrosis. Fasciotomies to relieve pressure and debridement of necrotic tissue comprise primary treatment. My purpose is to present initial experience using negative pressure wound therapy with instillation and dwell time (NPWTi-d)* to treat fasciotomy wounds in two patients. NPWTi-d provides automated, volumetric control of instilled topical wound solutions with a dwell time in combination with negative pressure wound therapy (NPWT). Patient 1, a 33-year-old male injured in a motorcycle accident, developed ACS within 24 hours of hospitalization. Prior treatments included wet-to-dry dressings and NPWT†. In the latter course of treatment, NPWTi-d was applied; 40 ml of normal saline (NS) were instilled with a ten-minute dwell time, followed by four hours of NPWT at ‑125 mmHg. After five days of NPWTi‑d, granulation tissue covered the bone. Four days later, the patient was discharged home. The wound continued to improve and, at the last recorded visit, was completely closed. Patient 2, a 44-year-old male, developed right lower extremity ACS due to complications post cardiac surgery. NPWT was initiated in the hospital and continued post-discharge to a nursing home. The patient was readmitted to the hospital with a right leg wound infection that was surgically debrided. NPWTi-d was then applied; 60 ml of NS were instilled with a ten-minute dwell time, followed by 3.5 hours of NPWT at -125 mmHg. After ten days of NPWTi-d, granulation tissue covered the bone. In Patient 2, NPWTi-d improved the likelihood of healing in a malnourished patient who had been critically ill by promoting granulation tissue over exposed bone. The use of NPWTi-d with NS contributed to positive outcomes for both patients. *V

  19. Designing plasmas for chronic wound disinfection (United States)

    Nosenko, T.; Shimizu, T.; Morfill, G. E.


    Irradiation with low-temperature atmospheric-pressure plasma provides a promising method for chronic wound disinfection. To be efficient for this purpose, plasma should meet the following criteria: it should significantly reduce bacterial density in the wounded area, cause a long-term post-irradiation inhibition of bacterial growth, yet without causing any negative effect on human cells. In order to design plasmas that would satisfy these requirements, we assessed the relative contribution of different components with respect to bactericidal properties due to irradiation with argon plasma. We demonstrate that plasma-generated UV radiation is the main short-term sterilizing factor of argon plasma. On the other hand, plasma-generated reactive nitrogen species (RNS) and reactive oxygen species (ROS) cause a long-term 'after-irradiation' inhibition of bacterial growth and, therefore, are important for preventing wound recolonization with bacteria between two treatments. We also demonstrate that at certain concentrations plasma-generated RNS and ROS cause significant reduction of bacterial density, but have no adverse effect on human skin cells. Possible mechanisms of the different effects of plasma-generated reactive species on bacteria and human cells are discussed. The results of this study suggest that argon plasma for therapeutic purposes should be optimized in the direction of reducing the intensity of plasma-generated UV radiation and increasing the density of non-UV plasma products.

  20. The association of perioperative dexamethasone, smoking and alcohol abuse with wound complications after laparotomy

    DEFF Research Database (Denmark)

    Dahl, Rikke M; Wetterslev, Jørn; Jorgensen, Lars N


    BACKGROUND: A number of perioperative risk factors may suppress the immune system and contribute to the development of post-operative complications. The association between surgical site infection (SSI) and other wound-related complications resulting from immunosuppression through either perioper......BACKGROUND: A number of perioperative risk factors may suppress the immune system and contribute to the development of post-operative complications. The association between surgical site infection (SSI) and other wound-related complications resulting from immunosuppression through either......, smoking status and alcohol abuse with the primary outcome, being a composite of SSI, anastomotic leak, wound dehiscence, burst abdomen and 30-day mortality. RESULTS: The primary outcome occurred in 21% of patients receiving dexamethasone versus 28% of patients not receiving dexamethasone...... was not significantly associated with SSI or other wound-related complications. Conversely, smoking and alcohol abuse were both significant predictors of the primary outcome consisting of wound-related complications and mortality....


    Directory of Open Access Journals (Sweden)



    Full Text Available BACKGROUND AND OBJECTIVE: It is an established fact now that the normal skin of healthy human beings harbours a rich bacterial fl ora. Normally considered non - pathogenic , these organisms way be a potential source of infection of the surgical wound. Approximately 20% of the resident flora is beyond the reach of surgical scrubs and antiseptics. The goal of surgical preparation of the skin with antiseptics is to remove transient and pathogenic microorganisms on the skin surface and to reduce the resident flora to a low level. Povidone iodine (I odophors and chlorhexidine are most often used antiseptics for pre - operative skin preparation. OBJECTIVES : To evaluate the efficacy of povidone iodine alone and in combination with antiseptic agent containing alcoholic chlorhexidine in preoperative skin p reparation by taking swab culture. (2 To compare the rate of postoperative wound infection in both the groups. METHODS: One hundred patients (fifty in each group undergoing clean elective surgery with no focus of infection on the body were included in th e study. The pre - operative skin preparation in each group is done with the respective antiseptic regimen. In both the groups after application of antiseptics , sterile saline swab culture was taken immediately from site of incision. In cases which showed gr owth of organisms , the bacteria isolated were identified by their morphological and cultural characteristics. Grams staining , coagulase test and antibiotic sensitivity test were done wherever necessary and difference in colonization rates was determined as a measure of efficacy of antiseptic regimen. RESULTS: The results of the study showed that when compared to povidone iodine alone , using a combination of povidone iodine and alcoholic solution of chlorhexidine , the colonization rates of the site of incisi on were reduced significantly. As for the rate of post - operative wound infection , it is also proven that wound infections are also

  2. Vacuum-assisted closure versus closure without vacuum assistance for preventing surgical site infections and infections of chronic wounds: a meta-analysis of randomized controlled trials. (United States)

    Tansarli, Giannoula S; Vardakas, Konstantinos Z; Stratoulias, Constantinos; Peppas, George; Kapaskelis, Anastasios; Falagas, Matthew E


    We sought to examine whether vacuum-assisted closure (VAC) is associated with fewer surgical site infections (SSIs) or infections of chronic wounds than other management procedures for surgical wounds. The PubMed and Scopus databases were searched systematically. Randomized controlled trials (RCTs) comparing the development of SSIs or infections of chronic wounds between patients treated with VAC for acute or chronic wounds and those whose wounds were treated without VAC were considered eligible for inclusion in the study. Eight RCTs met the inclusion criteria for the study. Four of the studies included chronic or diabetic lower extremity wounds and four included fractures. In three of four studies reporting on fractures, the wounds were not closed post-operatively, whereas in one study primary closure of the wound was performed. With regard to wounds left open after the stabilization of fractures, patients whose wounds were treated with VAC developed fewer SSIs than those whose wounds were treated without VAC ([367 patients (196 with VAC; 171 without VAC) relative risk [RR], 0.47; 95% CI 0.28-0.81]). On the contrary, no difference in the development of SSIs occurred among patients with chronic or diabetic lower-extremity wounds treated with VAC and those whose wounds were treated without VAC ([638 patients (320 with VAC; 318 without VAC) RR 1.67; 95% CI: 0.71-3.94]). The available evidence suggests that the development of infections in wounds treated with VAC depends on the type of wound being treated.

  3. Detection of RAGE expression and its application to diabetic wound age estimation. (United States)

    Ji, Xin-Yi; Chen, Yang; Ye, Guang-Hua; Dong, Miao-Wu; Lin, Ke-Zhi; Han, Jun-Ge; Feng, Xiang-Ping; Li, Xing-Biao; Yu, Lin-Sheng; Fan, Yan-Yan


    With the prevalence of diabetes, it is becoming important to analyze the diabetic wound age in forensic practice. The present study investigated the time-dependent expression of receptor for advanced glycation end products (RAGE) during diabetic wound healing in mice and its applicability to wound age determination by immunohistochemistry, double immunofluorescence, and Western blotting. After an incision was created in genetically diabetic db/db mice and control mice, mice were killed at posttraumatic intervals ranging from 6 h to 14 days, followed by the sampling of wound margin. Compared with control mice, diabetic mice showed the delayed wound healing. In control and diabetic wound specimens, RAGE immunoreactivity was observed in a small number of polymorphonuclear cells (PMNs), a number of macrophages, and fibroblasts. Morphometrically, the positive ratios of RAGE in macrophages or fibroblasts considerably increased in diabetic wounds during late repair, which exceeded 60% at 7 and 10 days post-injury. There were no control wound specimens to show a ratio of >60% in macrophages or fibroblasts. By Western blotting analysis, the ratios of RAGE to GAPDH were >1.4 in all diabetic wound samples from 7 to 10 days post-injury, which were >1.8 at 10 days after injury. By comparison, no control wound specimens indicated a ratio of >1.4. In conclusion, the expression of RAGE is upregulated and temporally distributed in macrophages and fibroblasts during diabetic wound healing, which might be closely involved in prolonged inflammation and deficient healing. Moreover, RAGE is promising as a useful marker for diabetic wound age determination.

  4. The Effect of Mechanical Wounding on the Composition of Essential Oil from Ocimum Minimum L. Leaves


    S. Grant Wyllie; Dimitrios Zabaras


    The effect of mechanical damage on the composition of the essential oil obtained from eugenol-rich Ocimum minimum leaves was determined over 48 hours. Changes in the levels of five oil-constituents were detected in the first post-wounding day but only one of those components (camphor) exhibited the same behaviour the day after. The levels of eugenol (-4.8%) and linalool (+2.5%) were affected the most by the wounding process. Principal component analysis (PCA) showed the post-wounding response...

  5. Risk analysis and outcome of mediastinal wound and deep mediastinal wound infections with specific emphasis to omental transposition

    LENUS (Irish Health Repository)

    Parissis, Haralabos


    Abstract Background To report our experience, with Deep mediastinal wound infections (DMWI). Emphasis was given to the management of deep infections with omental flaps Methods From February 2000 to October 2007, out of 3896 cardiac surgery patients (prospective data collection) 120 pts (3.02%) developed sternal wound infections. There were 104 males & 16 females; (73.7%) CABG, (13.5%) Valves & (9.32%) CABG and Valve. Results Superficial sternal wound infection detected in 68 patients (1.75%) and fifty-two patients (1.34%) developed DMWI. The incremental risk factors for development of DMWI were: Diabetes (OR = 3.62, CI = 1.2-10.98), Pre Op Creatinine > 200 μmol\\/l (OR = 3.33, CI = 1.14-9.7) and Prolong ventilation (OR = 4.16, CI = 1.73-9.98). Overall mortality for the DMWI was 9.3% and the specific mortality of the omental flap group was 8.3%. 19% of the "DMWI group", developed complications: hematoma 6%, partial flap loss 3.0%, wound dehiscence 5.3%. Mean Hospital Stay: 59 ± 21.5 days. Conclusion Post cardiac surgery sternal wound complications remain challenging. The role of multidisciplinary approach is fundamental, as is the importance of an aggressive early wound exploration especially for deep sternal infections.

  6. Incisional Negative Pressure Wound Therapy

    DEFF Research Database (Denmark)

    Hyldig, Nana; Vinter, Christina Anne; Bille, Camilla

    Background: Obese women undergoing caesarean section are at increased risk of surgical wound complications, which may lead to delayed recovery, pain, reduced quality of life, and increased health care cost. The aim of this study is to evaluate the effect of incisional Negative Pressure Wound...

  7. Critical Advances in Wound Care (United States)


    Nutritionist  Infectious disease specialist  Administrator  Physical and occupational therapist  Nurse practitioner Wound clinic manager...of high AKA amputations with accompanying fungal infections – Need for local therapy • Wound VAC™ Instill® therapy • Dakin’s irrigation solution

  8. Effect of discarded keratin-based biocomposite hydrogels on the wound healing process in vivo

    Energy Technology Data Exchange (ETDEWEB)

    Park, Mira [Department of Organic Materials & Fiber Engineering, Chonbuk National University, Jeonju 561–756 (Korea, Republic of); Shin, Hye Kyoung [Department of Chemistry, Inha University, 100 Inharo, Incheon 402–751 (Korea, Republic of); Kim, Byoung-Suhk [Department of BIN fusion technology, Chonbuk National University, Jeonju 561–756 (Korea, Republic of); Kim, Myung Jin; Kim, In-Shik [Department of Veterinary Anatomy, College of Veterinary Medicine and Bio-safety Research institute, Chonbuk National University, Jeonju 561–756 (Korea, Republic of); Park, Byung-Yong, E-mail: [Department of Veterinary Anatomy, College of Veterinary Medicine and Bio-safety Research institute, Chonbuk National University, Jeonju 561–756 (Korea, Republic of); Kim, Hak-Yong, E-mail: [Department of BIN fusion technology, Chonbuk National University, Jeonju 561–756 (Korea, Republic of)


    Biocompatible keratin-based hydrogels prepared by electron beam irradiation (EBI) were examined in wound healing. As the EBI dose increased to 60 kGy, the tensile strength of the hydrogels increased, while the percentage of elongation of the hydrogels decreased. After 7 days, the dehydrated wool-based hydrogels show the highest mechanical properties (the % elongation of 1341 and the tensile strength of 6030 g/cm{sup 2} at an EBI dose of 30 kGy). Excision wound models were used to evaluate the effects of human hair-based hydrogels and wool-based hydrogels on various phases of healing. On post-wounding days 7 and 14, wounds treated with either human hair-based or wool-based hydrogels were greatly reduced in size compared to wounds that received other treatments, although the hydrocolloid wound dressing-treated wound also showed a pronounced reduction in size compared to an open wound as measured by a histological assay. On the 14th postoperative day, the cellular appearances were similar in the hydrocolloid wound dressing and wool-based hydrogel-treated wounds, and collagen fibers were substituted with fibroblasts and mixed with fibroblasts in the dermis. Furthermore, the wound treated with a human hair-based hydrogel showed almost complete epithelial regeneration, with the maturation of immature connective tissue and hair follicles and formation of a sebaceous gland. - Highlights: • Biocompatible keratin-based hydrogels were examined for wound healing process. • Human hair-based hydrogel is superior to wool-based hydrogel in wound healing. • Discarded keratin-based hydrogels are expected more eco-friendly therapeutic agents.

  9. Antimicrobial stewardship in wound care

    DEFF Research Database (Denmark)

    Lipsky, Benjamin A; Dryden, Matthew; Gottrup, Finn


    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...... antibiotics. OBJECTIVES: This guidance document is aimed at providing clinicians an understanding of: the basic principles of why AMS is important in caring for patients with infected wounds; who should be involved in AMS; and how to conduct AMS for patients with infected wounds. METHODS: We assembled a group...... 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...

  10. Surgical Management of Chronic Wounds. (United States)

    Johnston, Benjamin R; Ha, Austin Y; Kwan, Daniel


    In this article, we outline the important role the surgeon plays in the management of chronic wounds. Debridement and washout are required for grossly infected wounds and necrotizing soft tissue infections. Cutaneous cancers such as squamous cell carcinomas may contribute to chronic wounds and vice versa; if diagnosed, these should be treated with wide local excision. Arterial, venous, and even lymphatic flows can be restored in select cases to enhance delivery of nutrients and removal of metabolic waste and promote wound healing. In cases where vital structures, such as bones, joints, tendons, and nerves, are exposed, vascularized tissue transfers are often required. These tissue transfers can be local or remote, the latter of which necessitates anastomoses of arteries and veins. Pressure sores are managed by relieving pressure, treating acute trauma or infection, and using rotation fasciocutaneous flaps. Lastly, the surgeon must always consider the possibility of osteomyelitis and retained foreign body as etiology for chronic wounds.

  11. Deep Sequencing Transcriptome Analysis of Murine Wound Healing: Effects of a Multicomponent, Multitarget Natural Product Therapy-Tr14. (United States)

    St Laurent, Georges; Seilheimer, Bernd; Tackett, Michael; Zhou, Jianhua; Shtokalo, Dmitry; Vyatkin, Yuri; Ri, Maxim; Toma, Ian; Jones, Dan; McCaffrey, Timothy A


    Wound healing involves an orchestrated response that engages multiple processes, such as hemostasis, cellular migration, extracellular matrix synthesis, and in particular, inflammation. Using a murine model of cutaneous wound repair, the transcriptome was mapped from 12 h to 8 days post-injury, and in response to a multicomponent, multi-target natural product, Tr14. Using single-molecule RNA sequencing (RNA-seq), there were clear temporal changes in known transcripts related to wound healing pathways, and additional novel transcripts of both coding and non-coding genes. Tr14 treatment modulated >100 transcripts related to key wound repair pathways, such as response to wounding, wound contraction, and cytokine response. The results provide the most precise and comprehensive characterization to date of the transcriptome's response to skin damage, repair, and multicomponent natural product therapy. By understanding the wound repair process, and the effects of natural products, it should be possible to intervene more effectively in diseases involving aberrant repair.

  12. Automatic wound infection interpretation for postoperative wound image (United States)

    Hsu, Jui-Tse; Ho, Te-Wei; Shih, Hsueh-Fu; Chang, Chun-Che; Lai, Feipei; Wu, Jin-Ming


    With the growing demand for more efficient wound care after surgery, there is a necessity to develop a machine learning based image analysis approach to reduce the burden for health care professionals. The aim of this study was to propose a novel approach to recognize wound infection on the postsurgical site. Firstly, we proposed an optimal clustering method based on unimodal-rosin threshold algorithm to extract the feature points from a potential wound area into clusters for regions of interest (ROI). Each ROI was regarded as a suture site of the wound area. The automatic infection interpretation based on the support vector machine is available to assist physicians doing decision-making in clinical practice. According to clinical physicians' judgment criteria and the international guidelines for wound infection interpretation, we defined infection detector modules as the following: (1) Swelling Detector, (2) Blood Region Detector, (3) Infected Detector, and (4) Tissue Necrosis Detector. To validate the capability of the proposed system, a retrospective study using the confirmation wound pictures that were used for diagnosis by surgical physicians as the gold standard was conducted to verify the classification models. Currently, through cross validation of 42 wound images, our classifiers achieved 95.23% accuracy, 93.33% sensitivity, 100% specificity, and 100% positive predictive value. We believe this ability could help medical practitioners in decision making in clinical practice.

  13. Therapeutic Effects of Acupuncture through Enhancement of Functional Angiogenesis and Granulogenesis in Rat Wound Healing

    Directory of Open Access Journals (Sweden)

    Sang In Park


    Full Text Available Acupuncture regulates inflammation process and growth factors by increasing blood circulation in affected areas. In this study, we examined whether acupuncture has an effect on wound healing in injured rat. Rats were assigned randomly into two groups: control group and acupuncture group. Acupuncture treatment was carried out at 8 sites around the wounded area. We analyzed the wound area, inflammatory cytokines, proliferation of resident cells, and angiogenesis and induction of extracelluar matrix remodeling. At 7 days after-wounding the wound size in acupuncture-treat group was decreased more significantly compared to control group. In addition, the protein levels of proinflammatory cytokines such as tumor necrosis factor-α (TNF-α and interleukin-1β (IL-1β were significantly decreased compared to the control at 2 and 7 days post-wounding. Also, we analyzed newly generated cells by performing immunostaining for PCNA and using several phenotype markers such as CD-31, α-SMA, and collagen type I. In acupuncture-treated group, PCNA-positive cell was increased and PCNA labeled CD-31-positive vessels, α-SMA- and collagen type I-positive fibroblastic cells, were increased compared to the control group at 7 days post-wounding. These results suggest that acupuncture may improve wound healing through decreasing pro-inflammatory response, increasing cell proliferation and angiogenesis, and inducing extracellular matrix remodeling.

  14. Wound repair in Pocillopora (United States)

    Rodríguez-Villalobos, Jenny Carolina; Work, Thierry M.; Calderon-Aguileraa, Luis Eduardo


    Corals routinely lose tissue due to causes ranging from predation to disease. Tissue healing and regeneration are fundamental to the normal functioning of corals, yet we know little about this process. We described the microscopic morphology of wound repair in Pocillopora damicornis. Tissue was removed by airbrushing fragments from three healthy colonies, and these were monitored daily at the gross and microscopic level for 40 days. Grossly, corals healed by Day 30, but repigmentation was not evident at the end of the study (40 d). On histology, from Day 8 onwards, tissues at the lesion site were microscopically indistinguishable from adjacent normal tissues with evidence of zooxanthellae in gastrodermis. Inflammation was not evident. P. damicornis manifested a unique mode of regeneration involving projections of cell-covered mesoglea from the surface body wall that anastomosed to form gastrovascular canals.

  15. Managing burn wounds with SMARTPORE Technology polyurethane foam: two case reports. (United States)

    Imran, Farrah-Hani; Karim, Rahamah; Maat, Noor Hidayah


    Successful wound healing depends on various factors, including exudate control, prevention of microbial contaminants, and moisture balance. We report two cases of managing burn wounds with SMARTPORE Technology polyurethane foam dressing. In Case 1, a 2-year-old Asian girl presented with a delayed (11 days) wound on her right leg. She sustained a thermal injury from a hot iron that was left idle on the floor. Clinical inspection revealed an infected wound with overlying eschar that traversed her knee joint. As her parents refused surgical debridement under general anesthesia, hydrotherapy and wound dressing using SMARTPORE Technology Polyurethane foam were used. Despite the delay in presentation of this linear thermal pediatric burn injury that crossed the knee joint, the patient's response to treatment and its outcome were highly encouraging. She was cooperative and tolerated each dressing change without the need of supplemental analgesia. Her wound was healed by 24 days post-admission. In Case 2, a 25-year-old Asian man presented with a mixed thickness thermal flame burn on his left leg. On examination, the injury was a mix of deep and superficial partial thickness burn, comprising approximately 3% of his total body surface area. SMARTPORE Technology polyurethane foam was used on his wound; his response to the treatment was very encouraging as the dressing facilitated physiotherapy and mobility. The patient rated the pain during dressing change as 2 on a scale of 10 and his pain score remained the same in every subsequent change. His wound showed evidence of epithelialization by day 7 post-burn. There were no adverse events reported. Managing burn wounds with SMARTPORE Technology polyurethane foam resulted in reduced pain during dressing changes and the successful healing of partial and mixed thickness wounds. The use of SMARTPORE Technology polyurethane foam dressings showed encouraging results and requires further research as a desirable management option in

  16. Gunshot wounds: epidemiology, wound ballistics, and soft-tissue treatment. (United States)

    Dougherty, Paul J; Najibi, Soheil; Silverton, Craig; Vaidya, Rahul


    The extremities are the most common anatomic location for gunshot wounds. Because of the prevalence of gunshot injuries, it is important that orthopaedic surgeons are knowledgeable about caring for them. The most common injuries seen with gunshot wounds are those of the soft tissues. Nonsurgical management of patients who have gunshot wounds with minimal soft-tissue disruption has been successfully accomplished in emergency departments for several years; this includes extremity wounds without nerve, intra-articular, or vascular injury. Stable, nonarticular fractures of an extremity have also been successfully treated with either minimal surgical or nonsurgical methods in the emergency department. Indications for surgical treatment include unstable fractures, intra-articular injuries, a significant soft-tissue injury (especially with skin loss), vascular injury, and/or a large or expanding hematoma.

  17. Receptor-Interacting Protein Kinase 3 Deficiency Delays Cutaneous Wound Healing.

    Directory of Open Access Journals (Sweden)

    Andrew Godwin

    Full Text Available Wound healing consists of a complex, dynamic and overlapping process involving inflammation, proliferation and tissue remodeling. A better understanding of wound healing process at the molecular level is needed for the development of novel therapeutic strategies. Receptor-interacting protein kinase 3 (RIPK3 controls programmed necrosis in response to TNF-α during inflammation and has been shown to be highly induced during cutaneous wound repair. However, its role in wound healing remains to be demonstrated. To study this, we created dorsal cutaneous wounds on male wild-type (WT and RIPK3-deficient (Ripk3-/- mice. Wound area was measured daily until day 14 post-wound and skin tissues were collected from wound sites at various days for analysis. The wound healing rate in Ripk3-/- mice was slower than the WT mice over the 14-day course; especially, at day 7, the wound size in Ripk3-/- mice was 53% larger than that of WT mice. H&E and Masson-Trichrome staining analysis showed impaired quality of wound closure in Ripk3-/- wounds with delayed re-epithelialization and angiogenesis and defected granulation tissue formation and collagen deposition compared to WT. The neutrophil infiltration pattern was altered in Ripk3-/- wounds with less neutrophils at day 1 and more neutrophils at day 3. This altered pattern was also reflected in the differential expression of IL-6, KC, IL-1β and TNF-α between WT and Ripk3-/- wounds. MMP-9 protein expression was decreased with increased Timp-1 mRNA in the Ripk3-/- wounds compared to WT. The microvascular density along with the intensity and timing of induction of proangiogenic growth factors VEGF and TGF-β1 were also decreased or delayed in the Ripk3-/- wounds. Furthermore, mouse embryonic fibroblasts (MEFs from Ripk3-/- mice migrated less towards chemoattractants TGF-β1 and PDGF than MEFs from WT mice. These results clearly demonstrate that RIPK3 is an essential molecule to maintain the temporal manner of the

  18. Cell therapy for full-thickness wounds: are fetal dermal cells a potential source? (United States)

    Akershoek, J J; Vlig, M; Talhout, W; Boekema, B K H L; Richters, C D; Beelen, R H J; Brouwer, K M; Middelkoop, E; Ulrich, M M W


    The application of autologous dermal fibroblasts has been shown to improve burn wound healing. However, a major hurdle is the availability of sufficient healthy skin as a cell source. We investigated fetal dermal cells as an alternative source for cell-based therapy for skin regeneration. Human (hFF), porcine fetal (pFF) or autologous dermal fibroblasts (AF) were seeded in a collagen-elastin substitute (Novomaix, NVM), which was applied in combination with an autologous split thickness skin graft (STSG) to evaluate the effects of these cells on wound healing in a porcine excisional wound model. Transplantation of wounds with NVM+hFF showed an increased influx of inflammatory cells (e.g., neutrophils, macrophages, CD4(+) and CD8(+) lymphocytes) compared to STSG, acellular NVM (Acell-NVM) and NVM+AF at post-surgery days 7 and/or 14. Wounds treated with NVM+pFF presented only an increase in CD8(+) lymphocyte influx. Furthermore, reduced alpha-smooth muscle actin (αSMA) expression in wound areas and reduced contraction of the wounds was observed with NVM+AF compared to Acell-NVM. Xenogeneic transplantation of NVM+hFF increased αSMA expression in wounds compared to NVM+AF. An improved scar quality was observed for wounds treated with NVM+AF compared to Acell-NVM, NVM+hFF and NVM+pFF at day 56. In conclusion, application of autologous fibroblasts improved the overall outcome of wound healing in comparison to fetal dermal cells and Acell-NVM, whereas application of fetal dermal fibroblasts in NVM did not improve wound healing of full-thickness wounds in a porcine model. Although human fetal dermal cells demonstrated an increased immune response, this did not seem to affect scar quality.

  19. Human skin wounds: a major and snowballing threat to public health and the economy. (United States)

    Sen, Chandan K; Gordillo, Gayle M; Roy, Sashwati; Kirsner, Robert; Lambert, Lynn; Hunt, Thomas K; Gottrup, Finn; Gurtner, Geoffrey C; Longaker, Michael T


    ABSTRACT In the United States, chronic wounds affect 6.5 million patients. An estimated excess of US$25 billion is spent annually on treatment of chronic wounds and the burden is rapidly growing due to increasing health care costs, an aging population and a sharp rise in the incidence of diabetes and obesity worldwide. The annual wound care products market is projected to reach $15.3 billion by 2010. Chronic wounds are rarely seen in individuals who are otherwise healthy. In fact, chronic wound patients frequently suffer from "highly branded" diseases such as diabetes and obesity. This seems to have overshadowed the significance of wounds per se as a major health problem. For example, NIH's Research Portfolio Online Reporting Tool (RePORT;, directed at providing access to estimates of funding for various disease conditions does list several rare diseases but does not list wounds. Forty million inpatient surgical procedures were performed in the United States in 2000, followed closely by 31.5 million outpatient surgeries. The need for post-surgical wound care is sharply on the rise. Emergency wound care in an acute setting has major significance not only in a war setting but also in homeland preparedness against natural disasters as well as against terrorism attacks. An additional burden of wound healing is the problem of skin scarring, a $12 billion annual market. The immense economic and social impact of wounds in our society calls for allocation of a higher level of attention and resources to understand biological mechanisms underlying cutaneous wound complications.

  20. Hydrodebridement of wounds: effectiveness in reducing wound bacterial contamination and potential for air bacterial contamination

    Directory of Open Access Journals (Sweden)

    Armstrong David G


    Full Text Available Abstract Background The purpose of this study was to assess the level of air contamination with bacteria after surgical hydrodebridement and to determine the effectiveness of hydro surgery on bacterial reduction of a simulated infected wound. Methods Four porcine samples were scored then infected with a broth culture containing a variety of organisms and incubated at 37°C for 24 hours. The infected samples were then debrided with the hydro surgery tool (Versajet, Smith and Nephew, Largo, Florida, USA. Samples were taken for microbiology, histology and scanning electron microscopy pre-infection, post infection and post debridement. Air bacterial contamination was evaluated before, during and after debridement by using active and passive methods; for active sampling the SAS-Super 90 air sampler was used, for passive sampling settle plates were located at set distances around the clinic room. Results There was no statistically significant reduction in bacterial contamination of the porcine samples post hydrodebridement. Analysis of the passive sampling showed a significant (p 3 to 16780 CFUs/m3 were observed with active sampling of the air whilst using hydro surgery equipment compared with a basal count of 582 CFUs/m3. During removal of the wound dressing, a significant increase was observed relative to basal counts (p Conclusion The results suggest a significant increase in bacterial air contamination both by active sampling and passive sampling. We believe that action might be taken to mitigate fallout in the settings in which this technique is used.

  1. Lumican binds ALK5 to promote epithelium wound healing.

    Directory of Open Access Journals (Sweden)

    Osamu Yamanaka

    Full Text Available Lumican (Lum, a small leucine-rich proteoglycan (SLRP family member, has multiple matricellular functions both as an extracellular matrix component and as a matrikine regulating cell proliferation, gene expression and wound healing. To date, no cell surface receptor has been identified to mediate the matrikine functions of Lum. This study aimed to identify a perspective receptor that mediates Lum effects on promoting wound healing. Transforming growth factor-β receptor 1 (ALK5 was identified as a potential Lum-interacting protein through in silico molecular docking and molecular dynamics. This finding was verified by biochemical pull-down assays. Moreover, the Lum function on wound healing was abrogated by an ALK5-specific chemical inhibitor as well as by ALK5 shRNAi. Finally, we demonstrated that eukaryote-specific post-translational modifications are not required for the wound healing activity of Lum, as recombinant GST-Lum fusion proteins purified from E. coli and a chemically synthesized LumC13 peptide (the last C-terminal 13 amino acids of Lum have similar effects on wound healing in vitro and in vivo.

  2. Low Intensity Laser Therapy Applied in the Healing of Wounds (United States)

    Kahn, Fred; Matthews, Jeffrey


    Objective: The aim of this study was to determine the outcomes of Low Intensity Laser Therapy (LILT) on wound healing for patients presenting with pain, compromised neurological and physical function and tissue damage associated with vascular/diabetic ulcerations of the lower extremity. Methods: A retrospective case review of six patients treated with LILT (GaAlAs SLD, 660 nm, 750 mW, 3.6 J/cm2; GaAlAs SLD, 840 nm, 1,500 mW, 6.48 J/cm2; GaAlAs laser, 830 nm, 75 mW, 270 J/cm2) was conducted of clinical features including pain, measured by visual analogue scale (VAS), motor function, measured by range of motion (ROM) and visual outcome, measured by wound dimensions for six patients (n = 6; 5 males, 1 female; age = 67.83 years). Results: Significant progress with regard to alleviation of pain (ΔVAS = -5), improvements in motor function (ΔROM = +40%), epithelialization (wound closure rate = 3%/week) and complete wound closure was achieved. No recurrence of pathology at least one month post cessation of therapy was evident (x¯% reduction in wound area = 100%). Conclusions: LILT achieved consistent, effective and clear endpoints, was cost effective, created no adverse effects and ultimately led to the salvage of extremities.


    African Journals Online (AJOL)


    of wound infection will be helpful in the control of wound infection and selection of empiric antimicrobial therapy as an infection control ... the skin (1). The exposed subcutaneous tissues provides a favourable substratum for a wide variety of microorganisms to contaminate and colonize, and .... Ayton M. Wound care. Wounds ...

  4. Negative Pressure Wound Therapy in Maxillofacial Applications

    Directory of Open Access Journals (Sweden)

    Adam J. Mellott


    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.

  5. The external microenvironment of healing skin wounds

    DEFF Research Database (Denmark)

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


    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...... and carbon dioxide), pH, and anti-microbial treatment on the wound. These factors are well described in the literature and can be modified with treatment methods available in the clinic. Understanding the roles of these factors in wound pathophysiology is of central importance in wound treatment...... methods that directly alter the features of the external wound microenvironment indirectly affect the internal wound microenvironment due to the exchange between the two compartments. In this review, we focus on the effects of temperature, pressure (positive and negative), hydration, gases (oxygen...

  6. Postoperative washing of sutured wounds

    Directory of Open Access Journals (Sweden)

    Conrad Harrison


    Full Text Available A best evidence topic was written according to the structured protocol. The three part question addressed was: [In patients undergoing closure of surgical wounds with sutures] does [keeping the wound dry for the first 48 h after closure] [reduce the incidence of surgical site infections (SSIs]? 4 relevant papers were culled from the literature and appraised. The authors, date, country, population, study type, main outcomes, key results and study weaknesses were tabulated. Current NICE guidelines recommend cleaning surgical wounds with sterile saline only for the first 48 h following skin closure. We found no evidence that washing wounds with tap water during this period increases the incidence of SSIs compared to keeping them dry. Further randomised controlled trials will enable the construction of conclusive systematic reviews and meta-analyses.

  7. New trends in healing chronic wounds


    KREJSKOVÁ, Kamila


    Basic theoretical bases As a chronic wound is called a secondarily healing wound which despite adequate therapy does not tend to heal for a period of 6-9 weeks. The cause of the chronic wound occurrence and its transformation into an acute wound can be infection, influence of associated diseases, skin top layer microtraumatization or skin necrosis cavity. Among the most frequent types of chronic wounds there are aligned venous ulcerations, arterial rodent ulcers, decubitus ulcers and neuropat...

  8. Wound bed preparation from a clinical perspective


    Halim, A. S.; Khoo, T L; Mat Saad, A. Z.


    Wound bed preparation has been performed for over two decades, and the concept is well accepted. The ′TIME′ acronym, consisting of tissue debridement, i nfection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management. While the focus has usually been concentrated around the wound, the evolving concept of wound bed preparation promotes the treatment of the patient as a whole. This article discusses wound bed preparation and ...

  9. Moist dressing coverage supports proliferation and migration of transplanted skin micrografts in full-thickness porcine wounds. (United States)

    Hackl, Florian; Kiwanuka, Elizabeth; Philip, Justin; Gerner, Philipp; Aflaki, Pejman; Diaz-Siso, J Rodrigo; Sisk, Geoffroy; Caterson, E J; Junker, Johan P E; Eriksson, Elof


    Transplantation of skin micrografts in a 1:100 ratio regenerate the epidermis of full-thickness wounds in pigs within 14 days in a wet environment. The aim of the current study was to combine micrografts and commercially available moist dressings. We hypothesized that micrografts regenerate the epidermis when covered with a moist dressing. 5cm×5cm and 10cm×10cm full-thickness wounds were created on the backs of pigs. Wounds were transplanted with 0.8mm×0.8mm micrografts created from a split-thickness skin graft in a 1:100 ratio. 5cm×5cm wounds were treated with wound chambers, moist dressings or dry gauze (non-transplanted control group). 10cm×10cm wounds were compared to non-transplanted wounds, both covered with moist dressings. Reepithelialization was assessed in biopsies from day 10, 14 and 18 post-transplantation. 5cm×5cm transplanted wounds covered with moist dressings showed 69.5±20.6% reepithelialization by day 14 and 90.5±10.4% by day 18, similar to wounds covered with a wound chamber (63.9±16.7 and 86.2±11.9%, respectively). 18 days post-transplantation, 10cm×10cm transplanted wounds covered with moist dressings showed 66.1±10.3% reepithelialization, whereas nontransplanted wounds covered with moist dressings were 40.6±6.6% reepithelialized. We conclude that micrografts combined with clinically available moist dressings regenerate the epidermis of full-thickness wounds. Copyright © 2013 Elsevier Ltd and ISBI. All rights reserved.

  10. Dressing wounds with potato peel

    Directory of Open Access Journals (Sweden)

    Patange Vidya


    Full Text Available The use of boiled potato peel (PP in dressing of various skin conditions was studied. A total of 11 patients were selected, which included resistant wounds of pemphigus, bullous pemphigoid and leg ulcers. An autoclaved PP dressing with a thin layer of antiseptic cream was applied at 25 sites. It was covered with multilayered gauze and the dressing was secured firmly with either a roller bandage or with an adhesive tape. Complete epithelization was seen at 20 sites (80%, near complete epithelization at one site. There was no satisfactory response at three sites and at one site the result could not be evaluated. The mean duration of healing was one week for superficial wounds and three weeks for deep wounds. The PP dressing facilitates the wound and three weeks for deep wounds. The PP dressing facilitates the wound healing process by providing and maintaining a moist environment. The PP dressing is easy to prepare, apply as well as remove. It is a comfortable dressing and is also cost effective.

  11. Topical oxygen wound therapies for chronic wounds: a review. (United States)

    Dissemond, J; Kröger, K; Storck, M; Risse, A; Engels, P


    Chronic wounds are an increasing problem in our ageing population and can arise in many different ways. Over the past decades it has become evident that sufficient oxygen supply is an essential factor of appropriate wound healing. Sustained oxygen deficit has a detrimental impact on wound healing, especially for patients with chronic wounds. This has been proven for wounds associated with peripheral arterial occlusive disease (PAOD) and diabetic foot ulcers (particularly in combination with PAOD). However, this is still under debate for other primary diseases. In the past few years several different new therapeutic approaches for topical oxygen therapies have been developed to support wound healing. These tend to fall into one of four categories: (1) delivery of pure oxygen either under pressurised or (2) ambient condition, (3) chemical release of oxygen via an enzymatic reaction or (4) increase of oxygen by facilitated diffusion using oxygen binding and releasing molecules. In this review article, the available therapeutic topical oxygen-delivering approaches and their impact on wound healing are presented and critically discussed. A summary of clinical data, daily treatment recommendations and practicability is provided. J. Dissemond received an honorarium for lectures, advisory boards and/or clinical studies from the following companies: 3M, B. Braun, BSN, Coloplast, Convatec, Draco, Hartmann, KCI, Lohmann&Rauscher, Medoderm, Merz, Sastomed, Systagenix, UCB-Pharma, Urgo. K. Kröger received an honorarium for lectures, advisory boards and/or clinical studies from the following companies: Bayer, Sanofi, GSK, Hartmann, Sastomed, UCB-Pharma, Urgo. M. Storck received an honorarium for lectures for the following companies: KCI, Systagenix, and UCB-Pharma. A. Risse received an honorarium for lectures, advisory boards and/or clinical studies from the following companies: Bracco, Coloplast, Draco, Lilly Deutschland, NovoNordisk, Sastomed, Urgo. P. Engels received an

  12. [Influence of different inner dressings in negative-pressure wound therapy on escharectomy wound of full-thickness burn rabbits]. (United States)

    Lin, J H; Chen, J; Xue, D J; Huang, W X; Su, G L


    Objective: To explore the influence of different inner dressings in negative-pressure wound therapy (NPWT) on escharectomy wound of full-thickness burn rabbits. Methods: Eighteen Japanese white rabbits were inflicted with full-thickness burn on unilateral back. They were divided into polymer dressing group (PD), biological dressing group (BD), and silver biological dressing group (SBD), according to the random number table, with 6 rabbits in each group. On 3 days post burn, the wounds were performed with escharectomy, and then wounds of rabbits in group PD were covered with polyurethane foam. Wounds of rabbits in group BD were covered with porcine acellular dermal matrix (ADM) and wounds of rabbits in group SBD were covered with silver porcine ADM. Then continuous NPWT was performed on rabbits of the three groups for 7 days. Immediately after surgery and on post surgery day (PSD) 7, general observation of wound was conducted and tissue around the wound was harvested for determination of dry to wet weight ratio. The content of bacteria was counted and the content of tumor necrosis factor α (TNF-α), interleukin-1β (IL-1β), and IL-6 in wound was determined by enzyme-linked immunosorbent assay. Fibroblasts in wound were counted after Masson staining and number of microvessels was counted after CD31 antibody immunohistochemical staining. Data were processed with analysis of variance for repeated measurement, LSD-t test, paired samples t test, and Bonferroni correction. Results: (1) Immediately after surgery, there was no granulation tissue in basal wound of rabbits in the three groups, with rich blood supply and obvious edema. On PSD 7, much granulation tissue was found in basal wound of rabbits in the three groups, with no or mild edema and no obvious redness and swelling in wound edge. (2) There were no significant differences in dry to wet weight ratios of tissue around the wound among and within the three groups immediately after surgery and on PSD 7 (with F

  13. The Effect of Mechanical Wounding on the Composition of Essential Oil from Ocimum Minimum L. Leaves

    Directory of Open Access Journals (Sweden)

    S. Grant Wyllie


    Full Text Available The effect of mechanical damage on the composition of the essential oil obtained from eugenol-rich Ocimum minimum leaves was determined over 48 hours. Changes in the levels of five oil-constituents were detected in the first post-wounding day but only one of those components (camphor exhibited the same behaviour the day after. The levels of eugenol (-4.8% and linalool (+2.5% were affected the most by the wounding process. Principal component analysis (PCA showed the post-wounding response to be independent from the pre-wounding levels of the particular compounds expressing the response and from the overall leaf oil-composition.

  14. Use of Multiple Adjunctive Negative Pressure Wound Therapy Modalities to Manage Diabetic Lower-Extremity Wounds


    Cole, Windy?E.


    Objective: Various treatment options exist for wound healing; however, clinical assessment of the patient and the wound environment must be considered before determining an optimal wound treatment plan. Negative pressure wound therapy alone and/or with an instilled topical solution can be effective in adjunctive management of acute and chronic wounds. Hyperbaric oxygen therapy has also been shown to contribute to the wound-healing process. A pilot evaluation using a multistep approach of adju...

  15. Negative Pressure Wound Therapy in the Management of Combat Wounds: A Critical Review


    Maurya, Sanjay; Bhandari, Prem Singh


    Significance: Wounds sustained in a combat trauma often result in a composite tissue loss. Combat injuries, due to high energy transfer to tissues, lead to trauma at multiple anatomical sites. An early wound cover is associated with lower rate of infections and a faster wound healing. The concept of negative pressure wound therapy (NPWT) in the management of combat-related wounds has evolved from the civilian trauma and the wounds from nontraumatic etiologies.

  16. The application of the modified surgical wound dressing in wound care after tracheotomy


    Feng Mei; Wu Ying; Zhu Jing; Wu Xiaoling


    Introduction: This study was performed to observe the efficacy of a modified surgical wound dressing applied as part of decannulation wound care after tracheotomy. Methods: Eighty-four patients were randomly allocated into a traditional care group, a surgical wound dressing group, and a modified surgical wound dressing group. Each group comprised 28 patients. The following outcomes were observed and analyzed: infection rate, wound closure time, dressing change frequency, cost of wound care...

  17. [Application of laser speckle perfusion imaging in predicting wound healing time of burn patients]. (United States)

    Jiang, M J; Chu, Z G; Xie, Q H; Huang, W W; Ruan, J J; Xie, W G


    Objective: To explore the application effect of laser speckle perfusion imaging (LSPI) in predicting wound healing time of burn patients. Methods: LSPI was performed in 84 adult burn patients hospitalized in department of burns of Tongren Hospital of Wuhan University & Wuhan Third Hospital within post injury hour (PIH) 24 to 72 to detect the blood perfusion values of the wounds. The wound healing time was recorded. The 128 wounds were divided into superficial group (wound healing time shorter than or equal to 14 d, n=57) and deep group (wound healing time longer than 14 d and shorter than or equal to 28 d, n=71) according to the healing time. The blood perfusion values of the two groups were compared. Data were processed with t test or chi-square test. The receiver operating characteristic (ROC) curve was drawn and Youden index was calculated to determine the optimal critical blood perfusion value of wound healing time of the two groups, and the validity of the critical value was assessed by Kappa consistency test. Results: (1) The blood perfusion value of woundsin superficial group was (6.8±1.8) perfusion unit (PU), which was significantly higher than (3.5±1.3) PU in deep group (t=11.404, Phealing time was 0.931 (with 95% confidence interval 0.887-0.975, Phealing time of the two groups, with sensitivity of 76.9% and specificity of 94.7%. (3) The healing time of 44 wounds predicted was shorter than or equal to 14 d, and the healing time of 84 wounds predicted was longer than 14 d and shorter than or equal to 28 d, while the actual number of wounds was 57 and 71, respectively. The Kappa coefficient of consistency test was 0.754 (Phealing time of burn wounds.

  18. Photobiomodulation improves cutaneous wound healing in an animal model of type II diabetes. (United States)

    Byrnes, Kimberly R; Barna, Lauren; Chenault, V Michelle; Waynant, Ronald W; Ilev, Ilko K; Longo, Leonardo; Miracco, Clelia; Johnson, Bryan; Anders, Juanita J


    We investigated the effects of photobiomodulation (PBM) on cutaneous wound healing in an animal model of type II diabetes, Psammomys obesus (Sand Rats). 632-nm light has been established as the most effective wavelength for treatment of cutaneous wounds; however, the inconsistent efficacy of PBM may be due to inadequate treatment parameter selection. Using 632-nm light, an initial series of experiments were done to establish optimal treatment parameters for this model. Following creation of bilateral full-thickness skin wounds, non-diabetic Sand Rats were treated with PBM of differing dosages. Wound healing was assessed according to wound closure and histological characteristics of healing. Optimal treatment parameters were then used to treat type II diabetic Sand Rats while a diabetic control group received no irradiation. In order to elucidate the mechanism behind an improvement in wound healing, expression of basic fibroblast growth factor (bFGF) was assessed. Significant improvement in wound healing histology and wound closure were found following treatment with 4 J/cm(2) (16 mW, 250-sec treatments for 4 consecutive days; p wounds in the diabetic group in comparison to the non-irradiated diabetic group. Quantitative analysis of bFGF expression at 36 h post-injury revealed a threefold increase in the diabetic and non-diabetic Sand Rats after PBM. The results demonstrate that PBM at an energy density of 4 J/cm(2) is effective in improving the healing of cutaneous wounds in an animal model of type II diabetes, suggesting that PBM (632 nm, 4 J/cm(2)) would be effective in treating chronic cutaneous wounds in diabetic patients.

  19. Wounding alters blood chemistry parameters and skin mineralocorticoid receptors in house sparrows (Passer domesticus). (United States)

    Lattin, Christine R; DuRant, Sarah E; Romero, L Michael


    Because skin is an important physical barrier against pathogens, the ability to quickly and effectively heal wounds directly impacts an animal's health. The hormone corticosterone (CORT) has many complex effects on immune function and can slow wound healing. It has been suggested that CORT's role during wound healing may be to act as a "brake" on inflammation and cell proliferation. This project aimed to clarify the role of CORT in the healing process by quantifying concentrations of its two intracellular receptors, glucocorticoid receptors (GR) and mineralocorticoid receptors (MR), in the skin of wounded (n = 9) or unwounded (n = 8) house sparrows (Passer domesticus) using radioligand binding assays. We also quantified GR and MR in liver, spleen and pectoralis muscle, as well as several blood chemistry parameters, hypothesizing that wounding would alter whole-body energy use. One day post-wounding, wounded birds had higher blood glucose and lower aspartate aminotransferase (a marker indicating muscle damage or catabolism) compared to controls, which may be related to animals' changing metabolic needs in response to lymphocyte and macrophage recruitment at the wound site. Birds had significantly decreased MR, but not GR, in the skin of wounded legs compared to the skin of unwounded legs. There was also a trend towards lower MR in wounded skin compared to unwounded birds. Receptors in the three other tissues did not differ between groups. This study suggests that decreasing the skin's sensitivity to CORT immediately after wounding may be a necessary part of the normal healing process in wild birds. © 2015 Wiley Periodicals, Inc.

  20. Evaluation of wound healing potential of methanolic Crinum jagus bulb extract

    Directory of Open Access Journals (Sweden)

    Sunday Ositadimma Udegbunam


    Full Text Available Crinum jagus (J. Thomps. Dandy commonly called Harmattan or St. Christopher's lily belonging to the family Lilliaceae is widely used traditionally in Southeastern Nigeria for treatment of skin sores. This study investigated the wound healing potentials of methanolic Crinum jagus bulb extract (MCJBE using incision, excision and dead space wound healing models. Phytochemical screening showed the presence of alkaloids, glycosides, tannins, saponins in the extract but absence of flavonoids. In the incision and dead space wound models, rats were dosed orally with 300 mg/kg body weight (bw of 10 and 5% of methanolic Crinum jagus bulb extract (MCJBE solution, respectively, while in the excision wound model, rats were treated topically with 10 and 5% methanolic Crinum jagus bulb extract ointments (MCJBEO, respectively. The 10% MCJBE gave significantly (p<0.05 highest percentage rate of wound contraction, shortest re-epithelialization and complete healing time when compared with 5% MCJBE and reference drug, framycetin sulphate. The extract of Crinum jagus showed significant (p<0.05 concentration-dependent wound healing activity in incision, dead space and excision wound models. No contaminating microbial organism was isolated from wound sites of the rats dosed and treated with MCJBE throughout the study period. At day 7 post infliction of excision wound, histomorphological and histochemical studies revealed more fibroblasts and type 1 collagen deposits in wound site sections of rats treated with both 10 and 5% MCJBEO while those of the control showed more inflammatory cells and fewer type 1 collagen deposits. At day 14 post infliction of excision wound, more epithelial regeneration with overlying keratin were seen in the histological sections of wounds of rats treated with both 10 and 5% MCJBEO while histochemical study showed more type 1 collagen deposits in wound site sections of rats in 10% MECJ treated group. This study established that methanolic

  1. Wound dressings: selecting the most appropriate type. (United States)

    Broussard, Karen C; Powers, Jennifer Gloeckner


    Appropriate wound dressing selection is guided by an understanding of wound dressing properties and an ability to match the level of drainage and depth of a wound. Wounds should be assessed for necrosis and infection, which need to be addressed prior to selecting an ideal dressing. Moisture-retentive dressings include films, hydrogels, hydrocolloids, foams, alginates, and hydrofibers and are useful in a variety of clinical settings. Antimicrobial-impregnated dressings can be useful in wounds that are superficially infected or are at higher risk for infection. For refractory wounds that need more growth stimulation, tissue-engineered dressings have become a viable option in the past few decades, especially those that have been approved for burns, venous ulcers, and diabetic ulcers. As wounds heal, the ideal dressing type may change, depending on the amount of exudate and depth of the wound; thus success in wound dressing selection hinges on recognition of the changing healing environment.

  2. Comparison of silver nylon wound dressing and silver sulfadiazine in partial burn wound therapy. (United States)

    Abedini, Fereydoon; Ahmadi, Abdollah; Yavari, Akram; Hosseini, Vahid; Mousavi, Sarah


    The study aims to perform a comparative assessment of two types of burn wound treatment. To do the assessment, patients with partial thickness burn wounds with total body surface area nylon wound dressing or silver sulfadiazine cream. Efficacy of treatment, use of analgesics, number of wound dressing change, wound infection and final hospitalisation cost were evaluated. The study showed silver nylon wound dressing significantly reduced length of hospital stay, analgesic use, wound infection and inflammation compared with silver sulfadiazine. © 2012 The Authors. International Wound Journal © 2012 John Wiley & Sons Ltd and Inc.

  3. Pediatric tracheotomy wound complications: incidence and significance. (United States)

    Jaryszak, Eric M; Shah, Rahul K; Amling, June; Peña, Maria T


    To determine the incidence and to describe wound complications and associated risk factors of pediatric tracheotomy. Retrospective case series. Freestanding tertiary care academic pediatric hospital. Sixty-five consecutive children undergoing tracheotomy over 15 months. Postoperative wound complications objectively and independently documented by an advanced practice nurse specializing in tracheotomy care. Secondary outcome measures included comorbidities, mortality rates, and wound status after subsequent examinations and management. The mean (SEM) patient age at tracheotomy was 45 (8.7) months (median age, 9.1 months). The most common indication for tracheotomy was pulmonary disease (36.9%), followed by neurologic impairment and laryngeal abnormalities. There were 19 patients (29%) with and 46 patients (71%) without wound complications. There were no significant differences between the 2 groups in age (P = .68) or weight (P = .55); however, infants younger than 12 months had an increased complication rate (39% vs. 17%, P = .04). The type of tracheotomy tube was predictive of postoperative wound complications (P = .02). All patients with wounds received aggressive local wound care. Five of 13 patients had complete resolution of stomal wounds, whereas 8 patients had persistent wound issues. There were 5 non-wound-related mortalities. With attempts to classify tracheotomy wound breakdowns as reportable events, including never events, increasing emphasis is being placed on posttracheotomy care. This study demonstrates that wound breakdown in pediatric tracheotomy patients is common. These complications can be mitigated, although not prevented completely, with aggressive wound surveillance and specialized wound care.

  4. Bioimpedance measurement based evaluation of wound healing. (United States)

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


    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.

  5. Assessment of skin wound healing with a multi-aperture camera (United States)

    Nabili, Marjan; Libin, Alex; Kim, Loan; Groah, Susan; Ramella-Roman, Jessica C.


    A clinical trial was conducted at the National Rehabilitation Hospital on 15 individuals to assess whether Rheparan Skin, a bio-engineered component of the extracellular matrix of the skin, is effective at promoting healing of a variety of wounds. Along with standard clinical outcome measures, a spectroscopic camera was used to assess the efficacy of Rheparan skin. Gauzes soaked with Rheparan skin were placed on volunteers wounds for 5 minutes twice weekly for four weeks. Images of the wounds were taken using a multi spectral camera and a digital camera at baseline and weekly thereafter. Spectral images collected at different wavelengths were used combined with optical skin models to quantify parameters of interest such as oxygen saturation (SO2), water content, and melanin concentration. A digital wound measurement system (VERG) was also used to measure the size of the wound. 9 of the 15 measured subjects showed a definitive improvement post treatment in the form of a decrease in wound area. 7 of these 9 individuals also showed an increase in oxygen saturation in the ulcerated area during the trial. A similar trend was seen in other metrics. Spectral imaging of skin wound can be a valuable tool to establish wound-healing trends and to clarify healing mechanisms.

  6. Effect of virgin fatty oil of Pistacia lentiscus on experimental burn wound's healing in rabbits. (United States)

    Djerrou, Zouhir; Maameri, Z; Hamdi-Pacha, Y; Serakta, M; Riachi, F; Djaalab, H; Boukeloua, A


    This study aimed to assess the efficiency of the virgin fatty oil of Pistacia lentiscus (PLVFO) for burn wounds healing. It was carried out on 6 adult male New Zealand rabbits. Four burn wounds of deep third degree were made on the back of each animal. The first was not treated and served as control (CRL group); the others were covered immediately after burning procedure by 0.5g of one of the following products: Vaseline gel (VAS group), Madecassol(®) cream 1% (MAD group) or 1ml of PLVFO (PLVFO group). The treatments were repeated once daily until complete healing. For four days post burns, the percentage of wound contraction was assessed. Also, the different healing times were noted. The results showed that both PLVFO and Madecassol(®) significantly accelerated wound healing activity compared to wounds dressed with Vaseline and the untreated wounds. However, the level of wound contraction was significantly higher and the healing time was faster in PLVFO group than those of the MAD group, VAS group and CRL group. The different epithelization periods obtained in days were respectively: 30±3.94 (PLVFO group), 33.5±3.78 (MAD group), 34.66±3.88 (VAS group) and 37.16±3.54 (CRL group). We conclude that Pistacia lentiscus virgin fatty oil promotes significantly (p< 0.05) wound contraction and reduces epithelization period in rabbit model.

  7. Gene expression profiling of cutaneous wound healing

    Directory of Open Access Journals (Sweden)

    Wang Ena


    Full Text Available Abstract Background Although the sequence of events leading to wound repair has been described at the cellular and, to a limited extent, at the protein level this process has yet to be fully elucidated. Genome wide transcriptional analysis tools promise to further define the global picture of this complex progression of events. Study Design This study was part of a placebo-controlled double-blind clinical trial in which basal cell carcinomas were treated topically with an immunomodifier – toll-like receptor 7 agonist: imiquimod. The fourteen patients with basal cell carcinoma in the placebo arm of the trial received placebo treatment consisting solely of vehicle cream. A skin punch biopsy was obtained immediately before treatment and at the end of the placebo treatment (after 2, 4 or 8 days. 17.5K cDNA microarrays were utilized to profile the biopsy material. Results Four gene signatures whose expression changed relative to baseline (before wound induction by the pre-treatment biopsy were identified. The largest group was comprised predominantly of inflammatory genes whose expression was increased throughout the study. Two additional signatures were observed which included preferentially pro-inflammatory genes in the early post-treatment biopsies (2 days after pre-treatment biopsies and repair and angiogenesis genes in the later (4 to 8 days biopsies. The fourth and smallest set of genes was down-regulated throughout the study. Early in wound healing the expression of markers of both M1 and M2 macrophages were increased, but later M2 markers predominated. Conclusion The initial response to a cutaneous wound induces powerful transcriptional activation of pro-inflammatory stimuli which may alert the host defense. Subsequently and in the absence of infection, inflammation subsides and it is replaced by angiogenesis and remodeling. Understanding this transition which may be driven by a change from a mixed macrophage population to predominately M2

  8. β-glucan enriched bath directly stimulates the wound healing process in common carp (Cyprinus carpio L.)

    DEFF Research Database (Denmark)

    Przybylska, Dominika Alicja; Schmidt, Jacob; Jiménez, Natalia Ivonne Vera


    activated in all wounds regardless of treatment. Expression of all three interleukins was highly up regulated in control wounded muscle already at day 1 post-wounding and decreased at subsequent time-points. The reverse was the case with control wounded skin, where expression increased from day 1 through......Wound healing is a complex and well-organized process in which physiological factors and immune mechanisms are involved. A number of different immune modulators have been found to enhance the non-specific defence system in vertebrates, among which β-glucans are the most powerful and extensively...... investigated. The aim of the present study was to investigate the biological impact of two different commercially available β glucan containing products on the wound healing process in carp. Throughout a two week experiment fish were kept either untreated (control), or in water supplemented with the two...

  9. Antibiotics and antiseptics for surgical wounds healing by secondary intention. (United States)

    Norman, Gill; Dumville, Jo C; Mohapatra, Devi Prasad; Owens, Gemma L; Crosbie, Emma J


    treatments or wounds within the oral or aural cavities. Two review authors independently performed study selection, risk of bias assessment and data extraction. Eleven studies with a total of 886 participants were included in the review. These evaluated a range of comparisons in a range of surgical wounds healing by secondary intention. In general studies were small and some did not present data or analyses that could be easily interpreted or related to clinical outcomes. These factors reduced the quality of the evidence.Two comparisons compared different iodine preparations with no antiseptic treatment and found no clear evidence of effects for these treatments. The outcome data available were limited and what evidence there was low quality.One study compared a zinc oxide mesh dressing with a plain mesh dressing. There was no clear evidence of a difference in time to wound healing between groups. There was some evidence of a difference in measures used to assess wound infection (wound with foul smell and number of participants prescribed antibiotics) which favoured the zinc oxide group. This was low quality evidence.One study reported that sucralfate cream increased the likelihood of healing open wounds following haemorrhoidectomy compared to a petrolatum cream (RR: 1.50, 95% CI 1.13 to 1.99) over a three week period. This evidence was graded as being of moderate quality. The study also reported lower wound pain scores in the sucralfate group.There was a reduction in time to healing of open wounds following haemorrhoidectomy when treated with Triclosan post-operatively compared with a standard sodium hypochlorite solution (mean difference -1.70 days, 95% CI -3.41 to 0.01). This was classed as low quality evidence.There was moderate quality evidence that more open wounds resulting from excision of pyomyositis abscesses healed when treated with a honey-soaked gauze compared with a EUSOL-soaked gauze over three weeks' follow-up (RR: 1.58, 95% CI 1.03 to 2.42). There was also

  10. Wound cleansing for pressure ulcers. (United States)

    Moore, Zena E H; Cowman, Seamus


    Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the elderly, malnourished or acutely ill, who cannot reposition themselves. Pressure ulcers impose a significant financial burden on health care systems and negatively affect quality of life. Wound cleansing is considered an important component of pressure ulcer care. This systematic review seeks to answer the following question: what is the effect of wound cleansing solutions and wound cleansing techniques on the rate of healing of pressure ulcers? For this third update, we searched the Cochrane Wounds Group Specialised Register (searched 3 January 2013); The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library 2012, Issue 12); Ovid MEDLINE (2010 to November Week 3 2012); Ovid MEDLINE (In-Process & Other Non-Indexed Citations December 31, 2012); Ovid EMBASE (2010 to 2012 Week 52); and EBSCO CINAHL (2010 to 21 December 2012). Randomised controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion if they reported an objective measure of pressure ulcer healing. Two review authors extracted data independently and resolved disagreements through discussion. A structured narrative summary of the included studies was conducted. For dichotomous outcomes, risk ratio (RR), plus 95% confidence intervals (CI) were calculated; for continuous outcomes, mean difference (MD), plus 95% CI were calculated. Meta analysis was not conducted because of the small number of diverse RCTs identified. Two review authors independently assessed each included study using the Cochrane Collaboration tool for assessing risk of bias. One additional eligible study was identified from the updated searches, one study was added to the table of excluded studies. A total of three studies (169 participants) met the inclusion criteria for the

  11. Peripheral surgical wounding and age-dependent neuroinflammation in mice.

    Directory of Open Access Journals (Sweden)

    Zhipeng Xu

    Full Text Available Post-operative cognitive dysfunction is associated with morbidity and mortality. However, its neuropathogenesis remains largely to be determined. Neuroinflammation and accumulation of β-amyloid (Aβ have been reported to contribute to cognitive dysfunction in humans and cognitive impairment in animals. Our recent studies have established a pre-clinical model in mice, and have found that the peripheral surgical wounding without the influence of general anesthesia induces an age-dependent Aβ accumulation and cognitive impairment in mice. We therefore set out to assess the effects of peripheral surgical wounding, in the absence of general anesthesia, on neuroinflammation in mice with different ages. Abdominal surgery under local anesthesia was established in 9 and 18 month-old mice. The levels of tumor necrosis factor-α (TNF-α, interleukin-6 (IL-6, Iba1 positive cells (the marker of microglia activation, CD33, and cognitive function in mice were determined. The peripheral surgical wounding increased the levels of TNF-α, IL-6, and Iba1 positive cells in the hippocampus of both 9 and 18 month-old mice, and age potentiated these effects. The peripheral surgical wounding increased the levels of CD33 in the hippocampus of 18, but not 9, month-old mice. Finally, anti-inflammatory drug ibuprofen ameliorated the peripheral surgical wounding-induced cognitive impairment in 18 month-old mice. These data suggested that the peripheral surgical wounding could induce an age-dependent neuroinflammation and elevation of CD33 levels in the hippocampus of mice, which could lead to cognitive impairment in aged mice. Pending further studies, anti-inflammatory therapies may reduce the risk of postoperative cognitive dysfunction in elderly patients.

  12. Wound healing properties of Copaifera paupera in diabetic mice (United States)

    Amorim, Jorge Luis; Figueiredo, Janaína de Barros; Amaral, Ana Claudia Fernandes; Barros, Eliane Gouvêa de Oliveira; Palmero, Célia; MPalantinos, Maria Athana; Ramos, Aline de Souza; Ferreira, José Luiz Pinto; Silva, Jefferson Rocha de Andrade; Benjamim, Claudia Farias; Basso, Silvia Luciane; Nasciutti, Luiz Eurico


    Copaifera oleoresin is one of the most used natural products in popular medicine all over the world. Among other effects (i.e., anti-inflammatory, antinociceptive, microbicidal) one of the most well-known is its wound healing capacity. However, the mechanism by which the oleoresin presents its effect is still not clear. In this study, our aim was to evaluate the wound healing capacity of oleoresin obtained from Copaifera paupera, its mechanism of action and identify its major components. For these purposes, diabetic Swiss Webster mice were topically treated with oleoresin (100, 150 or 200 mg/kg) for 14 consecutive days after an excision was performed in the back of the mice. Cytokines, wound retraction and histological evaluation were conducted at 3, 7 and 10 days (for cytokines); 0, 3, 7, 10 and 14 days (for wound retraction); and 7 and 14 days (for histological evaluation). Our data indicate that oleoresin significantly reduced production of MCP-1 and TNF-α at days 7 and 10 post-excision and increased IL-10 production at both days. All treatments demonstrated an effect similar or higher to that in collagenase-treated mice. Histological evaluations demonstrated that higher dose treatment resulted in better resolution and closure of the wound and higher levels of collagen deposition and indexes of re-epithelialization even when compared with the collagenase-treated group. The treatment with oleoresin from Copaifera paupera demonstrated that it is even better than an ointment routinely used for improvement of wound healing, suggesting this oleoresin as an option for use in diabetic patients. PMID:29088304

  13. Wound healing properties of Copaifera paupera in diabetic mice.

    Directory of Open Access Journals (Sweden)

    Jorge Luis Amorim

    Full Text Available Copaifera oleoresin is one of the most used natural products in popular medicine all over the world. Among other effects (i.e., anti-inflammatory, antinociceptive, microbicidal one of the most well-known is its wound healing capacity. However, the mechanism by which the oleoresin presents its effect is still not clear. In this study, our aim was to evaluate the wound healing capacity of oleoresin obtained from Copaifera paupera, its mechanism of action and identify its major components. For these purposes, diabetic Swiss Webster mice were topically treated with oleoresin (100, 150 or 200 mg/kg for 14 consecutive days after an excision was performed in the back of the mice. Cytokines, wound retraction and histological evaluation were conducted at 3, 7 and 10 days (for cytokines; 0, 3, 7, 10 and 14 days (for wound retraction; and 7 and 14 days (for histological evaluation. Our data indicate that oleoresin significantly reduced production of MCP-1 and TNF-α at days 7 and 10 post-excision and increased IL-10 production at both days. All treatments demonstrated an effect similar or higher to that in collagenase-treated mice. Histological evaluations demonstrated that higher dose treatment resulted in better resolution and closure of the wound and higher levels of collagen deposition and indexes of re-epithelialization even when compared with the collagenase-treated group. The treatment with oleoresin from Copaifera paupera demonstrated that it is even better than an ointment routinely used for improvement of wound healing, suggesting this oleoresin as an option for use in diabetic patients.

  14. Topical silver for infected wounds. (United States)

    Beam, Joel W


    Vermeulen H, van Hattem JM, Storm-Versloot MN, Ubbink DT. Topical silver for treating infected wounds. Cochrane Database Syst Rev. 2007(1);CD005486. What is the clinical evidence base for silver dressings in the management of contaminated and infected acute and chronic wounds? Investigations were identified by Cochrane Wounds Group Specialized Register (2006), CENTRAL (2006), MEDLINE (2002-2006), EMBASE (2002-2006), CINAHL (2002-2006), and digital dissertations (2006) searches. Product manufacturers were contacted to identify additional eligible studies. The search terms included wound infection, surgical wound infection, ulcer, wound healing, and silver. Each study fulfilled the following criteria: (1) The study was a randomized controlled trial of human participants that compared dressings containing silver with any dressings without silver, dressings with other antiseptics, or dressings with different dosages of silver. (2) The participants were aged 18 years and older with contaminated and infected open wounds of any cause. (3) The study had to evaluate the effectiveness of the dressings using an objective measure of healing. No language or publication status restrictions were imposed, and participants could be recruited in any care setting. Studies were excluded if the wounds were ostomies (surgically formed passages). Study quality assessment was conducted independently by 3 authors using the Dutch Institute for Health Care Improvement and Dutch Cochrane Centre protocols. Characteristics of the study, participants, interventions, and outcome measures were extracted by one author and verified by a second using a standard form. The principal outcome measure was healing (time to complete healing, rate of change in wound area and volume, number and proportion of wounds healed within trial period). Secondary measures were adverse events (eg, pain, maceration, erythema), dressing leakage, and wound odor. Based on the unique comparisons in the studies, a meta

  15. Fungating wounds: management and treatment options. (United States)

    Tandler, Suzanne; Stephen-Haynes, Jackie


    This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised. A conclusion is made that the clinician can support the patient with a fungating wound by the delivery of evidenced-based care.

  16. Trauma and wound management: gunshot wounds in horses. (United States)

    Munsterman, Amelia S; Hanson, R Reid


    Bullet wounds in horses can cause a wide array of injuries, determined by the type of projectile, the energy of the bullet on entry, and the type of tissue the bullet encounters. Treatment includes identification of all structures involved, debridement of the permanent cavity, and establishing adequate drainage. Bullet wounds should be treated as contaminated, and broad-spectrum antibiotics, including those with an anaerobic spectrum, are indicated. Although musculoskeletal injuries resulting from gunshots are most common in horses, they carry a good prognosis for survival and return to function. Published by Elsevier Inc.

  17. Vacuum-assisted closure for sternal wounds: a first-line therapeutic management approach. (United States)

    Agarwal, Jayant P; Ogilvie, Michael; Wu, Liza C; Lohman, Robert F; Gottlieb, Lawrence J; Franczyk, Mietka; Song, David H


    . The authors report the largest series of patients treated with this therapy for post-sternotomy sternal wounds and believe it is safe and effective as a first-line therapy in the management of sternal wounds. The mortality rate from their study represents the patients' underlying disease process and comorbidities and is not a reflection of complications associated with the therapy. Vacuum-assisted closure therapy has been shown to decrease wound edema, decrease the time to definitive closure, and reduce wound bacterial colony counts. The authors have implemented the therapy for most patients with sternal wounds/mediastinitis at their institution, and believe it should be a standard protocol in the first-line management of these types of wounds.

  18. [Efficacy of photodynamic antimicrobial therapy for wound flora and wound healing of pressure sore with pathogen infection]. (United States)

    Wang, Chaoliang; Huang, Sufang; Zhu, Tao; Sun, Xuesheng; Zou, Yong; Wang, Yingzhen


    To explore the efficacy of photodynamic antimicrobial therapy in the treatment of pressure sore with pathogen infection. A total of 42 pressure sore patients with pathogen infection were divided randomly into experimental and control groups (n = 21 each). Fufanghuangbai liquid was used for external application with control group. In the experimental group, wound was treated with Fufanghuangbai liquid wet dressing and irradiated by semiconductor laser 30 min late. The distance from semiconductor laser probe to wound site was 10-15 cm, 20 min twice daily, continuous exposure to 7 days for 1 course. The results of bacterial culture and epidermal growth factor (EGF) expression of wound granulation tissue were observed before and after treatment. And the changes of healing rate of pressure sore were measured at post-treatment in each group. The positive rates of bacterial culture, rates of change around wound inflammation, healing rate of days 7 and 14, the high expression of EGF on healing wound granulation tissue was 9.75%, (32.2% ± 5.8%), (89.1% ± 5.6%), (12.4% ± 2.9%), (34.7% ± 3.6%), 14/21 in the treatment group versus 51.2%, (17.8% ± 2.0%), (57.3% ± 2.6%), (5.1% ± 1.1%), (10.5% ± 2.4%), 2/21 in the control group respectively. The inter-group differences were statistically significant (P Photodynamic antimicrobial therapy is an effective method for pressure sore with pathogen infection. Wound healing is promoted through an up-regulation of EGF.

  19. Wounds written in the genes

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    Adele Nunziante Cesàro


    Full Text Available In a psychodynamic framework, the authors reflect upon the transmission of the BRCA1/2 genes’ mutation. This mutation exposes carrier women to the risk of developing, during their lives, a form of breast and/or ovarian cancer. This illness has already affected different women of their family causing wounds inscribed in soma and in psyche. These wounds are significant in woman’s decision making of prevention strategies. It is very hard to care wounds inscribed in one’s own history that became a threat for femininity. The authors use women’s narration as material to be analysed in order to highlight the meanings linked to the mutation between identity, group and generational dimensions.

  20. [Application of modern wound dressings in the treatment of chronic wounds]. (United States)

    Triller, Ciril; Huljev, Dubravko; Smrke, Dragica Maja


    Chronic and acute infected wounds can pose a major clinical problem because of associated complications and slow healing. In addition to classic preparations for wound treatment, an array of modern dressings for chronic wound care are currently available on the market. These dressings are intended for the wounds due to intralesional physiological, pathophysiological and pathological causes and which failed to heal as expected upon the use of standard procedures. Classic materials such as gauze and bandage are now considered obsolete and of just historical relevance because modern materials employed in wound treatment, such as moisture, warmth and appropriate pH are known to ensure optimal conditions for wound healing. Modern wound dressings absorb wound discharge, reduce bacterial contamination, while protecting wound surrounding from secondary infection and preventing transfer of infection from the surrounding area onto the wound surface. The use of modern wound dressings is only justified when the cause of wound development has been established or chronic wound due to the underlying disease has been diagnosed. Wound dressing is chosen according to wound characteristics and by experience. We believe that the main advantages of modern wound dressings versus classic materials include more efficient wound cleaning, simpler placement of the dressing, reduced pain to touch, decreased sticking to the wound surface, and increased capacity of absorbing wound exudate. Modern wound dressings accelerate the formation of granulation tissue, reduce the length of possible hospital stay and facilitate personnel work. Thus, the overall cost of treatment is reduced, although the price of modern wound dressings is higher than that of classic materials. All types of modern wound dressings, their characteristics and indications for use are described.

  1. Recent advances in topical wound care

    Directory of Open Access Journals (Sweden)

    Sujata Sarabahi


    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.

  2. Wound healing in animal models: review article

    Directory of Open Access Journals (Sweden)

    Fariba Jaffary


    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.

  3. Clinical safety and effectiveness evaluation of a new antimicrobial wound dressing designed to manage exudate, infection and biofilm. (United States)

    Metcalf, Daniel G; Parsons, David; Bowler, Philip G


    The objective of this work was to evaluate the safety and effectiveness of a next-generation antimicrobial wound dressing (NGAD; AQUACEL ® Ag+ Extra™ dressing) designed to manage exudate, infection and biofilm. Clinicians were requested to evaluate the NGAD within their standard protocol of care for up to 4 weeks, or as long as deemed clinically appropriate, in challenging wounds that were considered to be impeded by suspected biofilm or infection. Baseline information and post-evaluation dressing safety and effectiveness data were recorded using standardised evaluation forms. This data included wound exudate levels, wound bed appearance including suspected biofilm, wound progression, skin health and dressing usage. A total of 112 wounds from 111 patients were included in the evaluations, with a median duration of 12 months, and biofilm was suspected in over half of all wounds (54%). After the introduction of the NGAD, exudate levels had shifted from predominantly high or moderate to low or moderate levels, while biofilm suspicion fell from 54% to 27% of wounds. Wound bed coverage by tissue type was generally shifted from sloughy or suspected biofilm towards predominantly granulation tissue after the inclusion of the NGAD. Stagnant (65%) and deteriorating wounds (27%) were shifted to improved (65%) or healed wounds (13%), while skin health was also reported to have improved in 63% of wounds. High levels of clinician satisfaction with the dressing effectiveness and change frequency were accompanied by a low number of dressing-related adverse events (n = 3; 2·7%) and other negative observations or comments. This clinical user evaluation supports the growing body of evidence that the anti-biofilm technology in the NGAD results in a safe and effective dressing for the management of a variety of challenging wound types. © 2016 Inc and John Wiley & Sons Ltd.

  4. Emergency Wound Care After a Natural Disaster (United States)

    ... Disease Transmission in Pet Shelters Protect Your Pets Emergency Wound Care After a Natural Disaster Language: English ( ... Tweet Share Compartir Print-and-Go Fact Sheet Emergency Wound Care After a Natural Disaster [NOTE: Health ...

  5. Novel wound sealants: biomaterials and applications. (United States)

    Peng, Henry T; Shek, Pang N


    Wound sealants provide an excellent alternative for closing surgical and non-surgical wounds, as well as stopping external bleeding for prehospital trauma injuries. Numerous biomaterials have been investigated to address specific requirements for their use as suitable wound sealants. This article focuses on the development of new wound sealant biomaterials and recent advances in the surgical applications of wound sealants. In the past 5 years, many new sealant materials had been reported, including keratin, mussel-adhesive proteins, dendrimers and in situ-forming hydrogels. Fibrin sealants remain the most clinically studied for a variety of surgical procedures, while clinical experience with wound sealants for orthopedic surgery is limited. Both liquid and solid wound sealants have been developed and found effective by possessing strong adhesive properties. Biocompatible and biodegradable wound sealants hold much promise in eventually replacing sutures in most surgical procedures.

  6. Wound-healing and antimicrobial properties of dichloromethane fraction of Dialium guineense (Wild) fruit coat. (United States)

    Okeke, Nnadi Charles; Udeani, Theophilus Kc; Onyebuchi, Ugwu Linus


    This research established the scientific bases for the folkloric use of the neglected Dialium guineense fruit coat in wound and microbial infection management in Nigeria. The phytochemical analysis of the crude extract, fractions and sub-fractions was performed by standard methods. Agar well diffusion protocol was adopted for the antimicrobial assay while the wound healing properties was determined by full thickness skin excision wound model. Phytochemical analysis showed high relative proportion of alkaloids (6.05 ± 0.98 %), saponins (3.91 ± 0.02 %) and tannins (1.86 ± 0.05 %). The only active fraction (DF) and sub-fraction (DF-5) were effective against Gram-positive (inhibition zone diameters, IZDs, 8-10 mm and 11-15 mm) and Gram-negative (IZDs, 15-19 mm and 16-21 mm) bacteria and fungi (6-8 mm) compared with 20-24 mm and 18-19 mm of the standard (ciprofloxacin) respectively. Fifty mg/kg of the DF-5 showed nearly equal percentage wound healing post-surgery days to Cicatrin®. The 50 mg/kg dose of DF and DF-5 showed more than 50 % wound healing at 10(th) day post-surgery, 50 mg/kg crude extract showed 54 % on day 14 while distilled water showed 56 % wound healing on day 17 with no sign of infection in all animal groups. All the treatments were significantly (P<0.01) different from control (distilled water) in wound healing by the 10(th) and 17(th) post-surgery days. The studies revealed that the fruit coat, which hitherto was treated as wastes could be explored for antimicrobial and wound healing properties against the backdrop of continually emerging antibiotic resistant strains of microorganisms.

  7. Soft tissue wound healing around teeth and dental implants. (United States)

    Sculean, Anton; Gruber, Reinhard; Bosshardt, Dieter D


    To provide an overview on the biology and soft tissue wound healing around teeth and dental implants. This narrative review focuses on cell biology and histology of soft tissue wounds around natural teeth and dental implants. The available data indicate that: (a) Oral wounds follow a similar pattern. (b) The tissue specificities of the gingival, alveolar and palatal mucosa appear to be innately and not necessarily functionally determined. (c) The granulation tissue originating from the periodontal ligament or from connective tissue originally covered by keratinized epithelium has the potential to induce keratinization. However, it also appears that deep palatal connective tissue may not have the same potential to induce keratinization as the palatal connective tissue originating from an immediately subepithelial area. (d) Epithelial healing following non-surgical and surgical periodontal therapy appears to be completed after a period of 7–14 days. Structural integrity of a maturing wound between a denuded root surface and a soft tissue flap is achieved at approximately 14-days post-surgery. (e) The formation of the biological width and maturation of the barrier function around transmucosal implants requires 6–8 weeks of healing. (f) The established peri-implant soft connective tissue resembles a scar tissue in composition, fibre orientation, and vasculature. (g) The peri-implant junctional epithelium may reach a greater final length under certain conditions such as implants placed into fresh extraction sockets versus conventional implant procedures in healed sites. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Non-interventional study to investigate the efficacy and safety of Tegaderm™ Matrix in the treatment of patients with therapy-refractory chronic wounds. (United States)

    Weindorf, Maren; Körber, Andreas; Klode, Joachim; Dissemond, Joachim


    Despite a variety of therapeutic approaches, many patients with chronic wounds remain refractory to treatment. Products such as Tegaderm™ Matrix were developed especially for such patients to alter the wound environment and reactivate the stagnant wound healing process. In this prospective post-authorization observational product study, a total of 314 patients with therapy-refractory chronic wounds of various origins were evaluated. Beside to the wound area reduction and healing rate, the occurrence of adverse events was documented. On average the wounds were 10 months old. The average wound size was 17.3 cm(2) (median 6.3 cm(2)) at the initial visit. In the course of treatment the wound size decreased to 13.0 cm(2) (median 3.5 cm(2)) and was finally reduced to 9.3 cm(2) (median 0.9 cm(2)) at end of the study. Taking the criteria of the European Wound Management Association for improving the quality of clinical studies into consideration, a wound size reduction of at least 50% is the parameter for successful treatment of chronic wounds. This study demonstrated a wound size reduction of at least 50% for 72.9% of the patients with therapy-refractory chronic wounds when treated with Tegaderm™ Matrix. The safety profile was evaluated; only 4.7% of the patients experienced a treatment-related adverse event such as a burning sensation. The results of the study demonstrate that Tegaderm™ Matrix along with treatment of underlying causes is a well tolerated wound dressing promoting wound size reduction up to healing for the majority of patients with previously therapy-refractory chronic wounds. © The Authors • Journal compilation © Blackwell Verlag GmbH, Berlin.

  9. Wound healing and all-cause mortality in 958 wound patients treated in home care. (United States)

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


    Skin wounds are associated with significant morbidity and mortality. Data are, however, not readily available for benchmarking, to allow prognostic evaluation, and to suggest when involvement of wound-healing experts is indicated. We, therefore, conducted an observational cohort study 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. During the first 3 weeks of therapy, healing was most likely to occur in surgical wounds (surgical vs. other wounds: adjusted hazard ratio [AHR] 2.21, 95% confidence interval 1.50-3.23), while from 3 weeks to 3 months of therapy, cancer wounds, and pressure ulcers were least likely to heal (cancer vs. other wounds: AHR 0.12, 0.03-0.50; pressure vs. other wounds: AHR 0.44, 0.27-0.74). Cancer wounds and pressure ulcers were further associated with a three times increased probability of mortality compared with other wounds (cancer vs. other wounds: AHR 3.19, 1.35-7.50; pressure vs. other wounds: AHR 2.91, 1.56-5.42). In summary, the wound type was found to be a significant predictor of healing and mortality with cancer wounds and pressure ulcers being associated with poor prognosis. © 2015 by the Wound Healing Society.

  10. Negative Pressure Wound Therapy in the Management of Combat Wounds: A Critical Review (United States)

    Maurya, Sanjay; Bhandari, Prem Singh


    Significance: Wounds sustained in a combat trauma often result in a composite tissue loss. Combat injuries, due to high energy transfer to tissues, lead to trauma at multiple anatomical sites. An early wound cover is associated with lower rate of infections and a faster wound healing. The concept of negative pressure wound therapy (NPWT) in the management of combat-related wounds has evolved from the civilian trauma and the wounds from nontraumatic etiologies. Recent Advances: Encouraged by the results of NPWT in noncombat-related wounds, the military surgeons during Operation Iraqi Freedom and Operation Enduring Freedom used this novel method in a large percentage of combat wounds, with gratifying results. The mechanism of NPWT in wound healing is multifactorial and often complex reconstructive procedure can be avoided in a combat trauma setting. Critical Issues: Wounds sustained in military trauma are heavily contaminated with dirt, patient clothing, and frequently associated with extensive soft tissue loss and osseous destruction. Delay in evacuation during an ongoing conflict carries the risk of systemic infection. Early debridement is indicated followed by delayed closure of wounds. NPWT helps to provide temporary wound cover during the interim period of debridement and wound closure. Future Directions: Future area of research in combat wounds is related to abdominal trauma with loss of abdominal wall. The concept of negative pressure incisional management system in patients with a high risk of wound breakdown following surgery is under review, and may be of relevance in combat wounds. PMID:27679749

  11. 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


    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

  12. 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


    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

  13. The mechanical fingerprint of murine excisional wounds. (United States)

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


    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

  14. Clinical assessment of wounds and antimicrobial susceptibility ...

    African Journals Online (AJOL)

    A study was conducted at two veterinary surgeries to investigate the common aerobic bacteria associated with dog bite wounds in dogs, and to determine their antimicrobial susceptibilities. From each wound, two swabs were collected for bacterial culture and cytology. A total of 50 wounds from 50 dogs were examined, with ...

  15. The evolution of negative pressure wound therapy: negative pressure wound therapy with instillation. (United States)

    Wolvos, Tom


    Complex wounds pose a considerable burden to patients and the health-care system. The development of negative pressure wound therapy (NPWT) has revolutionised the treatment of these wounds. NPWT helps create a favourable wound healing environment by removing infectious material, decreasing oedema and promoting perfusion and granulation tissue formation. Additionally, NPWT has been reported to help reduce time to wound closure and length of hospital stay. Modifications of this foundation of wound care have added intermittent instillation with a dwell time to NPWT (NPWTi-d). This new system offers more comprehensive wound care through automated wound irrigation, allowing more control over the wound environment and the opportunity to deliver topical wound solutions directly to the affected tissues. A comparison between the two therapies, NPWT and NPWTi-d, is described, and two real-world applications of NPWTi-d are presented.

  16. Emergency Management of Chronic Wounds (United States)


    arteriography if angioplasty , stenting , or bypass are considered. Contrast angiography, although still considered the gold standard [10] of pre-inter...disease Medications (corticosteroids, immunosuppressants etc.) Cigarette smoking Stress ( mechanical /emotional) Inadequate/inappropriate wound care...the process of recanalization valves are damaged, yielding essentially open tubes [24]. Five years after a significant DVT, 40% to 70% of pa- tients

  17. An improvised wound closure system

    NARCIS (Netherlands)

    Lapid, Oren


    BACKGROUND: Skin stretching harnesses the same viscoelastic properties of the skin as expansion, with the difference that the forces are applied externally and not internally. An improvised system for wound closure is presented. METHOD: The system is assembled using silicone vascular loops used as

  18. Collagen: Benefits in wound Healing

    Indian Academy of Sciences (India)

    First page Back Continue Last page Overview Graphics. Collagen: Benefits in wound Healing. As substrate for haemostasis. As chemotactic to cellular elements. As scaffold for transition to mature collagen production & alignment. Resistant to degradation. As template for cellular attachment, migration and proliferation.

  19. Extracellular matrix and wound healing. (United States)

    Maquart, F X; Monboisse, J C


    Extracellular matrix has been known for a long time as an architectural support for the tissues. Many recent data, however, have shown that extracellular matrix macromolecules (collagens, elastin, glycosaminoglycans, proteoglycans and connective tissue glycoproteins) are able to regulate many important cell functions, such as proliferation, migration, protein synthesis or degradation, apoptosis, etc., making them able to play an important role in the wound repair process. Not only the intact macromolecules but some of their specific domains, that we called "Matrikines", are also able to regulate many cell activities. In this article, we will summarize main findings showing the effects of extracellular matrix macromolecules and matrikines on connective tissue and epithelial cells, particularly in skin, and their potential implication in the wound healing process. These examples show that extracellular matrix macromolecules or some of their specific domains may play a major role in wound healing. Better knowledge of these interactions may suggest new therapeutic targets in wound healing defects. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  20. Post-operative wound infection in ~ developing country

    African Journals Online (AJOL)

    or intensive-care unit. There are two ... distances and everpresent transport problems, together with the ... b y Sa b in et G a tew a. y u n d er licen ce gra n ted b y th e P u b lish er ( d a ted. 2012) .... to patient delay, transportation difficulties and.

  1. Bacteriology of Post Caesarean Wound Infection in a Specialist ...

    African Journals Online (AJOL)

    Sierra Leone Journal of Biomedical Research. Journal Home · ABOUT THIS JOURNAL · Advanced Search · Current Issue · Archives · Journal Home > Vol 5, No 1 (2013) >. Log in or Register to get access to full text downloads.

  2. Microbiology of post-operative wound infection in implant surgery ...

    African Journals Online (AJOL)

    Conclusion: Staphylococcus aureus remains the most important microorganism responsible for POWI in implants and prosthesis. Resistant strains have emerged and previously reserved drugs have become first line. Anaerobic organisms remain important isolates were such are feasible. Metronidazole should be a ...

  3. Aerobic pathogenic bacteria in post-operative wounds at Moi ...

    African Journals Online (AJOL)

    Background: The emergence of bacterial antimicrobial resistance associated with acquired infections has made the choice of empirical therapy more difficult and expensive, hence the need for continuous research to determine their sensitivity patterns. Objectives: To identify the common aerobic pathogenic bacteria in ...

  4. Negative Pressure Wound Therapy on Closed Surgical Wounds With Dead Space


    Suh, Hyunsuk; Lee, A-Young; Park, Eun Jung; Hong, Joon Pio


    Background Closed incisional wound surgery frequently leaves dead space under the repaired skin, which results in delayed healing. The purpose of this study was to evaluate the effect of negative pressure wound therapy (NPWT) on incisional wounds with dead space after primary closure by evaluating the fluid volume through the suction drain, blood flow of the skin, tensile strength, and histology of the wounds. Methods Bilateral 25-cm-long incisional wounds with dead space were created on the ...

  5. Wound management in obese patients after median sternotomy using a negativ pressure wound dressing


    Navasardyan, Artashes


    Obesity is the most commonly identified risk factor for development of wound infection after median sternotomy. In these patients in the postoperative period, due to overweight, an enormous mechanical stress is exercised on the wound. This leads to an interruption of the continuity of the skin wound and facilitates penetration of the skin flora into the deep wound layers. This increases the risk of patients developing a wound infection (Gardlund A mechanism). A new method for the preventi...

  6. Wound care dressings and choices for care of wounds in the home. (United States)

    Adkins, Carrie L


    Statistics from various resources report that many patients in home healthcare settings have wounds. These vary from surgical, pressure, neuropathic, trauma, stasis, and venous wounds. These require the assessment, knowledge, and expertise of a clinician to assist them with wound care management. The purpose of this article is to identify and categorize types of wound care products appropriate for the various types of wounds that clinicians care for and manage in the home.

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

    Directory of Open Access Journals (Sweden)

    Kiefer Ann-Kathrin


    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.

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

    Directory of Open Access Journals (Sweden)

    Ayesha Bhatia


    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.

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

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


    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.

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

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


    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. PMID:27382602

  11. Wound-healing and potential anti-keloidal properties of the latex of Calotropis procera (Aiton) Asclepiadaceae in rabbits. (United States)

    Aderounmu, A O; Omonisi, A E; Akingbasote, J A; Makanjuola, M; Bejide, R A; Orafidiya, L O; Adelusola, K A


    Calotropis Procera (CP) has been used in the management of toothache, fresh skin burns, gum bleeding as well as others to make it qualify as a medicinal plant. This study was designed to assess its wound-healing property in rabbits and its potentials for anti keloidal activity.Fresh latex of Calotropis were obtained and evaluated phytochemically. Fifteen male rabbits were used and four excisional wounds were created on each rabbit. The rabbits were divided into five groups of three each. Group 1 was the negative control and received no treatment. The wounds of group 2 animals were treated with 2mL of Calotropis latex; group 3 with 2mL honey; and group 4 with a mixture of 1ml honey and 1 mL of the latex. The animals in group 5 were given 2mg triamcinolone intramuscularly. All the groups had their wounds treated daily for 21 days. The wounds' diameters were measured on the day of wound creation, thereafter on days 7, 14 and 21 post wound creation. Biopsies of the wounds were taken on days 3 and 21 and viewed histologically. Phytochemical study of the latex revealed the presence of glycosides, tannins and alkaloids. The wounds were found to be significantly (pCalotropis latex revealed the presence of florid granulation tissues on day 3 while there was a marked reduction in quantity and size of collagen fibres on day 21 post wound creation which was comparable with what was seen for the triamcinolone-treated group.The general effect of Calotropis latex on wound-healing was noted. Likewise it's similarity to that of triamcinolone, an anti-keloidal agent; this makes it a probable candidate for future anti-keloidal study using a suitable model.

  12. [Chronic wounds as a public health problem]. (United States)

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


    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

  13. Impaired wound healing in mice lacking the basement membrane protein nidogen 1. (United States)

    Baranowsky, Anke; Mokkapati, Sharada; Bechtel, Manuela; Krügel, Jenny; Miosge, Nicolai; Wickenhauser, Claudia; Smyth, Neil; Nischt, Roswitha


    Nidogens 1 and 2 are ubiquitous basement membrane (BM) components, whose interactions in particular with laminin, collagen IV and perlecan have been considered important for BM formation. Genetic deletion of either NID gene does not reveal BM alterations suggesting compensatory roles for nidogens 1 and 2. However, neurological deficits in nidogen 1 null mice, not seen in the absence of nidogen 2, also suggest isoform specific functions. To test this further, skin wound healing which requires BM reformation was studied in adult nidogen 1 deficient mice. Although re-epithelialization was not altered, the newly formed epidermis showed marked hyperproliferation and a delay in differentiation at day 10 post injury. Distinct to control wounds, there was also considerable alpha-smooth muscle actin staining in the dermis of nidogen 1 deficient wounds at this time point. Further, laminin deposition and distribution of the beta1 and beta4 integrin chains were also significantly altered whereas the deposition of other BM components, including nidogen 2, was unchanged. Surprisingly, these differences between control and mutant wounds at day 10 post wounding did not affect the ultrastructural appearance of the dermo-epidermal BM suggesting a non-structural role for nidogen 1 in wound repair.

  14. Timer switch to convert suction apparatus for negative pressure wound therapy application

    Directory of Open Access Journals (Sweden)

    Surath Amarnath


    Full Text Available Background: Negative pressure wound therapy (NPWT is an established modality in the treatment of chronic wounds, open fractures, and post-operative wound problems. This method has not been widely used due to the high cost of equipment and consumables. This study demonstrates an indigenously developed apparatus which gives comparable results at a fraction of the cost. Readily available materials are used for the air-tight dressing. Materials and Methods: Equipment consists of suction apparatus with adjustable pressure valve set to a pressure 125-150 mmHg. An electronic timer switch with a sequential working time of 5 min and a standby time of 3 min provides the required intermittent negative pressure. Readily available materials such as polyvinyl alcohol sponge, suction drains and steridrapes were used to provide an air tight wound cover. Results: A total of 90 cases underwent 262 NPWT applications from 2009 to 2014. This series, comprised of 30 open fractures, 21 post-operative and 39 chronic wounds. The wound healing rate in our study was comparable to other published studies using NPWT. Conclusion: The addition of electronic timer switch will convert a suction apparatus into NPWT machine, and the results are equally effective compared to more expensive counter parts. The use of indigenous dressing materials reduces the cost significantly.

  15. Protein matrices for wound dressings = (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

  16. Use of Multiple Adjunctive Negative Pressure Wound Therapy Modalities to Manage Diabetic Lower-Extremity Wounds. (United States)

    Cole, Windy E


    Objective: Various treatment options exist for wound healing; however, clinical assessment of the patient and the wound environment must be considered before determining an optimal wound treatment plan. Negative pressure wound therapy alone and/or with an instilled topical solution can be effective in adjunctive management of acute and chronic wounds. Hyperbaric oxygen therapy has also been shown to contribute to the wound-healing process. A pilot evaluation using a multistep approach of adjunctive negative pressure wound therapy with instillation and a dwell time, standard negative pressure wound therapy, and hyperbaric oxygen therapy was explored to manage postsurgical, diabetic lower-extremity wounds with a significant bioburden. Methods: Three diabetic patients with lower-extremity ulcers were treated after surgical intervention. Multistep wound therapy consisted of (1) negative pressure wound therapy with instillation of normal saline with a 20-minute dwell time, followed by 2 hours of negative pressure at -150 mm Hg for 3 to 4 days; (2) 1 to 3 weeks of continuous negative pressure at -150 mm Hg; and (3) multiple treatments of hyperbaric oxygen therapy. Results: After surgery, wound closure was achieved within 4 weeks postinitiation of multistep wound therapy. All patients regained limb function and recovered with no long-term sequelae. Conclusions: In these 3 cases, a multistep wound therapy approach after surgery resulted in successful outcomes; however, larger prospective studies are needed to demonstrate the potential efficacy of this approach in the postsurgical management of complex, diabetic lower-extremity wounds.

  17. Pathological axes of wound repair: Gastrulation revisited

    Directory of Open Access Journals (Sweden)

    Aller Maria-Angeles


    Full Text Available Abstract Post-traumatic inflammation is formed by molecular and cellular complex mechanisms whose final goal seems to be injured tissue regeneration. In the skin -an exterior organ of the body- mechanical or thermal injury induces the expression of different inflammatory phenotypes that resemble similar phenotypes expressed during embryo development. Particularly, molecular and cellular mechanisms involved in gastrulation return. This is a developmental phase that delineates the three embryonic germ layers: ectoderm, endoderm and mesoderm. Consequently, in the post-natal wounded skin, primitive functions related with the embryonic mesoderm, i.e. amniotic and yolk sac-derived, are expressed. Neurogenesis and hematogenesis stand out among the primitive function mechanisms involved. Interestingly, in these phases of the inflammatory response, whose molecular and cellular mechanisms are considered as traces of the early phases of the embryonic development, the mast cell, a cell that is supposedly inflammatory, plays a key role. The correlation that can be established between the embryonic and the inflammatory events suggests that the results obtained from the research regarding both great fields of knowledge must be interchangeable to obtain the maximum advantage.

  18. Determination of effective miRNAs in wound healing in an experimental Rat Model. (United States)

    Coskunpinar, E; Arkan, H; Dedeoglu, B G; Aksoz, I; Polat, E; Araz, T; Aydos, A; Oztemur, Y; Akbas, F; Onaran, I


    The larvae of Lucilia sericata have been used for centuries as medicinal maggots in the healing of wounds. The present study aimed to screen potential microRNAs related to ES-induced wound healing in rat skin wounds and to investigate the potential mechanisms contributing to accelerated wound healing. Healthy, male, 12 weeks old Wistar albino rats weighing 250-300 g were supplied by the Animal Experimental Center. All animal studies were performed in accordance with the NIH Guide for the Care and Use of Laboratory Animals. Wistar albino rats were treated by ES after post wounding and the differentially expressed miRNAs in wound biopsies were screened by microarray analysis at the end of treatments for 4,7 and 10 days. In addition, bioinformatics approaches were used to identify the potential target genes of differentially expressed miRNAs and the functions of their target genes. We found a significant up-regulation of rno-miR-99a* and rno-mir-877 in response to ES treatment. Further investigation of rno-miR-99a* and rno-mir-877 and their target genes (TGFa, TNF, TAGLN, MAPK1, MMP-9) implicated in present study could provide new insight for an understanding lead to the development of new treatment strategies. The identified miRNAs can be new biomarkers for ES- induced wound healing.

  19. Temporary Rectal Stenting for Management of Severe Perineal Wounds in Two Dogs. (United States)

    Skinner, Owen T; Cuddy, Laura C; Coisman, James G; Covey, Jennifer L; Ellison, Gary W

    Perineal wounds in dogs present a challenge due to limited local availability of skin for closure and constant exposure to fecal contaminants. This report describes temporary rectal stenting in two dogs following severe perineal wounds. Dog 1 presented with a 4 × 4 cm full-thickness perineal slough secondary to multiple rectal perforations. A 12 mm internal diameter endotracheal tube was placed per-rectum as a temporary stent to minimize fecal contamination. The stent was removed 18 days after placement, and the perineal wound had healed at 32 days post-stent placement, when a minor rectal stricture associated with mild, intermittent tenesmus was detected. Long-term outcome was deemed good. Dog 2 presented with multiple necrotic wounds with myiasis, circumferentially surrounding the anus and extending along the tail. A 14 mm internal diameter endotracheal tube was placed per-rectum. The perineal and tail wounds were managed with surgical debridement and wet-to-dry and honey dressings prior to caudectomy and negative pressure wound therapy (NPWT). Delayed secondary wound closure and stent removal were performed on day six without complication. Long-term outcome was deemed excellent. Temporary rectal stenting may be a useful technique for fecal diversion to facilitate resolution of complex perineal injuries, including rectal perforation.

  20. The Efficacy and Safety of Tetrachlorodecaoxide in Comparison with Super-oxidised Solution in Wound Healing

    Directory of Open Access Journals (Sweden)

    Romil Parikh


    Full Text Available BackgroundSome of the relatively newer, more efficacious, and potent topical wound dressing solutions include tetrachlorodecaoxide and super-oxidised solution. This study compares the efficacy and safety of these two drugs.MethodsThis is a block-randomised, double blind, parallel-arm, post-marketing study. One hundred fifty patients with ulcers (75 blocks uniform for sex, ulcer aetiology, diabetes mellitus, and wound area score were randomised into the two treatment arms. Patients were observed for eight weeks with weekly assessments. One hundred and twenty patients completed the study. Wound healing was objectively assessed by measurement of wound area, scoring of wound exudation and tissue type, and using the pressure ulcer scale of healing Tool (validated for multiple wound aetiologies. Subjective improvement in pain was noted using a visual analogue scale. Both groups were compared using Mann–Whitney U test on all indicators.ResultsDifference in change in wound tissue type in the two groups was significant (α=0.05 by intention-to-treat (ITT and per-protocol (PP analysis at the end of week two (ITT and PP, P0.05. No study-related adverse events were observed.ConclusionsBoth drugs are efficacious. Tetrachlorodecaoxide yields healthy granulation tissue earlier. Both drugs appear to be safe for application.

  1. Perforating Cervical, Thoracic, and Abdominal Wounds. (United States)

    Risselada, Marije


    Most body wall injuries in small animals are caused by bite wounds or vehicular trauma. Penetrating gunshot wounds are less common. Bite wounds are characterized by massive trauma to the body wall with associated defects, but fewer internal injuries, whereas gunshot wounds are associated with a high number of internal injuries. Vehicular accident injuries are caused by blunt force trauma and can lead to both body wall defects and internal organ damage. Impalement injuries are rare and are typically associated with internal damage. Exploratory surgery, herniorrhaphy, and aggressive wound management are recommended in the treatment of these injuries. Published by Elsevier Inc.

  2. Enhancement of skin wound healing with decellularized scaffolds loaded with hyaluronic acid and epidermal growth factor

    Energy Technology Data Exchange (ETDEWEB)

    Su, Zhongchun; Ma, Huan; Wu, Zhengzheng [Institute of Biomedicine, National Engineering Research Center of Genetic Medicine, Key Lab for Genetic Medicine of Guangdong Province, Jinan University, Guangzhou 510632 (China); Zeng, Huilan [Department of Hematology, The First Affiliated Hospital, Jinan University, Guangzhou 510632 (China); Li, Zhizhong [Department of Bone, The First Affiliated Hospital, Jinan University, Guangzhou 510632 (China); Wang, Yuechun; Liu, Gexiu [Department of Physiology, School of Medicine, Jinan University, Guangzhou 510632 (China); Xu, Bin; Lin, Yongliang; Zhang, Peng [Grandhope Biotech Co., Ltd., Building D, #408, Guangzhou International Business Incubator, Guangzhou Science Park, Guangzhou 510663, Guangdong (China); Wei, Xing, E-mail: [Institute of Biomedicine, National Engineering Research Center of Genetic Medicine, Key Lab for Genetic Medicine of Guangdong Province, Jinan University, Guangzhou 510632 (China)


    Current therapy for skin wound healing still relies on skin transplantation. Many studies were done to try to find out ways to replace skin transplantation, but there is still no effective alternative therapy. In this study, decellularized scaffolds were prepared from pig peritoneum by a series of physical and chemical treatments, and scaffolds loaded with hyaluronic acid (HA) and epidermal growth factor (EGF) were tested for their effect on wound healing. MTT assay showed that EGF increased NIH3T3 cell viability and confirmed that EGF used in this study was biologically active in vitro. Scanning electron microscope (SEM) showed that HA stably attached to scaffolds even after soaking in PBS for 48 h. ELISA assay showed that HA increased the adsorption of EGF to scaffolds and sustained the release of EGF from scaffolds. Animal study showed that the wounds covered with scaffolds containing HA and EGF recovered best among all 4 groups and had wound healing rates of 49.86%, 70.94% and 87.41% respectively for days 10, 15 and 20 post-surgery compared to scaffolds alone with wound healing rates of 29.26%, 42.80% and 70.14%. In addition, the wounds covered with scaffolds containing EGF alone were smaller than no EGF scaffolds on days 10, 15 and 20 post-surgery. Hematoxylin–Eosin (HE) staining confirmed these results by showing that on days 10, 15 and 20 post-surgery, the thicker epidermis and dermis layers were observed in the wounds covered with scaffolds containing HA and EGF than scaffolds alone. In addition, the thicker epidermis and dermis layers were also observed in the wounds covered with scaffolds containing EGF than scaffolds alone. Skin appendages were observed on day 20 only in the wound covered with scaffolds containing HA and EGF. These results demonstrate that the scaffolds containing HA and EGF can enhance wound healing. - Highlights: • HA can increase the adsorption of EGF to decellularized scaffolds. • HA can sustain the release of EGF from

  3. Effectiveness of helium-neon laser irradiation on viability and cytotoxicity of diabetic-wounded fibroblast cells. (United States)

    Houreld, N N; Abrahamse, H


    This study investigated the effectiveness of helium-neon (He-Ne) laser irradiation at increasing intervals on diabetic-induced wounded human skin fibroblast cells (WS1) at a morphological, cellular, and molecular level. The controversies over light therapy can be explained by the differing exposure regimens and models used. No therapeutic window for dosimetry and mechanism of action has been determined at the level of individual cell types, particularly in diabetic cells in vitro. WS1 cells were used to simulate an in vitro wounded diabetic model. The effect of the frequency of He-Ne irradiation (632.8 nm) at a fluence of 5 J/cm(2) was determined by analysis of cell morphology, viability, cytotoxicity, and DNA damage. Cells were irradiated using three different protocols: they were irradiated at 30 min only; irradiated twice, at 30 min and at 24 h; or irradiated twice, at 30 min and at 72 h post-wound induction. A single exposure to 5 J/cm(2) 30 min post-wound induction increased cellular damage. Irradiation of cells at 30 min and at 24 h post-wound induction decreased cellular viability, cytotoxicity, and DNA damage. However, complete wound closure as well as an increase in viability and a decrease in cytotoxicity and DNA damage occurs when cells were irradiated at 30 min and at 72 h post-wound induction. Wounded diabetic WS1 cells irradiated to 5 J/cm(2) showed increased cellular repair when irradiated with adequate time between irradiations, allowing time for cellular response mechanisms to take effect. Therefore, the irradiation interval was shown to play an important role in wound healing in vitro and should be taken into account.

  4. In vivo diabetic wound healing potential of nanobiocomposites containing bamboo cellulose nanocrystals impregnated with silver nanoparticles. (United States)

    Singla, Rubbel; Soni, Sourabh; Patial, Vikram; Kulurkar, Pankaj Markand; Kumari, Avnesh; S, Mahesh; Padwad, Yogendra S; Yadav, Sudesh Kumar


    In diabetes, hyperglycemic state immensely hinders the wound healing. Here, nanobiocomposites (NCs) developed by impregnation of in situ prepared silver nanoparticles in the matrix of bamboo cellulose nanocrystals were investigated for their ability to hasten the progress of healing events in streptozotocin induced diabetic mice model. Wounds treated with topically applied NCs (hydrogels) showed full recovery (98-100%) within 18days post wounding in contrast to the various control groups where incomplete healing (88-92%) was noticed. Biochemical estimations documented a marked decrease in the levels of pro-inflammatory cytokines IL-6 and TNF-α leading to decreased inflammation in NCs treated mice. Significantly increased expression of collagen and growth factors (FGF, PDGF, VEGF) upon NCs treatment resulted in improved re-epithelialization, vasculogenesis and collagen deposition as compared to control groups. Hence, developed nanobiocomposites showcased potential to serve as highly effective and biocompatible wound dressings for diabetic patients. Copyright © 2017 Elsevier B.V. All rights reserved.

  5. Βeta-glucans promote wound healing in common carp (Cyprinus carpio L.)

    DEFF Research Database (Denmark)

    Przybylska, Dominika Alicja; Schmidt, Jacob; Nielsen, Michael Engelbrecht

    of the experiment the fish were kept in ordinary tap water or in tap water supplemented with two different β–glucans to a final concentration of 0.1µg/ml. Skin and muscle tissue from wounded and unwounded areas were collected at 24 hours, 3 days and 2 weeks post injury and subjected to real-time RT...... weight, water solubility, degree of branching and polymer length [3]. In vitro studies in mammals have shown that β-glucans directly activate leukocytes by increasing phagocytosis, cytotoxicity, antimicrobial and antiviral activity and reactive oxygen production. In addition, β-glucans affect the wound......-associated molecular pattern) cause inflammation. The aim of this study was to investigate capability to modulate immune parameters during the wound healing processes of two commercially available β–glucans. In in vivo study, carps of ~50g were anaesthetised and wounded with 5mm biopsy punches. During the extent...

  6. Beta-glucan bath promote wound healing in common carp (Cyprinus carpio L.)

    DEFF Research Database (Denmark)

    Przybylska, Dominika Alicja; Schmidt, Jacob; Nielsen, Michael Engelbrecht

    of the experiment the fish were kept in ordinary tap water or in tap water supplemented with two different β–glucans to a final concentration of 0.1µg/ml. Skin and muscle tissue from wounded and unwounded areas were collected at 24 hours, 3 days and 2 weeks post injury and subjected to real-time RT...... weight, water solubility, degree of branching and polymer length [3]. In vitro studies in mammals have shown that β-glucans directly activate leukocytes by increasing phagocytosis, cytotoxicity, antimicrobial and antiviral activity and reactive oxygen production. In addition, β-glucans affect the wound......-associated molecular pattern) cause inflammation. The aim of this study was to investigate capability to modulate immune parameters during the wound healing processes of two commercially available β–glucans. In in vivo study, carps of ~50g were anaesthetised and wounded with 5mm biopsy punches. During the extent...

  7. First evidence of sternal wound biofilm following cardiac surgery.

    Directory of Open Access Journals (Sweden)

    Haytham Elgharably

    Full Text Available Management of deep sternal wound infection (SWI, a serious complication after cardiac surgery with high morbidity and mortality incidence, requires invasive procedures such as, debridement with primary closure or myocutaneous flap reconstruction along with use of broad spectrum antibiotics. The purpose of this clinical series is to investigate the presence of biofilm in patients with deep SWI. A biofilm is a complex microbial community in which bacteria attach to a biological or non-biological surface and are embedded in a self-produced extracellular polymeric substance. Biofilm related infections represent a major clinical challenge due to their resistance to both host immune defenses and standard antimicrobial therapies. Candidates for this clinical series were patients scheduled for a debridement procedure of an infected sternal wound after a cardiac surgery. Six patients with SWI were recruited in the study. All cases had marked dehiscence of all layers of the wound down to the sternum with no signs of healing after receiving broad spectrum antibiotics post-surgery. After consenting patients, tissue and/or extracted stainless steel wires were collected during the debridement procedure. Debrided tissues examined by Gram stain showed large aggregations of Gram positive cocci. Immuno-fluorescent staining of the debrided tissues using a specific antibody against staphylococci demonstrated the presence of thick clumps of staphylococci colonizing the wound bed. Evaluation of tissue samples with scanning electron microscope (SEM imaging showed three-dimensional aggregates of these cocci attached to the wound surface. More interestingly, SEM imaging of the extracted wires showed attachment of cocci aggregations to the wire metal surface. These observations along with the clinical presentation of the patients provide the first evidence that supports the presence of biofilm in such cases. Clinical introduction of the biofilm infection concept in deep

  8. Management of wound infection after lumbar arthrodesis maintaining the instrumentation

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    Asdrubal Falavigna


    Full Text Available OBJECTIVE: To determinate whether a surgical protocol with immediate extensive debridement, closed irrigation system and antibiotic therapy would be effective to achieve healing of deep wound infection without removing the instrumentation.METHODS: Prospective cohort study with 19 patients presenting degenerative spinal stenosis or degenerative spondylolisthesis, who developed infection after posterior lumbar arthrodesis. The diagnosis was confirmed by a microbial culture from subfascial lumbar fluid and/or blood. Patients were treated with a protocol of wound exploration, extensive flushing and debridement, placement of a closed irrigation system that was maintained for five days and intravenous antibiotics. The instrumentation system was not removed.RESULTS: Mean age was 59.31 (±13.17 years old and most patients were female (94.7%; 18/19. The mean period for the identification of the infection was 2 weeks and 57.9% underwent a single wound exploration. White blood count, erythrocyte sedimentation rate and C-reactive protein showed a significant decrease post-treatment when compared to pre-treatment values. A significant reduction of erythrocyte sedimentation rate and C-reactive protein was also observed at the final evaluation. No laboratory test was useful to predict the need for more than one debridement.CONCLUSION: Patients with wound infection after instrumentation can be treated without removal of the instrumentation through wound exploration, extensive flushing, debridement of necrotic tissue, closed irrigation system during 5 days and proper antibiotic therapy. The blood tests were not useful to predict surgical re-interventions.

  9. Physics of Wound Healing I: Energy Considerations

    CERN Document Server

    Apell, S Peter; Papazoglou, Elisabeth S; Pizziconi, Vincent


    Wound healing is a complex process with many components and interrelated processes on a microscopic level. This paper addresses a macroscopic view on wound healing based on an energy conservation argument coupled with a general scaling of the metabolic rate with body mass M as M^{\\gamma} where 0 <{\\gamma}<1. Our three main findings are 1) the wound healing rate peaks at a value determined by {\\gamma} alone, suggesting a concept of wound acceleration to monitor the status of a wound. 2) We find that the time-scale for wound healing is a factor 1/(1 -{\\gamma}) longer than the average internal timescale for producing new material filling the wound cavity in corresondence with that it usually takes weeks rather than days to heal a wound. 3) The model gives a prediction for the maximum wound mass which can be generated in terms of measurable quantities related to wound status. We compare our model predictions to experimental results for a range of different wound conditions (healthy, lean, diabetic and obses...

  10. Challenges in the Treatment of Chronic Wounds. (United States)

    Frykberg, Robert G; Banks, Jaminelli


    Significance: Chronic wounds include, but are not limited, to diabetic foot ulcers, venous leg ulcers, and pressure ulcers. They are a challenge to wound care professionals and consume a great deal of healthcare resources around the globe. This review discusses the pathophysiology of complex chronic wounds and the means and modalities currently available to achieve healing in such patients. Recent Advances: Although often difficult to treat, an understanding of the underlying pathophysiology and specific attention toward managing these perturbations can often lead to successful healing. Critical Issues: Overcoming the factors that contribute to delayed healing are key components of a comprehensive approach to wound care and present the primary challenges to the treatment of chronic wounds. When wounds fail to achieve sufficient healing after 4 weeks of standard care, reassessment of underlying pathology and consideration of the need for advanced therapeutic agents should be undertaken. However, selection of an appropriate therapy is often not evidence based. Future Directions: Basic tenets of care need to be routinely followed, and a systematic evaluation of patients and their wounds will also facilitate appropriate care. Underlying pathologies, which result in the failure of these wounds to heal, differ among various types of chronic wounds. A better understanding of the differences between various types of chronic wounds at the molecular and cellular levels should improve our treatment approaches, leading to better healing rates, and facilitate the development of new more effective therapies. More evidence for the efficacy of current and future advanced wound therapies is required for their appropriate use.

  11. Wound bed preparation from a clinical perspective

    Directory of Open Access Journals (Sweden)

    A S Halim


    Full Text Available Wound bed preparation has been performed for over two decades, and the concept is well accepted. The ′TIME′ acronym, consisting of tissue debridement, i nfection or inflammation, moisture balance and edge effect, has assisted clinicians systematically in wound assessment and management. While the focus has usually been concentrated around the wound, the evolving concept of wound bed preparation promotes the treatment of the patient as a whole. This article discusses wound bed preparation and its clinical management components along with the principles of advanced wound care management at the present time. Management of tissue necrosis can be tailored according to the wound and local expertise. It ranges from simple to modern techniques like wet to dry dressing, enzymatic, biological and surgical debridement. Restoration of the bacterial balance is also an important element in managing chronic wounds that are critically colonized. Achieving a balance moist wound will hasten healing and correct biochemical imbalance by removing the excessive enzymes and growth factors. This can be achieved will multitude of dressing materials. The negative pressure wound therapy being one of the great breakthroughs. The progress and understanding on scientific basis of the wound bed preparation over the last two decades are discussed further in this article in the clinical perspectives.

  12. Late sensory function after intraoperative capsaicin wound instillation

    DEFF Research Database (Denmark)

    Aasvang, E K; Hansen, J B; Kehlet, H


    BACKGROUND: Intense capsaicin-induced C-fiber stimulation results in reversible lysis of the nerve soma, thereby making capsaicin wound instillation of potential interest for the treatment of post-operative pain. Clinical histological and short-term sensory studies suggest that the C-fiber function...... is partly re-established after skin injection of capsaicin. However, no study has evaluated the long-term effects of wound instillation of purified capsaicin on sensory functions. METHODS: Patients included in a double-blind placebo-controlled randomized study of the analgesic effect of capsaicin after...... treatment. RESULTS: Twenty (100%) capsaicin and 16 (76%) placebo-treated patients were seen at the 2 1/2 year follow-up. Hyperalgesia was seen in five capsaicin- vs. one placebo-treated patient (P=0.2). The mechanical detection threshold was significantly increased on the operated side in the capsaicin vs...

  13. Stress predicts the trajectory of wound healing in living kidney donors as measured by high-resolution ultrasound. (United States)

    Maple, Hannah; Chilcot, Joseph; Lee, Vanessa; Simmonds, Shanique; Weinman, John; Mamode, Nizam


    Psychological stress has been shown to be an influential factor on the rate of wound healing; however these findings have been demonstrated predominantly on artificially created wounds. Due to the absence of major co-morbidities, living kidney donors are a unique group in which to study this relationship. This study investigated the effect of preoperative stress and personality on surgical wound healing through the use of high-resolution ultrasound. Living kidney donors due to undergo a hand-assisted laparoscopic donor nephrectomy were asked to complete the Perceived Stress Scale, the Life Orientation Test-Revised and the Ten Item Personality Inventory prior to surgery. High-resolution ultrasound scans of surgical wounds were performed on the first three post-operative days and once following discharge (mean=15.3 days; s.d. 2.8). Two measurements from each image were obtained: wound width (size of wound) and median intensity (a marker of tissue fluid). Latent Growth Curve Models (LGCMs) were used to evaluate wound healing. 52 living kidney donors participated. Higher pre-operative life stress, lower optimism and lower conscientiousness were associated with delayed wound healing in living kidney donors for both outcomes. Increased emotional stability was associated with faster wound healing as demonstrated by a change in median intensity. Possible confounding factors, such as age, BMI, smoking status, local anaesthetic use and wound drain placement were not influential. This study, which measured wound healing in a novel patient sample using a novel technique, has demonstrated a negative association between stress and wound healing and the positive influence of optimism, conscientiousness and emotional stability. Copyright © 2014 Elsevier Inc. All rights reserved.

  14. [Suspected anaphylaxis by wound treatment with polyhexanide derivate wound products]. (United States)

    Schrøder, Morten A; Kirketerp-Møller, Klaus; Winther, Lone


    Only four cases of anaphylaxis triggered by polyhexanide have been reported in the literature. We report a case of anaphylaxis in a Danish patient treated with polyhexanide derivate (Prontosan) wound products. We emphasise the importance of intramuscular injection of adrenaline as part of the treatment protocol in the initial phase of anaphylaxis and stress the importance of being aware of polyhexanide as a potential trigger of anaphylaxis.

  15. Open Wound Drainage Versus Wound Excision on the Modern Battlefield (United States)


    penicillin coverage to eliminate the threat of invasive bacteremia by hemolytic streptococcus , presumably produced conditions that insured unimpeded...pyemia, septicemia and erysipelas remained major causes of death in the war wounded (10). Friedrich originated the idea of excising the bacteria...hemolytic streptococcus in 10 to 15% of cases, but after a week in the hospital over 90% of w-unds were infected with this bacteria (12,13), and

  16. Progress in corneal wound healing (United States)

    Ljubimov, Alexander V.; Saghizadeh, Mehrnoosh


    Corneal wound healing is a complex process involving cell death, migration, proliferation, differentiation, and extracellular matrix remodeling. Many similarities are observed in the healing processes of corneal epithelial, stromal and endothelial cells, as well as cell-specific differences. Corneal epithelial healing largely depends on limbal stem cells and remodeling of the basement membrane. During stromal healing, keratocytes get transformed to motile and contractile myofibroblasts largely due to activation of transforming growth factor-β system. Endothelial cells heal mostly by migration and spreading, with cell proliferation playing a secondary role. In the last decade, many aspects of wound healing process in different parts of the cornea have been elucidated, and some new therapeutic approaches have emerged. The concept of limbal stem cells received rigorous experimental corroboration, with new markers uncovered and new treatment options including gene and microRNA therapy tested in experimental systems. Transplantation of limbal stem cell-enriched cultures for efficient re-epithelialization in stem cell deficiency and corneal injuries has become reality in clinical setting. Mediators and course of events during stromal healing have been detailed, and new treatment regimens including gene (decorin) and stem cell therapy for excessive healing have been designed. This is a very important advance given the popularity of various refractive surgeries entailing stromal wound healing. Successful surgical ways of replacing the diseased endothelium have been clinically tested, and new approaches to accelerate endothelial healing and suppress endothelial-mesenchymal transformation have been proposed including Rho kinase (ROCK) inhibitor eye drops and gene therapy to activate TGF-β inhibitor SMAD7. Promising new technologies with potential for corneal wound healing manipulation including microRNA, induced pluripotent stem cells to generate corneal epithelium, and

  17. Cefazolin concentration in surgically created wounds treated with negative pressure wound therapy compared to surgically created wounds treated with nonadherent wound dressings. (United States)

    Coutin, Julia V; Lanz, Otto I; Magnin-Bissel, Geraldine C; Ehrich, Marion F; Miller, Emily I; Werre, Stephen R; Riegel, Thomas O


    To compare cefazolin concentrations in biopsied tissue samples collected from surgically created wounds treated with negative pressure wound therapy to those collected from surgically created wounds treated with nonadherent dressings. Prospective, controlled, experimental study. Adult female spayed Beagles (n = 12). Full thickness cutaneous wounds were created on each antebrachium (n = 24). Immediately after surgery, cefazolin (22 mg/kg intravenously [IV]) was administered to each dog and continued every 8 hours during the study. The right wound was randomly assigned to group I or group II whereas the wound on the contralateral antebrachium was assigned to the other group. Group I wounds were treated with negative pressure wound therapy (NPWT) and group II wounds were treated with nonadherent dressings for 3 days. Dressings were changed and tissue biopsies obtained from wound beds at 24 hours intervals for both groups. Cefazolin wound tissue and plasma concentrations were measured by liquid chromatography mass spectrometry (LC-MS/MS). Blood samples for measuring plasma cefazolin concentrations were collected before biopsy sampling. At the time of surgery and at each subsequent bandage change, wound beds were swabbed and submitted for aerobic and anaerobic culture. After initiating cefazolin treatment, wound tissue antibiotic concentrations between treatment groups were not significantly different at any sampling time. Similarly, after initiating cefazolin treatment, plasma cefazolin concentrations were not significantly different at any sampling time for individual dogs. Using a canine experimental model, NPWT treatment of surgically created wounds does not statistically impact cefazolin tissue concentrations when compared with conventional nonadherent bandage therapy. © Copyright 2014 by The American College of Veterinary Surgeons.

  18. Rapid identification of slow healing wounds. (United States)

    Jung, Kenneth; Covington, Scott; Sen, Chandan K; Januszyk, Michael; Kirsner, Robert S; Gurtner, Geoffrey C; Shah, Nigam H


    Chronic nonhealing wounds have a prevalence of 2% in the United States, and cost an estimated $50 billion annually. Accurate stratification of wounds for risk of slow healing may help guide treatment and referral decisions. We have applied modern machine learning methods and feature engineering to develop a predictive model for delayed wound healing that uses information collected during routine care in outpatient wound care centers. Patient and wound data was collected at 68 outpatient wound care centers operated by Healogics Inc. in 26 states between 2009 and 2013. The dataset included basic demographic information on 59,953 patients, as well as both quantitative and categorical information on 180,696 wounds. Wounds were split into training and test sets by randomly assigning patients to training and test sets. Wounds were considered delayed with respect to healing time if they took more than 15 weeks to heal after presentation at a wound care center. Eleven percent of wounds in this dataset met this criterion. Prognostic models were developed on training data available in the first week of care to predict delayed healing wounds. A held out subset of the training set was used for model selection, and the final model was evaluated on the test set to evaluate discriminative power and calibration. The model achieved an area under the curve of 0.842 (95% confidence interval 0.834-0.847) for the delayed healing outcome and a Brier reliability score of 0.00018. Early, accurate prediction of delayed healing wounds can improve patient care by allowing clinicians to increase the aggressiveness of intervention in patients most at risk. © 2015 by the Wound Healing Society.

  19. Surgical Burn Wound Infections and Their Clinical Implications (United States)

    Posluszny, Joseph A.; Conrad, Peggie; Halerz, Marcia; Shankar, Ravi; Gamelli, Richard L.


    Typically, burn wound infections are classified by the organisms present in the wound within the first several days following injury or later, by routine surveillance cultures. With universal acceptance of early excision and grafting, classification of burn wound colonization in unexcised burn wounds is less relevant shifting clinical significance to open burn-related surgical wound infections (SWI). To better characterize SWIs and their clinical relevance, we identified the pathogens responsible for SWIs, their impact on rates of regrafting, and the relationship between SWI and nosocomial infection (NI) pathogens. Epidemiologic and clinical data for 71 adult patients with ≥20% TBSA burn were collected. Following excision and grafting, if a grafted site had clinical characteristics of infection, a wound culture swab was obtained and organism identified. Surveillance cultures were not obtained. SWI pathogen, anatomic location, post-burn day of occurrence and need for regrafting were compiled. A positive culture obtained from an isolated anatomic location at any time point after excision and grafting of that location was considered a distinct infection. Pathogens responsible for NIs (urinary tract infections, pneumonia, bloodstream and catheter-related bloodstream infections, pseudomembranous colitis and donor site infections) and their post-burn day were identified. The profiles of SWI pathogens and NI pathogens were then compared. Of the 71 patients included, 2 withdrew, 6 had no excision or grafting performed and 1 had incomplete data. Of the 62 remaining, 24 (39%) developed a SWI. In these 24 patients, 70 distinct infections were identified of which 46% required regrafting. Candida species (24%), Pseudomonas aeruginosa (22%), Serratia marcescens (11%) and Staphylococcus aureus (11%) comprised the majority of pathogens. The development of a SWI with the need for regrafting increased overall length of stay, area of autograft, number of operative events and was

  20. 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.


    Skin wounds are associated with significant morbidity and mortality. Data are, however, not readily available for benchmarking, to allow prognostic evaluation, and to suggest when involvement of wound-healing experts is indicated. We, therefore, conducted an observational cohort study...... 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...

  1. Multifunctional activities of KSLW synthetic antimicrobial decapeptide: Implications for wound healing (United States)

    Williams, Richard Leroy

    Wound healing is a complex process leading to the maintenance of skin integrity. Stress is known to increase susceptibility to bacterial infection, alter proinflammatory cytokine expression, and delay wound closure. Recently, antimicrobial peptides have generated interest due to their prokaryotic selectivity, decreased microbial resistance and multifunctional roles in wound healing, including fibroblast stimulation, keratinocyte migration and leukocyte migration. The objective of this dissertation project was to evaluate the effect of a synthetic antimicrobial decapeptide (KSLW) on bacterial clearance inflammation, and wound closure during stress-impaired healing. SKH-1 mice were randomly assigned to either control or restraint-stressed (RST) groups. Punch biopsy wounds (3.5 mm in diameter) were created bilaterally on the dorsal skin. Wounds were injected with 50 microL of empty carriers or KSLW prepared in Pluronic-F68, phospholipid micelles, or saline. Bacterial assays of harvested wounds were conducted on BHI agar. Wound closure was determined by photoplanimetry. Cytokine and growth factor mRNA expression was assessed with real-time RT-PCR. Human neutrophil migration assays and checkerboard analyses were performed using Transweli plates, and counting on hemacytometer. Oxidative burst activity was measured by spectrophotometric analysis of 2,7-dichlorofluorescein oxidation. KSLW-treatment resulted in significant reductions in bacterial load among RST mice, with no difference from control after 24h. The effect was sustained 5 days post-wounding, in RST mice treated with KSLW-F68. Temporal analysis of gene induction revealed reversals of stress-induced altered expression of growth factors, proinflammatory cytokines, and chemokines essential for favorable wound healing, at various time points. KSLW-treatment in RST mice demonstrated faster wound closure throughout the stress period. KSLW, at micromolar concentrations, demonstrated a significant effect on neutrophil

  2. Management of minor acute cutaneous wounds: importance of wound healing in a moist environment. (United States)

    Korting, H C; Schöllmann, C; White, R J


    Moist wound care has been established as standard therapy for chronic wounds with impaired healing. Healing in acute wounds, in particular in minor superficial acute wounds - which indeed are much more numerous than chronic wounds - is often taken for granted because it is assumed that in those wounds normal phases of wound healing should run per se without any problems. But minor wounds such as small cuts, scraps or abrasions also need proper care to prevent complications, in particular infections. Local wound care with minor wounds consists of thorough cleansing with potable tap water or normal saline followed by the application of an appropriate dressing corresponding to the principles of moist wound treatment. In the treatment of smaller superficial wounds, it appears advisable to limit the choice of dressing to just a few products that fulfil the principles of moist wound management and are easy to use. Hydroactive colloid gels combining the attributes of hydrocolloids and hydrogels thus being appropriate for dry and exuding wounds appear especially suitable for this purpose - although there is still a lack of data from systematic studies on the effectiveness of these preparations. © 2010 The Authors. Journal of the European Academy of Dermatology and Venereology © 2010 European Academy of Dermatology and Venereology.

  3. Incisional Negative Pressure Wound Therapy in High Risk Patients Undergoing Panniculectomy: A Prospective Randomized Controlled Trial (United States)


    Complications Wounds; Negative Pressure Wound Therapy; Wound Healing Delayed; Incisional; Panniculectomy; Incisional Negative Pressure Wound Therapy; Incisional Vac; Wound Vac; Obese; Renal Failure; Kidney Transplant; Complications; Wound Healing Complication

  4. Current management of wound healing

    DEFF Research Database (Denmark)

    Gottrup, F; Karlsmark, T


    While the understanding of wound pathophysiology has progressed considerably over the past decades the improvements in clinical treatment has occurred to a minor degree. During the last years, however, new trends and initiatives have been launched, and we will continue to attain new information...... in the next decade. It is the hope that increasing parts of the new knowledge from basic wound healing research will be implemented in daily clinical practice. The development of new treatment products will also continue, and especially new technologies with combined types of dressing materials or dressing...... containing active substances will be accentuated. Further developments in the management structure and education will also continue and consensus of treatment guidelines, recommendations and organization models will hopefully be achieved....

  5. Topical Application of Aloe vera Accelerated Wound Healing, Modeling, and Remodeling: An Experimental Study. (United States)

    Oryan, Ahmad; Mohammadalipour, Adel; Moshiri, Ali; Tabandeh, Mohammad Reza


    Treatment of large wounds is technically demanding and several attempts have been taken to improve wound healing. Aloe vera has been shown to have some beneficial roles on wound healing but its mechanism on various stages of the healing process is not clear. This study was designed to investigate the effect of topical application of A. vera on cutaneous wound healing in rats. A rectangular 2 × 2-cm cutaneous wound was created in the dorsum back of rats. The animals were randomly divided into 3 groups of control (n = 20), low-dose (n = 20), and high-dose (n = 20) A. vera. The control and treated animals were treated daily with topical application of saline, low-dose (25 mg/mL), and high-dose (50 mg/mL) A. vera gel, up to 10 days, respectively. The wound surface, wound contraction, and epithelialization were monitored. In each group, the animals were euthanized at 10 (n = 5), 20 (n = 5), and 30 (n = 10) days post injury (DPI). At 10, 20, and 30 DPI, the skin samples were used for histopathological and biochemical investigations; and at 30 DPI, the skin samples were also subjected for biomechanical studies. Aloe vera modulated the inflammation, increased wound contraction and epithelialization, decreased scar tissue size, and increased alignment and organization of the regenerated scar tissue. A dose-dependent increase in the tissue level of dry matter, collagen, and glycosaminoglycans' content was seen in the treated lesions, compared to the controls. The treated lesions also demonstrated greater maximum load, ultimate strength, and modulus of elasticity compared to the control ones (P vera improved the biochemical, morphological, and biomechanical characteristics of the healing cutaneous wounds in rats. This treatment option may be valuable in clinical practice.

  6. Tissue extract from Eisenia foetida as a wound-healing agent. (United States)

    Matausijć-Pisl, M; Cupić, H; Kasuba, V; Mikecin, A-M; Grdisa, M


    This study was aimed at demonstrating the influence of Eisenia foetida earthworm extract (G-90) on wound healing in an animal model. Medicinal properties of earthworms have been long known, especially in Eastern countries. Four groups of Wister rats (36 in each group) were wounded under anaesthesia; the skin was surgically incised in a circular manner (the circular incision in reference measuring 2 cm in diameter) and afterwards daily treated for 24 days in a following manner: Group 0--the control group deprived from any treatment whatsoever; Group 1--treated with physiological saline solution; Group 2--treated with Panthenol D and serving as a positive control, and Group 3--treated with G-90 (10 ng/ml). The animals were sacrificed on days 3, 6, 9, 12, 18 and 24 post wounding and the diameter of wound was measured by virtue of photometric method. The excised wounds were routinely fixed and embedded into paraffin section and dully stained for histopathological analysis. The presence of microorganisms on the wounds was assessed as well. The best antibacterial wound shielding was achieved with G-90 treatment. Besides antibacterial shielding, the wounds treated with G-90 were also protected from inflammation. G-90 was shown to shorten the inflammatory, and accelerate the proliferative and the maturation phase, stimulating thereby the regeneration of an injured epidermis. Statistical analysis revealed G-90 (p=0.018) to be superior over other treatments. Thus, Eisenia foetida earthworm extract (G90) might be considered as a new wound-healing agent suitable for use in both veterinary and human medicine practice.

  7. Wound Dressing in Maxillofacial Trauma. (United States)


    E. Cutright, Commander, Institute of Dental Research. .1 !!. -𔃾 -- 𔄁 - .4. o - o - .- ° .oo -° °° °. ,.. .. . - . . . . o o . . . o° . . ° o...agent, epinaphrine is used mostly in dental surgical procedures. Gingi-Pak (Gingi-Pak Laboratories) is a dental retraction cord which is available with...rapidly. This may be the release required for hemostatic action. The utility as a vasoconstrictor in wound dressing is questionable, and the duffusion

  8. Photobiomodulation of surgical wound dehiscence in a diabetic individual by low-level laser therapy following median sternotomy

    Directory of Open Access Journals (Sweden)

    Snehil Dixit


    Full Text Available In this single case study, we attempt to outline the possible effect of low-level laser therapy (LLLT on delayed wound healing and pain in chronic dehiscent sternotomy of a diabetic individual. The methods that were employed to evaluate changes pre and post irradiation were wound photography, wound area measurement, pressure ulcer scale of healing (PUSH, and visual analogue scale (VAS for pain. After irradiation, proliferation of healthy granulation tissue was observed with decrease in scores of PUSH for sternal dehiscence and VAS for bilateral shoulders and sternal dehiscence. We found that LLLT irradiation could be a novel method of treatment for chronic sternal dehiscence following coronary artery bypass grafting, as it augments wound healing with an early closure of the wound deficit. Hence, this might be translated into an early functional rehabilitation and decreased pain perception of an individual following surgical complication.

  9. Biofilm-infected wounds in a dog. (United States)

    Swanson, Elizabeth A; Freeman, Lynetta J; Seleem, Mohamed N; Snyder, Paul W


    A 4-year-old spayed female Mastiff was evaluated for treatment of chronic nonhealing pressure wounds over both elbow regions resulting from attempts at hypertrophic callus excision. The wound bed granulation tissue was mottled red and yellow with hyperemic, rolled epithelial edges. The right wound communicated with a large fluid pocket along the thoracic wall. The dog had an inflammatory leukogram with a left shift. The wounds were debrided, and tissue specimens were collected for histologic evaluation, microbial culture, and bacterial identification by means of molecular diagnostic techniques. The left wound was closed immediately. Calcium alginate rope with silver was packed into the right wound. Vacuum-assisted closure was applied for 6 days. Debridement was repeated, and a thoracodorsal axial pattern flap was used to cover the wound. Systemic treatment with antimicrobials was initiated, and pressure over the elbow regions was relieved. Bacterial biofilms were identified histologically in tissue specimens from both wounds. Staphylococcus intermedius, Staphylococcus epidermidis, and Streptococcus canis were cultured and identified by 16S rRNA fragment sequencing. Pyrosequencing identified multiple bacterial species and no fungal organisms. Both wounds healed successfully. Biofilms are implicated in infected orthopedic implants in veterinary patients; however, this is the first report of a bacterial biofilm in chronic wounds in a dog. In human wound care, extensive debridement is performed to disrupt the biofilm; a multimodal treatment approach is recommended to delay reformation and help clear the infection. In this case, biofilm reformation was prevented by systemic treatment with antimicrobials, by reducing local pressure on the wounds, and by wound closure.

  10. Bacterial Contribution in Chronicity of Wounds. (United States)

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


    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.

  11. Examination of the skin barrier repair/wound healing process using a living skin equivalent (LSE) model and matrix-assisted laser desorption-ionization-mass spectrometry imaging (MALDI-MSI). (United States)

    Lewis, E E L; Barrett, M R T; Freeman-Parry, L; Bojar, R A; Clench, M R


    Examination of the skin barrier repair/wound healing process using a living skin equivalent (LSE) model and matrix-assisted laser desorption/ionization-mass spectrometry imaging (MALDI-MSI) to identify lipids directly involved as potential biomarkers. These biomarkers may be used to determine whether an in vivo wound is going to heal for example if infected. An in vitro LSE model was wounded with a scalpel blade and assessed at day 4 post wounding by histology and MALDI-MSI. Samples were sectioned at wound site and were either formalin fixed paraffin embedded (FFPE) for histology or snapped frozen (FF) for MSI analysis. The combination of using an in vitro wounded skin model with MSI allowed the identification of lipids involved in the skin barrier repair/wound healing process. The technique was able to highlight lipids directly in the wound site and distinguish differences in lipid distribution between the epidermis and wound site. This novel method of coupling an in vitro LSE with MSI allowed in depth molecular analysis of the skin barrier repair/wound healing process. The technique allowed the identification of lipids directly involved in the skin barrier repair/wound healing process, indicating these biomarkers may be potentially be used within clinic. These biomarkers will help determine, which stage of the skin barrier repair/wound healing process the wound is in to provide the best treatment. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  12. Wound contraction and macro-deformation during negative pressure therapy of sternotomy wounds

    Directory of Open Access Journals (Sweden)

    Ingemansson Richard


    Full Text Available Abstract Background Negative pressure wound therapy (NPWT is believed to initiate granulation tissue formation via macro-deformation of the wound edge. However, only few studies have been performed to evaluate this hypothesis. The present study was performed to investigate the effects of NPWT on wound contraction and wound edge tissue deformation. Methods Six pigs underwent median sternotomy followed by magnetic resonance imaging in the transverse plane through the thorax and sternotomy wound during NPWT at 0, -75, -125 and -175 mmHg. The lateral width of the wound and anterior-posterior thickness of the wound edge was measured in the images. Results The sternotomy wound decreased in size following NPWT. The lateral width of the wound, at the level of the sternum bone, decreased from 39 ± 7 mm to 30 ± 6 mm at -125 mmHg (p = 0.0027. The greatest decrease in wound width occurred when switching from 0 to -75 mmHg. The level of negative pressure did not affect wound contraction (sternum bone: 32 ± 6 mm at -75 mmHg and 29 ± 6 mm at -175 mmHg, p = 0.0897. The decrease in lateral wound width during NPWT was greater in subcutaneous tissue (14 ± 2 mm than in sternum bone (9 ± 2 mm, resulting in a ratio of 1.7 ± 0.3 (p = 0.0423, suggesting macro-deformation of the tissue. The anterior-posterior thicknesses of the soft tissue, at 0.5 and 2.5 cm laterally from the wound edge, were not affected by negative pressure. Conclusions NPWT contracts the wound and causes macro-deformation of the wound edge tissue. This shearing force in the tissue and at the wound-foam interface may be one of the mechanisms by which negative pressure delivery promotes granulation tissue formation and wound healing.

  13. Adjuvant use of acoustic pressure wound therapy for treatment of chronic wounds: a retrospective analysis. (United States)

    Cole, Pamela S; Quisberg, Jennifer; Melin, M Mark


    Small studies have indicated that the addition of acoustic pressure wound therapy (APWT) to conventional wound care may hasten healing of chronic wounds. We evaluated our early clinical experience using APWT as an adjunct to conventional wound care. The study was a retrospective chart review of consecutive patients receiving APWT in addition to conventional wound care in a hospital-based, primarily outpatient setting. Medical records of all patients treated with APWT between August 2006 and October 2007 were reviewed. Analysis included the 41 patients with 52 wounds who received APWT at least 2 times per week during the study period. Statistical comparisons were made for wound dimensions, tissue characteristics, and pain at start versus end of APWT. Thirty-eight percent of wounds (N = 20) healed completely with a mean 6.8 weeks of APWT. Median wound area and volume decreased significantly (88% [P wounds with greater than 75% granulation tissue increased from 26% (n = 12) to 80% (n = 41) (P wounds (P = .006). This early experience supplementing conventional wound care with APWT suggests it may promote healing in chronic wounds, where the ordered cellular and molecular processes leading to healing have stalled.

  14. Wound Blush Obtainment Is the Most Important Angiographic Endpoint for Wound Healing. (United States)

    Utsunomiya, Makoto; Takahara, Mitsuyoshi; Iida, Osamu; Yamauchi, Yasutaka; Kawasaki, Daizo; Yokoi, Yoshiaki; Soga, Yoshimistu; Ohura, Norihiko; Nakamura, Masato


    This study aimed to assess the optimal angiographic endpoint of endovascular therapy (EVT) for wound healing. Several reports have demonstrated acceptable patency and limb salvage rates following infrapopliteal interventions for the treatment of critical limb ischemia (CLI). However, the optimal angiographic endpoint of EVT remains unclear. We conducted a subanalysis of the prospective multicenter OLIVE (Endovascular Treatment for Infrainguinal Vessels in Patients with Critical Limb Ischemia) registry investigation assessing patients who received infrainguinal EVT for CLI. We analyzed data from 185 limbs with ischemic ulcerations classified as Rutherford class 5 or 6, managed with EVT alone (i.e., not undergoing bypass surgery). The wound healing rate after EVT was estimated by the Kaplan-Meier method. The association between final angiographic data and wound healing was assessed employing a Cox proportional hazards model. The overall wound healing rate was 73.5%. The probabilities of wound healing in patients with wound blush obtainment was significantly higher than that of those without wound blush (79.6% vs. 46.5%; p = 0.01). In the multivariate analysis, wound blush obtainment was an independent predictor of wound healing. The presence of wound blush after EVT is significantly associated with wound healing. Wound blush as an angiographic endpoint for EVT may serve as a novel predictor of wound healing in patients with CLI. Copyright © 2017 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  15. Point-of-care wound visioning technology: Reproducibility and accuracy of a wound measurement app.

    Directory of Open Access Journals (Sweden)

    Sheila C Wang

    Full Text Available Current wound assessment practices are lacking on several measures. For example, the most common method for measuring wound size is using a ruler, which has been demonstrated to be crude and inaccurate. An increase in periwound temperature is a classic sign of infection but skin temperature is not always measured during wound assessments. To address this, we have developed a smartphone application that enables non-contact wound surface area and temperature measurements. Here we evaluate the inter-rater reliability and accuracy of this novel point-of-care wound assessment tool.The wounds of 87 patients were measured using the Swift Wound app and a ruler. The skin surface temperature of 37 patients was also measured using an infrared FLIR™ camera integrated with the Swift Wound app and using the clinically accepted reference thermometer Exergen DermaTemp 1001. Accuracy measurements were determined by assessing differences in surface area measurements of 15 plastic wounds between a digital planimeter of known accuracy and the Swift Wound app. To evaluate the impact of training on the reproducibility of the Swift Wound app measurements, three novice raters with no wound care training, measured the length, width and area of 12 plastic model wounds using the app. High inter-rater reliabilities (ICC = 0.97-1.00 and high accuracies were obtained using the Swift Wound app across raters of different levels of training in wound care. The ruler method also yielded reliable wound measurements (ICC = 0.92-0.97, albeit lower than that of the Swift Wound app. Furthermore, there was no statistical difference between the temperature differences measured using the infrared camera and the clinically tested reference thermometer.The Swift Wound app provides highly reliable and accurate wound measurements. The FLIR™ infrared camera integrated into the Swift Wound app provides skin temperature readings equivalent to the clinically tested reference thermometer

  16. Foxn1 Transcription Factor Regulates Wound Healing of Skin through Promoting Epithelial-Mesenchymal Transition.

    Directory of Open Access Journals (Sweden)

    Barbara Gawronska-Kozak

    Full Text Available Transcription factors are key molecules that finely tune gene expression in response to injury. We focused on the role of a transcription factor, Foxn1, whose expression is limited to the skin and thymus epithelium. Our previous studies showed that Foxn1 inactivity in nude mice creates a pro-regenerative environment during skin wound healing. To explore the mechanistic role of Foxn1 in the skin wound healing process, we analyzed post-injured skin tissues from Foxn1::Egfp transgenic and C57BL/6 mice with Western Blotting, qRT-PCR, immunofluorescence and flow cytometric assays. Foxn1 expression in non-injured skin localized to the epidermis and hair follicles. Post-injured skin tissues showed an intense Foxn1-eGFP signal at the wound margin and in leading epithelial tongue, where it co-localized with keratin 16, a marker of activated keratinocytes. This data support the concept that suprabasal keratinocytes, expressing Foxn1, are key cells in the process of re-epithelialization. The occurrence of an epithelial-mesenchymal transition (EMT was confirmed by high levels of Snail1 and Mmp-9 expression as well as through co-localization of vimentin/E-cadherin-positive cells in dermis tissue at four days post-wounding. Involvement of Foxn1 in the EMT process was verified by co-localization of Foxn1-eGFP cells with Snail1 in histological sections. Flow cytometric analysis showed the increase of double positive E-cadherin/N-cadherin cells within Foxn1-eGFP population of post-wounded skin cells isolates, which corroborated histological and gene expression analyses. Together, our findings indicate that Foxn1 acts as regulator of the skin wound healing process through engagement in re-epithelization and possible involvement in scar formation due to Foxn1 activity during the EMT process.

  17. News in wound healing and management

    DEFF Research Database (Denmark)

    Gottrup, Finn; Jørgensen, Bo; Karlsmark, Tonny


    . In the treatment of wounds, the new trend in the wound device marked is to produce dressings containing compounds or drugs. This could be local antiseptics (silver, other antiseptics, honey) and pain relieving drugs such as ibuprofen and morphine. New treatments such as anti-tumor necrosis factor alfa (anti...... is still at an exploratory level. Organizing models for optimal wound management are constantly being developed and refined. SUMMARY: Recent knowledge on the importance of new dressing materials containing active substances, new treatments for atypical wounds, influencing factors on the healing process...... and organization in the wound area are increasingly been launched. This may in the coming years significantly improve the treatment outcome of problem wounds....

  18. A current affair: electrotherapy in wound healing (United States)

    Hunckler, Jerome; de Mel, Achala


    New developments in accelerating wound healing can have immense beneficial socioeconomic impact. The wound healing process is a highly orchestrated series of mechanisms where a multitude of cells and biological cascades are involved. The skin battery and current of injury mechanisms have become topics of interest for their influence in chronic wounds. Electrostimulation therapy of wounds has shown to be a promising treatment option with no-device-related adverse effects. This review presents an overview of the understanding and use of applied electrical current in various aspects of wound healing. Rapid clinical translation of the evolving understanding of biomolecular mechanisms underlying the effects of electrical simulation on wound healing would positively impact upon enhancing patient’s quality of life. PMID:28461755

  19. Chitin and chitosan: biopolymers for wound management. (United States)

    Singh, Rita; Shitiz, Kirti; Singh, Antaryami


    Chitin and chitosan are biopolymers with excellent bioactive properties, such as biodegradability, non-toxicity, biocompatibility, haemostatic activity and antimicrobial activity. A wide variety of biomedical applications for chitin and chitin derivatives have been reported, including wound-healing applications. They are reported to promote rapid dermal regeneration and accelerate wound healing. A number of dressing materials based on chitin and chitosan have been developed for the treatment of wounds. Chitin and chitosan with beneficial intrinsic properties and high potential for wound healing are attractive biopolymers for wound management. This review presents an overview of properties, biomedical applications and the role of these biopolymers in wound care. © 2017 Inc and John Wiley & Sons Ltd.

  20. [Wound Ballistics – a Brief Overview]. (United States)

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


    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.

  1. Wound infections following open reduction and internal fixation of calcaneal fractures with an extended lateral approach

    NARCIS (Netherlands)

    Backes, Manouk; Schepers, Tim; Beerekamp, M. Suzan H.; Luitse, Jan S. K.; Goslings, J. Carel; Schep, Niels W. L.


    Post-operative wound infections (PWI) following calcaneal fracture surgery can lead to prolonged hospital stay and additional treatment with antibiotics, surgical debridement or implant removal. Our aim was to determine the incidence of superficial and deep PWI and to identify risk factors (RF).

  2. Spectroscopic Biomarkers for Monitoring Wound Healing and Infection in Wounds (United States)


    collecting Raman spectra of wound effluent, and anticipate the completion of that task by the end of the grant cycle (September 30th, 2015...tomographic imaging of canine bone tissue. J Biomed Opt 2008; 13:020506. 69. Chrit L, Hadjur C, Morel S, Sockalingum G, Lebourdon G, Leroy F, Manfait M. In...C for 1 minute, followed by 35 cycles of96°C for 15 seconds, 60°C for 45 seconds, and 72°C for 45 seconds. Final extension at 72°C was clone for 2

  3. Keratin-based Wound Care Products for Treatment of Resistant Vascular Wounds


    Than, Martin P.; Smith, Robert A.; Hammond, Catherine; Kelly, Robert; Marsh, Clive; Maderal, Andrea D.; Kirsner, Robert S.


    Use of new keratin-based wound dressings represent a novel approach to wound management. The authors present three patients with recalcitrant, venous and mixed venous, and arterial leg ulcers treated with these dressings. Improvement in each case was observed.

  4. [Wound information management system: a standardized scheme for acquisition, storage and management of wound information]. (United States)

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


    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.

  5. Advances in Wound Healing: A Review of Current Wound Healing Products

    Directory of Open Access Journals (Sweden)

    Patrick S. Murphy


    Full Text Available Successful wound care involves optimizing patient local and systemic conditions in conjunction with an ideal wound healing environment. Many different products have been developed to influence this wound environment to provide a pathogen-free, protected, and moist area for healing to occur. Newer products are currently being used to replace or augment various substrates in the wound healing cascade. This review of the current state of the art in wound-healing products looks at the latest applications of silver in microbial prophylaxis and treatment, including issues involving resistance and side effects, the latest uses of negative pressure wound devices, advanced dressings and skin substitutes, biologic wound products including growth factor applications, and hyperbaric oxygen as an adjunct in wound healing. With the abundance of available products, the goal is to find the most appropriate modality or combination of modalities to optimize healing.

  6. Expression and function of connexin 43 in human gingival wound healing and fibroblasts.

    Directory of Open Access Journals (Sweden)

    Rana Tarzemany

    Full Text Available Connexins (C×s are a family of transmembrane proteins that form hemichannels and gap junctions (GJs on the cell membranes, and transfer small signaling molecules between the cytoplasm and extracellular space and between connecting cells, respectively. Among C×s, suppressing C×43 expression or function promotes skin wound closure and granulation tissue formation, and may alleviate scarring, but the mechanisms are not well understood. Oral mucosal gingiva is characterized by faster wound closure and scarless wound healing outcome as compared to skin wounds. Therefore, we hypothesized that C×43 function is down regulated during human gingival wound healing, which in fibroblasts promotes expression of genes conducive for fast and scarless wound healing. Cultured gingival fibroblasts expressed C×43 as their major connexin. Immunostaining of unwounded human gingiva showed that C×43 was abundantly present in the epithelium, and in connective tissue formed large C×43 plaques in fibroblasts. At the early stages of wound healing, C×43 was strongly down regulated in wound epithelial cells and fibroblasts, returning to the level of normal tissue by day 60 post-wounding. Blocking of C×43 function by C×43 mimetic peptide Gap27 suppressed GJ-mediated dye transfer, promoted migration, and caused significant changes in the expression of wound healing-associated genes in gingival fibroblasts. In particular, out of 54 genes analyzed, several MMPs and TGF-β1, involved in regulation of inflammation and extracellular matrix (ECM turnover, and VEGF-A, involved in angiogenesis, were significantly upregulated while pro-fibrotic ECM molecules, including Collagen type I, and cell contractility-related molecules were significantly down regulated. These responses involved MAPK, GSK3α/β and TGF-β signaling pathways, and AP1 and SP1 transcription factors. Thus, suppressed function of C×43 in fibroblasts promotes their migration, and regulates expression of

  7. RNA-Seq Transcriptomic Responses of Full-Thickness Dermal Excision Wounds to Pseudomonas aeruginosa Acute and Biofilm Infection.

    Directory of Open Access Journals (Sweden)

    S L Rajasekhar Karna

    Full Text Available Pseudomonas aeruginosa infections of wounds in clinical settings are major complications whose outcomes are influenced by host responses that are not completely understood. Herein we evaluated transcriptomic changes of wounds as they counter P. aeruginosa infection-first active infection, and then chronic biofilm infection. We used the dermal full-thickness, rabbit ear excisional wound model. We studied the wound response: towards acute infection at 2, 6, and 24 hrs after inoculating 106 bacteria into day-3 wounds; and, towards more chronic biofilm infection of wounds similarly infected for 24 hrs but then treated with topical antibiotic to coerce biofilm growth and evaluated at day 5 and 9 post-infection. The wounds were analyzed for bacterial counts, expression of P. aeruginosa virulence and biofilm-synthesis genes, biofilm morphology, infiltrating immune cells, re-epithelialization, and genome-wide gene expression (RNA-Seq transcriptome. This analysis revealed that 2 hrs after bacterial inoculation into day-3 wounds, the down-regulated genes (infected vs. non-infected of the wound edge were nearly all non-coding RNAs (ncRNAs, comprised of snoRNA, miRNA, and RNU6 pseudogenes, and their down-regulation preceded a general down-regulation of skin-enriched coding gene expression. As the active infection intensified, ncRNAs remained overrepresented among down-regulated genes; however, at 6 and 24 hrs they changed to a different set, which overlapped between these times, and excluded RNU6 pseudogenes but included snRNA components of the major and minor spliceosomes. Additionally, the raw counts of multiple types of differentially-expressed ncRNAs increased on post-wounding day 3 in control wounds, but infection suppressed this increase. After 5 and 9 days, these ncRNA counts in control wounds decreased, whereas they increased in the infected, healing-impaired wounds. These data suggest a sequential and coordinated change in the levels of transcripts

  8. RNA-Seq Transcriptomic Responses of Full-Thickness Dermal Excision Wounds to Pseudomonas aeruginosa Acute and Biofilm Infection (United States)

    Chen, Tsute; Qian, Li-Wu; Fourcaudot, Andrea B.; Yamane, Kazuyoshi; Chen, Ping; Abercrombie, Johnathan J.; You, Tao; Leung, Kai P.


    Pseudomonas aeruginosa infections of wounds in clinical settings are major complications whose outcomes are influenced by host responses that are not completely understood. Herein we evaluated transcriptomic changes of wounds as they counter P. aeruginosa infection—first active infection, and then chronic biofilm infection. We used the dermal full-thickness, rabbit ear excisional wound model. We studied the wound response: towards acute infection at 2, 6, and 24 hrs after inoculating 106 bacteria into day-3 wounds; and, towards more chronic biofilm infection of wounds similarly infected for 24 hrs but then treated with topical antibiotic to coerce biofilm growth and evaluated at day 5 and 9 post-infection. The wounds were analyzed for bacterial counts, expression of P. aeruginosa virulence and biofilm-synthesis genes, biofilm morphology, infiltrating immune cells, re-epithelialization, and genome-wide gene expression (RNA-Seq transcriptome). This analysis revealed that 2 hrs after bacterial inoculation into day-3 wounds, the down-regulated genes (infected vs. non-infected) of the wound edge were nearly all non-coding RNAs (ncRNAs), comprised of snoRNA, miRNA, and RNU6 pseudogenes, and their down-regulation preceded a general down-regulation of skin-enriched coding gene expression. As the active infection intensified, ncRNAs remained overrepresented among down-regulated genes; however, at 6 and 24 hrs they changed to a different set, which overlapped between these times, and excluded RNU6 pseudogenes but included snRNA components of the major and minor spliceosomes. Additionally, the raw counts of multiple types of differentially-expressed ncRNAs increased on post-wounding day 3 in control wounds, but infection suppressed this increase. After 5 and 9 days, these ncRNA counts in control wounds decreased, whereas they increased in the infected, healing-impaired wounds. These data suggest a sequential and coordinated change in the levels of transcripts of multiple

  9. RNA-Seq Transcriptomic Responses of Full-Thickness Dermal Excision Wounds to Pseudomonas aeruginosa Acute and Biofilm Infection. (United States)

    Karna, S L Rajasekhar; D'Arpa, Peter; Chen, Tsute; Qian, Li-Wu; Fourcaudot, Andrea B; Yamane, Kazuyoshi; Chen, Ping; Abercrombie, Johnathan J; You, Tao; Leung, Kai P


    Pseudomonas aeruginosa infections of wounds in clinical settings are major complications whose outcomes are influenced by host responses that are not completely understood. Herein we evaluated transcriptomic changes of wounds as they counter P. aeruginosa infection-first active infection, and then chronic biofilm infection. We used the dermal full-thickness, rabbit ear excisional wound model. We studied the wound response: towards acute infection at 2, 6, and 24 hrs after inoculating 106 bacteria into day-3 wounds; and, towards more chronic biofilm infection of wounds similarly infected for 24 hrs but then treated with topical antibiotic to coerce biofilm growth and evaluated at day 5 and 9 post-infection. The wounds were analyzed for bacterial counts, expression of P. aeruginosa virulence and biofilm-synthesis genes, biofilm morphology, infiltrating immune cells, re-epithelialization, and genome-wide gene expression (RNA-Seq transcriptome). This analysis revealed that 2 hrs after bacterial inoculation into day-3 wounds, the down-regulated genes (infected vs. non-infected) of the wound edge were nearly all non-coding RNAs (ncRNAs), comprised of snoRNA, miRNA, and RNU6 pseudogenes, and their down-regulation preceded a general down-regulation of skin-enriched coding gene expression. As the active infection intensified, ncRNAs remained overrepresented among down-regulated genes; however, at 6 and 24 hrs they changed to a different set, which overlapped between these times, and excluded RNU6 pseudogenes but included snRNA components of the major and minor spliceosomes. Additionally, the raw counts of multiple types of differentially-expressed ncRNAs increased on post-wounding day 3 in control wounds, but infection suppressed this increase. After 5 and 9 days, these ncRNA counts in control wounds decreased, whereas they increased in the infected, healing-impaired wounds. These data suggest a sequential and coordinated change in the levels of transcripts of multiple

  10. [The wounded body, knowledge and art symbolism]. (United States)

    Segura Jorda, Gloria


    A brief tour through all art periods, analyzing and searching, to determine the meaning and symbolism of the wound in each period. To study the relationship and symbolism art / body / wound, is a vast and complex task. Can be approached from every angle imaginable. Different disciplines such as anthropology history and philosophy medicine, and now the art, we have provided different interpretations about the meaning representation and wounded human body through the centuries.

  11. Alternatives for animal wound model systems. (United States)

    Stephens, Phil; Caley, Matthew; Peake, Matthew


    In this chapter a review of animal model systems already being utilized to study normal and pathologic wound healing is provided. We also go into details on alternatives for animal wound model systems. The case is made for limitations in the various approaches. We also discuss the benefits/limitations of in vitro/ex vivo systems bringing everything up to date with our current work on developing a cell-based reporter system for diabetic wound healing.

  12. Dermal Coverage of Traumatic War Wounds (United States)


    healing/non-healing of wound and donor site • Graft loss • Heterotrophic ossification • Infection • Scar contracture • Durability (i.e. abrasions/ injuries ...AWARD NUMBER: W81XWH-13-2-0004 TITLE: "Dermal Coverage of Traumatic War Wounds ” PRINCIPAL INVESTIGATOR: Dr. Leon Nesti CONTRACTING...REPORT DATE January 2017 2. REPORT TYPE Final 3. DATES COVERED (From - To) 31 Oct 2012- 30 Oct 2016 " Dermal Coverage of Traumatic War Wounds ” 5a

  13. Results of vacuum assisted wound closure application. (United States)

    Atay, Tolga; Burc, Halil; Baykal, Yakup Barbaros; Kirdemir, Vecihi


    In recent past, various methods have been used for wound treatment purpose. In this study, we aimed to compare our results established from the vacuum-assisted wound closure method, which has gained popularity day by day, with the literature. A total of 48 patients, who received vacuum-assisted wound closure treatment in our clinic between 2007and 2010, were included in this study. Etiological distribution of the patients was as follows: 32 traumatic, 6 pressure sore, 9 diabetic, and 1 iliac disarticulation. All cases were evaluated in terms of age, gender, etiology, period of treatment, and size of the wound. In the patients studied, 42 were men (87.5 %) and 6 were women (12.5 %). Mean age of the patients was 39.6 years (11-61 years). All of our traumatic patients suffered from open fracture. After the vacuum-assisted wound closure application, wound size reduced by 28.8 %, while the mean area of the surface of the wound was 94.7 cm(2) (13.7-216.3 cm(2)) on average. After the wounds became ready for surgery, 15 of them were treated with split-thickness grafting, 9 of them were treated with secondary suture, 18 of them were treated with full-thickness grafting, and 6 of them were treated with flap. Average period of the application of vacuum-assisted wound closure was 11.6 days (7-15 days). Results of vacuum-assisted wound closure can be regarded as satisfactory when cases are selected properly. This system has three different effect mechanisms. Firstly, it increases local blood flow on the wound bed. Secondly, cell proliferation is triggered following the mechanic stress. Thirdly, vacuum removes the proteases from the environment which obstructs healing. Therefore, it is intended to prepare alive wound bed which is required for subsequent soft tissue reconstructions.

  14. Preventive incisional negative pressure wound therapy (Prevena) for an at-risk-surgical closure in a female Rottweiler. (United States)

    Nolff, M C; Flatz, K M; Meyer-Lindenberg, A


    This case report describes a combination of negative pressure-wound-therapy (NPWT) and NPWT assisted incision management after resection of an abscess located at the right thoracic wall in a Rottweiler. The patient had a history of severe incisional complications after surgical interventions performed in the past, including repeated episodes of wound dehiscence, major skin necrosis and infection with and without a multiresistant strain of Staphylococcus aureus and several episodes of open wound management with healing rates between months and a year. Wound closure after resection of the mass was performed as a staged procedure. After two days of open NPWT the wound was primarily closed and a preventive incisional vacuum assisted therapy (CI-NPWT) was started for 7 days. The patient was discharged during therapy with the portable device in place. The Unit was removed at day 7 post wound closure, suture removal followed at day 10. Wound healing was uneventful and no major complications occurred at a follow up time of 8 months. This is the first description of closed incisional negative pressure wound therapy in the dog.

  15. Topical Antimicrobial Therapy for Treating Chronic Wounds

    National Research Council Canada - National Science Library

    Benjamin A. Lipsky; Christopher Hoey


    .... Topical therapy affords many potential advantages but also has disadvantages. Opinions differ on which clinical signs define wound infection and on whether quantitative microbiological studies are useful...

  16. Practices in Wound Healing Studies of Plants

    Directory of Open Access Journals (Sweden)

    Rupesh Thakur


    Full Text Available Wounds are the result of injuries to the skin that disrupt the other soft tissue. Healing of a wound is a complex and protracted process of tissue repair and remodeling in response to injury. Various plant products have been used in treatment of wounds over the years. Wound healing herbal extracts promote blood clotting, fight infection, and accelerate the healing of wounds. Phytoconstituents derived from plants need to be identified and screened for antimicrobial activity for management of wounds. The in vitro assays are useful, quick, and relatively inexpensive. Small animals provide a multitude of model choices for various human wound conditions. The study must be conducted after obtaining approval of the Ethics Committee and according to the guidelines for care and use of animals. The prepared formulations of herbal extract can be evaluated by various physicopharmaceutical parameters. The wound healing efficacies of various herbal extracts have been evaluated in excision, incision, dead space, and burn wound models. In vitro and in vivo assays are stepping stones to well-controlled clinical trials of herbal extracts.

  17. Wound Healing in Mac-1 Deficient Mice (United States)


    other studies have demonstrated that the treatment of wounds with M2 macrophages does not benefit wound healing. 15 Given the importance of... Wound healing in Mac-1 deficient mice Lin Chen, MD, PhD 1 ; Sridevi Nagaraja, PhD 2 ; Jian Zhou, BS 1 ; Yan Zhao, BS 1 ; David Fine, BS 1...Alexander Y. Mitrophanov, PhD 2 ; Jaques Reifman, PhD 2 ; Luisa A. DiPietro, DDS, PhD 1 1 Center for Wound Healing and Tissue Regeneration, College of

  18. Shock wave therapy in wound healing. (United States)

    Qureshi, Ali A; Ross, Kimberly M; Ogawa, Rei; Orgill, Dennis P


    Recently, shock wave therapy has been investigated as an adjuvant therapy in the treatment of acute and chronic wounds. There are several devices with focused and unfocused shock waves that have been administered to a heterogenous group of wounds. Encouraging preclinical and clinical studies suggest that shock wave therapy may promote wound healing with little or no adverse events, prompting investigations into the mechanism of action and additional clinical trials. The peer-reviewed literature within the past 10 years was studied using an evidence-based approach. Preclinical studies demonstrate that shock wave therapy affects cellular function and leads to the expression of several genes and elaboration of growth factors known to promote wound healing. Limited clinical trials are encouraging for the use of shock wave therapy in the treatment of acute and chronic wounds. Serious complications, including wound infections, bleeding, hematomas, seromas, and petechiae, have not been reported in the largest of these studies. Shock wave therapy is an intriguing physical modality that may play an important role as an adjuvant therapy in wound healing. To date, there is no consensus on which wounds are most likely to benefit from shock wave therapy and what the optimal power, degree of focus, and frequency or number of cycles should be. Well-designed preclinical and clinical studies are necessary to better understand shock wave therapy in wound healing.

  19. A current affair: electrotherapy in wound healing

    Directory of Open Access Journals (Sweden)

    Hunckler J


    Full Text Available Jerome Hunckler, Achala de Mel UCL Division of Surgery and Interventional Sciences, Faculty of Medical Sciences, University College London, London, UK Abstract: New developments in accelerating wound healing can have immense beneficial socioeconomic impact. The wound healing process is a highly orchestrated series of mechanisms where a multitude of cells and biological cascades are involved. The skin battery and current of injury mechanisms have become topics of interest for their influence in chronic wounds. Electrostimulation therapy of wounds has shown to be a promising treatment option with no-device-related adverse effects. This review presents an overview of the understanding and use of applied electrical current in various aspects of wound healing. Rapid clinical translation of the evolving understanding of biomolecular mechanisms underlying the effects of electrical simulation on wound healing would positively impact upon enhancing patient’s quality of life. Keywords: electrotherapy, wound healing, infection, bioelectric current, exogenous current, bioelectric medicine, electrical stimulation, chronic wound, acute wound

  20. Corneal wound healing after excimer laser keratectomy. (United States)

    Kaji, Yuichi; Yamashita, Hidetoshi; Oshika, Tetsuro


    Excimer laser keratectomy is widely used to correct refractive errors. Several complications of excimer laser keratectomy are reported including corneal infection, regression, corneal haze formation, glare and halo. Most of the complications are closely related to the corneal stromal wound healing process. In order to perform the excimer laser keratectomy with minimum complications, we should understand the mechanism of the corneal stroma wound healing process. In addition, such knowledge will help us to regulate the corneal stromal wound healing process in the future. In the present article, we discuss the molecular mechanism of the corneal stromal wound healing process after excimer laser keratectomy and its regulation by anti-inflammatory agents.

  1. Principles of management of shotgun wounds. (United States)

    Walker, M L; Poindexter, J M; Stovall, I


    As an instrument of close range combat, the shotgun has no parallel. At short distances, its destructive capacity parallels that seen from high velocity missile injury. In this study, the history of the shotgun, wound ballistics, principles of initial therapy and special management problems related to shotgun wounds of specific sites are reviewed. An analysis of pooled data on abdominal shotgun wounds is presented. A subset of patients who do not require abdominal exploration exists. Specific problems encountered in defining this subset are enumerated. Three algorithms are presented that summarize our current management approach to shotgun wounds of the torso and extremities.


    Directory of Open Access Journals (Sweden)

    Zahir Hussain


    Full Text Available BACKGROUND Abdominal wound dehiscence is a preventable complication, but is still seen. When present, it poses problem in the management of the case, increases the morbidity and mortality of the patient. The present study is a prospective study done from January 2010-May 2016 with an objective to find out the incidence of wound dehiscence, the most common pathologies associated with dehiscence and to find out the statistical significance of the difference risk factors causing wound dehiscence and to evaluate the role of tension sutures in prevention of wound dehiscence. MATERIALS AND METHODS 291 major laparotomies were followed from January 2010-September 2016. There were 21 cases of dehiscence and from the remaining 270 cases, 58 patients were chosen as controls who underwent the same procedure, but without dehiscence. 15 factors were analysed and compared between the dehiscence and control groups. RESULTS The incidence was found to be 7.2%. Peritonitis was the most common pathology. The significant factors were age more than 50, wound infection. Tension suture application has shown to reduce the incidence of wound dehiscence. CONCLUSIONS  Intra-abdominal sepsis (peritonitis increases the incidence of wound dehiscence.  Age >50, Uraemic, Jaundiced, Obesity, Malnutrition increases the incidence of wound dehiscence.  Wound infection was a highly significant factor having 8 times more risk of dehiscence.

  3. Bioinspired porous membranes containing polymer nanoparticles for wound healing. (United States)

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


    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.

  4. Oral administration of antioxidants improves skin wound healing in diabetic mice. (United States)

    Pessoa, Ana Flávia Marçal; Florim, Juliana Costa; Rodrigues, Hosana Gomes; Andrade-Oliveira, Vinicius; Teixeira, Simone A; Vitzel, Kaio Fernando; Curi, Rui; Saraiva Câmara, Niels Olsen; Muscará, Marcelo N; Lamers, Marcelo Lazzaron; Santos, Marinilce Fagundes


    Oxidative stress aggravates several long-term complications in diabetes mellitus. We evaluated the effectiveness of the oral administration of antioxidants (vitamins E and C, 40 and 100 mg/kg b.w., respectively) on skin wound healing acceleration in alloxan-induced diabetic mice. Mice were wounded 30 days after the induction of diabetes. Antioxidants were effective in preventing oxidative stress, as assessed by TBARS. The enzymes catalase, glutathione reductase, glutathione peroxidase, and superoxide dismutase were increased in diabetics on the 3rd day post-wounding; catalase and glutathione peroxidase remained still augmented in diabetics after 14th day postwounding, and the treatment with vitamins restored their activities to control. After 3 days, diabetic mice showed lower infiltration of inflammatory cells (including CD11b + and Ly6G + cells) and reduced levels of KC, TNF-α, IL-1β, and IL-12 p40 when compared with control mice. The treatment restored cytokine levels. After 14 days, diabetic mice showed late wound closure, persistent inflammation and delayed reepithelialization, accompanied by an increase in MIG + /CD206 - macrophages whereas CD206 + /MIG - macrophages were decreased. Cytokines IL-12p40, TNF-α, IL-1β, and KC were increased and normal levels were restored after treatment with antioxidants. These results suggest that oxidative stress plays a major role in diabetic wound healing impairment and the oral administration of antioxidants improves healing by modulating inflammation and the antioxidant system with no effect on glycemia. © 2016 by the Wound Healing Society.

  5. Preliminary evaluation of the wound healing effect of Vitex doniana sweet (Verbenaceae) in mice. (United States)

    Amegbor, K; Metowogo, K; Eklu-Gadegbeku, K; Agbonon, A; Aklikokou, K A; Napo-Koura, G; Gbeassor, M


    Vitex doniana is traditionally used in Togo to treat various diseases including wounds. The aim of this work was to evaluate the efficiency of Vitex doniana on cutaneous wound healing. Wounds were induced in ICR mice divided into four groups as following: Group I received carbopol 974P NF empty gel, Groups II and III were treated topically with carbopol gel containing 2.5% and 5% of Vitex doniana extract. Group IV received Betadine® 10% as standard drug. The efficacy of treatment was evaluated by planimetry and histological analysis. We secondary used the gel containing Vitex doniana at 2.5% and the pure extract at 10 mg/ml on the model of ear edema induced by xylene. Skin toxicity test was performed with the gel containing Vitex doniana at 5% and the pure extract at 30 mg/ml. Vitex doniana at 5% and 2.5% provided better wound contraction (91.14% and 86.38%) at day 12 post-excision when compared to control (51.15%). The results of histological evaluation supported the outcome of excision wound model. Moreover Vitex doniana inhibited significantly edema induced by xylene when compared to control (ptoxicity test, no abnormal symptoms were developed over 14 day-time period. Vitex doniana inhibits the topical inflammation and accelerate cutaneous wound repair.

  6. Honey and wound dehiscence: A study of surgical wounds in the ...

    African Journals Online (AJOL)


    Aug 20, 2014 ... The smaller the initial circumference of the surgical wound, the shorter the duration of healing and this was significant (P = 0.001) in .... initial circumference of the wound and duration of clinical healing of the surgical wounds after .... for the “respiratory burst” in macrophages which is an important part of their ...

  7. Expedited wound healing with noncontact, low-frequency ultrasound therapy in chronic wounds: a retrospective analysis. (United States)

    Kavros, Steven J; Liedl, David A; Boon, Andrea J; Miller, Jenny L; Hobbs, Julie A; Andrews, Karen L


    To evaluate the clinical role of noncontact, low-frequency ultrasound therapy (MIST Therapy System; Celleration, Eden Prairie, Minnesota) in the treatment of chronic lower-extremity wounds. A retrospective observational study. A multidisciplinary, vascular wound-healing clinic. One hundred sixty-three patients who received MIST Therapy plus standard of care (treatment group) and 47 patients who received the standard of care alone (control group). All wounds in the control and treatment groups received the standard of wound care and were followed for 6 months. In the treatment group, MIST Therapy was administered to wounds 3 times per week for 90 days or until healed. Proportion of wounds healed and wound volume reduction. Rate of healing was also quantified using 1-way analysis of variance to determine the slope of the regression line from starting volume to ending volume, where a steeper slope indicates a faster healing rate. Outcomes were evaluated in all wounds and etiology-specific subgroups. A significantly greater percentage of wounds treated with MIST Therapy and standard of care healed as compared with those treated with the standard of care alone (53% vs 32%; P = 0.009). The slope of the regression line in the MIST arm (1.4) was steeper than the slope in the control arm (0.22; P = .002), indicating a faster rate of healing in the MIST-treated wounds. The rate of healing and complete closure of chronic wounds in patients improved significantly when MIST Therapy was combined with standard wound care.

  8. Late post-operative hypoxaemia and organ dysfunction

    DEFF Research Database (Denmark)

    Kehlet, H; Rosenberg, J


    Constant and episodic hypoxaemia are common after major operations in the late post-operative period in the surgical ward. Recent studies have shown that hypoxaemia may be related to the development of myocardial ischaemia and cardiac arrhythmias. Experimental and clinical studies have demonstrated...... an adverse effect of tissue hypoxia on wound healing and on resistance to bacterial wound infections. Finally, mental confusion and surgical delirium may be related to inadequate arterial oxygenation during the late post-operative period. Late post-operative constant and episodic hypoxaemia may therefore...


    Directory of Open Access Journals (Sweden)

    O. V. Voskresensky


    Full Text Available BACKGROUND Penetrating chest injuries are a common cause of hospitalization for young patients.Various types of thoracotomy prevails over the other surgical approaches performed both under absolute and relative indications, depending on the location of wounds.PURPOSE To analyze the tactics and evaluate the possibility of thoracoscopy in order to reduce the number of unreasonable thoracotomies and reduce trauma due to surgical intervention.MATERIAL AND METHODS We studied 596 medical histories of victims who had been operated in 2002–2012. Thoracoscopy was performed in 236 patients, traditional tactics was applied in 360 victims. Wounds in the diaphragmatic area of the chest were in 210 victims, in the “heart” area — in 172 patients, in the intersection of these two zones — 44 cases, in the projection of the lung peripheral part — 49 cases and paravertebral area of the chest — in 52 patients. Typical thoracotomy (TT was performed in 27% of cases, atypical thoracotomy (AT — 42.5%, and drainage of the pleural space (DPS — 30.3% of cases.RESULT Thoracoscopy (TS could be carried out in 42.2% of patients who had undergone TT, and in 79.4% of patients who had undergone AT. Overall performance of the TS was possible in 70% of patients with penetrating chest wounds (PCW. Absolute contraindications for TS occurred in 29.1% of the victims.

  10. New treatment strategies to reduce burn wound progression

    Directory of Open Access Journals (Sweden)

    Schmauss, Daniel


    Full Text Available [english] Background: After a burn injury certain superficial partial-thickness burn wounds spontaneously progress into deep partial-thickness or full-thickness burn wounds. This poorly understood phenomenon is called burn wound progression. The aim of this study was to investigate whether treatment strategies using warm water (preservation of microcirculation on the one side and erythropoietin (EPO (molecule with anti-inflammatory, anti-apoptotic, vasodilatory and neoangiogenic properties can prevent, delay and/or reduce secondary burn wound progression in a rat model.Methods: We used a burn comb model in 63 rats, creating eight rectangular contact burns (2x1 cm each intercalated by unburned zones (2x0.5 cm prone to burn wound progression. In a first experimental set we treated burn wounds with locally applied warm (37°C or cold (17°C water for 20 minutes.In a second experimental set, animals were treated systemically with EPO at two different dosages of 500 and 2,500 IU/kg bodyweight (bw and initiated at 2 different time-points (45 minutes vs. 6 hours after burn injury. Evaluation of microcirculatory perfusion, interspace necrosis and burn depth was performed using respectively laser Doppler flowmetry, planimetry and histology. For statistical analysis the two-way ANOVA-test followed by an adequate post-hoc test (Bonferroni were used. Results: In untreated control animals a conversion from superficial to full-thickness burns was observed within 24 hours. Warm and cold water treatment significantly delayed burn depth progression, nevertheless after 4 days, burn depth was similar in all three groups. Warm water significantly reduced interspace necrosis compared to untreated controls and cold water with a significantly improved perfusion in the warm water group. Surface extension and particularly burn depth progression were significantly decreased by EPO only if administered at a dosage of bw and initiated 45 minutes after burn injury. EPO

  11. Contributions of ocular surface components to matrix-metalloproteinases (MMP-2 and MMP-9 in feline tears following corneal epithelial wounding.

    Directory of Open Access Journals (Sweden)

    Andrea Petznick

    Full Text Available PURPOSE: This study investigated ocular surface components that contribute to matrix-metalloproteinase (MMP-2 and MMP-9 found in tears following corneal epithelial wounding. METHODS: Laboratory short-haired cats underwent corneal epithelial debridement in one randomly chosen eye (n = 18. Eye-flush tears were collected at baseline and during various healing stages. Procedural control eyes (identical experimental protocol as wounded eyes except for wounding, n = 5 served as controls for tear analysis. MMP activity was analyzed in tears using gelatin zymography. MMP staining patterns were evaluated in ocular tissues using immunohistochemistry and used to determine MMP expression sites responsible for tear-derived MMPs. RESULTS: The proMMP-2 and proMMP-9 activity in tears was highest in wounded and procedural control eyes during epithelial migration (8 to 36 hours post-wounding. Wounded eyes showed significantly higher proMMP-9 in tears only during and after epithelial restratification (day 3 to 4 and day 7 to 28 post-wounding, respectively as compared to procedural controls (p0.05. Immunohistochemistry showed increased MMP-2 and MMP-9 expression in the cornea during epithelial migration and wound closure. The conjunctival epithelium exhibited highest levels of both MMPs during wound closure, while MMP-9 expression was reduced in conjunctival goblet cells during corneal epithelial migration followed by complete absence of the cells during wound closure. The immunostaining for both MMPs was elevated in the lacrimal gland during corneal healing, with little/no change in the meibomian glands. Conjunctival-associated lymphoid tissue (CALT showed weak MMP-2 and intense MMP-9 staining. CONCLUSIONS: Following wounding, migrating corneal epithelium contributed little to the observed MMP levels in tears. The major sources assessed in the present study for tear-derived MMP-2 and MMP-9 following corneal wounding are the lacrimal gland and CALT. Other

  12. Cost analysis of one of the first outpatient wound clinics in the Netherlands. (United States)

    Rondas, A A L M; Schols, J M G; Halfens, R J G; Hull, H R; Stobberingh, E E; Evers, S M A A


    To perform, from an insurance perspective, a cost analysis of one of the outpatient community wound care clinics in the Netherlands, the Knowledge Centre in Wound Care (KCWC) at Venray. This study involved a cost analysis based on an observational cohort study with a one-year pre-admission and a one-year post-admission comparison of costs. Patients were included when they first consulted the outpatient wound care clinic. Participants were all insured by the same health insurance company, Coöperatie Volksgezondheidszorg (VGZ). A standard six-step procedure for performing cost studies was used to calculate the costs. Given the skewed cost data, non-parametric bootstrapping was used to test for statistical differences. There were 172 patients included in this study. The difference in costs related to wound care between the year before and the year after initial admission to the wound clinic amounted to an average reduction of €2621 (£1873) per patient in the base case analysis. The categories 'general practitioner', 'hospital care', 'mental health care' and 'transport' scored lower, indicating lower costs, in the year after admission to the wound clinic. In this study, only the reimbursement data of patients of one health insurance company, and specifically only those made under the 2006 Dutch Health Insurance Act, were available. Because of the observational design, definitive conclusions cannot be made regarding a demonstrated reduction of costs in the year post admission. Nevertheless, this study is a first attempt of a cost analysis of an equipped outpatient wound clinic as an innovative way of responding to the increasing number of chronic wounds in the Netherlands. The calculations show that savings in wound care are possible. A possible conflict of interest should be mentioned. First author AALM Rondas, PhD student at Maastricht University, is working at the KCWC wound clinic at Venray in the Netherlands as a physician. However, the research data were

  13. Bi-Layer Wound Dressing System for Combat Casualty Care

    National Research Council Canada - National Science Library

    Martineau, Lucie; Shek, Pang N


    .... Biopsies taken from full-thickness, pig wounds infected with Ps. aeruginosa and Staph. epidermidis showed a 2- to 5-log reduction in the bacterial load of antiseptic-treated wounds compared to those of control wounds...

  14. Critical Review of Noninvasive Optical Technologies for Wound Imaging


    Jayachandran, Maanasa; Rodriguez, Suset; Solis, Elizabeth; Lei, Jiali; Godavarty, Anuradha


    Significance: Noninvasive imaging approaches can provide greater information about a wound than visual inspection during the wound healing and treatment process. This review article focuses on various optical imaging techniques developed to image different wound types (more specifically ulcers).

  15. Beneficial effects of hydrogen-rich saline on early burn-wound progression in rats.

    Directory of Open Access Journals (Sweden)

    Song Xue Guo

    Full Text Available Deep burn wounds undergo a dynamic process known as wound progression that results in a deepening and extension of the initial burn area. The zone of stasis is more likely to develop more severe during wound progression in the presence of hypoperfusion. Hydrogen has been reported to alleviate injury triggered by ischaemia/reperfusion and burns in various organs by selectively quenching oxygen free radicals. The aim of this study was to investigate the possible protective effects of hydrogen against early burn-wound progression.Deep-burn models were established through contact with a boiled, rectangular, brass comb for 20 s. Fifty-six Sprague-Dawley rats were randomly divided into sham, burn plus saline, and burn plus hydrogen-rich saline (HS groups with sacrifice and analysis at various time windows (6 h, 24 h, 48 h post burn. Indexes of oxidative stress, apoptosis and autophagy were measured in each group. The zone of stasis was evaluated using immunofluorescence staining, ELISA, and Western blot to explore the underlying effects and mechanisms post burn.The burn-induced increase in malondialdehyde was markedly reduced with HS, while the activities of endogenous antioxidant enzymes were significantly increased. Moreover, HS treatment attenuated increases in apoptosis and autophagy postburn in wounds, according to the TUNEL staining results and the expression analysis of Bax, Bcl-2, caspase-3, Beclin-1 and Atg-5 proteins. Additionally, HS lowered the level of myeloperoxidase and expression of TNF-α, IL-1β, and IL-6 in the zone of stasis while augmenting IL-10. The elevated levels of Akt phosphorylation and NF-κB p65 expression post burn were also downregulated by HS management.Hydrogen can attenuate early wound progression following deep burn injury. The beneficial effect of hydrogen was mediated by attenuating oxidative stress, which inhibited apoptosis and inflammation, and the Akt/NF-κB signalling pathway may be involved in regulating the

  16. Abdominal wound closure: current perspectives

    Directory of Open Access Journals (Sweden)

    Williams ZF


    Full Text Available Zachary F Williams, William W Hope Department of Surgery, South East Area Health Education Center, New Hanover Regional Medical Center, Wilmington, NC, USA Abstract: This review examines both early and late wound complications following laparotomy closure, with particular emphasis on technical aspects that reduce hernia formation. Abdominal fascial closure is an area of considerable variation within the field of general surgery. The formation of hernias following abdominal wall incisions continues to be a challenging problem. Ventral hernia repairs are among the most common surgeries performed by general surgeons, and despite many technical advances in the field, incisional hernia rates remain high. Much attention and research has been directed to the surgical management of hernias. Less focus has been placed on prevention of hernia formation despite its obvious importance. This review examines the effects of factors such as the type of incision, suture type and size, closure method, patient risk factors, and the use of prophylactic mesh. Keywords: incisional, abdominal, hernia, prevention, wound closure techniques 

  17. What wound up the Universe

    Energy Technology Data Exchange (ETDEWEB)

    Davies, P.


    One general property of physical systems is the irreversible rise of disorder. This fact is formalised in terms of entropy with the second law of thermodynamics, which states that in a closed system entropy never decreases. The consequences on a cosmic scale are illustrated by reference to Thomas the Tank engine being wound up and stopping when the energy is used up. In the cosmic analogy, what wound up the universe. If it was simply created and has been unwinding ever since, what evidence is there for entropy of the primeval cosmos. Three pieces of evidence are given in support of the Big Bang hypothesis. Expansion is an important aspect of the unwinding mechanism with the nature of the microwave background (the spectrum of which has a black-body form) being the most relevant fact to support this. The attempts to explain the driving force behind the Big Bang are reviewed. Strong and weak forces and the grand unified theories and antigravity are explained. The Higgs field, an excited state which can give rise to antigravity, could have driven the Universe at birth with a huge repulsive force for a brief moment sending it into a runaway expansion. This would mean that antigravity was responsible for winding up the Universe. (U.K.).

  18. Mucopolysaccharides from psyllium involved in wound healing

    NARCIS (Netherlands)

    Westerhof, W.; Das, P. K.; Middelkoop, E.; Verschoor, J.; Storey, L.; Regnier, C.


    Mucopolysaccharides derived from the husk of psyllium (Plantago ovata) have properties beneficial for wound cleansing and wound healing. Recent studies indicate that these mucopolysaccharides also limit scar formation. Our in vitro and in vivo studies aimed to investigate the mechanisms involved,

  19. Fibromodulin Enhances Angiogenesis during Cutaneous Wound Healing

    Directory of Open Access Journals (Sweden)

    Zhong Zheng, PhD


    Conclusions: Altogether, we demonstrated that in addition to reducing scar formation, FMOD also promotes angiogenesis. As blood vessels organize and regulate wound healing, its potent angiogenic properties will further expand the clinical application of FMOD for cutaneous healing of poorly vascularized wounds.

  20. December 2004 - 38 War Wounds with Fractures

    African Journals Online (AJOL)



    Dec 2, 2004 ... Historically, on a conventional battlefield, about 70% of the wounded present injuries to the limbs, the remaining 30% have central wounds involving head, chest or abdomen. The longer the delay in transport to hospital facilities, especially with inadequate first aid, the higher the death rate in the central ...

  1. Antimicrobial, Wound Healing And Antioxidant Activities Of ...

    African Journals Online (AJOL)

    claims of the plant in skin diseases, wound healing activity was studied, besides antioxidant activity to understand the mechanism of wound healing. The alchoholic and aqueous extract of this plant showed significant antibacterial and antifungal activity against almost all the organisms: Micrococcus luteus, Bacillus subtilis, ...

  2. Biomechanics and Wound Healing in the Cornea


    Dupps, William J.; Wilson, Steven E.


    The biomechanical and wound healing properties of the cornea undermine the predictability and stability of refractive surgery and contribute to discrepancies between attempted and achieved visual outcomes after LASIK, surface ablation and other keratorefractive procedures. Furthermore, patients predisposed to biomechanical failure or abnormal wound healing can experience serious complications such as keratectasia or clinically significant corneal haze, and more effective means for the identif...

  3. Status of wound management in Korea. (United States)

    Namgoong, Sik; Han, Seung-Kyu


    In spite of a period of intense economic, social, and political hardship following the Korean War, the Republic of Korea has made great strides in economic growth over the past half century, and also remarkable progress in the medical field. However, wound research has been slow to take off in South Korea. Meanwhile, as is the case in many countries in Western Europe and North America, South Korea is seeing a steady increase in its aged population. The growth in the geriatric population has in turn brought on more cases of chronic wounds. Though South Korea only began to recognize the importance of wound management in the early 2000s, it was fortunate enough to have sophisticated related industries, such as biotechnology and information technology, and brilliant, industrious, and eager wound researchers, contributing to rapid development of the field. The country has particular strengths in research for innovative cell-based treatments and products for managing wounds. Notwithstanding government policy ill-equipped to sufficiently support such advancement, better communication between experts and public officials will no doubt bring forth even more achievements in this very promising field. It is in this context that this article aims to summarize current wound management practices, research, training, product development, and government policies regarding wound management in South Korea as of the year 2017. © 2017 by the Wound Healing Society.

  4. [Skillful care for chronic vascular wounds]. (United States)

    Goullet de Rugy, C; Lazareth, I; You, C; Stansal, A; Priollet, P


    In vascular medicine, wound care requires pluridisciplinary expertise and nursing skill. Care must be perfectly adapted to each individual patient, the specificities of each particular wound, and the underlying vascular disease. The goal is to achieve wound healing. Inappropriate care can retard healing or even aggravate the wound. The skin should be cleaned with water a non-allergic detergent and should concern the entire limb in addition to the wound itself. Fibrin or necrosis detersion is an important step that can be painful. Different tools are available. The skin around the wound should be hydrated and protected, focusing on fragile areas, such as the tibial crest and heals, in order to prevent the development of new wounds. Other more complex interventions include tenosynovectomy, bone gouging and reduction of the necrotic toe that when properly performed can prevent a new passage in the operating room. If the ischemia becomes critical, the foot should be held warm with a carded cotton, taking care to separate the toes with dry dressings in order to preserve the healthy tissue and avoid induced wounds. Finally, compression bands are indispensable in cases with edema or venous hyperpressure. A skillful banding technique is essential, especially for legs with complex morphology. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

  5. Soft Tissue Wounds and Principles of Healing (United States)


    carbon dioxide and waste products. The adhesion of platelets to the denuded subendothelial matrix is the hallmark of the acute phase providing an...antiseptics such as vinegar and wine in preparation for delayed primary or secondary closure [20]. Despite much being known about wounds and wound care

  6. Topical silver for treating infected wounds

    NARCIS (Netherlands)

    Vermeulen, H.; van Hattem, J. M.; Storm-Versloot, M. N.; Ubbink, D. T.


    BACKGROUND: Topical silver treatments and silver dressings are increasingly used for the local treatment of contaminated or infected wounds, however, there is a lack of clarity regarding the evidence for their effectiveness. OBJECTIVES: To evaluate the effects on wound healing of topical silver and

  7. Topical negative pressure for treating chronic wounds

    NARCIS (Netherlands)

    Ubbink, Dirk T.; Westerbos, Stijn Joël; Evans, Debra; Land, Lucy; Vermeulen, Hester


    BACKGROUND: Chronic wounds mainly affect the elderly and those with multiple health problems. Despite the use of modern dressings, some of these wounds take a long time to heal, fail to heal, or recur, causing significant pain and discomfort to the person and cost to health services. Topical

  8. Categorizing Wounds to Improve Clinical Management and ...

    African Journals Online (AJOL)

    Trauma and surgeries are common causes of wounds that require proper management to prevent complications, economic losses, pain and suffering, death or euthanasia of the affected animals. A retrospective study of 243 wounds in cattle, sheep and goats treated between 1981 and 2006 is described. It describes ...


    African Journals Online (AJOL)

    OF LAPAROSTOMY WOUNDS: CASE SERIES. J. O. GISORE AND S. O. KHAINGA. SUMMARY. Laparostomy or the open abdomen can be a lifesaving intervention in surgical emergencies for abdominal compartment syndrome, wound dehiscence, trauma and intra-abdominal sepsis. However, the open abdomen imposes ...

  10. Low level diode laser accelerates wound healing. (United States)

    Dawood, Munqith S; Salman, Saif Dawood


    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.

  11. Histomorphological evaluation of wound healing - Comparison ...

    African Journals Online (AJOL)

    Vernonia amygdalina leaf juice, similar to honey, enhanced fibroblasts recruitment, epithelia cells migration, neovascularization and reduced polymorphonuclear leukocytes (PMNL) infiltration as compared to the NC at the early phase of wound healing (days 3 and 5). Vernonia amygdalina might enhance cutaneous wound ...

  12. Multiple bacterial species reside in chronic wounds

    DEFF Research Database (Denmark)

    Gjødsbøl, Kristine; Christensen, Jens Jørgen; Karlsmark, Tonny


    . aeruginosa were found to be significantly larger than ulcers without the presence of P. aeruginosa (P wound is colonised by multiple bacterial species and that once they are established many of them persist in the wound. Our results suggest that the presence...

  13. Stimulation Of Wound Healing By Lasers (United States)

    Lyons, Richard F.; Abergel, R. Patrick; Lam, Thomas s.; White, Rodney A.; Dwyer, Richard M.; Uitto, Jouni


    Clinical observations have suggested that low energy lasers might stimulate wound healing. To understand the mechanism of the biostimulation, we have previously examined the effects of low energy lasers on collagen production by human skin fibroblasts and reported an increase of collagen synthesis in vitro (J. Am. Acad. Derm. 11:1142-1150, 1980. To examine the effects of low energy lasers in vivo, hairless mice were experimentally wounded, sutured and subjected to laser irradiation by He-Ne laser with a power output of 1.56 mW, and an energy fluence of 1.22 J/cm2. Experimental wounds were subjected to laser treatment every other day, for a total duration of 2 months; control wounds remained untreated. Specimens from the wounds were then examined for histology, tensile strength and total collagen content. Results demonstrated a considerable improvement of the tensile strength of the laser-irradiated wounds at 1 and 2 weeks. Furthermore, the total collagen content was significantly increased at 2 months when compared to control wounds. These results suggest a beneficial effect of He-Ne laser on wound healing in vivo.

  14. Wound healing and infection in surgery

    DEFF Research Database (Denmark)

    Sørensen, Lars Tue


    : The aim was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved.......: The aim was to clarify how smoking and nicotine affects wound healing processes and to establish if smoking cessation and nicotine replacement therapy reverse the mechanisms involved....

  15. The Effect of Intravenous Regional Perfusion of the Distal Limb With Amikacin Sulfate on Wounds Healing by Second Intention in Horses. (United States)

    Edwards-Milewski, Margaux L; Morello, Samantha L; Zhao, Qianqian; Mattan-Bell, Cynthia


    To compare the gross and histological effects of intravenous regional limb perfusion (IVRLP) using amikacin sulfate on second intention healing of distal limb wounds in adult horses with healing in untreated wounds. In vivo experimental study. Adult horses (n = 7). Two full thickness wounds (2.5 × 2.5 cm) were created aseptically on the dorsal aspect of each metacarpus and maintained under sterile bandages. One forelimb was randomly selected from each horse for IVRLP on days 2, 3, and 4 post-wounding. Sequential biopsies were taken from 1 wound on each limb to evaluate the histological effects of IVRLP. Photographs were obtained of nonbiopsied wounds from days 2 to 62 for gross assessment and wound measurement. Wound size and contraction, healing rate during and immediately after IVRLP treatment, total healing rate, and histological scores for edema, hemorrhage, inflammatory infiltrate, and fibrovascular proliferation were compared. No differences were observed between groups for wound size, wound contraction, healing rates during or after IVRLP treatment periods, or total healing rate. Wound size over time was larger in the IVRLP group compared with the control group; however, this difference did not reach statistical significance. Mononuclear cell infiltration was greater in the IVRLP group compared with controls. No differences were observed for other histological variables. All wounds healed without the formation of exuberant granulation tissue. Treatment for 3 consecutive days with IVRLP using amikacin sulfate did not negatively affect surgical wounds healing by second intention in the distal limb of horses. © Copyright 2015 by The American College of Veterinary Surgeons.

  16. MRI findings of post-traumatic osteomyelitis of distal phalanx following neglected open fracture

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Dong Eon; Lee, Ji Hee; Bae, Kung Eun; Kang, Min Jin; Kim, Jea Hyung; Cho, Woo Ho; Jeong, Myeong Ja; Kim, Soung Hee; Kim, Ji Young; Kim, Soo Hyun [Dept. of Radiology, Inje University Sanggye Paik Hospital, Seoul (Korea, Republic of)


    Careful radiologic examination of the osteolytic lesion is important for patients with fracture. Differential diagnosis includes osteonecrosis, neoplasm and infections. In this report, we presented MRI findings of post-traumatic osteomyelitis following neglected open fracture of 3rd distal phalanx with open wound. Early suspicion and imaging of wound or soft tissue inflammation around osteolytic lesion could be helpful for diagnosis of osteomyelitis.

  17. Effect of chitosan acetate bandage on wound healing in infected and noninfected wounds in mice (United States)

    Burkatovskaya, Marina; Castano, Ana P.; Demidova-Rice, Tatiana N.; Tegos, George P.; Hamblin, Michael R.


    HemCon® bandage is an engineered chitosan acetate preparation designed as a hemostatic dressing, and is under investigation as a topical antimicrobial dressing. We studied its effects on healing of excisional wounds that were or were not infected with Staphylococcus aureus, in normal mice or mice previously pretreated with cyclophosphamide (CY). CY significantly suppressed wound healing in both the early and later stages, while S. aureus alone significantly stimulated wound healing in the early stages by preventing the initial wound expansion. CY plus S. aureus showed an advantage in early stages by preventing expansion, but a significant slowing of wound healing in later stages. In order to study the conflicting clamping and stimulating effects of chitosan acetate bandage on normal wounds, we removed the bandage from wounds at times after application ranging from 1 hour to 9 days. Three days application gave the earliest wound closure, and all application times gave a faster healing slope after removal compared with control wounds. Chitosan acetate bandage reduced the number of inflammatory cells in the wound at days 2 and 4, and had an overall beneficial effect on wound healing especially during the early period where its antimicrobial effect is most important. PMID:18471261

  18. Significant Differences in Nurses’ Knowledge of Basic Wound Management

    DEFF Research Database (Denmark)

    Zarchi, Kian; Latif, Seemab; Haugaard, Vibeke B


    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....

  19. Animal models of chronic wound care

    DEFF Research Database (Denmark)

    Trøstrup, Hannah; Thomsen, Kim; Calum, Henrik


    on nonhealing wounds. Relevant hypotheses based on clinical or in vitro observations can be tested in representative animal models, which provide crucial tools to uncover the pathophysiology of cutaneous skin repair in infectious environments. Disposing factors, species of the infectious agent(s), and time....... An inhibiting effect of bacterial biofilms on wound healing is gaining significant clinical attention over the last few years. There is still a paucity of suitable animal models to recapitulate human chronic wounds. The etiology of the wound (venous insufficiency, ischemia, diabetes, pressure) has to be taken...... of establishment of the infection are well defined in suitable animal models. In addition, several endpoints can be involved for evaluation. Animals do not display chronic wounds in the way that humans do. However, in many cases, animal models can mirror the pathological conditions observed in humans, although...

  20. Small intestinal submucosa: utilization as a wound dressing in full-thickness rodent wounds. (United States)

    Prevel, C D; Eppley, B L; Summerlin, D J; Sidner, R; Jackson, J R; McCarty, M; Badylak, S F


    Wound dressings are used as a temporary wound covering to promote wound healing, control wound exudate, and decrease wound contamination as well as evaporative water loss. A new material, porcine small intestinal submucosa, has been used successfully as an arterial and venous graft in both canine and primate animal models with graft patency and infection rates equal to autologous vein. Based on these studies, small intestinal submucosa was used as a biological wound dressing in 20 x 20 mm full-thickness wounds made on Sprague-Dawley rats. In the controls (group I, n = 12), an acrylic frame (20 x 20 mm) was sutured to the wound edges, followed by placement of a thin polyurethane film. In the small intestinal submucosa-treated animals (group II, n = 12), the wound was covered with small intestinal submucosa and then with the acrylic frame and polyurethane film. The wounds were examined both visually and histologically at postapplication days 3, 7, 14, 28, 42 and 56. In addition, the wound contraction rate of 6 animals in both groups were recorded at postapplication day 0 and then at 1 week, 1 month, 2 months, and 3 months. Histological analysis (hematoxylin-eosin and periodic acid-Schiff stains) of the small intestinal submucosa-treated wounds revealed no host-versus-graft rejection and a rate of epithelialization equal to that of the control group. The wound contraction rate was statistically significant (higher; p < .05) in the control group compared to the small intestinal submucosa-treated group. Porcine small intestinal submucosa merits further study as both a biological wound dressing and as a substrate for cultured cells.

  1. Quantifying wound morphology and tissue energetics for diagnosis and treatment of chronic wounds (United States)

    McQuiston, Barbara K.; Stytz, Martin R.; Whitestone, Jennifer J.; Henderson, Richard


    The care and efficacy of treatment for chronic wounds is typically determined by observing and measuring the wound's response to a given treatment protocol. The traditional measures of wound morphology typically include photographs taken over time, alginates for determining wound volume, and rulers or concentric circles to estimate a wound's diameter. Although the traditional wound morphology measures are generally non-invasive, they are subjective and non-repeatable. Information on tissue response is generally limited to gross metabolic measurements acquired through standard diagnostic testing, bacteriological information from biopsied material and transcutaneous oximetry taken at the periphery of the wound. Information related to tissue response is generally acquired using invasive techniques. This paper describes a non-invasive method for assessing wound morphology and response being used to assess and study chronic wounds at the USAF Medical Center at Wright-Patterson AFB. This new technique exploits the properties of laser surface scanning and magnetic resonance spectroscopy to acquire its measurements. The method used employs a CyberwareTM laser surface scanner to capture both range and color information from the patient's wound surface. The color and range data are then registered to 1 mm accuracy for visualization of the patient's surface. The Magnetic Resonance Spectroscopy (MRS) data are then captured for the same wound using a surface localization and spectra collection protocol. The MRS data includes phosphorous MRS as an indicator of cellular energy balance. Spatial registration is used to combine the Cyberware and MRS datasets. The resulting data are then presented as a 3D volume with additional parameters, such as surface area, volume, and perimeter, portrayed for the total wound and specific tissue types. Results to date for our approach include the development of an automatic feature extraction algorithm that recognizes and extracts a wound edge

  2. Post clamp (United States)

    Ramsey, John K. (Inventor); Meyn, Erwin H. (Inventor)


    A pair of spaced collars are mounted at right angles on a clamp body by retaining rings which enable the collars to rotate with respect to the clamp body. Mounting posts extend through aligned holes in the collars and clamp body. Each collar can be clamped onto the inserted post while the clamp body remains free to rotate about the post and collar. The clamp body is selectively clamped onto each post.

  3. 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


    Moris Topaz


    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 i...

  4. Enhanced wound-healing performance of a phyto-polysaccharide-enriched dressing - a preclinical small and large animal study. (United States)

    Wang, Chih-Hsin; Chang, Shu-Jen; Tzeng, Yuan-Sheng; Shih, Yu-Jen; Adrienne, Chang; Chen, Shyi-Gen; Chen, Tim-Mo; Dai, Niann-Tzyy; Cherng, Juin-Hong


    Alginate is a natural rich anionic polysaccharide (APS), commonly available as calcium alginate (CAPS). It can maintain a physiologically moist microenvironment, which minimises bacterial infection and facilitates wound healing at a wound site. Patients with burn injuries suffer from pain and an inflammatory response. In this study, we evaluated the CAPS dressing and traditional dressing containing carboxymethyl cellulose (CMC) for wound healing and scar tissue formation in a burn model of rat and swine. In our pilot study of a burn rat model to evaluate inflammatory response and wound healing, we found that the monocyte chemoattractant protein (MCP)-1 and transforming growth factor (TGF)-β were up-regulated in the CAPS treatment group. Next, the burn swine models tested positive for MCP-1 in a Gram-positive bacterial infection, and there was overproduction of TGF-β during the burn wound healing process. Rats were monitored daily for 1 week for cytokine assay and sacrificed on day 28 post-burn injury. The swine were monitored over 6 weeks. We further examined the pain and related factors and inflammatory cytokine expression in a rodent burns model monitored everyday for 7 days post-burn. Our results revealed that the efficacy of the dressing containing CAPS for wound repair post-burn was better than the CMC dressing with respect to natural wound healing and scar formation. The polysaccharide-enriched dressing exerted an antimicrobial effect on burn wounds, regulated the inflammatory response and stimulated anti-inflammatory cytokine release. However, one pain assessment method showed no significant difference in the reduction in levels of adenosine triphosphate in serum of rats after wound dressing in either the CAPS or CMC group. In conclusion, a polysaccharide-enriched dressing outperformed a traditional dressing in reducing wound size, minimising hypertrophic scar formation, regulating cytokines and maximising antimicrobial effects. © 2017

  5. 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.

  6. The use of negative pressure wound therapy in the treatment of infected wounds. Case studies. (United States)

    Jones, Daniel de Alcântara; Neves Filho, Wilson Vasconcelos; Guimarães, Janice de Souza; Castro, Daniel de Araújo; Ferracini, Antonio Marcos


    To evaluate the results and benefits obtained from the topical use of negative pressure wound therapy (NPWT) in patients with infected wounds. 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. ® (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. 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 cm 2 ; p  wound with complete eradication of the infection. No complication directly caused by NPWT was observed. NPWT stimulates infection-free scar tissue formation in a short time, and is a quick and comfortable alternative to conventional infected wounds treatment methods.

  7. Bacterial isolates from infected wounds and their antibiotic susceptibility pattern: some remarks about wound infection. (United States)

    Bessa, Lucinda J; Fazii, Paolo; Di Giulio, Mara; Cellini, Luigina


    Wound infection plays an important role in the development of chronicity, delaying wound healing. This study aimed to identify the bacterial pathogens present in infected wounds and characterise their resistance profile to the most common antibiotics used in therapy. Three hundred and twelve wound swab samples were collected from 213 patients and analysed for the identification of microorganisms and for the determination of their antibiotic susceptibility. Patients with diverse type of wounds were included in this retrospective study, carried out from March to September 2012. A total of 28 species were isolated from 217 infected wounds. The most common bacterial species detected was Staphylococcus aureus (37%), followed by Pseudomonas aeruginosa (17%), Proteus mirabilis (10%), Escherichia coli (6%) and Corynebacterium spp. (5%). Polymicrobial infection was found in 59 (27·1%) of the samples and was mainly constituted with two species. The most common association was S. aureus/P. aeruginosa. All Gram-positives were susceptible to vancomycin and linezolid. Gram-negatives showed quite high resistance to the majority of antibiotics, being amikacin the most active against these bacteria. This study is mostly oriented to health care practitioners who deal with wound management, making them aware about the importance of wound infection and helping them to choose the adequate treatment options to control microbial infection in wounds. © 2013 The Authors. International Wound Journal © 2013 Inc and John Wiley & Sons Ltd.

  8. Polysaccharides of Aloe vera induce MMP-3 and TIMP-2 gene expression during the skin wound repair of rat. (United States)

    Tabandeh, Mohammad Reza; Oryan, Ahmad; Mohammadalipour, Adel


    Polysaccharides are the main macromolecules of Aloe vera gel but no data about their effect on extracellular matrix (ECM) elements are available. Here, mannose rich Aloe vera polysaccharides (AVP) with molecular weight between 50 and 250 kDa were isolated and characterized. Open cutaneous wounds on the back of 45 rats (control and treated) were daily treated with 25mg (n=15) and 50 mg (n=15) AVP for 30 days. The levels of MMP-3 and TIMP-2 gene expression were analyzed using real time PCR. The levels of n-acetyl glucosamine (NAGA), n-acetyl galactosamine (NAGLA) and collagen contents were also measured using standard biochemical methods. Faster wound closure was observed at day 15 post wounding in AVP treated animals in comparison with untreated group. At day 10 post wounding, AVP inhibited MMP-3 gene expression, while afterwards MMP-3 gene expression was upregulated. AVP enhanced TIMP-2 gene expression, collagen, NAGLA and NAGA synthesis in relation to untreated wounds. Our results suggest that AVP has positive effects on the regulation of ECM factor synthesis, which open up new perspectives for the wound repair activity of Aloe vera polysaccharide at molecular level. Copyright © 2014 Elsevier B.V. All rights reserved.

  9. Wound Healing Angiogenesis: Innovations and Challenges in Acute and Chronic Wound Healing (United States)

    Demidova-Rice, Tatiana N.; Durham, Jennifer T.; Herman, Ira M.


    Background Formation of new blood vessels, by either angiogenesis or vasculogenesis, is critical for normal wound healing. Major processes in neovascularization include (i) growth-promoting or survival factors, (ii) proteolytic enzymes, (iii) activators of multiple differentiated and progenitor cell types, and (iv) permissible microenvironments. A central aim of wound healing research is to “convert” chronic, disease-impaired wounds into those that will heal. The problem Reduced ability to re-establish a blood supply to the injury site can ultimately lead to wound chronicity. Basic/Clinical Science Advances (1) Human fetal endothelial progenitor cells can stimulate wound revascularization and repair following injury, as demonstrated in a novel mouse model of diabetic ischemic healing. (2) Advances in bioengineering reveal exciting alternatives by which wound repair may be facilitated via the creation of vascularized microfluidic networks within organ constructs created ex vivo for wound implantation. (3) A “personalized” approach to regenerative medicine may be enabled by the identification of protein components present within individual wound beds, both chronic and acute. Clinical Care Relevance Despite the development of numerous therapies, impaired angiogenesis and wound chronicity remain significant healthcare problems. As such, innovations in enhancing wound revascularization would lead to significant advances in wound healing therapeutics and patient care. Conclusion Insights into endothelial progenitor cell biology together with developments in the field of tissue engineering and molecular diagnostics should not only further advance our understanding of the molecular mechanisms regulating wound repair but also offer innovative solutions to promote the healing of chronic and acute wounds in vivo. PMID:24527273

  10. Wound complications and surgical events in de novo heart transplant patients treated with everolimus

    DEFF Research Database (Denmark)

    Rashidi, Mitra; Esmaily, Sorosh; Fiane, Arnt E


    .5 years (median) was an overall risk factor for surgical wound complications regardless of treatment group (p=0.025). There was no difference in the EVE versus CyA group with regards to other surgical events. Majority of events were in 1/3 of the patients. CONCLUSION: De novo initiation of EVE and early......OBJECTIVES: The use of mammalian target of rapamycin (mTOR) inhibitors have been limited by adverse events (AE), including delayed wound healing. We retrospectively reviewed all AE and serious AE (SAE) in The Scandinavian heart transplant (HTx) everolimus (EVE) de novo trial with early calcineurin...... (CNI) avoidance (SCHEDULE). The aim of the study was to compare wound complications between EVE and CNI based regimen. MATERIALS AND METHODS: A total of 115 patients (mean age 51 ± 13 years, 73% men) were randomized within five days post-HTx to low dose EVE and reduced dose Cyclosporine (CyA) followed...

  11. Acute effects of low-level laser therapy (660 nm) on oxidative stress levels in diabetic rats with skin wounds. (United States)

    Denadai, Amanda Silveira; Aydos, Ricardo Dutra; Silva, Iandara Schettert; Olmedo, Larissa; de Senna Cardoso, Bruno Mendonça; da Silva, Baldomero Antonio Kato; de Carvalho, Paulo de Tarso Camillo


    Laser therapy influences oxidative stress parameters such as the activity of antioxidant enzymes and the production of reactive oxygen species. To analyze the effects of low-level laser therapy on oxidative stress in diabetics rats with skin wounds. Thirty-six animals were divided into 4 groups: NDNI: non-diabetic rats with cutaneous wounds that not received laser therapy; NDI: non-diabetic rats with cutaneous wounds that received laser therapy; DNI: diabetic rats with skin wounds who did not undergo laser therapy; DI: rats with diabetes insipidus and cutaneous wounds and received laser therapy. The animals were treated with LLLT (660 nm, 100 mW, 6 J/cm, spot size 0.028 cm). On the day of killing the animals, tissue-wrapped cutaneous wounds were collected and immediately frozen, centrifuged, and stored to analyze malondialdehyde (MDA) levels. Significant difference was observed within the groups of MDA levels (ANOVA, p = 0.0001). Tukey's post-hoc test showed significantly lower values of MDA in irradiated tissues, both in diabetic and non-diabetic rats. ANOVA of the diabetic group revealed a significant difference (p < 0.01) when all groups, except NDI and DI, were compared. LLLT was effective in decreasing MDA levels in acute surgical wounds in diabetic rats.

  12. Proline-Rich Peptide Mimics Effects of Enamel Matrix Derivative on Rat Oral Mucosa Incisional Wound Healing. (United States)

    Villa, Oscar; Wohlfahrt, Johan C; Mdla, Ibrahimu; Petzold, Christiane; Reseland, Janne E; Snead, Malcolm L; Lyngstadaas, Staale P


    Proline-rich peptides have been shown to promote periodontal regeneration. However, their effect on soft tissue wound healing has not yet been investigated. The aim of this study is to evaluate the effect of enamel matrix derivative (EMD), tyrosine-rich amelogenin peptide (TRAP), and a synthetic proline-rich peptide (P2) on acute wound healing after a full-thickness flap procedure in an incisional rat model. This experimental study has a split-mouth, randomized, placebo-controlled design. Test and control wounds were created on the palatal mucosa of 54 Sprague-Dawley rats. Wounds were histologically processed, and reepithelialization, leukocyte infiltration, and angiogenesis were assessed at days 1, 3, and 7 post-surgery. EMD and P2 significantly promoted early wound closure at day 1 (P healing (P = 0.03 and 0.001, respectively). Leukocyte infiltration was decreased in EMD-treated wounds at day 1 (P = 0.03), and P2 and TRAP induced a similar effect at days 3 (P = 0.002 and P <0.0001, respectively) and 7 (P = 0.005 and P <0.001). EMD and P2 promoted reepithelialization and neovascularization in full-thickness surgical wounds on rat oral mucosa.

  13. Management of gunshot wounds to the mandible. (United States)

    Peleg, Michael; Sawatari, Yoh


    The gunshot wound to the mandible is a unique traumatic injury. The resultant injury from the gunshot wound is diverse because of the variability of the projectile, motion, velocity, and tissue characteristics. When a high-velocity projectile strikes the mandible, often times the wound will consist of a severely comminuted mandible surrounded by nonvital soft tissues and the implantation of multiple foreign bodies. This represents a challenge for the treating surgeon. The anatomy and function of the mandible make it such that the care of the gunshot wound requires a combination of trauma and reconstructive surgeries. There are varying techniques advocated for the management of gunshot wound to the face. However, for the comminuted mandible fracture sustained from a gunshot wound, an approach involving the fabrication of an occlusal splint, intermaxillary fixation, aggressive debridement of hard and soft tissues, and immediate reconstruction with a titanium plate is a comprehensive approach that can restore the appropriate function and contour of the patient. At the Division of Oral and Maxillofacial Surgery, University of Miami, this approach to the comminuted mandible fracture secondary to the gunshot wound has led to the effective management of this specific subset of injury. The complication rate is comparable with the current literature and provides an advantage as a 1-stage management to restore appropriate function and cosmesis to the patient.

  14. Non-healing wounds: the geriatric approach. (United States)

    Jaul, Efraim


    The most common types of non-healing wounds are four types: pressure ulcers, diabetic ulcers, ischemic ulcers and venous ulcers. Many of those wounds develop among the elderly, becoming non-healing to the extent that the patient may live with them all of his life, or even die because of them. Not enough attention is paid to the underlying contributing problems specific to the elderly patient. Those factors are physiologic (aging skin, immune state and atherosclerosis) and pathologic situation (diabetic disease, ischemia of leg). Therefore, the geriatric approach to a non-healing wound is comprehensive and multidisciplinary. Those including: patient's co-morbidities, functional state as measured by the activities of daily living (ADL) scale, nutritional status, social support, ethical beliefs and quality of life and not only the wound itself. Each discipline (the nursing staff, physician, dietitian, occupational, physical therapists and social worker) has its own task in preventing and treating such wounds. The ultimate goal therefore has been altered from healing of the wounds to symptom control, prevention of complications and to contribute to the patient's overall wellbeing. This review discusses all those items in a geriatric point of view, and how to deal with the non-healing wounds as a geriatric syndrome.

  15. Enamel Matrix Derivative Promotes Healing of a Surgical Wound in the Rat Oral Mucosa. (United States)

    Maymon-Gil, Tal; Weinberg, Evgeny; Nemcovsky, Carlos; Weinreb, Miron


    Enamel matrix proteins (EMPs) play a role in enamel formation and the development of the periodontium. Sporadic clinical observations of periodontal regeneration treatments with enamel matrix derivative (EMD), a commercial formulation of EMPs, suggest that it also promotes post-surgical healing of soft tissues. In vitro studies showed that EMD stimulates various cellular effects, which could potentially enhance wound healing. This study examines the in vivo effects of EMD on healing of an oral mucosa surgical wound in rats. A bilateral oral mucosa wound was created via a crestal incision in the anterior edentulous maxilla of Sprague-Dawley rats. Full-thickness flaps were raised, and, after suturing, EMD was injected underneath the soft tissues on one side, whereas the EMD vehicle was injected in the contralateral side. Animals were sacrificed after 5 or 9 days, and the wound area was subjected to histologic and immunohistochemical analysis of the epithelial gap, number of macrophages, blood vessels, proliferating cells, and collagen content in the connective tissue (CT). Gene expression analysis was also conducted 2 days post-surgery. EMD had no effect on the epithelial gap of the wound. On both days 5 and 9, EMD treatment increased significantly the number of blood vessels and the collagen content. EMD also enhanced (by 20% to 40%) the expression of transforming growth factors β1 and β2, vascular endothelial growth factor, interleukin-1β, matrix metalloproteinase-1, versican, and fibronectin. EMD improves oral mucosa incisional wound healing by promoting formation of blood vessels and collagen fibers in CT.

  16. [Antisepsis of wounds: when and what?]. (United States)

    Mulaj, Ryve Ramosaj; Mühlstädt, Michael; Barouti, Neda


    Bacterial colonisation of a wound is a normal process and usually not dangerous. The role of micro-organisms in the healing process is not fully elucidated, however it is well known that infection interrupts healing and even worse can severely threaten the organism. We present the different types of antiseptics that are used in treating wounds as well as their interactions. We would like to remind the reader that antiseptics are more effective than antibiotics with much fewer resistances. Finally, we provide a flow chart for a reasonable treatment of chronic wounds.

  17. Effect of Malva sylvestris cream on burn injury and wounds in rats

    Directory of Open Access Journals (Sweden)

    Ebrahim Nasiri


    Full Text Available Objectives: Burn injury is one of the most health-threatening problems in the world. Malva sylvestris (M. sylvestris flowershave a high mucilage content and are used as a remedy for cut wound and dermal infected wounds in Iranian folklore Medicine. The purpose of this study was to investigate the effect of M. sylvestris cream on the second degree burn injury in rats. Materials and Methods: Five groups of 10 rats per group were burned with hot metal plate. Animals were administrated divided as control, normal saline, standard silver sulfadiazine 1% (SSD, 5% M. sylvestris, and 10% M. sylvestris into separate groups. Wound area, percentage of wound contraction, and histological and bacteriological assessments were evaluated. Results: Wound sizes were not significantly different among groups on 1st and 3rd days after burn injury, while they were significantly different among groups after 7th day post-burn injury. The average areas of wounds on the 15th day were 7.5±2.9, 6.7±2, 10.5±1.6, 4.7±2, and 4.5±2 cm2 for base cream, normal saline, SSD, 5% M. sylvestris, and 10% M. sylvestris, respectively. The results of histology exhibited well-formed horizontally-oriented collagen fibers in MS topical treatment groups. Microorganisms existed in the SSD group were most probably Staphilococcus epidermitis and for NS group were staphylococcus saprophiteccus. Conclusion: M. sylvestris cream improved histological changes of tissue components in the process of healing when compared with SSD cream. Therefore, it can be used as a topical treatment agent for burn wound.

  18. Decellularized scaffolds containing hyaluronic acid and EGF for promoting the recovery of skin wounds. (United States)

    Wu, Zhengzheng; Tang, Yan; Fang, Hongdou; Su, Zhongchun; Xu, Bin; Lin, Yongliang; Zhang, Peng; Wei, Xing


    There is no effective therapy for the treatment of deep and large area skin wounds. Decellularized scaffolds can be prepared from animal tissues and represent a promising biomaterial for investigation in tissue regeneration studies. In this study, MTT assay showed that epidermal growth factor (EGF) increased NIH3T3 cell proliferation in a bell-shaped dose response, and the maximum cell proliferation was achieved at a concentration of 25 ng/ml. Decellularized scaffolds were prepared from pig peritoneum by a series of physical and chemical treatments. Hyaluronic acid (HA) increased EGF adsorption to the scaffolds. Decellularized scaffolds containing HA sustained the release of EGF compared to no HA. Rabbits contain relatively large skin surface and are less expensive and easy to be taken care, so that a rabbit wound healing model was use in this study. Four full-thickness skin wounds were created in each rabbit for evaluation of the effects of the scaffolds on the skin regeneration. Wounds covered with scaffolds containing either 1 or 3 μg/ml EGF were significantly smaller than with vaseline oil gauzes or with scaffolds alone, and the wounds covered with scaffolds containing 1 μg/ml EGF recovered best among all four wounds. Hematoxylin-Eosin staining confirmed these results by demonstrating that significantly thicker dermis layers were also observed in the wounds covered by the decellularized scaffolds containing HA and either 1 or 3 μg/ml EGF than with vaseline oil gauzes or with scaffolds alone. In addition, the scaffolds containing HA and 1 μg/ml EGF gave thicker dermis layers than HA and 3 μg/ml EGF and showed the regeneration of skin appendages on day 28 post-transplantation. These results demonstrated that decellularized scaffolds containing HA and EGF could provide a promising way for the treatment of human skin injuries.

  19. Intraoperative handling and wound healing of arthroscopic portal wounds: a clinical study comparing nylon suture with wound closure strips. (United States)

    Bhattacharyya, Mayukh; Bradley, Helen


    This prospective, single-centre study compared wound closure methods in patients undergoing arthroscopy. Closure of arthroscopic portal wounds with sterile adhesive strips is effective and convenient for wound management. The method was associated with a reduced potential for infection, faster renewal of tensile strength, greater cost effectiveness, and better cosmetic effects comparing with suture closure. This method of wound closure may also reduce the incidence of needle stick injury in the theatre environment. Thereby the incidence of percutaneous exposure following a surgical procedure may not facilitate transmission of blood borne pathogens such as human immunodeficiency virus (HIV), hepatitis C virus and hepatitis B virus. As a result it may reduce litigation in today's changing healthcare climate.

  20. [Negative Pressure Wound Therapy with Instillation in the Treatment of Critical Wounds]. (United States)

    Gathen, M; Petri, M; Krettek, C; Omar, M


    In recent decades, negative pressure wound therapy (NPWT) has become the gold standard in the treatment of infected wounds. Negative pressure wound therapy with instillation (NPWTi) is a new development, that combines conventional NPWT with instillation of fluids. The purpose of this study was to review the results of current literature on the clinical use of NPWTi in acute and chronic wounds. A literature search was performed using Pubmed and the Cochrane Library, including articles in English and German. The data suggest that NPWTi is a promising therapeutic option in the treatment of wounds, and applicable in various fields. NPWTi appears to be a useful adjunct in the treatment of critical wounds. However, data from prospective randomised trials to support the validity of the results are sparse. Georg Thieme Verlag KG Stuttgart · New York.

  1. Honey dressing versus silver sulfadiazene dressing for wound healing in burn patients: A retrospective study

    Directory of Open Access Journals (Sweden)

    Shilpi Singh Gupta


    Full Text Available Objective : The aim was to evaluate the effect of honey dressing and silver sulfadiazene (SSD dressing on wound healing in burn patients. Materials and Methods : We retrospectively reviewed the records of 108 patients (14-68 years of age, with first and second degree burns of less than 50% of the total body surface area admitted to our institution, over a period of 5 years (2004-2008. Fifty-one patients were treated with honey dressings and 57 with SSD. Time elapsed since burn, site, percentage, degree and depth of burns, results of culture sensitivity at various time intervals, duration of healing, formation of post-treatment hypertrophic scar, and/or contracture were recorded and analyzed. Results : The average duration of healing was 18.16 and 32.68 days for the honey and SSD group, respectively. Wounds of all patients reporting within 1 h of burns became sterile with the honey dressing in less than 7 days while there was none with SSD. All wounds treated with honey became sterile within 21 days while for SSD-treated wounds, this figure was 36.5%. A complete outcome was seen in 81% of all patients in the "honey group" while in only 37% patients in the "SSD group." Conclusion : Honey dressings make the wounds sterile in less time, enhance healing, and have a better outcome in terms of hypertropic scars and postburn contractures, as compared to SSD dressings.

  2. Predictive Value of Nutritional Markers for Wound Healing Complications in Bariatric Patients Undergoing Panniculectomy. (United States)

    Barbour, John Richard; Iorio, Matthew L; Oh, Christine; Tung, Thomas H; O'Neill, Patrick J


    Hypoproteinemia and nutritional deficiencies are common after bariatric surgery, and although massive weight loss (MWL) patients experience increased wound complication rates, the association has not been causatively determined. This study investigated preoperative nutritional parameters and wound complications in MWL patients (postbariatric and diet-controlled) undergoing panniculectomy at 2 academic institutions. One hundred sixty-one consecutive patients undergoing elective panniculectomy after bariatric surgery or diet-controlled weight loss were identified. Patient demographics and nutritional indices (serum protein, albumin, and micronutrient levels) were analyzed. Complications including wound separation, infection, and operative debridements were compared. Post hoc comparisons tested for correlation between complications and nutritional markers. Postbariatric patients lost an average of 151 lb and presented at an average of 32 months after gastric bypass. Diet-controlled weight loss patients lost an average of 124 lb. Despite MWL, albumin levels were higher in the bariatric group (3.8 vs 3.4 g/dL, P bariatric patients experienced increased wound complications (27% vs 14%; P Bariatric patients presenting for elective operations are at risk for protein and micronutrient deficiency. Despite aggressive replacement and normalization of nutritional markers, bariatric patients experience increased wound complications when compared to nonbariatric patients and traditional measures of nutritional evaluation for surgery may be insufficient in bariatric patients.

  3. Debriding effect of bromelain on firearm wounds in pigs. (United States)

    Hu, Wei; Wang, Ai-Min; Wu, Si-Yu; Zhang, Bo; Liu, Shuai; Gou, Yuan-Bin; Wang, Jian-Min


    Wound excision is the standard treatment for firearm wounds. However, achieving a satisfactory curative effect is difficult because of the traumatic mechanism of high-velocity projectiles. We propose a new therapy by using topical bromelain as a supplement to wound incision for the debridement of firearm wounds. We clarified the debriding effect of bromelain on firearm wounds in pigs. In vitro, muscle tissues around the wound track and normal muscle were incubated in bromelain solutions of different concentrations. Tissue hydrolization was estimated by measuring tissue weight and the release of total amino acids. In vivo, the hind limbs of 15 pigs were wounded with high-velocity projectiles. Five groups were classified as follows: wound excision (E), wound incision (I), bromelain (B), incision + bromelain (IB), and control (C). Debriding effectiveness was estimated using bacterial content, histopathologic examination, and wound healing time. In vitro, hydrolization of wound tissue was significantly more intensive than that of normal tissue. Bromelain solution (10 mg/mL) hydrolyzed wound tissue rapidly with minimal proteolysis of normal tissue. In vivo, the wound-track bacterial content of group IB was similar to that of group E and was significantly lower than that of groups I, B, and C. The wound healing time of group IB was also shorter. Bromelain is effective in the debridement of uncomplicated firearm wounds if used as a supplement to simple wound incision. This new therapy shows notable advantages over conventional surgical debridement as it greatly simplifies the procedures.

  4. A review of wound healing | Hassan | Nigerian Veterinary Journal

    African Journals Online (AJOL)

    Wounds have been credited to be the most common and frequent reason for seeking medical attention. This review highlights the existing information on several aspects of wound healing. While the review presents the traditional information on wounds such as the etiology, classification and stages involved in wound ...

  5. Assessment and management of surgical wounds in clinical practice. (United States)

    Vuolo, Julie Caroline

    Successful nursing care of surgical wounds is dependent on the nurse's knowledge and understanding of normal wound healing physiology, the type of surgery performed, the method of closure and the optimal treatment of the resultant wound. Using this knowledge, nurses can provide a systematic and holistic patient assessment, and consider any potential wound-related complications.

  6. Hyperbaric oxygen therapy for treating acute surgical and traumatic wounds

    NARCIS (Netherlands)

    Eskes, Anne; Ubbink, Dirk T.; Lubbers, Maarten; Lucas, Cees; Vermeulen, Hester


    Hyperbaric oxygen therapy (HBOT) is used as a treatment for acute wounds (such as those arising from surgery and trauma) however the effects of HBOT on wound healing are unclear. To determine the effects of HBOT on the healing of acute surgical and traumatic wounds. We searched the Cochrane Wounds

  7. Hyperbaric oxygen therapy for treating acute surgical and traumatic wounds

    NARCIS (Netherlands)

    Eskes, Anne; Vermeulen, Hester; Lucas, Cees; Ubbink, Dirk T.


    Hyperbaric oxygen therapy (HBOT) is used as a treatment for acute wounds (such as those arising from surgery and trauma). However, the effects of HBOT on wound healing are unclear. To determine the effects of HBOT on the healing of acute surgical and traumatic wounds. We searched the Cochrane Wounds

  8. Anti-infective and wound healing properties of Flabellaria paniculata ...

    African Journals Online (AJOL)

    The methanol leaf extract of Flabellaria paniculala was studied for its potency on normal wounds and infected wounds in rats. Wounds were inflicted on Wistar rats using excision model. Local infection was introduced into rat abdominal wounds using a 108 bacteria/ml inoculum. Two groups of infection were used: ...

  9. Wound scabs protect regenerating tissue against harmful ultraviolet radiation

    NARCIS (Netherlands)

    van der Pol, E.; Mudde, Y. D.; Coumans, F. A. W.; van Leeuwen, T. G.; Sturk, A.; Nieuwland, R.


    Benefits attributed to wound scabs include prevention of blood loss and protection against infection. However, when formation of a wound scab is prevented, the risk of infection is reduced. Moreover, in the absence of a wound scab, wounds heal faster and scar formation is reduced. The question

  10. Wound Inflammatory Index: A “Proof of Concept” Study to Assess Wound Healing Trajectory


    Bharara, Manish; Schoess, Jeffrey; Nouvong, Aksone; David G. Armstrong


    Diabetes around the globe results in one major limb amputation every 30 seconds, over 2500 limbs lost per day. The underlying pathophysiology sometimes leads to a chronic inflammatory stage, which may prevent appropriate healing, and therefore, the need for a clear strategy for assessing and classifying wounds and wound healing cannot be overstated. Temperature is a surrogate marker for inflammation. Quantitative thermography using a numerical index provides a useful way to assess wound heali...

  11. Matrix metalloproteinase-9 delays wound healing in a murine wound model. (United States)

    Reiss, Matthew J; Han, Yan-Ping; Garcia, Edwin; Goldberg, Mytien; Yu, Hong; Garner, Warren L


    Metalloproteinase-9 (MMP-9) is a type IV collagenase found at elevated levels in chronic wounds. As wounds heal, MMP-9 diminishes. In this study, we investigated whether MMP-9 directly contributes to chronic wound pathogenesis. Recombinant proMMP-9 was prepared using immortalized keratinocytes transduced by a lentivirus. ProMMP-9 was purified from cell culture media and activated using 4-aminophenylmercuric acetate. Active MMP-9 was then suspended in xanthan gum to a concentration paralleling that found in human chronic wounds. Two parallel 6-mm punch biopsies were made on the backs of C57BL mice. Wounds were treated daily with MMP-9 or vehicle. Wound areas were measured and tissues examined by densitometry, real-time RT-PCR, histology, and immunohistochemistry at days 7, 10, and 12. Exogenous MMP-9, at the level found within chronic wounds, delayed wound healing in this animal model. By 7 days, wounds in the MMP-9-injected group were 12% larger than control wounds (P = .008). By day 12, wounds in the MMP-9-injected group were 25% larger than those of the control group (P = .03). Histologic examination shows that high levels of active MMP-9-impaired epithelial migrating tongues (P = .0008). Moreover, consistent with elevated MMP-9, the collagen IV in the leading edge of the epithelial tongue was diminished. MMP-9 appears to directly delay wound healing. Our data suggests that this may occur through interference with re-epithelialization. We propose that MMP-9 interferes with the basement membrane protein structure, which in turn impedes keratinocyte migration, attachment, and the reestablishment of the epidermis. Copyright 2010 Mosby, Inc. All rights reserved.

  12. Evaluation of Mouse Wound Models for Probiotics-Based Wound Infection Prevention Study (United States)


    to aid in prevention of infection in both traumatic and surgical settings. We used established methods to produce typical wounds in a reproducible...highly desirable. The objectives of this study were to (1) establish reproducible, small animal models of infectious wounds and (2) assess if probiotics...been some interest in using these organisms in early wound care to aid in prevention of infection in both traumatic and surgical settings. Such a

  13. Paper tape in the closure of abdominal wounds. (United States)

    Chao, T C; Tsaez, F Y


    Wounds closed by adhesive tapes have less inflammatory reaction, a lower rate of wound infection, greater tensile strength and better cosmetic results than sutured or stapled wounds. Special backing tapes, such as Steri-Strip, have been reported to have satisfactory results in closing laparotomy wounds. However, they are more expensive than paper tape. Sterile paper tape had adequate adhesive and supporting strength in the closure of abdominal wounds. The wounds closed with paper tape healed well and had satisfactory cosmetic results. Paper tape is a nonexpensive and convenient alternative to close abdominal wounds.

  14. Reduced prevalence and severity of wounds following implementation of the Champions for Skin Integrity model to facilitate uptake of evidence-based practice in aged care. (United States)

    Edwards, Helen E; Chang, Anne M; Gibb, Michelle; Finlayson, Kathleen J; Parker, Christina; O'Reilly, Maria; McDowell, Jan; Shuter, Patricia


    To evaluate the implementation of the Champions for Skin Integrity model on facilitating uptake of evidence-based wound management and improving skin integrity in residents of aged care facilities. The incidence of skin tears, pressure injuries and leg ulcers increases with age, and such wounds can be a serious issue in aged care facilities. Older adults are not only at higher risk for wounds related to chronic disease but also injuries related to falls and manual handling requirements. A longitudinal, pre-post design. The Champions for Skin Integrity model was developed using evidence-based strategies for transfer of evidence into practice. Data were collected before and six months after implementation of the model. Data on wound management and skin integrity were obtained from two random samples of residents (n = 200 pre; n = 201 post) from seven aged care facilities. A staff survey was also undertaken (n = 126 pre; n = 143 post) of experience, knowledge and evidence-based wound management. Descriptive statistics were calculated for all variables. Where relevant, chi-square for independence or t-tests were used to identify differences between the pre-/postdata. There was a significant decrease in the number of residents with a wound of any type (54% pre vs 43% post, χ(2) 4·2, p = 0·041), as well as a significant reduction in specific wound types, for example pressure injuries (24% pre vs 10% post, χ(2) 14·1, p Integrity model has the potential to improve uptake of evidence-based wound management and improve skin integrity for older adults. © 2017 John Wiley & Sons Ltd.

  15. The Point Prevalence of Malignancy in a Wound Clinic. (United States)

    Ghasemi, Farhad; Anooshirvani, Niloofar; Sibbald, R Gary; Alavi, Afsaneh


    The aim of this study was to determine the prevalence of malignant leg ulcers and to identify the most frequent characteristics of such wounds. This study was a retrospective investigation of patients with chronic leg ulcers in a North American tertiary wound clinic. Between January 2011 and September 2013, a total of 1189 patients with lower extremity wounds, including 726 patients with leg wounds, were identified. A total of 124 of the 726 had undergone a biopsy of their atypical wound, 16.1% (20/124) of which were malignant. Patients with malignant wounds were older than patients with nonmalignant leg wounds (P hypergranulation tissue (P < .0001), and friable/bleeding wound surface (P < .0001). The frequency of malignant wounds in patients with chronic leg ulcers highlights the need for a systematic approach, which would involve biopsy of wounds to identify malignancy in this patient population early on. © The Author(s) 2016.

  16. Chronic Wound Healing: A Review of Current Management and Treatments. (United States)

    Han, George; Ceilley, Roger


    Wound healing is a complex, highly regulated process that is critical in maintaining the barrier function of skin. With numerous disease processes, the cascade of events involved in wound healing can be affected, resulting in chronic, non-healing wounds that subject the patient to significant discomfort and distress while draining the medical system of an enormous amount of resources. The healing of a superficial wound requires many factors to work in concert, and wound dressings and treatments have evolved considerably to address possible barriers to wound healing, ranging from infection to hypoxia. Even optimally, wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. This article will review wound healing physiology and discuss current approaches for treating a wound.

  17. Rapid hemostatic and mild polyurethane-urea foam wound dressing for promoting wound healing. (United States)

    Liu, Xiangyu; Niu, Yuqing; Chen, Kevin C; Chen, Shiguo


    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 50-130μm, 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 13days, 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. Copyright © 2016 Elsevier B.V. All rights reserved.

  18. Active wound dressing with artificial capillaries for temporary wound irrigation and skin cell supply. (United States)

    Plettig, Jörn; Johnen, Christa M; Bräutigam, Kirsten; Zeilinger, Katrin; Borneman, Reinhard; Gerlach, Jörg C


    Medical treatment of burns and chronic wounds remains a challenge. We discussed a therapy concept that combines skin cell spray transplantation with a novel wound dressing based on artificial hollow fiber membrane capillaries. In skin cell-based therapy development, autologous skin progenitor cells are isolated from a healthy skin area and sprayed onto the wound. A medical device was introduced that uses perfused capillaries, known from clinical plasma separation, as a temporarily applied extracorporeal wound capillary bed. The functions of the dressing are comparable with those of dialysis; the capillaries, however, are applied externally onto the wound. Perfusion with a clinical peripheral nutrition and buffer solution can provide wound irrigation, wound debris removal, cell nutrition, pH regulation, and electrolyte balance while potentially serving to address delivery of regenerative factors and antibiosis. An innovative active skin wound dressing that provides cell support and stimulates regeneration by wound irrigation is discussed. © 2011, Copyright the Authors. Artificial Organs © 2011, International Center for Artificial Organs and Transplantation and Wiley Periodicals, Inc.

  19. Influence of hydrophilic polymers on functional properties and wound healing efficacy of hydrocolloid based wound dressings. (United States)

    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


    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.

  20. Penetrating Stab Wound of the Right Ventricle

    Directory of Open Access Journals (Sweden)

    Onursal Buğra


    Full Text Available 18 years old male patient was admitted to our emergency unit with a penetrating stab wound to the right ventricle. A stab wound to the right ventricle was found to be 3 cm in diameter. The bleeding was controlled by insertion of a Foley catheter and inflation of the balloon. The stab wound had transected distal acute marginal side ofthe right coronary artery. A successful repair was performed with the use of a foley catheter and application of the Medtronic Octopus Tissue Stabilization System. The wound was closed with pledgeted mattress sutures. The distal acute marginal side of the right coronary artery was ligated. In this presentation, the surgical intervention method was reported and followed by a discussion of emergency surgical procedures of the heart.

  1. Thrombomodulin promotes corneal epithelial wound healing

    National Research Council Canada - National Science Library

    Huang, Yi-Hsun; I, Ching-Chang; Kuo, Cheng-Hsiang; Hsu, Yun-Yan; Lee, Fang-Tzu; Shi, Guey-Yueh; Tseng, Sung-Huei; Wu, Hua-Lin


    To determine the role of thrombomodulin (TM) in corneal epithelial wound healing, and to investigate whether recombinant TM epidermal growth factor-like domain plus serine/threonine-rich domain (rTMD23...

  2. Cyanoacrylate for Intraoral Wound Closure: A Possibility?

    Directory of Open Access Journals (Sweden)

    Parimala Sagar


    Full Text Available Wound closure is a part of any surgical procedure and the objective of laceration repair or incision closure is to approximate the edges of a wound so that natural healing process may occur. Over the years new biomaterials have been discovered as an alternate to conventional suture materials. Cyanoacrylate bioadhesives are one among them. They carry the advantages of rapid application, patient comfort, resistance to infection, hemostatic properties, and no suture removal anxiety. Hence this study was undertaken to study the effect of long chain cyanoacrylate as an adhesive for intraoral wound closure and also to explore its hemostatic and antibacterial effects. Isoamyl-2-cyanoacrylate (AMCRYLATE was used as the adhesive in the study. In conclusion isoamyl cyanoacrylate can be used for intraoral wound closure, as an alternative to sutures for gluing the mucoperiosteum to bone, for example, after impaction removal, periapical surgeries, and cleft repair. Its hemostatic and antibacterial activity has to be further evaluated.

  3. [Corneal wound healing after penetrating keratoplasty with EGF application. Experimental studies]. (United States)

    Szaflik, J; Fryczkowski, A W; Liberek, I; Czubak, M; Brix, M; Broniek, G; Fryczkowski, P


    To check post penetrating keratoplasty (PK) corneal wound healing characteristics after epidermal growth factor (EGF) application and to compare it with controls. The PK was performed in the group of 72 young, healthy New Zealand rabbits (36 females and 36 males). Slit-lamp examination, tonometry and corneal topography by Tomey's corneal modeling system (TMS-1) were carried out before and after surgery. The PK was performed in both eyes. Half of animals were used as a bilateral donor for the other half, with a rule: right eye cornea to the right eye and left eye cornea to the left eye. As a result, after completed surgery 36 rabbits had bilateral grafts. The animals were divided into 3 equal groups (12 in each). Two drops of the human recombined EGF dissolved in the saline solution with concentration varied from 500 to 1500 ng in each drop were applied to the right eye according to schedule. The left eye was used as a control and did not receive EGF. Time of observation varied from 24 hours to 6 months. The tensinometry and the histopathologic study--light and electron microscopy were performed to determine corneal scarring. The wound healing pattern after PK was characteristic and constant in each group. The corneal wound healing significantly accelerated in the EGF treated group of rabbits compared with the controls (p times/day, after two weeks of application we noted increase of the wound strength up to 600 folds, comparing with controls. Well-organized scar was histologically seen on the 21st post-surgery day. The post-operative corneal astigmatism was less expressed in the eyes treated with EGF comparing to controls. These preliminary results of our experimental study indicated accelerated effect on the corneal wound healing after PK with topical, low dose hrEGF application. Clinical observation of utilization of similar low doses of the hrEGF after PK--is in progress.

  4. Gelatin hydrogel impregnated with platelet-rich plasma releasate promotes angiogenesis and wound healing in murine model. (United States)

    Notodihardjo, Priscilla Valentin; Morimoto, Naoki; Kakudo, Natsuko; Matsui, Makoto; Sakamoto, Michiharu; Liem, Pham Hieu; Suzuki, Kenji; Tabata, Yasuhiko; Kusumoto, Kenji


    Platelet-rich plasma (PRP) contains numerous growth factors to promote wound healing and angiogenesis. The objective of this study was to explore the efficacy of biodegradable gelatin hydrogel impregnated with PRP releasate (PRPr) in the wound healing process compared with the single application of PRPr prepared from mouse PRP centrifuged by a double-spin method. Gelatin hydrogel disks with an isoelectric point of 5.0 were used in this study. A total of 180 mice (n = 45/group) were randomly assigned to the following 4 experimental groups: control group, biodegradable gelatin hydrogel group, PRPr group and gelatin hydrogel impregnated with PRPr (PRPrG) group. Wound area and epithelialization were compared on days 1, 5, 7, 14 and 21 post-wounding. After complete epithelialization, wound contraction was also evaluated. Neovascularization using immunohistochemical staining of von Willebrand factor was analyzed on day 14. The wound area of PRPrG on days 5, 7 and 14 was smaller than that in the other groups (p < 0.01). The epithelialization lengths of PRPrG on days 7 and 14 were significantly longer than the others (p < 0.01). The capillary formation of PRPrG was also superior to those in all other groups on day 14. On day 21, all wounds were completely epithelialized and PRPrG prevented wound contraction the most. It is concluded that the sustained-release system of gelatin impregnated with PRPr can stimulate angiogenesis and accelerate wound healing compared with the single application of PRP.

  5. Photobiomodulation by helium neon and diode lasers in an excisional wound model: A single blinded trial. (United States)

    Dixit, Snehil; Maiya, Arun; Rao, Laxmi; Rao, M Arjun; Shastry, Barkur Ananthakrishna; Ramachandra, L


    Application of different kinds of lasers in clinical and experimental studies causes photobiomodulation that works at localized cellular and humoral level on various biological systems. Increased numbers of fibroblasts, myofibroblast, and degranulation of mast cells have been the observed benefits post-irradiation. Was to find out the effect of irradiation with energy densities of 3.38 J/cm(2), 8 J/cm(2), and 18 J/cm(2) on animal tissue (albino wistar rats) in an excisional wound model and to assess changes in biochemical (hydroxyproline) and histopathological levels in excisional wound model. The animals were divided into 4 groups, which were labeled as L1, diode laser (18 J/cm(2)), L2 Helium-neon (He-Ne, 8 J/cm(2)), L3 diode laser (3.38 J/cm(2)), and sham treatment for control was depicted by C, respectively. Histological and hydroxyproline analysis was performed on 7, 14, 21 days of post-wounding. One-way analysis of variance, ANOVA and Bonferroni's multiple comparison tests were done for tissue hydroxyproline levels. There was no significant increase in the hydroxyproline content (P neon laser of 8 J/cm(2) intensity facilitated photo stimulation by tissue repair, but failed to show significant tissue hydroxyproline levels in excisional wound model.

  6. Preferential recruitment of bone marrow-derived cells to rat palatal wounds but not to skin wounds.

    NARCIS (Netherlands)

    Verstappen, J.; Rheden, R.E.M. van; Katsaros, C.; Torensma, R.; Hoff, J.W. Von den


    OBJECTIVE: To investigate the contribution of bone marrow-derived cells to oral mucosa wounds and skin wounds. BACKGROUND: Bone marrow-derived cells are known to contribute to wound healing, and are able to differentiate in many different tissue-specific cell types. As wound healing in oral mucosa

  7. A current affair: electrotherapy in wound healing


    Hunckler,Jerome; de Mel,Achala


    Jerome Hunckler, Achala de Mel UCL Division of Surgery and Interventional Sciences, Faculty of Medical Sciences, University College London, London, UK Abstract: New developments in accelerating wound healing can have immense beneficial socioeconomic impact. The wound healing process is a highly orchestrated series of mechanisms where a multitude of cells and biological cascades are involved. The skin battery and current of injury mechanisms have become topics of interest for their in...

  8. Multicultural understanding of infected wound care.


    Rono, Ruth; Åstrand, Loise; Tatala, Sinthia


    The aim of the study was to focus on the challenges nurses encounter while caring for multicultural patients with infected wounds. The purpose was to describe what sort of challenges nurses encounter with multicultural patients and how culture affects the patients’ care. The goal was to gain more knowledge/understanding on multicultural patients for the improvement of nursing practice in infected wound care. The study was done using a qualitative method and inductive analysis. The theoret...

  9. Microbiology of equine wounds and evidence of bacterial biofilms


    Westgate, S.J.; Percival, S.L.; Knottenbelt, D.C.; Clegg, P.D.; Cochrane, C.A.


    Abstract Horse wounds have a high risk of becoming infected due to their environment. Infected wounds harbour diverse populations of microorganisms, however in some cases these microorganisms can be difficult to identify and fail to respond to antibiotic treatment, resulting in chronic non-healing wounds. In human wounds this has been attributed to the ability of bacteria to survive in a biofilm phenotypic state. Biofilms are known to delay wound healing, principally due to their r...

  10. Equine distal limb wounds: new and emerging treatments. (United States)

    Alford, Christopher G; Caldwell, Fred J; Hanson, Reid


    Distal limb wounds occur commonly in horses, and treatment can be frustrating for owners and veterinarians. Caring for these wounds is often very expensive, labor intensive, and prolonged. Many commercial products and clinical techniques have been developed to help treat these wounds. Healing of these wounds depends on many factors. With proper wound evaluation and treatment, affected horses can return to function sooner than in the past.

  11. Wound healing and hyper-hydration - a counter intuitive model


    Ousey, Karen; Cutting, Keith


    Winters seminal work in the 1960s relating to providing an optimal level of moisture to aid wound healing (granulation and re-epithelialisation) has been the single most effective advance in wound care over many decades. As such the development of advanced wound dressings that manage the fluidic wound environment have provided significant benefits in terms of healing to both patient and clinician. Although moist wound healing provides the guiding management principle confusion may arise betwe...

  12. Grand challenge in Biomaterials-wound healing (United States)

    Salamone, Joseph C.; Salamone, Ann Beal; Swindle-Reilly, Katelyn; Leung, Kelly Xiaoyu-Chen; McMahon, Rebecca E.


    Providing improved health care for wound, burn and surgical patients is a major goal for enhancing patient well-being, in addition to reducing the high cost of current health care treatment. The introduction of new and novel biomaterials and biomedical devices is anticipated to have a profound effect on the future improvement of many deleterious health issues. This publication will discuss the development of novel non-stinging liquid adhesive bandages in healthcare applications developed by Rochal Industries. The scientists/engineers at Rochal have participated in commercializing products in the field of ophthalmology, including rigid gas permeable contact lenses, soft hydrogel contact lenses, silicone hydrogel contact lenses, contact lens care solutions and cleaners, intraocular lens materials, intraocular controlled drug delivery, topical/intraocular anesthesia, and in the field of wound care, as non-stinging, spray-on liquid bandages to protect skin from moisture and body fluids and medical adhesive-related skin injuries. Current areas of entrepreneurial activity at Rochal Industries pertain to the development of new classes of biomaterials for wound healing, primarily in regard to microbial infection, chronic wound care, burn injuries and surgical procedures, with emphasis on innovation in product creation, which include cell-compatible substrates/scaffolds for wound healing, antimicrobial materials for opportunistic pathogens and biofilm reduction, necrotic wound debridement, scar remediation, treatment of diabetic ulcers, amelioration of pressure ulcers, amelioration of neuropathic pain and adjuvants for skin tissue substitutes. PMID:27047680

  13. Mechanoregulation of Wound Healing and Skin Homeostasis

    Directory of Open Access Journals (Sweden)

    Joanna Rosińczuk


    Full Text Available Basic and clinical studies on mechanobiology of cells and tissues point to the importance of mechanical forces in the process of skin regeneration and wound healing. These studies result in the development of new therapies that use mechanical force which supports effective healing. A better understanding of mechanobiology will make it possible to develop biomaterials with appropriate physical and chemical properties used to treat poorly healing wounds. In addition, it will make it possible to design devices precisely controlling wound mechanics and to individualize a therapy depending on the type, size, and anatomical location of the wound in specific patients, which will increase the clinical efficiency of the therapy. Linking mechanobiology with the science of biomaterials and nanotechnology will enable in the near future precise interference in abnormal cell signaling responsible for the proliferation, differentiation, cell death, and restoration of the biological balance. The objective of this study is to point to the importance of mechanobiology in regeneration of skin damage and wound healing. The study describes the influence of rigidity of extracellular matrix and special restrictions on cell physiology. The study also defines how and what mechanical changes influence tissue regeneration and wound healing. The influence of mechanical signals in the process of proliferation, differentiation, and skin regeneration is tagged in the study.

  14. Occurrence of Wounds in Nigerian Horses. (United States)

    Agina, Onyinyechukwu A; Ihedioha, John I


    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 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.

  15. Lead poisoning after gunshot wound

    Directory of Open Access Journals (Sweden)

    Paulo Roberto de Madureira


    Full Text Available CONTEXT: Despite the absence of symptoms in the majority of patients carrying lead bullet fragments in their bodies, there needs to be an awareness of the possible signs and symptoms of lead intoxication when bullets are lodged in large joints like knees, hips and shoulders. Such patients merit closer follow-up, and even surgical procedure for removing the fragments. OBJECTIVE: To describe a patient who developed clinical lead intoxication several years after a gunshot wound. DESIGN: Case report. CASE REPORT: A single white 23-year-old male, regular job as a bricklayer, with a history of chronic alcohol abuse, showed up at the emergency department complaining of abdominal pain with colic, weakness, vomiting and diarrhea with black feces. All the symptoms had a duration of two to three weeks, and had been recurrent for the last two years, with calming during interval periods of two to three weeks. Abdominal radiograms showed a bullet lodged in the left hip, with a neat bursogram of the whole synovial capsule. A course of chelating treatment using calcium versenate (EDTACaNa2 intravenously was started. After the chelation therapy the patient had recurrence of his symptoms and a radical solution for the chronic mobilization of lead was considered. A hip arthroplasty procedure was performed, leading to complete substitution of the left hip.

  16. Adaptation of evidence-based surgical wound care algorithm. (United States)

    Han, Jung Yeon; Choi-Kwon, Smi


    This study was designed to adapt a surgical wound care algorithm that is used to provide evidence-based surgical wound care in a critical care unit. This study used, the 'ADAPTE process', an international clinical practice guideline development method. The 'Bonnie Sue wound care algorithm' was used as a draft for the new algorithm. A content validity index (CVI) targeting 135 critical care nurses was conducted. A 5-point Likert scale was applied to the CVI test using a statistical criterion of .75. A surgical wound care algorithm comprised 9 components: wound assessment, infection control, necrotic tissue management, wound classification by exudates and depths, dressing selection, consideration of systemic factors, wound expected outcome, reevaluate non-healing wounds, and special treatment for non-healing wounds. All of the CVI tests were ≥.75. Compared to existing wound care guidelines, the new wound care algorithm provides precise wound assessment, reliabilities of wound care, expands applicability of wound care to critically ill patients, and provides evidence and strength of recommendations. The new surgical wound care algorithm will contribute to the advancement of evidence-based nursing care, and its use is expected as a nursing intervention in critical care.

  17. Surgical wound assessment and documentation of nurses: an integrative review. (United States)

    Ding, S; Lin, F; Gillespie, B M


    Surgical site infections (SSI) are serious complications that can lead to adverse patient outcomes such as prolonged hospital length of stay, increased health-care costs, and even death. There is an imperative worldwide to reduce the morbidity associated with SSIs. The importance of surgical wound assessment and documentation to reduce SSI complications is increasingly recognised. Evidence-based guidelines have been published internationally to highlight recommended practices. The aim of this integrated review is to evaluate current surgical wound assessment and documentation practices of nurses in order to inform future evidence-based research on acute wound care practices. Databases including CINAHL, Cochrane, Medline and Proquest Nursing were searched using key terms of 'wound assessment' AND 'surgical, wound assessment' AND 'documentation, wound assessment' AND 'practice, wound assessment' AND 'postoperative, wound assessment' AND 'nurse, and wound assessment' AND 'surgical site infection'. A total of 188 articles were identified from the database searches; searching the reference lists provided an additional 8 articles. After careful exclusion processes, a total of six papers were included in the review. Despite the recommendations around wound assessment, there is little discussion on how the clinical characteristics of surgical wounds should be assessed, the frequency of the wound assessments and to what extent wound assessments are documented in the literature. There is limited research evidence on acute wound assessment and documentation. Therefore, further research is needed to provide evidence for surgical nurses in relation to wound assessment and documentation practices. The authors declare that they have no conflict of interest.

  18. La Poste

    CERN Multimedia

    2004-01-01 The French Post Office has issued ten commemorative envelopes bearing original images depicting CERN and its history. This special fiftieth anniversary collector's edition will be available on the French Post Office (« La Poste ») stand at the Open Day on 16 October, in the CMS experiment hall at Cessy. Information for collectors: a pictorial postmark and date stamp have been specially designed and produced for the occasion with the assistance of CERN's graphics team. Sending a philatelic souvenir is a great way to commemorate the Open Day, so La Poste will be setting up a large post-box for that very purpose next to its stand. A perfect way to send images of CERN all around the world...

  19. Clinical and histological findings of cutaneous wound healing in the red-eared slider turtle (Trachemys scripta elegans) housed in unheated outdoor enclosures. (United States)

    Negrini, Joao; Ginel, Pedro J; Novales, Manuel; Guerra, Rafael; Mozos, Elena


    Cutaneous wounds are common in chelonians. The clinical and histological features of wound healing in these species are not well described and this prevents evaluation of new therapies. To describe clinical and histopathological features of cutaneous wound healing in the red-eared slider turtle (Trachemys scripta elegans). Twenty four healthy adult females housed in outdoor facilities with free access to water and exposed to daily variations in temperature. Full thickness 6 mm skin biopsy punch wounds were created in the rear limbs. The turtles were assigned to Group 1 (n = 12 for clinical evaluation) and Group 2 (n = 12 for microscopic study). Group 1 was photographed on Day 1 and weekly, until 28 days post wounding. Wound retraction was expressed as the percentage of perimeter reduction. For Group 2, three skin wounds were sampled at 2, 7, 14, 21, 28, 42, 60 and 135 days post wounding for histological study. The avidin-biotin-peroxidase (ABC) staining method was used to evaluate five commercial antibodies. Wound contraction was limited; crust persisted at least 28 days. Re-epithelialization was complete by Day 14 in many animals; active inflammation persisted until 28 days; connective tissue re-constitution and remodelling was achieved from 42 to 135 days. Antibodies AE1/AE3, Factor VIII, MAC 387, CD3 and NCL-MSA showed cross reactivity with the cell counterpart in turtle tissues. Second intention wound healing progressed slowly and with an indolent behaviour. Microscopically there was marked overlapping of the inflammatory and proliferative phases over a long time period. © 2016 ESVD and ACVD.

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

    Directory of Open Access Journals (Sweden)

    Hossein kaboli


    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.

  1. SNaP® Wound Care System: Ultraportable Mechanically Powered Negative Pressure Wound Therapy. (United States)

    Fong, Kenton D; Marston, William A


    Negative pressure wound therapy (NPWT) is a well-accepted modality for treatment of difficult wounds, but has traditionally required a bulky electrically powered pump that was difficult to procure and use for both caregivers and patients. Often times, treatment of refractory smaller-sized wounds was impractical even though they may benefit from NPWT. Spiracur (Sunnyvale, CA) has developed a simple, easy-to-use, single-use, off-the-shelf, mechanically powered NPWT device that weighs Smart Negative Pressure (SNaP®) Wound Care System is a novel light-weight NPWT device that does not require an electrically powered pump. Instead, the SNaP system utilizes specialized springs to generate a preset (-75, -100, and -125 mmHg) continuous subatmospheric pressure level to the wound bed. This technology has demonstrated similar efficacy and increased usability for both clinicians and patients when compared with electrically powered NPWT devices. Chronic, acute, traumatic, subacute, and dehisced wounds, partial-thickness burns, ulcers (such as diabetic or pressure), and surgically closed incisions and flaps. Wounds with excess necrotic tissue, active infection, fistulas, exposed vital structures, untreated osteomyelitis, and that are highly exudative. The SNaP system was not designed for wounds that exceed the size of the dressing in surface area or have exudate levels greater than capacity of the cartridge.

  2. Keratin-based Wound Care Products for Treatment of Resistant Vascular Wounds (United States)

    Than, Martin P.; Smith, Robert A.; Hammond, Catherine; Kelly, Robert; Marsh, Clive; Maderal, Andrea D.


    Use of new keratin-based wound dressings represent a novel approach to wound management. The authors present three patients with recalcitrant, venous and mixed venous, and arterial leg ulcers treated with these dressings. Improvement in each case was observed. PMID:23277802

  3. Anterior gradient 2 is induced in cutaneous wound and promotes wound healing through its adhesion domain. (United States)

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


    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.

  4. Innate Defense Regulator Peptide 1018 in Wound Healing and Wound Infection

    DEFF Research Database (Denmark)

    Steinstraesser, Lars; Hirsch, Tobias; Schulte, Matthias


    -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...

  5. Wound-induced suberization genes are differentially expressed during closing layer and wound periderm formation (United States)

    Tuber wounds incurred at harvest and upon seed cutting require rapid suberization as a major part of the healing process to prevent infection and desiccation. The first stage of this healing process is referred to as closing layer development and is followed by the second stage, wound periderm deve...

  6. Effects of topical insulin on second-intention wound healing in the red-eared slider turtle (Trachemys scripta elegans) - a controlled study. (United States)

    Negrini, Joao; Mozos, Elena; Escamilla, Alejandro; Pérez, José; Lucena, Rosario; Guerra, Rafael; Ginel, Pedro J


    Compared with mammals, wound healing in reptiles is characterized by reduced wound contraction and longer healing times. The aim of this study is to describe the clinical and histopathological effects of topical insulin on second-intention healing of experimentally induced wounds in skin without dermal bony plates of Trachemys scripta elegans exposed to daily variations in ambient temperature and in an aquatic environment. Forty-four healthy adult females were assigned to two groups: Group 1 (n = 24) was used to assess clinical features such as wound contraction; Group 2 (n = 20) was used for histological evaluation and morphometric analysis. Topical porcine insulin (5 IU/ml diluted in glycerol) was applied daily 1 week. For each control time (2, 7, 14, 21 and 28 days post-wounding), re-epithelisation and wound remodelling were evaluated histologically and the number of main inflammatory cells (heterophils, macrophages, lymphocytes and fibroblasts) was scored. Mean wound contraction was higher in the insulin-treated group at each time point and differences were significant at day 28 (P insulin-treated wounds had significantly higher mean counts of heterophils (day 7), macrophages (days 2, 7 and 14) and fibroblasts (days 14 and 21), whereas lymphocyte counts were significantly lower at day 21. These results demonstrate that topical insulin modifies the inflammatory response of turtle skin up-regulating inflammatory cells at early stages and promoting wound healing. Topical insulin is a potentially useful therapy in skin wounds of Trachemys scripta and should be evaluated in non-experimental wounds of turtles and other reptiles.

  7. Expression of Cry1Ac in transgenic tobacco plants under the control of a wound-inducible promoter (AoPR1) isolated from Asparagus officinalis to control Heliothis virescens and Manduca sexta. (United States)

    Gulbitti-Onarici, Selma; Zaidi, Mohsin Abbas; Taga, Ibrahim; Ozcan, Sebahattin; Altosaar, Illimar


    Expression of cry1Ac gene from Bacillus thuringiensis (Bt) was evaluated under the control of a wound-inducible AoPR1 promoter from Asparagus officinalis in transgenic tobacco plants. The leaves of transgenic plants were mechanically wounded to evaluate the activity of the AoPR1 promoter in driving the expression of Cry1Ac protein at the wound site. Our results indicate that mechanical wounding of transgenic plants was effective in inducing the expression of Cry1Ac protein. As a result of this induction, the accumulated levels of Cry1Ac protein increased during 6-72 h post-wounding period. The leaves of transgenic tobacco plants were evaluated for resistance against Heliothis virescens and Manduca sexta in insect bioassays in two different ways. The detached tobacco leaves were either fed directly to the insect larvae or they were first mechanically wounded followed by a 72 h post-wounding feeding period. Complete protection of mechanically wounded leaves of transgenic plants was observed within 24 h of the bioassay. The leaves of transgenic plants fed directly (without pre-wounding) to the larvae achieved the same level of protection between 24 and 72 h of the bioassay.

  8. Cat keratoplasty wound healing and corneal astigmatism. (United States)

    Tripoli, N K; Cohen, K L; Proia, A D


    A major contributor to postkeratoplasty astigmatism may be donor/recipient disparity. Deficient or excess cornea at the wound is thought to influence the directions of the steep and flat meridians. Using an established model of penetrating keratoplasty in the cat, this study evaluated the morphometry of histopathologic wound features in the steep and flat meridians. Thirteen cats had successful penetrating keratoplasties after intentionally misshapen donor corneas were misaligned in misshapen recipient beds. At 9.50 +/- 0.32 (mean +/- 1 SEM) months after keratoplasty, photokeratography was performed and analyzed, corneas were sectioned along the steep and flat meridians, and four histologic sections were processed. Features of the wounds were measured using a Zeiss Videoplan. The relationships between the morphometry of each feature and every other feature, between the morphometry of each feature and eccentricity, and between the steep and flat section morphometry of each feature were statistically evaluated. Epithelial thickness, area of lamellar alteration, length of Descemet's membrane produced postoperatively, and the depth that preoperative Descemet's membrane was embedded in the stroma were correlated with eccentricity (corneal astigmatism). Stromal thickness and the presence or absence of folded and fragmented Descemet's membrane were not correlated with eccentricity. Wound morphometry at the steep meridians was neither correlated with nor significantly different from wound morphometry at the flat meridians. Differences between healing at the steep and flat meridians were not likely contributors to astigmatism. Disproportionate availability of tissue in wound regions may have affected healing throughout the entire wound over time. The absence of Bowman's layer in cats restricts application of our results to understanding the etiology of corneal astigmatism after penetrating keratoplasty in humans.

  9. Incisional Negative Pressure Wound Therapy for Prevention of Postoperative Infections Following Caesarean Section (United States)


    Surgical Wound Infection; Infection; Cesarean Section; Cesarean Section; Dehiscence; Complications; Cesarean Section; Complications; Cesarean Section, Wound, Dehiscence; Wound; Rupture, Surgery, Cesarean Section

  10. Expression of serum amyloid a in equine wounds

    DEFF Research Database (Denmark)

    Sørensen, Mette Aamand; Jacobsen, Stine; Berg, Lise Charlotte


    higher (P wounds healing with EGT formation than in body and limb wounds with normal healing. In body wounds and limb wounds with normal healing SAA expression was very low, in EGT SAA expression levels varied from low to very high. CONCLUSIONS SAA is a major equine acute phase protein......OBJECTIVES Aberrant wound healing with formation of exuberant granulation tissue (EGT) occurs frequently in horses and may affect their athletic career and quality of life. The objective of the study was to determine mRNA expression levels of serum amyloid A (SAA) in normal and aberrant wound...... healing in horses. METHODS Experimental wounds were made in six horses on both metatarsi and on regio brachii. One limb was bandaged to provoke formation of EGT. Biopsies were collected on day 21 and were divided in three groups: body wounds (regio brachii), unbandaged limb wounds (normal healing...

  11. Wound bed preparation: A novel approach using HydroTherapy. (United States)

    Atkin, Leanne; Ousey, Karen


    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.

  12. Emerging drugs for the treatment of wound healing. (United States)

    Zielins, Elizabeth R; Brett, Elizabeth A; Luan, Anna; Hu, Michael S; Walmsley, Graham G; Paik, Kevin; Senarath-Yapa, Kshemendra; Atashroo, David A; Wearda, Taylor; Lorenz, H Peter; Wan, Derrick C; Longaker, Michael T


    Wound healing can be characterized as underhealing, as in the setting of chronic wounds, or overhealing, occurring with hypertrophic scar formation after burn injury. Topical therapies targeting specific biochemical and molecular pathways represent a promising avenue for improving and, in some cases normalizing, the healing process. A brief overview of both normal and pathological wound healing has been provided, along with a review of the current clinical guidelines and treatment modalities for chronic wounds, burn wounds and scar formation. Next, the major avenues for wound healing drugs, along with drugs currently in development, are discussed. Finally, potential challenges to further drug development, and future research directions are discussed. The large body of research concerning wound healing pathophysiology has provided multiple targets for topical therapies. Growth factor therapies with the ability to be targeted for localized release in the wound microenvironment are most promising, particularly when they modulate processes in the proliferative phase of wound healing.

  13. Wound inflammatory index: a "proof of concept" study to assess wound healing trajectory. (United States)

    Bharara, Manish; Schoess, Jeffrey; Nouvong, Aksone; Armstrong, David G


    Diabetes around the globe results in one major limb amputation every 30 seconds, over 2500 limbs lost per day. The underlying pathophysiology sometimes leads to a chronic inflammatory stage, which may prevent appropriate healing, and therefore, the need for a clear strategy for assessing and classifying wounds and wound healing cannot be overstated. Temperature is a surrogate marker for inflammation. Quantitative thermography using a numerical index provides a useful way to assess wound healing. Advances in technology have afforded the availability of low-cost, high-resolution thermal imaging systems, which can be used to quantify sensitive changes on the skin surface and may be particularly useful to develop monitoring strategies for wounds. This article provides a standardized technique for calculating a thermal index (TI) supported with a case report from assessment of a diabetic foot ulcer. In this single case study, the TI/wound inflammatory index indicates a shift from negative to positive (p Diabetes Technology Society.

  14. Biomaterials and Nanotherapeutics for Enhancing Skin Wound Healing

    Directory of Open Access Journals (Sweden)

    Subhamoy Das


    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.

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

    Directory of Open Access Journals (Sweden)

    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.

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

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    Yang Woo Kim


    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.

  17. Bacterial flora of combat wounds from eastern Ukraine and time-specified changes of bacterial recovery during treatment in Ukrainian military hospital. (United States)

    Valentine, Kovalchuk P; Viacheslav, Kondratiuk M


    positive swab-cultures after first week were nonfermentative Gram-negative bacilli (68% of swab-cultures), which in 53% of the swab-cultures belonged to the genus Acinetobacter, and in 15% to the genus Pseudomonas. The incidence of polymicrobial wound cultures increased from first week to second post-injury week. The most frequent microbial mixture were Acinetobacter baumannii with Enterobacteriaceae or other nonfermentative Gram negative rods with Enterococcus spp. We observed bacteria recovery from wounds during proliferation phase. These wounds had no pure inflammation signs and were free of devitalized tissues. Any wound is at some risk of becoming infected. In the event of infection, a wound fails to heal, treatment costs rise, and general wound management practices become more resource demanding. Determining the microorganisms which colonize battle wounds and cause wound infection is paramount. This information can help to treat battle wound infections or even changes infection control strategies. The fact of shifting in wound microbiology in the favor of bacteria responsible for healthcare-associated infections support to the proposition that these changes are nosocomially related [4, 14]. For Ukrainian military medicine this study is the first time-specified assessment of battle wound colonization from the World War II.

  18. Biological post


    Kumar, B. Suresh; Kumar, Senthil; N S Mohan Kumar; Karunakaran, J. V.


    Anterior tooth fracture as a result of traumatic injuries, is frequently encountered in endodontic practice. Proper reconstruction of extensively damaged teeth can be achieved through the fragment reattachment procedure known as ?biological restoration.? This case report refers to the esthetics and functional recovery of extensively damaged maxillary central incisor through the preparation and adhesive cementation of ?biological post? in a young patient. Biological post obtained through extra...

  19. The contribution of distance learning to the knowledge of nursing lecturers regarding assessment of chronic wounds. (United States)

    Gonçalves, Márcia Beatriz Berzoti; Rabeh, Soraia Assad Nasbine; Terçariol, César Augusto Sangaletti


    to identify the contribution made by a refresher course on the assessment of chronic wounds, offered through the Moodle virtual learning environment (VLE), to the knowledge relating to this issue of nursing lecturers and nurses linked to higher education. a prospective, quasi-experimental study, with data collection before and after the educational intervention. The study was undertaken in three stages using the Moodle VLE. The sample was made up of 28 participants who answered the pre-test on the knowledge, devised in accordance with international guidelines on chronic wounds. Afterwards, the refresher course was offered (intervention) and was accessed in accordance with individuals' schedules, during the established time period. At the end of the course, 26 participants answered the post-test. Those who did not participate in the post-tests were excluded from the study, as it is pairwise analysis of the sample. the participants obtained, on average, 55.5% of correct answers in the pre-test on their knowledge, and 73.4% in the post-test, this difference being statistically significant. There was a negative correlation between the time of experience in lecturing and the performance in the test on their knowledge. the participation in the online refresher course contributed to improving the lecturers' performance in the test on their knowledge, in relation to the recommendations for assessing chronic wounds, based in scientific evidence.

  20. Inhaled methoxyflurane for pain and anxiety relief during burn wound care procedures: an Australian case series. (United States)

    Wasiak, Jason; Mahar, Patrick D; Paul, Eldho; Menezes, Hana; Spinks, Anneliese B; Cleland, Heather


    Pain is a common and significant feature of burn injury. The use of intravenous opioids forms the mainstay of procedural burn pain management, but in an outpatient setting, the demand for novel agents that do not require parenteral access, are easy to administer and have a rapid onset are urgently needed. One such agent is the inhaled anaesthetic agent, methoxyflurane (MF). The aim of this study was to conduct a pilot investigation into the clinical effectiveness of MF inhaler on pain and anxiety scores in patients undergoing burn wound care procedures in an outpatient setting. A prospective case series involved recruiting patients undergoing a burn wound care procedure in an ambulatory burn care setting. Pain and anxiety were assessed using numerical rating scales. Overall, median numerical pain rating score was significantly higher post-dressing [pre-dressing: 2; interquartile range (IQR): 1-3 versus post-dressing: 3; IQR 1·5-4; P = 0·01], whereas median numerical anxiety score significantly reduced following the dressing (pre-dressing: 5; IQR 4-7 versus post-dressing: 2; IQR 1-2; P burn care procedures in the ambulatory care setting. However, there is an urgent need for larger case series and randomised controlled trials to determine its overall clinical effectiveness. © 2012 The Authors. International Wound Journal © 2012 Inc and John Wiley & Sons Ltd.

  1. The Effects of Hydrogen Peroxide Solution and Tetracycline Ointment in Healing of Traumatic Facial Wounds: A Comparative Study

    Directory of Open Access Journals (Sweden)

    B. Barati


    Full Text Available Background and objectives Wound repair after a surgical operation or traumatic injuries is a coordinated process, which is highly dependent to the pre- and post-operative or traumatic care. There is no consensus on the best wound care method and application of topical therapeutic agents including diluted oxygen peroxide solution and antibiotics. This study is aimed to compare the healing effects of oxygen peroxide and tetracycline ointment in management of traumatic facial injuries. Methods 76 patients divided into two groups were entered into this randomized clinical trial. All patients sustained facial injuries requiring primary repair. The first group received 2% topical oxygen peroxide solution for 5 days, and the second group received sterile 1% tetracycline topical ointment for 5days. At the end of the fourth day, wound healing status was assessed with a chart designed for this purpose.Results No statistically significant difference was observed between the tetracycline and hydrogen peroxide groups in regards to the distance of wound margins, erythema and dehiscence. Conclusion According to our results, there is no difference in the effects of hydrogen peroxide solution or tetracycline ointment on the healing of traumatic facial wounds.Keywords: Wound Healing, Tissue Repair, Hydrogen Peroxide, Tetracycline

  2. Cellular fibronectin and tenascin in experimental perforating scleral wounds with incarceration of the vitreous. (United States)

    Tervo, K; Latvala, T; Suomalainen, V P; Tervo, T; Immonen, I


    Posterior perforating eye injury carries a high risk of visual loss due to the formation of intravireal and epiretinal scar tissue. Intraocular scar formation in patients with retinal detachment has been shown to be associated with elevated intravitreal FN levels. The extracellular matrix glycoproteins fibronectin (FN) and tenascin (TN) have been located in epiretinal scar membranes. As both FN and TN are also involved in healing of cutaneous and corneal wounds, we undertook to study their expression in rabbit perforating scleral wounds with vitreous incarceration. A perforating scleral wound was produced and sutured without removal of vitreous from the wound in 18 pigmented rabbits. The rabbits were killed at various times (1 h to 21 days) after the operation, and the indirect immunohistochemical method was used for demonstration of FN and TN. Monoclonal mouse hybridoma antibodies 52 DH1 and 100 EB2, recognizing the cellular form of FN (cFN) and TN, respectively, were used. During the first post-operative week immunoreaction for glycoproteins, both the locally produced cFN and TN, were observed at the scar tissue containing the prolabed vitreous and the adjacent sclera. Subsequently, the reaction gradually shifted to the vitreal side of the wound, and 3 weeks after the operation it was almost completely restricted to a separated mass of vitreous beneath the scar. The expression of cFN and TN in the scleral scar and vitreous is indicative of their local synthesis. The shift of the expression of those proteins to the vitreal side of the wound with time suggests that the scarring process in the vitreous is delayed compared to the sclera.

  3. Effect of virtual reality on adolescent pain during burn wound care. (United States)

    Jeffs, Debra; Dorman, Dona; Brown, Susan; Files, Amber; Graves, Tamara; Kirk, Elizabeth; Meredith-Neve, Sandra; Sanders, Janise; White, Benjamin; Swearingen, Christopher J


    The objective of this study was to compare the effect of virtual reality to passive distraction and standard care on burn treatment pain in adolescents.This single-blinded, randomized controlled study enrolled 30 adolescents who were 10 to 17 years of age from the burn clinic of a large children's hospital. After providing informed consent/assent, these participants were randomly assigned to one of three groups during wound care: standard care, passive distraction watching a movie, or virtual reality (VR) using a tripod-arm device rather than an immersive helmet. Before wound care, participants completed the Spielberger's State-Trait Anxiety Inventory for Children and Pre-Procedure Questionnaire while blinded to group assignment. A total of 28 participants completed the study and rated treatment pain after wound care by using the Adolescent Pediatric Pain Tool and completed a Post-Procedure Questionnaire. The VR group reported less pain during wound care than either the passive distraction or standard care group as determined by multivariable linear regression adjusted for age, sex, preprocedure pain, state anxiety, opiate use, and treatment length. The VR group was the only group to have an estimated decrease in pain perception from baseline preprocedure pain to procedural pain reported. Adolescents pretreated with opiate analgesics and female adolescents reported more pain during wound care.This between-subjects clinical study provides further support for VR, even without requiring wearing of an immersive helmet, in lessening burn wound care pain in adolescents. Passive distraction by watching a movie may be less effective in reducing treatment pain. Additional between-subjects randomized controlled trials with larger samples of children and during other healthcare treatments may further support VR's effectiveness in pediatric procedural pain management.

  4. Photobiomodulatory effects of superpulsed 904nm laser therapy on bioenergetics status in burn wound healing. (United States)

    Yadav, Anju; Gupta, Asheesh; Keshri, Gaurav K; Verma, Saurabh; Sharma, Sanjeev K; Singh, Shashi Bala


    Burn wounds exhibit impaired healing as the progression through the normal sequential stages of tissue repair gets hampered by epidermal barrier disruption, compromised blood circulation, abrogated defence mechanism, pathologic inflammation, and septicemia. Our earlier results reported that superpulsed 904nm LLLT enhanced healing and attenuated inflammatory response in burn wounds. The present study investigated the effect of superpulsed 904nm LLLT (200ns pulse width; 100Hz; 0.7mW mean output power; 0.4mW/cm(2) average irradiance) on biochemical and molecular markers pertaining to bioenergetics and redox homeostasis on full-thickness burn wounds in experimental rats. Results indicated that superpulsed laser irradiation for 7days post-wounding propelled the cellular milieu towards aerobic energy metabolism as evidenced by significantly enhanced activities of key energy regulatory enzymes viz. HK, PFK, CS and G6PD, whereas LDH showed reduced activity as compared to the non-irradiated controls. LLLT showed a significant increased CCO activity and ATP level. Moreover, LLLT also regulated redox homeostasis as evidenced by enhanced NADPH levels and decreased NADP/NADPH ratio. Western blot analysis demonstrated that LLLT produced an up-regulation of GLUT1, pAMPKα and down-regulation of glycogen synthase1 (GS1). Our findings suggest that superpulsed 904nm LLLT augments burn wound healing by enhancing intracellular energy contents through modulation of aerobic metabolism for maximum energy output. Bioenergetic activation and maintenance of redox homeostasis could be one of the noteworthy mechanisms responsible for the beneficial NIR photobiomodulatory effect mediated through superpulsed 904nm LLLT in burn wound healing. Copyright © 2016. Published by Elsevier B.V.

  5. Wound healing in total joint arthroplasty. (United States)

    Jones, Richard E


    Obtaining primary wound healing in total joint arthroplasty is essential to a good result. Wound healing problems can occur and the consequences can be devastating. Determination of the host healing capacity can be useful in predicting complications. Cierney and Mader classified patients as type A, no healing compromises; and type B, systemic or local healing compromising factors present. Local factors include traumatic arthritis, multiple previous incisions, extensive scarring, lymphedema, poor vascular perfusion. Systemic compromising factors include diabetes, rheumatic diseases, renal or liver disease, immunocompromise, steroids, smoking, and poor nutrition. In high-risk patients, the surgeon should encourage positive choices such as smoking cessation and nutritional supplementation to elevate the total lymphocyte count and total albumin. Careful planning of incisions, particularly in patients with scarring or multiple previous operations, is productive. Around the knee the vascular viability is better in the medial flap. Thus, use the most lateral previous incision, do minimal undermining, and handle tissue meticulously. We perform all potentially complicated total knee arthroplasties without tourniquet to enhance blood flow and tissue viability. The use of perioperative anticoagulation will increase wound problems. If wound drainage or healing problems occur, immediate action is required. Deep sepsis can be ruled out with a joint aspiration and cell count (>2000), differential (>50% polys), and negative culture and sensitivity. All hematomas should be evacuated and necrosis or dehiscence should be managed by debridement to obtain a live wound. Copyright 2010, SLACK Incorporated.

  6. Healing of small circular model wounds (United States)

    Cochet, Olivier; Marcq, Philippe; Ranft, Jonas; Reffay, Myriam; Buguin, Axel; Silberzan, Pascal


    We develop a new method to produce numerous circular wounds in an epithelial tissue of MDCK cells in a non-traumatic fashion. The reproducibility of the wounds allows for a quantitative study of the dynamics of healing and for a better understanding of the key processes involved in those collective morphogenetic movements. First, we show different mechanisms of closing depending on the initial size of the wound. We then focus on the healing of the smallest wounds from an experimental and theoretical point of view. At the onset of closure, an actomyosin ring is formed around the wound and small protrusions appear and invade the free surface. Using inhibition and laser ablation experiments, we show the relative contribution of both processes to the dynamics of closing. Finally, we develop a theoretical model of the tissue as a whole, combined with the observed forces, in order to better understand the underlying mechanics of this process. We hope that this qualitative and quantitative description will prove useful in the future for the study of epithelial architecture, collective mechanisms in migrating tissues and, on a broader context, cellular invasion in cancerous tissues.

  7. Activities of MSCs Derived from Transgenic Mice Seeded on ADM Scaffolds in Wound Healing and Assessment by Advanced Optical Techniques

    Directory of Open Access Journals (Sweden)

    Ning Wang


    Full Text Available Background/Aims: Bone marrow Mesenchymal stem cells (MSCs are promising for promoting cutaneous wound healing through reinforcing cellular processes. We evaluated the effect of GFP-tagged MSCs transplantation on skin regeneration in excisional wounds in mice. Methods: MSCs from GFP-labeled transgenic mice were co-cultured with acellular dermal matrix (ADM scaffolds, and MSC-ADM scaffolds were transplanted into surgical skin wounds of BALB/c mice. After implantation, the survival and behavior of MSCs were examined by second harmonic generation and two-photon excitation fluorescence imaging, western blotting and DNA amplification and sequencing. Results: GFP-tagged MSCs were retained inside the regenerating skin until day 14 post-transplantation. Alpha-smooth muscle actin (α-SMA and vimentin (VIM were detected at 3, 5, 7, and 14 days post-transplantation by immunofluorescence double labeling. Although the GFP+/α-SMA+- and GFP+/VIM+-cell numbers decreased gradually with healing time, α-SMA+- and VIM+-cell numbers significantly increased, most of them were endogenous functional cells which were related to angiogenesis and collagen fiber structural remodeling. Conclusion: Therefore, in the initial stage of wound healing, transplanted MSCs differentiated into functional cells and played paracrine roles to recruit more endogenous cells for tissue remodeling. With the disappearance of exogenous cells, endogenous cells were responsible for the latter stage of cutaneous wound healing.

  8. Does human immunodeficiency virus status affect early wound healing in open surgically stabilised tibial fractures?: A prospective study. (United States)

    Howard, N E; Phaff, M; Aird, J; Wicks, L; Rollinson, P


    We compared early post-operative rates of wound infection in HIV-positive and -negative patients presenting with open tibial fractures managed with surgical fixation. The wounds of 84 patients (85 fractures), 28 of whom were HIV positive and 56 were HIV negative, were assessed for signs of infection using the ASEPIS wound score. There were 19 women and 65 men with a mean age of 34.8 years. A total of 57 fractures (17 HIV-positive, 40 HIV-negative) treated with external fixation were also assessed using the Checkett score for pin-site infection. The remaining 28 fractures were treated with internal fixation. No significant difference in early post-operative wound infection between the two groups of patients was found (10.7% (n = 3) vs 19.6% (n = 11); relative risk (RR) 0.55 (95% confidence interval (CI) 0.17 to 1.8); p = 0.32). There was also no significant difference in pin-site infection rates (17.6% (n = 3) vs 12.5% (n = 5); RR 1.62 (95% CI 0.44 to 6.07); p = 0.47). The study does not support the hypothesis that HIV significantly increases the rate of early wound or pin-site infection in open tibial fractures. We would therefore suggest that a patient's HIV status should not alter the management of open tibial fractures in patients who have a CD4 count > 350 cells/μl.

  9. Wound healing activity of Elaeis guineensis leaf extract ointment. (United States)

    Sasidharan, Sreenivasan; Logeswaran, Selvarasoo; Latha, Lachimanan Yoga


    Elaeis guineensis of the Arecaceae family is widely used in the traditional medicine of societies in West Africa for treating various ailments. To validate the ethnotherapeutic claims of the plant in skin diseases, wound healing activity was studied. The results showed that E. guineensis leaf extract had potent wound healing capacity as evident from the better wound closure (P guineensis in the treatment of the wound. E. guineensis accelerated wound healing in rats, thus supporting its traditional use. The result of this study suggested that, used efficiently, oil palm leaf extract is a renewable resource with wound healing properties.

  10. Angiotensin II inhibitor facilitates epidermal wound regeneration in diabetic mice

    Directory of Open Access Journals (Sweden)

    Maria eKamber


    Full Text Available Tissue regeneration and wound healing are severely impaired in diabetes and are associated with poor circulation and dysfunctional blood vessels. Angiotensin II inhibitors are anti-hypertensive drugs used in clinical practice to regulate blood pressure and could affect tissue remodeling. We hypothesize that blocking angiotensin II, using Losartan, could facilitate tissue regeneration in diabetic mice. To this end, we established an experimental model of wound healing in streptozotocin-induced diabetic mice. Our data demonstrated that Losartan accelerates wound repair and normalizes wound stromal responses, having a beneficial role in diabetic wounds. Our findings highlight a potential therapeutic use of Losartan in improving wound repair in diabetic conditions.

  11. Diagnosing Surgical Site Infection Using Wound Photography: A Scenario-Based Study. (United States)

    Sanger, Patrick C; Simianu, Vlad V; Gaskill, Cameron E; Armstrong, Cheryl A L; Hartzler, Andrea L; Lordon, Ross J; Lober, William B; Evans, Heather L


    Postoperative surgical site infections (SSI) are common and costly. Most occur post discharge, and can result in potentially preventable readmission or unnecessary urgent evaluation. Mobile health approaches incorporating patient-generated wound photos are being implemented in an attempt to optimize triage and management. We assessed how adding wound photos to existing data sources modifies provider decision making. We used a web-based simulation survey using a convenience sample of providers with expertise in surgical infections. Participants viewed a range of scenarios, including surgical history, physical exam, and description of wound appearance. All participants reported SSI diagnosis, diagnostic confidence, and management recommendations (main outcomes) first without, and then with, accompanying wound photos. At each step, participants ranked the most important features contributing to their decision. Eighty-three participants completed a median of 5 scenarios (interquartile range 4 to 7). Most participants were physicians in academic surgical specialties (n = 70 [84%]). The addition of photos improved overall diagnostic accuracy from 67% to 76% (p < 0.001), and increased specificity from 77% to 92% (p < 0.001), but did not significantly increase sensitivity (55% to 65%; p = 0.16). Photos increased mean confidence in diagnosis from 5.9 of 10 to 7.4 of 10 (p < 0.001). Overtreatment recommendations decreased from 48% to 16% (p < 0.001), and undertreatment did not change (28% to 23%; p = 0.20) with the addition of photos. The addition of wound photos to existing data as available via chart review and telephone consultation with patients significantly improved diagnostic accuracy and confidence, and prevented proposed overtreatment in scenarios without SSI. Post-discharge mobile health technologies have the potential to facilitate patient-centered care, decrease costs, and improve clinical outcomes. Copyright © 2016 American College of Surgeons. Published by

  12. Comparison of a new laser beam wound camera and a digital photoplanimetry-based method for wound measurement in horses. (United States)

    Van Hecke, L L; De Mil, T A; Haspeslagh, M; Chiers, K; Martens, A M


    The aim of this study was to compare the accuracy, precision, inter- and intra-operator reliability of a new laser beam (LB) wound camera and a digital photoplanimetry-based (DPB) method for measuring the dimensions of equine wounds. Forty-one wounds were created on equine cadavers. The area, circumference, maximum depth and volume of each wound were measured four times with both techniques by two operators. A silicone cast was made of each wound and served as the reference standard to measure the wound dimensions. The DPB method had a higher accuracy and precision in determining the wound volume compared with the LB camera, which had a higher accuracy in determining the wound area and maximum depth and better precision in determining the area and circumference. The LB camera also had a significantly higher overall inter-operator reliability for measuring the wound area, circumference and volume. In contrast, the DPB method had poor intra-operator reliability for the wound circumference. The LB camera was more user-friendly than the DPB method. The LB wound camera is recommended as the better objective method to assess the dimensions of wounds in horses, despite its poorer performance for the measurement of wound volume. However, if the wound measurements are performed by one operator on cadavers or animals under general anaesthesia, the DPB method is a less expensive and valid alternative. Copyright © 2014 Elsevier Ltd. All rights reserved.

  13. Comparison of 180-degree and 90-degree needle rotation to reduce wound size in PIT-injected juvenile Chinook salmon

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    Bryson, Amanda J.; Woodley, Christa M.; Karls, Rhonda K.; Hall, Kathleen D.; Weiland, Mark A.; Deng, Zhiqun; Carlson, Thomas J.; Eppard, Matthew B.


    Animal telemetry, which requires the implantation of passive transponders or active transmitters, is used to monitor and assess fish stock and conservation to gain an understanding of fish movement and behavior. As new telemetry technologies become available, studies of their effects on species of interest are imperative as is development of implantation techniques. In this study, we investigated the effects of bevel rotation (0-, 90-, 180-degree axis rotation) on wound extent, tag loss, and wound healing rates in juvenile Chinook salmon injected with an 8-gauge needle, which is required for implantation of the novel injectable Juvenile Salmon Acoustic Telemetry Systems (JSATS) acoustic transmitter or large passive integrated transponder (PIT) tags. Although the injection sites were not closed after injection (e.g., with sutures or glue), there were no mortalities, dropped tags, or indications of fungus, ulceration, and/or redness around the wound. On Day 0 and post-implantation Day 7, the 90-degree bevel rotation produced smaller wound extent than the 180-degree bevel rotation. No axis rotation (0-degrees) resulted in the PIT tag frequently misleading or falling out upon injection. The results of this study indicated the 90-degree bevel rotation was the more efficient technique, produced less wound extent. Given the wound extent compared to size of fish, we recommend researchers should consider a 90-degree rotation over the 180-degree rotation in telemetry studies. Highlights •Three degrees of needle rotation were examined for effects in Chinook salmon. •Mortality, tag loss, wound extent, healing, and infection indicators were measured. •There were no mortalities, tag loss, or indications of infection. •The 90-degree needle rotation through Day 7 produced the smallest wound extent.

  14. How to administer lidocaine in wounds. (United States)

    Welsh, Jeanette; Rowe, Graham


    Before a wound can be cleaned and/or closed, the use of a local anaesthetic such as lidocaine is often required to enable the nurse to assess the wound thoroughly and plan the optimal method of repair. This article explains how to administer lidocaine safely and effectively, including how to infiltrate a wound with lidocaine before cleaning or suturing. There are potentially serious consequences associated with the use of local anaesthesia, but careful preparation will ensure patient safety and contribute towards a positive patient experience. How to articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of. ©2012 RCN Publishing Company Ltd. All rights reserved. Not to be copied, transmitted or recorded in any way, in whole or part, without prior permission of the publishers.

  15. [Definition and management of wound infections]. (United States)

    Maier, S; Körner, P; Diedrich, S; Kramer, A; Heidecke, C-D


    Surgical site infections (SSI) in the postoperative period represent the sword of Damocles in surgery. In spite of the medical progress in recent years these infections cannot always be avoided and occur in 25% of all nosocomial infections in Germany. They also generate up to 50% of the required costs in this context. The consequences vary from extended duration of hospitalization to elevated mortality. The degree of contamination of surgical wounds is of great importance as well as the patient's immune status and comorbidities. Prevention of infected surgical wounds is essential and important measures should begin even prior to the surgical procedure. In addition, during and following the surgical procedure several standards have to be followed. Rapid confirmation of diagnosis and correct management of surgical site infections are essential for the course of the disease. This study provides information on development, prevention and therapy of surgically infected wounds.

  16. Wound biofilms: lessons learned from oral biofilms (United States)

    Mancl, Kimberly A.; Kirsner, Robert S.; Ajdic, Dragana


    Biofilms play an important role in the development and pathogenesis of many chronic infections. Oral biofilms, more commonly known as dental plaque,are a primary cause of oral diseases including caries, gingivitis and periodontitis. Oral biofilms are commonly studied as model biofilm systems as they are easily accessible, thus biofilm research in oral diseases is advanced with details of biofilm formation and bacterial interactions being well-elucidated. In contrast, wound research has relatively recently directed attentionto the role biofilms have in chronic wounds. This review discusses the biofilms in periodontal disease and chronic wounds with comparisons focusing on biofilm detection, biofilm formation, the immune response to biofilms, bacterial interaction and quorum sensing. Current treatment modalities used by both fields as well as future therapies are also discussed. PMID:23551419

  17. Skin wound healing and phytomedicine: a review. (United States)

    Pazyar, Nader; Yaghoobi, Reza; Rafiee, Esmail; Mehrabian, Abolfath; Feily, Amir


    Skin integrity is restored by a physiological process aimed at repairing the damaged tissues. The healing process proceeds in four phases: hemostasis, inflammation, proliferation and remodeling. Phytomedicine presents remedies, which possess significant pharmacological effects. It is popular amongst the general population in regions all over the world. Phytotherapeutic agents have been largely used for cutaneous wound healing. These include Aloe vera, mimosa, grape vine, Echinacea, chamomile, ginseng, green tea, jojoba, tea tree oil, rosemary, lemon, soybean, comfrey, papaya, oat, garlic, ginkgo, olive oil and ocimum. Phytotherapy may open new avenues for therapeutic intervention on cutaneous wounds. This article provides a review of the common beneficial medicinal plants in the management of skin wounds with an attempt to explain their mechanisms. © 2014 S. Karger AG, Basel.

  18. [Gunshot wounds of the skull during peacetime]. (United States)

    Kunz, U; Seidel, B U; Stolke, D; Dietz, H


    66 patients with gunshot wounds were treated at the Department of Neurosurgery of Hanover University up to May 1982. These included wounds inflicted by bolt guns of the type used in slaughter houses, and by bolt-setting or nail-setting tools used in building construction work. The total mortality was 50%. Seventeen patients died directly after admission or within the first 24 hours. Operation was not indicated in cases which appeared hopeless. In patients with mild neurological deficits, only the superficial skin wounds were treated to avoid additional damage to the brain. CT scans performed in approximately one-half of the patients yielded valuable information on the path of the bullet and on haematomas. Postoperatively, there were several complications, mainly pneumonia and cerebrospinal fluid fistulas; in fact, pneumonia was responsible for the death of some patients. The mortality is compared with the findings by other authors. No patients remained in need of care after rehabilitation.

  19. Systemic antibiotics for treating malignant wounds. (United States)

    Ramasubbu, Darshini A; Smith, Valerie; Hayden, Fiona; Cronin, Patricia


    Malignant wounds are a devastating complication of cancer. They usually develop in the last six months of life, in the breast, chest wall or head and neck regions. They are very difficult to treat successfully, and the commonly associated symptoms of pain, exudate, malodour, and the risk of haemorrhage are extremely distressing for those with advanced cancer. Treatment and care of malignant wounds is primarily palliative, and focuses on alleviating pain, controlling infection and odour from the wound, managing exudate and protecting the surrounding skin from further deterioration. In malignant wounds, with tissue degradation and death, there is proliferation of both anaerobic and aerobic bacteria. The aim of antibiotic therapy is to successfully eliminate these bacteria, reduce associated symptoms, such as odour, and promote wound healing. To assess the effects of systemic antibiotics for treating malignant wounds. We searched the following electronic databases on 8 March 2017: the Cochrane Wounds Specialised Register, the Cochrane Central Register of Controlled Trials (CENTRAL; the Cochrane Library, 2017, Issue 3), Ovid MEDLINE, Ovid Embase and EBSCO CINAHL Plus. We also searched the clinical trial registries of the World Health Organization (WHO) International Clinical Trials Registry Platform ( and on 20 March 2017; and OpenSIGLE (to identify grey literature) and ProQuest Dissertations & Theses Global (to retrieve dissertation theses related to our topic of interest) on 13 March 2017. Randomised controlled trials that assessed the effects of any systemic antibiotics on malignant wounds were eligible for inclusion. Two review authors independently screened and selected trials for inclusion, assessed risk of bias and extracted study data. A third reviewer checked extracted data for accuracy prior to analysis. We identified only one study for inclusion in this review. This study was a prospective, double-blind cross

  20. Wound assessment tools and nurses' needs: an evaluation study. (United States)

    Greatrex-White, Sheila; Moxey, Helen


    The purpose of this study was to ascertain how well different wound assessment tools meet the needs of nurses in carrying out general wound assessment and whether current tools are fit for purpose. The methodology employed was evaluation research. In order to conduct the evaluation, a literature review was undertaken to identify the criteria of an optimal wound assessment tool which would meet nurses' needs. Several freely available wound assessment tools were selected based on predetermined inclusion and exclusion criteria and an audit tool was developed to evaluate the selected tools based on how well they met the criteria of the optimal wound assessment tool. The results provide a measure of how well the selected wound assessment tools meet the criteria of the optimal wound assessment tool. No tool was identified which fulfilled all the criteria, but two (the Applied Wound Management tool and the National Wound Assessment Form) met the most criteria of the optimal tool and were therefore considered to best meet nurses' needs in wound assessment. The study provides a mechanism for the appraisal of wound assessment tools using a set of optimal criteria which could aid practitioners in their search for the best wound assessment tool. © 2013 The Authors. International Wound Journal published by Inc and John Wiley & Sons Ltd.

  1. Honey: A Potential Therapeutic Agent for Managing Diabetic Wounds (United States)

    Islam, Md. Asiful; Gan, Siew Hua; Khalil, Md. Ibrahim


    Diabetic wounds are unlike typical wounds in that they are slower to heal, making treatment with conventional topical medications an uphill process. Among several different alternative therapies, honey is an effective choice because it provides comparatively rapid wound healing. Although honey has been used as an alternative medicine for wound healing since ancient times, the application of honey to diabetic wounds has only recently been revived. Because honey has some unique natural features as a wound healer, it works even more effectively on diabetic wounds than on normal wounds. In addition, honey is known as an “all in one” remedy for diabetic wound healing because it can combat many microorganisms that are involved in the wound process and because it possesses antioxidant activity and controls inflammation. In this review, the potential role of honey's antibacterial activity on diabetic wound-related microorganisms and honey's clinical effectiveness in treating diabetic wounds based on the most recent studies is described. Additionally, ways in which honey can be used as a safer, faster, and effective healing agent for diabetic wounds in comparison with other synthetic medications in terms of microbial resistance and treatment costs are also described to support its traditional claims. PMID:25386217

  2. Negative Pressure Wound Therapy: Experience in 45 Dogs (United States)

    Pitt, Kathryn A.; Stanley, Bryden J.


    Objective To report experience with negative pressure wound therapy (NPWT) in 45 consecutive dogs admitted with extensive cutaneous wounds and to determine if NPWT is feasible in veterinary hospital practice. Study Design Prospective descriptive study Animals Dogs (n = 45) Methods Collected data were organized into 6 categories: patient data, wound data, NPWT data, adjunctive treatments, complications, and final outcome Results Wounds (53 in 45 dogs) were largely traumatic in origin, and distributed fairly evenly to the trunk, proximal and distal aspects of the limbs. Most wounds (34 dogs, 76%) had no granulation tissue and were treated a mean of 4.2 days after wounding, whereas 11 dogs had granulating wounds that were initially treated a mean of 87 days after wounding. Median NPWT use was 3 days with a mean hospitalization of 7.8 days. Most wounds (33; 62%) were closed surgically after NPWT and were healed by 14 days. The other 18 wounds healed (mean, 21 days) by second intention after hospital discharge. Overall, 96% of the wounds healed; 2 dogs died before definitive closure could be attempted. Conclusion NPWT is applicable to a wide variety of canine wounds is well tolerated, allows for several days between dressing changes, and can used to optimize the wound bed for surgical closure or second intention healing. PMID:24512302

  3. Negative pressure wound therapy technologies for chronic wound care in the home setting: A systematic review. (United States)

    Rhee, Susan M; Valle, M Frances; Wilson, Lisa M; Lazarus, Gerald; Zenilman, Jonathan M; Robinson, Karen A


    The use of negative pressure wound therapy (NPWT) is increasing in both the inpatient and outpatient settings. We conducted a systematic review on the efficacy and safety of NPWT for the treatment of chronic wounds in the home setting. We searched MEDLINE, Embase, the Cochrane Central Register of Controlled Trials, and the Cumulative Index to Nursing and Allied Health Literature, up to June 2014. Two independent reviewers screened search results. Seven studies met our criteria for inclusion. Six of the studies compared NPWT devices to other wound care methods and one study compared two different NPWT technologies. Data were limited by variability in the types of comparator groups, methodological limitations, and poor reporting of outcomes. We were unable to draw conclusions about the efficacy or safety of NPWT for the treatment of chronic wounds in the home setting due to the insufficient evidence. Consensus is needed on the methods of conducting and reporting wound care research so that future studies are able inform decisions about the use of NPWT in the home environment for chronic wounds. © 2015 by the Wound Healing Society.

  4. Application of NCRP 156 Wound Models for the Analysis of Bioassay Data from Plutonium Wound Cases. (United States)

    Poudel, Deepesh; Guilmette, Raymond A; Klumpp, John A; Bertelli, Luiz; Waters, Tom L


    The NCRP 156 wound model was heavily based on data from animal experiments. The authors of the report acknowledged this limitation and encouraged validation of the models using data from human wound exposures. The objective of this paper was to apply the NCRP 156 wound models to the bioassay data from four plutonium-contaminated wound cases reported in the literature. Because a wide variety of forms of plutonium can be expected at a nuclear facility, a combination of the wound models-rather than a single model-was used to successfully explain both the urinary excretion data and wound retention data in three cases. The data for the fourth case could not be explained by any combination of the default wound models. While this may possibly be attributed to the existence of a category of plutonium whose solubility and chemistry are different than those described by the NCRP 156 default categories, the differences may also be the result of differences in systemic biokinetics. The concept of using a combination of biokinetic models may be extended to inhalation exposures as well, where more than one form of radionuclide-particles of different solubility or different sizes-may exist in a workplace.

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

    Directory of Open Access Journals (Sweden)

    Lenka Vinklárková


    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.

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

    Directory of Open Access Journals (Sweden)

    Purushottam V. Gawande


    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.

  7. Ghrelin accelerates wound healing in combined radiation and wound injury in mice. (United States)

    Liu, Cong; Hao, Yuhui; Huang, Jiawei; Li, Hong; Yang, Zhangyou; Zeng, Yiping; Liu, Jing; Li, Rong


    Impaired wound healing caused by radiation happens frequently in clinical practice, and the exact mechanisms remain partly unclear. Various countermeasures have been taken to tackle with this issue. Ghrelin was considered as a potent endogenous growth hormone-releasing peptide, and its role in enhancing wound repair and regeneration was firstly investigated in whole-body irradiated (γ-ray) mice in this study. Collagen deposition and neovascularization were mostly discussed. The results demonstrated that ghrelin administration promoted cutaneous wound healing in irradiated mice, followed with reduced average wound closure time, increased spleen index (SI) and improved haematopoiesis. After isolation and analysis of granulation tissues in combined radiation and wound injury (CRWI) mice treated with and without ghrelin, a phenomenon of increased DNA, hexosamine, nitrate and nitrite synthesis, elevated collagen content and enhanced neovascularization was observed after ghrelin treatment. Western blotting indicated that ghrelin also increased the expression of vascular endothelial growth factor (VEGF) and transforming growth factor-β (TGF-β), both responsible for wound healing. However, previous administration of growth hormone secretagogue receptor 1a (GHS-R1a) blocker blunted these therapeutic effects of ghrelin on CRWI mice. Our results identify ghrelin as a novel peptide that could be used for radiation-induced impaired wound healing. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  8. Evaluation of dense collagen matrices as medicated wound dressing for the treatment of cutaneous chronic wounds. (United States)

    Helary, Christophe; Abed, Aicha; Mosser, Gervaise; Louedec, Liliane; Letourneur, Didier; Coradin, Thibaud; Giraud-Guille, Marie Madeleine; Meddahi-Pellé, Anne


    Cutaneous chronic wounds are characterized by an impaired wound healing which may lead to infection and amputation. When current treatments are not effective enough, the application of wound dressings is required. To date, no ideal biomaterial is available. In this study, highly dense collagen matrices have been evaluated as novel medicated wound dressings for the treatment of chronic wounds. For this purpose, the structure, mechanical properties, swelling ability and in vivo stability of matrices concentrated from 5 to 40 mg mL(-1) were tested. The matrix stiffness increased with the collagen concentration and was associated with the fibril density and thickness. Increased collagen concentration also enhanced the material resistance against accelerated digestion by collagenase. After subcutaneous implantation in rats, dense collagen matrices exhibited high stability without any degradation after 15 days. The absence of macrophages and neutrophils evidenced their biocompatibility. Subsequently, dense matrices at 40 mg mL(-1) were evaluated as drug delivery system for ampicillin release. More concentrated matrices exhibited the best swelling abilities and could absorb 20 times their dry weight in water, allowing for an efficient antibiotic loading from their dried form. They released efficient doses of antibiotics that inhibited the bacterial growth of Staphylococcus Aureus over 3 days. In parallel, they show no cytotoxicity towards human fibroblasts. These results show that dense collagen matrices are promising materials to develop medicated wound dressings for the treatment of chronic wounds.

  9. Negative pressure wound therapy as an adjunct in healing of chronic wounds. (United States)

    Langer, Vijay; Bhandari, Prem S; Rajagopalan, Satyamoorthy; Mukherjee, Mrinal K


    Negative pressure wound therapy (NPWT) has emerged as a cutting-edge technology and provides an alternative solution to the problem of wounds. This study was undertaken to assess the efficacy of this technique in the treatment of chronic wounds. A prospective clinical study was used to evaluate our experience in use of NPWT in the healing of pressure ulcers and chronic wounds over 2 years. The primary end point of the study group was the time taken for appearance of healthy granulation tissue and full reepithelialisation without drainage. All patients with sepsis were excluded from the study. The statistical analysis of the data was carried out. Of the 60 patients studied, 41 had associated comorbidities including diabetes mellitus. The commonest site of occurrence was the lower limb. Coverage in the form of a flap was required at presentation in 63·33% of patients. However, after initiation of NPWT, none of them required the procedure and they healed spontaneously either by secondary intention or by skin grafting. The time taken for appearance of healthy granulation tissue was 14·36 ± 4·24 days. Complete healing of wounds occurred by 33·1 ± 10·22 days. There was a statistically significant difference in the volume of the wounds before and after the intervention (P = 0·000). Complications resulting from NPWT were minimal. This technique is an excellent adjunct to surgical debridement. © 2013 The Authors. International Wound Journal © 2013 Inc and John Wiley & Sons Ltd.

  10. Post operative pain control in inguinal hernia repair: comparison of ...

    African Journals Online (AJOL)

    Background: Post-operative pain control is a key factor in surgery. It greatly increases patient satisfaction, and influences the hospital stay period. Local wound infiltration has often been used to control postoperative pain following hernia surgery, with the use of the conventional local anesthetics like Lidocaine or ...

  11. Orthopaedic Implants And Prosthesis: Economic Costs Of Post ...

    African Journals Online (AJOL)

    OBJECTIVE: To assess the economic impact of post-operative wound infection in trauma patients who had open reduction and internal fixation with implants and prostheses following fractures of the femur. METHOD: This is a 2-year case controlled prospective study carried out at the National Orthopaedic Hospital, Lagos.

  12. Agriculture and Biological Sciences Post-harvest deterioration of ...

    African Journals Online (AJOL)

    Post harvest dterioration of Irish potato (Solanum tuberosum) (L) under storage was investigated in the laboratory and found to be caused by fusarium solani. This fungus is a primary invader of the tubers and entry is through wounds arising from harvesting and handling. A range of growth media were used and potato ...

  13. [Influence of covering of auto-crosslinked sodium hyaluronate gel in combination with xenogenic acellular dermal matrix on healing of full-thickness skin defect wound in pig]. (United States)

    Qiu, Y X; Zhang, G A; Wan, J B; Zhao, X Z


    To explore the influence of covering of auto-crosslinked sodium hyaluronate gel in combination with xenogenic acellular dermal matrix (ADM) on healing of full-thickness skin defect wound in pig. Totally four 10 cm×10 cm full-thickness skin defect wounds were reproduced symmetrically on both sides of spine on the back of each one of the six Chinese experimental minipigs. After autologous microskin grafting, the 4 wounds in each pig were divided into 4 groups according to the random number table, with 6 wounds in each group. Wounds in allogenic skin group (AS) were covered by full-thickness skin from one (not the recipient) of the 6 pigs; wounds in xenogenic skin group (XS) were covered by full-thickness skin of sheep; wounds in xenogenic ADM group (XA) were covered by ADM of sheep; wounds in combination group (C) were covered by ADM of sheep combined with auto-crosslinked sodium hyaluronate gel. The wounds were bound up with pressure, and the dressing was changed once every 7 days. On post surgery day (PSD) 7, 14, 21, 28, 35, and 42 when changing dressing, the condition of wounds and the exfoliation of the covering on microskin were observed, and the complete exfoliation time of the covering was recorded. On PSD 28, 35, and 42, the wound healing rate was calculated. Data were processed with one-way analysis of variance and SNK test. (1) On PSD 7, no fluid appeared under the covering of wounds in groups AS and C, while plenty of fluid appeared under the covering of wounds in groups XS and XA. From PSD 14 to 35, most of the full-thickness skin of pig in group AS did not exfoliate. All the full-thickness skin of sheep in group XS exfoliated, leaving a lot of crusts on the surface of the wounds on PSD 14. Most of the ADM of sheep in group XA separated from the wound with the crusts turning dry and exfoliating on PSD 14. All the ADM of sheep exfoliated with most of the wounds healed in group C on PSD 35. On PSD 42, all the full-thickness skin of pig in group AS

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


    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. PMID:25713753

  15. Methods for identifying surgical wound infection after discharge from hospital: a systematic review

    Directory of Open Access Journals (Sweden)

    Moore Peter J


    Full Text Available Abstract Background Wound infections are a common complication of surgery that add significantly to the morbidity of patients and costs of treatment. The global trend towards reducing length of hospital stay post-surgery and the increase in day case surgery means that surgical site infections (SSI will increasingly occur after hospital discharge. Surveillance of SSIs is important because rates of SSI are viewed as a measure of hospital performance, however accurate detection of SSIs post-hospital discharge is not straightforward. Methods We conducted a systematic review of methods of post discharge surveillance for surgical wound infection and undertook a national audit of methods of post-discharge surveillance for surgical site infection currently used within United Kingdom NHS Trusts. Results Seven reports of six comparative studies which examined the validity of post-discharge surveillance methods were located; these involved different comparisons and some had methodological limitations, making it difficult to identify an optimal method. Several studies evaluated automated screening of electronic records and found this to be a useful strategy for the identification of SSIs that occurred post discharge. The audit identified a wide range of relevant post-discharge surveillance programmes in England, Scotland and Wales and Northern Ireland; however, these programmes used varying approaches for which there is little supporting evidence of validity and/or reliability. Conclusion In order to establish robust methods of surveillance for those surgical site infections that occur post discharge, there is a need to develop a method of case ascertainment that is valid and reliable post discharge. Existing research has not identified a valid and reliable method. A standardised definition of wound infection (e.g. that of the Centres for Disease Control should be used as a basis for developing a feasible, valid and reliable approach to defining post

  16. Management of the Chronic Burn Wound. (United States)

    Elkins-Williams, Stephen Tyler; Marston, William A; Hultman, Charles Scott


    This article reviews the current evidence in using hyperbaric oxygen therapy (HBOT) in burn wounds. There is also separate consideration of diabetic foot burns and a protocol for use of HBOT in a specific case. The challenges of using HBOT in an acute burn care setting are reviewed. Next the pathophysiology of Marjolin ulcers is reviewed. The current thinking in diagnosis, treatment, and prevention of Marjolin ulcers is discussed. Finally, a background in using topical growth factors (tGF) is provided, followed by a summary of the current evidence of tGF in burn wounds. Copyright © 2017 Elsevier Inc. All rights reserved.

  17. Contributions of ocular surface components to matrix-metalloproteinases (MMP)-2 and MMP-9 in feline tears following corneal epithelial wounding. (United States)

    Petznick, Andrea; Madigan, Michele C; Garrett, Qian; Sweeney, Deborah F; Evans, Margaret D M


    This study investigated ocular surface components that contribute to matrix-metalloproteinase (MMP)-2 and MMP-9 found in tears following corneal epithelial wounding. Laboratory short-haired cats underwent corneal epithelial debridement in one randomly chosen eye (n = 18). Eye-flush tears were collected at baseline and during various healing stages. Procedural control eyes (identical experimental protocol as wounded eyes except for wounding, n = 5) served as controls for tear analysis. MMP activity was analyzed in tears using gelatin zymography. MMP staining patterns were evaluated in ocular tissues using immunohistochemistry and used to determine MMP expression sites responsible for tear-derived MMPs. The proMMP-2 and proMMP-9 activity in tears was highest in wounded and procedural control eyes during epithelial migration (8 to 36 hours post-wounding). Wounded eyes showed significantly higher proMMP-9 in tears only during and after epithelial restratification (day 3 to 4 and day 7 to 28 post-wounding, respectively) as compared to procedural controls (pTears from wounded and procedural control eyes showed no statistical differences for pro-MMP-2 and MMP-9 (p>0.05). Immunohistochemistry showed increased MMP-2 and MMP-9 expression in the cornea during epithelial migration and wound closure. The conjunctival epithelium exhibited highest levels of both MMPs during wound closure, while MMP-9 expression was reduced in conjunctival goblet cells during corneal epithelial migration followed by complete absence of the cells during wound closure. The immunostaining for both MMPs was elevated in the lacrimal gland during corneal healing, with little/no change in the meibomian glands. Conjunctival-associated lymphoid tissue (CALT) showed weak MMP-2 and intense MMP-9 staining. Following wounding, migrating corneal epithelium contributed little to the observed MMP levels in tears. The major sources assessed in the present study for tear-derived MMP-2 and MMP-9 following

  18. GM-CSF Ameliorates Micro-vascular Barrier Integrity via Pericytes Derived Ang-1 in Wound Healing. (United States)

    Yan, Min; Hu, Yange; Yao, Min; Bao, Shisan; Fang, Yong


    Skin wound healing involves complex coordinated interactions of cells, tissues and mediators. Maintaining microvascular barrier integrity is one of the key events for endothelial homeostasis during wound healing. Vasodilation is observed after vasoconstriction, which causes blood vessels to become porous, facilitates leukocyte infiltration and aids angiogenesis at the wound-area, post-injury. Eventually, vessel integrity has to be re-established for vascular maturation. Numerous studies have found that granulocyte macrophage colony-stimulating factor (GM-CSF) accelerates wound healing by inducing recruitment of repair cells into the injury area and releases of cytokines. However, whether GM-CSF is involving in the maintaining of micro-vascular barrier integrity and the underlying mechanism remain still unclear. Aim of this study was to investigate the effects of GM-CSF on modulation of micro-vascular permeability in wound healing and underlying mechanisms. Wound closure and micro-vascular leakage was investigated using a full-thickness skin wound mouse model after GM-CSF intervention. The endothelial permeability was measured by Evans-blue assay in vivo and in vitro endothelium/pericyte co-culture system using a FITC-Dextran permeability assay. To identify the source of angiopoietin-1 (Ang-1), double staining is used in vivo and ELISA and qPCR are used in vitro. To determine the specific effect of Ang-1 on GM-CSF maintaining micro-vascular stabilization, Ang-1 siRNA was applied to inhibit Ang-1 production in vivo and in vitro. Wound closure was significantly accelerated and micro-vascular leakage was ameliorated after GM-CSF treatment in mouse wound sites. GM-CSF decreased endothelial permeability through tightening endothelial junctions and increased Ang-1 protein level that was derived by perictye. Furthermore, applications of siRNAAng-1 inhibited GM-CSF mediated protection of micro-vascular barrier integrity both in vivo and in vitro. Our data indicate that GM

  19. 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.

  20. The wound that nearly got away: a case presentation. (United States)

    Kool, B


    Chronic cavity wounds are not commonly seen in pediatrics, and little literature is available on their management. A pediatric patient with juvenile dermatomyositis (JDMS) who had a chronic cavity surgical wound with an enterocutaneous fistula presented a nursing challenge. The patient had complex medical and surgical problems that greatly influenced her ability to heal. Nursing management of the wounds had to be innovative and flexible to adapt to these challenges. Factors affecting the patient's wound healing included JDMS; decreased mobility; persistently low serum magnesium, zinc and albumin; malnutrition; infection; and prolonged glucocorticosteroid therapy. Nursing management of her complex wounds included the following strategies: absorption of excessive exudate, wound support, debridement, wound irrigation, wound bagging, healing by secondary intention, and control of hypergranulation.