Longitudinal monitoring and prediction of long-term outcome of scar stiffness on pediatric patients

Reliability and validity of skin elasticity meter to measure skin mechanical properties in patients with lower extremity cancer-related edema

[Purpose] This study aimed to clarify the reliability and validity of a skin elasticity meter for evaluating the skin mechanical properties. [Participants and Methods] We conducted a prospective observational study using data from 35 patients diagnosed with unilateral lower extremity edema caused by cancer-related. We evaluated the skin's mechanical properties (relative parameter; R0, distensibility; R2, gross elasticity; R5, net elasticity; R6, viscoelasticity; R7, biological elasticity) of the thigh and lower leg using a skin elasticity meter. Intra-rater reliability was calculated using interclass correlation (ICC). Validity was also examined by comparing the edema and non-edema sides of the data obtained using a skin elasticity meter and correlating them with the circumferential diameter difference. [Results] ICC values ranged from 0.787 to 0.997 for each site. A significant difference in skin mechanical properties (offset + R0, R2, R6, and R7) of the upper extremities was observed between the lymphedema and non-lymphedema groups. A correlation was found between the R0 + offset between the R0 + offset parameter and the difference in circumference. [Conclusion] This study suggested that the skin elasticity meter is a reliable and valid method for evaluating the mechanical properties of the skin in patients with lower extremity cancer-related edema.

Nanocellulose significantly reduces number of anesthetics, hospital days, and in-patient dressing changes compared to PU-Foam Dressing: A prospective cohort study in children

BACKGROUND

Pediatric thermal injuries can have profound physical and psychological effects. Long-term care, including wound dressing selection, significantly impacts outcomes. This study compared treatment related variables and long-term results of bacterial nanocellulose (BNC) and polyurethane foam (PU-foam) dressings in pediatric burn care.

METHODS

A prospective cohort study comparing BNC (2018-2020) and PU-foam (2016-2018) in pediatric burn patients. Data included demographics, wound characteristics, infection rates, treatment duration, anesthesia procedures, dressing changes, scar assessments (POSAS, VSS), colorimeter measurements, and quality of life (CDLQI). Regression analyses were performed to correct for differences in burn depth.

RESULTS

After correction for burn depth, BNC showed a shorter hospital stay duration (p = 0.007), a lower number of procedures under general anesthesia (p<0.0001) and a reduced number of inpatient dressing changes (p = 0.006), compared to PU-foam, whereas wound infection rates did not differ between the treatment groups (p = 0.169). Scar outcomes (POSAS, VSS, colorimeter measurements) and quality of life (CDLQI) were comparable for both treatments.

DISCUSSION

BNC dressing benefits include significantly fewer anesthesia procedures, a reduced number of inpatient dressing changes and a shorter hospital stays, supporting the use of BNC dressing. Long-term scar outcomes with BNC are comparable to established dressings like PU-foam. Further randomized trials are necessary to confirm these findings.

Gold nanobipyramids-based laser-activated sealants for effective skin sealing and repair

Anisotropic gold nanostructures have gained increased attention for biomedical applications because of their remarkable optical properties. An emerging type of gold nanostructure-gold nanobipyramids (AuNBP)-has been shown to exhibit superior absorption properties compared to conventionally used gold nanoparticles, which makes them attractive for photothermal applications. We generated a high-shape-purity dispersion of AuNBP using a seed-mediated method and embedded them as photothermal conversion agents in a silk fibroin matrix to investigate their efficacy in photothermal sealing of incisional wounds in immunocompetent mice. These AuNBP-doped laser-activated sealants, or AuNBP-LASE were able to absorb near-infrared laser energy and convert it to heat, thereby inducing transient hyperthermia in the wound and the surrounding tissue. This photothermal conversion facilitated rapid sealing of the skin tissue by the AuNBP-LASE, which resulted in faster functional recovery of skin barrier function compared to nylon sutures at the early stages of repair. Further, the biomechanical properties of the healing skin closed with AuNBP-LASE those of intact skin more rapidly compared to incisions approximated with sutures. Histology studies indicated higher penetration of the LASE within the volume of the incision in skin tissue, lower scab formation, and a similar epidermal gap compared to conventional suturing. These results demonstrate that AuNBP-LASEs can be effective as wound approximation devices for photothermal sealing.

Hypertrophic Scar

Hypertrophic scars frequently develop post-burn, and are characterized by their pruritic, painful, raised, erythematous, dyschromic, and contractile qualities. This article aims to synthesize knowledge on the clinical and molecular development, evolution, management, and measurement of hypertrophic burn scar for both patient and clinician knowledge.

A quantitative comparison of devices for in vivo biomechanical characterization of human skin

Non-invasive skin characterization devices are emerging as a valuable tool in clinical skin research. In recent years, the range of available experimental techniques and methods used to determine the biomechanical properties of skin has increased considerably. Although a substantial amount of work has been devoted to assessing the working principle of macroscopic skin characterization devices individually, a rationalization and comparison between them is still lacking. This motivated the present study, which aimed to characterize and compare three commonly used working principles: suction, dynamic shear loading, and indentation. A synthetic model system with tunable mechanical properties was used to assess the three devices, and the results rationalized based on corresponding finite element models. In vivo measurements were performed on healthy volunteers to investigate the capability of differentiating the biomechanical properties of skin at different body locations, and to assess the intra- and inter-rater reliability of each device. The present comparative analysis indicates that the analyzed functional principles perceive the stiffness of human skin differently, with relevant implications for the interpretation of the respective measurement results.