Nutrition 1: a vital consideration in the management of skin wounds

Wound, pressure ulcer, and burn guidelines - 3: Guidelines for the diagnosis and treatment of diabetic ulcers and gangrene, second edition

The Japanese Dermatological Association aimed to prepare a second edition of guidelines for the management of diabetic ulcer/gangrene with emphasis on the diagnosis and treatment of skin symptoms. This new edition serves as a tool to improve the quality of the diagnosis and treatment in each patient and, further, to improve the level of care for such skin conditions. All sections have been updated by collecting documents published since the publication of the first edition. In the antibacterial drug treatment for bacterial infection of ulcers, oral administration was added after consideration. In the treatment of antibacterial drugs for bacterial infection of ulcers, not only infusion but also oral administration was mentioned. In addition, clinical questions (CQs) for imaging tests for diagnosing ischemia of the limbs were newly created. The titles of some CQs were changed to conform to the actual clinical setting. (i) The content has been updated by adding and collecting documents for all sections; (ii) we have additionally included oral antibiotic treatment for bacterial infection of ulcers; (iii) we have added CQs pertaining to imaging tests for diagnosing ischemia of the limbs; and (iv) we have revised the titles of some CQs to conform to the actual clinical setting. In particular, the recommendation levels of dressing materials newly covered by Japanese national health insurance are mentioned. In addition, CQs regarding the initial treatment of electrical (CQ15) and chemical burns (CQ16), and the use of escharotomy (CQ22) have been created.

Do malnutrition and nutritional supplementation have an effect on the wound healing process?

Although nutrition is an extrinsic factor regulating wound healing, nutritional supplementation for the modulation of wound healing remains experimental. Evidence on the efficacy of supplementation in animals and humans is reviewed.

Histological study of tendon healing in malnourished Wistar rats treated with ultrasound therapy

PURPOSE: To investigate the effects of therapeutic ultrasound on the healing of tendon injuries in malnourished rats. METHODS: After the intended nutritional states had been attained, the animals (N=36) were distributed into three groups, named: G1(N=12), control group; G2(N=12), malnourished rats treated with 3 MHz ultrasound at an intensity of 0.5 W/cm²; and G3 (N=12), normal animals treated with 3 MHz at 0.5 W/cm². The injuries were induced by means of an operation to expose the heel tendon and crush it using Allis forceps. RESULTS: The data obtained relating to leukocyte counts, fibroblasts, vessel neoformation, fibrosis and collagen were subjected to statistical treatment using analysis of variance (ANOVA) and Student's t test. Results of p < 0.05 were obtained for fibrosis and collagen. CONCLUSION: The ultrasound was shown to be effective in repairing the tendon, even in malnourished animals whose healing process was retarded.