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Díaz-Hurtado D, Etxart-Lasa MP, Izaga-González O, Lodoso-Gibaja L, Ruiz de Larramendi-Fernández MT, Riaño-Fernández I. Effect of a topical silicone gel and a polyurethane dressing on the evolution of scars. Enferm Clin (Engl Ed) 2024:S2445-1479(24)00036-5. [PMID: 38642837 DOI: 10.1016/j.enfcle.2024.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 02/11/2024] [Accepted: 02/12/2024] [Indexed: 04/22/2024]
Abstract
OBJECTIVE To assess the effectiveness and safety of a topical silicone gel (BE + Gel reductor y reparador de cicatrices) and a polyurethane dressing (BE + Apósito reductor y reparador de cicatrices) on the evolution of scars of patients who were previously recruited in the emergency care unit while seeking wound care. METHOD A single center, stratified observational, open label study was performed in the emergency care unit of Donostia Universitary Hospital (recruitment) and in the Biodonostia Health Research Institute (intervention). Scars located in unexposed body areas with the dressing, and scars located in exposed areas with either the gel or the dressing. Investigators assessed interventions at day 1 and on weeks 4, 8 and 12. Vancouver Scar Scale (VSS) and a photographical assessment were used to determine the scars evolution, and the subjective perception of the scar was evaluated by means of a questionnaire administered to the patients. RESULTS Patients whose scars were treated with the silicone gel had an average initial VSS score of 5.4 ± 2.08. This value was reduced to 0.86 ± 1.17 after 90 days of treatment. Patients treated with the polyurethane dressing had an average initial VSS score of 5.8 ± 2.29. After 90 days of treatment, this average score was reduced to 0.33 ± 0.66. Positive evolution of scars was also supported by photographs and by a patient questionnaire. CONCLUSIONS Both treatments appear to be safe and effective, objectively, and subjectively, in the context of scar evolution.
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Affiliation(s)
- David Díaz-Hurtado
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain; Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain.
| | - María Pilar Etxart-Lasa
- Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain
| | - Oihane Izaga-González
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain
| | - Leire Lodoso-Gibaja
- Unidad de Urgencias, Hospital Universitario de Donostia, Osakidetza, San Sebastián, Spain
| | | | - Ioana Riaño-Fernández
- Instituto de Investigación Sanitaria Biodonostia, Plataforma de Investigación Clínica, San Sebastián, Spain
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2
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Lei P, Gao F, Qi J, Li Z, Zhong D, Su S. A new dressing system for accelerating wound recovery after primary total knee arthroplasty: a feasibility study. BMC Surg 2024; 24:112. [PMID: 38622645 PMCID: PMC11017543 DOI: 10.1186/s12893-024-02409-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Accepted: 04/09/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE Currently, postoperative wound infection and poor healing of total knee arthroplasty have been perplexing both doctors and patients. We hereby innovatively invented a new dressing system to reduce the incidence of postoperative wound complications. METHODS We enrolled 100 patients who received primary unilateral total knee arthroplasty and then applied the new dressing system. The data collected included the number of dressing changes, postoperative hospital stay, Visual Analogue Scale score (VAS), the Knee Society Score (KSS), the Knee Injury and Osteoarthritis Outcome Score (KOOS), ASEPSIS scores, The Stony Brook Scar Evaluation Scale (SBSES), wound complications, dressing cost, the frequency of shower and satisfaction. Subsequently, a statistical analysis of the data was performed. RESULTS Our findings demonstrated the average number of postoperative dressing changes was 1.09 ± 0.38, and the average postoperative hospital stay was 3.72 ± 0.98 days. The average cost throughout a treatment cycle was 68.97 ± 12.54 US dollars. Collectively, the results of VAS, KSS, and KOOS revealed that the pain and function of patients were continuously improved. The results of the four indexes of the ASEPSIS score were 0, whereas the SBSES score was 3.58 ± 0.52 and 4.69 ± 0.46 at two weeks and one month after the operation, respectively. We observed no wound complications until one month after the operation. Remarkably, the satisfaction rate of the patients was 91.85 ± 4.99% one month after the operation. CONCLUSION In this study, we invented a new dressing system for surgical wounds after total knee arthroplasty and further confirmed its clinical feasibility and safety. CHINESE CLINICAL TRIAL REGISTRY ChiCTR2000033814, Registered 13/ June/2020.
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Affiliation(s)
- Pengfei Lei
- Department of Orthopedics, The First Affiliated Hospital, College of Medicine, Zhejiang University, No.1367 West Wenyi Road, 310003, Hangzhou, Zhejiang Province, China
- Hunan Engineering Research Center of Biomedical Metal and Ceramic Implants, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
| | - Fawei Gao
- Department of Orthopedics, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
| | - Jun Qi
- Department of Orthopedics, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
| | - Zhigang Li
- Department of Orthopedics, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
| | - Da Zhong
- Department of Orthopedics, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
- Hunan key laboratary of aging biology, Xiangya Hospital, Central South University, No.87 Xiangya Road, 410008, Changsha, Hunan Province, China
| | - Shilong Su
- Department of Orthopedics, Peking University Third Hospital, No.49 North Garden Road. Haidian, 100191, Beijing, China.
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González-Restrepo D, Zuluaga-Vélez A, Orozco LM, Sepúlveda-Arias JC. Silk fibroin-based dressings with antibacterial and anti-inflammatory properties. Eur J Pharm Sci 2024; 195:106710. [PMID: 38281552 DOI: 10.1016/j.ejps.2024.106710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 01/03/2024] [Accepted: 01/22/2024] [Indexed: 01/30/2024]
Abstract
Silk fibroin is a fibrillar protein obtained from arthropods such as mulberry and non-mulberry silkworms. Silk fibroin has been used as a dressing in wound treatment for its physical, chemical, mechanical, and biological properties. This systematic review analyzed studies from PubMed, Web of Science, and Scopus databases to identify the molecules preferred for functionalizing silk fibroin-based dressings and to describe their mechanisms of exhibiting anti-inflammatory and antibacterial properties. The analysis of the selected articles allowed us to classify the dressings into different conformations, such as membranes, films, hydrogels, sponges, and bioadhesives. The incorporation of various molecules, including antibiotics, natural products, peptides, nanocomposites, nanoparticles, secondary metabolites, growth factors, and cytokines, has allowed the development of dressings that promote wound healing with antibacterial and immunomodulatory properties. In addition, silk fibroin-based dressings have been established to have the potential to regenerate wounds such as venous ulcers, arterial ulcers, diabetic foot, third-degree burns, and neoplastic ulcers. Evaluation of the efficacy of silk fibroin-based dressings in tissue engineering is an area of great activity that has shown significant advances in recent years.
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Affiliation(s)
- David González-Restrepo
- Grupo Infección e Inmunidad, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Augusto Zuluaga-Vélez
- Grupo Infección e Inmunidad, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Lina M Orozco
- Grupo Infección e Inmunidad, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia; Grupo Polifenoles, Facultad de Tecnologías, Escuela de Química, Universidad Tecnológica de Pereira, Pereira, Colombia
| | - Juan C Sepúlveda-Arias
- Grupo Infección e Inmunidad, Facultad de Ciencias de la Salud, Universidad Tecnológica de Pereira, Pereira, Colombia.
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Esposito C, Autorino G, Cerulo M, Del Conte F, Coppola V, Esposito G, Chiodi A, Di Mento C, Bagnara V, Escolino M. Video-assisted anal fistula treatment (VAAFT) combined with ozonide oil dressing: standardization of technique in pediatric patients. Surg Endosc 2024; 38:2273-2279. [PMID: 38443498 PMCID: PMC10978665 DOI: 10.1007/s00464-024-10759-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 02/16/2024] [Indexed: 03/07/2024]
Abstract
BACKGROUND Anal fistula and perianal abscess are commonly acquired anorectal pathologies in children. Surgical treatment options commonly adopted are fistulotomy, fistulectomy, cutting seton placement, and more recently video-assisted anal fistula treatment (VAAFT). Optimal postoperative wound dressing remains debated. This study aimed to report our series of pediatric patients, who received VAAFT and postoperative wound dressing using ozonide oil. METHODS All patients who underwent VAAFT between August 2018 and May 2023 were included in the study. Demographics, clinical features, pre-operative imaging, surgical details, outcome, and mid-term outcome data were retrospectively reviewed for each patient. All VAAFT procedures were performed under general anesthesia and using a 10-Ch fistuloscope. RESULTS Thirty-three VAAFT procedures were performed in 30 patients over the study period. The median patient age was 5.7 years (range 1.75-14). Anal fistula was idiopathic in 26/30 (86.6%), iatrogenic in 2/30 (6.7%), and secondary to Crohn's disease in 2/30 (6.7%). The median duration of surgery was 23 min (range 18-40). All patients received ozonide oil dressing twice a day for 5 weeks postoperatively. The median hospital stay was 24 h (range 9-36). The median healing time was 28 days (range 17-39). With a median follow-up of 2 years (range 0.5-5), disease recurrence occurred in 3/30 (10%) patients with idiopathic fistula, who were re-operated using the same technique, with no further recurrence. No fecal incontinence or soiling was observed. CONCLUSION Our series confirmed that VAAFT is a safe and effective technique to treat children with perianal fistula. The technique is versatile, allowing to treat fistulae of different etiologies. Postoperative course was painless and fast. Future comparative prospective studies are needed to better establish these conclusions.
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Affiliation(s)
- Ciro Esposito
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Giuseppe Autorino
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Mariapina Cerulo
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Fulvia Del Conte
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Vincenzo Coppola
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | | | - Annalisa Chiodi
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Claudia Di Mento
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Vincenzo Bagnara
- Department of Pediatric Surgery, Policlinico G.B. Morgagni, Catania, Italy
| | - Maria Escolino
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy.
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Tao C, Yu N, Ren Q, Wen M, Qiu P, Niu S, Li M, Chen Z. Dressing and undressing MOF nanophotosensitizers to manipulate phototoxicity for precise therapy of tumors. Acta Biomater 2024; 177:444-455. [PMID: 38325709 DOI: 10.1016/j.actbio.2024.01.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 01/19/2024] [Accepted: 01/25/2024] [Indexed: 02/09/2024]
Abstract
Photodynamic therapy (PDT) is a clinically approved treatment for tumors, and it relies on the phototoxicity of photosensitizers by producing reactive oxygen species (ROS) to destroy cancer cells under light irradiation. However, such phototoxicity is a double-edged sword, which is also harmful to normal tissues. To manipulate phototoxicity and improve the therapy effect, herein we have proposed a dressing-undressing strategy for de-activating and re-activating therapy functions of photosensitizer nanoparticles. One kind of metal organic framework (PCN-224), which is composed of Zr(IV) cation and tetrakis (4-carboxyphenyl) porphyrin (TCPP), has been prepared as a model of photosensitizer, and it has size of ∼70 nm. These PCN-224 nanoparticles are subsequently coated with a mesoporous organic silica (MOS) shell containing tetrasulfide bonds (-S-S-S-S-), realizing the dressing of PCN-224. MOS shell has the thickness of ∼20 nm and thus can block 1O2 (diffusion distance: <10 nm), deactivating the phototoxicity and preventing the damage to skin and eyes. Furthermore, PCN-224@MOS can be used to load chemotherapy drug (DOX·HCl). When PCN-224@MOS-DOX are mixed with glutathione (GSH), MOS shell with -S-S-S-S- bonds can be reduced by GSH and then be decomposed, which results in the undressing and then confers the exposure of PCN-224 with good PDT function as well as the release of DOX. When PCN-224@MOS-DOX dispersion is injected into the mice and accumulated in the tumor, endogenous GSH also confers the undressing of PCN-224@MOS-DOX, realizing the in-situ activation of PDT and chemotherapy for tumor. Therefore, the present study not only demonstrates a general dressing-undressing strategy for manipulating phototoxicity of photosensitizers, but also provide some insights for precise therapy of tumors without side-effects. STATEMENT OF SIGNIFICANCE: Photosensitizers can generate reactive oxygen species (ROS) under light radiation to destroy cancer cells. However, this phototoxicity is a double-edged sword and also harmful to normal tissues such as the skin and eyes. To control phototoxicity and improve therapeutic efficacy, we prepared a PCN-224@MOS-DOX nanoplatform and proposed a dressing and undressing strategy to deactivate and reactivate the therapeutic function of the photosensitizer nanoparticles. The MOS shell can block the diffusion of 1O2, eliminate phototoxicity, and prevent damage to the skin and eyes. When injected into mice and accumulated in tumors, PCN-224@MOS-DOX dispersions are endowed with an endogenous GSH-driven undressing effect, achieving in situ activation of PDT and tumor chemotherapy.
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Affiliation(s)
- Cheng Tao
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Nuo Yu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Qian Ren
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Mei Wen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Pu Qiu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Shining Niu
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China
| | - Maoquan Li
- Department of Interventional and Vascular Surgery, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai 200072, China; Shanghai Clinical Research Center for Interventional Medicine, Shanghai 200072, China.
| | - Zhigang Chen
- State Key Laboratory for Modification of Chemical Fibers and Polymer Materials, College of Materials Science and Engineering, Donghua University, Shanghai 201620, China.
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Ambrosio L, Vadalà G, Tavakoli J, Scaramuzzo L, Brodano GB, Lewis SJ, Kato S, Cho SK, Yoon ST, Kim HJ, Gary MF, Denaro V. Surgeon Preference Regarding Wound Dressing Management in Lumbar Fusion Surgery: An AO Spine Global Cross-Sectional Study. Neurospine 2024; 21:204-211. [PMID: 38569644 PMCID: PMC10992664 DOI: 10.14245/ns.2347168.584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 11/30/2023] [Accepted: 12/03/2023] [Indexed: 04/05/2024] Open
Abstract
OBJECTIVE To evaluate the global practice pattern of wound dressing use after lumbar fusion for degenerative conditions. METHODS A survey issued by AO Spine Knowledge Forums Deformity and Degenerative was sent out to AO Spine members. The type of postoperative dressing employed, timing of initial dressing removal, and type of subsequent dressing applied were investigated. Differences in the type of surgery and regional distribution of surgeons' preferences were analyzed. RESULTS Right following surgery, 60.6% utilized a dry dressing, 23.2% a plastic occlusive dressing, 5.7% glue, 6% a combination of glue and polyester mesh, 2.6% a wound vacuum, and 1.2% other dressings. The initial dressing was removed on postoperative day 1 (11.6%), 2 (39.2%), 3 (20.3%), 4 (1.7%), 5 (4.3%), 6 (0.4%), 7 or later (12.5%), or depending on drain removal (9.9%). Following initial dressing removal, 75.9% applied a dry dressing, 17.7% a plastic occlusive dressing, and 1.3% glue, while 12.1% used no dressing. The use of no additional coverage after initial dressing removal was significantly associated with a later dressing change (p < 0.001). Significant differences emerged after comparing dressing management among different AO Spine regions (p < 0.001). CONCLUSION Most spine surgeons utilized a dry or plastic occlusive dressing initially applied after surgery. The first dressing was more frequently changed during the first 3 postoperative days and replaced with the same type of dressing. While dressing policies tended not to vary according to the type of surgery, regional differences suggest that actual practice may be based on personal experience rather than available evidence.
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Affiliation(s)
- Luca Ambrosio
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Gianluca Vadalà
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
- Research Unit of Orthopaedic and Trauma Surgery, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Rome, Italy
| | - Javad Tavakoli
- School of Biomedical Engineering, Faculty of Engineering and Information Technology, University of Technology Sydney, Sydney, Australia
| | - Laura Scaramuzzo
- Spine Surgery Division 1, IRCCS Ospedale Galeazzi-Sant'Ambrogio, Milan, Italy
| | | | - Stephen J Lewis
- UHN-Orthopedics, University of Toronto, Toronto Western Hospital, Toronto, ON, Canada
| | - So Kato
- Department of Orthopaedic Surgery, The University of Tokyo, Tokyo, Japan
| | - Samuel K Cho
- Department of Orthopaedic Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - S Tim Yoon
- Department of Orthopaedics, Emory University, Atlanta, GA, USA
| | - Ho-Joong Kim
- Spine Center and Department of Orthopaedic Surgery, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Korea
| | - Matthew F Gary
- Departments of Neurosurgery and Orthopaedic Surgery, Emory University, Atlanta, GA, USA
| | - Vincenzo Denaro
- Operative Research Unit of Orthopaedic and Trauma Surgery, Fondazione Policlinico Universitario Campus Bio-Medico, Rome, Italy
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Clutton JM, Kinghorn AF, Trickett RW. Does Dressing Choice Affect Infection Rate in Percutaneous K-Wiring of the Hand and Wrist? - A Systematic Review. J Hand Surg Asian Pac Vol 2024; 29:3-11. [PMID: 38299244 DOI: 10.1142/s2424835524500012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
Background: Percutaneous Kirschner wire (K-wire) fixation of hand and wrist fractures is a common trauma procedure, yet there remains little consensus on the best management of wires postoperatively. If wire's ends are left external to the skin, it remains unknown which dressing regimen best reduces infection risk. We felt that a systematic review was required to assess the current consensus on this question within the published literature. Methods: An electronic search was carried out across multiple databases. Abstracts were screened by two independent reviewers against inclusion criteria and, where necessary, full texts were reviewed. Nine eligible papers were identified, and data regarding type of procedure, dressing choice and infection rate was extracted. Results: The included studies were widely heterogenous, and the standard of the evidence was, in general, poor. In most, dressing choice and infection incidence were not the primary intervention/outcome under study. Conclusions: Based on the available literature, insufficient evidence exists to establish one dressing choice as having a lower infection rate. This highlights the need for further high-quality evidence in this area. Level of Evidence: Level III (Therapeutic).
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Herculano RD, Dos Reis CE, de Souza SMB, Pegorin Brasil GS, Scontri M, Kawakita S, Carvalho BG, Bebber CC, Su Y, de Sousa Abreu AP, Mecwan MM, Mandal K, Fusco Almeida AM, Mendes Giannini MJS, Guerra NB, Mussagy CU, Bosculo MRM, Gemeinder JLP, de Almeida BFM, Floriano JF, Farhadi N, Monirizad M, Khorsandi D, Nguyen HT, Gomez A, Tirpáková Z, Peirsman A, da Silva Sasaki JC, He S, Forster S, Burd BS, Dokmeci MR, Terra-Garcia M, Junqueira JC, de Mendonça RJ, Cardoso MR, Dos Santos LS, Silva GR, Barros NR, Jucaud V, Li B. Amphotericin B-loaded natural latex dressing for treating Candida albicans wound infections using Galleria mellonella model. J Control Release 2024; 365:744-758. [PMID: 38072085 DOI: 10.1016/j.jconrel.2023.12.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 11/19/2023] [Accepted: 12/03/2023] [Indexed: 12/17/2023]
Abstract
Amphotericin B (AmB) is the gold standard for antifungal drugs. However, AmB systemic administration is restricted because of its side effects. Here, we report AmB loaded in natural rubber latex (NRL), a sustained delivery system with low toxicity, which stimulates angiogenesis, cell adhesion and accelerates wound healing. Physicochemical characterizations showed that AmB did not bind chemically to the polymeric matrix. Electronic and topographical images showed small crystalline aggregates from AmB crystals on the polymer surface. About 56.6% of AmB was released by the NRL in 120 h. However, 33.6% of this antifungal was delivered in the first 24 h due to the presence of AmB on the polymer surface. The biomaterial's excellent hemo- and cytocompatibility with erythrocytes and human dermal fibroblasts (HDF) confirmed its safety for dermal wound application. Antifungal assay against Candida albicans showed that AmB-NRL presented a dose-dependent behavior with an inhibition halo of 30.0 ± 1.0 mm. Galleria mellonella was employed as an in vivo model for C. albicans infection. Survival rates of 60% were observed following the injection of AmB (0.5 mg.mL-1) in G. mellonella larvae infected by C. albicans. Likewise, AmB-NRL (0.5 mg.mL-1) presented survival rates of 40%, inferring antifungal activity against fungus. Thus, NRL adequately acts as an AmB-sustained release matrix, which is an exciting approach, since this antifungal is toxic at high concentrations. Our findings suggest that AmB-NRL is an efficient, safe, and reasonably priced ($0.15) dressing for the treatment of cutaneous fungal infections.
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Affiliation(s)
- Rondinelli Donizetti Herculano
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA.
| | - Camila Eugênia Dos Reis
- Fundação Educacional do Município de Assis (FEMA), 1200 Getulio Vargas Avenue, 19807-130 Assis, SP, Brazil
| | | | - Giovana Sant'Ana Pegorin Brasil
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Mateus Scontri
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Satoru Kawakita
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Bruna Gregatti Carvalho
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; University of Campinas (UNICAMP), Department of Materials and Bioprocesses Engineering, School of Chemical Engineering, 13083-852 Campinas, SP, Brazil
| | - Camila Calderan Bebber
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Yanjin Su
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Ana Paula de Sousa Abreu
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Marvin M Mecwan
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Kalpana Mandal
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Ana Marisa Fusco Almeida
- São Paulo State University (UNESP), Department of Clinical Analysis, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Maria José Soares Mendes Giannini
- São Paulo State University (UNESP), Department of Clinical Analysis, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | | | - Cassamo Ussemane Mussagy
- Escuela de Agronomía, Facultad de Ciencias Agronómicas y de los Alimentos, Pontificia Universidad Católica de Valparaíso, Chile
| | - Maria Rachel Melo Bosculo
- University Center of the Integrated Faculties of Ourinhos (UNIFIO), Km 338, BR-153, 19909-100 Ourinhos, SP, Brazil
| | - José Lúcio Pádua Gemeinder
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; University Center of the Integrated Faculties of Ourinhos (UNIFIO), Km 338, BR-153, 19909-100 Ourinhos, SP, Brazil
| | | | - Juliana Ferreira Floriano
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil; São Paulo State University (UNESP), School of Sciences, 17033-360 Bauru, SP, Brazil
| | - Neda Farhadi
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Mahsa Monirizad
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Danial Khorsandi
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Huu Tuan Nguyen
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Alejandro Gomez
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Zuzana Tirpáková
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; University of Veterinary Medicine and Pharmacy in Košice, Komenského 73, 041 81 Košice, Slovak Republic
| | - Arne Peirsman
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Plastic, Reconstructive and Aesthetic Surgery, University Hospital Ghent, Ghent, Belgium
| | - Josana Carla da Silva Sasaki
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Siqi He
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Samuel Forster
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA
| | - Betina Sayeg Burd
- São Paulo State University (UNESP), Bioengineering & Biomaterials Group, School of Pharmaceutical Sciences, 14800-903 Araraquara, SP, Brazil
| | - Mehmet Remzi Dokmeci
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Maíra Terra-Garcia
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), 12244-514 São José dos Campos, SP, Brazil
| | - Juliana Campos Junqueira
- Department of Biosciences and Oral Diagnosis, Institute of Science and Technology, São Paulo State University (UNESP), 12244-514 São José dos Campos, SP, Brazil
| | - Ricardo José de Mendonça
- Department of Biochemistry, Pharmacology and Physiology, Federal University of Triangulo Mineiro (UFTM), Uberaba, Minas Gerais, Brazil
| | - Marcos Roberto Cardoso
- São Carlos Institute of Physics, University of São Paulo, PO Box 369, 13561-970 São Carlos, SP, Brazil
| | - Lindomar Soares Dos Santos
- Faculty of Philosophy, Sciences and Languages of Ribeirão Preto, Universidade de São Paulo University (USP), 3900 Bandeirantes Avenue, 14, 040-901 Ribeirão Preto, SP, Brazil
| | - Gláucio Ribeiro Silva
- Federal Institute of Education, Science, and Technology of Minas Gerais, s/n São Luiz Gonzaga Street, 35577-010, Formiga, MG, Brazil
| | - Natan Roberto Barros
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Vadim Jucaud
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA
| | - Bingbing Li
- Terasaki Institute for Biomedical Innovation (TIBI), 11507 W Olympic Blvd, Los Angeles, CA, USA; Autonomy Research Center for STEAHM (ARCS), California State University, Northridge, CA 91324, USA.
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9
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Aydin A, Golian M, Klein A, Redpath C, Davis DR, Ramirez DF, Nair GM, Green M, Sadek M, Nery PB, Hansom SP, Corrales-Medina V, Wells GA, Birnie DH. Do barrier dressings reduce cardiac implantable device infection: Protocol for a randomized controlled trial (BARRIER-PROTECT). Heliyon 2023; 9:e22229. [PMID: 38046145 PMCID: PMC10686845 DOI: 10.1016/j.heliyon.2023.e22229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2023] [Revised: 11/03/2023] [Accepted: 11/07/2023] [Indexed: 12/05/2023] Open
Abstract
Background Cardiac implantable electronic device (CIED) procedures can be associated with serious complications, including infection with significant mortality and morbidity, necessitating removal of the device and prolonged hospitalization. One potential pathophysiological mechanism is pocket contamination at the time of device implantation. Therefore, steps taken to prevent contamination at this stage can potentially reduce CIED infections.The barrier dressing, an adhesive material applied to the skin, has the potential to reduce the colonization of the surgical site with host flora that can predispose to infection. There are a limited number of randomized prospective studies on barrier dressing use during various surgeries, but it has never been systematically studied in CIED implantation. Objectives Do Barrier Dressings Reduce Cardiac Implantable Device Infection? (BARRIER-PROTECT trial; NCT04591366) is a single-centre, prospective, double-armed, single-blinded, randomized controlled trial designed to evaluate the use of an intra-operative adhesive barrier dressing to reduce the risk of end-of-procedure pocket swab positivity. We hypothesize that adhesive draping during implant procedures will reduce the risk of contamination from the skin flora. Also, we aim to investigate if the end-of-procedure pocket swab culture positivity can be used as a potential surrogate marker of CIED infection. Methods and Design Patients undergoing a second or later procedure on the same device pocket (pulse generator change, lead/pocket revision or upgrade) will be enrolled. Eligible and consenting patients will be equally randomized to the use of barrier dressing or not using an automated web-based system. Patients, but not the operator, will be blinded to the arm. The person performing the pocket swabs will also be blinded. The primary endpoint is the end-of-procedure pocket swab culture positivity. The main secondary endpoint is the CIED infection rate. Discussion This is the first randomized controlled trial to assess the effectiveness of using a barrier adhesive draping on reducing the end-of-procedure pocket swab culture positivity. In this study, we are exploring a low-cost intervention that may significantly reduce CIED infection. Also, having a valid surrogate marker for CIED infection at the time of implant will facilitate design of future clinical trials.
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Affiliation(s)
- Alper Aydin
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Mehrdad Golian
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Andres Klein
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Calum Redpath
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Darryl R. Davis
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Daniel F. Ramirez
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Girish M. Nair
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Martin Green
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Mouhannad Sadek
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Pablo B. Nery
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Simon P. Hansom
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - Vicente Corrales-Medina
- Division of Infectious Diseases, Department of Medicine, University of Ottawa, and The Ottawa Hospital, Canada
| | - George A. Wells
- Division of Cardiology, University of Ottawa Heart Institute, Canada
| | - David H. Birnie
- Division of Cardiology, University of Ottawa Heart Institute, Canada
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10
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Tyeb S, Verma V, Kumar N. Polysaccharide based transdermal patches for chronic wound healing: Recent advances and clinical perspective. Carbohydr Polym 2023; 316:121038. [PMID: 37321732 DOI: 10.1016/j.carbpol.2023.121038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 05/02/2023] [Accepted: 05/17/2023] [Indexed: 06/17/2023]
Abstract
Polysaccharides form a major class of natural polymers with diverse applications in biomedical science and tissue engineering. One of the key thrust areas for polysaccharide materials is skin tissue engineering and regeneration, whose market is estimated to reach around 31 billion USD globally by 2030, with a compounded annual growth rate of 10.46 %. Out of this, chronic wound healing and management is a major concern, especially for underdeveloped and developing nations, mainly due to poor access to medical interventions for such societies. Polysaccharide materials have shown promising results and clinical potential in recent decades with regard to chronic wound healing. Their low cost, ease of fabrication, biodegradability, and ability to form hydrogels make them ideal candidates for managing and healing such difficult-to-heal wounds. The present review presents a summary of the recently explored polysaccharide-based transdermal patches for managing and healing chronic wounds. Their efficacy and potency of healing both as active and passive wound dressings are evaluated in several in-vitro and in-vivo models. Finally, their clinical performances and future challenges are summarized to draw a road map towards their role in advanced wound care.
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Affiliation(s)
- Suhela Tyeb
- Department of Materials Engineering, Indian Institute of Science Bangalore, Bengaluru 560012, India
| | - Vivek Verma
- Department of Materials Science and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India; Centre for Environmental Sciences and Engineering, Indian Institute of Technology Kanpur, Kanpur 208016, India; Samtel Centre for Display Technologies, Indian Institute of Technology Kanpur, Kanpur 208016, India; National Centre for Flexible Electronics, Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - Nitesh Kumar
- Department of Materials Engineering, Indian Institute of Technology Jammu, Jammu 181221, India.
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Esposito C, Leva E, Gamba P, Sgrò A, Ferrentino U, Papparella A, Chiarenza F, Bleve C, Mendoza-Sagaon M, Montaruli E, Escolino M. Pediatric endoscopic pilonidal sinus treatment (PEPSiT): report of a multicentric national study on 294 patients. Updates Surg 2023; 75:1625-1631. [PMID: 37145226 PMCID: PMC10435587 DOI: 10.1007/s13304-023-01508-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Accepted: 04/17/2023] [Indexed: 05/06/2023]
Abstract
This study aimed to report a multicentric national experience about the outcomes of pediatric endoscopic pilonidal sinus treatment (PEPSiT). The medical records of all pediatric patients, aged up to 18 years, who underwent PEPSiT in the period 2019-2021, were retrospectively reviewed. Patients' demographics, operative details, and post-operative outcomes were assessed. A total of 294 patients (182 boys), with median age of 14 years (range 10-18), receiving PEPSiT in the study period, were enrolled. Pilonidal sinus disease (PSD) was primary in 258 (87.8%) and recurrent in 36 (12.2%). The median operative time was 36 min (range 11-120). The median VAS pain score was 0.86 (range 0-3) and the median duration of analgesic use was 27 h (range 12-60). The overall success rate was 95.2% (280/294) and the median time to full healing was 23.4 days (range 19-50). Six/294 (2.0%) patients developed Clavien 2 post-operative complications. The recurrence rate was 4.8% (14/294) and all recurrences were re-operated using PEPSiT. Redo-surgery for wound debridement was performed in one (0.3%) patient with late healing. On multivariate analysis, hirsutism and typology of sinus (pits ≥ 2, paramedian and more proximal to the anus) were predictors of PSD recurrence (p = 0.001). To date, this is the largest series of PEPSiT published in the pediatric population. The outcomes reported after a 3 years experience confirm that PEPSiT is a safe, effective, and real minimally invasive procedure to treat adolescents with PSD. It provides patients quick and painless recovery, satisfactory success, and high quality of life.
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Affiliation(s)
- Ciro Esposito
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy
| | - Ernesto Leva
- Division of Pediatric Surgery, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Piergiorgio Gamba
- Division of Pediatric Surgery, Medical University of Padua, Padua, Italy
| | - Alberto Sgrò
- Division of Pediatric Surgery, Medical University of Padua, Padua, Italy
| | - Umberto Ferrentino
- Division of Pediatric Surgery, University Hospital San Giovanni di Dio e Ruggi d'Aragona, Salerno, Italy
| | - Alfonso Papparella
- Division of Pediatric Surgery, University Hospital Luigi Vanvitelli, Naples, Italy
| | - Fabio Chiarenza
- Division of Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy
| | - Cosimo Bleve
- Division of Pediatric Surgery, San Bortolo Hospital, Vicenza, Italy
| | - Mario Mendoza-Sagaon
- Division of Pediatric Surgery, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | - Ernesto Montaruli
- Division of Pediatric Surgery, Ospedale Regionale di Bellinzona e Valli, Bellinzona, Switzerland
| | - Maria Escolino
- Division of Pediatric Surgery, Federico II University Hospital, Via Pansini 5, 80131, Naples, Italy.
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12
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Poondru S, Scott K, Riley JM. Patient perspectives of wound care management in hidradenitis suppurativa. Arch Dermatol Res 2023; 315:1847-1850. [PMID: 36811730 DOI: 10.1007/s00403-023-02576-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/09/2023] [Accepted: 02/08/2023] [Indexed: 02/24/2023]
Abstract
Wound care management and costs in hidradenitis suppurativa (HS) are unmet needs. This study explored patient perspectives of at-home management of acute flares of HS and chronic daily wounds, their satisfaction with current wound care methods, and the financial burden of wound care supplies. An anonymous, multiple choice, cross-sectional questionnaire was distributed among online HS-related forums between August and October 2022. Participants 18 years or older with a diagnosis of HS who live in the United States were included. In total, 302 participants completed the questionnaire: 168 White (55.6%), 76 Black (25.2%), 33 Hispanic (10.9%), 7 Asian (2.3%), 12 multiracial (4.0%), and 6 other (2.0%). Dressings commonly reported included gauze, panty liners or menstrual pads, tissues or toilet paper, antiseptic dressing, abdominal pads, and adhesive bandages. Commonly reported topical remedies for acute flares of HS included warm compresses, Epsom salt baths, Vicks VapoRub, tea tree oil, witch hazel, and bleach baths. One-third of participants (n = 102) reported dissatisfaction with current wound care methods, and 48.8% (n = 103) believed that their dermatologist does not meet their wound care needs. Nearly half (n = 135) reported being unable to afford the type and quantity of dressings and wound care supplies they would ideally want. Black participants were more likely than White participants to report being unable to afford their dressings and find the cost as very burdensome. Overall, dermatologists must improve patient education of wound care methods in HS and address the financial burden of wound care supplies by exploring insurance-funded options.
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Affiliation(s)
- Sneha Poondru
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA
| | - Kourtney Scott
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA
| | - Julia M Riley
- Department of Dermatology, Northwestern University Feinberg School of Medicine, 676 N St. Clair St Ste 1600, Chicago, IL, 60611, USA.
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DUTTO M, ZAVATTERO C, VINAI E, LAURIA G, VANIN S. [Diagnostic atypique d'une myiase]. Med Trop Sante Int 2023; 3:mtsi.v3i2.2023.370. [PMID: 37525680 PMCID: PMC10387311 DOI: 10.48327/mtsi.v3i2.2023.370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Figures] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/27/2023] [Indexed: 08/02/2023]
Abstract
Muscoid larvae were observed on self-medicated dressing material loaded with purulent material taken from a 91-year-old hospital patient. These larvae were identified as Lucilia sericata. However, no larvae were found in the patient's tissues. The observation of larvae on dressings should not automatically lead to a diagnosis of cutaneous myiasis.
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Affiliation(s)
- Moreno DUTTO
- Former Medical Entomology and Zoology Consultant, Santa Croce e Carle General Hospital, Cuneo, Italy
| | - Carla ZAVATTERO
- Division Pathological Anatomy, Regina Montis Regalis Hospital, Mondovì, Italy
| | - Elio VINAI
- Biomedic Laboratory, Regina Montis Regalis Hospital, Mondovì, Italy
| | - Giuseppe LAURIA
- Department Emergency and Acceptance, Santa Croce e Carle General Hospital, Cuneo, Italy
| | - Stefano VANIN
- Department of Earth, Environmental and Life Sciences, University of Genova, Genova, Italy
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14
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Wang Y, Shi Y, Liu J, Yang W, Tang H, Li H. Developing hyaluronic acid-proline-ferric ion cross-linked film for efficient wound healing application. Int J Pharm 2023:123140. [PMID: 37354928 DOI: 10.1016/j.ijpharm.2023.123140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 05/27/2023] [Accepted: 06/10/2023] [Indexed: 06/26/2023]
Abstract
A novel cross-linked film dressing that can accelerate wound healing and guard against bacterial infection was presented in this work. The hyaluronic acid-proline-ferric ion (HA-Pro-Fe3+) film was successfully prepared by physically cross-linking method, which the carboxyl groups of the HA and Pro molecules should be in coordination with Fe3+. The HA-Pro-Fe3+ cross-linked film showed three-dimensional porous structure, appropriate water vapor permeability and swelling property, favorable cytocompatibility and hemocompatibility, antibacterial and antioxidative capability. The results of rat skin wound healing confirmed that HA-Pro-Fe3+ film could accelerate epithelial regeneration and collagen deposition, promote angiogenesis and significantly improve skin wound healing. Elisa analysis indicated that HA-Pro-Fe3+ material could down-regulate the expression of IL-6 and TNF-α, and up-regulate the level of TGF-β1 and VEGF. Given its biocompatibility, antibacterial ability, promotion of cell proliferation and angiogenesis, the wide application of HA-Pro-Fe3+ cross-linked film in wound repair would be anticipated.
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Affiliation(s)
- Yihua Wang
- College of Pharmaceutical Science & Key Laboratory of Pharmaceutical Quality Control of Hebei Province, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of the Ministry of Education, Hebei University, Baoding 071002, China
| | - Yanxia Shi
- College of Pharmaceutical Science & Key Laboratory of Pharmaceutical Quality Control of Hebei Province, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of the Ministry of Education, Hebei University, Baoding 071002, China
| | - Jie Liu
- College of Pharmaceutical Science & Key Laboratory of Pharmaceutical Quality Control of Hebei Province, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of the Ministry of Education, Hebei University, Baoding 071002, China
| | - Wendhi Yang
- College of Pharmaceutical Science & Key Laboratory of Pharmaceutical Quality Control of Hebei Province, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of the Ministry of Education, Hebei University, Baoding 071002, China.
| | - Hongbo Tang
- Department of Pharmacy, Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing Maternal and Child Health Care Hospital, 100026 PR China.
| | - Haiying Li
- College of Pharmaceutical Science & Key Laboratory of Pharmaceutical Quality Control of Hebei Province, Key Laboratory of Medicinal Chemistry and Molecular Diagnosis of the Ministry of Education, Hebei University, Baoding 071002, China.
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15
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Abstract
Injury to the skin provides a difficult challenge, as wound healing is a complex and dynamic process. Wound healing process recruits three different phases: inflammation, proliferation, and maturation. The sequence of events involved in wound healing can be affected by numerous disease processes, resulting in chronic, non-healing wounds that give significant discomfort and distress to the patients while draining the medical fraternity of enormous resources. Wound tissue never reaches its pre-injured strength and multiple aberrant healing states can result in chronic non-healing wounds. There is a growing concern about the usage of correct materials for wound dressings. The development of new and effective treatments in wound care still remains an area of intense research. There are a number of wound dressings available in the market. The objective of the article is to enhance knowledge about characteristics of an ideal wound dressing and guide in finding the correct dressing material. It also provides a detailed classification of traditional and modern wound dressings.
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Affiliation(s)
- Surbhi D Bhoyar
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
| | - Karan Malhotra
- Department of Dermatology, Desun Hospital, Kolkata, West Bengal, India
| | - Bhushan Madke
- Department of Dermatology, Venereology and Leprosy, Datta Meghe Institute of Higher Education and Research, Jawaharlal Nehru Medical College, Wardha, Maharashtra, India
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16
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Fang H, Xu J, Ma H, Liu J, Xing E, Cheng YY, Wang H, Nie Y, Pan B, Song K. Functional materials of 3D bioprinting for wound dressings and skin tissue engineering applications: A review. Int J Bioprint 2023; 9:757. [PMID: 37457938 PMCID: PMC10339425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 01/31/2023] [Indexed: 07/18/2023] Open
Abstract
The skin plays an important role in vitamin D synthesis, humoral balance, temperature regulation, and waste excretion. Due to the complexity of the skin, fluids loss, bacterial infection, and other life-threatening secondary complications caused by skin defects often lead to the damage of skin functions. 3D bioprinting technology, as a customized and precise biomanufacturing platform, can manufacture dressings and tissue engineering scaffolds that accurately simulate tissue structure, which is more conducive to wound healing. In recent years, with the development of emerging technologies, an increasing number of 3D-bioprinted wound dressings and skin tissue engineering scaffolds with multiple functions, such as antibacterial, antiinflammatory, antioxidant, hemostatic, and antitumor properties, have significantly improved wound healing and skin treatment. In this article, we review the process of wound healing and summarize the classification of 3D bioprinting technology. Following this, we shift our focus on the functional materials for wound dressing and skin tissue engineering, and also highlight the research progress and development direction of 3D-bioprinted multifunctional wound healing materials.
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Affiliation(s)
- Huan Fang
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
- Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, Henan, China
| | - Jie Xu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
- Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, Henan, China
| | - Hailin Ma
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
- Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, Henan, China
| | - Jiaqi Liu
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
| | - Erpai Xing
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
| | - Yuen Yee Cheng
- Institute for Biomedical Materials and Devices, Faculty of Science, University of Technology Sydney, NSW 2007, Australia
| | - Hong Wang
- Department of Orthopaedics, Dalian Municipal Central Hospital Affiliated of Dalian University of Technology, Dalian 116033, China
| | - Yi Nie
- Zhengzhou Institute of Emerging Industrial Technology, Zhengzhou 450000, Henan, China
| | - Bo Pan
- Department of Breast Surgery, The Second Hospital of Dalian Medical University, Dalian 116023, China
| | - Kedong Song
- State Key Laboratory of Fine Chemicals, Dalian R&D Center for Stem Cell and Tissue Engineering, Dalian University of Technology, Dalian 116024, Liaoning, China
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17
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Robijns J, Aquilano M, Banerjee S, Caini S, Wolf JR, van den Hurk C, Beveridge M, Lam H, Bonomo P, Chow E, Behroozian T. Barrier Films and Dressings for the Prevention of Acute Radiation Dermatitis: A Systematic Review and Meta-Analysis. Support Care Cancer 2023; 31:219. [PMID: 36929087 DOI: 10.1007/s00520-023-07671-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 03/06/2023] [Indexed: 03/18/2023]
Abstract
PURPOSE This systematic review and meta-analysis aimed to evaluate the efficacy of barrier films and dressings in preventing acute radiation dermatitis (RD). METHODS OVID Medline, Embase, and Cochrane databases were searched from 1946 to September 2020 to identify randomized controlled trials on the use of barrier films or dressings to prevent RD. For comparable outcomes between studies, pooled effect sizes and 95% confidence intervals (CI) were calculated using the random effects analysis in RevMan 5.4. RESULTS Fourteen and 11 studies were included in the qualitative and quantitative analyses, respectively. Five types of barrier films used for RD were identified: Hydrofilm, StrataXRT®, Mepitel® Film, 3 M™ Cavilon™ No-Sting Barrier Film, and silver leaf nylon dressing. Hydrofilm and Mepitel Film significantly reduced the development of RD grade ≥ 2 in breast and head and neck cancer patients (RR 0.32, 95%CI 0.19, 0.56, p < 0.0001; RR 0.21, 95%CI 0.05, 0.89, p = 0.03, resp.). Moreover, Hydrofilm had a beneficial effect on patient-reported outcomes (PROs) (SMD -0.75, 95%CI -1.2, -0.29, p = 0.001). The meta-analyses on the other barrier films did not show any significant effect. CONCLUSION This review and meta-analysis demonstrated that Hydrofilm and Mepitel Film could effectively reduce RD severity and improve PROs. The evidence is generally weak for all the studies on barrier films and dressings due to a limited study number, high risk of bias, small sample sizes, and minimal comparable outcome measures. It's potential has been proven, but future research in this field is recommended to confirm the efficacy of these products and assess real-world feasibility.
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Affiliation(s)
- Jolien Robijns
- Faculty of Medicine and Life Sciences, Limburg Clinical Research Center, Hasselt University, Hasselt, Belgium
| | - Michele Aquilano
- Department of Biomedical, Experimental, and Clinical Sciences "Mario Serio", University of Florence, Florence, Italy
| | - Suvam Banerjee
- Department of Health and Family Welfare, Government of West Bengal, Burdwan Medical College and Hospital, The West Bengal University of Health Sciences, West Bengal, India
| | - Saverio Caini
- Cancer Risk Factors and Lifestyle Epidemiology Unit, Institute for Cancer Research, Prevention and Clinical Network (ISPO), Florence, Italy
| | - Julie Ryan Wolf
- Departments of Dermatology and Radiation Oncology, University of Rochester Medical Centre, Rochester, NY, USA
| | | | - Mara Beveridge
- Department of Dermatology, University Hospitals, Cleveland, OH, USA
| | - Henry Lam
- Sunnybrook Health Sciences Centre, University of Toronto, Toronto, ON, Canada
| | - Pierluigi Bonomo
- Department of Radiation Oncology, Azienda Ospedaliero-Universitaria Careggi, Florence, Italy
| | - Edward Chow
- Department of Radiation Oncology, University of Toronto, Toronto, ON, Canada
| | - Tara Behroozian
- Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada.
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Sahraneshin-Samani F, Kazemi-Ashtiani M, Karimi H, Shiravandi A, Baharvand H, Daemi H. Regioselective sulfated chitosan produces a biocompatible and antibacterial wound dressing with low inflammatory response. Biomater Adv 2022; 139:213020. [PMID: 35882163 DOI: 10.1016/j.bioadv.2022.213020] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 06/13/2022] [Accepted: 07/04/2022] [Indexed: 06/15/2023]
Abstract
The aim of current study is to tailor chitosan derivate which is water-soluble while presents original biological features of chitosan. For this purpose, the 6-O chitosan sulfate (CS) with naked amine groups was synthesized via regioselective modification of chitosan (C) during which both crosslinking capacity and antibacterial properties of the C were remained intact. This was achieved by sulfation the C under controlled acidic conditions using chlorosulfonic acid/sulfuric acid mixture. Subsequently, a chemically crosslinked hydrogel of the CS was used as a wound dressing substrate. The modified sulfate groups retained the biocompatibility of C and showed antibacterial effects against gram-positive and gram-negative bacteria. In addition, the presence of sulfate groups in the CS chemical structure improved its anticoagulant activity compared to the unmodified C. Both in vitro and in vivo enzyme-linked immunosorbent assay (ELISA) measurements showed that CS had a higher potential to bind and scavenger anti-inflammatory cytokines, including IL-6 and transforming growth factor-β (TGF-β), both of which play critical roles in the early stage of the wound healing process. After treatment of full-thickness wounds with CS hydrogels, the macrophage cells (c.a. 6 × 104 cells) expressed significantly more M2 phenotype markers compared to the C group (4.2 × 104 cells). Furthermore, the CS hydrogel induced better re-epithelialization and vascularization of full-thickness wounds in mice compared to the C hydrogel during 30 days.
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Affiliation(s)
- Fazel Sahraneshin-Samani
- Faculty of Basic Sciences and Advanced Medical Technologies, Royan Institute, ACECR, Tehran, Iran
| | - Mohammad Kazemi-Ashtiani
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hassan Karimi
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Biomaterials, Zharfandishan Fanavar Zistbaspar (ZFZ) Chemical Company, Tehran, Iran
| | - Ayoub Shiravandi
- Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran
| | - Hossein Baharvand
- Department of Stem Cells and Developmental Biology, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran; Department of Developmental Biology, School of Basic Sciences and Advanced Technologies in Biology, University of Science and Culture, Tehran, Iran
| | - Hamed Daemi
- Faculty of Basic Sciences and Advanced Medical Technologies, Royan Institute, ACECR, Tehran, Iran; Department of Cell Engineering, Cell Science Research Center, Royan Institute for Stem Cell Biology and Technology, ACECR, Tehran, Iran.
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Aliyev O, Aghazada A, Demirkıran CB, Uzer G, Citak M, Tuncay İ, Yıldız F. Could intermittent change of conventional dressing affect risk of periprosthetic joint infection after primary total joint arthroplasty? Arch Orthop Trauma Surg 2022; 142:1681-1687. [PMID: 34247306 DOI: 10.1007/s00402-021-04061-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 07/03/2021] [Indexed: 11/24/2022]
Abstract
PURPOSE Periprosthetic joint infection (PJI) is one of the most dreaded and challenging complications after total joint arthroplasty (TJA). The aim of this study was to evaluate the effect of keeping the dressing without change on the occurrence of PJI in patients undergoing TJA. METHODS 4877 Patients with a minimum follow-up of 90 days were included to investigate the effect of dressing on the PJI occurring within 3 months of surgery. Patients were divided into two consecutive groups as the intermittent change of traditional dressing (group 1-before 2019) and keeping dressing for 5 days without change (group 2-after 2019). A backward stepwise logistic regression model was used to estimate independent risk factors for PJI. RESULTS Group 1 and group 2 consisted of 4172 and 705 patients, and the numbers of diagnosed PJI cases in the groups were 40 (1.0%) and 10 (1.4%), respectively (p = 0.1). The backward stepwise logistic regression model analysis revealed that keeping the dressing unchanged and removing it after the first week postoperatively was not an independent risk factor for the occurrence of PJI. Older age, diabetes mellitus and coronary artery diseases were independent risk factors for PJI (p < 0.05). CONCLUSION Our study results present, that intermittent change of conventional dressing is unnecessary, because it does not decrease the risk of PJI after TJA. LEVEL OF EVIDENCE Level III Therapeutic.
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Affiliation(s)
- Orkhan Aliyev
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Aghamazahir Aghazada
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Cemil Burak Demirkıran
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Gökçer Uzer
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Mustafa Citak
- ENDO-Klinik Hamburg, Holstenstraße 2, 22767, Hamburg, Germany.
| | - İbrahim Tuncay
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
| | - Fatih Yıldız
- Department of Orthopaedics and Traumatology, Bezmialem Vakıf University, İskender Paşa Mh Adnan Menderes Bulvarı, Adnan Menderes Blv.Fatih, 34093, İstanbul, Turkey
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20
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Jensen NM, Steenstrup S, Ravn C, Schmal H, Viberg B. The use of negative pressure wound therapy for fracture-related infections following internal osteosynthesis of the extremity: A systematic review. J Clin Orthop Trauma 2021; 24:101710. [PMID: 34881170 PMCID: PMC8627993 DOI: 10.1016/j.jcot.2021.101710] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Revised: 10/22/2021] [Accepted: 11/13/2021] [Indexed: 11/28/2022] Open
Abstract
This study aimed to systematically review the current literature on studies using negative pressure wound therapy (NPWT) or dressings following fracture-related infection (FRI) in internal osteosynthesis of the extremity. Articles were analyzed on fracture and wound healing and included when comparing or describing the use of either NPWT or dressings in FRI. We conducted a systematic literature search in four electronic databases: Embase, Medline, the Cochrane Library, and Scopus. The studies were screened by two authors using Covidence.org and evaluated for risk of bias. A total of 8576 records were identified. No articles compared NPWT to dressings. Seven case reports and three case series included a total of 115 patients treated for FRI. Fracture healing was achieved in 21 out of 67 patients treated with NPWT (4 amputations and 46 not described) and all 48 patients in the dressing group (4 patients needed additional sequestrectomy procedures). Five studies did not describe fracture healing. In 57 out of 67 patients treated with NPWT, the wounds were described as healed, closed, or requiring soft tissue reconstruction (4 amputations and six lacking description). The dressing group had complete wound coverage in 18 patients and partial coverage in 30 patients. Studies were generally at high risk of bias because of insufficient descriptions of both patient demographics and outcomes. No studies compared NPWT to dressings, and the existing literature is at high risk of bias. The included studies were of low-level evidence. NPWT can be neither recommended nor advised against to cover infected osteosynthesis.
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Affiliation(s)
- Niels Martin Jensen
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital Part of Lillebaelt Hospital, Sygehusvej 22, 6000, Kolding, Denmark,Corresponding author. Pilevangen 15, 5450, Otterup, Denmark.
| | - Signe Steenstrup
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital Part of Lillebaelt Hospital, Sygehusvej 22, 6000, Kolding, Denmark
| | - Christen Ravn
- Department of Orthopaedic Surgery and Traumatology, Kolding Hospital Part of Lillebaelt Hospital, Sygehusvej 22, 6000, Kolding, Denmark
| | - Hagen Schmal
- Department of Orthopaedic Surgery and Traumatology, Freiburg University Hospital, Hugstetter Straße 55, 79106, Freiburg, Germany
| | - Bjarke Viberg
- Department of Orthopaedic Surgery and Traumatology, Odense University Hospital, J. B. Winsloewsvej 4, 5000, Odense C, Denmark
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21
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Tanaka JL, Costa-Orlandi CB, Burd BS, Pegorin GS, da Silva TV, Guerra NB, Mendes-Giannini MJS, Fusco-Almeida AM, Herculano RD, de Barros NR. Natural rubber dressing loaded with silver sulfadiazine for the treatment of burn wounds infected with Candida spp. Int J Biol Macromol 2021; 189:597-606. [PMID: 34418421 DOI: 10.1016/j.ijbiomac.2021.08.102] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Revised: 08/07/2021] [Accepted: 08/12/2021] [Indexed: 01/02/2023]
Abstract
Millions of people are burned worldwide every year and 265,000 of the cases are fatal. The development of burn treatment cannot consist only of the administration of a single drug. Due to the infection risk, antibiotics are used in conjunction with gels and damp bandages. In this work, an inexpensive curative based on silver sulfadiazine (SS) and natural rubber latex (NRL) was developed to treat burn wounds. It was produced by the casting method. The infrared spectrum presented no interaction between drug and biopolymer. At the same time, electronic micrographs showed that the SS crystals are inserted on the polymeric dressing surface. Mechanical properties after the drug incorporation were considered suitable for dermal application. About 32.4% of loaded SS was released in 192 h by the dressings that also inhibited the growth of Candida albicans and Candida parapsilosis at 75.0 and 37.5 μg·mL-1, respectively. The curative proved to be biocompatible when applied to fibroblast cells, in addition to enhancing cellular proliferation and, in the hemocompatibility test, no hemolytic effects were observed. The good results in mechanical, antifungal and biological assays, combined with the average bandage cost of $0.10, represent an exciting alternative for treating burn wounds.
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22
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Ahmed A, Getti G, Boateng J. Medicated multi-targeted alginate-based dressings for potential treatment of mixed bacterial-fungal infections in diabetic foot ulcers. Int J Pharm 2021; 606:120903. [PMID: 34293470 DOI: 10.1016/j.ijpharm.2021.120903] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 07/14/2021] [Accepted: 07/16/2021] [Indexed: 01/13/2023]
Abstract
Recently developed medicated dressings target either bacterial or fungal infection only, which is not effective for the treatment of mixed infections common in diabetic foot ulcers (DFUs). This study aimed to develop advanced bioactive alginate-based dressings (films and wafers) to deliver therapeutically relevant doses of ciprofloxacin (CIP) and fluconazole (FLU) to target mixed bacterial and fungal infections in DFUs. The alginate compatibility with the drugs was confirmed by SEM, XRD, FTIR and texture analysis, while the medicated wafers showed better fluid handling properties than the films in the presence of simulated wound fluid. The dressings showed initial fast release of FLU followed by sustained release of CIP which completely eradicated E. coli, S. aureus, P. aeruginosa and reduced fungal load (C. albicans) by 10-fold within 24 h. Moreover, the medicated dressings were biocompatible (>70% cell viability over 72 h) with human primary adult keratinocytes and in-vitro scratch assay showed 65-68% wound closure within 7 days.
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Affiliation(s)
- Asif Ahmed
- School of Science, Faculty of Engineering and Science, University of Greenwich, Medway, Central Ave., Chatham Maritime, Kent ME4 4TB, UK
| | - Giulia Getti
- School of Science, Faculty of Engineering and Science, University of Greenwich, Medway, Central Ave., Chatham Maritime, Kent ME4 4TB, UK
| | - Joshua Boateng
- School of Science, Faculty of Engineering and Science, University of Greenwich, Medway, Central Ave., Chatham Maritime, Kent ME4 4TB, UK.
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23
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Shetty AJ, Sweta KM, Ramesh PB. A case series of second-degree burn patients managed with Patoladi vikeshika, an Ayurvedic contact layer dressing. J Ayurveda Integr Med 2021; 12:544-548. [PMID: 34362607 PMCID: PMC8377186 DOI: 10.1016/j.jaim.2021.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/26/2021] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Management of burn injury is a challenging task as it can lead to considerable amount of agony and disability to the victims. An estimated annual burn incidence in India is 6-7 million. Depending on the degree of burn or the thickness of skin involved, the healing period will vary from 1 to 3 weeks. The aims of dressing in burn injury are to decrease the agony from pain in the wound, to protect or isolate the burn wound from the irritation caused by the dress worn and external environment, and to the hasten the healing of the wound. There are several established advanced dressings in use which hold the qualities of ideal contact layer dressing. Patoladi vikeshika is an attempt to bring in such contact layer dressings in Ayurveda.Patoladi vikeshika was prepared by impregnating Patoladi sikta taila, which was prepared as per Taila paka vidhi, over 10 cm × 10 cm sterile gauzes. These impregnated gauzes were packed and sterilized. The prepared Vikeshika was applied as a contact layer dressing over second-degree burn wounds of 3 patients, after cleaning with normal saline once in every 48 h. Within 4-5 dressings, wounds healed completely without any complications like infection. Patoladi vikeshika seems to have the qualities of an ideal contact layer dressing and therapeutically it has shown good results in the above cases.
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Affiliation(s)
- Ashwin Jayaram Shetty
- Department of PG Studies in Shalya tantra, Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru, India.
| | - K M Sweta
- Department of PG Studies in Shalya tantra, Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru, India
| | - P Bhat Ramesh
- Department of PG Studies in Shalya tantra, Sri Sri College of Ayurvedic Science and Research Hospital, Bengaluru, India
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24
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Karakaya AE, Güler AG, Doğan AB. Dressing or Not after Tubularized Incised Plate Urethroplasty. Urol Int 2021; 105:1029-1033. [PMID: 34192707 DOI: 10.1159/000516682] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 04/05/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Many surgical techniques, as well as dressing models, were identified in the treatment of hypospadias. There are many publications in the literature that are the result of the effort to find the ideal dressing after hypospadias surgery. The dressing has some benefits; however, it has some adverse effects. The present study aimed to discuss outcomes of the patients who have been operated through the tubularized incised plate urethroplasty (TIPU) method and followed with and without dressing postoperatively. METHODS Patients operated on through the TIPU method between March 2015 and August 2019 were reviewed retrospectively. The patients were divided into two groups, dressing and undressing. Preoperative hypospadias severity was evaluated according to the Glans-Urethral Meatus-Shaft (GMS) scoring method. The care results of the patients were recorded. Postoperative outcomes were compared according to the Hypospadias Objective Scoring Evaluation (HOSE) scale, and statistical analyses were conducted. The results of both groups were compared statistically. RESULTS One hundred and nineteen patients were divided into two groups: dressing (n = 56) and nondressing (n = 63). The patients' average age was 3.54 ± 2.97 years in group 1 and 3.50 ± 3.01 years in group 2 (p = 0.940). There was not any statistically significant difference between the two groups for demographic data. Minimal bleeding had stopped in three patients in the nondressing group spontaneously before discharging. No severe edema or hematoma, which might have concerned the parents, appeared. Two (3.5%) and 3 (4.7%) patients underwent a maximum of three urethral dilation sessions in dressing and nondressing groups, respectively (p = 0.556). We found no significant difference between groups in the comparison of preoperative GMS and postoperative HOSE scoring. DISCUSSION The most important limitation of the study is that it is retrospective. Pre- and postoperative scoring systems are objective. The data obtained in the literature show that surgeons prefer to apply dressings commonly after the TIPU technique. Advantages and disadvantages of dressing are mentioned in the literature. Even if the paradigm is dressing in hypospadias surgery, according to the results of our study, dressing may not affect the functional and cosmetic results of TIPU repair. CONCLUSION Postoperative functional and cosmetic results of TIPU in hypospadias appear to be independent of dressing. However, the results must be supported by further research.
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Affiliation(s)
- Ali Erdal Karakaya
- Department of Pediatric Surgery, Sütçü İmam University School of Medicine, Kahramanmaras, Turkey
| | - Ahmet Gökhan Güler
- Department of Pediatric Surgery, Sütçü İmam University School of Medicine, Kahramanmaras, Turkey
| | - Ahmet Burak Doğan
- Department of Pediatric Surgery, Erciyes University School of Medicine, Kayseri, Turkey
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25
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Lu YX, Wu Y, Liang PF, Wu RC, Tian LY, Mo HY. Efficacy of combination of localized closure, ethacridine lactate dressing, and phototherapy in treatment of severe extravasation injuries: A case series. World J Clin Cases 2021; 9:4599-4606. [PMID: 34222426 PMCID: PMC8223846 DOI: 10.12998/wjcc.v9.i18.4599] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 02/24/2021] [Accepted: 04/06/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND The management of severe extravasation injuries is still controversial. Extravasation injuries can be treated in many ways.
AIM To present a series of patients with severe extravasation injuries due to infusion who were managed with ethacridine lactate dressing combined with localized closure and phototherapy.
METHODS In this study, we evaluated the data of eight patients, including six from the Department of Burn, one (with colorectal carcinoma) from the Veteran Cadre Department, and one (with leukemia) from the Hematology Department. Of these, three patients were male and five were female. Age of the patients ranged from 10 mo to 72 years, including two children (10 and 19 mo of age). In this study, the infusion was stopped immediately when the extravasation was identified. The extravasation event was managed routinely using a blocking solution. A ring-shaped localized closure was performed using the blocking agents. Moreover, ethacridine lactate dressing and phototherapy were applied for 3-5 d.
RESULTS In this study, the drugs contained in the infusates were iodixanol, norepinephrine, alprostadil, amino acids, fat emulsion, cefoselis, cefoxitin, and potassium chloride + concentrated sodium chloride. All of the patients achieved complete healing after treatment and no obvious adverse reactions were observed.
CONCLUSION The treatment of severe extravasation injuries using a combination of localized closure, ethacridine lactate dressing, and phototherapy resulted in satisfactory outcomes in patients.
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Affiliation(s)
- Yan-Xu Lu
- Xiangya Stomatological Hospital & School of Stomatology , Central South University, Changsha 410000, Hunan Province, China
| | - Ying Wu
- Teaching and Research Section of Clinical Nursing, Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Peng-Fei Liang
- Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Rong-Chan Wu
- Phase 1 Clinical Trial Center, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
| | - Ling-Yun Tian
- School of Nursing, Anhui University of Chinese Medicine, Hefei 230012, Anhui Province, China
| | - Hui-Ying Mo
- Department of Burn and Reconstructive Surgery, Xiangya Hospital of Central South University, Changsha 410008, Hunan Province, China
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Shaydakov ME, Ting W, Sadek M, Aziz F, Diaz JA, Raffetto JD, Marston WA, Lal BK, Welch HJ; American Venous Forum Research Committee. Review of the Current Evidence for Topical Treatment for Venous Leg Ulcers. J Vasc Surg Venous Lymphat Disord 2021:S2213-333X(21)00305-X. [PMID: 34171531 DOI: 10.1016/j.jvsv.2021.06.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/06/2021] [Indexed: 01/30/2023]
Abstract
OBJECTIVE The development of a venous leg ulcer (VLU) represents the most severe clinical manifestation of a chronic venous disease. Despite major progress, there is a limited understanding of VLU pathogenesis and wound healing biology. Treatment of VLUs remains a serious challenge for physicians of different specialties. This communication focuses on describing the rationale and scientific basis for topical wound care in the management of VLUs. METHODS A literature review was performed to summarize methods with proven efficacy in VLU management. A systematic literature search was also performed to identify new evidence from the randomized controlled trials published within 2014-2021. The scientific challenges, clinical practice concerns, economic obstacles, and possible directions for further research have been discussed. RESULTS Hundreds of topical products have been advertised for the treatment of VLUs. Published data on topical treatment of venous ulcers is insufficient, scattered, weak, and has significant methodological flaws. Forty-three randomized controlled trials on topical treatment of VLUs have been published within 2014-2021. Clinical practice guidelines need to be updated. Major gaps in knowledge have been identified, and suggestions for future research directions have been provided. CONCLUSIONS The American Venous Forum Research Committee would like to bring attention to topical wound care for VLUs as a critical gap in knowledge, and encourage scientists, practitioners, and industry to collaborate to fill this gap.
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Esposito C, Montaruli E, Autorino G, Mendoza-Sagaon M, Escolino M. Pediatric endoscopic pilonidal sinus treatment (PEPSiT): what we learned after a 3-year experience in the pediatric population. Updates Surg 2021. [PMID: 34021885 DOI: 10.1007/s13304-021-01094-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Accepted: 05/13/2021] [Indexed: 12/27/2022]
Abstract
This paper aimed to report a multi-institutional 3-year experience with pediatric endoscopic pilonidal sinus treatment (PEPSiT) and describe tips and tricks of the technique. We retrospectively reviewed all patients < 18 years, with primary or recurrent pilonidal sinus disease (PSD), undergoing PEPSiT in the period 2017-2020. All patients received pre-operative laser therapy, PEPSiT and post-operative dressing and laser therapy. Success rate, healing rate/time, post-operative management, short- and long-term outcome and patient satisfaction were assessed. A total of 152 patients (98 boys) were included. Median patient's age was 17.1 years. Fifteen/152 patients (9.8%) presented a recurrent PSD. All patients resumed full daily activities 1 day after surgery. The post-operative course was painless in 100% of patients (median VAS pain score < 2/10). Patient satisfaction was excellent (median score 4.8). The median follow-up was 12.8 months (range 1-36). Complete healing in 8 weeks was achieved in 145/152 (95.4%) and the median healing time was 24.6 days (range 16-31). We reported post-operatively immediate Clavien grade 2 complications (3 oedema, 2 burns) in 5/152 (3.3%) and delayed Clavien grade 2 complications (3 granulomas, 8 wound infections) in 11/152 (7.2%). Disease recurrence occurred in 7/152 (4.6%), who were re-operated using PEPSiT. PEPSiT should be considered the standard of care for surgical treatment of PSD in children and teenagers. PEPSiT is technically easy, with short and painless post-operative course and low recurrence rate (4.6%). Standardized treatment protocol, correct patient enrollment and information, and intensive follow-up are key points for the success of the procedure.
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28
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Koken ZO, Yalcin YC, van Netten D, de Bakker CC, van der Graaf M, Kervan U, Verkaik NJ, Caliskan K. Driveline exit-site care protocols in patients with left ventricular assist devices: a systematic review. Eur J Cardiothorac Surg 2021; 60:506-515. [PMID: 33963835 PMCID: PMC8434872 DOI: 10.1093/ejcts/ezab195] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2020] [Revised: 02/14/2021] [Accepted: 02/17/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES Driveline infections continue to be a significant complication following left ventricular assist device (LVAD) implantation. Driveline exit-site care is crucial for the prevention of infections; however, there are no uniform guidelines. The goal of this study was to provide an overview of the currently published driveline exit-site care protocols in patients with LVAD. METHODS A systematic literature review was performed. Studies before 15 December 2020 were included if the number of driveline infections was a primary outcome and the driveline exit-site care protocol was explained. RESULTS Eleven articles were included in the systematic review, including 1602 patients with LVADs. The median of the frequency of driveline infections in the articles was 13.8% with a range of 0–52.6%. There was a marked variability in the methods of care of driveline exit sites, without a standardized driveline dressing technique in patients with LVADs. The frequency of driveline infections was 6–7.5% in studies using a dressing kit that included chlorhexidine, a silver-based dressing and an anchoring device. Furthermore, there was variability in the anchoring devices and the frequency of dressing changes, which varied from daily to weekly. No specific anchoring device or change frequency was found to be superior. CONCLUSIONS Based on this systematic review, driveline exit care protocols that included chlorhexidine, a silver-based dressing, the use of an anchoring device and dressing kits might be best in reducing driveline infection rates. However, prospective studies with larger cohorts are needed to establish the optimal protocol for driveline exit-site care.
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Affiliation(s)
- Zeliha Ozdemir Koken
- Department of Cardiology, Unit of Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus University Medical Center, Rotterdam, Netherlands.,Surgical Nursing Department, Faculty of Nursing, Hacettepe University, Ankara, Turkey
| | - Yunus C Yalcin
- Department of Cardiology, Unit of Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Cardio-thoracic Surgery, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Diana van Netten
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Chantal C de Bakker
- Department of Cardiology, Unit of Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Maaike van der Graaf
- Department of Cardiology, Unit of Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Umit Kervan
- Department of Cardiovascular Surgery, University of Health Sciences, Ankara City Hospital, Ankara, Turkey
| | - Nelianne J Verkaik
- Department of Medical Microbiology and Infectious Diseases, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Kadir Caliskan
- Department of Cardiology, Unit of Heart Failure, Heart Transplantation and Mechanical Circulatory Support, Erasmus University Medical Center, Rotterdam, Netherlands
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Many BT, Benyamen B, Moeckel CM, Sarkar A, Goldstein SD, Grabowski J, Johnson EK, Raval MV. To wrap or not to wrap: A retrospective review of circumcision dressing and post-procedural bleeding. J Pediatr Surg 2021; 56:795-799. [PMID: 32593427 DOI: 10.1016/j.jpedsurg.2020.05.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 04/30/2020] [Accepted: 05/01/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Bleeding is an infrequent, but important, complication after circumcision. Our aim was to examine postoperative bleeding events after circumcision comparing patients managed with a circumferential wrap to ointment alone. METHODS Boys ≤18 years of age who underwent circumcision at a tertiary children's hospital were retrospectively reviewed between 2017 and 2018. Postoperative bleeding was defined by phone calls, clinic or Emergency Department visits, or return to the operating room. Outcomes were examined by univariate association and multivariable modeling. RESULTS Of 681 boys undergoing circumcision, 503 (74%) patients received a wrap dressing and 178 (26%) only ointment. There were 28 (4%) patients who had a postoperative bleeding event: 14/503 (2.7%) among wrap dressings and 14/178 (7.8%) among ointment alone (p < 0.01). The majority of events were phone calls related to bleeding (75%). Univariate analysis demonstrated no association between postoperative bleeding and surgeon specialty (p = 0.72), age at circumcision (p = 0.44) or technique type (p = 0.09). After controlling for age, technique type, and surgeon specialty, dressing type remained significantly associated with postoperative bleeding (OR = 2.81, p < 0.01). CONCLUSION This single-center, retrospective review found circumferential wrap dressings are associated with a decrease in bleeding events after circumcision. LEVEL OF EVIDENCE III - retrospective case-control study.
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Affiliation(s)
- Benjamin T Many
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA.
| | - Beshoy Benyamen
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
| | - Camille M Moeckel
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
| | - Arjun Sarkar
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
| | - Seth D Goldstein
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
| | - Julia Grabowski
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
| | - Emilie K Johnson
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Urology, Department Of Urology, Chicago, IL, USA
| | - Mehul V Raval
- Northwestern University Feinberg School of Medicine and Ann & Robert H. Lurie Children's Hospital of Chicago, Division of Pediatric Surgery, Department Of Surgery, Chicago, IL, USA
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Abstract
Wound healing consists of four overlapping phases. Holistic assessment of a wound is essential and can confirm whether healing is progressing as anticipated. Frameworks can assist the clinician to conduct the assessment in a systematic way and to plan appropriate care for the patient. Dressings form a relatively small part of the overall care plan, but with such an array available the choice can be overwhelming. This article provides an update on wound assessment using the TIMERS framework and considers the factors influencing dressing choice.
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Affiliation(s)
- Alexandra Bishop
- Senior Clinical Nurse, DDRC Healthcare and Tissue Viability Nurse Specialist, Plymouth Wound Care
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Sittikijyothin W, Phonyotin B, Sangnim T, Huanbutta K. Using carboxymethyl gum from Tamarindus indica and Cassia fistula seeds with Chromolaena odorata leaf extract to develop antibacterial gauze dressing with hemostatic activity. Res Pharm Sci 2021; 16:118-128. [PMID: 34084199 PMCID: PMC8102929 DOI: 10.4103/1735-5362.310519] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 07/12/2020] [Accepted: 01/06/2021] [Indexed: 11/29/2022] Open
Abstract
Background and purpose: Gauze dressing is a barrier against microbial infection in wounds. The seed gums of Tamarindus indica and Cassia fistula are abundant in tropical countries; we used them as a coating material of cotton gauzes to improve the liquid absorption ability. Moreover, Chromolaena odorata leaf extract was loaded on the gums for antibacterial gauze dressing with hemostatic activity. Experimental approach: Crude gums were extracted from T. indica and C. fistula seeds and carboxymethyl gums were then derived and chracterized. C. Odorata ethanolic extract was also prepared by maceration and its antimicrobial and blood clotting activities were determine coated gauze dressing containing different concentrations of carboxymethyl gum was prepared in the presence of various concentrations of C. odorata extract. Then, the physical properties, antibacterial activity, and skin-irritating effects of the coated gauze were analyzed. Findings/Results: The results indicated that the amount of carboxymethyl gum affected the physical properties and absorption capacity of the coated gauze. C. odorata extract exhibited better bactericidal activity against Staphylococcus aureus than against Escherichia coli. The blood clotting effects of C. odorata extract indicated that it had dramatic hemostatic efficacy. The coated gauze exhibited bactericidal activity against S. aureus. In the human skin irritation test, the coated gauze caused no adverse effects on human skin. Conclusion and implication: Coated gauze has the potential to serve as a prototype for primary hemostasis in first aid for opened wounds such as abrasions and lacerations.
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Affiliation(s)
- Wancheng Sittikijyothin
- Department of Chemical Engineering, Faculty of Engineering, Burapha University, 169, Saensook, Muang, Chonburi, 20131 Thailand
| | - Bussaba Phonyotin
- Department of Chemical Engineering, Faculty of Engineering, Burapha University, 169, Saensook, Muang, Chonburi, 20131 Thailand
| | - Tanikan Sangnim
- Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand
| | - Kampanart Huanbutta
- Faculty of Pharmaceutical Sciences, Burapha University, Chonburi 20131, Thailand
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Ibrahim A, Soliman M, Kotb S, Ali MM. Evaluation of fish skin as a biological dressing for metacarpal wounds in donkeys. BMC Vet Res 2020; 16:472. [PMID: 33272259 PMCID: PMC7713020 DOI: 10.1186/s12917-020-02693-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2020] [Accepted: 11/23/2020] [Indexed: 12/15/2022] Open
Abstract
Background The use of biological dressings has recently emerged in the management of burns and wounds. The aim of the present study was to evaluate the Nile tilapia skin as a biological dressing for full-thickness cutaneous metacarpal wounds in donkeys. The study was conducted on nine clinically healthy donkeys (n = 9). Here, fish skin dressings were obtained from fresh Nile tilapia (Oreochromis niloticus and sterilized by immersion in silver nanoparticles (AgNPs) solution for 5 min, with no change in collagen content. Bilateral, circular full-thickness excisional skin wounds (2 cm in diameter) were created on the dorsal aspect of the mid-metacarpals of each donkey. Wounds on the right metacarpals (treated wounds, n = 9) were dressed with sterile fish skins, while wounds on the left metacarpals (control wounds, n = 9) were dressed with sterile non-adherent dressing pads without any topical applications. Wound dressings were changed weekly. Wounds were evaluated microbiologically, grossly, and histologically on days 7, 14, and 21 post-wound inductions. Results Fish skin-dressed wounds showed a significant (P < 0.0001) reduction in microbial counts (Total viable bacterial count, Staphylococcal count, and Coliform count), a significant (P < 0.0001) decrease in the wound size, and a significant reduction (P < 0.0001) in the epithelial gap compared to the untreated wounds. No frequent dressing changes were needed. Conclusions Fish skin dressing accelerated the wound healing process and efficiently inhibited the local microbial activity and exuberant granulation tissue formation suggesting its reliable and promising application for metacarpal wounds of donkeys.
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Affiliation(s)
- Ahmed Ibrahim
- Veterinary Teaching Hospital, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt.
| | - Mahmoud Soliman
- Department of Veterinary Pathology and Clinical Pathology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Saber Kotb
- Department of Animal and Poultry Hygiene, and Environmental Sanitation, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
| | - Magda M Ali
- Department of Surgery, Anesthesiology, and Radiology, Faculty of Veterinary Medicine, Assiut University, Assiut, 71526, Egypt
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Kowalski G, Zawadzki M, Leppert W, Szpot P, Siczek M, Słowiński K, Sobieszczańska M, Gawłowska A, Wieczorowska-Tobis K. Analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds. Burns 2021; 47:880-7. [PMID: 33293157 DOI: 10.1016/j.burns.2020.10.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2020] [Revised: 07/21/2020] [Accepted: 10/07/2020] [Indexed: 12/29/2022]
Abstract
BACKGROUND The aim of this study was to assess the analgesic efficacy of sufentanil in dressings after surgical treatment of burn wounds. PATIENTS AND METHODS Twenty adult patients, who underwent surgical treatment of third-degree burn wounds under general anesthesia, were included. Two of the patients underwent surgery twice. During surgery, patients received 50-100 μg fentanyl every 20-30 min and, after surgery, patients received 100 mg ketoprofen twice daily. Additionally, ten patients (group 1) received 50 μg sufentanil added to the burn wound dressings soaked in octenidine and phenoxyethanol while 10 patients (group 2) received 25 μg sufentanil added to the same dressings. The rescue analgesic, which was administered when pain intensified, was 5 mg subcutaneous morphine. Plasma sufentanil concentrations were assayed at 1, 2, 3, and 6 h after surgery completion and when pain was reported, along with pain intensity evaluation. RESULTS Sufentanil was not detected in the serum of any patients. Rescue morphine was given during the postoperative period (24 h) in one patient in group 1 (who underwent surgery twice) and three patients in group 2. The mean sufentanil concentration in dressings was higher in group 1 (0.13 ± 0.03) than group 2 (0.06 ± 0.03 μg/mL; p < 0.001). The group 1 patient who received rescue morphine had a sufentanil concentration of 0.10 μg/mL, which was the lowest concentration in group 1. Group 2 patients who received rescue morphine had sufentanil concentrations of at least two-fold lower (0.03-0.05 μg/mL). No adverse effects were observed. CONCLUSIONS Sufentanil in dressings after burn wound surgery provides effective and safe analgesia and the sufentanil concentration in dressings should be ≥0.10 μg/mL in a solution of octenidine and phenoxyethanol.
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Nabri M, Alharbi M, Al-Sayyid A, Alabdrabalrasol K, Hassan K, Al-Jehani H. Sub-galeal abscess: A rare sequel of an infected scalp sebaceous cyst. Int J Surg Case Rep 2020; 76:30-32. [PMID: 33010610 PMCID: PMC7530221 DOI: 10.1016/j.ijscr.2020.09.063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2020] [Revised: 09/08/2020] [Accepted: 09/08/2020] [Indexed: 11/24/2022] Open
Abstract
Subgaleal abscess with skull osteomyelitis is a rare. Diabetic patient with progressive whole scalp swelling and headache for 2 weeks, associated with fever. High suspicion will help in diagnosis, CT scan will confirm the diagnosis, detect osteomyelitis or intracranial extension. Vacuum assisted closure dressing, worked dwell for us, post drainage and debridement which never describe in this condition.
Introduction Subgaleal abscess is a rare condition in which suppuration under the galea aponeurotica (epicranial aponeurosis) occurs. Diagnosis of subgaleal abscess is guided by high index of suspicion, imaging of the head by computed topography will confirm the diagnosis and detect osteomyelitis or intracranial extension. Presentation of case We describe a case of extensive subgaleal abscess that presented as an infected scalp sebaceous cyst, in male diabetic patient, its management and the role of vaccum assisted closure (V.A.C.) dressing which was never described in such atypical presentation. Discussion The subgaleal space is the between the galea aponeurotica and periosteum of the cranial bones, subgaleal abscess may result from hematogenous infection or contiguous spread, and the diagnosis may not be initially obvious4 The predominant organism isolated from post-traumatic and post-surgical scalp infections is Staphylococcus aureus (Haines and Chou, 1985). Diagnosis and management will be guided by head CT scan, management of subgaleal abscess should focus on effective intravenous antibiotic therapy, immediate surgical drainage of abscess and debridement of necrotic tissue. Conclusion Subgaleal abscess is a rare complication, imaging can prevent serious complications. Negative pressure wound therapy is an invaluable tool for closure of the wounds.
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Affiliation(s)
- Mamoun Nabri
- Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
| | - Mohammed Alharbi
- Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Amnah Al-Sayyid
- Medical Intern, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Kawthar Alabdrabalrasol
- Medical Student in Imam Abdulrahman Bin Faisal University, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Khairi Hassan
- Department of Surgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
| | - Hussam Al-Jehani
- Department of Neurosurgery, King Fahad Hospital of University, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia
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Heald R, Bennett M, Subramaniam VV, Dusane D, Lochab V, Sundaram PM, Salyer S, West J, Stoodley P, Prakash S. Printed Electroceutical Dressings for the Inhibition of Biofilms and Treatment of Chronic Wounds. J Microelectromech Syst 2020; 29:918-923. [PMID: 33519170 PMCID: PMC7839981 DOI: 10.1109/jmems.2020.2999260] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
We report on an innovative, fabric-based conformable, and easily fabricated electroceutical wound dressing that inhibits bacterial biofilm infections and shows significant promise for healing chronic wounds. Cyclic voltammetry demonstrates the ability of the electroceutical to produce reactive oxygen species, primarily HOCl that is responsible for bacterial inhibition. In vitro investigation with the lawn biofilm grown on a soft tissue mimic assay shows the efficacy of the dressing against both gram-positive and gram-negative bacteria in the biofilm form. In vivo, the printed electroceutical dressing was utilized as an intervention treatment for a canine subject with a non-healing wound due to a year-long persistent polymicrobial infection. The clinical case study with the canine subject exhibited the applicability in a clinical setting with the results showing infection inhibition within 11 days of initial treatment. This printed electroceutical dressing was integrated with a Bluetooth® enabled circuit allowing remote monitoring of the current flow within the wound bed. The potential to monitor wounds remotely in real-time with a Bluetooth® enabled circuit proposes a new physical biomarker for management of infected, chronic wounds.
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Affiliation(s)
- Rachel Heald
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Molly Bennett
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Vish V. Subramaniam
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Devendra Dusane
- Devendra Dusane was previously with the Department of Microbial Infection and Immunity, The Ohio State University and is now at the Nationwide Children’s Hospital, Columbus, OH, USA
| | - Varun Lochab
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Prashanth Mohana Sundaram
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Sarah Salyer
- Sarah Salyer is with the Department of Veterinary Clinical Sciences, The Ohio State University, Columbus, OH, USA
| | - J.D. West
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
| | - Paul Stoodley
- Paul Stoodley is with the Department of Microbial Infection and Immunity and the Department of Orthopedics, The Ohio State University, Columbus, OH, USA. He is also affiliated with the National Centre for Advanced Tribiology at Southampton and the National Biofilm Innovation Centre, Dept. Mechanical Engineering, University of Southampton, UK
| | - Shaurya Prakash
- Rachel Heald, Molly Bennett, Vish V. Subramaniam, Varun Lochab, Prashanth Mohana Sundaram, J. D. West
- Shaurya Prakash () are all with the Department of Mechanical and Aerospace Engineering, The Ohio State University, Columbus, OH, USA
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Esposito C, Del Conte F, Cerulo M, Coppola V, Esposito G, Ricciardi E, Crocetto F, Castagnetti M, Calignano A, Escolino M. Evaluation of efficacy of oxygen-enriched oil-based gel dressing in patients who underwent surgical repair of distal hypospadias: a prospective randomised clinical trial. World J Urol 2020; 39:2205-2215. [PMID: 32852619 PMCID: PMC8217004 DOI: 10.1007/s00345-020-03419-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 08/17/2020] [Indexed: 11/21/2022] Open
Abstract
Purpose This study aimed to evaluate the efficacy of oxygen-enriched oil-based gel dressing on wound healing and postoperative outcome in children who underwent distal hypospadias repair. Methods We included all patients with distal hypospadias, who underwent Snodgrass urethroplasty and preputioplasty over an 18-months period. The patients were randomized in two groups according to the type of medication: oxygen-enriched oil-based gel (G1) and hyaluronic acid cream (G2). After discharge, parents changed the dressing twice a day for 2–3 weeks postoperatively. The patients were evaluated at 7, 14, 21, 30, 60 and 180 postoperative days and thereafter annually. Results One-hundred and fourteen patients (median age 18 months) were included in the study and randomized in two groups, each of 57 patients. The wound healing was significantly faster in G1 compared with G2 (p = 0.001). G1 reported significantly higher SWAS and modified HOPE scores compared with G2 (p = 0.001) at all steps of follow-up. No adverse skin reactions occurred. Foreskin dehiscence and re-operations rates were significantly lower in G1 compared with G2 (p = 0.001). Postoperative foreskin retractability was better in G1, with a significantly higher incidence of secondary phimosis in G2 (p = 0.001). The median treatment costs were significantly lower in G1 compared with G2 (p = 0.001). Conclusion Postoperative dressing using oxygen-enriched oil-based gel was highly effective, promoting a faster wound healing in patients who underwent distal hypospadias repair. It reported a lower incidence of foreskin dehiscence and better foreskin retractability compared with the control group. It was cost-effective and clinically safe without allergy or intolerance to the product.
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Affiliation(s)
- Ciro Esposito
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy.
| | - Fulvia Del Conte
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Mariapina Cerulo
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Vincenzo Coppola
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Giovanni Esposito
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Elisabetta Ricciardi
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Felice Crocetto
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
| | - Marco Castagnetti
- Division of Pediatric Urology, Medical University of Padua, Padua, Italy
| | - Antonio Calignano
- Department of Pharmacy, Federico II University of Naples, Naples, Italy
| | - Maria Escolino
- Division of Pediatric Surgery, Federico II University of Naples, Via Pansini 5, 80131, Naples, Italy
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Li SH, Zhang WF, Hu XL, Wang YC, Han F, Ji P, Han F, Hu DH, Guan H. [Clinical application of negative-pressure wound therapy in split-thickness skin grafting at hard-to-fix sites]. Zhonghua Shao Shang Za Zhi 2020; 36:528-33. [PMID: 32842398 DOI: 10.3760/cma.j.cn501120-20200224-00086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To compare the clinical effects of continuous negative-pressure wound therapy (NPWT) and conventional pressure dressing at at hard-to-fix sites after split-thickness skin grafting. Methods: From September 2017 to August 2019, 129 patients who met the inclusion criteria and had spilt-thickness skin grafting at hard-to-fix sites were admitted to the First Affiliated Hospital of Air Force Medical University and included in this retrospective cohort study. The patients were divided into NPWT group (67 patients, 41 males and 26 females, aged (32±6) years) and conventional pressure dressing group (62 patients, 37 males and 25 females, aged (30±5) years) according to whether the hard-to-fix sites were applied with NPWT after spilt-thickness skin grafting. After debridement and spilt-thickness skin grafting at hard-to-fix sites in patients of 2 groups, the wounds of patients in conventional pressure dressing group were applied with conventional pressure bandaging after being filled with dry gauze; for the wounds of patients in NPWT group, the semi-permeable membrane was pasted and sealed for continuous negative pressure suction after filled with dry gauze and placed the drainage foam or drainage tube, with the negative pressure ranging from -16.6 to -9.9 kPa. The bandage was opened during the first dressing change on the 5th day after surgery in NPWT group and on the 7th day after surgery in conventional pressure dressing group. The skin graft surviving area and proportion, the area and proportion of hematoma, the incidence of common complications of skin graft were observed and calculated. The times of postoperative dressing change and the length of hospital stay were counted. Data were statistically analyzed with two independent sample t test, Cochran & Cox approximate t test, chi-square test, and Fisher's exact probability test. Results: (1) At the first dressing change, the skin graft surviving area of patients in NPWT group was (420±94) cm(2), which was significantly larger than (322±97) cm(2) in conventional pressure dressing group (t'=12.33, P<0.01); the skin graft surviving area proportion of patients in NPWT group was (97.0±2.3)%, which was significantly higher than (74.4±4.8)% in conventional pressure dressing group (t'=50.11, P<0.01). (2) At the first dressing change, the skin hematoma area of patients in conventional pressure dressing group was (31.7±10.1) cm(2), which was significantly larger than (3.2±0.7) cm(2) in NPWT group (t'=23.04, P<0.01); the skin hematoma area proportion of patients in conventional pressure dressing group was (7.3±2.3)%, which was significantly higher than (0.7±0.3)% in NPWT group (t'=76.21, P<0.01). (3) At the first dressing change, there was 1 case of skin movement and no case of skin graft edge tear in NPWT group with an incidence of 1.5% (1/67). In the conventional pressure dressing group, there were 4 cases of skin movement and 2 cases of skin graft edge tear with an incidence of 9.7% (6/62), P<0.05. The incidence of complication of skin graft of patients in NPWT group was significantly lower than that in conventional pressure dressing group (P<0.05). (4) The times of postoperative dressing change of patients in NPWT group was significantly less than that in conventional pressure dressing group (t=7.93, P<0.01). The postoperative length of hospital stay in NPWT group was significantly less than that in conventional pressure dressing group (t=11.71, P<0.01). Conclusions: Continuous NPWT can effectively promote wound healing, improve the survival rate of skin graft, reduce the incidence of complications after skin grafting, and shorten the length of hospital stay in split-thickness skin grafting at hard-to-fix sites.
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Fard ZR, Azadi A, Khorshidi A, Mozafari M, O'Connor T, Budri AMV, Moore Z, Patton D. A comparison of faculty led, mentorship program and peer mentoring on nursing students wound dressing clinical skills. Nurse Educ Today 2020; 89:104378. [PMID: 32209490 DOI: 10.1016/j.nedt.2020.104378] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Revised: 12/07/2019] [Accepted: 02/15/2020] [Indexed: 06/10/2023]
Abstract
BACKGROUND The promotion of clinical nursing education requires using modern educational methods to develop students' knowledge and skills. There are however many different models by which education can be delivered with a wealth of literature supporting varying approaches. This is of particular relevance to clinical education where to date no singular approach has been identified as being the most appropriate. OBJECTIVES This study aimed to compare and investigate the effect of a peer education method, a mentor-led education method versus a traditional faculty-led method for instruction regarding surgical wound care skills among nursing students. DESIGN This study used an experimental three-group pre- and post-test design. SETTINGS The research was conducted within two surgical wards of a university-affiliated hospital in the west of Iran. PARTICIPANTS A total of 102 nursing students (first and second year) were assigned to three groups; peer-led learning group (n = 34), mentorship-led group (n = 34) or a faculty-led control group (n = 34). METHODS To ascertain performance in surgical dressing skill, data was collected in each group before and after the respective educational intervention. Data was collected using a surgical dressing skills checklist made by the research team which was piloted prior to the study. All statistical analysis was performed using SPSS v.22.0 (SPSS Inc., Chicago, IL). RESULTS Based on findings, after the intervention, the mean (SD) scores of surgical dressing and wound care skills were 28.24 (4.63), 31.76 (4.89), and 29.12 (5.33) for the peer-led, mentor-led and faculty-led groups, respectively. There was no significant difference between mentor group and faculty group or between peer group and faculty group (P > 0.05). However, the findings did demonstrate statistical difference in performance in surgical dressings and wound care techniques in the mentorship group method compared to the peer method (P = 0.006). CONCLUSIONS Although participants in the mentor group performed best of all groups, our findings demonstrate that those in the peer method group performed as well as those in the faculty-led group in surgical dressing performance. Therefore, it is recommended that peer and mentor learning methods are given consideration by curriculum planners in for use in the development of student nurse clinical skill and competence in surgical wound care.
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Affiliation(s)
- Zeynab Rezaei Fard
- Student research committee, Department of nursing, Faculty of Nursing and Midwifery, Ilam University of Medical sciences, Ilam, Iran
| | - Arman Azadi
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran.
| | - Ali Khorshidi
- Department of Community Medicine, Faculty of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mosayeb Mozafari
- Department of Nursing, Faculty of Nursing and Midwifery, Ilam University of Medical Sciences, Ilam, Iran
| | - Tom O'Connor
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Lida Institute, Shanghai, China; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia.
| | - Aglecia Moda Vitoriano Budri
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland
| | - Zena Moore
- Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Lida Institute, Shanghai, China; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Australia; Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University; University of Wales, United Kingdom
| | - Declan Patton
- RCSI School of Nursing and Midwifery, Deublin Ireland; Skin, Wounds and Trauma Research (SWaT) Centre, RCSI, Dublin Ireland; Fakeeh College of Health Sciences, Jeddah, Saudi Arabia; Faculty of Science, Medicine and Health, University of Wollongong, Australia
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Gámez-Herrera E, García-Salinas S, Salido S, Sancho-Albero M, Andreu V, Pérez M, Luján L, Irusta S, Arruebo M, Mendoza G. Drug-eluting wound dressings having sustained release of antimicrobial compounds. Eur J Pharm Biopharm 2020; 152:327-339. [PMID: 32473289 DOI: 10.1016/j.ejpb.2020.05.025] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 05/12/2020] [Accepted: 05/25/2020] [Indexed: 01/07/2023]
Abstract
Wound healing is a complex and costly public health problem that should be timely addressed to achieve a rapid and adequate tissue repair avoiding or even eliminating potential pathogenic infection. Chronic infected non-healing wounds represent a serious concern for health care systems. Efficient wound dressings with tailored therapy having the best response and highest safety margin for the management of chronic non-healing wounds are still needed. The use of novel wound dressing materials has emerged as a promising tool to fulfil these requirements. In this work, asymmetric electrospun polycaprolactone (PCL)-based nanofibers (NFs) were decorated with electrosprayed poly(lactic-co-glycolic acid) microparticles (PLGA MPs) containing the natural antibacterial compound thymol (THY) in order to obtain drug eluting antimicrobial dressings having sustained release. The synthesized dressings successfully inhibited the in vitro growth of Staphylococcus aureus ATCC 25923, showing also at the same doses cytocompatibility on human dermal fibroblasts and keratinocyte cultures after treatment for 24 h, which was not observed when using free thymol. An in vivo murine excisional wound splinting model, followed by the experimental infection of the wounds with S. aureus and their treatment with the synthesized dressings, pointed to the reduction of the bacterial load in wounds after 7 days, though the total elimination of the infection was not reached. The findings indicated the relevance of the direct contact between the dressings and the bacteria, highlighting the need to tune their design considering the wound surface and the nature of the antimicrobial cargo contained.
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Affiliation(s)
- Enrique Gámez-Herrera
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain
| | - Sara García-Salinas
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain
| | - Sofía Salido
- Department of Inorganic and Organic Chemistry, Faculty of Experimental Sciences, University of Jaén, Agrifood Campus of International Excellence (ceiA3), 23071 Jaén, Spain
| | - María Sancho-Albero
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Vanesa Andreu
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
| | - Marta Pérez
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza & AgriFood Institute of Aragon (IA2), C/ Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Lluís Luján
- Department of Animal Pathology, Veterinary Faculty, University of Zaragoza & AgriFood Institute of Aragon (IA2), C/ Miguel Servet, 177, 50013 Zaragoza, Spain
| | - Silvia Irusta
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain.
| | - Manuel Arruebo
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain.
| | - Gracia Mendoza
- Department of Chemical Engineering, Aragon Institute of Nanoscience (INA), University of Zaragoza, Campus Río Ebro-Edificio I+D, C/ Poeta Mariano Esquillor S/N, 50018 Zaragoza, Spain; Networking Research Center on Bioengineering, Biomaterials and Nanomedicine, CIBER-BBN, 28029 Madrid, Spain; Aragon Health Research Institute (IIS Aragon), 50009 Zaragoza, Spain
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Kilic GS, Demirdag E, Findik MF, Tapisiz OL, Sak ME, Altinboga O, Sak S, Unlu BS, Evsen MS, Zeybek B, Borahay M, Kuo YF. Impact of timing on wound dressing removal after caesarean delivery: a multicentre, randomised controlled trial. J OBSTET GYNAECOL 2020; 41:348-352. [PMID: 32312139 DOI: 10.1080/01443615.2020.1736015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
We compared wound dressing removal at 24 hours versus 48 hours following low-risk caesarean deliveries. This multicentre, randomised, controlled study included patients 18-44 years of age with low-risk term, singleton pregnancies. The randomisation was done weekly. Scheduled caesarean deliveries without labour were included. For comparison, the Additional treatment, Serous discharge, Erythema, Purulent exudate, Separation of deep tissues, Isolation of bacteria, Stay in hospital > 14 days (ASEPSIS) score for wound healing assessment was modified. The absolute scores were obtained based on a one-day reading rather than the five-day reading used in ASEPSIS. Zero ("0") was assigned as a complete healing. Higher scores were associated with more severe disruption of healing. The patients were enrolled between March 2015 and February 2017. The demographics were not statistically different. The wound scoring was similar in the groups at discharge and first-week evaluation. At the six weeks post-surgery, the wound scoring was significantly less in the 48-hour (3.9%) versus the 24-hour group (9%; p = .002). Dressing removal at 48 hours had a lower scoring in the low-risk population with scheduled caesarean deliveries.IMPACT STATEMENTWhat is already known on this subject? Surgical dressings are used to provide suitable conditions to heal caesarean incisions. There has been a limited number of studies on the evaluation of ideal timing on wound dressing removal after a caesarean delivery. These studies concluded there are no increased wound complications with removal at six hours versus 24 hours or within or beyond 48 hours after surgery.What do the results of this study add? The postoperative removal of the wound dressing at 48 hours had a lower wound score at six weeks than the removal at 24 hours for women with uncomplicated scheduled caesarean deliveries.What are the implications of these findings for clinical practice and/or further research? Early discharge after caesarean delivery is becoming more common. Dressing removal at 24 hours versus 48 hours becomes more crucial and needs to be clarified. Besides, high-risk populations, different skin closure techniques, and patients in labour should be addressed separately.
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Affiliation(s)
- Gokhan Sami Kilic
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Erhan Demirdag
- Department of Obstetrics and Gynaecology, Gazi Üniversitesi Tıp Fakültesi, Ankara, Turkey
| | - Mehmet Fatih Findik
- Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Omer Lutfi Tapisiz
- Department of Obstetrics and Gynecology, Etlik Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Muhammet Erdal Sak
- Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Orhan Altinboga
- Department of Obstetrics and Gynecology, Zubeyde Hanim Women's Health Training and Research Hospital, Ankara, Turkey
| | - Sibel Sak
- Department of Obstetrics and Gynecology, Sedef Medical Center, Diyarbakir, Turkey
| | - Bekir Serdar Unlu
- Department of Obstetrics and Gynecology, The University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Mehmet Siddik Evsen
- Department of Obstetrics and Gynecology, Dicle University School of Medicine, Diyarbakır, Turkey
| | - Burak Zeybek
- Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA
| | - Mostafa Borahay
- Department of Obstetrics and Gynecology, Johns Hopkins University, Baltimore, MD, USA
| | - Yong-Fang Kuo
- Office of Biostatistics, Preventive Medicine and Community Health, The University of Texas Medical Branch at Galveston, TX, USA
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Tan T, Lee H, Huang MS, Rutges J, Marion TE, Mathew J, Fitzgerald M, Gonzalvo A, Hunn MK, Kwon BK, Dvorak MF, Tee J. Prophylactic postoperative measures to minimize surgical site infections in spine surgery: systematic review and evidence summary. Spine J 2020; 20:435-47. [PMID: 31557586 DOI: 10.1016/j.spinee.2019.09.013] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 09/12/2019] [Accepted: 09/13/2019] [Indexed: 02/08/2023]
Abstract
BACKGROUND CONTEXT There are three phases in prophylaxis of surgical site infections (SSI): preoperative, intraoperative and postoperative. There is lack of consensus and paucity of evidence with SSI prophylaxis in the postoperative period. PURPOSE To systematically evaluate the literature, and provide evidence-based summaries on postoperative measures for SSI prophylaxis in spine surgery. STUDY DESIGN Systematic review, meta-analysis, evidence synthesis. METHODS A systematic review conforming to PRIMSA guidelines was performed utilizing PubMed (MEDLINE), EMBASE, and the Cochrane Database from inception to January 2019. The GRADE approach was used for quality appraisal and synthesis of evidence. Six postoperative care domains with associated key questions were identified. Included studies were extracted into evidence tables, data synthesized quantitatively and qualitatively, and evidence appraised per GRADE approach. RESULTS Forty-one studies (nine RCT, 32 cohort studies) were included. In the setting of preincisional antimicrobial prophylaxis (AMP) administration, use of postoperative AMP for SSI reduction has not been found to reduce rate of SSI in lumbosacral spine surgery. Prolonged administration of AMP for more than 48 hours postoperatively does not seem to reduce the rate of SSI in decompression-only or lumbar spine fusion surgery. Utilization of wound drainage systems in lumbosacral spine and adolescent idiopathic scoliosis corrective surgery does not seem to alter the overall rate of SSI in spine surgery. Concomitant administration of AMP in the presence of a wound drain does not seem to reduce the overall rate of SSI, deep SSI, or superficial SSI in thoracolumbar fusion performed for degenerative and deformity spine pathologies, and in adolescent idiopathic scoliosis corrective surgery. Enhanced-recovery after surgery clinical pathways and infection-specific protocols do not seem to reduce rate of SSI in spine surgery. Insufficient evidence exists for other types of spine surgery not mentioned above, and also for non-AMP pharmacological measures, dressing type and duration, suture and staple management, and postoperative nutrition for SSI prophylaxis in spine surgery. CONCLUSIONS Despite the postoperative period being key in SSI prophylaxis, the literature is sparse and without consensus on optimum postoperative care for SSI prevention in spine surgery. The current best evidence is presented with its limitations. High quality studies addressing high risk cohorts such as the elderly, obese, and diabetic populations, and for traumatic and oncological indications are urgently required.
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Rajakulasingam R, Iqbal A, James SL, Botchu R. Surface adhesive and hand-aided needle-assisted biopsy technique (SAHNA). Skeletal Radiol 2020; 49:469-73. [PMID: 31641806 DOI: 10.1007/s00256-019-03320-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2019] [Revised: 09/15/2019] [Accepted: 09/26/2019] [Indexed: 02/02/2023]
Abstract
OBJECTIVE We describe a novel and efficient CT biopsy technique that we have termed 'skin adhesive and hand-aided biopsy technique', shortened to the acronym SAHNA. This technique is ideal for biopsying surface osseous lesions where there is a lack of subcutaneous fat. This avoids the need for the radiologist's hand to be in close proximity to the CT scanner beam at the time of intervention. METHODS The SAHNA technique uses a plastic surgical forceps towel clamp to stabilise the biopsy needle just proximal to the lesion after piercing through the skin. The clamp itself is stabilised via a self-adhesive dressing which is stuck down to the skin at its shank. RESULTS In our institution, we have already used the SAHNA technique successfully in over 5 cases. CONCLUSION The SAHNA technique is a widely accessible and effective way of stabilising the CT biopsy needle in technically challenging superficial bony lesions.
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Artuso M, Mas V, Ilharreborde B, Mazda K, Jehanno P. External fixation: Role in decreasing postoperative complications of complex syndactyly release - A review of 18 patients. Orthop Traumatol Surg Res 2019; 105:1187-1191. [PMID: 31353234 DOI: 10.1016/j.otsr.2019.05.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2018] [Revised: 04/16/2019] [Accepted: 05/08/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Primary and revision surgery for complete complex congenital syndactyly (CCCS) of the hand carries a risk of complications such as web maceration, which can result in flap or graft loss and alter the final appearance. No consensus emerges from the scant published data on postoperative care after CCCS surgery. The objective of this study was to assess the role for temporary external fixation in stabilising the commissure and facilitating surgical wound care. HYPOTHESIS Using external fixation after CCCS release facilitates postoperative wound care and decreases the complication rate. MATERIAL AND METHODS Eighteen patients requiring primary CCCS surgery or revision CCCS surgery due to adhesions or web creep were included in a single-centre retrospective study. After release, an external fixator made of Kirschner pins was installed to temporarily immobilise the inter-phalangeal joints. The dressing was changed every 3 days for 3 weeks, and the external fixator was then removed. The parents and nurses completed questionnaires that used 0-10 point scales to assess ease and duration of dressing changes and perceptions and apprehensions experienced by parents and nurses, as well as pain by patients, during dressing changes. RESULTS No patient experienced maceration or failure of a graft or flap. Pin site discharge was noted in 1 patient and resolved fully after pin removal. Pain intensity was estimated at 4.2/10 during the first dressing change and 1.3/10 during the last dressing change. In the parents, apprehension was 9.6/10 and 5.1/10 during the first and last dressing changes, and stress was 8.1/10 and 4.1/10, respectively. Dressing change difficulty was rated 1.1/10 at the first and 0.9/10 at the last dressing change. Dressing change duration decreased from 13 to 10minutes. CONCLUSION These encouraging results support temporary commissure stabilisation by an external fixator to decrease postoperative complication rates and facilitate dressing changes after CCCS release. LEVEL OF EVIDENCE IV, retrospective observational study.
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Affiliation(s)
- Mickaël Artuso
- Department of Pediatric Orthopaedics, Robert Debré Hospital, AP-HP, Paris Diderot University, 48, Bd Sérurier, 75019 Paris, France.
| | - Virginie Mas
- Department of Pediatric Orthopaedics, Robert Debré Hospital, AP-HP, Paris Diderot University, 48, Bd Sérurier, 75019 Paris, France
| | - Brice Ilharreborde
- Department of Pediatric Orthopaedics, Robert Debré Hospital, AP-HP, Paris Diderot University, 48, Bd Sérurier, 75019 Paris, France
| | - Keyvan Mazda
- Department of Pediatric Orthopaedics, Robert Debré Hospital, AP-HP, Paris Diderot University, 48, Bd Sérurier, 75019 Paris, France
| | - Pascal Jehanno
- Department of Pediatric Orthopaedics, Robert Debré Hospital, AP-HP, Paris Diderot University, 48, Bd Sérurier, 75019 Paris, France
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Abstract
Wound management is a major clinical challenge and puts a significant financial burden on the NHS. Because of the rise in long-term conditions including diabetes, obesity and an ageing population, practitioners regularly encounter a wide variety of wound types. In recent years, there has been a resurgence of interest in the use of medical-grade honey in the management of wounds. Honey is anti-inflammatory in action and has the capability to treat local infection, promote autolytic debridement, deodorise wounds and promote granulation tissue. Revamil is a recent addition to the range of honey dressings available and is intended to manage the majority of problems that may arise during wound care episodes. The attributes of Revamil will be illustrated through four case studies.
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Affiliation(s)
- Nader Henry
- Plastic Surgery ST3 Registrar, Health Education England West Midlands, Queen Elizabeth Hospital Birmingham, University Hospitals Birmingham NHS Foundation Trust
| | - Steven Jeffery
- Professor of Wound Healing, Birmingham City University, Honorary Visiting Professor, Cardiff University
| | - Ishan Radotra
- Plastic Surgery ST3 Registrar, Health Education England West Midlands, Sandwell District General Hospital, Sandwell and West Birmingham Hospitals NHS Trust
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Lupon E, Turrian U, Malloizel-Delaunay J, Bura-Rivière A, Grolleau JL. [Medical residents and wound healing: A French national survey]. J Med Vasc 2019; 44:324-30. [PMID: 31474342 DOI: 10.1016/j.jdmv.2019.06.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Accepted: 05/30/2019] [Indexed: 11/22/2022]
Abstract
OBJECTIVES Around 2.5 million wounds are recorded in France, representing, in terms of cost and quality of life, a real problem of public health issue. In France, residents are among the first line personnel having to manage wounds and their complications: this study is carried out to identify the view and feelings of residents concerning their preparation and training in this field. MATERIALS AND METHODS A questionnaire was distributed to residents throughout France. Residents' characteristics, interests and training in wound healing, training courses and opinions concerning their training were recorded. RESULTS Seven hundred and eleven French residents answered the questionnaire, the majority of whom (79 %) had not experienced training in wound healing. The majority of residents (69 %) believe that all physicians are concerned. Training in wound management and wound healing is considered insufficient (94 %) and most (79 %) had never received any training in wound management and wound healing. Ninety-eight percent stated they needed additional training courses in wound management. CONCLUSIONS Wound management and healing is a topic of interest to residents. Residents need more training in wound management in their curriculum to improve their practice.
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Han CM, Yu MR, Wang XG. [Summary of advances in the research of wound therapy]. Zhonghua Shao Shang Za Zhi 2019; 34:864-867. [PMID: 30585049 DOI: 10.3760/cma.j.issn.1009-2587.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Wound healing is a complex and sequential biological process involving various cells and factors under body's regulation. Appropriate interventions play positive roles in promoting effective wound healing and improving healing quality. In the clinical practice, there are many new instruments, dressings, and drugs developed for wound care, including antibacterial dressings, wet dressings, precise debridement, negative pressure wound therapy, cytokines/growth factors, and dermal substitutes, which provide revolutionary means for wound treatment. This article summarizes the effective or mature methods in wound care, providing theoretical and practical basis for choosing appropriate treatment methods in different stages of wound.
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Affiliation(s)
- C M Han
- Department of Burns, the Second Affiliated Hospital of Zhejiang University School of Medicine, Hangzhou 310009, China
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Holbert MD, Griffin BR, McPhail SM, Ware RS, Foster K, Bertoni DC, Kimble RM. Effectiveness of a hydrogel dressing as an analgesic adjunct to first aid for the treatment of acute paediatric thermal burn injuries: study protocol for a randomised controlled trial. Trials 2019; 20:13. [PMID: 30612585 PMCID: PMC6322255 DOI: 10.1186/s13063-018-3057-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 11/16/2018] [Indexed: 01/13/2023] Open
Abstract
Background Burns are a painful and traumatic experience, particularly in children. Reduced pain and anxiety positively influences re-epithelialisation rates in paediatric burn patients, however current literature fails to fully explain the effects of pain and anxiety and their links with wound healing. This study will determine if Burnaid® hydrogel dressing is an effective treatment for reducing pain in the acute period of a burn injury. It is hypothesised that a reduction in pain will then improve re-epithelialisation time in comparison to plastic wrap, which is standard practice at our institution — a metropolitan tertiary paediatric hospital located in Brisbane, Australia. Methods/design A randomised controlled trial will be conducted to assess the effectiveness of Burnaid® as an analgesic adjunct to cold running water first aid for the treatment of paediatric burns. Participants will include children aged between 0 and 16 years with an acute thermal burn injury (total burn surface area < 20%) presenting to the Department of Emergency within 24 h of the burn occurring. Participants will be randomised into one of two groups: (1) Burnaid® hydrogel (intervention arm) or (2) plastic wrap (control arm). Participants will also be stratified into one of two groups based on factors that influence pain intensity: (1) high pain risk or (2) low pain risk. High pain risk factors include foot burns, hot coal/ash/fire pit burns, burn area greater than 5%, and circumferential burns. The primary outcome is the intervention’s effect on reducing acute pain. Secondary outcomes include days to re-epithelialisation, pulse rate, temperature, salivary cortisol and α-amylase, anxiety, and cost-effectiveness. Sample size calculations have shown that 36 participants will be recruited into each group. Discussion This study will provide comprehensive data on the analgesic properties of Burnaid® as an adjunct to first aid for the treatment of acute paediatric thermal burns. If the intervention is effective in reducing pain, Burnaid® will be integrated as standard practice within the hospital’s Department of Emergency. This study replicates a real-world scenario in order to identify clinically significant analgesic and wound-healing effects. Trial registration Australian New Zealand Clinical Trials Registry, ACTRN12617001274369. Prospectively registered on 5 Sept 2017. Electronic supplementary material The online version of this article (10.1186/s13063-018-3057-x) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Maleea D Holbert
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia. .,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia.
| | - Bronwyn R Griffin
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia.,School of Nursing, Queensland University of Technology, Brisbane, Australia
| | - Steven M McPhail
- Centre for Functioning and Health Research, Metro South Health, Buranda, Australia.,School of Public Health & Social Work and Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Robert S Ware
- Menzies Health Institute Queensland, Griffith University, Brisbane, Australia
| | - Kelly Foster
- Paediatric Emergency Research Unit, Children's Health Queensland, South Brisbane, Australia
| | - Demi C Bertoni
- Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia
| | - Roy M Kimble
- Centre for Children's Burns and Trauma Research, The University of Queensland, Brisbane, Australia.,Pegg Leditschke Paediatric Burns Centre, Lady Cilento Children's Hospital, South Brisbane, Australia
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Abstract
BACKGROUND The umbilical cord is a major route of infection among newborns. In Ghana, infections among neonates accounts for majority of under-five deaths. This study sought to investigate what mothers apply to the umbilical cord of their newborns and what motivates them to put such applications on the cord. METHODS This was a descriptive cross-sectional study of neonatal cord care practices among mothers and caregivers in the Nkwanta South District of the Volta region of Ghana. Quantitative and qualitative methods were used. RESULTS Majority of the mothers/caregivers used substances that have not been recommended for umbilical cord dressing (64.3%). Factors such as level of education [χ2=8.2, p=0.02], place of delivery [χ2 = 40.1, p<0.001], relationship with whoever has made a recommendation for a particular dressing to be used [χ2=95.2, p<0.001] and number of days it takes the umbilical cord to fall off [χ2=6.2, p=0.05] were found to influence the type of dressing used on the umbilical cord. CONCLUSION AND GLOBAL HEALTH IMPLICATIONS In order to reduce the number of neonates who die due to avoidable cord-related infections, the type of substances used on the umbilical cord should be approved substances. Health education particularly on neonatal cord care targeting community members and health care providers at the lower levels of the healthcare delivery system should be intensified.
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Affiliation(s)
| | | | - Rosemond Tetteh
- Research & Development Division, Ghana Health Service, Accra, Ghana
| | - Abraham Hodgson
- Research & Development Division, Ghana Health Service, Accra, Ghana
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49
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Heinemann N, Solnica A, Abdelkader R, Gutman J, Nalbandian N, Raizman E, Hochner-Celnikier D. Timing of staples and dressing removal after cesarean delivery (the SCARR study). Int J Gynaecol Obstet 2018; 144:283-289. [PMID: 30582610 DOI: 10.1002/ijgo.12757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 09/25/2018] [Accepted: 12/21/2018] [Indexed: 11/11/2022]
Abstract
OBJECTIVE To investigate optimal timing of dressing and staples removal after cesarean delivery (CD). METHODS This prospective clustered clinical trial enrolled women undergoing CD between January 1, 2013, and October 31, 2014, at Hadassah-Hebrew University Hospital, Jerusalem. Women were assigned to one of five clusters differing in timing of dressing and staples removal. We assessed scar healing at 6 weeks. RESULTS 920 women completed telephone questionnaires. Wound healing did not differ significantly among the clusters: the healing complication rate was 21% in the control group (n=46) and ranged from 18% to 26% (n=27-50) in clusters two to five (P=0.49). More healing complications were observed in women with a body mass index (BMI) of more than 35 kg/m2 versus 35 kg/m2 or less (P=0.016), urgent versus elective CD (P=0.013), preterm premature rupture of the membranes (PPROM) versus intact membranes (P=0.016), and chorioamnionitis at delivery versus no chorioamnionitis (P=0.001). 586 (64%) women underwent physician assessment at staples removal and at 6 weeks post CD. CONCLUSIONS Timing of dressing and staples removal has no effect on CD scar healing in low- and high-risk parturients. A BMI of more than 35 kg/m2 , urgent CD, PPROM, and chorioamnionitis were associated with mal-healing, regardless of cluster. Clinicaltrials.gov: NCT01724255.
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Affiliation(s)
- Netanella Heinemann
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Amy Solnica
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Rana Abdelkader
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Jakov Gutman
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Noemzar Nalbandian
- Department of Nursing Administration, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ela Raizman
- Department of Nursing Administration, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Drorith Hochner-Celnikier
- Department of Obstetrics and Gynecology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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Abstract
Background and Objectives Dementia is accompanied by increasing need for support in activities of daily living (ADLs). This brief report/literature review summarizes the practices to care for early stage, middle stage, and late stage ADL needs (dressing, toileting, and eating/nutrition), and examines commonalities across ADL needs and the extent to which practices are reflected in guidelines and/or evidence. Research Design and Methods A review of the grey and peer-reviewed literature, using some but not all procedures of a systematic review. Key terms were identified for ADLs overall and for each of the 3 ADLs, and a search was conducted using these words in combination with (a) dementia, Alzheimer's disease, and similar terms, and (b) practices, interventions, guidelines, recommendations, and similar terms. Searches were conducted using databases of peer-reviewed literature as well as the Grey Literature Reports and Google search engine. Sources were included if they provided evidence or recommendations on interventions to address ADL functioning for dressing, toileting, and feeding for persons living with dementia. Results As cognitive and functional impairment increases, the number of care practices and themes that embody care practices increases. The majority of practices are evidence-based, and most evidence is incorporated into guidelines. Discussion and Implications Virtually all practices reflect person-centered care principles. Five recommendations summarize the evidence and recommendations related to providing support to persons living with dementia in relation to dressing, toileting, and eating/nutrition.
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Affiliation(s)
- Lindsay P Prizer
- Division of General Medicine & Geriatrics, Emory University School of Medicine, Atlanta, Georgia.,Atlanta VA Medical Center, Veterans Affairs Administration, Decatur, Georgia
| | - Sheryl Zimmerman
- Cecil G. Sheps Center for Health Services Research and the School of Social Work, The University of North Carolina at Chapel Hill
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