Search

Objective: To investigate the clinical effects of negative pressure wound therapy (NPWT) in treating the poor healing of incisions after different abdominal operations. Methods: The retrospective observational study was conducted. From June 2019 to December 2020, 42 patients with poor healing of incisions after abdominal surgery were admitted to Center of Burns and Trauma of the First Affiliated Hospital of Naval Medical University, including 29 males and 13 females, aged 23-81 years. The disease course of poor healing of abdominal incision was 3-60 d. The preoperative examination of patients was completed after admission, and NPWT was used after debridement. According to the dehiscence level of incision, the negative pressure value of -10.64 to -6.65 kPa was set. The incisions were sutured in the second stage when the incisions had good blood circulation. The cause of abdominal surgery, the dehiscence level and the cause of poor healing of abdominal incision were investigated, and the final healing of abdominal incision and the occurrence of complication were observed. Results: The causes of abdominal operations in this group of patients who ocurred poor healing of abdominal incisions were ranked according to the composition ratio, with the top 4 causes being colon cancer (9 cases, accounting for 21.4%), bile duct disease (8 cases, accounting for 19.0%), liver cancer (5 cases, accounting for 11.9%), and appendicitis (4 cases, accounting for 9.5%). There were 25 cases (59.5%) with dehiscence of abdominal incision in the deep fascia layer, and the other 17 cases (40.5%) with dehiscence of abdominal incision in the superficial fascia layer. The causes of poor healing of abdominal incision were ranked according to the composition ratio, with the top 3 causes being infection (24 cases, accounting for 57.1%), fat liquefaction (11 cases, accounting for 26.2%), and suture reaction (5 cases, accounting for 11.9%). The blood circulation in 40 patients was improved after being treated with NPWT, and the incisions were sutured in the second stage. The incisions healed well when the suture lines were removed in the second to third week. Intestinal fistula and bile leakage developed during the NPWT treatment, respectively in the other 2 patients, in which negative pressure equipment was removed subsequently, and the incisions healed after adequate drainage and conventional dressing changes. Conclusions: NPWT is effective in treating poor healing of abdominal incision after different abdominal surgeries. The clinicians need to comprehensively assess the patient's condition to determine when and how to use NPWT to avoid the occurrence of intestinal fistula, bile leakage, and other complications.

The present paper aims to formulate and characterize four phytotherapeutic ointments based on Hippophae fructus , Calendulae flos , Bardanae folium , and Millefolii herba , which are included in a novel ointment base. In order to investigate the healing properties of the ointments, in vivo experimental wound models of linear incision, circular excision, and thermal burn were performed on Wistar rats. Topical treatment was performed daily for 21 days. Determination of the wound contraction rate (WCR), the period of reepithelization, and histopathological examination were achieved. Additionally, for the tested ointments, oscillatory and rotational rheological tests were carried out, and for the extracts, HPLC analysis was performed. The results demonstrate that the tested novel ointments are safe for use and the most effective ointment proved to be the one based on Arctium lappa , followed by that of Calendulae flos .

Objective: In clinical practice, split-thickness skin graft (STSG) transplantation remains the gold standard for covering large skin defects. Currently, there is no consensus on the optimal thickness of skin grafts. The purpose of our study was to compare the early healing processes of recipient and donor wounds after STSG transplantation using grafts of different thickness., Method: This prospective, randomised clinical trial included 84 patients that underwent STSG transplantation surgery for post-burn, post-traumatic or postoperative skin defects. Patients were randomised to receive a skin graft of either 0.2mm, 0.3mm or 0.4mm thickness. After skin transplantation, the wound healing parameters of both the recipient and donor wounds were evaluated after three days, one week, two weeks and one month., Results: The greatest mean epithelialisation scores and highest rate of complete wound epithelialisation were identified in the recipient and donor wounds of the 0.2mm transplant group, at all time points. When the recipient wound pain scores were evaluated, the greatest visual analogue scale (VAS) values were found in the 0.2mm transplant group. The opposite result was found for the donor wound, where the highest VAS scores were identified in the 0.4mm transplant group. There were no significant differences, at any follow-up period, when wound secretion, erythema, swelling, localised warmth and fluctuation were compared., Conclusion: The early healing of recipient wounds after STSG transplantation with grafts of various thickness differed considerably, especially regarding wound epithelialisation and pain.

Objective: To identify the most appropriate, most suitable and most efficient dressing for split-thickness skin graft (STSG) donor sites. Comparing the wound healing rate, pain severity and duration, as well as the dressing change frequency in four randomised patient groups., Methods: A single-centre non-blinded randomised controlled trial was carried out during 2010-2014. All patients treated for skin defects/lesions (due to burns, trauma or ulcers) using STSG were included in the study. All patients were randomly allocated in four different donor site treatment groups; polyurethane (PU group, Mepilex); polyurethane with silicone membrane (PUSM group; Mepilex border,); transparent, breathable film (TBF group; Mepitel film) and cotton gauze dressings (CG group) using Excel 2007. We evaluated: wound healing time, pain severity and duration, the frequency of dressing change, donor site re-epithelialisation, donor site complications (signs of inflammation or infection). Patients were assessed on postoperative days: 1, 3, 6, 9, 12, 15, 18 and 21., Results: After random allocation of study participants the number of patients in each group were: PU group n=25; PUSM group n=24; TBF group n=24; CG group n=25. The groups were homogenous according to gender, age, main pathology, donor site area and wound size. The STSG donor site healing time varied from 9 to 21 days. The mean healing time in the CG group was 14.76 days, whereas in the PU, PUSM, and TBF group it was significantly shorter; 12.25 days, 11.63 days and 10 days, respectively. Patients in the TBF group demonstrated the most rapid healing time with 66.7% of STSG donor sites healed by postoperative day 9. The pain duration interval in modern dressing groups (PU, PUSM and TBF groups) was 0-9 days, whereas it was 6-18 day in the CS group. Pain intensity mean on postoperative day 1 was 2.21 in the PU group; 1.67 in the PUSM group; 1.46 in the TBF group and 3.04 in the CG group. The average pain duration in Group PU, PUSM, and TBF was 4.08 days; 2.5 days; 2.29 days, respectively. The average number of times each dressing was changed in each group was, 2.83 times in the PU group and PUSM group and 1.46 times in the TBF group. The CG dressing group were changed once when the donor site wound re-epithelialised. There was one patient in the PU group who experienced signs of infection, was treated accordingly and excluded from the study., Conclusion: The fastest healing time was demonstrated by patients in the TBF group. The pain was not as severe and for a shorter period of time in modern dressing study groups. However, the pain was lightest and felt shortest in TBF dressing group. The modern dressings PU and PUSM had to be changed more frequently than TBF.

Background: Wound healing is a dynamic process whereby cells, growth factors (GFs), and the extracellular matrix (ECM) interact to restore the architecture of damaged tissue. Chronic wounds can be difficult to treat due to the increased presence of inflammatory cells that degrade the ECM, GF, and cells necessary for wound healing to occur. Cellular and acellular matrix products can be used in the management of a variety of chronic wounds including venous, diabetic, and pressure ulcers and other conditions such as burns, epidermolysis bullosa, pyoderma gangrenosum, and surgical wounds. These matrices provide cells, GF, and other key elements that act as a scaffold and promote reepithelialization and revascularization of the wound bed., Methods: This article focuses on cellular and acellular matrix products that have been well-studied clinically with positive results in randomized clinical trials and widely available matrices for chronic nonhealing wounds. We present trial results as well as their indications, techniques, and outcomes., Results: There are a variety of matrix products available on the market. Some of these products are used to treat chronic wounds, for example, diabetic foot ulcers, venous leg ulcers, pyoderma gangrenosum, and pressure ulcers. In this review, we found that wounds of different etiologies have been treated with a variety of matrices, with successful outcomes compared with standard wound care., Conclusions: Both cellular and acellular matrix products are useful in the management of a variety of chronic wounds. These matrices provide cells, GF, and other key elements that promote reepithelialization and revascularization of the wound bed while preventing degradation of the ECM. The treatment of chronic wounds with matrix products in combination with standard wound care has been proven to aid in wound healing when added to standard of care.

Background: Pressure garment therapy (PGT) is well accepted and commonly used by clinicians in the treatment of burns scars and grafts. The medium to high pressures (24-40 mmHg) in these garments can support scar minimisation, and evidence is well documented for this particular application. However, PGT specifically for burn donor sites, of which a sequela is also scarring, is not well documented. This study protocol investigates the impact of a low pressure (4-6 mmHg) interim garment on donor site healing and scarring. With a primary purpose of holding donor dressings in place, the application of the interim pressure garment (IPG) appears to have been twofold. IPGs for donor sites have involved inconsistent application with a focus on securing wound dressing rather than scar management. However, anecdotal and observational evidence suggests that IPGs also make a difference to some patient's scar outcomes for donor sites. This study protocol outlines a randomised controlled trial designed to test the effectiveness of this treatment on reducing scarring to burn donor sites., Methods/design: This study is a single-centre, single (assessor)-blinded, randomised control trial in patients with burns donor sites to their thighs. Patients will be randomly allocated to a control group (with no compression to donor sites) or to an experimental group (with compression to donor sites) as the comparative treatment. Groups will be compared at baseline regarding the important prognostic indicators: donor site location, depth, size, age, and time since graft (5 days). The IPG treatment will be administered post-operatively (on day 5). Follow-up assessments and garment replacement will be undertaken fortnightly for a period of 2 months., Discussion: This study focuses on a unique area of burns scar management using a low-pressure tubular support garment for the reduction of donor site scars. Such therapy specifically for donor scar management is poorly represented in the literature. This study was designed to test a potentially cost-effective scar prevention for patients with donor sites to the thigh. No known studies of this nature have been carried out to date, and there is a need for rigorous clinical evidence for low-pressure support garments for donor site scar minimisation., Trial Registration: Australian New Zealand Clinical Trials Registry identifier ACTRN12610000127000 . Registered 8 Mar 2010.

Introduction: In a single-center, prospective, randomized clinical trial three different configured wound dressings Biobrane(®), Dressilk(®) and PolyMem(®) were compared with each other regarding objective and subjective healing parameters and cost efficiency., Methods: 28 burn patients received surgical treatment with split-thickness skin grafting, while utilizing Biobrane(®), Dressilk(®) and PolyMem(®) as a single bound donor site wound dressing in all patients. Following a standardized case report form, we monitored several parameters such as pain, transparency of the dressing, active bleeding, exudation and inflammation by using the Verbal Rating Scale 1-10 through out., Results: With regard to re-epithelialization, pain and acute bleeding all three dressings were equivalent. Dressilk(®) and Biobrane(®) presented clearly superior to PolyMem(®) in both wound assessment and in the reduction of mild inflammation and exudation. High subjective satisfaction rates were reported with Dressilk(®) and Biobrane(®) dressings in regard to comfort and mobility. During the continuous monitoring period Biobrane(®) outperformed Dressilk(®) by providing higher wound transparency rates and offering a better level of wound control during the entire study period. Regarding their cost efficiency, PolyMem(®) and Dressilk(®) are clearly superior to Biobrane(®)., Conclusion: The "ideal" wound dressing maximizes patients' comfort while reducing pain and the risk of pulling off migrating epidermal cells from the wound surface. In addition reliable wound status evaluation (minimizing complications), an increase of treatment cost value efficacy, and reduced hospitalization rates should be provided. Dressilk(®) and Biobrane(®) were favored by patients and surgeons for providing an effective and safe healing environment, with overall low complication rates with respect to infection and exudation. Regarding cost-effectiveness PolyMem(®) and Dressilk(®) presented superior to Biobrane(®)., (Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.)