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Wounds: a Compendium of Clinical Research and Practice

Guangyu Wang, Yu Wang, Fusheng Wang, Yi Ding, Yudong Kang, Yu Dong, Peiwen Lv, Xuying Xu
INTRODUCTION: Chronic, nonhealing skin ulcers of the lower limbs associated with diabetes pose a clinical challenge as their treatment requires more sophisticated and delicate approaches than in patients without diabetes. OBJECTIVE: Herein, the authors demonstrate and discuss the implementation of their use of topical traditional Chinese medicines in several sample cases of lower limb nonhealing ulcers in patients with diabetes. MATERIALS AND METHODS: A series of diabetic ulcer cases were treated with various approaches...
October 26, 2018: Wounds: a Compendium of Clinical Research and Practice
Man-Li Zha, Bao-Fang Yuan, Ji-Yu Cai, Yi-Ping Song, Hong-Lin Chen
BACKGROUND: Patient-controlled analgesia (PCA) has become a common practice after surgery, but research has shown that the use of PCA is also a significant risk factor for pressure ulcers. However, no meta-analysis or conclusive review has investigated whether patients using PCA have a significantly higher prevalence of pressure ulcers. OBJECTIVE: This study explores the association between the use of postoperative PCA and the prevalence of pressure ulcers. MATERIALS AND METHODS: PubMed, the Cochrane Controlled Register of Trials, Web of Science, China National Knowledge Infrastructure, Wanfang, and Vip databases were searched to identify studies, published up until November 2016, concerning the association between PCA and pressure ulcer prevalence...
October 26, 2018: Wounds: a Compendium of Clinical Research and Practice
John P McQuilling, Mitchell Sanders, Lindsay Poland, Mia Sanders, Giacomo Basadonna, Norman E Waldrop, Katie C Mowry
INTRODUCTION: Healing of tendon injuries is often plagued by significant scar formation and compromised biomechanical function. For those with diabetes, these injuries are further complicated by alterations to the extracellular matrix of the tendon, poor circulation, and delayed wound healing; consequently, complications and re-rupture rates for patients with diabetes are reported higher than the typical patient population. Placental derived membranes, specifically dehydrated human amnion/chorion membranes (dACMs), have been utilized clinically as an adhesion barrier, and these membranes have been shown to reduce scarring and aid in tissue repair...
October 26, 2018: Wounds: a Compendium of Clinical Research and Practice
Abdulnaser Alkhalil, Bonnie C Carney, Taryn E Travis, Seid Muhie, Stacy-Ann Miller, Jessica C Ramella-Roman, Pejhman Ghassemi, Rasha Hammamieh, Marti Jett, Lauren T Moffatt, Jeffrey W Shupp
INTRODUCTION: The value of compression studies and applications in hypertrophic scar (HTS) treatment is often undermined due to the lack of ideal controls, patient compliance, and clear action mechanisms. OBJECTIVE: This study assesses the genome-wide compression effects on scars under well-controlled conditions. MATERIALS AND METHODS: An automated pressure delivery system (APDS) applied controlled doses of pressure to scars in a red Duroc swine HTS model...
September 30, 2018: Wounds: a Compendium of Clinical Research and Practice
Geva Landau, Sami Gabario, Shaked Menashe, Hodaya Saadon, Lior Heller
BACKGROUND: Trichloroacetic acid (TCA) is a nontoxic chemical that has been used for more than 20 years in skin rejuvenation treatments for various skin conditions. Currently, there is no single accepted protocol for local burn care following TCA peeling. OBJECTIVE: This pilot study assesses the efficacy and tolerability of a silver-based gel compared with fusidic acid cream as a complementary topical treatment for burns following TCA peeling. MATERIALS AND METHODS: The authors conducted a comparative study on healthy female patients in the Department of Plastic and Reconstructive Surgery at Assaf Harofe Medical Center (Zerifin, Israel)...
September 19, 2018: Wounds: a Compendium of Clinical Research and Practice
Frank da Silva Torres, Leila Blanes, Taís Freire Galvão, Lydia Masako Ferreira
A skin tear is a partial-thickness wound whose main characteristic is the presence of a skin flap. There are many contributing factors to skin tears, but few practical guidelines are available in the literature for their prevention and management. OBJECTIVE: The aim of this study is to develop a manual for the prevention and treatment of skin tear injuries. METHODS: A literature review on skin tears was conducted. The manual was organized into 7 chapters of topics of interest to health care professionals...
September 19, 2018: Wounds: a Compendium of Clinical Research and Practice
Aurelie Thuleau, Jose Dugay, Catherine Dacremont, Zaineb Jemmali, Jacqueline Elard, Yann De Ricke, Nathalie Cassoux, Sarah Watson, Marie-Christine Escande, Isabelle Fromantin
INTRODUCTION: During the metabolic processes of malignant wounds, bacteria produce a large amount of volatile organic compounds (VOCs) that are responsible for malodors and may have a major impact on the patient's quality of life with a risk of isolation. OBJECTIVE: A translational study was conducted on 32 malignant breast wounds by combining the identification of bacterial strains present on wounds, the identification of VOCs produced by these bacterial strains, and sensory evaluation to assess odor intensity and quality of odorous bacteria...
August 23, 2018: Wounds: a Compendium of Clinical Research and Practice
Jeanette Sams-Dodd, Frank Sams-Dodd
Antimicrobial approaches (eg, antibiotics and antiseptics) have been used for decades in the treatment of infected wounds, ulcers, and burns. However, an increasing number of meta-analyses have raised questions regarding the therapeutic value of these approaches. Newer findings show that the body actively hosts an ecosystem of bacteria, fungi, viruses, and mites on its outer surfaces, known as the microbiome, as part of its defense against pathogens. Antimicrobials would disrupt this system and thereby work against the strategy the body has chosen...
November 2018: Wounds: a Compendium of Clinical Research and Practice
Adolfo Maria Tambella, Stefano Martin, Andrea Cantalamessa, Evelina Serri, Anna Rita Attili
Platelet-rich plasma, platelet-rich fibrin, fibrin glue, and platelet lysate are the most widely used nontransfusional hemocomponents that, as biological and therapeutic aids, enhance the physiological reactions after an injury to facilitate the repair and regeneration processes. Recently, this type of therapy also has significantly expanded in veterinary medicine. Due to many similarities, the animal patient could be a good reference as a study model for humans, especially for chronic and difficult-to-heal injuries...
November 2018: Wounds: a Compendium of Clinical Research and Practice
Walter F D'Costa, Dorothy H Kurtz Phelan
Treatment of lower extremity ulcers remains a challenge to physicians and surgeons. These wounds lead to an increased risk of amputation and increased mortality rate and must be treated aggressively, in many cases requiring surgical debridement, to prevent these complications. The objective of this retrospective case series is to evaluate the safety and efficacy of a viable cryopreserved placental membrane (vCPM) in 12 patients with 16 wounds of mixed etiologies when surgically debrided and augmented with vCPM 1 time, followed by standard of care (nonadherent dressing, gauze, and compression) until healed...
November 2018: Wounds: a Compendium of Clinical Research and Practice
Alexandra Tilt, Reuben A Falola, Anagha Kumar, Tessa J Campbell, Jacob M Marks, Christopher E Attinger, Karen K Evans
INTRODUCTION: Plastic surgeons are often consulted by other surgical teams for management of wound dehiscence following abdominopelvic surgery. OBJECTIVE: The purpose of this study is to determine whether operative debridement and primary closure of abdominopelvic wounds are safe and expeditious for patients. MATERIALS AND METHODS: A retrospective analysis was conducted on a database of patients who underwent operative debridement and closure at a single institution between January 2011 and December 2015 for dehisced abdominal or pelvic wounds acquired from prior obstetric, gynecologic, transplant, plastic, or general surgery procedures...
November 2018: Wounds: a Compendium of Clinical Research and Practice
Amanda L Killeen, Kara M Brock, Rosabel Loya, Cece S Honculada, Phyllis Houston, Jodi L Walters
INTRODUCTION: Chronic ulcerations on weightbearing surfaces of the lower extremities are uniquely challenging and can lead to complications such as infection or amputation. OBJECTIVE: This 3-patient case series of 4 chronic wounds of various etiologies outlines the use of a fully synthetic bioengineered nanomedical scaffold that exhibits durability and allows for cell migration and angiogenesis while resisting enzymatic degradation. MATERIALS AND METHODS: The nanomedical scaffold was rehydrated in sterile saline at room temperature for 3 to 5 minutes until translucent and pliable, then it was fenestrated with a scalpel...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Bryce French, Katherine Mandell, Ryan Martinez
INTRODUCTION: Aspergillus is a rare cause of surgical site infection most often seen in immunocompromised patients undergoing cardiac, transplant, ophthalmologic, or burn operations; an unusual case following a colon resection is presented here. CASE REPORT: The authors report a case of an invasive Aspergillus fumigatus infection following a subtotal colectomy for toxic megacolon. The patient was on antibiotics following the operation and chronic immunosuppression with steroids and infliximab...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Matthews J Dietz, Joseph T Hare, Cristiane Ueno, Bonhomme J Prud'homme, Jonathan W Boyd
INTRODUCTION: In the surgical setting, the most accepted technique for measuring tissue perfusion includes subjective identification, with visual and tactile inspections of the tissue, performed by a surgeon. Recently, fields such as ophthalmology, plastic surgery, and other surgical specialties, such as cardiac, vascular, and transplant surgery, have seen the emergence of laser-assisted fluorescent angiography (LAFA) to visualize real-time tissue perfusion during procedures. CASE REPORT: The case of an 80-year-old woman, who presented with a wound over the left medial elbow following a subacute recurrent elbow dislocation, illustrates the use of this technology in the field of orthopedics...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Michael Wilson, Richard Simman
Deep tissue injuries (DTIs) are the manifestation of multiple layers of tissue necrosis and are often secondary to chronic mechanical stress to an area of bony prominence. The prevalence of these injuries among the chronically ill and patients in long-term care require a strong understanding of their etiology and a highly sensitive identification algorithm. Although the National Pressure Ulcer Advisory Panel (NPUAP) has released new guidelines with accurate descriptions as to how these injuries present, there is a significant segment of patients that present atypically and, as such, the treatment plan and prognosis are difficult to predict based on physical presentation, which can lead to either delays in necessarily aggressive care or conversely an overzealous treatment plan in hopes of addressing a pathology that may be self-limiting...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Travis L Perry, Lindsay M Kranker, Erin E Mobley, Eileen E Curry, R Michael Johnson
INTRODUCTION: Fournier's gangrene (FG) remains a forbidding necrotizing soft tissue infection (NSTI) that necessitates early recognition, prompt surgical excision, and goal-directed antibiotic therapy. Traditionally, surgical management has included wide radical excision for sepsis control, but this management often leaves large, morbid wounds that require complex wound coverage, prolonged hospitalizations, and/or delayed healing. OBJECTIVE: The purpose of this case series is to report the outcomes of FG using a surrogate approach of concurrent debridement of spared skin and soft tissue, negative pressure wound therapy (NPWT), and serial delayed primary closure (DPC)...
October 2018: Wounds: a Compendium of Clinical Research and Practice
Jonathan F Arnold
INTRODUCTION: Routine noninvasive vascular study results can be affected by a multitude of factors and do not provide information specific to the location of the wound. Results must be extrapolated and may prompt a false sense of security that adequate perfusion for healing exists. CASE REPORT: The case of an 80-year-old Caucasian man, who presented with chronic ulceration of the left lateral malleolus and fifth metatarsal base with concurrent metatarsal osteomyelitis, is presented...
September 2018: Wounds: a Compendium of Clinical Research and Practice
Tanushree Agrawal, Stephanie Fuentes Rojas, Rosalyn Adigun, Manjulatha Badam
INTRODUCTION: Mycobacterium smegmatis is a common microbe found in soil, dust, and water that rarely causes infections in humans. CASE REPORT: A 45-year-old man with a past medical history of hypertension presented with a nonhealing surgical wound in his anterior chest wall, measuring 0.5 cm x 0.5 cm x 0.3 cm with minimal serosanguinous drainage, that had been present for more than 1 year. Wound swab showed M smegmatis. He required a 3-month course of antibiotic treatment and advanced wound care that included packing the sinus wounds with silver-alginate dressings for the first 2 weeks followed by iodoform packing; once the infection and drainage had improved after 2 months of treatment, packing was changed to a collagen dressing...
September 2018: Wounds: a Compendium of Clinical Research and Practice
Laura Bolton
No abstract text is available yet for this article.
September 2018: Wounds: a Compendium of Clinical Research and Practice
Eric Teplicki, Qianli Ma, David E Castillo, Mina Zarei, Adam P Hustad, Juan Chen, Jie Li
INTRODUCTION: Aloe vera is sometimes used as a folk remedy for minor wounds and burns, but its mechanisms of action in wound healing are unclear. OBJECTIVE: In this study, the authors evaluate the effects of A vera on wound healing. MATERIALS AND METHODS: In vitro analyses of cell proliferation and migration were conducted on normal human primary skin fibroblasts and keratinocytes in growth media with A vera solution and preservatives at various concentrations...
September 2018: Wounds: a Compendium of Clinical Research and Practice
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