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Wound debridement

Ronaldo Roberto Tait Caleffe, Stefany Rodrigues de Oliveira, Adriana Aparecida Sinópolis Gigliolli, Maria Claudia Colla Ruvolo-Takasusuki, Helio Conte
Larval therapy (LT) comprises the application of sterile Calliphoridae larvae for wound debridement, disinfection, and healing in humans and animals. Larval digestion plays a key role in LT, where the salivary glands and gut produce and secrete proteolytic and antimicrobial substances. The objective of this work was to bioprospect the salivary glands of Chrysomya megacephala (Fabricius, 1794) larvae, using ultrastructural, morphological, and histological observations, and the total protein electrophoretic profile...
June 8, 2018: Micron: the International Research and Review Journal for Microscopy
Haojie Cui, Ge Xiong, Chunlin Zhang, Zirun Xiao
Objective: To investigate pathogenesis, diagnosis, and treatment of crush syndrome of chest and arm. Methods: Between January 2010 and January 2015, 5 cases of crush syndrome of chest and arm caused by pressing oneself in a coma after CO poisoning or alcoholic intoxication were treated. There were 4 males and 1 female with an average age of 36.7 years (range, 28-46 years). Two patients involved left upper limb and chest, while the other three patients involved right upper limb and chest...
June 1, 2018: Chinese Journal of Reparative and Reconstructive Surgery
Benjamin A Minden-Birkenmaier, Gary L Bowlin
Over the past few decades, there has been a resurgence in the clinical use of honey as a topical wound treatment. A plethora of in vitro and in vivo evidence supports this resurgence, demonstrating that honey debrides wounds, kills bacteria, penetrates biofilm, lowers wound pH, reduces chronic inflammation, and promotes fibroblast infiltration, among other beneficial qualities. Given these results, it is clear that honey has a potential role in the field of tissue engineering and regeneration. Researchers have incorporated honey into tissue engineering templates, including electrospun meshes, cryogels, and hydrogels, with varying degrees of success...
June 14, 2018: Bioengineering
Jianghua Li, Kaixi Zhang, Lin Ruan, Seow Fong Chin, Nirmani Wickramasinghe, Hanbin Liu, Vikashini Ravikumar, Jinghua Ren, Hongwei Duan, Liang Yang, Mary B Chan-Park
Biofilms and rapid evolution of multi-drug resistance complicate the treatment of bacterial infections. Antibiofilm agents such as metallic/inorganic nanoparticles or peptides act by exerting anti-bacterial effects and hence do not combat biofilms of antibiotics-resistant strains. In this paper we show that the block copolymer DA95B5, dextran-block-poly((3-acrylamidopropyl) trimethylammonium chloride (AMPTMA)-co-butyl methacrylate (BMA)), effectively removes preformed biofilms of various clinically relevant multi-drug resistant Gram-positive bacteria including Methicillin-resistant Staphylococcus aureus, Vancomycin-Resistant Enterococci (VRE V583) and Enteroccocus faecalis (OG1RF)...
June 14, 2018: Nano Letters
Alexandra Schulz, Paul Christian Fuchs, Christian Oplaender, Leandra Börner Valdez, Jennifer Lynn Schiefer
Several reports have concluded that enzymatic debridement based on Bromelain (NX) is selective and efficient. Although clinical trials showed that viable tissue is not damaged at the macroscopic level, the effect on the cellular level is largely unknown. The current study is meant to close this gap by evaluating whether NX has an effect on vital cells of the human dermis on a cellular level. In an experimental in vitro study design, the effect of NX on human keratinocytes, fibroblasts, and macrophages was analyzed...
June 13, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Nor Hazla Mohamed Haflah, Min Hwei Ng, Mohd Heikal Mohd Yunus, Amaramalar Selvi Naicker, Ohnmar Htwe, Kamarul Arifin Abdul Razak, Ruszymah Idrus
CASE: A 22-year-old man sustained a laceration that measured 180 cm, after debridement, over the anterolateral aspect of the right leg following a road traffic accident. The wound was treated with MyDerm (Universiti Kebangsaan Malaysia), a cell-based, bilayered, bioengineered dermal substitute that contains no animal-derived components and is fully autologous. For its construction, only a small area of skin was harvested from the left groin, which was closed primarily with absorbable sutures...
June 13, 2018: JBJS Case Connector
Alexandra Schulz, Paul Christian Fuchs, Nadine Hans, Christian Opländer, Leandra Boerner Valdez, Jennifer Lynn Schiefer
An enzyme mixture containing bromelain (NexoBrid®) was found to be suitable for enzymatic debridement of burn wounds, as determined by the criteria of patient comfort and pain, selectivity, and efficiency. Nevertheless, daily experience showed that pretreatment of burn wounds with several other clinical agents may inhibit debridement efficiency. Therefore, the current study was performed to identify those agents and evaluate their debridement inhibition capabilities. The impact of several common agents as well pH, on NexoBrid® debridement efficiency was evaluated in vitro...
April 20, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
Matthew L Costa, Juul Achten, Julie Bruce, Elizabeth Tutton, Stavros Petrou, Sarah E Lamb, Nick R Parsons
Importance: Open fractures of the lower limb occur when a broken bone penetrates the skin. There can be major complications from these fractures, which can be life-changing. Objectives: To assess the disability, rate of deep infection, and quality of life in patients with severe open fracture of the lower limb treated with negative pressure wound therapy (NPWT) vs standard wound management after the first surgical debridement of the wound. Design, Setting, and Participants: Multicenter randomized trial performed in the UK Major Trauma Network, recruiting 460 patients aged 16 years or older with a severe open fracture of the lower limb from July 2012 through December 2015...
June 12, 2018: JAMA: the Journal of the American Medical Association
Li-Feng Zhai, Gou-Ping Ma, Li-Feng Shen, Qiao-Feng Guo, Chun Zhang
OBJECTIVE: To explore the methods and results of modified one-stage revision procedure for treating proximal femoral infected nonunion after intramedullary nail fixation. METHODS: From June 2010 to June 2015, 10 patients of proximal femoral infected nonunion after intramedullary nail fixation were treated with modified one-stage revision procedure, including 9 males and 1 female, ranging in age from 35 to 77 years old. There were 3 cases of intertrochanteric fractures, 2 cases of intertrochanteric fractures accompanied with proximal femoral fractures and 5 cases of subtrochaneric fracures...
May 25, 2018: Zhongguo Gu Shang, China Journal of Orthopaedics and Traumatology
Tellez German Alberto, Zapata Jesica Alejandra, Toro Lily Johanna, Henao Diana Carolina, Bedoya Juan Pablo, Rivera Juan David, Trujillo Juan Valentin, Rivas Bruno, Richard Onalbi Hoyos Lopez, Castano Jhon Carlos
Maggots from the Lucilia sp. genus are used for debridement of infected and necrotic wounds. Broad-spectrum antimicrobial activity has been described in the excretion/secretions (ES1 ) of these larvae. This study identifies the genetic sequence of a cecropin-like antimicrobial peptide from Lucilia eximia. Total RNA was extracted and used for PCR-RACE amplification of a cecropin, the native peptide was immunolocalized in the tissues and secretions of the larvae, and a synthetic analog was used to explore its antimicrobial, cytotoxic, LPS neutralizing and wound-healing activities in vitro...
June 8, 2018: Acta Tropica
Chase H Foster, Michael Karsy, Michael R Jensen, Jian Guan, Ilyas Eli, Mark A Mahan
BACKGROUND: Peripheral nerve injuries (PNIs) of the lower extremities have been assessed in small cohort studies; however, the actual incidence, national trends, comorbidities, and cost of care in lower extremity PNI are not defined. Lack of sufficient data limits discussion on national policies, payors, and other aspects fundamental to the delivery of care in the US. OBJECTIVE: To establish estimates of lower extremity PNIs incidence, associated diagnoses, and cost in the US using a comprehensive database with a minimum of a decade of data...
June 8, 2018: Neurosurgery
Christopher Alcala-Marquez, Rubén Torrealba, Amir A Mehbod, John M Dawson, Thomas D Dressel, Ensor E Transfeldt
STUDY DESIGN: This study retrospectively reviewed recurrences of surgical site infections (SSI) in spinal patients treated with vacuum-assisted closure (VAC) technology. OBJECTIVE: Identify patient and treatment factors associated with recurrence of SSI after VAC treatment. SUMMARY OF BACKGROUND DATA: Patients treated with VAC can achieve healing of deep spine wound infections; however, some patients develop a recurrent infection. Risk factors associated with a recurrence have not been identified...
June 7, 2018: Clinical Spine Surgery
Gg Salzler, B Long, Ed Avgerinos, Ra Chaer, S Leers, E Hager, Ms Makaroun, Mh Eslami
OBJECTIVE: Mycotic aneurysms of the extremities occur infrequently but can cause severe life and limb complications. Traditional treatment typically includes debridement and revascularization, though in select patients ligation may be well tolerated. We reviewed our experience with these aneurysms treated with these two modalities. METHODS: A retrospective review of patients treated for peripheral mycotic aneurysms at one institution from January 2005 to December 2015 was performed under an Institutional Review Board-approved protocol...
June 7, 2018: Annals of Vascular Surgery
Nicole Todd, Julia E Boucher, Mylène Bassal, Tania Dumont, Nathalie Fleming
BACKGROUND: An 18-month-old female presenting with severe vulvar ulcers and pancytopenia with investigations revealing P.aeruginosa bacteremia. CASE: Previously healthy 18-month-old female presented with 6 days of fevers, vulvar rash and ulcers. Vulvar cultures demonstrated S.aureus and P.aeruginosa. Bloodwork showed pancytopenia and P.aeruginosa bacteremia. She started broad spectrum antibiotics. Bone marrow aspirate revealed a hypocellular marrow with erythroid dysplasia...
June 6, 2018: Journal of Pediatric and Adolescent Gynecology
Iulia Tevanov, Dan Mircea Enescu, Madalina Carp, Andrei Dusca, Alin Ladaru, Alexandru Ulici
Open fractures of the leg with large loss of tissue require extensive reconstructive methods that can injure the donor area. The use of negative pressure wound therapy (NPWT) may minimise the impact of these reconstructive methods because of its capacity to create granulation tissue that will form a wound bed for the skin graft, thus reducing the volume of soft tissue defect and saving the donor region. This case study describes the effectiveness of NPWT in the treatment and reconstruction of an open fracture of the leg, with massive loss of soft tissue, associated with elastic intramedullary nailing in a 10-year-old female patient, who was a victim of a car accident...
June 1, 2018: Journal of Wound Care
Ling-Jia Yu, Wen-Jing Li, Shi-Gong Guo, Yu Zhao
BACKGROUND: The aim of this study was to evaluate the early clinical safety and efficacy of transforaminal thoracic interbody fusion (TTIF) with interbody cage application for thoracic myelopathy caused by anterior compression (TMAC). METHODS: A total of 10 patients who underwent TTIF for TMAC from July 2009 to July 2014 were retrospectively reviewed. Thoracic spinal lesions included thoracic disc herniation, thoracic ossification of posterior longitudinal ligament, thoracic vertebral compression fracture, and thoracic spine fracture dislocation...
June 7, 2018: Der Orthopäde
Sergey Y Turin, Daniel D Li, Elbert E Vaca, Neil Fine
BACKGROUND: Mastectomy flap necrosis (MFN) remains a challenging complication in immediate tissue expander breast reconstruction (ITEBR). Nitroglycerin ointment has been shown to reduce the incidence of MFN in a randomized controlled study, using 45g per breast and treating one side only in bilateral cases. This study was conducted to determine the efficacy of 15g of nitroglycerin ointment per breast - therefore permitting application to both breasts in cases of bilateral mastectomy. METHODS: A retrospective cohort study of patients undergoing ITEBR by a single reconstructive surgeon was conducted...
June 2, 2018: Plastic and Reconstructive Surgery
Benjamin P Erickson, Paula W Feng, Sophie D Liao, Yasha S Modi, Audrey C Ko, Wendy W Lee
Dog bites result in a diverse range of injuries and complications in the periocular region, particularly in school aged children. It is therefore incumbent on the oculoplastic surgeon to be well versed in both acute and long-term management. The intent of this review is to provide a systematic evaluation of the epidemiology, principles of dog bite wound care, and specific considerations related to common patterns of ophthalmic injury. Review of clinical literature from 1976 to 2014. The majority of periocular injuries result from seemingly benign interactions between young children and familiar dogs...
June 6, 2018: Orbit
Z Feldbrin, E Omelchenko, A Lipkin, M Shargorodsky
BACKGROUND: The present study was designed to investigate the impact of osteopontin (OPN) in different tissue (e.g., plasma, muscles and bone) on amputation rate (in-hospital and during one year follow-up) for non-healing diabetic foot ulcers (DFUs). METHODS: This pilot study consisted of 30 diabetic patients, hospitalized due to non-healing DFUs. Patients were divided into two groups: Group 1 included 14 patients who underwent limb-preserved debridement procedure without amputation; Group 2 included 16 subjects who underwent amputation...
May 17, 2018: Journal of Diabetes and its Complications
Steven L Percival, Rui Chen, Dieter Mayer, Anne-Marie Salisbury
Surfactants are widely used as detergents, emulsifiers, wetting agents, foaming agents, and dispersants in both the food and oil industry. Their use in a clinical setting is also common, particularly in wound care. Complicated or chronic wounds show clinical signs of delayed healing, persistent inflammation, and the production of non-viable tissue. These types of wounds also present challenges such as infection and potentially house antimicrobial-tolerant biofilms. The use of wound cleansers to aid cleaning and debridement of the wound is essential...
June 5, 2018: International Wound Journal
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