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Wound debridement

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https://www.readbyqxmd.com/read/29675321/burn-injured-tissue-detection-for-debridement-surgery-through-the-combination-of-non-invasive-optical-imaging-techniques
#1
Juan Heredia-Juesas, Jeffrey E Thatcher, Yang Lu, John J Squiers, Darlene King, Wensheng Fan, J Michael DiMaio, Jose A Martinez-Lorenzo
The process of burn debridement is a challenging technique requiring significant skills to identify the regions that need excision and their appropriate excision depths. In order to assist surgeons, a machine learning tool is being developed to provide a quantitative assessment of burn-injured tissue. This paper presents three non-invasive optical imaging techniques capable of distinguishing four kinds of tissue-healthy skin, viable wound bed, shallow burn, and deep burn-during serial burn debridement in a porcine model...
April 1, 2018: Biomedical Optics Express
https://www.readbyqxmd.com/read/29673678/uterine-rupture-at-33rd-week-of-gestation-after-laparoscopic-myomectomy-with-signs-of-fetal-distress-a-case-report-and-review-of-literature
#2
Hiroyuki Yazawa, Kaoru Takiguchi, Fumihiro Ito, Keiya Fujimori
OBJECTIVE: We describe a case of uterine rupture (UR) during pregnancy after laparoscopic myomectomy (LM) and discuss the risk factors of UR. CASE REPORT: A 37-year-old woman with multiple myomas underwent laparoscopic myomectomy. Subserosal and intramural myomas were enucleated, and the myometrial wounds were repaired with single-layer suturing. Sixteen months after the operation, the patient conceived. At 33 weeks of gestation, emergency cesarean section was performed for the indication of fetal distress...
April 2018: Taiwanese Journal of Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29673562/candida-tropicalis-burn-wound-sepsis-a-series-of-histopathology-confirmed-cases
#3
Chunjie Fan, Qingfen Tian, Guobao Huang, Lei Zhang, Qiuhe Wu, Keyan Zhang
Fungal infection in severely burned patients is a serious problem due to various factors, such as the extensive application of antibiotics. In this study, we report on the course of severely burned patients with Candida tropicalis burn wound sepsis. Five such cases were reviewed. The patients were treated with itraconazole intravenously and simultaneous antibiotics to prevent bacterial infections. In addition, dermabrasion was used to excise the eschar and the wound surface was covered immediately with dermatoplasty...
April 16, 2018: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/29673408/long-term-scar-quality-after-hydrosurgical-versus-conventional-debridement-of-deep-dermal-burns-hycon-trial-study-protocol-for-a-randomized-controlled-trial
#4
Catherine M Legemate, Harold Goei, Esther Middelkoop, Irma M M H Oen, Tim H J Nijhuis, Kelly A A Kwa, Paul P M van Zuijlen, Gerard I J M Beerthuizen, Marianne K Nieuwenhuis, Margriet E van Baar, Cornelis H van der Vlies
BACKGROUND: Deep dermal burns require tangential excision of non-viable tissue and skin grafting to improve wound healing and burn-scar quality. Tangential excision is conventionally performed with a knife, but during the last decade hydrosurgery has become popular as a new tool for tangential excision. Hydrosurgery is generally thought to be a more precise and controlled manner of burn debridement leading to preservation of viable tissue and, therefore, better scar quality. Although scar quality is considered to be one of the most important outcomes in burn surgery today, no randomized controlled study has compared the effect of these two common treatment modalities with scar quality as a primary outcome...
April 19, 2018: Trials
https://www.readbyqxmd.com/read/29672274/cutaneous-mucormycosis-as-a-presenting-feature-of-type-1-diabetes-in-a-boy-case-report-and-review-of-the-literature
#5
Ganesh Jevalikar, Siddhnath Sudhanshu, Sanjay Mahendru, Smita Sarma, Khalid J Farooqui, Ambrish Mithal
BACKGROUND: Mucormycosis is a potentially fatal complication of diabetes. The rhino-orbito-cerebral form is the most common presentation, however, rarely other types can also be seen. CASE PRESENTATION: We describe the case of a 4½ -year-old boy not previously known to be a diabetic who presented to the plastic surgery department for gangrene of the left middle finger with surrounding erythema and induration. After the diagnosis of diabetes and initial treatment, pus from the wound showed broad aseptate hyphae suggestive of mucormycosis which was further confirmed on culture...
April 19, 2018: Journal of Pediatric Endocrinology & Metabolism: JPEM
https://www.readbyqxmd.com/read/29671175/characterisation-of-bone-and-joint-infections-due-to-group-b-streptococcus-serotype-iii-sequence-type-283
#6
Sean W Ong, Timothy Barkham, Win Mar Kyaw, Hanley J Ho, Monica Chan
In 2015, an epidemic of Group B Streptococcus (GBS) serotype III sequence type 283 (ST283) disease was reported in Singapore, associated with consumption of raw freshwater fish. In this study, we further characterise the characteristics of bone and joint infections associated with ST283 GBS in adults and the differences between ST283 and non-ST283 manifestations. A retrospective study of 54 inpatients with invasive GBS disease involving bones and/or joints from 2010 to 2015 was performed. Archived isolates were identified as GBS serotype III and ST283 positive using PCR methods...
April 18, 2018: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29667926/proximal-tibia-stress-fracture-with-osteoarthritis-of-knee-radiological-and-functional-analysis-of-one-stage-tka-with-long-stem
#7
Dhanasekaran Soundarrajan, Natesan Rajkumar, Palanisamy Dhanasekararaja, Shanmuganathan Rajasekaran
INTRODUCTION: Proximal tibia stress fractures with knee osteoarthritis pose a challenging situation. We evaluated the radiological and functional outcome of one-stage total knee arthroplasty (TKA) and long stem for patients with varied grades of knee arthritis and proximal tibia stress fractures.  Methods: We analysed 20 patients from April 2012 to March 2017 with proximal tibia stress fractures associated with knee osteoarthritis of varied grades. Out of 20 patients, five were acute fresh fractures...
2018: SICOT-J
https://www.readbyqxmd.com/read/29661553/development-of-a-contaminated-ischemic-porcine-wound-model-and-the-evaluation-of-bromelain-based-enzymatic-debridement
#8
Adam J Singer, Jimmy Toussaint, Won Taek Chung, Steve A McClain, Richard A F Clark, Eilon Asculai, Dafna Geblinger, Lior Rosenberg
OBJECTIVES: There are no well accepted animal models of chronic wounds, limiting advances in understanding and treatment of chronic ulcers. We developed a porcine wound model which combines multiple factors involved in chronic wounds to create a contaminated necrotic eschar and evaluated the debriding efficacy of a novel bromelain based enzymatic debriding agent (EscharEx). METHODS: Contaminated ischemic wounds were created on the flanks of domestic pigs by 'sandwiching' the skin between 2 'O' rings (1 placed on the surface of the skin and the other underneath the skin) for 24h prior to dermatomal excision of the necrotic eschar and its contamination with Staphylococcus aureus and Candida albicans...
April 13, 2018: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29651400/management-of-a-case-of-mucor-colonization-in-breast-tissue-expander-seroma-pocket
#9
Danielle N Atwood, Pallavi A Kumbla, Brian Yuen, James C Yuen
Mucormycosis has a mortality rate reaching 90%, and is imperative that therapy be initiated rapidly once a diagnosis is made. Successful treatment consists of management of underlying risk factors, surgical debridement, and antifungal therapies. The dilemma whether or not to pursue extensive debridement presents when the wound is cultured positive but the patient is not systemically ill. We present the first reported case of successful medical treatment of a seroma pocket colonized with mucor in a patient undergoing bilateral reconstruction with tissue expander and acellular dermal matrix...
January 2018: World Journal of Plastic Surgery
https://www.readbyqxmd.com/read/29649067/outpatient-negative-pressure-wound-therapy-following-surgical-debridement-results-and-complications
#10
Eran Tamir, Aharon S Finestone, Itay Wiser, Yoram Anekstein, Gabriel Agar
OBJECTIVE: To present results and complications in a case series of outpatients with diabetic and neuropathic foot ulcers with exposed bone following surgical debridement treated with negative-pressure wound therapy (NPWT). METHODS: Retrospective data were obtained from digital medical records from the Maccabi Health Services High Risk Foot Clinic in Tel Aviv, Israel, between 2009 and 2014. Medical records examined were those of clinic outpatients with exposed bone following partial foot amputation or selective bone debridement (University of Texas grade III-A) treated with NPWT...
April 11, 2018: Advances in Skin & Wound Care
https://www.readbyqxmd.com/read/29644315/limb-salvage-and-reconstruction-following-a-zebra-attack
#11
Jacob T Carlson, James C Yuen, Matthew R Smeds
Animal bites are fairly rare events but can cause devastating traumatic injuries to the victim. In addition to the soft tissue, vascular, and orthopedic trauma inflicted by these occurrences, bite injuries also have the potential to introduce an inoculum of microbes, which may progress to an infection if not treated properly and expeditiously. We present the case of a healthy male who sustained multiple bite wounds from a domestic zebra to his left upper extremity. This attack caused severe damage, including devascularization of the arm at the brachial artery, disruption of the distal biceps and brachialis, stripping of the forearm nerves, and shearing of the overlying soft tissue...
June 2017: Trauma Case Reports
https://www.readbyqxmd.com/read/29642540/instillation-of-sericin-enhances-corneal-wound-healing-through-the-erk-pathway-in-rat-debrided-corneal-epithelium
#12
Noriaki Nagai, Yuya Fukuoka, Miyu Ishii, Hiroko Otake, Tetsushi Yamamoto, Atsushi Taga, Norio Okamoto, Yoshikazu Shimomura
Sericin is a major constituent of silk produced by silkworms. We previously found that the instillation of sericin enhanced the proliferation of corneal epithelial cells, and acted to promote corneal wound healing in both normal and diabetic model rats. However, the mechanisms by which sericin promotes the proliferation of corneal cells have not been established. In this study, we investigated the effects of sericin on Akt and ERK activation in a human corneal epithelial cell line (HCE-T cells) and rat debrided corneal epithelium...
April 9, 2018: International Journal of Molecular Sciences
https://www.readbyqxmd.com/read/29628671/scrotal-reconstruction-with-integra-following-necrotizing-fasciitis
#13
Briar L Dent, Anant Dinesh, Khuram Khan, Ryan Engdahl
Scrotal loss from Fournier's gangrene can be a devastating injury with esthetic and functional consequences. Local reconstructive options can be limited by the presence of infection or the loss of neighboring tissue from debridement. IntegraTM bilayer matrix wound dressing is a well-established reconstructive modality, but only one report exists of its use in scrotal reconstruction and this was not in the setting of Fournier's gangrene. We report the successful use of Integra and a subsequent split-thickness skin graft for reconstruction of the anterior scrotum and coverage of the exposed testes in a 43-year-old man who developed Group A Streptococcus necrotizing fasciitis of his right lower extremity, groin, and scrotum requiring serial operative debridements...
January 2018: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/29627258/does-prior-failed-debridement-compromise-the-outcome-of-subsequent-two-stage-revision-done-for-periprosthetic-joint-infection-following-total-knee-arthroplasty
#14
Ashok Rajgopal, Inayat Panda, Arun Rao, Vivek Dahiya, Himanshu Gupta
BACKGROUND: There has been a debate regarding the outcomes of 2-stage revision total knee arthroplasty (TKA) when debridement, antibiotics, irrigation, and implant retention (DAIR) had been carried out previously. The purpose of this study is to evaluate the influence of prior failed DAIR (F-DAIR) on the outcomes of 2-stage revision TKA done for periprosthetic joint infection (PJI). METHODS: This is a retrospective study of a consecutive series of 184 knees that completed 2-stage revision TKA for PJI, operated by a single surgeon between January 2000 and July 2011...
March 9, 2018: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29619144/efficacy-of-chitosan-based-dressing-for-control-of-bleeding-in-excisional-wounds
#15
Anne-Heloise Stricker-Krongrad, Zahra Alikhassy, Nicolette Matsangos, Raul Sebastian, Guy Marti, Frank Lay, John W Harmon
Introduction: Excessive bleeding is a complication of wound debridement in patients receiving anticoagulation treatment. Chitosan is a linear, positively charged polysaccharide that has potential as a hemostatic topical dressing. This study examined the hemostatic efficacy of the chitosan based Opticell dressing (Medline Industries, Chicago, Ill) in heparinized rats with excisional wounds mimicking debridement. Methods: Three paired 12-mm excisional wounds were created on the dorsum of 600-g Sprague-Dawley rats 2 hours after intraperitoneal injection of heparin 800 IU/kg...
2018: Eplasty
https://www.readbyqxmd.com/read/29617058/multicenter-randomized-controlled-observer-blinded-study-of-a-nitric-oxide-generating-treatment-in-foot-ulcers-of-patients-with-diabetes-pronox1-study
#16
Michael E Edmonds, Harvey J Bodansky, Andrew Jm Boulton, Paul J Chadwick, Cuong N Dang, Ryan D'Costa, Atholl Johnston, Brian Kennon, Graham Leese, Satyan M Rajbhandari, Thomas E Serena, Matthew J Young, Joanne E Stewart, Arthur T Tucker, Marissa J Carter
The aim of this multi-center, prospective, observer-blinded, parallel group, randomized controlled trial was to assess the safety and efficacy of EDX110, a nitric oxide generating medical device, in the treatment of diabetic foot ulcers in a patient group reflecting "real world" clinical practice compared against optimal standard care. Participants were recruited from ten hospital sites in multidisciplinary foot ulcer clinics. The ulcers were full thickness, with an area of 25-2500mm2 and either a palpable pedal pulse or ankle brachial pressure index >0...
April 4, 2018: Wound Repair and Regeneration
https://www.readbyqxmd.com/read/29615440/inhibition-of-soluble-epoxide-hydrolase-2-ameliorates-diabetic-keratopathy-and-impaired-wound-healing-in-mouse-corneas
#17
Haijing Sun, Patrick Lee, Chenxi Yan, Nan Gao, Jiemei Wang, Xianqun Fan, Fu-Shin Yu
EPHX2 (soluble Epoxide Hydrolase 2, sEH) converts biologically active epoxyeicosatrienoic acids (EETs), anti-inflammatory and pro-fibrinolytic effectors into the less biologically active metabolites, dihydroxyeicostrienoic acids. We sought to characterize the expression and the function of EPHX2 in diabetic corneas and during wound healing. The expression of EPHX2 at both mRNA and protein levels, as well as sEH enzymatic activity, were markedly upregulated in the tissues/cells, including corneal epithelial cells as well as the retina of human type-2, mouse type-1 (STZ-induced) and/or type-2 diabetes...
April 3, 2018: Diabetes
https://www.readbyqxmd.com/read/29614369/candida-parapsilosis-isolates-from-burn-wounds-can-penetrate-an-acellular-dermal-matrix
#18
Erika Okuno, Isabele Carrilho Jarros, Patricia Souza Bonfim-Mendonça, Glória Vicente de Rezende, Melyssa Negri, Terezinha Estivalet Svidzinski
We isolated and identified yeasts from burn wounds and evaluated the ability of Candida parapsilosis isolates from burn wounds to penetrate an acellular dermal matrix (ADM). A prospective study was conducted with patients from the burn treatment center of North Paraná University Hospital in Londrina, Brazil from February 2015 to January 2016. Yeast cultures were obtained from the tissue of burn wounds that had been debrided and cleansed with 2% chlorhexidine. After identification and confirmation of the purity of the culture, the yeasts were placed on ADM fragments and incubated for three or seven days...
March 31, 2018: Microbial Pathogenesis
https://www.readbyqxmd.com/read/29609282/-advances-in-the-research-of-dermabrasion-in-burn-wounds
#19
R Zhao, Y Q Cao, C Y Zang, Y B Wang
The process of burn wounds healing includes the removal of necrotic tissue, the hyperplasia of granulation tissue and epithelialization. The removal of necrotic tissue is the first step in dealing with burn wounds. Although there are a variety of adjuvant drugs for removing necrotic tissue, surgical debridement is still the main way of debridement of burn wounds. Surgical debridement of burn wounds includes escharectomy, tangential excision and dermabrasion. Escharectomy and tangential excision have been widely used in clinical practice, while dermabrasion has not been known to the majority of burns colleagues...
March 20, 2018: Zhonghua Shao Shang za Zhi, Zhonghua Shaoshang Zazhi, Chinese Journal of Burns
https://www.readbyqxmd.com/read/29596643/supercharging-extra-large-anterolateral-thigh-flaps-for-single-stage-resurfacing-of-massive-burn-defects-over-upper-extremity-elbow-joints
#20
Shao-Yu Hung, Charles Yuen Yung Loh, Hung-Chang Chen
The resurfacing of soft tissue over extensor side of elbow joint after a full thickness burn injury is challenging due to greater amount of soft tissue needed. Local or regional flaps in the upper limb are not readily available and the use of free flap is the consensus. We want to present the first report of an extra-large anterolateral thigh (ALT) flap for a 1-stage coverage of an extensive elbow defect. The versatility of the ALT flap in design offers the surgeon the added option of supercharging the flap for increased survival when using a large flap for extensive wound coverage in the elbow...
January 20, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
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