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Wound debridement

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https://www.readbyqxmd.com/read/28644234/efficacy-of-sodium-hyaluronate-in-murine-diabetic-ocular-surface-diseases
#1
Guohu Di, Xia Qi, Xiaowen Zhao, Songmei Zhang, Qingjun Zhou
PURPOSE: To evaluate the efficacy of sodium hyaluronate (HA) eye drops for the treatment of diabetic ocular surface diseases in mice. METHODS: Male 6- to 8-week-old C57BL/6 mice underwent induction of type 1 diabetes with intraperitoneal injections of streptozotocin, with normal mice as the control. Topical 0.3% HA, 0.1% HA, 0.4% polyethylene glycol eye drops, and normal saline were administered to diabetic mice with an intact or debrided corneal epithelium. Normal saline was applied in the controls...
June 21, 2017: Cornea
https://www.readbyqxmd.com/read/28644207/enzymatic-versus-traditional-surgical-debridement-of-severely-burned-hands-a-comparison-of-selectivity-efficacy-healing-time-and-three-month-scar-quality
#2
Alexandra Schulz, Yaron Shoham, Lior Rosenberg, Irene Rothermund, Walther Perbix, Paul Christian Fuchs, Alexandra Lipensky, Jennifer Lynn Schiefer
Severe burns of the hands are extremely challenging, given their anatomic complexity and vulnerability. Although excisional debridement with autografting remains the standard of care (SOC), previous studies have shown that use of enzymatic debridement with bromelain (NexoBrid, EDNX) enables rapid, selective enzymatic debridement, preserving viable tissue. To date, only two studies accruing data on EDNX in this setting have been published. The current study was conducted to compare EDNX with traditional surgical debridement (TSD) of deep dermal and full-thickness hand burns...
July 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28643380/microscopy-visualisation-confirms-multi-species-biofilms-are-ubiquitous-in-diabetic-foot-ulcers
#3
Khalid Johani, Matthew Malone, Slade Jensen, Iain Gosbell, Hugh Dickson, Honhua Hu, Karen Vickery
Increasing evidence within the literature has identified the presence of biofilms in chronic wounds and proposed that they contribute to delayed wound healing. This research aimed to investigate the presence of biofilm in diabetic foot ulcers (DFUs) using microscopy and molecular approaches and define if these are predominantly mono- or multi-species. Secondary objectives were to correlate wound observations against microscopy results in ascertaining if clinical cues are useful in detecting wound biofilm. DFU tissue specimens were obtained from 65 subjects...
June 23, 2017: International Wound Journal
https://www.readbyqxmd.com/read/28640728/wound-bed-preparation-a-vital-step-in-the-healing-process
#4
Simon Barrett
Non-healing wounds are a significant burden to healthcare systems, where it is estimated that 4-5% of the adult population has a problem wound at any one time ( Guest et al, 2017 ). It is suggested that infection is the most frequent complication in non-healing wounds where it can prolong patient treatment times and increase resource use ( Gottrup et al, 2013 ). Wound infection develops as a result of an imbalance between the patient's immune system and the conditions in the wound, which subsequently can promote bacterial proliferation ( Wounds UK, 2013 )...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28640720/fungating-wounds-management-and-treatment-options
#5
Suzanne Tandler, Jackie Stephen-Haynes
This article defines fungating wounds and considers the underlying cause, location and presentation. The clinical challenges presented by fungating wounds are discussed, with reference to evidence-based care delivery. This includes wound assessment, cleansing, debridement and management of malodour, infection, bleeding and exudate. Guidance on the use of wound management dressings is considered in relation to symptom management. The importance of clinical decision-making and educational preparation in the delivery of evidenced-based care for those with fungating wounds is emphasised...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28631809/anabolic-steroids-for-treating-pressure-ulcers
#6
REVIEW
Cho Naing, Maxine A Whittaker
BACKGROUND: Pressure ulcers, also known as bed sores, pressure sores or decubitus ulcers develop as a result of a localised injury to the skin or underlying tissue, or both. The ulcers usually arise over a bony prominence, and are recognised as a common medical problem affecting people confined to a bed or wheelchair for long periods of time. Anabolic steroids are used as off-label drugs (drugs which are used without regulatory approval) and have been used as adjuvants to usual treatment with dressings, debridement, nutritional supplements, systemic antibiotics and antiseptics, which are considered to be supportive in healing of pressure ulcers...
June 20, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28630851/vacuum-assisted-closure-in-patients-with-post-operative-infections-after-instrumented-spine-surgery-a-series-of-12-cases
#7
Maya Kale, Pravin Padalkar, Varshil Mehta
INTRODUCTION: Post-operative wound infections after spinal surgery is a very serious problem, leading to a risk of significant morbidity which may even lead to prolonged hospitalization. Various treatment protocols have been recommended for debridement, antibiotic, and soft-tissue management, but with mixed results. However, the risk of morbidity is still high with these treatment options. Vacuum-assisted closure (VAC) system has been gaining popularity recently in the management of subacute, acute, and chronic wounds...
January 2017: Journal of Orthopaedic Case Reports
https://www.readbyqxmd.com/read/28630248/chest-x-ray-of-a-patient-with-history-of-pleural-effusion
#8
Ewa Konik, John Schirger
The presented chest X-ray depicts the thoracic duct anatomy of a 50-year-old man who underwent heart transplantation. His postoperative course was complicated by Candida mediastinitis, treated with débridements and closure of the anterior chest wound with myocutaneous flaps. Postoperatively, he had persistent output from a right-sided chest tube. The fluid appeared milky and its triglycerides level was elevated at 254 mg/dL. The drainage persisted despite a low fat diet. The interventional radiologist identified a leak in the upper thoracic duct...
June 18, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28616706/surgical-treatment-of-unstable-pelvic-fractures-with-concomitant-acetabular-fractures
#9
Leyi Cai, Yiting Lou, Xiaoshan Guo, Jianshun Wang
PURPOSE: To explore the diagnosis, treatment, and clinical prognosis of patients with both unstable pelvic fractures and concomitant acetabular fractures. MATERIAL AND METHODS: We retrospectively analyzed 21 cases of unstable pelvic fractures with concomitant acetabular fractures treated between January 2013 and December 2014. All 21 patients (18 males, 3 females), aged 43.5-55 years (range: 21-55 years), underwent surgery within four to 15 days (average = 6...
June 14, 2017: International Orthopaedics
https://www.readbyqxmd.com/read/28616231/lymph-node-transfer-for-refractory-infectious-sites-caused-by-trauma
#10
Makoto Mihara, Hisako Hara, Kazuki Kikuchi
OBJECTIVE: In this report, we placed focus on the immunological function of lymph nodes and performed lymph node transfer via a free flap to a site of refractory infection. CASE AND RESULTS: Case 1 describes a 34-year-old male suffering from compound fractures with severe crush injuries and burns in the right ankle joint. A 20 × 15 cm skin defect was observed around the right malleolus medialis, along with denuded tendons with bacterial infection. After conservative treatment, we transferred a lymph-node-containing free superficial circumflex iliac artery perforator flap to the region, with minimum debridement...
2017: SAGE open medical case reports
https://www.readbyqxmd.com/read/28616060/early-recognition-of-methicillin-resistant-staphylococcus-aureus-surgical-site-infections-using-risk-and-protective-factors-identified-by-a-group-of-italian-surgeons-through-delphi-method
#11
G Sganga, C Tascini, E Sozio, S Colizza
BACKGROUND: Surgical site infections (SSIs) constitute a major clinical problem in terms of morbidity, mortality, duration of hospital stay, and overall costs. The bacterial pathogens implicated most frequently are Streptococcus pyogenes (S. pyogenes) and Staphylococcus aureus (S. aureus). The incidence of methicillin-resistant S. aureus (MRSA) SSIs is increasing significantly. Since these infections have a significant impact on hospital budgets and patients' health, their diagnosis must be anticipated and therapy improved...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28606790/unstable-open-posterior-subtalar-dislocation-treated-with-a-ring-external-fixator-a-case-report-and-review-of-the-literature
#12
Alex Quok An Teo, Fucai Han, Yu Han Chee, Gavin Kane O'Neill
Traumatic dislocation of the subtalar joint is an infrequently occurring injury, with open true posterior dislocation an even rarer injury. We describe our treatment of a young motorcyclist who was brought into hospital after a road traffic accident, having sustained an open posterior subtalar dislocation. After initial reduction and resuscitation in the emergency department, he was taken to the operating theater for emergent wound debridement and external fixation of his ankle using a unilateral external fixator device...
June 9, 2017: Journal of Foot and Ankle Surgery: Official Publication of the American College of Foot and Ankle Surgeons
https://www.readbyqxmd.com/read/28604553/flow-through-free-fibula-osteocutaneous-flap-in-reconstruction-of-tibial-bone-soft-tissue-and-main-artery-segmental-defects
#13
Zonghuan Li, Aixi Yu, Baiwen Qi, Zhenyu Pan, Junhui Ding
OBJECTIVE: The aim of this report was to present the use of flow-through free fibula osteocutaneous flap for the repair of complex tibial bone, soft tissue, and main artery segmental defects. PATIENTS AND METHODS: Five patients with bone, soft tissue, and segmental anterior tibial artery defects were included. The lengths of injured tibial bones ranged from 4 to 7 cm. The sizes of impaired soft tissues were between 9 × 4 and 15 × 6 cm. The lengths of defect of anterior tibial artery segments ranged from 6 to 10 cm...
June 9, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28602265/diep-flap-for-breast-reconstruction-is%C3%A2-abdominal-fat-thickness-associated-with-post-operative-complications
#14
Ali Modarressi, Camillo Theo Müller, Xavier Montet, Eva Meia Rüegg, Brigitte Pittet-Cuénod
INTRODUCTION: Some surgeons consider a high body mass index (BMI) or important abdominal fat excess as contraindications for breast reconstruction with free deep inferior epigastric perforator (DIEP) flap. This study aimed to identify factors associated with post-operative complications by using this type of flap, with an emphasis on BMI and abdominal subcutaneous fat thickness. METHODS: A retrospective chart review of 105 consecutive patients who underwent DIEP flap breast reconstruction at our institution was performed to assess post-operative complications...
May 18, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28599051/maggot-therapy-for-wound-care-in-austere-environments
#15
Ronald A Sherman, Michael R Hetzler
The past 25 years have seen an increase in use of maggot therapy for wound care. Maggot therapy is very effective in wound debridement; it is simple to apply and requires very little in the way of resources, costs, or skilled personnel. These characteristics make it well suited for use in austere environments. The use of medical-grade maggots makes maggot therapy nearly risk free, but medical grade maggots may not always be available, especially in the wilderness or in resource-limited communities. By understanding myiasis and fly biology, it should be possible even for the nonentomologist to obtain maggots from the wild and apply them therapeutically, with minimal risks...
2017: Journal of Special Operations Medicine: a Peer Reviewed Journal for SOF Medical Professionals
https://www.readbyqxmd.com/read/28598758/management-of-fournier-s-gangrene-non-healing-wounds-by-autologous-skin-micrograft-biotechnology-a-new-technique
#16
M A Bocchiotti, P Bogetti, A Parisi, F Rivarossa, A Frenello, E A Baglioni
Fournier's gangrene is an acute bacterial infection producing necrosis of the perineum and external genitalia that generally affects elderly men. Although skin grafts and flaps are the standard procedure for reconstruction, sometimes wounds can become chronic. Rigenera Protocol is a new technique based on autologous skin micrografts that reactivates and supports wound healing. A 40-year-old male with Fournier's gangrene, due to a rectal microperforation following diarrhoea, was treated with surgical debridement, negative pressure wound therapy and subsequently coverage with skin grafts...
June 2, 2017: Journal of Wound Care
https://www.readbyqxmd.com/read/28598492/use-of-2-octyl-cyanoacrylate-adhesive-and-polyester-mesh-for-wound-closure-in-primary-knee-arthroplasty
#17
Andrew J Holte, Josef N Tofte, Greta J Dahlberg, Nicolas Noiseux
Wound closure in primary knee arthroplasty is important both for surgical success, by minimizing the risk of wound complications and infection, and for patient satisfaction with wound care and cosmesis. This article reports the use of a topical self-adhering, pressure-sensitive polyester mesh combined with 2-octyl cyanoacrylate adhesive for final skin closure of primary knee arthroplasty without external staples or sutures. During a 2.5-year period, 360 consecutive primary knee arthroplasty procedures (321 total knee arthroplasty procedures and 39 partial knee arthroplasty procedures) performed by 1 surgeon at 1 institution were reviewed...
June 9, 2017: Orthopedics
https://www.readbyqxmd.com/read/28596335/inflammation-and-metabolism-in-tissue-repair-and-regeneration
#18
REVIEW
Sabine A Eming, Thomas A Wynn, Paul Martin
Tissue repair after injury is a complex, metabolically demanding process. Depending on the tissue's regenerative capacity and the quality of the inflammatory response, the outcome is generally imperfect, with some degree of fibrosis, which is defined by aberrant accumulation of collagenous connective tissue. Inflammatory cells multitask at the wound site by facilitating wound debridement and producing chemokines, metabolites, and growth factors. If this well-orchestrated response becomes dysregulated, the wound can become chronic or progressively fibrotic, with both outcomes impairing tissue function, which can ultimately lead to organ failure and death...
June 9, 2017: Science
https://www.readbyqxmd.com/read/28594806/-a-new-method-of-endoscopic-harvesting-of-the-great-saphenous-vein-in-an-open-system
#19
Iu Iu Vecherskiĭ, V V Zatolokin, K A Petlin, Sh D Akhmedov, V M Shipulin
We examined a total of 246 patients subjected to coronary artery bypass grafting with the use of the great saphenous vein (GSV). The patients were subdivided into two groups. Group One (n=121) patients endured procurement of the great saphenous vein by a new endoscopic technique in an open system with the help of the equipment Karl Storz and electric dissector Ligasure. In Group Two (n=125) patients the vein was harvested by means of the traditional open method. In all patients we evaluated complications in the early postoperative period 13±2...
2017: Angiologii︠a︡ i Sosudistai︠a︡ Khirurgii︠a︡, Angiology and Vascular Surgery
https://www.readbyqxmd.com/read/28591186/increasing-incidence-of-mucormycosis-in-a-large-spanish-hospital-from-2007-to-2015-epidemiology-and-microbiological-characterization-of-the-isolates
#20
Jesús Guinea, Pilar Escribano, Antonio Vena, Patricia Muñoz, María Del Carmen Martínez-Jiménez, Belén Padilla, Emilio Bouza
We studied 19 cases of proven/probable mucormycosis diagnosed from 2007 to 2015 in our hospital and assessed the microbiological characteristics of the isolates. We recorded the incidence of mucormycosis and clinical and microbiological data of infected patients. Isolates were identified to molecular level and tested for their antifungal susceptibility to azoles, amphotericin B, and liposomal amphotericin B according to the CLSI M-38 A2 procedure. The incidence of mucormycosis in cases/100,000 hospital admissions during 2007-2015 increased significantly with respect to that reported in 1988-2006 (3...
2017: PloS One
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