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Wounds teach us what we were vulnerable to and what vulnerabilities we may yet bear. But wounds are often met with doubt and disbelief, suggesting that their lessons may be hard to learn. Through an analysis of advocacy movements to believe victims of sexual assault set in conversation with Caravaggio's Incredulity of Thomas, this paper argues for an understanding of vulnerability as part of a process of learning from wounds that is sometimes marked by emotional incredulity, an expression of doubt or denial of what one knows to be true because of the way its realization feels. Emotional incredulity in these circumstances is not a denial of vulnerability that pretends to mastery, but one that expresses the challenge of learning, together, how much we do not know of ourselves. [ABSTRACT FROM AUTHOR]

Hard-to-heal wounds can be detrimental to patients' quality of life. Currently, there is scarcity of therapeutic alternatives to mainstay surgical treatment, which uses the principles of tissue debridement, temporary wound coverage, and subsequent tissue reconstruction. Here, a new approach is proposed that harnesses the regenerative power of autologous peripheral blood, through a process termed hypoxia-adjusted in vitro preconditioning. The effectiveness of this method is demonstrated with six cases of surgical wounds, including two cases of large full-thickness dermal wounds that developed as a result of skin necrosis following abdominoplasty and buttock-lift procedures in heavy smokers, as well as a case of extensive inflammatory tissue damage that occurred following breast surgery. While these wounds differed in size (4-160 cm²), geometry and location, all of them could be managed conservatively with topical application of growth factor-enriched hypoxia preconditioned serum derived from the patient's own peripheral blood. This treatment led to complete wound closure by latest 135 days. The finding of complete skin regeneration even in large (>10 cm²), full-thickness wounds, where initially no dermal tissue was available in the wound bed, strongly suggests that the treatment targeted key cellular regenerative mechanisms, including differentiation, angiogenesis, granulation tissue induction, contraction and epithelialization. The method is readily clinically applicable, cost effective, and overcomes limitations of the classic reconstructive approach. [ABSTRACT FROM AUTHOR]

In this autoethnography I explore the impact of my father's alcohol dependency on my relationship with him and implications for my own recovery from alcohol-related harm. Sketching, layering and poetic interludes help to move around the hyphenated space of son-father relations showing the wounds associated with his alcohol ab/use. The writing shows how I internalised and embodied other family members' shame, compounding my detachment and father hunger. It also shows how "energy of the wound" fuelled positive adaptations, learning to be "with" my adult-child-of-an-alcoholic-ness. I hope the writing helps both writer and readers make things better by offering new vistas on hardship, loss, adapting and healing. Connecting with clinical audiences, potential implications for effective counselling are discussed. [ABSTRACT FROM AUTHOR]

This study aimed to investigate the toxicological profile of hyperforin (HP) in silico and to assess it in vivo after topical application of an HP-rich St. John's wort (SJW) extract. The former analysis predicted low toxicity because of HP's inability to bind DNA or proteins, but structural alerts for skin irritation/corrosion, carcinogenicity, and mutagenicity were found. Animal studies involved the treatment of excision wounds in Wistar rats with poloxamer 407/borage oil formulations (bigels; Bs) containing HP-rich SJW extract previously developed by us. The effects of semisolids comprising 'free' extract (B/SJW) or extract loaded in nanostructured lipid carriers (B/NLC-SJW) were compared to positive (commercial herbal product) and negative (untreated) controls after 2-, 7-, 14-, and 21-day applications. Malondialdehyde (MDA) and ABTS assays evaluated the degree of oxidative stress—treatment with bigels did not affect MDA favorably but led to an increased radical-cation scavenging capacity (compared to controls). Gamma-glutamyl transferase (GGT), aspartate aminotransferase (ASAT), alanine aminotransferase (ALAT), and lactate dehydrogenase (LDH) enzyme levels were measured as indicators for liver/tissue damage. Treatment with both B/SJW and B/NLC-SJW for 21 days resulted in lower GGT and ASAT levels than those in controls. Two-day application of the biphasic semisolids contributed to normalized ALAT levels (lower than in both negative and positive controls), and the same trends were observed in LDH levels after a 7-day treatment. The promising results obtained after the B/NLC-SJW application suggest that this drug delivery system may not only preserve HP in SJW extract effectively but also 'expose' its cyto-/hepatoprotective potential. [ABSTRACT FROM AUTHOR]

The present study was conducted to estimate prevalence and nature of various musculoskeletal injuries in populations of free-ranging rhesus macaques in Shivalik Hills of Himachal Pradesh in Northern India. Data were collected over a period of 2 years and analyzed in relation to sex, age-group and season. In total, 1522 (44.6%) cases of musculoskeletal injuries were recorded; of these, 645 (47.1%) were males and 877 (43%) were females. Data revealed that differences observed between sex, season and age were statistically significant. Musculoskeletal injuries were more common during winter season followed by monsoon and then summer (27.4%). Males (47.1%) were injured more frequently than females (43.1%), while adults (47.9%) were injured more frequently than juvenile (42.8%) and young ones (28.8%). Of all the musculoskeletal injuries, wounds (84.5%) were most common followed by fractures (7.2%), amputations (4.5%) and snares/pellets (3.9%). The result from present study indicated that musculoskeletal injuries were frequent in rhesus macaque population studied. Musculoskeletal injuries occurring throughout year likely reflect the multiple causes viz predation, disease, vehicle trauma and electrocution, which may act independently or jointly. Understanding the role primates play in local culture and religion, therefore, is essential for understanding the underlying basis of commensalisms and conflict. [ABSTRACT FROM AUTHOR]

The idea and archetype of the Wounded Healer is informative for depth psychotherapy and Jungian analysis. In this enterview, three seasoned Jungian analysts share what it has meant to them in their work and life. [ABSTRACT FROM AUTHOR]

Performing interrupted intradermal suture during bi-layered skin closure is time consuming. The oblique intradermal suture is hypothesized to be a faster choice for intradermal closure while yielding similar wound cosmetic outcomes. This study aims to demonstrate the equivalence of wound outcomes between the interrupted oblique intradermal suture (OIS) and conventional interrupted intradermal suture (IS) methods. This prospective, multicenter, double-blind randomized equivalence trial included patients scheduled to undergo elective surgery with a linear incision wound. A split-wound model was used. One half of the wound was sutured using IS method and the other using OIS method. Wounds were evaluated at 1 week and 2 months after surgery. Of the 120 patients, OIS was found to be equivalent to IS for all clinical outcome parameters. OIS was associated with 50% reduction in suture time and the number of stitches required, and a 40% reduction in suture material used (p < .001). Rates of wound dehiscence and infection were not different between methods. Wound outcomes using OIS were equivalent to those observed when using IS, except that OIS yielded reductions in suturing time, number of stitches and suturing material used. OIS is a cost and clinically effective wound closure method. Trial registration: ClinicalTrials.gov registration number NCT03001856 Meeting presentation: 7th Bozner Symposium of Plastic Surgery, Bozen, Italy, January 2017. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa and its lipopolysaccharides play a key role in the pathogenesis of diabetic foot infection, for which, currently no effective therapeutic agents are available. Hence, newer forms of therapeutic agents are required for treating Pseudomonas aeruginosa infection. In this present study, nanocrystalline silver nanoparticles (AgNPs) were synthesized using culture filtrate of Brevibacillus brevis KN8(2) followed by an investigation of its in vivo anti-pseudomonal and anti-endotoxic properties. Biosynthesized AgNPs was predominantly cubical in shape with an average particle size of 15.40 nm as observed through field emission scanning electron microscopy (FESEM) and X-ray diffraction analysis. The LC-ESI-MS/MS analysis indicates the presence of surfactin in culture filtrate of B. brevis KN8(2). The MIC of surfactin-stabilized AgNPs against P. aeruginosa was 10 μg ml−1 and its wound repair activity was observed in P. aeruginosa-infected wounds of diabetic mice by measuring wound area closure, bacterial counts, mRNA expressions, and histopathology. Further, surfactin-stabilized AgNPs suppressed the transcription of LPS-triggered expression of the TNF-α in wounds that LPS-assisted extension of wound repair in diabetes mellitus conditions was circumvented quite well. Results gathered in this study established that surfactin-stabilized AgNPs could effectively offer to the novel treatment of Gram-negative bacilli infection in diabetic wounds. [ABSTRACT FROM AUTHOR]

Background:Biofilms are diverse groups of microorganisms encased in a self-produced matrix that offers protection against unfavorable conditions and antibiotics. Methods:We performed a literature search using the MEDLINE electronic database. Only original articles published in English were considered for review. Results:Biofilms have been implicated in the pathogenesis of acne, eczema, hidradenitis suppurativa, onychomycosis, miliaria, and impetigo. Adverse dermal-filler reactions are also linked to biofilms. Strict aseptic technique and prophylactic antibiotics are recommended in order to avoid such complications. Finally, biofilms are implicated in wounds, mainly chronic and diabetic, where they impede healing and cause recurrent infections. Several novel anti-biofilm agents and wound debridement have been shown to be beneficial. Conclusions:Biofilms are a significant cause of disease with wide implications in the field of dermatology. Several novel treatments have been found to be effective against biofilms, depending on the underlying microbes and type of disease. [ABSTRACT FROM PUBLISHER]

This study investigated the occurrence of wounds in Nigerian horses. The study population was 1,621 horses sold at the Obollo Afor horse lairage in Enugu State, Nigeria, during a 6-month period: 3 months of dry season and 3 months of rainy season (February–April and June–August 2012). A total of 207 horses were systematically sampled and subjected to a comprehensive physical examination. Those with wounds were marked, recorded, and clinically examined. Of the 207 horses sampled, 21 (10.1%) had wounds. The body distribution of the wounds was 9.5% head, 9.5% forelimbs, 19.1% hind limbs, 4.8% tail, 14.3% flank, 9.5% loin, 19.1% hip, 9.5% barrel, and 4.8% croup. The occurrence of the wounds was not significantly associated with sex or season, but the occurrence in adults was significantly (p< .05) higher than that in the young and aged horses. It was concluded that the occurrence of wounds is relatively high (10.1%), and mainly the hind limbs, hip, and flank of adult horses are affected. It was recommended that horse guardians and handlers should be properly educated on the care of horses. [ABSTRACT FROM AUTHOR]

Objective: To compare the short-term maternal postpartum complications associated with cesarean section (CS), vaginal delivery (VD), repeated CS and vaginal birth after cesarean section (VBAC) in a large national sample.Methods: This was a population-based study of the Taiwan National Health Insurance Research Database (NHIRD). Outcomes include post-discharge (2 weeks) urinary tract infection (p-UTI), complications of obstetrical surgical wounds (p-wound) and postpartum hemorrhage (p-hemorrhage). A logistic regression model with generalized estimating equations were utilized, and adjustments were made for maternal and hospital characteristics.Results: The incidence of p-UTI was 0.79%. CS was associated with a significantly higher risk of p-UTI compared with VD (odds ratio [OR] 1.14; 95% confidence interval [CI], 1.003-1.29). The incidence of p-wound was 4.07%. CS and repeated CS were associated with a higher risk of p-wound compared with VD (OR 1.68; 95% CI, 1.28-2.21 and OR 1.64; 95% CI, 1.22-2.20, respectively). Age, maternal diseases and hospital and obstetrician volumes were associated with patient outcomes.Conclusions: Women with a delivery mode of CS have a higher risk of p-UTI and p-wound than women with VD. Maternal characteristics and hospital and obstetrician volumes may also influence postpartum outcomes. [ABSTRACT FROM AUTHOR]

This article explores ideas about male heterosexuality and disability in the context of the Great War. In the early years of the war, there was considerable anxiety about how young men who had been disabled through war service were going to be reintegrated into British society. Heteronormative masculinity required mutilated men to join their non-disabled age-cohort through sexuality within marriage. This would also reinforce women's gendered role as nurturing, empathetic companions. A crucial problem was how the marriage and reproduction of these young men was going to be facilitated. The League for the Marrying of Broken Heroes was one attempt to match respectable women with disabled men. [ABSTRACT FROM AUTHOR]

Sharon Heath discusses her introduction to Jung in this enterview with Robert Henderson. She shares her experiences with Facebook and looks at both her lived and unlived life, which is present in her novel The History of My Body. She also presents her understanding of healing and wounds as well as her views on the fascination of the breast and her experience with breast cancer. [ABSTRACT FROM AUTHOR]

This study investigated how inclusion of grass/clover silage affected the time budgets and social behaviour of growing/finishing pigs. The behaviour of 128 pigs was observed through video recordings. Pigs fed intact or chopped silage spent a larger proportion of their time active compared with pigs fed silage in pelleted form or fed only cereal-based feed. There was a trend for pigs fed silage in pelleted form or fed only cereal-based feed to respond strongly to social interactions more often than pigs fed intact or chopped silage, irrespective of initial performing pig behaviour. Pigs in groups fed intact silage had a lower number of wounds from violent social interactions on their bodies. Thus, additional provision of silage in an environment enriched with straw can further improve pig welfare. [ABSTRACT FROM PUBLISHER]

Wound is one of the oldest suffering associated with the mankind and its history is as old as humanity. Advances in the field of medical sciences created a pile of knowledge and paved the path for the development of a separate branch specifically devoted for wound healing. The understanding and treatment strategies for wound healing have gone through a great revolution. This article reviews all the aspects of wound healing including the pathway, types and recent advances made in the wound care management in particular moist wound dressings using natural polymers, skin grafts, debridement, growth factor and drug delivery. [ABSTRACT FROM AUTHOR]

When using hospital discharge data to shape sports injury prevention policy, it is important to correctly identify cases. The objectives of this study were to examine the ease with which snow-skiing and snowboarding injury cases could be identified from national hospital discharge data and to assess the suitability of the information obtained for shaping policy. Hospital discharges for 2000–2004 were linked to compensated claims and searched sequentially using coded and narrative information. One thousand three hundred seventy-six eligible cases were identified, with 717 classified as snowboarding and 659 as snow-skiing. For the most part, cases could not be identified and distinguished using simple searches of coded data; keyword searches of narratives played a key role in case identification but not in describing the mechanism of injury. Identification and characterisation of snow sport injury from in-patient discharge records is problematic due to inadequacies in the coding systems and/or their implementation. Narrative reporting could be improved. [ABSTRACT FROM AUTHOR]

The state of Texas was ranked 10th for all-terrain vehicle-related deaths among all states from 2007–2009. Health Service Region 4/5N of eastern Texas has a statistically significant higher rate of all-terrain vehicle-related injuries in children under the age of 18 than Texas as a whole (p < 0.001.) It is unknown why east Texas has a higher all-terrain vehicle-related injury rate. A retrospective analysis of the registry of the Texas Trauma Service Area G, which serves the east Texas area, from the years 2004–2010 was performed. Variations within the region were assessed using a geographic information system and the analysis demonstrated that the highest rates of all-terrain vehicle-related injuries in east Texas are found in two neighboring rural eastern counties. Recording mechanism of injury was an important adjunct to identifying all-terrain vehicle-related injuries. Using E-codes alone underestimated the actual injuries. Other findings demonstrated that children under age 16 had a high rate of injury, one third of those injured sustained a head injury, and helmet use was very low. This analysis can be used by the Texas Department of State Health Services in conjunction with key regional partners to direct further investigation in these areas into the role of the rural environment, other factors associated with the high injury rates, and to plan and conduct preventive intervention at the community level. [ABSTRACT FROM PUBLISHER]

The objective of the study was to examine the effects of overweight and obesity on times to recovery among Canadian youth who have suffered one or more types of injury. The data source was the 2002 Canadian Health Behaviour in School-Aged Children (HBSC) survey. The study population included 7266 youth in grades 6 through 10 sampled from all Canadian provinces and territories. Of these, 2831 students reported an injury event and were included in the analysis. Kaplan-Meier curves and hazard ratios (HR) were used to profile survival functions and estimate relative hazards for non-recovery from injury events among normal weight, overweight and obese youth. Youth who were obese and suffered a combined injury (broken bone and strain/sprain) took longer to recover (HR: 1.81, 95% CI 0.99-3.32) compared to normal weight youth. HR for injury recovery in obese youth were not significantly elevated for broken bones (1.15, 95% CI 0.61-2.19) and sprain/strains (1.17, 95% CI 0.73-1.85) in isolation. Obesity was associated with times for injury recovery among injured youth. If these findings are confirmed in other settings, clinicians providing an injury recovery prognosis may need to take into account BMI status and allow for extra recovery time for patients in this age range. [ABSTRACT FROM AUTHOR]

The authors present their experience with the use of sural fasciocutaneous flaps for the treatment of various soft tissue defects in the lower limb. This paper is a review of these flaps carried out between 2003 and 2008. The series consists of 16 patients, 12 men and 4 women with an average age of 40 years (17-81) and with a follow-up period between 1 and 8 years. The etiology was major velocity accident in six cases, diabetes mellitus with osteomyelitis after ORIF for fractures (3), work accident in five, and another two cases with complications of lower limb injuries. The defect areas were located on calcaneus, malleolar area, tarsal area and lower tibia. Associated risk factors in the patients for the flap performance were diabetes (five patients) and cigarette smoking (eleven patients). The technique is based on the use of a reverse-flow island sural flap combined with other flaps in three cases (medial plantar, peroneal, gastrocnemius). The anatomical structures which constituted the pedicle were the superficial and deep fascia, the sural nerve, the lesser saphenous vein and skin. The flap was viable in all 16 patients. Five cases had a superficial necrosis that were skin grafted, 2 cases experienced a partial skin necrosis which were treated with a secondary flap (posterior tibial perforator and medial plantar artery) and another case demonstrated a delayed skin healing. The sural fasciocutaneous flap is useful for the treatment of severe and complex injuries and their complications in diabetic and non diabetic lower limbs. Its technical advantages are easy dissection, preservation of more important vascular structures in the limb and complete coverage of the soft tissue defects in just one operation without the need of microsurgical anastomosis. Thus this flap offers excellent donor sites for repairing soft tissue defects in foot and ankle. [ABSTRACT FROM AUTHOR]

Electrical stimulation (ES) is a modality used to increase skin blood flow (SBF) and to aid in wound healing. A greater SBF in non wounded skin is induced if ES is used in a warm environment compared to a thermoneutral environment, where ES is usually applied. Therefore, in this paper, a method to investigate the effect of local heating and ES on the SBF is developed. A total of 33 males (18–40 years) were divided into group G ( n = 15) who received the ES during a global heating protocol and group L ( n = 18) who received ES during a local heating protocol. In the global heating protocol, ES (30 Hz, 250 μs) was applied for 15 min on the subject's thigh in thermoneutral (25 ± 0.5°C) and warm (35 ± 0.5°C) environments. In the local heating protocol, ES was applied for 15 minutes at 25°C, 35°C and 40°C local skin temperatures. A laser Doppler imager measured the SBF in both protocols pre, during, and post ES. The results of the experiment showed the significant differences in the SBFs were found at pre, during, and post ES in a thermoneutral environment or when the skin was locally cooled to 25°C. The SBFs were significantly increased during and post ES after global heating or during local heating at 35°C and 40°C. There were no significant differences in SBFs between the warm environment and at 35°C of local heating. However, the SBF response to ES was the highest at 40°C of local heating. Thus, ES during local heating of the skin, as well as during global heating is an effective method to increase SBF. [ABSTRACT FROM AUTHOR]

When electrical stimulation is used on wounds, the electrical current has difficulty penetrating areas where there is necrotic tissue. Further, for an irregularly shaped wound, current distribution is poor in some areas of the wound since conventional two-electrode delivery systems provide the greatest current in a line directly between the electrodes. A new stimulator and electrode system is described which uses three electrodes spaced around a wound to disperse current more evenly. The stimulator senses tissue impedance and then redirects current by altering its Thevenin's output impedance for each electrode; each of the three electrodes becomes the active one in sequence while the remaining are the sink electrodes. Eight subjects were examined to test the stimulator. Electrical stimulation was applied to the skin above the quadriceps muscle at currents of 15 mA in six subjects without wounds and in two subjects with wounds. The relationship between electrode position and current dispersion on the skin was examined with a two-electrode vs. a three-electrode system to set stimulation parameters for the computer. The results showed that the three-electrode system could (1) detect areas of the skin with high impedance; (2) compensate by altering the Thevenin's output impedance at each of the three electrodes to shift current to high impedance areas; (3) provide uniform current across the skin as assessed by skin current and blood flow measurements with a laser Doppler flow imager. [ABSTRACT FROM AUTHOR]

This article examines the reality of trauma in our world and the possibility of utilizing forgiveness as a therapeutic tool to enable victims to transform the wounds of trauma. It attempts to define forgiveness and proposes instances when forgiveness will be appropriate and situations when it would be clearly inappropriate. doi:10.1300/J515v09n02_03 [ABSTRACT FROM PUBLISHER]

The formation of pressure ulcers and other skin wounds is considered to be a multifactorial process. Cycles of ischemia–reperfusion have been considered to be significant contributing factors in the pathogenesis of pressure ulcers. This study reports the development of a reproducible murine model of ischemia–reperfusion injury by the external application of magnets. Mice were sedated with 50% CO2:50% O2 for 50–60 s. Dorsal hair was shaved and the area cleaned. The skin was gently pulled and placed between two round ceramic magnetic plates (5 × 12 mm diameter, 2.4 g weight, 1000 G magnetic force). The resultant “pinch” procedure was designed to leave a 5-mm skin bridge between the magnets, creating 50 mm Hg pressure between the plates. Three 12-h ischemia–reperfusion cycles were employed to cause pressure ulcer formation. Animals tolerated the procedure well. They returned to normal activity a few minutes after magnet placement. The lesions reached their maximum at 10 days postinjury. Full-thickness skin loss with damage and necrosis of subcutaneous tissue (ulcer stage 3) was observed in all cases, reaching a mean stage score of 3.6 0.6 of based on a 0–5 scale for extent of injury by visual assessment. Thus, an inexpensive, reproducible murine pressure ulcer model was developed, which results in graded injury without long-term immobilization of the animals. This method will facilitate the development of new prevention and management strategies. [ABSTRACT FROM AUTHOR]

Solid infinite elements are used in conjunction with finite elements to compute the stress and displacement distribution resulting from the suturing of wounds of symmetric and nonsymmetric shapes in orthotropic, abdominal human skin. The optimal pattern of suturing of wounds are investigated from a stress perspective. Highly accurate, quantitative and qualitative improvements over the use of finite elements to approximate distant boundaries are obtained. Numerical results quantitatively agree with analytic results computed using complex analysis techniques. The technique used and the results obtained will aid surgeons in closing nonsymmetrical wounds on regions of the body that exhibit orthotropy. [ABSTRACT FROM AUTHOR]

The article provides information on the national policy, which develops to prevent an injury and violence against the individual. It has been said that the policy has contained with essential elements such as vision, targets and action that was generated in response to the reported increased death rate due to violence, road accidents and health diseases. However, it is added that the implementation of the policy is also depending on the coordination of anyone who observes safety.

Objective: To investigate the relative importance of features of gloves for medical staff working with problem wounds. Design: Prospective, consecutive, crossover, open questionnaire investigation. Setting: University hospital, Copenhagen, Denmark. Subjects: 38 doctors, nurses, and podiatrists. Interventions: Two types of powder-free, non-sterile gloves (No powder Ansell Medical and Skinsense Biogel coated examination glove) were evaluated in the outpatient clinic and the ward of the Copenhagen Wound Healing Center. Main outcome measures: Features of gloves regarded as important in the treatment of wounds and a comparison of the features based on the following criteria: much better = 2, better = 1, no difference = 0, worse = -1, much worse = -2. Results: The first questionnaire showed that 84% of the respondents needed a new type of non-sterile glove, and for 66% the price of the glove was a main feature. The study of individual features of gloves showed that "protection" was ranked highest followed by "durability" and "sensitivity". Least important was the "length of the gloves" (p < 0.01). The gloves were tested in two different time periods. The Skinsense Biogel glove was evaluated better or much better for "durability" (82%-92% (period 1, 2), p < 0.001), "protection" (76%-80%, p < 0.001) and "ease of donning" (68%-71%, p < 0.001). The Ansell Medical glove was evaluated as better or much better for "tactile sensitivity" (77%-79%, p < 0.001). The Skinsense Biogel glove showed more positive changes in skin condition than the Ansell Medical glove. The quality of packing of the Ansell Medical glove in the containers also resulted in more gloves being unusable when unpacked. Conclusion: The powder-free, non-sterile gloves were useful in a wound healing department. The Skinsense Biogel glove showed more advantageous features, less changes for the worse in the skin condition, and was better packed in the containers. [ABSTRACT FROM AUTHOR]