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Background: Experimental studies of wound healing often use survival analysis and time to event outcomes or differences in wound area at a specific time point. However, these methods do not use a potentially large number of observations made over the course of a trial and may be inefficient. A model-based approach can leverage all trial data, but there is little guidance on appropriate models and functional forms to describe wound healing. Methods: We derive a general statistical model and review a wide range of plausible mathematical models to describe wound healing. We identify a range of possible derived estimands and their derivation from the models. Using data from a trial of an intervention to promote ulcer healing in patients affected by leprosy that included three measurement methods repeated across the course of the study, we compare the goodness-of-fit of the models using a range of methods and estimate treatment effects and healing rate functions with the best-fitting models. Results: Overall, we included 5,581 ulcer measurements of 1,578 unique images from 130 patients. We examined the performance of a range of models. The square root, log square root, and log quadratic models were the best fitting models across all outcome measurement methods. The estimated treatment effects magnitude and sign varied by time post-randomisation, model type, and outcome type, but across all models there was little evidence of effectiveness. The estimated effects were significantly more precise than non-parametric alternatives. For example, estimated differences from the three outcome measurements at 42-days post-randomisation were − 0.01 cm2 (-0.77, 0.74), -0.44 cm2 (-1.64, 0.76), and 0.11 cm2 (-0.87, 1.08) using a non-parametric method versus − 0.03 cm2 (-0.14, 0.06), 0.06 cm2 (-0.05, 0.17), and 0.03 cm2 (-0.07, 0.17) using a square-root model. Conclusions: Model-based analyses can dramatically improve the precision of estimates but care must be taken to carefully compare and select the best fitting models. The (log) square-root model is strongly recommended reflecting advice from a century ago. [ABSTRACT FROM AUTHOR]

OBJECTIVE To describe the use of a novel wound dressing that delivers nitric oxide (NO) to naturally occurring traumatic wounds in dogs. ANIMALS 24 client-owned dogs with 30 wounds. METHODS Dogs were presented with acute traumatic wounds requiring open wound management. Wounds were bandaged with a novel NO wound dressing and reassessed as needed for continued open wound management until wounds healed by second intention or wound closure was recommended. Dogs could be removed from the study at any point at the clinician’s discretion. RESULTS All wounds had the novel NO wound dressing used during open wound management until wound closure was recommended. Median time to wound closure was 6 days (range, 2 to 42). There were no complications directly attributed to the use of the novel wound dressing that clinically affected the dogs. Three wounds dehisced following wound closure. Wound healing was confirmed in 19 dogs with 25 wounds, with 3 dogs lost to follow-up prior to suture removal. Only 7.1% of wounds had clinical signs consistent with wound infection following wound closure. CLINICAL RELEVANCE The novel NO wound dressing was easy to use and well tolerated in dogs with naturally occurring traumatic wounds. It can be used throughout all phases of wound healing, simplifying open wound management. [ABSTRACT FROM AUTHOR]

To realize the potential for the use of N-chlorotaurine (NCT) in healthcare, a better understanding of the long-term stability of the compound in water is needed. An array of analytical procedures is required that can measure changes in NCT concentration over time and allow for the detection and identification of contaminants and likely degradation end products. We used UV-Vis and NMR spectroscopy, HPLC, and LCMS to establish the stability of NCT in solutions subjected to prolonged ambient and elevated temperatures. Stability proved to be dependent on concentration with half-lives of ~120 days and ~236 days for 1% and 0.5% solutions of NCT at ~20 °C. Regardless of initial pH, all solutions shifted toward and maintained a pH of ~8.3 at 20 °C and 40 °C. NCT at 500 µg/mL and 250 µg /mL inhibited biofilm formation by Pseudomonas aeruginosa and Staphylococcus aureus but did not disperse established biofilms. NCT exposure to the biofilms had profound effects on the viability of both bacteria, reducing live organisms by >90%. Exposure of Interleukin-6 (IL-6) to 11 µM NCT reduced the binding of IL-6 to an immobilized specific antibody by ~48%, which is 5× the amount required for HOCl to bring about the same effect in this test system. Our data demonstrate the potency of the compound as an antimicrobial agent with potential benefits in the management of infected chronic wounds and suggest that NCT may contribute to anti-inflammatory processes in vivo by direct modification of cytokine mediators. [ABSTRACT FROM AUTHOR]

Diabetes is a diverse metabolic disease that is caused by increased levels of blood glucose, which also leads to the generation of several other complications. The formation of wounds and their delayed healing are among the main areas of concern. Wound repair is a process, which replaces damaged cells with healthy cells; it generally occurs in four steps – haemostasis, inflammation, proliferation and remodelling. This review covers the causes of diabetes mellitus, its prevalence, its impact on wound healing, different types of wounds and their management. Diabetes mellitus impairs wound healing through several mechanisms such as impaired angiogenesis, altered collagen production, etc. [ABSTRACT FROM AUTHOR]

Introduction: Photodynamic Therapy has been an important ally in tissue repair, with positive effects in the treatment of wounds and infections. Objective: To analyze the effects of the Healing Acceleration Methodology (MAC®) using propolis and toluidine blue on lower limb ulcers. Methods: Single-center, experimental, randomized and controlled study. Carried out between April 2021 and May 2022 at the outpatient clinic of the school clinic in a Brazilian capital. Patients were randomly assigned in a 1:1 ratio to receive photodynamic therapy (experimental group) or conventional dressing alone (control group). Patients over 18 years of age diagnosed with lower limb ulcers were included. Ten patients comprised the experimental group and 10 the control group. Patients were seen three times a week and monitored for two months. The primary outcome was the assessment of healing progress and the secondary outcome was the microscopic analysis of wound smears for the presence of cells and microorganisms. Results: In the experimental group, two wounds did not heal completely while in the control group, none of the 10 wounds healed completely during the 60-day follow-up. In the experimental group, 90% of patients did not have bacteria and fungi at the end of 30 days versus 40% in the control group. Conclusion: The present study showed that photodynamic therapy is a potential effective treatment in the healing process of lower limb ulcers. This can impact cost reduction and quality of life. Larger, well-designed studies are needed to corroborate the findings of the present study. [ABSTRACT FROM AUTHOR]

Wound management presents a significant global challenge, necessitating a comprehensive understanding of wound care products and clinical expertise in selecting dressings. Bioactive dressings (BD) represent a diverse category of dressings, capable of influencing wound healing through various mechanisms. These dressings, including honey, hyaluronic acid, collagen, alginates, and polymers enriched with polyhexamethylene biguanide, chitin, and chitosan derivatives, create a conducive environment for healing, promoting moisture balance, pH regulation, oxygen permeability, and fluid management. Interactive dressings further enhance targeted action by serving as substrates for bioactive agents. The continuous evolution of BDs, with new products introduced annually, underscores the need for updated knowledge in wound care. To facilitate dressing selection, a practical algorithm considers wound exudate, infection probability, and bleeding, guiding clinicians through the process. This algorithm aims to optimize wound care by ensuring the appropriate selection of BDs tailored to individual patient needs, ultimately improving outcomes in wound management. [ABSTRACT FROM AUTHOR]

The reconstruction of patients who possess multi morbid medical histories remains a challenge. With the ever-increasing number of patients with diabetes, infections, and trauma, there is a consistent need for promotion of soft tissue healing and a reliable substrate to assist with every aspect of soft tissue reconstruction, as well as the loss of fascial domain. Several proprietary products filled some of these needs but have failed to fulfill the needs of the clinician when faced with reconstructing multiple soft tissue systems, such as the integument and the musculoskeletal system. In this paper we discuss the use of decellularized human dermis (DermaPure®, Tissue Regenix, Universal City, TX, USA) through which a unique human tissue processing technique (dCELL® technology, Tissue Regenix, Universal City, TX, USA) and the creation of multiple product forms have proven to exhibit versatility in a wide range of clinical needs for successful soft tissue reconstruction. The background of human tissue processing, basic science, and early clinical studies are detailed, which has translated to the rationale for the success of this unique soft tissue substrate in orthoplastic reconstruction, which is also provided here in detail. [ABSTRACT FROM AUTHOR]

Background and purpose: Accelerating the wound healing process is of paramount importance. Cutaneous wounds are associated with cellular damage and can impair the physiological function of the skin. Wound healing is a multifaceted process that involves cells, cytokines, and the vascular system. This process occurs in distinct phases: hemostasis, inflammation, proliferation, and remodeling of the skin's structure and architecture. The utilization of plant-derived products in wound healing has garnered significant interest among researchers due to their anti-inflammatory, antibacterial, and antioxidant properties. In Persian traditional medicine, there is evidence supporting the topical application of chamomile (Matricaria chamomilla L.), Echinacea purpurea, and Calendula officinalis individually; however, the synergistic effects of these two products on wound healing remain unclear. Therefore, this study aimed to compare the efficacy of chamomile cream and Calendite-E cream, a combination of marigold and Echinacea, on the healing process of surgical wounds. Materials and methods: 32 male rats were divided into four groups of 8: control, Kamil Cream, Calendit E, and Oserin. Wound area and histopathological findings were examined and compared on days 0, 3, 7, 21, and 7 and 21, respectively. Among the many properties of Matricaria chamomilla L in Persian traditional medicine, its antiinflammatory, antibacterial, and antioxidant properties are confirmed. 32 male rats were divided into four groups (8 rats in each group) including the control, chamomilla cream containing 0.5% essential oil, and 5% chamomile extract, calendar-E and control were divided with Oserin base cream. The wound area was compared on days 0, 3, 7, and 21, and histopathological findings on 7 and 21 days, respectively. Results: There was no difference between the groups on the wound area on the third day, but on the 7th day, there was a significant difference (P=0.020). So the average wound area in the Calendit E group was significantly lower than the control group (P=0.008) and also compared to the Oserin group (P=0.019). Unlike other groups, wound healing was completely achieved on the 21st day in Calandit E and Kamil Cearm. In terms of histopathological indicators, on the seventh day, in the Kamil cream group, the restoration of the epithelial cells was better than the other groups (P=0.038) on the 21st day, in terms of regeneration of the lining cells and the process of fibroplasia of the Calendit-E group, and in terms of the extent of the fibrotic reaction, the amount of edema and swelling, and the assessment of both Calendit-E and Kamil cream bleeding, it had a significant effect (P<0.05). Conclusion: Calendite E and chamomilla Cream had positive effects on wound healing factors, and due to its availability and cheapness, it is recommended as an herbal product without complications, a suitable product for wound healing. [ABSTRACT FROM AUTHOR]

Health care in terms of palliative care for neoplastic wounds is characterized by a comprehensive assessment, determining coverage, measuring the wound, minimizing suffering and pain, in addition to supporting the family, working with the other health professionals. The challenges faced by these professionals are great, as knowledge is still lacking, and there is a need for qualification and continuous permanent education. Thus, the objective was to reflect on palliative care with regard to neoplastic wounds. It was possible to conclude that it is possible to observe that the patient with the presence of neoplastic wounds still represents a challenge? for the healthcare team that provides direct assistance in managing the signs and symptoms that the wound imposes, in addition to caring for the injuries. It is evident that the lack of knowledge about how to manage and manipulate neoplastic wounds is a reality present in health institutions and among team members, which hinders the quality of patient treatment. It was realized that continuing education is the key for care to be properly carried out, aiming to improve the health team's assistance in a comprehensive manner. The research highlighted this result, reflecting and debating on the topic with professional diversity in mind. [ABSTRACT FROM AUTHOR]

Skin conditions are numerous and often have a major impact on patients' quality of life, and effective and safe treatment is very important. The conventional drugs used for skin diseases are usually corticosteroids and antimicrobial products that can induce various side effects, especially with long-term use, which is why researchers are studying alternatives, especially biologically active natural products. Three products caught our attention: bee venom (BV), due to reported experimental results showing anti-inflammatory, antibacterial, antiviral, antioxidant, antimycotic, and anticancer effects, Ficus carica (FC) due to its demonstrated antioxidant, antibacterial, and anti-inflammatory action, and finally Geranium essential oil (GEO), with proven antifungal, antibacterial, anti-inflammatory, and antioxidant effects. Following a review of the literature, we produced this paper, which presents a review of the potential therapeutic applications of the three products in combating various skin conditions and for skin care, because BV, FC, and GEO have common pharmacological actions (anti-inflammatory, antibacterial, and antioxidant). We also focused on studying the safety of the topical use of BV, FC, and GEO, and new approaches to this. This paper presents the use of these natural therapeutic agents to treat patients with conditions such as vitiligo, melasma, and melanoma, as well as their use in treating dermatological conditions in patients with diabetes. [ABSTRACT FROM AUTHOR]

Background: Xylazine is an alpha-2 adrenergic receptor agonist that has emerged as a contaminant in the illicit drug supply of fentanyl. Xylazine use may be suspected in naloxone-resistant overdoses and atypical, chronic wounds in people who use drugs (PWUD). This case is unique because it is the first case to our knowledge describing wound care for a xylazine-induced wound with a confirmatory xylazine test strip (XTS) in the setting of a syringe services program (SSP) and in the state of Florida. Case presentation: A 43-year-old woman with a past medical history of severe opioid use disorder and stimulant use disorder presented to a student-run clinic at a Miami SSP for wound care. She had multiple ulcerations diffusely over her bilateral forearms with surrounding erythema and warmth. Seven weeks later, she presented to clinic again for wound care because her wounds had progressed. At this visit, a XTS was used to confirm the presence of xylazine in her urine. Wound care management and harm reduction strategies employed at both visits were informed by best clinical judgement due to lack of formal guidelines at the time. Wound outcomes are unknown as the patient has not returned to clinic. Conclusions: Many PWUD at highest risk for acute and chronic health consequences of xylazine-adulterated fentanyl do not have access to healthcare outside of low barrier clinics and SSPs due to lack of insurance or mistrust of the traditional healthcare system due to stigma. There is an urgent need for access to XTS for PWUD and clinical practice guidelines for the treatment of xylazine-related wounds in outpatient clinics. [ABSTRACT FROM AUTHOR]

Ulcerations of the lower extremities are a frequently encountered problem in clinical practice and are of significant interest in public health due to the high prevalence of underlying pathologies, including chronic venous disease, diabetes and peripheral arterial occlusive disease. However, leg ulcers can also present as signs and symptoms of various rare diseases and even as an adverse reaction to drugs. In such cases, correct diagnosis ultimately relies on histopathological examination. Apart from the macroscopic presentation, patient history and anatomic location, which are sometimes indicative, most ulcers have very distinct histopathological features. These features are found in different layers of the skin or even associated vessels. In this narrative review, we discuss and highlight the histopathological differences of several types of leg ulcers that can contribute to efficient and accurate diagnosis. [ABSTRACT FROM AUTHOR]

Woyke, Simon, Anja Hütter, Christopher Rugg, Willi Tröger, Bernd Wallner, Mathias Ströhle, and Peter Paal. Sex differences in mountain bike accidents in Austria from 2006 to 2018: a retrospective analysis. High Alt Med Biol. 25:89–93, 2024. Introduction: Mountain biking is becoming increasingly popular, and mountain bike (MTB) accidents are on the rise. The aim of this study was to assess sex differences in mountain biking accidents in the Austrian Alps. Methods: This retrospective study includes all MTB accidents in Austria from 2006 to 2018. Data were collected by Alpine Police officers and recorded in a national digital registry. Results: The accidents involved 5,095 mountain bikers (81% men and 19% women). The number of MTB accidents rose markedly from 208 in 2006 to 725 in 2018. Men wore a helmet more often than did women (95% vs. 92%; p = 0.001). The most common injury category was "wound/bleeding" for both sexes (men 40% and women 41%). Women were more frequently transported by helicopter or terrestrially (p > 0.001). Conclusion: In the Austrian Alps, the number of MTB accidents more than tripled between 2006 and 2018. Women were involved in only one fifth of all accidents. Sex differences in MTB accidents include (1) women wearing helmets less often, (2) women being less frequently injured, (3) women suffering fewer serious injuries, and (4) women being more frequently transported by helicopter or terrestrially, while men more often did not require transportation. [ABSTRACT FROM AUTHOR]

Introduction: This study aimed to assess the analgesic efficacy of oxycodone at doses of 10 mg and 20 mg in dressings after surgery of burn wounds. Material and Methods: Twenty adult patients who underwent surgical treatment of third-degree burn wounds under general anaesthesia were included. Burn wounds were treated with dressings, to which oxycodone was added at 20 mg in Group 1 and 10 mg in Group 2. After the surgery, plasma oxycodone and noroxycodone concentrations were assayed, and pain intensity was assessed with Numerical Rating Scale (NRS). Results: In Group 1, no patient reported pain; in Group 2, four patients reported pain. The pain intensity, according to NRS, was 1–8. Plasma concentration of oxycodone in the blood serum was in the range of 1.24–3.15 ng/mL and 1.09–1.28 ng/mL in Group 1 and Group 2, respectively. Noroxycodone was not detected in the plasma. Adverse effects were not observed in any of the treated patients. Conclusions: Oxycodone in dressings provides patients with adequate and safe analgesia. [ABSTRACT FROM AUTHOR]

Wild salmonid fish are faced with the challenge of infections from the ectoparasitic salmon louse, which thus dictates the management of salmon aquaculture in areas where farms and wild populations co‐exist. The mortality risk of wild Atlantic salmon is used as an indicator of threat levels when monitoring wild populations, and therefore the aim of this study was to robustly investigate the effect of infection intensity on probability of mortality in salmon of wild origin. To assess critical infection levels, recently‐smoltified Atlantic salmon were infected with intensities ranging from 0 to 2.5 lice g−1 and exposed to a 48‐h simulated migration. The first mortalities occurred when preadults appeared and ceased as lice became adults. Infection intensity negatively affected mortality probability and survival time, whereas the simulated migration had no influence on the probability of mortality. Individual‐level effects of infection on host mortality is difficult to quantify in the field; however, the correlation between louse load and mortality probability obtained in this study can facilitate indirect estimates of mortality risk of wild salmon populations and contribute to conservation efforts associated with this parasite. [ABSTRACT FROM AUTHOR]

Objective: The objective of this study was to typify the clinical and epidemiologic profile of outpatients with chronic lower extremity ulcers in two reference centers of the public health system in Paraná state, in Southern Brazil. Methods: Demographic, clinical, and anthropometric data about the patients were collected at each assessment, as well as information on the etiology, size, and duration of ulcers. Results: There were 68 study participants, 40 (58.82%) men and 28 (41.18%) women, with an average age of 65.1 (± 13.6) years and an average 1.6 ulcers per patient. The average duration of ulcers was 9.7 (± 12.2) years, and the average size of the largest lesion of each patient was 80.0 (± 140.0) cm². Regarding body mass index, 19 (27.94%) patients were eutrophic, 21 (30.88%) were overweight, 23 (33.82%) were obese and 5 (7.35%) were underweight. The most common etiology was venous ulcers, present in 39 (57.35%) patients. Conclusion: The clinical and epidemiologic profile of patients is similar to that in developed nations. There was a longer time since onset and a larger average size of ulcers than described in the medical literature. [ABSTRACT FROM AUTHOR]

The article focuses on a 4-year-old spayed female Yorkshire Terrier presenting with opisthotonos after being attacked by a larger dog, resulting in cervical trauma. Topics include the clinical signs of opisthotonos, neurologic assessment, and management of traumatic injuries, highlighting the importance of prompt veterinary intervention in cases of severe trauma.

Wound healing is a complex process influenced by age, systemic conditions, and local factors. The wound microbiota's crucial role in this process is gaining recognition. This concise review outlines wound microbiota impacts on healing, emphasizing distinct phases like hemostasis, inflammation, and cell proliferation. Inflammatory responses, orchestrated by growth factors and cytokines, recruit neutrophils and monocytes to eliminate pathogens and debris. Notably, microbiota alterations relate to changes in wound healing dynamics. Commensal bacteria influence immune responses, keratinocyte growth, and blood vessel development. For instance, Staphylococcus epidermidis aids keratinocyte progression, while Staphylococcus aureus colonization impedes healing. Other bacteria like Group A Streptococcus spp. And Pseudomonas affect wound healing as well. Clinical applications of microbiota-based wound care are promising, with probiotics and specific bacteria like Acinetobacter baumannii aiding tissue repair through molecule secretion. Understanding microbiota influence on wound healing offers therapeutic avenues. Tailored approaches, including probiotics, prebiotics, and antibiotics, can manipulate the microbiota to enhance immune modulation, tissue repair, and inflammation control. Despite progress, critical questions linger. Determining the ideal microbiota composition for optimal wound healing, elucidating precise influence mechanisms, devising effective manipulation strategies, and comprehending the intricate interplay between the microbiota, host, and other factors require further exploration. [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]

Cells are routinely exposed to agents that cause plasma membrane (PM) injury. While pore‐forming toxins (PFTs), and chemicals cause nanoscale holes dispersed throughout the PM, mechanical trauma causes focal lesions in the PM. To examine if these distinct injuries share common repair mechanism, membrane trafficking is monitored as the PM repairs from such injuries. During the course of repair, dispersed PM injury by the PFT Streptolysin O activates endocytosis, while focal mechanical injury to the PM inhibits endocytosis. Consequently, acute block of endocytosis prevents repair of diffuse, but not of focal injury. In contrast, a chronic block in endocytosis depletes cells of early endosomes and inhibits repair of focal injury. This study finds that both focal and diffuse PM injury activate Ca2+‐triggered exocytosis of early endosomes. The use of markers including endocytosed cargo, Rab5, Rab11, and VAMP3, all reveal injury‐triggered exocytosis of early endosomes. Inhibiting Rab5 prevents injury‐triggered early endosome exocytosis and phenocopies the failed PM repair of cells chronically depleted of early endosomes. These results identify early endosomes as a Ca2+‐regulated exocytic compartment, and uncover the requirement of their dual functions – endocytosis and regulated exocytosis, to differentially support PM repair based on the nature of the injury. [ABSTRACT FROM AUTHOR]

Background: Wounds inflict pain and affect human health causing high expenditure on treatment and management. Herbal crude extracts are used in traditional medicine as a treatment for wounds and other illnesses. However, the progress in the use of plants has been deterred due to their poor solubility and poor bioavailability requiring administration at high doses. It has been established that nanoencapsulation of herbal products in nanocarriers (size 1 nm to 100 nm) such as nanofibers, nanoparticles, nanospheres, and nanoliposomes greatly improves their efficacy. Due to their small and large surface area, nanocarriers are more biologically active, improve bioavailability, protect the drug from deterioration, and release it to the targeted site in a sustainable manner. Aim: The review aims to collate and appraise evidence on the efficacy of nano encapsulated herbal extracts in the treatment of induced wounds in animal models. Methods: The review will be protocol-driven and conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis for Protocols (PRISMA-P) and protocol guidelines for systematic review and meta-analysis for animal intervention studies. The final review will be conducted and reported with reference to PRISMA 2020 statement. Studies will be searched in Pub Med, ProQuest, Web of Science, Medline Ovid, EMBASE, and Google Scholar. The PRISMA flow criteria will be followed in screening the articles for inclusion. Data extraction form will be designed in Excel spreadsheet 2013 and data extracted based on the primary and secondary outcomes. Risk of bias assessment will be done using SYRCLE's risk of bias tool for animal studies. Data analysis will be done using narrative and quantitative synthesis. Expected results: We hope to make meaningful comparisons between the effectiveness of the herb-loaded nanomaterials and other interventions (controls) in the selected studies, based on the primary and secondary outcome measures. We expect that these findings to inform clinical practice on whether preclinical studies show enough quality evidence on the efficacy and safety of herbal-loaded nanomaterials that can be translated into clinical trials and further research. Systemic review registration: PROSPERO 330330. The protocol was submitted on the 11th of May 2022. [ABSTRACT FROM AUTHOR]

Considering the documented health benefits of bacterial exopolysaccharides (EPSs), specifically of bacterial levan (BL), including its intrinsic antimicrobial activity against certain pathogenic species, the current study concentrated on the development of active pharmaceutical ingredients (APIs) in the form of colloid systems (CoSs) containing silver nanoparticles (AgNPs) employing in-house biosynthesized BL as a reducing and capping agent. The established protocol of fermentation conditions implicating two species of lactic acid bacteria (LAB), i.e., Streptococcus salivarius K12 and Leuconostoc mesenteroides DSM 20343, ensured a yield of up to 25.7 and 13.7 g L−1 of BL within 72 h, respectively. An analytical approach accomplished by Fourier-transform infrared (FT-IR) spectroscopy allowed for the verification of structural features attributed to biosynthesized BL. Furthermore, scanning electron microscopy (SEM) revealed the crystalline morphology of biosynthesized BL with a smooth and glossy surface and highly porous structure. Molecular weight (Mw) estimated by multi-detector size-exclusion chromatography (SEC) indicated that BL biosynthesized using S. salivarius K12 has an impressively high Mw, corresponding to 15.435 × 104 kilodaltons (kDa). In turn, BL isolated from L. mesenteroides DSM 20343 was found to have an Mw of only 26.6 kDa. Polydispersity index estimation (PD = Mw/Mn) of produced BL displayed a monodispersed molecule isolated from S. salivarius K12, corresponding to 1.08, while this was 2.17 for L. mesenteroides DSM 20343 isolate. The presence of fructose as the main backbone and, to a lesser extent, glucose and galactose as side chain molecules in EPS hydrolysates was supported by HPLC-RID detection. In producing CoS-BL@AgNPs within green biosynthesis, the presence of nanostructured objects with a size distribution from 12.67 ± 5.56 nm to 46.97 ± 20.23 was confirmed by SEM and energy-dispersive X-ray spectroscopy (EDX). The prominent inhibitory potency of elaborated CoS-BL@AgNPs against both reference test cultures, i.e., Pseudomonas aeruginosa, Escherichia coli, Enterobacter aerogenes, and Staphylococcus aureus and those of clinical origin with multi-drug resistance (MDR), was confirmed by disc and well diffusion tests and supported by the values of the minimum inhibitory and bactericidal concentrations. CoS-BL@AgNPs can be treated as APIs suitable for designing new antimicrobial agents and modifying therapies in controlling MDR pathogens. [ABSTRACT FROM AUTHOR]

Objective: Ictal injuries have long been considered typical signs of epileptic seizures. However, studies have shown that patients with functional seizures (FS)—also named psychogenic nonepileptic seizures—can also present these signs, misleading physicians and delaying a correct diagnosis. This systematic review aimed to assess the prevalence of injuries from FS. Methods: A literature search was performed in PubMed, Embase, LILACS (Latin American and Caribbean Health Sciences Literature), Scopus, Web of Science, PsycINFO, Google Scholar, OpenGrey, and ProQuest. Observational studies were included. The risk of bias was assessed using the Joanna Briggs Institute (JBI) checklist for studies reporting prevalence data. RStudio was used for meta‐analyses. Cumulative evidence was evaluated according to Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) criteria. Results: From the 2607 identified records, 41 studies were included in the qualitative synthesis, and 28 were included in meta‐analyses. A meta‐analysis of 13 studies, including 1673 individuals, resulted in an overall lifetime prevalence of injuries due to FS per person of 25% (95% confidence interval [CI] = 19%–32%, I2 = 88%). Considering a limited period (video‐electroencephalographic [VEEG] monitoring days), a meta‐analysis of 13 studies, including 848 individuals, resulted in an injury prevalence due to FS per person of.7% (95% CI = 0%–3%, I2 = 73%). Also, a meta‐analysis of eight studies, including 1000 individuals, resulted in a prevalence of injuries per FS of.1% (95% CI = 0%–.98%, I2 = 49%). The certainty in cumulative evidence assessed by GRADE was rated "very low" for lifetime prevalence of injuries per person, "low" for prevalence per person during VEEG monitoring, and "moderate" for prevalence per number of FS. Significance: Overall pooled lifetime prevalence of injuries due to FS per person was 25%. In comparison, the prevalence of injuries per person during VEEG monitoring and per functional seizure was.7% and.1%, respectively. [Correction added on 07 October 2023, after first online publication: In the preceding sentence, 'consecutively' was corrected to 'respectively'.] The evidence of the occurrence of injuries due to FS breaks the paradigm that epileptic seizures can cause injuries but FS cannot. [ABSTRACT FROM AUTHOR]

A wound evolves with variable pHs depending on the healing stage, and the maintenance of mild acidic condition can help healing by deterring the formation of a biofilm. Herein, a dual‐layer wound dressing with an acid‐responsive zeolitic imidazolate framework–8 (ZIF‐8) layer and an acid‐modulating layer is designed to control the acid‐dependent release of therapeutic agents for the improved healing process. The outer dressing layer is coated with curcumin‐incorporated ZIF‐8, where curcumin and zinc ions are released upon dissociation of ZIF‐8 in an acidic condition. The inner layer, a pH modulator, is fabricated by electrospinning polyvinylpyrrolidone with addition of acetic acid. In vitro release test shows that the outer layer dressing attains a considerably higher release of curcumin and Zn2+ under an acidic condition. Combined with the inner acidic layer, the dual layer dressing exhibits facilitated release of effective agents regardless of environmental pHs, attributed to the proper pH modulation to about 6.5. The anti‐oxidant activity of curcumin and antibacterial activity of Zn2+ are confirmed. The study highlights the novel proof‐of‐concept design of active wound dressing demonstrating the dual functions of pH regulation and the stimulus‐responsive drug delivery. [ABSTRACT FROM AUTHOR]

Background: Burns are one of the most prevalent and mortifying forms of trauma. Patients burn with significant thermal injury require immediate intensive care unit (ICU) care to minimize morbidity and mortality. Burns patients are generally more predisposed to sepsis because of two main reasons, i.e., burn wound infection and catheter-related bloodstream infection (CRBSI). Due to extensive skin barrier disruption and an alteration in the cellular and humoral immune responses burn wounds has a much higher incidence of sepsis as compared to other forms of trauma. Aims and Objectives: The present study was undertaken to study the bacteriological profile and sources of sepsis in burns patients and their antimicrobial susceptibility pattern. Materials and Methods: It is a prospective observational study conducted in the Department of Burns, Plastic and Maxillofacial Surgery, ICU and Department of Microbiology of a tertiary care hospital, Uttar Pradesh, India, between January 2020 and June 2022. Adult patients with 30–70% of total body surface area burns with central venous catheter (CVC) inserted during ICU admission were enrolled in the study. The presence of clinical sepsis in the burn patients was evaluated using the American Burn Association Sepsis criteria. For all patients with suspected clinical sepsis, paired blood cultures were collected simultaneously; one from the CVC and another from a peripheral site and were sent for bacteriological culture. Blood culture samples were processed as per standard procedures. CRBSI was defined if the same organism was isolated in paired blood cultures. Burn wound biopsy was sent for quantitative culture and 105 organisms/g of tissue were considered significant. Results: In the present study, the overall incidence of clinical sepsis was 28.4% (39/137), out of which 48.7% of cases were found to be due to CRBSI and the most common organism involved was Klebsiella spp. (42.1%), 33.3% of cases were due to burn wound sepsis and the most common organism involved was Pseudomonas spp. (61.5%); and 18.0% of cases were those in which no known source could be found. Possible explanations for these cases could be sepsis without bacteremia due to endotoxins and Gram-negative endotoxemia. Conclusion: To find out microorganisms causing burn wound infection by culture and provide suitable antibiotics according to their antibiotic sensitivity patterns helping us in managing these infection and decreasing overall morbidity and mortality in burn patients. [ABSTRACT FROM AUTHOR]

Hydrogels are three-dimensional structures with specific features that render them useful for biomedical applications, such as tissue engineering scaffolds, drug delivery systems, and wound dressings. In recent years, there has been a significant increase in the search for improved mechanical properties of hydrogels derived from natural products to extend their applications in various fields, and there are different methods to obtain strengthened hydrogels. Cationic guar gum has physicochemical properties that allow it to interact with other polymers and generate hydrogels. This study aimed to develop an ultra-stretchable and self-healing hydrogel, evaluating the influence of adding PolyOX [poly(ethylene oxide)] on the mechanical properties and the interaction with cationic guar gum for potential tissue engineering applications. We found that variations in PolyOX concentrations and pH changes influenced the mechanical properties of cationic guar gum hydrogels. After optimization experiments, we obtained a novel hydrogel, which was semi-crystalline, highly stretchable, and with an extensibility area of approximately 400 cm2, representing a 33-fold increase compared to the hydrogel before being extended. Moreover, the hydrogel presented a recovery of 96.8% after the self-healing process and a viscosity of 153,347 ± 4,662 cP. Therefore, this novel hydrogel exhibited optimal mechanical and chemical properties and could be suitable for a broad range of applications in different fields, such as tissue engineering, drug delivery, or food storage. [ABSTRACT FROM AUTHOR]

Penetrating cardiac injuries are rare but are one of the most urgent emergencies because they require early intervention in order to prevent death. The mortality rate of such injuries, including pre-hospitalization deaths, goes up to 90%. The most commonly injured heart chamber is the right ventricle since it takes over half of the anterior thoracic wall. The left ventricle is injured less often, but these patients usually have worse prognoses and higher mortality rates because such injuries lead to hemodynamic instability faster. We present a unique case of a suicide attempt in which the patient stabbed himself with a knife, penetrated the left ventricle, and survived even though he transected the second diagonal branch of the left anterior descending coronary artery and pulled the knife out of his chest. [ABSTRACT FROM AUTHOR]

Objectives: Xylazine has emerged as a consistent part of the unregulated drug supply in recent months. We discuss major domains of xylazine's harm, current knowledge deficits, clinical and harm reduction strategies for minimizing harm, and xylazine's public health and policy context. As an interdisciplinary team from across the USA, we have pooled our knowledge to provide an overview of xylazine's current and emerging contexts. Methods: To inform this essay, the pertinent literature was reviewed, clinical knowledge and protocols were shared by multiple clinicians with direct expertise, and policy and public health context were added by expert authors. Results: We describe xylazine's major harm domains—acute poisoning, extended sedation, and wounds, along with anemia and hyperglycemia, which have been reported anecdotally but lack as clear of a connection to xylazine. Current successful practices for xylazine wound care are detailed. Understanding xylazine's epidemiology will also require greater investment in drug checking and surveillance. Finally, approaches to community-based wound care are discussed, along with an orientation to the larger policy and public health context. Conclusions: Addressing the harms of xylazine requires interdisciplinary participation, investment in community-based harm reduction strategies, and improved drug supply surveillance. The relatively unique context of xylazine demands buy-in from public health professionals, harm reduction professionals, clinicians, basic science researchers, policymakers and more. [ABSTRACT FROM AUTHOR]

Aim: The current research aimed to evaluate the potential effect of adding platelet-rich fibrin (PRF) to the decellularized bovine pericardium (DBP) on the distal limb of donkeys' full-thickness cutaneous wounds healing (Equus asinus). Materials and Methods: Healthy male donkeys (n = 12) were used in this study. Under general anesthesia, 6 cm2 full-thickness incisions were made on the middle dorsolateral surface of both forelimbs' metacarpi. The left forelimbs were control wounds, while the right wounds were treated with PRF/DBP. Control wounds were bandaged with a standard dressing after saline irrigation and were evaluated at days 4, 7, 10, 13, 16, 19, 22, 25, and 28 post-wounding. PRF/DBP-treated wounds were dressed with a combination of PRF/DBP at the first, second, and third weeks post-wounding. Clinical and histopathological examinations of the wounds were performed to assess the healing process. Additionally, the immunohistochemical evaluation and gene expression profiles of myofibroblastic and angiogenic genes (transforming growth factor-β1, vascular endothelial growth factor-A, fibroblast growth factor 7 (FGF-7), and collagen type 3α1) were analyzed. Results: PRF/DBP wounds had a significantly faster healing process (61.3 ± 2.6 days) than control wounds (90.3 ± 1.4 days) (p < 0.05). The immunohistochemical examination and gene expression profile revealed significant enrichment in PRF/DBP wounds compared to control wounds. Conclusion: PRF/DBP dressing can be considered a natural and cost-effective biomaterial for enhancing the recovery of donkeys' distal limb injuries. [ABSTRACT FROM AUTHOR]

Background: Necrotizing fasciitis (NF) is a serious infectious disease that can initially place the patient's life in danger and, after successful surgical and antibiotic treatment, leaves extensive wounds with sometimes even exposed bones and tendons. Autologous skin grafts are not always possible or require adequate wound bed preparation. Novel intact fish skin grafts (iFSGs; Kerecis® Omega3 Wound, Kerecis hf, Isafjördur, Iceland) have already shown their potential to promote granulation in many other wound situations. Faster wound healing rates and better functional and cosmetic outcomes were observed due to their additionally postulated anti-inflammatory and analgesic properties. Therefore, iFSGs may also be essential in treating NF. We present our initial experience with iFSGs in treating leg wounds after NF and review the literature for the current spectrum of clinical use of iFSGs. Case Presentations: We present two male patients (aged 60 and 69 years) with chronic or acute postsurgical extensive leg ulcers six weeks and six days after necrotizing fasciitis, respectively. Both suffered from diabetes mellitus without vascular pathologies of the lower limbs. A single application of one pre-meshed (Kerecis® Graftguide) and one self-meshed 300 cm2 iFSG (Kerecis® Surgiclose) was performed in our operation room after extensive surgical debridement and single circles of negative wound pressure therapy. Application and handling were easy. An excellent wound granulation was observed, even in uncovered tibia bone and tendons, accompanied by pain relief in both patients. Neither complications nor allergic reactions occurred. The patients received autologous skin grafting with excellent functional and cosmetic outcomes. Conclusions: iFSGs have the potential to play a significant role in the future treatment of NF due to the fast promotion of wound granulation and pain relief. Our experience may encourage surgeons to use iFSGs in NF patients, although high-quality, large-sized studies are still required to confirm these results. The observed effects of iFSGs on wounds associated with NF may be transferred to other wound etiologies as well. [ABSTRACT FROM AUTHOR]

Hyperspectral Imaging (HSI) has grown to be one of the most crucial optical imaging modalities with applications in numerous industries. The non‐invasive nature of HSI has led to widening its horizon to the medical domain, especially in areas like early diagnosis of various diseases. HSI combines both imaging and spectroscopy properties, thereby exploiting spectral and spatial dimensions of images captured, providing quick and accurate interpretation of data. The current study aims to give an exhaustive overview of HSI's applications pertaining to the medical industry for fast detection of diseases and aiding in surgical procedures. The survey focuses on hyperspectral imaging combined with various approaches ‐ machine learning, deep learning, genetic algorithms, and anomaly detection for the treatment of disorders. In addition, the survey highlights accompanying pre‐processing approaches, performance metrics, inferences, and future prospects of HSI in the medical domain. The current study can gauge computer vision specialists, researchers in machine and deep learning domain, doctors, and scientists by giving them a platform for improving existing treatment methods for the betterment of society. [ABSTRACT FROM AUTHOR]

Purpose and background: To assess feasibility and functional acceptability of lateral calcaneal artery fascio-cutaneous flap (LCAFCF) in providing cover to posterior heel defects in single stage. Aims and objectives: To provide stable and sensate cover to small and moderate posterior heel defects. Materials and methods: This review was conducted in department of Burns & Plastic Surgery of Postgraduate Institute of Medical Sciences (PGIMS), Rohtak, Haryana between October 2021 and September 2022 to analyse the clinical outcome of LCAFCF in 24 patients (18 males, 6 females) aged between 20 and 35 years who had chronic dry wounds n = 9, failed primary reconstruction by reverse sural flap n = 1, granulated wounds n = 8, exposed achilles tendons n = 4 and scarred tissue restricting ankle joint movements n = 2 in region of posterior heel following trauma, while riding motor-cycle. Course of lateral calcaneal artery was marked with hand-held doppler. Flap size ranged from 3 to 3.5 cm in width and 5.5–7.5 cm length. The donor sites were split skin grafted. Sutures were removed on 22nd day of surgery. Mean follow up was 13 months. Results: All flaps survived. Two had partial loss of skin graft and two developed hyperkeratosis on grafted site. Sensations in flap, regain of movements of ankle joint, comfort of walking and driving were acceptable. Conclusions: LCAFCF is handy, safe and reliable flap for re-surfacing difficult wounds of posterior heel, therefore should be included in surgical armamentarium. [ABSTRACT FROM AUTHOR]

Hazelnut shells, the main waste deriving from hazelnut processing, represent an interesting source of active molecules useful in pharmaceutics, although they have not yet been examined in depth. A hydrosoluble extract (hazelnut shell extract, HSE) was prepared by the maceration method using a hydroalcoholic solution and used as the active ingredient of patches (prepared by casting method) consisting of composites of highly deacetylated chitosan and green clay. In vitro studies showed that the formulation containing HSE is able to stimulate keratinocyte growth, which is useful for healing purposes, and to inhibit the growth of S. aureus (Log CFU/mL 0.95 vs. 8.85 of the control after 48 h); this bacterium is often responsible for wound infections and is difficult to treat by conventional antibiotics due to its antibiotic resistance. The produced patches showed suitable tensile properties that are necessary to withstand mechanical stress during both the removal from the packaging and application. The obtained results suggest that the developed patch could be a suitable product to treat wounds. [ABSTRACT FROM AUTHOR]

MolecuLight i:X® is a handy instrument capable of visualizing the bacterial adhesion over 10,000 CFU/g by recognizing porphyrin and pyoverdine as fluorescence. We took a total of 55 clinical photographs and fluorescence images (20 cases) from May 2021 to December 2021, after which the correlation between fluorescence observation and culture results was investigated. In addition, the course of fluorescent and ulcer status was shown in representative cases. The results suppose that MolecuLight i:X® is in real‐time use and would be helpful in determining the range of collection of bacterial cultures as well as in judging therapeutic necessity for intractable skin ulcers. [ABSTRACT FROM AUTHOR]

Muslims regard Islam as a complete code of conduct because it provides guidance in all aspects of life. Islamic teachings cover nearly all areas of knowledge, including medical sciences. Islam offers a unique perspective on how to treat wounds and illnesses. Islamic wound treatment methods are distinct and recognized by modern science. For Muslims, the only true treatment for illnesses and injuries is that mentioned in the Holy Quran and practiced by the Holy Prophet himself throughout his lifetime. Islamic treatments for various internal and external wounds and illnesses, such as the use of honey, black cumin, Indian incense, cupping, and cauterization, are extremely beneficial in treating both internal and external wounds. Islamic diets are high in beneficial nutrients for the body, such as ginger, figs, dates, and olive oil, and Islamic rituals such as five daily prayers, ablution, and fasting are very effective at keeping the body wound resistant. A healthy body has a strong immune system that can fight off various illnesses and injuries. To reach a definitive conclusion, a thorough examination of Islam's original and fundamental sources, such as the Holy Quran and the sayings of the Holy Prophet, was carried out. Although modern science has validated the majority of the approaches emphasized by Islamic teachings, much more research is needed to validate Islamic sayings about medical sciences. [ABSTRACT FROM AUTHOR]

Wounds are the loss or destruction of part of the body's tissue, if the wound is not treated it will lead to infection and may interfere with livestock production. The faster the healing process occurs, the less likely secondary infections are to develop and become more severe. Clinically, various treatments and medicines, mainly those of chemical origin, have been introduced to facilitate and accelerate the wound healing process, but their use is limited due to side effects or low efficiency. Some substances and active substances are used to accelerate the process, but in this case herbal or medicinal plants can be used as an alternative in treating wounds in livestock, these plants have long been used as herbal medicines for humans and livestock. Moringa leaves contain phytochemicals that have antioxidant, anti-inflammatory and antimicrobial activities that can help the wound healing process. Compounds in Moringa leaves that play a role in wound healing include flavonoids, saponins, tannins, antibacterial, antiseptic, antimicrobial, and polyphenolic compounds. This review discusses and explains Moringa leaves on their medicinal function in livestock. Wound healing is the most important property for organisms and is the process of cell recovery because poor wound healing can cause physical pain, discomfort, and also bring a series of psychological problems to livestock. In addition, wounds that are difficult to heal can cause a further decline in the quality of life of livestock and result in a heavy economic burden. [ABSTRACT FROM AUTHOR]

The pharmaceutical industry is one of those that are developing, such a market is characterized by a large supply and demand, the number of brands, not to mention the sales market, which includes all citizens of the country without exception. Issues related to the formation and development of the pharmaceutical market in Ukraine concern not only representatives of pharmaceutical companies, pharmacists, and pharmacists but also doctors. A great deal in medicine and society, in general, depends on the harmony, stability, and civility of the pharmaceutical market. Today, the state of the pharmaceutical market and the structure of relations between its main participants in our country leave much to be desired. This adversely affects both the economy and health care. Medicines occupy the largest share in sales volumes of "pharmacy basket" products. The key characteristics of the Ukrainian pharmaceutical market today are a low level of per capita consumption of medicines and it is important to mark. [ABSTRACT FROM AUTHOR]

Objective To study the outcomes in terms of airway, voice and swallowing as well as the economic impact of the trauma on patients' finances and the constrained health infrastructure due to the pandemic. Materials and methodsStudy design Retrospective study. Setting: Tertiary care teaching hospital. Subjects and methods: A retrospective study was done of the 19 subjects who sustained acute laryngotracheal trauma during the SARS CoV-2 pandemic and was managed at our institution from January 2020 to September 2021. Results Change in voice was the most common presenting symptom and thyroid cartilage fractures were the commonest cartilage injury noted. It was found that 93% (decannulated) of the patients had good functional outcome and 90% of them required financial support to meet the medical expenses. Conclusion During the COVID 19 pandemic, it was not only, early presentation, timely detection and intervention by the treating team, but also the multidisciplinary teamwork and the support system that facilitated the recuperation and restoration of these traumatized individuals back into society with good laryngeal function. [ABSTRACT FROM AUTHOR]

This study was designed to establish the composition of wound dressing based on poly(2‐hydroxyethylmethacrylate)‐chitosan (PHEM‐CS) hydrogels‐loaded cerium oxide nanoparticle (CeONPs) composites for cutaneous wound healing on nursing care of the chronic wound. The as‐synthesised PHEM‐CS/CeONPs hydrogels nanocomposites were characterised by using UV–visible spectroscopy, scanning electron microscopy, Fourier transform infrared spectroscopy, X‐ray diffraction, and thermo gravimetric analysis. The influence of PHEM‐CS/CeONPs hydrogels nanocomposites on the gelation time, swelling ratio, in vitro degradation, and mechanical properties was investigated. The as‐prepared PHEM‐CS/CeONPs hydrogels nanocomposites dressing shows high antimicrobial activity against Staphylococcus aureus and Escherichia coli. Similar trends were observed for the treatment of biofilms where PHEM‐CS/CeONPs hydrogels nanocomposites displayed better efficiency. Furthermore, the biological properties of PHEM‐CS/CeONPs hydrogels nanocomposites had non‐toxic in cell viability and excellent cell adhesion behaviour. After 2 weeks, the wounds treated with the PHEM‐CS/CeONPs hydrogels nanocomposite wound dressing achieved a significant closure to 98.5 ± 4.95% compared with the PHEM‐CS hydrogels with nearly 71 ± 3.55% of wound closure. Hence, this study strongly supports the possibility of using this novel PHEM‐CS/CeONPs hydrogels nanocomposites wound dressing for efficient cutaneous wound healing on chronic wound infection and nursing care. [ABSTRACT FROM AUTHOR]

Introduction: Staphylococcus aureus, which is part of the normal flora accounts for most acute and chronic infections in humans, and treatment options are greatly limited, when infection is caused by methicillin-resistant Staphylococcus aureus (MRSA). This study was to determine the prevalence and antimicrobial susceptibility pattern of MRSA from clinical samples obtained randomly from patients in Buea Health District. Methods: a total of 264 wounds, nasopharynx, and urine samples were collected from patients from different hospitals in Buea and transported to the laboratory in the University of Buea, for analysis. Samples were inoculated on mannitol salt agar for S. aureus isolation, characterized morphologically by gram staining and biochemically by catalase, coagulase, and hemolysis tests. Diagnosis of S. aureus was confirmed by molecular identification of the nuc gene. MRSA was identified from S. aureus by oxacillin screening and confirmed by molecular identification of the mecA gene. The data were analyzed using SPSS version 17.0. Results: S. aureus was isolated from 70 (26.52%) and all were confirmed molecularly by nuc gene amplification. MRSA by oxacillin screening was 36 (13.64%) while MRSA detected by mecA gene amplification was 34 (12.88%). Antimicrobial susceptibility testing revealed 100% resistance to ampicillin, 88.24% to cefixime and 70.59% to ceftriaxone while low resistance was observed to meropenem (11.76%), doxycycline (14.71%), and vancomycin (17.67%). Conclusion: MRSA isolated from Buea Health District are resistant to ampicillin, cefixime, and ceftriaxone. The antimicrobials (meropenem, doxycycline, and vancomycin) should be used to treat MRSA infections in Buea Health District. [ABSTRACT FROM AUTHOR]

Epidermal growth factor (EGF) can be efficiently used in wound healing process; but the main obstacle of its clinical use is its susceptibility to proteolysis and maintaining its effective concentration in the site of action. In this study, chitosan nanoparticles containing EGF is formulated using a simple method to increase its stability in physiological pH as well as protect its biological activity and effectiveness in wound healing process. Nanoparticles with different ratios of chitosan/EGF were prepared and evaluated in vitro and in vivo. Obtained results showed nanoparticles with 2:1 ratio of chitosan/EGF were able to release 80% of encapsulated protein after 12 h. Cell proliferation study demonstrated that prepared nanoparticles could protect EGF functionality in physiological pH. In vivo results showed that nanoparticles with 2:1 ratio of chitosan/EGF could significantly accelerate the wound closure‐rate, re‐epithelialisation and collagen deposition. In conclusion, the designed nanoparticles in optimal ratio can be considered as a potential vehicle for EGF delivery to wounds with the aim of improving healing process. [ABSTRACT FROM AUTHOR]

Pseudomonas aeruginosa can colonize the body when wounds disrupt the skin barrier, compromising immune status, and expressing virulence factors that aid its establishment in the host. Honey is highly medicinal and capable of promoting healing in infected wounds that defy conventional antibiotic therapy. This study assessed the antibacterial activities of honey against multi-drug resistant virulent P. aeruginosa isolates recovered from wounds. Sixty-one P. aeruginosa isolates were recovered, and their virulence factors were determined using phenotypic screening methods. Antibiotic susceptibility testing was evaluated with the Kirby-Bauer disc-diffusion method, while the antibacterial activities of honey were determined by agar-well and disc-diffusion techniques. The components of the honey samples were evaluated using Gas Chromatography-Mass Spectrometry (GC-MS). All isolates were multidrug-resistant (MDR) with 100% resistance to ticarcillin, tigecycline, and nitrofurantoin; the highest susceptibility to piperacillin, meropenem, and imipenem at 4.9%, 6.6%, and 9.8% respectively; and Multiple Antibiotic Resistance Indices (MARI) of = 0.2. All isolates produced hemolysin, but none produced DNase. All the sixty-one isolates extruded multiple virulence factors via phenotypic screening and 96.7% possessed = 50% of virulence determinants analyzed. GC-MS analyses revealed three variants of honey. The isolates exhibited resistance to the honey samples; the most effective honey sample types being H5 and H6. Possession of multiple virulence factors, multi-resistance to antibiotics, and to honey, which is well acclaimed for its wound healing characteristics by isolates raises the probability of invasion to deeper tissues and development of complications, underscoring the necessity to prevent contamination of wounds, a significant cause of morbidity and mortality. [ABSTRACT FROM AUTHOR]

Background: The conflict in Ukraine during the past year has resulted in increased deaths and injuries to soldiers and civilians from military weapons and large and small caliber firearms. Unlike clinicians in some Western countries, until recently, clinicians working in Ukraine hospitals had little experience managing patients with gunshot wounds. Case Report: A 16-year-old boy was admitted as an emergency following a gunshot wound to the back of the neck from a Makarov pistol. The gun was reported to have been fired at a distance of more than 15 cm. Imaging showed the 9-mm bullet hit the cervical spine, causing nerve root involvement at C4 to C7, traveled upwards, and lodged in the left posterior maxilla. On examination, the patient had facial asymmetry and paralysis of the left shoulder, arm, hand, and wrist and was in pain and shock. Intubation and emergency surgery were performed, with the removal of a 9×18-mm bullet shell from the pterygopalatine fossa, deep to the infratemporal fossa, and posterior to the maxilla. The patient underwent postoperative physical therapy and continues to improve his physical function. Conclusions: This report has shown the importance of immediate evaluation of gunshot wounds so that surgery can be planned and performed rapidly, with a view to postoperative recovery and active physical therapy. [ABSTRACT FROM AUTHOR]

This study aimed to develop a hydroxyethyl cellulose-based topical formulation containing probiotics and to evaluate its antimicrobial action using in vivo and ex vivo models. Initially, the antagonistic effects of Lacticaseibacillus rhamnosus ATCC 10863, Limosilactobacillus fermentum ATCC 23271, Lactiplantibacillus plantarum ATCC 8014 and Lactiplantibacillus plantarum LP-G18-A11 were analyzed against Enterococcus faecalis ATCC 29212, Klebsiella pneumoniae ATCC 700603, Staphylococcus aureus ATCC 27853 and Pseudomonas aeruginosa ATCC 2785. The best action was seen for L. plantarum LP-G18-A11, which presented high inhibition against S. aureus and P. aeruginosa. Then, lactobacilli strains were incorporated into hydroxyethyl cellulose-based gels (natrosol); however, only the LP-G18-A11-incorporated gels (5% and 3%) showed antimicrobial effects. The LP-G18-A11 gel (5%) maintained its antimicrobial effects and viability up to 14 and 90 days at 25 °C and 4 °C, respectively. In the ex vivo assay using porcine skin, the LP-G18-A11 gel (5%) significantly reduced the skin loads of S. aureus and P. aeruginosa after 24 h, while only P. aeruginosa was reduced after 72 h. Moreover, the LP-G18-A11 gel (5%) showed stability in the preliminary and accelerated assays. Taken together, the results show the antimicrobial potential of L. plantarum LP-G18-A11, which may be applied in the development of new dressings for the treatment of infected wounds. [ABSTRACT FROM AUTHOR]

Background: A dog bite causing an auricular avulsion is a rare cause of an outer ear defect. By nature of the high-energy trauma inflicted by canine bites and the anatomic variability of the outer ear, no two such avulsion injuries are the same. If the native cartilage cannot be preserved after trauma, placement of a graft capable of forming grooves and ridges is required to reconstruct the complex anatomy of the outer ear. Such intricacies often make postoperative results cosmetically disappointing. In select cases, the native cartilaginous framework of the avulsed ear segment may be preserved and used in reconstruction. Case Report: We report a case of a pediatric total auricular avulsion following a dog bite, reconstructed using prelaminated native ear cartilage. Conclusion: After traumatic avulsion of the outer ear when native cartilage is preserved, effective reconstruction can be achieved using a 2-stage technique of native cartilage lamination via posterior auricular pocket formation and placement of a skin graft. [ABSTRACT FROM AUTHOR]

Acute and chronic wounds caused by assorted reasons impact patient's quality of life. Films are one of the main types of moisture retentive dressings for wounds. To improve the healing of the wound, films must ensure there is no microorganism contamination, protect from negative environmental effects, and support optimal moisture content. The aim of this study was to formulate optimal film-forming gel compositions that would have good physico-chemical properties and be suitable for wound treatment. Nitrocellulose, castor oil, ethanol (96%), ethyl acetate, and cinnamon leaf essential oil were used to create formulations. During the study, the drying rate, adhesion, flexibility, tensile strength, cohesiveness, swelling, water vapor penetration, pH value, and morphology properties of films were examined. Results showed that optimal concentrations of nitrocellulose for film-forming gel production were 13.4% and 15%. The concentrations of nitrocellulose and cinnamon leaf essential oil impacted the films' physicochemical properties (drying rate, swelling, adhesion, flexibility, etc.). The swelling test showed that films of formulations could absorb significant amounts of simulant wound exudate. Film-forming gels and films showed no microbial contamination and were stable three months after production. [ABSTRACT FROM AUTHOR]

The skin serves as the body's first line of defense, guarding against mechanical, chemical, and thermal damage to the interior organs. It includes a highly developed immune response that serves as a barrier against pathogenic infections. Wound healing is a dynamic process underpinned by numerous cellular activities, including homeostasis, inflammation, proliferation, and remodeling, that require proper harmonious integration to effectively repair the damaged tissue. Following cutaneous damage, microorganisms can quickly enter the tissues beneath the skin, which can result in chronic wounds and fatal infections. Natural phytomedicines that possess considerable pharmacological properties have been widely and effectively employed forwound treatment and infection prevention. Since ancient times, phytotherapy has been able to efficiently treat cutaneous wounds, reduce the onset of infections, and minimize the usage of antibiotics that cause critical antibiotic resistance. There are a remarkable number of wound-healing botanicals that have been widely used in the Northern Hemisphere, including Achiella millefolium, Aloe vera, Althaea officinalis, Calendula officinalis, Matricaria chamomilla, Curcuma longa, Eucalyptus, Jojoba, plantain, pine, green tea, pomegranate, and Inula. This review addresses the most often used medicinal plants from the Northern Hemisphere that facilitate the treatment of wounds, and also suggests viable natural alternatives that can be used in the field of wound care. [ABSTRACT FROM AUTHOR]

We assessed the efficacy of polydeoxyribonucleotide (PDRN) in accelerating the healing of diabetic wounds in a murine model of streptozotocin (STZ)-induced diabetes. After the creation of diabetic wounds, the mice of the PDRN SC, PDRN IP and PBS groups received a subcutaneous, an intra-peritoneal injection of PDRN and a subcutaneous injection of PBS, respectively. After euthanasia, time-dependent changes in the wound diameter and histologic scores were measured and vascular endothelial growth factor (VEGF), transforming growth factor-β1 (TGF-β1) and collagen types I and III were assessed for their expression levels. The PDRN SC and the PDRN IP groups showed a significantly smaller diameter of diabetic wounds, significantly higher histologic scores, a significantly greater expression of VEGF, a significantly lower expression of TGF-β1 and a significantly greater expression of collagen types I and III as compared with the PBS group (p < 0.05 or 0.0001). In conclusion, PDRN might be effective in promoting the healing of diabetic wounds in a murine model of STZ-induced diabetes. [ABSTRACT FROM AUTHOR]

The Strait of Gibraltar is an important habitat for seven regularly occurring cetacean species. These waters are heavily used for fishing and therefore experience extraordinary levels of shipping traffic. Photography provides a valuable and non-invasive tool to monitor the health of cetacean populations, where external injuries may indicate specific anthropogenic impacts, such as vessel strikes or fishery interactions. We manually screened 27,866 photos taken during whale-watching operations between 2016-20 for human-induced injuries. Injuries of potential anthropogenic origin were detected in 228 cases. The severity of these injuries ranged from superficial linear marks to severe traumas that may affect survival and fitness. Severe injuries included a gunshot wound, vessel-related traumata and abrasions, signs of previous severe entanglements and deep lacerations which could stem from recreational fishery activities or propellor cuts and occasionally served as an entry point for dermal infections. In 2007, Spanish legislation introduced regulations on how to approach cetaceans by boat, but recreational fishery vessels have been commonly observed to disregard this law. We therefore urge stricter control and enforcement of existing laws and collaboration between the Spanish and Moroccan authorities to mitigate the human impact on cetaceans in this region. [ABSTRACT FROM AUTHOR]

The kidney is the most commonly injured urinary tract organ in pediatric trauma with blunt mechanisms, causing around 80% of cases. Nonoperative management (NOM) remained the first choice for minor blunt renal trauma; however, its value for major trauma is still under debate. We present three children with high-grade isolated renal trauma diagnosed using computed tomography scans and treated using NOM as the main strategy of treatment. The first patient (12-year-old) fully recovered without needing an auxiliary procedure. The second patient (6-yearold) developed urinoma and underwent percutaneous drainage of urinoma and double J stent (DJ) with an uneventful result. The third patient (14-year-old) developed urinoma and underwent percutaneous drainage and DJ stent. However, he experienced continuous hematuria that was treated via super-selective embolization. In conclusion, NOM for isolated high-grade renal trauma is feasible with good outcomes. If complications were developed during follow-up, minimally invasive procedures, such as superselective angioembolization in continuing hemorrhage and initial drainage in urinoma, offered a comparable outcome without needing open surgery. [ABSTRACT FROM AUTHOR]