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Black men are disproportionately affected by firearm assaults in the United States, and these disparities are rooted in structural and social inequities. The objective of this scoping review of research was to identify risk and protective factors for firearm assault injuries among Black men at all levels of the social-ecological framework. The search was conducted in 2021. The initial search generated 1,122 articles. Studies were eligible if they (a) included an analysis of modifiable risk or protective factors for firearm assaults among Black men; (b) reported an estimate of correlation, association, or effect between risk or protective factors and firearm assault injuries, firearm violence, and/or firearm homicides; and (c) were published peer-reviewed articles. In all, 19 articles were identified for review. Risk factors identified at each ecological level include the following: (1) Individual: firearm possession/weapon use and criminal legal system interaction; (2) Relationships: gang membership and exposure to other people who have experienced a firearm assault; (3) Community: indicators for socioeconomic status and racial residential segregation; and (4) Societal: historical racist policy. Individual-level substance use had mixed results. Few (26%) studies examined protective factors at any ecological level, but community-level factors like neighborhood tree cover were identified. Future research needs to examine risk and protective factors at the societal level and multiple ecological levels simultaneously leading to more effective multi-level interventions that will guide policy formation. A greater diversity of study designs, research methods, and theoretical frameworks is needed to better understand factors associated with firearm assault among Black men.

BackgroundPediatric renal trauma is rare and lacks sufficient population-specific data to generate evidence-based management guidelines. A nonoperative approach is preferred and has been shown to be safe. However, bleeding risk assessment and management of collecting system injury are not well understood. We introduce the Multi-institutional Pediatric Acute Renal Trauma Study (Mi-PARTS), a retrospective cohort study designed to address these questions. This article describes the demographics and contemporary management of pediatric renal trauma at Level I trauma centers in the United States.MethodsRetrospective data were collected at 13 participating Level I trauma centers on pediatric patients presenting with renal trauma between 2010 and 2019. Data were gathered on demographics, injury characteristics, management, and short-term outcomes. Descriptive statistics were used to report on demographics, acute management, and outcomes.ResultsIn total, 1,216 cases were included in this study. Of all patients, 67.2% were male, and 93.8% had a blunt injury mechanism. In addition, 29.3% had isolated renal injuries, and 65.6% were high-grade (American Association for the Surgery of Trauma Grades III-V) injuries. The mean Injury Severity Score was 20.5. Most patients were managed nonoperatively (86.4%), and 3.9% had an open surgical intervention, including 2.7% having nephrectomy. Angioembolization was performed in 0.9%. Collecting system intervention was performed in 7.9%. Overall mortality was 3.3% and was only observed in patients with multiple injuries. The rate of avoidable transfer was 28.2%.ConclusionThe management and outcomes of pediatric renal trauma lack data to inform evidence-based guidelines. Nonoperative management of bleeding following renal injury is a well-established practice. Intervention for renal trauma is rare. Our findings reinforce differences from the adult population and highlights opportunities for further investigation. With data made available through Mi-PARTS, we aimed to answer pediatric specific questions, including a pediatric-specific bleeding risk nomogram, and better understanding indications for interventions for collecting system injuries.Level of evidencePrognostic and Epidemiological; Level IV.

The gun assault case fatality rate measures the fraction of shooting victims who die from their wounds. Considerable debate has surrounded whether gun assault case fatality rates have changed over time and what factors may be involved. We use crime event data from Los Angeles to examine the victim and situational correlates of gun assault case fatality rates over time. We estimated log binomial regression models for the probability of death in each year from 2005 to 2021, conditioned on situational and victim characteristics of the crime. Case fatality rates increased by around 1.3% per year between 2005 and 2021 from around 15.9 to 19.7%. Baseline case fatality rates differed systematically by most situational and victim but followed similar temporal trends. Only victim age significantly covaried with the temporal trend in case fatality rates. An individual shot in Los Angeles in 2021 was 23.7% more likely to die than the equivalent victim in 2005. The steady increase in case fatality rates suggests that there were around 394 excess fatalities over what would have occurred if case fatality rates remained at the 2005 level. Increases in the average age of victims over time may contribute to the general temporal trend. We hypothesize that older victims are more likely to be shot indoors where lethal close-range wounds are more likely.

PURPOSE: Following motor vehicle collisions (MVCs), patients often undergo extensive computed tomography (CT) imaging. However, pregnant trauma patients (PTPs) represent a unique population where the risk of fetal radiation may supersede the benefits of liberal CT imaging. This study sought to evaluate imaging practices for PTPs, hypothesizing variability in CT imaging among trauma centers. If demonstrated, this might suggest the need to develop specific guidelines to standardize practice. METHODS: A multicenter retrospective study (2016-2021) was performed at 12 Level-I/II trauma centers. Adult (≥18 years old) PTPs involved in MVCs were included, with no patients excluded. The primary outcome was the frequency of CT. Chi-square tests were used to compare categorical variables, and ANOVA was used to compare the means of normally distributed continuous variables. RESULTS: A total of 729 PTPs sustained MVCs (73% at high speed of ≥ 25 miles per hour). Most patients were mildly injured but a small variation of injury severity score (range 1.1-4.6, p < 0.001) among centers was observed. There was a variation of imaging rates for CT head (range 11.8-62.5%, p < 0.001), cervical spine (11.8-75%, p < 0.001), chest (4.4-50.2%, p < 0.001), and abdomen/pelvis (0-57.3%, p < 0.001). In high-speed MVCs, there was variation for CT head (12.5-64.3%, p < 0.001), cervical spine (16.7-75%, p < 0.001), chest (5.9-83.3%, p < 0.001), and abdomen/pelvis (0-60%, p < 0.001). There was no difference in mortality (0-2.9%, p =0.19). CONCLUSION: Significant variability of CT imaging in PTPs after MVCs was demonstrated across 12 trauma centers, supporting the need for standardization of CT imaging for PTPs to reduce unnecessary radiation exposure while ensuring optimal injury identification is achieved.

INTRODUCTION: The purpose of this study was to describe the outcomes after operative repair of ballistic femoral neck fractures. To better highlight the devastating nature of these injuries, we compared a cohort of ballistic femoral neck fractures to a cohort of young, closed, blunt-injury femoral neck fractures treated with open reduction and internal fixation (ORIF). METHODS: Retrospective chart review identified all patients presenting with ballistic femoral neck fractures treated at three academic trauma centers between January 2016 and December 2021, as well as patients aged ≤50 with closed, blunt-injury femoral neck fractures who received ORIF. The primary outcome was failure of ORIF, which includes the diagnosis of non-union, avascular necrosis, conversion to total hip arthroplasty, and conversion to Girdlestone procedure. Additional outcomes included deep infection, postoperative osteoarthritis, and ambulatory status at last follow-up. RESULTS: Fourteen ballistic femoral neck fractures and 29 closed blunt injury fractures were identified. Of the ballistic fractures, 7 (50%) patients had a minimum of 1-year follow-up or met the failure criteria. Of the closed fractures, 16 (55%) patients had a minimum of 1-year follow-up or met the failure criteria. Median follow-up was 21 months. 58% of patients with ballistic fractures were active tobacco users. Five of 7 (71%) ballistic fractures failed, all of which involved non-union, whereas 8 of 16 (50%) closed fractures failed (p=0.340). No outcomes were significantly different between cohorts. CONCLUSION: Our results demonstrate that ballistic femoral neck fractures are associated with high rates of non-union. Large-scale multicenter studies are necessary to better determine optimal treatment techniques for these fractures. LEVEL OF EVIDENCE: Level III. Retrospective cohort study.

BackgroundDuring the wars in Afghanistan and Iraq most injuries to service members involved the musculoskeletal system. These wounds often occurred around joints, and in some cases result in traumatic arthrotomy-a diagnosis that is not always clear, especially when there is no concomitant articular fracture. The aim of the present study is to evaluate the diagnosis and treatment of peri-articular blast injuries without fracture.MethodsThe study cohort included 12 consecutive patients (12 involved extremities) who sustained peri-articular blast wounds of the extremities without fractures. The diagnosis of penetrating articular injury was based on clinical examination, radiographic findings, or aspiration. A peri-articular wound was defined as any wound, or radio-opaque blast fragment, within 5 cm of a joint. The New Injury Severity Score (NISS) was calculated for each patient. Four patients had upper, and 8 patients had lower extremity injuries. Nine of 12 patients had joint capsular penetration and underwent joint irrigation and debridement.ResultsTwo patients had retained intra-articular metal fragments. One patient had soft tissue blast wounds within 5 cm of a joint but did not have joint capsule penetration. There were no significant differences (p = 0.23) between the distribution of wounds to upper versus lower extremities. However, there were a significantly greater number of blast injuries attributed to Improvised Explosive Devices (IEDs) than from other blast mechanisms (p = 0.01).ConclusionExtremity blast injuries in the vicinity of joints involving only soft tissues present a unique challenge in surgical management. A high index of suspicion should be maintained for joint capsular penetration so that intra-articular injuries may be appropriately treated.

Firearms are a major source of preventable morbidity and mortality in the United States, contributing to over 48,000 deaths in 2022 and generating societal costs in excess of $500 billion. A body of work has examined the relationship between US state level firearm laws and health outcomes, generally finding that some firearm regulations are associated with lower firearm-related mortality. Alcohol has been identified as an additional risk factor for both homicides and suicide and stronger state alcohol laws have been associated with lower rates of suicide. To date, there are no empirical studies that have investigated the impact of laws over a long period of time that target the intersection of alcohol and firearm. One reason for this may be because there is no existing dataset that includes the range of these state laws over time. This study describes the protocol for collecting, coding and operationalizing these legal data.

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]

Introduction and purpose Botulinum toxin has been used in medicine since the 1970s, although many years earlier it was known only as a biological weapon. Originally, it was used in medicine to treat strabismus in children. Over time, it has been used in the treatment of neurological disorders, excessive sweating of the armpits, wrinkles, and bladder disorders. In recent years, botulinum toxin has also begun to be used in wound healing. The paralyzing effect of botulinum toxin on the muscles within the wound eliminates micro-injuries caused by tension in these muscles. The aim of the article is to summarize information on the effects of botulinum toxin on the wound, its impact on inflammation, and the type of scar formation. Materials and methods The literature included in the PubMed databases is searched through the words such as botulinum toxin, wounds, and scars. Description of the state of knowledge: The literature review shows the breadth of the issue. Scientific studies showing the effect of using botulinum toxin on wounds emphasize its beneficial effects. However, it should be remembered that wound healing has a complex, dynamic course supported by numerous cellular processes that must be closely coordinated to effectively repair damaged tissues. Determinants influencing the course of wound healing include both local and systemic factors. Important factors influencing the process of proper wound healing are specialized wound preparation, pharmacotherapy, and other aspects of therapeutic intervention. Conclusions The range of applications of botulinum toxin is constantly expanding. In addition to reducing muscle tension within the wound, it also inhibits the production of inflammatory transmitters, limiting its development, and also reduces the development of microcirculation by preventing the development of vessels in hypertrophic scars. [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]

Summary: Skin grafting is a simple technique that can be performed by equine practitioners to improve cosmetic outcomes in wounds with large skin defects that would not heal functionally or cosmetically with standard wound therapy interventions. Successful skin grafting is not difficult but relies upon appropriate preparation of the wound bed and effective immobilisation of the grafted area after skin graft placement. Prior to grafting, the wound bed should be treated with a moist wound healing dressing to prepare the granulation tissue bed to receive the graft. For best results, skin grafts should be placed in wounds free of infection with healthy granulation tissue, and motion should be reduced in the graft region in the early postoperative period. When successful, skin grafts cover granulation tissue and encourage wound contraction and epithelialisation while decreasing exuberant granulation tissue resulting in a more cosmetic result. This review will advance practitioners' understanding of skin grafting in horses, including graft classification and techniques, donor site selection, recipient site preparation and postoperative management strategies to optimise graft retention and ongoing research in this field. [ABSTRACT FROM AUTHOR]

Background Adequate nutrition is essential for individuals with diabetes and wounds to optimise both wound healing and blood glucose control. Previous systematic reviews have evaluated the effectiveness of nutrition supplementation for wound healing in individuals with diabetes. However, none have reported comprehensively on the range of dietary interventions utilised in this population, despite these being common within clinical practice. Therefore, the aim of this systematic review is firstly to evaluate the effectiveness of dietary interventions for wound prevention and management in people with diabetes, and secondly to describe intervention characteristics. Methods Using PRISMA-P to guide the review, five databases will be searched for intervention studies (Medline, Embase, CINAHL, Scopus, Cochrane Library) as well as clinical trials registries. The Rob-2 and ROBINS tools will assess risk of bias. Studies will be described narratively, and a meta-analysis conducted if adequate levels of homogeneity exist between included studies and outcome variables, including study types, and characteristics of the sample including sample size. An appropriate model will be chosen to undertake meta-analysis. Discussion The systematic review results will inform clinicians on the most effective dietary interventions to optimise wound healing in individuals with diabetes. Study results will inform design and conduct of future nutrition interventions in wound healing. [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]

Background: Any portion of the body that has sustained damage due to mechanical force is referred to as an injury or wound. Weapon use, blunt force, and sharp force can all cause mechanical injuries. In many nations, the most common method of homicide is the use of sharp objects, particularly knives. One of a forensic pathologist's main responsibilities in the realm of forensics is wound examination. By identifying prospective criminal suspects and tracking the origin and progression of violent occurrences, wound assessment supports criminal investigations. Aim: The current review provides a view on wounds/injuries, their classifications, incised wounds, how to differentiate them from lacerations, and the importance of wound examination in the field of forensics. Conclusion: In summary, researchers have classified wounds/injuries according to many factors, and they frequently emphasize the significance of wound examination in the field of forensics. [ABSTRACT FROM AUTHOR]

We identified a high prevalence (46.4%) of wound colonization with methicillin-resistant Staphylococcus aureus (MRSA) in patients hospitalized in a center devoted to the treatment of cutaneous tropical diseases in Benin. The proportion of MRSA among S aureus isolates was 54.3%. Thirty percent of these MRSA were identified in outpatients. The analysis of pulsed-field gel electrophoresis demonstrated an important diversity of strains but also identified 8 small clusters containing between 2 and 4 isolates suggesting cross-transmission. • Almost half of patients' wounds were colonized with MRSA. • Total 30% of MRSA were identified in outpatients. • Diversity of MRSA isolates according to pulsed-field gel electrophoresis. • Several small clusters suggest direct or cross-transmission inside the center. • Need for rural African health care settings to refer to a microbiology laboratory. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background: Infections are complications in the wound healing process, and their treatment can lead to antibiotic overuse and bacterial resistance. Antimicrobial photodynamic therapy (aPDT) is used to treat infectious diseases caused by fungi, viruses, or bacteria. Methylene blue (MB) and its derivatives are commonly used dyes in antimicrobial photodynamic therapy (aPDT–MB). Methods: This study is a PRISMA systematic review of animal models used to discuss the usefulness and therapeutic parameters of aPDT–MB or its derivatives for treating infected skin wounds. Results: After an extensive literature review, 13 controlled trials totaling 261 animals were selected to evaluate skin infection by leishmaniasis and cutaneous bacterial and fungal infections. All studies found results favoring the use of aPDT–MB. Great variability in parameters was found for radiant exposure from 12 to 360 J/cm2, MB diluted in saline solution or distilled water, irradiation time from 40 to 3600 s, irradiance most commonly at a maximum of 100 mW/cm2, and wavelength used mainly in the 630–670 nm range. Conclusion: MB is a safe and promising agent used as a photosensitizer in aPDT for skin‐infected lesions. There is great variability in the parameters found. Comparisons concerning concentration, irradiation time, and light intensity need to be performed. [ABSTRACT FROM AUTHOR]

Introduction. Surgical exploration in complete ureteropelvicjunction disruption (CUPJD) is still recommended by many authors. Conservative approach to pediatric renal trauma (RT) includes minimally invasive techniques such as nephrostomy, angioembolization or double-J stent placement. Clinical case. A 14-year-old patient with CUPJD was treated conservatively. CT-scan revealed active bleeding of the renal artery and significant urine extravasation. Coil angioembolization and nephrostomy placement were performed. An attempt to place a double-J stent was unsuccessful and surgical reconstruction was scheduled. Before surgery, methylene-blue was injected through the nephrostomy observing blue urine output through urethra. Antegrade pyelogram revealed drainage from the urinoma to the ureter. A new attempt to place an internalexternal double-J-stent was successful. After 5 weeks, it was removed with total restoration of the urinary tract. Conclusion. Complete urinary tract restoration in some cases of CUPJD following RT is possible through a nonoperative approach. It can be safe and effective, reducing the risk of complications associated with complex surgeries. [ABSTRACT FROM AUTHOR]

Copyright of Die Unfallchirurgie is the property of Springer Nature and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Negative pressure wound therapy is currently one of the most popular treatment approaches that provide a series of benefits to facilitate healing, including increased local blood perfusion with reduced localized oedema and control of wound exudate. The porous foam dressing is a critical element in the application of this therapy and its choice is based on its ability to manage exudate. Industry standards often employ aqueous solutions devoid of proteins to assess dressing performance. However, such standardized tests fail to capture the intricate dynamics of real wounds, oversimplifying the evaluation process. This study aims to evaluate the technical characteristics of two different commercial polyurethane foam dressings during negative pressure wound therapy. We introduce an innovative experimental model designed to evaluate the effects of this therapy on foam dressings in the presence of viscous exudates. Our findings reveal a proportional increase in dressing fibre occupancy as pressure intensifies, leading to a reduction in dressing pore size. The tests underscore the pressure system's diminished efficacy in fluid extraction with increasing fluid viscosity. Our discussion points to the need of establishing standardized guidelines for foam dressing selection based on pore size and the necessity of incorporating real biological exudates into industrial standards. [ABSTRACT FROM AUTHOR]

Background: Fireworks related injuries in children occur in Kosovo particularly during New Year celebrations. Aim: To report the pattern of fireworks- related injuries in children up to 16 years of age treated at the Emergency Center and Plastic Surgery, University Clinical Centre of Kosovo during the 2008 and 2009 New Year celebrations. Methods: Retrospective review of hospital records Results: During the New Year celebrations in 2008, a total of 65 cases were admitted, 32 (49.2%) of who were children injured by fireworks. The ages of the children ranged from 5 to 16 years with a mean of 10.5years. The modal age affected was the 10 – 14 year-old group (53.6%). Boys constituted 93.8% of patients and girls 6.3%. During the 2009 New Year celebration, 17 cases were admitted with fireworks injuries, 12 (70.58%) of who were children ranging in age from 8 to 15 years (mean 11.5 years) with a modal age group of 10 – 14 years (66.7%). Boys accounted for 88.3% and girls for 16.7% of patients. Conclusions: The frequency of fireworks injuries reduced appreciably after introduction of laws restricting sales of fireworks devices and banning their use by children. Recommendations: It is recommended that parents play a greater role in controlling the activities of their children during festivities. The government and police should also ensure compliance with the law on the use of fireworks during the holidays.

The review reflects modern vision about combat injuries. Particular attention is paid to injuries of the extremities and methods of their treatment. Despite advances in surgical techniques and medical technology, treating extremity combat injuries remains challenging. Regular debridement, local negative pressure wound therapy, and reconstructive surgery are currently considered the mainstay of treatment for these types of high-energy injuries. The limited literature suggests that the use of local negative pressure wound therapy in the treatment of high-energy combat wounds of the extremities reduces the incidence of wound complications, leads to a significant reduction in the size of the wound surface, cleanses wounds, stimulates the formation of granulation tissue and, ultimately, promotes wound closure. The use of the local negative pressure wound therapy has become an important method for the treatment of combat injuries, but its use in the treatment of gunshot and mine-blast wounds has not yet been sufficiently studied, which is primarily due to the difficult conditions for conducting scientific research during combat operations.

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 anti-inflammatory, 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

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]

Background In 1937, oral phenytoin medication was introduced as an anti-epileptic drug. For many years, researchers have shown interest in how topical phenytoin may be used to promote wound healing in various wounds. Purpose This review article aims to summarise and critically appraise the clinical evidence available on the effects of topical phenytoin on wound healing. Methods By using the keywords phenytoin, injuries, wound, wound care, and wound healing, we extracted articles published up to April 2022 through a search in PubMed, ISI Web of Science, SID, Google Scholar and Scopus. Result We identified 17 studies performed on human subjects and eight on rats. Phenytoin effectiveness is also compared with other wound care substances, including tretinoin, silver sulfadiazine, EUSOL, honey, dexamethasone and hypericin. Conclusion This review illustrated the significant effects and rare adverse events of topical phenytoin on wound healing. [ABSTRACT FROM AUTHOR]

Copyright of Revista Foco (Interdisciplinary Studies Journal) is the property of Revista Foco and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

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]

This study delves into the foraging ecology of the cookiecutter shark (Isistius brasiliensis) in the Saint Peter and Saint Paul Archipelago (SPSPA), assessing bite marks on pelagic fishes collected between March and September 2018. Examination of 200 individuals from five species revealed the shark's predilection for targeting adult fish, ensuring efficient removal of energy‐rich tissue layers. However, a notable exception is Thunnus albacares, preyed on predominantly during its juvenile stage, possibly due to vertical spatial segregation. Recent bites were pervasive across species, with wahoo displaying a distinctive pattern. Cookiecutter shark bites predominantly targeted the lateral body portion (>55%) except for yellowfin tuna, which exhibited a preference for the ventral region (95%). The estimated length distribution suggests the SPSPA as a potential nursery area for cookiecutter sharks. Bite mark positions and frequencies may be linked to fish behavior, swimming velocity, and fishing gear strategy, highlighting the complex interplay in pelagic ecosystems. [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]

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]

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]

Background In patients with chronic lower extremity (LE) wounds, chronic osteomyelitis confers additional complexity to achieving adequate treatment. Previous reviews demonstrate increased rates of osteomyelitis recurrence in patients who receive muscle flaps compared with fasciocutaneous flaps for LE limb salvage; however, these studies were not limited to atraumatic populations who receive exclusively free flaps. Thus, this study compared rates of recurrence in chronic osteomyelitis patients undergoing LE reconstruction with fasciocutaneous versus muscle free flaps. Methods Patients undergoing free tissue transfer (FTT) between July 2011 and July 2021 were retrospectively reviewed. Patients were stratified into fasciocutaneous and muscle free flap groups. Primary outcomes included osteomyelitis recurrence, flap complications, limb salvage, and ambulatory status. Results Forty-eight patients with pathologic diagnosis of chronic osteomyelitis of the wound bed were identified, of which 58.3% received fasciocutaneous (n = 28) and 41.7% received muscle flaps (n = 20). The most common comorbidities included diabetes mellitus (n = 29, 60.4%), peripheral neuropathy (n = 27, 56.3%) and peripheral vascular disease (n = 24, 50.0%). Methicillin-resistant or methicillin -sensitive Staphylococcus aureus were the most common pathogen in 18.7% (n = 9) of procedures. The majority of patients underwent a median of three debridements followed by negative pressure wound therapy prior to receiving FTT. At a median follow-up of 16.6 months, the limb salvage and ambulatory rates were 79.2 (n = 38) and 83.3% (n = 40), respectively. The overall rate of microsurgical flap success was 93.8% (n = 45). Osteomyelitis recurred in 25% of patients (n = 12) at a median duration of 4.0 months. There were no significant differences in rates of osteomyelitis recurrence, flap complications, limb salvage, ambulation, and mortality. On multivariate analysis, flap composition remained a nonsignificant predictor of osteomyelitis recurrence (odds ratio: 0.975, p = 0.973). Conclusion This study demonstrates that flap composition may not influence recurrence of osteomyelitis following free flap reconstruction of chronic LE wounds, suggesting that optimal flap selection should be based on wound characteristics and patient goals. [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]

The number of consumers following plant-based diets has increased and in turn, the variety of plant-based foods available on the market has also increased. Many plantbased foods aim to mimic the functionality and sensory properties of conventional dairy products; however, they may not be suitable for specific populations. Dysphagia, for example, is a swallowing condition requiring texture-modified foods that meet specific criteria. While many conventional thickened products exist that are safe for individuals with dysphagia, the growing interest in plant-based eating alongside the increasing prevalence of dysphagia prompts a need for research on the use and safety of thickened plant-based alternatives. This study investigated the sensory properties of a thickened protein-enhanced ice cream (dairy and whey) compared to thickened protein-enhanced plant-based frozen desserts (cashew and pea, and coconut and pea). The formulations were evaluated using the International Dysphagia Diet Standardization (IDDSI) Spoon Tilt Test and a sensory trial (n = 104 participants, 47 flexitarians and 57 typical consumers) using static (hedonic scales and check-all-that-apply [CATA]), and dynamic (temporal check-all-that-apply (TCATA)) methods. The dairy and whey sample consistently passed the IDDSI test, while the plant-based samples did not. TCATA identified that the plant-based samples had an increased cohesiveness and adhesiveness, and decreased slipperiness when compared to the dairy and whey sample. The differences in textural properties may explain why the plant-based samples did not pass the IDDSI test. The study identified that although plant-based foods strive to mimic conventional dairy products, they have different textural and flavor properties. [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]

Plastic surgery (PS) in Africa is a relatively young surgery specialty, and the number of available plastic surgeons on average is one or two surgeons per country in many African low-income countries. This systematic review aims to geographically map the research activities through scientific publications of African PS centres, between February 2012-February 2023. We searched four literature databases (Medline, Embase, Google Scholar and African Journal Online) and did a manual search. We included case reports, randomised controlled trials, and clinical, comparative, observational and multicentre studies conducted in Africa and published in English and French. In the Google Scholar database, we analysed the first 200 references (scientific articles) selected per relevance according to the Boolean terms. In the African Journals Online database, we analysed the references from the first five pages. The selected keywords were: burns, trauma reconstruction, pressure injuries, wound, cleft lip and palate, breast reconstruction, microsurgery, aesthetic surgery, face surgery, head and neck surgery, hand surgery, open fracture surgery, oculoplastic surgery, skin surgery, and soft tissue surgery. We retrieved a total of 228 articles. Out of the 73 African centres we identified, 27 were in the North, 22 in the West, 8 in the East, 3 in the Centre, and 14 in the South. Most of the retrieved 228 articles involved burns (60, 26.31%), congenital abnormalities (52, 22.80%) and reconstruction (28,12.80%); however, other conditions, such as breast or skin cancer, hand surgery, microsurgery or aesthetics are emerging. The studies were case reports/case series (93, 40.78%), retrospective (78, 34.21%), prospective (36, 15.78%), randomised controlled studies (10, 4.38%), cross-sectional (5, 2,19%) and cohort (2, 0.87%). Beyond burns, congenital abnormalities, or reconstructions, other PS indications are emerging, such as skin cancer, breast reconstruction, hand surgery, microsurgery, and aesthetics. [Display omitted] [ABSTRACT FROM AUTHOR]

Wound infections and abscesses in rabbits are a common problem in veterinary practice and their treatment can be challenging. Bacterial culture and antimicrobial susceptibility testing are important tools in these cases. While some studies are available on bacteria associated with wound infections and abscesses in rabbits, the numbers of animals included is generally limited. Monitoring of antibiotic resistance in clinical practice is also an important part of good antibiotic stewardship. Multiple antibiotic resistances are frequently encountered in Staphylococcus and Pseudomonas spp., 2 groups of bacteria commonly associated with abscesses in rabbits. This retrospective study evaluated the results of aerobic bacterial cultures and antibiotic susceptibility tests in swabs from abscesses (A) (n = 541) and from skin and wounds (SW) (n = 308) submitted to a commercial diagnostic laboratory. Samples submitted between January 2017 and October 2020 were included in the study. Antimicrobial susceptibility testing for Staphylococcus and Pseudomonas spp. was evaluated and compared. In A, 465 bacterial isolates including 35 different species were isolated while 394 bacterial isolates, including 35 different species, were found in SW. The most frequently isolated bacteria were Staphylococcus spp. (A = 21.7%, SW = 36.5%) followed by Pasteurella spp. in A (13.3%) and aerobic spore-forming bacteria in SW (11.2%). Pseudomonas spp. was the third most commonly isolated genus in both sample types (A = 11.6%, SW = 8.9%). Pseudomonas aeruginosa isolated from A were more often resistant to the tested antibiotics than other Pseudomonas species. These results support the need for bacterial culture and antibiotic susceptibility testing of wounds and abscesses from rabbits. [ABSTRACT FROM AUTHOR]