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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]

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]

Wounds are an increasing global concern, mainly due to a sedentary lifestyle, frequently associated with the occidental way of life. The current prevalence of obesity in Western societies, leading to an increase in type II diabetes, and an elderly population, is also a key factor associated with the problem of wound healing. Therefore, it stands essential to find wound dressing systems that allow for reestablishing the skin integrity in the shortest possible time and with the lowest cost, avoiding further damage and promoting patients' well-being. Wounds can be classified into acute or chronic, depending essentially on the duration of the healing process, which is associated withextent and depth of the wound, localization, the level of infection, and the patient's health status. For each kind of wound and respective healing stage, there is a more suitable dressing. The aim of this review was to focus on the possible wound dressing management, aiming for a more adequate healing approach for each kind of wound. [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]

Surgical sutures play a crucial role in wound closure, facilitating the tissue-healing process across various fields of medicine. The objective of this study was to analyse the impact of seasoning time during the initial days/weeks of seasoning in Ringer's solution on the mechanical properties of five commercial absorbable sutures: SafilQuick+®, Novosyn®, MonosynQuick®, Monosyn® and Monoplus®, each with different absorption periods. The results demonstrated that the SafilQuick+ and MonosynQuick sutures lost strength within 9–12 days, as evidenced by statistically significant changes in tensile strength. In contrast, the Novosyn and Monoplus sutures did not exhibit significant changes in strength during the study period. Statistical analysis confirmed significant differences in the behaviour of the individual sutures, highlighting the importance of selecting appropriate suture material in the context of the specific medical procedure. [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]

Wide-Awake Local Anesthesia No Tourniquet (WALANT) offers a cost-effective alternative to general anesthesia (GA) for wound debridement, improving patient safety, surgical accessibility, and cost-efficiency. This study explores WALANT’s cost-effectiveness and patient outcomes in a resource-limited setting. The patient, E.M., a 27-year-old woman, presented with left upper limb swelling, which began a week after Implanon device removal at another facility. Upon admission, she displayed severe sepsis symptoms, including a blood pressure of 100/58 mmHg, a heart rate of 144 beats per minute, a respiratory rate of 24 breaths per minute, and a temperature of 39.2℃. Her left upper limb showed swelling, redness, and shininess, leading to a diagnosis of necrotizing fasciitis with septic shock. Initially, wound debridement was conducted under GA. However, the patient’s choice to undergo WALANT for her second debridement saved her 89.1% of the cost of performing debridement under GA. This cost reduction significantly benefited the uninsured patient, alleviating the financial burden and also achieved a favorable patient outcome within the constraints of a resource-limited setting.

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

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]

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]

Endovascular stents are predominantly utilized for intra-arterial interventions; however, their application in managing venous injuries, especially traumatic ones, lacks comprehensive guidelines and long-term outcome studies. This case report discusses the innovative deployment of an infrarenal inferior vena cava stent for a traumatic inferior vena cava injury after a gunshot wound in a polytrauma patient. This case aims to enhance the existing evidence on the feasibility and potential outcomes of endovascular stenting in traumatic venous injuries.

Abstract 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: Background: The internet has led to the realization that the world is a global village. Due to technological advancements, anyone can access the internet and various video sharing platforms and in turn, get access to or share information across the world. One of the most sought-after critical pieces of information on the internet, as well as social media platforms, is information regarding wounds. Objective: To determine the views of patients with chronic wounds regarding the internet and other social media platforms as a source of information regarding wounds. Methodology: A descriptive prospective study covering the period between November 1, 2022, and January 30, 2023. All patients with chronic wounds presenting in the plastic outpatient clinic, together with patients presenting themselves in the wound clinic at Kenyatta National Hospital (KNH) during this period, were informed about the study and asked to participate. After consenting, they were then required to sign an informed consent form after agreeing to participate. Data collection was done through interviews and filled out in structured questionnaires. Data points included demographics, information on internet use, and interaction with the various social media platforms. Results: 83.4% of the participants were of the opinion that the contents shared were done so by professionals, compared to 12.5% who indicated that the owners or uploaders of the contents were laymen. 2.6% and 1.5%, on the other hand, opined that the owners or uploaders of the contents were unknown and difficult to tell, respectively. Discussion: The participants in the current study felt that some aspects regarding content on wounds that is shared on the internet as well as other social media platforms would need further improvement. Such areas included information regarding wound dressing concepts, the etiology and pathophysiology of wounds, complications of wounds, and wound pain management.

Aim. To investigate possible rhythm and conduction disturbances, as well as the blood pressure (BP) profile in young and middle-aged patients with combat wounds. Materials and methods. The cross-sectional study enrolled 102 patients who suffered limb injuries in the period from 13 to 114 days (median 38 days) before admission to the hospital. The age of the patients included in the study ranged from 20 to 59 years, with an average of 35.7±8.5 years. Patients underwent Holter ECG monitoring and 24-hour BP monitoring. The following questionnaires and scales were used: a questionnaire to identify signs of autonomic changes (A. Vein), a scale for assessing the severity of psychophysiological response to stress, an insomnia severity index, the Hamilton scale for assessing anxiety, the Hamilton scale for assessing depression, a questionnaire for PTSD screening, visual analog pain scale. Results. The mean heart rate per day reached 84.6±11.1 per minute, the minimum heart rate was 56.9±10.1, the maximum heart rate was 134.4±18.6 per minute. The group mean duration of tachycardia was 498.1±316 minutes (8 hours 18 minutes). There was an inverse correlation between the age of patients and the duration of tachycardia per day (r=-0.29; p=0.04), maximum heart rate (r=-0.28; p=0.007), minimum heart rate per day (r=-0.23; p=0.02). In patients 20-29 years old, the maximum heart rate reached 141.4±19.4, in patients over 40 years old – 134.3±17.9 (p=0.009). The mean value of the circadian index for the group was 1.17±0.13 (0.68-1.47). In 69.7%, the circadian index was rigid. Heart rate variability was within normal values in 32.2% of the examined patients, in 48.8% it was reduced, and in 19.1% it was sharply reduced. Heart rhythm disturbances were recorded in 65.5% of patients. The most frequently detected sinus arrhythmia (in 76.2% of cases of all arrhythmias), migration of the supraventricular pacemaker (in 27.0%) and atrial rhythm (in 11.1%). Arterial hypertension was detected in 67.7% of the examined patients. The maximum systolic BP (SBP) corresponding to arterial hypertension of the 1st degree was registered in 43.9% of patients, grade 2 – in 19.7%, grade 3 – in 3.0%, high normal BP – in 16.7%, normal BP – in 16.7%. Maximum diastolic BP (DBP) corresponding to grade 1 hypertension was found in 30.8% of patients, grade 2 – in 30.8%, grade 3 – in 15.4%, high normal BP – in 10.8%, normal BP – in 12.3%. The mean daily SBP was 126 mm Hg, DBP was 81 mm Hg. The mean daytime SBP was 128 mm Hg, DBP was 82 mm Hg. The mean nighttime SBP is 118 mm Hg, DBP is 77 mm Hg. The maximum SBP was 148 mm Hg, DBP was 97 mm Hg. When analyzing the types of daily BP curves, the vast majority of patients (44.6%) were classified as “non-dipper” type, both for SBP and DBP. Conclusions. The study results indicate that patients with combat injuries very often have sinus tachycardia, which is recorded over a long period of time. Heart rate is highest in the youngest injured patients and decreases as age increases. Sinus arrhythmia is very common, other rhythm and conduction disorders are much less common. High BP, especially DBP, is often recorded.

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 and aims: Bacteria in wounds can lead to stagnation of wound healing as well as to local or even systemic wound infections up to potentially lethal sepsis. Consequently, the bacterial load should be reduced as part of wound treatment. Therefore, the efficacy of simple mechanical wound debridement should be investigated in terms of reducing bacterial colonisation. Patients and methods: Patients with acute or chronic wounds were assessed for bacterial colonisation with a fluorescence camera before and after mechanical wound debridement with sterile cotton pads. If bacterial colonisation persisted, a second, targeted wound debridement was performed. Results: A total of 151 patients, 68 (45.0%) men and 83 (55.0%) women were included in this study. The male mean age was 71.0 years and the female 65.1 years. By establishing a new analysis method for the image files, we could document that the bacterial colonised areas were distributed 21.9% on the wound surfaces, 60.5% on the wound edges (up to 0.5 cm) and 17.6% on the wound surroundings (up to 1.5 cm). One mechanical debridement achieved a significant reduction of bacterial colonised areas by an average of 29.6% in the wounds, 18.9% in the wound edges and 11.8% in the wound surroundings and was increased by performing it a second time. Conclusions: It has been shown that even a simple mechanical debridement with cotton pads can significantly reduce bacterial colonisation without relevant side effects. In particular, the wound edges were the areas that were often most contaminated with bacteria and should be included in the debridement with special attention. Since bacteria remain in wounds after mechanical debridement, it cannot replace antimicrobial therapy strategies, but offer a complementary strategy to improve wound care. Thus, it could be shown that simple mechanical debridement is effective in reducing bacterial load and should be integrated into a therapeutic approach to wounds whenever appropriate. [ABSTRACT FROM AUTHOR]

From previous studies, we have shown that viable colony forming units of bacteria and bacterial biofilms are reduced after sequential treatment with a surfactant‐based dressing. Here, we sought to test the impact on visible bacterial pigments and the ultrastructural impact following the sequential treatment of the same surfactant‐based dressing. Mature Pseudomonas aeruginosa biofilms were grown on ex vivo porcine skin explants, and an imaging‐based analysis was used to compare the skin with and without a concentrated surfactant. In explants naturally tinted by bacterial chromophores, wiping alone had no effect, while the use of a surfactant‐based dressing reduced coloration. Similarly, daily wiping led to increased immunohistochemical staining for P. aeruginosa antigens, but not in the surfactant group. Confocal immunofluorescent imaging revealed limited bacterial penetration and coating of the dermis and loose pieces of sloughing material. Ultrastructural analysis confirmed that the biofilms were masking the extracellular matrix (ECM), but the surfactant could remove them, re‐exposing the ECM. The masking of the ECM may provide another non‐inflammatory explanation for delayed healing, as the ECM is no longer accessible for wound cell locomotion. The use of a poloxamer‐based surfactant appears to be an effective way to remove bacterial chromophores and the biofilm coating the ECM fibres. [ABSTRACT FROM AUTHOR]

Gregory's Homily 12 on the Song of Songs offers one opportunity to trace the legacies of the compelling claim, in Galatians 6:17, that Paul bears "the marks of Christ" on his body. Gregory appeals to this verse to aid his exegesis of Song 5:7 (a violent passage he calls "repellant in its plain sense") and develop his claims that "the wound", after all, is "an admirable thing". My paper probes social and ethical dimensions of this exegetical and cultural conceptual lineage. It surveys wounds and marks in Homily 12; suggests how other works by Gregory support "striking and wounding" as enacting spiritual healing (ἴασιν); considers contexts for violence in the name of guardianship and instruction in late antiquity; and closes by considering violence enacted in the name of Christianization and "civilization" in Canada's residential schools. This study embeds Gregory's treatment of Gal 6:17 in a larger attempt to raise critical questions about the persistence of benevolent understandings of trauma and violence across diverse Christian exegetical contexts and the harms such understandings may perpetuate. [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]

Losses and the economic impact of dog attacks (DAs) on livestock are often overlooked and include factors such as decreased production, expenses for treatment and handling, and death of injured animals. This study evaluated the epidemiological, therapeutic, and pathological findings of DAs on livestock over an 11-year survey using the records of farm animals referred to a Veterinary Teaching Hospital. Livestock attacked by dogs included 31 sheep, 11 horses, 3 cattle, 3 goats, and 2 pigs, totaling 50 animals. Anatomical locations injured by dog bites were identified as head/neck, thoracic/pelvic limbs, abdomen/flank, rump/tail, and multiple affected regions (two or more bite sites). Additionally, the severity of the injuries was classified into four degrees adapted from the classification of dog bite injuries in children. Most livestock presented Grade 1 (26%) and Grade 2 (28%) injuries, while Grade 3 and Grade 4 injuries were observed in 46% of DAs. Furthermore, 35 animals (70%) were discharged, 9 (18%) died, and 6 (12%) were humanely euthanized. DAs may represent a significant cause for referring livestock species to clinical care, severe injuries, and a considerable number of deaths. In this study, we provide information regarding DAs on livestock for the first time in Midwestern Brazil. [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]

The emerging evidence has indicated the role of microRNAs (miRNA) in various physiological or pathological processes. Also, documents have suggested that exercise, by affecting miRNA regulation, may enhance burn wound healing. The current study aims to systematically review the role of exercise in regulating miRNAs related to burn wound healing to provide potential therapeutic targets. A comprehensive, systematic search was performed in different international electronic databases, such as Embase, PubMed and Google Scholar search engine, Science Direct, ProQuest and Ovid using keywords extracted from Medical Subject Headings from 2010 to September 2023. The keywords, including 'exercise' AND 'burn wound' AND 'microRNA' and finally, six cases were achieved. Evidence has indicated that exercise may promote the healing of burn wounds by regulating certain miRNAs. Studies have found that exercise regulates the expression of miRNAs such as mir‐155, miR‐21, let‐7a, miR‐146a, miR‐122 and mir‐210 in burn wound tissue, which regulate inflammation and angiogenesis. These findings suggest that miRNAs may play a role in the positive effect of exercise on burn wound healing. However, further research is needed to understand the mechanisms involved fully. [ABSTRACT FROM AUTHOR]

Skin is constantly exposed to injury and infectious agents that can compromise its structural integrity and cause wounds. When this occurs, microorganisms from the skin microbiota and external bacteria and fungi can penetrate the wound and cause an infection, which complicates the healing process. Nowadays, there are several types of wound dressings available to treat wounds, some of which are incorporated with antimicrobial agents. However, the number of microorganisms resistant to these substances is rising. Therefore, the search for new, natural alternatives such as essential oils (EOs) and plant extracts (PEs) is on the rise. However, these substances present some limitations (poor bioavailability and poor target capacity), which limits their efficiency. Their incorporation in formulations in the form of films and hydrogels (HGs) can help to overcome these issues and may be a potential alternative to the current treatments. HGs and films incorporated with PEs and EOs have antimicrobial activity, promote the viability of skin cells and fibroblast migration, and are non-toxic and biocompatible. This review discusses the use of films and HGs for the topical delivery of EOs and PEs for wound treatment and their formulations as effective wound dressings, while debating some mechanisms and biological properties to elucidate their presumptive clinical relevance and possible applications. [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]

Aim: To investigate the level of agreement between the SEM 200 and Provisio® subepidermal moisture sacral delta measurements, which may indicate increased pressure injury risk, in healthy adults during 120 min of prolonged 60° head of bed elevation. This position, which requires the elevation of the patient's upper body at a 60° angle above the horizontal plane for an extended period, is used by clinicians to prevent or manage a patient's medical or surgical conditions. Design: This prospective exploratory study recruited 20 healthy adults during October 2021 and collected sacral subepidermal moisture delta measurements using the SEM 200 and Provisio® devices. Methods: Delta measurements were taken at 20‐min intervals over 120 min resulting in seven data collection timepoints. Descriptive statistics and a Bland Altman plot analysis were conducted. Results: A total of 280 sacral subepidermal moisture delta measurements were gathered or 140 per device. There were good levels of agreement between the two devices at baseline (T0) [mean 0.025; SD 0.137] and following 60‐ (T3) [mean 0.025; SD 0.111], 80‐ (T4) [mean −0.01; SD 0.177] and 100 min (T5) [mean 0.01; SD 0.129] of prolonged 60° head of bed elevation. Head of bed elevations can increase a patient's risk of sacral pressure injuries. In some countries, nurses have access to the SEM 200 and/or the Provisio® device, so our findings may increase nurses' confidence in the interchangeability of the device measurements, although further research is needed to confirm this. The SEM 200 and Provisio® subepidermal moisture scanners show promise in gathering similar objective pressure injury risk data which could prompt clinicians to implement prevention strategies. Impact: Current pressure injury risk assessment is largely subjective in nature. This quantitative study on healthy human sacral tissue found a good level of agreement in the SEM 200 and Provisio® subepidermal moisture scanners, which may increase nurses' confidence in the interchangeability of the devices in clinical practice. [ABSTRACT FROM AUTHOR]

The availability of new products and strategies to manage wounds has taken a quantum leap in recent years. Healthcare professionals now have an extensive range of products to choose from, but while positive this also raises dilemmas in real-world clinical practice to decide on the most appropriate treatment for a given patient. Clinical trials confirm the effectiveness of the unique combination of hyaluronic acid and amino acids (Vulnamin®) in a range of wounds, but are these results replicated in real-world clinical practice? International experts presented their clinical experience with the use of the combination in difficult-to-treat wounds. The objective was to reach a consensus on how and when to use the unique combination products to provide a cost-effective, convenient option, in all healthcare settings that improves QoL for patients and their carers. [ABSTRACT FROM AUTHOR]

In this study, we explored the use of thermal imaging technology combined with computer vision techniques for assessing surgical incision healing. We processed 1189 thermal images, annotated by experts to define incision boundaries and healing statuses. Using these images, we developed a machine learning model based on YOLOV8, which automates the recognition of incision areas, lesion segmentation and healing classification. The dataset was divided into training, testing and validation sets in a 7:2:1 ratio. Our results show high accuracy rates in incision location recognition, lesion segmentation and healing classification, indicating the model's effectiveness as a precise and automated diagnostic tool for surgical incision healing assessment. Conclusively, our thermal image‐based machine learning model demonstrates excellent performance in wound assessment, paving the way for its clinical application in intelligent and standardized wound management. [ABSTRACT FROM AUTHOR]

Joint injuries are among the leading causes of disability. Present concentrations were focused on oral drugs and surgical treatment, which brings severe and unnecessary difficulties for patients. Smart patches with high flexibility and intelligent drug control-release capacity are greatly desirable for efficient joint management. Herein, we present a novel kirigami spider fibroin-based microneedle triboelectric nanogenerator (KSM-TENG) patch with distinctive features for comprehensive joint management. The microneedle patch consists of two parts: the superfine tips and the flexible backing base, which endow it with great mechanical strength to penetrate the skin and enough flexibility to fit different bends. Besides, the spider fibroin-based MNs served as a positive triboelectric material to generate electrical stimulation, thereby forcing drug release from needles within 720 min. Especially, kirigami structures could also transform the flat patch into three dimensions, which could impart the patch with flexible properties to accommodate the complicated processes produced by joint motion. Benefiting from these traits, the KSM-TENG patch presents excellent performance in inhibiting the inflammatory response and promoting wound healing in mice models. The results indicated that the mice possessed only 2% wound area and the paw thickness was reduced from 10.5 mm to 6.2 mm after treatment with the KSM-TENG patch, which further demonstrates the therapeutic effect of joints in vivo. Thus, it is believed that the proposed novel KSM-TENG patch is valuable in the field of comprehensive treatments and personalized clinical applications.

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.

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.

Nonmissile penetrating spine injuries are relatively common in developing countries. Associated injuries are most commonly pneumothoraxes or bowel injuries and rarely vascular injuries. Penetrating aortic injuries are life-threatening and require prompt workup and management. A 51-year-old male patient presented after being stabbed in the back with a blade lodged at vertebral body T10/T1l. The blade tip was in the lumen of the descending thoracic aorta. This patient was successfully managed with thoracotomy and aortic repair, followed by the removal of the blade via an open laminectomy. The patient remained neurologically intact with no complicating features. Patients with penetrating spine injuries and retained blades need adequate workup to exclude other injuries prior to the removal of the blade. A multidisciplinary approach is important in the management of these patients to prevent devastating outcomes.

Abstract 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.

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.

Wounds are an increasing global concern, mainly due to a sedentary lifestyle, frequently associated with the occidental way of life. The current prevalence of obesity in Western societies, leading to an increase in type II diabetes, and an elderly population, is also a key factor associated with the problem of wound healing. Therefore, it stands essential to find wound dressing systems that allow for reestablishing the skin integrity in the shortest possible time and with the lowest cost, avoiding further damage and promoting patients’ well-being. Wounds can be classified into acute or chronic, depending essentially on the duration of the healing process, which is associated withextent and depth of the wound, localization, the level of infection, and the patient’s health status. For each kind of wound and respective healing stage, there is a more suitable dressing. The aim of this review was to focus on the possible wound dressing management, aiming for a more adequate healing approach for each kind of wound.

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.

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]

Surgical wounds may arise due to harm inflicted upon soft tissue during surgical intervention, and many complications and injuries may accompany them. These complications can lead to prolonged hospitalization and poorer clinical outcomes. Also, Machine learning (ML) is a Section of artificial intelligence (AI) that has emerged in medical care and is increasingly used for diagnosis, complications, prognosis and recurrence prediction. This study aims to investigate surgical wound risk predictions and management using a ML algorithm by R programming language analysis. The systematic review, following PRISMA guidelines, spanned electronic databases using search terms like 'machine learning', 'surgical' and 'wound'. Inclusion criteria covered experimental studies from 1990 to the present on ML's application in surgical wound evaluation. Exclusion criteria included studies lacking full text, focusing on ML in all surgeries, neglecting wound assessment and duplications. Two authors rigorously assessed titles, abstracts and full texts, excluding reviews and guidelines. Ultimately, relevant articles were then analysed. The present study identified nine articles employing ML for surgical wound management. The analysis encompassed various surgical procedures, including Cardiothoracic, Caesarean total abdominal colectomy, Burn plastic surgery, facial plastic surgery, laparotomy, minimal invasive surgery, hernia repair and unspecified surgeries. ML was skillful in evaluating surgical site infections (SSI) in seven studies, while two extended its use to burn‐grade diagnosis and wound classification. Support Vector Machine (SVM) and Convolutional Neural Network (CNN) were the most utilized algorithms. ANN achieved a 96% accuracy in facial plastic surgery wound management. CNN demonstrated commendable accuracies in various surgeries, and SVM exhibited high accuracy in multiple surgeries and burn plastic surgery. In sum, these findings underscore ML's potential for significant improvements in postoperative management and the development of enhanced care techniques, particularly in surgical wound management. [ABSTRACT FROM AUTHOR]

WOUND‐Q is a condition‐specific patient‐reported outcome measure developed for all types of chronic wounds, located anywhere on the body. To establish reliability and validity of a patient‐reported outcome measure, multiple pieces of evidence are required. The purpose of this study was to examine the measurement properties of 9 of the 13 WOUND‐Q scales and perform a test–retest reproducibility study in an international sample. In August 2022, we invited members of an international online community (Prolific.com) with any type of chronic wound to complete a survey containing the WOUND‐Q scales, the Wound‐QoL and EQ‐5D. A test–retest survey was performed 7 days after the first survey. It was possible to examine the reliability and validity of eight of the nine WOUND‐Q scales by Rasch Measurement Theory (RMT). To examine test–retest reproducibility intraclass correlation coefficients (ICCs), the standard error of the measurement and the smallest detectable change were calculated. In total, 421 patients from 22 different countries with 11 different types of chronic wounds took part in this study. Our analyses provided further evidence of the reliability and validity of the scales measuring wound characteristics (assessment, drainage, smell), health‐related quality of life (life impact, psychological, sleep, social) and wound treatment (dressing). [ABSTRACT FROM AUTHOR]

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]

Aging is the result of a gradual functional decline at the cellular, and ultimately, organismal level, resulting in an increased risk of developing a variety of chronic illnesses, such as cardiovascular disease, stroke, cancer and diabetes. The skin is the largest organ of the human body, and the site where signs of aging are most visible. These signs include thin and dry skin, sagging, loss of elasticity, wrinkles, as well as aberrant pigmentation. The appearance of these features is accelerated by exposure to extrinsic factors such as ultraviolet (UV) radiation or pollution, as well as intrinsic factors including time, genetics, and hormonal changes. At the cellular level, aging is associated with impaired proteostasis and an accumulation of macromolecular damage, genomic instability, chromatin reorganization, telomere shortening, remodelling of the nuclear lamina, proliferation defects and premature senescence. Cellular senescence is a state of permanent growth arrest and a key hallmark of aging in many tissues. Due to their inability to proliferate, senescent cells no longer contribute to tissue repair or regeneration. Moreover, senescent cells impair tissue homeostasis, promote inflammation and extracellular matrix (ECM) degradation by secreting molecules collectively known as the “senescence-associated secretory phenotype” (SASP). Senescence can be triggered by a number of different stimuli such as telomere shortening, oncogene expression, or persistent activation of DNA damage checkpoints. As a result, these cells accumulate in aging tissues, including human skin. In this review, we focus on the role of cellular senescence during skin aging and the development of agerelated skin pathologies, and discuss potential strategies to rejuvenate aged skin. [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]