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Results of an investigation of the wound-healing activity and toxicity parameters of a gel based on guanidine-containing pectin derivatives are presented. It is established that the developed 0.5% pectin guanidine gel exhibits a high rate of wound healing that reaches 82% on the 7th day of treatment. The gel belongs to class VI of relatively harmless compounds, with an LD50 value of >3000 mg/kg for cutaneous application to rats. There were no signs of skin irritation in the form of redness, peeling, or changes in the fur cover in local shaven and adjacent regions in rats. Chronic toxicity studies showed that daily skin application of the pectin guanidine gel for 30 d did not produce any toxic effects on the quantitative composition and morphology of peripheral blood in experimental animals. [ABSTRACT FROM AUTHOR]

The primary goal of this systematic review article was to provide an outline of the use of diabetic autologous adipose-derived mesenchymal stem cells (DAAD-MSCs) in the treatment of wounds and ulcers in animal models and patients with diabetes mellitus (DM). The secondary goal was to present the outcomes of pretreatment of diabetic adipose-derived mesenchymal stem cells (DAD-MSCs) with probable different agents in the treatment of diabetic foot ulcers (DFUs) and wounds. In view of possible clinical applications of AD-MSC-mediated cell therapy for DFUs, it is essential to evaluate the influence of DM on AD-MSC functions. Nevertheless, there are conflicting results about the effects of DAAD-MSCs on accelerating wound healing in animals and DM patients. Multistep research of the MEDLINE, PubMed, Embase, Clinicaltrials.gov, Scopus database, and Cochrane databases was conducted for abstracts and full-text scientific papers published between 2000 and 2020. Finally, 5 articles confirmed that the usage of allogeneic or autologous AD-MSCs had encouraging outcomes on diabetic wound healing. One study reported that DM changes AD-MSC function and therapeutic potential, and one article recommended that the pretreatment of diabetic allogeneic adipose-derived mesenchymal stem cells (DAlD-MSCs) was more effective in accelerating diabetic wound healing. Recently, much work has concentrated on evolving innovative healing tactics for hastening the repair of DFUs. While DM alters the intrinsic properties of AD-MSCs and impairs their function, one animal study showed that the pretreatment of DAlD-MSCs in vitro significantly increased the function of DAlD-MSCs compared with DAlD-MSCs without any treatment. Preconditioning diabetic AD-MSCs with pretreatment agents like photobiomodulation (PBM) significantly hastened healing in delayed-healing wounds. It is suggested that further animal and human studies be conducted in order to provide more documentation. Hopefully, these outcomes will help the use of DAAD-MSCs plus PBM as a routine treatment protocol for healing severe DFUs in DM patients. [ABSTRACT FROM AUTHOR]

Background: Alnus glutinosa (L) is a widespread medicinal plant on the territory of the Republic of Belarus. Alnus glutinosa (L) leaves tincture has an anti-inflammatory effect on the diseases of the throat, intestines, in rheumatism and gout. Water extracts from collective fruit, leaves and bark are used for gargling in stomatitis and gum bleeding. The purpose of the research was to establish wound healing activity of gels based on alcohol extracts from Alnus glutinosa (L) leaves on the model of a surface full flap skin wound on laboratory animals. Methods: Regenerating action of new drugs (gels) based on tinctures of Alnus glutinosa (L) leaves was studied on a model of planar full-layer skin wound in laboratory animals. Wounds were treated daily with gels applied to complete healing. The wound area was measured planometrically to assess the effectiveness of drugs and then the percentage of area reduction was calculated. Regenerative action of the gels developed was compared to widely used in medical practice 4% Dexpanthenol Gel and Reparef-2 Ointment. 15 g of Reparef-2 Ointment contains 1200 mg of bien and 75 mg of dioxidine. Results: Wound healing activity of gels containing tinctures of Alnus glutinosa (L) leaves based on 30% and 60% alcohol as to the rate of healing and the area of wounds epithelialization has been proved. Wound area treated with the gel based on Alnus glutinosa (L) extract containing 60% alcohol on day 13 of the experiment decreased by 95.59% ± 0.9% (p ≤ 0.05); based on the tincture containing 30% alcohol - by 92.93% ± 1.11%. Medicinal preparations with proved wound healing activity were compared: Reparef-2 Ointment (reduction percentage of wound area on day 13 of the experiment made 92.24% ± 2.21%) and Dexpanthenol Gel (reduction percentage of wound area on day 13 of the experiment made 83.09% ± 3.41%). Compared with the control group the gel based on 60% tincture of Alnus glutinosa (L) leaves showed a decrease in the epithelialization period by 29.5%; based on 30% tincture - by 24.6%; Reparef-2 Ointment - by 23.6% and Dexpanthenol Gel - by 13.8%. Conclusions: The results of this study showed that the developed gels based on Alnus glutinosa (L) have a regenerating action and can be used to treat wound processes taking into account previously established antimicrobial activity. [ABSTRACT FROM AUTHOR]

The use of topical antimicrobials is beneficial for infection control in wound care because wound infection is the major cause of delayed healing. The advantages of topical over systemic antimicrobials include a higher concentration at the target site, fewer systemic adverse effects, and a lower incidence of antimicrobial resistance. Nowadays, topical antimicrobials are divided into three groups: disinfectants, antiseptics, and antibiotics. Only antiseptics and antibiotics can be applied to living skin; therefore, this review will focus only on these groups. The advantages of each topical antimicrobial are well established; however, their disadvantages remain prominent. It is widely known that antiseptics show higher cytotoxicity and a broader spectrum of activity than antibiotics, whereas antibiotics show a higher probability of bacterial resistance development. However, there are still many adverse effects, resulting from each topical antimicrobial. This review aims to summarize the possible adverse effects of commonly used antiseptics (biguanide, silver, iodine, chlorine compounds, and other antiseptics), antibiotics (bacitracin, mafenide, mupirocin, neomycin, and silver sulfadiazine), and natural antimicrobials (curcumin and honey). Moreover, the antimicrobials that should be avoided in particular populations are also summarized in this review in order to increase awareness for antimicrobial selection in those populations. [ABSTRACT FROM AUTHOR]

Background: Split-thickness skin grafting (STSG) is the most commonly used technique in the treatment of traumatic, post-burn, and post-operative wounds, when direct wound edge closure is unavailable. There is currently no general agreement on the optimal thickness of skin grafts. We aimed to analyze the early results of recipient wound healing after STSG, using grafts of different thicknesses.Methods: This randomized, controlled, and parallel-group pilot clinical trial included 98 adult patients who underwent STSG transplantation surgery for post-burn, post-traumatic, or post-operative skin defects. Patients were randomized into three groups to receive a skin graft of 0.2, 0.3, or 0.4-mm thickness. After skin transplantation, the healing parameters of the recipient wounds were evaluated after 3 days, 7 days, 2 weeks, and 1 month. At each time, epithelialization and pain parameters were evaluated.Results: Our study showed that thinner split-thickness skin grafts had better epithelialization scores at the second post-operative week. However, thinner split-thickness skin grafts caused greater pain to the patients.Conclusions: Thickness of the skin graft is a significant factor affecting recipient wound healing parameters. It is necessary to evaluate healing of the donor wound, as well as distant treatment outcomes, such as scarring, pigmentation, and esthetic results of skin grafting with different thickness grafts.Level of Evidence: Level I, therapeutic study. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess two methods of mass abdominal closure with the fishing line as an alternative suture material for abdominal wall closure. Eighteen healthy male white rabbits weighing approximately 2.5 kg were used in this study. Animals were separated into three groups: control group (CG) (n = 06), interrupted pattern suture experimental group (IEG) (n = 06), and continuous pattern suture experimental group (CEG) (n = 06). Incisional wounds (4 cm) were performed in the right flank of abdominal wall. In control group (CG), the abdominal muscles and peritoneum were sutured in one layer with simple interrupted pattern using PGA resorbable suture and the skin with commercial synthetic suture (nylon). Then, in experimental groups, closure of peritoneum, abdominal muscles, and skin was performed with one-layer pattern using translucent nylon fishing line. Daily scores were allocated for signs of infection, wound healing, and wound adhesion. A faster wound closure time was recorded in control group (9 days) compared to experimental groups (13 days). All study animals showed low adhesion scores that were very important in the muscular wall. Almost similar histopathology profiles were observed in all groups. This study has demonstrated that fishing line, as suture material, is suitable for mass abdominal closure in rabbit model. [ABSTRACT FROM AUTHOR]

The need for treatment of chronic and infected wounds has increased during recent years due to demographic changes and the increasing number of patients with severe comorbidities. An increasingly larger selection of treatment options as well as wound dressings for the treatment of acute and chronic wounds have become available in recent years. Due to the diversity of increasingly specialized bandages and wound dressings, a standardized, phase-adapted treatment of acute, chronic and infected wounds is useful and recommended. The comprehensive treatment of problematic wounds should also include treatment of any comorbidities present as well as the elimination of noxious agents that may compromise wound healing. For these reasons, treatment of complicated wounds should be interdisciplinary and in close cooperation with the nursing staff. This article presents excerpts from our phase-adapted wound treatment concepts of the 'Wound Compendium Boberg', by which we are able to maintain a standardized and high quality treatment for problematic wounds. [ABSTRACT FROM AUTHOR]

Purpose: Following its renaissance in ophthalmology during the 1990s, preserved human amniotic membrane (HAM) has become an attractive biomaterial for all surgical disciplines. This article reviews the current and potential use of HAM in oral and maxillofacial surgery, its postulated properties and common preservation techniques. Methods: Literature was identified by an electronic search of PubMed in July 2012; this was supplemented from the reference lists of the consulted papers. Results: HAM has been used in the field of oral and maxillofacial surgery from 1969 onwards because of its immunological preference and its pain-reducing, antimicrobial, mechanical and side-dependent adhesive or anti-adhesive properties. The effects of HAM on dermal and mucosal re-epithelialisation have been highlighted. Typically, HAM is applied after being banked in a glycerol-preserved, DMSO-preserved or freeze-dried and irradiated state. Whereas the use of HAM in flap surgery and in intra-oral and extra-oral lining is reported frequently, novel HAM applications in post-traumatic orbital surgery and temporomandibular joint surgery have been added since 2010. Tissue engineering with HAM is a fast-expanding field with a high variety of future options. Conclusions: Preserved HAM is considered to be a safe and sufficient biomaterial in all fields of oral and maxillofacial wound healing. Recently published novel indications for HAM application lack a high level of evidence and need to be studied further. [ABSTRACT FROM AUTHOR]

Pyoderma gangrenosum is rarely seen in the surgical disciplines. In the described case the patient was initially diagnosed with necrotizing fasciitis and admitted to the intensive care unit suffering from septic shock. The automated implantable cardioverter defibrillator (AICD), the suspected focus for infection, had already been removed. Following weeks of broad spectrum antibiotics and wound debridement without clinical improvement the alternative diagnosis of pyoderma gangrenosum was reached. Consequently the patient was treated with immunosuppressive therapy and his condition improved rapidly such that he was ultimately discharged to rehabilitation. [ABSTRACT FROM AUTHOR]

Wounds expose a patient to serious hazards like wound infection, tissue destruction, disfiguring and disabling scars. Use of superoxidised solution (oxum) in infected wounds, ulcers, diabetic wounds, abcesses, burns reduced morbidity and hospital stay with its early wound healing effect. To evaluate the effect of superoxidised water (Oxum) V/s povidone iodine (Betadine) on similar types of wounds. We retrospectively analysed the records of two hundred patients with different types of wounds who attended Department of Surgery, Guru Nanak Dev Hospital/Govt. Medical College, Amritsar from January 2008 to January 2009. The patients were divided into two groups. Group A where topical management and dressing was done using oxum and group B where topical management and dressing was done using betadine. A standard grading in terms of percentage decrease in wound size, periwound oedema/erythema, pus discharge and percentage increase in granulation, fibrin and epithelisation was noted in various types of wounds in both groups. Oxum treated wounds showed reduction in inflammation and their healing earlier than betadine group. Oxum application was safe having no pain and allergic manifestation. [ABSTRACT FROM AUTHOR]

The already known benefits produced by the interaction of coherent light (laser) with biologic tissues determine its use as an adjuvant in the treatment of several complications associated with diabetes. Non-coherent light, such as that emitted by light emitting diodes (LEDs), becomes a promising alternative, because of its low cost and easy handling in these applications. Thirty-six rats were given surgical dorsum lesions. The lesions for the control group did not receive any supporting therapy. The other groups were irradiated only once, 30 min after the establishment of the lesion, with LED (640 nm with 40 nm full bandwidth at half maximum) or laser (660 nm). The histomorphological and histomorphometrical parameters were quantified. The coherent and non-coherent lights produced similar effects during a period of 168 h after the lesions had been made. For the group composed of diabetic animals, 72 h after creation of the lesion, it was observed that the therapy with LEDs had been more efficient than that with the laser in the reduction of the wounds' diameters. [ABSTRACT FROM AUTHOR]

The fundamental mechanism for hernia formation is loss of the mechanical integrity of abdominal wall structural tissue that results in the inability to offset and contain intra-abdominal forces during valsalva and loading of the torso. There is evidence that genetic or systemic extracellular matrix disorders may predispose patients to hernia formation. There is also evidence that acute laparotomy wound failure leads to hernia formation and increases the risk of recurrent hernia disease. It may be that hernia formation is a heterogeneous disease, not unlike cancer, where one population of patients express an extracellular matrix defect leading to primary hernia disease, while other subsets of patients acquire a defective, chronic wound phenotype following failed laparotomy and hernia repairs. It is evident that an improved understanding of structural tissue matrix biology will lead to improved results following abdominal wall reconstructions. [ABSTRACT FROM AUTHOR]

Lasers are now widely used for treating numerous cutaneous lesions, for scar revision (hypertrophic and keloid scars), for tissue welding, and for skin resurfacing and remodeling (wrinkle removal). In these procedures lasers are used to generate heat. The modulation of the effect (volatilization, coagulation, hyperthermia) of the laser is obtained by using different wavelengths and laser parameters. The heat source obtained by conversion of light into heat can be very superficial, yet intense, if the laser light is well absorbed (far-infrared:CO or Erbium:Yttrium Aluminum Garnet [Er:YAG] lasers), or it can be much deeper and less intense if the laser light is less absorbed by the skin (visible or near-infrared). Lasers transfer energy, in the form of heat, to surrounding tissues and, regardless of the laser used, a 45-50°C temperature gradient will be obtained in the surrounding skin. If a wound healing process exists, it is a result of live cells reacting to this low temperature increase. The generated supraphysiologic level of heat is able to induce a heat shock response (HSR), which can be defined as the temporary changes in cellular metabolism. These changes are rapid and transient, and are characterized by the production of a small family of proteins termed the heat shock proteins (HSP). Recent experimental studies have clearly demonstrated that HSP 70, which is over-expressed following laser irradiation, could play a role with a coordinated expression of other growth factors such as transforming growth factor (TGF)-β. TGF-β is known to be a key element in the inflammatory response and the fibrogenic process. In this process, the fibroblasts are the key cells since they produce collagen and extracellular matrix. In conclusion, the analysis of the literature, and the fundamental considerations concerning the healing process when using thermal lasers, are in favor of a modification of the growth factors synthesis after laser irradiation, induced by an HSR. An extensive review of the different techniques and several clinical studies confirm that thermal lasers could effectively promote skin wound healing, if they are used in a controlled manner. [ABSTRACT FROM AUTHOR]