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

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

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]

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

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

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

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

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

The persistence of organisms as biofilms and the increase in antimicrobial resistance has raised the need for alternative strategies. The study objective was to compare the ability of isolated bacteriophages to remove in vitro biofilms formed by Pseudomonas aeruginosa isolated from the environment with those isolated from diabetic and non-diabetic wounds. P. aeruginosa were isolated from clinical and environmental sites, and antimicrobial susceptibility was tested. Bacteriophages were isolated and characterized based on plaque morphology and host range. A reduction in the viable count assayed the lytic ability of candidate phages. The crystal violet method was used to determine the residual biofilm after 24 h of phage treatment on 72-h-old biofilms. The statistical significance of phage treatment was tested by one-way ANOVA. Of 35 clinical isolates, 17 showed resistance to 1 antibiotic at least, and 7 were multidrug resistant. Nineteen environmental isolates and 11 clinical isolates were drug-sensitive. Nine phages showed 91.2% host coverage, including multidrug-resistant isolates. Phages eradicated 85% of biofilms formed by environmental isolates compared to 58% of biofilms of diabetic isolates and 56% of biofilms of non-diabetic isolates. Clinical isolates are susceptible to phage infection in planktonic form. Biofilms of P. aeruginosa isolated from diabetic wounds and non-diabetic wounds resist removal by phages compared to biofilms formed by environmental isolates. All phages were efficient in dispersing PAO1 biofilms. However, there was a significant difference in their ability to disperse PAO1 biofilms across the different surfaces tested. Partial eradication of biofilm by phages can aid in complementing antibiotics that are unable to penetrate biofilms in a clinical set-up. [ABSTRACT FROM AUTHOR]

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

Background: The drive for patients to be actively involved in their own healthcare received significant attention during the COVID-19 pandemic. For patients living with wounds, shared care usually encompasses aspects of care planning, and wound care tasks, but the suddenness of the pandemic meant many patients were unsure how to do this sufficiently. Objectives: The aim of this project was to explore experiences of shared wound care during a pandemic from a patient and healthcare professional perspective. Methods: Semi-structured qualitative interviews were undertaken with 25 patients living with wounds and five informal carers. A healthcare professional focus group (n=5) explored experiences of providing shared care information to patients. Thematic analysis was used to analyse the data. Results: The patient and carer interviews revealed five main themes (explanation of wound and wound type; access to healthcare services and the impact of the COVID-19 pandemic; wound education; patient and carer involvement in shared care tasks; the type of wound education that would be most helpful) and eight subthemes. The healthcare professional focus group revealed three main themes (patients who could be involved in shared care; trust education and standardising guidance; supporting people to share care) and five subthemes. Conclusions: This study has highlighted the importance of targeted education for patients living with wounds and their informal carers. Standardising education and guidance for healthcare professional is important to build confidence. Early patient engagement in shared care and personalised care plans are key to maximise acceptance. [ABSTRACT FROM AUTHOR]

Unprecedentedly, this article presents a useful management protocol for the workers in emergency situations assisting victims of white weapon aggressions with a dual innovation. It could presage a possible advance in the healthcare management of these patients and support important repercussions in the legal field when this type of wound is inflicted due to an aggression. The MLuq protocol has been agreed by consensus in a multidisciplinary manner including experts belonging to the state security forces (judicial and scientific Police), to the healthcare area (surgical nursing, emergency medicine, general cardiothoracic and digestive surgery, and the legal and forensic medicine area), to the legal system (a jurist specialized in the area), and to the academic sphere. It is the first paper to propose purse string sutures as a weapon immobilization technique, as well as a set of actions designed to obtain biological traces of legal interest and to preserve the chain of custody. Therefore, it is a useful tool for the health and legal personnel, and especially for the victims. [ABSTRACT FROM AUTHOR]

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

The current study conducted to identify the bacterial isolates from burns and wound infections that are responsible for various skin complication in such conditions and determination the development of antimicrobial resistance among these bacterial isolates. This study is carried out Between September 2020 to December 2020, a total number of (103) burns and wound swabs were taken from different patients from different hospitals in Baghdad city, the specimens were collected from; burns (57) and wound (46) swabs, the specimens were included; (51) female and (52) Male, the age average between (2 - 70 years). The positive bacterial containing specimens are (93) swabs, most of them are mixed (82 specimens) with different types of bacterial species and only (11 specimens) are contained with one type of bacterial isolate, while the negative bacterial containing are (10) swabs that showed no aerobic bacterial growth.. Staphylococcus sp. is recorded the most prevalence organisms found in wounds and burns 75/163(46%) included 31(41.3%) and 44(58.7%) isolated from burns and wounds respectively. Whereas Enterobacteriaceae sp. revealed that 57/163 ( 35%), 25(44%) from wounds and 32(56%) from burns. Also Pseudomonas sp. 23/163( 14.1%), Acinetobacter sp. 5/163(3.1%), and Corynebacterium sp. 3/163(1.8%) were isolated from infected wound in a percentage (47.8%,60%,and 33.3%) and from burns (52.2%, 40% and 66.7%) respectively. Another experiment was performed to measure the antimicrobial susceptibility against several antimicrobial agents included; Methicillin, Caphalothin, Tobramycin, Azithromycin, Bacitracin, Novobiocin, Levofloxacin and Sulfamethoxazole + Trimethoprim. The results showed increasing the resistance percentages among different bacterial isolates, and developed multidrug resistant bacteria. [ABSTRACT FROM AUTHOR]

At present, the development trend of dressing materials is being multifunctional for convenient and long-term nursing care process of some complicated wounds. Here, basing on the theory of wound moist healing, an injectable and self-healing hydrogel comprising of collagen (COL), chitosan (CS) and oxidation modified Konjac glucomannan (OKGM), which acts as a macromolecular cross-linker to construct dynamic Schiff-base bonds was smartly designed. The strategy of introducing the silver nanoparticles (Ag NPs) into the COL–CS–OKGM hydrogel matrix achieved a markedly enhanced antibacterial activity derived from the synergistical effect between the Ag+ and the mild photothermal efficacy of Ag NPs, which also improved the local capillary blood circulation of the wound area to further facilitate wound healing process. The excellent syringeability and self-healing behaviors endowed the COL–CS–OKGM–Ag hydrogel with self-adapting ability for the wounds with irregular and large area needing frequent applying and changing without secondary injuries. In vitro and in vivo evaluations verified that so-designed COL–CS–OKGM–Ag hydrogel also with hemostatic performance is a promising multifunctional dressing for the treatments of infected wound with not only good biocompatibility and convenient use, but also with desired regenerative healing prognoses benefited from hydrogel moist environment and physiotherapy. [ABSTRACT FROM AUTHOR]

Objective: to evaluate management outcomes of post-sternotomy wounds. Study Design: Retrospective longitudinal study. Place and Duration of Study: Department of Plastic Surgery, Shifa International Hospital, Islamabad Pakistan, from Jan 2020 to Dec 2021. Methodology: We reviewed 35 patients who had developed sternal wound infections post-cardiothoracic surgery. Outcomes of the study were measured using the SF-36 Quality of Life questionnaire. Results: Our patients presented with either Pairolero Type-II 11(31.4%) or Type-III 19(54.2%) sternal wound infection. Pre-operatively patients scored 296.667±69.40 in physical functional, 100.00±30.51 in limitations due to physical health, 16.67±37.90 in role limitation due to emotional problems, energy/fatigue scored 43.53±23.70, emotional well-being 163.33±23.54, social functioning as 11.40±11.66, pain score 31.25±19.90 and general health 131.67±35.31. The improvement in scores was noted in all domains postoperatively. Physical functioning mean scored as 790.00±48.07, role limitations due to physical health scored as 310.34±67.32, role limitations due to emotional problems scored as 266.67±47.94, energy/fatigue 284.67±18.71, emotional wellbeing 448.67±18.71, social functioning 185.83±12.60, pain score 164.17±22.01 and general health 316.67±34.95. Thirty-four (97.1%) out of 35 patients recovered well postoperative, with a maximum follow-up of 4 years and a minimum follow-up of 1 year. One patient expired on the sixth day of muscle flap coverage of the wound due to cardiac arrest. Conclusion: A positive prognosis can be obtained by this treatment protocol. [ABSTRACT FROM AUTHOR]

Background. The aim of the study was to find out the influence of excess copper and zinc ions in drinking water on the bile-forming and bile-secreting functions of the liver in the conditions of mechanical trauma and the effectiveness of the antidote therapy. Material and methods. The experiments were performed on 60 Wistar strain male rats weighing 180-200 g. There were 3 groups of experimental animals in the experiment: 1 group - only skeletal trauma was simulated; 2 group - a skeletal injury was simulated and zinc and copper salts were administered; 3 group - skeletal trauma + zinc and copper salts followed by Unithiol treatment. Results. In the late period of traumatic illness (14-28 days), after a severe skeletal injury, the intensity of bromsulfalein increased in the liver tissue, and there were signs of increased formation of direct bilirubin in terms of additional intake of copper and zinc ions. The animals with severe skeletal trauma were accompanied by a significant deterioration in the functional state of the liver in comparison to the animals with similar skeletal trauma without additional intoxication. Conclusions. Under conditions of additional intake of copper and zinc ions (in the 2nd group), after 14 days and 28 days of observation, all the studied indicators are much higher than in the group of the animals without additional intoxication with these ions. The use of Unithiol reduced the toxic effect of copper and zinc ions on the studied indicators of the functional state of the liver both in the early and late period of the traumatic disease. [ABSTRACT FROM AUTHOR]

Copper has intrinsic antimicrobial properties. Wound dressings impregnated with cuprous oxide microparticles (hereafter termed COD) have been cleared for the management of acute and chronic wounds by the FDA and other regulatory bodies. The COD reduced the viable microbial titers of a wide spectrum of microbes by more than 10,000-fold (4-logs) within 3 h of exposure at 37 °C (p < 0.001). Similar microbial titer reductions were achieved by 3-year naturally aged COD dressings, showing the stability of the biocidal efficacy over time. The potent biocidal efficacy of the COD was maintained even after 7 daily consecutive inoculations of the dressings with ~106 CFU. COD with an adhesive contour blocked the passage of bacteria from the exterior environment to the wound bed side of the dressing even after 7 daily consecutive inoculations of different bacteria on the outer surface of the dressings. Taken together, the study demonstrates the wide spectrum potent in vitro biocidal efficacy of the cuprous oxide impregnated dressings against a wide panel of microorganisms. [ABSTRACT FROM AUTHOR]

Trauma management forms a significant component of any health system. It can affect any body system, and as such knowledge of the wide possible presentations and sequalae are critical. Systemic air embolism (SAE) is a rare presentation in trauma, though it can be associated with significant morbidity and mortality. We present the case of a 23-year-old gentleman with isolated penetrating trauma to the chest who developed widespread neurological insult as a result of SAE, and review historical and proposed contemporary management of SAE. [ABSTRACT FROM AUTHOR]

Recent advances in polymer composites have led to new, multifunctional wound dressings that can greatly improve healing processes, but assessing the moisture status of the underlying wound site still requires frequent visual inspection. Moisture is a key mediator in tissue regeneration and it has long been recognised that there is an opportunity for smart systems to provide quantitative information such that dressing selection can be optimised and nursing time prioritised. Composite technologies have a rich history in the development of moisture/humidity sensors but the challenges presented within the clinical context have been considerable. This review aims to train a spotlight on existing barriers and highlight how laser-induced graphene could lead to emerging material design strategies that could allow clinically acceptable systems to emerge. [ABSTRACT FROM AUTHOR]

Introduction: Injuries sustained by adolescents in Canada represent a costly public health issue. Much of the limited research in this area uses administrative data, which underestimate injury prevalence by ignoring injuries that are not treated by the health care system. Self-reported data provide population-based estimates and include contextual information that can be used to identify injury correlates and possible targets for public health interventions aimed at decreased injury burden. Methods: The 2017 wave of the Canadian Community Health Survey was used to calculate the prevalence of self-reported total, intentional and unintentional injuries. We compared injury prevalence according to age, sex, employment status, presence of a mood disorder, presence of an anxiety disorder, smoking and binge drinking. Analyses were performed using logistic regression to identify significantly different injury prevalence estimates across key correlates. Methods: The 2017 wave of the Canadian Community Health Survey was used to calculate the prevalence of self-reported total, intentional and unintentional injuries. We compared injury prevalence according to age, sex, employment status, presence of a mood disorder, presence of an anxiety disorder, smoking and binge drinking. Analyses were performed using logistic regression to identify significantly different injury prevalence estimates across key correlates. Conclusion: The data suggest that injury prevention interventions aimed at reducing alcohol consumption, particularly binge drinking, may be effective in reducing adolescent injury across Canada. Future research is needed to determine how provincial context (such as mental health support for adolescents or programs and policies aimed at reducing substance use) impacts injury rates. [ABSTRACT FROM AUTHOR]

Background: Clinical outcomes after negative-pressure wound therapy (NPWT) and standard treatment of conflict-related extremity wounds are similar. In resource-limited settings, cost affects the choice of treatment. We aimed to estimate treatment-related costs of NPWT in comparison with standard treatment for conflict-related extremity wounds. Methods: We derived outcome data from a randomized, controlled superiority trial that enrolled adult (≥ 18 years) patients with acute (≤ 72 h) conflict-related extremity wounds at two civilian hospitals in Jordan and Iraq. Primary endpoint was mean treatment-related healthcare costs (adjusted to 2019 US dollars). Results: Patients were enrolled from June 9, 2015, to October 24, 2018. A total of 165 patients (155 men [93.9%]; 10 women [6.1%]; and median [IQR] age, 28 [21–34] years) were included in the analysis. The cost per patient treated with NPWT was $142 above that of standard treatment. Overall, results were robust in a sensitivity analysis. Conclusions: With similar clinical outcomes compared to standard care, our results do not support the use of NPWT in routine treatment of conflict-related extremity wounds at civilian hospitals in resource scarce settings. Trial registration NCT02444598. [ABSTRACT FROM AUTHOR]

Skin tears are traumatic acute wounds that continue to increase with the aging population and the associated physiological skin changes. They are known to cause significant pain, affect quality of life of patients and lead to large amounts of unscheduled and scheduled visits for the district nurses, as well as inappropriate call outs for the paramedics. These type of wounds occur mainly on the arms and legs, they are both preventable and respond well to early intervention. South Warwickshire Foundation Trust TVN's started a three month project, where residential homes carers would be taught how to prevent and manage skin tears, only referring to the district nurses if the wound developed complications. Documentation including care plans and a skin tear first aid box were provided to each home. The project resulted in 93% of all skin tears managed from injury to healing by the residential home. Improving the resident's quality of life, empowering residential home staff, reducing unscheduled and scheduled referrals into the district nurses and callout for paramedics. The project is now being rolled out to all care homes across South Warwickshire Foundation Trust. [ABSTRACT FROM AUTHOR]

The treatment and care of human wounds represent an enormous burden on the medical system and patients alike. Chronic or delayed healing wounds are characterized by the inability to form proper granulation tissue, followed by deficiencies in keratinocyte migration and wound re-epithelialization, leading to increased likelihood of infection and poor wound outcomes. Human reticular acellular dermal matrix (HR-ADM) is one type of tissue graft developed to enhance closure of delayed healing wounds that has demonstrated clinical utility through accelerating closure of lower extremity diabetic ulcers, but the mechanisms underlying this clinical success are not well understood. The authors utilized a diabetic murine splinted excisional wound model to investigate the effects of HR-ADM application on wound closure. The authors demonstrate that application of HR-ADM served as a dermal scaffold and promoted rapid re-epithelialization and keratinocyte proliferation, resulting in accelerated wound closure while minimizing granulation tissue formation. HR-ADM-applied wounds also demonstrated evidence of cellular infiltration, neovascularization and collagen remodeling by the host organism. These data suggest that HR-ADM supports epidermal closure in delayed healing wounds and remodeling of the matrix into host tissue, lending further support to the clinical success of HR-ADM described in clinical reports. [ABSTRACT FROM AUTHOR]

• Administrative health data was used to study rates of injury related hospitalization in children. • Rates of injuries resulting in hospitalization were higher for youth living with IDD. • Self-harm injuries were higher for youth living with IDD. Introduction: Children and adolescents living with intellectual and developmental disability (IDD) have a higher risk of experiencing morbidities and premature death when compared to children and adolescents living without IDD. Childhood injuries are a leading cause of morbidity and death, yet there are limited studies that explore the prevalence of childhood injuries for individuals living with IDD. The purpose of this study was to analyze Ontario health administrative data to identify and compare rates of injury resulting in hospitalization in children and adolescents living with and without IDD. Methods: This is a cross-sectional study of all Ontarians aged 0–19 years with and without IDD. The outcome of interest was the rate of injury resulting in hospitalization. Results: This study found that children and adolescents with IDD had 1.79 (CI 1.66, 1.92) times higher rates of both intentional and unintentional injuries that resulted in hospitalization when compared to children and adolescents without IDD. Hospitalizations for self-harm related injuries were 3.16 (CI 3.09, 3.23) times higher in the IDD group. Conclusion : Children and adolescents with IDD have a higher risk of sustaining serious injuries, particularly injuries resulting from self-harm. Practical Applications: This study provides evidence of increased injury related hospitalizations for children and adolescents with IDD when compared to their peers without IDD. [ABSTRACT FROM AUTHOR]

Background and Aim: Horse wounds can be easily infected with bacteria depending on the nature of its cause such as laceration, abrasion, or puncture as well as the nature of its environment. Various treatments are available in managing open wounds, including the usage of topical antibiotics and antiseptics. However, antibiotic resistance has been a major concern attributed with chronic wound infection. The aim of this study was to test the efficacy of ionized water at different pH against the growth of common bacteria from horse wounds. Materials and Methods: Ten swab samples from equine infected wounds were collected and bacteria isolation and identification were performed. The antibacterial effect of the ionized water of pH 2.5, 4.5, 7.0, and 11.5 was tested on Staphylococcus aureus, Staphylococcus pseudintermedius, Staphylococcus intermedius, Escherichia coli, Pantoea agglomerans, and Klebsiella pneumoniae. The time-kill profiles of the ionized waters were determined at time 0, 2, 4, 6, and 8 h. Results: Ionized water of pH 2.5 and 4.5 showed antibacterial activity against S. aureus, S. pseudintermedius, and S. intermedius with significant (p>0.05) reduction in colony-forming unit/mL within 2-8 h. The degree of bactericidal effect of the acidic ionized water differs between the species with S. intermedius more susceptible. However, there was no antibacterial effect at pH 2.5, 4.5, 7.0, and 11.5 on the Gram-negative bacteria tested. Conclusion: Ionized water of pH 2.5 and 4.5 is effective in minimizing the growth of Gram-positive bacteria; thus it could be of clinical importance as an antiseptic for surface wound lavage in horses. [ABSTRACT FROM AUTHOR]

Aim: Although most defects can close by primary suturing after radical surgery of gynecological malignancies, different reconstruction options are available when large defects that require reconstruction occur. In this study, we present the treatment strategy and results for patients who underwent reconstruction after resection for gynecological cancer in the vulva and perineum. Material and Methods: A total of 18 patients who underwent reconstruction between May 2018 and July 2020 were included in this retrospective study. Demographics and clinical data, the resection operation, characteristics of the defect, and the reconstruction methods applied were evaluated. Postoperative treatment strategy and complication rates were evaluated. Results: The mean age was 62.3±13.2 (42-83) years. 88.9% of the patients had additional diseases. Pelvic exentration was performed in 5 (27.8%) patients, anterior resection in 2 (11.1%) patients and vulvectomy in 11 (61.1%) patients. The most common malignancy was squamous cell carcinoma, and mean defect size was 106±97 (12-476) cm2. Reconstruction was performed with a local fasciocutaneous flap in 16 (88.9%) patients, pedicled rectus myocutaneous flap in one (5.6%) patient, and skin graft in one (5.6%) patient. Wound complications occurred in 5 (27.8%) patients, partial flap necrosis in one (5.6%) patient, and recurrence in one (5.6%) patient in the long term. Conclusion: It is possible to reconstruction most of the vulva and perineal defects with local flaps after oncological resections, Considering the characteristics of the area and patient comorbidities, it should be kept in mind that prolonged wound problems may be seen, especially in vulvectomy patients. [ABSTRACT FROM AUTHOR]

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Introduction: Research has shown that during the 2003 SARS pandemic, emergency department (ED) visits among the pediatric population decreased. We set out to investigate if this was also true for injury-related ED visits during the COVID-19 pandemic. Methods: Using data from the Canadian Hospitals Injury Reporting and Prevention Program (CHIRPP), we looked at 28 years of injury-related ED visits at the Montreal Children's Hospital, a provincially designated Pediatric Trauma Centre. We compared data from a two-month period during the COVID-19 lockdown (16 March to 15 May) to the same period in previous years (1993-2019) to determine whether the 2020 decrease in ED visit numbers was unprecedented (i.e. a similar decrease had never occurred) for different age groups, nature of injuries, mechanisms and severity. Results: The 2020 decrease was unprecedented across all age groups between 1993 and 2019. When compared with the 2015 to 2019 average, the decrease was smallest in children aged 2 to 5 years (a 35% decrease), and greatest in the group aged 12 to 17 years (83%). Motor vehicle collisions and sports-related injuries practically vanished during the COVID-19 lockdown. Surprisingly, more children aged 6 to 17 years presented with less urgent injuries during the COVID-19 lockdown than in previous years. Conclusion: As was the case with SARS in 2003, COVID-19 acted as a deterrent for pediatric ED visits. The lockdown in particular had a profound impact on injury-related visits. The de-confinement period will be monitored to determine the impact in both the short and the long term. [ABSTRACT FROM AUTHOR]

Medical grade honey (MGH) has antimicrobial and pro‐healing properties. We here demonstrate that MGH is an easily applicable, safe, and cost‐effective approach for severe wounds. The use of MGH should more often be considered to treat all kinds of pediatric wounds. [ABSTRACT FROM AUTHOR]

Traumatic left ventricular pseudoaneurysms are rare and surgical correction is the treatment of choice. In this article, it is reported a case of a myocardial stab injury with primary suture and development of a giant pseudoaneurysm, five years later, that underwent surgical repair. [ABSTRACT FROM AUTHOR]

Background: Injuries are among the top 10 leading causes of death in Canada. However, the types and rates of injuries vary between rural versus urban settings. Injury rates increase with rurality, particularly those related to motor vehicle collisions. Factors such as type of work, hazardous environments and longer driving distances contribute to the difference in rural and urban injury rates. Further examination of injuries comparing rural and urban settings with increased granularity in the nature of injuries and severity is needed. Methods: The study population consisted of records from the electronic Canadian Hospitals Injury Reporting and Prevention Program (eCHIRPP) from between 2011 and July 2017. Rural and urban status was determined based on postal codes as defined by Canada Post. Proportionate injury ratios (PIRs) were calculated to compare rural and urban injury rates by nature and severity of injury and sex, among other factors. Results: Rural injuries were more likely to involve multiple injuries (PIR = 1.66 for 3 injuries) and crush injuries (PIR = 1.72). More modestly elevated PIRs for rural settings were found for animal bites (1.14), burns (1.22), eye injuries (1.32), fractures (1.20) and muscle or soft tissue injuries (1.11). Injuries in rural areas were more severe, with a higher likelihood of cases being admitted to hospital (1.97), and they were more likely to be due to a motor vehicle collision (2.12). Conclusion: The nature of injuries in rural settings differ from those in urban settings. This suggests a need to evaluate current injury prevention efforts in rural settings with the aim to close the gap between rural and urban injury rates. [ABSTRACT FROM AUTHOR]

This article examines the treatment of facial wounds in early modern Britain through a close study of the casebook of St Bartholomew's Hospital surgeon Joseph Binns (d. 1664). It explores surgeons' and related practitioners' special attention to the care and infliction of facial wounds and scarring in their practice, including impairments to facial movement and expression, the use of specific suturing techniques and the reduced use of stitches, and the development of agglutinative medicaments. The face was recognised as a site of immense vulnerability and exposure, requiring particular care, and this vulnerability was mirrored in the capacity for facial scarring to detrimentally advertise a practitioner's skill. This essay reads Binns' unpublished notes against the cases and theoretical ideals set out in published texts from surgeons such as the Scottish Alexander Read, the East India Company surgeon John Woodall, and the London surgeon and physician Daniel Turner. I argue that both the textbooks and Binns' practice demonstrate awareness of the special role of the face in the early modern period, and that this guided the medical approach to disfiguring injuries and conditions. [ABSTRACT FROM AUTHOR]

Aim: Defects of the extremities due to high-energy trauma are common and it is necessary to repair these defects. Reconstruction is possible with simple surgeries using skin grafts and negative pressure therapy (NPT). In this study, we present our results of the reconstruction of extremity defects caused by high-energy trauma with a simple surgical procedure using NPT Methods: Patients with soft tissue defects of the upper and lower extremities caused by high energy trauma, who were treated with NPT between November 2009 and June 2015, were included in the study. Results: NPT was performed in 63 patients. The average defect size was 60 cm². The patients underwent an average of nine sessions. The average length of hospital stay was 26 days. The defects were reconstructed using skin grafts and local flaps in 58 and two patients, respectively. None of the patients required free flaps. Conclusion: Extremity defects occurring due to high energy trauma can be closed by simple surgical techniques using NPT, patients can be protected from the complications of free tissue transfer, and also treatment is possible at much lower costs. [ABSTRACT FROM AUTHOR]

Chronic wounds are a common and debilitating complication for the diabetic population. It is challenging to study the development of chronic wounds in human patients; by the time it is clear that a wound is chronic, the early phases of wound healing have passed and can no longer be studied. Because of this limitation, mouse models have been employed to better understand the early phases of chronic wound formation. In the past few years, a series of reports have highlighted the importance of reactive oxygen species and bacterial biofilms in the development of chronic wounds in diabetics. We review these recent findings and discuss mouse models that are being utilized to enhance our understanding of these potentially important contributors to chronic wound formation in diabetic patients. [ABSTRACT FROM AUTHOR]

BACKGROUND: This prospective observational study aimed to determine the infection rate of simple hand laceration (SHL), and to compare infection rates between patients who were prescribed antibiotics and those who were not. METHODS: The study was performed at two urban hospitals enrolling 125 emergency department (ED) patients with SHL. Exclusion criteria included patients with lacerations for more than 12 hours, immunocompromized patients, patients given antibiotics, and patients with gross contamination, bites or crush injuries. Wound infection was defined as clinical infection at a follow-up visit (10-14 days) or wound was treated with antibiotics. Patient satisfaction was also measured using a visual analogue scale 1-10, asking the patients about wound appearance. Demographic data and wound characteristics were compared between the infected and non-infected wounds. The infection rates were also compared between patients who received prophylactic antibiotics and those who did not. The results were presented with medians and quartiles or percentages with 95% confidence intervals (CI). RESULTS: In the 125 patients with SHL [median age: 28 (18, 43); range: 1-102 years old; 36% female], 44 (35%, 95% CI: 27%-44%) were given antibiotics in the ED. Wound infection was reported in 6 patients (4.8%, 95% CI: 2%-10%). Age, gender, history of diabetes and wound closure were not associated with wound infection (P>0.05). The infection rate was not significantly different between patients with or without antibiotic prophylaxis [7% (3/44), 95% CI: 2%-10% vs. 4% (3/81), 95% CI: 1%-11%, P=0.66]. Patient's satisfaction with appearance of infected and non-infected wounds were significantly different [7.5 (6, 8) vs. 9 (8, 10), P=0.01]. CONCLUSION: Approximately 5% of simple hand lacerations become infected. Age, gender, diabetes, prophylactic antibiotics and closure technique do not affect the risk of infection. [ABSTRACT FROM AUTHOR]

Recent research has started to identify mood disorders and problems associated with acute and chronic wounds, which have been shown to contribute to delayed healing, poor patient well-being and a reduced quality of life. Furthermore, mood disorders have been shown to have a negative impact on financial costs for service providers and the wider society in terms of treatment and sickness absence. This study aimed to survey a multinational sample of health professionals to explore their perspective and awareness of mood disorders amongst acute and chronic wound patients. Responses were received from n = 908 health professionals working in Asia, Africa, Australia, Europe, North America and South America. A strong awareness of the prevalence of mood disorders appeared to be widespread among the health professionals across the world, in addition to a view on the potential factors contributing to these problems with mood. Despite this, it was thought that few patients were actually receiving treatment for their mood disorders. Implications for clinical practice include the need for health professionals to engage actively with their patients to enable them to learn from their experiences. Studies that explore the benefits of treatments and techniques appropriate for minimising mood disorders in patients with wounds would provide empirical evidence for health professionals to make recommendations for patients with acute and chronic wounds. [ABSTRACT FROM AUTHOR]

Epidermolysis Bullosa (EB) is a rare genetic skin disorder characterised by fragility and blistering of skin and mucous membranes. Skin can blister and shear away from minimal friction, trauma and every day activities. The disease causes a wide range of complications but wound care is the major challenge to severe EB, and good wound care is an essential part of wound management. The goal of wound care was to choose a product that protects the fragile skin, limits friction, decreases pain and promotes healing. However, access to wound dressings for those people living with EB is challenging. This article discusses the availability of EB dressings in a number of countries around the world and also describes an innovative National Epidermolysis Bullosa Dressings Scheme (NEBDS) in Australia, which aims to improve the quality of life of people with EB, by reducing the financial burden associated with the provision of dressings accordingly. [ABSTRACT FROM AUTHOR]

Uses of small firearms inflict gunshot wounds posing a risk to the health and life of animals. Different aspects associated with the evaluation and treatment of gunshot wounds, therefore, must be known by veterinarians. Due to the fact that gunshot wounds are received by soldiers on battlefields, saving the injured and treatment of such wounds is usually in the realm of battlefield medicine (field surgery). Despite, extensive experience gained during military conflicts and numerous criminal events, the investigation of factors affecting gunshot wounds have recently aroused much controversy. It has been attempted to elucidate and evaluate the complexity of bullet-organism (human or animal) interactions based on numerous experiments involving shooting materials that mimic live tissues and organs, human cadavers or live animals. Even though a series of these experiments has confirmed the complexity and unpredictability of each shot, many publications, as indicated in the present review, contained numerous errors and distortions which could not be confirmed in reliable experiments and in vivo observations. These errors are often copied unquestioningly by authors of other publications. As veterinarians are forced to gain knowledge on gunshot wounds mainly from human medicine literature, this review attempted to compile the major subjects on gunshot wounds in animals. [ABSTRACT FROM AUTHOR]

Background Few national studies of hospitalizations due to injuries among the First Nations population have been conducted. Data and methods Based on 2004/2005 to 2009/2010 data from the Discharge Abstract Database, this study examines associations between unintentional injury hospitalizations, socio-economic status and location relative to an urban core in Dissemination Areas (DAs) with a high percentage of First Nations identity residents versus a low percentage of Aboriginal identity residents. Results Unintentional injury hospitalization rates were higher in the less affluent and the most remote DAs. When DAs with the same socio-economic status and location were compared, the risk of hospitalizations was greater in high-percentage First Nations identity DAs relative to low percentage Aboriginal identity DAs. Interpretation Socio-economic conditions and remote location accounted for some, but not all, of the differences in unintentional injury hospitalizations between high-percentage First Nations identity and low-percentage Aboriginal identity DAs. This suggests that characteristics not measured in this analysis-such as environmental, behavioural or other factors-play an additional role in DA-level unintentional injury hospitalization risk. [ABSTRACT FROM AUTHOR]

Purpose: To conduct a study to measure the pressure effects of the different scrotal supports applied on a simulated expanding scrotal hematoma. Materials and Methods: We created a model of an expanding hematoma with simultaneous pressure recording using a urodynamics system. Pressures were recorded independently first without application of any support. Then, three types of scrotal supports were tested, including Euron Net Knickers, scrotal suspensory bandage, and tight swimming trunks brand Speedo® brief and shorts. Subsequent pressures were recorded using the model created, which was applied inside the supports worn by two male volunteers A and B. Results: Without any external compression, the pressure inside the simulated expanding hematoma "balloon" reached a maximum of 15 cmH2O. The pressures measured whilst wearing "Netelast knickers" in both subjects A and B reached a maximum of 15 cmH2O suggesting that this garment exerted no measurable compression. The suspensory scrotal support was then tested in both subjects. As the balloon started to fill with saline, the simulated hematoma pushed the scrotal support forward resulting in falling of the balloon outside the scrotal support. Subsequently, Speedo® briefs and shorts were tested. With Speedo® briefs, maximum filling pressures of 49 cmH2O and 40 cmH2O were reached in subjects A and B, respectively. When using Speedo® shorts, however, maximum pressures of 55 cmH2O in subject A and 54 cmH2O in subject B were reached at the end of the balloon filling to 300 mL of saline. Conclusion: The use of tight swimming trunks (Speedo®) has led to satisfactory results in the prevention of hematoma post scrotal surgery. [ABSTRACT FROM AUTHOR]

Introduction Injury is the first cause of death worldwide in the population aged 1 to 44. In developed countries, the most common trauma-related injuries resulting in death during childhood are traffic accidents, followed by drowning. Methods This retrospective study based on autopsy examinations describes the epidemiology profile of deaths by trauma-related causes in individuals younger than 18 years from 2001 to 2008 in the city of Campinas. The aim is to identify epidemiology changes throughout the years in order to develop strategies of prevention. Results There were 2,170 deaths from all causes in children < 18 years old, 530 of which were due to trauma-related causes, with a male predominance of 3.4:1. The age distribution revealed that 76% of deaths occurred in the 10-17 age group. The most predominant trauma cause was firearm injury (47%). Other frequent causes were transport-related injuries (138 cases-26%; pedestrians were struck in 57.2% of these cases) and drowning (55 cases-10.4%). Asphyxia/suffocation was the cause of death in 72% of cases in children < 1 year old; drowning (30.8%) was predominant in the 1-4 age group; transport-related deaths were frequent in the 5-9 age group (56%) and the 10-14 age group (40.4%). Gun-related deaths were predominant (68%) in the 14-17 age group. 51% of deaths occurred at the scene. Conclusions There was a predominance of deaths in children and adolescents males, between 15-17 years old, mainly from gun-related homicides, and the frequency has decreased since 2004 after the disarmament statute and the combating of violence. [ABSTRACT FROM AUTHOR]

Objective To retrospectively investigate the experience at one urban level one trauma center with gunshot femoral fractures with vascular injury and to examine the implication of surgical sequence with regards to short-term complications and ischaemia time. Methods We performed a retrospective study of 24 patients treated at an urban level one trauma center over a 10-year period with low velocity gunshot wounds resulting in femur fractures and major vascular injury. Data were stratified according to sequence of surgical intervention. Results The mean age was 31.3 years. Mean time to revascularization was highest in patients undergoing definitive orthopaedic fixation first (660 min) and lowest in patient undergoing shunting first (210 min). Most complications in patients undergoing vascular repair first, included two disrupted repairs requiring immediate revision after subsequent orthopaedic fixation. Other complications included compartment syndrome and one amputation. Conclusion Surgical sequence did not appear to impact the outcome with regard to limb loss, compartment syndrome, or mortality. Orthopaedic repair following vascular repair, however, is a risk for disruption of the vascular repair. We suggest that close and early direct communication between the orthopaedic and vascular surgeons take place in order to facilitate a satisfactory outcome. [ABSTRACT FROM AUTHOR]

Abstract: After tail loss in lizards no infections occur indicating the presence of an effective anti-microbial barrier in the exposed tissues of the tail stump. Previous molecular studies on the lizard Anolis carolinensis have identified some beta-defensin-like genes and the deduced peptides that may be involved in anti-infective protection. The present study has analyzed the tissues of wounded and normal tails in lizards in order to immune-localize one of the beta-defensins previously found (AcBD15) and to detect variation in its gene expression during wounding. No immunoreactivity for this beta-defensin is present in normal tissues or in the epidermis of lizards, except for some sparse granulocytes. The latter are seen during the first 1–6days after tail amputation and AcBD15 immunoreactivity is present in their granules. Degenerating granulocytes are incorporated, together with dead erythrocytes, platelets and keratinocytes into the scab. Real time RT-PCR and western blotting analysis indicates up-regulation of AcBD15 expression during wounding with respect to normal tissues, indicating that production, storage and release of this beta-defensin from granulocytes are active following wounding. The production of beta-defensins from granulocytes would allow protection of exposed tissues from microbial invasion avoiding a persistent inflammation, a process that leads to tissue regeneration. [Copyright &y& Elsevier]

The brown recluse spider bite can cause an enlarging necrotic skin wound, traditionally treated with expectant management, anti-inflammatory drugs and late reconstructive surgery. In this paper we report 2 cases where we used Vacuum-Assisted Closure therapy (VAC®) for the successful management of these wounds. We believe that VAC® therapy is very effective in reducing wound size and skin necrosis, and also in accelerating patient recovery time. [ABSTRACT FROM AUTHOR]

Abstract: Introduction: A January 2007 ice storm occurred in Oklahoma, causing power outages and hazardous travel conditions. The objective of this investigation was to describe the nature of winter storm-related injuries among Oklahoma residents, to determine populations at risk, and to inform prevention-planning personnel. Methods: Winter storm-related injuries were a temporarily reportable condition; all acute-care hospitals and the state medical examiner logged storm-related injuries and deaths during January 12−30, 2007. Medical records were retrospectively abstracted. Risk of injury was described by demographic group, injury type, and mechanism. Results: Among 6,047 persons experiencing winter storm-related injuries, 74% were injured in falls, 13% in motor-vehicle collisions (MVCs), 8% while sledding, 1% by unintentional carbon monoxide poisoning, 1% in cleanup activities, and 3% by other mechanisms. Median age of injured persons was 39years. Persons aged≥40years were 1.4 times more likely to experience falls as the cause of injury than those aged <40years, and falls were twice as likely as other mechanisms to cause fractures among persons aged≥40years. Injured persons aged <40years were 2.2 times more likely to experience MVC-related injuries, and 19 times more likely to experience sledding-related injuries than persons aged≥40years. Conclusions: Younger persons were more likely injured in MVCs and sledding incidents, whereas older persons were more likely to experience falls and fractures. Impact on industry: Prevention messages for winter storm-related injuries should target winter-driving safety tips to younger adults and precautions regarding falls to older adults. [Copyright &y& Elsevier]

Background: firearm wounds are relatively frequent and show high incidence at the head and face area. Temporomandibular joint may be involved, and also some important anatomic structures as the facial nerve directing the need for an interdisciplinary team in order to promote an efficient treatment. Procedures: a case report related to a comminuted condyle fracture caused by firearms with a nonsurgical treatment associated to myofunctional therapy. The patient was referred to Speech and Language Pathologist after the conduct of oral and maxillofacial surgery team, without removing the bullet, lodged superficially near the origin of the sternocleidomastoid muscle on the right side; with comminuted condyle fracture and facial nerve damage. Myofunctional evaluation found an important reduction in the mandibular movement amplitude with severe deviations as for the affected side, no contralateral laterality, muscle pain; paralysis and paresthesia on the right side of the face. Myofunctional therapy followed a specific protocol for facial trauma including: drainage of edemas, specific ipsilateral manipulations on jaw muscles; correction and enlargement of the mandibular movements, specific procedures related to facial paralysis and directed functional reorganization. Results: after eight therapy sessions we obtained: mandibular movements with adequate amplitude and symmetry, chewing reorganization, adequacy of swallowing and speech, remission of painful symptoms and remission of paralysis in the medium third of the face. Conclusion: the conservative treatment for comminuted condyle fracture through myofunctional therapy resulted in functional rehabilitation of the jaw and face, directing the movements and stimulating the adequacy of the sthomatognatic functions. [ABSTRACT FROM AUTHOR]

Issues arising in wound healing are very common, and chronic wound infections affect approximately 1.5% of the population. The main substances used in wound washing, cleansing and treatment are antiseptics. Today, there are many compounds with a known antiseptic activity. Older antiseptics (e.g., boric acid, ethacridine lactate, potassium permanganate, hydrogen peroxide, iodoform, iodine and dyes) are not recommended for wound treatment due to a number of disadvantages. According to the newest guidelines of the Polish Society for Wound Treatment and the German Consensus on Wound Antisepsis, only the following antiseptics should be taken into account for wound treatment: octenidine (OCT), polihexanide (PHMB), povidone-iodine (PVP-I), sodium hypochlorite (NaOCl) and nanosilver. This article provides an overview of the five antiseptics mentioned above, their chemical properties, wound applications, side effects and safety. [ABSTRACT FROM AUTHOR]

Wounds are likely to have existed ever since mankind has existed. Wound healing is an enormously complicated process and the actual scientific mechanisms and events that take place during healing are far more complex and dynamic than might be imagined. Essential elements, especially trace elements are believed to be pivotal to the wound healing process. Their involvement in tissue regeneration and repair appears to be wide ranging and their deficiencies have been reported to impair the healing process. However, further research is required to establish the involvement of trace elements and their specific species in the wound healing process. Thus assessments of trace element levels in wound tissues using new, reliable, verified and validated technologies could be beneficial for trace element based wound healing. Here, is an attempt made to assess the link between trace element concentrations and healing processes of chronic and acute wounds. Wound tissue samples from 58 chronic leg ulcers and 50 acute wounds were analysed for concentrations of Fe, Zn, Cu, Mn, Ca, Sn, Cr, Cd and Pb using atomic absorption spectrophotometer. Blood samples were also collected from the same patients and analysed in the same manner. All the data were tested for normality by Ryan-Joiner normality test (α= 0.05) and one- way ANOVA was done for the normally distributed data. The results showed that the concentration of Ca, Zn, Cu and Mn were similar in both acute and chronic wounds. Apart from Ca, which showed elevated concentrations, other metal concentrations are either similar or lower than the analysed concentrations in blood. It appears that there is a significant difference in the concentrations of iron accumulated in the tissues of chronic and acute wounds. The concentrations of Sn, Cr, Cd and Pb, which are considered as toxic metals, were not present in detectable levels with the graphite furnace atomic absorption spectrophotometry in both types of wound tissues. [ABSTRACT FROM AUTHOR]