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Quality of life (QOL) may be impacted by foot ulcer‐related factors, with prevention of diabetes‐related foot ulcers or more effective early healing helping to improve overall patient QOL. This study, which examined the relationship between foot ulcer‐related factors and QOL in patients with diabetes, was conducted as a secondary analysis of a prospective observational study entitled: "Factors associated with the discontinuation of wound care specialist clinic visits in patients with diabetic foot ulcers". We investigated EQ‐5D‐5L, patient characteristics and foot ulcer‐related factors of 73 patients with diabetes‐related foot ulcers who visited one wound clinic in Indonesia between August 2020 and February 2021. Results showed that the mean health utility was 0.294 ± 0.371. Factors selected for the multiple regression analysis included inflammation/infection of DMIST, first‐ever foot ulcer, and size of DMIST. First‐ever foot ulcer (β = 0.309, p = 0.003) and size of DMIST (β = −0.316, p = 0.015) were significantly associated with the health utility (p < 0.001). Significant improvement in the health utility of 15 patients was observed when the ulcer healed (Wilcoxon signed‐rank sum test, p = 0.001). In conclusion, not only ulcer severity but also the first‐ever foot ulcer itself affected the QOL in patients with diabetes. These results suggest there will be a greater impact on the QOL of patients who develop diabetes‐related foot ulcers for the first time, along with the importance of prevention and early healing, through early infection control and wound size reduction. [ABSTRACT FROM AUTHOR]

Introduction: Nutritional supplements have been known to play an effective role in wound healing. Lack of nutrition has been linked to a decline in wound tensile strength and increased infection rates. The present study aims to compare and evaluate the efficacy of nutritional supplements on the healing of the socket in patients undergoing bilateral maxillary first premolar extraction. Methods:This prospective split-mouth trial includes twenty patients undergoing orthodontic treatment and requiring bilateral maxillary first premolars extraction. They were split into two groups: 'Group 14' received only analgesics, while 'Group 24' received analgesics and additional supplements of multivitamins and minerals. Both the groups underwent extractions at the gap of one month in which '14' was extracted prior to '24' and socket dimensions, Buccolingual width (B), Mesiodistal width (M), and Depth (D) were measured on the day of extraction, day seven and day twenty-one to assess healing. Results: In this study, 20 patients were split into 'Group 14' (no supplements) and 'Group 24' (with supplements). The patients, 10 males and 10 females had an average age of 18.20 ± 3.23 years. 'Group 24' had a slight reduction in M width on day seven and a slight reduction in B width on day twenty-one when compared to 'Group 14'. However, no values were statistically significant. Conclusions: The study shows that nutritional supplements led to slight socket healing improvement, but this wasn't statistically significant. It recommends nutrient-rich diets for healing, alongside balanced nutrition, oral hygiene, and advice post-operative instructions. [ABSTRACT FROM AUTHOR]

Objective: To quantify the reduction in wound size and change in wound quality following low-cost topical oxygen therapy (TOT) in patients with acute traumatic musculoskeletal wounds of the foot and ankle. Method: This prospective interventional study included patients with acute traumatic musculoskeletal wounds of the foot and ankle of <3 weeks' duration after they had undergone debridement and required subsequent wound coverage. A sterile C-Arm cover was used to cover the wound and 100% oxygen was administered at 1 atm, at a rate of 10l/min for 90 minutes on each of four consecutive days, through a suction catheter connected to an oxygen cylinder. The cycle was repeated after a three-day break. Wound surface area (by plotting on graph paper) and wound quality (by modified wound infection checklist score and swabs for culture and Gram staining) were assessed before and after TOT application. Results: The study cohort included 20 patients ≥18 years of age. There was a statistically significant (p<0.001) reduction in mean wound surface area from 79.3cm2 at baseline to 69.6cm2 after two cycles of TOT. The mean modified wound infection checklist score was 13.6 and 0.8, respectively, before and after two cycles of TOT, suggesting statistically significant improvement (p=0.02) in wound quality. All patients showed no growth in their wound culture after TOT. Conclusion: TOT appears to be a promising and cost-effective alternative in the management of traumatic wounds. However, future studies with larger sample sizes and control groups for comparison are needed to establish the benefit of TOT in acute traumatic musculoskeletal wounds. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of Negative Pressure Wound Therapy (NPWT) in patients with foot and/or ankle injury compared with conventional dressing techniques. Study Design: Randomized controlled trial (Trial No: NCT04569305). Place and Duration of Study: Department of Plastic Surgery, Dr Ruth K.M. Pfau Civil Hospital, Karachi Pakistan, from Dec 2019 to Oct 2020. Methodology: All patients with foot and ankle injury resulting in soft tissue injury with or without bones and tendons exposed were included. Thirty-five patients were randomized into the NPTW-Group and 35 into the Conventional Treatment Group using the lottery method. NPTW was applied to an injured foot and ankle area after debridement and cleaning the necrosed tissue. The effect of the technique was assessed by measuring the wound surface area covered with healthy granulation tissue measured in a centimetre square on follow-up. Results: Mean wound grade at the start of treatment was estimated as 3.20±0.71 in the NPWT-Group and 3.14±0.73 in the Control-Group, and at the end of treatment as 1.20±0.53 in the NPWT-Group and 1.71±0.78 in the Control Group. The mean wound size at the start of treatment was estimated as 52.74±21.92 cm2 in the NPWT-Group and 54.08±23.28 cm2 in Controls. At the end of treatment, an average wound size was estimated as 21.61±13.46 in NPTW and 30.40±16.50 in controls. NPTW significantly reduced wound grade and size more effectively than the conventional technique (p<0.05). Conclusion: Negative pressure wound therapy was more effective for soft tissue injury of the foot and/or ankle injury than the conventional dressing technique. [ABSTRACT FROM AUTHOR]

Objective: To determine the effect of Negative Pressure Wound Therapy (NPWT) in patients with foot and/or ankle injury compared with conventional dressing techniques. Study Design: Randomized controlled trial (Trial No: NCT04569305). Place and Duration of Study: Department of Plastic Surgery, Dr Ruth K.M. Pfau Civil Hospital, Karachi Pakistan, from Dec 2019 to Oct 2020. Methodology: All patients with foot and ankle injury resulting in soft tissue injury with or without bones and tendons exposed were included. Thirty-five patients were randomized into the NPTW-Group and 35 into the Conventional Treatment Group using the lottery method. NPTW was applied to an injured foot and ankle area after debridement and cleaning the necrosed tissue. The effect of the technique was assessed by measuring the wound surface area covered with healthy granulation tissue measured in a centimetre square on follow-up. Results: Mean wound grade at the start of treatment was estimated as 3.20±0.71 in the NPWT-Group and 3.14±0.73 in the Control-Group, and at the end of treatment as 1.20±0.53 in the NPWT-Group and 1.71±0.78 in the Control Group. The mean wound size at the start of treatment was estimated as 52.74±21.92 cm2 in the NPWT-Group and 54.08±23.28 cm2 in Controls.At the end of treatment, an average wound size was estimated as 21.61±13.46 in NPTW and 30.40±16.50 in controls. NPTW significantly reduced wound grade and size more effectively than the conventional technique (p

Objective: This study was done in the ovariectomized rat model to optimize the dose of Marantodespumilum (MP) for the treatment of open wound healing activities. Materials and Methods: Total fifty-six rats were taken for this study which was split into four groups based on four extracts such as Marantodes pumilum var. pumila (MPvp) leaf and root extracts and Marantodes pumilum var. alata (MPva) leaf and root extracts; each group contains fourteen rats. Each group was further divided into seven subgroups with equally distributed rats which consisted with one control group without treatment (Control) and six treated groups with different concentrations: 0.1% Conc, 0.5% Conc, 1.0% Conc, 2.0% Conc, 3.0% Conc and 4.0% Conc of each MP extract. After punch biopsy, rats were treated with ointment prepared by cetomacrogol emulsifying agent and MP extract on daily basis, beginning from the wound creation until healed completely. The parameters studied were the macroscopic observation andthe wound area measurement. Results: Wounds with treated 1.0% and 4.0% Conc of MPvpleaf and root extracts and 2.0%, 3.0% and 4.0% Conc of MPvaleaf and root extracts were healed completely at day 9, whereas wounds of control groups were healed at day 12 for each extract group. The wound area was significantly reduced in the treated groups with 1.0% and 4.0% Conc of MPvpleaf and root extracts (p < 0.05) and 2.0%, 3.0% and 4.0% Conc of MPvaleaf and root extracts (p < 0.05) than their respective control group. Conclusion: The dose of 1.0% concentration for both leaf and root extracts of MPvp and 2.0% concentration for both leaf and root extracts of MPva exhibited the best effect to expedite for open wound healing compared to control group and other concentrations in the ovariectomized rat model. [ABSTRACT FROM AUTHOR]

This study aims to evaluate the healing effect of topical Apigenin cream 2% in the skin of rabbits. Twenty Four healthy Newzealand adult male rabbits approximately at the same age were involved in this study. All animals were anesthetized using a mixture of 40 mg/kg ketamine injection and xylazine 4 mg/kg intramuscularly. The skin of the dorsum area of each rabbit was shaved; then, three incisions (1cm in length) were made. Wounds were left without suturing to heal by secondary intention healing, and each animal had three wounds (wounds divided into three groups according to the type of treatment): one treated with Apigenin cream twice a day, the other with cold cream twice a day, and the third wound was left untreated. The application of cream was repeated daily; the wound size and the ratio of wound contraction were assessed at the first, fourth, and seventh days of study. The results revealed that the group treated with apigenin showed significantly better wound healing capacity in the skin of rabbits; wound size and wound contraction ratio was superior in the Apigenin group compared to control positive and negative groups. It can be concluded that apigenin cream has beneficial value for improving the wound healing potential of skin in rabbits. [ABSTRACT FROM AUTHOR]

Introduction: Traditionally, moist dressings are being in used routinely by surgeons for management of diabetic foot ulcers. Recently, there is an encouraging trend of using VAC dressings in such patients. This study aimed to compare the outcome of VAC with moist dressing for management of diabetic foot ulcer. Study Design: Prospective randomized controlled trial. Setting: Department of Surgery, Al-Bukyriah General Hospital, Al-Bukayriah, Alqaseem KSA. Period: June 2012 to 07 December 2016. Methods and Material: 200 patients with diabetic foot ulcers. The patients were divided in two equal groups containing 100 patients each. In group A, 100 patients received VAC dressing treatment while in group B, 100 patients received wet dressings. Wound size, % reduction in wound size, appearance of granulation tissue and fate of wound were main outcome measured which were noted at start of study and at the end of study (4th week of therapy). Results: In group A, there were 73 (73%) men and 27 (27%) women with a mean age of 54.98+7.68 years and in group B, there were there were 75 (75%) men and 25 (25%) women with a mean age of 55.23+6.98 years. Size of wound before treatment in group A was 14.23± 6.78 cm2 which reduced to 5.11±1.91 cm2 at 4th wee and in group B it was 14.41±5.93 cm2 in the start which reduced to 11.29±3.63 cm2 at 4th week (p<0.05). Mean %reduction in wound size in group A was 63.22±9.19 and 22.92±7.18 in group B (p<0.05). In group A, 43 (43%) wounds healed spontaneously with shrinkage and group B only 2(2%) healed spontaneously (p<0.05). Conclusions: VAC therapy is superior to moist dressing in terms of achieving early granulation tissue, reduction in wound size and spontaneous wound shrinkage. [ABSTRACT FROM AUTHOR]

The use of ground-based skidding is well accepted practice for the extraction of timber from the forest, but this has tended to cause the greatest environmental problems. We test the hypothesis that, over time, there was a statistically significant difference among the progressive decay and wound healing or closure in the residual trees of different species. The present study aims to address the following items: proportion of the remaining trees, how extensive is the spread of wound decay in individual stems by wound size and wound age. Long-term impact evaluation on residual damaged trees was carried out in the Tavir forest management plan in Aliabad-e-Katoul. Variation in wound infection frequency could be attributed to several factors, such as differences in size and age of wounds, position of wound on a tree. The results showed that there was a significant relationship between the species type and amount of healing. By increasing the diameter of the tree species, the ratio of healing decreased. By increasing the height of wound from the stump, wound-healing rate increased. The results showed that the deep wounds of the trunk will be healed later than superficial wounds. Regardless of the type species, by increasing the size of the wound, the wound healing significantly (in a logarithmic relationship) was reduced. The results showed that there was not a statistically significant relationship between scar closure and wound age. Damage to the residual stand might be reduced by proper planning and training the logging crews.

Chronic soft tissue wounds of the lower limbs are debilitating, painful and often unresponsive to advanced dressing treatments. Extracorporeal shock wave therapy (ESWT) could represent an alternative treatment. Ten patients with chronic soft tissue wounds of the legs, unresponsive to advanced dressing treatments for more than 3 mo, underwent three defocused ESWT sessions at 72-h intervals. In every session, the sum of 300 standard pulses + 100 pulses per square centimeter was applied at 0.15 mJ/mm2 and 4 Hz over the edge of the wound. The wound size in square centimeters, Bates-Jensen Wound Assessment Tool and visual analogue scale were used as outcome measures. A significant reduction in wound size and Bates-Jensen Wound Assessment Tool and visual analogue scale values from pre-treatment to 90 d was observed. Seven of ten ulcers healed completely and nine of ten patients reported complete pain relief. Defocused ESWT represents a non-invasive, feasible strategy for difficult-to-treat soft tissue wounds of the lower limbs. [ABSTRACT FROM AUTHOR]

To study the question whether and how the size and position of the temporary cavity influence the morphology and especially the size of a bullet exit wound, test shots were fired to composite models consisting of gelatine and pig soft tissue covered with skin (at the exit site). The dimensions of the composite model were determined such that the exit planes were located either at the level of the narrow channel or within the temporary cavity or behind it. The chronological sequence of wound formation and its relation to the current position of the bullet were documented by means of a high-speed camera. Test shots were fired from a distance of 10 m using 5.56 × 45 mm cartridges with full metal-jacketed pointed bullets ( v ∼ 912 m/s, E ∼ 1,663 J). The study proved that the extension and position of the temporary wound cavity was decisive for the size of the exit wound: An exit plane within the cavity resulted in particularly large skin lesions, whereas the wound diameters were much smaller if the exit plane was located in front or behind the cavity. The exit hole reaches its maximum size only after the bullet has left the target synchronous to the staggered expansion of the temporary cavity. [ABSTRACT FROM AUTHOR]

Physical and biological disturbances can damage and remove biomass from marine invertebrates such as sponges. To determine the effect of wound size on sponge recovery, individuals of the Demospongiae Latrunculia wellingtonensis (Alvarez, Berqguist and Battershill) and Polymastia croceus (Kelly-Borges and Bergquist) had 50%, 75%, 90% or none (control) of their volume removed. Regeneration (measured by oscule development), growth (percent and volume change), biofouling and survival were monitored often over 203 days using in situ photographs. The rate of regeneration and growth varied between the two sponges, being greatest for L. wellingtonensis. Interspecific variation may result from differences in choanosome structure: the choanosome in L. wellingtonensis is poorly differentiated but is well developed in P. croceus. For each species, recovery rates were similar between 50%, 75% and 90% removed sponges. All damaged L. wellingtonensis and P. croceus survived, demonstrating the remarkable ability of some sponge species to recovery from massive injuries. L. wellingtonensis and P. croceus are often found in exposed habitats. Good recovery after injury may therefore be an adaptation to reduce the damaging effects of storms and strong water movement. [Copyright &y& Elsevier]

Aims: To assess the wound size reduction and time course for healing and to establish equations to predict the time course of wound healing in neuropathic, neuroischemic, and ischemic diabetic foot ulcers. Methods: This prospective study evaluates wound healing over at least a 10-week period in 31 Type 1 or Type 2 diabetic patients with plantar foot ulcers. Thirteen consecutive diabetic patients with neuropathic foot ulceration, 10 consecutive diabetic patients with neuroischemic ulceration, and 8 diabetic patients with peripheral occlusive vascular disease were selected for the study. All patients received identical ulcer wound care including use of proper footwear, non-weight-bearing limb support, use of appropriate antibiotics, debridement, tight control of serum glucose levels, and careful monitoring of the ulcer. Ulcer healing was assessed by planimetric measurement of the wound area every second week until wound healing. The time course of wound healing was calculated by the daily wound radius reduction. Results: The wound area (mean±S.E.) in the patients with neuropathic foot ulceration was 61.2±17.1 at the beginning and 3.2±1.5 mm2 after 70 days (P=.005). The wound radius decreased by 0.045 mm (95% confidence interval [CI] 0.039–0.055) per day, with most of the wound healing being achieved between the first and seventh week of ulcer care. The average healing time was 77.7 (95% CI 62–93) days. In the neuroischemic group, the initial average wound area was 26.6±7.0 mm2, and 6.25±1.7 mm2 after 10 weeks (P=.007). The wound radius reduction was 0.019 mm/day (95% CI 0.017–0.023) with an average healing time of 123.4 (95% CI 101–145) days. The diabetic patients with peripheral occlusive vascular disease had an average wound size of 32.6±13.1 at the beginning and 23.9±10.7 mm2 after 70 days of ulcer care (P=.06). The daily wound radius reduction was 0.0065 mm (95% CI 0.0039–0.0091). Average ulcer duration was 133 (95% CI 116–149) days, but three of eight patients achieved no wound healing. Conclusions: Providing standard care, the time course of wound healing in diabetic foot ulcers is predominantly determined by etiologic factors, and less by wound size. Taking wound etiology and wound radius into account, the expected healing time can reliably be estimated in neuropathic and neuroischemic ulcers. [Copyright &y& Elsevier]