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Collagen (Col) from marine organisms has been emerging as an important alternative for commercial Col and it has been considered highly attractive by the industry. Despite the positive effects of Col from marine origin, there is still limited understanding of the effects of this natural biomaterial in the process of wound healing in animal studies. In this context, the purpose of this study was to perform a systematic review of the literature to examine the effects of Col from different marine species in the process of skin tissue healing using experimental models of skin wound. The search was carried out according to the orientations of Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), and the descriptors of the Medical Subject Headings (MeSH) were defined: "marine collagen," "spongin," "spongin," "skin," and "wound." A total of 42 articles were retrieved from the databases PubMed and Scopus. After the eligibility analyses, this review covers the different marine sources of Col reported in 10 different papers from the beginning of 2011 through the middle of 2019. The results were based mainly on histological analysis and it demonstrated that Col-based treatment resulted in a higher deposition of granulation tissue, stimulation of re-epitalization and neoangiogenesis and increased amount of Col of the wound, culminating in a more mature morphological aspect. In conclusion, this review demonstrates that marine Col from different species presented positive effects on the process of wound skin healing in experimental models used, demonstrating the huge potential of this biomaterial for tissue engineering proposals.

Objective: To explore the related factors of tension on wound skin healing and its solution. Methods: According to the analysis and discussion of 60 trauma patients admitted to the emergency department of our hospital, they were randomly divided into two groups, 30 patients in each group (Observation and control group). The other group was systematically studied for the related factors affecting wound healing and we gave the relevant nursing measures to the control group. Results: The healing rate of the two groups were compared after treatment and nursing. The observation group was better than the control group, and the difference was statistically significant (P < 0.001). Conclusion: Effective reduction of wound tension can induce immune response and have obvious effect on skin repair and regeneration. On the other hand, the prevention and treatment of abnormal hyperplasia and scar were also improved. Avoid other factors affecting wound healing, strengthen postoperative management, reduce scar formation and promote skin regeneration.

Introduction: Wound is the result of physical trauma that severs skin continuities. The damage typically causes an inflammatory reaction marked by increase ROS and tissue inflammation. However, this process is still needed to be further investigated. Therefore, this study aimed to evaluate plasma MDA, IL-6, TNF-α, Caspase-3 and VEGF levels, and the granulation tissue thickness at different time points during the wound healing process. Methods: An experimental post-test only control group study was conducted using white male rats (Rattus Norvegicus) and the rats were wounded and assessed on day 5 (K1), day 10 (K2), and day 15 (K3). The level of plasma MDA, IL-6, TNF-α, Caspase-3 and VEGF level was assessed as well as the granulation tissue thickness.Results: The OneWay ANOVA test results showed significant differences in plasma MDA, IL-6, TNF-α, Caspase-3 and VEGF levels (P

Background and Aim: Himatanthus sucuuba (Spruce) Woodson (Apocynaceae) is a medicinal plant known as "Bellaco- Caspi" widely distributed in Loreto, Peru. In the Peruvian traditional medicine, the latex of the plant is used for the treatment of wounds, inflammation, ulcers, and other ailments. This study aims to evaluate the wound healing effect of the latex of H. sucuuba in BALB/C albino mice. Materials and Methods: Thirty BALB/C male mice were used for wound healing study. In the experimental procedures, wound skin incision was performed at 2.0 cm in length until subcutaneous on the paravertebral of each animal. Under locally anesthetized with procaine cream, the treatment was conducted. All the mice were divided into three groups, the control group (A), zinc oxide cream (B), and H. sucuuba latex (C). The entire surface of the wound was treated for all the groups, and the treatments were performed daily for 15 days. The experiments were stopped on days 1, 7, and 15, respectively. Results: The histopathological study of tissues revealed significant changes in wound healing effect in H. sucuuba latex compared to the control and B groups. Consequently, the mice treated with latex showed a significant reduction in epithelialization time and collagen formation. Furthermore, the latex showed a dose-dependent significant reduction of inflammation in the first 24 h of treatment. Conclusion: BALB/C mice treated with the latex of H. sucuuba possess a wound healing effect that can scientifically prove the traditional use of the plant as a wound healing agent.

Besides the pandemic caused by the coronavirus outbreak, many other pathogenic microbes also pose a devastating threat to human health, for instance, pathogenic bacteria. Due to the lack of broad-spectrum antibiotics, it is urgent to develop nonantibiotic strategies to fight bacteria. Herein, inspired by the localized "capture and killing" action of bacteriophages, a virus-like peroxidase-mimic (V-POD-M) is synthesized for efficient bacterial capture (mesoporous spiky structures) and synergistic catalytic sterilization (metal-organic-framework-derived catalytic core). Experimental and theoretical calculations show that the active compound, MoO3 , can serve as a peroxo-complex-intermediate to reduce the free energy for catalyzing H2 O2 , which mainly benefits the generation of •OH radicals. The unique virus-like spikes endow the V-POD-M with fast bacterial capture and killing abilities (nearly 100% at 16 µg mL-1 ). Furthermore, the in vivo experiments show that V-POD-M possesses similar disinfection treatment and wound skin recovery efficiencies to vancomycin. It is suggested that this inexpensive, durable, and highly reactive oxygen species (ROS) catalytic active V-POD-M provides a promising broad-spectrum therapy for nonantibiotic disinfection.

Aim: The aim of this research was to determine the angiogenesis activity of Jatropha curcas latex in cream formulation on CD34 immune expression during wound healing phase in mice skin. Materials and Methods: Amount of 36 2-month-old male mice were used between 30 and 40 g. To surgical procedures, wound skin incision was performed 2.0 cm in length until subcutaneous on the paravertebral of each animal. The treatment was carried under locally anesthetized with procaine cream. All mice were divided into four groups, namely the base cream as control group (A), sulfadiazine 0.1% cream (B), Jatropha curcas latex cream 10% (C), and J. curcas latex cream 15% (D). All groups were treated entire surface of wound. All experiments were performed twice a day for 10 days. Experiments were terminated on days 3, 7, and 10, respectively. The wound healing was assayed in stained histological section in immunohistochemical of the wounds. The CD34 expression was investigated under a microscope. Results: The results showed that the cream from 10% and 15% latex J. curcas revealed moderate immune reaction to CD34 on days 3 and 7 in wound healing of mice skin. Conclusion: We concluded that the cream from 10% and 15% latex J. curcas has potential as angiogenesis activity in wound healing of mice skin.

Outra Photobiomodulation (FBM) has been indicated in cases of tissue repair due to characteristics such as: stimulation of fibroblast proliferation, reduction of the inflammatory process, and acceleration of collagen synthesis. The objective of the present study was to evaluate the application of the 670 nm laser isolated and associated with the vitamin A and carboxyethyl gamma aminobutyric acid (CEGABA) in the treatment of wounds on the back. This study was approved by the Animal Ethics Committee of UFSCar. 60 male Wistar rats were divided into 6 groups (n = 10), with Control (CG); Laser (LG); GaAlAs 670nm continuous pulse, 30mW power, energy density 14.28J/cm2, irradiating 1 spot per wound for 30s; Vitamin A (VitAG) on a high hydrolipidic basis; CEGABA (CgG) 1% CEGABA/volume on a high hydrolipidic basis; Laser + Vitamin A (LVitAG) Laser + CEGABA (LCgG). Three wounds of 10mm diameter were induced by dermatological punch on the animal's back. The treatment totaled 15 consecutive days. Samples were collected on the 4th, 11th and 16th day for histological analysis of HE, Picrosirius-Red, immunohistochemistry (COX-2, TNF-α, VEGF and collagen I). For the statistical analyzes, the one-way and two-way ANOVA test were used for the intra and inter-group evaluations, respectively, and the Tukey and Bonferroni post-test. The level of significance was 5%. The results for the histopathological analysis showed a statistically significant difference for lower values of inflammatory infiltrate in LG versus GG on the 16th day; in LG versus CG and VitAG on the 4th day; and for the increase of collagen in LG versus CG on the 11th and 16th days of treatment. There was a statistically significant difference for the increase of VEGF on the 4th and 11th day for LG and L+VitAG when compared to the other groups. Decrease of TNF-α on the 4th and 11th day for LG and increase of collagen type 1 on the 4th and 16th days in LG when compared to the other groups. The birefringence analysis was a statistically significant difference for increase of collagen fibers on the 11th day for LG when compared to the other groups. In view of the presented results, it is pertinent to point out that FBM is effective in helping the kinetics of the cutaneous wound healing process in rats and promoted the necessary stimuli so that the healing process evolved with quality and in a satisfactory way, tissue considered structurally desirable A fotobiomodulação (FBM) vem sendo indicada em casos de reparação tecidual devido a características como: estimulação à proliferação de fibroblastos, redução do processo inflamatório e aceleração na síntese de colágeno. O objetivo deste estudo foi analisar a ação do laser 670 nm isolado e associado à aplicação tópica da vitamina A e ácido carboxietil gama aminobutírico (CEGABA) no tratamento de feridas no dorso de ratos. Este estudo foi aprovado pelo Comitê de Ética em Animais da UFSCar. 60 ratos Wistar, machos foram divididos em 6 grupos (n=10), sendo Controle (GC); Laser (GL), GaAlAs 670 nm pulso contínuo, potência 30mW, densidade de energia 14,28J/cm2, irradiando 1 ponto por ferida por 30s; Vitamina A (GVitA) em base com elevado teor hidrolipídico; CEGABA (GCg) 1% de CEGABA/volume em base com elevado teor hidrolipídico; Laser + Vitamina A (GLVitA); Laser + CEGABA (GLCg). Foram induzidas 3 feridas de 10mm de diâmetro cada, por punch dermatológico, no dorso do animal. O tratamento totalizou 15 dias consecutivos. As coletas das amostras ocorreram no 4º, 11º e 16º dias para análises histológica de HE, Picrosirius-Red, imunohistoquímica (COX-2, TNF-α, VEGF e colágeno tipo I). Para as análises estatísticas foram utilizados o teste de ANOVA one-way e two-way para as avaliações intra e entre-grupos e o pós-teste de Tukey e Bonferroni, respectivamente. O nível de significância foi de 5%. Os resultados da analise histopatológica mostraram uma diminuição do infiltrado inflamatório para o grupo GL quando comparado com ao GVitA no 4º dia e para o GC no 4º e 16º da; e para o aumento do colágeno no GL no 11º e 16º dias de tratamento comparado ao GC. Houve diferença estatística significante para o aumento de VEGF no 4º e 11º dias para o GL e GL + VitA quando comparados aos demais grupos; diminuição de TNF-α no 4º e 11º dia para o GL comparado aos demais grupos e aumento de colágeno tipo 1 no 4º e 16º dias para o GL em relação aos demais grupos. A análise de birrefringência das fibras de colágeno no 11º dia do tratamento teve aumento estatístico significante para o GL em relação aos demais grupos. Diante dos resultados apresentados neste estudo, é pertinente ressaltar que a FBM e a vitamina A aplicadas isoladamente promoveram estímulos positivos no processo de cicatrização de feridas cutânea em ratos e a FBM associada à aplicação tópica de Vitamina A apresentou estímulos benéficos para os mecanismos envolvidos na fase inflamatória

Knee medial contractures are formed after burns of the knee posterior surface (FM). The anatomy and treatment of this contracture type have not been explored and highlighted in the literature. When a burn wound is healing, scars form a fold that covers the entire popliteal fossa. In the fold’s sheets there is a surface deficit in length (contracture cause) and a scar surface surplus allowing medial contracture elimination with local adipose-cutaneous trapezoid flaps. The fold’s sheets have a surface deficit in length of a trapezoid form, which is the real cause of contracture. These anatomical observations enabled us to develop data that allowed us to develop a technique to convert fold sheets into trapezoid flaps and to eliminate contracture with a trapezoid flap. Rough ulcerous scar should be excised, and wound skin should be grafted. These new data are presented in this chapter.

The present study shows the effect of a mixture of C.asiatica and Z.officinale (Ginger). The plants powder was applied on injured cat skin caused by accident, with a proportion of 5g of each plant powder. After one week of treatment, the diameter of the wound skin decreases from 4 to 2 cm. The wound disappear totally after two weeks. The result can be explained by the effect of Asiaticoside (triterpene glycoside) present in C. asiatica powder on the wounded skin. The ginger act by its anti-inflammatory effect, the powder contains inhibitors against prostaglandin biosynthesizing enzyme (PG synthetize).

Dynamic mechanical analysis (DMA) was carried out to understand the effect of the application of elastin on wound skin of hairless mice. Wound group, placebo group, and elastin group were selected to evaluate that effect. As the results of DMA testing, the wound and the placebo groups showed lower storage and loss moduli than the elastin group. On the result of loss tangent, there is a small difference between these groups, and the elastin group showed the lowest value. Consequently, the application of elastin on the wounded skin showed the possibility for recovery the skins.

Emu oil blended nanofibrous membranes scaffolds were fabricated successfully via electrospinning with different composition ratios with polyurethane (PU). Emu oil is derived from the emu (Dromaius novaehollandiae), which originated in Australia, and has been reported to have anti-inflammatory properties. It has been observed that 10 wt.% is the optimum oil content in the electrospun solution to get good morphology ultrafine PU/emu oil blended nanofibers. The influences of emu oil content in nanofibrous morphology, and the viability and proliferation properties of cells (3T3-L1 fibroblasts) on blended nanofibers were analyzed. The composite material could support long-term cell growth, form three-dimensional networks of the nanofibrous structure, and provide good antibacterial activity. The antibacterial activity of this composite material was found to be active in both Gram positive and Gram negative species. So according to our results this composite material can be successfully applied in various biomedical fields, including wound dressing, skin disease treatments, etc.

PURPOSE: To evaluate the healing effect of the topic administration of the hydroalcoholic extract of aroeira in open wounds in the dorsocostal region of rats. METHODS: Sixty Wistar rats, males, were used. In all animals one skin fragment was removed, with two centimeters in diameter. Inhalatory anesthesia with ethyl ether was done, The rats were divided in two groups of 30 animals: aroeira group, submitted to an topic application of the hydralcoholic extract of the plant, and control group, with the same process but with 0.9% saline solution. Each group was divided in three sub-groups of 10 animals according to the period of observation: 7, 14 and 21 days. The areas of the injuries were analyzed by the macrocospic aspect and digital planimetry, and the resected segments of the wounds were studied by optic microscopy stainned with hematoxilin-eosine and trichromium of Masson. RESULTS: The macrocospic findings showed early complete reepitelization in the control group by the 14th day. According to the digital planimetry the average wound areas of the rats from the control group (0.5278 cm2) had been smaller than those from the wounds of the rats of the aroeira group (0.6897 cm2), with statistical significance to the 14th day (p=0.036). The hystologic study showed statistical difference (p=0.023) regarding the mononuclear cells in 14th day of evaluation, with larger number in the aroeira group, without significant differences regarding other parameters in all the remaining days. CONCLUSION: The topic use of the hydralcoholic extract of aroeira delayed the reepitelization of the skin wounds in rats.

Objective: A randomised controlled trial was designed to determine whether or not early intervention with a suitable skin barrier preparation could prevent skin breakdown. This study was conducted to compare the efficacy and cost-effectivenss of two skin protectants, Cavilon No Sting Barrier Film (NSBF) (3M Health Care) and zinc paste compound, in the management of maceration and irritation of the peri-wound area of venous leg ulcers. Method: Thirty-five patients with venous leg ulcers and surrounding skin problems were randomised to receive either NSBF or zinc paste compound. The preparation was then applied at each dressing change for 12 weeks. All patients had been receiving compression bandaging before entering the study and continued wearing it throughout the 12-week study period. Results: The decrease in wound area was 5.11 ± 8.39cm2 in the NSBF group and 4.59 ± 5.83cm2 in the zinc paste group. The healing rate was 0.046cm per week with NSBF and 0.039cm per week with zinc paste. There was a significant difference in the time required to remove and re-apply the skin protectants: an average of 0.19 (± 0.17) minutes in the NSBF group and 5.53 (± 2.10) minutes in the zinc paste group (pConclusion: Both products were effective barrier preparations. However, NSBF was easy to apply and transparent. The zinc paste was messy to apply and difficult to remove, and thus took up considerably more nursing time than NSBF. Declaration of interest: This study was supported by 3M Health Care.

To evaluate the efficacy of cultured cutaneous substitute (CCS) in accelerating the healing of combined radiation-skin wound injury (CRWI) in minipigs.Autologous porcine bone marrow-derived mesenchymal stem cells (BMSC) and skin-derived keratinocytes (SK) were infected by recombinant retrovirus expressing human (h) platelet-derived growth factor-A (hPDGF-A). CCS was constructed by loading acellular human amniotic membrane (HAM) with normal porcine BMSC and SK (BMSC-/SK-CCS) or with hPDGF-A modified counterparts (BMSC+/SK+CCS). The expression of exogenous hPDGF-A in cells and CCS was assessed by reverse transcription polymerase chain reaction (RT-PCR) and enzyme linked immunosorbent assay (ELISA). The CCS or HAM were grafted to the dorsal CRWI sites (20 Gy local irradiation plus full-thickness skin removal, diameter = 40 mm) of minipigs. Wound healing rate and pathological changes were observed.High levels of hPDGF-A expression were confirmed in gene-modified cells (3780 pg/ml), cultured CCS (506 pg/ml) and transplanted CCS (250 pg/ml). The transplantation of the BMSC+/SK+CCS resulted in a shorter healing time (16-18, days) (P 0.05 vs. other groups). The healing rates ranked as BMSC+/SK+CCS BMSC-/SK-CCS HAM wound control. Pathologically, there were better granulation formation and re-epithelialisation, and collagen deposition in BMSC+/SK+CCS-treated wound than those in other groups. The angiogenesis ability followed the same order as healing rate of different groups. At day 7, the area densities of vasculature in granulation tissue of group BMSC+/SK+CCS, BMSC-/SK-CCS, HAM, wound only were 15.4, 10.3, 6.0 and 5.7%, respectively, while the number densities of vasculature was 767, 691, 126 and 109 (number/mm(2)), respectively.Topical transplantation of hPDGF-A modified CCS may be applicable to the management of refractory wounds.

Rapid and exact healing of skin wound, such as severe burns, trauma, diabetic, decubitus or venous stasis ulcers, is desirable in clinical. In this paper, the degraded agarose was mixed with gelatin as sprayable wound skin dressing. Agarose with different molecular weight was obtained through the degradation of agarose with hydrogen peroxide for different intervals. The formation of agarose gel was monitored by scattered light turbidimeter. The degraded agarose was activated by epichlorohydrin. The activated agarose/gelatin solution was sprayed to form gel coating rabbit wound skin. The gel dressing was not toxic and had a good repair effect on rabbit skin lesion without infection and liquid exudation. H&E staining results showed that the repair tissue was similar to the normal one. The activated low molecular agarose /gelatin gels are promising biomaterials as wound dressings for healing burns or ulcers.

Objective: To summarise the clinical and economic literature relating to the effect of Cavilon No Sting Barrier Film on the incidence of incontinence-associated dermatitis, which is a risk factor for pressure ulceration and exudate-related peri-wound skin damage. Method: A systematic literature search was performed using available computerised databases for publications on Cavilon barrier film and other relevant terms. Six clinical studies were identified providing data on 1,563 patients treated with the barrier film or a comparator. The publications comprised prospective studies, randomised and non-randomised studies, multicentre trials, single-centre reports and a volunteer study. Due to the nature of the comparators, five studies were open-label. Differences in methodology and outcomes made a qualitative review the most appropriate analysis. Results: The barrier film was at least as effective as petroleum ointments and more effective than zinc oxide formulations in preventing incontinence-associated dermatitis. The barrier film was also effective in peri-wound skin protection, although its clinical efficacy was not significantly different to that of petroleum ointments and zinc oxide formulations. Nevertheless, the barrier film was more cost-effective than either petroleum ointments or zinc oxide formulations in managing incontinence-associated dermatitis and peri-wound skin protection, largely due to savings in nursing time. Conclusion: The barrier film is at least as clinically effective and potentially more cost-effective in incontinence-associated dermatitis prophylaxis and peri-wound skin protection than petroleum ointments or zinc oxide formulations, releasing health care resources for alternative use. Further studies are required to quantify the relative efficacy and cost-effectiveness of the barrier film and other barrier formulations in different clinical settings and enhance the quality of the evidence base. Conflict of interest: This review was sponsored by 3M Health Care, manufacturers of Cavilon barrier film. However, the authors have no other conflicts of interest that are directly relevant to the content of this manuscript, which remains their sole responsibility.

Thunbergia laurifolia Lindl (TL) has been traditionally used as an antidote, anti-inflammatory, and anti-drug addiction. This study investigated the burn wound healing activity of TL leaf extract (TLL) from supercritical CO 2 extraction in rats. The extract was prepared to 2.5%, 5%, and 10% gel (TLL gel). Rats were induced to second-degree burn wounds. They were randomly divided into six groups (six rats/group), which five groups were topically applied gel base, 1% silver sulfadiazine gel, 2.5%, 5%, and 10% TLL gel, respectively, for 14 days. Six untreated burn rats were used as the control group. The rats in each group were evaluated for wound healing rate, histological parameters, and wound collagen content. Rats treated with 10% TLL gel had a higher wound healing rate than rats in the control and untreated groups. An increase in collagen content, which indicates good regeneration of wound skin, was observed in the TLL treated rats from a pathological study by Masson′s trichrome and collagen content assay. The results from this study suggest that T. laurifolia leaf extract obtained by supercritical CO 2 extraction promotes the recovery of wound skin by shortening the inflammation phase, increasing collagen content, and stimulating fibroblasts proliferation and migration in wound healing.

A moist environment provides the optimum conditions for wound healing, but maintaining control of exudate and preventing its contact with the surrounding skin remain a challenge to carers. An essential part of management is identifying the underlying pathology of the wound. Correct diagnosis of the cause of increased exudate production is necessary for the implementation of appropriate interventions. Continual assessment of the wound and surrounding skin, together with evaluation of dressing performance, are integral to manage the different stages of wound healing.

but prevent the deleterious effects of exudate such as maceration, excoriation and peri wound burns , which can lead to increased wound size, pain, strikethrough, associated odour, as well as a reduced quality of life for patients. A healthy wound bed will facilitate the migration of epithelial cells, whereas damaged peri wound skin will not. In addition, toofrequent dressing changes can affect the wound margins and lead to skin stripping and trauma as a result of the adhesive properties of some products. Inadequate absorptive capacity of some dressings can lead to maceration and excoriation as mentioned. It is imperative that clinicians monitor highly exuding wounds carefully and change management strategies accordingly, in an effort to manage the exudate efficiently and offset the frequency of complications. White (2003) argues that the means to facilitate exudate control is not always obvious, and while it is a commonly encountered problem, it is not always easily achieved. Exudate can be an excellent indicator of what is happening at the wound bed. The volume, consistency, and particularly odour and colour of exudate will inform the practitioner about

A report of a study which evaluated two products designed to protect the skin surrounding wounds

The aim of this investigation was to provide more research data on the behavior of the plasma scalpel, a surgical tool based on the use of the energy flow of ionized gases for the treatment of skin wounds. The effect of the ionized gas flow on wound skin wound healing was tested on three series of six rabbits. Experimental methods and results are given for the biochemical interaction of the skin with the plasma.

A prospective randomised study of four different methods of leg wound skin closure after removal of the long saphenous vein was carried out in 113 patients undergoing coronary artery bypass grafting. These methods were: (1) continuous nylon vertical mattress suture (27 patients); (2) continuous subcuticular absorbable (Dexon) suture (29 patients); (3) metal skin staples (Autosuture) (27 patients); and (4) adhesive sutureless skin closure ("Op-site") (30 patients). All wounds were examined by two independent observers at five, 10, and 45 days after operation. At five days, inflammation, extent of oedema, discharge, and infection were assessed. At 10 days attention was paid to the state of wound healing and at 45 days to the final cosmetic appearance. The use of continuous subcuticular suture resulted in significantly less discharge than did the use of metal staples, nylon vertical mattress suture, or Op-site. The incidence of established wound infection was 4.5% overall, with no infection in the wounds closed with Dexon. Assessment of the healing process showed subcuticular Dexon to be more effective than metal staples or vertical mattress nylon suture. The final cosmetic result showed continuous subcuticular suture to be superior to nylon vertical mattress suture and skin staples but as effective as Op-site sutureless skin closure.

SUMMARY Microsomal preparations from petrolatum-treated wound skin contained significantly less arachidonic acid-dependent oxidative capacity when compared to activities in untreated wounded skin (t = 6.06, P < 0.001). Microsomes from both untreated and petrolatum-treated wounded skin produced similar quantities of PGE2 and PGF2α; however, microsomal lipoxygenase activity in petrolatum-treated wounded skin was depressed when compared to that in untreated wounded skin. Microsomal preparations from normal pig skin treated with petrolatum oxidized arachidonic acid at a similar rate to those from untreated control skin. Increasing quantities of petrolatum progressively inhibited the synthesis of PGE2 and PGF2α by fetal calf skin microsomes in vitro as determined by both the oxidation of arachidonic acid and the quantification of radioactive product. Topical application of banal compounds that contain lipid substances may therefore alter the cutaneous inflammatory response by local suppression of pathways that generate hydroxy-fatty acids, substances that are known to be chemotactic and pro-inflammatory.

Complications from skin closure after median sternotomy or standard thoracotomy incision, although uncommon, may be the source of undesireable morbidity and even death. A prospective randomized study of 3 different methods of wound skin closure has been carried out in 205 patients undergoing cardiothoracic surgery. These methods were: 1. continuous nylon vertical mattress suture; 2. continuous subcuticular absorbable (Dexon) suture; 3. adhesive sutureless skin closure (Op-Site). All wounds were examined by independent observers at 5, 10 and 45 days after operation, and the findings were graded from 0 to 4. At 5 days, assessments were made of inflammation, edema, discharge and infection. At 10 days, attention was paid to the state of wound healing, and at 45 days to the final cosmetic appearance. The use of continuous subcuticular Dexon suture resulted in less discharge than Op-site (p less than 0.001) and less swelling or redness than nylon (p less than 0.001). Assessment of the final cosmetic appearance of the wound 6 weeks following surgery showed subcuticular Dexon to be superior to either nylon (p less than 0.01) or Op-site (p less than 0.01).