Healing Status Research Articles

Clinical study on low-energy semiconductor laser treatment in the promotion of wound healing after maxillofacial fracture surgery.

This study aims to evaluate the clinical effect of low-energy semiconductor laser treatment on the promotion of wound healing after maxillofacial fracture surgery. A prospective randomized controlled study was conducted. Patients with maxillofacial fractures who were hospitalized in the Department of Trauma and Plastic Surgery, West China Hospital of Stomatology, Sichuan University, from August 2021 to June 2023 were selected as the study subjects and randomly divided into experimental and control groups. The experimental group was treated with a low-energy semiconductor laser once a day for six consecutive days after daily routine dressing change on the first day after surgery. The control group only underwent routine dressing change treatment and did not receive low-energy semiconductor laser treatment. Wound healing times, wound healing conditions, modified Stony Brook scar evaluation scale (mSBSES) scores, pain indices, and wound infection rates were compared between the two groups. A total of 211 patients were included in this study. A total of 104 and 107 cases comprised the experimental and control groups, respectively. A total of 128 males and 83 females were included. After low-energy semiconductor laser treatment, the facial skin wound healing time of the experimental group was found to be significantly shorter than that of the control group (P<0.05). Moreover, the wound grade A healing rate of the experimental group was higher than that of the control group on the seventh day after surgery (P<0.05). Among postoperative facial skin wound evaluation indices, the mSBSES scores of the experimental group at all observation points were higher than those of the control group (P<0.05), and the scores of the experimental group were higher than those of the control group in terms of wound width reduction, height reduction, color lightening, and incision line loss (P<0.05). In postoperative wound pain evaluation, the pain index of the experimental group after low-energy semiconductor laser treatment was significantly lower than that of the control group (P<0.05). No significant difference in wound infection rates was found between the two groups (P>0.05). For facial skin wounds in maxillofacial fracture surgery, low-energy semiconductor laser treatment can effectively promote wound healing, improve wound healing quality, fade scars, and relieve wound pain.

L-shape technique with concentrated growth factor for horizontal bone defects in the maxillary anterior region: a clinical and radiographic study.

To study the clinical effect of the L-shape technique combined with concentrated growth factor on the horizontal bone defects of maxillary anterior teeth. Twenty-five implants from 25 patients who underwent single maxillary anterior tooth implantation with simultaneous bone grafting were selected as the study subjects. Based on the bone grafting techniques, the patients were divided into a test group (L-shaped technique with guided bone regeneration combined with concentrated growth factor, 11 cases) and a control group (traditional guided bone regeneration combined with concentrated growth factor, 14 cases). The early discomfort and wound healing conditions in the two groups at two weeks after surgery were compared. The horizontal bone thickness, vertical bone thickness, and grayscale values in the augmentation area were measured immediately postsurgery and six months after surgery. Implant stability, hard tissue resorption within six months, and grayscale values were compared between the two groups. Differences in early discomfort, wound healing, implant stability, and grayscale values between the two groups were not statistically significant (P>0.05). Vertical bone thickness in the test group was significantly better than that in the control group at six months after surgery (P<0.05). The variation in horizontal bone thickness in the test group was significantly higher than that in the control group (P<0.05). The application of the L-shape technique with concentrated growth factor for horizontal bone defects in the anterior maxillary area yielded satisfactory short-term results in terms of bone augmentation, early discomfort, wound healing, and implant stability at six months after surgery.

Bioelectronic osteosynthesis plate to monitor the fracture bone healing using electric capacitive variations

BackgroundBone fractures represent a global public health issue. Over the past few decades, a sustained increase in the number of incidents and prevalent cases have been reported, as well as in the years lived with disability. Current monitoring techniques predominantly rely on imaging methods, which can result in subjective assessments, and expose patients to unnecessary cumulative doses of radiation. Besides, they are costly and incapable of providing continuous daily detection of fracture healing stages. Technological advances are still required to design fixation systems with the ability to minimize the risk of delayed healing and nonunion conditions for timely medical intervention, such that preventive procedures can be provided. This work proposes.MethodsAn innovative bioelectronic osteosynthesis plate, minimally customized from a fixation device used in clinical practice, was developed to monitor the bone-implant interface to effectively detect the progression of bone fractures stages. Our technology includes a network-architectured capacitive interdigitated system, a Bluetooth module, an analog-to-digital converter, a multiplexer, a microcontroller, and a miniaturized battery.ResultsBoth experimental tests with biological tissues and numerical simulations show strong evidence that this bioelectronic implant is able: (i) to detect the four distinct bone healing stages, with capacitance decreases throughout the healing process; and (ii) to monitor the callus formation across multiple target regions.ConclusionsThis work provides a significant contribution to the design of bioelectronic implant technologies for highly personalized sensing of biointerfaces. Our bioelectronic fixation implant supports faster fracture healing, mainly for delayed healing and non-union conditions.

The Use of Adipose-Derived Mesenchymal Stem Cells in the Treatment of Claw Lesions in Cows

The treatment of claw lesions in cattle is one of the most pressing aspects of veterinary surgery. The main options of treatment include claw trimming along with various methods to speed up healing. At the same time, the problem of finding new agents to improve tissue regeneration remains. Mesenchymal stem cells (MSCs) cells may be considered as such a remedy. To evaluate the ability of bovine MSCs from adipose tissue (AT-MSCs) when used after claw trimming to heal the ulcers of digital caushion in the heel area (Ulcus Pulvinus Digitalis) or postoperative wounds after excision of interdigital hyperplasia (tyloma) in dairy cows. The experimental and comparison groups included 5 cows with ulcers and 5 with tylomas each. All the animals underwent claw trimming with primary surgical treatment including the tyloma excision. Then, cows in experimental group were once injected with a cell transplant into the skin area of the fornix of the interdigital cleft. The cows in comparison group received a single intramuscular injection of antibiotic and topical treatment of lesions with a spray. The therapy outcomes were assessed in dynamics of the wound healing and general condition. AT-MSCs at a dose of 5×106 cells in 2 ml in the case of ulcers and 107cells in 4 ml of saline solution in the case of tylomas shortens the wound healing period by (7.0 ± 2.1, P&lt; .05) days as compared to the treatment with antibiotic and topical spray. The mesenchymal stem cells-based therapy may be used for wound healing in cow hooves. Keywords: Adipose tissue, claws and hooves, dairy cow, mesenchymal stem cells, wound healing.

A Lack of Joint Line Tenderness Is Consistent With a Healed Meniscus, But Positive Clinical Examination Findings and MRI Scans Are Inconsistent in Identifying Failure After Meniscal Repair: A Systematic Review and Subgroup Meta-analysis.

The number of meniscal repairs being completed each year is increasing; however, the optimal, cost-effective postoperative assessment to determine the success or failure of a meniscal repair is not well known. The purpose of this systematic review was to identify the clinical examination testing that correlates with objective magnetic resonance imaging (MRI) or second-look arthroscopy (SLA) findings to determine an optimal clinical workup for assessing postoperative meniscal repair healing. It was hypothesized that specific clinical tests would correlate with meniscal repairs that did not heal. Systematic review and meta-analysis; Level of evidence, 4. This systematic review included all clinical studies investigating meniscal repairs, meniscal repair outcomes, and meniscal healing with clinical findings, MRI, and/or SLA, published in a peer-reviewed journal and with full English text available. All included studies were evaluated for bias using the Methodological Index for Non-Randomized Studies (MINORS). The clinical tests included those using "Barrett's criteria," with the assessment of effusion, joint line tenderness, locking, McMurray testing, and radiographs. This parameter has also been abbreviated to "modified Barrett's criteria" to include only joint line tenderness, effusion, and McMurray testing. No significant correlations were found between clinical tests and MRI or SLA. A subgroup meta-analysis between Barrett's and non-Barrett's studies reported no significant subgroup differences (χ12 = 0.24; P = .62). A meta-analysis of diagnostic accuracy using a group of 7 studies that reported on true-positive, true-negative, false-positive, and false-negative data for SLA demonstrated that only a lack of joint line tenderness had a high specificity for a healed meniscal repair, with a log diagnostic odds ratio of 2.62 (95% CI, 0.47-4.76). This study found no significant correlation with any specific clinical test for meniscal repair healing status using postoperative MRI and/or SLA findings. However, it was found that no healing (when compared with complete or incomplete healing) on MRI and joint line tenderness should be considered when assessing the status of postoperative meniscal repair healing. In addition, a subgroup meta-analysis found that a lack of joint line tenderness was highly correlated with a healed meniscal repair.

Diabetic foot ulcer photography study: a study within a trial to assess the reliability of two-dimensional (2D) photography for the assessment of ulcer healing in patients with diabetes-related foot ulcers—protocol paper

BackgroundThe primary endpoint in diabetes-related foot ulcer (DFU) trials is often time to healing, defined as complete re-epithelialisation with absence of drainage, requiring clinical expert assessment as the gold standard....

Application of infrared thermography for predicting pressure injury healing: A prospective study.

An accurate assessment of pressure injury healing is crucial for the timely implementation of nursing intervention. This study aimed to investigate the accuracy of infrared thermography-based wound temperature measurement in predicting wound outcomes. This prospective, 16 days observational study included 156 adults with pressure injury. The temperature of wound bed, periwound skin and normal skin was recorded by using infrared thermography every three days. After that, three relative temperatures of PI were analyzed. The aim was to assess the significance of wound temperature in predicting healing outcomes for pressure injuries. Relative temperature between periwound skin and normal skin was positively correlated with pressure injury healing (r>0.64). Particularly the first day of follow up, it was found to be closely related to pressure injury healing (r=0.687). On the last day and median time (the eighth to ninth day) of follow up, the optimal cutoff values of the indicator were negative values (periwound skin temperature was lower than normal skin). COX proportional hazard regression model analysis showed that relative temperature between periwound skin and normal skin on the first day of follow-up was the most significant predictor of pressure injury healing, and the healing risk increased largest- 8.79 times (95%CI: 4.53, 17.05), when its temperature greater than 0.000°C. Relative temperature between periwound skin and normal skin monitoring by infrared thermography better than visual assessment which can objectively serve as an indicator for predicting the healing status of pressure injury.

Biomechanical Analysis of the System “External Fixation Device – Bone” Behavior at the Stages of Tibial Diaphyseal Fracture Healing

Summary. The use of external fixation devices for the treatment of diaphyseal fractures of the tibia has become the standard. However, most external fixation device (EFD) modifications have insufficient stiffness. Therefore, there is a need to develop an EFD design that could provide early limb loading with an optimal range of interfragmentary motion. A related challenge lies in determining the strength of bone regeneration during fracture healing, which cannot be objectively assessed in a clinical setting. However, these values can be calculated using the Finite Element Method (FEM). Objective. The objective of our work was to study the biomechanical behavior of the proposed “External Fixation Device – Tibia” system at the stages of bone regeneration under the condition of its loading by body weight using the FEM. Material and Methods. A computer simulation was carried out, at the initial stage of which a semi-full-scale prototype of the “External Fixation Device – Tibia” bone fragments fixation system was developed. Based on it, the next step was to create solid 3D models of the tibia and the EFD using the SolidWorks software package (Dassault, France). The EFD design used in the work consisted of 4 semi-rings (160 mm), 9 connecting beams (150 mm), two through pins (5 mm), 2 spongiosis screws (5 mm), 2 cortical screws (5 mm), and 6 clamps. All the components of the EFD were made of AISI320 stainless steel. Results and Discussion. Simulation computer modeling of the fixation capabilities of the proposed EFD showed that its stiffness is sufficient to provide a controlled load on the damaged limb within 20-24% of body weight from the first days of formation of granulation cartilage regenerate. It should be noted that the supporting function of the fibula is restored within 5-6 weeks after its fusion and is approximately 17-30% of the body weight. Therefore, in general, a controlled load on the limb can reach 50% of the body weight after 6 weeks of treatment. Subsequently, when mature bone tissue is formed around the fracture (most often within 8-17 weeks), the load on the limb can reach 130% of the body weight, which ensures the patient’s movement without additional support. Conclusions. The performed computer simulation modeling makes it possible to determine the behavior of the biomechanical environment of the proposed “External Fixation Device – Bone” system and allows to establish the amouth of limb loading in the process of developing a scientifically based rehabilitation program to create optimal conditions for fracture healing. The proposed design of the EFD can be used for the final treatment of diaphyseal fractures of the tibia and provides for the possibility of early loading on the “External Fixation Device – Bone” system.

A glucose responsive multifunctional hydrogel with antibacterial properties and real-time monitoring for diabetic wound treatment.

The healing of complex diabetic wounds with a hyperglycemic microenvironment and bacterial infection is considered an important clinical issue. In this study, glucose oxidase (GOx) and gold nanoclusters (AuNCs) were encapsulated in quaternary carboxymethyl chitosan (QCMCS)/sodium alginate oxide (OSA) hydrogels and were immersed in tannic acid (TA) solution to achieve antioxidant, antibacterial, pro-angiogenesis, pro-collagen deposition and real-time monitoring functions. In vitro studies showed that TA-QCMCS/OSA@GOx@AuNC hydrogels had inhibition rates of 98.99% and 99.99% against S. aureus and E. coli, respectively, and the survival rate of mouse fibroblasts (L929) was over 95%. In vivo studies showed that TA-QCMCS/OSA@GOx@AuNC hydrogels were 97.28% effective in healing diabetic wounds. In addition, image signals from TA-QCMCS/OSA@GOx@AuNC hydrogels can be collected in real time to accurately obtain glucose concentration values of diabetic wounds and reflect the healing status of diabetic wounds in a timely manner. The results showed that TA-QCMCS/OSA@GOx@AuNC hydrogels provide a novel idea for real-time monitoring of diabetic wound treatment.

ВЛИЯНИЕ СУЛЬФАТИАЗОЛА СЕРЕБРА НА ЗАЖИВЛЕНИЕ КОЖНЫХ РАН, ОБРАЗУЮЩИХСЯ ПРИ ПРОРЕЗЫВАНИИ СПИЦАМИ АППАРАТОВ НАРУЖНОЙ ФИКСАЦИИ

The study of the healing mechanisms of skin wounds resulting from damage to the skin by transosseous needles of external fixation devices in the treatment of osteoarticular pathology with the aim of further targeted correction of these processes is one of the urgent tasks of modern traumatology and orthopedics. The effect of silver sulfathiazole, recommended for the prevention of infectious complications, on the healing of this type of wound has not been studied previously. The aim of the study was to investigate the effect of silver sulfathiazole on the healing of skin wounds formed during the cutting of external fixation devices by pins. The experimental study was performed on 35 sexually mature male Wistar rats. Modeling of a skin wound formed during the cutting of external fixation devices by pins was carried out in sterile operating room conditions, under drug anesthesia of animals that underwent transosseous osteosynthesis of the femur using an original design of the external fixation device. By tractional movement of the proximal pin with a dosed stretching of the supports at a rate of 1 mm in 4 steps, tension and cutting of the skin were carried out for 10 days (the distraction period), then the device was in a static position for 15 days (the period of fixation of the limb in the device), after which the device was dismantled and observation was carried out for another 30 days. The animals were divided into 2 groups. In the control group, the simulated wound healed under natural healing conditions; in the experimental group, silver sulfathiazole applications were performed twice daily during the distraction period. Skin wounds were examined using light microscopy and morphometry after 10 days of distraction, 15 days of fixation, and 30 days after the apparatus was removed. The thickness of the epidermis, dermis, and the numerical density of the sebaceous glands and hair follicles were measured on digital images of histological preparations stained with hematoxylin and eosin. The volume density of elastic fibers was determined on preparations stained with orcein according to Tenzer-Unn. The obtained quantitative data were subjected to statistical analysis. The study showed that the formation of a skin wound with transosseous pins is accompanied by tissue tension. Healing of this type of wound occurs with a delay in epithelialization and an increase in the duration of the inflammatory phase. This affects the mechanisms of extracellular matrix synthesis and leads to the formation of scar tissue in the area of damage. The use of silver sulfathiazole applications promotes accelerated wound closure by epithelium, a reduction in the period of inflammation, normalization of elastin synthesis, and a decrease in cicatricial changes in the skin regenerate.

Comparison of Single-Use Negative-Pressure Wound Therapy (sNPWT) and Standard Dressings Applied to the Same Patient During Bilateral Tissue Expander-to-Implant Exchanges.

Breast cancer is the most common cancer among women. The number of cases is increasing among young women, and consequently, breast reconstructions are performed more often. Postoperative complications, wound healing, and the quality of scars influence the final cosmetic outcomes. The aim of the study was to investigate the effect of using a negative-pressure therapy compared to a standard dressing on two postoperative wounds in the same woman, after bilateral tissue expander replacement surgery-when identical healing conditions occur. This study includes a single-center evaluation of the application of two different dressings during bilateral exchanges of tissue expanders with breast implants. The study included 22 patients with a history of breast cancer after bilateral mastectomy with two-stage reconstruction. During the second stage, a sNPWT was applied to one breast and a standard dressing to the other. A statistically significant difference in skin elasticity in favor of sNPWT was visible after 7 days, while the greatest difference was visible in the evaluation after 6 months (mean of 0.806 vs. 0.607). A difference in temperature measurements was shown 7 days after the procedure. However, after 30 days, these measurements were similar. There was also a reduced incidence of postoperative complications as well as seroma accumulation in the breasts with negative pressure. The results indicate faster healing, better scar quality, and improved skin elasticity in breasts with sNPWT compared to the standard dressing. The number of postoperative complications were also reduced, which is especially important in high-risk patients.

Land-Based Radical Healing with Black Ecologies and Critical Native Studies

Recognizing oppression as traumatizing allows us to see that such trauma is political and healing requires liberation. Healing, then, is a political act. Increasingly, leisure scholars are interrogating the politics of leisure research and practice to understand how leisure functions as both a traumatizing tool of oppression and a facilitator of liberatory healing. We point to a need for more leisure research to take a collective view of healing in the context of colonial and racial oppression and to include the land as part of the collective. Radical healing offers an understanding of healing and trauma as highly political and collectively experienced, whereby social justice is a necessary condition for healing. However, radical healing lacks fluency in land and analyses of settler colonialism. We suggest modifying radical healing through an engagement with Black ecologies and Critical Native Studies scholarship on the collective healing of people and places.

Clinical and Molecular Impact of Advanced Platelet-Rich Fibrin on Pain, Swelling, and Distal Periodontal Status of Mandibular Second Molars After Mandibular Third-Molar Extraction.

Background and Objectives: This study aimed to evaluate the role of A-PRF (advanced platelet-rich fibrin) in the enhancement of wound healing and protecting the periodontal health of mandibular second molars after the extraction of mandibular third molars. Additionally, the study assessed the levels of pro-inflammatory cytokines in the gingival crevicular fluid (GCF) of mandibular second molars as markers of inflammation. Materials and Methods: Twenty-five systemically healthy adult patients with bilateral removal of impacted mandibular third molars were included. Each patient received A-PRF in one extraction site, while the contralateral site served as a control. Periodontal parameters of the adjacent second molar, including probing depth (PD) and clinical attachment level (CAL), were measured in distal-vestibular (DV) and distal-lingual (DL) sites. Pain, swelling, and overall healing were subjectively evaluated. Levels of tumor necrosis factor-alpha (TNF-α), interleukin 1 beta (IL-1β), and interleukin 6 (IL-6) in the GCF were analyzed. Evaluations occurred at baseline and three months post-surgery. Results: A-PRF significantly improved PD (from 4.69 ± 0.61 mm to 3.85 ± 0.34 mm in DV, and from 4.71 ± 0.65 mm to 3.79 ± 0.27 mm in DL, respectively) and CAL (from 2.41 ± 0.25 mm to 1.82 ± 0.21 mm in DV, and from 2.40 ± 0.36 mm to 1.75 ± 0.19 mm in DL, respectively) of the adjacent second molar, compared to control sites, three months post-surgery. Pain and swelling scores were notably lower on the 7th postoperative day in the A-PRF group. A-PRF also reduced pro-inflammatory cytokines in GCF, significantly more than in control sites, at three months post-surgery. Conclusions: A-PRF enhances the periodontal and inflammatory status of adjacent teeth and wound healing after the extraction of mandibular third molars.

Management of Bone Defects and Complications After Bone Tumor Resection Using Ilizarov Method.

Ilizarov technology is highly effective in addressing complex orthopedic challenges. This study aims to describe our experience with distraction osteogenesis in managing bone tumors in the lower extremity, focusing on composite bone defects and associated complications. A retrospective clinical study was conducted to analyze patients with primary bone tumors who underwent distraction osteogenesis using the Ilizarov method from 2010 to 2020. Some young children received epiphyseal distraction and bone transport as part of their sarcoma surgical treatment. Additionally, external fixation, bone transport, or limb lengthening were employed to address complex postoperative complications associated with bone tumors. The clinical outcomes assessed included the patient's general information, the location of bone defects, the length of bone repair, the status of bone healing, and limb function. Eleven patients were followed up for an average of 66 months (range, 24-132 months). The average length of repaired bone defects was 13 cm (range, 2.5-32 cm). The cohort comprised three females and eight males, with ages at presentation ranging from 6 to 42 years (mean, 18 years). The sites of involvement included the distal femur (n = 4), femoral diaphysis (n = 3), proximal tibia (n = 2), and the distal tibia (n = 2). Nine patients were diagnosed with osteosarcoma, while one presented with Ewing's sarcoma and another with a giant cell tumor of bone. Three young children were successfully treated with epiphyseal stretching; however, one patient experienced treatment failure. Additionally, seven patients underwent external fixation to address complex postoperative complications, including infection, bone defects, and limb shortening. At the last follow-up, with the exception of one failure, the average Musculoskeletal Tumor Society (MSTS) limb function scores for the remaining 10 patients were 25 (range, 21-30). Three months post-fixator removal, the Asociación Latinoamericana de Oncología (ASAMI) bone score was rated as excellent in 63.6% (7/11) of patients, whereas the ASAMI function score was excellent in 36.4% (4/11) and good in 54.5% (6/11) of cases. The Ilizarov method demonstrates some clinical value in the resection and reconstruction of bone tumors, as well as in the management of postoperative complications associated with such tumors.

Key Decision-Making in Post-Failed Internal Fixation of Intertrochanteric Fractures Hip Arthroplasty: A Multicenter Retrospective Study onFractureHealing'sImpact on Femoral Component Selection.

Following failed internal fixation of intertrochanteric fractures (FIF-ITF), the decision to use a long-stem or standard-stem femoral implant in hip arthroplasty is still debated. This study aimed to explore how the healing status of fractures after FIF-ITF failure affects the choice of femoral stem and clinical outcomes. Our retrospective cohort study reviewed 105 cases of patients with FIF-ITF who underwent hip arthroplasty at three tertiary Grade A hospitals between December 2012 and December 2022. We compared the clinical outcomes between patients with healed and unhealed fractures, focusing on the selection of femoral stems in relation to proximal medial support and the healing status of the greater trochanter. The primary outcomes measured were functional results, operative time, blood loss, and incidence of complications. A subgroup analysis was conducted to further evaluate the influence of the proximal medial buttress and greater trochanteric healing on femoral stem selection. Statistical analysis included binary and ordinal logistic regression to identify factors influencing the choice of femoral stems. Additionally, a decision tree model was developed to visually represent and explore the relationship between fracture healing status and the selection of femoral components. The study included 38 patients with healed fractures and 67 patients with unhealed fractures. Patients in the healed group predominantly chose standard stems and experienced better functional outcomes (p < 0.001, p = 0.002). In contrast, the unhealed group preferred long stems, resulting in longer surgical durations and increased blood loss (p = 0.008, p < 0.001). Binary logistic regression analysis revealed that nonunion of the proximal femoral medial buttress was an independent risk factor for long stems (p < 0.0001, OR = 10.402). The selection of femoral prostheses following FIF-ITF is influenced by the fracture healing status, particularly the presence of proximal femoral medial buttress. The decision tree model suggested that long-stem prostheses are more appropriate when there is inadequate fracture healing and the proximal femoral medial buttress is absent.

Evaluation of the clinical efficacy of modified LSC transplantation plus BCL implantation in the treatment of pterygium

ObjectiveTo explore the clinical efficacy of modified limbal stem cell transplantation(Modified LSC transplantation) and bandage contact lens(BCL) implantation in pterygium surgery.MethodsA total of 479 patients with primary pterygium who were admitted to our hospital from March 2019 to March 2023 were randomly divided into three groups: the normal group (Group A: 89 patients), the control group (Group B: 195 patients), and the modified group (Group C: 195 patients). Each group received different intervention measures. Group A did not undergo surgical treatment and were required to follow up as outpatients. Group B received LSC transplantation combined with interrupted suturing plus BCL, whereas Group C received modified LSC transplantation combined with BCL. The degree of corneal irritation symptoms, wound healing and graft status under slit lamp, incidence and recurrence rate of complications, tear film rupture time, tear secretion test, intraocular pressure, ocular surface inflammation response(IL-1β, PGE2, TNF-α, VEGF), and visual quality were compared and analyzed at various time points after surgery.ResultsCompared with those in the Group B, patients in the Group C experienced faster normalization of corneal epithelium recovery, fewer corneal irritation symptoms, and better wound healing. The break-up time (BUT) of the tear film at 1 week to 1 year postoperatively was significantly greater in the Group C than Group B, with values approaching those of Group A by 3 months (P < 0.05). The Schirmer test results revealed a similar trend to that of the BUT. Further analysis of intraocular pressure (IOP) at different time points revealed no significant differences among the three groups at postoperative Day 1. However, due to the use of corticosteroid eye drops postoperatively, IOP was greater in both the Group B(17.24 ± 2.12 mmHg) and Group C (17.02 ± 2.37 mmHg) than Group A (13.92 ± 1.57 mmHg) at 1 week. By 1 month, Group C had a lower IOP (15.77 ± 1.63 mmHg) than Group B(17.78 ± 2.41 mmHg). There were no significant differences in IOP among the three groups from 3 months to 1 year (P > 0.05). The ELISA results indicated that the expression levels of the ocular surface inflammatory factors IL-1β, TNF-α, PEG2, and VEGF in the Group C were lower than those in Group B from 1 week to 1 year post surgery. Under both natural light and low-light conditions (spatial frequency/6 cd), Group C had better best-corrected visual acuity and contrast sensitivity than Group B at 1 week to 1 year postoperatively. Additionally, Group C had lower corneal higher-order aberrations (including astigmatism, spherical aberrations, and total higher-order aberrations) and superior vision-related quality of life scores at 1 year postoperatively than Group B, with statistically significant differences (P < 0.05).ConclusionModified LSC transplantation combined with BCL implantation provided superior treatment outcomes for patients with pterygium, which was worthy of further clinical promotion.

Bigger is not necessarily better - 2-ring circular frames associated with shorter duration of treatment in the management of complex tibial fractures - a retrospective cohort study.

Frame configuration for the management of complex tibial fractures is highly variable and is dependent upon both fracture pattern and surgeon preference. The optimal number of rings to use when designing a frame remains uncertain. Traditionally larger, multi-ring-per-segment constructs have been assumed to offer optimal stability and therefore favourable conditions for fracture healing but there is little in-vivo evidence for this and the recent concept of reverse dynamisation challenges this approach. We compared the clinical outcomes in 302 consecutive patients with tibial fractures treated in our unit with either a stable two-ring circular frame or a three-or-more-ring (3+) frame. The primary outcome measure was time spent in frame. Secondary outcomes were the incidence of malunion and the need for further surgical procedures to achieve bone union. The mean time in frame was 168 days for the 2-ring group and 202 days for the 3+ rings group (p = 0.003). No significant differences were found in the rate of malunion or the requirement for secondary surgical intervention to achieve union. The groups were evenly matched for age, co-morbidities, energy of injury mechanism, post-treatment alignment and presence of an open fracture. This study finds that 2-ring frame constructs are a reliable option associated with shorter duration of treatment and no increase in rates of adverse outcomes compared with larger, more complex frame configurations.

Effect of oral trehalose supplementation on inflammation and wound healing in patients with peri-trochanteric fractures: study protocol for a randomised clinical trial

IntroductionPeri-trochanteric fractures, common among the elderly with osteoporosis, pose significant morbidity and mortality risks. These fractures are increasing due to the ageing population, with Nordic countries seeing a high incidence....

The effect of nanoceria on the alginate-gum arabic crosslinking mechanism and in vitro behavior as a wound dressing.

Medical practice has proven that chronic wounds can be treated successfully if the dressing is chosen according to the healing phase of the wound. Correct intervention from the hemostasis and inflammatory phase can prevent oxidative stress and ensure optimal conditions for healing. It is important to design a new wound dressing that does not cause additional injury, has an antioxidant effect, removes dead cells, and promotes wound healing. Considering that the traditional dressings are not moisture-retentive, we proposed an alginate-gum arabic polymeric matrix enhanced with cerium oxide nanoparticles. The cryogels were prepared by cross-linking polysaccharides and cerium oxide nanoparticles via calcium cations to form a sponge-like structure. The blend of micro- and macro-pores provides a suitable environment for nutrient distribution and keeps an adequate moisture level, mimicking the functions of the native cellular matrix. The release of cerium oxide nanoparticles occurs gradually, at the same time as the degradation of the biopolymer, promoting the attachment and viability of keratinocytes and fibroblast cells. It was found that stimulating epithelial regeneration is improved through the antioxidant effect and the adsorption capacity of hemoglobin. The results also indicate good in vitro biocompatibility and recommend them as promising dressings for skin wound treatments.

Design strategy of hydrogel wound dressings based on oral special environment.

Oral wounds caused by injuries, surgeries, diseases, and chemical irritations bring pain to the patient and increase the risk of infection. Effective wound protection and repair are crucial for improving patients' quality of life and maintaining oral health. Wound dressings provide ideal healing conditions by isolating the wound from the oral environment. However, in the highly moist, microbiologically rich environment of the oral cavity, maintaining the stability of wound dressings remains a considerable challenge. Hydrogels show promising prospects for oral applications and are gradually becoming a research hotspot for addressing the challenges of oral wound protection and repair due to their excellent biocompatibility and versatile performance. In this paper, the current design strategies of hydrogel wound dressings that overcome the unique oral environment, achieve sustained adhesion and fulfill their functions are reviewed to provide new insights for the design of ideal oral wound barrier materials.