Duration Of Healing Research Articles

Clinical efficacy and mechanism of the combination of autologous platelet-rich gel and recombinant human acidic fibroblast growth factor in the management of refractory diabetic foot

ObjectiveThis study aims to explore the influence of combining autologous platelet-rich gel (APG) with continuous vacuum-sealed drainage (CVSD) and the exogenous recombinant human acidic fibroblast growth factor (rh-aFGF) on the healing processes of diabetic foot ulcers (DFU). The primary objective is to elucidate the complex molecular mechanisms associated with DFU, providing innovative perspectives for its treatment.MethodsNinety patients diagnosed with DFU were randomly allocated into three distinct groups. Group A underwent CVSD following wound cleansing to facilitate healing. In Group B, in addition to conventional treatment, negative pressure wound therapy was applied, and rh-aFGF was introduced into normal saline for lavage, building upon the procedures of Group A. Group C received APG along with the interventions applied in Group B. The clinical efficacy of each group was systematically observed and analyzed. Additionally, changes in plasma oxidative stress, inflammatory markers, vascular endothelial growth factor (VEGF), and pigment epithelium-derived factor (PEDF) were assessed both before treatment and 14 days post-treatment.ResultsFollowing treatment, all groups exhibited commendable clinical efficacy. Group C demonstrated a superior wound healing rate, reduced frequency of dressing changes, and shorter wound healing duration (P< 0.05). Compared to baseline measurements, the levels of superoxide dismutase and PEDF increased, while malondialdehyde, VEGF, interleukin-6, interleukin-8, and monocyte chemotactic factor MCP-1 decreased in the wound tissue across all groups. Notably, Group C showed the most significant improvement in clinical efficacy and fortification of molecular mechanisms against oxidative stress (all P< 0.05).ConclusionsThe integrative therapeutic approach combining APG with CVSD and rh-aFGF demonstrates notable efficacy in advancing wound healing. This effectiveness is evident through the reduced frequency of dressing changes and alleviation of wound-related pain. Additionally, the treatment regimen improves the cure rate for challenging, refractory wounds. These favorable outcomes can be attributed to the reduction of oxidative stress levels, attenuation of the local inflammatory response, and the enhancement of the balance between PEDF and VEGF.

Implant Stability After Graftless Motor-Driven Crestal Sinus Elevation: A Cohort Study.

Graftless motor-driven crestal sinus elevation may be a preferable alternative to conventional methods due to the reduction of postsurgical complications and lower cost. This prospective cohort study evaluated the stability of implants installed using this technique. Twenty-nine Straumann BLT (bone level tapered) implants in 29 patients were included in the sample. Average implant stability quotients (ISQ) were measured immediately after surgery (mean: 73.5 ± 9.2) and after a period of healing (mean: 77.1 ± 4.5) using resonance frequency analysis (RFA). There was a significant increase in implant stability after healing (P = .035). The healing duration did not significantly influence how implant stability increased (P =.373). The mean ISQ after healing was significantly higher than the clinically acceptable stability value of 65 ISQ (P < .001). Implant length and width were not significantly correlated with ISQ increase (P = .764 and P = .085, respectively). In addition, there were no significant differences in average ISQ values measured immediately postsurgery (at baseline) or after healing between implants with and without registered perforations during surgery (P = .118 and P = .366, respectively). The posthealing stability of 4 implants that did not achieve primary stability was not significantly less stable after the healing period than those that had achieved primary stability (P = .086). Moreover, the level of insertion torque significantly impacted implant stability immediately postsurgery (P < .001), but the ISQ values measured after healing were not significantly different based on the initial insertion torque values (P = .131). This study suggests that implants installed using graftless motor-driven crestal sinus elevation may achieve clinically acceptable stability as measured by RFA.

Topical Anti-ulcerogenic Effect of the Beta-adrenergic Blockers on Diabetic Foot Ulcers: Recent Advances and Future Prospectives.

Patients with diabetes suffer from major complications like Diabetic Retinopathy, Diabetic Coronary Artery Disease, and Diabetic Foot ulcers (DFUs). Diabetes complications are a group of ailments whose recovery time is especially delayed, irrespective of the underlying reason. The longer duration of wound healing enhances the probability of problems like sepsis and amputation. The delayed healing makes it more critical for research focus. By understanding the molecular pathogenesis of diabetic wounds, it is quite easy to target the molecules involved in the healing of wounds. Recent research on beta-adrenergic blocking drugs has revealed that these classes of drugs possess therapeutic potential in the healing of DFUs. However, because the order of events in defective healing is adequately defined, it is possible to recognize moieties that are currently in the market that are recognized to aim at one or several identified molecular processes. The aim of this study was to explore some molecules with different therapeutic categories that have demonstrated favorable effects in improving diabetic wound healing, also called the repurposing of drugs. Various databases like PubMed/Medline, Google Scholar and Web of Science (WoS) of all English language articles were searched, and relevant information was collected regarding the role of beta-adrenergic blockers in diabetic wounds or diabetic foot ulcers (DFUs) using the relevant keywords for the literature review. The potential beta-blocking agents and their mechanism of action in diabetic foot ulcers were studied, and it was found that these drugs have a profound effect on diabetic foot ulcer healing as per reported literatures. There is a need to move forward from preclinical studies to clinical studies to analyze clinical findings to determine the effectiveness and safety of some beta-antagonists in diabetic foot ulcer treatment.

Does the use of stem-cell injection therapy benefit duration of healing in adults with large joint injuries?

Does the use of stem-cell injection therapy benefit duration of healing in adults with large joint injuries?

A Prospective, Interventional, Comparative Study to Evaluate the Efficacy of Using Combined Platelet-Rich Plasma and Platelet-Rich Fibrin Over Standard Cleaning and Dressing in Chronic Wounds.

Chronic wounds are defined as wounds that have failed to proceed through the orderly process that produces satisfactory anatomic and functional integrity or that have proceeded through the repair process without producing an adequate anatomic and functional result. The majority of wounds that have not healed in three months are considered chronic, although a duration as low as four weeks has been used to indicate chronicity.Our study aimed to compare the efficacy of autologous platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) versus standard cleaning and dressing as a regenerative medicine strategy to promote healing in chronic wounds. A prospective randomized controlled trial was undertaken to test the efficacy of autologous PRPand PRFin the healing of chronic wounds. A series of 60 cases was compiled from patients attending the outpatient department regularly for the management of chronic wounds. A total of 30 cases were randomly chosen for study with autologous PRP and PRF and 30 cases received conventional dressing. The average healing duration in the study was significantly shorter for the PRP & PRF group. The mean healing time for this group was 4.45 weeks (31.2 ± 3.07 days) compared to 9.61 weeks (67.27 ± 9.19 days) for the conventional dressing group. PRP and PRF belong to a new generation of platelet concentrates that help efficaciously for enhanced healing and functional recovery, safely and cost-effectively. They help by shortening the recovery period overall, improving the quality of life of patients, and altogether eliminating the additional morbidity of operative procedures.

Antibacterial and Healing Potential of Zn-Al LDHs/Cellulose Acetate Nanocomposite in Burns and Wounds: A Study on Earthworms as a Human Skin Model

AbstractProtection against microbial invasion has gained much attention to accelerate wound healing. Layered double hydroxides (LDHs) have antimicrobial properties due to their partial release of metallic ions. In this study, Zn-Al LDHs was chemically prepared and then supported on cellulose acetate (CA) in the form of nanocomposite. This novel Zn-Al LDHs/CA nanocomposite was in vitro characterized, and its antibacterial efficacy was determined using the agar well diffusion method. Moreover, healing capabilities of the nanocomposite were evaluated via topical application on wounds and burns induced in earthworms as a model of human skin like. The average crystallite sizes of Zn-Al LDHs and 50% Zn-Al/CA nanocomposite were 18.4 nm and 14.8 nm, respectively. TEM micrographs revealed that pure CA, pure Zn-Al LDHs, and 50% Zn-Al LDHs/CA nanocomposites had an average particle size of 27.7 ± 13.5, 296.2 ± 123, and 223.2 ± 83.4 nm, respectively. Pure Zn-Al LDHs showed antibacterial activity against different bacterial strains (Inhibition zone: 15 ± 2 to 20 ± 4 mm). However, when 50% Zn-Al LDHs was supported on CA, the inhibition zone was significantly higher (20 ± 3 to 26 ± 2 mm). Visual inspection, scanning electron microscopy and histological studies of earthworm skin revealed better morphology and shorter healing duration with Zn-Al LDHs/CA nanosystem (66 h for wounds and 144 h for burns) when compared with untreated control (&gt; 400 h). In conclusion, these findings reveal that Zn-Al LDHs/CA nanocomposite is a promising promoter for wound and burn healing due to its biocompatibility and antibacterial activity.

Exploring the Changes in IL-6 and Related Cytokines in Angiogenesis after Tibial Transverse Transplantation in Diabetic Foot Ulcers.

The transverse tibial transfer technique is employed primarily to treat diabetic foot ulcers (DFUs), aiming to enhance leg circulation and promote new blood vessel growth. This technique is also beneficial for various conditions associated with poor blood flow in the lower extremities. However, there is no clear molecular mechanism to explain the relationship between the transverse tibial transfer technique and angiogenesis in patients with diabetic foot. This study aims to preliminarily explore the change of IL-6 and related cytokines in promoting angiogenesis during transverse tibial transplantation, providing a direction for future research. We retrospectively assessed a study from April 2022 to November 2023 on 76 patients with severe DFUs at Wagner stages 3-4. Flow cytometry was used to detect the levels of 12 cytokines in serum before the operation and 3, 7, 14, 21, and 35 days after the operation. Ankle-brachial index (ABI), transcutaneous oxygen tension (TcPO2), and glycosylated hemoglobin (Hba1c) were recorded at admission and discharge. We examined the variations in cytokine levels, wound healing duration, amputation rates, infection incidence, and other key outcomes. In our investigation, a total of 76 individuals participated, comprising 49 males and 27 females. These subjects had an average age of 64.7 years, with a standard deviation of 13 years. The mean ulcer healing time was 74 ± 31 days, amputation occurred in 3 patients, pin tract infection occurred in one patient (1.3%), and incision infection occurred in one patient (1.3%). By day 35 following the surgery, both the ABI and TcPO2 values showed a significant increase from their preoperative levels. HbA1c significantly improved compared with presurgery (p < 0.001), IL-6 levels were significantly increased compared with presurgery (p < 0.05), and then decreased. The transverse tibial transfer (TTT) technique is safe and efficient for managing DFUs. The wound healing time in patients who smoke or consume alcohol is statistically significant compared with that of nonsmoking and nondrinking patients. IL-6 exhibited substantial changes at various postoperative time points. Future research could investigate the role of IL-6 in tibial transverse translation.

The Efficacy of Modified Ilizarov Distraction-Tension Device on Limb Wound Difficult to Cover with Skin Flaps.

Closure of complex limb wounds poses challenges and requires innovative approaches. This research aimed to evaluate the effectiveness of a modified distraction-tension device using Ilizarov external fixation for wound closure in challenging cases. A retrospective analysis was conducted on 43 patients with extremity wounds that were difficult to cover with skin flaps between January 2019 and December 2022. Tension-relieving traction was applied using the Ilizarovexternal fixator apparatus, tailored to individual wound characteristics. Three types of wire-pin connections were used in this study. The distraction begins on the third postoperative day, with a speed of 0.5mm/d. Clinical wound healing scores were evaluated at 5 and 30 days postoperatively. Complications were documented following the Paley classification system. Traction using modified Ilizarovexternal fixation promoted a significant reduction in wound size. The mean traction period was 11.2 ± 7.3 days, and the mean healing duration was 17.0 ± 3.7 days. The clinical wound healing score improved from 3.7 ± 2.9 at 5 days to 1.7 ± 0.7 at 30 days postoperatively (p < 0.05). Complications were minimal, with no significant obstacles or sequelae observed. Direct closure healing was achieved in 21 cases, skin graft healing in 13 cases, and suture healing in 9 cases. No recurrences were reported. Using Paley's classified complications, there were 17 problems, 9 obstacles, and 0 sequelae. The Ilizarov tension-relieving traction shows promise in facilitating wound closure that is challenging to manage with skin flaps. The modified three types of pin-skin connection configuration could satisfy various types of wound closure.

Robot-assisted internal fixation of calcaneal fractures versus conventional open reduction internal fixation: a systematic review and meta-analysis.

The aim of the study was to compare the efficacy and safety of robot-assisted (RA) percutaneous hollow screw fixation with traditional open reduction internal fixation (ORIF) for the treatment of calcaneal fractures through a systematic review and meta-analysis. An extensive search was conducted in the following databases-PubMed, CNKI, Embase, and the Cochrane Library-to gather research on patients with calcaneal fractures published up to July 2024. This search focuses on studies comparing the effectiveness of robot-assisted percutaneous cannulated screw fixation versus ORIF. We will include studies published in both English and Chinese. Our screening process adhered strictly to predefined inclusion and exclusion criteria, emphasizing randomized controlled trials (RCTs) and cohort studies. The ROBINS-I tool was utilized to evaluate the risk of bias in non-randomized studies. Meta-analysis was conducted using Review Manager 5.4.1. The final analysis incorporated six retrospective cohort studies comprising 247 patients-122 treated with robotic-assisted percutaneous cannulated screw fixation and 125 with conventional open reduction and internal fixation. The findings indicated that patients undergoing robotic-assisted percutaneous cannulated screw fixation experienced advantages over those receiving conventional treatment in terms of reduced hospital stay, lower estimated blood loss, and higher AOFAS scores at both 3 and 6months. No statistically significant differences were observed between the two methods concerning operative time, fracture healing duration, or the frequency of intraoperative fluoroscopies. Robotic-assisted percutaneous cannulated screw fixation is a safe and viable treatment approach for patients with calcaneal fractures. When compared to ORIF methods, this robotic-assisted technique demonstrated significant benefits, including reduced hospital stay, lower estimated blood loss, and improved AOFAS scores at both 3 and 6months.

The Recovery from Grade II Burns in Test Mice (Mus Musculus Linn) After Using Iodine Leaf Latex Gel (Jatropha Multifida Linn)

Burn injuries are emergencies that pose a severe threat and require immediate action to save lives. The saponins, tannins, alkaloids, and flavonoids in iodine leaf latex gel (Jatropha multifida Linn) are known to speed up the healing process for burn wounds. The research aimed to investigate the effect of iodin leaf latex gel on the recovery of grade II burn wounds in male mice (Mus musculus Linn). The research employed a true-experimental laboratory method with-a-post-test-only control design group at the Kusuma Husada University Laboratory in Surakarta. A total of 24 test mice were manipulated and divided into three groups: the positive control group, the negative control group, and the iodine leaf latex gel group. Burn wounds utilized a 1,5 cm superheated mental surface applied to the backs of the mice for 5-10 seconds to induce burn injuries. The observed parameters included the burn wound area, the percentage of burn wound healing, and the duration of burn wound healing. Data analysis operated One-Way ANOVA. The research revealed that iodine leaf latex gel had a restorative time of 8 days and healing percentage of 30,75%. It was better than the other control groups. The statistical analysis indicated significance (&lt;0,05) in the burn wound recovery percentage. In conclusion, a 6% concentration of iodine leaf latex gel had a more favorable effect on burn wound healing than other control groups.

Real-Life Data on Wound Healing Speed and Duration to Wound Closure by Different Aetiology in a Primary Care Centre in the Netherlands.

Correct classification of wounds is of paramount importance for diagnostic and therapeutic pathways. The aim of this study was to provide insight in the incidence of different aetiology of wounds and the healing time in a primary care setting. All patients with a wound presented in Primary Care (PC) practice from January 2017 through 2020 were included. A retrospective analysis related to age, sex, duration of wound healing, healing-rates, aetiology and comorbidity of the patients was performed. The prevalence of wounds in primary care was is 3.9 per 1000. In more than 90% of the wounds heal within 37 days. The wound healing speed and duration to closure differ significantly (P = .002) between aetiology. This study shows that 90% of wounds that enter a Dutch GP practice heal within 37 days. This study provides unique data on wound healing rates differentiated by etiology.

INDICADORES DE QUALIDADE EM TERAPIA NUTRICIONAL (IQTN) NA AVALIAÇÃO DO CUIDADO NUTRICIONAL EM UNIDADES HOSPITALARES DO BRASIL: UMA REVISÃO DE LITERATURA

Malnutrition is understood as an imbalance caused by low nutrient intake or increased nutritional needs, in the hospital environment, malnutrition has a direct influence on the clinical course of the patient and is often neglected, resulting in complications such as: infections, delayed healing and prolonged duration of treatment. Hospitalization time. In these cases, nutritional therapy (NT) is used and, along with the implementation, adverse events may prevent the effective implementation of nt. in this context, the use of quality indicators in nutritional therapy (IQTN) are applied, aiming to ensure the effectiveness of daily routines associated with nutritional management. Thus, this work aims to verify the use of the iqtn tool in the evaluation of nutritional care in hospital units in Brazil. the present study is a bibliographical review of the literature, built from scientific articles in the medline database (pubmed), portal periódicos capes and latin american literature in health sciences (lilacs) using the descriptors “Protein-Energy Malnutrition”, “Quality Indicators in Health Care”, “Nutritional Therapy”. Articles that did not correspond to the topic of interest and those published in the last 11 years were excluded. After cataloging, 08 articles were added that demonstrated the implementation of IQTN in the evaluation of nutritional care in services provided in hospitals in Brazil. most studies present indicators in accordance with the proposed goals, but it is worth mentioning that there is a significant prevalence of malnutrition in all the studies selected in this research, however those that have greater adequacy in indices related to nutritional assessment and prescription x calorie and protein infusion has a better prognosis for hospitalized patients. Therefore, the implementation of the IQTN tool becomes necessary in hospital units, as through this method it is possible to assess the compliance of nutritional care in order to minimize risks and intercurrences.

Pengaruh Pemberian Seduhan Daun Sirih terhadap Lama Penyembuhan Luka Perineum Ibu Nifas di PMB Endang Pasar Minggu Jakarta Selatan

perineal injury in puerperal mothers refers to tears that occur in the birth canal, both caused by Labor and episiotomy. This tear can occur spontaneously or through an episiotomy. Perineal care is important to prevent infection, as inadequate care can lead to infection, which is one of the causes of postpartum maternal death. Based on this, the researchers tried an alternative by using betel leaf steeping to accelerate the healing of perineal wounds. This study aims to determine the effect of betel leaf steeping on the duration of perineal wound healing in puerperal mothers in PMB Endang Pasar Minggu, South Jakarta. this study uses a quantitative approach with Pre-Experimental design and One-Shot Case Study. The sampling technique used was consecutive sampling, with a total of 20 participants. research shows that most postpartum mothers experience rapid perineal wound healing after receiving treatment with betel leaf steeping. The one sample proportion test revealed that 60% of respondents experienced a decrease in perineal injuries after being given betel leaf steeping. there is an effect of betel leaf steeping on long-term perineal injury in puerperal mothers in PMB Endang Pasar Minggu Jakerta Selatan.

The laser pilonidoplaty

Background: The aim of our study was to evaluate the safety, efficacy and clinical outcome of a laser procedure for the treatment of pilonidal sinus. Objectives were to investigate its effectiveness in terms of operation time, healing time, and the duration of hospitalization, resumption of normal activity, the degree of postoperative complications and rate of recurrence patient satisfaction. Methods: Patients suffering from pilonidal sinus were operated by laser pilonidoplasty at our institute. Laser pilonidoplasty done under spinal anesthesia or local + sedation after a small primary pit excision (0.5-1 cm incision), excision of secondary pits and careful cleaning of the sinus tracts with a curette. After curettage, the laser energy laser set at a wavelength of 1470 nm) was delivered in continuous mode 10 w/sec into the sinus tract f/b saline wash and dressing. Results: Mean duration of procedure was 35.5 min, mean duration of hospital stay was 1.3 days, mean resumption of normal activity within 8.4 days, mean duration for complete wound healing by secondary intention 29.33 days. Among complications, non-healing ulcer reported in 34% and pain noted in 26%. Recurrence rate was 14%. Success rate was 86% and overall patient’s satisfaction was 94%. Conclusions: Laser pilonidopasty proved to be a safe and effective procedure for treating patients suffering from pilonidal sinus with average success rate, less morbidity, fewer complications with better patient satisfaction rate.

Atypical Periprosthetic Femoral Fracture Might be Considered a Distinct Subtype of Atypical Femoral Fracture: A Retrospective Study.

The exact relationship among atypical periprosthetic femoral fractures (APFFs), typical periprosthetic femoral fractures (PFFs), and atypical femur fractures (AFFs) remains unclear. This study aimed to investigate the prevalence of APFFs among PFFs and to identify the clinical characteristics, management, and prognosis that distinguish APFFs from typical PFFs and AFFs to further determine the relationship among these three fracture types. In this retrospective study, we reviewed the clinical data of 117 consecutive patients who had PFFs after hip arthroplasty between January 2012 and December 2022 and further classified them into an APFF group and a typical PFF group according to the revised ASBMR diagnostic criteria for AFF. Moreover, patients who had subtrochanteric or femoral shaft fractures in the same period and met the diagnostic criteria for AFF were recruited and classified into the AFF group. Demographic information, minor features of AFF, comorbidities, history of medication usage, management, and complications were collected and compared among patients with typical PFFs, APFFs, and AFFs. Eleven PFFs were identified as APFFs, and the prevalence of APFFs among PFFs was 9.4%. Significant differences were found in generalized increase in cortical thickness (p = 0.019), prodromal symptoms (p < 0.001), and the incidence of bilateral fractures (p = 0.010) among the groups, where the incidences of these minor features in the APFF group and the AFF group were higher than those in the typical PFF group. Of note, the duration of fracture healing of APFFs was significantly longer than that of typical PFFs and AFFs (p < 0.001 and p = 0.004, respectively). In addition, the APFF group and the AFF group had higher proportions of patients with rheumatoid arthritis (p = 0.004 and p = 0.027, respectively), bisphosphonate (BP) usage (p = 0.026 and p < 0.001, respectively), and longer duration of BP usage (p = 0.003 and p = 0.007, respectively) than the typical PFF group. Furthermore, significant differences were found in management (p < 0.001) and complication rate (p = 0.020) among the groups, and the rate of complications in the APFF group and the AFF group was higher than that in the typical PFF group. APFFs not only fulfilled the mandatory and major diagnostic criteria for AFF but also had many clinical characteristics, management and prognosis distinguishing them from typical PFFs but resembling AFFs; hence, the diagnostic criteria for AFF might be revised to incorporate APFF as a distinct subtype of the condition.

Neonatal Riga-Fede disease: A systematic review of 84 cases collected over 120 years

Background: Traumatic ulceration of the tongue due to congenital teeth is known as Riga-Fede disease (RFD). The literature on RFD consists largely of anecdotal case reports, thereby lacking valid clinical recommendations. While managing a newborn with RFD complicated by Ludwig’s angina, this knowledge gap was recognized. Therefore, this systematic review was conducted to gain insight into the optimal management and the possible complications of RFD. Methods: A literature search was conducted using PubMed, Google Scholar, and Science Direct, supplemented with African Journals Online, Indmed, and manual searches. Papers published between 1900 and July 2023 in any language were retrieved. Neonates with natal or neonatal teeth and ulceration of the oral mucosa were included. Papers with incomplete data and review articles were excluded. Results: A total of 84 newborns with RFD from 62 published reports (including the case reported herein) were analyzed. Most of the reports were from the Indian subcontinent, and the frequency of reporting has increased since the year 2000. Tongue ulceration in all cases was due to mandibular incisors. There was no significant difference in the median duration of healing between the tooth extraction group (14 days) and the conservative management group (18 days). There was only a very weak positive correlation between the duration of symptoms and healing time, which was statistically insignificant. Conclusion: Healing of mucosal ulcers in RFD is often protracted and does not appear to be influenced by the duration of symptoms or by the modality of treatment. Extraction of the offending teeth is more common (75% of cases) than conservative management, such as grinding (ameloplasty) or resin capping of teeth. RFD is mostly a benign disorder; however, serious complications such as meningitis, Ludwig’s angina, and soft tissue abscesses can rarely occur with Staphylococcus aureus infections.

EFFECTIVENESS OF AUTOLOGOUS PLATELET-RICH PLASMA FOR HEALING DIABETIC FOOT ULCERS

Autologous platelet-rich plasma (APRP) is widely used to accelerate the healing of chronic wounds. However, the advisability of its use in patients with diabetic foot ulcers (DFU), which develop in various forms of the disease and are associated with complex metabolic conditions, is still being discussed. This study consisted in a comparative analysis of the effectiveness of local use of autologous platelet-rich plasma in the treatment of DFU in patients with neuropathic and neuroischemic forms of the disease. A total of 106 patients with type 2 diabetes mellitus undergoing hospital treatment were divided into a study group (n=48) and a traditional wound therapy group (n=58), similar in ankle-brachial index values ​​and ulcer size. Systemic therapy in both groups of patients included measures to regulate metabolism and nutrition, and infection control. Treatment results were assessed by the area of foot wounds and duration of healing. The duration of therapy and the mean platelet concentration in autologous plasma did not differ between groups. The wound healing time in patients with the neuropathic form (60.4±23.77 days) and the neuroischemic form of the disease (64.8±29.6 days) during treatment with APRP was significantly shorter than in the subgroups of the comparison group with traditional treatment of DFU (85.11±40.7 and 90.40±47.12 days respectively) (p&lt;0.01), but there was no significant difference between the subgroups receiving treatment with APRP. Although there was no significant difference in the average daily healing area among all subgroups (p&gt;0.05), the rate of wound healing in the subgroups with APRP was higher (14.85±10.66 and 15.33±14.91 mm2/day, respectively) than in the subgroups of the comparison group (8.39±6.02 and 8.79±7.13 mm2/day, respectively), which confirms the effectiveness of local treatment with APRP in combination with traditional systemic therapy.

Too hot to handle − Microwaved drinkware: An emerging cause of contact burn injuries?

Purpose of the studyTo investigate the local and national incidence of contact burns secondary to microwave-heated drinkware and specifically those with a metallic coating. MethodsThis retrospective analysis from November 2018 to December 2022 includes UK-wide data on burn mechanism, demographics, TBSA (total body surface area), depth and additionally, local data on injury details, management, complications, healing duration, return-to-work time, and follow-up duration within our service. ResultsNational: In the UK, 87 patients sustained burns related to microwave heating of drinkware. Median (IQR) burn size was 0.21% (+/−0.15) TBSA. Most burn injuries were superficial dermal (SD) (88.7%). All cases were treated conservatively.Regional: Contact burns from microwave-heated metallic coated drinkware were identified in 28 patients. The median (IQR) TBSA was 0.12% (+/−0). Most injuries were assessed as SD (90%, 45/50), however, 4/5 (80%) of the deeper burns were caused by metallic-coated drinkware. The median (IQR) follow-up was 6.04 days (+/−4.5). Median (IQR) healing time was 14.17 (+/−0) days and mean time to return to work was 7.57 (+/−3.5) days. ConclusionsMicrowave-heated drinkware burns, while constituting a small portion of referrals to UK burns services, may have a larger true population incidence. Due to their size, these injuries are probably treated locally without referral to a burns service. Regional data analysis highlighted that metallic coated drinkware related injuries were associated with longer healing times.

Comparative study of transepithelial versus alcohol-assisted photorefractive keratectomy

Aim The aim of this study was to compare the clinical, refractive, and visual outcome of transepithelial photorefractive keratectomy (T-PRK) to the alcohol-assisted photorefractive keratectomy (AA-PRK). Patients and methods This is a prospective randomized controlled trial that included 60 myopic patients (120 eyes). They were randomized into two groups, 60 eyes each: group I (AA-PRK) and group II (T-PRK). The operation was performed in both groups by the same Excimer laser machine (EX 500 Excimer laser WaveLight). In the alcohol-assisted group, the corneal epithelium was removed by 20% ethyl alcohol followed by Excimer laser to correct the amount of ametropia. In the T-PRK group, the Streamlight PRK software (WaveLight EX 500) was used, which incorporated Excimer laser stromal ablation and epithelial removal in a single step. After completion of each procedure in both groups, mitomycin C with a concentration of 0.02% was used for 30 s, followed by copious irrigation with a cold balanced salt solution. A soft bandage contact lens was applied until epithelial healing was complete for 5 days and changed after 48 h. The patients were evaluated postoperatively on the first, third, and fifth day, then after 1 week, 1 month, and 3 months. On the first visit, uncorrected visual acuity (UCVA), epithelial healing, and postoperative pain were evaluated. At 1-week and 1-month follow-up visits, UCVA, best-corrected visual acuity (BCVA), manifest refraction spherical equivalent (MRSE), Schirmer’s I, and tear break-up time (TBUT) tests were evaluated. The corneal haze was evaluated using a slit lamp biomicroscope and subjectively graded. At the 3-month follow-up, UCVA, BCVA, MRSE, Schirmer’s I test, TBUT test, and root mean square (RMS) assessment for total higher-order aberration were evaluated. Results There was an insignificant difference between the studied groups regarding all baseline ophthalmological assessments including UCVA, BCVA, MRSE, central corneal thickness, RMS, TBUT, and Schirmer’s test (P=0.839, 0.057, 0.187, 0.537, 0.219, 0.013, and 0.151, respectively). After 3 months, the median UCVA was the same in both groups (1.0), while the MRSE did not differ significantly between the two groups (P=0.126), with a median (interquartile range) of −0.25 D (−0.75 to 0.25 D) in the AA-PRK group compared to −0.25 D (−0.50 to 0.3125 D) in the T-PRK group. The healing duration was significantly shorter in the T-PRK group (median=3.0 days) than in the AA-PRK group (5.0 days, P&lt;0.001). The median postoperative pain was also significantly higher in the AA-PRK group (4.0) than in the T-PRK group (3.0, P&lt;0.001). The RMS was significantly lower in the T-PRK group (median=0.35) than in the AA-PRK group (median=0.65, P&lt;0.001). The corneal haze did not differ significantly between the two groups after 1 month (P=0.783). After 3 months, the Schirmer’s test was significantly lower in the AA-PRK group (median=18.0 mm) than in the T-PRK group (19.0 mm, P&lt;0.001), while the TBUT test showed no significant difference (P=0.055). Conclusion The T-PRK technique provided a faster visual recovery with a better refractive outcome, faster healing response, less pain score, and less dryness than the AA-PRK.

The Potential Activity of Kecombrang (Etlingera elatior) Leaf, Flower, and Stem Extracts on the Duration of Wound Healing in Mice (Mus musculus)

Wound is skin tissue damage due to trauma from a sharp object. Kecombrang flower extract is known to be effective in speeding up the healing of wounds because it contains flavonoids, saponins, tannins and steroids. The leaves and stems also contain these compounds, so this research was conducted to see the difference in the potential activity of the wound healing process of the kecombrang plant on the time of wound healing. Natural ingredient extracts are wound healing agents that can fight infection and speed up wound healing. This study used 5 treatment groups consisting of control (-) distilled water, control (+) Povidone Iodine 10 %, leaf extract 10 %, flower extract 10 %, and stem extract 10 %. The parameters observed were the length of the wound and the condition of the wound until the wound healed. The obtained data were analyzed statistically using ANOVA for complately randomized factorial designed. The results of the research show that extracts of kecombrang leaves, flowers, and stems have activity in accelerating the healing process of cut wounds and produce different effects on healing time. Wound healing time for leaf extract is 12 days, flower extract and stem extract is 10 days. The conclusion of this study shows that there is a very real difference in wound healing from treatment with the best treatment for wound healing is the flower extract with highest healing score of 6.42.