Early Wound Healing Research Articles

Primary closure method after asymmetrical excision of a pilonidal sinus treatment: A retrospective cohort study

Background/Aim: There is no gold standard method in pilonidal sinus surgery, because each technique has a recurrence rate. This study aims to evaluate the outcomes of pilonidal sinus surgeries performed by a single surgeon using excision and primary closure technique in a state hospital. Methods: The study included 159 pilonidal sinus patients operated on by a single surgeon in the General Surgery Department between September 2014 and May 2022. The patients were investigated retrospectively, and age, gender, surgical technique, type of anesthesia administered, time needed to return to normal life, history of previous abscess drainage, long-term complaints in the incision area, number of intergluteal sinuses, postoperative complications and recurrence rates were recorded. Missing information was completed with polyclinic medical records and phone calls. Patients with incomplete data were excluded from the study. An excision and primary closure method was performed on all patients included in the study. Results: Sixty-seven (42.1%) of the patients were male and 92 (57.9%) were female. The mean age was 27.8 (8.97) years. Twenty-one (13.2%) patients were operated on under local anesthesia, whereas 138 (86.8%) received spinal anesthesia. The mean operative time was 28.87 (8.01) minutes (range: 14-47 minutes). The mean length of hospital stay was determined to be one day (range: 6-24 hours). Surgical-site infections developed in 4 (2.5%) patients and wound dehiscence developed in 14 (8.8%) patients during the postoperative period. Patients developing these conditions were followed up with dressing and antibiotic treatment. The mean postoperative follow-up period was 67 months (range: 1-105 months). Recurrence was detected in six patients during the follow-up period, representing a recurrence rate of 3.8%. Conclusion: Primary closure after asymmetrical excision of the pilonidal sinus is an easily performed technique with minimal postoperative pain and early wound healing. Additionally, this method has early return-to-work rates and low recurrence rates. We think that this method would be more applicable in pilonidal sinus surgery due to these advantages.

The impact of sufentanil versus remifentanil on surgical site wound healing in caesarean section primiparas undergoing epidural anaesthesia: A systematic meta-analysis.

Caesarean section (C-section) is a prevalent obstetric surgical procedure, with the choice of analgesic agents playing a pivotal role in postoperative recovery. This systematic meta-analysis aimed to compare the effects of sufentanil (ST) and remifentanil (RT) on postoperative wound healing in caesarean section primiparas undergoing epidural anaesthesia. A comprehensive search was conducted across multiple databases, adhering to PRISMA guidelines, yielding eight randomized controlled trials (RCTs) for inclusion. The primary outcome was wound healing assessment using the REEDA (redness, edema, ecchymosis, discharge, approximation) scale on the third, fifth and tenth postoperative days. The meta-analysis encompassed 691 primiparas. A significant difference in wound healing was observed between ST and RT on the third (I2 = 99%; Random: SMD: 6.75, 95% CIs: 3.11-10.39, p < 0.01) and fifth days (I2 = 99%; Random: SMD: 3.63, 95% CIs: 1.56-5.70, p < 0.01) postcaesarean section. However, no significant difference was noted on the tenth day (I2 = 5%; Random: SMD: 0.00, 95% CIs: -0.45-0.45, p = 0.35). Sufentanil and remifentanil exhibit differential effects on early postoperative wound healing in caesarean section primiparas undergoing epidural anaesthesia. While both opioids are effective analgesics, sufentanil demonstrates a more pronounced impact on wound healing during the immediate postoperative days. Clinicians should consider these findings when selecting an opioid for pain management in this patient population.

Knotless barbed suture versus conventional polydioxanone suture material for intraoral surgical incisions - A randomized controlled trial

PurposeTo evaluate and compare the perioperative wound management and healing of intraoral surgical incisions between the conventional and knotless barbed Polydioxanone suture materials. Materials and methodsA Randomized Controlled Trial was conducted with well-constructed inclusion and exclusion criteria. 46 participants were allotted into the control and test groups based on a computer-generated randomization sequence. The materials used were 3–0 Stratafix™ knotless barbed PDS suture and conventional 3–0 Ethicon PDSTMII suture materials. Parameters assessed included intraoperative time taken for closure and assessment with Early Wound Healing Score (EHS) on postoperative day 1 and Landry, Turnbull, and Howley (LTH) Healing index on postoperative days 3 and 7. Statistical analyses were done using the Chi-square test and student's t-test with a p-value less than 0.05 indicating statistical significance. Results32 patients had surgical intervention for maxillofacial fracture management and 14 patient for orthognathic osteotomies. Surgical sites (n = 60) included maxillary and mandibular vestibules. Intraoperative closure time was better in the test group with statistical significance (p-value = 0.0472). The healing scores on the 3rd and 7th postoperative days were compared between the control and test groups exhibiting statistical significance favouring the test group. The p-values were 0.0479 and 0.0393 respectively. ConclusionTo conclude, our study concurred with the existing literature in terms of reduced operating time, and better wound healing observed with the knotless barbed suture. Along with statistical significance, all the variables exhibited clinical relevance and better wound management in the test group.

Influence of locally delivered doxycycline on the clinical and molecular inflammatory status of intrabony defects prior to periodontal regeneration: A double-blind randomized controlled trial.

To test the effect of locally delivered doxycycline (DOX) administered 2 weeks prior to minimally invasive periodontal regeneration in terms of presurgical inflammatory status and cytokine expression profile in the gingival crevicular fluid (GCF). Secondary aim was to assess the early wound healing index (EHI) at 2 weeks after surgery. It is hypothesized that healing after periodontal regeneration is dependent on preoperative soft tissue condition, and that local antibiotics may improve the site-specific inflammatory status at short time. Sites associated with periodontal intrabony defects requiring regenerative surgery and showing bleeding on probing (BoP) were included. At T0, experimental sites were randomly treated with subgingival instrumentation with or without topic DOX application. After 2 weeks (T1), defects were approached by means of minimally invasive surgical technique. GCF was sampled at both T0 and T1 for inflammatory biomarker analysis. Two weeks after surgery, the EHI was evaluated (T2). Forty-four patients were included. At T1, the number of BoP+ sites was statistically significantly less in the test group (27.3% vs. 72.7%; p < .01). The total amount of interleukin (IL)-1β (p < .001), matrix-metalloproteinases (MMP)-8 (p < .001), and MMP-9 (p = .010) in the GCF significantly decreased in the test group at T1, with relevant differences compared to controls. At T2, the EHI had an average value of 1.45 ± 0.86 in the test group while in the control, it was 2.31 ± 1.43 (p = .027). A statistically significantly positive correlation was observed between the amount of IL-1β and MMP-9 and EHI scores. Within the limitations of this study, sites treated with DOX showed improved clinical and molecular inflammatory parameters before surgery, as well as soft tissue healing 2 weeks after surgery.

Does Submucosal Placentrex® Injection Hasten the Soft Tissue Healing in Mandibular Third Molar Impaction Surgery? A Prospective Randomized Split-Mouth Study

Background: This study focused to evaluate the potency of injection Placentrex® by assessing the rate of soft tissue healing with bilateral symmetrical third molar impaction by using early wound healing score. Materials and Methods: The split mouth study included 23 patients with bilaterally symmetrical third molar impaction. Randomly one side was selected as study group and other side as control group. 2 ml of Placentrex® injection was administered submucosally before surgical removal on the buccal and retromolar region in study group while control group was allowed to heal naturally. Parameters like soft tissue healing, pain, trismus and swelling were assessed on 1st,3rd and 7th post operative days. Early healing score was used to assess the soft tissue healing after surgical removal. Results: The mean re-epithelialization based on CSR on 3rd post operative day showed characteristic significance with mean score of 4.56 (p&lt;0.05) when compared to the control group which showed a mean score of 2.73. The inflammation based on CSI on 3rd postoperative day for the study group revealed a mean value of 1.73 (p&lt;0.05) whereas for the control group a mean of 1.04 was recorded proving significance. It was found that there was no significant statistical difference in the case and control group in relevance to post operative pain, swelling and mouth opening. Conclusion: Placentrex® exhibited characteristic significance in early soft tissue healing with signs of less inflammation and early reepithelialisation.

Fistulotomy versus fistulotomy with marsupialization, a randomized controlled trial.

Objective: To compare the efficacy of fistulotomy and fistulotomy with marsupialization in the management of simple anal fistula. Study Design: Randomized Controlled study. Setting: Department of Surgery, District Head Quarter Hospital, Mardan, Pakistan. Period: 1st September 2021 to 31st August 2022. Material &amp; Methods: A total of 60 Patients coming to hospital with simple anal fistula were randomized into two equal groups. In group A, 30 patients were treated with fistulotomy, while in group B, 30 patients were treated with fistulotomy with marsupialization. The primary outcome was set as time required for complete wound healing. Secondary outcomes were operation time, postoperative pain, anal incontinence, incidence of recurrence and patient satisfaction. Results: The mean wound healing time after 6 weeks was shorter in group B in comparison to group A (4.7± 0.74 versus 6.4± 0.85 weeks; p=0.0001). There was no significant difference in mean operation time between Group B and Group A. The difference in mean pain score was also not statistically significant. There was no significant difference in the incidence of anal incontinence, incidence of recurrence and patient’s satisfaction among two groups. Conclusion: Fistulotomy with marsupialization is more effective procedure than fistulectomy alone in shape of early wound healing without increase in operation time and therefore can be taken as surgical procedure of choice for the simple anal fistula.

Effects of Advanced Platelet Rich Fibrin (A-PRF+), Enamel Matrix Derivative (EMD) and Open Flap Debridement on clinical and wound healing parameters in molar furcation sites: A case series from a RCT study

AimTo study effects of advanced platelet rich Fibrin (A-PRF+) and enamel matrix derivative (EMD) compared to open flap debridement (OFD) alone in molar furcation sites grade II on clinical and wound healing parameters.Materials and methodsA randomized controlled trial was designed. Eligible patients were randomly allocated in one of three treatment groups: A-PRF+, EMD or OFD. The patients and clinical examiners were blinded for the treatment received. A minimally invasive microsurgical approach was performed for the three modalities. Clinical measurements were scored at baseline and 6 months postoperatively. The clinical healing of each furcation was scored via Early Wound Healing Index on day 3, 1 week, 2 weeks and 6 weeks.Results17 patients (A-PRF+ n = 6, EMD n = 5, OFD n = 6) completed the 6 months follow-up. The further completion of the trial had to be cancelled due to the COVID-19 pandemic. In three patients in the A-PRF+ group, the grade II of the treated furcation regressed to grade I; the corresponding number in the EMD and OFD groups were zero and one respectively. Further, 3, 1 and 4 patients in the PRF, EMD and OFD groups respectively, showed a gain of bone level ≥1 mm. The defects in the A-PRF+ group showed delayed early healing compared to EMD and OFD groups.ConclusionThe case series (RCT design) suggest a slight advantage for A-PRF+ over EMD and OFD, regarding the regressing of a furcation II to grade I, however this treatment showed delayed early wound healing compared to EMD or OFD.Clinical Trial Registrationhttps://www.isrctn.com/, identifier ISRCTN13520922.

Complications following alveolar ridge augmentation procedures.

Oral rehabilitation through implant supported dental restorations often requires a ridge augmentation procedure (RAP) prior to implant fixture placement since tooth extraction/loss results in alveolar ridge deficiencies. Although RAP-related surgical techniques and biomaterials have been in practice for several decades, outcomes are not always predictable. Post-surgical complications experienced during the early or late wound healing phases may jeopardize the targeted ideal ridge dimensions, required for implant fixture placement, and may have other consequences, such as negatively impacting the patient's quality of life. This review describes reported post-surgical complications following RAP under the following subtitles: complications by tissue type, complications in function and aesthetics, complications by healing time, complications by biomaterial type, and complications by surgical protocol modalities. Specifically, RAP performed by using particulate bone graft substitutes and related complications are explored. Modalities developed to prevent/manage these complications are also discussed.

EHO-85, Novel Amorphous Antioxidant Hydrogel, Containing Olea europaea Leaf Extract-Rheological Properties, and Superiority over a Standard Hydrogel in Accelerating Early Wound Healing: A Randomized Controlled Trial.

Many advanced wound healing dressings exist, but there is little high-quality evidence to support them. To determine the performance of a novel amorphous hydrogel (EHO-85) in relation to its application, we compared its rheological properties with those of other standard hydrogels (SH), and we assessed the induction of acceleration of the early stages of wound healing as a secondary objective of a prospective, multicenter, randomized, observer-blinded, controlled trial. The patients were recruited if they had pressure, venous, or diabetic foot ulcers and were treated with EHO-85 (n = 103) or VariHesive® (SH) (n = 92), and their response was assessed by intention-to-treat as wound area reduction (WAR (%)) and healing rate (HR mm2/day) in the second and fourth weeks of treatment. Results: EHO-85 had the highest shear thinning and G'/G″ ratio, the lowest viscous modulus, G″, and relatively low cohesive energy; EHO-85 had a significantly superior effect over SH in WAR and HR, accelerating wound healing in the second and fourth weeks of application (p: 0.002). This superiority is likely based on its optimal moisturizing capacity and excellent pH-lowering and antioxidant properties. In addition, the distinct shear thinning of EHO-85 facilitates spreading by gentle hand pressure, making it easier to apply to wounds. These rheological properties contribute to its improved performance.

Alveolar ridge preservation of damaged or periodontally compromised extraction sockets with bovine- and porcine-derived block bone substitutes: A retrospective case-control study.

Alveolar ridge preservation (ARP) was introduced to minimize postextraction alveolar bone loss and extraction socket remodeling; however, current knowledge of the ARP procedure for nonintact extraction sockets is still limited and inconclusive. This retrospective study aimed to evaluate the difference between using deproteinized bovine bone mineral with 10% collagen (DBBM-C) and deproteinized porcine bone mineral with 10% collagen (DPBM-C) when performing ARP procedures in damaged or periodontally compromised extraction sockets based on clinical, radiographic, and profilometric outcomes. In total, 108 extraction sockets were grafted with 67 DBBM-C and 41 DPBM-C. Changes in radiographic (horizontal width and vertical height) and profilometric outcomes were measured after the ARP procedure and before the implant surgery. Postoperative discomfort (including the severity and duration of pain and swelling), early wound healing outcomes (including spontaneous bleeding and persistent swelling), implant stability, and treatment modalities for implant placement were also assessed. Radiographically, the DBBM-C group decreased by -1.70 ± 2.26 mm (-21.50%) and - 1.39 ± 1.85 mm (-30.47%) horizontally and vertically, and the corresponding DPBM-C group decreased by -1.66 ± 1.80 mm (-20.82%) and -1.44 ± 1.97 mm (-27.89%) horizontally and vertically at an average of 5.6 months. There were no serious or adverse complications in any of the cases, and none of the measured parameters differed significantly between the groups. Within the limitations of this study, ARP with DBBM-C and DPBM-C showed similar clinical, radiographic, and profilometric outcomes in nonintact extraction sockets.

Effectiveness of Aloe Vera Gel in Management of Superficial Burn in Children

Background: Aloe vera has been used traditionally for healing burn and inflammation. Though, the evidence for the effectiveness of aloe vera for healing burn is not sufficient.&#x0D; Objective: The aim of this study was to assess the effectiveness of aloe vera gel in management of superficial burn in children.&#x0D; Methods: This retrospective study was taken place in the Department of Burn and Reconstructive Surgery, Bangladesh Shishu Hospital &amp; Institute, Dhaka and other two privet clinics at Dhaka, from September, 2019 to March, 2022. Total 47 patients with superficial partial thickness burn was included in the study.&#x0D; Results: In this study, majority (48.94%) patients were belonged to the age group of £24 months. The mean age was found 38.9±26.31 months. The current study observed that almost two third (61.70%) patients were male. In our study, majority (63.83%) patients stayed hospital for 1-5 days. In the present study, mean (±SD) pain relief time was 3.56±1.24 days and mean (±SD) wound healing time was found 8.19±1.6 days. The current study observed that only 3(6.38%) patients had found wound infection. In current study showed that mean treatment cost was found 76.46±31.88 Taka.&#x0D; Conclusion: Aloe vera gel facilitated early pain alleviation, wound healing, and costeffective superficial burn treatment in children. Therefore, it can be utilized to treat superficial burns in children to get better results.&#x0D; DS (Child) H J 2021; 38(1): 39-43

#4976 DIFFERENTIAL ROLES OF REGNASE3 IN RESIDENT MACROPHAGE VERSUS TUBULAR EPITHELIAL CELLS IN THE HEALTHY OR POSTISCHEMIC KIDNEY

Abstract Background and Aims Acute kidney injury (AKI) is a prevalent yet severe condition that occurs in clinical settings. The prognosis for AKI is poor, with many patients progressing to AKD, CKD, and even ESKD especially in those who were admitted to the ICU. RNA-binding proteins (RBPs) are a class of proteins that play a vital role in regulating gene expression and have been implicated in a wide range of diseases. Regnase3 is a member of the Regnase RBPs family and has been shown to promote inflammation by increasing TNF in macrophages. Despite this knowledge, the full extent of the role played by Regnase3 in AKI remains unknown. Therefore, we hypothesized that Regnase3 plays a role in both macrophages and tubular epithelial cells, influencing inflammation and tubular repair in AKI. Method In order to investigate the role of Regnase3 in kidney injury, a series of genetically-modified mice were developed on the C57BL/6J genetic background. These mice included the paired box gene 8 (Pax8)-reverse tetracycline transactivator (rTtA, Pax8rTtA), tetracycline resistance protein (TetO)-Cre (TetOCre), transgenic receptor activator of nuclear factor kappa-Β (Rank)-Cre (RankCre), and Regnase3 floxed (Regnase-3fl/fl) mice. Using these genetically modified mice, we applied a range of experimental animal models to study the effects of Regnase3 on kidney injury, including unilateral kidney ischemia-reperfusion surgery with or without nephrectomy and nephrocalcinosis-related kidney injury. Additionally, we employed in vitro models utilizing primary cells to study Regnase3 on the cellular level. Furthermore, we utilized scRNA-seq and RNA-seq to investigate the underlying mechanisms of Regnase3’s function. Results We conducted a thorough investigation and discovered that the Regnase3 is highly expressed in macrophages located within the kidney after AKI. The scRNA-seq showed the expression Regnase3 positively correlated with the phagocytosis, chemokines, and monocyte maturation. Furthermore, Rank-Regnase3 mice suffered from more inflammation and kidney injury after AKI, characterized by an increase in CCR2 positive leukocyte infiltration. Additionally, in vitro experiments revealed that Regnase3 is involved in modulating macrophage behavior, acting as a regulator of macrophage polarization towards an M1 and M2 phenotype and influencing the capacity of cell migration. These findings indicate that Regnase3 is essential in the migration of macrophages after AKI, which contribute to both early phase inflammation and progression towards AKI- CKD. Next, we aimed to examine the role of Regnase3 in the context of renal tubule injury. We observed that Regnase3 is highly expressed in healthy renal tubules, but its expression is reduced following injury. Through in silico, in vivo and in vitro experiments, we found that Regnase3 controls early apoptosis, cell death, proliferation, and wound healing capability of tubular epithelial cells. These effects contribute to kidney injury in postischemic kidneys. Additionally, we discovered that the deletion of Regnase3 provides protection against ischemic AKI (Figure 1). Mechanistically, Regnase3 targets pre-RNA and modulates alternative splicing by increasing the proportion of targeted skipped exon events and decreasing the probability of targeted retained intron events. Overall, our findings indicate that Regnase3 plays a vital role in tubular epithelial cells in the response to kidney injury by regulating alternative splicing. Conclusion In summary, our findings indicate that Regnase3 contributes to kidney injury in postischemic kidneys. However, the impact of Regnase3 is contingent upon the specific cell lineage in question. The Rank-Regnase3 leads to an exacerbation of kidney injury by increasing macrophage recruitment, whereas the Pax8-Regnase3 leads to an improvement in kidney injury through its effects on cell death and wound healing capability of tubular epithelial cells. Therefore, the role of Regnase3 in kidney injury is dependent on the cell lineage, which ultimately determines the detrimental or beneficial impact on kidney injury.

Maternal Intake of Either Fructose or the Artificial Sweetener Acesulfame-K Results in Differential and Sex-Specific Alterations in Markers of Skin Inflammation and Wound Healing Responsiveness in Mouse Offspring: A Pilot Study.

Growing evidence has demonstrated that maternal artificial sweetener (AS) consumption may not be a beneficial alternative when compared to sugar-sweetened beverages and potentially leads to metabolic dysfunction in adult offspring. Compromised skin integrity and wound healing associated with type 2 diabetes can lead to complications such as diabetic pressure injury (PI). In this context, the skin plays an important role in the maintenance of metabolic homeostasis, yet there is limited information on the influence of sugar- or AS-sweetened beverages during pregnancy on developmental programming and offspring skin homeostasis. This study examined the impact of maternal fructose or acesulfame-k consumption on offspring wound healing. Female C57Bl/6 mice received a chow diet ad libitum with either water (CD), fructose (FR; 34.7 mM fructose), or AS (AS; 12.5 mM Acesulfame-K) throughout pregnancy and lactation. PIs were induced in offspring at 9 weeks of age (n = 6/sex/diet). PIs and healthy skin biopsies were collected for later analysis. Maternal AS intake increased skin inflammatory markers in healthy biopsies while an FR diet increased Tgfb expression, and both diets induced subtle changes in inflammatory markers post-wound inducement in a sex-specific manner. Furthermore, a maternal FR diet had a significant effect on pressure wound severity and early wound healing delay, while AS maternal diet had a sex-specific effect on the course of the healing process. This study demonstrates the need for a better understanding of developmental programming as a mediator of later-life skin integrity and wound responsiveness.

Histopathological Study on Collagen in Full-Thickness Wound Healing in Fraser's Dolphins (Lagenodelphis hosei).

Fraser's dolphins (Lagenodelphis hosei) possess great healing abilities. Their skin composition can be restored after wounding, including collagen spacing, orientation, and bundle thickness. However, it remains unclear how collagens are involved in the wound-healing process and eventually regain normality in Fraser's dolphins. Learned from the other two scarless healing animals, changes in type III/I collagen composition are believed to modulate the wound healing process and influence the scarring or scarless fate determination in human fetal skin and spiny mouse skin. In the current study, Herovici's, trichrome, and immunofluorescence staining were used on normal and wounded skin samples in Fraser's dolphins. The results suggested that type I collagens were the main type of collagens in the normal skin of Fraser's dolphins, while type III collagens were barely seen. During the wound healing process, type III collagens showed at early wound healing stages, and type I collagen increased in the mature healed wound. In an early healed wound, collagens were organized in a parallel manner, showing a transient hypertrophic-like scar, and eventually restored to normal collagen configuration and adipocyte distribution in the mature healed wound. The remarkable ability to remove excessive collagens merits further investigation to provide new insights into clinical wound management.

A Novel Strategy to Manage Below-Knee-Amputation (BKA) Stump Complications for Early Wound Healing and BKA Salvage.

The optimal management of major stump complications (operative infection or dehiscence) following below-knee-amputation (BKA) is unknown. We evaluated a novel operative strategy to aggressively treat major stump complications hypothesizing it would improve our rate of BKA salvage. Retrospective review of patients requiring operative intervention for BKA stump complications between 2015 and 2021. A novel strategy employing staged operative debridement for source control, negative pressure wound therapy, and reformalization was compared to standard care (less structured operative source control or above knee amputation). 32 patients were studied, 29 of which were male (90.6%) with an average age of 56.1 ± 9.6y. 30 (93.8%) had diabetes and 11 (34.4%) peripheral arterial disease (PAD). The novel strategy was used in 13 patients and 19 had standard care. Novel strategy patients had higher BKA salvage rates, 100% vs 73.7% (P = .064), and postoperative ambulatory status, 84.6% vs 57.9% (P = .141). Importantly, none of the patients undergoing the novel therapy had PAD, while all progressing to above-knee amputation (AKA) did. To better assess the efficacy of the novel technique, patients progressing to AKA were excluded. Patients undergoing novel therapy who had their BKA level salvaged (n = 13) were compared to usual care (n = 14). The novel therapy's time to prosthetic referral was 72.8 ± 53.7days vs 247 ± 121.6days (P < .001), but they did undergo more operations (4.3 ± 2.0 vs 1.9 ± 1.1, P < .001). Utilization of a novel operative strategy for BKA stump complications is effective in salvaging BKAs, particularly for patients without PAD.

Efficacy of Jatyadi, Madhughrita and honey tulle in wound management: a three-arm randomized controlled clinical trial

BackgroundAyurveda underlines the significance of wounds and wound healing. Acharya Susruta has highlighted the need for shastiupakramas in the management of the wound. Even with a multitude of therapeutic concepts and formulations in Ayurveda, wound management has yet to gain acceptance. ObjectiveTo evaluate the effect of Jatyadi tulle, Madhughrita tulle, and honey tulle in the management of Shuddhavrana (clean wound). Materials and methodsA three-arm randomized, parallel group, active-controlled, open-label clinical trial. Randomization was done through online random number generator software to allocate 45 patients treatment into three groups. Trial groups were treated with Jatyadi tulle (JT), Madhughrita tulle (MG), and control group was treated with Honey tulle (HT) for 10 days, and assessment was done on the 5th and 10th day. The wound was assessed using the Bates Jensen wound assessment tool, and the efficacy of the dressing material was assessed using the Worcestershire tissue viability team dressing assessment form. The study outcomes were early wound healing and clinical cure. ResultsWithin-group results were assessed using the Wilcoxon matched pairs test, and between-group results were assessed by Kruskal–Wallis ANOVA and Mann–Whitney U test. Significant results were obtained within-group (p value < 0.05) from day 0 and at various time points. The results between groups were found to be comparable; JT and MG were found to be significant in ease of application, removal, and patient comfort. No adverse drug events were identified throughout the study. ConclusionJT and MG tulle have shown significant results in the management of shuddhavrana.

Early Mobilization pada Ibu Post Pospartum Mempercepat Penyembuhan Luka Sectio Ceserea di RSUD dr Doris Sylvanus

inhibits the wound healing process, causing morbidity and mortality. Postoperative care is needed to prevent complications in the cesarean section. The first treatment that must be done after surgery is early mobilization and proper wound dressing. Early mobilization motivates the patient to move the feet and legs as soon as possible within 24 hours, leading to improved circulation, stimulating gastrointestinal function to return to normal. Objective: To determine the effectiveness of Early Mobilization in postpartum mothers on wound healing after Sectio Ceserea. This type of research is quasi-experimental with a Posttest Only Control Group Design. Purposive sampling technique. Samples of postpartum mothers with Sectio Ceserea post were 30 respondents in the intervention group, 30 control respondents, data analysis with the chi square test. The results of statistical tests showed that after the Early ambulance intervention in the treatment group the wound healing results were 100%. The relationship between early ambulation and wound healing in the treatment group was statistically significant (p&lt;0.05). The external variable of clinical anemia (Risk Ratio) was 1.72. Primipara parity Risk Ratio 2.22 . Risk Ratio Grande result 2.07. Early Mobilization in postpartum mothers after Sectio Cesarea surgery is effective in accelerating wound drying

Comparative Evaluation of the Effects of Low-Level Laser Therapy and Ozone Application on Wound Healing After Gingivectomy and Gingivoplasty: A Randomized Control Clinical Trial

AIM: The aim of this randomized controlled clinical trial was to clinically evaluate and compare the effect of ozonated water and Low level laser therapy (LLLT) on the early wound healing period of gingivectomy and gingivoplasty wounds by clinical analysis. Materials &amp; Methods: Forty-five patients were randomly allocated into 3 groups, test group 1 (ozone therapy n=15), test group 2 (LLLT application n=14) and control group (no treatment n=15). Ozone irrigation was done on the surgical site with a concentration of 4ppm for 5-10 minutes, LLLT application was performed with diode LASER (810 nm) immediately after the surgical therapy and on day 3, day 7, day 21. Wound surface area, wound healing index, quality of life, plaque index, sulcus bleeding index were investigated. Results: At day 21 statistically significant smaller wounds were observed in both ozone and LLLT groups compared to control group. However, intergroup comparison between the ozone and LLLT group did not show statistically significant difference in wound surface area evaluated by staining technique and image J analysis. The wound healing index, VAS score OHIP -14 questionnaire, analgesics consumed, plaque index, sulcus bleeding index showed a statistically significant reduction from baseline to day 21in all groups. Conclusion: Ozone therapy is safe and effective in promoting wound healing during the 1st 3 weeks post-surgery. Ozone therapy and LLLT application enhanced wound healing after gingivectomy and gingivoplasty procedures, accompanied by better quality of life and reduced pain .

Clinical, Radiographic, and Histological Evaluation of the Mineralized Plasmatic Matrix/Xenograft Mixture in Maxillary Sinus Floor Augmentation (A Randomized Controlled Clinical Trial)

Introduction: Maxillary sinus pneumatization and alveolar ridge resorption following the extraction of posterior teeth make the installation of dental implants in the maxillary posterior region challenging. The direct sinus lift procedure proved to be a viable treatment option for such conditions. Aim of the study: to evaluate the mineralized plasmatic matrix/xenograft mixture in sinus elevation surgery. Materials and Methods: Eighteen patients were selected and randomly allocated into two groups; study group received a mineralized plasmatic matrix/xenograft mixture, while the control group received xenograft alone following sinus lifting. Results: The early wound healing index score showed a non-significant difference between both groups. Also, bone height was evaluated at the 6-month follow-up period, and there was a non-statistically significant difference. Core biopsies were taken for histological examination by H&amp;E from both groups, revealing the presence of a more mature bone matrix in relation to the test group. Conclusion: The addition of mineralized plasmatic matrix to xenograft can speed up bone formation, thus reducing treatment duration.

Investigation of Inflammatory Effects of Morphine and Fentanyl on Early Wound Healing in Rats: an Experimental Study

Investigation of Inflammatory Effects of Morphine and Fentanyl on Early Wound Healing in Rats: an Experimental Study