Early Wound Research Articles

Improvement in community wound management: why simple changes in clinical practice matter

Background/Aims Wounds continue to be an increasing burden to society, healthcare systems and patients. Wound care is an urgent challenge that requires new management strategies to help facilitate wound healing. This study aimed to evaluate an early intervention wound project facilitated by the COMPASS programme in a Swedish community setting in terms of treatment outcomes and health economic benefits. Methods An evaluation of wound care practice was completed using data collected on all wounds treated in 1 week in March 2021 (n=97). Single-use negative pressure wound therapy (sNPWT) was then introduced, alongside specialist education for all nurses. A post-intervention evaluation was carried out the following year with data on all wounds treated in 1 week in October 2022 (n=36). The samples were compared in terms of proportion of static and deteriorating wounds, wound characteristics, average number of dressing changes per wound and proportion of wounds requiring the patient to be admitted to hospital or referred to a specialist. Costs of care were calculated and compared for the two samples. Results Wounds in the post-intervention dataset were in a better overall condition (size and depth), with a lower proportion being classified as static or deteriorating (58.8% vs 44.4%). There was a non-significant difference in the average number of dressing changes required per week, with post-intervention wounds requiring fewer changes. A significantly lower proportion of patients required a referral to a specialist in the post-intervention sample compared to the pre-intervention sample (43.3% vs 16.7%; P<0.01). Conclusions Implementing a sNPWT pathway, alongside nurse education and increased involvement of nurses with specialist knowledge, can help to improve wound care outcomes and reduce the burden of wounds on nursing time and healthcare resources.

Mechanical state transitions in the regulation of tissue form and function.

From embryonic development, postnatal growth and adult homeostasis to reparative and disease states, cells and tissues undergo constant changes in genome activity, cell fate, proliferation, movement, metabolism and growth. Importantly, these biological state transitions are coupled to changes in the mechanical and material properties of cells and tissues, termed mechanical state transitions. These mechanical states share features with physical states of matter, liquids and solids. Tissues can switch between mechanical states by changing behavioural dynamics or connectivity between cells. Conversely, these changes in tissue mechanical properties are known to control cell and tissue function, most importantly the ability of cells to move or tissues to deform. Thus, tissue mechanical state transitions are implicated in transmitting information across biological length and time scales, especially during processes of early development, wound healing and diseases such as cancer. This Review will focus on the biological basis of tissue-scale mechanical state transitions, how they emerge from molecular and cellular interactions, and their roles in organismal development, homeostasis, regeneration and disease.

The efficacy and safety of different does of intravenous tranexamic acid on blood loss in fresh foot and ankle fractures: a prospective, randomized controlled study

BackgroundThere are a few studies on the effectiveness and safety of intravenous administration of tranexamic acid(TXA) in patients who underwent foot and ankle surgery, especially for preoperative hidden blood loss in patients with freshfoot and ankle fractures. Thus, the aim of this study was to investigate whether intravenous administration of different doses of TXA can effectively reduce perioperative blood loss and blood loss before surgery and to determine its safety.MethodsA total of 150 patients with fresh closed foot and ankle fractures from July 2021 to July 2023 were randomly divided into a control group (placebo controlled [PC]), standard-dose group (low-dose group [LD], 1 g/24 h; medium-dose group [MD], 2 g/24 h), and high-dose group (HD, 3 g/24 h; ultrahigh-dose group [UD], 4 g/24 h). After admission, all patients completed hematological examinations as soon as possible and at multiple other time points postsurgery.ResultsThere was a significant difference in the incidence of hidden blood loss before the operation between the TXA group and the control group, and the effect was greater in the overdose groups than in the standard-dose groups. There were significant differences in surgical blood loss (intraoperative and postoperative), postoperative HGB changes, and hidden blood loss among the groups. The TXA groups showed a significant decrease in blood loss compared to that of the control group, and the overdose groups had a more significant effect than the standard-dose groups. A total of 9 patients in the control group had early wound infection or poor healing, while only 1 patient in the other groups had this complication, and the difference among the groups was significant. No patients in any group suffered from late deep wound infection, cardiovascular or cerebrovascular events or symptomatic VTE.ConclusionThis is the first study on whether TXA can reduce preoperative hidden blood loss in patients with freshfoot and ankle fractures. In our study, on the one hand, intravenous application of TXA after foot and ankle fractures as soon as possible can reduce preoperative blood loss and postoperative blood loss. On the other hand, TXA can also lower wound complications, and over-doses of TXA are more effective than standard doses. Moreover, overdoses of TXA do not increase the incidence of DVT.

Chitosan-based dressing for management of palatal donor site: A randomized clinical trial.

This study aimed to evaluate the effectiveness of a chitosan-based dressing (CD) in achieving early wound healing and hemostasis at palatal donor sites in patients undergoing free gingival graft (FGG) surgery. Thirty-two patients requiring FGG were treated in this randomized controlled clinical trial. Complete epithelialization (CE) and color match (CM) at donor sites were assessed by a blinded examiner on postoperative days 7, 14, 21, and 28. Donor sites were compressed for 2 min with wet gauze (WG) alone in control group (CG) or WG + CD in test group (TG) immediately after graft harvesting, and immediate bleeding (IB) was recorded (yes/no). Delayed bleeding (DB) (for 1 week), and number of analgesic tablets consumed, and VAS scores for pain (for 2 weeks) were recorded by patient every day. Twenty-eight patients (14 in each group) were included in final analysis. The prevalence of CE (at weeks 2 and 3) and VAS scores for CM scores were higher in TG but the intergroup differences were statistically significant only for CM (at week 4). Number of patients exhibiting IB and DB was significantly fewer in the TG (p < .05). Although average pain scores and analgesic consumption were higher in TG up to 5 days, differences between two groups were not statistically significant at any time point. Our data suggests that the application of CD increased re-epithelialization and accelerated wound healing process, although it did not reach statistical significance. Moreover, CD was found to significantly reduce bleeding complications, but it did not decrease the pain levels.

[Modified mini-SLET for treatment of complex cases in pterygium surgery].

The major problem associated with the benign but destructive growing pterygium is the high recurrence rate. Anew surgical technique to lower recurrence rates is minor ipsilateral simple limbal epithelial transplantation (mini-SLET), where the regeneration potential of limbal stem cells is used in combination with amniotic membrane transplantation (AMT) for surgical reconstruction. The aim of this study is to assess the surgical outcome of the mini-SLET technique with tenonectomy, mitomycinC, and AMT as used in the authors' hospital. Atotal of 16eyes from 15patients undergoing mini-SLET after surgical pterygium removal with tenonectomy, mitomycinC, and AMT were analyzed retrospectively. Two different groups of pterygia were enrolled: group1 included recurrent pterygia (n = 10) and group2 comprised primary large pterygia such as double-head pterygia (n = 6). In addition to assessment of best corrected visual acuity and compete ophthalmological examination, preoperative slip-lamp examination with photo documentation served to calculate the corneal size of the pterygium head using VISUPAC software (Zeiss, Oberkochen, Germany). Postoperatively, best corrected visual acuity and slit-lamp examination were routinely evaluated. The surgical outcome was defined by the postoperatively achieved best corrected visual acuity, restoration of the ocular surface, recurrence rate, and rate of postoperative complications. Median follow-up in all patients was 27months; in groups1 and 2 it was 30.7and 25.3months, respectively. No recurrence developed in 15eyes (93.75%). Only one group1 patient (6.25%) suffered arecurrent lesion after 10months. Postoperatively, logMAR visual acuity did not change significantly. During follow-up, complications were limited to one case of early wound dehiscence. Mini-SLET in combination with tenonectomy, mitomycinC, and AMT enables good surgical reconstruction of the ocular surface, and almost complete healing in the sense of restitutio ad integrum is possible. The results of the present study have shown the technique's effectiveness for recurrence prevention.

Histological evaluation of edentulous alveolar ridge horizontal bone augmentations using a xenogeneic bone substitute and autologous platelet concentrates: a case series.

This case series aimed to assess the efficacy of a novel horizontal ridge augmentation modality using histology. Combinations of "sticky bone" and tenting screws without autologous bone were used as augmentative materials. Five individuals presenting healed, atrophic, partially edentulous sites that required horizontal bone augmentation before implant placement were enrolled. Patients underwent the same augmentation type and five months of postoperative reentry procedures. The first surgery served as implant site development, while the biopsy and corresponding implant placement were performed during reentry. The bone was qualitatively analyzed using histology and histomorphometry and quantitatively evaluated using cone-beam computed tomography (CBCT). Four individuals healed uneventfully. Early wound dehiscence occurred in one case. Histology showed favorable bone substitute incorporation into the newly formed bone and intimate contact between de novo bone and graft material in most cases. Histomorphometry revealed an average of 48 + 28% newly formed bone, 19 + 13% graft material, and 33 + 26% soft tissue components. The CBCT-based mean alveolar ridge horizontal increase was 3.9 + 0.6 mm at five months postoperatively. The described augmentation method appears suitable for implant site development resulting in favorable bone quality according to histology. However, clinicians must accommodate 1-2 mm resorption in augmentative material width at the buccal aspect.

Improved Short-Term Prognosis of Pediatric Partial-Thickness Burns: Emergency Conservative Debridement Under Topical Anesthesia.

Early wound management for pediatric patients with partial-thickness burns in the emergency department remains debatable. This study aims to evaluate the value of emergency conservative debridement under topical anesthesia in improving short-term prognosis of pediatric partial-thickness burns. This retrospective cohort study enrolled children with partial-thickness thermal burns presenting to the emergency department within 6 hours postburn. All the enrolled patients were divided into 2 groups: the debridement group and the dressing group. The associations between emergency conservative debridement and time to reepithelialization was analyzed by using Kaplan-Meier curves with log rank test and multivariate Cox regression analysis. Moreover, the associations between emergency conservative debridement and in-hospital cost and length of stay were also evaluated. All baseline characteristics between groups were comparable (all P > 0.05). Emergency conservative debridement under topical anesthesia significantly decreased the median value of time to reepithelialization (13 vs 14 days, P = 0.02). Cox regression analysis showed that emergency conservative debridement significantly improved wound reepithelialization after adjusting for burn size (odds ratio, 4.07; 95% confidence interval, 1.64-10.11; P < 0.01). The mean length of stay of patients receiving conservative wound debridement was lower than that of patients in the wound dressing group (14.3 ± 7.3 vs 18.8 ± 10.4 days, P < 0.01), but not in terms of mean in-hospital cost per 1% total body surface area (2.8 ± 1.9 vs 3.0 ± 2.1 × 103 RMB per 1% total body surface area, P = 0.58). Emergency conservative debridement of pediatric partial-thickness burns under topical anesthesia significantly improves the wound healing outcomes without increasing health care burden.

In Vivo Osteogenic and Angiogenic Properties of a 3D-Printed Isosorbide-Based Gyroid Scaffold Manufactured via Digital Light Processing.

Osteogenic and angiogenic properties of synthetic bone grafts play a crucial role in the restoration of bone defects. Angiogenesis is recognised for its support in bone regeneration, particularly in larger defects. The objective of this study is to evaluate the new bone formation and neovascularisation of a 3D-printed isosorbide-based novel CSMA-2 polymer in biomimetic gyroid structures. The gyroid scaffolds were fabricated by 3D printing CSMA-2 polymers with different hydroxyapatite (HA) filler concentrations using the digital light processing (DLP) method. A small animal subcutaneous model and a rat calvaria critical-size defect model were performed to analyse tissue compatibility, angiogenesis, and new bone formation. The in vivo results showed good biocompatibility of the 3D-printed gyroid scaffolds with no visible prolonged inflammatory reaction. Blood vessels were found to infiltrate the pores from day 7 of the implantation. New bone formation was confirmed with positive MT staining and BMP-2 expression, particularly on scaffolds with 10% HA. Bone volume was significantly higher in the CSMA-2 10HA group compared to the sham control group. The results of the subcutaneous model demonstrated a favourable tissue response, including angiogenesis and fibrous tissue, indicative of the early wound healing process. The results from the critical-size defect model showcased new bone formation, as confirmed by micro-CT imaging and immunohistochemistry. The combination of CSMA-2 as the 3D printing material and the gyroid as the 3D structure was found to support essential events in bone healing, specifically angiogenesis and osteogenesis.

The impact of early nutritional support on postoperative wound healing in patients with complex fractures: A meta-analysis review.

Complex fractures present significant challenges in orthopaedic surgery, particularly in terms of postoperative wound healing. Nutritional status plays a crucial role in the recovery process, with early nutritional support potentially influencing wound healing outcomes. This meta-analysis aimed to assess the impact of early nutritional interventions on postoperative wound healing and scar formation in patients with complex fractures. From an initial pool of 1742 articles, 7 studies were selected for analysis. The results revealed that preoperative nutritional support significantly improved early wound healing, as indicated by lower REEDA scores (SMD = -14.06, 95% CI: [-16.79, -11.32], p < 0.01) 1 week post-surgery. Furthermore, there was a notable reduction in scar formation, as demonstrated by lower Manchester Scar Scale scores (SMD = -25.03, 95% CI: [-30.32, -19.74], p < 0.01) 3 months post-surgery. These findings highlight the importance of incorporating nutritional strategies into the management of complex fractures to optimize postoperative recovery.

A Prospective Comparative Study of Pre-debridement and Post-debridement Cultures in Open Fractures of the Extremities.

Introduction Amputations and recurrent infections are two terrible outcomes of open fractures that can leave patients with permanent impairments. Rapid and effective treatment can protect patients from open fracture sequelae and the long-term financial burden these injuries frequently cause. Over 50% of open fractures are caused by high energy trauma, which most frequently happens in car accidents or severe falls. There hasn't been much research done on the first bacterial ecology of open fracture wounds in the Indian environment. Therefore, the need of the current assignment was to assess the effectiveness of pre-debridement and post-debridement culture in open fractures of the extremities. Methodology A prospective comparative study was carried out with 65 patients who were hospitalized from the OPD and Emergency departments at the R. L. Jalappa Hospital and Research Center. The time frame of study was betweenDecember 2020 and July 2022. Prior to the trial, each participant's written informed consent was obtained and strict protocol was followed in accordance with the Institutional Ethics Committee. Results Among the study participants, the majority of cases (26.15%) belonged to the 21-30 years of age group. A total of 14 participants belonged to the 41-50 years of age group. Out of the total, nine patients were aged less than 20 years.Out of the total, in pre-debridement culture the majority of cases had presence of growth of Staphylococcus aureus followed by Acinetobacter species, Enterobacter species and Pseudomonas species. Only six patients had growth of Klebsiella species. After debridement and treatment for bacterial infection, on subsequent culture examination, no growth was found among 61 patients. Although in four patients, there was presence of Pseudomonas species, Enterobacter species and Proteus microorganisms. Conclusion Although the validity of sequential cultures has been questioned in a number of investigations, this study has demonstrated that debridement cultures have a significant impact inpostoperative infection. Debridement culture is therefore advised to offer information about the selection of antimicrobial medication, which when paired with a complete wound debridement will permit an early wound closure and better overall outcome functionally.

Bilateral reconstruction of palmar soft tissues defects of the hands after thermal injury

Introduction Thermal injury to the palmar surface of the hand is usually complicated by flexion desmogenic contracture of the finger joints. This condition is more complicated with significant wound areas and depths of soft tissue destruction. Conventional surgical methods and soft tissue reconstructions may fail to provide full restoration of the hand function.The objective was to present the optimal treatment strategy for patients with scar flexion contractures of the fingers after thermal injury to the palmar surface of both hands using a pediatric case report.Material and methods A child aged 2 years and 4 months underwent surgical treatment to include excision of scars, skin grafting of both hands with a vascularized fasciocutaneous flap raised with the radial artery.Result The patient could regain all types of hand grip on both sides 12 years after surgical treatment. Both hands were aesthetically acceptable.Discussion Treatment of patients with thermal injury and substantial soft tissue damage is a complex disease process. Conservative treatment and surgical procedures using non-vascularized skin flaps are normally used for the condition. These approaches are associated with cicatricial and arthrogenic flexion contracture of the finger joints. The radical treatment includes thorough wound debridement and early flap coverage and wound closure using a flap with an axial-pattern blood supply, free flaps and reverse-flow flaps. The surgical approach helps to avoid flexion contracture of the fingers initiating early restoration of professional, social stereotypes and stereotypes in everyday life.Conclusion The clinical observation has shown the possibility of one-stage organ-preserving surgical treatment using flaps with an axial blood supply.

External Mechanical Stability Regulates Hematoma Vascularization in Bone Healing Rather than Endothelial YAP/TAZ Mechanotransduction.

Bone fracture healing is regulated by mechanobiological cues. Both, extracellular matrix (ECM) deposition and microvascular assembly determine the dynamics of the regenerative processes. Mechanical instability as by inter-fragmentary shear or compression is known to influence early ECM formation and wound healing. However, it remains unclear how these external cues shape subsequent ECM and microvascular network assembly. As transcriptional coactivators, the mechanotransducers yes-associated protein 1 (YAP)/transcriptional coactivator with PDZ-binding motif (TAZ) translate physical cues into downstream signaling events, yet their role in sprouting angiogenesis into the hematoma after injury is unknown. Using bone healing as model system for scar-free regeneration, the role of endothelial YAP/TAZ in combination with tuning the extrinsic mechanical stability via fracture fixation is investigated. Extrinsically imposed shear across the gap delayed hematoma remodeling and shaped the morphology of early collagen fiber orientations and microvascular networks, suggesting that enhanced shear increased the nutrient exchange in the hematoma. In contrast, endothelial YAP/TAZ deletion haslittle impact on the overall vascularization of the fracture gap, yet slightly increasesthe collagen fiber deposition under semi-rigid fixation. Together, these data provide novel insights into the respective roles of endothelial YAP/TAZ and extrinsic mechanical cues in orchestrating the process of bone regeneration.

Early Wound and Sternal Management Following Pediatric Cardiac Surgery.

Early postoperative wound management following congenital heart surgery remains an area without equipoise. Precautionary restrictions can impact quality of life, development, and delay access to other needed care. The influence of different practices on wound healing and complications is unknown. We surveyed Pediatric Acute Care Cardiology Collaborative member centers regarding postoperative wound closure, wound vacuum-assisted closure (VAC) use, sternal precautions, and restrictions in the early postoperative period. We analyzed responses using descriptive statistics. Responses were submitted by 35/46 (76%) centers. Most centers perform primary skin closure with subcutaneous sutures. Wound covers are removed after 48 h at 43% (15/35) of centers and after ≥72 h at 34% (12/35) of centers. For delayed sternal closure, 16 centers close skin with interrupted, externalized sutures, 5 utilize wound VAC-assisted closure, and 12 use variable practices. Generally, 33 centers use wound VACs for wound care. Patient selection for VAC use and length of therapy varies. We found great variability in duration of sternal precautions and in activity, bathing, and submersion restrictions. Finally, 29 centers require a waiting period between cardiothoracic surgery and other surgeries such as tracheostomy or gastrostomy tube placement. Postoperative wound and sternal management lack consistency across North American pediatric heart institutes. Some restrictive practices may prolong length of stay and/or negatively impact quality of life and neurodevelopment. Practices may also impact wound infection rates. Research linking practices with clinical outcomes is needed to better define standards of care and reduce potential negative consequences of overly conservative or aggressive practices.

Management of Skin Lesions in Patients with Epidermolysis Bullosa by Topical Treatment: Systematic Review and Meta-Analysis.

Epidermolysis bullosa (EB) is the overarching term for a set of rare inherited skin fragility disorders that result from mutations in at least 20 different genes. Currently, there is no cure for any of the EB subtypes associated with various mutations. Existing therapies primarily focus on alleviating pain and promoting early wound healing to prevent potential complications. Consequently, there is an urgent need for innovative therapeutic approaches. The objective of this research was to assess the efficacy of various topical treatments in patients with EB with the goal of achieving wound healing. A secondary objective was to analyse the efficacy of topical treatments for symptom reduction. A literature search was conducted using scientific databases, including The Cochrane Library, Medline (Pubmed), Web of Science, CINHAL, Embase, and Scopus. The protocol review was registered in PROSPERO (ID: 418790), and inclusion and exclusion criteria were applied, resulting in the selection of 23 articles. Enhanced healing times were observed compared with the control group. No conclusive data have been observed on pain management, infection, pruritus episodes, and cure rates over time. Additionally, evidence indicates significant progress in gene therapies (B-VEC), as well as cell and protein therapies. The dressing group, Oleogel S-10, allantoin and diacerein 1%, were the most represented, followed by fibroblast utilisation. In addition, emerging treatments that improve the patient's innate immunity, such as calcipotriol, are gaining attention. However, more trials are needed to reduce the prevalence of blistering and improve the quality of life of individuals with epidermolysis bullosa.

Entire Papilla Preservation Technique with Recombinant Human Fibroblast Growth Factor-2 and Autogenous Bone Grafting in the Treatment of Isolated Non-Contained Intrabony Defect: Case Report of a 5-Year Follow-Up.

Regenerative periodontal surgery is an effective procedure for the treatment of intrabony defects. Various flap designs preserving the defect-associated interdental papilla have been proposed to improve early wound stability. This case report describes the long-term results of a regenerative treatment in severely compromised mandibular canine using entire papilla preservation technique. Surgical access was provided by a single buccal vertical incision without any papilla incision. Combination of autogenous bone harvested from the same surgical site and recombinant human fibroblast growth factor-2 was applied to non-contained intrabony defect following the granulation tissue removal. Surgical site was closed with single interrupted sutures. The clinical outcomes and 5-year stability of pocket closure with no increase in gingival recession show the potential of entire papilla preservation technique with the use of combined biomaterials.

Electrospun membranes chelated by metal magnesium ions enhance pro-angiogenic activity and promote diabetic wound healing

Diabetic wounds, resulting from skin atrophy due to localized ischemia and hypoxia in diabetic patients, lead to chronic pathological inflammation and delayed healing. Using electrospinning technology, we developed magnesium ion-chelated nanofiber membranes to explore their efficacy in antibacterial, anti-inflammatory, and angiogenic applications for wound healing. These membranes are flexible and elastic, resembling native skin tissue, and possess good hydrophilicity for comfortable wound bed contact. The mechanical properties of nanofiber membranes are enhanced by the chelation of magnesium ions (Mg2+), which also facilitates a long-term slow release of Mg2+. The cytocompatibility of the nanofibrous membranes is influenced by their Mg2+ content: lower levels encourage the proliferation of fibroblasts, endothelial cells, and macrophages, while higher levels are inhibitory. In a diabetic rat model, magnesium ion-chelated nanofibrous membranes effectively reduced early wound inflammation and notably accelerated wound healing. This study highlights the potential of magnesium ion-chelated nanofiber membranes in treating diabetic wounds.

Efficacy of one-hour negative pressure wound therapy and magnetic field energy in wound healing.

Wound healing is an important aspect of health but needs further research to identify the effects and interactions of different treatment approaches on healing. The aims of this study were to investigate the effectiveness of one-hour negative pressure wound therapy (NPWT) and compare histological differences between one-hour NPWT and magnetic field energy (MFE) in rats on early-stage wound healing, wound size and angiogenesis. Standardised wounds were created on Wistar rats that were allocated and divided into NPWT, MFE and control groups. Both treatments were applied for 1 hour/day for 10 days. Wound size, histological changes and wound area blood flow were assessed. The wound size of all groups was similar on days 0, 2 and 10. The MFE group's wound size was smaller than the NPWT group on days 4, 6 and 8 (p<0.05). Development of the granulation tissue in both the one-hour NPWT and MFE groups was greater than in the control group. Additionally, the inflammatory phase was shorter, and wounds entered the proliferative stage faster in the MFE group than both of the other groups. Treatment with MFE may be more effective in terms of early stage wound closure and angiogenesis. On the other hand, the NPWT group's wound area blood flow was significantly greater than the other two groups. MFE is superior to one-hour NPWT in terms of wound area and angiogenesis. Furthermore, it is worthwhile to note that one-hour NPWT increases bloodflow in the wound area, which stimulates healing.

Impact of enhanced recovery after surgery protocols on surgical site wound infection rates in urological procedures.

This meta-analysis assesses the impact of Enhanced Recovery After Surgery (ERAS) protocols on surgical site wound infections (SSWIs) in urological procedures. Analysing data from 10 studies, our focus was on SSWI rates on the third and seventh postoperative days. The results reveal a significant reduction in SSWI rates for patients managed under ERAS protocols compared with traditional care. Notably, Figure 4 demonstrates a substantial decrease in SSWI on the third day (I2  = 93%; random: standardized mean difference [SMD]: -6.25, 95% confidence interval [CI]: -7.42 to -5.05, p < 0.01), and Figure 5 mirrors this trend on the seventh day (I2  = 95%; random: SMD: -4.72, 95% CI: -6.28 to -3.16, p < 0.01). These findings underscore the effectiveness of ERAS protocols in minimizing early postoperative wound infections, emphasizing their importance for broader implementation in urological surgeries.

Crown Lengthening by Conventional Diode Laser and Blue Laser: A Randomised Clinical Trial

Introduction: Crown lengthening is a reliable procedure that enables the restoration of teeth with a short clinical crown, extensive subgingival caries, and correction of excessive gingival display for aesthetic purposes. Blue laser, a recent technology in dentistry, has shown significant effectiveness at low power settings, promoting favourable wound healing effects. Aim: To compare the Visual Analogue Scale (VAS) scores and wound healing outcomes between blue laser and denlase in performing crown lengthening procedures. Materials and Methods: A randomised clinical trial was conducted in the Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India, involving 14 patients who were divided into two groups. Participants were recruited from September 2021 to April 2022. Ethical clearance was obtained from the Institutional Ethics and Review Board. Group-A underwent crown lengthening using blue laser (445 nm), while Group-B received treatment with denlase (980 nm). VAS scores and the wound healing index were recorded and compared between the two groups at baseline, 10 days, and one month after the surgery. Statistical tests such as the Mann-Whitney U test, unpaired t-test, and repeated measures ANOVA were used for analysis. Results: The study revealed a statistically significant difference (p-value=0.006) in VAS scores between the blue laser group (mean value of 0.5) and the denlase group (mean value of 1.3). However, statistically significant differences in Wachtel’s early wound healing index were not observed in either of the groups. Conclusion: Blue laser treatment was found to be more comfortable for patients, as indicated by the lower VAS scores. Both groups demonstrated good wound healing properties based on Wachtel’s early wound healing index, with no significant difference between them. It is important to note that literature on blue laser technology is still in its early stages and requires further comprehensive investigation.

Comparative efficacy of silver alginate dressings versus standard gauze in enhancing wound healing post-mastectomy for triple-negative breast cancer: A systematic review and meta-analysis.

This meta-analysis evaluates the efficacy of silver alginate dressings (SAD) compared to standard gauze (SG) in enhancing wound healing and reducing scar formation post-mastectomy in patients with triple-negative breast cancer. From an initial pool of 1245 articles, five studies met the inclusion criteria. The analysis revealed that SAD significantly improve early wound healing 1 week post-mastectomy, as indicated by lower Redness, Edema, Ecchymosis, Discharge, and Approximation (REEDA) scales (I2 = 85%; Random: SMD: -7.08, 95% CI: -8.26 to -5.98, p < 0.01), compared to SG. Additionally, long-term scar outcomes measured by the Manchester Scar Scale (MSS) 5 months post-mastectomy showed a notable reduction in scar formation (I2 = 95%; Random: SMD: -12.97, 95% CI: -16.20 to -9.75, p < 0.01)) in the silver alginate group. The findings support the use of SAD in post-mastectomy care for triple-negative breast cancer patients but highlight the need for further research on long-term safety and cost-effectiveness.