Evolution Of Healing Research Articles

Use of Figueiredo’s technique for treating extensive infected skin lesions – a case report

Demonstrate that a low-complexity surgical technique can effectively solve problems of extensive skin lesions in cities where microsurgical techniques are not available. We present a 59-year-old male patient with diabetes mellitus and an extensive and infected lesion in his right ankle region, suggestive of a diabetic foot. Urgent surgical treatment was performed with debridement of the devitalized tissues, drainage of a large amount of purulent secretion, and exhaustive washing with 0.9% saline solution. After a new debridement, abundant washing with 0.9% saline solution and coverage of the extensive bloody area with a polypropylene prosthesis were performed. He remained under outpatient follow-up, and subsequently, twice, new cleanings were performed, and a small diameter mesh was applied due to the good evolution of healing. A good range of motion was maintained in the right ankle and foot, with the medial wound completely healed, leaving only a small area of the lateral wound to complete the healing process. Figueiredo’s technique, described in 2017 for fingertip lesions, uses a flexible thermoplastic polymer, which can be obtained from a small portion of silicone from a saline bag, to form a semi-occlusive dressing that allows the drainage of secretions and provides a favorable environment and temperature for healing. The exact limits of this technique are not yet well established, but the practice has shown excellent results in larger lesions. Figueiredo’s technique is a simple, low-cost, and effective option for treating extensive infected skin lesions. Level of Evidence IV; Therapeutic studies; Case Report.

Elastic Damage Healing Model Coupling Secondary Damage Variable for Self Healing Materials

A one-dimensional constitutive model, based on the principles of continuum damage mechanics, is developed for capturing healing in certain materials during unloading and rest periods. A secondary damage variable is defined to address the drawback of existing models for damage and healing in capturing the complete material failure. An energy-based damage evolution function is adopted for primary and secondary damage variables, and phenomenological healing evolution is defined. The proposed implicit elastic damage-healing model is implemented by the return-mapping technique, and the model response is demonstrated for different loading histories.

The Prepetrous Segment of the Internal Carotid Artery as a Neglected Site of Symptomatic Atherosclerosis: A Single-Center Series.

(1) Background: Non-stenotic complicated plaques are a neglected cause of stroke, in particular in young patients. Atherosclerosis has some preferential sites in extracranial arteries and the prepetrous segment of the internal carotid artery has been rarely described as site of atheroma in general and of complicated atheroma in stroke patients. The aim of this study is to describe the rate of the prepetrous internal carotid artery's (ICA) involvement in a single-center case series of young stroke patients. (2) Methods: All patients < 50 years old with acute ischemic stroke admitted to a single-center Stroke Unit during two time periods (the first one from 1 January 2018 to 31 December 2019, and the second one from 1 January 2021 to 30 June 2022), were prospectively investigated as part of a screening protocol of the Searching for Explanations for Cryptogenic Stroke in the Young: Revealing the Etiology, Triggers, and Outcome (SECRETO) study [ClinicalTrials.gov ID NCT01934725], including extracranial vascular examination by using computed tomography (CT) or magnetic resonance imaging (MRI). (3) Results: Two out of ninety-three consecutive patients (2.15%) had a complicated atheroma in the prepetrous ICA as the cause of stroke and both CT angiography and high-resolution vessel wall MRI were applied to document the main features of positive remodeling, cap rupture, ulceration, intraplaque hemorrhage, and a transient thrombus superimposed on the atheroma. The two patients had a different evolution of healing in the first case and a persisting ulceration at 12 months in the second case. (4) Conclusions: The prepetrous ICA is a rarely described location of complicated atheroma in stroke patients at all ages and it represents roughly 2% of causes of acute stroke in this single-center case series in young people.

Multi-stress damage and healing mechanics in quasi-brittle materials: Theoretical overview

This work introduces a theoretical framework for continuum damage and healing mechanics by extending stress decomposition to account for tensile, compressive, and shear stresses. In addition to the spectral stress decomposition into tensile and compressive components, we extend the existing stress decomposition method to address shear stresses. The extraction of shear stresses employs two hypotheses, considering both same-signed and opposite-signed principal stresses. This stress decomposition approach yields three damage variables [Formula: see text] and three healing variables [Formula: see text]. The damage formulation is discussed in terms of equivalent strain and conjugate force, while the healing formulation is based on the initial damage state and healing time. We explore the influence of material parameters and healing time on damage and healing evolution. Furthermore, we analyze the relationship between nominal stress-to-effective stress ratio, damage variables, and healing time. Lastly, we present a thermodynamically consistent formulation for damage-healing processes, acknowledging that this work establishes a theoretical formulation. The proposed method is validated by analyzing the performance of an L-shaped concrete specimen using three damage variables and one healing variable. These results illustrate the model's ability to effectively capture the damage and healing phenomena. The practical implementation of the proposed formulation will be pursued numerically using innovative healing techniques and a pseudo-damage healing approach, which will be detailed in future work.

Amnios con cobertura antibiótica: eficacia en pacientes sometidas a conización

Objective: To compare the evolution of healing in patients in whom amnion with antibiotic coverage was applied, with another group in which it was not applied, after cervical conization performed in cervical pathology consultations of the San Cristobal Central Hospital, between February and May 2023. Methods: Experimental, randomized, longitudinal comparison. It included 66 patients, randomly divided into two groups. Group 1: in which amnion was applied (n = 36/54.5 %); Group 2: no treatment (n = 30/45.5%). The researcher prepared the amnions of placentas obtained by cesarean section or vaginal delivery, in the operating room. Informed consent was obtained from both donors and recipients. Results: On day 14, none of the patients in the group 1 had epithelialization. In the group 2, one patient (2.7%) had 50% epithelialization and 35 (94.6%) had reached 100% (p &lt; 0.001). Epithelialization was total in 13.3% of the first group and 94.6% of the second group (Odds Ratio of 227 (95% CI: 24.0 to 2157.0; p &lt; 0.001). There were no cases of cervical infection. Five patients (16.7%) in the group 1 and one in the group 2 (2.8%) had ectopias (p = 0.051). There was no association between complete or partial epithelialization and clinical characteristics (p ˂ 0.05). Conclusion: Amnion with antibiotic coverage is associated with better healing outcomes in conized patients. Its effectiveness as a medical therapy was proven when placed on the surgical wound. Keywords: Amnion, Epithelion, Placenta.

Healing evolution of surgical wound dehiscence in sternotomy

Objetivo: Descrever a evolução cicatricial de uma deiscência de ferida operatória em esternotomia de uma paciente em pós-operatório de troca valvar mitral e aórtica. Métodos: Estudo descritivo, do tipo estudo de caso, desenvolvido na clínica médica de um Hospital Unversitário da rede EBSERH, em uma paciente com deiscência de ferida operatória em esternotomia. Os dados foram obtidos por meio da avaliação direta da lesão, avaliação fotográfica e dos registros escritos no prontuário da paciente no período de julho a setembro de 2021. O estudo foi aprovado pelo comitê de ética em pesquisa do Hospital Universitário da Universidade Federal do Piauí - HUUFPI (Número do Parecer: 5.726.375). Resultados: A paciente evoluiu com redução das medidas da área da lesão deiscente, proliferação de bom tecido de granulação e aproximação das bordas da lesão, com a utilização da Terapia por Pressão Negativa e coberturas adequadas a cada fase do processo de cicatrização. Conclusão: O conhecimento acerca do processo de cicatrização de feridas associado ao uso de produtos e tecnologias, como a Terapia por Pressão Negativa, foram fundamentais no tratamento da deiscência de ferida operatória, evitando uma nova abordagem cirúrgica, bem como reduzindo custos e tempo de internação hospitalar.

Morphological characteristics of beak-like tooth in spotted knifejaw (Oplegnathus punctatus) and mechanisms of dental development regulation by the Wnt, BMP, FGF and SHH signalling pathways

Oplegnathus punctatus is a fish species with beak-like tooth that feeds on algae, oysters, sea urchins, and other organisms attached to rocks. Currently, there are no research reports on the development and regulatory mechanisms of O. punctatus beak-like tooth. This present study firstly elucidated the nesting structure pattern of the beak-like tooth with dental formula (4, 15–16, 10–1) for O. punctatus. Four critical periods during early beak-like tooth development (28dph, 40dph, 50dph, 60dph) were also identified. In addition, 11 key genes (bmp2, bmpr2, smad1, wnt5a, msx, axin2, fgfr1a, fgfr2, pitx2, ptch1, cyp27a1) closely related to the development of beak-like tooth were discovered, with the highest expression levels in the initial stages of functional teeth and replacement teeth development, and expression in the mesenchymal and epithelial tissues of the teeth. Further research found that the cyp27a1 gene, related to vitamin D metabolism and calcium accumulation, was expressed in the maxilla and base of the tooth in O. punctatus. This study provides support for the biological theory of tooth development and healing and provides a reference for the adaptive evolution of tooth healing in special habitats.

Thermodynamics of healing of asphalt binders with free energy

Inspired by self-healing attributes, one of the key topics in the field of pavement engineering is changing the way that asphalt materials behave for prolonged service life and environmental savings. Extensive experimental approaches, models and technologies have been developed to characterize the evolution of healing influenced by internal and external factors. The purpose of this study is to explore the local kinetics of asphalt binders that energetically favor autonomous self-healing as well as its mechanism using free energy method. With consideration of driving forces including internal stress and interfacial forces of attraction (or surface energy) responsible for energy redistribution during the rest period, the healing of an asphalt binder was first modeled as a function of thermodynamic parameters. New healing indexes were then defined by the total free energy change for healing (ΔGH) and fast-rate response ratio (RH) of initial healing in duration to the total rest time. Thirdly, a fatigue-healing test was performed on #70 asphalt binder and SBS-modified asphalt binder to examine the potential and reactivity of healing affected by different damage levels. Finally, the effectiveness of proposed thermodynamic healing indexes in describing healing ability was discussed by considering their relations with properties measured by mechanical analysis. Results show that more negative ΔGH indicates a greater tendency to spontaneous healing while less negative ΔGH suggests a poor healing potential as crack propagates to a certain length. In contrast to #70 asphalt binder, SBS-modified asphalt binder exhibits a superior healing potential on a shorter crack length scale. RH gradually increases with the increase of crack length for both #70 asphalt binder and SBS-modified asphalt binder, implying limited mobility of molecules. By contrast with mechanistic healing indexes assessing properties before and after healing (i.e. the degree of healing), the thermodynamic healing indexes provide a new vision regarding healing potential, which reveals the true ability of a material to autonomously repair damaged areas.

An Experimental Model of Myocardial Infarction for Studying Cardiac Repair and Remodeling in Knockout Mice.

Cardiovascular disease is the most prevalent cause of death in Western countries, with acute myocardial infarction (MI) being the most prevalent form. This paper describes a protocol for studying the role of galectin 3 (Gal-3) in the temporal evolution of cardiac healing and remodeling in an experimental animal model of MI. The procedures described include an experimental model of MI with a permanent coronary ligature in male C57BL/6J (control) and Gal-3 knockout (KO) mice, an echocardiography procedure to study cardiac remodeling and systolic function in vivo, a histological evaluation of interstitial myocardial fibrosis with picrosirius red-stained and rhodamine-conjugated lectin-stained sections for studying myocyte hypertrophy by the cross-sectional area (MCSA), and the quantification of infarct size and cardiac remodeling (scar thinning, septum thickness, and expansion index) by planimetry in slices stained with Masson's trichrome and triphenyl tetrazolium chloride. Gal-3 KO mice with MI showed disrupted cardiac remodeling and an increase in the scar thinning ratio and the expansion index. At the onset of MI, myocardial function and cardiac remodeling were also severely affected. At 4 weeks post MI, the natural evolution of fibrosis in infarcted Gal-3 KO mice was also affected. In summary, the experimental model of MI is a suitable model for studying the temporal evolution of cardiac repair and remodeling in mice with the genetic deletion of Gal-3 and other animal models. The lack of Gal-3 affects the dynamics of cardiac repair and disrupts the evolution of cardiac remodeling and function after MI.

Modelling of self-healing in viscoelastic materials

A novel viscoelastic damage-healing model for self-healing materials is proposed coupling continuum damage healing mechanics (CDHM) framework with a viscoelastic constitutive model for self-healing during unloading and rest periods. The viscoelastic damage-healing model is coupled with the novel secondary damage internal variable accounting for the subsequent damage of healed material. The proposed viscoelastic damage-healing model formulation is numerically implemented by return mapping approach employing the elastic strain equivalence hypothesis from CDHM, and model response as stress update is obtained for several strain histories. Detailed parametric studies are conducted by varying the material constants appearing in the damage and healing evolution equations, and their influence on the constitutive model response is analysed. Various tangent moduli expressions are finally derived, and successfully coupled with an in-house developed plane strain nonlinear finite element code while solving different boundary value problems.

A Digital Tool for Measuring Healing of Chronic Wounds Treated with an Antioxidant Dressing: A Case Series

(1) Abstract: Wound monitoring is an essential aspect in the evaluation of wound healing. This can be carried out with the multidimensional tool HELCOS, which develops a quantitative analysis and graphic representation of wound healing evolution via imaging. It compares the area and tissues present in the wound bed. This instrument is used for chronic wounds in which the healing process is altered. This article describes the potential use of this tool to improve the monitoring and follow-up of wounds and presents a case series of various chronic wounds with diverse etiology treated with an antioxidant dressing. (2) Methods: A secondary analysis of data from a case series of wounds treated with an antioxidant dressing and monitored with the HELCOS tool. (3) Results: The HELCOS tool is useful for measuring changes in the wound area and identifying wound bed tissues. In the six cases described in this article, the tool was able to monitor the healing of the wounds treated with the antioxidant dressing. (4) Conclusions: the monitoring of wound healing with this multidimensional HELCOS tool offers new possibilities to facilitate treatment decisions by healthcare professionals.

Effects of mechanical forces on the formation of cutaneous wounds during skin expansion and emerging therapies for wound healing and scar prevention.

To update a possible role of cosmeceutical topic treatment to obtain a better scar. This is a preliminary supportive study. A total of 14 patients who went to the General Hospital of Mexico City, Mexico, between May and December 2020, for breast reconstruction were included in the current study. The biopsies were carried out to the scar area of the previous I° and II° surgery. The patients were thus divided into 2 groups: those who used Cicolea cream® as a treatment supplement and those who used only petrolatum. Collagen fibers arranged in a regular pattern in the group treated with Cicolea compared to dispersed collagen fibers in the group treated with pure petrolatum. Furthermore, the patients who presented hypertrophic or keloid scars secondary to mastectomy, developed after insertion of breast expanders an organized scarring process, with improvement of scar if treated with Cicolea. Based on our observations, it is possible to propose that the action of the polyphenols present in the different components of Cicolea® cream leads to a better evolution of the wound healing compared to the action of petrolatum composition.

Ultrasonic evaluation of self-healing cementitious materials with superabsorbent polymers: Mortar vs. concrete

The inclusion of superabsorbent polymers (SAPs) has become increasingly attractive to promote the self-healing ability of cementitious materials, thereby reducing the costs related to manual repairs. To advocate the use of these additives within large-scale constructions, an assessment of the self-healing ability is needed to ensure the safety of infrastructures. A non-destructive evaluation method was found in the adoption of ultrasonic monitoring. Thanks to the sensitivity of ultrasound to the elastic properties, the technique allows to determine the self-healing effectiveness and to compare the healing capacity between different mixtures. However, most studies concerning ultrasonic assessments of the healing evolution were conducted on mortars, lacking large aggregates. Therefore, to upgrade to the most commonly used construction material, self-healing of concrete is monitored, and its performance is compared to mortar. Ultrasonic surface wave monitoring shows the potential to evaluate the crack closure in either mixture and the effect of different SAPs included.

Transcendental medication: The evolution of mind, culture, and healing. ChrisLynn, Routledge, 2022. 130 pp

Transcendental medication: The evolution of mind, culture, and healing. ChrisLynn, Routledge, 2022. 130 pp

Obturator Bypass Remains a Useful Option

The femoral tripod remains technically crucial in vascular surgery, as well for an elective revascularization as for an extensive approach to the arterial tree. The management of septic complications and healing disorders in this area is really challenging. Obturator bypass (OB) represents an alternative sometimes employed in this context, but few recent series were recently published. The objectives of this work were thus to evaluate the results of OB in terms of patency, morbi-mortality, healing evolution and absence of reinfection. This was a monocentric retrospective study including all the patients treated by OB, whatever the cause, between January 2010 and December 2020. Primary outcomes were the primary and the secondary patencies. The secondary outcomes were the morbi-mortality, freedom from infection and healing. During this period, 23 OBs were carried out in 22 patients, with a majority of men (77%) whose median age was 70years [34-87]. The indications were infection in 19 patients (86%), and iterative thrombosis in 3 patients (14%). The substitute was an arterial allograft in 82% of the cases, and the outflow was the deep femoral artery only in 14% of the cases. The median operative time was 224min [111-391] and median blood losses were 900mL [300-3,900]. We observed 7 systemic (32%), and 8 local complications (36%). Healing was obtained in 90% of the cases, and freedom from infection was obtained in 100% of the cases. The median duration of follow-up was 594days [5-2,517]. One-year, 2-year and 3-year primary patency rates were 84%, 78%, and 63%, respectively. One-year, 2-year and 3-year secondary patencies were 94%, 94%, and 80%, respectively. One-month, 1-year, 2-year and 3-year survival rates were 86%, 73%, 67%, and 53%, respectively. Our study showed that the OB represents a relevant alternative in the event of complex lesions of the femoral tripod, with good patency and healing rates and good infection control. On the other hand, its consequences in terms of morbi-mortality confirm that OB is a major surgery that should be used when a traditional approach is not possible.

Laser therapy and application of Aloe vera for wound treatment after mastopexy complications: A case report

Mammoplasty is a surgery aimed at reducing breasts, being an invasive procedure and with the possibility of post-surgical complications. In the case presented, the patient had healing difficulties which progressed to an intense inflammatory process that evolved to necrosis of the areolas, laser therapy sessions were applied using lasers with red LED and blue LED in order to treat the inflammatory process, stimulate regeneration of tissue and collagen synthesis, treat the patient's pain, hydrate the tissues, fight infections and skin diseases and whiten the area. It was associated with the application of Aloe vera in natura to treat wounds and heal the local. It was observed that after treatment there was a significant improvement in areola necrosis, healing of the injured part and improvement in collagen production. Making an evaluation during the 24 sessions, we were able to assess that in synergy between the Red Laser, Infrared, Blue LED and the use of the active ingredient Aloe vera corroborate the evolution of tissue healing.

Constitutive modelling of a self-healing composite matrix polymer material

In this work, a constitutive model of an intrinsically self-healing composite matrix material is presented. The developed model comprises a micro-damage initiation and evolution model, and a healing evolution model, which are combined with the von Mises linear isotropic hardening plasticity. It is implemented into the Abaqus/Standard user material subroutine UMAT and validated using experimental results of static tensile and two-cycle tensile tests performed on partially neutralised poly(ethylene-co-methacrylic acid) (EMAA) ionomer copolymer, Surlyn® 8940. In the development of the model, Continuum Damage Healing Mechanics (CDHM) concepts of nominal and healing configurations are used. In addition, these concepts are used along with the strain equivalence hypothesis to streamline the numerical implementation. The strain equivalence hypothesis relates strain and stress tensors in the nominal and the healing configuration. Finally, successful validation has shown that the developed model is able to accurately predict behaviour of Surlyn® 8940 coupons during tensile tests and it can precisely predict the accumulation of plastic strain.

Short and long term follow up of humeral condylar fracture type II treated by lag screw and anti-rotational pin associated to olecranon osteotomy

Humeral condylar fractures are relatively common in dogs and are most often associated with low-energy trauma, mainly affecting young animals. Anatomical reduction and rigid stabilization are mandatory to correct these types of articular fractures and achieve the main goals as early return of limb function, pain-free elbow movement, and prevent or at least reduce degenerative joint disease. Even with optimal anatomic reduction, surgical outcome complications associated to this type of fractures may be very common, giving this kind of osteosynthesis a reserve prognosis and making it challenging to the surgeon. In the case report, an adult mixed-breed dog, 3,9 kg, has fractured the lateral condylar portion of the left humerus after a 4 meters fall. Corrective osteosynthesis was performed using an association of a transcondylar lag screw and an anti-rotational pin through an olecranon osteotomy access. Monthly clinical and radiographic follow up were carried out with the intent to show bone healing evolution. Within 45 days consolidation of the fracture could already be seen. And after 180 days follow up, no signals of osteoarthrosis were found in the elbow joint, and the dog is fine, painless, has good weight bearing and optimal limb function.

Use of the corneal bioreactor to evaluate the anti‐edema effect and the ulcer healing rate between two commercial hyperosmotic eye drops: ODM5 and Muro 128

AbstractPurposeThe corneal bioreactor (BR) in our laboratory, with an intraocular pressure (IOP) of 21 mmHg and the renewal of the culture medium, allows to maintain the homeostasis of the 3 layers of the cornea. We showed that an IOP reduced to 10 mmHg allowed to simulate a corneal edema (760 ± 57 µm) with a healthy epithelium.AimTo compare 2 hyperosmolar eye drops in the evolution of corneal deturgescence and epithelial ulcer healing: ODM5 composed mainly of NaCl 5% and hyaluronic acid (Horus Pharma, Saint‐Laurent‐du‐Var, France) and Muro 128 composed mainly of NaCl 5% and various excipients (Bausch+Lomb, Bridgewater, NJ)MethodsBeforehand, 3 pairs of human corneas were preserved for 2 weeks in the BR filled with CorneaMax (Eurobio, France), with a pressure maintained at 10 mmHg. A central epithelial ulcer of 6.64 ± 0.04 mm in diameter was made (D0). Each cornea received a drop of Muro 128 or ODM5 four times a day. Corneal central volume measurement (Casia 1, Tomey) was performed daily at the beginning and end of the day. Ulcer healing was monitored daily by fluorescein labelling and quantified by image analysis (Fiji) taken with a macroscope. At D14, the corneas were removed and fixed for immunostaining of E‐Cad (cell architecture), Zo‐1 (tight junctions), MUC16 (mucins), K3K12 (cell maturity) and for histology (Saffron Eosin Hemathein).ResultsMean daily volume loss was comparable: 2.43 ± 1.55 mm3 with ODM5 vs. 2.18 ± 1.71 mm3 with Muro 128 (p = 0.698 3). Corneal ulcers in all 3 pairs healed at D4, D5, D5 with ODM5 vs. D5, D13, and 1 cornea never healed with Muro 128. In IHC and histology, the epithelium was of better quality with ODM5.ConclusionsThe efficacy of the 2 eye drops is comparable. Epithelial preservation is partly better with ODM5, possibly related to the presence of hyaluronic acid.

A chemo-mechanically coupled continuum damage-healing model for chemical reaction-based self-healing materials

In this paper, a chemo-mechanically coupled continuum damage-healing theory is developed for transient damage-healing problems of chemical reaction-based self-healing materials. The deformation-diffusion-chemical reaction coupling behavior and the damage-healing dynamic process of the materials are connected and unified innovatively. In line with different damage mechanisms, the damage is divided into non-chemical-reaction damage and chemical-reaction damage. The damage-healing behavior of chemical reaction-based self-healing materials is modeled as three coupling dynamic processes of damage, mass diffusion and chemical-reaction healing. Within the framework of thermodynamics, the fully coupled nonlinear constitutive relations and nonlinear damage-healing kinetic laws are formulated. And the material parameters involved in the governing equations are further specified as functions of independent variables of non-chemical-reaction damage degree, concentrations of diffusive species and extents of chemical reactions. The obtained damage-healing model is then applied to simulate the transient self-healing problem of engineering cement-based composites (ECCs) to show the model ability in fully reflecting the multi-time-scale and multi-physical-field coupling characteristics of the damage-healing process. By analyzing the self-healing mechanism and correlating the extent of precipitation reaction, the stress state, the evolutions of elastic modulus and diffusion coefficient, the stress-reaction–diffusion coupling mathematical model of self-healing ECCs is formulated. Based on this model, the transient self-healing problem of ECC thick plate with bottom constraint is numerically solved, and the transient evolution patterns of healing degree, concentration of carbonate, structural stress and elastic modulus are given. The effects of reaction rate and damage degree on the healing evolution pattern are analyzed thoroughly. The results show that the damage degree is the dominant factor affecting the healing rate and evolution pattern of ECC, and only when the damage is serious, can the healing time be significantly shortened by increasing the healing reaction rate.