Duration Of Healing Research Articles

Correlation analysis of patients with diabetic foot ulcers treated with tibial cortex transverse transport surgery and platelet-to-lymphocyte ratio and monocyte-to-neutrophil ratio.

Diabetic foot ulcers (DFUs) represent one of the most severe late-stage complications of diabetes. Tibial cortex transverse transport (TTT) surgery stands as the prevailing method for addressing DFUs. This surgical intervention holds the promise of expediting DFU wound healing and diminishing the rate of amputations, with the mitigation of inflammatory responses playing a pivotal role. In this study, we aim to explore the correlation between inflammation and TTT surgery, with the overarching goal of facilitating swift prognostic assessments in clinical practice. The correlation between the severity of DFUs and clinical test results remains ambiguous. A clinical prediction model was devised to explore the connection between DFU severity and the efficacy of TTT surgery, utilizing straightforward and efficient clinical indicators. Clinical data and examination results were gathered by tracking hospitalized DFU patients who underwent TTT surgery at the First Affiliated Hospital of Guangxi Medical University (Nanning, China). Indicators associated with DFU severity and wound healing time post-surgery were identified through logistic regression and least absolute shrinkage and selection operator (LASSO) regression analyses. Subsequently, a clinical prediction model was constructed. Finally, the intersection of these 2 sets of indicators revealed factors correlated with wound severity and post-operative healing duration. Our study was comprised of 202 patients who were categorized into 2 groups based on Wagner's grading classifications. Utilizing Student's t-tests, LASSO regression and logistic regression analyses, we identified 3 factors indicative of DFU severity: platelet-to-lymphocyte ratio (PLR), mixed lymphocyte reaction (MLR) and hemoglobin (HGB). Univariate COX regression analysis revealed 12 factors such as: white blood cells (WBC), neutrophils (NEUT), monocytes (MO), PLR, MLR, neutrophil-to-lymphocyte ratio (NLR), erythrocyte sedimentation rate (ESR), age, lymphocytes (LY), monocyte-to-neutrophil ratio (MNR), uric acid (UA), and albumin (ALB) associated with the postoperative healing duration. Ultimately, we identified 2 factors, PLR and MNR, at the intersection of these 2 datasets. Platelet-to-lymphocyte ratio and MNR were identified as factors associated with both the severity of DFUs and the prognosis following TTT surgery.

Assessment of Vacuum-Assisted Closure (VAC) Therapy in Orthopaedic Infections.

Introduction Chronic and infected orthopaedic wounds may result in profound morbidity, amputation, sepsis andeven death. It may need prolonged hospitalization and multiple surgical procedures for treatment. Vacuum-assisted dressing (VAD) is a comparatively newer modality for treating chronic non-healing wounds which helps in faster wound healing, decreases the frequency of dressing and reduces hospitalization time. The aim of our study is to evaluate the outcome of vacuum-assisted dressing (VAD) in the management of orthopaedic wounds. Materials and methods A case series including 20 patients with post-traumatic open fracture wounds, post-operative infected wounds and wounds with underlying chronic osteomyelitis were treated with VAD. Wound size was measured pre- and post-debridement and every five days, at the time of dressing change until the wound healed or grafted. The duration of wound healing or wound closure was measured and documented. Results Wound size decreased significantly and healthy granulation tissues were observed in all wounds after the application of vacuum-assisted dressing. Wound size decreased by an average of 22% after debridement and first vacuum-assisted dressing removal. Infection control was achieved in 18 out of 20 patients (90%) who had wounds closed either by secondary closure or by skin grafting. Conclusion We conclude that VAD is an efficient technique in the management of orthopaedic wounds, especially in the management of open fracture wounds but less effective in chronically infected wounds with underlying osteomyelitis.

Role of Adipose-Derived Mesenchymal Stem Cells in Bone Regeneration.

Bone regeneration involves multiple factors such as tissue interactions, an inflammatory response, and vessel formation. In the event of diseases, old age, lifestyle, or trauma, bone regeneration can be impaired which could result in a prolonged healing duration or requiring an external intervention for repair. Currently, bone grafts hold the golden standard for bone regeneration. However, several limitations hinder its clinical applications, e.g., donor site morbidity, an insufficient tissue volume, and uncertain post-operative outcomes. Bone tissue engineering, involving stem cells seeded onto scaffolds, has thus been a promising treatment alternative for bone regeneration. Adipose-derived mesenchymal stem cells (AD-MSCs) are known to hold therapeutic value for the treatment of various clinical conditions and have displayed feasibility and significant effectiveness due to their ease of isolation, non-invasive, abundance in quantity, and osteogenic capacity. Notably, in vitro studies showed AD-MSCs holding a high proliferation capacity, multi-differentiation potential through the release of a variety of factors, and extracellular vesicles, allowing them to repair damaged tissues. In vivo and clinical studies showed AD-MSCs favoring better vascularization and the integration of the scaffolds, while the presence of scaffolds has enhanced the osteogenesis potential of AD-MSCs, thus yielding optimal bone formation outcomes. Effective bone regeneration requires the interplay of both AD-MSCs and scaffolds (material, pore size) to improve the osteogenic and vasculogenic capacity. This review presents the advances and applications of AD-MSCs for bone regeneration and bone tissue engineering, focusing on the in vitro, in vivo, and clinical studies involving AD-MSCs for bone tissue engineering.

Endoscopic pilonidal sinus treatment (EPSiT) for sacrococcygeal pilonidal sinus disease: a prospective long-term study

Objective: To assess short-term and long-term outcomes of endoscopic pilonidal sinus treatment for pilonidal sinus disease. Method: The prospective study was conducted at Shifa International Hospital, Islamabad, Pakistan, from July 2015 to July 2021, and comprised all pilonidal sinus cases undergoing minimal invasive endoscopic pilonidal sinus treatment who were treated by a single surgical team. The primary outcomes were duration of healing, post-operative morbidities, persistence of discharge and recurrence at 1-7 years. The secondary outcomes were operative time, return to work, cosmetic results and patient satisfaction. The patients were observed for wound healing and discharge on follow-up in the out-patient department at 1, 3, 6 and 24 weeks. They were further followed up every year through telephonic survey for persistence or recurrence of symptoms. Patient satisfaction was assessed using the 36-item Short Form Survey questionnaire filled at admission and then at 6 weeks post-surgery. Data was analysed using SPSS 23. Results: Of the 67 patients, 55(82%) were males and 12(18%) were females. The overall mean age was 25.69±8.305 years. There were 13(19.4%) patients with a history of recurrent disease and previous procedures for pilonidal sinus, while 54(80.6%) had no previous surgery. The median operative time was 35 minutes (interquartile range: 20-45 minutes). Complete wound healing was achieved in 60(89.6%) patients, while recurrence was seen in 7(10.4%). The median time off work was 2.5 days (interquartile range: 1-3 days). Patient satisfaction with the procedure was significantly high (p<0.05). Conclusion: Endoscopic pilonidal sinus treatment appeared to be a good minimally invasive surgical technique for the treatment of pilonidal sinus disease in terms of both short-term and long-term outcomes. Key Words: Pilonidal sinus disease, Minimally invasive surgery, Endoscopic pilonidal sinus treatment, EPSiT, Recurrent pilonidal sinus.

Outcome of Honey and Ghee Dressing as Compared to Regular Dressing Materials: A Comparative Study

Background: Ghee and honey has been advocated and used as dressing for infected wounds by Sushruta (600BC). The gratifying results observed with the dressing have prompted this study which aims to establish its efficacy in chronic infected wounds over one year period A standardised ghee and honey dressing was used to treat: chronic post- operative wounds and infected per op wounds, Honey and ghee dressing markedly reduces the foul odour and discharge, significantly improving the quality of life. The study will tell us comparative result of honey and ghee dressing as compared to expensive vacuum dressing and the regular dressing materials. Innumerable Randomised Control Trials (RCTs) reported on honey dressing for infected wounds, there is substantial evidence that ghee and honey dressing has at least comparable results to other modes of treatment. The easy availability and low cost of this treatment makes it significant in developing countries. Specially in rural population, Required permission has been from the HOD of orthopaedics. Material and Methods: Total 20 patients with compound fracture and chronic infected wound, were studied during the period of March 2023 to June 2023 at BVP RMC Loni, Maharashtra. Honey and ghee were taken from a fresh sealed box in 50:50 portion according to size of wound and mixed well then it was applied on the wound directly and covered with gauge and, the dressing was changed is cleaned with sterile normal saline as compared to normal dressing materials ie betadin, povidon iodine ointment, spirit. All Patients data was collected and compiled in Microsoft excel and were statistically analysed using appropriate statistical test using SPSS software. Results: Majority patient were males. Mean duration of wound healing among honey and ghee dressing was 15.3 and of regular dressing was 8.9 days. Conclusion: Honey is one alternative solution that can be used for non-pharmacological therapy. Honey can be used as a topical dressing .........

Self-powered biosensing sutures for real-time wound monitoring

Effective wound management has the potential to reduce both the duration and cost of wound healing. However, traditional methods often rely on direct observation or complex and expensive biological testing to monitor and evaluate the invasive damage caused by wound healing, which can be time-consuming. Biosensors offer the advantage of precise and real-time monitoring, but existing devices are not suitable for integration with sensitive wound tissue due to their external dimensions. Here, we have designed a self-powered biosensing suture (SPBS) based on biofuel cells to accurately monitor glucose concentration at the wound site and promote wound healing. The anode of the SPBS consists of carbon nanotubes-modified carbon fibers, tetrathiafulvalene (TTF), and glucose oxidase (GOx), while the cathode is composed of Ag2O and carbon nanotubes modified nanotubes modified carbon fibers. It was observed that SPBS exhibited excellent physical and chemical stability in vitro. Regardless of different bending degrees or pH values, the maximum power density of SPBS remained above 92%, which is conducive to long-term dynamic evaluation. Furthermore, the voltage generated by SPBS reflects blood glucose concentration, and measurements at wound sites are consistent with those obtained using a commercially available blood glucose meter. SPBS achieves the healing effect of traditional medical sutures after complete healing within 14 days. It offers valuable insights for intelligent devices dedicated to real-time wound monitoring.

Testing The Effectiveness Of Burns Healing Of Gel Preparations Jatropagar ( Jatropha Curcas L) Leaf Extract On Male White Rats ( Rattus Norvegicus)

Indonesia has a variety of traditional medicinal plants for treating burns. One of them is Jatropha leaves which contain active substances such as saponins, tannins, alkaloids and flavonoids which have antibacterial, antioxidant, anticancer and anti-inflammatory properties. The aim of this research was to determine the effectiveness of Jatropha leaf preparations with extract concentrations of 10%, 15%, 20% on healing burns. This research stage includes plant determination, simplicia making, extract making, phytochemical screening testing, physical quality testing of gel preparations and animal testing. The research was experimental by comparing the effectiveness of healing burns in grouped mice and Jatropha leaf extract gel preparations and the most effective formula for healing burn wounds was Jatropha leaf extract gel preparations at concentrations of 10%, 15%, 20%. Statistical test results showed that there was a difference in the duration of healing of burn wounds in male white rats between Jatropha curcas (Jatropha curcas L) leaf gel preparations with concentrations of 10%, 15%, 20%, bioplaceton gel and gel base.

Application of conjunctival graft surgery in the treatment of corneal ulcers in dogs

The study of conjunctival graft surgery for treating corneal ulcers in dogs was conducted at Alpha Pet Veterinary Clinic and Bang Pham Veterinary Hospital from August 2021 to August 2022. Dogs were clinically examined with corneal ulcers and corneal perforations, corneal reflexes, and then fluorescein 2% reagent was used to examine and measure the diameter of the corneal damaged area by using Castroviejo calipers. The surgical method of conjunctival stem grafting was applied and evaluated effects of treatment on corneal ulcers in dogs. A total of 3,024 dogs were examined and treated during the study period. There were 195 dogs with eye diseases, accounting for 6.45% of the cases. The rate of corneal ulcers was 15.90% (31/195 cases). Among the corneal ulcer cases, conjunctival graft surgery was performed in 14 cases. The successful rate of conjunctival stem grafting was 71.43%. The complication rate of conjunctival stem grafting was 42.86%, in which 2 cases of mild complications were successfully treated. The average wound healing duration was 39.45 days. The occurrence of complications depended on the types of complication. Mild complications including suture detachment and corneal edema appeared after 2.5 to 5.5 days while corneal epithelial cysts and ocular edema occurred at 22 to 42 days after surgery. Therefore, this method could be used in treatment of corneal ulcers, particularly in cases of deep ulcers or corneal perforations that required to directly connect to blood vessels.

Natural and Synthetic Drugs Approached for the Treatment of Recurrent Aphthous Stomatitis Over the Last Decade.

Recurrent aphthous stomatitis (RAS) refers to a sore and frequently recurring inflammation of the oral tissues, distinguished by the presence of small ulcers that cause significant discomfort and cannot be attributed to any underlying disease. Different treatments have been used for RAS. This review aims to provide a comprehensive overview of the treatment options over the past decade for recurrent aphthous stomatitis (RAS), encompassing both natural and synthetic treatments. It will utilize clinical efficacy studies conducted in vivo and in vitro, along with a focus on the pharmaceutical approach through advancements in drug delivery development. We conducted a thorough literature search from 2013 to 2023 in prominent databases such as PubMed, Scopus, and Cochrane, utilizing appropriate keywords of recurrent aphthous stomatitis, and treatment. A total of 53 clinical trials with 3022 patients were included, with 35 using natural materials in their research and a total of 16 articles discussing RAS treatment using synthetic materials. All the clinical trials showed that natural and synthetic medicines seemed to benefit RAS patients by reducing pain score, ulcer size, and number of ulcers and shortening the healing duration.

The role of traditional Chinese medicine in postoperative wound complications of gastric cancer.

Due to the high risks of postoperative complications brought on by gastric cancer, traditional Chinese medicine (TCM) as a commonly used therapy, has exerted its vital role in postoperative recovery care. In this sense, this meta-analysis was conducted to explore the related documents about TCM's impact on gastric cancer postoperative recovery. During the research, we explored a total of 1549 results from databases PubMed, China National Knowledge Infrastructure (CNKI), Embase, Cochrane Library and Web of Science (WoS). Thirty-two clinical randomized trials (RCTs) were then selected and analysed for this meta-analysis by using the software RevMan 5.4 (under PRISMA 2020 regulations), with a population of 3178 patients. Data prove that TCM therapy reduced the risks for postoperative complications exposure by an estimated average of 19% (95% CI). Among the complications, TCM therapy suppressed the risks of wound infection and incisional infections by 53% and 48% respectively. Meanwhile, the patient's wound healing duration exhibited a significant reduction compared to those without TCM treatment, with a difference at around 0.74 days (95% CI). TCM also exerted its potential to strengthen the patient's immune and health conditions, leading to a significantly promoted gastrointestinal function in the patients with a shorter duration to release first exhaustion and defecation compared to those with no TCM therapy. In addition, similar promoted phenomena also exist in those patients with TCM therapy in terms of their immunity and nutritional conditions. These facts all indicate a positive impact of TCM therapy in clinical applications.

THE EFFECT OF LOCAL ANESTHESIA ON HEALING TIME PERINEUM WOUNDS ON NIFAS' MOTHER AT PMB NUNUNG TANGERANG

Background: WHO in 2020, stated that maternal deaths during pregnancy, childbirth and postpartum were 295,000 worldwide. Africa, Sub-Saharan and South Asia account for about 86%. Meanwhile, the maternal mortality rate in Indonesia in 2020 is 230 per 100,000 live births. One of the causes of maternal death is bleeding and infection. Suturing perineal tears with anesthesia is one of the maternal care programs, which aims to reduce the pain experienced by mothers during the suturing process of birth canal wounds. Giving anesthesia can also cause damage to the immune system which results in a decrease in body resistance so that there will be a lengthening of wound healing 2-3 days than without anesthesia. Research Objective: Knowing the administration of local anesthesia on the healing duration of perineal wounds in puerperal mothers. Research Method: Quasi-experiment with post-test group design. The samples in this study were all postpartum mothers who experienced perineal injuries at PMB Nunung in November-December 2023 as many as 40 people. The sampling technique uses the total sampling technique. Results of the study: The frequency distribution of long healing of perineal wounds in the majority intervention group was slow and in the majority control group was fast. The effect of local anesthesia on the healing time of perineal wounds in puerperal mothers (p. value 0.000). Conclusion and Suggestion: The effect of local anesthesia on the healing time of perineal wounds in puerperal mothers. It is expected that midwives provide counseling to postpartum mothers to properly care for perineal wounds and eat nutritious foods to accelerate the healing of perineal wounds.

Emerging Insights into Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis Induced by Immune Checkpoint Inhibitor and Tumor-Targeted Therapy.

Anticancer drugs have revolutionized tumor therapy, with cutaneous toxicities such as Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) being common immune-related adverse events. The debate over the efficacy of systemic corticosteroids in treating these conditions persists, while tumor necrosis factor (TNF)-alpha inhibitors show promise. This study aims to evaluate the effectiveness and safety of combination therapy involving the TNF-α inhibitor adalimumab for SJS/TEN induced by anticancer drugs. A literature review of SJS/TEN cases induced by anticancer drugs from 1992 to 2023 was conducted, alongside an analysis of patients admitted to the First Affiliated Hospital of Fujian Medical University during the same period. Clinical characteristics, skin healing time, mortality, and adverse events were evaluated in two treatment groups: SJS/TEN patients treated with targeted anticancer therapies and immunotherapies. Among the 27 patients studied (18 with SJS or SJS-TEN overlapping and 9 with TEN), combination therapy with adalimumab significantly reduced mucocutaneous reepithelization time and healing duration compared to corticosteroid monotherapy. Patients receiving adalimumab combined with corticosteroids had lower actual mortality rates than those on corticosteroid monotherapy. The combination therapy also showed a trend towards reducing standardized mortality rates based on the Score of Toxic Epidermal Necrolysis (SCORTEN). The findings suggest that adalimumab in combination with corticosteroids provides significant clinical benefits and is safer than corticosteroids alone for treating SJS/TEN induced by targeted anticancer therapies and immunotherapies. This study contributes valuable insights into potential treatment strategies for severe cutaneous adverse reactions to anticancer drugs, highlighting the importance of exploring alternative therapies such as TNF-α inhibitors in managing these conditions effectively.

FEATURES OF CLINICAL AND LABORATORY PRESENTATIONS OF PURULENT SURGICAL DISORDERS AFFECTING SOFT TISSUES IN THE CONTEXT OF DIABETES MELLITUS AND DIFFUSE TOXIC GOITER

In the context of concurrent endocrine conditions such as diabetes mellitus and diffuse toxic goiter, managing patients with purulent surgical soft tissue diseases presents notable challenges. This study aimed to explore the clinical characteristics of purulent surgical soft tissue diseases in the presence of diabetes mellitus and the combination of diffuse toxic goiter. Patients were divided into two groups: Group I comprised individuals with purulent surgical soft tissue diseases and diabetes mellitus, while Group II included patients with purulent surgical soft tissue diseases alongside a combination of diabetes mellitus and diffuse toxic goiter. The examination of patients with purulent-necrotic soft tissue diseases alongside comorbidities like diabetes mellitus and diffuse toxic goiter revealed distinct features in the wound healing process: parameters related to organism intoxication, wound cleansing, and healing duration tended to normalize at a slower pace in Group II compared to Group I, with a lag of approximately 2 days. Theaverage duration of bed rest for Group II was 10 ± 1.4 days, whereas in Group I, it was 8 ± 1.5 days.

Dealing With Pericylindrical Melts in Keratoprosthesis: Tenon Patch Graft to the Rescue.

The aim of this study was to describe the outcomes of autologous Tenon patch graft in the management of Auro keratoprosthesis-related pericylindrical corneal melt. We report 3 cases of sterile pericylindrical corneal melt in patients with Auro keratoprosthesis implantation after a mean duration of 5 years (1.5-8 years). Case 1 was a patient with severe graft-versus-host disease. Cases 2 and 3 were cases of chemical injury.All these cases of sterile pericylindrical corneal melt (4-6 mm) underwent autologous Tenon patch graft. The technique included freshening of the edges around the melt, followed by measuring the size of the defect. A Tenon graft harvested from the patient's own eye was used to seal the defect and act as a scaffold. The Tenon patch graft was spread over the melt and held in place by the application of fibrin glue and/or interrupted 10-0 nylon sutures. A bandage contact lens was then placed on the eye. Tenon patch graft was well taken in all patients. The mean duration of epithelial healing was 1 month. Globe integrity was well maintained with no postoperative complications at a mean follow-up duration of 12 months (6-18 months). Corneal melt is one of the most dreaded complications of KPro because its occurrence could threaten visual prognosis and globe integrity. Autologous Tenon patch is a simple yet innovative and effective option to steer such eyes away from potentially dreadful complications.

Road Performance and Self-Healing Property of Bituminous Mixture Containing Urea-Formaldehyde Microcapsules.

Urea-formaldehyde (UF) is a common shell material for self-healing microcapsules; however, the influence of urea-formaldehyde microcapsules (UFMs) on the road performance of bituminous mixtures and the sensitivity of their healing abilities remains unclear. In this paper, UFMs were prepared via in situ polymerization (ISP), followed by an investigation into the road performance of UFM self-healing bituminous mixtures through various tests, including wheel tracking, immersed Marshall, freeze-thaw splitting, low-temperature bending, and three-point bending fatigue tests. Subsequently, the impact of the damage degree, healing duration, and temperature on the self-healing property was discussed. The results indicated that incorporating 3 wt% UFMs into bitumen significantly improved the high-temperature stability and fatigue resistance of the bituminous mixture; for example, its dynamic stability and fatigue life could be increased by about 16.5% and 10%, respectively. However, it diminished the thermal crack resistance, as evidenced by decreases in bending tensile strength and strain by 3.7% and 10.1%, respectively. And it did not markedly improve the moisture susceptibility. Additionally, the maximum improvement observed in the healing rate was about 9%. Furthermore, the healing duration and temperature positively influenced the bituminous mixture's self-healing, whereas the degree of damage exerted a negative impact, with a relatively significant effect.

Shoelace and honey technique: An innovative and inexpensive method of wound healing

Wound closure and wound infection have been a great enemy to orthopaedic surgeons since the beginning of time. Many wound closure technique have been described and controversy exists as a optimal method. Healing by secondary intension used to be commonly employed technique but less popular nowadays. Most wound closure require split skin thickness grafting which increases morbidity and scarring and additional wound at donor site .gradual mechanical dermal apposition technique that is shoelace technique have gained popularity and have shown to be effective in closure of wounds .Shoelace technique for wound closure is widely used in other medico-surgical specialties, this technique is unusual in orthopedics surgery, but the simplicity of the procedure, demanded us to follow to our cases.Honey is most ancient wound dressing biomaterial .Honey is known for its anti-oxidant, anti-bacterial and anti-inflammatory properties which were used for better and faster wound healing. Both the methods combined together make it a magic formula for the wound healing.We have 21 patients presenting to VDGMC, LATUR from a period from May 2020 to December 2023, with difficult primary wound closure were included in the study. The patients underwent the surgical fracture fixation (if any), followed by application of shoelace technique and honey dressing for the patient. An infant feeding tube and skin staples were used for the technique. Patients were followed till the complete wound healing occurred. The average time required for the wound healing using this technique was 3.2 weeks. Once the skin was approximated by dermatotraction, delayed primary suturing was done and regular dressing protocol was followed.Our study showed an excellent wound healing in 20 cases with duration of wound healing less den 3 weeks, which also waived of the need for an extra procedure of skin grafting. 1wound had continuous wound discharge which needed an extra debridement procedure longer duration for closure.The successful out-come observed in these cases, and at a very low cost, allows for its consideration as indicated for situations similar to that presented in this study, especially in patients with poor economic background.

Faktor-Faktor yang Berhubungan dengan Lama Penyembuhan Laserasi Perineum Ibu Nifas Di Puskesmas Singotrunan-Banyuwangi

Perineal wound at the puerperium can be caused by episiotomy and lacerations during childbirth at the first labour or more. Factors that cause perineal lacerations are parity, birth spacing, breathing and pushing technique at giving birth, maternal age. fetal presentation and weight. The classification of wound healing perineum laceration is divided into 3 phases, firts is inflammatory phase (24 hours-48 hours), poliferation phase (48 hours-5 days), and the maturation phase (5 days and more). The purpose of this study was to analyze the factors associated with the healing time of perineal laceration wounds in puerperal mothers. This research method is quantitative with a cross sectional design of 34 respondents with total sampling techniques.This research was conducted at desember 2022-Januari 2023 at Singotrunuan Village, Subdistric Banyuwangi. Independent variables are patterns of nutritional fulfillment, personal hygiene, and early mobilization. The dependent variable is the healing of perineal laceration wounds. The collection data is using questionaire and analyzed using Chi Square statistical test. The results of the study found that there was a correlation between personal hyegiene, early mobilization, and nutritional fulfillment patterns with the duration of healing of perineal laceration wounds at the puerperal mother with p sig value of <0.005.It is hoped that this study can add insight and knowledge to postpartum mothers with perineal laceration wounds about factors that affect the healing time of perineal laceration wounds.

Risk Factors for Non-Healing Wounds-A Single-Centre Study.

Background: Chronic wounds present a significant clinical, social, and economic challenge. This study aimed to objectify the risk factors of healing outcomes and the duration of chronic wounds from various etiologies. Methods: Patients treated for non-healing wounds at the surgical outpatient clinic of the Olomouc Military Hospital were involved. Data from patients treated between 8/2021 and 9/2023 were selected. Patients were mostly treated as outpatients, with microbiological follow-up indicated in cases of advanced signs of inflammation. Results: There were 149 patients who met our selection criteria (the mean age was 64.4 years). Predominant causes of wounds involved diabetes (30.9%), post-trauma (25.5%), pressure ulcers (14.8%), surgical site infections (14.8%), and vascular ulcers (14.1%). Patient outcomes included wound resolution in 77.2% of patients (with a mean healing time of 110.9 days), amputation in 14.1%, and wound-related death in 8.7% of patients. Non-healing cases (amputation/death) were predicted by several local factors including an initial depth greater than 1 cm, wound secretion, inflammatory base, and a maximum wound size. Systemic factors included most strongly clinically manifested atherosclerosis and its risk factors. Of the 110 swabs performed, 103 identified at least 1 bacterial genus. The dominant risk factor for a prolonged healing duration was bacterial infection. Wounds contaminated by Proteus or Pseudomonas had prolonged healing times of 87 days (p = 0.02) and 72 days (p = 0.045), respectively. Conclusions: The early identification of local and systemic risk factors contributes to the successful resolution of chronic wounds and a reduced duration of healing.

Evaluation of Clinical Outcomes of Negative-Pressure Wound Therapy in Gustilo-Anderson Type IIIA/IIIB Open Fractures of Extremities.

Background Open fractures are common and serious injuries that primarily affect young males. Fracture management has improved in the last decade. However, infections with their complications are still a concern, especially in open fractures for primary closure of the injured area. A newer technique called vacuum-assisted therapy has become a therapy of choice for many orthopedic surgeons. This study aimed to determine whether vacuum-assisted closure reduces the duration of wound healing and the frequency of infections after fixation of Gustilo-Anderson Type IIIA/IIIB fractures of the extremities. Methodology An observational analytical study was conducted among 34 patients with Gustilo-Anderson Type IIIA/IIIB fractures of the limbs who presented to the Department of Orthopaedics, R. L. Jalappa Hospital, Kolar, from December 2019 to July 2021. Negative-pressure wound therapy was employed for wound closure after fixation of fractures. Patients were followed up for one month. Results The mean age of the patients was 37.06 ± 10.340 years. The prevalence of infection before vacuum-assisted closure dressing was 80.6%, and the prevalence of infection after vacuum-assisted closure dressing was 19.4%. The difference in proportion before versus after the intervention was statistically significant (p < 0.001) according to the McNemar Test.Hence, vacuum-assisted closure dressing decreased the rate of infection. The mean dimension of the wound before vacuum-assisted closure therapy was 66.05 cm2 and the mean dimension of the wound after vacuum-assisted closure therapy was 27.97 cm2. The difference in the mean before and after the intervention was statistically significant according to the paired t-test (p < 0.001). Hence, vacuum-assisted closure dressing helped decrease the wound size which was proven statistically. Conclusions Vacuum-assisted closure is a viable and beneficial treatment option for complicated fractures with large soft-tissue abnormalities.

Healing Process after High-Intensity Focused Ultrasound Treatment of Benign Skin Lesions: Dermoscopic Analysis and Treatment Guidelines.

Background: High-Intensity Focused Ultrasound (HIFU) has emerged as a precise and non-invasive modality for tissue ablation and healing. This study presents a detailed dermoscopic analysis of skin healing post-High-Intensity Focused Ultrasound (HIFU) treatment, focusing on common benign skin lesions, such as seborrheic keratosis, sebaceous hyperplasia, vascular lesions, and sebaceous nevi. Methods: Prior to HIFU treatment, a comprehensive assessment was conducted, integrating ultrasound scanning and clinical evaluations. The TOOsonix System ONE-M was employed for HIFU treatments, with parameters tailored to each lesion type. Results: A common pattern observed across all lesions includes initial whitening post treatment, followed by scab formation and the development of a pink area with reparative vessels. This study, however, highlights distinct differences in fibrosis patterns and healing timelines across different lesion types. Each lesion type exhibited unique fibrosis patterns post treatment. Flatter variants of seborrheic keratosis healed within a month, displaying hypopigmentation and reparative vessels, alongside a distinct lattice fibrosis pattern in more verrucous forms, which took about two months to heal. Sebaceous hyperplasia, characterized by rapid healing within three weeks, demonstrated fibrosis with pink areas and perpendicular white lines, concluding with a slight depression. Vascular lesions varied in healing time based on depth, with superficial ones showing whitening and crust formation, while deeper lesions had vessel occlusion and size reduction accompanied by concentric fibrotic bands. Sebaceous nevi presented the longest healing duration of three months, characterized by amorphous white-gray structures, scab formation, and the emergence of pink areas with branching vessels, leading to clear skin with reduced white lines. Conclusions: in conclusion, this meticulous clinical evaluation highlights the unique healing characteristics and timelines for each skin lesion type treated with HIFU. These insights are invaluable for optimizing follow-up assessments, identifying potential complications, and refining treatment protocols. By providing detailed insights into the healing timelines and patterns for different types of lesions, patients can be better informed about their post-treatment journey.