Incisional Wound Research Articles

The Effect of Andaliman Fruit Extract on the Incision Wound Healing the Wistar Male White Rats and Collagen Type III

The extract of andaliman fruit has antimicrobial activity. The active compounds of andaliman fruit are believed to positively contribute to human health, one of which is flavonoids, which can improve the wound healing process because of their function as an antioxidant and anti-inflammatory. This study aims to determine the effect of giving ethanol extract of andaliman fruit on the healing process of incision wounds in Wistar strain white rats and collagen type III. This research is an experimental posttest-only controlled group design. This study used five groups: NaCL treatment, betadine treatment, 1% andaliman ethanol extract treatment, 3% andaliman ethanol extract treatment, and 5% andaliman ethanol extract treatment, where each group had six rats. Data analysis used normality tests, homogeneity tests, and ANOVA tests. The results showed that the ethanol extract of andaliman fruit contains several active compounds such as alkaloids, saponins, tannins, and glycosides. The fastest incision wound healing was the fourth test group, the test group with 3% andaliman fruit ethanol extract treatment on day 14, with an average length of incision wound healing of 3.44mm. The 3% andaliman ethanol extract had the potential to accelerate wound healing activity.

Can we use superglues for superfi cial lacerations?

Objectives: To compare the histopathological and cosmetic outcomes of ethyl-cyanoacrylate to n-butyl-2-cyanoacrylate in rats using an incision wound model. Methods: Two longitudinal incisions were made on the dorsal region of the back of 18 Wistar rats after ketamine anesthesia. Rats were divided into three groups of six: the incisions were closed either using medical tissue adhesive or superglue or were left for secondary wound healing. In each group, three rats were randomly euthanized on the 7th day. The rest were euthanized on the 21st day of the procedure. Tissue samples taken on days 7 and 21 were Histopathologically evaluated blindly by a histologist. The cosmetic appearance was evaluated by a plastic surgeon blinded to the method of closure using a visual analog scale. Results: Histopathological evaluation revealed impaired epithelialization, infl ammation, fi brosis, and dehiscence on connective tissue, and foreign substance reactions were worse in the ethyl-2-cyanoacrylate group when compared with the other groups. A statistically signifi cant diff erence was not found among groups regarding the cosmetic outcome. Conclusions: Cyanoacrylate glues produced for commercial purposes should not be used for the repair of skin lacerations due to their worse histopathological results of epithelialization, infl ammation, fi brosis, dehiscence on connective tissue, and foreign substance reaction. Keywords: Lacerations, Wound closure techniques, Tissue adhesives, Cyanoacrylates, Wound healing.

Increase of Fibroblast Cells in Wound Healing of Diabetes Mellitus Male Rats (Rattus Norvegicus) Using Aloin

The healing process wound on the skin diabetic experience slowdown because dysfunction fibroblasts. Aloins boost expression fibroblasts that can accelerating the process of wound healing in patients with Diabetes Mellitus (DM). Objective study that is for now effect enhancement cell fibroblasts in wound healing wound I t mouse male DM with aloe giving. Method study use principle true experimental with approach post-test serial only control group design. Treatment form wound cut on mice. Group study using 4 groups with a negative control in the form mouse healthy, positive control form DM mouse. group action 1 in the form of DM rats were given 1.25 mg/ kg BW aloin and treatment 2 was in the form of DM rats given 2.5 mg/ kg BW aloin. Expression fibroblasts calculated on day 7 and day 14. Analysis bivariate using the Friedman test continued with the Wilcoxon Post- Hoc test. Research results that are there is enhancement fibroblasts significant in the group treatment given with aloein a dose of 1.25 mg/ kg and a dose of 2.5 mg/ kg. The conclusion is that Aloin accelerates wound healing wound incision in DM rats with mechanism enhancement expression fibroblasts with minimum dose of 1.25 mg/ KgBB. Research suggestions that is examination of re- epithelialization and density Dermal collagen in wound healing wound I t DM rats given aloein in the study next.

Utilisation of Snails for Wound Healing: A Review

Snails exhibit remarkable adaptability, allowing them to flourish in diverse environmental conditions and resulting in thriving populations in specific regions. This abundance has led communities to harness snails for various purposes, including their use as animal feed, daily dietary source, and in traditional wound-healing practices with historical roots. The primary objective of this systematic review is to identify the snail species commonly employed in wound healing and evaluate the bioactivity of compounds derived from different snail species. This review was conducted using literature review method, drawing from international databases such as Scopus, and encompassed publications from 2013 to 2023. A total of 22 articles met the inclusion and exclusion criteria. Snail body parts that have been explored for wound-healing purposes include both the body and the shell, along with snail secretions, particularly their mucus. Various methods have been employed to extract mucus, involving manual stimulation of the snail's body, spraying with a saline solution (NaCl), application of electric shock, and the use of ozone gas through nebulisation. Prominent snail species found to be beneficial for wound healing include Achatina fulica, Helix aspersa, Eobania desertorum, Helix lucurus, Cornu bistrialis, Theba pisana, and Megalobulimus lopesi. These snail species demonstrate potential applications in the treatment of burns, excision wounds, incision wounds, and diabetic ulcers. Key compounds within snail secretions encompass mucopolysaccharides, polyphenols, peptides, and glycosaminoglycans. These compounds exert significant effects on haemostasis, inflammation control, cellular proliferation, and re-epithelialisation, significantly contributing to the wound healing process.

Topical Application of Cha-Koji, Green Tea Leaves Fermented with Aspergillus Luchuensis var Kawachii Kitahara, Promotes Acute Cutaneous Wound Healing in Mice

“Koji” is one of the most well-known probiotic microorganisms in Japan that contribute to the maintenance of human health. Although the beneficial effects of some probiotics on ulcer healing have been demonstrated, there have been no reports on the wound healing effects of koji to date. In the present study, we investigated the effects of “cha-koji”, green tea leaves fermented with Aspergillus luchuensis, on cutaneous wound healing, using a linear incision wound mouse model. Topical application of autoclave-sterilized cha-koji suspension on the dorsal incision wound area healed the wound significantly faster and, notably, with less scarring than did the green tea or the control distilled water treatment. Further in vitro experiments revealed that the accelerated effects of cha-koji could be attributed to its increased anti-bacterial activity, enhanced epidermal cell proliferation and migration, augmented expression of the anti-inflammatory cytokine transforming growth factor-β1, reduced expression of inflammatory cytokine interleukin-6 in macrophages, and decreased endoplasmic reticulum stress. In addition, we conducted a skin sensitizing potential test, which revealed that cha-koji had no adverse effects that posed a sensitizing risk. Thus, cha-koji may have a potent therapeutic effect on cutaneous wound healing, opening up a new avenue for its clinical application as a medical aid.

Zinc-Alpha-2-Glycoprotein Peptide Downregulates Type I and III Collagen Expression via Suppression of TGF-β and p-Smad 2/3 Pathway in Keloid Fibroblasts and Rat Incisional Model.

Keloids and hypertrophic scars result from abnormal collagen accumulation and the inhibition of its degradation. Although the pathogenesis remains unclear, excessive accumulation of the extracellular matrix (ECM) is believed to be associated with the TGF-β/SMAD pathway. Zinc-alpha-2-glycoprotein (ZAG) inhibits TGF-β-mediated epithelial-to-mesenchymal transdifferentiation and impacts skin barrier functions. In this study, we investigated the potential of a small ZAG-derived peptide against hypertrophic scars and keloids. The study examined cell proliferation and mRNA expression of collagen types I and III in human dermal fibroblast (HDF) cell lines and keloid-derived fibroblasts (KF) following ZAG peptide treatment. A rat incisional wound model was used to evaluate the effect of ZAG peptide in scar tissue. Significantly lower mRNA levels of collagen types I and III were observed in ZAG-treated fibroblasts, whereas matrix metalloproteinase (MMP)-1 and MMP-3 mRNA levels were significantly increased in HDFs and KFs. Furthermore, ZAG peptide significantly reduced protein expression of collagen type I and III, TGF-β1, and p-Smad2/3 complex in KFs. Rat incisional scar models treated with ZAG peptide presented narrower scar areas and reduced immature collagen deposition, along with decreased expression of collagen type I, α-SMA, and p-Smad2/3. ZAG peptide effectively suppresses the TGF-β and p-Smad2/3 pathway and inhibits excessive cell proliferation during scar formation, suggesting its potential therapeutic implications against keloids and hypertrophic scars.

Nursing outcome "Knowledge: Wound management" for surgical incision wound care: Update, translate, and culturally adapt.

This study has two objectives: (1) to identify the indicators of the nursing outcome "Knowledge: Wound management (3209)" related to the evaluation of knowledge about the care of surgical wounds; (2) to translate and culturally adapt the nursing outcome "Knowledge: Wound management (3209)" into Brazilian Portuguese and Colombian Spanish. This is a methodological study with two steps. Initially, a scoping review was conducted based on the methodology of the Joanna Briggs Institute. Subsequently, the translation and cultural adaptation of the outcome were performed by adapting Beaton's recommendations, which included the label, definition, indicators, and measurement scale. The review identified 31 indicators to evaluate knowledge about surgical wound care. Of these, 16 are described in the original outcome, and 15 new indicators are proposed to be included in the classification. Following this, the label, definition, indicators, and outcome measurement scale were reviewed, translated, and adapted with appropriate terminology for the cultural contexts of Brazil and Colombia. The outcome "Knowledge: Wound management (3209)" for evaluating the knowledge of surgical wounds consists of 31 indicators, all supported by scientific literature. The translated and adapted versions into Brazilian Portuguese and Colombian Spanish were found to be equivalent to the original. It is inferred that the identified indicators and the translated versions of the outcome will provide nursing professionals with an accurate assessment of knowledge about surgical incision wound care in daily practice. This study reviews the scientific literature on the outcome "Knowledge: Wound management (3209)," facilitating the comprehensive measurement of specific knowledge about the care of surgical wounds in practice, education, or research. Additionally, it makes available the translated and adapted versions of the outcome in Brazilian Portuguese and Colombian Spanish. PROPÓSITO: Este estudio tiene dos objetivos: (1) Identificar los indicadores del resultado de enfermería "Knowledge: Wound Management (3209)" relacionados a la evaluación del conocimiento sobre el cuidado de las heridas quirúrgica; (2) traducir y adaptar culturalmente el resultado de enfermería "Knowledge: Wound Management (3209)" al portugués de Brasil y al español de Colombia. MÉTODOS: Estudio metodológico de dos pasos. Inicialmente, fue realizada una revisión de alcance orientados en la metodología de la Joanna Briggs Institute. Posteriormente, se realizó la traducción y adaptación cultural del resultado adaptando las recomendaciones de Beaton e incluyó la etiqueta, definición, indicadores y escala de medición. En la revisión fueron identificados 31 indicadores para evaluar el conocimiento sobre el cuidado de las heridas quirúrgicas. De los 31 indicadores, 16 son descritos en el resultado y 15 nuevos indicadores propuestos para ser incluidos en la clasificación. A continuación, la etiqueta, definición, indicadores y escala de medición del resultado fueron revisados, traducidas y adaptados con la terminología adecuada para los entornos culturales de Brasil y Colombia. CONCLUSIÓN: El resultado "Knowledge: Wound Management (3209)" para el cuidado de las heridas quirúrgicas está compuesto por 31 indicadores todos sustentados con la literatura científica. Las versiones traducidas y adaptadas al portugués de Brasil y al español de Colombia del resultado fueron equivalentes al original. Se infiere que los indicadores identificados y las versiones traducidas del resultado le proporcionaran al profesional de enfermería una evaluación precisa del conocimiento sobre el cuidado de las heridas quirúrgicas en la práctica diaria. IMPLICACIONES PARA LA PRÁCTICA DE ENFERMERÍA: Este estudio revisa la literatura científica del resultado "Knowledge: Wound Management (3209)" favoreciendo la medición integral del conocimiento específico sobre el cuidado de las heridas quirúrgicas en la práctica, educación o investigación. Además, pone a disposición la versión traducida y adaptada del resultado en portugués de Brasil y en español de Colombia.

The use of incisional negative pressure wound therapy on high-risk breast cancer mastectomy patients

BackgroundThe main complications seen in patients who have undergone modified radical mastectomy (MRM) are seroma, surgical site infection, hematoma, wound dehiscence, flap necrosis, and nerve damage. While these complications lead to some problems the most feared effect in the early period is that they cause a delay in adjuvant treatment. Incisional Negative Pressure Wound Therapy (iNPWT) decreases wound dehiscence by reducing oedema and tension, especially in the incision line. This study aim to compare recovery times and wound site complications between patients treated with conventional wound dressings and patients treated with iNPWT after MRM. MethodsA retrospective screening was made of the data of 50 patients who underwent MRM because of breast cancer in the General Surgery Clinic of XXX Hospital between 2018 and 2022, and were at high-risk of wound site complications. Two groups were formed as 30 patients applied with iNPWT and 20 patients applied with conventional dressings. ResultsThe mean age of the 50 female patients was 53.58 years (range, 30–80 years). The most frequently seen complications were seroma (20 patients) and partial flap ischaemia (14 patients). The mean number of iNPWT applications was 1.30 (range, 1–2), and the mean number of days of application was 4.47 (range, 2–9). Postoperative seroma was observed in 8 patients in the iNPWT group and in 12 patients in the conventional dressings group (p = 0.018). Flap ischaemia and the probability of dehiscence was determined at a statistically significantly higher rate in the patients in the conventional dressings groups (p = 0.005, p = 0.021). ConclusionThe results of this study demonstrated that the use of iNPWT significantly reduced the amount of postoperative drainage, thereby contributing to early drain removal. Furthermore, iNPWT significantly reduced postoperative seroma, flap ischaemia, and flap dehiscence compared to conventional dressings.

Therapeutic potential of cannabis for surgical wound healing in rats.

This study was conducted to evaluate the wound-healing activities of a Cannabis sativa L. plant extract and cannabidiol on incision wounds. An incision was created and sutured in rats under anaesthesia. Routine wound care procedures were applied for 10 days, followed by histological wound examinations. The cellular bioactivities of the hemp extract and CBD were assessed for MCP-1, EGF, BFGF, IL-8, and COL-1 using ELISA on the rat skin wound healing activity. A one-way ANOVA was used for the data analysis. The EGF values in the plasma were similar in the povidone-iodine, hemp seed oil, and hemp essential oil groups (P > 0.05). However, the EGF levels were lower in the CBD group compared to the other groups (P < 0.001, P < 0.005). The MCP-1 values in the hemp seed oil, hemp essential oil, and CBD were similar (P > 0.05), whereas povidone iodine exhibited lower MCP-1 levels compared to the other groups (P < 0.001, P < 0.005). It was determined that the plasma BFGF, IL-8, and COL 1 values of the groups were similar (P > 0.05). To our knowledge, this study is the first to evaluate the effects of CBD, seed oil, and hemp leaf extract on incision wound healing. It demonstrates that hemp extract holds greater potential benefits for wound healing compared to CBD.

A PROSPECTIVE, RANDOMIZED STUDY COMPARING THE ANALGESIC EFFICACY OF SCALP BLOCK WITH 0.25% BUPIVACAINE VS PRE-INCISIONAL LOCAL INFILTRATION WITH 0.25% BUPIVACAINE WITH ADRENALINE (1:400,000) IN PATIENTS UNDERGOING ELECTIVE CRANIOTOMIES

Background and Aims: Pain is often referred to as the fifth vital sign. Pain management in patients undergoing craniotomies pose a great challenge to the anaesthesiologists. Scalp block forms an important aspect in the multimodal approach to the post-craniotomy pain. The following study compares the analgesic efficacy of Scalp block with traditionally used local wound infiltration technique in providing analgesia to craniotomy patients. Methods: Performed double blinded, prospective, randomized controlled trial on 60 patients undergoing elective craniotomies divided into 2 groups comparing the analgesic efficacy of Scalp block with 0.25% Bupivacaine vs Pre- incisional wound infiltration with 0.25% Bupivacaine with Adrenaline (1:400,000). Results:There were significant differences in intra-operative hemodynamics between the two groups. Scalp block resulted in statistically significant reduction in HR, SBP, DBP &amp; MAP. There was increased duration of post-operative analgesia in scalp block group when compared with the local infiltration group. The opioid requirement in the intra-operative period was significantly lesser in scalp block group when compared with the local infiltration group. Requirement of rescue analgesic is significantly lesser during early post-operative period (Upto 8 hours) in the scalp block group when compared with local infiltration group. Conclusion :Scalp block with 0.25% Bupivacaine is effective and superior to Pre-incisional Local infiltration with 0.25% Bupivacaine with 1:400,000 Adrenaline in attenuating hemodynamic responses, providing increased duration of post-operative analgesia, significant reduction in intra-operative opioids and post-operative rescue analgesic requirements.

Daily crowding stress has limited, yet detectable effects on skin and head kidney gene expression in surgically tagged atlantic salmon (Salmo salar)

To ensure welfare-friendly and effective internal tagging, the tagging process should not cause a long-term burden on individuals given that tagged fish serve as representatives for the entire population in telemetry applications. To some extent, stress is inevitable within regular aquaculture practices, and thus, the consequences of long-term stress should be described in terms of their effects on internal tagging. In fish, stressors activate the Hypothalamus-Pituitary-Interrenal (HPI) and Brain-Sympathetic-Chromaffin Cell (BSC) axes, leading to neuroimmunoendocrine communication and paracrine interactions among stress hormones. The interrelation between wound healing and stress is complex, owing to their shared components, pathways, and energy demands. This study assessed 14 genes (mmp9, mmp13, il-2, il-4, il-8a, il-10, il-12, il-17d, il-1b, tnfa, ifng, leg-3, igm, and crh) in the skin (1.5 cm from the wound) and head kidney over eight weeks. These genes, associated with cell signaling in immunity, wound healing, and stress, have previously been identified as influenced and regulated by these processes. Half of a group of Atlantic salmon (n = 90) with surgically implanted dummy smart-tags were exposed to daily crowding stress. The goal was to investigate how this gene panel responds to a wound alone and then to the combined effects of wounding and daily crowding stress. Our observations indicate that chronic stress impacts inflammation and impedes wound healing, as seen through the expression of matrix metalloproteinases genes in the skin but not in the head kidney. This difference is likely due to the ongoing internal wound repair, in contrast to the externally healed wound incision. Cytokine expression, when significant in the skin, was mainly downregulated in both treatments compared to control values, particularly in the study's first half. Conversely, the head kidney showed initial cytokine downregulation followed by upregulation. Across all weeks observed and combining both tissues, the significantly expressed gene differences were 12 % between the Wound and Stress+ groups, 28 % between Wound and Control, and 25 % between Stress+ and Control. Despite significant fluctuations in cytokines, sustained variations across multiple weeks are only evident in a few select genes. Furthermore, Stress+ individuals demonstrated the most cytokine correlations within the head kidney, which may suggest that chronic stress affects cytokine expression. This investigation unveils that the presence of stress and prolonged activation of the HPI axis in an eight weeklong study has limited yet detectable effects on the selected gene expression within immunity, wound healing, and stress, with notable tissue-specific differences.

Wound Healing Effectiveness of Berberis baluchistanica and Daphne oleoides Extracts Native to Pakistan

Traditionally in Turkish medicines, Berberis baluchistanica and Daphne oleoides plant are used for the treatment of rheumatism, fever, lumbago, gonorrhea, boils, snake bite antidote, piles, hemorrhoids, as laxative, ulcers and wound healing. The study objective was based on the scientific investigation of traditional claim of wound healing potential of both these wild plants extract in healthy inbreed male albino rats. The wound healing activity of both the extracts was evaluated by adopting excision and incision wound models with a topical dose of 100 mg/kg b.w /day. Wound healing process effectiveness was assessed by measuring wound contraction and epithelization period, measurement of tensile strength of healing skin and histopathological studies of granulating tissue. D. oleoides roots crude methanolic extract (CME) encouraged pronounced wound repairing process in both adopted wound models. In this case, boosted wound retrenchment rate (P &lt; 0.001), shrinkage of epithelialization period (10.13 ± 0.11), high skin disintegration strength (410.0 ± 1.8) and remarkable enhanced granulation tissue weight (P &lt; 0.001) were experienced in albino rats. As well as the granulation tissue histological examination exhibited more collagen with reduced inflammatory cells number propagation versus control. In B. baluchistanica stems CME treated animals, wound contraction, and granulation tissue content were not much prevailed being (P &lt; 0.05) moderately high. The histology of the granulation tissue disclosed greater number of inflamed cells with less collagen than the D. oleoides treated animals. However, it was more amplified compared to control group. The collective research data emphasized that D. oleoides possesses significant wound management activity versus B. baluchistanica, furthermore both extracts rationalize the traditional claim to cure wounds and can be utilized in different wound healing therapies in human beings as well.

Effect of macrophages combined with supernatant of mesenchymal stem cell culture and macrophage culture on wound healing in rats

Wound healing is an orderly sequence of events restoring the integrity of the damaged tissue. It consists of inflammatory, proliferation, and remodeling phases. The objective of the current study was to investigate the effect of local transplantation of cultured macrophage loaded with mesenchymal stem cell/macrophage culture supernatants on wound healing. Sixty-four healthy adult male Wistar rats were randomized into 4 groups of sixteen animals each: 1) SHAM group. 2) MAC-MSC/SN group: One-milliliter application of a mixture comprising mesenchymal stem cell and macrophage culture supernatants in a 1:1 ratio was administered locally to the wound bed. 3) MAC group: Local transplantation of macrophage cells cultured in the wound bed. 4) MAC + MAC-MSC/SN group: Local transplantation of cultured macrophage in combination with mesenchymal stem cell/ macrophage culture supernatants in the wound bed. An incisional wound model was used for biomechanical studies, while an excisional wound model was used for biochemical, histopathological, and planimetric assessments. The wound area was significantly reduced in the MAC + MAC-MSC/SN group compared to other groups (P < 0.05). Biomechanical measurements from the MAC + MAC-MSC/SN group were significantly higher compared to other experimental groups (P < 0.05). Biochemical and quantitative histopathological analyses revealed a significant difference between MAC + MAC-MSC/SN and other groups (P < 0.05). MAC + MAC-MSC/SN showed the potential to improve wound healing significantly. This appears to work by angiogenesis stimulation, fibroblast proliferation, inflammation reduction, and granulation tissue formation during the initial stages of the healing process. This accelerated healing leads to earlier wound area reduction and enhanced tensile strength of the damaged area due to the reorganization of granulation tissue and collagen fibers.

Incisional Negative Pressure Wound Therapy for Wounds in Patients with Lower Intestinal Perforations.

Laparotomy for lower intestinal perforation is associated with a high incidence of surgical site infections. This study aimed to assess whether incisional negative pressure wound therapy (iNPWT) could reduce the incidence of these infections and wound dehiscence in patients with lower intestinal perforation. This single-center prospective study was conducted between September 2019 and July 2022. In the therapy group, wounds were closed with subcuticular sutures, and iNPWT was applied at -120 mmHg for 5 days. A total of 10 days of iNPWT was employed. These patients were compared with a historical control group. The iNPWT group (Group A) comprised 22 patients.The historical control group (Group B) had 65 patients. Table outlines patient characteristics and compares the two study groups. Patient characteristics were demographically similar. The incidence of surgical site infections was lower in the therapy group than in the control group (9.1% vs. 52.3%, p < 0.001). Wound dehiscence was not observed in the therapy group but was noted in three patients (4.6%) in the control group. In univariate and multivariate analysis, an application of the therapy device was associated with reduced incidence of surgical site infections (p < 0.001 and p = 0.002, respectively). The application of iNPWT in patients with lower intestinal perforation was associated with reduced surgical site infections.

Black Soldier Fly (Hermetia illucens L.) Larvae Oil Ointment to Accelerate Incision Wound Healing in Mice

Larvae of the Black Soldier Fly (BSF) are a natural material that has the potential to become a new alternative for accelerating wound healing due to their nutritional content. This study aims to analyze the potential of BSF larvae oil ointment in accelerating the healing of incisional wounds in mice. The study was conducted as an experimental research with six treatments and four repetitions, including a control group without treatment, ointment base, gentamicin ointment, BSF larvae oil ointment at 5% concentration, BSF larvae oil ointment at 10% concentration, and BSF larvae oil ointment at 15% concentration. The parameters observed included the percentage of wound healing, area under the curve (AUC) values, and anti-inflammatory efficacy percentage. The results showed no significant differences between groups based on statistical analysis (P&gt;0.05) for the observed parameters. However, the 5% BSF larvae oil ointment showed a 100% healing percentage on the fourteenth day. Based on AUC values and anti-inflammatory efficacy percentage, the 5% BSF larvae oil ointment had values close to commercial gentamicin ointment. This indicates that treatment with BSF larvae oil ointment, especially at the lowest dose, plays a role in accelerating incisional wound healing and has great potential to be developed as a commercial ointment in the future.

Bioelectronic Sutures with Electrochemical pH‐Sensing for Long‐Term Monitoring of the Wound Healing Progress

AbstractThe physiological pH level at wound sites is one of the fundamental factors for monitoring wound conditions in clinical practice. To continuously assess the wound conditions, a variety of bioelectronic pH sensors are extensively developed. However, despite significant advances in bioelectronics for wound monitoring, the application of existing bioelectronic devices, primarily designed as bandages or patches, remains challenging for monitoring pH levels in deep wounds. Here, a flexible pH‐sensing suture is introduced that can be simultaneously used as both a precise pH sensor for wound monitoring and a conventional medical suture. The electrochemical pH‐sensing suture comprises Au nanoparticle‐based flexible electrodes functionalized with polyaniline for the working electrode and Ag/AgCl for the reference electrode, seamlessly integrated onto a standard medical suturing thread. This dual‐function sensing suture offers a reliable and high sensitivity of 58.9 mV pH−1, negligible hysteresis, high stability, and excellent selectivity in pH sensing. The biocompatibility of the sensing suture is systematically verified for its in vivo use. To demonstrate the capabilities of the pH‐sensing suture, it is successfully applied to an incision and chronic wound model of mouse to perform continuous and accurate monitoring of the inflammation and healing progress of the wound throughout the healing period.

Incisional negative pressure wound therapy (PrevenaTM) vs. conventional post-operative dressing after immediate breast reconstruction: a randomized controlled clinical trial

BackgroundSurgical complications following breast reconstruction remain a significant concern. This study aimed to investigate if incisional negative pressure wound therapy (iNPWT) using Prevena™ provides superior wound treatment for patients undergoing immediate breast reconstruction (IBR) compared to conventional postoperative dressing. Additionally, we investigated whether intraoperative indocyanine green angiography (ICG-A) could predict and prevent postoperative complications.MethodsA randomized controlled study (RCT) comprising 39 patients was conducted. The primary outcome was time until surgical drain removal. ICG-A was applied to evaluate tissue perfusion and compared to rate of postoperative complications. Patients were followed for one year, including postoperative complications, quality of life (QoL), scar evaluation, incidence of lymphedema and timely administration of adjuvant therapy.ResultsNo significant differences were observed in time to surgical drain removal, hospitalization or incidence of postoperative complications between the two groups. Analysis revealed no significant association between ICG-A results and postoperative complications. After one year, both groups exhibited similar QoL and satisfaction with scars. One patient developed lymphedema during follow-up, and adjuvant treatment was timely administered in 82%.ConclusionsThis RCT investigated iNPWT by Prevena™ compared to conventional postoperative dressing in IBR using implants or tissue expanders. ICG-A was applied to assess tissue perfusion and compared to postoperative complications. We did not find any significant differences in recovery time, hospitalization duration, postoperative complication rates, QoL, or scar satisfaction between the two groups within a one-year follow-up. Additionally, there were no significant association between ICG-A and postoperative complications. Larger randomized studies incorporating intraoperative ICG-A are needed to obtain higher quality data.Level of Evidence: Level I, Risk/Prognostic

Evaluation of wound healing and anti-inflammatory activity of hydro-alcoholic extract and solvent fractions of the leaves of Clerodendrum myricoides (Lamiaceae) in mice.

Wounds significantly affect people's quality of life and the clinical and financial burden of healthcare systems around the world. Many of the current drugs used to treat wounds have problems such as; allergies and drug resistance. Hence, the exploration of new therapeutic agents from natural origin may avert this problem. Clerodendrum myricoides have long been used to treat wounds in Ethiopia. Despite this, nothing has so far been reported about the wound healing and anti-inflammatory activity of C. myricoides. This study aimed to evaluate the wound healing and anti-inflammatory activity of 80% methanol extract and solvent fractions of C. myricoides leaves in mice. Leaves of C. myricoides were extracted using the maceration technique. The extract was formulated as 5% and 10% w/w ointments. The wound healing activity of the extract was evaluated using excision, incision, and burn wound models whereas the healing activities of solvent fractions were evaluated using the excision wound model. A carrageenan-induced paw edema model was used for the anti-inflammatory test. In the dermal toxicity test, 2000 mg/kg of 10% extract was found to be safe. In excision and burn wound models, treatment with 10% and 5% extract showed a significant (p<0.001) wound contraction. Solvent fractions of the extract significantly reduced wound contraction. A significant reduction in periods of epithelialization and favorable histopathology changes were shown by extract ointments. In incision wounds, 10% (p<0.001) and 5% (p<0.01) extracts significantly increase skin-breaking strength. After one hour of treatment, 400 mg/kg (p<0.001) and 200 mg/kg (p<0.05) showed significant reduction in paw edema. Results of this study indicate that 80% methanol extract and the solvent fraction of the leaves of C. myricoides possess wound-healing and anti-inflammatory activity and support traditional claims.

Single-port laparoscopic surgery for cecum cancer with intussusception: a case report

BackgroundMost adult cases of intussusception are caused by colorectal cancer, and emergency surgery is performed when symptoms such as abdominal pain and vomiting are present. The patient must customarily undergo both bowel decompression and radical surgery for colorectal cancer at the same time, and laparotomy is generally the procedure of choice.Case presentationAn 86-year-old woman presented to our hospital with diarrhea and bloody stools. Preoperative examination revealed the presence of a cancerous tumor in the advanced part of the transverse colon and bowel intussusception. Radical surgery was successfully performed using the laparoscopic single-port technique through a small incision at the umbilical site to treat intussusception caused by cecum cancer.ConclusionsWith only one wound site at the umbilicus, this single-port laparoscopic approach is much less invasive than endoscopic surgery that requires four to five incision wounds to perform the procedure. Furthermore, the patient was discharged without major complications and this surgical technique could be of great benefit if established as a standard procedure in the future.

Efficacy of incisional negative pressure wound therapy in reducing groin wound complications following vascular reconstructive procedures: A randomized controlled trial

Efficacy of incisional negative pressure wound therapy in reducing groin wound complications following vascular reconstructive procedures: A randomized controlled trial