Wound Pain Research Articles

Development of the Formulation and Evaluation of the Anti-arthritic Activity of Vitex negundo Gel and Latex

The important oil is Vitex negundo Linn. It is used in the treatment of eye diseases, toothache, infl ammation, leukoplakia, splenomegaly, skin ulcers, catarrh, rheumatoid arthritis, gonorrhea and bronchitis. It is also used as a tonic, insect repellent, galactagogue, menstrual agent, antibacterial, antipyretic and antihistamine. The plant component arrangements of V. negundo, are used commercially in a variety of Ayurvedic medicines and ointments for the treatment of a variety of ailments including rheumatism, arthritis, gout, cervical spondylitis, infl ammatory musculoskeletal, hemorrhoids (hemorrhoids), painful wounds, painful wounds. wounds, painful sores, burns and fungal infections of the skin. From the in vitro diff usion of drugs, we concluded that Emulgel composed of HPMC polymers can control drug secretion for a long time, which helps to prevent more fl uctuation and also reduces the cost of treatment. Due to the advantages of latex for improved spreadability, adhesion, viscosity, and extrudability, this new type of drug delivery is gaining popularity, besides systemic action, the local topical utility of hydrophobic dispensers is also of interest.

A clinical comparative study of thyroid surgeries with and without drain.

Most of the thyroid surgeries are accompanied by drain placement. The possibility of hematoma or seroma formation postoperatively is of concern to surgeons, as, thyroid is a highly vascular structure and a minor hemorrhage might also turn out to be life threatening, despite actual incidence of it being only 0.3-1%. Thus, drains are placed with an intention to obliterate dead space and clear the collecting blood or serum. Conversely, several studies have indicated chances of clots blocking the drainage tube and resulting in missing out of early detection of a massive bleed. Drains have also been known to add more discomfort to the patient, increase chances of infection, increase post operative pain, scar formation and longer duration of hospital stay. Thus, some surgeons believe in not placing a drain. To compare the outcomes of thyroid surgeries done with drain versus those thyroid surgeries done without drain. 40 patients, of either sex, between 18 and 70years of age, who underwent thyroid surgeries for various thyroid disorders over a period of 6months, were randomly allocated to either 'with drain' (group A) or 'without drain' (group B). The surgeon was made aware of drain status only intraoperatively. Patients were assessed for post-operative pain based on Visual Analogue Scale (VAS) at 6 and 24h post-operatively. Post-operative complications including hematoma, seroma, and wound infection, if any, along with duration of hospitalization, were also documented. Patient was followed up one week post-operatively for wound check and suture removal. Both groups were homogenous according to age, sex, TIRADS, Bethesda, diagnosis and surgery performed. Postoperative pain at 6 and 24h was significantly higher in group A than in group B [6.15 ± 1.31 vs 3.50 ± 0.88 (p = 0.001) (6h), 4.45 ± 0.99 vs 1.20 ± 1.10 (p = 0.001) (24h)]. Mean duration of hospitalization following thyroid surgery was significantly higher among group A than group B [3.80 ± 1.15 vs 2.15 ± 0.36days (p = 0.001)]. Though not statistically significant, wound pain at 1week and overall complications were higher in Group A than in Group B (p = 0.182, p = 0.127 respectively). Thyroid surgeries done without drain placement are likely to cause significantly lesser post-operative pain and shorter duration of hospitalization.

Effect of hydrocolloid dressing combined with low molecular weight heparin and calcium on scar hyperplasia in burn patients with venous thromboembolism.

The purpose of this study is to investigate the effect of hydrocolloid dressing combined with low molecular weight heparin calcium on scar hyperplasia in burn patients with venous thromboembolism. A retrospective analysis was made on 98 patients with burns complicated with venous thromboembolism in Renmin Hospital, Hubei University of Medicine from January 2020 to April 2021. According to different treatment methods, they were divided into a control group (48 cases) and a research group (50 cases), who were given low molecular weight heparin calcium combined with routine treatment and hydrocolloid dressing on the basis of the control group. The wound healing time, dressing change times and infection symptom regression time in the study group were significantly lower than those in the control group (P < .05). After the intervention, the degree of wound pain in both groups was reduced, and the degree of wound pain in the study group was significantly lower than that in the control group, with statistical significance (P < .05). Fibrinogen, activated partial thromboplastin (APPT), D-dimer, fibrinolytic degradation products, prothrombin time and activated partial prothrombin time of the two groups were all improved. The degree of scar hyperplasia in both groups was improved, and the degree of scar hyperplasia in the study group was significantly better than that in the control group, and the difference was statistically significant (P>.05). Complications in the study group were lower than those in the control group, and the difference was statistically significant (P < .05). The hydrocolloid dressing combined with low molecular weight heparin calcium can effectively shorten the wound healing time and infection symptom regression time of burn patients with venous thromboembolism, reduce the number of dressing changes, reduce the degree of pain, have no influence on coagulation function, reduce the degree of scar, and reduce the incidence of complications.

Neoadjuvant radiotherapy plus single-incision thoracoscopic surgery in the treatment of type B3 thymomas.

Although minimally invasive surgery is the standard treatment for thymomas, minimally invasive thymectomy is difficult for patients with type B3 thymomas, especially for giant or aggressive lesions. These tumors are frequently treated with radical radiation therapy or surgery plus adjuvant radiotherapy. Few studies, however, have tested the efficacy of neoadjuvant radiotherapy prior to thoracoscopic surgery. Patients with type B3 thymomas >5cm or with infiltrates into vital organs on CT-guided puncture biopsy who underwent neoadjuvant radiotherapy followed by single-incision minimally invasive thymectomy from March 2016 to July 2020 were retrospectively evaluated. Reduction ratios, TNM stage changes according to WHO stage criteria, resectability, long-term survival, and the response in terms of RECIST v1.1 criteria achieved by preoperative RT were analyzed. The 11 patients who underwent neoadjuvant radiotherapy plus minimally invasive thymectomy included five men and six women, of mean age 49.5 years. Four patients had myasthenia gravis. Neoadjuvant radiotherapy consisted of 50 Gy in 25 fractions, with all patients showing varying degrees of lesion reduction after radiotherapy. Surgery was performed about 1 month after neoadjuvant radiotherapy, with none of these patients having severe radiation pneumonitis. All patients underwent radical resection of the tumor and adjacent tissue, with none experiencing tumor seeding or rupture during surgery. The median postoperative hospital stay was 3 days (range: 2-6 days) and the frequency of additional regular analgesics (including those for wound pain and neuralgia) was 2.5 times per person. On follow-up, one patient experienced pleural metastasis and one experienced pulmonary metastasis, with the other nine patients showing no evidence of tumor recurrence. Neoadjuvant radiotherapy followed by minimally invasive surgery was a safe and efficacious procedure for the treatment of type B3 thymomas, with less postoperative pain and faster recovery. This strategy, of tumor shrinkage prior to surgery, may make possible the easier removal of type B3 thymomas by single-incision thoracoscopy.

Analisis Efektivitas Tehnik Relaksasi Progresif Terhadap Nyeri Luka Episiotomi Pada Ibu Post Partum di RSUD Genteng Banyuwangi

Postpartum pain experienced by every woman has varying degrees of pain with different pain thresholds. Post partum pain is caused by a tear in the birth canal / perineum due to an episiotomy with the aim of preventing spontaneous perineal tearing and facilitating delivery. The research method used is experimental research with pre-experimental design research techniques. Experimental research method is a research method carried out to find the effect of certain treatments under controlled conditions. The research variables consisted of the independent variable (progressive relaxation technique) and the dependent variable (episiotomy wound pain). The population was 35 respondents with episiotomy wounds at the Genteng Regional Hospital Banyuwangi. The sampling method in this study used a total sampling technique so that the sample used was 35 respondents. The instrument in this study used MC Gill's observation sheet with the aim of assessing pain response in mothers with episiotomy wounds. The analytical test used is the Wilcoxone test (sig value &lt;0.05 then Ha is accepted) and is used as an alternative to the Paired Sample T Test if the data is not normally distributed. From the results of the study, it was concluded that there was a difference in pain scale between the pre test and post test (sig value 0.000, where the sig value was 0.000 &lt;0.05). Progression relaxation has a positive impact on quality of life which includes multiple dimensions such as increased sleep quantity and quality, decreased physical restrictions, mothers will be more independent in carrying out activities, social relationships, sexual life can take place according to the postpartum phase &#x0D; Keywords: Episiotomy pain, Post partum, Progressive relaxation

The effect of sage (Salvizan gel) compared to triamcinolone acetonide on the treatment of recurrent aphthous stomatitis: a double-blinded randomized clinical trial

BackgroundRecurrent Aphthous Stomatitis (RAS) is one of the most common lesions of the oral mucosa. Herbal medicine can be used for the treatment of this disease. The present study aimed to compare the effects of topical application of Sage (Salvizan) and triamcinolone acetonide gels on RAS.MethodsThis double-blind clinical study recruited sixty patients with minor aphthous ulcers. Half of the patients were treated with Salvizan gel, and the other half were treated with oral triamcinolone acetonide gel. The effect of Salvizan topical gel was evaluated and compared with that of oral triamcinolone acetonide gel. Factors such as Pain recovery time, wound healing time, and pain level was evaluated. Data were analyzed by SPSS version 22 using independent t-test, paired t-test, repeated measures ANOVA, and survival analysis, including Kaplan-Meier and Cox regression.ResultsThe mean duration of pain recovery was 1.5 days for Salvizan and 2.5 days for triamcinolone acetonide (p < 0.001). Moreover, the duration of wound healing was 3.3 days for Salvizan and 6 days for triamcinolone acetonide (p < 0.001). Patients’ satisfaction from factors such as taste and smell had no significant difference between the two groups.ConclusionThe results of this study showed that Salvizan gel is very effective in the treatment of RAS. It was significantly better than triamcinolone acetonide in the pain recovery and wound healing. These promising results favor herbal treatments and show that they can be used more commonly for treating diseases such as RAS.Trial registrationThis study was approved by the ethics committee of Isfahan University of Medical Sciences (IR.MUI.RESEARCH.REC.1399.834) on 17/03/2021. It was also registered in the Iranian Registry of Clinical Trials (IRCT20100202003251N7).

Multilayer Methacrylate-Based Wound Dressing as a Therapeutic Tool for Targeted Pain Relief

This study presents an innovative wound dressing system that offers a highly effective therapeutic solution for treating painful wounds. By incorporating the widely used non-steroidal anti-inflammatory drug diclofenac, we have created an active wound dressing that can provide targeted pain relief with ease. The drug was embedded within a biocompatible matrix composed of polyhydroxyethyl methacrylate and polyhydroxypropyl methacrylate. The multilayer structure of the dressing, which allows for sustained drug release and an exact application, was achieved through the layer-by-layer coating technique and the inclusion of superparamagnetic iron platinum nanoparticles. The multilayered dressings' physicochemical, structural, and morphological properties were characterised using various methods. The synergistic effect of the incorporated drug molecules and superparamagnetic nanoparticles on the surface roughness and release kinetics resulted in controlled drug release. In addition, the proposed multilayer wound dressings were found to be biocompatible with human skin fibroblasts. Our findings suggest that the developed wound dressing system can contribute to tailored therapeutic strategies for local pain relief.

Wounds caused by vasculitis-Current classification, diagnostics and treatment

Wounds of the skin can have very different causes. Especially in clinically atypical or non-healing wounds, the very heterogeneous group of vasculitides is of particularly important differential diagnostic significance. Nowadays, the classification of vasculitis is based on the affected vessels according to the Chapel Hill consensus conference. Thus, potentially any part of the vascular system can be affected. It becomes clear that there is often arisk of systemic diseases with high interdisciplinary relevance.Clinically, the usually very painful wounds in cutaneous vasculitis develop from necrosis and are typically surrounded by an erythematous-livid rim in the florid phase. In addition to clinical inspection, the histopathological examination of biopsies is of particular importance in the usually extensive diagnostic work-up.Therapeutically, adequate wound treatment should always be performed with afocus on pain prevention and infection prophylaxis. In the case of edema, compression therapy also supports wound healing. In addition, it is often necessary to initiate systemic treatment with immunosuppressive or immunomodulating drugs. Whenever possible, causally relevant factors and comorbidities should be diagnosed early and avoided or treated. Otherwise, there is arisk of severe or even fatal disease progression.

An Integrative Ayurvedic Approach In Management Of Shashtrakruta (Post-Operative) Complicated Gudajacharmakeela Arsha(Anal Warts) – A Rare Case Report

CharmakeelaArsha (Anal warts) are small growths in and around the anal region caused by the human papillomavirus (HPV). The patient, the age 39- years female, came to O.P.D. of shalyatantra complaining of baddhamalapravruti (hard stools), sarakta malapravruti (bleeding per rectum on and off), Guda pradeshi Mamsankura prachiti (feeling of mass at anal region), sashoola malapravruti (pain during and after defecation) since six months. Clinically diagnosed patient as a case of Charmakeelaarsha (anal warts) with internal piles and sentinel tag. Chedana (Excision) of anal warts and Sentinel tag by Agnikarma (electric cautery) was performed with ligation haemorrhoidectomy under spinal anaesthesia. It is challenging to manage post-operative wound healing with simple ointments. So there is a need to intervene in the ayurvedic ointments and treatment of post-operative wounds to heal them faster with no complications. After the operative procedure, the patient was managed with Ayurvedic protocols like laghu ahara, deepana, panchana, Virecheniya dravya, and Vranaropaka ointment for 15 days. The patient was assessed by Subjective and Objective parameters like the Numerical pain Scale, WHO are bleeding Scale, and VranaPariksha based on signs and Symptoms. The patient showed improvement in signs and Symptoms on the 15th Day. After two months of follow-up, the patient recovered well, and no recurrence or complaint was observed. Hence, such a study is more important for better wound healing and pain management. Instead of taking more extended oral therapies or anaesthetic blocks in post-operative management, the short procedure, like the present study, can save time. This case proved the efficacy of ayurvedic management in Shashtrakruta Charmakeela Arsha.

Care of Bullet-related Injuries: A Cross-sectional Study of Instructions and Prescriptions Provided on Discharge from the Emergency Department.

There are more than 80,000 emergency department (ED) visits for non-fatal bullet-related injuries (BRI) per year in the United States. Approximately half of these patients are discharged home from the ED. Our objective in this study was to characterize the discharge instructions, prescriptions, and follow-up plans provided to patients discharged from the ED after BRI. This was a single-center, cross-sectional study of the first 100 consecutive patients who presented to an urban, academic, Level I trauma center ED with an acute BRI beginning on January 1, 2020. We queried the electronic health record for patient demographics, insurance status, cause of injury, hospital arrival and discharge timestamps, discharge prescriptions, and documented instructions regarding wound care, pain management, and follow-up plans. We analyzed data using descriptive statistics and chi-square tests. During the study period, 100 patients presented to the ED with an acute firearm injury. Patients were predominantly young (median age 29, interquartile range 23-38 years), male (86%), Black (85%), non-Hispanic (98%), and uninsured (70%). We found that 12% of patients did not receive any type of written wound care instruction, while 37% received discharge paperwork that included instructions to take both an NSAID and acetaminophen. Fifty-one percent of patients received an opioid prescription, with a range from 3-42 tablets (median 10 tablets). The proportion of patients receiving an opioid prescription was significantly higher among White patients (77%) than among Black patients (47%). There is variability in prescriptions and instructions provided to survivors of bullet injuries upon ED discharge at our institution. Our data indicates that standardized discharge protocols could improve quality of care and equity in the treatment of patients who have survived a BRI. Current variable quality in discharge planning is an entry point for structural racism and disparity.

Terapi Kompresi pada Pasien Vena Varises yang Menjalani Operasi

This study aims to determine the effectiveness of compression therapy in varicose veins patients to reduce pain and increase wound healing after surgery. The method used was a systematic review using a checklist of protocols and rules (PRISMA) and a flowchart with the feasibility of studies assessed using the PICOT framework, searches using five databases, Science Direct, CINAHL, Scopus, SAGE, and ProQuest. The results showed that as many as ten articles were obtained discussing the effects of compression therapy in patients with varicose veins, with different discussions in each study bringing positive impacts. In conclusion, compression therapy is considered the most effective conservative treatment for varicose veins, which has been shown to benefit from several research results. Namely, compression improves the healing of varicose veins compared to no reduction. Still, compression therapy has not been proven to provide long-term effects—benefits for postoperative varicose veins patients to return to normal activities.&#x0D; Keywords: Surgery, Compression Therapy, Varicose Veins

A randomized, double-blind, prospective study to assess lidocaine jelly for pain control during Mohs surgery

A randomized, double-blind, prospective study to assess lidocaine jelly for pain control during Mohs surgery

Patient experiences of left-sided colorectal resection by robotic, conventional laparoscopic and open approaches: a qualitative study.

Robotic surgery (RS) is increasingly employed in colorectal surgical practice, widening the range of surgical techniques offered to patients. We investigated the perceptions of patients with colorectal cancer in relation to RS, open surgery (OS) and conventional laparoscopic surgery (CLS), to identify ideas or assumptions which, in the context of shared surgeon-patient decision-making, may affect the resultant choice of surgical technique. We also investigated salient factors affecting patients' perioperative experience, including those of RS patients, to guide improvements in care and preoperative patient preparation. This study was conducted on patients who underwent resection of left-sided colorectal cancer at a large UK teaching hospital from November 2020 to July 2021. Purposive sampling was used to ensure a roughly equal proportion of patients who underwent RS, CLS and OS. The patients included in the study participated in semi-structured interviews sixweeks postoperatively. The interview schedule allowed discussion around patients' experience of their surgery and postoperative recovery, and their perceptions of surgical techniques. Interview transcripts were coded manually using inductive thematic analysis, and analyst triangulation was employed to refine coding schemes and ensure reliability of emerging themes. Twenty-seven patients were recruited to the study; RS n = 9 (median age 69 [range 60-80] years); CLS n = 10 (median age 72 [range 32-82] years; OS n = 8 (median age 71 [range 60-75] years). Patients understood the technological benefits of RS but were concerned by a risk of technological failure causing patient harm. OS was understood to be associated with more pain and longer recovery than RS or CLS. Patients perceived CLS to be more technically challenging compared with OS. Less pain and smaller wounds than expected were significant positive factors in the experience of RS and CLS patients specifically. Complications and emotional impact were significant factors in the experience of all groups, for which many patients felt underprepared. Patients generally have a positive view of RS and technical innovation in surgery. Concerns mostly centred around failure of technology. Many patients felt unprepared for significant factors in their perioperative experience. Surgeons and healthcare providers should be prepared to address patients' perceptions and expectations of colorectal surgery preoperatively.

Chronic limb-threatening ischaemia and confronting amputation: A Heideggerian derived understanding of Being-with and discourse.

To explore the notion of Being-with and authentic discourse for people making decisions about major amputation. Chronic limb-threatening ischaemia is a devastating disease with a high burden of pain and complex wounds. Patients may deteriorate suddenly after multiple revascularisation procedures and, amputation is offered when further reperfusion is considered futile. Delayed decisions about amputation have negative consequences for patients, families and health systems, yet little attention is given to training clinicians for the sophisticated communication required. Clinicians need to engage in authentic discourse about amputation to create shared meaning and facilitate decision-making. Qualitative study using hermeneutic Heideggerian phenomenology. Twelve patients offered major amputation, and 13 family participants from three vascular units in Australia engaged in 42 semi-structured interviews, representing 19 cases of chronic limb-threatening ischaemia. Hermeneutic phenomenology using the Heideggerian tenet of Being-with as an analytic framework, a philosophically based understanding of Being-with and Discourse related to treatment discussions and decisions was derived. The research was reported in accordance with the COREQ checklist. Effective discourse between the person and family was hampered by changed circumstances of Being-with, characterised by guilt, and a retreat from discourse through deficient discourse and filtering information. Clinician Being-with was hampered by discourse that was deficient, poorly delivered, discordant and disconnected through a lack of empathetic listening. There were also examples of enhanced clinician Being-with that made room for more constructive discourse and more timely decisions about amputation. Heidegger's construct of Being-with provides a useful framework to reveal the role of authentic discourse in improving patient and family experience and decisions about treatment. This study did not engage consumers other than as patient and carer participants. Decisions about amputation are often difficult for patients or family members who may be substitute decision-makers. A better understanding of the experience may assist clinicians in their interactions with patients and families.

Enhanced recovery after surgery (ERAS) protocol in geriatric patients underwent unicompartmental knee arthroplasty: A retrospective cohort study.

The enhanced recovery after surgery (ERAS) pathway was formulated with the aim to reduce surgical stress response, alleviate pain and guarantee the best-fit experience of patients' perioperative period. However, the application of ERAS in geriatric patients who underwent unicompartmental knee arthroplasty (UKA) was relatively lacking. We hypothesize that UKA patients can benefit from the ERAS protocol. A total of 238 patients were recruited in this retrospective study from August 2018 to December 2021, and Oxford phase III UKA was applied to all patients. ERAS pathway included nutrition support, anesthesia mode, interoperative temperature, and blood pressure control, application of tranexamic acid, early initiation of oral intake and mobilization, and pain management. Demographic data, operation-relative variables, and postoperative complications were analyzed. Forgotten Joint Scores, Oxford Knee Score, Lysholm score, numerical rating scale, and knee range of motion were introduced to estimate the activity function and pain of surgical knee, and these variables were compared between the 2 groups. There were 117 patients in the ERAS group and 121 patients in the traditional group, respectively. The ERAS group had a shorter length of surgical incision and less intraoperative blood loss. Postoperative hemoglobin and albumin of patients in the ERAS group were better than those in the traditional group (P < .05), after 17.0 ± 10.8 months follow-up, the numerical rating scale, Lysholm, Oxford Knee Score, Forgotten Joint Scores, and knee range of motion of patients in the ERAS group were significantly better than the traditional group. The length of hospital stay for patients who underwent ERAS was 11.7 ± 3.8 days and the postoperative complication rate was lower for the ERAS group patients (P = .000 and 0.031). ERAS can reduce the length of hospital stay, and patients can achieve excellent postoperative knee function. The formulation and implementation of the ERAS protocol require good collaboration across multiple disciplines, as well as a deep understanding of the existing clinical evidence and the concept of the ERAS program.

A Comparison Between Comma Incision and Ward's Incision in Third Molar Extraction in Terms of Postoperative Sequel.

Aim We aim to look at the differences between the standard Ward's incision and the comma-shaped incision and how they affect complications after surgery to remove an impacted mandibular third molar. Materials and methods Mandibular third molars had to be carefully extracted from a total of 40 patients who were randomly divided into two groups of 20 patients each. At first, patients were evaluated before surgery. In group A, a standard Ward's incision was made, and in group B, a comma incision was made to match the mucoperiosteal fold. Afterward, the impacted third molars were carefully removed. The evaluation criteria for pain, swelling, lockjaw, and healing of wounds were done before surgery, after three hours, and on the first, third, and seventh dayafter surgery. Result The pain scores that were recorded right after surgery, three hours later, and on days 1, 3, and 7 in the surgical area with comma-shaped incision were all lower than the pain scores that were recorded in the area where standard incisions were made. Enlarging was less with comma entry point than with standard Ward's incision. After surgery, there was a big difference between the two entry points in how the mouth opened and how the wounds were fixed. These findings showed that the comma incisionis better than the standard Ward's incision when it comes to pain, enlargement, lockjaw, and healing of wounds. Conclusion The study results showed that the comma-shaped incision was better than the traditional method (Ward's incision) because there were fewer problems after surgery.

Responsive Nanostructure for Targeted Drug Delivery

Currently, intelligent, responsive biomaterials have been widely explored, considering the fact that responsive biomaterials provide controlled and predictable results in various biomedical systems. Responsive nanostructures undergo reversible or irreversible changes in the presence of a stimulus, and that stimuli can be temperature, a magnetic field, ultrasound, pH, humidity, pressure, light, electric field, etc. Different types of stimuli being used in drug delivery shall be explained here. Recent research progress in the design, development and applications of biomaterials comprising responsive nanostructures is also described here. More emphasis will be given on the various nanostructures explored for the smart stimuli responsive drug delivery at the target site such as wound healing, cancer therapy, inflammation, and pain management in order to achieve the improved efficacy and sustainability with the lowest side effects. However, it is still a big challenge to develop well-defined responsive nanostructures with ordered output; thus, challenges faced during the design and development of these nanostructures shall also be included in this article. Clinical perspectives and applicability of the responsive nanostructures in the targeted drug delivery shall be discussed here.

Effect of Low-Level Laser Therapy on Early Wound Healing and Levels of Inflammatory Mediators in Gingival Crevicular Fluid Following Open Flap Debridement.

Introduction Low-level laser therapy (LLLT) has a beneficial effect on pain relief and wound healing. This study aims at a clinical evaluation of early wound healing and a biochemical evaluation of inflammatory mediators in gingival crevicular fluid (GCF) following LLLT with an open flap debridement (OFD) in periodontal therapy. Material and methods This randomized controlled trial included 40 chronic periodontitis patients with bilateral attachment loss, pocket depths of 5 mm affecting at least two quadrants, and radiographic evidence of horizontal bone loss. 120 control sites were randomly selected to receive OFD, and contralateral 120 test sites received bio-stimulation with a diode laser (890 nm) after OFD.The wound healing index was recorded at the 1stand 2ndweeks, and clinical parameters such as the plaque index, gingival index, pocket probing depth, clinical attachment level, and GCF inflammatory mediators were evaluated at baseline, 3, and 6 months. Results From the start of the study to 6 months later, there was astatistically significant dropin plaque index, gingival index, probing pocket depth, and gain clinical attachment levels in both groups. However, when the two groups were compared, there were no significant differences at any time intervals. GCFinflammatory mediators tumor necrosis factor (TNF) alpha and matrixmetalloproteinases (MMP-8) decrease, and osteoprotegerin (OPG)levels increase in both the test group and control group from baseline to 3 months and 6 months. In intergroup comparisons, there was a statistically significant reduction in the test group as compared to the control group at 6 months. There was a decline in gingivalcrevicular fluid- interleukin-6 (GCF IL-6) levels from baseline to 3 months and 6 months in both the groups but when analysed statistically, the results were not significant on intergroup and intragroup comparison at any time interval.The Landry Wound Healing Index values in the 1st and2nd weeks were showing statistically significant improved healing in the test group as compared to the control group. There was significantly better wound healing at sites where a diode laser was used. Conclusion LLLT increases early wound healing after periodontal surgical procedures.

Assessing and managing wound pain

Different wounds produce different types of pain. Pain assessment should form part of the initial wound assessment and be reassessed regularly. Verbal cues and pain assessment tools are useful when assessing pain, and observing non-verbal cues, such as grimacing, guarding the affected area and limited movement can also be helpful. Nurses should stay up to date on how to minimise pain during dressing changes, as this has been shown to cause some of the highest levels of pain. Several types of analgesia can be used to manage wound pain, and the type prescribed should be based on the type of wound pain and level of pain experienced by the patient. It is key that health professionals always acknowledge how pain impacts their patient's quality of life.

Comparison between platelet-rich plasma (PRP) and mechanically emulsified fat grafts in management of chronic wounds

Backgroundchronic wounds represent a challenge in treatment, due to diverse pathogenesis, resistance to ordinary treatment complex and lack of direct methods of treatment In this study, the aim is to compare the effect of Platelet -rich plasma (PRP) and mechanically emulsified fat grafts on the outcome of the healing process of chronic wounds. Patients and methodsIn the current study, 30 patients with chronic wounds were divided into two groups (Group I, 15 patients had application of PRP on chronic wounds). Whereas (Group II, 15 patients had application of mechanically emulsified fat on chronic wounds). In both groups assessment of the healing rates and histopathological changes that were determined by observing the parameters of wound healing, including peri-lesional skin quality, observation of the wound size and depth, assessment of the pain indicated by Visual analog scale score. ResultsPatient were followed up for 6 months. Group II showed a better healing rate 64% in comparison to Group I 55%. Wound parameters and pain score were recorded in both groups with no statistically significant difference. ConclusionBoth PRP and mechanically emulsified fat grafts were found to be efficient treatment modalities in management of chronic “non-healing” wounds. But mechanically emulsified fat grafts represent a better treatment method for chronic wounds.