Wound Pain Research Articles

Middle Phalangectomy for the Correction of Macrodactyly of the 2nd Digit in an Adult Patient: A Case Report

Macrodactyly, a rare congenital anomaly characterised by localised gigantism of one or more digits, presents significant challenges in therapeutic management due to the absence of established guidelines. The present case report explored the surgical management of an 18-year-old female patient with macrodactyly of the second digit, addressing discomfort, footwear issues and psychological distress. The study adapts techniques from prior paediatric cases to suit adult care needs, particularly focusing on middle phalangectomy as a feasible treatment option for isolated macrodactyly. Clinical examination and radiographic assessments confirmed primary macrodactyly affecting the patient’s left second toe. The surgical intervention involved middle phalangectomy, debulking of fibrofatty tissue, joint capsule and tendon repair, along with a Winograd wedge resection procedure. Postoperative care included pain management and wound dressing. Despite encountering delayed wound healing and mild necrotic changes, the patient reported manageable pain levels and expressed satisfaction with the cosmetic outcome and improved footwear options at the six-month follow-up. The present case report contributes valuable insights into the management of macrodactyly, highlighting the efficacy of middle phalangectomy in adult patients. Preoperative assessment for peripheral arterial disease is emphasised to mitigate neurovascular complications. Proactive patient counseling regarding potential postoperative complications is crucial for informed decision-making. Overall, the findings underscore the importance of tailored surgical approaches in addressing macrodactyly and improving patients’ quality of life.

Common maternal health problems and their correlates in early post-partum mothers.

Mothers experience a wide range of maternal health problems after childbirth, which in turn, affect their well-being and ability to care for their newborn. These problems may be influenced by factors such as mode of delivery or socio-economic status. This study aims to investigate the prevalence of common maternal health problems and their correlates in a public primary healthcare institution in Singapore. This was a cross-sectional study, based on a self-administered questionnaire. A total of 373 mothers (mean age 31.9 years) who accompanied their infants for their 4- to 8-week development assessments at a public primary care clinic in Singapore completed a self-administered questionnaire from June 2021 to December 2021. The questionnaire assessed demographic factors, mode of delivery, number of children, number of individuals providing significant help, and the frequency of common physical and mental maternal health problems using a 5-point Likert-type scale. The five most common maternal health problems were fatigue (77.7%), lower back pain (59.3%), Caesarean wound pain (54.3%), upper back pain (53.0%) and vaginal pain (41.2%). The prevalence of depression and anxiety was 22.0% and 11.3%, respectively. With respect to the symptoms' correlates, pain on passing urine was more frequent after assisted vaginal deliveries than all other forms of deliveries (all pairwise p < 0.01), and pain on passing motion was more frequent in vaginal deliveries than in Caesarean deliveries (all pairwise p < 0.05). Mothers having a larger number of children more frequently experienced headaches (β = 0.17, SE = 0.05, p = 0.002) and less frequently experienced breastfeeding difficulties (β = -0.28, SE = 0.08, p < 0.001). Mothers experienced a high prevalence of maternal health problems in multiple domains during the first 8 weeks after childbirth. Mode of delivery and number of children were associated with increased prevalence of certain problems. Mothers' physical and mental well-being should be investigated early after delivery and addressed with adequate treatments and resources.

Relationship of Wound Pain Intensity Sectio Caesarea Problems with the Quality of Sleep in Patients Post-Partum

Relationship of Wound Pain Intensity Sectio Caesarea Problems with the Quality of Sleep in Patients Post-Partum

Efficacy of Plasma Rich in Growth Factors for Healing Chronic Skin Ulcers: A Systematic Review of Randomized Controlled Trials With Meta-Analysis

Background. Chronic skin ulceration is a serious pathological condition for which the adjuvant use of platelet-rich plasma (PRP) has been indicated. However, evidence for the use of PRP in patients with chronic skin ulcers remains insufficient due to a large heterogeneity in experimental designs, PRP composition, and preparation protocols. Objective. To assess previously published reports of the clinical effect of plasma rich in growth factors (PRGF) on chronic skin wounds. Methods. A comprehensive search of the PubMed, Cochrane Library, and Scopus databases was performed to identify randomized controlled trials (RCTs) assessing the effect of PRGF on chronic ulcer healing, with no limitation regarding publication date (up to September 1, 2022). Percentage area reduction and probability of complete healing in chronic ulcers, pain reduction, infection risk, and cost savings were analyzed. A meta-analysis was performed, and the overall evidence was qualified using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) approach. Results. A total of 113 studies were identified. After full-text screening, 5 RCTs met the inclusion criteria. The meta-analysis showed a significant effect of PRGF on both wound area reduction (mean difference, 56.90% [95% CI, 52.28-61.51], I² = 0%; P = .56) and on the probability of complete healing (RR, 7.07 [95% CI, 1.84-27.16], I² = 0%; P = .53) in chronic ulcers. The overall risk of bias rating was “some concerns,” whereas the certainty of evidence was high for both outcomes. A qualitative analysis suggested that PRGF did not increase infection risk and was able to reduce wound pain. Conclusion. The use of PRGF significantly enhances wound area reduction and also the probability of complete healing in chronic ulcers. More studies are needed to assess the effect of PRGF on pain and infection, as well as its cost-effectiveness.

Utility of dexmedetomidine on surgical site wound pain undergoing thoracoscopic surgery: A meta-analysis.

We conducted this study aimed to evaluate the analgesic effect of dexmedetomidine in thoracoscopic surgery on postoperative wound pain, and to provide a reference for clinical use of the drug. We searched PubMed, Embase, Cochrane Library, Web of Science, Wanfang, Chinese Biomedical Literature Database and China National Knowledge Infrastructure databases, and supplemented with manual searching. We searched from database inception to October 2023, to collect the randomised controlled trials (RCTs) on dexmedetomidine application in thoracoscopic surgery. Two researchers screened all the literature according to the inclusion and exclusion criteria and the literature included in the study was evaluated for quality, extracted information and required data. Stata 17.0 software was employed for data analysis and the outcomes were 2 6, 12, 24 and 48 h postoperative wound visual analog scores (VAS). Twenty-four RCTs totalling 2246 patients undergoing thoracoscopic surgery were finally included. The analysis revealed dexmedetomidine applied to thoracoscopic surgery significantly reduced the postoperative wound VAS scores at 2 h (SMD: -0.96, 95% CI: -1.57 to -0.36, p = 0.002), 6 h (SMD: -0.98, 95% CI: -1.27 to -0.69, p < 0.001), 12 h (SMD: -1.19, 95% CI: -1.44 to -0.94, p < 0.001), 24 h (SMD: -0.91, 95% CI: -1.16 to -0.66, p < 0.001) and 48 h (SMD: -0.75, 95% CI: -1.02 to -0.48, p < 0.001). Our results suggest dexmedetomidine applied to thoracoscopic surgery can significantly reduce postoperative wound pain, which is worthy of clinical application.

Differences in vacuum suction drainage pressure following mastectomy and its impact on the clinical outcome of breast cancer patients

Background: Vacuum suction drainage is an obligatory practice for long past following mastectomy for breast cancer. But recent studies are showing that the pressure of the vacuum suction drain is of value in determining the volume of seroma formation and thereby the drain indwelling time, duration of hospital stays and patient morbidity. Half vacuum suction may be of greater value in this regard comparing full vacuum suction drainage. Objectives were to assess and compare the clinical outcome of half versus full vacuum suction drainage following modified radical mastectomy for breast cancer. Methods: Forty patients of histologically proven breast cancer had been chosen purposively and systematically randomized in two equal groups. Group A with half vacuum suction (device was squeezed up to half of its vertical length) and group B with full vacuum suction (device was squeezed to its maximum). The outcome measured were postoperative drainage, drain indwelling time and post-surgery length of hospital stay. Results: Patients having half vacuum suction had a significantly reduced mean total drainage volume (364.25±128.52 ml versus 822.00±251.30 ml), drain indwelling time (5.50±1.32 days versus 9.05±1.90 days) and post-surgery hospital stay (7.15±2.58 days versus 10.25±2.55 days) in comparison to the full vacuum suction group. No significant difference found in regards to postoperative pain and other wound related complications. Conclusions: We concluded that half vacuum suction drain ensures a lower drain collection and were removed earlier and hence reduced the hospital stay significantly than full vacuum suction drains.

The impact of paravertebral nerve blockade on postoperative surgical site wound pain management in patients undergoing video-assisted thoracoscopic surgery for pulmonary carcinoma resection.

Management of postoperative pain is of vital importance for patients undergoing Video-Assisted Thoracoscopic Surgery (VATS) for Pulmonary Carcinoma Resection. The study evaluates the impact of Paravertebral Nerve Blockade (PNB) in conjunction with general anaesthesia on postoperative pain relief, as compared with general anaesthesia alone. A retrospective analysis was carried out from May 2020 to May 2023, involving 100 patients with pathologically confirmed pulmonary carcinoma. The patients were divided into two groups: a control group that received general anaesthesia and an observation group that received a combination of general anaesthesia and PNB. The intensity of postoperative pain was assessed at various time intervals using the visual analogue scale (VAS), while the effectiveness of patient-controlled analgesia was also evaluated. Additionally, the study examined the incidence rates of chronic pain in the postoperative period. Statistical analysis was performed using IBM SPSS version 27.0. Significant reductions in VAS scores for both resting and cough-induced pain were observed in the observation group at 2 and 6 h post-operation (p < 0.01). However, the difference diminished over time. The observation group had fewer patient-controlled analgesia activations and required lower dosages of hydromorphone at both 24- and 48-h post-operation. The incidence of chronic pain was also significantly lower in the observation group (24.00%) compared with the control group (54.00%) (p < 0.01). PNB, when administered in combination with general anaesthesia, significantly reduces immediate postoperative pain and the requirement for additional analgesics in patients undergoing VATS for pulmonary carcinoma resection. The effect diminishes over time but has a lasting impact on reducing the incidence of chronic postoperative pain.

COLD COMPRESS FOR REDUCE PERINEAL WOUNDS PAIN : EVIDENCE BASED CASE REPORT

Introduction: Perineal tear due to labor can cause secondary pain in postpartum women. Not resolved pain will be negative impact on the social and emotional of the mother. The one of non-pharmacological method in reducing perineal pain is cold compress. Method: This report is evidence based case report (EBCR). The evidence articles searched on science direct, google scholar, and Pubmed databased that were published in the last 5 years with cold method on perineal pain as the keywords. The articles selected with inclusion and exclusion criteria, then analyzed to become the basis cold compress application on this report. Objectives: This report discusses cold compress as one of methods for reducing perineal pain. Result: Cold compress reduced perineal wound pain and the application process was comfortable. Conclusion: Cold compress was easy and affordable as perineal pain relief.

Wound healing after therapy of oral potentially malignant disorders with a 445-nm semiconductor laser: a randomized clinical trial

ObjectivesOral potentially malignant disorders (OPMDs) are the most clinically relevant precursor lesions of the oral squamous cell carcinoma (OSCC). OSCC is one of the 15 most common cancers worldwide. OSCC is with its high rate of mortality an important cause of death worldwide. The diagnosis and therapy of clinically relevant precursor lesions of the OSCC is one of the main parts of prevention of this malignant disease. Targeted therapy is one of the main challenges concerning an oncologically safe tissue removal without overwhelming functional and aesthetic impairment.Materials and methodsIn this randomized controlled trial, a newly introduced intraoral 445-nm semiconductor laser (2W; cw-mode; SIROLaser Blue, Dentsply Sirona, Bensheim, Germany) was used in the therapy of OPMDs. Duration and course of wound healing, pain, and scar tissue formation were compared to classical cold blade removal with primary suture by measuring remaining wound area, tissue colorimetry, and visual analogue scale. The study includes 40 patients randomized using a random spreadsheet sequence in two groups (n1 = 20; n2 = 20).ResultsThis comparative analysis revealed a significantly reduced remaining wound area after 1, 2, and 4 weeks in the laser group compared to the cold blade group (p < 0.05). In the laser group, a significantly reduced postoperative pain after 1 week was measured (p < 0.05).ConclusionLaser coagulation of OPMDs with the investigated 445-nm semiconductor laser is a safe, gentle, and predictable surgical procedure with beneficial wound healing and reduced postoperative discomfort.Clinical relevanceCompared to the more invasive and bloody cold blade removal with scalpel, the 445-nm semiconductor laser could be a new functional less traumatic tool in the therapy of OPMDs. The method should be further investigated with regard to the identification of further possible indications.Trail registrationGerman Clinical Trials Register No: DRKS00032626.

The role of nursing care in the management of post-burn epidermal cancer: A narrative review

Severe burns, affecting over 20% of the body, induce systemic dysfunction and immune suppression, correlating with increased cancer risk, especially skin cancer. Nurses play a crucial role in averting complications, which is explored in this study through a comprehensive literature review. The literature review focused on nursing care for post-burn skin cancer; a systematic search covered databases including Magiran, Scientific Information Database, and PubMed and Google Scholar search engine. Keywords "nursing", "skin cancer", and "burn" were strategically combined with Boolean operators. From an initial 580 articles, 10 met eligibility post-screening. The results have shown that optimal care for burn patients necessitates an interdisciplinary approach with the burn nurse at its core, coordinating patient care across multiple disciplines. The nurse's responsibilities encompass a comprehensive understanding of multisystem organ failure, critical care methodologies, diagnostic procedures, and psychosocial skills. Meticulous wound care, infection prevention, and pain management are pivotal, with the nurse actively engaging in nursing research. The origin of cancers within burns involves hypotheses of persistent cell proliferation, chronic inflammation, toxin exposure, and compromised immunological defense. Nursing care, particularly in detecting and treating wound inflammation, is pivotal in preventing cancer. Nurses contribute to patient education on skin cancer prevention, emphasizing lifestyle choices and providing crucial psychological support. Nursing diagnoses, based on symptomatology studies, include "risk for impaired skin integrity", "impaired skin integrity", "acute pain", "chronic pain", and "impaired comfort". These diagnoses guide tailored interventions to prevent skin cancer incidence.In sum, nurses are pivotal in comprehensive burn care, overseeing wound care, infection prevention, and patient education on UV radiation dangers. They advocate healthy lifestyles to reduce skin cancer risk, provide psychological support, and encourage commitment to prevention practices. Nursing diagnoses guide tailored interventions, contributing to ongoing improvements in burn care and enhancing the quality of life for survivors.

Therapeutic Effect of Indometacin, Furazolidone, and Cuscohygrinolis α-Acetylbenzoacetate Suppository Combined with Fuzhiqing Ointment in Treating Anal Fissure: An Observation of 98 Cases

Objective: To assess the efficacy of the combined application of indometacin, furazolidone, and cuscohygrinolis α-acetylbenzoacetate suppository and Fuzhiqing ointment in treating patients with anal fissures. Methods: A total of 98 patients diagnosed with anal fissures between January 2021 and December 2022 were selected as the study participants. They were randomly assigned to two groups using the random number table method. The control group received treatment with indometacin, furazolidone, and cuscohygrinolis α-acetylbenzoacetate suppository, while the observation group underwent a combination treatment involving indometacin, furazolidone, and cuscohygrinolis α-acetylbenzoacetate suppository and Fuzhiqing ointment. The two groups were compared in terms of pain level, wound bleeding, and changes in wound granulation health. Additionally, the time for symptom disappearance, improvement in anal function, and occurrence of related adverse reactions were recorded. Results: The observation group exhibited lower pain score, wound bleeding score, and wound granulation health score compared to the control group (P &lt; 0.05). The observation group also showed shorter times for the disappearance of symptoms as well as a quicker time for complete anal fissure healing compared to the control group (P &lt; 0.05). No relevant adverse reactions were observed in any of the patients. Conclusion:The addition of Fuzhiqing ointment to the treatment of patients with anal fissures using metronidazole ester suppositories promotes the improvement of disease symptoms and enhances the health of wound granulations. This combined treatment demonstrates a positive effect on the overall healing process of the disease, indicating a broad application value.

Artificial dermis combined with split-thickness skin autograft in the treatment of hand thermal compression wounds: a single center case-control study.

To explore the clinical effect of artificial dermis combined with split-thickness skin autograft in treating hand thermal compression wounds. Forty-two patients in our hospital from January 2016 to October 2022 with thermal compression wounds were divided into two groups. The survival rate of autologous skin grafts seven days after skin grafting, the number of operations, total hospital stay, total hospitalization cost, and bacterial culture results of secretions were recorded. The visual analog scale was used to evaluate the wound pain. The condition of skin graft rupture was recorded and the scar status of the donor site was evaluated by the Vancouver Scar Scale. It showed combination of artificial dermis, split-thickness skin autograft, and vacuum sealing drainage improves the treatment of hand thermal compression wounds by enhancing the survival rate of skin grafting (95.24% > 66.67%), reducing the number of operations (P < 0.001), relieving wound pain (P < 0.001), effectively controlling wound infection (4.76% < 9.52%), and reducing the skin graft rupture rate after surgery (4.8% < 28.6%). There was no evident scar hyperplasia in the donor (P = 0.003) and skin graft areas (P < 0.001), which had a good recovery of hand function (P = 0.037); however, this treatment strategy may prolong the hospital stay (P = 0.030) and increase the total hospitalization cost (P = 0.030). The composite transplantation of artificial dermis and split-thickness skin combined with the VSD significantly improves treatment and aesthetic outcomes in patients with thermal compression wounds to the hand, which is worth promoting and applying in clinical practice.

Biofabrication of Cellulose-based Hydrogels for Advanced Wound Healing: A Special Emphasis on 3D Bioprinting.

Even with the current advancements in wound management, addressing most skin injuries and wounds continues to pose a significant obstacle for the healthcare industry. As a result, researchers are now focusing on creating innovative materials utilizing cellulose and its derivatives. Cellulose, the most abundant biopolymer in nature, has unique properties that make it a promising material for wound healing, such as biocompatibility, tunable physiochemical characteristics, accessibility, and low cost. 3D bioprinting technology has enabled the production of cellulose-based wound dressings with complex structures that mimic the extracellular matrix. The inclusion of bioactive molecules such as growth factors offers the ability to aid in promoting wound healing, while cellulose creates an ideal environment for controlled release of these biomolecules and moisture retention. The use of 3D bioprinted cellulose-based wound dressings has potential benefits for managing chronic wounds, burns, and painful wounds by promoting wound healing and reducing the risk of infection. This review provides an up-to-date summary of cellulose-based dressings manufactured by 3D bioprinting techniques by looking into wound healing biology, biofabrication methods, cellulose derivatives, and the existing cellulose bioinks targeted toward wound healing.

Effect of Using Virtual Reality as Non-pharmacological Therapy to Reduce Pain in chronic septic Wounds for patient with cancer

Effect of Using Virtual Reality as Non-pharmacological Therapy to Reduce Pain in chronic septic Wounds for patient with cancer

Comparative Study between Subcostal Transverses Abdominis Block and Erector Spinae Plane Block for Post-operative Opioid Sparing Analgesia in Laparoscopic Cholecystectomy Patient

Background and Aim: Laparoscopic cholecystectomy is one of the most commonly performed minimally invasive intra abdominal surgeries to remove the diseased gallbladder. Though associated with complications like pneumoperitoneum. Major benefits include reduced postoperative pain and fewer wound related adverse effects. Growing need for opioid sparing analgesia has led to use of regional techniques for post-operative pain relief. Aim of this study is to compare quality and duration of post-operative analgesia between subcostal transverses abdominis block and erector spinae plane block. Methods: It is a prospective study, where 40 patients were randomly allocated into two groups of 20 each. All the patients received 40 ml of inj 0.25% bupivacaine + 10 mcg inj dexmedetomidine in total. Erector spinae plane (EPS) block was performed in one group of patients and other received sub costal transverses abdominis plane (SCTAP) block. Quality of post-operative analgesia is documented using visual analogue score (VAS) and duration being assessed by the need for rescue analgesia for the set duration of post-operative stay. Results: In the erector spinae plane block group the VAS is considerably lower compared to subcostal transverses abdominis block group. Need for rescue analgesia with NSAIDs was lower in erector spinae plane block group patients. No complications related to the block were documented in either group. Conclusion: In conclusion ultrasound guided bilateral erector spinae plane block provides analgesia superior to bilateral subcostal transverses abdominis plane block.

A Comparative Study to Evaluate the Effectiveness of Crushed Ice Pack Application and Sitz Bath on Episiotomy Pain and Wound Healing Among Postnatal Mothers

An episiotomy is an incision made in the perineum- the tissue between the vaginal opening and the anus during child birth. Pain at the episiotomy site is more distressing for the mother during postnatal period. An ice pack application or warm shallow bath (sitz bath) may increase comfort and promotes healing. The main aim of this present study was to compare the effect of Crushed ice pack application and Sitz bath on episiotomy pain and wound healing among postnatal mothers. A Matched group design was adopted in this study. By using Non probability purposive sampling technique 22 postnatal mothers with episiotomy were selected as samples at Ramakrishna Hospital, Coimbatore and 11mothers were assigned randomly to each group I and group II. Episiotomy pain was assessed by using Numerical Pain Intensity scale and Wound healing was assessed by using Davidson REEDA scale. Group I received crushed ice pack application and Group II received sitz bath. Intervention was given for 10 minutes twice a day for three consecutive days from first postnatal day. Data were analysed by using descriptive and inferential statistical methods. The statistical analysis revealed that the calculated mean scores of episiotomy pain in the group I and group II was1.72 and 2.9 respectively and the mean difference is 1.2 with the standard deviation of group I and group II was 0.64 and 0.53 respectively. The calculated ‘t’ value 11.3 was greater than the table value of 2.086 at 0.05 level of significance. The calculated mean scores of episiotomy wound healing in the group I and group II was 1.54 and 1.81 respectively and the mean difference is 0.27 with the standard deviation of group I and group II was 0.5 and 0.6 respectively. The calculated‘t’ value 2.6 was greater than the table value of 2.086 at 0.05 level of significance. Finally, the study concluded that the crushed ice pack application was more effective than sitz bath in reducing the level of episiotomy pain and promotes wound healing among postnatal mothers.

Simplified Pain Management Including Fentanyl TTS in PACU Patients With Hip Fracture Surgery to Improve Patients’ Well-Being: A Double-Blind Randomized Trial

Adequate pain management is eminently relevant for elderly and more vulnerable patients with hip fractures in the setting of pre and postoperative pain. This study compares postoperative hip fracture patients treated with standard pain management with a variety of medications or an approach with only one option in each medication category (nonopioid: acetaminophen; opioid: fentanyl TTS 12,5 mcg/hour; rescue medication: piritramide) to simplify the treatment algorithm for nurses and improve patient well-being. Double-blind randomized controlled trial. The sample was cognitively intact patients (N = 141) with hip fractures in a tertiary university hospital. Administration of fentanyl12mcg/hourtransdermal therapeutic system was administered by the nurses in the postanesthesia care unit (PACU) to address basal wound pain to improve patientwell-beingand patient treatment inthe PACU for24hours to bettercontrolfor early complications. Well-being was equally increased in both groups in comparison to our preintervention data from 35.7% to over 60% and did not differ significantly between the intervention and control group. No statistically significant differences in numeric rating scale scores, rescue opioid dosage (piritramide i.v.) or in complications were present. This one-size-fits-all simplified pain management approach did not improve patient well-being or any other outcome but highlighted the importance of adequate pain management and a sufficient nurse-to-patient ratio.

Effect of rapid rehabilitation care on surgical site wound infection and pain in patients with intertrochanteric femoral fractures: A meta-analysis.

This study examines the effects of rapid rehabilitation on surgical site wound infections and pain in patients with intertrochanteric femoral fractures. A computerised search was conducted for randomised controlled trials (RCTs) on rapid rehabilitation care in patients undergoing surgery for intertrochanteric femoral fractures published in the China National Knowledge Infrastructure, China Biomedical Literature Database, Wanfang Database, VIP, PubMed, Embase, Cochrane Library and Web of Science. The search was conducted from the time of the database construction to August 2023. Two investigators independently performed literature screening, data extraction and quality assessment based on predefined inclusion and exclusion criteria. Meta-analysis was performed via RevMan 5.4 software. Encompassing 21 studies involving 2004 patients, with 1007 patients receiving rapid rehabilitation care and 997 receiving routine care, our analysis revealed that rapid rehabilitation care significantly reduced postoperative complications (odds ratio [OR] = 0.24, 95% confidence interval [CI]: 0.17-0.33, p < 0.001), wound infections (OR = 0.30, 95% CI: 0.14-0.65, p = 0.002) and hospital stay (mean difference [MD] = -5.23, 95% CI: -6.03 to -4.43, p < 0.001). Moreover, compared with routine care, it notably improved wound pain (MD = -1.51, 95% CI: -1.98 to -1.05, p < 0.001) in patients undergoing surgery for intertrochanteric femoral fractures. Our findings underscore the effectiveness of rapid rehabilitation care in reducing wound pain, postoperative complications and wound infections among patients with intertrochanteric femoral fractures.

Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis.

In a meta-study, we evaluated the effectiveness and security of the combination of topical anaesthetic and dexmedetomidine in the treatment of postoperative pain in patients with lumbar disease. Four databases were systematically searched for possible related articles. Only English-language research was taken into account on the Internet. Furthermore, we only took into account the studies that were published prior to 2023. Only those that fulfilled the eligibility criteria were considered: (1) in adults who were about to undergo spine operation, (2) dexmedetomidine combined with local anaesthesia, (3) Visual Analog Scale scores at 4 and 24 h after the event and (4) this was a randomized or nonrandomized, controlled study. The meta-analysis was carried out with Revman 5.3 software. A ROBINS-I-based instrument was used to evaluate controlled studies. All trials were synthesized by computing the end results with either a fixed or a random effect model, which was dependent on statistical diversity. Five trials showed a marked reduction in wound pain at 4 h after the operation in patients who were treated with dexmedetomidine for lumbar spinal surgery (MD, -0.81; 95% CI, -1.24, -0.35; p = 0.0005). In the case of lumbar spinal operations, the addition of dexmedetomidine to the postoperative treatment resulted in a marked reduction in the pain at 24 h post-operation (MD, -0.64; 95% CI, -0.79, -0.48; p < 0.0001). The quality of the data we evaluated was 'moderate' to 'good'; thus, we have limited confidence in the impact estimation, and the actual impact might be significantly different from what we had expected. Additional studies should concentrate on practices that are well known to cause severe postoperative pain, especially for cases where the improvement of pain management may lead to substantial clinical benefits in terms of reduction of morbidity or cost-effectiveness in terms of quicker healing and release.

Painful Non-healing Wounds In A 97-Year-Old Patient: Could It Be Angiosomal?

97-year-old female resident of a long-term care facility presented to the Wound Care Clinic with two painful ulcers on her left foot that appeared in the previous two months. She was referred to a Vascular Surgeon six months into treatment as the wounds were not healing and continued to cause pain. This case report looks at some of the issues involved in managing this complex patient.