Reduced Healing Time Research Articles

Effect of gallium maltolate on a model of chronic, infected equine distal limb wounds.

Distal limb wounds are common injuries sustained by horses and their healing is fraught with complications due to equine anatomy, prevalence of infection, and challenges associated with wound management. Gallium is a semi-metallic element that has been shown to possess antimicrobial properties and aid in wound healing in various preclinical models. The effects of Gallium have not been studied in equine wound healing. Therefore, the objective of this study was to compare healing rates between gallium-treated and untreated wounds of equine distal limbs and to demonstrate the antimicrobial effects of gallium on wounds inoculated with S. aureus. Using an established model of equine wound healing we demonstrated beneficial effects of 0.5% topical gallium maltolate on equine wound healing. Specifically we documented reduced healing times, reduced bioburden, and reduced formation of exuberant granulation tissue in wounds treated with gallium maltolate as compared with untreated wounds. Gallium appeared to exert its beneficial effects via its well-described antimicrobial actions as well as by altering the expression of specific genes known to be involved in wound healing of horses and other animals. Specifically, gallium maltolate appeared to increase expression of transforming growth factor-β in both infected and un-infected wounds. Further work is needed to document the effects of gallium on naturally occurring equine wounds and to compare the effects of gallium with other wound treatment options. These data, however, suggest that gallium may be an attractive and novel means of improving equine distal limb wound healing.

Cost of managing patients with venous leg ulcers.

The aim of this study was to estimate costs associated with the management of patients with venous leg ulcers (VLUs) from the perspective of the UK National Health Service (NHS). The analysis was undertaken through the Secure Anonymised Information Linkage Databank which brings together and anonymously links a wide range of person‐based data from around 75% of general practitioner (GP) practices within Wales (population coverage ~2.5 million). The data covered an 11‐year period from 2007 to 2017. All patients linked to the relevant codes were tracked through primary care settings, recording the number of GP practice visits (number of days with an event recorded), and wound treatment utilisation (eg, dressings, bandages, etc.) Resources were valued in monetary terms (£ sterling) and the costs were determined from national published sources of unit costs. This is the first attempt to estimate the costs of managing of VLUs using routine data sources. The direct costs to the Welsh NHS are considerable and represent 1.2% of the annual budget. Nurse visits are the main cost driver with annual estimates of £67.8 million. At a UK level, these costs amount to £1.98 billion. Dressings and compression bandages are also major cost drivers with annual Welsh estimates of £828 790. The direct cost of managing patients with VLUs is £7706 per patient per annum, which translates to an annual cost of over £2 billion, when extrapolated to the UK population. The primary cost driver is the number of district nurse visits. Initiatives to reduce healing times through improving accuracy of initial diagnosis, and improved evidence‐based treatment pathways would result in major financial savings.

Accelerated Corneal Cross-linking as an Adjunct Therapy in the Management of Presumed Bacterial Keratitis: A Cohort Study.

To compare the outcomes of accelerated photoactivated chromophore for keratitis corneal cross-linking (PACK-CXL) as an adjunct treatment for bacterial keratitis (PACK-CXL plus standard antibiotic therapy) for patients receiving only standard antibiotic therapy. Retrospective cohort study of outcomes of patients with moderate infectious presumed bacterial keratitis (ulcer diameter 2 to 7 mm and stromal depth < 300 µm) were compared before and after initiation of a new treatment protocol of PACK-CXL in addition to standard antibiotic treatment. A total of 70 eyes of 70 patients were included: 39 eyes in the PACK-CXL plus antibiotic (PACK-ABX) group and 31 eyes in the antibiotic only (ABX) control group. The PACK-ABX group showed shorter times to complete reepithelialization (9.3 ± 6.0 vs 16.0 ± 12.7 days, P = .01) and did not require tectonic emergency keratoplasty (0% versus 19.4%, P = .006). The PACK-ABX group also showed a higher percentage of eyes with complete reepithelialization in 6 days or less (46.2% vs 6.5%, P < .001) and a trend for shorter hospitalizations (6.3 ± 5.0 vs 8.5 ± 4.5 days, P = .06). A multivariate analysis controlling for age showed that PACK-ABX treatment remained significantly associated with early ulcer reepithelialization (odds ratio = 0.09, 95% confidence interval = 0.02 to 0.48, P = .005). This study validates previous findings regarding the use of accelerated PACK-CXL in the treatment of bacterial keratitis. Adding PACK-CXL improved clinical outcomes (reducing healing time) when compared to antibiotics alone. [J Refract Surg. 2020;36(4):258-264.].

Comparison of Primary Closure, Secondary Closure, and Limberg Flap in the Surgical Treatment of Pilonidal Cysts.

There are few studies comparing methods for pilonidal cyst closure. This study was conducted to compare simple surgical closure, secondary healing, and closure using a Limberg flap in the treatment of patients affected with pilonidal cysts. In total, 150 patients with pilonidal cysts were selected and randomized into 3 groups, with 50 participants in each group. Group A underwent primary closure, Group B underwent secondary closure, and Group C underwent closure with a Limberg flap. Operating time, amount of pain after surgery, time to mobilization, time until return to work, time for complete healing, time until being able to sit on the toilet without pain, postoperative complications including infection and recurrence, and seroma and edema after surgery were compared among the 3 groups. Duration of surgery in the Limberg flap group was significantly longer than the duration of surgery in Group A or Group B (p < .001). The time to patient mobilization, the time when the patient returned to work, the time to complete healing, and the time to being able to sit on the toilet without pain were significantly shorter in Group C than in Group A or Group B (p < .001). Although the procedure takes longer when using a Limberg flap, it appears to be a more effective method in the surgical treatment of patients with pilonidal cyst because of the reduced healing time and improved functional status after the procedure.

In dogs does low level laser therapy reduce healing time?

Clinical bottom line&#x0D; Category of research question&#x0D; Treatment&#x0D; The number and type of study designs reviewed&#x0D; Five papers were critically reviewed. Four were randomised controlled trials and one was a case report&#x0D; Strength of evidence&#x0D; Moderate&#x0D; Outcomes reported&#x0D; Three out of the five studies currently available assessing low level laser therapy to improve wound healing, suggest that low level laser therapy has no beneficial effect on the healing of open or incisional wounds. Of the papers that used statistical analysis, no statistical significance was found in wound surface area over time or tissue histological findings between wounds treated with laser therapy and those who were not. Two papers identified did find decreased wound healing times however the strength of evidence is far poorer for both, with only subjective assessment of the wound in the controlled trial and the other being a case report without control&#x0D; Conclusion&#x0D; Currently there is no strong evidence that low level laser therapy increases the speed of wound contracture and reduced healing time. More studies are recommended to provide stronger evidence towards the use of low level laser therapy in wound healing, preferably with a larger population of dogs and with laser settings which are consistent with previous studies for comparison&#x0D; How to apply this evidence in practice&#x0D; The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources.&#x0D; Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care. &#x0D; &#x0D;

A comparative randomized clinical trial to assess the effectiveness of the diode lasers in both contact and non-contact mode and 0.1% triamcinolone acetonide mouth paste in treatment of oral ulcers—an in vivo study

Ulceration is the breach in the oral epithelium, which typically exposes nerve endings in the underlying lamina propria, resulting in pain and soreness. Oral ulcers are very common, with an estimated point prevalence of 4% worldwide. Current treatment options available include topical agents, systemic and topical corticosteroids, cauterization, antibiotics, multivitamins, adhesive pastes, local antiseptics, analgesics, anti-inflammatory, mouth rinses containing active enzymes, and photobiomodulation therapy (PBMT). Laser constitutes an alternative to processes that alleviate pain and inflammatory reaction and is now widely used in management of diseases that require tissue regeneration. Keeping in mind the analgesic, anti-inflammatory, and bio-stimulatory properties of PBMT, we conducted a study to analyze the effectiveness of PBMT in both contact and non-contact mode in relation to pain in ulcer, size, and healing time. A total of 45 patients with ulcers were included and randomly divided them into 3 equal groups undergoing laser therapy (contact mode, non-contact mode) and conventional treatment, i.e., 0.1%triamcinolone acetonide. All the patients were examined on day 0, 2, 4, and 6 to check for pain, size of ulcer, and healing time. Also, frequency of recurrence was also assessed in a 1-year follow-up. ANOVA followed by post hoc comparison by Bonferroni method was done which revealed that PBMT in non-contact mode provided immediate pain relief and significantly reduced healing time with less recurrence followed by PBMT in contact mode. PBMT in non-contact mode was more effective in relieving pain and reducing the healing time during the treatment of oral ulcers compared with triamcinolone acetonide and laser in contact mode. Also, less recurrence was seen even after 1-year of follow-up. Hence, it can be concluded that PBMT in non-contact and contact mode is a safe and clinically effective therapy for treating oral ulcers.

Lipoconstruct surface topography grating size influences vascularization onset in the dorsal skinfold chamber model

After skin tissue injury or pathological removal, vascularization timing is paramount in graft survival. As full thickness skin grafts often fail to become perfused over larger surfaces, split-thickness grafts are preferred and can be used together with biomaterials, which themselves are non-angiogenic. One way of promoting vascular ingrowth is to “pre-vascularize” an engineered substitute by introducing endothelial cells (ECs). Since it has been previously demonstrated that surface structured biomaterials have an effect on wound healing, skin regeneration, and fibrosis reduction, we proposed that a microvascular-rich lipoconstruct with anisotropic topographical cues could be a clinically translatable vascularization approach. Murine lipofragments were formed with three polydimethylsiloxane molds (flat, 5 µm, and 50 µm parallel gratings) and implanted into the dorsal skinfold chamber of male C57BL/6 mice. Vascular ingrowth was observed through intravital microscopy over 21 days and further assessed by histology and protein identification. Our investigation revealed that topographical feature size influenced the commencement of neovascular ingrowth, with 5 µm gratings exhibiting early construct perfusion at 3 days post-operation, and 50 µm being delayed until day 5. We therefore postulate that surface structured lipoconstructs may serve as an easily obtained and produced construct suitable for providing soft tissue and ECs to tissue defects. Statement of SignificanceSkin graft failures due to inadequate or uneven perfusion frequently occur and can be even more complicated in deep, difficult to heal wounds, or bone coverage. In complex injuries, biomaterials are often used to cover bone structures with a standard split thickness graft; however, perfusion can take up to 3 weeks. Thus, any means to promote faster and uniform vascularization could significantly reduce healing time, as well as lower patient down-time. As pre-vascularized constructs have reported success in research, we created a cost-efficient, translatable method with no additional laboratory time as adipose tissue can be harvested and used immediately. We further used surface topography as an aspect to modulate construct perfusion, which has been reported for the first time here.

Effects of a topical ointment on responses to treatments used for common genital diseases and on quality of life

Abstract This study assessed the impacts of an ointment on treatment efficacy, side effects and global tolerance of most common genital diseases. This observational study enrolled symptomatic patients with LS and psoriasis under maintenance therapy (topical steroids); patients with condyloma acuminata treated with liquid nitrogen and/or imiquimod; patients suffering from vulvodynia under multidisciplinary treatment. The tested ointment was added to the usual treatment. Subjective and objective clinical scores, tolerance and Dermatology Life Quality Index (DLQI) were evaluated. One hundred patients completed the study: 26 LS, 6 psoriasis, 52 CA and 16 vulvodynia. There were significant reductions in global symptom and clinical scores for LS (−80.61% and −59.20%, respectively, mean follow-up 66 days) and psoriasis (−82.88% and −82.80%, respectively, mean follow-up of 51 days). The DLQI decreased by 40.17% for LS and 76.92% for psoriasis. The use of ointment resulted in low post-treatment scores for CA (Symptom score: 1.92/maximum 50, clinical score: 2.46/24 maximum, mean follow-up of 17 days). Tolerance was good for all except two patients (one CA, one vulvodynia). Our results indicated the daily applications of an ointment improved treatments for lichen sclerosus, psoriasis (symptoms, clinical signs and quality of life) and for condyloma acuminata (reduced healing time) and was well tolerated during vulvodynia.

Dissecting the Antimicrobial Composition of Honey.

Honey is a complex sweet food stuff with well-established antimicrobial and antioxidant properties. It has been used for millennia in a variety of applications, but the most noteworthy include the treatment of surface wounds, burns and inflammation. A variety of substances in honey have been suggested as the key component to its antimicrobial potential; polyphenolic compounds, hydrogen peroxide, methylglyoxal and bee-defensin 1. These components vary greatly across honey samples due to botanical origin, geographical location and secretions from the bee. The use of medical grade honey in the treatment of surface wounds and burns has been seen to improve the healing process, reduce healing time, reduce scarring and prevent microbial contamination. Therefore, if medical grade honeys were to be included in clinical treatment, it would reduce the demand for antibiotic usage. In this review, we outline the constituents of honey and how they affect antibiotic potential in a clinical setting. By identifying the key components, we facilitate the development of an optimally antimicrobial honey by either synthetic or semisynthetic production methods.

Cost-effectiveness of adjunct haemoglobin spray in the treatment of hard-to-heal wounds in a UK NHS primary care setting.

To evaluate the cost-effectiveness of topical haemoglobin spray as adjunct therapy in the treatment of hard-to-heal wounds within a UK National Health Service (NHS) community setting. In a previously published comparative clinical evaluation, 50 consecutive patients treated with topical haemoglobin spray, as adjunct to standard care and followed up over 26 weeks, were compared with 50 consecutive retrospective controls from the same clinic treated with the same standard care protocol in the year prior to the introduction of adjunct topical haemoglobin spray. A de novo cost-effectiveness and break-even analysis were performed, using data from the previously published clinical evaluation, for all patients (intent-to-treat) and for patients with complete follow-up using a micro-costing approach and considering only wound care dressing costs. At 26 weeks, the total cost of dressings for all patients in the intervention group was £6953 with 874 cumulative weeks healed, compared with £9547 with 278 cumulative weeks healed for all patients in the control group. The incremental cost-effectiveness ratio (ICER), the incremental cost per additional week healed with adjunct topical haemoglobin spray, is therefore negative (dominant). Total treatment costs per week were lower from week six onwards, with break-even estimated to be at week 10.2. When considering only patients with complete follow-up, the results were similarly dominant, with a mean 10.9 more weeks healed, a mean dressing cost saving per patient of £81.83 by week 26 (-37%). Cost savings were realised from week five, and a break-even was estimated to occur at week 8.0. Topical haemoglobin spray has the potential to restore the healing process, reduce healing times and reduce dressing costs in a NHS community setting, within a few weeks of adoption.

Development of self-healing linear actuator unit using thermoplastic resin*

High operational continuity in robots requires considerable ongoing manual maintenance, which can be replaced by enabling robots to self-heal. Extensive research on self-healing has been carried out toward the realization of this notion. The introduction of self-healing methods into mechanical systems has been investigated in recent years. However, these studies have been inadequate in terms of usage environment and self-healing efficiency. Therefore, in this work, we developed a self-healing actuator unit that can be applied to conventional mechanical systems by incorporating self-healing ability using a thermoplastic resin inserted at the actuator location. First, thermal simulation was performed to understand the design requirements to reduce healing time and ensure stable self-healing efficiency. Subsequently, experiments were performed with an actual machine, in which self-healing was consecutively carried out four times, resulting in an average self-healing efficiency of 110% and a maximum self-healing efficiency of 115%. These results show that it is possible to carry out healing without any reduction in the fracture strength of the healing mechanism, depending on the healing conditions and the designs of the parts in contact with the thermoplastic resin.

Identification of Metagenomics Structure and Function Associated With Temporal Changes in Rat (Rattus norvegicus) Skin Microbiome During Health and Cutaneous Burn.

The cutaneous skin microbiome is host to a vast ensemble of resident microbes that provide essential capabilities including protection of skin barrier integrity and modulation of the host immune response. Cutaneous burn-injury promotes alteration of cutaneous and systemic immune response that can affect both commensal and pathogenic microbes. A cross-sectional study of a limited number of burn patients revealed a difference in the bacteriome of burned versus control participants. Temporal changes of the skin microbiome during health and cutaneous burn-injury remains largely unknown. Furthermore, how this microbial shift relates to community function in the collective metagenome remain elusive. Due to cost considerations and reduced healing time, rodents are frequently used in burn research, despite inherent physiological differences between rodents and human skin. Using a rat burn model, a longitudinal study was conducted to characterize the rat skin bacterial residents and associated community functions in states of health (n = 30) (sham-burned) and when compromised by burn-injury (n = 24). To address the knowledge gap, traumatic thermal injury and disruption of cutaneous surface is associated with genus-level changes in the microbiota, reduced bacterial richness, and altered representation of bacterial genes and associated predicted functions across different skin microbial communities. These findings demonstrate that, upon burn-injury, there is a shift in diversity of the skin's organismal assemblages, yielding a core microbiome that is distinct at the genome and functional level. Moreover, deviations from the core community correlate with temporal changes post-injury and community transition from the state of cutaneous health to disease (burn-injury).

First aid is associated with improved outcomes in large body surface area burns

BackgroundAnimal studies indicate treating burn injuries with running water (first aid) for 20 min up to 3 h after burn reduces healing time and scarring. We have previously demonstrated the benefits of first aid in minor burn injuries with respect to a reduction in wound depth, faster healing, and decreased skin grafting utilisation. The purpose of this cohort study was to assess the effect of first aid on clinical outcomes in large body surface area burn injuries (≥20%). MethodsData was prospectively collected for patients with ≥20% TBSA burns from 2004– 2018. Multivariate regression analysis was used to determine the association of adequate first aid with 8 outcomes – mortality, total length of stay, total body surface area (TBSA), percentage/proportion of TBSA that was full thickness [PFTI], TBSA grafted, number of re-grafting sessions, intensive care admission, and intensive care length of stay. Adequate first aid was defined as the application of 20 min of cool, running tap water up to 3 h following the burn injury. Findings390 patients were identified. Adequate first aid was received in 35.6% (139) of patients. There was a trend towards a reduction in mortality (OR 0.37; 95% CI 0.12–1.13; P = 0.08). Patients who received adequate first aid had a statistically significant 9.8% reduction in TBSA (95% CI −13.6% to −6.1%; P < 0.0001) as well as a 12% lower PTFI compared to patients who received inadequate first aid (95% CI −19% to −4%; P < 0.01). Whilst there was no significant effect of adequate first aid on the TBSA grafted (P = 0.37), adequate first aid was associated with a significantly less number of re-grafting sessions (95% CI −-0.29 to −0.08; P < 0.001). InterpretationAdequate first aid with 20 min of running water is associated with improved outcomes in large burn injuries. Significant benefits are seen in a reduction in TBSA, proportion of the burn wound that is full thickness, as well as decreased re-grafting. This has significant patient and health system benefits and adds to the body of evidence supporting 20 min of cooling in burns care.

Is Platelet Rich Plasma (PRP) an Effective Treatment for Pressure Ulcers?

Background: Platelet rich plasma (PRP) has been used as an effective treatment over the years indifferent medical and surgical fields. It has a high concentration of cytokines and growth factors that play a significant role in the wound healing process. This literature review is looking at whether PRP is effective in treating pressure ulcers as they are a major problem causing a significant increase in health care costs, have a huge impact on patients’ quality of life and cause great morbidity and mortality. Study design and methods: A comprehensive review of the literature was performed. Pubmed, Ovid Medline, OvidEMBASE and CINHAL were used to conduct the literature search using the following MESH headings: PRP, Platelet rich plasma, Chronic wound*, pressure ulcer*, pressure sore*. Cochrane library was searched for systemic reviews and reference lists of relevant publications were used to identify further studies. Results: The literature search identified studies that looked at PRP’s effect on different chronic wounds including pressure ulcers in terms of healing. Some studies looked at pressure ulcers separately. The included studies in this literature review are: one randomised double blind controlled trial, three randomised open label controlled trial, one observation study, five case series and two case reports. Conclusion: PRP promotes the healing of chronic wounds. Individual case series and case reports showed that PRP aids the healing of pressure ulcers improving their vascularity and decreasing ulcer area and volume. Also, some reported significant reduction in healing time. However, further research and randomised controlled trials focusing on the effect of PRP on pressure ulcers need to be conducted in order to support the hypothesis.

The action of Platelet and Leukocyte Rich Fibrin (L‐PRF) on bone neoformation – A systematic review

Background PRF was developed by Choukroun to be used in oral and maxillofacial surgery and, in the Dental Medicine field, it has various applications such as the increase of bone tissue for implantology, sinus lift, alveolar bone graft, periodontal surgeries and others. The present systematic review addresses the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) in bone neoformation. Aim/Hypothesis The objective of this review was to determine if the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) produces beneficial effects for bone neoformation. Material and Methods Electronic databases (PUBMED, EMBASE COCHRANE, LILACS and CINAHL) were retrospectively consulted through 2003, using the following keywords- Rich Platelet-Leukocyte Fibrin and Leukocyte and Platelet-Rich Fibrin. During the selection of the studies, the evaluation of the titles and abstracts identified in the initial search was done by two researchers, independently and blinded. At that time, 34 articles were collected that addressed the relationship of Rich Fibrin in Platelets and Leukocytes in bone neoformation. Articles identified by the initial search strategy were independently assessed by the two researchers, according to the following inclusion criteria-(1) population (human) + (2) dental surgical intervention and+(3) presented histomorphometric studies. Results As a result of the search criteria according to the following inclusion criteria- (1) population (human), (2) dental surgery and (3) presented histomorphometric studies, a single article was selected- Platelet-rich fibrin (PRF)- A second-generation platelet concentrate. Part V- Histologic evaluations of PRF effects on bone allograft maturation in sinus lift (Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2006; 101: 299–303). In this study, the authors performed nine sinus level increases. At 6 sites, L-PRF was added to FDBA particles (test group) and at 3 sites FDBA was used without PRF (control group). Four months later for the test group and 8 months later for the control group, bone samples were collected from the increased region during the implant insertion procedure. These specimens were treated for histological analysis. The authors showed that in cases of sinus floor enlargement with FDBA associated with L-PRF leads to a reduction in healing time before implant placement Conclusion and Clinical Implications This work shows that there are numerous articles that demonstrate that the action of Rich Fibrin on Platelets and Leucocytes (L-PRF) produces beneficial effects for bone neoformation. However, there is a need for more large-scale studies, combining the following inclusion criteria in the same article- (1) population (human), (2) dental surgery and (3) histomorphometric studies.

Pilot Study to Assess Safety and Usability of the Kyron NPWT System.

Background:There is an evident need for Negative Pressure Wound Therapy (NPWT) systems specifically designed for use in resource-constrained settings to aid in the treatment of open wounds.Methods:Prospective single-arm interventional pilot study of 14 patients with complex wounds was conducted at Kirtipur Hospital in Kathmandu, Nepal. A novel NPWT device, the Kyron Suction Unit, was used by 4 plastic surgeons. Primary outcomes were ease of use (10-point Likert scale) and device safety (adverse events recorded). Pain (Visual Analogue Scale score), quality of life (modified EuroQol Derived Single Index scores), and wound dimensions were recorded.Results:User ratings on the 10-point Likert scale indicated high confidence and ease of use: median confidence setting up the device of 1.0 [interquartile range (IQR), 1.0; mean 2.3], median confidence maintaining the device of 1.0 (IQR, 1.0; mean, 1.5), and median ease of disassembly of 1.0 (IQR, 1.0; mean, 1.4). Significant improvement in Visual Analogue Scale scores (P = 0.03), modified EuroQol Derived Single Index scores (P < 0.001), and a reduction in wound volume [median, 47.25–9.75 cm3 (P = 0.01)]. Image analysis of wounds pretreatment and posttreatment demonstrated increase in granulation tissue surface area [median, 7.6–28.7 cm2 (P = 0.003)] and decrease in open wound surface area [median, 48.33–33.6 cm2 (P = 0.01)].Conclusions:The Kyron Suction Unit was safe and easily managed by plastic surgeons. The device design promoted access to NPWT, a therapy proven to reduce healing time and decrease complications for patients with open wounds, in a resource-constrained setting.

Comparison of modified vacuum dressing and wet normal saline dressing in treatment of non-healing diabetic foot ulcers

Background: Diabetic foot a complication of diabetes can lead to significant morbidity and have financial burden. The standard of dressing diabetic foot ulcers has been saline dressings. Negative pressure vacuum devices have come and had a significant impact on treatment of diabetic ulcers. But in developing countries the cost associated with it makes it inaccessible to a large population. Our study aims to compare the use of modified vacuum dressing against saline dressing and compare healing rates, costs involved and hospital stay of patients.Methods: Our study was prospective study of 80 patients randomised into two groups, of 40 each. Group A consisted of patients with modified vacuum dressing and group B with wet saline dressing. Simple randomisation technique was used. They were compared for healing rates, hospital stay and cost involved.Results: There was a 43.75% decrease in area of the ulcer in group A compared to 25.15% in group B after 4 weeks. Decrease in wound depth was 55.41% and 26.94% in group A and B respectively. The mean hospital stay was 33.18 days in group A compared to 45.58 days in group B. The average cost incurred for patients in group A was rupees 14,381 compared to 19,465 rupees in group B.Conclusions: From our study we found that modified vacuum dressing in spite of being cheap it reduces healing time, hospital stay there by the cost incurred to patients. So we recommended modified vacuum dressings as a go to method of treating diabetic foot ulcers.

Rapid Regeneration of Vascularized Bone by Nanofabricated Amorphous Silicon Oxynitrophosphide (SiONP) Overlays.

Fracture healing is a complex biological process. Severe bone loss and ischemia from traumatic fractures lead to inflammation and accumulation of damaging reactive oxygen species (ROS). Fixative devices that not only provide mechanical support but also stimulate antioxidants such as superoxide dismutase (SOD1) and influence signaling pathways for extracellular matrix (ECM) mineralization, are critical for normal healing of such fractures. In this study, we report a novel biomaterial, silicon oxynitrophosphide (SiONP) that provides sustained release of ionic silicon (Si+4) and phosphorous (P) over few weeks under physiological conditions. Anti-oxidant role of Si+4 and augmented ECM mineralization by P ions lead to enhanced osteogenesis coupled with quick revascularization for rapid bone regeneration. Plasma enhanced chemical vapor deposition (PECVD) provided a conformal, well adherent and highly reproducible surface chemistry overlaid onto nanofabricated bioinspired surfaces. The Nitrogen to P and O content ratio was observed to change the dissolution rate and the release kinetics of the overlaid film. The SiONP films with optimal release kinetics promoted anti-oxidant expression via enhanced SOD1, which downstream upregulated other osteogenic markers with MC3T3-E1 cells. These surfaces also promoted angiogenesis evident by formation of thicker tubules by Human umbilical vein endothelial cells (HUVEC). In-vivo evaluation using a rat critical-sized calvarial defect model showed rapid bone-regeneration for these nanofabricated biomaterials as compared to control groups, and opens new horizon for future clinical trials of new antioxidant materials on biomedical devices that can reduce healing time, lower medical care cost, and increase the quality of newly formed bone in critical size defects.

Clinical Evaluation of 660 nm Diode Laser Therapy on the Pain, Size and Functional Disorders of Recurrent Aphthous Stomatitis.

BACKGROUND:Minor recurrent aphthous stomatitis (MiRAS) is one of the most common, recurrent, and painful mucosal pathological condition. It is characterised by round or shallow oval ulcers, less than 10 mm in diameter, surrounded by a thin erythematous halo. It involves non-keratinized mucosa such as the labial and buccal mucosa, the ventral surface or borders of the tongue and the floor of the mouth, but it is uncommon to occur on the keratinised mucosa. It heals spontaneously within 10-14 days without scarring. There is no curative remedy to prevent its recurrence; also, available modalities only reduce the symptoms and severity of the lesion.AIM:Since these lesions may be extremely painful, we decided to estimate the pain-relieving and healing properties of low energy level laser therapy using diode laser 660 nm on MiRAS.MATERIAL AND METHODS:Twenty healthy patients suffering from minor aphthous ulcers were randomly selected from the Out-Patient Clinic of Oral Medicine Department, Faculty of Dentistry, Alexandria University. They were equally divided into two groups, study group who received 660 nm diode laser irradiation while the control group received placebo (sodium bicarbonate rinse). The visual analogue scale, size reduction, effectiveness indices and functional disorders were compared between the groups.RESULTS:Both groups presented a statistically significant difference from baseline to follow up periods. But, diode laser 660 nm treatment showed more remarkable improvements in reduction of healing time, pain and lesion size.CONCLUSION:We concluded that diode laser 660 nm should be further considered as an effective alternative therapeutic regimen to patients who suffer from recurrent aphthous stomatitis.

Platelet-Rich Fibrin and its Emerging Therapeutic Benefits for Musculoskeletal Injury Treatment.

New therapies that accelerate musculoskeletal tissue recovery are highly desirable. Platelet-rich fibrin (PRF) is a leukocyte- and platelet-rich fibrin biomaterial that acts as a binding site for both platelets and growth factors. Through increasing the local concentration of growth factors at specific tissues, PRF promotes tissue regeneration. PRF has been frequently used in combination with bone graft materials to reduce healing times and promote bone regeneration during maxillofacial surgery. However, its benefits during muscle repair and recovery are less well-documented. Here, we perform a narrative review on PRF therapies and muscle injuries to ascertain its beneficial effects. We reviewed the factors that contribute to the biological activity of PRF and the published pre-clinical and clinical evidence to support its emerging use in musculoskeletal therapy. We include in vitro studies, in vivo animal studies and clinical articles highlighting both the success and failures of PRF treatment. PRF can promote the healing process when used in a range of orthopaedic and sports-related injuries. These include cartilage repair, rotator cuff surgery and anterior cruciate ligament surgery. However, conflicting data for these benefits have been reported, most likely due to inconsistencies in both PRF preparation protocols and dosing regimens. Despite this, the literature generally supports the use of PRF as a beneficial adjuvant for a range of chronic muscle, tendon, bone or other soft tissue injuries. Further clinical trials to confirm these benefits require consistency in PRF preparation and the classification of a successful clinical outcome to fully harness its potential.