Scar Of Wound Research Articles

Effect of intra-abdominal hypertension on the strength of the postoperative scar of a laparotomic wound

Annotation. One of the main factors of postoperative eventration is intra-abdominal hypertension, which occurs in various surgical pathologies of the abdominal cavity. Despite the presence of a large number of scientific papers on the negative effect of intra-abdominal hypertension on the morphological state of granulation tissue in the area of the laparotomy wound, there are no publications on the impact on the strength of the postoperative scar. Therefore, the study aimed to investigate in an experiment on small laboratory animals the effect of intra-abdominal hypertension on the mechanical strength of the postoperative scar of a laparotomy wound. The experiment was performed on 120 laboratory rats, which underwent a median laparotomy and brought together the edges of the musculoaponeurotic layer of the anterior abdominal wall with simple nodal sutures. The main group consisted of 72 animals who developed intra-abdominal hypertension by inserting a container (condom) with a certain amount of Furacilin into the abdominal cavity. The comparison group consisted of 48 animals who had an empty condom inserted into the abdominal cavity after laparotomy. The mechanical strength of the postoperative scar of the laparotomy wound was determined by the method of G. V. Petrovich (2010) on the 1st, 3rd, and 5th day after the creation of intra-abdominal hypertension, by measuring the level of intra-abdominal pressure at the time of rupture of the postoperative scar of the laparotomy wound. Statistical analysis of the results was performed using Microsoft Excel spreadsheets and a package of statistical processing software PAST. Differences between study groups were determined using Mann-Whitney criteria. The results of the study indicate that the created intra-abdominal hypertension leads to a decrease in the mechanical strength of the postoperative scar of the laparotomy wound. The degree of the negative impact of intra-abdominal hypertension on the strength of the postoperative scar is inversely proportional to the level of intra-abdominal pressure.

Short-Term Results of Endoscopic Percutaneous Longitudinal Tenotomy for Noninsertional Achilles Tendinopathy and the Presentation of a Simplified Operative Method.

This study was aimed to review the short-term results of endoscopic percutaneous longitudinal tenotomy for noninsertional Achilles tendinopathy using the Centerline Endoscopic Carpal Tunnel Release instrument (Arthrex). This method simplifies the operation technique, allows a good endoscopic visualisation of the Achilles tendon with very promising results. We performed multiple percutaneous longitudinal tenotomies under local anesthesia in 24 patients (25 tendons) with Achilles tendinopathy or peritendinitis that had failed conservative treatment between January 2013 and September 2016. All ambulatory procedures consisted of paratenon release and longitudinal tenotomies. The results were reviewed in 22 patients (23 tendons) at an average follow-up period of 22.5 months (range 10-36 months). Patients' satisfaction and functional outcomes were evaluated using the Victorian Institute of Sports Assessment-Achilles (VISA-A) questionnaire, the pain visual analog scale (VAS), and the functional foot index. Initial results are very promising with excellent results in 12 patients, good results in 9 patients, and fair result in 1 patient. One patient developed a postoperative thrombosis of the operated limb. Another patient developed a hypertrophic painful scar of the incision wound. The VAS for pain decreased drastically after the index procedure and averaged to 0.2 (SD 0.447). The VISA-A questionnaire score had improved from 42 ± 7.2 points preoperatively to 96.8 ± 14.3 points postoperatively (P = .004). The functional foot index decreased from 84 (SD 30.517) to 33.4 (SD 6.452) on the follow-up examination. The endoscopic-assisted longitudinal tenotomies procedure of the Achilles tendon is easily feasible and can be performed on an outpatient basis, produces minimal complications and shows excellent results. The described technique is recommended for all surgeons especially for those familiar with endoscopy of the Achilles tendon. Therapeutic, Level IV: Case Series.

Surgical techniques for the treatment of tongue tie in children: a comparative study

<p class="abstract"><strong>Background:</strong> Ankyloglossia is another name for tongue tie which in mild form is characterized by mucous membrane bands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth. It can affect feeding, speech, and oral hygiene as well as have mechanical/social effects. Ankyloglossia can also prevent the tongue from contacting the anterior palate.</p><p class="abstract"><strong>Methods:</strong> The study aimed to find out best possible surgical modality of frenectomy by comparing scalpel, electro-cautery and CO<sub>2</sub> laser in the treatment of tongue tie. This is a prospective randomized clinical trial conducted in the department of ENT, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. All patients were categorized in to three groups randomly as group A, group B and group C. Each group contains 18 patients and among group A, B and C, frenectomy was done by conventional scalpel technique, by bipolar cautery and CO<sub>2</sub> laser respectively. Then patients were assessed on post op day 1 for symptomatology and inflammatory signs, on post op day 7 for wound healing and any complications and also after 1 month post-op for scar and contracture of wound. </p><p class="abstract"><strong>Results:</strong> In our study, about 61% of population is of male child and female child were remaining 39% (ratio 1.6:1) which is matching with the previous studies. Amongst all patients most common age group is between 1-4 years of age group. Most of the patients were in Kotlow’s class III having severe ankyloglossia (3‑7 mm) followed by class I having Mild ankyloglossia (12‑16 mm).</p><p><strong>Conclusions:</strong> Laser and electro-cautery treatment used for frenectomy operations provides better patient perception in terms of postoperative pain and function than that obtained by the scalpel technique.</p>

Surgical Techniques for the Treatment of Tongue Tie in Children: A Comparative Study

Background: Ankyloglossia is another name for tongue tie which in mild form is characterized by mucous membrane bands to complete ankyloglossia whereby the tongue is tethered to the floor of the mouth. It can affect feeding, speech, and oral hygiene as well as have mechanical/social effects. Ankyloglossia can also prevent the tongue from contacting the anterior palate. Methods: The study aimed to find out best possible surgical modality of frenectomy by comparing scalpel, electro-cautery and CO 2 laser in the treatment of tongue tie. This is a prospective randomized clinical trial conducted in the department of ENT, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra. All patients were categorized in to three groups randomly as group A, group B and group C. Each group contains 18 patients and among group A, B and C, frenectomy was done by conventional scalpel technique, by bipolar cautery and CO 2 laser respectively. Then patients were assessed on post op day 1 for symptomatology and inflammatory signs, on post op day 7 for wound healing and any complications and also after 1 month post-op for scar and contracture of wound. Results: In our study, about 61% of population is of male child and female child were remaining 39% (ratio 1.6:1) which is matching with the previous studies. Amongst all patients most common age group is between 1-4 years of age group. Most of the patients were in Kotlow’s class III having severe ankyloglossia (3‑7 mm) followed by class I having Mild ankyloglossia (12‑16 mm). Conclusions: Laser and electro-cautery treatment used for frenectomy operations provides better patient perception in terms of postoperative pain and function than that obtained by the scalpel technique.

Hypertrophic Scar Formation on Application of Terpenoid Fraction of Tuberous Root of Mirabilis jalapa L. on Excision Wound Model in Wistar Albino Rats.

The study was designed to evaluate the effects of hydromethanolic extract of tuberous root of M. jalapa and its terpenoid and flavonoid fractions on cutaneous wound healing in Wistar Albino rats. The hydromethanolic extract was subfractionated by sequential extraction in solvents (moderately nonpolar to polar). The extract and its (terpenoid and flavonoid) fractions were used for cutaneous wound healing studies by using excision wound model on rat. Their effects on wound contraction rate, biochemical and histological changes, and expression of growth factors such as collagen 3A, basic fibroblast growth factor, and vascular endothelial growth factor were investigated. The results indicated that flavonoid treated group showed significant decrease (P < 0.05) in antioxidant enzyme level as compared to control in wound healing process, whereas terpenoid fraction showed significant increase (P < 0.05) in expression of growth factor levels but regeneration and remodeling stages were delayed due to formation of thicker ulcus layer and also there were no hair follicle-like blood capillaries formation which ultimately may lead to formation of hypertrophic scar of wound. Therefore, from this study, it can be concluded that terpenoid fraction prolongs proliferation phase and hence may have tendency to convert the wound into hypertrophic wound.

Creating thick linear scar by inserting a gelatin sponge into rat excisional wounds

The rat incisional wound is an important model for wound scarring research, but it is also difficult to mimic thick human incisional scarring. We hypothesized that such a thick linear scarring can be generated by inserting a gelatin sponge into a rat excisional wound. The results demonstrated that the new wound model could generate 11 times wider wound width (at day 7) and 4-5 times wider scar width (at days 14, 21, and 60), respectively, than the widths of incisional wounds (p<0.05) in adult Sprague-Dawley rats. The thick linear scar created was grossly apparent in contrast to the grossly unobvious scar of the incisional wound, and a regular linear shape could be achieved with a similar scar width along the wound. The mechanism study revealed several factors that might contribute to the enhanced scarring, including delayed wound healing, enhanced inflammation, increased expression of fibrotic factors, and abnormal wound remodeling due to the insertion of the gelatin sponge. These results indicate that the new wound model of thick linear scar might be valuable for clinically relevant study of scar manipulation. Moreover, this model may serve as a tool for studying gene-mediated tissue regeneration during wound repair using inserted gelatin sponge as a gene carrier.

Extrusion of the peritoneal catheter of a VP shunt system through a gastrostomy wound

Background A variety of complications can occur following ventriculoperitoneal shunt. We report a case of extrusion of the catheter tip through the old scar of the percutaneous endoscopic gastrostomy (PEG) wound. Case description A 70-year-old male suffered from an intracerebral hemorrhage and then developed hydrocephalus. He required a ventriculoperitoneal shunt. This patient required a PEG for gastroenteric feeding. The PEG was removed 4 years after the insertion because of infection. The tip of the distal shunt tube extruded through the scar of the PEG wound 2 years later. Conclusion The catheter end of VP shunt can extrude through the weak point of an old PEG scar. This kind of complication should be brought to mind while performing abdominal surgery in patients with VP shunts.