Shorter Healing Time Research Articles

The Clinical Efficacy of ReCell® Autologous Cell Regeneration Techniques Combined with Dermabrasion Treatment in Acne Scars.

To evaluate the efficacy of ReCell® autologous cell regeneration techniques combined with dermabrasion treatment on the therapy of acne scars. We analyzed retrospectively 78 patients with acne scars who presented to the Department of Plastic Surgery at Peking Union Medical College Hospital from May 2015 to May 2017; 30 patients were treated with dermabrasion (Group 1), and the other 48 patients were treated with ReCell® autologous regeneration techniques combined with dermabrasion (Group 2). Efficacy was evaluated through self-evaluation of the patient, third-party evaluation and photographs taken before and after treatment. The wound healing time and postoperative complication rate were also recorded. The study revealed a significant difference in healing time (P < 0.001) between patients treated with dermabrasion (Group 1) and patients treated with ReCell® autologous regeneration techniques combined with dermabrasion (Group 2). The average healing time of Group 1 was 12.30 ± 1.725days, while the average healing time of Group 2 was 5.27 ± 1.086days. In Group 2, patient self-evaluation and third-party evaluation were more satisfactory than those of Group 1 (P < 0.001). Moreover, there were no postoperative complications in Group 2 such as pigmentation and scar hyperplasia. The ReCell® technique is simple, minimally invasive, biocompatible and effective in the treatment of acne scars. It can shorten healing time and reduce the occurrence of postoperative complications, thereby providing a safe and effective treatment approach for patients with facial acne scars. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266.

Measurement of Adhesion of Sternal Wires to a Novel Bioactive Glass-Based Adhesive.

Stainless steel wires are the standard method for sternal closure because of their strength and rigidity, the simplicity of the process, and the short healing time that results from their application. Despite this, problems still exist with sternal stability due to micromotion between the two halves of the dissected and wired sternum. Recently, a novel glass-based adhesive was developed which, in cadaveric trials and in conjunction with wiring, was shown to restrict this micromotion. However, in order to avoid complications during resternotomy, the adhesive should adhere only to the bone and not the sternal wire. In this study, sternal wires were embedded in 8 mm discs manufactured from the novel glass-based adhesive and the constructs were then incubated at 37 °C for one, seven, and 30 days. The discs were manufactured in two different thicknesses: 2 and 3 mm. Wire pull-out tests were then performed on the constructs at three different strain rates (1, 0.1, and 0.01 mm/min). No statistically significant difference in pull-out force was found regardless of incubation time, loading rate, or construct thickness. The pull-out forces recorded were consistent with static friction between the wire and adhesive, rather than the adhesion between them. Scanning electron micrographs provided further proof of this. These results indicate that the novel adhesive may be suitable for sternal fixation without complicating a potential resternotomy.

Erbium YAG laser and diode laser applications for the second phase of implant surgery: a comparison of clinical outcomes

This study assessed the clinic outcomes of erbium: yttrium/aluminum/garnet (Er:YAG) laser and diode laser use in second phase of implant surgery. Fifty implants scheduled for stage II implant surgery were randomly assigned to 4 groups. In the first group (G1), Lite-touch Er:YAG laser was selected, and a vacuum-formed template was used for each site to indicate surgical entrance. For the second group (G2), Lite-touch Er:YAG laser was used and the surgery was performed in a free-hand way. The third group (G3) adopted free-hand surgery while diode laser was used. In the last group (G4), LightWalker Er:YAG laser was applied by free hand. The surgeon was allowed to look at cross-sectional images and 3D reconstruction in the computer to obtain implant position in G2, G3, and G4. The time of operation, healing time, and accuracy of operation were assessed. G1 and G4 took the shortest time in surgery than that of the other two groups (P 0.05). The healing time of Lite-touch Er:YAG laser with or without surgical guide was the shortest when compared with the other two groups (P < 0.05). G3 had the longest healing time among the 4 treatment modalities (P < 0.05). When applied in the implant uncover surgery, Er:YAG laser presents shorter healing time than diode laser. Contact laser operation provides more accuracy than noncontact operation.

Clinical study of percutaneous hollow screw combined with tension band internal fixation for comminuted patellar fracture after arthroscopic reduction

Objective To investigate the clinical effect of percutaneous hollow screw combined with tension band internal fixation for comminuted patellar fracture after arthroscopic reduction. Methods 105 patients with comminuted patellar fracture in our hospital from April 2013 to September 2017 were selected and divided into observation group (n=53) and control group (n=52) according to different treatment schemes. The control group was treated with conventional open reduction and Kirschner wire combined with tension band internal fixation, while the observation group was treated with arthroscopic assisted reduction and percutaneous cannulated screw combined with wire tension band internal fixation. The operation status and postoperative fracture healing time of the two groups were compared. One-year follow-up was performed after operation. The incidence of complications, the excellent and good rate of operation, and the preoperative and postoperative pain scores (VAS) and knee were compared. Hospital for special surgery knee score (HSS), Activity of Daily Life Scale (ADL), quality of life score (the Mos 36-item Short Form Health Survey, SF-36) were compared. Results The observation group had fewer fluoroscopy times during operation, shorter incision length and shorter healing time after operation than the control group (P<0.05); the incidence of complications in the observation group was 3.85%, lower than 20.00% in the control group, and the excellent and good rate of operation was 96.15%, higher than 82.00% in the control group (P<0.05); the VAS scores of the two groups were lower than those of the control group one year after operation, and the scores of HSS, ADL and SF-36 were lower than those of the control group. The preoperative improvement was higher in the observation group than in the control group (P<0.05). Conclusions Arthroscopic reduction combined with percutaneous hollow screw and tension band internal fixation for patellar comminuted fracture can reduce surgical trauma and accelerate the rehabilitation of patients. It can reduce the incidence of complications, relieve pain, improve knee function, daily living ability and quality of life, and the effect is remarkable. Key words: Arthroscopy; Patella; Fractures, comminuted; Fracture fixation, internal; Bone screws; Bone wires

Stability of femoral neck fracture fixation: A finite element analysis

Femoral neck fractures represent a relatively uncommon injury in the non-elderly population often resulting from high-energy trauma. Clinical outcome in these patients can be improved by optimizing surgical procedures and selecting appropriate fixation methods. The aim of this study was to develop a numerical fracture model to investigate the influence of critical mechanical factors on the stability of fixation methods for femoral neck fractures. The mechanical stability of fracture fixation was assessed through employing finite element models and simulating progressive consolidation of the fracture for a vertical femoral neck fracture (i.e. Pauwels type III in which the angle between the fracture line and the horizontal plane is greater than 70°). Mechanical performance was compared among three different fixation methods (cannulated screws, dynamic hip screw with de-rotational screw, and proximal femoral locking plate). Axial femoral head displacement varied from 2.3 mm for cannulated screws to 1.12 mm for proximal femoral locking plate, although dynamic hip screw with de-rotational screw indicated a value of 0.94 mm. Considering a consolidated fracture and full weight-bearing load case, average displacements of fracture fragments were obtained of about 1.5, 3 and 70 µm for dynamic hip screw with de-rotational screw, proximal femoral locking plate and cannulated screws methods, respectively. In terms of interfragmentary movements at the fracture site, outcomes of this study demonstrated that, in agreement with our previous experimental research, the dynamic hip screw with de-rotational screw implant is a more effective choice than cannulated screws and proximal femoral locking plate techniques for vertical femoral neck fractures in young patients. Thus, one may conclude that the use of dynamic hip screw with de-rotational screw, particularly during the early stages of bone healing, could provide suitable mechanical environments that facilitate direct bone formation and shorter healing times.

Application of Alginate Oligosaccharides and Sodium Alginate in Breast Abscess Incision and Drainage

Objective: To evaluate the efficacy of alginate oligosaccharides and sodium alginate (seaweed biological glue) after incision drainage for breast abscess. Methods: randomly selected 80 patients with breast abscess, observation group and control group 40 cases, observation group using alginate oligosaccharides, sodium alginate (seaweed biological glue) for postoperative patients with breast abscess incision drainage treatment disposal, the control group with saline treatment disposal, using t test to compare two groups of patients with postoperative incision healing time, switching frequency, the satisfaction degree of the patients of postoperative scar, using chi-square test to compare the postoperative recurrence rate. Results: the incisions of the two groups were completely healed, and the observation group had shorter healing time, fewer drug changes, lower recurrence rate and higher satisfaction to postoperative scars than the control group. Conclusion: the treatment of patients with breast abscess after open and drainage with algal oligosaccharide and sodium alginate (alginate biogel) after operation can significantly shorten the wound healing time of patients, reduce The Times of dressing changes, and improve patients’ satisfaction with scars and reduce recurrence.

Surgical drainage of lactational breast abscess with ultrasound-guided Encor vacuum-assisted breast biopsy system.

Lactational breast abscess is a serious complication of mastitis and commonly diagnosed in breast‐feeding women. The traditional drainage of breast abscess was often performed with incisive technique which may result in prolonged healing time, regular dressings, dressing pain, interfering with breastfeeding and unsatisfactory cosmetic outcome. As minimal invasive alternatives to incisive drainage, needle aspiration or percutaneous catheter placement cannot completely replace incisive drainage for the inability to treat large, multiloculated or chronic abscess. Vacuum‐assisted breast biopsy system (VABB) has been successfully applied in the treatment of benign breast diseases with satisfactory cosmetic outcomes. Among VABB devices, EnCor system has some distinctive features that make it an appropriate candidate for the treatment of lactational breast abscesses. In this study, for the first time, we investigated the feasibility, efficacy, and cosmetic results of surgical drainage of lactational breast abscess with US‐guided Encor VABB system. Our data suggests this procedure could serve as a promising alternative for women with lactational breast abscess who require incisive intervention with high cure rate, relatively short healing time, low recurrence rate, few complications, satisfactory cosmetics outcome and without interfering with breastfeeding.

Is it safe to incise skin by monopolar electrocautery? A comparative study

Background: The present study of evaluation of the use of electrocautery to incise the skin has been done to evaluate and assess basically. The advantages and disadvantages of the electrocautery to incise the skin when compared with that of scalpel. The results of the use of electrocautery on skin wound are then assessed to formulate the criteria for proper case selection for this procedure.Methods: A total of 100 patients were taken for this study. 50 patients underwent electrocautry monopolar mode incision (group A) who were compared with 50 scalpel incision patients (group B). Study was done from 01 January 2016 to 30 September 2017. Variables used in this study were complication like pain, lack of apposition and skin infection at the site of incision, pain, sinus formation and induration. This method was also evaluated with respect to following parameters: days of hospitalization, cosmetic result, rate of infection, wound apposition and requirement of secondary suturing.Results: As per our study, results are in favour of electrocautry by means of hemostasis. But we found that infection rate and complications are more with it. Moreover number of dressings required and hospital stay was also more with patient undergoing skin incision with electrocautry.Conclusions: For locally overlying healthy skin with no compromise of vascularity or any oedema and there is less fat, electrocautery use for skin incision can still be recommended for better cosmetic result and shorter healing time with less complication and rapid surgery.

SAT-006 Dihydrotestosterone (DHT) Enhances Major Burn Injury Wound Healing by Regulating the Inflammatory Response in Mice

Androgen analogy (Oxandrolone) have been reported to better maintain lean body mass, with improved hypermetabolic responses and shortened healing time for major burn injured patients. This is contradictory to that androgens inhibit local wound repair in men and male mice. The aim of this study therefore is to identify the role of pure androgen dihydrotesterone (DHT) in complex major burn injury, in particularly whether androgen targets local healing process or systemic burn induced hypermetabolism. A DHT silastic tube was subcutaneously implanted to male Balb/c mice prior to surgery as the treatment group. A 2 X 2 cm2 full thickness contact burn wound was created on the dorsal skin of wild type littermates (control) or DHT treated mice. Wound healing rate and body weight changes were measured and compared between treatment and non-treatment group. The serum level of inflammatory cytokine/chemokine was measured using a Multiplex Immunoassay System. Spleen immune cells enumeration was analysis by flow cytometry. Inflammation, re-epithelialization, cell proliferation and collagen deposition was analysed using histology, immunohistochemistry and RT-PCR. In the present study, we found DHT treatment better maintained the body weight in mice and significantly promoted wound healing over 14 days, whereas DHT treatment had no effect on burn-induced hypermetabolism. In control group, major burn injury triggered an acute systematic inflammation response, resulting in significant increased weight of spleen, excess infiltration of nucleated erythroid cells in red pulps of spleen and a significant increase in number of splenic monocytes over 21 days. DHT treatment shortened the systemic inflammation response, evidenced via reduced splenic weight and the number of monocytes in spleen and circulation at day 14 and 21. This finding is further confirmed by less infiltration of macrophages in wound area at day 14 and 21 compared to control group. Taken together, our results suggesting the DHT treatment significantly improve wound healing by accelerated turnover of inflammation response but not through the metabolism. Further studies are necessary to define the exact mechanisms and DHT treatment could be a new therapeutic approach to improve the survivability of major burn injured patient.

Neodermis Formation in Full Thickness Wounds Using an Esterified Hyaluronic Acid Matrix.

The role of the dermis is essential for the proper orchestration of all phases of the normal wound healing process. Wounds with seriously damaged or even absent dermis consistently show seriously impaired wound healing and/or long-term complications such as hypertrophic scarring. Replacing a damaged dermis requires a dermal matrix that is compatible with, or even stimulates, the process of wound healing. Hyaluronic acid (HA), in an esterified form, is among the many matrices that are available. HA has been used in a number of indications, such as ulcers (ie, diabetic foot ulcers and venous leg ulcers), trauma, including burns, and for the repair of contractures and hypertrophic scars. The shorter healing time and the decrease of recurring hypertrophy demonstrate the efficiency of HA-derived matrices. Biopsies, taken up to 12 months post-reconstruction show a neodermis that histologically is largely comparable to normal skin, which probably is a function of HA playing such a pivotal role in normal, unwounded skin, as well as in the process of healing.

The effects of Chinese herbal medicines for treating diabetic foot ulcers: A systematic review of 49 randomized controlled trials

ObjectiveTo assess the effects and associated risks of Chinese herbal medicine (CHM) for diabetic foot ulcer (DFU). MethodsWe systematically searched seven electronic databases for randomized controlled trials (RCTs) about Chinese herbal medicines for treating diabetic foot ulcers. The methodological quality of RCTs was assessed by the Cochrane risk of bias tool. Data was synthesized using review manager (RevMan) 5.3. Meta-analysis was conducted if the data were available. A summary of finding table was generated by The GRADEpro Guideline Development Tool (GDT) online. ResultsForty-nine RCTs, all conducted in China, involving 3646 participants were included. Most of the included trials had unclear or high risk of bias. Twenty-six trials could be pooled in five Meta-analyses, the remaining trials could not be pooled due to the obvious clinical heterogeneity. Only low evidence showed CHM therapy may have 42%–60.4% participants healed completely after treatment, approximately twice (RR 1.42–1.76) as much as the healed rates in conventional therapy (or plus hot water foot bath) group. Majority of the included trials reported benefit of CHM group on shortening healing time (4–23 days) and reducing ulcer wound size (at least 2 cm2). No serious adverse events were reported related to the medication in all trials. ConclusionWeak evidence showed benefit of CHM as add-on treatment of conventional therapy on increasing number of ulcer heals in patients with DFU. That's about twice the healing rate of the conventional treatment (or plus hot water foot bath) group. With insufficient information, we could not draw confirmative conclusion on safety of CHM administration. These findings need to be tested in further large, rigorous trials.

Spray on skin for diabetic foot ulcers: an open label randomised controlled trial

BackgroundOne Australian loses a limb every 3 h as a result of infected diabetic foot ulcers (DFU). This common condition accounts for substantial morbidity and mortality for affected individuals and heavy economic costs for the health sector and the community. There is an urgent need to test interventions that improve wound healing time, prevent amputations and recurrent ulceration in patients presenting with DFU whilst improving quality of life and reducing health care costs.MethodsOne hundred and fifty eligible participants will be randomised to receive an autologous skin cell suspension, also termed ‘spray-on’ skin (ReCell®) or standard care interventions for their DFU. The primary outcome is complete wound healing at 6 months, but participants will be followed up for a total of 12 months to enable secondary outcomes including total overall costs, ulcer free days at 12 months and quality of life to be assessed.DiscussionOutpatient costs for dressings, home nursing visits and outpatient appointments are key cost drivers for DFU. If spray-on skin is effective, large cost savings to WA Health will be realised immediately through a shortened time to healing, and through a higher proportion of patients achieving complete healing. Shortened healing times may enable participants to return to work earlier. Any economic benefits are likely to be amplified across Australia and other similar demographic settings where aging populations with increased diabetes rates are considered major future challenges.Trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12618000511235. Registered on 9 April 2018.

Segmental resection combined with anoplasty for the treatment of circumferential mixed hemorrhoids.

Circumferential mixed hemorrhoids are very difficult to treat non-surgically. Therefore, it is important to explore the surgical methods for its complete resolution as well as maintenance of normal anal anatomy and function. The present study was designed to evaluate the effect of segmented and plastic hemorrhoidectomy (SPH) on patients with circumferential mixed hemorrhoids. A total of 300 patients with circumferential mixed hemorrhoids were divided into experimental group (n=150) undergoing SPH and control group (n=150) undergoing Milligan-Morgan hemorrhoidectomy. There were no differences in cure and effectiveness rates between two groups. Compared with the control group, patients in the experimental group had shorter healing time (15.7±1.3 vs 12.5±0.7 days) and recovery to normal activity (18.5±2.7 vs 14.7±1.2 days). In addition, anal function of all patients in the experimental group was normal during short- and long-term follow-up. However, more cases in the control group showed anal dampness and itching, and poor control of intestinal liquid. Compared with the control group, patients in the experimental group had better outcomes in overall anal function and smoothness at 6, 12, and 18 months after operation as well as patient satisfaction. Furthermore, the rating in the visual analogue scale for defecation pain and edema in the experimental group was less than that in the control group. SPH was more effective, had fewer complications, better protection of anal function, and a better cosmetic result.

Ligation of intersphincteric fistula tract technique in the management of anorectal fistula

Background and aims Anorectal fistula is one of the most common problematic anal conditions in daily surgical practice. Many treatment modalities are used. This study evaluates the ligation of intersphincteric fistula tract procedure on the basis of its postoperative outcomes. Patients and methods This study was carried out on 25 patients. Participants of either sex diagnosed with anal fistula (transsphincteric fistula, either high or low) were included in the study between April 2016 and May 2018. Patients with recurrent fistulas, Crohn’s disease, and anal or distal rectal cancers were excluded from the study. Results The mean age group of the study participants was 36.6±8.34. The sex distribution showed a higher number of men (n=17) compared with women (n=8). The mean operative time was 35.46±3.6 min and the mean healing time was 6 weeks. Anal incontinence was not observed (0%). A total of two (8%) participants developed recurrence. Conclusion The Ligation of intersphincteric fistula tract procedure is an effective and sphincter-preserving technique for fistula-in-ano with a shorter healing time and a lower incidence of recurrence.

Nursing and application effect of closed negative pressure drainage combined with external fixator in severe open fracture of limbs

Objective To explore the nursing and application effect of closed negative pressure drainage combined with external fixator in severe open fracture of limbs. Methods A total of 270 cases of patients with severe open fractures of limbs were selected for external fixator fixation, and were divided into control group, treatment group and nursing group with 90 cases each according to the random number table method.The control group was given conventional dressing dressing combined with conventional nursing, the treatment group was given closed negative pressure drainage combined with conventional nursing, and the nursing group was given closed negative pressure drainage combined with targeted nursing.The efficacy, infection status, wound healing time, SDS and SAS scores and nursing satisfaction of the three groups were compared. Results There were statistically significant differences in efficacy, total effective rate, infection rate, wound healing time and satisfaction between the three groups (P 0.05). After intervention, all 3 groups were lower than before intervention, and the treatment group and nursing group were lower than the control group, nursing group was lower than the treatment group, the difference was statistically significant (P<0.05). Conclusions The curative effect of closed negative pressure drainage + external fixator is significant in the treatment of severe open fracture of limbs. Targeted nursing can further improve the curative effect, reduce infection rate, shorten wound healing time, improve depression and anxiety, and improve nursing satisfaction. Key words: Closed negative pressure drainage; External fixation; Limb open fracture; Anxiety; Depression

Efficacy of long-term treatment with Teriparatide on osteoporotic intertrochanteric fracture in the elderly

Objective To observe the efficacy of long-term treatment with Teriparatide on osteoporotic intertrochanteric fracture in the elderly. Methods The elderly patients with osteoporotic intertrochanteric fracture meeting inclusion and exclusion criteria were recruited.They received proximal femoral nail anti-rotation(PFNA)surgery with the combined intakes of calcium of 600 mg/day and 1-alpha, 25-(OH)2-vitamin D3 analogs of 0.5 μg/day as a basic standard treatment protocol(BSTP). The study subjects included control group(n=10)who underwent PFNA surgery plus oral calcium and vitamin D supplements without teriparatide(20 μg/d), and the observation group who received PFNA surgery plus oral calcium and vitamin D supplements with teriparatide(20 μg/d), for more than twelve months or over at our department from October 2012 to February 2016.Gender, age, socio-demographics and clinical values of the American Society of Anesthesiologists(ASA)score, fracture types, preoperative serum albumin level, preoperative BMI, bone mineral density 1 week postoperatively, serum N-terminal propeptide of type I collagen(PINP)and C-terminal telopeptides of type 1 collagen(β-CTX)1 week postoperatively were matched between the two groups, no statistically significant difference was found(all P>0.05). Levels of PINP and β-CTX 3, 6 and 12 months postoperatively, BMD 1 year postoperatively, fracture healing time and complications were compared between the two groups.The prognosis of 1 case of patient undergoing conservative treatment was observed. Results There was no significant difference between the two groups in serum levels of PINP and β-CTX 1 week postoperatively(P=0.362 and 0.517, respectively). Serum level of PINP was significantly increased in observation group at 3, 6 and 12 months postoperatively versus at 1 week postoperatively(P=0.008, 0.001 and 0.004, respectively), while serum level of PINP had no significant difference in control group at 3, 6 and 12 months postoperatively versus at 1week postoperatively(P>0.05). Serum levels of PINP 3, 6 and 12 months postoperatively were higher in the observation group than in control(P=0.002, 0.002 and 0.000, respectively). In the observation group, serum β-CTX level reached the peak at 6 months after surgery, which was higher than that at 1 week after surgery(P=0.041), and slowly decreased at 12 months after surgery.In the control group, β-CTX slowly increased at 3, 6 and 12 months postoperatively versus at 1 week postoperatively(P>0.05). There was no significant difference in BMD of lumbar spine and contralateral hip between the two groups at 1 week postoperatively(P=0.440 and 0.325). At 1 year postoperatively versus at 1 week postoperatively, the BMD of lumbar spine and contralateral hip was increased(P=0.039 and 0.009)in the observation group, while was decreased(P>0.05)in control group.The fracture healing time was shorter in observation group than in control group(13.6±2.2 weeks vs.17.6±3.4 weeks, P=0.033). No one had a delayed fracture healing in observation group and 1 patient showed a delayed fracture healing in the control group.There were no complications such as lag screw sliding, refracture, pressure ulcer and deep vein thrombosis in both groups.The fracture nonunion was found in the patient undergoing conservative treatment after 20 months of teriparatide treatment. Conclusions The medium-and long-term of teriparatide treatment can significantly promote bone formation, improve BMD of the lumbar spine and hip, and shorten fracture healing time in patients with osteoporotic intertrochanteric fracture, but it is not a substitute for surgical treatment. Key words: Osteoporosis; Hip fractures; Teriparatide

Application of red light phototherapy in the treatment of radioactive dermatitis in patients with head and neck cancer

BackgroundTo observe the effect of red light phototherapy (RLPT) on radioactive dermatitis (RD) caused by radiotherapy in patients with head and neck cancer (HNC).MethodsSixty patients with HNC admitted to our hospital were randomly divided into experimental group and control group, 30 patients in each group. The control group received routine daily care during radiotherapy treatment. In the experimental group, in addition to routine daily care during radiotherapy treatment, photon therapy apparatus RLPT was added, 10 min/time, 2 times/day, and lasted until the end of radiotherapy. The pain and conditions of the patients’ skin were assessed daily, and the skin pain and dermatitis grades of the two groups were compared.ResultsIn terms of the reaction degree of RD, experimental group was mainly grade 0–2, and control group was mainly grade 2–3, with a significant difference (P < 0.05). In terms of skin pain, according to the pain records at week 2, 3, and 4, the pain degree increased with time. However, the score of wound pain in experimental group was significantly lower than that in control group, and there was a significant difference between the two groups (P < 0.05).ConclusionsThe application of RLPT in the treatment of RD can help accelerate wound healing and significantly shorten healing time. It can not only reduce wounds pain of patients, promote inflammation and ulcer healing, but also ensure the smooth progress of patients’ radiotherapy and improve their quality of lives, which is worth popularization and application in the clinical practice.

Idiopathic granulomatous mastitis: A retrospective cohort study between 44 patients with different treatment modalities.

BackgroundIdiopathic granulomatous mastitis (IGM) is an uncommon benign chronic inflammatory disease which can clinically and radiographically mimic abscess or breast cancer. Definitive diagnosis was made by histopathology and exclusion of an identifying etiology. Optimal treatment has not been yet established. The aim of this study was to report and describe the clinical signs, radiological findings, managements, clinical course, and clinical outcomes after treatment of IGM.MethodWe retrospectively studied IGM medical records of 44 patients in our institute collected from March 1990 to October 2016. The patient characteristics, clinical presentations, radiological findings, microbiological workups, tissue pathology, treatment modalities, outcomes, and follow-up data were reviewed and analyzed. The success rate, recurrence rate and time-to-healing were compared focusing on the treatment modalities to find the proper treatments for IGM patient.ResultsForty-four patients were diagnosed as IGM. The median follow-up time was 20.73 months ranging from 1.26 to 118.8 months while the median time of the diagnosis was 21 days ranging from 2 to 246 days. Due to the follow-up period, only thirty-nine patient data were used for the analysis. In the first setting, 30 patients were treated by surgery, 6 patients were treated by using steroid while other 3 patients were treated by other different treatments. Only 25 from 39 patients (64.10%) were cured by the first modality. The overall median time-to-healing was 84 days while the medians of time-to-healing treated by surgery, steroid and the rest were 75, 114.5, and 238 days respectively. The surgical treatment had the shortest time-to-healing but not statistically significant (p = 0.23). Thirteen patients out of twenty-five (52%) had wound complications after performing an excision. Lastly, five patients out of thirty-nine (12.82%) had recurrence.ConclusionIGM is an uncommon benign disease which is hardly distinguished from malignancy. There is not a significant difference among treatment modalities in term of time-to-healing and recurrence of disease. The result shows that surgery is outperformed by the shortest healing time. However, the surgical treatment must be chosen with careful due to high rate of wound complications. Multimodality treatment is recommended as the proper treatments for IGM patient.

Osteonecrosis of the jaw related to non-antiresorptive medications: a systematic review.

The reporting of osteonecrosis of the jaw (ONJ) related to anticancer agents without known antiresorptive properties (non-antiresorptives), such as antiangiogenics, tyrosine kinase inhibitors, mammalian target of rapamycin inhibitors, immune checkpoint inhibitors, and cytotoxic chemotherapy is increasing. To review characteristics of ONJ in cancer patients receiving non-antiresorptives. A systematic review of the literature between 2009 and 2017 was conducted by the Bone Study Group of MASCC/ISOO. Of 6249 articles reviewed and from personal communication, 42 ONJ cases related to non-antiresorptives were identified. No gender predilection was noted. Median age was 60years and ONJ stage 2 was most common, with predilection for posterior mandible. Exposed bone, pain, and infection were common at diagnosis. In comparison to bone targeting agents (BTAs), radiology, histology, and management were similar, with medication often discontinued. Delayed diagnosis (median 8weeks) was noted. Important differences included earlier time to ONJ onset (median 20weeks), absence of trigger event (40%), and greater likelihood of healing and shorter healing time (median 8weeks) as compared to BTA-related ONJ. Gastrointestinal cancers predominated, followed by renal cell carcinomas compared to breast, followed by prostate cancers in BTA-related ONJ, reflecting different medications. Data about non-antiresorptive-related ONJ is sparse. This type of ONJ may have better prognosis compared to the BTA-related ONJ, suggested by greater likelihood of healing and shorter healing time. However, the delay in diagnosis highlights the need for more education. This is the first attempt to characterize ONJ associated with different non-antiresorptives, including BRAF and immune checkpoint inhibitors.

Effect of Hydrocolloid Dressing versus Paraffin Gauze Dressing on Wound Healing and Pain for Split Thickness Skin Graft Donor Site

Ideal wound care for split-thickness skin graft donor sites should include dressings that promote healing, prevent complications, and are cost-effective. The aim of this study is to evaluate the effect of hydrocolloid dressing versus paraffin gauze dressing for split thickness skin grafting donor sites in terms of pain and wound healing. Methods: quasi-experimental design was conducted over period of one year for 35 patients who admitted for skin graft. The participants were recruited from one of the big teaching hospitals in Cairo at Egypt. The Numeric Rating Scale (NRS) and Bates Wound Assessment Tool (BWAT) were used alongside a background/medical data sheet to collect the data. The selected two dressing material were changed for three to four times. Result it was observed that there was a gradual decrement in the Bates Wound Assessment Tool scores during 4th ,7th ,10th ,and 14th days during changing the dressing at duoderm /hydrocolloid and paraffin gauze dressing sites, But, decrement at the duoderm sites was greater and faster than paraffin gauze dressing sites with a mean and standard deviation equal to(23.34±.998, 16.20±2.03, and 13.77±1.13 versus 25.80±1.53, 23.14±2.15,and 18.85±1.61)respectively. The mean healing time for complete re –epithelialization was equal to 8.6 day ±1.08, for hydrocolloid sites versus 15.2 day± 3.02 for paraffin gauze site)respectively. Also, there were a statistical significance difference between the three durations of changing the dressing at the paraffin and duoderm sites for the same subjects with F/ratio/P value equal to( 17783.959 / .000*).As regards to pain subjects exhibited lesser pain intensity during ,7th ,10th ,and 14th days during changing duoderm dressing sites in comparison with paraffin gauze sites. Conclusion: Hydrocolloid dressing resulted in shorter healing time, faster re –epithelialization, fewer dress­ing changes and reduced pain when compared with paraffin gauze dressing. Recommendation Hydrocolloid dressing is recommended dressing for partial split thickness skin grafting donor sites. A larger randomized study is required to generalize the findings.