Superficial Wounds Research Articles

Anatomical consideration and techniques in thread nose augmentation with mesh scaffold implant

Introduction Non-surgical rhinoplasty has evolved with the introduction of volumizing threads, which offer a less invasive alternative to traditional methods by enhancing nasal contours while minimizing filler use. This technique is gaining popularity, particularly in Southeast Asia, due to its shorter recovery time, reduced risk profile, and ability to prevent the ‘Avatar nose’ effect. However, there is limited anatomical guidance available for its application, especially in the Asian population. Materials and Methods This study analyzes the anatomical layers of the nose to guide the proper placement of volumizing threads. Three cases are presented, highlighting different approaches to nasal bridge enhancement, nasal tip augmentation, and combined use of threads and fillers. The placement of threads in the deep fat layer beneath the fibromuscular layer was emphasized to avoid vascular complications. Results The cases demonstrated with mesh thread (Tess Inc., Korea) successful outcomes with well-defined nasal contours and patient satisfaction. The techniques used allowed for precise enhancements while minimizing risks associated with superficial thread placement and vascular injury. Conclusion Volumizing threads provide an effective and safe method for non-surgical rhinoplasty, particularly when informed by a thorough understanding of nasal anatomy. The results support the growing use of this technique in esthetic practice, especially in regions like Southeast Asia.

Determination of the Perpetrator-Victim Position in a Case of Severe Traumatic Brain Injury due to a Less-Lethal Weapon Projectile, Based on Brain Injuries

Less-lethal (or non-lethal) weapons cause lethal and non-lethal injuries; this depends on many factors, including the shot distance and the modifications made to the operation of the weapon and the projectiles. This type of weapon has a similar shape to a firearm, shares the same physical and chemical operating principle and uses the combustion of a chemical substance to eject the projectile. In technical terms, the only difference is the projectile. Currently with the changes in weapons and projectiles, it is difficult to make a correlation. Just like lethal firearm projectiles and due to their operation, they leave macroscopic gunshot residues such as powder tattooing or soot deposition, only occasionally a contusion ring. In addition, there is a variety in the appearance of the entrance wounds. Therefore, it is very important to process the scene and carefully dissect the external wound and the surrounding area and, if possible, the recovery of the projectile. We present a case where a non-penetrating superficial injury to the skull produced trauma consistent with a coup contrecoup brain injury, which allows us to identify the perpetrator-victim position.

Sociodemographic profile, clinical spectrum, and centers for disease control and prevention categorical evaluation of wound sepsis: Experience in a tertiary care hospital in India

Background: Over the last decade, the rate of cesarean sections has steadily increased owing to various reasons, and along with it the incidence of wound sepsis. Different risk factors identified are maternal age, socioeconomic status, educational status, antenatal visits, pregestational diabetes, obesity, recurrent pregnancy losses, duration of surgery, preterm rupture of membranes, etc. Hence, assessing infections and their management is an integral part of health care, as it helps develop strategies for prevention, better management of infection, reducing the hospital stay, and cost of healthcare. Aims and Objectives: The aim of the study was to assess and note the variability of social and demographic profiles of patients undergoing cesarean sections and developing wound infection, along with its various presentations and categories. Materials and Methods: A prospective observational study was conducted on patients who developed wound sepsis after undergoing cesarean section at a tertiary center in India. Results: Among the patients enrolled, 35.83% were illiterate and 45.83% were educated up to the tenth standard. About 74% of patients were not registered during the antenatal period. Furthermore, the majority of patients were overweight and obese (74%) and were from lower socioeconomic strata. About 85% of the patients who developed wound infection had their surgery lasting for more than 60 minutes. About 87.50% developed a superficial category of infection, and 68.33% presented within the first 5 days of surgery. Patients with deep infected wounds had significantly bigger wounds and longer hospitalization. Conclusion: Illiteracy and lower socioeconomic conditions predispose women to wound sepsis. A longer duration of surgery was associated with a higher risk of infection. Superficial wounds are the most common type of infection encountered. Deep and organ space categories of wound infection are associated with increased morbidity and longer hospitalization warranting aggressive management. Reducing the incidence of wound sepsis can help to reduce morbidity by identifying risk factors before pregnancy and supporting the implementation of preconception counseling centers and prenatal programs to educate and raise awareness among patients.

Suprathel® and water-filtered infrared-A radiation (wIRA) as a new treatment strategy for toxic epidermal necrolysis (TEN): A prospective study

Toxic epidermal necrolysis (TEN) is a life-threatening condition with a mortality rate of approximately 25% to 30%. Early and adequate wound coverage is necessary due to largescale skin defects. Suprathel® is a modern wound dressing that shows promising results when treating superficial wounds such as scald, burns and abrasions. Previous reports on wound care in TEN patients using Suprathel® have described radical debridement of the entire affected body surface prior to the application of Suprathel®. However, the heavy wound secretion frequently results in the loss of a significant portions of Suprathel® over time. Prolonged operation time increases the risk of hypothermia. In addition, the large open wound areas result in an increased risk for hypovolemic shock, wound infection, and subsequent sepsis. This study presents a new strategy that involves serial hydrotherapeutic wound debridement and the stepwise application of Suprathel® to the affected areas. Water-filtered infrared A light (wIRA) was used to keep the Suprathel®-covered areas dry. Retrospective data from patients who received polyhexanide gel treatment (control group 1) and those who only received Suprathel® (control group 2) were collected for matched-pair analysis. The length of stay in the intensive care unit (ICU) and the need for catecholamines were compared among the three groups. By using serial debridement and combining wIRA treatment with Suprathel® dressings, we were able to significantly reduce the need for catecholamines, lower the risk of hypothermia and infection, and shorten ICU stay compared to the two control groups. We propose incorporating this methodology into the standard of care to promote wound closure and healing when treating TEN patients.

Chitosan-Clay Mineral Nanocomposites with Antibacterial Activity for Biomedical Application: Advantages and Future Perspectives.

Polymers of natural origin, such as representatives of various polysaccharides (e.g., cellulose, dextran, hyaluronic acid, gellan gum, etc.), and their derivatives, have a long tradition in biomedical applications. Among them, the use of chitosan as a safe, biocompatible, and environmentally friendly heteropolysaccharide has been particularly intensively researched over the last two decades. The potential of using chitosan for medical purposes is reflected in its unique cationic nature, viscosity-increasing and gel-forming ability, non-toxicity in living cells, antimicrobial activity, mucoadhesiveness, biodegradability, as well as the possibility of chemical modification. The intuitive use of clay minerals in the treatment of superficial wounds has been known in traditional medicine for thousands of years. To improve efficacy and overcome the ubiquitous bacterial resistance, the beneficial properties of chitosan have been utilized for the preparation of chitosan-clay mineral bionanocomposites. The focus of this review is on composites containing chitosan with montmorillonite and halloysite as representatives of clay minerals. This review highlights the antibacterial efficacy of chitosan-clay mineral bionanocomposites in drug delivery and in the treatment of topical skin infections and wound healing. Finally, an overview of the preparation, characterization, and possible future perspectives related to the use of these advancing composites for biomedical applications is presented.

Comparison of Secretome Dental Pulp Stem Cell And Mebo Ointment on The Amount of Fibroblast and Collagen In Superficial Dermal Burns

Secretome Dental Pulp Stem Cells have been proposed as a new alternative for wound burn. The aim of this study is to compare Secretome Dental Pulp Stem Cells and MEBO ointment against several fibroblasts and collagen in the healing process of superficial dermal burns. This study used a post-test only controlled group design by using 15 rats that were given superficial dermal burned wounds. Rats were divided into a negative control group of NaCl 0.9% (K1), a treatment group of MEBO (K2), and a treatment group of DPSCs-secretome (K3). Histopathology was done on the 5th, 14th, and 21st days post-induction wound burn. Network-prepared histopathology by colouring Messon Trichomes. Then, it was observed under a microscope with 200x magnification. Scoring in a way semi-qualitative for assessing fibroblasts and collagen. The total score of fibroblasts in the MEBO group was higher than the DPSCs-secretome group on day 5th. In comparison, the score for increasing the amount of collagen in the DPSCs-secretome group on days 5th and 14th was higher than the MEBO group. DPSCs-secretome has better effectiveness in increasing the amount of collagen but not better in increasing fibroblasts compared to MEBO.

First report of Diaporthe tulliensis causing leaf spot on Millettia speciosa in China.

Millettia speciosa Champ, renowned for its diverse applications in traditional medicine, is extensively cultivated in the Guangxi region of China, spanning roughly 5,973 hectares. In July 2021, a plantation in Yulin, Guangxi, China (22°64'N; 110°29'E), exhibited severe leaf spot disease on M. speciosa. Notably, a 46,690 square meters area had over 40% leaf spot incidence. Initially, symptoms appeared as small, circular, pale-yellow lesions on the leaves, then turned into irregular, dark brown spots with yellow halos, leading to the wilt and defoliation of leaves. To identify the responsible pathogen, a total of five symptomatic leaves were collected and sterilized systematically. Small tissue segments (5×5 mm) from lesion peripheries were aseptically excised, then surface sterilized with 75% ethanol for 10 s, and 1% sodium hypochlorite (NaClO) for 3 min. Following this, the sterilized tissues were triple-rinsed with sterile water and cultured on potato dextrose agar (PDA) at 28 °C in the dark for 7 d. A total of seven isolates were obtained through single-spore isolation, and one representative isolate, N2-3, was selected for further analysis. After 7 d of incubation, colonies displayed flat, white, and extensively branched aerial hyphae. Over time, the reverse side of the colony changed from white to yellowish-white. The pycnidia were black with conidial droplets ranging from cream to pale yellow exuding from their ostioles. The α-conidia were one-celled, hyaline, ovoid to cylindrical, typically with one or two droplets, 2.6 to 5.9 ×1.4 to 3.9 μm (n=50). These morphological traits align with those of the genus Diaporthe, as reported by Li et al. (2022) and Crous et al. (2015). To identify the species, isolate N2-3 underwent sequencing of the internal transcribed spacer (ITS), β-tubulin (BT), and translation elongation factor 1 alpha (EF1-α) sections (Huang et al. 2021). Obtained sequences of ITS, BT and EF1-α (Genebank accessions nos. OR600532, OR662169 and OR662168) displayed a 99% similarity to Diaporthe tulliensis (Genebank accessions nos. OP219651, ON932382, OL412437, respectively). Based on the concatenated ITS, BT and EF1-α, a neighbor-joining phylogenetic analyses using MEGA7.0 clustered with D. tulliensis. Therefore, the fungus was identified as D. tulliensis (teleomorph name) based on morphological and molecular features. A pathogenicity test was conducted on 1-year-old M. speciosa seedlings by gently abrading healthy leaves with sterilized toothpicks to create superficial wounds. Wounded leaves were then inoculated with 5 mm diameter mycelial plugs, while control seedlings received PDA plugs. Three leaves per plant and five plants per treatment were selected for assessment. All seedlings were kept in a controlled greenhouse (12/12h light/dark, 25 ± 2 °C, 90% humidity). After 7 d, the inoculated leaves showed symptoms like those in the field, while control plants remained healthy. The fungus was consistently reisolated from the infected leaves, satisfying Koch's postulates. Notably, D. tulliensis has caused Boston ivy leaf spot, bodhi tree leaf spot, cacao pod rot, and jasmine stem canker (Huang et al. 2021; Li et al. 2022; Serrato-Diaz et al. 2022; Hsu et al. 2023). This discovery is significant as it marks the first report of Diaporthe tulliensis causing leaf spot on Millettia speciossa in China, which has direct implications for the development of diagnostic tools and research into potential disease management strategies.

Simplified arthroscopic anterior talofibular ligament repair with inferior extensor retinaculum reinforcement: technical notes and preliminary results

PurposeCompared with open surgery, arthroscopic anterior talofibular ligament (ATFL) repair has many advantages and good clinical outcome. Inferior extensor retinaculum (IER) reinforcement is a supplement procedure that increase the strength of the ATFL. There is still no gold standard for arthroscopic ATFL repair. The purposes of this study were to describe a simplified technique for arthroscopic ATFL repair with IER reinforcement and to analyze its preliminary clinical results.MethodsTwenty-seven patients with chronic lateral ankle instability (CLAI) who underwent this simplified surgery were analyzed in this retrospective study. The patients’ characteristics and operative times were evaluated. Intraoperative photos, radiographs from the anterior drawer test and talar tilt test and postoperative MR images were recorded. The American Orthopaedic Foot and Ankle Society (AOFAS) ankle-hindfoot score and visual analog scale (VAS) score were also recorded. With the assistance of a needle, we performed ATFL repair and IER reinforcement with one Pushlock anchor and nonabsorbable sutures.ResultsNo complications namely skin necrosis, superficial fibular nerve injury or wound infection, were reported. The AOFAS score and VAS score improved from 64.74 ± 9.47 and 6.00 ± 1.56 to 90.74 ± 6.46 and 1.07 ± 1.09, respectively. The talar advancement and talar tilt angle were improved after surgery. One year after the operation, the ATFL appeared to be continuous on MR images.ConclusionIn this study, we proposed a simple and effective arthroscopic ATFL repair with IER reinforcement technique. The short-term follow-up examination revealed satisfactory clinical outcomes. Our technique might be a new surgical option for the treatment of CLAI.

Bioinspired shape-changing nanofiber dressings for intelligent wrapping and promoting healing of superficial wounds

The use of dressings in clinical settings is common for the purpose of wound wrapping and creating an optimal microenvironment to enhance the healing process. Proper coverage of wounds with dressings serves as the fundamental basis for effective wound healing. Unfortunately, non-standard coverage by hands can cause pain and secondary damage to patients, while slow manual application during treatment of extensive burns may increase the risk of wound infection. Herein, drawing inspiration from the microstructure and hygroscopic deformation observed in pine cones, we propose a polyvinyl alcohol/polysulfone (PVA/PSF) smart dressing. This bioinspired smart dressing exhibits rapid bending deformation under high moisture condition, allowing easy adjustment of bending amplitude, speed, and direction. Moreover, the smart dressing is capable of rapid bending and autonomous wrapping around “artificial wounds” on a doll’s body, as well as fitting irregularly shaped “hand wounds” and extensive “arm wounds” on human subjects. By integrating two layers into one dressing design, we endow it with dual functionality: The hygroscopic PVA layer facilitates transversal liquid transport to effectively reduce exudate accumulation in the wound bed while maintaining proper moisture levels; meanwhile, the highly hydrophobic PSF layer repels various aqueous solutions to protect against external contaminants. In vivo results confirm that this multifunctional smart dressing promotes collagen synthesis and accelerates angiogenesis for accelerated wound healing. We believe that this innovative multifunctional approach to wound management will provide valuable insights into wound healing therapy.

Characterization and treatment protocol of injuries inflicted to humans by synurbic European wild boars (Sus scrofa).

Wild boar (Sus scrofa) has spread and colonized urban areas. The closer contact with humans can lead to wild boar-inflicted injuries. The objectives of this study are: 1) to systematically review the literature on wild boar-inflicted injuries; 2) to describe our wild boar-inflicted wound management protocol; and 3) to analyse the features, outcomes and complications of our case series. First, a systematic search of the literature was performed using the PubMed (MEDLINE) electronic database. Then, our evidence-based wild boar-inflicted wound management protocol was described. Finally, a retrospective case series study including all the patients with wild boar-inflicted injuries attended in our Emergency Department (2020-2022) was analysed. Fourteen studies (twelve case reports and two case series) were selected for the literature review. Our case series included 34 patients: 50.0% of them presented superficial wounds and 38.2% penetrating wounds. Most of the wounds occurred in the lower limbs (71.9%). Following our protocol, 30.0% of the wounds were primarily closed, the 70.0% of the patients received antibiotics (92.3% in penetrating injuries) and the 26.7% received an antitetanic vaccine. Only one patient (2.9%) presented a complication. This study reports the first specific wild boar inflicted-wound management protocol, which led to a low complication rate. Open wounds affecting the lower limbs were the most common lesions. Care should be taken with penetrating tusk injuries. Wide-spectrum antibiotic and antitetanic treatments are recommended. Decisions on wound management should be taken case-by-case, while antirabies vaccination depends on the local status of the disease.

An in situ forming cartilage matrix mimetic hydrogel scavenges ROS and ameliorates osteoarthritis after superficial cartilage injury

Superficial cartilage defects represent the most prevalent type of cartilage injury encountered in clinical settings, posing significant treatment challenges. Here, we fabricated a cartilage extracellular matrix mimic hydrogel (GHC, consisting of Gelatin, Hyaluronic acid, and Chondroitin sulfate) to avoid the exacerbation of cartilage deterioration, which is often driven by the accumulation of reactive oxygen species (ROS) and a pro-inflammatory microenvironment. The GHC hydrogel exhibited multifunctional properties, including in situ formation, tissue adhesiveness, anti-ROS capabilities, and the promotion of chondrogenesis. The enhancement of tissue adhesion was achieved by chemically modifying hyaluronic acid and chondroitin sulfate with o-nitrobenzene, enabling a covalent connection to the cartilage surface upon light irradiation. In vitro characterization revealed that GHC hydrogel facilitated chondrocyte adhesion, migration, and differentiation into cartilage. Additionally, GHC hydrogels demonstrated the ability to scavenge ROS in vitro and inhibit the production of inflammatory factors by chondrocytes. In the animal model of superficial cartilage injury, the hydrogel effectively promoted cartilage ECM regeneration and facilitated the interface integration between the host tissue and the material. These findings suggest that the multifunctional GHC hydrogels hold considerable promise as a strategy for cartilage defect repair. Statement of significanceSuperficial cartilage defects represent the most prevalent type of cartilage injury encountered in the clinic. Previous cartilage tissue engineering materials are only suitable for full-thickness cartilage defects or osteochondral defects. Here, we developed a multifunctional GHC hydrogel composed of gelatin, hyaluronic acid, and chondroitin sulfate, which are natural cartilage extracellular matrix components. The drug-free and cell-free hydrogel not only avoids immune rejection and drug toxicity, but also shows good mechanical properties and biocompatibility. More importantly, the GHC hydrogel could adhere tightly to the superficial cartilage defects and promote cartilage regeneration while protecting against oxidation. This natural ingredients and multifunctional hydrogel is a potential material for repairing superficial cartilage defects.

Effect of proteins from the coelomic fluid of superficially wounded holothurians on the activity of phagocytes

Holothurians are among the most capable of regenerating animals. Their phagocytes are analogues of macrophages, but the mechanisms of their participation in wound healing have not been studied. The aim of the work is to determine the effect of individual protein components isolated from the coelomic fluid of holothurians with superficial damage to the body wall on the functional activity of the two types of phagocytes (P1 and P2) in holothurian Eupentacta fraudatrix. Protein components of the coelomic fluid of holothurians with superficial wounds of the body wall were analyzed and collected by gel permeation chromatography. We used proteins whose content changed significantly during the wound healing period in preliminary experiments. Two proteins and a peptide were added to phagocytes, isolated by gradient centrifugation, simultaneously with the thermostable toxin of Yersinia pseudotuberculosis and incubated for 24 h. The production of superoxide anion radical was determined by the reduction of nitroblue tetrazolium (NBT) using a colorimetric method. To assess the specificity of the proteins, bovine serum albumin (BSA) was used as an internal control. In one-day in vivo experiments, proteins were administered to wounded animals. Two proteins, when compared with the effect of BSA, did not show a specific effect on the production of reactive oxygen species in phagocytes in vitro. However, a comparison of the effect of the peptide on the oxidative activity and viability of phagocytes with those of BSA revealed the specificity of its action. The peptide reduced the oxidative activity of P1 phagocytes and increased it in P2 phagocytes in a direct concentration-dependent manner. One of the two proteins being administered to wounded holothurians caused a multidirectional concentration-dependent effect on the oxidative activity of the two types of phagocytes, with a predominant suppression of the P1 phenotype activity. The ability of protein components to cause a shift in the ratio of oxidative activity of the two types of phagocytes towards the preferential activation of P2 phagocytes, which are considered as functional analogues of M2 macrophages, suggests that they act as anti-inflammatory agents.

The Impact of Low-Power Therapeutic Lasers at 904 nm on the Healing Process of Wounds and the Relationships Between Extracellular Matrix Components and Myofibroblasts.

The goal of the study was to further our understanding of the functions that myofibroblasts do, how they interact with the matrix's extracellular elements, and how laser therapy at 904 nm works. Thirty Wistar rats with superficial wounds on the backs were used in this study. The laser therapy device used two energy levels of a 904 nm laser with an output power of 60 mW. The outcomes had been evaluated for one, three, five, seven, and fourteen days following laser therapy. Numerous methods, including as histology, immunohistochemistry, and scanning electron microscopy, have been used to evaluate the tissues.There was a statistically important (P ≤ .05) decrease in the number of inflammatory cells and the degree of edema after laser therapy. On the other hand, the amounts of elastic fiber as well as collagen slightly increased. On the third post-laser treatment day, there was a statistically significant distinction (P < .05) in the number of myofibroblasts with the desmin; smooth muscle alpha-actin phenotype between the laser-treated and control groups.These results suggest that, compared to a higher energy of 5.6 J, laser therapy at a lower energy of 3.6 J may be more effective in stimulating myofibroblast differentiation during the initial phases of wound healing. These findings show how low-power laser therapy promotes wound healing.

A novel chlorin derivative Shengtaibufen (STBF) mediated photodynamic therapy combined with iodophor for the treatment of chronic superficial leg wounds infected with methicillin-resistant Staphylococcus aureus: A retrospective clinical study

ObjectiveChronic wounds are costly and difficult to treat, resulting in morbidity and even mortality in some cases due to a high methicillin-resistant Staphylococcus aureus (MRSA) burden contributing to chronicity. We aimed to observe the antimicrobial activity and healing-promoting effect of a novel photosensitizer Shengtaibufen (STBF)-mediated antibacterial photodynamic therapy (PDT) on MRSA-infected chronic leg ulcers. Patients and methodsThis was a retrospective, comparative, single-center clinical study. A total of 32 patients with chronic lower limb wounds infected with MRSA from January 2022 to December 2023 were finally included in this study by searching the electronic medical records of the dermatology department of Huadong Hospital, including a group of red light combined with iodophor (control+iodophor, n=16, receiving red light once a week for 8 weeks and routine dressing change with iodophor once a day) and a group of STBF-mediated PDT (STBF-PDT) combined with iodophor (STBF-PDT+iodophor, n=16, receiving STBF-PDT and routine dressing change with iodophor once a day). STBF-PDT was performed once a week (1 mg/ml STBF, 1 h incubation, 630 nm red light, 80 J/cm2) for 8 weeks. The primary endpoints included wound clinical signs, wound size, wound-related pain, re-epithelialization score, MRSA load and wound-related quality of life (wound-QoL). Any adverse events were also recorded. ResultsWe found that STBF-PDT+iodophor could effectively alleviate clinical infection symptoms, accelerate wound closure, reduce average biological burden and improve wound-QoL without severe adverse events in comparison to the control+iodophor group. The STBF-PDT+iodophor group obtained a mean percentage reduction of 65.22% in wound size (from 18.96±11.18 cm2 to 6.59±7.94 cm2) and excellent re-epithelialization scores, as compared with a decrease of 30.17% (from 19.23±9.80 cm2 to 13.43±9.32 cm2) for the control+iodophor group. Significant differences in wound area were observed at week 6 (p=0.028*) and week 8 (p=0.002**). The bacterial load decreased by 99.86% (from 6.45 × 107±2.69 × 107 to 8.94 × 104±1.92 × 105 CFU/cm2, p<0.0001) in the STBF-PDT+iodophor group and 1.82% (from 6.61 × 107±2.13 × 107 to 6.49 × 107±2.01 × 107 CFU/cm2, p=0.029) in the control+iodophor group. The wound-QoL in STBF-PDT+iodophor group had a 51.62% decrease in overall score (from 29.65±9.33 at the initial to 14.34±5.17 at week 8, p<0.0001) compared to those receiving red light and routine wound care (from 30.73±17.16 to 29.32±15.89 at week 8, p=0.003). Moreover, patients undergoing STBF-PDT+iodophor exhibited great improvements in all domains of wound-QoL (physical, psychological and everyday-life), whereas the control+iodophor group ameliorated in only one field (everyday-life). ConclusionOur data confirmed that a novel photosensitizer, STBF-mediated PDT, when combined with iodophor, served as a potential modality for MRSA infection and a possible therapy for other drug-resistant microorganisms, and as a promising alternative for chronic cutaneous infectious diseases.

Topical Tranexamic Acid on Donor Wounds in Burn Patients: A Randomized Placebo-controlled Trial.

Patients with major burn injuries are prone to massive blood loss owing to tangential excision of burn wounds and donor skin harvesting. In general, topical application of the antifibrinolytic drug tranexamic acid (TXA) to surgical wounds reduces bleeding; however, its effect on bleeding and re-epithelialization in superficial wounds of burns has not been explored. This study aimed to investigate the therapeutic potential of topical TXA in reducing blood loss and its effect on wound re-epithelialization in burn surgery. Split-thickness skin graft donor wounds in burn patients were paired and randomized to topical application of either TXA (25 mg/mL) or placebo. Endpoints were postoperative bleeding as measured by dressing weight gain per cm2 wound area, blood stain area per wound area, and visual evaluation of bleeding in the dressings. Healing time was recorded to analyze the effect on wound re-epithelialization. There was no significant difference in bleeding or time to re-epithelialization between the TXA and placebo wounds. A post hoc subanalysis of wounds with dressing weight gain above the median, showed a significant difference in favor of TXA. However, use of tumescence may have influenced end points. No significant adverse events related to the study drugs were observed. This study demonstrates that topical application of TXA (25 mg/mL) to split-thickness skin graft donor wounds does not delay re-epithelialization. Although a reduction in bleeding is suggested, further studies are needed to determine the role of topical TXA in reducing bleeding in burn surgery.

EXPERT-EPIDEMIOLOGICAL FEATURES OF NON-LETHAL MOTORCYCLE-RELATED TRAUMA

The forensic examination of victims of motorcycle trauma is a current issue in forensic practice. However, the forensic characteristics of contemporary nonfatal motorcycle injuries have not been adequately investigated. Aim of the work. To investigate the epidemiology of nonfatal motorcycle injuries and to determine the forensic characteristics of injuries typical of victims of motorcycle traffic accidents. Materials and methods. The study material consisted of 40 forensic medical reports on individuals affected by motorcycle injuries, performed at the Ternopil Regional Forensic Medical Bureau between 2016 and 2023. The data extraction was performed in a formalised card for each case, containing details about the injured person, circumstances, location and conditions of the injury. The types of injuries, their location and distribution by body part (head, trunk, limbs) were meticulously recorded. The data obtained were processed using variational statistical methods. Results. Research shows that the majority of nonfatal injuries to motorcyclists occur on the roads during the summer and early autumn, with peaks in June and September, typically as a result of collisions with other vehicles (usually cars). The victims are predominantly male (35 (87.5%)), young (19 (47.5%)) and mature (13 (32.5%)). Of these, 31 (77.5%) were motorcyclists, 6 (15.0%) were passengers and only 3 (7.5%) were pedestrians (p≤0.01). Different lower limb injuries were identified in 35 victims (87.5%, p≤0.01), upper limb injuries in 22 (55%) of the injured and head injuries in 20 (50%). Combined injuries involving two or more different anatomical parts of the body (head, torso and limbs) were found in 35 (87.5%) victims. Head injuries presented as abrasions, bruises or contusions, mainly to the face, often to several facial areas at the same time, typically accompanied by concussion or cerebral contusion. All victims with torso trauma were diagnosed with various soft tissue injuries, of which 18 (90%) were located on the anterior surface of the chest, in the pelvic or abdominal area (often in combination), with spinal injuries occurring in only 2 (10%) victims. Upper limb trauma was associated with various soft tissue injuries, as well as fractures and ligamentous damage in more than half of the victims with upper limb injuries. Victims with lower limb trauma had both superficial soft tissue injuries (abrasions, bruises, haematomas, contusions) and deeper injuries (lacerations or crush injuries), together with open or closed fractures of the femur, tibia and fibula, or multiple fractures. Isolated injuries involving only the trunk or upper extremities, or only the head and trunk, or only the trunk and lower extremities in nonfatal motorcycle trauma were found only in isolated cases. Conclusions. Non-fatal motorcycle trauma usually occurs on the road, in warm weather conditions, as a result of the motorcycle colliding with another vehicle. The majority of victims are motorcyclists, young and middle-aged males. Characteristic features of non-lethal motorcycle trauma are: a significant number of superficial soft tissue injuries and their predominance over fractures or internal organ injuries; the combination of head, trunk and limb injuries with a predominance of lower limb injuries; the predominant location of injuries on the frontal surface of the victims' bodies.

Obstructed vein delivery of ceftriaxone via poly(vinyl-pyrrolidone)-iodine-chitosan nanofibers for the management of diabetic foot infections and burn wounds

Superficial skin injuries especially burn injuries and unhealed diabetic foot open wounds remain troubling for public health. The healing process is often interrupted by the invasion of resistant pathogens that results in the failure of conventional procedures outside the clinical settings. Herein, we designed nanofibers dressing with intrinsic antibacterial potential of poly(vinyl-pyrrolidone)-iodine/ poly (vinyl)-alcohol by electrospinning with chitosan encapsulating ceftriaxone (CPC/NFs). The optimized electrospun CPC/NFs exhibited smooth surface morphology with average diameter of 165 ± 7.1 nm, drug entrapment and loading efficiencies of 76.97 ± 4.7 % and 8.32 ± 1.73 %, respectively. The results displayed smooth and uniformed fibers with adequate thermal stability and ensured chemical doping. The enhanced in vitro antibacterial efficacy of CPC/NFs against resistant E. coli isolates and biosafety studies encourage the use of designed nanofibers dressing for burn injuries and diabetic foot injuries. In vivo studies proved the healing power of dressing for burn wounds model and diabetic infected wounds model. Immunofluorescence investigation of the wound tissue also suggested promising healing ability of CPC/NFs. The designed approach would be helpful to treat these infected skin open wounds in the hospitals and outside the clinical settings.

Prevalence of unintentional injuries and its risk factors among under-five children residing in urban poor resettlements in Rishikesh.

A community-based study on childhood injuries would provide valuable information on the epidemiology of injuries to undertake appropriate preventive measures. Therefore, the current study was conducted in urban poor resettlements of Rishikesh to estimate the prevalence of unintentional injuries and to document the sociodemographic risk factors associated with unintentional injuries among under-five children. Estimation of the prevalence of unintentional injuries and their risk factors among under-five children of urban poor resettlements in Rishikesh. A community-based cross-sectional study was conducted in urban poor resettlement areas of Rishikesh for a period of 1 year. It included 300 children selected using a simple random sampling technique to collect data on injury status. The prevalence of unintentional injury among study participants was 16%. Falls were (64.6%) the major cause of injury, followed by dog bites (12.5%). The major sites of the injury were the head (25%), face (22.9%), upper limb (27.1%), and lower limb (18.8%).75% of the injuries happened at home. 66% of injuries happened when the child was playing alone or playing with peers. About 20.8% of injuries were bruises or superficial injuries. 39.6% of children had cut/bite/open wound injuries. Fractures happened in 14.6% of injured children. More than half (54.2%) of children did not develop any physical disability due to injury. Among children who developed a disability, more than 90% are able to recover completely. The majority of study participants were taken to nearby hospitals (66.6%) or health centers (10.4%). Only one of them went to a traditional bone setter, rest all visited either a general practitioner or pharmacy. The median expenditure for the treatment of the injured child was INR 425 (175-2750). The age of the child and unintentional injury showed a statistically significant association. The prevalence of the injury was 16% (12-20.7%) similar to a number of similar studies. Although the majority of the injuries were mild in severity, injuries have also contributed to temporary disability among children and have led to loss of school days.

Promising Medicinal Plants and their Potential Active Constituents for Healing of Superficial Burn Wounds- A Review

Promising Medicinal Plants and their Potential Active Constituents for Healing of Superficial Burn Wounds- A Review

Preinjection With Ligation-Assisted Endoscopic Mucosal Resection for Barrett's Dysplasia and Early Esophageal Adenocarcinoma: Characteristic Histological Features of the Depth of Resection.

Endoscopic mucosal resection (EMR) is an established technique for the diagnosis and treatment of high-grade dysplasia (HGD) and early esophageal adenocarcinoma (EAC) in Barrett's esophagus. Submucosal preinjection is not universally used or generally recommended when performing routine ligation-assisted EMR. Prior studies, however, have demonstrated evidence of at least superficial muscle injury on ligation-assisted EMR without submucosal injection. There are limited published data supporting any potential benefit of submucosal preinjection. Our aim was to review this technique and determine the rate of any degree of muscle injury in patients with Barrett's HGD and EAC treated with submucosal preinjection before ligation-assisted EMR. Patients undergoing submucosal preinjection before ligation-assisted EMR for Barrett's esophagus at a single institution between 2012 and 2016 were identified. Data were collected regarding patient demographics and medical history, endoscopy and histopathology findings, adverse events, and subsequent outcomes. All EMR specimens were reviewed by an expert gastrointestinal pathologist. One hundred fifty consecutive EMR procedures were performed on 70 patients. Of 70 patients, 85.7% of patients were men, with a median age of 68 years. EAC was identified in 75 specimens (50%) and HGD in 44 specimens (29.3%). Deep resection margins were clear of adenocarcinoma in all specimens. Muscularis propria was not identified in any of the 150 specimens. There were no cases of post-EMR perforation. Preinjection before ligation-assisted EMR achieved complete excision with histologically clear margins, without histological evidence of any inadvertent muscularis propria.