Surgical Wound Healing Research Articles

Postoperative outcomes of combined surgery comprising dorsal laminectomy, transarticular screws, pedicle screws and polymethylmethacrylate for dorsal fixation in 21 dogs with degenerative lumbosacral stenosis.

To retrospectively review the efficacy of combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate as treatment for dogs with degenerative lumbosacral stenosis (DLSS). 21 client owned dogs diagnosed with DLSS and treated surgically. Based on clinical records, signalments, clinical signs, findings from orthopedic and neurological examinations, imaging findings, and postoperative complications were evaluated at the following time points: preoperatively, postoperatively, and 3, 6, 12, 24, and 36 months after surgery. In all 21 cases, clinical signs were alleviated, proprioceptive deficits were improved from 3 months after surgery, and no recurrence of clinical signs was observed during the observation period. Minor complications were observed in 6 cases (28.6%), including implant failure in 2 (9.5%), delayed healing of surgical wounds in 2 (9.5%), seroma in 1 (4.8%), and swelling of the affected area in 1 (4.8%). There was no case with major complications. Combined surgery comprising dorsal laminectomy and dorsal fixation using screws and polymethylmethacrylate is a useful treatment that can improve long-term clinical signs in dogs with DLSS.

The Relationship Of Early Mobilization With Operational Wound Healing In Postpartum Mothers With Post Section Ceasarea

Early mobilization is a movement that is carried out immediately after surgery. This is done with the aim of restoring the abdominal muscles so they are not stiff and relieve pain so that it can accelerate the wound healing process. Based on Riskesdas North Sumatra 2018, the proportion of delivery methods by cesarean section in North Sumatra Province was 23.89 percent and normal deliveries were 75.95 percent. The purpose of this study was to determine the relationship between early mobilization and surgical wound healing in postpartum mothers post sectio caesarea at the Ibu Kartini Kisaran General Hospital in 2022. This study is a quantitative type of research, with a cross sectional research design using the chi-square test. The population in this study were all postpartum mothers who had undergone post sectio caesarea while at the Ibu Kartini General Hospital in the range of 2022. The sample obtained was 40 people with accidental sampling technique. The statistical test used was the chi square test (p < 0.05). The results of this study indicate that there is a relationship between early mobilization and healing of surgical wounds in postpartum mothers after sectio caesarea at the Kartini General Hospital Kisaran in 2022 with a p value of 0.01. So it is hoped that nurses and midwives will be able to provide education and supervision of the implementation of mobilization for postpartum mothers post sectio caesarea to accelerate wound healing.

Efficacy of low-level laser therapy in oral mucosal surgical wound healing: a systematic review and meta-analysis

Aim: Wound healing is a complex phenomenon with various biological changes in tissue integrity, low-level laser therapy (LLLT) has acquired several unique components to help into accelerating tissue reconstruction and eventually wound healing. Thus, in the present systematic review and meta-analysis study, the role of LLLT in oral mucosal wound healing following surgical interventions was investigated. Methods: The study databases, including PubMed, Web of Knowledge, Google Scholar, Scopus, and Cochrane, were searched by two blinded investigators considering eligible studies based on the following keywords: “Wound Healing”, “Oral Mucosal Wound Healing”, “Laser therapy”, “Low-level laser therapy”, “Oral Surgery”, “Photobiomodulation therapy”, among 88 screened, only 12 articles were eligible for the final analysis. Results: There was a significant difference between control and laser group in all mentioned studies in the case of wound epithelialization in gingiva, with weighted mean difference (MD) of –0.28, [95% confidence interval (CI): –0.37, –0.19, P < 0.001], periodontium 1 day postoperative, with weighted MD of –0.56 (95% CI: –0.84, –0.27, P < 0.001) and 7 days postoperative, with weighted MD of –0.73 (95% CI: –0.97, –0.49, P < 0.001). In the cases of postoperative pain, LLLT has significantly declined pain in comparison with control group with weighted MD of –0.47 (95% CI: –0.69, –0.24, P < 0.001) for 7 days postoperative and –0.55 (95% CI: –0.96, –0.13, P = 0.005) 14 days postoperatively. Conclusions: LLLT can be used as a promising tool in oral surgeries because of its inevitable capability in accelerating wound healing and reducing intraoperative pain.

Negative Pressure Wound Therapy in Spinal Surgery

Negative pressure wound therapy (NPWT) has demonstrated promise in the management of surgical site infections as well as assisting in surgical wound healing. In this manuscript, we describe the mechanisms and applications of NPWT for surgical wounds and existing evidence for NPWT in cardiac, plastic, and general surgery, followed by a discussion of the emerging evidence base for NPWT in spinal surgery. We also discuss the different applications of NPWT for open wounds and closed incisions, and the promise of newer closed-incision NPWT (ciNPWT) devices. There is nominal but promising prospective evidence on NPWT's efficacy in select at-risk populations for post-operative wound complications after spinal surgery. As there is currently a paucity of robust clinical evidence on its efficacy, rigorous randomized prospective clinical trials are needed.

What are the effects of negative pressure wound therapy (NPWT) for adults with surgical wounds healing by primary closure?

What are the effects of negative pressure wound therapy (NPWT) for adults with surgical wounds healing by primary closure?

Tissue-Welding Device: Considerable Advantages for Spleen Surgery Based on Histological and Cardiorespiratory Investigation.

During splenic surgery, it is important to control blood loss and the potential risk of cardiac arrhythmia. The best way to prevent complications from surgery is to use the appropriate surgical devices; however, there is no guideline for the use of specific surgical devices for spleen incision. Therefore, the aim of this research was to compare the interactions of various surgical devices with spleen tissue, their cardiorespiratory effects during incision, and subsequent spleen surgical wound healing. A total of 75 rabbits were included in the study. CO2 laser (n = 15), radiofrequency device (n = 15), electrocoagulator (n = 15), tissue-welding device (n = 15), and scalpel (n = 15) were used to make incisions in rabbits' spleens. Spleen biopsies of the incision area were taken from each animal at the day 0, 7, and 14 after surgery. Contactless thermography was performed during surgery. Suturing was not used after incision with the tissue-welding device, but incisions made by other surgical devices were sutured. The results showed that the width of spleen necrosis differed significantly between the various surgical devices used on spleen tissues. There was a positive, strong, and linear association between necrosis width and the tissue temperature of cutting edges. Significant increases in the heart rate were observed during spleen surgery performed with laser, scalpel, and radiofrequency devices. In conclusion, the tissue-welding device confers a significant advantage in spleen surgery, as there is neither a need for sutures nor a significant deviation in the heart rate.

Importance of Surgical Wound Healing and Care

Importance of Surgical Wound Healing and Care

Extended Tourniquet Times and the Impact on Wound Healing in Foot Surgery.

The aim of this study was to compare the effect of tourniquet time less than or in excess of 120 minutes on foot surgery wound healing. A tourniquet time of over 120 minutes will not affect wound healing in foot surgery. A retrospective comparative cohort analysis was performed on 96 patients undergoing complex hindfoot surgery in a large central teaching hospital. Fifty-five patients receiving tourniquet pressure for >120 minutes and 41 receiving <120 minutes of tourniquet pressure were identified from electronic case records. The primary outcome was surgical wound healing. Secondary outcomes were discharge date and complication rate. There was no significant difference in reported time for wounds to heal in the <120-minute or >120-minute cohort. There were no other significant differences in secondary clinical outcomes and no significant variations in patient demographics. This study suggests that tourniquet times from 2 to 3 hours in foot and ankle surgery with pressures up to 300 mmHg are not associated with a significant effect on wound healing.

Analysis of the development trend of burn discipline from the literature published in Chinese Journal of Burns in 22 years

Objective: To analyze the literature published in Chinese Journal of Burns (now Chinese Journal of Burns and Wounds) in the last 22 years, and to explore the development trend of burn discipline. Methods: The relevant clinical and research literature published in Chinese Journal of Burns from January 1, 2000 to December 31, 2021 were retrieved through China National Knowledge Infrastructure database. Bibliometrics was used to classify and analyze the literature by research types, involved research fields, and reported causes of injury, and compare them every 3 years according to the year of publication (with literature published in 2021 being included in the last time period). Keywords of all the literature were retrieved, which were corrected and conversed later. CiteSpace 6.1.R2 software was used to visually cluster the included keywords, count high-frequency and high-centrality keywords, and divide the high-frequency keywords by time as before for segment comparison. Results: A total of 4 485 relevant papers were included, with an average of about 204 papers each year. The research types analysis of literature showed that clinical diagnosis and treatment literature had the highest proportion, reaching 65.3% (2 929/4 485), followed by cell experiment and animal experiment literature, accounting for 18.1% (812/4 485) and 13.2% (591/4 485), respectively. The proportion of various research types of the literature in each time period was basically stable. The analysis of the research fields involved in the literature showed that the literature in the field of systemic treatment of burns accounted for the highest proportion, reaching 60.2% (2 699/4 485), followed by the literature in the fields of acute wounds and plastic surgery, accounting for 20.2% (908/4 485) and 7.3% (326/4 485), respectively. The proportion of the literature in the field of systemic treatment of burns decreased from 84.0% (430/512) in 2000-2002 to 40.3% (373/926) in 2018-2021, with a decreasing proportion of 43.7%. While compared with that in 2000-2002, the proportions of literature in the fields of acute wounds, plastic surgery, chronic wounds, and burn rehabilitation were on the rise, with the proportions in 2018-2021 increased by 11.7%, 9.1%, 10.7%, and 5.5%, respectively. In the first 6 time periods, the number of literature in the field of discipline management was few and remained in single digits, but it increased to 49 in 2018-2021. Among the 1 099 literature in the field of systemic treatment of burns with a clear cause of injury, the literature on thermal burns was the most, accounting for 58.5% (643/1 099), followed by the literature on electrical burns and chemical burns, accounting for 19.8% (218/1 099) and 12.6% (138/1 099), respectively. The comparison by time period showed that the proportion of literature reporting thermal burns showed a significant downward trend, while the proportion of literature reporting other causes of injury did not change significantly. A total of 6 822 keywords from 2 236 literature were included for analysis. Visual cluster analysis showed that relevant studies focused on burns, surgical flaps, scars, and wound healing. The top 3 keywords in frequency were burns, wound healing, and surgical flaps, and the top 3 keywords in centrality were burns, scars, and skin transplantation. The comparison by time period showed that the only keyword with a stable frequency in the top 10 ranks was burns; with the passage of time, some keywords such as endotoxin/endotoxins and fibroblasts gradually dropped out of the top 10 ranks, while keywords such as wounds and injuries, surgical flaps, and negative-pressure wound therapy gradually entered the top 10 ranks. Conclusions: Among the literature published in Chinese Journal of Burns during the last 22 years, the literature on systemic treatment of burns and thermal burns has gradually decreased, while the literature on chronic wounds and burn rehabilitation has increased. Surgical flaps, wound healing, and scar prevention and treatment are the current research hot spots in burn discipline.

Development of curcumin-loaded liposomes in lysine–collagen hydrogel for surgical wound healing

BackgroundA surgical wound is an incision made by a surgeon. Slow surgical wound healing may lead to chronic wounds which may be a potential health problem. The aim of this study is to formulate curcumin-loaded liposomes in lysine–collagen hydrogel for enhancing surgical wound healing. Curcumin-loaded liposomes were prepared using thin-film hydration method. The liposomal formulation was characterized by analysing its size, morphology, encapsulation efficiency, and in vitro release. The hydrogel base was prepared, and then, curcumin-loaded liposomes were infused to give formulation (F1). Curcumin-loaded liposomes were infused into the hydrogel base after which lysine and collagen were incorporated to give (F2), while (F3) comprised lysine and collagen incorporated in hydrogel base. All formulations were characterized by evaluation of the safety, stability, swelling index, pH, rheological properties, and in vivo wound healing assay. Histology and histomorphometry of tissue samples of wound area treated with formulations F1, F2, and F3 and the control, respectively, were examined.ResultsCurcumin-loaded liposomes were 5–10 µm in size, and the values for encapsulation efficiency and flux of the loaded liposomes are 99.934% and 51.229 µg/cm2/h, respectively. Formulations F1, F2, and F3 had a pH of 5.8. F1 had the highest viscosity, while F2 had the highest swelling index indications for efficient sustained release of drug from the formulation. The in vivo wound healing evaluation showed that curcumin-loaded liposomes in lysine–collagen hydrogel had the highest percentage wound contraction at 79.25% by day three post-surgical operation. Histological evaluation reflected a normal physiological structure of the layers of the epidermis and dermis after surgical wound healing in tissue samples from wound areas treated with formulations F1 and F2. The histomorphometrical values show highest percentage of collagen, lowest inflammatory rates, highest presence of microvessels, and re-epithelization rates at wound site in wounds treated with formulation F2 (curcumin-loaded liposomes in lysine–collagen hydrogel).ConclusionCurcumin-loaded liposomes in lysine–collagen hydrogel was found to be the most effective of the three formulations in promoting wound healing. Hence, this formulation can serve as a prototype for further development and has great potential as a smart wound dressing for the treatment of surgical wounds.

DIAGNOSTIC PROCESS OF COMPOUND ODONTOMA IN PRIMARY DENTITION: CASE REPORT

Compound odontoma is a common odontogenic neoplasm; however, its detection in the primary dentition stage is uncommon. The objective of this work is to describe the diagnostic process of a composite odontoma in a 4-year-old child and review the literature about this lesion. A 4-year-old girl presented with a swelling in the anterior region maxilla. Computed tomography showed multiple hyperdense images suggestive of denticles, delimited by a hypodense halo, above the roots of teeth 51, 52, and 53 and near the germs of teeth 11 and 12. The patient underwent surgical excision of the lesion preserving the deciduous and permanent teeth. Histopathologic examination was compatible with a compound odontoma. Healing of surgical wound was uneventful without complications or recurrence during follow-up. The diagnosis and early management of the lesion allowed the preservation of the associated teeth, preventing further complications.

Cochrane in CORR®: Negative Pressure Wound Therapy for Surgical Wounds Healing by Primary Closure.

1Michael G. DeGroote School of Medicine, McMaster University, Hamilton, ON, Canada 2Division of Orthopedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada H. Johal ✉, Division of Orthopaedic Surgery, Department of Surgery, McMaster University, Hamilton, ON, L8L 8E7, Canada, Email: [email protected] A note from the Editor-in-Chief: We are pleased to publish the next installment of Cochrane in CORR®, our partnership between CORR®, The Cochrane Collaboration®, and McMaster University’s Evidence-Based Orthopaedics Group. In this column, researchers from McMaster University and other institutions will provide expert perspective on an abstract originally published in The Cochrane Library that we think is especially important. We welcome reader feedback on our editorials as we do on all of our columns and articles; please send your comments to [email protected]. (Norman G, Shi C, Goh EL, et al. Negative pressure wound therapy for surgical wounds healing by primary closure. Cochrane Database of Systematic Reviews. 2022, Issue 4. Art. No.: CD009261. DOI: 10.1002/14651858.CD009261.pub7.) Each author certifies that there are no funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc.) that might pose a conflict of interest in connection with the submitted article related to the author or any immediate family members. All ICMJE Conflict of Interest Forms for authors and Clinical Orthopaedics and Related Research® editors and board members are on file with the publication and can be viewed on request. The opinions expressed are those of the writers, and do not reflect the opinion or policy of CORR® or The Association of Bone and Joint Surgeons®. Cochrane Reviews are regularly updated as new evidence emerges and in response to feedback, and The Cochrane Library (http://www.thecochranelibrary.com) should be consulted for the most recent version of the review. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. This Cochrane in CORR® column refers to the abstract available at: DOI: 10.1002/14651858.CD009261.pub7.

Self-Care Intervention in Post Sectio Caesarea Mothers

Post-SC mothers will usually experience a lack of self-care such as maintaining post-SC wound hygiene, breast care and early mobilization. The lack of self-care hygiene is caused by the presence of post-SC pain which can affect the physical activity that will be carried out on the mother, the lack of education during the short treatment. The purpose of this article is to determine the types of self-care interventions for self-care in post-SC mothers. In this article, we use Arksey and O'Melley models in analyzing. The literature sources used are through online databases, Science Direct, Pubmed, Google Scholar from 2017 to 2021. Identification and analysis using Preferred Reporting Items for Systematic Reviews and Meta Analysis for Scooping Review (PRISMA-SR). From the results of 5 articles that were analyzed, this article has summarized the types of self-care and education interventions used for self-care in post-SC mothers, including; early mobilization of post sectio caesarea with surgical wound healing, early mobilization with the level of independence of post sectio caesarea patients, knowledge of post-sectio caesarea (SC) wound care with the level of patient independence, communication, information, education (IEC) with mother's motivation in doing early mobilization post sectio caesarea, postpartum education with booklet media for mothers after sectio caesarea.

Bigger Is Not Always Better: Effects of Electrocautery Setting on Tissue Injury in a Porcine Model.

IntroductionElectrosurgery for dissection and hemostasis remains one of the foundational tools for the field of surgery as a whole. Monopolar cautery remains the most utilized modality for achieving the aforementioned goals. Given the prolonged history and pre-modern development of "Bovie" cautery, there remains a paucity of data regarding appropriate settings and intensity for various tissue types, procedures, or locales. As a result, utilized settings depend on precedent and personal preference. We aimed to determine the amount of secondary soft tissue injury by volume and depth beyond the electrocautery pen tip in the skin and subcutaneous tissue as well as skeletal muscle. MethodsPorcine samples were used for experimental testing using two testing types: 1) skin and subcutaneous tissue and 2) Skeletal muscle. Sample sizes were standardized at 1 cm3 cubes. For skin samples, tissue injury was created with either a scalpel or electrocautery pen on cut setting, and tested at intensities from 10 to 150 in increments of 10. Skeletal muscle samples were similarly tested using the electrocautery pen only in either a cut or coagulation setting. Samples were tested at incremental intensities from 10 to 120 for both settings. Electrocautery was tested for a period of five seconds with a continuous current. All samples were placed in formalin and underwent histologic staining with hematoxylin and eosin staining to be assessed for the extent of tissue injury in terms of depth, radius, and volume. The measurements were recorded in millimeters.ResultsFor skin incision, there was a positive and significant correlation with respect to the radius (R=.73, p=0.006). When considering intensity with an interval of 10-70 there was a positive and significant correlation with respect to the radius, depth, and volume. The cold knife incision had no notable soft tissue injury beyond the depth of the incision. Regarding skeletal muscle, again, a significant and positive correlation between increasing monopolar settings was noted for both the coagulation and cut functions (R=.84, p=.0005; R=0.84, p=0.0006). A positive correlation was found between increasing cut intensity and volume of soft tissue injury (R=0.73, p=.008); this was not reflected in the coagulation setting. When limited to an intensity range of 10-60, a significant relationship was noted for depth, radius and volume (R=.95, p= <0.001; R=0.98, p= <.001; R=.92, p=.001).ConclusionIn all samples, apart from the cold knife skin incision, additional soft tissue injury beyond the tip of the electrocautery pen was noted. Given our findings, recommendations include using the lowest setting required for the purposes of the given surgical case as well as minimizing electrocautery use for skin incisions given its association with a larger volume of tissue injury in comparison with a scalpel. Additionally, electrocautery should be used with care in, and around neurovascular structures as soft tissue injury did occur several millimeters beyond the tip of the electrocautery pen. Further study is needed to see if these patterns are similar in living animals as well as human tissue and whether they bear any clinical impact on surgical wound healing or other surgical complications.

Histological Examination of Lemongrass Resorbable Dressing on Gingival Healing after Gingivectomy in Rats.

The present work aimed to evaluate the effect of lemongrass extract incorporated in a resorbable periodontal dressing on gingival wound healing microscopically, following gingivectomy in rats. Thirty healthy adult male Sprague-Dawley rats were used in this study. Gingivectomy was performed on anterior area of lower jaw in the labial surface of central incisive and, subsequently, wound areas were covered with povidone iodine gel (group P, positive control, n = 10), lemongrass resorbable dressing (group L, n = 10), and a cellulose-based dressing containing myrrh (group M, positive control, n = 10). Histological changes were monitored in days 4, 7, and 14 postsurgery to evaluate fibroblast and collagen deposition as repair stage of healing process. One-way analysis of variance (ANOVA) followed by Tukey's post hoc for multiple comparisons were employed to measure differences between pairs of means, p-value of 0.05 was considered statistically significant. We observed significant difference repair parameters of the healing process between surgical sites treated with lemongrass periodontal dressing and control groups. Wounds treated with lemongrass dressing had greater fibroblast compared with control groups in 4 and 7 days after surgery (p ≤ 0.05). The results suggest positive potential therapeutic effects for this new formulation of periodontal dressing on acceleration of surgical wound healing that lead to improvement of periodontal treatment consequences following gingivectomy.

Successful healing of non-healing surgical wound based on the release of platelet-derived growth factors from single donor allogeneic platelet-RICH plasma with one freeze-thaw cycle: a case report after a 1-year follow-up

BackgroundNon-healing surgical wounds is a risk in certain patients. Recently, allogenic plasma-rich-platelet (PRP) is used such as regenerative treatment of different non-healing surgical wounds.PurposeWe explore the potential role of using platelet-derived growth factors from single donor PRP, with a freeze-thaw process, for the treatment of surgical scar ulcer.MethodsWe have used a PRP preparation protocol that involved a single cycle of centrifugation at a mean speed of 2400–2800 rpm of donor blood taken with an apheresis machine.ResultsTo our knowledge, this is the first study using the platelet-derived growth factors (PDGF) from single donor apheresis, with a freeze-thaw process. Four weeks after daily application of al-PRP, the ulcer progressed satisfactorily; at six weeks, the ulcer had healed.ConclusionWe concluded that the healing of a surgical wound observed in our case, is promising and suggests that al-PRP might play a role in treating surgical scar ulcers. This must be confirmed in future studies.

PROSES PENYEMBUHAN LUKA OPERASI FASE INFLAMASI DENGAN TINDAKAN MOBILISASI DINI PASIEN POST SECTIO CAESAREA DI RSAD WIRA BHAKTI MATARAM

Early mobilization is a supporting factor in accelerating postoperative wound recovery and can prevent postoperative complications. By early mobilization, vascularization will be better so that it will affect post sectio caesarea wound healing because the wound requires good blood circulation for cell growth or repair. Based on the results of preliminary study interviews conducted by 9 out of 10 postpartum mothers after sectio caesarea, they were afraid to do early mobilization. One of the reasons was that postpartum mothers were afraid that the surgical sutures would come off. This study aims to determine the effectiveness of early mobilization with the wound healing process of sectio caesarea at the Wira Bhakti Hospital Mataram. The research design used is analytical observational. The sampling technique in this study used an accidental sampling technique with inclusion and exclusion criteria with a sample of 30 respondents and data scollection using an observation sheet.Based on the results of the study, it was found that from 30 respondents postpartum mothers who were examined were more likely to do early mobilization in the first 6-10 hours, namely 23 people (76.7%) and those who experienced wound healing in the inflammatory phase 0-3 days post-sectio. caesarea, namely 23 people (76.7%) and those who did not recover were none. While respondents who did not do early mobilization &gt;10 hours post sectio caesarea were 7 people (23.3%) and those who experienced wound healing in the inflammatory phase 0-3 days post sectio caesarea were none and those who did not heal were 7 people (23, 3%).Based on the results of the chi-square test, the p value is 0.000 with a = 0.05 then (p &lt;a), because p &lt; 0.05 means Ho is rejected and Ha is accepted so early mobilization of post sectio caesarea patients is effective in the wound healing process in the surgical phase. inflammation 0-3 days at Wira Bhakti Hospital Mataram in 2017. This study can be used as input in the context of implementing midwifery care programs, especially early mobilization for the first 6-10 hours of post sectio caesarea to be improved so that it is hoped that all patients who perform early mobilization in the first 6-10 hours of post sectio caesarea experience surgical wound healing.

Efficiency of hypericum perforatum, povidone iodine, tincture benzoin and tretinoin on wound healing

Different topical agents have been used to accelerate wound healing. The purpose of this study is to compare the safety and efficacy of topical application of the extract of Hypericum perforatum (HPE), povidone iodine (PI), tincture benzoin (TB) and tretinoin (T) on surgical wound healing. Ten adult female, Wistar albino rats were included in the study. HPE, PI, TB and T solutions were applied on the wounds. After seven days, tissue samples were collected and inflammatory cells, re-epithelialization, granulation tissue, angiogenesis, collagen accumulation, hemorrhage and lysis of cells were investigated histopathologically. No dermal toxicity was noted. HPE, TB, PI have all showed good epithelialization and granulation, but HPE showed the most advanced stage of healing within a short period of time. HPE had significantly higher values of re-epithelialization and collagen accumulation, but lower inflammatory cell count and granulation tissue. TB had the second best in re-epithelialization, collagen accumulation and the highest granulation tissue. PI induced better reepithelialization and granulation than the control group with remarkable cell lysis. As a result, HPE can be a safe, effective, and cheap agent that can be used for surgical wounds.

Acellular Dermal Matrix Favorably Modulates the Healing Response after Surgery.

When first described for breast reconstruction, the presence of acellular dermal matrices was associated with increased seroma formation and infection. However, clinical safety data have gradually improved with surgeon experience to an acceptable outcomes profile of acellular dermal matrix-assisted reconstruction when compared to submuscular implant coverage. In fact, acellular dermal matrix use potentially decreases capsular contracture rates and facilitates expansion for staged prepectoral breast reconstruction. Because of new regulatory requirements, the collection of unbiased, well-powered premarket approval data summarizing long-term clinical outcomes will be essential over the coming years to understand the clinical performance of acellular dermal matrix use in breast reconstruction. Currently, the authors can highlight the physiologic benefits of acellular dermal matrix use in breast reconstruction by evaluating the components of surgical wound healing that are favorably augmented by the implanted collagen substrate. Acellular dermal matrix takes advantage of the wound healing cascade to incorporate into the patient's tissues-a process that requires a coordinated inflammatory infiltrate and angiogenesis. The presence of acellular dermal matrix augments and modulates the wound healing process to its advantage by simultaneously increasing the invasion of appropriate cellular constituents to facilitate expeditious healing and accelerate angiogenesis. In this article, the authors summarize the wound healing literature to demonstrate the mechanisms acellular dermal matrices use to biointegrate and the literature in which cellular constituents and soluble growth factors are up-regulated in the presence of acellular dermal matrix. Lastly, the authors use their experimental observations of acellular dermal matrix incorporation to corroborate the literature.

Assessment of modified reconstructive technique effectiveness to treat chronic peri-implantitis

Relevance. The article presents positive clinical outcomes of using a modified reconstructive technique around 20 implants in 14 patients. Its effectiveness was statistically assessed using linear regression analysis. Material and methods. Clinical data of 20 patients treated from 2014 to 2021 for chronic peri-implantitis around 27 teeth provided the basis for the study. The patients formed two groups: control (6 patients (7implants)) and study (14 patients (20 implants)) groups. A staged treatment approach was applied to all patients and included anti-inflammatory, reconstructive and maintenance stages. In the control group of patients, we finished the treatment at the first stage, as stable clinical remission was achieved after the surgery. In the study group, there were two stages: anti-inflammatory treatment and reconstructive treatment with a modified reconstructive technique. Before and after treatment, we isolated biomarkers specific to surgery results, represented by independent and dependent variables. The received data were statistically evaluated using linear regression analysis (Gretl) to assess the effectiveness of a new surgical technique by studying numerical relationships between two groups of variables. Results . The modified reconstructive technique as a part of a staged approach increased the effectiveness of chronic peri-implantitis treatment up to 74%. The statistical analysis demonstrated a significant influence of the baseline bone resorption level (vr1), defect shape (fd) and inflammation level (s) on the formation of new tissue attachment around the implants (gz2). The intensity of surgically induced stress response (str) directly correlated with surgery injury (hm) and baseline inflammation level (s). Surgical wound healing (pk), most closely related to implant survival (del), did not have a meaningful relationship with surgery-induced stress response intensity (str), which indicates the crucial role of the microbial fac tor in surgical wound healing around implants. Conclusion . A new modified surgical technique increases the effectiveness of chronic peri-implantitis treatment to 74% due to the stability of a pedicled vascularized submucoperiosteal flap in the inflammation area. The study did not detect the direct impact of the periosteal reparative-regenerative potential on the radiological bone level restoration. However, it demonstrated clinically significant positive results. Inability to fully control microbial biofilm on the implant surface remains the main problem of chronic peri-implantitis treatment.