Traumatic Wounds Research Articles

‘Generative Traumatic Wounds’: Notes of a Female Artist – A Conversation with Chiara Lagani

‘Generative Traumatic Wounds’: Notes of a Female Artist – A Conversation with Chiara Lagani

Accelerating the healing of hard-to-heal wounds with food supplements: nutritional analysis in the Côte d'Ivoire.

Hard-to-heal wounds are an important, yet often neglected, public health issue in low- and middle-income countries (LMICs). Malnutrition has been identified as a risk factor for prolonged healing times. However, nutritional supplements are not routinely provided for patients with hard-to-heal wounds, and so this study aimed to investigate their benefits. This 9-month study was conducted in the Taabo Health and Demographic Surveillance System in the south-central part of Côte d'Ivoire. Patients with wounds (≥30mm2) were recruited. Treatment was standardised for inpatients (72%) and outpatients (28%). There were three intervention groups: supplemented with soy; orange flesh sweet potato (OFSP); or both. Another group was included without supplement, serving as control. General linear models were employed to assess the effects of log initial wound size, type of wound, food treatment group, haemoglobin, sex, age, place of treatment and body mass index on the rate of wound closure. The cohort consisted of 56 patients, 41 of whom were placed in intervention groups, and the remainder as controls. Within the cohort, 37 (66%) patients suffered from Buruli ulcer, 15 (27%) from traumatic wounds and four (7%) from erysipelas. We found a significant effect (p=0.004) of diet supplemented with OFSP on the wound healing rate. OFSP is a nutritional rehabilitation supplement, characterised by a high content of beta-carotene and carbohydrates. It is associated with shortened wound healing times, reduced discomfort and reduced cost of wound care. Further research should investigate the effect of a diet rich in beta-carotene, in combination with standard medical care, on hard-to-heal wound healing in LMICs.

To Di World: Jamaican soccer, poiesis and post-colonial transformation.

This article presents a case study of an innovative culturally based therapeutic approach using collective poiesis to improve the functioning of a youth sports team in Jamaica. In recent decades, Jamaica has endured high levels of violence and corruption, and has been ranked among the top four countries in the world in terms of murder rate per capita. We conjecture that a high prevalence of personality disorder linked to the legacy of slavery and colonialism often impedes Jamaicans from achieving success in diverse fields, including sports. Psychological interventions in the preparation of football teams are a novelty, and have been used mainly to enhance global team performance or individual player skill. The use of psychological interventions to address personality disorder psychopathology on the soccer pitch has not been reported. Psychohistoriographic cultural therapy (PCT) integrates psychological perspectives with a dialectic method of historical analysis and uses collective poiesis as a vehicle to translate insights through an embodied cognitive restructuring process. Two workshops were carried out with a high school football team using PCT techniques. The process of dialectic reasoning engaged their collective ideas and insights to establish a psychic centrality that was expressed in poetic form to illustrate the pathologies of the group in an emotionally safe and psychologically acceptable narrative. This poetic narrative of the group's psychic centrality counters the personality disorder psychopathology caused by the lingering intergenerational wounds of slavery, colonial oppression and collective trauma.

A Novel Treatment Protocol to Improve Outcomes with Transtibial Amputations

Category: Diabetes; Other Introduction/Purpose: A retrospective case series study was performed to evaluate the outcomes and risk factors of transtibial amputations (TTA) using a novel post operative treatment protocol. The study hypothesis is that a novel post operative treatment protocol could improve outcomes for TTAs. All patients who underwent a TTA from July 2019 through December 2022 were treated with this protocol. Outcomes identified included time to prosthetic fitting after surgery and complications including wound dehiscence and mortality at 30 days. Risk factors were also identified for the patients in this case series study. Methods: The novel post operative protocol includes a circumferential incisional negative pressure wound therapy (CiNPWT) dressing that covered with a novel residual limb shrinker (nRLS) and a limb protector (LP) applied after incision closure. The CiNPWT and nRLS were removed at the first follow up visit. Then the nRLS was applied as the primary dressing directly against the incision covering the residual limb. The nRLS was changed for wound cleansing and was sequentially decreased in size to facilitate consolidation of the residual limb. Results: There were 433 surgeries performed on 304 patients. This included 222 (73%) men and 81 (27%) women with an average age of 67 years (41-90 years). There were 129 revision surgeries including 25 above-the-knee amputations (AKA). The average time to prosthetic fitting for TTA was 8 weeks. The average study group BMI was 32 kg/m2, A1c 8.7%, albumin 2.6 g/dL and neutrophil to lymphocyte ratio (NLR) 4.9. Traumatic wound dehiscence from falls represented 26% of revision surgeries. Mortality at 30 days was 3.2% for all study participants. The early death average age was 70 years (41-90 years), 73% with end stage renal disease (ESRD) and 82% with diabetes mellitus (DM). Conclusion: The novel protocol for transtibial amputations decreased the 30 day mortality to 3.2% from a national average of 13.5%. The average time to prosthetic fitting was 8 weeks for the study group compared to 16 weeks for US Department of Veterans Affairs amputations. The early death group’s average albumin of 2.15 g/dL with a NLR of 8.9. The study demonstrated that a novel postoperative protocol may improve outcomes in transtibial amputations and that a few simple blood values may provide an indication of the diminished overall physiologic health of this patient population.

Effective Application and Outcome of Negative Pressure Wound Therapy in Management of Complex Wounds with External Fixator

Background: Negative pressure wound therapy ( NPWT ) has been commonly used in the management of complex traumatic wounds of extremities. It reduces oedema, increases perfusion and enhances granulation tissue formation. But presence of external fixator makes it difficult to apply and maintenance of seal in presence of external fixator thus affecting wound healing. Objective: To study the effective application and outcome of NPWT in the management of complex wounds. Methods: Retrospective study conducted in Department of Plastic and Reconstructive Mayo Hospital/KEMU over a period of 2 years (June20- June 22). All patients presenting with wounds on either upper or lower limb with external fixator applied during this period were included. After wound debridement NPWT was applied
 according to our technique. Demographic data of patients, mode of injury, time of presentation after injury and site/size of wound were noted. Outcome of seal (Effective maintenance of suction pressure at the completion of NPWT application and Seal failure as loss of suction within 72 hrs ) , no. of NPWT sessions and outcome of wound (skin grafting/flaps) were documented. Results: In this study, total number of patients was 26. Seventeen were (65.4%) males and 9(34.6%) females. Mode of injury was road traffic accident (69.8%) and machine injury (30.8%). Mean age was 23±14.2 years. Mean wound size 31.3±12.6 in2. Mean time of presentation after injury was 11.8±6.14 days. In 3 patients seal was not maintained. In 23 patients seal was maintained. Skin grafting was done in 21 patients and local/ distant flaps in 5 patients. Conclusion: NPWT has been in use for the management of wounds for many years. But problem arises in its application over wounds with external fixator. There are chances of air leakage and difficulty in maintaining seal. With our technique of application, we have been able to manage this problem. It is a simple, quick and inexpensive technique with overall good results. Use of this technique minimizes the use of major local and free flaps for soft tissue coverage of limbs.

Dehydrated human amnion/chorion membrane allograft with spongy layer to significantly improve the outcome of chronic non-healing wounds.

We investigated the healing effect of a new dehydrated amnion/chorion membrane with a spongy layer over a 30-month period in 32 patients with 53 chronic non-healing wounds of different aetiologies. Wounds with <40% surface reduction after 4 weeks of best wound treatment underwent weekly allograft application by a certified wound specialist based on national guidelines and a standardised protocol until complete healing or definite treatment interruption. The main outcome measure was the percentage of wound surface reduction from baseline calculated using digital planimetry follow-up photographs. Overall, 38 (71.7%) wounds presented a favourable outcome (70%-100% area reduction), with 35 (66%) completely healing over a median time of 77 days (range 29-350 days). Favourable outcomes were observed in 75% of traumatic wounds, surgical wounds, venous leg ulcers and pressure injuries, as well as in 50% of ischaemic wounds. Wounds being present <12 months were significantly more likely to have a favourable outcome than more long-standing wounds (χ2 = 7.799; p = 0.005; OR = 3.378; 95% CI, 1.410-8.092). Thus, treatment with dehydrated amnion/chorion membrane with a spongy layer improves the outcome of non-healing wounds of different aetiologies and, therefore, has to be considered early in the management of refractory wounds.

Sushruta’s concept of Seevana Karma - A Review Article

Ayurveda is eternal science and considered by many scholars to be the oldest healing science. Ayurveda consists of Ashtangas (8 branches of ayurveda) and Shalyatantra is one and foremost among them. Acharya Sushruta is considered as pioneer of Shalyatantra and contribution of Acharya Sushruta to Shalyatantra are innumerable. Ashtavidha Shastra Karma is unique contribution of Acharya Sushruta. Ashtavidha Shastra Karma includes Chedana, Bhedana, Lekhana, Eshana, Aharana, Vedhana, Visravana, Seevana.[1] These eight specific surgical procedures are useful in the management of all the diseases which require surgical intervention. In the present scenario though modern surgery has developed a lot but the basic concepts remain the same and they are base for these developments. Seevana is one among Ashtavidha Shastrakarma. Acharya Sushruta has emphasised clearly on Seevana Karma like its indication, contraindication, materials and the procedure. Suturing is the term used in Modern science for Seevana. A suture is any thread which brings into opposition two surfaces or tissues.[2] Suturing is a stich or series of stiches made to secure opposition of the edges of a surgical or traumatic wound. No surgery is complete without suturing. A lot of scope in developing suturing material told by Acharya Sushruta are on lines of modern medical science. Hence in this regard a small attempt has been made to through light on Seevana Karma and Suturing. This article summarises concept of Seevana Karma according to Acharya Sushruta.

A novel treatment approach for traumatic scalp defects with exposed calvaria denuded of pericranium by combined application of low-temperature plasma and negative pressure wound therapy: A case series.

Traumatic scalp defects with an exposed calvaria denuded of the pericranium are challenging to manage. In such cases, adjunctive therapies, such as milling the outer calvarial cortex and applying negative pressure wound therapy (NPWT), can promote granulation tissue. This case series describes the successful management of traumatic scalp defects after cortical craniectomy using a combination of low-temperature plasma (LTP) and NPWT. This is a retrospective single-surgeon case series. Three patients with traumatic scalp wound defects underwent cortical calvarial bone removal after LTP combined with NPWT. LTP was applied to the diploic space of the calvaria weekly or twice weekly using BioPlasmaJet BPJ1 (BIOPlasma System: Model-BioPlasmaJet System). Subsequently, NPWT was applied with a continuous pressure of 110 mmHg until good granulation tissue formation was achieved for skin graft placement. Two males and one female were included, and the mean follow-up duration was 7 (range 3-12) months. In addition, the average time to achieve good granulation tissue formation was 4 (2-6) weeks; all patients achieved successful split-thickness skin grafting within 3 weeks after placement without signs of calvarial infection. The combination of LTP and NPWT is a safe and effective treatment modality for scalp defects with exposed calvaria denuded of the pericranium resulting from trauma. Combining these two therapies may provide a synergistic effect that enhances granulation tissue formation and prevents local infections without complications.

Differential diagnosis of stage 2, 3 and 4 pressure injuries of the pelvis and lower extremity: a case series.

Constant, unrelieved pressure of local tissue, particularly over bony prominences, may provoke damage that progresses to necrosis and pressure injury (PI). Differentiating PIs from conditions of similar appearance is imperative to minimising complications and implementing prompt treatment. This case series describes several conditions that may be mistaken for a PI. Outlined are the key differences in patient history, presentation and clinical cues that assist in correctly identifying the true pathology behind these conditions. Conditions reviewed included: pyoderma gangrenosum; necrotising fasciitis; genital herpes; Marjolin ulcer, Rosai-Dorfman disease; vascular disease; coagulopathies; calciphylaxis; trauma and surgical wounds; pilonidal cysts; graft-versus-host disease; hidradenitis suppurativa; Stevens-Johnson syndrome; epidermolysis bullosa; radiation wounds; spider bites; and end-of-life skin failure pressure ulcers (also known as Kennedy ulcers). Although commonly recognised and diagnosed, stage 2, 3 and 4 PIs occasionally prove to be difficult to pinpoint, with undefined characteristics and similarities in presentation to several other conditions. Therefore, it is clinically vital to be aware of their appearance, risk factors and aetiology in order to make an appropriate patient assessment and avoid misdiagnosis.

Unveiling Traumatic Facial Wounds: A Comprehensive Study on Epidemiology, Diagnosis, and Therapeutic Approaches

Introduction: Dilapidated facial wounds are shredded injuries with loss of tissue substance. A surgical emergency characterized by complex anatomical clinic types that may expose vital organs. The objective of this study is to investigate their epidemiological, diagnostic, and therapeutic aspects. Material and method: This epidemiological, retrospective, descriptive, and cross-sectional study was conducted using patient records from individuals who experienced maxillofacial trauma resulting in decaying facial wounds between March 2017 and June 2021 at the Maxillofacial Surgery Department in Libreville, Gabon. All confirmed cases of traumatic dilapidated facial wounds were included, while patients with non-traumatic wounds were excluded. The analyzed parameters encompassed sex, age, etiology, clinical signs, and treatment. The criteria for patient assessment of the plasty outcomes were categorized as very satisfactory, satisfactory, not satisfactory, and disappointed. Results: A total of 33 cases were included in the study. The male-to-female sex ratio was 3.1:1. The average age of the patients was 29.8 ± 14.9 years. The majority of cases (36.4%) were attributed to road traffic accidents (AVP). Among the affected areas of the face, the lips were most frequently involved. Local plasty was performed in 24 patients, while 9 patients underwent regional plasty. The treatment outcomes were deemed satisfactory by 75.8% of the patients. However, 21.2% of the patients experienced functional sequelae as a result of the injuries. Conclusion: Young males are commonly afflicted by severe lesions, often leading to bone fractures. The application of local plasty has proven to yield favorable results in effectively managing these complex injuries.

Hyperbaric oxygen therapy a boon for complex post traumatic wounds

Post-traumatic wounds especially after run over accidents are difficult to manage. The vascularity and regenerative potential of the tissues is severely compromised. Surgical intervention is of limited value. A conservative approach with concomitant hyperbaric oxygen therapy (HBOT) serves as a great salvage in such cases. A case of post-traumatic forefoot gangrene in a 27-year-old laborer is presented to highlight and create an awareness of the potential benefit of HBOT in salvage of distal parts of the lower extremity where the blood supply is severely compromised.

Molecularly engineered dual-network photothermal hydrogel delivery system with enhanced mechanical properties, antibacterial ability and angiogenic effect for accelerating wound healing

Bacterial infection caused by trauma and chronic wounds in the most mobile area remains a challenge in clinic. It is difficult to achieve the synergistic effects of antibacterial capacity and skin regeneration using conventional therapeutic methods. Developing a multi-functional hydrogel dressing that can cope with the complex wound environment will contribute to the healing and therapeutic effects. In this work, a novel Cur@PAM/TA-Cu photothermal hydrogel delivery system was prepared by engineering tannic acid (TA) into covalent cross-linked polyacrylamide (PAM) on which the chelating tannic acid-copper metal–polyphenolic network (TA-Cu MPN) was imposed to form dual-crosslinked networks, and the natural medicine curcumin was loaded eventually. The molecularly engineered dual-crosslinked networks resulted in enhanced mechanical properties including bio-adhesion, tensile strength and self-healing, which made the hydrogel suitable for dynamic wound and various application scenarios. In addition, the excellent photothermal capacity, antioxidant effect and biocompatibility of the hydrogel were demonstrated. Notably, this curcumin loaded photothermal hydrogel exhibited superior antibacterial capacity (almost 100% killing ratio to E. coli and S. aureus) under 808 nm laser irradiation. Meanwhile, the in vivo wound healing experiment results revealed that the anti-inflammation and proangiogenic effect of Cur@PAM/TA-Cu hydrogel successfully shortened the healing time of wound and the reconstruction of skin structure and function. Thus, this dual-crosslinked multi-functional hydrogel delivery system is a promising wound dressing for accelerating wound healing.

Research progress on antimicrobial hydrogel dressing for wound repair

Hydrogels possess excellent biocompatibility and moisturizing properties and have been extensively studied for their ability to assist tissue repair in traumatic wound therapy. Antimicrobial dressing hydrogels are recognized for their potent antimicrobial properties and therapeutic benefits. Utilizing techniques like self-assembly, modification, and doping, numerous advanced antibacterial hydrogels have been developed, showcasing effective antibacterial performance based on distinct mechanisms. This study examines the preparation methods, antibacterial mechanisms, and effects of antibacterial dressing hydrogels, summarizing the latest research progress. It particularly elucidates the classification of cross-linking methods of antibacterial hydrogels and the selection and design of antibacterial components. By systematically outlining the properties of hydrogels across various antibacterial mechanisms, our intention is to provide valuable insights for the design of antibacterial hydrogel dressings and anticipate their potential in biomedical research and applications.

Dynamic hydrogel with environment-adaptive autonomous wound-compressing ability enables rapid hemostasis and inflammation amelioration for hemorrhagic wound healing

Severe trauma wound management remains a crucial challenge in the clinics owing to the uncontrollable bleeding and acute inflammatory responses. To achieve rapid hemostasis and reduce local inflammation of large hemorrhagic wounds, we proposed a composite hydrogel dressing through the free radical polymerization of methacrylate gelatin (GelMA), bisphosphonic acid (BP) and cyclodextrin (CD)-modified hyaluronic acid (HA) and loaded with anti-inflammatory drug resveratrol (RES) through supramolecular inclusion. After implantation into bleeding wounds, the hydrogel could electrostatically enrich blood cells and platelets around the wound area to accelerate thrombosis and also increase its own weight to compress local blood vessels for reducing blood loss. Moreover, the cross-linking degree of the HG-CB-based hydrogels could be enhanced in a self-evolving manner through coordination between BP and blood-derived iron ions, leading to increasing biomechanical performance to avoid hydrogel rupture and secondary bleeding. In addition, the hydrogel continuously released RES to increase secretion of anti-inflammation factors, which may stimulate fibroblast migration and accelerate collagen deposition at the wound site. Overall, the HG-CB-based composite hydrogels exhibited excellent rapid hemostatic properties for treating large bleeding wounds and accelerated wound repair via RES-mediated inflammation amelioration, which may provide an approach for managing severe traumatic wounds in the clinics.

A novel tension relief technique to aid the primary closure of traumatic equine wounds under excessive tension.

To achieve an excellent functional and cosmetic result, primary closure is preferred over leaving wounds to heal by secondary intention. However, traumatic wounds are often under excessive tension during wound closure and incorrect suture technique can compromise microcirculation, leading to skin necrosis and impaired wound healing. To describe an inexpensive and effective tension relief technique that helps the successful primary closure of a variety of equine wounds at high risk of dehiscence. Retrospective case series. All wounds that were managed with the Tension Tile System (TTS) at four Equine Hospitals between March 2017 and May 2021 were evaluated. The wounds were classified according to various criteria including anatomical location, time elapsed prior to surgery, depth of wound and post-surgical use of immobilisation. Outcome criteria were based on the success of primary intention healing. The duration of convalescence (weeks) after surgery was also recorded. During the study period, the TTS was used in 191/860 (22%) wounds repaired under general anaesthesia or standing sedation. Overall, primary intention healing (Group A) was achieved in 132 of 191 cases (69%, CI 62%-75%), with partial dehiscence (Group B) in a further 30/191 cases (16%, CI 11%-22%). Severe dehiscence (Group C) was recorded in 29/191 cases (15%, CI 11%-21%). The median convalescence time was 4 weeks (Range 3-15, interquartile range 4-6) in Group A. Retrospective nature of the study and subjective outcome assessment. The technique was applied to wounds under significant tension; however, this was based on a subjective assessment by the surgeons involved. The Tension Tile System is an economical and effective technique for challenging equine wounds under tension, in a variety of anatomical locations.

Negative-Pressure Wound Therapy (NPWT) in Horses: A Scoping Review.

Obtaining a healthy wound environment that is conductive to healing in horses can be challenging. Negative-pressure wound therapy (NPWT) has been employed in humans to enhance wound healing for decades. The existing evidence for the effectiveness of NPWT remains uncertain in equine medicine. The aim of this review is to investigate NPWT applications and benefits in horses. A scoping review was performed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) guidelines for scoping reviews on three databases (PubMed, Web of Science-Thompson Reuters, and Wiley Online Library). Twenty-four manuscripts were considered. After removing duplicates, 17 papers underwent abstract screening. Of these, 16 + 1 (cited by others) were evaluated for eligibility according to PICOs, including no case reports/retrospective studies, four original articles, and three reviews. Fifteen manuscripts met the inclusion criteria. The focus of the articles was wound management; they included three reports of wounds communicating with synovial structures. Traumatic wounds and surgical-site infections are indications for NPWT. NPWT presents several advantages and few complications making it an attractive alternative to conventional wound management. However, randomized controlled trials should be performed to quantify the benefits and establish precise protocols in horses.

Ulnar-Sided Upper Extremity Traumatic Wounds: What Should We Expect to Find?

Background: Upper limb traumatic injuries have a significant impact on social and professional life; however, there is still a paucity of studies focusing on the injuries of the ulnar border of the forearm, wrist and hand. Methods: We designed a retrospective single-blinded study, including all patients with deep traumatic wounds affecting the ulnar side of the forearm, wrist or hand, that received surgical treatment from 2006 until 2016. A characterisation of the sample, assessment of concomitant injuries and clinical outcomes, as well as neurological and functional evaluation were performed. Results: We obtained a sample of 61 patients, 69% with injuries affecting the wrist and 90% of patients with a neurological lesion, most frequently of the ulnar nerve lesion (UNL). Concomitant injuries included tendinous lesions, more frequently of the flexor carpi ulnaris (64%) and fractures (13%). And 39% of patients presented an ulnar artery lesion, without significant differences in outcomes regarding the completion of arteriorrhaphy or not. At the end of the 8.6 years follow-up, 34% of patients had no deficits; however, patients with UNL showed worse functional scores and greater risk of sequelae. Besides motor function compromise, sensory deficits were also associated with worst functional outcomes. Conclusions: The UNL subgroup showed important impairment of the first ray, probably related to the level of UNL. Furthermore, besides the implications of the motor sequelae, sensory deficits were also associated with worst functional scores. Due to the high percentage of neurovascular and tendinous lesions in ulnar-sided upper extremity wounds, the authors recommend surgical exploration of these lesions. Level of Evidence: Level IV (Therapeutic).

Prevalence of Bacterial Species in Traumatic, Burns and Post-Surgical Wounds: Focus on Emerging Drug Resistance

Introduction: Resistance of bacteria to antibiotics poses a serious challenge in managing and treating wound-related complications. Determining the antibiotic resistance patterns is crucial for guiding appropriate antibiotic therapy to avoid their overuse and emergence of deadly superbugs.&#x0D; Aim: The study was aimed to isolate and detect bacterial species responsible for causing infection in different types of traumatic, burns and post-surgical wounds and antibiotic resistance profile of isolated microorganisms.&#x0D; Methodology: The bacterial load and isolation of microbes was determined by plating of samples onto duplicate blood and MacConkey agar plates. The morphologically distinct bacterial isolates were identified by biochemical tests and susceptibility of bacteria against selected antibiotics was determined by Kirby-Bauer disc diffusion method.&#x0D; Results: The major bacterial strains isolated were Staphylococcus aureus, E. coli, Klebsiella sp. and Pseudomonas aeruginosa. The most prominent bacterial strain found was Staphylococcus aureus, present in more than 54% of collected samples, followed by E. coli, Klebsiella sp., and Pseudomonas aeruginosa, present in 17%, 11%, and 10% of collected samples, respectively. The study further explored that Pseudomonas spp. and Acinetobacter spp. showed resistance against various non-identical antibiotics such as Amikacin (aminoglycosides), Azithromycin (macrolides), Levofloxacin &amp; ciprofloxacin (fluoroquinolones) and Cefazolin (cephalosporins). However, Doxycycline (tetracycline) was the only antibiotic that inhibited the growth of all the bacterial species isolated from the infected wounds. levofloxacin was also one of the effective antibiotics in restricting the growth of Staphylococcus aureus, E. coli and Klebsiella spp.&#x0D; Consequently, the study suggests that Doxycycline followed by levofloxacin may be the most suitable antibiotics for controlling wound infection in this specific geographic region.

Thermosensitive hydrogel coupled with sodium ascorbyl phosphate promotes human umbilical cord-derived mesenchymal stem cell-mediated skin wound healing in mice.

Poor survival and restricted function of transplanted stem cells are regarded as limiting their efficacy in wound recovery greatly. Consequently, it is necessary to identify innovative therapeutic strategies to solve these issues. Firstly, the biological effect of PF-127 hydrogel alone and in combination with SAP on the survival, and migration of cultured HUCMSCs was assessed by cell viability, apoptosis, and scratch wound assays. S. aureus and E. coli were used to evaluate the antibacterial activity of PF-127 plus SAP combination. Further, the ability of HUCMSCs-conditioned medium (HUCMSCs-CM) to promote the angiogenesis and migration of human umbilical vein endothelial cells (HUVECs) in vitro was evaluated using tube formation and transwell migration assays. Finally, the HUCMSCs embedded in PF-127 plus SAP scaffold were administered onto mice's excisional cutaneous wound bed. Histological and immunohistochemical analyses were employed to investigate the wound healing capacity as well as cellular responses of PF-127/HUCMSCs/SAP hydrogel. PF-127 showed cytotoxicity on HUCMSCs, whereas the addition of SAP significantly promoted cell viability and alleviated apoptosis of HUCMSCs encapsulated in PF-127 hydrogel in vitro. SAP supplementation substantially abrogated the inhibiting effect of PF-127 on the migration of HUCMSCs in vitro. The combination of PF-127 and SAP exerted an obvious bacteriostatic function on S. aureus and E. coli. Moreover, the co-treatment with SAP could remarkably enhance the stimulative effect of HUCMSCs-CM on the angiogenesis and migration of HUVECs in vitro. PF-127 combined SAP-embedded HUCMSCs transplantation resulted in a potently accelerated wound healing process, promoted the number of proliferating cells and newly formed blood vessels, as well as enhanced expression of vascular endothelial growth factor. PF-127 coupled with SAP contributes to HUCMSCs-mediated traumatic wound closure in mice by promoting cell survival, antibacterial action, and angiogenesis. Our results offered a theoretical foundation for the clinical treatment of traumatic skin defects.

Antibiotics Resistance and Plasmid Curing Studies of Staphylococcus aureus associated with Wound Infection amongst Patients Accessing University of Port Harcourt Teaching Hospital, Rivers State, Nigeria

Staphylococcus aureus is a common hospital and community-acquired pathogen known to be frequently associated with wound infections, and has become important for its increasing level of resistance to antibiotics. Resistance of Staphylococcus aureus to antibiotics could be as a result of the presence of plasmids or resistance genes. The need to carry out plasmid curing of the isolates is very essential. The aim of the study was therefore to determine the antibiotics resistance pattern of staphylococcus aureus associated with wound infection amongst patients accessing university of Port Harcourt Teaching Hospital, Rivers State, Nigeria. A total of 150 specimens from different types of wounds (traumatic wound, caesarean section, scrotal wound, surgical wounds, burns, diabetic foot, and plastic surgery) were collected from the Hospital for a period of six months and processed for isolation of S. aureus, following standard microbiological procedures. The specimens were cultured on sterile Mannitol Salt Agar (MSA) plates and incubated at 37ºC for 24 hours. Antibiotic susceptibility tests of the isolates was performed using the Kirby-Bauer disc diffusion method, following CLSI guidelines. Plasmid genes of the isolates were cured using acridine orange. The study showed a decrease in antibiotic resistance of 17.3% for ofloxacin (OFL), 13.8% for gentamicin (GEN) and 3.5% for both ceftazidime (CAZ) and ceftriatone (CTR) after plasmid curing, with no apparent change in resistance for the rest of the antibiotics. The results of this study represent serious public health concerns, thus emphasizing the need for proper wound management.