Wound Healing Scores Research Articles

The Efficacy of Modified Ilizarov Distraction-Tension Device on Limb Wound Difficult to Cover with Skin Flaps.

Closure of complex limb wounds poses challenges and requires innovative approaches. This research aimed to evaluate the effectiveness of a modified distraction-tension device using Ilizarov external fixation for wound closure in challenging cases. A retrospective analysis was conducted on 43 patients with extremity wounds that were difficult to cover with skin flaps between January 2019 and December 2022. Tension-relieving traction was applied using the Ilizarovexternal fixator apparatus, tailored to individual wound characteristics. Three types of wire-pin connections were used in this study. The distraction begins on the third postoperative day, with a speed of 0.5mm/d. Clinical wound healing scores were evaluated at 5 and 30 days postoperatively. Complications were documented following the Paley classification system. Traction using modified Ilizarovexternal fixation promoted a significant reduction in wound size. The mean traction period was 11.2 ± 7.3 days, and the mean healing duration was 17.0 ± 3.7 days. The clinical wound healing score improved from 3.7 ± 2.9 at 5 days to 1.7 ± 0.7 at 30 days postoperatively (p < 0.05). Complications were minimal, with no significant obstacles or sequelae observed. Direct closure healing was achieved in 21 cases, skin graft healing in 13 cases, and suture healing in 9 cases. No recurrences were reported. Using Paley's classified complications, there were 17 problems, 9 obstacles, and 0 sequelae. The Ilizarov tension-relieving traction shows promise in facilitating wound closure that is challenging to manage with skin flaps. The modified three types of pin-skin connection configuration could satisfy various types of wound closure.

Comparison of Microsurgical and Conventional Techniques for Augmentation of Keratinized Mucosa Around Dental İmplants

Objective: This study aims to compare the clinical outcomes of periodontal microsurgery with conventional periodontal surgery in keratinized mucosa augmentation around the implant. Materials and Methods: Ten patients with at least 2 implants with a keratinized mucosal width of &lt; 2 mm were included. Free gingival graft (FGG) was applied in the test group with the microsurgery technique whereas in the control group with the conventional periodontal surgery technique. Keratinized mucosa width (KMW) and palatal mucosal thickness (MT) were measured at baseline and 3rd month. Graft shrinkage(GS) was evaluated at the 3rd month. Donor site wound healing was evaluated at the 10th day and 3rd month. Feedback forms were collected on the 10th day. Results: KMW values increased significantly in both groups at 3rd month compared to baseline. The percentage of GS was lower in the test group at 3rd month, but this difference was not significant. MT values in the test group were closer to the baseline values at 3rd month compared to the control group. Wound healing scores were similar in both groups at the 10th day and 3rd month. Postoperative pain levels decreased more rapidly in the test group. Conclusion: The microsurgical technique provides a faster increase in palatal mucosal thickness and lower graft shrinkage during the healing period and an earlier reduction in postoperative pain levels.

Oroantral Fistula Reconstruction by Pedicled Buccal Pad of Fat adjuvant with Advancement Flap (Clinical Study)

Aim: As well as highlighting the role of buccal fat of pad in closure large defects by evaluating healing process through pain, swelling and wound healing scores. Material and Method: A prospective evaluation study was conducted among patients who underwent surgical closure to OAC in both Ear Nose and Throat Department with the Maxillofacial Department of Al-Salam Teaching Hospital in Mosul City of Nineveh Province. Data recorded includes demographical Information and clinical evaluations. Two operators measured the parameters. Pain and swelling assessment through the visual analogue scale (VAS) assess the level of pain on the third, seventh and day twenty following surgery. Wound Evaluation Scale used to evaluate closure of the oroantral communication without nasal regurgitation at 1st week (day 7) and 20th days post- surgery and measure the surgical success. Results: The highest age group are between (20-29 years) with percent (56.5). male show high incidence (56.5%) more than female (43.47). In regard to cause extraction followed by tumors are the common cause for oroantral fistula (56.5%, 17.39). Day three and seven reflect different ranges of pain with highest percent for severe pain in day three (65.21%) and reduced to slight pain (82.60%) in day seven. In regard to swelling, in day three most of cases show very severe swelling (73.91%). In day seven the cases represent sever swelling (78.26%). Twenty-one patients from total 23 show incomplete healing at day seven while two patients have uncertain healing. In day 20 just one patient shows incomplete healing process. Conclusion: Buccal pad of fat can be used safely as adjuvant to buccal advancement flap for closure and is efficient in management of OAC to avoid diminished soft tissue in different size cases. Pain, swelling scales can be used as assessment for healing process added to them soft tissue wound healing scale.

Tendon graft through the coracoid tunnel versus under the coracoid for coracoclavicular/acromioclavicular reconstruction shows no difference in radiographic or patient-reported outcomes.

The purpose of this prospective study was to report the outcomes of two different methods in CC and AC reconstruction for the treatment of AC separation using a tendon graft and knot-hiding titanium clavicular implant. Twenty-seven patients with Rockwood grade III and V acromioclavicular (AC) separations were randomized into two groups. The primary outcome was whether taking the tendon graft through the coracoid risked a fracture. The following were secondary outcomes: follow-up of clavicular wound healing and Nottingham Clavicle score, Constant score, and Simple Shoulder Test results obtained preoperatively and 24months postoperatively. The anteroposterior radiographic change between the clavicular and coracoid cortexes and the clavicular tunnel diameter was measured postoperatively and 24months postoperatively. General patient satisfaction with the outcome (poor, fair, good, or excellent) was assessed 2years postoperatively. No coracoid fractures were detected. No issues in clavicular wound healing were detected. The mean Nottingham Clavicle score increased from a preoperative mean of 42.42 ± 13.42 to 95.31 ± 14.20 (P < 0.00). The Constant score increased from a preoperative mean of 50.81 ± 17.77 to 96.42 ± 11.51 (P < 0.001). The Simple Shoulder Test score increased from a preoperative mean of 7.50 ± 2.45 to 11.77 ± 1.18 (P < 0.001). The changes were significant. The coracoclavicular distance increased from 11.88 ± 4.00 to 14.19 ± 4.71 mm (P = 0.001), which was significant. The clavicular drill hole diameter increased from 5.5 to a mean of 8.00 ± 0.75 mm. General patient satisfaction was excellent. There were no significant differences between the two groups. There were no implant related complications in the clavicular wound healing. The results support the notion that good results are achieved by reconstructing both the CC and AC ligaments with a tendon graft. This clinical trial was registered on Clinicaltrials.gov.

Penerapan Hydrogel dan Antimicrobial Dressing terhadap Penyembuhan Luka dan Sensasi Perifer pada Pasien Gangrene Pedis

Gangrene is one of Diabetes Mellitus (DM) complication causing tissue death in wound and decreased peripheral sensation. Priority management of gangrene is through tissue reperfusion and wound care with modern dressing to enhance healing and increase periphery circulation. This research aimed to report wound healing progress and peripheral sensation gangrene in a patient who was given hydrogel and antimicrobial dressing. Research design used a descriptive case study approach. Sample involved one inpatient in West Java regional public hospital who was diagnosed with gangrene, had necrotic wounds, and poor peripheral perfusion, currently treated with modern dressing hydrogel and antimicrobial dressing. The instrument used is Bates Jensen Wound Assessment Tools (BJWAT), lowest score shows significant wound healing progress. Decreasing wound healing score using BJWAT questionnaire from 41 to 29, peripheral sensation (+), and monofilament score from 0/9 to 5/9 after the intervention. Modern dressing improved wound healing and peripheral sensation in gangrene pedis patient. Thus, it is expected to examine effectiveness of hydrogel and antimicrobial dressings on healing scores and peripheral sensation in gangrene pedis patients more extensively.

Effect of a Thermosensitive Hydroxybutyl Chitosan Hydrogel on Postoperative Sequalae and Quality of Life After Impacted Mandibular Third Molar Extraction

BackgroundThird molar (M3) extraction is a common surgery in oral and maxillofacial surgery, and composite wound dressings such as hydroxybutyl chitosan (HBC) may improve postoperative sequala following M3 removal. PurposeThe study purpose was to measure and compare differences in pain, swelling, trismus, wound healing and quality of life (QOL) between the HBC and the control sides in patients undergoing M3 removal. Study design, setting and sampleThis study is a double-blind, split-mouth, randomized clinical trial. Patients who required M3 removal between June 2022 and May 2023 were included. Exclusion criteria included seafood allergies, smoking, poor oral hygiene, and systemic diseases. Predictor variableThe predictor variable was the socket treatment technique. Subjects were randomly assigned to the HBC or control (physiologic saline) side. Primary outcome variableThe primary outcome variables, including pain assessed by visual analog scale, swelling, and maximal incisional opening (MIO), were measured on the first, third, and seventh postoperative days. The secondary outcome variables included QOL and wound healing score measured on the third and seventh days after surgery. CovariatesThe covariates included age, sex and operation time. AnalysesThe Shapiro‒Wilk test was used to evaluate the normality of the data distribution. The paired t test or Wilcoxon signed-rank test was adopted. Statistical significance was set at P <0.05. ResultsThe study included 60 patients (mean age: 25.81 ± 4.91;23 (38%) males, 37(62%) females). A statistically significant difference in the level of pain (HBC: 37.58 ± 4.39 mm, control: 47.00 ± 4.33 mm, day 1, P < 0.001; 21.88 ± 3.25 mm, 35.95 ± 1.57 mm, day 3, P < 0.001), MIO (23.92 ± 1.38 mm, 18.22 ± 1.82 mm, day 1, P<0.001; 30.00 ± 1.61 mm, 23.78 ± 1.70 mm, day 3, P <0.001) and swelling (6.86 ± 0.70 mm, 7.15±0.80 mm, day 3, P=0.006) was detected after surgery. A statistically significant difference in QOL was detected (HBC: 13.70 ± 1.65, control: 18.60 ±2.14, day 3, P<0.001). ConclusionThe application of HBC hydrogels to wounds after impacted mandibular M3 extraction reduces postoperative sequalae, promotes wound healing and improves postoperative quality of life.

The effect of autologous demineralized dentin matrix on postoperative complications and wound healing following lower third molar surgery: A split-mouth randomized clinical trial

Background/purposeAutologous dentin materials are among the most promising bone substitutes for preventing osseous defects on the distal side of the lower second molar. This study aimed to investigate the effects of autologous demineralized dentin matrix on postoperative complications and wound healing after lower third molar surgery. Materials and methodsThirteen patients with bilateral symmetrical lower third molars participated in this split-mouth randomized clinical trial. After removal surgery, one socket of the lower third molar was grafted with dentin material (demineralized dentin matrix side), and a piece of collagen sponge was used for the tooth socket of the remaining side (control side). The upper third molar on the same lateral side was extracted immediately before lower third molar surgery and used to create a demineralized dentin matrix according to the manufacturer's protocol (KometaBio). After lower third molar surgery, pain, swelling, trismus, and Inflammatory Proliferative Remodeling Scale scores were used to evaluate postoperative complications and wound healing. ResultsPain, swelling, and trismus of the demineralized dentin matrix and control sides were not significantly different at any assessment time (P > 0.05). The wound-healing scores of the demineralized dentin matrix side were better than those of the control side; however, the differences were only significant at 7th and 30th days (P < 0.05). ConclusionGrafting autologous demineralized dentin matrix into the tooth socket did not increase the postoperative complications after lower third molar surgery. However, wound healing on the graft side was comparatively better than that on the control side. Clinicaltrials.gov identifierNCT06073639, date 10 October, 2023. This is a retrospectively registered trial.

A Prospective, Blinded, Open-Label Clinical Trial to Assess the Ability of Fluorescent Light Energy to Enhance Wound Healing after Mastectomy in Female Dogs.

Mammary gland tumors represent the most frequently diagnosed malignant neoplasm in intact female dogs, and surgical removal represents the current gold standard treatment. To promote wound healing and prevent possible bacterial contamination, perioperative antimicrobials are commonly used in clinical practice, even though there are no publications establishing guidelines for the use of such drugs in canine mastectomy. The aim of the present study was to evaluate the ameliorative effect of fluorescent light energy on the quality of the healing process after mastectomy surgery in female dogs, in the absence of perioperative antimicrobial administration. Nine female dogs received a multiple-gland mastectomy due to gland tumors and received FLE application immediately after surgery and then five days after. The surgical incisions were evaluated by a blind investigator over time using the Modified Hollander Cosmesis and Modified Draize Wound Healing Score systems. Statistical analysis revealed a significant ameliorative effect of FLE in the control of step-off borders, contour irregularities, and excessive distortion. In addition, erythema, edema, and serous discharge were lower for those wounds managed with FLE. These results underscore the advantageous impact of FLE on the healing of post-mastectomy wounds in female dogs, offering the dual benefits of reducing potential infection risks and lessening the home care burden for pet owners.

A Randomized Controlled Trial Comparing Collagen Matrix to Hemostatic Gelatin Sponge as Socket Seal in Alveolar Ridge Preservation.

(1) Objectives: This study aimed to compare a collagen matrix to a hemostatic gelatin sponge as a socket seal in alveolar ridge preservation (ARP). (2) Methods: Systemically healthy patients planned for ARP at two sites with more than 50% of the buccal bone wall remaining after tooth extraction were eligible for inclusion. ARP involved socket grafting using collagen-enriched deproteinized bovine bone mineral. Sites were then randomly assigned to the test group (collagen matrix) or the control group (hemostatic gelatin sponge). The primary outcome was soft tissue thickness in the center of the site at 4 months, analyzed on cone-beam computed tomography. Secondary outcomes included the buccal and lingual soft tissue heights, horizontal bone loss, buccal soft tissue profile changes, wound dimensions, and Socket Wound Healing Score (SWHS). (3) Results: In total, 18 patients (12 females, 6 males) with a mean age of 57.3 years (SD 11.1) were included. Four months after ARP, the soft tissue thickness in the center of the site amounted to 2.48 mm (SD 0.70) in the test group and 1.81 mm (SD 0.69) in the control group. The difference of 0.67 mm (95% CI: 0.20-1.14) in favor of the collagen matrix was statistically significant (p < 0.009). The buccal soft tissue height was also statistically significantly higher for the collagen matrix (0.72 mm; 95% CI: 0.06-1.38; p = 0.034). A trend favoring the collagen matrix was found for the lingual soft tissue height (p = 0.066). No significant differences between the groups in terms of horizontal bone loss, buccal soft tissue profile changes, wound dimensions, and the SWHS were found. (4) Conclusions: The absence of significant differences in hard tissue outcomes suggests that both the collagen matrix and hemostatic gelatin sponge effectively sealed the extraction socket and supported bone preservation. However, the collagen matrix better maintained soft tissue dimensions. The clinical relevance of this finding with respect to the necessity for adjunctive soft tissue augmentation at the time of implant placement is yet to be studied.

Comparative Assessment of Gingival Depigmentation Using Scalpel Versus Microneedling With Ascorbic Acid: A Randomized Controlled Trial.

Background Gingival pigmentation (GP), characterized by the presence of melanin in the gingival tissues, is a common aesthetic concern in dental practice. While it poses no inherent health risks, the visible discoloration may cause psychological distress for individuals seeking optimal dental aesthetics. Understanding the efficacy of various methods is essential for refining treatment strategies and enhancing patient satisfaction in the realm of gingival depigmentation (GD). Aim The objective of the study was to compare the effectiveness of scalpel and microneedling (MN) with ascorbic acid in the treatment of GD. Materials and methods Sixteen patients who had a complaint of GP were included in the study, of whom eight were allocated for depigmentation with a scalpel, and the other eight patients were treated with the MN technique with ascorbic acid. Postoperative wound healing scores were evaluated on the first and seventh days, respectively. The intensity of depigmentation was assessed at baseline, in the first month, and at the end of the third month, respectively. Results The mean Dummett-Gupta Oral Pigmentation Index (DOPI) score at baseline was 2.65±0.16 and 2.61±0.17 in the surgical and microneedling groups with ascorbic acid, respectively. The mean DOPI score at the end of the third month was 1.67±0.39 and 0.87±0.17 in the scalpel and MN with ascorbic acid groups, respectively. There was a statistically significant difference between the scalpel and MN with ascorbic acid groups at the end of the first and third months, respectively, where MN with ascorbic acid showed aesthetically pleasing outcomes. Patients treated with the scalpel technique showed incomplete healing and ulceration on the first and seventh days after the procedure when compared to the MN technique with ascorbic acid. The healing index scores were statistically significant in the MN with ascorbic acid group. Conclusion The MN technique with ascorbic acid is a successful technique for treating GD. It showed aesthetically gratifying outcomes when compared to the conventional surgical technique.

Image-based non-invasive assessment of suction blister wounds for clinical safety and efficacy.

Recognising the need for objective imaging-based technologies to assess wound healing in clinical studies, the suction blister wound model offers an easily accessible wound model that creates reproducible epidermal wounds that heal without scarring. This study provides a comprehensive methodology for implementing and evaluating photography-based imaging techniques utilising the suction blister wound model. Our method encompasses a protocol for capturing consistent, high-quality photographs and procedures for quantifying these images via a visual wound healing score and a computer-assisted colour analysis of wound exudation and wound redness. We employed this methodology on 16 suction blister wounds used as controls in a clinical phase-1 trial. Our method enabled us to discern and quantify subtle differences between individual wounds concerning healing progress, erythema and wound exudation. The wound healing score exhibited a high inter-rater agreement. There was a robust correlation between the spectrophotometer-measured erythema index and photography-based wound redness, as well as between dressing protein content and photography-based dressing yellowness. In conclusion, this study equips researchers conducting clinical wound studies with reproducible methods that may support future wound research and aid in the development of new treatments.

Effects of Medicinal Plants Extracts in Healing Split-Thickness Skin Graft Donor Site Wounds: A Systematic Review of Randomized Clinical Trials

The literature on Split-Thickness Skin Graft (STSG) donor site dressings has not yet identified an ideal dressing, and most products tested by researchers for wound dressing are prohibitively expensive in Low- and Middle-income settings. Clinical trials using biological dressings have offered an alternative option for managing STSG donor sites wound. The aim of this systematic review is to find evidences regarding the effectiveness of medicinal plants on STSG donor site wound healing. A total of 249 papers were identified in the initial search. After removing duplicates and applying the inclusion and exclusion criteria, 6 Randomized Clinical Trials were deemed relevant and included in the final review. Over twenty years four medicinal plants have entered clinical trial to enhance STSG donor site wound healing. The medicinal plants reviewed have large effect size regarding time to complete wound healing and wound score. However, the effect size of Aloe vera regarding time to complete wound healing and pain control vary from study to study. No patient quality of life was assessed neither cost-effectiveness of these products. Medicinal plants are potential cost effective antimicrobial and wound healing products for STSG donor site wound dressing. However, more clinical researches including patient quality of life among outcome measures are needed.

Examining the relationship between nutritional status and wound healing in head and neck cancer treatment: A focus on malnutrition and nutrient deficiencies.

The research was conducted to examine the correlation between nutritional status and wound healing in individuals who were receiving treatment for head and neck cancer. Specifically, this study sought to identify crucial nutritional factors that influenced both the recovery process and efficacy of the treatment. From February 2022 to September 2023, this cross-sectional study was undertaken involving 300 patients diagnosed with head and neck cancer who were treated at Tianjin Medical University Cancer Institute and Hospital, Tianjin, China. In order to evaluate nutritional status, body mass index (BMI), serum protein levels and dietary intake records were utilized. The assessment of wound healing was conducted using established oncological wound healing scales, photographic documentation and clinical examinations. After treatment, we observed a noteworthy reduction in both BMI (p < 0.05) and serum albumin levels (p < 0.05). There was slightly increased prevalence of head and neck cancer among males (61.0%, p < 0.05). Over the course of 6 months, significant enhancement in wound healing scores was noted, exhibiting overall improvement of 86% in the healing process. An inverse correlation was identified between nutritional status and wound healing efficacy through multivariate analysis. A logistic regression analysis revealed a significant positive correlation (p < 0.05) between elevated levels of serum protein and total lymphocytes and enhanced wound healing. Conversely, negative correlation (p < 0.05) was observed between larger wound size at baseline and healing. The research findings indicated noteworthy association between malnutrition and impaired wound repair among individuals diagnosed with head and neck cancer. The results underscored the significance of integrating nutritional interventions into therapeutic protocol in order to enhance clinical results. This research study provided significant contributions to the knowledge of intricate nature of head and neck cancer management by advocating for multidisciplinary approach that incorporates nutrition as the critical element of patient care and highlighted the importance of ongoing surveillance and customized dietary approaches in order to optimize wound healing and treatment efficacy.

A systematic review of oral wound healing indices.

A complete literature electronic search in 5 databases was conducted by two reviewers. A combination of keywords related to oral wound healing was used. A total of 11 articles were included in the evaluation of various procedures (conventional periodontal procedures, guided tissue regeneration, soft tissue reconstruction procedures, and tooth extractions), at different time points (1 day to 12 weeks), with a focus on diverse clinical signs and symptoms. Frequently evaluated parameters included wound dehiscence/epithelialization (91%), tissue color (redness) (73%), suppuration (55%), swelling/edema (55%), and hemostasis (55%). Other less commonly used parameters include esthetics-related and patient-centered outcomes. The available indices evaluate a diverse group of subjective clinical signs and symptoms to estimate the underlying biological healing events and assess the degree of clinical success. The majority of the included indices are not validated. Quantitative and objective subclinical parameters including blood perfusion, biomaterial stability, and completeness of epithelialization, are needed for customized wound healing care and better outcome prediction.

Comparison of bone tacks and sutures in free gingival graft procedures a clinical study

Objective The aim of the present study was to compare the efficacy of bone tacks and sutures in free gingival graft FGG stabilization during gingival augmentation procedures. Materials and Methods Twelve subjects participated in this study. One site in each subject was randomly assigned into each of the following experimental groups. In the test group, the FGG was stabilized with bone tacks whereas FGG procedure with conventional sutures was performed in the control group. Clinical parameters assessed were the width of keratinized gingiva and plaque index PI scores at baseline 1 month and 3 months. Surface shrinkage SS was recorded at 15 days 1 month and 3 months. Early wound healing score EHS was recorded postoperatively after an interval of 1 week. Results Bone tacks stabilized with FGG were effective in increasing the width of the keratinized gingiva but did not show any added advantage over sutures with no statistical difference between both groups p0.49. In both groups there was similar SS EHS and PI scores with no statistical significance difference between them p1.00. Conclusion This trial was conducted over a period of 3 months and it was observed that bone tacks can be used to stabilize the FGG during mucogingival procedures.

Effect of monopolar diathermy power settings on postoperative pain, wound healing, and tissue damage after tonsillectomy: a randomized clinical trial

This study aimed to assess the impact of varying monopolar diathermy power settings on postoperative pain, hemorrhage, and wound healing following tonsillectomy. A single-center, prospective, randomized, double-blinded, controlled clinical study was conducted. During bilateral tonsillectomy procedures, one tonsil received low-power settings (15 W, cutting/blend) while the other tonsil received high-power settings (35 W, cutting/blend). Postoperative pain scores (0–10) and wound healing scores (0–3) were evaluated immediately after surgery and at 1, 2, and 4 weeks postoperatively using the visual analog scale. Additionally, histological analysis was performed on electrically resected tonsil tissues to assess tissue damage in the tonsil bed. The allocation of high and low power settings to each side was randomized. Results showed that 1 week after the surgery, the high-power group experienced significantly higher pain scores (mean ± standard deviation: 4.84 ± 2.21) compared to the low-power group (3.56 ± 2.24, p = 0.049). Moreover, the high-power side exhibited slower wound healing during the initial 1–2 weeks postoperatively, as indicated by lower wound scores at 2 weeks (high-power: 1.96 ± 0.64; low-power: 2.43 ± 0.59, p = 0.008). Furthermore, histological analysis revealed significantly deeper tissue degradation on the high-power side compared to the low-power side (p < 0.001), with mean depths of 565.2 ± 291.0 µm and 156.0 ± 36.8 µm, respectively. In conclusion, these findings suggest that when employing monopolar diathermy in tonsillectomy, lower power settings can lead to improved outcomes in terms of postoperative pain, wound healing, and tissue damage.Trial registration: CRIS identifier: KCT0005670 (cris.nih.go.kr, registration date: 11/12/2020).

The effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women: A triple-blind randomized clinical trial.

Episiotomy is one of the most commonly performed procedures in obstetrics. complications of episiotomy are pain, bleeding, infection, pain in the sitting position, and difficulty in taking care of the baby. This study aimed to investigate the effect of Camellia sinensis ointment on perineal pain and episiotomy wound healing in primiparous women. This triple-blinded randomized clinical trial was conducted on 60 primiparous women who were referred to the maternity ward of Al-Hadi hospital in Shoushtar and Ganjovian hospital in Dezful, Iran, from 2020 to 2021. Participants were randomly assigned into two groups of intervention (Camellia sinensis extract ointment) and control (placebo) with a follow-up of 14 days. REEDA scale (redness, edema, ecchymosis, discharge, and approximation) was used to measure wound healing and the Visual Analog Scale (VAS) was used to measure the pain intensity. There was no significant difference between two groups before intervention in terms of sociodemographic characteristics, pain intensity, and episiotomy wound status. Scores of pain intensity and wound healing reduced on days 7, 10, and 14 post-intervention in the intervention group compared to placebo. There was a significant decrease between the groups of intervention and control in terms of the mean score of pain intensity (VAS scale) on day 10 (1.33 ± 0.71, 1.77 ± 0.93) and day 14 (0.73 ± 0.74, 1.13 ± 0.81) post-intervention (P < 0.05). Also, on day 14 post-intervention, there was a significant decrease between the groups of intervention and control in terms of the mean score of episiotomy wound healing (REEDA index) (0.53 ± 0.77, 1.77 ± 1.46) (P < 0.05). The GLM test was applied for repeated measures. REEDA index and VAS scale changed during different times (time-variable) (p < .001). But, the studied groups (group variable) and the studied groups (interaction effect of group * time) did not affect the changes in the REEDA index (p = .292, p = .306) and VAS scale (p = .47) during different times. Our study showed that Camellia sinensis extract ointment has a small effect on the healing process and pain reduction of episiotomy wounds. to confirm its effect, a study with a larger sample size should be conducted. This trial was registered in the Iranian Registry of Clinical Trials on 04/10/2019 with the IRCT ID: IRCT20190804044428N1. Participants were enrolled between 11 April 2020 and 20 January 2021. URL of registry: https://en.irct.ir/trial/41326.

Early wound healing at 1 week postoperatively in periodontal tissue regeneration therapy: enamel matrix derivative versus recombinant human fibroblast growth factor.

Recombinant human fibroblast growth factor-2 (rhFGF-2) has demonstrated positive effects on wound healing at 2 weeks after periodontal surgery relative to enamel matrix derivative (EMD). However, the effects at earlier postoperative stages have not been reported. This retrospective study compared the early wound healing outcomes 1 week after surgery using the modified papilla preservation technique (mPPT) with either EMD or rhFGF-2 therapy. We compiled a list of all mPPT sites treated with EMD or rhFGF-2 during the survey period (September 2011 to March 2022). Early wound healing was assessed using the early wound healing score (EHS) and the modified early wound healing index (mEHI). Inter-rater reliability for the EHS and mEHI was established using intraclass correlation coefficients. Factors influencing mPPT were identified by analyzing the correlation coefficients between the EHS items, mEHI items, and potential influencing factors. After adjusting for factors impacting EHS, mEHI, and mPPT, we compared the EHS and mEHI between EMD and rhFGF-2 groups. In total, 72 sites were evaluated. The scores for incision line, step, and dehiscence were significantly higher in those receiving rhFGF-2 (n=42) compared to those treated with EMD (n=30). The EHS item scores did not differ significantly between groups. Among patients aged ≥50 years, but not those <50 years, significantly higher step and dehiscence scores were found in the rhFGF-2 group than the EMD group (P<0.01). Additionally, for patients exhibiting a clinical attachment level (CAL) ≥8 mm, the step score was significantly higher in the rhFGF-2 group than in the EMD group (P<0.05), but this trend was not reflected in those with a CAL <8 mm. In this study, early wound closure at mPPT sites was more effectively achieved with rhFGF-2 than with EMD. Nevertheless, biochemical assessments are required to compare the re-epithelialization effects of these therapies.

Sustainable Treatment of Oral Traumatic Ulcers with Licorice Containing Hydrogels: Integrating Computational Modeling, Quality by Design, Green Synthesis, and Molecular Biological Evaluation.

The urge to implement innovative approaches that align with eco-friendly practices and hold promise for enhancing oral health while promoting environmental sustainability has been increasing. This current work aims to develop a sustainable treatment for oral traumatic ulcers using licorice-based hydrogels (LHGs) containing hydroxyethyl cellulose (HEC) as the green gelling agent. Licorice root aqueous extract was phytochemically profiled using UPLC-ESI-MS/MS. Forty-three compounds were detected, with Glycyrrhizic acid being the major component of the extract (34.85 ± 2.77%). By implementing a Quality by Design (QbD) approach, the study investigates the effects of different licorice extract and HEC concentrations on key variables such as pH and viscosity of the prepared formulations, ulcer and wound healing scores, and tissue growth factors via a Full Factorial Experimental Design. The LHGs exhibited desirable consistency, spreadability, and clarity. Statistical analysis, employing an ANOVA test, revealed the high significance of the constructed models with the licorice concentration being the key independent factor affecting all dependent outputs. The pH as well as the viscosity of the prepared LHGs were positively influenced by licorice extract concentration, with higher concentrations leading to increased alkalinity and viscosity. Rheological behavior analysis revealed a pseudoplastic flow with demonstrated thixotropy which is advantageous for application and prolongation of residence time. The wound healing process was assessed through ulcer size, traumatic ulcer healing score (UHS), collagen-1 expression (COL-1), growth factors (EGF, VEGF), pro-inflammatory markers (TNF-α), wound healing score (WHS). LHGs prepared using higher levels of both factors, 30% dried licorice root extract and 4% HEC, demonstrated enhanced wound healing, elevated growth factor expression of 66.67% and 23.24%, respectively, and 88% reduced inflammation compared to the control group, indicating their potential in expediting oral ulcer recovery. Overall, these findings highlight the promising role of green licorice-based hydrogels in promoting sustainable oral mucosal healing.

Single-flap approach versus without concentrate growth factor in the treatment of periodontal supra-osseous defects: A randomized controlled clinical trial

ObjectivesWe aimed to compare treatment outcomes of periodontal supra-bony defects using single flap (SFA) plus concentrate growth factor versus SFA alone. Methods32 supra-bony periodontal defects were randomly assigned to test and control groups. Outcome variables were clinical attachment level (primary outcome). Probing pocket depths, gingival recessions, bone gain, post-surgical pain using visual analogue scale and wound healing index were recorded as secondary outcomes. Clinical and radiographic assessments were recorded at baseline and 6 months after treatment, whereas pain score and wound healing index were recorded within 10 days after surgery. ResultsTest group showed a significant improvement in all tested parameters compared to control group (P-value ≤ 0.05). Better patient centered outcomes (wound healing and pain scores) were highly achieved in the test group compared to controls. ConclusionThe tested combined approach offers better periodontal and patient centered treatment outcomes in management of periodontal supra-bony defects.