Wound Pain Research Articles

The Effects of Low-Level Laser Therapy on Wound Healing and Pain Management in Skin Wounds: A Systematic Review and Meta-Analysis

The Effects of Low-Level Laser Therapy on Wound Healing and Pain Management in Skin Wounds: A Systematic Review and Meta-Analysis

Surgeon experience affects perioperative pain in cats undergoing elective ovariohysterectomy: a randomized clinical trial.

This study aimed to compare the outcomes between surgeries performed by either experienced or inexperienced surgeons by assessing intraoperative nociception and perioperative analgesia. 16 healthy, client-owned female cats were randomly allocated into 2 groups of 8: one undergoing surgery by an experienced surgeon (GES group) and the other by inexperienced surgeons (GIS group). Both groups received IM premedication with acepromazine (0.05 mg/kg) and methadone (0.3 mg/kg). After 20 minutes, venipuncture and induction with propofol (dose-response, IV) were performed. Maintenance was achieved with inhaled isoflurane. Intraoperative vital parameters were monitored, and fentanyl (2.5 µg/kg, IV) was administered as rescue analgesia when needed. Postoperatively, pain was assessed with a visual analog scale and the multidimensional pain scale of the Universidade Estadual Paulista in Botucatu; morphine (0.2 mg/kg, IM) was used for rescue analgesia, as necessary. In the GIS group, significant increases in heart rate and systolic blood pressure were noted during surgery, especially during pedicle clamping. Respiratory rate and end-tidal isoflurane levels were higher in the GIS group at specific surgical stages. Survival analysis indicated that the GIS group had a greater need for fentanyl. Postoperative pain scores were generally low, but a higher proportion of GIS cats required rescue analgesia. Surgeon experience influences intraoperative parameters and fentanyl consumption. Inexperienced surgeons contribute to increased postoperative pain and poorer wound healing outcomes in cats undergoing elective ovariohysterectomy. Ovariohysterectomy is a common procedure in veterinary practice, and surgical expertise significantly impacts pain management and recovery. Yet, its effects have been underexplored, potentially compromising animal welfare.

The impact of an open-label design on human amniotic membranes vs. silver sulfadiazine dressings for second-degree burns: a randomized controlled clinical trial

BackgroundBurn wounds require optimal medical management due to associated psycho-emotional and socioeconomic impacts and severe pain. The use of synthetic and biological dressings improves healing and reduces burn wound complications. The present study aimed to compare the outcomes of using human amniotic membrane (hAM) dressings and conventional silver sulfadiazine (SSDZ) ointment dressings in the management of second-degree burn wounds.MethodsFifty patients who participated in this clinical trial were divided into two groups via simple randomization. All the enrolled patients, who had burnt in the last 24 h, had thermal damage mechanisms and were suffering from less than 20% second-degree heat-burn wounds on the skin surface. The target group (n = 25) was treated with hAM, and the control group (n = 25) was treated with SSDZ ointment. The researcher-designed checklist was used to determine the clinical performance in the follow-up assessments on days 7, 14, and 30.ResultsNo significant differences were detected in terms of sex, age, or percentage of burn wounds (p > 0.05). Wound epithelialization at days 7, 14, and 30, scar formation, wound pigmentation, pain severity, analgesia requirements, and hospital stay length (on day 30) were significantly lower in the target group (treated with hAM) than in the control group (treated with SSDZ ointment) (p < 0.05). However, treatment costs in the target group ($170) were significantly higher than those in the control group ($71) (p < 0.001).ConclusionDespite its higher cost, hAM, as a technology-based therapy dressing, demonstrates superiority over SSDZ ointment in terms of wound healing and pain management.

The effect of Traumeel LT ad us. vet. on the perioperative inflammatory response after castration of stallions: a prospective, randomized, double-blinded study.

Stallion castration is a standard procedure with a risk of post-surgical complications. Castration induces an acute phase response (APR). Serum Amyloid-A (SAA) is a well-studied major acute phase protein (APP), that has been shown to be a good marker for the development of post-surgical complications. The current gold standard for reducing the APR after castration is Flunixin-Meglumin, which is a non-steroidal anti-inflammatory drug (NSAID) inhibiting COX1/2. In contrast, Traumeel LT ad us. vet. can modulate the APR by induction of the inflammation resolution. The aim of this study was to compare the effect of Flunixin-Meglumin and Traumeel LT ad us. vet. on the acute phase response. A total of 60 stallions were recruited and 54 stallions entered the study with 27 stallions in each treatment group. The stallions were treated pre- and postoperatively with either Flunixin-Meglumin (FL) or with Traumeel LT ad us. vet. (TR). Blood was taken before and 24 h, 48 h and 72 h after castration. The following main parameters were assessed: SAA, fibrinogen, iron, white blood cells, neutrophils, Interleukin1ß, and cortisol. Wound healing and pain were assessed at 8 time points. The main variable SAA was increased after surgery reaching a mean value of 122 µg/ml in the FL group and a mean SAA of 226 µg/ml in the TR group 48 h after surgery, reaching a significant difference only at the 24 h timepoint (p = 0.03). All stallions had the highest pain summary score 8 hours after surgery, with decreasing values thereafter. The pain scores were not statistically different at any time point. In the FL group five stallions developed a suture dehiscence compared to only one stallion in the TR group (p = 0.001). Within the limitations of this study, Traumeel LT ad us. vet. seems to have proresolving effects on the inflammation induced by surgery making it a valuable treatment to reduce the APR induced by castration. Due to its different mode of action, Traumeel LT ad us. vet. might be an alternative treatment option if gastrointestinal side effects or renal side effects of NSAIDs should be avoided. Further studies are needed combining Traumeel LT ad us. vet. and Flunixin.

International Burn Disaster Nursing: Care, Commitment, Compassion, and Cost.

Burn mass casualty incidents can overwhelm local resources, challenging effective communication, triage, and provision of care. International responders can help by providing education and direct patient care. On November 5, 2021, a fuel tanker truck exploded in Freetown, Sierra Leone, killing or injuring hundreds of people. The needs of the severely burned survivors overwhelmed local resources, requiring an international response. Burn specialist teams from several countries, including the United States, were deployed to provide assistance. Members of the US burn care team educated local health care practitioners about wound care, physical therapy, and fluid and pain management. Educational content was delivered through lecture and discussion, case studies, clinical application, and bedside teaching. Demonstration of cultural competence and humility, as well as attentiveness to nuances of local communication, helped avoid ethnocentrism and other barriers to collaboration. Public congratulations and formal completion certificates were used to provide meaningful recognition of successful class participation. Before the lecture and discussion intervention, 57 students participating in a pretest assessment had an average score of 53.9% (high, 80%; low, 27.5%). After the intervention, 38 students participating in a posttest assessment had an average score of 79.3% (high, 95%; low, 55%), and local health care providers delivered care with more attention to patient comfort and shared new knowledge with colleagues. Providing optimal burn care and education under austere conditions requires cultural humility and a spirit of inquiry. Attentiveness to communication and cultural nuances promotes collaboration, improves educational effectiveness, and builds local burn care capacity.

RETRACTION: Effect of wound infiltration of dexmedetomidine in lumbar spine surgery on postoperative wound pain: A meta-analysis.

Retraction: X. Wang, Y. Peng, Y. Si, and X. Hu, "Effect of Wound Infiltration of Dexmedetomidine in Lumbar Spine Surgery on Postoperative Wound Pain: A Meta-Analysis," International Wound Journal 21, no. 3 (2024): e14523, https://doi.org/10.1111/iwj.14523. The above article, published online on 05 December 2023, in Wiley Online Library (http://onlinelibrary.wiley.com/), has been retracted by agreement between the journal Editor in Chief, Professor Keith Harding; and John Wiley & Sons, Ltd. It came to the publisher's attention from a third party that a number of articles shared concerning similarities in format and structure. Following an investigation by the publisher, the retraction has been agreed on as the peer review and publishing process for this article were found to be manipulated. The authors did not respond to the notice of retraction.

Investigating the Efficacy of Various Natural Products in Raw Form against Multidrug-Resistant Bacteria.

The alarming increase in antibiotic resistance urges alternative and efficacious antimicrobial solutions. Historically, medicinal plants have been used for therapeutic purposes, such as relieving pain and healing wounds. However, the evaluation of the natural therapeutic effects of medicinal plants in a manner that resembles how humans typically consume them is lacking. Therefore, in this study, many medicinal plants known to have some antimicrobial effects, including Frankincense, Garlic, Myrrh, and Ginger, were evaluated for their direct antibacterial activity in raw form. The direct antimicrobial activity of medicinal plants was evaluated against a variety of Gram-positive and Gram-negative bacterial strains, such as Staphylococcus aureus (S. Aureus), Acinetobacter baumannii and Klebsiella pneumoniae using agar well diffusion method and turbidity measurements in suspension culture. Out of all the tested medicinal plants, only raw garlic (Allium sativum) powder, when dissolved in water or vinegar, offered a straightforward antibacterial activity. A combination of garlic extract and vinegar increased antibacterial activity. Aqueous garlic extracts displayed robust antimicrobial activity against many resistant bacteria. Other medicinal plants used in this study had absent or minimal antibacterial effects. Only garlic in its raw form was effective against antibiotic-resistant bacteria. The increase in the antibacterial activity of garlic when combined with vinegar suggests the synergistic activity of garlic. The straightforward antibacterial action of raw garlic may be strategically harnessed to combat the continuous challenge of increasing antibiotic resistance. This work promotes additional testing of more natural products (in raw form) and assesses their therapeutic effects clinically.

Comparative study of the direct closure of surgical incision for external dacryocystorhinostomy using 6-0 Prolene versus Dermabond ®.

In this study, we aimed to compare closure of the incision for external dacryocystorhinostomy (ext-DCR) by suturing with 6-0 Prolene versus closure with 2-octyl cyanoacrylate and assess the results in terms of the aesthetic and functional aspects of the scar, operating time, postoperative symptoms and complications, and the economic cost of the two techniques. Sixty-three patients with distal lacrimal obstruction and indication of ext-DCR were initially enrolled in a longitudinal prospective cohort study. Patients underwent ophthalmologic evaluations including lacrimal probing, external examination with photograph, measurement of the surgical wound, timing the cutaneous closure phase of the surgery, recording postoperative wound pain using visual analog scale (VAS), and recording the patient's and clinician's subjective satisfaction with the scar using Patient and Observer Scar Assessment Scale (POSAS) at 6 months postsurgery. The 63 eyes were divided into two groups: the wounds in group 1 were closed with 6-0 Prolene using continuous locking suture and the wounds in group 2 were closed with 2-octyl cyanoacrylate. There was no difference in baseline characteristics (age, sex, and race), and no statistically significant differences were found in wound length, POSAS score, VAS score, or serious complications of the wound between the two groups. There were differences in surgery time and economic cost for group 2 compared to group 1 of -2.39 min and -€5.37/operation, respectively. This is the first study in the literature that compares 6-0 Prolene versus Dermabond ® . The latter one presents advantages compared to Prolene, given that it reduces the length of surgery, reduces costs, and allows for greater flexibility in postoperative follow-up visits.

324. A RETROSPECTIVE SINGLE CENTRE PROPENSITY-MATCHED ANALYSIS OF TRANSTHORACIC VERSUS TRANSABDOMINAL PROCEDURES FOR GIANT HIATAL HERNIAS

Abstract Background Transthoracic open procedure (TTO) was historically the preferred approach for treatment of giant hiatal hernias. However, the last decades transabdominal laparoscopic procedures (TAL) became the standard approach in many centres. The aim of the study was to compare short-term and midterm outcomes, as well as patient-reported outcome measures (PROMs, between TTO and TAL for giant hiatal hernias. Methods A retrospective analysis was conducted on all primary surgeries performed for giant hiatal hernias between 2008 and 2022. Patients who underwent TAL were propensity-matched (n= 36) to those who underwent TTO based on: age, gender, Charlson Comorbidity Score and hernia type. The two groups were compared in terms of surgery duration, length of stay (LOS), Clavien-Dindo score, intrahospital reoperation, hernia recurrence and need for reinterventions. PROMswere compared between total of TTO (n= 187) and TAL (n= 48): for symptom score, QoL-score, overall satisfaction and wound pain. Median clinical follow-up was 365.5 days. Median PROMsfollow-up was 55.3 months. Results Surgery duration (224 vs 177min, P&amp;lt;0.001) and LOS (11 vs 4days, P&amp;lt;0.001) were longer in TTO. Clavien-Dindo scores were alike (P= 0.260). Intrahospital reoperation was not statistically different (8.3% vs 0%, P= 0.239). Midterm recurrence rates suggested a non-significant trend towards lower recurrence in TTO (2.8% vs 16.7%, P= 0.107). Reintervention rates were alike (16.7% vs 11.1%, P= 0.735). QoL-score was inferior for TTO (0.705 vs 0.355, P= 0.036). Wound pain scores were higher in TTO (1 vs 0, P &amp;lt;0.001). Symptom score and satisfaction scores were alike, respectively 0.685 vs 0.760, P= 0.688 and 9 vs 9, P= 0.421. Conclusions TAL for giant hiatal hernias showed superior results compared to TTO for duration of surgery, length of hospital stay, QoL-score and wound pain scores. However, midterm results showed a noticeable trend towards higher recurrence rates for TAL. TAL should be considered when proceeding with surgery for giant hiatal hernias but a possible higher risk of recurrence must be taken into account. Further long-term clinical follow-up and comparison to PROMscould guide future decision-making.

Effects of low-frequency pulsed electrical stimulation at the common peroneal nerve on chronic refractory wounds of the lower limb: A randomized controlled trial.

Electrical stimulation (ES) has been shown to substantially enhance the quality of life by alleviating pain in patients with chronic wounds. This study aimed to observe the effects of low-frequency pulsed wearable ES at the common peroneal nerve on chronic refractory wounds of the lower limb. Forty-eight participants were randomly divided into control group (n = 24) and treatment group (n = 24) in this study. The control group received standard wound care (SWC) exclusively, whereas the treatment group was administered both SWC and the wearable low-frequency ES targeting the common peroneal nerve. Measurements of wound area, pain intensity, wound status, and quality of life scores were systematically recorded both before and after 4 weeks treatment. After 4 weeks of intervention, the percentage area reductionwas significantly higher in the treatment group compared to the control group (Z = -3.9, p < 0.001), and the healing rate of the treatment group was significantly higher than that of the control group (33% vs. 4%). Moreover, the visual Analog Scale for Pain score (β = -0.65, p = 0.019), the Bates-Jensen Wound Assessment Tool score (p < 0.05), and the questionnaire on quality of life with chronic wounds (Wound-Qol) score (β = -4.23, p = 0.003) were significantly decreased in the patients in the treatment group compared to the control group. The wearable low-frequency pulsed ES at the common peroneal nerve for the treatment of chronic refractory wounds showed significant improvement and were far superior compared to SWC. Future research should broaden its scope to include a diverse range of wound types and benefit from collaboration across multiple research centers.

A histology and immunochemistry study comparing open versus close and open-method endoscopic saphenous vein harvesting.

The introduction of endoscopic saphenous vein harvesting (ESVH) has been reported to reduce wound pain and infection, compared with open saphenous vein harvesting (OSVH) techniques. There are still controversies regarding this technique. The aim of our study is to investigate the endothelial preservation of saphenous vein (SV) grafts harvested by different techniques. Further observations were made for harvesting and closure time, incision length and effect of pressure distension of the veins to the vein endothelium. Prospective observational study of sixty human saphenous vein grafts was performed to evaluate endothelial preservation by haematoxylin-eosin and Cluster of Differentiation 31 (CD 31) staining. Saphenous vein was harvested endoscopically either by closed CO2 (carbon dioxide) ESVH, open CO2 ESVH or OSVH harvesting technique. Demographic data and intra-operative data were collected. Two saphenous vein samples were collected from each patient to compare differences before and after distension of the veins. Both haematoxylin-eosin and immunohistochemistry slides were imaged by a high-resolution slide scanning system. Open CO2 ESVH group showed the highest number of endothelial detachments. Mean scoring of the immunohistochemistry method using the CD31 antibody was much lower in the open CO2 ESVH group (33.25% ± 28.71, P < 0.0003). This represents a more poorly preserved endothelial cells in the Open CO2 ESVH than the closed CO2 ESVH. Closure time and incision lengths were significantly shorter in both ESVH groups compared to the OSVH group. Significant low scores of immunohistochemistry for samples were seen in distended veins (39.0% ± 30.08, p = 0.004). The OSVH in random sample B, which represents the conduit that will be used, had a far better endothelium preservation and less endothelial detachment when compared to ESVH. We observed more endothelial detachment in the open CO2 ESVH group, due to lack of subcutaneous tissue separation, poor visualization and traction stress across the wall of the saphenous vein. The closed CO2 ESVH group had more endothelial cells preserved, but the OSVH group fared the best with the least number of endothelial cell detachment and a higher score of CD31 antibody. The online version contains supplementary material available at 10.1007/s12055-024-01752-3.

The Prevalence of Skin Tears in an Acute Care Hospital: A Quality Improvement Project.

The purpose of this quality improvement project was to determine the prevalence of skin tears (STs) within an acute care hospital. The setting was a 676-bed Midwestern urban teaching hospital with Magnet designation in the United States. All adult, children, and neonatal patients were assessed during the data collection period with the exclusion of the mother/baby unit and patients who were unsafe to move, actively dying, off the unit during the survey assessment, or those who declined participation. ST prevalence data were collected concurrently with the quarterly Pressure Injury Prevalence Survey over a period of 12-months (beginning the third quarter of 2017 through the second quarter of 2018) by the Pressure Injury Prevalence Survey Skin Care Champions using the revised Payne-Martin classification system for STs. A data collection form developed by the Wound, Ostomy, and Continence nurse was also completed for the patients with ST(s). The prevalence of STs was 2.92% (46/1576 patients). Twenty-one patients were women and 25 were men, with a mean age of 69.90years (age range: 8days-96years). The majority of STs were found on the extremities (60 STs, 86.96%) and hospital-acquired (30 patients, 65.22%). Thirty STs (43.48%) were category III according to the revised Payne-Martin classification system for STs with major risk factors identified as frail skin (n=34), advanced age (n=30), and impaired mobility (n=24). STs are a common finding in the acute care setting spanning all age groups and are frequently overlooked by health care providers. This project provides a strategy to determine ST prevalence in a health care setting. Additional studies should focus on risk factor assessment and prevention strategies as these may decrease the incidence of this painful wound.

Micro Marsupialization Versus Modified Micro Marsupialization in The Management of Mucocoele of Lower Lip

The most prevalent kind of soft-tissue cyst of the small salivary glands in the lower lip is called a mucocele. It usually manifests as a fluctuating, bluish, not tendering sub-mucosal swelling with a usual overlying mucosa. The lower lip is where mucoceles are most frequently found, despite the fact that small salivary glands are present in most areas of the oral cavity with the exception of the gingiva. This is most likely because this area experiences more mechanical trauma than other locations. Objective: To compare the outcomes of surgical technique between micro- marsupialization and modified micro marsupialization in treatment of mucocele of lower lip. Methods: Experimental study was conducted at Department of OMFS, LUMHS, Jamshoro, by convenience sampling technique in time frame of Six months. Patients were called into two groups at random. Patients in group A were managed by micro-marsupialization and in group B by modified micro-marsupialization. All the patients were followed till one week to assess wound healing time and pain. The analysis of data was conducted using SPSS version 26.0. Results: In comparison of group A and B, wound healing time was noted as 9.7 ± 3.1 and 10.9 ± 4.01 days (P=0.180), duration of surgery 30.2 ± 3.7 and 29.9 ± 3.6 minutes (P=0.727) and postoperative pain at 7th day was noted 2.7 ± 1.8 and 2.17 ± 1.7 (P=0.257), respectively. Conclusion: It was concluded that insignificant difference was noted between micro-marsupialization and modified micro-marsupialization in outcomes of surgical technique in treatment of mucocele of lower lip

Survey on Eczema; Its Perceptions and Characterization

Eczema (atopic dermatitis) is a common inflammatory skin disease. It causes physical discomfort and also cause stress due to constant itching, which in the end leads to painful wounds. It can be triggered by environmental, genetic, stress, and anxiety factors. The symptoms of eczema are similar to other skin disorders. In some cases, incorrect diagnosis results in the administration of medication for other skin disorders. Objectives: To understand the patients’ knowledge about the disease and to create a sense of awareness for them. Methods: We prepared a questionnaire to get sense of people's understanding about eczema and surveyed students at Punjab University as well as we collected data with help of online google forms. There were 103 responses from people of both genders, age ranges from 20 to 35 years, and different educational backgrounds. Results: Most of the people think they understand what eczema is, but they have confused it with other skin conditions. According to the responses, sudden change in surroundings is the most triggering factor in causing eczema. Only 1% of people think it could be a contact disorder and can be triggered by pets and refined carbs. The most challenging weather for eczema is winter and the time is night. Conclusions: it was concluded that eczema is a really disturbing disease. This disorder is incurable yet. However, with proper care, timely treatment, and by taking preventive measures, can prevent to flare-up.

Lone-Star retractor perineal exposure method for laparoscopic abdominal perineal resection of rectal cancer.

The abdominal perineal resection (APR), historically referred to as Mile's procedure, stands as a time-honored surgical intervention for rectal cancer management. Advancements in surgical techniques and the advent of neoadjuvant therapies have significantly improved the rate of sphincter preservation among patients afflicted with rectal cancer, including those with ultralow rectal cancer. Despite these improvements, APR maintains its irreplaceable role in the clinical landscape, particularly for cases involving low rectal cancer with encroachment on the external anal sphincter or levator ani muscles. Optimal perineal exposure stands as a pivotal phase in APR, given that the precision of this maneuver is directly correlated with both the safety of the surgery and the patient's subsequent long-term prognosis. To evaluate the value of Lone-Star retractor (LSR) perineal exposure method in the treatment for laparoscopic APR of rectal cancer. We reviewed the records of 38 patients with rectal cancer at Anqing Municipal Hospital from January 2020 to December 2023, including 20 patients who underwent the APR procedure with a LSR perineal exposure method (LSR group) and 18 patients who underwent the APR procedure with a conventional perineal exposure method (control group). In the LSR group, following incision of the skin and subcutaneous tissue, the LSR was placed and dynamically adjusted according to the surgical plane to fully expose the perineal operative field. A total of 38 patients underwent laparoscopic APR, none of whom were found to have distant metastasis upon intraoperative exploration. Perineal blood loss, the postoperative hospital stays and the wound pain scores in the LSR group were significantly lower than those in the control group. A single surgeon completed the perineal operation significantly more often in the LSR group than in the control group (P < 0.05). The incidence of infection via the perineal incision in the LSR group was significantly lower than that in the control group (P < 0.05). No cases of distant metastasis or local recurrence were found among the patients at the postoperative follow-up. The application of the LSR technique might be helpful for performing perineal exposure during APR for rectal cancer and could reduce the incidence of perineal complications, shorten the postoperative hospital stay, improve postoperative pain, and allow one surgeon to perform the perineal operation.

COMPARATIVE STUDY BETWEEN THE EFFECTIVENESS OF AMNION-CollaGee [COLLAGEN–GELATIN–ELASTIN] AS A BIOLOGICAL PRODUCT WOUND DRESSING AND CONVENTIONAL DRESSING ON THE DONOR SITE OF THE SPLIT THICKNESS SKIN GRAFT IN ANIMALS MODEL (RATS)

Abstract Background The clinical application of amniotic membrane wound healing products is limited partially due to handling challenges. Amnion-CollaGee sponge dressing (ACS) provides better alternatives to traditional therapy in facilitating wound healing. Objective To optimize the effectiveness of ACS as a healing agent in donor-site split-thickness skin graft (STSG) based on in vitro outcomes. Followed by comparing wound healing rates, pain sensitivity, and risks of infection between investigator ACS dressing with currently conventional Duoderm dressing (DD) via in vivo analysis. Materials and methods Seven male Sprague-Dawley rats underwent STSG harvesting, with 1x1cm grafts taken from both the right and left sides of the animals' backs. The wounds on the right side (Group 1) were dressed with ACS, while the wounds on the left side (Group 2) were dressed with DD. The donor site wounds were assessed on the seventh, fourteenth, and twenty-first days of the experiment. Primary outcomes measured were rate of healing, pain sensitivity, potential risks of infection. Secondary outcomes were lesion vascularity, pigmentation and histopathological features. Results The size of the wounds treated with ACS was statistically smaller compared to that treated with DD. On day 21st, both types of dressings showed complete healing, thus, contributing to better aesthetic value. Additionally, superior pain suppression was witnessed at ACS-treated graft sites compared to DD. Histopathological reports displayed better post-traumatic wound site inflammatory control, less tissue scarring, and abundant collagen growth in the ACS wing compared to the DD counterpart. Conclusion The biological ACS dressing appeared to facilitate rapid wound healing rates, reduce the risk of exposed wound infections, and enhance pain suppression in rodent models. ACS based dressing agents are future interventional breakthroughs in graft donor site wound management.

Comparative Evaluation Between Cutting of the Intersphincteric Space vs Cutting Seton in High Anal Fistula: A Randomized Controlled Trial.

This study compared the efficacy of cutting of the intersphincteric space (COIS) with cutting seton (CS) procedure in treating high anal fistula. Patients diagnosed with high anal fistula were allocated into groups, who randomly received COIS and CS procedures. The primary outcome was wound healing time. Secondary outcomes included surgical parameters (operation time, hospital stay, and hospitalization expense), anal sphincter function, wound pain, wound size, clinical efficacy, recurrence after 12 months of follow-up, and complications. A total of 72 patients participated (36 in each group). The wound healing time was notably shorter in the COIS group than the CS group (35.75 ± 11.15 vs. 55.69 ± 13. 42 days; P< 0.001). The COIS group also demonstrated superior basic surgical parameters compared to the CS group (P< 0.001). Postoperatively, the COIS group exhibited significantly higher anal resting pressure and anal maximum contractile pressure than the CS group at 3 months postoperatively (58.39 ± 6.72 vs. 51.25 ± 4.33 mmHg; P< 0.001 and 143.72 ± 8.25 vs. 126.75 ± 11.49 mmHg; P< 0.001). The Wexner incontinence score at 3 months post-operation in the COIS group was significantly lower than in the CS group (0.50;0.00,1.00 vs. 3.00; 3.00,4.00; P< 0.001). The recurrence rate was 2.78% in the COIS group and 8.33% in the CS group without statistically difference (P= 0.607). In comparison to the CS procedure, COIS appears to be an effective treatment option for high anal fistulas, offering quicker wound healing time, enhanced sphincter function, less pain, minimal invasiveness, and cost-efficiency, while maintaining a high healing rate and low recurrence rate.

Evaluation of a Polyherbal Spray as Supportive Therapy for Wound and Arthritis Pain in Cows

Background: This study evaluated the effectiveness of a polyherbal spray (PHS) as a supportive treatment for pain and inflammation in dairy cows with wounds and arthritis. Fifteen cows experiencing pain and inflammation were treated with PHS for 14 days or until recovery. Researchers monitored pain, swelling, activity level, recovery time and product performance. Methods: Pain and swelling were reduced as early as day 2 of PHS application, corresponding improving the activity level. The average recovery time was 3.4 days and the owners rated the product performance highly. Result: These findings suggest that PHS could be a valuable supportive therapy for managing pain and inflammation in dairy cows with wounds or arthritis

Hexasodium fytate for the treatment of calciphylaxis: a randomised, double-blind, phase 3, placebo-controlled trial with an open-label extension

In the CALCIPHYX trial, we investigated hexasodium fytate, an inhibitor of vascular calcification, for the treatment of calcific uraemic arteriolopathy (calciphylaxis), a rare condition characterised by painful, non-healing skin lesions. In this international, phase 3, randomised, double-blind, placebo-controlled trial, adults with an ulcerated calciphylaxis lesion and pain visual analogue scale (VAS) score ≥50/100 were randomised 1:1 to hexasodium fytate 7mg/kg or placebo intravenously during maintenance haemodialysis. Primary efficacy outcomes were an 8-item modification of the Bates-Jensen Wound Assessment Tool (BWAT-CUA) and Pain VAS in the intention-to-treat population. ClinicalTrials.gov number: NCT04195906. Overall, 34/37 patients randomised to hexasodium fytate and 26/34 patients randomised to placebo completed the 12-week randomised treatment period. At Week 12, both groups (hexasodium fytate versus placebo) showed similar improvements in BWAT-CUA (mean [standard deviation (SD)],-5.3 [5.2] versus-6.0 [6.2]; least squares mean difference, 0.3 [96% confidence interval (CI):-2.5, 3.0]; p=0.88) and Pain VAS (mean [SD],-19.5 [26.9] versus-32.2 [38.5]; least squares mean difference, 11.5 [96% CI:-4.8, 27.8]; p=0.15). One patient randomised to placebo briefly received hexasodium fytate in error. Serious adverse events through Week 12 included: calciphylaxis-related events leading to hospitalisation (2/38 [5%] versus 11/33 [33%]) and death (1/38 [3%] versus 5/33 [15%]). During the subsequent 12 weeks of open-label hexasodium fytate and 4 weeks of follow-up, there were no additional calciphylaxis-related events leading to hospitalisation. Over the course of the entire trial, deaths were 2/38 [5%] for the hexasodium fytate group and 7/33 [21%] for the placebo group. In patients with calciphylaxis, BWAT-CUA and Pain VAS improved similarly in hexasodium fytate- and placebo-treated patients; over the course of the entire trial, there were fewer deaths and calciphylaxis-related events leading to hospitalisation in the hexasodium fytate group. Funded by Sanifit, a CSL Vifor company.

Lidocaine HCl-Loaded Polyelectrolyte Complex -Poloxamer Thermoresponsive Hydrogel: In Vitro- In Vivo Anesthetic Evaluations for Tooth Socket Wound Delivery.

Local anesthesia is essential in dental practices, particularly for managing pain in tooth socket wounds, yet improving drug delivery systems remains a significant challenge. This study explored the physicochemical characteristics of lidocaine hydrochloride (LH) incorporated into a polyelectrolyte complex and poloxamer thermosensitivity hydrogel, assessing its local anesthetic efficacy in mouse models and its onset and duration of action as topical anesthetics in clinical trials. The thermoresponsive hydrogel exhibited a rapid phase transition within 1-3minutes and demonstrated pseudo-plastic flow behavior. Its release kinetics followed Korsmeyer-Peppas, with 50% of biodegradation occurring over 48h. In mouse models, certain thermogels showed superior anesthetic effects, with rapid onset and prolonged action, as evidenced by heat tolerance in tail-flick and hot plate models. In clinical trials, the LH-loaded thermoresponsive hydrogel provided rapid numbness onset, with anesthesia (Ton) beginning at an average of 46.5 ± 22.5seconds and lasting effectively (Teff) for 202.5 ± 41.0seconds, ranging from 120 to 240seconds, indicating sustained release. These results highlight the promising properties of these formulations: rapid onset, prolonged duration, mucoadhesion, biodegradability, and high anesthesia effectiveness. This study demonstrates the potential for advancing local anesthesia across various medical fields, emphasizing the synergy between material science and clinical applications to improve patient care and safety.