Satisfactory Wound Research Articles

Rivaroxaban versus low molecular weight heparin for managing lower extremity deep vein thrombosis following thoracoscopic lung cancer surgery: a randomized controlled trial

ObjectiveTo assess the effectiveness and safety profiles of rivaroxaban compared to low molecular weight heparin (LMWH) in managing lower extremity deep vein thrombosis (DVT) subsequent to thoracoscopic lung cancer surgery.MethodsSixty patients diagnosed with lower extremity deep vein thrombosis (DVT) following thoracoscopic lung cancer surgery were randomly assigned to two groups: the experimental group comprising 30 patients treated with rivaroxaban, and the control group consisting of 30 patients treated with low molecular weight heparin (LMWH). The fundamental clinical characteristics of patients in both groups were documented, encompassing parameters, along with pre- and post-surgical lower limb vascular ultrasound findings. Additionally, variations in drainage volume over the initial three days following the procedure were also noted. Patients were subjected to a three-month follow-up period, during which data from one-month and three-month postoperative examinations were collected.ResultsPatients from both groups exhibited satisfactory wound healing postoperatively. D-dimer levels remained stable, and lower extremity vascular ultrasound evaluations showed no signs of additional thrombus formation. Moreover, there were no reported cases of distant postoperative complications such as pleural effusion, gingival bleeding, or gastrointestinal bleeding. Nonetheless, subcutaneous bruising was observed in six patients from the control group, all localized at the sites of LMWH injections.ConclusionRivaroxaban demonstrates efficacy comparable to LMWH in patients with lower extremity deep vein thrombosis following thoracoscopic lung cancer surgery, while exhibiting a superior safety profile compared to LMWH.

Cell membrane-camouflaged nanoparticles activate fibroblast-myofibroblast transition to promote skin wound healing.

The fibroblast-myofibroblast transition marked by extracellular matrix (ECM) secretion and contraction of actomyosin-based stress fibers, plays central roles in the wound healing process. This work aims to utilize the cell membrane-based nanoplatform to improve the outcomes of dysregulated wound healing. The cell membranes of myofibroblasts isolated from mouse skin are used as the camouflage for gold nanoparticles loaded with IL-4 cytokine. The membrane-modified nanoparticles show effective in situ clearance of bacterial infection, and act as the activator in IL-4Rα signaling pathway to induce pro-inflammatory M1 macrophages into the anti-inflammatory M2 phenotype. Thus, the poor bacteria-clearance and non-stop inflammation in refractory wounds are improved and accelerated. Furthermore, the nanoplatform releases myofibroblast membranes to propel primitive fibroblasts toward the fibroblast-myofibroblast transition in an epigenetic manner. Matrix-production, vascularization, and epithelial regeneration are then initiated, leading to the satisfactory wound closure. Our study devises a new strategy for activating fibroblasts into myofibroblasts under prolonged and continuous exposure to the fibrotic environment, and develops a promising biomimetic nanoplatform for effective treatment of dysregulated chronic wound healing.

Effectiveness of balloon angioplasty under intravascular ultrasound guidance in calcified below-the-knee tibial arteries.

This study aimed to assess the optimal balloon diameter for intravascular ultrasound (IVUS)-guided balloon angioplasty in calcified below-the-knee (BTK) tibial artery lesions. Between February 2024 and April 2024, a retrospective review was conducted on 17 patients with Rutherford category 4-6 severely calcified tibial arteries with >70% stenosis, treated with IVUS-guided balloon angioplasty. Sequentially, 3 mm and then 3.5 mm diameter balloons were inflated. The minimum lumen diameter and area were measured before and after the procedure in the proximal, mid, and distal segments of the tibial arteries. One- and three-month follow-ups were conducted using Doppler ultrasound. Significant increases in lumen diameter (P < 0.001 for all) and lumen area (P < 0.001, P = 0.003, P = 0.002, respectively) were observed in the proximal, mid, and distal segments of the BTK arteries following IVUS-guided 3.5 mm balloon angioplasty. Ultra-low iodinated contrast media was used [median 2 mL (range, 1-4 mL)]. Lumen area increase ratios were similar among the proximal, mid, and distal segments (P = 0.905). No target vessel revascularization, major amputation, or mortality was observed during follow-up. Wound healing was seen in 62.5% of the cases with foot ulcers. In the treatment of calcified BTK tibial arteries, a gradual balloon diameter increase up to 3.5 mm in IVUS-guided balloon angioplasty is safe and effective. Gradual balloon diameter increase up to 3.5 mm under IVUS guidance in calcified BTK lesions demonstrates significant potential. It enables ultra-low contrast usage, provides low complication rates, and achieves high patency and limb salvage, along with satisfactory wound healing in the short term.

Fluorescent alginate fiber with super-strong and super-tough mechanical performances for biomedical applications

Emerging research attentions are focused on the development of fluorescent biomaterials for various biomedical applications, including fluorescence-guided surgery. However, it is still challenging to prepare biomolecules-based fluorescent fibers with both satisfactory biocompatibility and optimal mechanical properties. Here, we develop a fluorescent robust biofiber through using a tetraphenylethene-containing surfactant as the contact points between polysaccharide chains of alginate. This newly developed contact points not only strengthen the cross-linking network of polysaccharide chains, but also afford enough energy-dissipating slippage for polysaccharide chains. Consequently, the generated fluorescent fiber is endowed with highly improved mechanical performances from plastic strain stage. The experimental results indicate that the fluorescent fiber shows good mechanical properties of breaking strength of 1.10 GPa (12.09 cN/dtex), Young's modulus of 39.81 GPa and toughness of 137.26 MJ/m3, which are comparable to those of dragline silk and outperforming spider silk proteins and other artificial materials. More importantly, its satisfactory biosafety and wound healing-promoting ability as a fluorescent suture are solidly proved by both in vitro and in vivo assays, which opens an opportunity for its biological and biomedical applications. This study provides a novel strategy for the development of robust fluorescent biomaterials.

Immobilizing DNase in ternary AuAgCu hydrogels to accelerate biofilm disruption for synergistically enhanced therapy of MRSA infections

Bacterial biofilm-related infections have become a significant global concern in public health and economy. Extracellular DNA (eDNA) is regarded as one of the key elements of extracellular polymeric substances (EPS) in bacterial biofilm, providing robust support to maintain the stability of bacterial biofilms for fighting against environmental stresses (such as antibiotics, reactive oxygen species (ROS), and hyperthermia). In this study, ternary AuAgCu hydrogels nanozyme with porous network structures were utilized for the immobilization of DNase (AuAgCu@DNase hydrogels) to realize enhanced biofilm decomposition and antibacterial therapy of MRSA. The prepared AuAgCu@DNase hydrogels can efficiently hydrolyze eDNA in biofilms so that the generated ROS and hyperthermia by laser irradiation can permeate into the interior of the biofilm to achieve deep sterilization. The typical interface interactions between AuAgCu hydrogels and DNase and the excellent photothermal-boost peroxidase-like performances of AuAgCu hydrogels take responsibility for the enhanced antibacterial activity. In the MRSA-infected wounds model, the in vivo antibacterial results revealed that the AuAgCu@DNase hydrogels possess excellent drug-resistant bacteria-killing performance with superb biocompatibility. Meanwhile, the pathological analysis of collagen deposition and fibroblast proliferation of wounds demonstrate highly satisfactory wound healing. This work offers an innovative path for developing nanozyme-enzyme antibacterial composites against drug-resistant bacteria and their biofilms.

Laparoscopic repair for a recurrent epigastric incisional hernia following xiphoidectomy: A case report

Introduction: Xiphodynia is a rare musculoskeletal disorder characterized by epigastric or anterior chest pain, for which xiphoidectomy is considered as a definitive treatment. This procedure and its complications are not well researched, particularly within Australasian populations. We describe the novel laparoscopic incisional hernia repair from a xiphoidectomy complicated by recurrent epigastric hernias. Case Report: A 49-year-old female presented with chronic epigastric pain post-xiphoidectomy for xiphoidynia. The patient previously underwent open mesh repair for an incisional epigastric hernia, complicated by infection and subsequent removal of the mesh. A vacuum-assisted closure device was then utilized, followed by delayed primary closure. However, she experienced ongoing pain, a recurrent mass, and hypertrophic scarring, confirmed by abdominal computed tomography (CT) scan. Our laparoscopic approach involved a standard supine position with three ports and preperitoneal dissection similar to transabdominal preperitoneal (TAPP) hernia repair. The defect was 5 × 8 cm in size. A simple prolene mesh (9 × 12 cm) was secured with AsorbaTack and Glubran 2, followed by peritoneal closure with a 3/0 V-Loc suture. At two months follow-up, the patient had no evidence of recurrent hernia, no ongoing pain, and satisfactory wound healing. Conclusion: Laparoscopic surgical repair using a TAPP approach is a safe alternative to open repair of an incisional recurrent epigastric hernia post-xiphoidectomy.

Duragen: A dermal substitute for the management of suboptimal wounds.

Using a flap in a large wound with a very small area of exposed vital structures may be an excessive intrusion and cause unnecessary donor site morbidity. Dermal matrix (DuraGen) was applied onto critical areas where bone or tendons were exposed and a split skin graft was placed thereon. All patients had satisfactory wound closure without the need for a flap. DuraGen appears to be a safe, single-stage alternative, to a flap for the healing of complex wounds.

The anterior neck scar outcomes of conventional thyroidectomy using a wound protector: a multicenter double-blinded randomized controlled trial.

This study aimed to investigate the effectiveness of a novel wound protector in enhancing the cosmetic outcomes of thyroidectomy. This multicenter, double-blinded randomized controlled trial enrolled 129 patients undergoing open thyroidectomy. The patients were divided into a wound protector group and a control group. Subjective patient assessments were conducted, measuring wound satisfaction, pain, and itchiness. Additionally, blinded observers evaluated scars using the Vancouver Scar Scale. The Vancouver Scar Scale revealed significant advantages for the wound protector group, demonstrating improvements in pigmentation ( P =0.002), vascularity ( P =0.014), pliability ( P =0.001), and height ( P =0.001). The thyroid wound protector offers a potential to improve postoperative cosmetic outcomes. Further research is warranted to explore patient experiences and optimize the application of this innovative wound protector across diverse surgical contexts.

Wound Healing and Cosmetic Outcomes in Neonatal Circumcision Using Three Different Techniques.

Circumcision of a male child is an integral part of some African cultures. An ideal technique of neonatal circumcision should be simple, safe and heal satisfactorily with good cosmetic appeal. The aim was to compare conventional dissection (CD), Plastibell (PB) and Gomco (GM) techniques of circumcision in neonates in terms of wound healing, wound healing complications, cosmetic outcome and parental satisfaction. A total of 144 male neonates were randomised into three study groups: CD, GM and PB groups. All procedures were performed under local anaesthesia as day case. Superficial wound healing was assessed on the 7 th post-operative day. The cosmetic outcome of the three techniques was assessed by a plastic surgeon and the parents using a 4-point Likert scale on the 4 th post-operative week. The three groups were comparable in terms of age ( P = 0.207) and weight ( P = 0.098) at circumcision. There was satisfactory wound healing in 48 (100%) patients in the GM group, compared to 47 (97.8%) in the CD group and 45 (93.8%) in the PB group ( P = 0.324). Wound healing complications were recorded in seven patients, 1 (2.1%) in the CD group with wound infection, 5 (10.4%) in the PB group with moderate pain despite the use of analgesia and 1 (2.1%) patient with skin bridge in the CD group. The plastic surgeon and the parents rated the cosmetic outcome of CD higher than the other two techniques. There is no significant difference in superficial wound healing amongst the three circumcision techniques. The cosmetic outcome of CD was significantly better than that of GM and PB circumcisions.

Application of a meshed artificial dermal scaffold and negative-pressure wound therapy in the treatment of full-thickness skin defects: a prospective in vivo study.

Artificial dermal scaffolds (ADSs) have great value in repairing deep skin defects. However, problems such as unsatisfactory angiogenesis and local dropsy or empyema often occur, resulting in delayed or even failed wound healing. Negative pressure wound therapy (NPWT) is an effective therapy to promote wound healing or shorten wound bed preparation time. Studies on whether it can improve the effects of ADSs have never been interrupted, and no consensus has been reached. In this study, an improved ADS was prepared by mesh technology, physicochemical experiments were conducted, cell adhesion and proliferation were assessed with the meshed ADS, and in vivo experiments were conducted to investigate the effects of meshed ADS or ADS combined with NPWT in repairing full-thickness skin defects. The results showed that the meshed ADS showed through-layer channels arranged in parallel longitudinal and transverse intersections. The cell experiments confirmed the good cytocompatibility. The in vivo experiments showed that there were no differences in the take rate or contraction of grafted skin among all experiment groups. The meshed ADS exhibited good histocompatibility, and there were no differences in tissue inflammation, dermal angiogenesis, or degradation among all groups. In addition, necrosis, dropsy, or empyema of the dermal scaffold were found in all experiment groups except for the meshed ADS + NPWT group, which showed better wound repair results, including fewer scaffold-related complications and satisfactory skin graft survival and wound contraction. In conclusion, this novel meshed ADS, which has a regular through-layer mesh structure and possesses stable physicochemical properties and good biocompatibility, combined with NPWT can ensure adequate subdermal drainage and reduce the risk of scaffold-related complications, thereby improving the quality and efficiency of wound repair, promoting a broader application of biomaterials, and helping physicians and readers implement more effective wound management.

Nurses' Knowledge and Practice Regarding Burn Wound Dressing in Sulaimaniyah, Iraq

Background: Burn is a public health issue, and the disinfected practice plays an important role in caring for patients with burns to reduce infection faster, recover, and maintain the status.&#x0D; &#x0D; Objectives: To assess nurses' knowledge and practice regarding burn wound dressing and utilizing aseptic techniques in dressing burn wounds.&#x0D; &#x0D; Patients and Methods: The quantitative descriptive study using a non-probability convenience sample technique was used to recruit 45 nurses at Burn Plastic and Reconstructive Surgery Hospital, Sulaimaniyah, Iraq, from April to September 2022. A questionnaire was used to collect nurses' sociodemographic characteristics and their knowledge, while an observational checklist was used to evaluate their practice regarding burn wound management.&#x0D; &#x0D; Results: The mean age of participants was 40.8±6.7, most of whom were Nursing Institute graduates (86.7%). The mean score of experience as a nurse and in burn units were 16.1±5.6 and 14.8±4.9, respectively, and most of them (91.1%) had good knowledge regarding burn wound management. The proportion of satisfactory practice levels regarding preparation, procedure of burn wound dressing and general practice were 64.4%, 68.9%, and 66.7%, respectively. The proportion of regular introducing self, explaining the procedure, hand hygiene before the process, and documentation were zero.&#x0D; &#x0D; Conclusions: The nurses' knowledge of burn wound management was good, and most had satisfactory overall wound dressing practice. However, introducing themselves, explaining the procedure, hand washing, and documentation were the weakest aspects of the practice.

The Outcome of under 10 mm Single-Incision Surgery Using a Non-Specialized Volar Plate in Distal Radius Fractures: A Retrospective Comparative Study.

The distal radius fracture is a common orthopedic injury. We aimed to share the surgical steps and investigate the outcomes of treating distal radius fractures with wounds ≤10 mm using a globally accessible locking plate. We collected 46 patients who underwent surgery via a <10 mm wound, with a control group consisting of 40 patients who underwent conventional procedures. Both groups were treated using the same volar plate. We compared the radiographic reduction quality, including volar tilt angle, radial inclination angle, and ulna variance. Additionally, clinical outcomes, such as pain assessed using VAS, Q-Dash score, and PRWE, were evaluated. Patient satisfaction with the wound was also analyzed. The follow-up time for the clinical outcomes was 24.2 ± 13.47 months. There were no differences in the quality of reduction in parameters such as the volar tilt angle (p = 0.762), radial inclination angle (p = 0.986), and ulna variance (p = 0.166). Both groups exhibited comparable results in pain VAS (p = 0.684), Q-Dash score (p = 0.08), and PRWE (p = 0.134). The ≤10 mm incision group displayed an increase in satisfaction with the wound (p < 0.001). Treating distal radius fractures with a <10 mm wound using a non-specialized locking plate is a feasible approach. It does not compromise the quality of fracture reduction or functional scores and improves wound satisfaction.

Development of an Antiswelling Hydrogel System Incorporating M2-Exosomes and Photothermal Effect for Diabetic Wound Healing.

Diabetic wounds represent a persistent global health challenge with a substantial impact on patients' health and overall well-being. Herein, a hydrogel system that integrates functionalized gold nanorods (AuNRs) and M2 macrophage-derived exosomes (M2-Exos) was developed to achieve an efficient and synergistic therapy for diabetic wounds. We introduced an ion-cross-linked dissipative network into a prefabricated covalent cross-linked network (long-chain polymer network), which was prepared using AuNRs as a specific cross-linker. The ion network was then cross-linked with the long-chain polymer in situ to form a specific network structure, imparting antiswelling and photothermal effects to the hydrogel. This integrated hydrogel system effectively scavenged reactive oxygen species levels, inhibited inflammation, promoted angiogenesis, and stimulated photothermal antibacterial activity through near-infrared (NIR) irradiation. To demonstrate the potential of the hydrogel, we established experimental animal models of oral mucosa ulceration and full-thickness skin defects. In vivo results confirmed that M2-Exos released from the hydrogels played a crucial role in wound closure. Furthermore, the synergistic effect of AuNRs and NIR photothermal effects eradicated bacterial infections in the wound area. Overall, our integrated hydrogel system is a promising tool for accelerating chronic diabetic wound healing and tissue regeneration. This study highlights the potential benefits of combining bioactive M2-Exos and the photothermal effect of AuNRs into an antiswelling hydrogel platform to achieve satisfactory wound healing in patients with diabetes.

Indwelling Needle Puncture and Irrigation in the Conservative Treatment of Breast Abscess During Non-Lactation Period.

The objective of this study is to observe the effect of indwelling needle puncture and irrigation in the conservative treatment of breast abscesses in the non-lactation period. Non-lactating breast abscess patients were treated at the Daping Medical Breast Surgery Clinic, Chongqing. In the Incisive drainage group, 21 patients were treated with conventional incision and drainage. In the Indwelling needle group, 20 patients were treated by puncture and irrigation with a 20 G indwelling needle. The pain VAS scores and wound satisfaction in the Indwelling needle group were significantly lower than those in the Incisive drainage group (P < 0.001), and the cure time and complications were also significantly lower in the Indwelling needle group (P < 0.05). The cure rates of the two groups were similar (P > 0.05). There was a difference in the duration of illness, location, and number of pus cavities between the treatment failure and the treatment recovery (P < 0.05). However, there was no difference in the size of the pus cavity and the maximum amount of pus aspiration (P > 0.05). The indwelling needle can be used as an effective tool for puncture and irrigation of single breast abscess in a non-lactation period, potentially for non-invasive treatment of breast abscesses.

Differences in Decreasing Bacteria Colonization Wound Irrigation using 0.9% Nacl Compared with Wound Irrigation using Active Ingredients Polyhexanide 0.1% and 0.1% Betaine in Open Fractures of Long Bone

BACKGROUND: An open fracture is an emergency case that must be treated quickly to prevent infection. The use of an irrigation solution containing 0.1% of the antimicrobial polyhexanide and 0.1% of the surfactant betaine has been associated with more satisfactory wound healing. AIM: This study was comparing irrigation with polyhexanide 0.1% and betaine 0.1% (P + B) in reducing bacterial colonization of open fractures compared to using 0.9% natrium chloride (NaCl) solution. METHODS: This study uses a pre- and post-control group design. Sampling was carried out in the operation room of the emergency care installation, inpatient installation, and outpatient installation of prof. Hospital. Dr. I.G.N.G Ngoerah Denpasar, between September and November 2022. From a sample population suffering from open fractures of the lower extremities, samples of patients were taken who were irrigated with 0.9% NaCl solution with a mixture of polyhexanide 0.1% and betaine 0.1%. The presence or absence of bacterial colonization was examined using a surgical wound base swab with the Levine technique. RESULTS: In the 30 patients in this study, there was a significant decrease in bacterial levels (Log colony-forming unit [CFU]/g) after irrigation, both from irrigation with NaCl (p = 0.04) and NaCl + P + B (p &lt; 0.001). The reduction in bacterial levels was more significant with NaCl + P + B compared with NaCl alone, at post-irrigation (p &lt; 0.001), H+3 (p = 0.003), and H + 7 (p &lt; 0.001). CONCLUSION: Wound irrigation using a combination of 0.9% NaCl, 0.1% polyhexanide, and 0.1% betaine reduced bacterial colonization more than using 0.9% NaCl-only solution in open fractures of long bones.

Single-port hidden incision endoscopic (HIdES) pediatric nephrectomy via pfannenstiel incision

Laparoendoscopic single-site surgery (LESS) and hidden incision endoscopic surgery techniques are increasingly used in pediatric urology. For pediatric nephrectomy, access through a single Pfannenstiel incision is novel and may offer cosmetic benefit. In this retrospective study, we describe this approach and assess operative outcomes associated with this technique. Patients who underwent LESS nephrectomy through a single Pfannenstiel incision had minimal blood loss, short length of stay, low risk of surgical complications, and satisfactory wound healing. The Pfannenstiel approach to LESS nephrectomy is feasible, versatile, and achieves excellent operative and cosmetic outcomes, although direct comparison to other approaches is warranted.

The second dorsal metacarpal artery flap relaying the dorsal island flap of the index finger for the repair of soft tissue defect of thumb

To investigate the effectiveness of the second dorsal metacarpal artery fascial vascular pedicle retrograde island flap relaying the dorsal island flap of the index finger in repairing skin and soft tissue defects of the thumb. The clinical data of 8 patients with skin and soft tissue defects of thumb between October 2019 and January 2021 were retrospectively analyzed. There were 3 males and 5 females with an average age of 35 years (range, 18-52 years). The causes of injury included machine injury in 2 cases, crush injury in 3 cases, and cutting injury in 3 cases. There were 2 cases of dorsal defect of the proximal part, 1 dorsal defect of the distal part, and 5 instances of the distal part defect. The skin and soft tissue defects ranged from 1.7 cm×1.4 cm to 3.0 cm×2.5 cm. The time from injury to flap repair was 7-21 days, with an average of 14 days. Firstly, the dorsal island flap of the index finger (dorsal side of the proximal part of the index finger) was used to repair the defect of the thumb. Then the second dorsal metacarpal artery fascia vascular pedicle retrograde island flap (near the radial side of the back of the hand) was used to repair the dorsal defect of the index finger; the donor site was sutured directly. Vascular crisis of the flap occurred in 1 case within 48 hours after operation, and the flap was bloated and bruised in 1 case due to excessive suture tension, and all the flaps survived after symptomatic treatment; partial skin margin of the flap was necrotic in 1 case after operation, and the incision healed after dressing change; the other 5 flaps survived, and all the wounds in the donor and recipient sites healed by first intention. All the 8 patients were followed up 3-10 months, with an average of 6 months. One patient had mild scar; the other patients had no significant difference in the color of the flap and the surrounding skin, no adhesion of tendons, and little interference of index finger function, and there was no obvious pain and dysfunction in the donor and recipient sites of the flap. At last follow-up, the extension-flexion range of motion of the metacarpophalangeal joint of the thumb was 0°-55°, and that of the interphalangeal joint was 0°-75°; the extension-flexion range of motion of the metacarpophalangeal joint of the index finger was 0°-82°, that of the proximal interphalangeal joints was 0°-90°, and that of the distal interphalangeral joints was 0°-65°. The application of the second dorsal metacarpal artery fascial vascular pedicle retrograde island flap relaying the dorsal island flap of the index finger to repair skin and soft tissue defect wounds of thumb is a feasible treatment with reliable blood supply, less postoperative complications, no need for skin grafting, less interference to the function of the index finger, and satisfactory wound repair effect.

INVERSE RELATIONSHIP BETWEEN PLASMA PROTEINS AND SATISFACTORY SURGICAL WOUNDS OUTCOME.

This study investigated the factors associated with satisfactory early postoperative wound conditions. A prospective study was conducted with patients (n=179) submitted to osteosynthesis in general, in a hospital orthopedics service. In the preoperative period, patients underwent laboratory exams and the surgical indications were based on the type of fracture and the patient's clinical conditions. In the postoperative period, patients were evaluated based on the presence of complications and considering their surgical wounds. Chi-square, Fisher, Mann-Whitney, and Kruskal-Wallis tests were used in the analysis. To identify the factors associated with wound condition, univariate and multiple logistic regression analysis was used. In the univariate analysis, each transferring unit reduction increased the chance of satisfactory outcome by 1.1% (p=0.0306; OR= 0.989 (1.011); 95%CI= 0.978;0.999; 1.001;1.023). The presence of SAH increased 2.7 fold the chance of satisfactory outcome (p=0.0424; OR= 2,667; 95%CI= 1,034;6,877). Hip fracture increased 2.6 fold the chance of satisfactory outcome (p=0.0272; OR=2.593; IC95%=1.113; 6.039). And the absence of a compound fracture increased 5.5 fold the chance of satisfactory wound outcome (p=0.0004; OR=5,493; 95%CI=2,132;14,149). In the multiple analysis, patients with non compound fractures were 9.7 times more likely to experience a satisfactory outcome when compared to patients with compound fractures (p=0.0014; OR=9,687; 95%CI= 2,399; 39,125). There was an inverse relationship between plasma proteins levels and satisfactory surgical wounds outcome. Only exposure remained associated with wound conditions. Level Of Evidence: II, Prospective Study.

Pilomatricoma with Osseous Metaplasia in the Shoulder Joint: A Common Lesion with Rare Differentiation

Pilomatricoma, also known as calcifying epithelioma of Malherbe, is a tumour that shows differentiation towards hair cortex cells. It was first described by Malherbe and Chenantais in 1880. It most commonly occurs in the first two decades of life, with a female preponderance, and accounts for 1% of all benign skin lesions. Pilomatricoma undergoes calcification and ossification, but ossification is rare and poorly documented. The head and neck region, as well as the upper extremities, are the most common sites. Here, the authors present a rare case of pilomatricoma with osseous metaplasia in a 15-year-old male who presented with shoulder swelling for one year. The patient had a firm to hard, mobile swelling over the right shoulder, which was not fixed to the overlying skin or underlying structures. Clinically, calcified epidermal cysts were considered. Excision was performed in a minor operation theatre, and the specimen was sent for histopathological examination. On gross examination, the specimen was a firm to hard, globular 1×0.8 cm tissue that was difficult to cut. Microscopic examination revealed a lesion composed of two types of epithelium: inner shadow cells and outer basophilic cells. Bony trabeculae with osteocyte rimming were present around the shadow cells, and giant cells were also observed. Based on the histopathological examination, the diagnosis of pilomatricoma with osseous metaplasia was made. The patient was discharged after one week and followed-up for three months, during which satisfactory wound healing and no local recurrence were observed. Pilomatricoma with osseous metaplasia should be considered as a differential diagnosis when a patient presents with a firm to hard nodule.

Zn2+-Loaded adhesive bacterial cellulose hydrogel with angiogenic and antibacterial abilities for accelerating wound healing.

Wound healing is a process that requires angiogenesis and antibacterial activities and it remains a challenge for both experimental and clinical research worldwide. Zn2+ has been reported to be widely involved in angiogenesis and exerts antibacterial effects, making it suitable as a treatment to promote wound healing. Therefore Zn2+-loaded adhesive bacterial cellulose hydrogel was designed to observe its angiogenic and antibacterial abilities in the wound healing process. The characterization, tensile strength, swelling behaviors and antibacterial activity of bacterial cellulose/polydopamine/zeolitic imidazolate framework-8 (BC/PDA/ZIF8) hydrogels were tested. Cell-Counting-Kit-8 (CCK8), transwell, tube formation and real time qunantitative PCR (qRT-PCR) assays were performed to evaluate the cell compatibility of BC/PDA/ZIF8 hydrogels in vitro. A full-thickness defect wound model and histological assays were used to evaluate the BC/PDA/ZIF8 hydrogels in vivo. The prepared BC/PDA/ZIF8 hydrogels exhibited suitable mechanical strength, excellent swelling properties, good tissue adhesion, efficient angiogenic and antibacterial effects and good performance as a physical barrier. In vivo experiments showed that the BC/PDA/ZIF8 hydrogels accelerated wound healing in a full-thickness defect wound model by stimulating angiogenesis. This study proved that BC/PDA/ZIF8 hydrogels possess great potential for promoting satisfactory wound healing in full-thickness wound defects through antibacterial effects and improved cell proliferation, tissue formation, remodeling and re-epithelialization.