Wounds : a compendium of clinical research and practice最新文献

Introduction: CAMPs are used for treating refractory DFUs where other treatments have failed. PLA is a CAMP that has demonstrated effectiveness in promoting healing in burns and acute wounds.

Objective: A single-center, prospective, randomized controlled trial comparing PLA-guided closure matrices versus collagen dressings was conducted to assess healing of Wagner grades 1 and 2 DFUs.

Materials and methods: A total of 30 participants were randomized to receive weekly debridement, wound care, and DFU offloading plus either PLA or collagen CAMPs. The primary outcome was the time to achieve full healing, and the secondary outcome was the proportion of ulcers healed at 12 weeks.

Results: The median time to achieve full healing was 9.3 ± 2.9 weeks in the PLA group versus 14.8 ± 8.1 weeks in the collagen group (P = .021), representing a 44% reduction in the time to heal. Furthermore, by 12 weeks, 80% of the PLA-treated ulcers were healed compared to only 33% in the collagen group (P = .025).

Conclusion: The results of this study show PLA matrices induce a potent healing response that leads to reduced healing time and an increased OR for achieving healing by 12 weeks.

Introduction: Large soft tissue defects resulting from trauma in the pediatric population are common. MLLs are a rare subset of these injuries with no standard treatment regimen. Thorough surgical debridement of these lesions is often warranted to remove necrotic tissue and contamination, which results in a large, open soft tissue defect. STSGs may be used to provide tissue coverage; however, they have limitations, including donor site morbidity and additional surgical time and cost.

Case report: A 12-year-old female with a cutaneous thermal contact burn and an MLL of the right lower medial thigh declined STSG to avoid additional operations. The wound was treated with an SHSFM that is engineered to mimic the structure and architecture of human extracellular matrix and supports cellular infiltration and proliferation with minimal inflammatory response. Over a 4-month period, the SHSFM was applied 6 times at 2- to 3-week intervals, resulting in complete regranulation and wound closure with no further surgical procedures required.

Conclusions: This case demonstrates the utility of the SHSFM in the management of pediatric surgical wounds and highlights the flexibility of the SHSFM in achieving the goals of both patient and physician alike.

Introduction: Drug-resistant fungal infections in chronic wounds represent a major clinical challenge to clinicians. Fungal infections delay wound healing by prolonging inflammation and encouraging biofilm formation, which protects microbes against host defenses and anti-infective medications. As such, interventions that prevent and control nosocomial fungal infections without interfering with the wound healing process are increasingly required. Although conventional antiseptics can effectively exert fungicidal effects, they also have adverse effects on human cells. SOS is a well-known bactericidal agent that enhances the wound healing process, especially for chronic wounds. However, few studies have evaluated the antimicrobial activity of SOS on fungi.

Objective: The objective of this study was to evaluate whether SOS exerts fungicidal activities against common fungal species.

Materials and methods: The efficacy of SOS was tested against 6 fungal species (Candida albicans, Candida auris, Candida tropicalis, Candida parapsilosis, Sporothrix schenckii, Trichophyton mentagrophytes) using an in vitro time-kill assay.

Results: SOS achieved 99.9999% reduction of all tested fungi within 1 minute of exposure.

Conclusions: This study shows that SOS may be an effective tool for the prevention and control of fungal infections.

Introduction: PAD frequently co-occurs with diabetes, often leading to chronic nonhealing wounds. Foot gangrene and amputation are common outcomes of untreated CLI.

Case report: A 67-year-old male with diabetes and deteriorating limb ischemia following surgical stress underwent successful surgical repair after emergency PTA of the SFA for extensive heel necrosis. After surgical debridement of necrotic heel tissue, the ABI on the affected side suddenly reduced to 0.36, but it improved to 1.06 at 4 weeks following stenting angioplasty, allowing the subsequent flap surgery to repair the heel defect. At the 1-year follow-up visit, the patient exhibited durable heel coverage and the restoration of weightbearing function. No signs or symptoms indicative of restenosis were evident in the blood vessel treated with stent angioplasty.

Conclusion: This case highlights the importance of proper evaluation of critical ischemic conditions and the need for prompt endovascular interventions in preserving the at-risk diabetic foot.