Wound Medicine最新文献

Background

Aspalathus linearis (rooibos) has been reported to have a high content of phenolic compounds which elicit antioxidant and anti-inflammatory activity in biological systems. In the present study, we evaluated the effects of “fermented” (oxidised) and green rooibos extracts embedded in gentamicin loaded acrylate copolymer based hydrogels on inflammatory response in surgical wounds in vivo.

Method

The major phenolic compounds and a phenolic precursor present in the rooibos extracts were quantified by HPLC. Acute toxicity of the extracts in Swiss albino mice was evaluated up to 1 g/kg body weight. A modification of free radical initial polymerisation of the alkyl acrylate polymer was utilised to formulate hydrogels loaded with different concentrations of the extracts. The hydrogels were evaluated for swelling, skin irritancy, gel index and pH. Surgical wounds were inflicted on 40 healthy male Sprague Dawley rats, randomly designated to groups treated with the extract loaded hydrogels, hydrogel (without extract; control) and 1% framycetin sulphate containing gauze (positive control). In vivo wound healing test post-surgical intervention was carried out following histomorphometric studies.

Results

All extract loaded hydrogels shortened the time taken for complete wound closure compared to the control. Hydrogels loaded with fermented rooibos extract performed better than those loaded with green rooibos extract or the positive control by significantly (p < 0.05) shortening the time to complete wound closure from 14 to 10 days. The histologic section of skin showed the absence of inflammatory cell infiltrates within the underlying dermis and subcutaneous fat for all extract loaded hydrogels and no increased dermal stromal fibrosis or other abnormalities in three of the fermented rooibos extract and two unfermented rooibos extract hydrogel formulations compared to the control (p < 0.05).

Conclusion

Therapeutic properties of green and fermented rooibos extract loaded hydrogels have been established in vivo, with the best wound healing indices shown by the hydrogels containing fermented rooibos extract. This is possibly a result of a shorter inflammatory phase resulting in quicker wound closure and reduced fibrosis.

Background

Tridax procumbens(L.) leaves are traditionally used in wound healing by tribal people. The matured leaves are crushed to make a paste and applied on the surface of the wound.

Purpose

The aim of the present investigation was to evaluate the wound healing activity of ethanolic extract of Tridax procumbens (L.) (EETP) in streptozotocin induced diabetic and non- diabetic laboratory animals. There is no scientific literature, claiming the use of leaves of Tridax procumbens (L.) in diabetic wounds.

Study Design

The simple ointment base (2.5 % and 5% w/w) of EETP was formulated to evaluate the wound healing potential on diabetic and non-diabetic rats, using incision, excision and burn wound model.

Methods

In incision wound model, epithelization period, wound index, % contraction area, hydroxyproline content, DNA estimation, total protein and histopathological evaluations were done. In excision wound model, tensile strength was measured. In burn model, contraction rate, wound contraction (%) and epithelization period were evaluated.

Results

Secondary metabolite as tannin, flavonoids were present. In the excision model, animals treated with 2.5 % and 5% w/w EETP showed significant result in wound contraction, epithelization period and wound index. Hydroxyproline, total protein and DNA concentration in healing tissue were more in comparison to control and as well as standard in diabetic and non- diabetic. The parameters evaluated showed significant response at 2.5 % and 5% w/w EETP.

Conclusion

Flavonoids and tannin were accountable for wound healing. The findings confirmed the ethanomedicinal claim of Tridax procumbens(L.) in wound healing in diabetic and nondiabetic conditions.

Extralevator Abdominoperineal excision (ELAPE) for low rectal cancer results in a large perineal defect, often requiring reconstruction by a biological or absorbable mesh or a flap as compared to conventional Abdominoperineal excision (CAPE). Although there are indications for oncological superiority with ELAPE, the incidence of wound-related complications is postulated to be higher when compared to CAPE due to the removal of more amount of tissue around the anorectum. On the other hand, the incidence of inadvertent rectal tube perforation during dissection is lesser in ELAPE and hence perineal wound breakdown and infection are postulated to be lesser in some other studies. We conducted a retrospective study in the department of colorectal surgery, Christian Medical College; Vellore from 2011 to 2017 to compare the perineal wound-related complications following CAPE and ELAPE. The data were retrieved from the prospectively maintained computerized inpatient and out-patient follow up records and comparisons were made in terms of incidence of perineal wound outcomes, need for reoperations and duration of hospital stay. A total of 138 patients underwent CAPE and 57 patients underwent ELAPE over a period of 7 years. There was no statistical difference in baseline characteristics and patients who underwent neo-adjuvant chemoradiation between the two groups. Perineal wound complications were seen in 63% (87) of the patients after CAPE compared to 64.9% (37) of the patients after ELAPE. There was no perineal herniation or wound dehiscence following ELAPE, whereas these complications occurred in 1 and 5 patients respectively after CAPE. Similarly, the incidence of reoperations was 8% in CAPE as compared to 5.4% in ELAPE although not statistically significant. There was no difference in the length of hospital stay. Hence, in our experience, perineal wound complications were similar in the Extralevator approach to APE (ELAPE) as compared to conventional APE (CAPE) for rectal adenocarcinoma.

Wound healing is a general repair response or process of the body immediately after the disruption of the skin integrity. However wound healing is a complex process in which body repairs itself. The aim of this research is to study the wound healing activity of ethanolic extract of Plumeria obtusa L. leaves and to study the efficacy of formulated 2.5%, 5% and 10% Plumeria obtusa sprays in in-vivo wound healing models. The spray was prepared in three formulations F1, F2 and F3 containing 2.5% (50 mg/kg BW), 5% (100 mg/kg BW) and 10% (200 mg/kg BW) extract of P. obtusa leaves respectively. The wound healing activity was studied by invivo method. In excision model the % wound closure rate on epidermal skin of white Wistar albino rats was studied and was compared with standard Hansaplast Wound spray. The tensile strength or skin breaking strength was measured on the 10^th post wounding day in anesthetized experimental rats in incision model. The results obtained by 3 formulations F1, F2 and F3 were studied and compared with the control group. The formula F3 shows complete wound healing on day 17, while the F1 and F2 showed complete healing on day 21 and 19 respectively in excision wound model. In incision wound model the tensile strength was found to be high about 404 gm by application of formula F3 spray. Formula F1 and F2 showed 354 gm and 385 gm tensile strength respectively. The conclusion is ethanolic extract of the leaves of plant P. obtusa showed promising wound healing activity as studied by the invivo models. The study shows that Formula F3 with 10% (200 mg/kg BW) P. obtusa extract spray shows better and efficient wound healing activity than formula F1 with 2.5% (50 mg/kg BW) and formula F2 with 5% (100 mg/kg BW) extract spray.

Background

Wound closure is the prime objective in the treatment of deep and extensive burns, where the dermis layer is partially or completely destroyed and the inherent capability of spontaneous re-epithelialization is greatly reduced or absent leading to high mortality rate. Scar formation as a result of burn wounds results in aesthetic and functional impairment, causing emotional distress in patients. Induced regeneration of skin could be a solution to improve the quality of life of burned patients.

Materials and methods

Nano calcium oxide (NCO) was prepared by thermal decomposition method. In situ gels (ISG) were formulated using micronized xanthan gum and NCO in different concentrations by geometric mixing. The formulations were evaluated for their particle size, surface morphology, elemental composition, clarity, pH, gelling and in vivo burn wound healing properties.

Results

The average particle size and polydispersity index of NCO was found to be 345.3 nm and 0.23 respectively. Three formulations were prepared, each containing varied concentrations of NCO (12.5, 25 and 50 ppm). The SEM analysis of the formulation exhibited particle sizes ranging from 1 nm to 468 nm and EDX characterization showed intense peaks of calcium and oxygen. The percentage of wound size reduction was significantly increased in wounds treated with prepared in situ gels in contrast to commercial product (calcium alginate dressing) and control (untreated) group. With an increase in concentration of NCO, the rate of healing also increased. In situ gels containing 50 ppm of NCO exhibited a better rate of wound healing in comparison to other formulations, within a period of 15 days. Histopathological analysis indicated that in situ gels had better wound healing properties.

Conclusion

In situ gels of NCO were developed as a formulation for effective treatment of burns and to aid in skin regeneration.

Background

The major problem in the management of burn wounds are infections. Methicillin-resistant Staphylococcus aureus (MRSA) is one of the major cause of infection in burn wounds. Antibiotic resistant bacteria around the world has become a major therapeutic challenge. Bacteriophages and their lysine are suggested as an antimicrobial alternative agent. Phage display technique is suggested for production of recombinant lysine by Nano carrier technology. The approach of this study was to evaluate the potential of recombinant Nano phage efficacy in MRSA burn wound infection in vivo.

Materials and methods

The 3rd degree burn wounds were induced in 54 rats and infected with MRSA ATCC 33591 via the topical route in four groups. Burn wound size was measured in 0, 14, 21, 28 days. The efficacy of Nano phage gel was assessed on the basis of percentage collagen deposition, granulation tissue, neovascularization, fibroblastic maturity, re-epithelization, and scar formation in rats following treatment in 14, 21, 28 days.

Results

The results showed that the percentage of wound size were 3 cm on base line day and the average macroscopic wound healing rates were increased in the prevention groups receiving the recombinant Nano phage gel and natural phage gel, in the treatment groups with secondary infection receiving the recombinant Nano phage gel and the natural phage gel, and in the two control groups respectively. The average microscopic wound healing rates were increased in the prevention groups receiving the recombinant Nano phage gel and natural phage gel, in the treatment groups with secondary infection receiving the recombinant Nano phage gel and the natural phage gel, and in the two control groups respectively.

Conclusions

In conclusion the recombinant Nano phage gel is efficacy to treat and prevent MRSA burn wound infection.

Background

Chronic, non-healing wounds remain a major challenge for health care practitioners and for society in general, both in terms of the enormous economic burden on health care systems and the decreased quality of life of the patients.

Objective and methods

To provide the first overview of the use of CACIPLIQ20®, a matrix therapy agent, over the past 10 years on 4 continents and 15 countries. CACIPLIQ20® was used as a last resort for these wounds, which had not shown any evidence of improvement with conventional care and had no expectation of healing. Cases with fully healed wounds were evaluated in order to assess how long complete wound healing can be achieved using this therapy.

Results

Through the evaluation of a selected 119 cases, we found that regardless of wound size or age, treatment with CACIPLIQ20® resulted in complete healing (full closure) in about 2 months of a variety of chronic wounds including diabetic foot ulcers, burns, post-amputation/surgical wounds, among others. Moreover, CACIPLIQ20® was found to be cost-effective, it’s current spray format potentially costing 74 euros (64 GBP) to treat wounds measuring an average area of 14 cm² to wound closure. CACIPLIQ20® was also widely reported to provide marked pain relief as a consequence of healing.

Conclusions

CACIPLIQ20® can heal chronic wounds of various etiologies, sizes and ages in approximately two months, while being cost-effective. By doing so, this treatment can provide major improvement of quality of life through rapid and complete healing of chronic, hard-to-heal wounds and can reduce the economic burden of chronic wounds for health care agencies.

Weakly acidic hypochlorous acid (HClO; 200 ppm, pH 6.5) is effective against a broad range of microorganisms. We have previously reported a study of developing antimicrobial biomaterials made up of chitin-nanofiber sheet (CNFS) -immobilized silver nanoparticles (CNFS/Ag NPs) and showed that either cleansing with HClO or covering with CNFS/Ag NPs daily for more than 7 days resulted in delayed wound healing. This study aimed to evaluate disinfection and wound healing by a combination of cleansing with HClO and covering with CNFS/Ag NPs daily for 3 days. Applying HClO + CNFS/Ag NPs daily for 3 days and then cleansing with just pure water and covering with CNFS alone daily for 9 days were performed for Pseudomonas aeruginosa-infected wounds in db/db diabetic mice. We found a significant enhancement of wound healing and a reduction of bacteria counts compared to the controls. Histological examination showed significantly advanced granulation tissue and capillary formations in the wounds on Day 12. These results suggest that limited disinfection to 3 days with HClO + CNFS/Ag NPs may be sufficient to avoid negative effects on wound repair.

Honey, pomegranate peel extract and bee venom, were used in combination with polyvinyl alcohol to develop a novel nanofibrous wound dressing. Methanolic pomegranate peel extract was prepared and mixed with either Manuka honey or lyophilized multiflora honey powder together with bee venom. The formulas were tested for their antibacterial activity, cytotoxicity, and wound healing activity in an excisional wound rat model. Scanning electron microscopy showed that lyophilized honey fibers had smaller and more uniform diameter than Manuka honey fibers. Moderate swelling and higher weight loss capacities were detected when compared to polyvinyl alcohol mats. Antibacterial tests showed significant antibacterial activity against S. aureus and E. coli compared to negative controls (P < 0.0001). No cytotoxicity was observed. In vivo wound healing study showed that all treatment groups enhanced wound healing as shown by increased wound closure percentages compared to negative control groups at days 3,5 and 10 (P < 0.0001), and histological examination. In comparison to treatment groups, Medihoney® calcium alginate dressing significantly enhanced healing compared to negative controls at days 3 and 5. However, healing was delayed afterwards. These results indicate that Manuka honey/Pomegranate/Bee Venom nanofibers are promising for wound healing.

Objective

this study was designed to better understand the evolution of the ankle brachial Index (ABI) over time, so as to better inform clinical decision-making.

Methods

patient selection included consecutive patients with at least two documented ABI Indexes obtained at Emory Healthcare between April 2005 and April 2013. Retrospective chart reviews were conducted on consecutive patients to assess ABI Index values, time between ABIs and whether revascularization had occurred between the two ABI measures. Qualifying patients included 76 patients with two ABIs and without a surgical intervention between the two measures.

Results

the primary study outcome measure was the change in ABI per day. The average change in ABI per year was calculated as -0.012045. Extrapolating from these data, the estimated time in which meaningful deterioration (0.1) was found to be 8.3 years.

Conclusion

these data demonstrate a change in ABI that is minimal and thus suggest that without intervening medical treatments that would change the ABI, routinely repeating this test is not warranted.