The Use of Biologic Wound Healing Agents in Cheek Reconstruction

2021 ◽  
Author(s):  
Monal Depani ◽  
James Thornton
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Wound Care ◽  
Mobile Element ◽  
Excisional Biopsy ◽  
Advancement Flap ◽  
Mobile Elements ◽  
Skin Closure ◽  
Comorbid Conditions ◽  
The Face

AbstractThe unique requirements of reconstructing cheek defects, often with its proximity to the mobile elements of the face including the lip and the eyelid, have been met very handily with the directed and thoughtful use of biologic wound healing agents. One of the key advantages of these agents is their ability to provide coverage in patients with multiple comorbid conditions for the mobile elements of the cheek where the cervicofacial advancement flap is contraindicated due to its anesthetic requirement. The biologic agents are also highly successful coverage options for patients who have limited skin laxity to provide for proper skin closure using the standard cheek closure techniques with local flaps. In addition, these agents provide an ability to provide stable wound closure with minimal wound care while waiting for the excisional biopsy results to be finalized. This article describes the unique indications for biologic wound agents, including preservation of lip and eyelid mobile element anatomy without retraction from a local flap, which has not been previously described.

Management of Acute Wounds

2019 ◽  
Author(s):  
Lee D. Faucher ◽  
Angela L. Gibson
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Wound Closure ◽  
Wound Care ◽  
Connective Tissue Diseases ◽  
Skin Grafting ◽  
Adjunctive Treatment ◽  
Local Trauma ◽  
Life Threatening ◽  
Acute Wound

Acute wounds are the result of local trauma and may be associated with severe life-threatening injuries. All patients with acute wounds should be assessed for comorbidities such as malnutrition, diabetes, peripheral vascular disease, neuropathy, obesity, immune deficiency, autoimmune disorders, connective tissue diseases, coagulopathy, hepatic dysfunction, malignancy, smoking practices, medication use that could interfere with healing, and allergies. The authors address the key considerations in management of the acute wound, including anesthesia, location of wound repair (e.g. operating room or emergency department), hemostasis, irrigation, débridement, closure materials, timing and methods of closure, adjunctive treatment (e.g. tetanus and rabies prophylaxis, antibiotics, and nutritional supplementation), appropriate closure methods for specific wound types, dressings, postoperative wound care, and potential disturbances of wound healing.  This review contains 11 figures, 31 tables, and 92 references. Keywords: wound, wound infection, burns, suture, staple, wound closure, wound healing, dehiscence, skin grafting

scholarly journals Surgical glue- a promising technology for wound healing

2018 ◽  
Vol 1 (1) ◽  
pp. 9-11
Author(s):  
K. V. Swathi Krishna ◽  
L. S. Uma Maheswari ◽  
G Rajeswari
Keyword(s):  
Wound Healing ◽  
Cost Effectiveness ◽  
Wound Closure ◽  
Cost Effective ◽  
Daily Basis ◽  
Skin Closure ◽  
Tissue Glue ◽  
Closure Time ◽  
Anesthesia Awareness ◽  
Long Time

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred.

scholarly journals Comparison of Topical Skin Adhesive and Simple Interrupted Nylon Sutures for Wound Closure in Forefoot Surgery: A Prospective Randomised Trial

2020 ◽  
Vol 5 (4) ◽  
pp. 2473011420S0039
Author(s):  
Robbie Ray ◽  
Thomas A. Goff ◽  
Paul M. Dearden ◽  
Peter W. Robinson ◽  
Peter Lam ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Wound Care ◽  
Randomised Trial ◽  
Data Set ◽  
Prospective Randomised Trial ◽  
Forefoot Surgery ◽  
High Satisfaction ◽  
Patient Reported

Category: Bunion Introduction/Purpose: There are many options for wound closure in forefoot surgery. The purpose of this study was to compare topical skin adhesive (2-Octyl-cyanoacrylate) to standard simple interrupted nylon sutures with attention to the quality of wound healing and the acceptability to the patient. Methods: Patients undergoing elective 1st ray forefoot surgery utilising a medial incision, either Hallux Valgus correction or 1st Metotarsophalangeal joint arthrodesis, were recruited to this study. Patients were randomly allocated during surgery to final layer wound closure with either the intervention topical skin adhesive (TSA) or the control interrupted nylon sutures (INS). Practicality was assessed by time taken for wound closure and subsequent time to perform wound care at 2 weeks postoperatively, wound care pain (VAS) and quality of wound healing was assessed at this point with a dedicated scoring tool, patient satisfaction and acceptability was assessed at 6 weeks postoperative. Results: 70 patients (18 bilateral) were recruited, resulting 42 feet in each study group (after 4 exclusions for incomplete data set). Mean age 61 (29-83). There were no statistical differences in the demographics or surgery performed between groups. Wound closure time was significantly slower for TSA (272 secs (SD 72.2) vs 229 secs (SD 58.8), p=0.0038). At 2 weeks postoperative wound care time was significantly faster for TSA (71 secs (SD 50.8) vs 120 Secs (SD 47.8), p<0.0001), and patient reported pain was significantly less with TSA (VAS 0 vs 2, p=0.025). Significantly more inflammation and wound edge separation was recorded with TSA (17 vs 5 cases, p=0.006) and (12 vs 3 cases, p=0.02) respectively. High satisfaction was reported in both groups with no signifcant difference. Conclusion: Topical skin adhesive and interrupted nylon sutures are both acceptable closure methods for forefoot surgery with high satisfaction rates, low pain scores and low complications. However, the observation of significantly more inflammation and areas of wound separation at the early post-operative period with topical skin adhesive is sufficient to recommend routine use of sutures.

scholarly journals Optimal Support of Wound Healing: New Insights

Dermatology ◽  
2020 ◽  
Vol 236 (6) ◽  
pp. 593-600 ◽  
Author(s):  
Jens Malte Baron ◽  
Martin Glatz ◽  
Ehrhardt Proksch
Keyword(s):  
Wound Healing ◽  
Best Practices ◽  
Wound Closure ◽  
Wound Care ◽  
Clinical Approach ◽  
Visual Appearance ◽  
Rapid Repair ◽  
Wound Recovery ◽  
Scar Management ◽  
Three Phases

<b><i>Background:</i></b> The ultimate goal of wound healing following minor injury is to form a tissue regenerate that has functionality and visual appearance as close to the original skin as possible. The body’s physiological response to any wound is traditionally characterised by three distinct steps: inflammation, proliferation and remodelling. <b><i>Summary:</i></b> New insights suggest that the three phases overlap (and even occur in parallel) in both time and space in the wound, necessitating a clinical approach that targets each stage simultaneously to ensure rapid repair and wound closure without further complications. Ingredients that exhibit activity across each of the three phases, such as dexpanthenol, are of value in the context of minor wound care and scar management. <b><i>Key Messages:</i></b> In addition to treatment and ingredient selection, it is also important to consider broader clinical best practices and self-care options that can be used to optimise the management of minor wounds. An individualised approach that can account for a patient’s unique requirements and preferences is critical in achieving effective wound recovery.

scholarly journals Clinical Outcome and Wound Healing following Carpal Tunnel Decompression: A Comparison of Two Common Suture Materials

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Robert J. MacFarlane ◽  
Thomas D. Donnelly ◽  
Yousaf Khan ◽  
Syam Morapudi ◽  
Mohammad Waseem ◽  
...  
Keyword(s):  
Wound Healing ◽  
Patient Satisfaction ◽  
Carpal Tunnel ◽  
Wound Closure ◽  
Suture Material ◽  
Skin Closure ◽  
Suture Materials ◽  
Vas Scores ◽  
The Mean ◽  
The Ideal

Introduction. Debate exists amongst surgeons regarding the ideal suture material for skin closure in carpal tunnel decompression (CTD). This study compares wound related complications, patient satisfaction, and functional outcome following open carpal tunnel decompression in patients undergoing wound closure with either of two common absorbable and nonabsorbable suture types.Materials and Methods. 53 patients underwent CTD with either 4/0 polypropylene (ProleneTM,n= 28) or 4/0 polyglactin (Vicryl RapideTM,n= 25) for skin closure. QuickDASH, VAS satisfaction scores, and Southampton wound scores were assessed preoperatively and at 2 and 6 weeks postoperatively.Results. At 6 weeks the mean QuickDASH scores postoperatively were 18.54 and 17.70 for absorbable and nonabsorbable sutures, respectively, (P= 0.86). The mean VAS scores were 0.61 and 0.42 (P= 0.91), respectively. All patients achieved a Southampton wound score of 0 by 6 weeks except one, who achieved 1C in the nonabsorbable group, equivalent to mild erythema. There were no complications in either group.Conclusion. Both suture types are safe and effective materials for CTD, and we recommend surgeons to choose according to personal preference, handling properties, and resources available for suture removal.

scholarly journals Comparative study of time taken for skin closure, infection rate and postoperative pain in skin closure with sutures and staplers in open inguinal hernioplasty

2020 ◽  
Vol 11 (2) ◽  
pp. 1352-1357
Author(s):  
Rajasenthil V ◽  
Sriraman K B ◽  
Kaliyappa C
Keyword(s):  
Wound Healing ◽  
Inguinal Hernia ◽  
Infection Rate ◽  
Wound Closure ◽  
Skin Infection ◽  
Skin Closure ◽  
Absorbable Suture ◽  
Hernia Surgery ◽  
Local Conditions ◽  
Inguinal Hernia Surgery

Wound healing is a complex and dynamic process and is influenced by surgical technique. Optimal wound healing, with a minimal scar that compromises neither appearance nor function, is the desired result. This process is affected by both local and systemic factors. Many local conditions are readily controlled at the time of wound closure, and several fundamental principles of surgical wound closure exist that should be adhered to in the management. Skin is usually closed with sutures then later with skin staplers.Skin staplers are quick and easy to use, but an assistant is usually required to hold the skin edges accurately with forceps or skin hooks.Stapler's closure also causes considerably less damage to wound defenses than closure with least reactive non-absorbable suture. Standard suturing causes significantly more necrosis than stapling in myocutaneous flaps. We did this study to compare the time required for the closure of skin, infection rate, pain at the operated site with sutures and staplers in open inguinal hernia repair. 80 patients who were posted for elective open inguinal hernia surgery at Sri Ramachandra Medical College & Research Institute, porur, Chennai was included in this study. Time taken for closure of skin, infection rate and the pain was less in patients with stapler closure than with skin sutures

scholarly journals Wound Healing with Electrical Stimulation Technologies: A Review

Polymers ◽  
2021 ◽  
Vol 13 (21) ◽  
pp. 3790
Author(s):  
Yt Jun Cheah ◽  
Muhamad Ramdzan Buyong ◽  
Mohd Heikal Mohd Mohd Yunus
Keyword(s):  
Tissue Engineering ◽  
Wound Healing ◽  
Electrical Stimulation ◽  
Care Management ◽  
Wound Repair ◽  
Wound Closure ◽  
Wound Care ◽  
Smart Biomaterials

Electrical stimulation (ES) is an attractive field among clinicians in the topic of wound healing, which is common yet complicated and requires multidisciplinary approaches. The conventional dressing and skin graft showed no promise on complete wound closure. These urge the need for the exploration of electrical stimulation to supplement current wound care management. This review aims to provide an overview of electrical stimulation in wound healing. The mechanism of galvanotaxis related to wound repair will be reviewed at the cellular and molecular levels. Meanwhile, different modalities of externally applied electricity mimicking a physiologic electric field will be discussed and compared in vitro, in vivo, and clinically. With the emerging of tissue engineering and regenerative medicine, the integration of electroconductive biomaterials into modern miniaturised dressing is of interest and has become possible with the advancing understanding of smart biomaterials.

Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽  
2019 ◽  
Vol 39 (2) ◽  
pp. 9-18
Author(s):  
Wai Sze Ho ◽  
Wai Kuen Lee ◽  
Ka Kay Chan ◽  
Choi Ching Fong
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Negative Pressure Wound Therapy ◽  
Assessment Tool ◽  
Wound Care ◽  
Wound Therapy ◽  
Treatment Pathways ◽  
Wound Assessment ◽  
One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

Comparison of the ficus for the wound healing activity in various species

2020 ◽  
Vol 10 (4) ◽  
pp. 67-70
Author(s):  
Mothilal K ◽  
Akila CR ◽  
Mahender K ◽  
Chaitanya Kumar K ◽  
Ravi D
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Subcutaneous Tissue ◽  
Significant Activity ◽  
Herbal Extracts ◽  
Standard Drug ◽  
Excision Wound ◽  
Injuries And Wounds ◽  
Skin Conditions ◽  
Wound Healing Activity

Injuries and wounds are any sorts of damage to the skin or subcutaneous tissue. Usually, any wounds of such sorts are self-healed. Sometimes, there may be a delay in healing, and that delay is caused due to the functional delays in various processes of wound healing. All the Ficus plants show similar activities like the antioxidant, anti-inflammatory and wound healing properties 7including skin conditions like ulcers and rheumatism. The anthelmintic property and immunomodulatory are also seen. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. All the extracts showed a better healing ability, but the extract of FBO-100 showed the highest activity followed by FMO followed by FHO and finally the FRO. Overall, the activity of the extract ointment was comparable and was significant compared to the standard drug ointment. The wound closure of the extract ointment treated groups were better and were completed in 12 days, and the activity was more than 96%. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. The plants of microcarpa, benghalensis, religiosa and hispida are compared for the activity, and the order showed for the activity was FBO>FMO>FHO>FRO.

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