scholarly journals Moist wound dressing and its application in distant skin flap in cats

2021 ◽  
Vol 14 (3) ◽  
pp. 734-738
Author(s):  
Erwin Erwin ◽  
Etriwati Etriwati ◽  
Rumi Sahara Zamzami ◽  
Cindy Trie Permatasari Hosea
Keyword(s):  
Wound Dressing ◽  
Drug Effect ◽  
Skin Flap ◽  
Healing Process ◽  
Donor Site ◽  
Skin Flaps ◽  
Wound Debridement ◽  
Complex Process ◽  
Thoracic And Abdominal ◽  
Flap Closure

Background and Aim: Wound healing is a dynamic and complex process that requires an appropriate environment to promote healing process. The healing of distant flaps in cats is determined by vascularization, nutrient sufficiency for the cells, and stability of skin flaps. This study aims to evaluate the healing of distant flaps treated with moist wound dressing through subjective and objective observation in five cats with wounds in the forelimb and hindlimb area to determine the time to cut the skin flaps from the donor site. Materials and Methods: In this study, five Indonesian local cats with wounds of various sizes in the limb were brought to the Veterinary Teaching Hospital. The sterile wound treatment included the administration of anesthesia, wound debridement, and distant flap closure in the thoracic and abdominal area. The distant flap and time to cut the skin flaps from the donor site were evaluated through subjective and objective examinations. Results: The subjective observation on the color of the distant skin flaps showed redness and response to pain on day 3 after surgery, whereas the objective observation, which was based on drug absorption capability and drug effect showed good results. On day 7 after surgery, the skin flaps from the donor site were cut and showed good progress. Conclusion: Overall, moist dressing helps in stabilizing the distant flap, allowing the distant flaps from the donor site to be cut on day 7 after surgery.

scholarly journals Capsaicin on the viability of random-pattern skin flaps in rats

2010 ◽  
Vol 25 (5) ◽  
pp. 440-443 ◽  
Author(s):  
Gustavo Roberto de Godoy ◽  
Richard Eloin Liebano ◽  
Juliana Barbosa Corrêa ◽  
Bernardo Hochman ◽  
Lydia Masako Ferreira
Keyword(s):  
Surgical Procedure ◽  
Wistar Rats ◽  
Skin Flap ◽  
Donor Site ◽  
Control Group ◽  
Random Pattern ◽  
Skin Flaps ◽  
Flap Necrosis ◽  
Group A

PURPOSE: To evaluate the effects of capsaicin on the viability of ischemic random-pattern skin flaps in rats. METHODS:Forty EPM1-Wistar rats were randomized into two groups of 20 animals each, the capsaicin group and the control group. A random-pattern skin flap measuring 10 x 4cm was raised and a plastic barrier was placed between the flap and the donor site. After the surgical procedure, the control group was treated with an inert vehicle in the form of a cream applied uniformly to a rayon bandage which, in turn, was applied to the surface of the skin flap. The capsaicin group was treated in the same way, but in this case capsaicin was added to the cream. This procedure was repeated for two consecutive days. RESULTS: There was a significantly smaller amount of flap necrosis in the capsaicin group (35.07%) than in the control group (44.75%) (p=0.035). CONCLUSION:Topical administration of capsaicin improved the viability of ischemic random-pattern skin flaps in rats.

scholarly journals Application of WALANT technique for repairing finger skin defect with a random skin flap

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Jianhua Xu ◽  
Lu Yin ◽  
Shuming Cao ◽  
Haihua Zhan ◽  
Jianbing Zhang ◽  
...  
Keyword(s):  
Skin Flap ◽  
Donor Site ◽  
Operation Time ◽  
Pedicled Flap ◽  
Skin Defect ◽  
Skin Flaps ◽  
Abdominal Skin ◽  
Vas Score ◽  
Finger Skin ◽  
Wide Awake

Abstract Background Wide-awake local anesthesia no tourniquet (WALANT) technique has emerged among hand surgeons with other indications. Surgeries involving pedicled flap and revascularization are no longer used as contraindications. The present study aimed to evaluate the feasibility and merits of the WALANT technique in random skin flap surgery. Methods From May 2018 to March 2019, 12 patients with finger skin defects repaired with random skin flaps were reviewed. Abdominal skin flaps or thoracic skin flaps were used to cover the wound. Both the fingers and the donor sites were anesthetized by the WALANT technique. A 40-mL conventional volume consisted of a mixture of epinephrine and lidocaine. A volume of 5 mL was injected at the distal palmar for nerve block, the other 5 mL was injected around the wound for hemostasis, and the remaining was injected at the donor site of flaps for both analgesia and hemostasis. Baseline data with respect to sex, age, side, type of finger, donor sites, flap size, dosage of anesthetics, usage of finger tourniquet, intraoperative and postoperative pain, hemostasis effect, operation time, Disabilities of the Arm, Shoulder, and Hand Questionnaire (QuickDASH) score, and hospitalization expense, were collected. Results All patients tolerated the procedure, and none of them needed sedation. Single finger skin defect in 8 patients and double finger skin defect occurred in 4 patients; 5 patients were repaired by abdominal skin flaps, and 7 patients were repaired by thoracic skin flaps. The good surgical field visibility was 91.7%. All flaps survived adequately, without necrosis, pulling fingers out, and other complications. The average visual analog scale (VAS) score of the maximal pain was 1.1 in fingers vs. 2.1 in donor sites during the operation. On postoperative day one, the average VAS score of the maximal pain in fingers and donor sites was 1.3 and 1.1, respectively. The average hospitalization expense before reimbursement of the whole treatment was 11% less expensive compared to the traditional method. The average QuickDASH score was 9.1. Conclusions Under wide-awake anesthesia, patients have the ability to control their injured upper extremities consciously, avoiding the complications due to pulling flap pedicles. With the merits of safety, painlessness, less bleeding, and effectivity, the WALANT technique in random skin flaps is feasible and a reliable alternative to deal with finger skin defect.

Evaluating the Properties of an Alginate Wound Dressing for Skin Repair

2013 ◽  
Vol 683 ◽  
pp. 141-144 ◽  
Author(s):  
Rúben Pereira ◽  
Ausenda Mendes ◽  
Paulo J. Bártolo
Keyword(s):  
Wound Dressing ◽  
Healing Process ◽  
Aloe Vera ◽  
Skin Lesions ◽  
Synthetic Drugs ◽  
Skin Repair ◽  
Complex Process ◽  
Aloe Vera Gel ◽  
Therapeutic Properties ◽  
Calcium Alginate Gels

The treatment of skin lesions is a costly and complex process, for which different strategies are currently available. In this study, we investigated the properties of novel films composed of alginate and aloe vera gel for application as wound dressing material. The films combine the occlusive and haemostatic properties of calcium alginate gels with the therapeutic properties of aloe vera. We expect that these films may improve the healing process through the release of aloe vera compounds directly into the wound bed and could be an alternative to the administration of synthetic drugs to infected wounds. The films exhibited high transparency in both dry and wet state, as well as adequate mechanical properties for skin use. The results indicated that the films present great potential to be explored as wound dressing material.

Skin flaps

2021 ◽  
pp. 39-50
Author(s):  
Donald Dewar
Keyword(s):  
Blood Supply ◽  
Subcutaneous Tissue ◽  
Skin Flap ◽  
Donor Site ◽  
Pedicled Flap ◽  
Local Flaps ◽  
Skin Flaps ◽  
Local Skin ◽  
Recipient Vessel ◽  
Composite Defect

Flaps can reconstruct defects of the integument, resurface mucosal defects, as well as contribute to contour. They are used where grafting is not feasible because of the nature of the defect and/or where the aims of reconstruction would be better served by vascularized tissue with both cutaneous and subcutaneous components. A skin flap can also be combined with fascia, muscle, or bone to reconstruct a complex or composite defect, and to provide tissue to restore function. Flaps may be classified according to the origin of the flap: local skin flaps are raised from tissue adjacent to the defect (usually deriving their blood supply from the subcutaneous tissue and subdermal plexus), and distant flaps are raised on dedicated vascular pedicles from a non-contiguous region. A distant flap may be moved to the defect maintaining the continuity of the pedicle (a ‘regional’ or ‘pedicled’ flap) or as a free flap, where the flap is elevated from its remote donor site and the pedicle is divided to allow the flap to be transported ‘free’ to the defect and then the vascular continuity is re-established by anastomosis to a recipient vessel in the defect. This chapter focuses on local flaps.

scholarly journals Profil Darah Pada Kucing Selama Proses Kesembuhan Luka Melalui Teknik Skin Flaps Rotasi Yang Dirawat Dengan Dry Dressing Dan Moist Dressing

2020 ◽  
Vol 10 (1) ◽  
pp. 37
Author(s):  
Erwin Erwin ◽  
Rusli Rusli ◽  
Fidella Diva Jones
Keyword(s):  
Skin Flap ◽  
Healing Process ◽  
Treatment Method ◽  
Wound Healing Process ◽  
Skin Flaps ◽  
Blood Profile ◽  
Treatment Groups ◽  
Significant Difference ◽  
Group 2 ◽  
Method Group

The skin flap is one of the techniques employed to reconstruct defects and close wounds. This study aims to observe the blood profile in cats during the healing process of rotation skin flaps that were treated with a dry and moist dressing. This study used six male cats within the age of 1-2 years old and weighed among 2-4 kg, divided into two treatment groups. All of the specimens were treated with the following procedure; the fur on the abdominal area was shaved and disinfectant was applied to the area between the os sacrum and os femur, lastly, 2 cm2 triangle wound was deliberately made on the area. The treatment of the wound was done by the rotation skin flaps method. Group 1 was treated with sterile bandage and group 2 was treated with sofratulle®. Blood samples were taken from the cephalica antebrachii vein on the 1st, 3rd, 6th, and 12th days. The erythrocytes, hemoglobin, hematocrit, platelets, leukocytes, neutrophils, basophils, eosinophils, monocytes, and lymphocytes were counted by hematology analyzer. The results showed that there is a significant difference (P<0.05) in the increase of neutrophil levels between the group treated with sterile kassa (P-1) and the group treated with sofratulle® (P-2). The number of the cats’ red blood cells rose on the 3rd day and rose again on the 12th day after the treatment with a significant difference (P<0.05) during the observation. In conclusion, the rotation flaps treatment method with dry dressing and moist dressing in the wound healing process affected the cats’ blood profile and the moist dressing was preferred to the dry dressing. 

Bilateral caudal superficial epigastric skin flap and perineal urethrostomy for wound reconstruction secondary to traumatic urethral rupture in a cat

2011 ◽  
Vol 24 (02) ◽  
pp. 142-145 ◽  
Author(s):  
L. Findji ◽  
B. S. Clarke
Keyword(s):  
Skin Necrosis ◽  
Skin Flap ◽  
Clinical Signs ◽  
Skin Flaps ◽  
Wound Debridement ◽  
Retrograde Urethrography ◽  
Initial Injury ◽  
History Of ◽  
Large Wound ◽  
Urethral Rupture

SummaryUse of a bilateral caudal superficial epigastric skin flap and perineal urethrostomy for reconstruction of a wound which occurred secondary to rupture of the distal urethra and extravasation of urine is reported. A 10-month-old male neutered Domestic Shorthaired cat was presented with a history of trauma, signs of pain of the hind quarters and anuria. Progression of the clinical signs, including anuria, lethargy, anorexia, and azotemia, prompted referral and investigation 108 hours following the initial injury. Retrograde urethrography indicated a rupture of the distal pelvic urethra with extravasation of urine subcutaneously. Development of extensive skin necrosis of the perineum and rump progressed leaving a large wound defect which was managed with wound debridement and dressing. The wound was closed using staged caudal superficial epigastric skin flaps and perineal urethrostomy as part of the reconstruction.

A Comprehensive Review On Alginate As Wound Dressing Biomaterial

2020 ◽  
Vol 04 ◽  
Author(s):  
Sourav Mohanto ◽  
Prithviraj Chakraborty ◽  
Chidambaram Soundra Pandian ◽  
Shubhradeep Manna ◽  
Joni Dutta
Keyword(s):  
Therapeutic Efficacy ◽  
Wound Dressing ◽  
Chronic Wound ◽  
Healing Process ◽  
Wound Healing Process ◽  
Detailed Knowledge ◽  
Pathophysiological Mechanisms ◽  
Moist Environment ◽  
Bioactive Agents ◽  
Mechanical Nature

Background: The design and characteristics of alginate biomaterial have a significant role in wound dressing and tissue regeneration. The ideal biomaterial for wound dressing must have biodegradable, biocompatible, non-inflammatory, non-toxic. Objective: Wound dressing should promote the re-epithelization and protect the wound for further infection by creating a moist environment. The physical and mechanical nature of the alginate biopolymer has the potential to influence the pathophysiological mechanisms in the chronic wound actively. The application of this biomaterial provides an ampule advantage to synthetic polymers. Method: The wound healing process is a critical step involved in different phases. The presence of cross-linkers, polymers along with alginate lead to a decrease in the mechanical property of dressing. Hence the effective material choosing along with alginate is a very critical decision. The therapeutic efficacy of the alginate dressing system (film, hydrogel, wafer, etc.) influenced by the incorporation of different materials such as bioactive agents, nanoparticles, cross-linker, nature of the excipients, etc. Results: The ion exchange occurring between dressing and exudates resulted in the formation of gel, due to the glucuronic acid presence in alginate. This gel absorbs moisture and maintains an appropriate moist environment and actively influence the pathophysiological mechanisms in the chronic wound. Conclusion: This review gives a detailed knowledge of the researchers to work with alginate and provides knowledge about the incorporation of the appropriate material and their therapeutic efficacy in wound dressing.

Punch Grafting for the Management of Hard-to-Heal Diabetic Foot Ulcers: A Prospective Case Series

2021 ◽  
pp. 153473462110310
Author(s):  
Marta García-Madrid ◽  
Irene Sanz-Corbalán ◽  
Aroa Tardáguila-García ◽  
Raúl J. Molines-Barroso ◽  
Mateo López-Moral ◽  
...  
Keyword(s):  
Wound Healing ◽  
Clinical Outcomes ◽  
Diabetic Foot ◽  
Donor Site ◽  
Case Series ◽  
Foot Ulcers ◽  
Diabetic Foot Ulcers ◽  
Wound Debridement ◽  
Prospective Case Series

Punch grafting is an alternative treatment to enhance wound healing which has been associated with promising clinical outcomes in various leg and foot wound types. We aimed to evaluate the clinical outcomes of punch grafting as a treatment for hard-to-heal diabetic foot ulcers (DFUs). Six patients with chronic neuropathic or neuroischemic DFUs with more than 6 months of evolution not responding to conventional treatment were included in a prospective case series between May 2017 and December 2020. All patients were previously debrided using an ultrasound-assisted wound debridement and then, grafted with 4 to 6 mm punch from the donor site that was in all cases the anterolateral aspect of the thigh. All patients were followed up weekly until wound healing. Four (66.7%) DFUs were located in the heel, 1 (16.7%) in the dorsal aspect of the foot and 1 (16.7%) in the Achilles tendon. The median evolution time was 172 (interquartile range [IQR], 25th-75th; 44-276) weeks with a median area of 5.9 (IQR; 1.87-37.12) cm2 before grafting. Complete epithelization was achieved in 3 (50%) patients at 12 weeks follow-up period with a mean time of 5.67 ± 2.88 weeks. Two of the remaining patients achieved wound healing at 32 and 24 weeks, respectively, and 1 patient showed punch graft unsuccessful in adhering. The median time of wound healing of all patients included in the study was 9.00 (IQR; 4.00-28.00) weeks. The wound area reduction (WAR) at 4 weeks was 38.66% and WAR at 12 weeks was 88.56%. No adverse effects related to the ulcer were registered through the follow-up period. Autologous punch graft is an easy procedure that promotes healing, achieving wound closure in chronic DFUs representing an alternative of treatment for hard-to-heal DFUs in which conservative treatment has been unsuccessful.

scholarly journals Preclinical efficacy of stem cell therapy for skin flap: a systematic review and meta-analysis

2021 ◽  
Vol 12 (1) ◽  
Author(s):  
Yuan Li ◽  
Qi-lin Jiang ◽  
Leanne Van der Merwe ◽  
Dong-hao Lou ◽  
Cai Lin
Keyword(s):  
Systematic Review ◽  
Stem Cells ◽  
Stem Cell ◽  
Survival Rate ◽  
Meta Analysis ◽  
Skin Flap ◽  
Cochrane Library ◽  
Skin Flaps ◽  
Cell Based Therapy ◽  
Stem Cell Treatment

Abstract Background A skin flap is one of the most critical surgical techniques for the restoration of cutaneous defects. However, the distal necrosis of the skin flap severely restricts the clinical application of flap surgery. As there is no consensus on the treatment methods to prevent distal necrosis of skin flaps, more effective and feasible interventions to prevent skin flaps from necrosis are urgently needed. Stem therapy as a potential method to improve the survival rate of skin flaps is receiving increasing attention. Methods This review followed the recommendations from the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statements. Twenty studies with 500 animals were included by searching Web of Science, EMBASE, PubMed, and Cochrane Library databases, up until October 8, 2020. Moreover, the references of the included articles were searched manually to obtain other studies. All analyses were conducted using Review Manager V.5.3 software. Results Meta-analysis of all 20 studies demonstrated stem cell treatment has significant effects on reducing necrosis of skin flap compared with the control group (SMD: 3.20, 95% CI 2.47 to 3.93). Besides, subgroup analysis showed differences in the efficacy of stem cells in improving the survival rate of skin flaps in areas of skin flap, cell type, transplant types, and method of administration of stem cells. The meta-analysis also showed that stem cell treatment had a significant effect on increasing blood vessel density (SMD: 2.96, 95% CI 2.21 to 3.72) and increasing the expression of vascular endothelial growth factor (VEGF, SMD: 4.34, 95% CI 2.48 to 6.1). Conclusions The preclinical evidence of our systematic review indicate that stem cell-based therapy is effective for promoting early angiogenesis by up regulating VEGF and ultimately improving the survival rate of skin flap. In summary, small area skin flap, the administration method of intra-arterial injection, ASCs and MSCs, and xenogenic stem cells from humans showed more effective for the survival of animal skin flaps. In general, stem cell-based therapy may be a promising method to prevent skin flap necrosis.

scholarly journals Keratin Scaffolds Containing Casomorphin Stimulate Macrophage Infiltration and Accelerate Full-Thickness Cutaneous Wound Healing in Diabetic Mice

Molecules ◽  
2021 ◽  
Vol 26 (9) ◽  
pp. 2554
Author(s):  
Marek Konop ◽  
Anna K. Laskowska ◽  
Mateusz Rybka ◽  
Ewa Kłodzińska ◽  
Dorota Sulejczak ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Dressing ◽  
Healing Process ◽  
Skin Wound ◽  
Wound Healing Process ◽  
Diabetic Mice ◽  
Full Thickness ◽  
Skin Wound Healing ◽  
Impaired Wound Healing

Impaired wound healing is a major medical challenge, especially in diabetics. Over the centuries, the main goal of tissue engineering and regenerative medicine has been to invent biomaterials that accelerate the wound healing process. In this context, keratin-derived biomaterial is a promising candidate due to its biocompatibility and biodegradability. In this study, we evaluated an insoluble fraction of keratin containing casomorphin as a wound dressing in a full-thickness surgical skin wound model in mice (n = 20) with iatrogenically induced diabetes. Casomorphin, an opioid peptide with analgesic properties, was incorporated into keratin and shown to be slowly released from the dressing. An in vitro study showed that keratin-casomorphin dressing is biocompatible, non-toxic, and supports cell growth. In vivo experiments demonstrated that keratin-casomorphin dressing significantly (p < 0.05) accelerates the whole process of skin wound healing to the its final stage. Wounds covered with keratin-casomorphin dressing underwent reepithelization faster, ending up with a thicker epidermis than control wounds, as confirmed by histopathological and immunohistochemical examinations. This investigated dressing stimulated macrophages infiltration, which favors tissue remodeling and regeneration, unlike in the control wounds in which neutrophils predominated. Additionally, in dressed wounds, the number of microhemorrhages was significantly decreased (p < 0.05) as compared with control wounds. The dressing was naturally incorporated into regenerating tissue during the wound healing process. Applied keratin dressing favored reconstruction of more regular skin structure and assured better cosmetic outcome in terms of scar formation and appearance. Our results have shown that insoluble keratin wound dressing containing casomorphin supports skin wound healing in diabetic mice.

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