Comparison of vacuum assisted closure therapy with conventional dressing in the management of necrotizing fasciitis wound

Background: The purpose of our study was to compare the effect of vacuum assisted closure (VAC) therapy and conventional dressings in patients with open wounds due to necrotizing fasciitis (NF) on the basis of healing rate, infection control, frequency of dressing and pain score.Methods: The study evaluated 50 patients admitted with NF requiring surgery over a period of 18 months. The patients were randomized to two groups. In group A patients, the wounds were managed with conventional dressings and in group B patients, negative pressure wound therapy (NPWT) was applied. Serial assessment of both groups was done for four weeks. The parameters including size of wound, wound bed, granulation tissue formation, color, amount and odor of exudate, edema, frequency of dressing, re-debridement and pain were monitored and analysed.Results: In our study, patients with NF wounds who underwent VAC therapy had earlier granulation tissue formation, resolution of infection and readiness for skin grafting. The frequency of dressing, requirement of re-debridement, resolution of edema, odor, skin maceration, inflammation around wound and pain significantly reduced in group B (VAC) when compared to conventional dressing group.Conclusions: When compared to the conventional dressing on NF wound, application of VAC helped in early appearance of granulation tissue, significant reduction of inflammation, wound odor, exudate, need for re-debridement, frequency of dressing and pain. Thus, VAC dressing can be considered as a better option in the management of NF wounds.

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Therapeutic effect of local photothermal heating of gold nanoparticle-coated self-expandable metallic stents for suppressing granulation tissue formation in the mouse colon

PLoS ONE ◽

10.1371/journal.pone.0249530 ◽

2021 ◽

Vol 16 (4) ◽

pp. e0249530

Author(s):

Yeong-Cheol Heo ◽

Dong-Kyoon Han ◽

Min Tae Kim

Keyword(s):

Therapeutic Effect ◽

Granulation Tissue ◽

Stent Placement ◽

Local Heating ◽

Tissue Formation ◽

Sems Placement ◽

Granulation Tissue Formation ◽

Mouse Colon ◽

Group A ◽

Group B

Purpose To investigate the therapeutic effect of local photothermal (PT) heating on suppression of stent-induced granulation tissue formation in mouse colon. Materials and methods A gold nanoparticle (GNP)-coated self-expandable metallic stent (SEMS) was prepared using a two-step synthesis process for local PT heating under near-infrared laser irradiation. Twenty-four mice were randomly divided into two groups of 12 and subjected to SEMS placement in the colon. Group A received a GNP-coated SEMS without local heating and Group B received a GNP-coated SEMS and underwent local heating at 55°C after SEMS placement. The therapeutic effect of local heating was assessed by comparing the histopathological, immunohistochemical, and endoscopic results. Results Four mice were excluded because of stent migration (n = 3, group B) or death (n = 1, group A). Stent-induced granulation tissue-related variables were significantly lower in group B than in group A (p < 0.001). In vivo endoscopic images, 4 weeks after stent placement, showed granulation tissue formation over the wire mesh in group A and relatively good patency of the stented colon with no definite irregularities in group B. There was more vascular endothelial growth factor (VEGF) positivity in group A than in group B. Conclusion Local PT heating suppresses granulation tissue formation after stent placement in mouse colon.

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Surgical outcomes in acute dacryocystitis patients undergoing endonasal endoscopic dacryocystorhinostomy with or without silicone tube intubation

International Journal of Ophthalmology ◽

10.18240/ijo.2021.06.08 ◽

2021 ◽

Vol 14 (6) ◽

pp. 844-848

Author(s):

Bo Yu ◽

◽

Jia-Ying Sun ◽

Qian Ye ◽

Yun-Hai Tu ◽

...

Keyword(s):

Granulation Tissue ◽

Tissue Formation ◽

Success Rates ◽

Granulation Tissue Formation ◽

Treatment Groups ◽

Group A ◽

Silicone Intubation ◽

Silicone Tube Intubation ◽

Group B

AIM: To establish the necessity of silicone tube intubation in acute dacryocystitis (AD) patients undergoing endonasal endoscopic dacryocystorhinostomy (En-DCR). METHODS: Patients presenting with unilateral AD were randomly assigned to two treatment groups. En-DCR procedures were performed following lacrimal abscess formation, with the operation being performed with silicone intubation for patients in group B but not group A. Functional success was defined by an absence of additional AD episodes, no epiphora, and ostium patency as established via endoscopic evaluation or fluorescein irrigation. Operative success rates and demographic variables were compared between treatment groups. RESULTS: In total, 66 patients were analyzed in the present study (33 per group), with complete postoperative data having been successfully collected from 27 and 22 patients in group A and group B, respectively. All patients exhibited complete resolution of acute inflammation. Upon follow-up, granulation tissue was detected around the ostium at higher rates in group B (9/22, 40.9%) relative to group A (4/27, 14.8%). At the 12-month follow-up time point, patients in group A exhibited higher success rates (25/27, 92.6%) relative to patients in group B (20/22, 90.9%), but this difference was not significant. Cases of lacrimal passage reconstruction failure in both groups were attributed to excessive fibrous and/or granulation tissue formation proximal to the intranasal ostium. CONCLUSION: Given that these two operative approaches are associated with similar rates of operative success and in light of differences in granulation tissue formation, cost, and operative duration, these data do not support the routine silicone intubation of AD patients following En-DCR surgery.

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KHASIAT DAUN BINAHONG (Anredera cordifolia (Ten.) Steenis) TERHADAP PEMBENTUKAN JARINGAN GRANULASI DAN REEPITELISASI PENYEMBUHAN LUKA TERBUKA KULIT KELINCI

Jurnal e-Biomedik ◽

10.35790/ebm.1.2.2013.3250 ◽

2014 ◽

Vol 1 (2) ◽

Author(s):

Suci Ariani

Keyword(s):

Wound Healing ◽

Granulation Tissue ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Temperature Changes ◽

Traditional Medicines ◽

Epithelial Regeneration ◽

Microscopic Features ◽

Group A ◽

Group B

Latar Belakang: Luka merupakan keadaan dimana kontinuitas jaringan rusak oleh karena trauma dari benda tajam atau tumpu, perubahan suhu, kimiawi, listrik, radiasi, atau gigitan hewan. Proses penyembuhan luka bisa dipercepat dengan menggunakan pengobatan tradisional, salah satunya adalah tanaman binahong (Anredera cordifolia (Ten.) Steenis). Tujuan: Untuk melihat khasiat daun binahong terhadap pembentukan jaringan granulasi dan reepitelisasi penyembuhan luka terbuka kulit kelinci secara makroskopik dan mikroskopik. Metode: Penelitian ini menggunakan metode eksperimental dengan subjek 5 ekor kelinci. Satu ekor kelinci untuk meilhat struktur jaringan kulit normal kelinci. Empat ekor kelinci dibuat luka, pada punggung kanan diberikan daun binahong dan luka pada punggung kiri tidak diberikan daun binahong. Kelompok A terdiri dari dua ekor kelinci yang diambil dan dilihat jaringan luka pada hari kelima, kelompok B terdiri dari dua ekor kelinci yang diambil dan dilihat jaringan lukanya pada hari ke-14. Hasil: Secara makroskopik luka yang diberi daun binahong terlihat lebih kecil dan kering, sedangkan yang tidak diberi daun binahong terlihat luka masih dalam, dan kemerahan. Secara mikroskopik luka yang diberi daun binahong terbentuk jaringan granulasi yang lebih banyak dan reepitelisasi lebih cepat dibandingkan dengan yang tidak diberi daun binahong. Simpulan: Pemberian daun binahong pada luka membantu penyembuhan luka dengan pembentukan jaringan granulasi yang lebih banyak dan reepitelisasi terjadi lebih cepat dibandingkan dengan luka yang tidak diberi daun binahong.Kata Kunci: Luka terbuka, daun binahong, jaringan granulasi, reepitelisasi.Background: Wound is a condition when the continuity of tissue are damaged by the trauma of sharp or blunt objects, temperature changes, chemicals, electricity, radiation, or animal bites. The process of wound healing can be accelerated by using traditional medicines, one of them is a plant called Binahong (Anredera cordifolia (Ten.) Steenis). Objective: To observe the influences of binahong leaf in granulation tissue formation and epithelial regeneration of an open wound healing of skin rabbit, both macroscopic and microscopic features. Method: Experimental research employed five adult rabbits as the subject: one rabbit as a control – to observe the structure of rabbit skin tissue. The four rabbits are made wounds, to the back right were given binahong leafs and wounds to the back left were not. Group A and B - two rabbits in each group. Rabbits in group A are used to observe the wounded tissue in the fifth day. Rabbits in group B are used to observe the wounded tissue in the fourteenth day. Results: The macroscopic result of wounds with binahong had smaller shape and dry, while the wound without binahong leafs are still look deeper, wet, and redness. By microscopic examination, wounds with binahong leafs formed granulation tissue and epithelial regeneration more and faster than those which not given binahong leafs. Conclusions: Binahong leafs help in healing the wounds with forming more granulation tissue and faster in epithelial regeneration than the wounds without binahong leafs.Keywords: Open wounds, binahong leaf, granulation tissue, epithelial regeneration.

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Photothermal Therapy via a Gold Nanoparticle-Coated Stent for Treating Stent-Induced Granulation Tissue Formation in the Rat Esophagus

10.21203/rs.3.rs-133808/v1 ◽

2020 ◽

Author(s):

Young Chul Cho ◽

Jeon Min Kang ◽

Wooram Park ◽

Dong-Hyun Kim ◽

Ji Hoon Shin ◽

...

Keyword(s):

Gold Nanoparticle ◽

Granulation Tissue ◽

Stent Placement ◽

Photothermal Therapy ◽

Near Infrared ◽

Local Heating ◽

Metallic Stent ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Group A

Abstract Minimally invasive therapies using stent technology are currently limited by stent-induced granulation tissue formation adjacent to the stent. The effectiveness of photothermal therapy (PTT) using a gold nanoparticle (AuNP)-coated stent for treating stent-induced granulation tissue formation in the rat esophagus was investigated. All experiments were approved by the animal research committee of our institution. An AuNP-coated, self-expandable metallic stent (SEMS) was produced to conduct PTT under near-infrared laser irradiation. Forty rats were randomly divided into four groups (10 rats each). The animals in group A (non-coated SEMS) and group B (AuNP-coated SEMS with local heating at 65°C at 4 weeks) were sacrificed 4 weeks after stent placement. The rats in group C (AuNP-coated SEMS with local heating at 65°C at 4 weeks) and group D (AuNP-coated SEMS with local heating at 65°C at 4 and 8 weeks) were sacrificed 8 weeks after stent placement. The effectiveness of local heating was assessed by histopathology. All procedures were successful in all of the animals. Seven rats were excluded because of stent migration (n = 2) and death (n = 5). Granulation tissue formation-related variables were significantly higher in group A than in groups B-D (all p < 0.05). HSP70 and TUNEL expression were significantly lower in group A than in groups B-D (all p < 0.05). Granulation tissue formation-related variables were significantly higher in group C than in groups B and D (all p < 0.05). PTT using AuNP-coated SEMS successfully treated granulation tissue formation after stent placement in the rat esophagus.

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A comparative study of phenytoin dressing versus honey dressing in the treatment of cronic ulcers in tertiary care hospital

Medpusle International Journal of Surgery ◽

10.26611/1061912 ◽

2021 ◽

Vol 19 (1) ◽

pp. 05-09

Author(s):

Sandesh M ◽

Keyword(s):

Wound Healing ◽

Granulation Tissue ◽

Chronic Wounds ◽

Tertiary Care ◽

Skin Grafting ◽

Care Hospital ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Diabetic Ulcers

Background: Diabetic foot infections are the leading cause of hospitalization morbidity and mortality in diabetics worldwide In India it accounts for 20% of hospitalizations. honey has been investigated to treat ulcers like pressure ulcers, venous ulcers, diabetic ulcers, traumatic wounds and burns. Phenytoin is also now known to promote wound healing and can be an alternative to normal saline specifically in chronic wounds related to diabetes. The present study compares these two modalities in management of diabetic ulcers. Objective: To compare the efficacy of topical phenytoin vs topical honey in chronic diabetic ulcers in terms of rate of wound healing, granulation tissue formation and quality of graft bed for skin grafting. Methods: A comparative prospective study of 50 patients with chronic diabetic ulcers selected based on a predefined criteria divided into two groups: Group A (Phenytoin group) (n=25) and Group B (honey group) (n=25). Final wound area was measured on 30th day. Comparison between the wound size reduction among two groups done at end of 30th day. Outcome was measured in terms of wound reduction, granulation tissue formation and quality of bed for skin grafting between the two groups. Results: This study has shown faster rate of wound healing, better granulation tissue formation and quality graft bed for skin grafting in patients who received topical phenytoin dressing as compared to topical honey dressing.

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COMPARATIVE STUDY OF ROLE OF WOUND OUTCOME IN VACUUM ASSISTED CLOSURE OF WOUNDS TO CLASSICAL (MOIST) WOUND CLOSURES

International Journal of Medical and Biomedical Studies ◽

10.32553/ijmbs.v5i6.1961 ◽

2021 ◽

Vol 5 (6) ◽

Author(s):

Aprajita Kumari ◽

Atul Vyas

Keyword(s):

Granulation Tissue ◽

Average Rate ◽

Maximum Length ◽

Research Centre ◽

Tissue Formation ◽

Vacuum Assisted Closure ◽

Maximum Width ◽

Granulation Tissue Formation ◽

Group I ◽

Group Ii

Background & Method: This study is conducted at General Surgery department of Index Medical College Hospital and Research Centre, Indore (M.P.) To Analysis of wound outcome in Vacuum assisted closure of wounds in comparison to classical (moist) wound closure in terms of rate of granulation tissue formation, culture at presentation, complications and recommendations. The wound of the patient was assessed by measuring the maximum length and maximum width of the wound. Then on day 7th, 14th and day 21st, the maximum length and maximum width of the granulation tissue covering the same wound was measured. Result: In Group I Mean age of patients is 39 ± 13 years and in Group II it is 42 ± 14 years. In Group I and Group II there is no difference in the gender wise distribution. The most common disease in both the groups I and II is bed sore followed by compound fractures. The most common organism on culture in group I is S. aureus (9) followed by polymicrobial growth (7), and in group II is S. aureus (10) followed by E.coli (7). The average rate of granulation in group I on day 7th is 27.63 ± 23.23, on day 14th it increased to 35.92 ± 25.75, and on day 21st it further increased to 65.6 ± 15.20. The average rate of granulation in group II on day 7th is 31.34 ± 18.22, on day 14th it is increased to 57.4 ± 17.55, and on day 21st it further increased to 75.16 ± 6.732. Group I had higher number of complications (8) in comparison to group II (6). There is no complication in 44 patients of group II and 42 patients of group I. Conclusion: In our present study it was concluded that the rate of granulation tissue formation was better in the VAC group in comparison to the conventional dressing group. Vacuum assisted closure dressing was found to be totally safe, although technically demanding. Thus, we conclude that the surgeon’s discretion is very much needed in VAC being the choice of dressings in certain wounds and where there is much difficulty in performing VAC dressings, the conventional dressings should be the choice. Keywords: wound, vacuum, moist & outcome.

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Photothermal therapy via a gold nanoparticle-coated stent for treating stent-induced granulation tissue formation in the rat esophagus

Scientific Reports ◽

10.1038/s41598-021-90182-x ◽

2021 ◽

Vol 11 (1) ◽

Author(s):

Young Chul Cho ◽

Jeon Min Kang ◽

Wooram Park ◽

Dong-Hyun Kim ◽

Ji Hoon Shin ◽

...

Keyword(s):

Gold Nanoparticle ◽

Granulation Tissue ◽

Stent Placement ◽

Photothermal Therapy ◽

Near Infrared ◽

Local Heating ◽

Metallic Stent ◽

Tissue Formation ◽

Granulation Tissue Formation ◽

Group A

AbstractMinimally invasive therapies using stent technology are currently limited by stent-induced granulation tissue formation adjacent to the stent. The effectiveness of photothermal therapy (PTT) using a gold nanoparticle (AuNP)-coated stent for treating stent-induced granulation tissue formation in the rat esophagus was investigated. All experiments were approved by the animal research committee of our institution. An AuNP-coated, self-expandable metallic stent (SEMS) was produced to conduct PTT under near-infrared laser irradiation. Forty rats were randomly divided into four groups (10 rats each). The animals in group A (non-coated SEMS) and group B (AuNP-coated SEMS with local heating at 65 °C at 4 weeks) were sacrificed 4 weeks after stent placement. The rats in group C (AuNP-coated SEMS with local heating at 65 °C at 4 weeks) and group D (AuNP-coated SEMS with local heating at 65 °C at 4 and 8 weeks) were sacrificed 8 weeks after stent placement. The effectiveness of local heating was assessed by histopathology. All procedures were successful in all of the animals. Seven rats were excluded because of stent migration (n = 2) and death (n = 5). Granulation tissue formation-related variables were significantly higher in group A than in groups B–D (all p < 0.05). Heat-shock protein 70 (HSP70) and TUNEL expression were significantly lower in group A than in groups B–D (all p < 0.05). Granulation tissue formation-related variables were significantly higher in group C than in groups B and D (all p < 0.05). PTT using AuNP-coated SEMS successfully treated granulation tissue formation after stent placement in the rat esophagus.

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Is vacuum assisted closure dressing better than conventional management of diabetic wounds?

International Surgery Journal ◽

10.18203/2349-2902.isj20182222 ◽

2018 ◽

Vol 5 (6) ◽

pp. 2199

Author(s):

Abhijit Bagul ◽

Nandkishor Narwade ◽

Ankit Bhupatkar ◽

Sridevi Murali ◽

Yashraj Shah

Keyword(s):

Granulation Tissue ◽

Foot Ulcers ◽

Vacuum Therapy ◽

Vacuum Assisted Closure ◽

Prolonged Length ◽

Early Appearance ◽

Patients With Diabetes ◽

Group A ◽

Group B ◽

Diabetic Wounds

Background: Foot ulcers are a major cause of hospitalization in patients with Diabetes Mellitus (DM) which increases hospital stay because of multiple surgical procedures, prolonged length of stay. The objectives of this study were to test the conventional therapy for diabetic wounds with respect to time and wound healing, to compare the outcomes of the two methods after a stipulated period and to prove the efficacy of one method over the other by appropriate statistical methods at the end of data collection.Methods: A prospective randomized hospital based observational study of 47 patients was conducted at the Hospital of D. Y. Patil University School of Medicine, Nerul, Navi Mumbai, Maharashtra, India for a period of 24 months (June 2014 to June 2016). All these 47 patients were studied, and the data was statistically evaluated to determine the efficacy of vacuum assisted closure in healing of diabetic wounds and to compare it with conventional method of treatment of diabetic wounds. The patients were divided into 2 groups, Group ‘A’ which consisted of 22 who received Vacuum Therapy (VAC), Group ‘B’ which consisted of 25 and received conventional dressing.Results: The patients on VAC therapy had early appearance of granulation tissue as compared to patients treated by Conventional dressing (90.9% Vs 76% at the end of one week. All patients developed granulation tissue by the end of 2 weeks.Conclusions: We thus conclude that VAC appears to be superior compared to conventional dressings in the treatment of diabetic foot ulcers in terms of early appearance of granulation tissue and decrease in wound depth.

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A Novel Autologous Micrografts Technology in Combination with Negative Pressure Wound Therapy (NPWT) for Quick Granulation Tissue Formation in Chronic/Refractory Ulcer

Healthcare ◽

10.3390/healthcare8040513 ◽

2020 ◽

Vol 8 (4) ◽

pp. 513

Author(s):

Satoshi Takagi ◽

Takuto Oyama ◽

Shiro Jimi ◽

Arman Saparov ◽

Hiroyuki Ohjimi

Keyword(s):

Combination Therapy ◽

Granulation Tissue ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Ulcer Patient ◽

Skin Grafting ◽

Tissue Formation ◽

Wound Therapy ◽

Granulation Tissue Formation ◽

Wide Range

Negative pressure wound therapy (NPWT) has been commonly used over the years for a wide range of chronic/refractory lesions. Alternatively, autologous micrografting technology is recently becoming a powerful modality for initiating wound healing. The case presented is of a patient with a lower leg ulcer that had responded poorly to NPWT alone for three weeks. Consequently, the patient was put on a combination therapy of NPWT and micrografting. After injection of a dermal tissue micrografts suspension into the entire wound bed, NPWT was performed successively for two weeks, resulting in fresh granulation tissue formation. Thereafter, the autologous skin graft was taken well. This case study indicates that for a chronic/refractory ulcer patient with poor NPWT outcome, combination therapy using micrografting treatment and NPWT could rapidly initiate and enhance granulation tissue formation, creating a favorable bedding for subsequent skin grafting.

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Vacuum-assisted closure versus moist dressings in the treatment of diabetic wound ulcers after partial foot amputation: A retrospective analysis in 65 patients

Journal of Orthopaedic Surgery ◽

10.1177/2309499018799769 ◽

2018 ◽

Vol 26 (3) ◽

pp. 230949901879976 ◽

Cited By ~ 1

Author(s):

Erhan Sukur ◽

Abdulhalim Akar ◽

Ahmet Çagrı Uyar ◽

Ozgur Cicekli ◽

Alauddin Kochai ◽

...

Keyword(s):

Weight Bearing ◽

Wound Dressings ◽

Diabetic Patients ◽

Diabetic Wound ◽

Vacuum Assisted Closure ◽

Vac Therapy ◽

Significant Difference ◽

Group A ◽

Group B ◽

Partial Foot Amputation

Purpose: Changes in weight-bearing patterns after partial foot amputations may lead to new localized high-pressure points and keratosis due to ulcerations in patients with neuropathies and hypovascular limbs. As a result, diabetic foot ulcers (DFUs) after partial foot amputations are very complex. The aim of this study was to compare the effectiveness of vacuum-assisted closure (VAC) therapy with conventional moist wound dressings in the treatment of diabetic wound ulcers after partial foot amputations. Methods: Sixty-five diabetic patients with a DFU, who had previously undergone partial foot amputation surgery, were assigned to treatment with VAC (group A: 31 patients) or conventional wound moist dressing (group B: 34 patients). The final results were considered as failed treatment if reamputation was required. Conversely, reaching 90% of wound granulation was considered to be a successful endpoint. Results: The average time to reach 90% granulation tissue was significantly lower in group A (7.8 ± 1.2 weeks vs. 11.1 ± 1.2 weeks; p < 0.001). However, there was no significant difference regarding the reamputation requirements; 38.7% (12 patients) in group A and 41.2% (14 patients) in group B, ( p = 0.839). Conclusion: The results of this study allowed us to conclude that VAC therapy system appears to be an effective treatment for patients with complex DFUs who had previously undergone partial foot amputation.

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