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 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.

scholarly journals Eradication of Mature Bacterial Biofilms with Concurrent Improvement in Chronic Wound Healing Using Silver Nanoparticle Hydrogel Treatment

Biomedicines ◽  
2021 ◽  
Vol 9 (9) ◽  
pp. 1182
Author(s):  
Hanif Haidari ◽  
Richard Bright ◽  
Sanjay Garg ◽  
Krasimir Vasilev ◽  
Allison J. Cowin ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Wound Closure ◽  
In Vivo Studies ◽  
Release Mechanism ◽  
Impaired Wound Healing ◽  
Biofilm Model ◽  
Infected Wounds ◽  
Delivery Platform

Biofilm-associated infections are a major cause of impaired wound healing. Despite the broad spectrum of anti-bacterial benefits provided by silver nanoparticles (AgNPs), these materials still cause controversy due to cytotoxicity and a lack of efficacy against mature biofilms. Herein, highly potent ultrasmall AgNPs were combined with a biocompatible hydrogel with integrated synergistic functionalities to facilitate elimination of clinically relevant mature biofilms in-vivo combined with improved wound healing capacity. The delivery platform showed a superior release mechanism, reflected by high biocompatibility, hemocompatibility, and extended antibacterial efficacy. In vivo studies using the S. aureus wound biofilm model showed that the AgNP hydrogel (200 µg/g) was highly effective in eliminating biofilm infection and promoting wound repair compared to the controls, including silver sulfadiazine (Ag SD). Treatment of infected wounds with the AgNP hydrogel resulted in faster wound closure (46% closure compared to 20% for Ag SD) and accelerated wound re-epithelization (60% for AgNP), as well as improved early collagen deposition. The AgNP hydrogel did not show any toxicity to tissue and/or organs. These findings suggest that the developed AgNP hydrogel has the potential to be a safe wound treatment capable of eliminating infection and providing a safe yet effective strategy for the treatment of infected wounds.

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.

Wound Care

2018 ◽  
pp. 27-40
Author(s):  
Amit Ramjit ◽  
Saad Shebrain
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Healing Process ◽  
Repair Process ◽  
Wound Healing Process ◽  
Invasive Procedures ◽  
Previous Trauma ◽  
Life Threatening ◽  
History Of ◽  
Patient At Risk

The skin and subcutaneous tissues protect the body from the external environment. Invasive procedures compromise the skin, necessitating these structures to heal which restores their protective function. Skin undergoes a systematic physiologic and predictable repair process. However, pathological conditions such as infection result in abnormal wound healing, which requires the healthcare provider to monitor the wound-healing process closely. Failure in wound healing can place the patient at risk for deeper infection, life-threatening complications such as necrotizing fasciitis (NF), and cosmetically unacceptable wounds. Abnormal healing outcomes, such as a history of keloid or hypertrophic scarring from previous trauma or invasive procedures, give the clinician clues to managing additional procedures properly. Knowledge of wound care techniques such as dressings allows the clinician to manage wounds properly during the repair process.

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 A central role for vimentin in regulating repair function during healing of the lens epithelium

2014 ◽  
Vol 25 (6) ◽  
pp. 776-790 ◽  
Author(s):  
A. S. Menko ◽  
B. M. Bleaken ◽  
A. A. Libowitz ◽  
L. Zhang ◽  
M. A. Stepp ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Repair ◽  
Wound Closure ◽  
Cell Function ◽  
Healing Process ◽  
Critical Role ◽  
Focal Adhesions ◽  
Lens Epithelium ◽  
Wound Healing Process ◽  
Vimentin Filaments

Mock cataract surgery provides a unique ex vivo model for studying wound repair in a clinically relevant setting. Here wound healing involves a classical collective migration of the lens epithelium, directed at the leading edge by an innate mesenchymal subpopulation of vimentin-rich repair cells. We report that vimentin is essential to the function of repair cells as the directors of the wound-healing process. Vimentin and not actin filaments are the predominant cytoskeletal elements in the lamellipodial extensions of the repair cells at the wound edge. These vimentin filaments link to paxillin-containing focal adhesions at the lamellipodial tips. Microtubules are involved in the extension of vimentin filaments in repair cells, the elaboration of vimentin-rich protrusions, and wound closure. The requirement for vimentin in repair cell function is revealed by both small interfering RNA vimentin knockdown and exposure to the vimentin-targeted drug withaferin A. Perturbation of vimentin impairs repair cell function and wound closure. Coimmunoprecipitation analysis reveals for the first time that myosin IIB is associated with vimentin, linking vimentin function in cell migration to myosin II motor proteins. These studies reveal a critical role for vimentin in repair cell function in regulating the collective movement of the epithelium in response to wounding.

scholarly journals Preparation of Novel Arabic Gum-C6H9NO Biopolymer as a Bedsore for Wound Care Application

2020 ◽  
Author(s):  
Zahra Doozandeh ◽  
Saeed Saber-Samandari ◽  
Amirsalar Khandan
Keyword(s):  
Wound Healing ◽  
Wound Care ◽  
Basal Layer ◽  
Gum Arabic ◽  
Cell Types ◽  
Sem Analysis ◽  
Cartilage Tissue ◽  
Joint Infections ◽  
Tissue Organization ◽  
Life Threatening

The subcutaneous or hypodermic tissue is the innermost layer of the skin, which is essential for adipose tissue. The dermal attachment to the epidermis is a basal layer composed of collagen. This basal layer performs four different functions and acts as a scaffold for soft tissue organization. It is citing for regeneration that has selective permeability for serum filtration. Also, it is a barrier between different cell types, and cite where the epithelium subcutaneous to the cells. Untreated, bedsores can lead to serious complications, one of which is cellulite, a potentially life-threatening bacterial infection. As the bedsore wound spreads to the joints and bones, it may cause bone and joint infections that can damage the cartilage, tissue, and reduce joint function. The bacteria can then enter the bloodstream through wounds, leading to shock and life-threatening conditions. Stage II wounds can heal in one to six weeks, but wounds that lead to stage three or four may last several months or may never heal, especially in children with health problems. The purpose of this study was to design bio-based wounds with gelatin, Gum Arabic, and polyurethane. The wounds were made with different bio composite specimens. The procedure is gelatin, and gum Arabic was combined with certain percentages. The temperature of mixing and solubilization was set at 50°C. After complete fabrication of the material and complete dissolution of the samples in the solvent without any agglomeration, the samples were placed in a low-temperature freezer at -70°C and were placed in a freeze dryer. After the drying process is completed and the pores are ready on the wound heal sample, in the next stages, several tests are carried out to check the suitability of the produced wounds. The SEM analysis was performed on bio-based wounds in which the results showed the suitability and porosity of these wound dress were suitable. The presence of proper porosity and moisture level for wound healing and non-acidity, as well as the use of bed wound healing, have been distinguished from other conventional wound healing products in the market and research domain.

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.

Principles of Wound Management and Soft Tissue Repair I

2018 ◽  
Author(s):  
Jonathan S. Friedstat ◽  
Michelle R Coriddi ◽  
Eric G Halvorson ◽  
Joseph J Disa
Keyword(s):  
Wound Healing ◽  
Soft Tissue ◽  
Wound Closure ◽  
Free Tissue Transfer ◽  
Skin Grafting ◽  
Free Flaps ◽  
Wound Management ◽  
Soft Tissue Coverage ◽  
Contamination Assessment ◽  
Secondary Intention

Principles of initial wound management include adequate debridement, bacterial contamination assessment, nutritional optimization, and moist wound healing versus the use of negative-pressure wound therapy. The main goals of coverage procedures are to achieve a healed wound and avoid infection. Aside from allowing to heal by secondary intention, options for wound closure include primary closure, skin grafting, local flaps, and free flaps. Each wound should be evaluated on an individual basis to determine which method of coverage is most appropriate. This review contains 13 figures, 2 tables, and 22 references. Key Words: free tissue transfer, pedicle flaps, soft-tissue coverage, wound closure, wound healing, wound management, wound reconstruction, tissue flaps

Adenosine A2A receptors promote adenosine-stimulated wound healing in bronchial epithelial cells

2006 ◽  
Vol 290 (5) ◽  
pp. L849-L855 ◽  
Author(s):  
D. S. Allen-Gipson ◽  
J. Wong ◽  
J. R. Spurzem ◽  
J. H. Sisson ◽  
T. A. Wyatt
Keyword(s):  
Wound Healing ◽  
Epithelial Cells ◽  
Adenosine Receptor ◽  
Wound Repair ◽  
Wound Closure ◽  
Bronchial Epithelial Cells ◽  
Dependent Manner ◽  
Closure Rate ◽  
Concentration Dependent Manner ◽  
Bronchial Epithelial

Adenosine produces a wide variety of physiological effects through the activation of specific adenosine receptors (A1, A2A, A2B, A3). Adenosine, acting particularly at the A2A adenosine receptor (A2AAR), is a potent endogenous anti-inflammatory agent and sensor of inflammatory tissue damage. The complete healing of wounds is the final step in a highly regulated response to injury. Recent studies on epidermal wounds have identified the A2AAR as the main adenosine receptor responsible for altering the kinetics of wound closure. We hypothesized that A2AAR promotes wound healing in bronchial epithelial cells (BECs). To test this hypothesis, the human BEC line BEAS-2B and bovine BECs (BBECs) were used. Real-time RT-PCR of RNA from unstimulated BEAS-2B cells revealed transcriptional expression of A1, A2A, A2B and A3 receptors. Western blot analysis of lysates from BEAS-2B cells and BBECs detected a single band at 44.7 kDa in both the BECs, indicating the presence of A2AAR. In a wound healing model, we found that adenosine stimulated wound repair in cultured BBECs in a concentration-dependent manner, with an optimal closure rate observed between 4 and 6 h. Similarly, the A2AAR agonist 5′-( N-cyclopropyl)carboxamidoadenosine (CPCA) augmented wound closure, with a maximal closure rate occurring between 4 and 6 h. Inhibition of A2AAR with ZM-241385, a known A2AAR antagonist, impeded wound healing. In addition, ZM-241385 also attenuated adenosine-mediated wound repair. Kinase studies revealed that adenosine-stimulated airway repair activates PKA by ligating A2AAR. Collectively, the data suggest that the A2AAR is involved in BEC adenosine-stimulated wound healing and may prove useful in understanding purinergic-mediated actions on airway epithelial repair.

Sign in / Sign up

Export Citation Format

Share Document