Role of topical insulin therapy as an adjunct in the management of pressure ulcer

2020 ◽  
Vol 2 (3) ◽  
pp. 01-03
Author(s):  
Ravi Chittoria

Pressure ulcer or pressure sore is one of the complications seen in bedridden patients. Management of these ulcers is often challenging. But there is no well-established method that accelerates the wound healing rate. Various adjunctive methods are used for wound bed preparation before definitive reconstruction plan is made. Here we describe our experience in the role of insulin therapy as an adjunct in the management of pressure sores.

2020 ◽  
Vol 2 (3) ◽  
pp. 01-03
Author(s):  
Shucheng Gang

Pressure ulcer or pressure sore is one of the complications seen in bedridden patients. Management of these ulcers is often challenging. But there is no well-established method that accelerates the wound healing rate. Various adjunctive methods are used for wound bed preparation before definitive reconstruction plan is made. Here we describe our experience in the role of insulin therapy as an adjunct in the management of pressure sores.


2020 ◽  
Vol 2 (4) ◽  
pp. 01-03
Author(s):  
Ravi Chittoria

Wound healing is a complex process with overlapping steps of haemostasis, the inflammatory and proliferative phases, remodelling .Any problem with the edge of the wound can be detrimental to healing and may cause delay in wound healing. In this article, we share our experience of using topical insulin therapy for wound bed preparation in non-healing ulcer over the amputation stump.


2013 ◽  
Vol 61 (10) ◽  
pp. E2105
Author(s):  
Norihiro Kobayashi ◽  
Muramatsu Toshiya ◽  
Tsukahara Reiko ◽  
Ito Yoshiaki ◽  
Hirano Keisuke

2020 ◽  
Vol 63 (10) ◽  
pp. 623-632
Author(s):  
Myeong Ok Kim

Pressure sores or pressure injury is a serious complication of a spinal cord injury (SCI), representing a challenging problem for patients, their caregivers, and their physicians. Persons with SCI are vulnerable to pressure sores throughout their life. Pressure sores can potentially interfere with the physical, psychosocial, and overall quality of life. Outcomes directly depend on education and prevention along with conservative and surgical management. Therefore, it is very important to understand everything about pressure sores following SCI. This review covers epidemiology, cost, pathophysiology, risk factors, staging, evaluation tools, prevention, education, conservative wound care methods, surgical treatment, and future trends in wound healing related to post-SCI pressure sores. A change in nomenclature was adopted by the National Pressure Ulcer Advisory Panel in 2016, replacing “pressure ulcer”with “pressure injury.” New concepts of pressure injury staging, such as suspected deep tissue injuries and unstageable pressure injuries, were also introduced. A systematic evidence-based review of the prevention of and therapeutic interventions for pressure sores was also discussed.


2018 ◽  
Vol 47 (1) ◽  
pp. 201-211 ◽  
Author(s):  
Takahiro Mizoguchi ◽  
Koji Ueno ◽  
Yuriko Takeuchi ◽  
Makoto Samura ◽  
Ryo Suzuki ◽  
...  

Background/Aims: We have developed a mixed-cell sheet consisting of autologous fibroblasts and peripheral blood mononuclear cells with a high potency for angiogenesis and wound healing against refractory cutaneous ulcers in mouse and rabbit models. To increase the effectiveness of the mixed sheet, we developed a multilayered mixed sheet. Methods: We assessed the therapeutic effects of multilayered sheets on cutaneous ulcers in mice. Growth factors and chemokines were assessed by enzyme-linked immunosorbent assay. Angiogenesis and fibroblast migration were measured by using tube formation and migration assays. Wound healing rate of cutaneous ulcers was evaluated in mice with diabetes mellitus. Results: The concentration of secreted vascular endothelial growth factor, hepatocyte growth factor, transforming growth factor, C-X-C motif chemokine ligand (CXCL)-1, and CXCL-2 in multilayered sheets was much higher than that in single-layered mixed-cell sheets (single-layered sheets) and multilayered sheets of fibroblasts alone (fibroblast sheets). The supernatant in multilayered sheets enhanced angiogenic potency and fibroblast migration compared with single-layered and fibroblast sheets in an in vitro experiment. The wound healing rate in the multilayered sheet-treated group was higher compared with the no-treatment group (control) at the early stage of healing. Moreover, both vessel lumen area and microvessel density in tissues treated with multilayered sheets were significantly increased compared with tissues in the control group. Conclusion: Multilayered sheets promoted wound healing and microvascular angiogenesis in the skin by supplying growth factors and cytokines. Accordingly, our data suggest that multilayered sheets may be a promising therapeutic material for refractory cutaneous ulcers.


Author(s):  
Jie Zhang ◽  
Xiaolin Feng ◽  
Yuxia Wang ◽  
Dakang Chen ◽  
Bo Zhang

Research purposes: Autologous platelet-rich plasma gel (Platelet-Rich Plasma, PRP) was prepared and used for transplantation for the treatment of traumatic trauma wounds of extremities. Explore platelet-rich plasma gel (PRP) to promote the healing of exposed bone and tendon wounds. Methods: Fifteen patients with extremity bone and tendon exposed wounds were treated with autologous platelet-rich plasma gel (PRP) transplantation to observe the wound healing rate and wound healing time. Results: Among the 15 patients, 8 cases healed directly, 7 cases had active granulation growth, and second-stage skin graft wound healing; the wound healing rate was 100%, and the average wound healing time was 36 days. Conclusion: Autologous platelet-rich plasma gel (PRP) transplantation for the treatment of traumatic trauma hard wounds of the extremities, can inhibit the bacterial growth of the wounds, effectively promote the repair of soft tissue defects and accelerate the healing of bone and tendon wounds of the extremities.


2019 ◽  
Vol 20 (17) ◽  
pp. 4157 ◽  
Author(s):  
Lara Cristóbal ◽  
Nerea de los Reyes ◽  
Miguel A. Ortega ◽  
Melchor Álvarez-Mon ◽  
Natalio García-Honduvilla ◽  
...  

The growth hormone is involved in skin homeostasis and wound healing. We hypothesize whether it is possible to improve pressure ulcer (PU) healing by locally applying the recombinant human growth hormone (rhGH) in a human skin mouse model. Non-obese diabetic/severe combined immunodeficient mice (n = 10) were engrafted with a full-thickness human skin graft. After 60 days with stable grafts, human skin underwent three cycles of ischemia-reperfusion with a compression device to create a PU. Mice were classified into two groups: rhGH treatment group (n = 5) and control group (n = 5). In the rhGH group for local intradermal injections, each had 0.15 mg (0.5IU) applied to the PU edges, once per week for four weeks. Evaluation of the wound healing was conducted with photographic and visual assessments, and histological analysis was performed after complete wound healing. The results showed a healing rate twice as fast in the rhGH group compared to the control group (1.25 ± 0.33 mm2/day versus 0.61 ± 0.27 mm2/day; p-value < 0.05), with a faster healing rate during the first 30 days. The rhGH group showed thicker skin (1953 ± 457 µm versus 1060 ± 208 µm; p-value < 0.05) in the repaired area, with a significant decrease in collagen type I/III ratio at wound closure (62 days, range 60–70). Local administration of the rhGH accelerates PU healing in our model. The rhGH may have a clinical use in pressure ulcer treatment.


2021 ◽  
Vol 15 (4) ◽  
pp. 316-322
Author(s):  
Romulo Silva de Oliveira ◽  
Mayara Marques Pereira Fernandes ◽  
Millena do Nascimento Mesquita ◽  
Ana Caroline Lima da Cruz ◽  
Charles Pelizzari ◽  
...  

This study’s objective was to evaluate the efficacy of treating cutaneous wounds in Wistar rats using a therapeutic laser alone or in combination with topical application of andiroba oil. Twenty-four Wistar rats were distributed into three groups (T4, T7, and T14) of eight animals. To prepare the wounds, a total of four skin fragments per animal were removed using an 8-mm cutaneous biopsy punch. Each animal was inflicted with four surgical wounds, and each wound was subjected to one treatment. The treatments were as follows: saline solution (control, Cn); laser therapy (L), using a 660-nm laser wavelength and 10-J/cm² energy density; fresh andiroba oil (An); laser therapy followed by topical andiroba oil administration (LAn). All treatments in all animals were conducted for 4- (T4), 7- (T7), and 14- (T14) day periods. Edema and purulent secretion were observed in three animals in the An group, and the appearance of an exuberant crust was also observed in one animal from the same group. The LAn group presented the worst wound healing rate and contraction velocity (p < 0.05). Microscopically, there was no difference between groups regarding the presence of inflammation, necrosis, formation of granulation tissue, fibroplasia, and the presence of types 1 and 3 collagen at different treatment times. It was concluded that laser treatment of cutaneous wounds in conjunction with andiroba oil application did not present benefits in reference to the 0.9% NaCl.


2021 ◽  
Vol 31 (3) ◽  
pp. 20-26
Author(s):  
Undraa Bold ◽  
Gerelt Gaadan ◽  
Byambajav Tseesuren ◽  
Undrakhbayar Tserendorj ◽  
Naranmandakh Shinen

As a result of previous studies, we have established the “Fomitop” gel with extracts from the fungus Fomitopsis officinalis has antibacterial properties against some strains such as Staphylococcus aureus, Micrococcus luteus, Bacillus subtilis, and Enterococcus faecalis. Based on these results, we have conducted this research to identify the “Fomitop” gel has a healing effect on the burn wound. For this purpose, were conducted the comparative analysis of healing effects of the “Fomitop” gel with the standard ointment - silver sulfadiazine cream, on artificial burn wounds created on the back skin of a mouse. Total 27 Balb/c mice were included in the experiment and they are divided into three equivalent groups. In the first treatment, the group was applied to the “Fomitop” gel, the second standard group was applied silver sulfadiazine cream, and the third control group untreated by any ointment. On the 1, 5, 12, 21, and 35th days after wound creation, were taken the histological samples from the wound and near areas of the wound. The wound healing process was evaluated based on histological analysis. The burn wounds of the treatment group of mice (applied “Fomitop” gel) fully healed on the 33rd day of the experiment. While the wound healing rate of the standard group of mice (applied silver sulfadiazine cream) was 92.2% on the same day. And the control group mice wound healing rate was 78% (p<0.05). The results of the histological analysis were confirmed an active regeneration of epithelial cells and wound healing in the treatment group. It was good compared to the standard and control groups. As a result of this study, were determined the “Fomitop” gel application is accelerated the tissue regeneration of burn wounds and so on heals wound in a short time. Фомитоп гелин түрхлэгийн түлэнхийн шарханд үзүүлэх үйлдлийн судалгаа Бид өмнө гүйцэтгэсэн хар модны агил мөөгнөөс бэлтгэсэн “Фомитоп” гелин түрхлэгийн антибиотик төст үйлдлийг шалгах шинжилгээгээр Staphylococcus aureus, Micrococcus luteus, Bacillus subtilis, Enterococcus faecalis зэрэг бактерийн ургалтыг дарангуйлдаг болохыг илрүүлсэн. Уг үр дүнд үндэслэн “Фомитоп” гелин түрхлэг шархыг идээлүүлэхгүйгээр эдгээх боломжтой эсэхийг тогтоох энэхүү судалгааг гүйцэтгэв. Энэ зорилгоор “Фомитоп” гелин түрхлэгийг хулганы нурууны арьсанд үүсгэсэн химийн гаралтай түлэгдэлтийн зохиомол шарханд үзүүлэх нөлөөг стандарт эм болох мөнгөний сульфадиазин түрхлэгтэй харьцуулан судлав. Судалгаанд Balb/c үүлдрийн нийт 27 цагаан хулганыг тэнцүү тоогоор гурван бүлэгт хувааж хамруулав. Үүнд: 1-р бүлэг-агил мөөгнөөс бэлтгэсэн гелин түрхлэгийг хэрэглэсэн туршилтын бүлэг, 2-р бүлэг-мөнгөний сульфадиазин түрхлэг хэрэглэсэн стандарт бүлэг, 3-р бүлэг түрхлэг хэрэглээгүй хяналтын бүлэг. Шарх үүсгэснээс хойш 1, 5, 12, 21, 35 хоногуудад шарх, түүний ойр орчмын эдээс дээж авч гистологийн шинжилгээ хийж, шархны эдгэрэлтийг үнэлсэн. “Фомитоп” гелин түрхлэгийг хэрэглэсэн эмчилгээний бүлгийн түлэнхийн шарх туршилтын 33 дахь хоногт бүрэн эдгэрсэн бол мөнгөний сульфадиазин түрхлэг хэрэглэсэн стандарт бүлгийн шархны эдгэрэлт тухайн хоногт 92.2%, харин эм хэрэглээгүй хяналтын бүлгийн шархны эдгэрэлт нь 78% байлаа (p<0.05). Мөн гелин түрхлэг хэрэглэсэн бүлэг нь стандарт болон хяналтын бүлэгтэй харьцуулахад түлэнхийн шархны эдгэрэл, хучуур эсийн нөхөн төлжилт идэвхтэй явагдаж байгаа нь гистологийн шинжилгээний үр дүнгээр батлагдав. Судалгааны үр дүнд “Фомитоп” гелин түрхлэг нь түлэнхийн шархны нөхөн төлжилтийг хурдасгах, улмаар богино хугацаанд аниулах үйлдэл үзүүлж байгааг тогтоов.  Түлхүүр үг: Агил мөөг, мөнгөний сульфадиазин, гистологийн шинжилгээ, шархны эдгэрэл


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