Technical Note: Novel Use of CytoSorb™ Haemadsorption to Provide Wound Healing Support in Case of Severe Burn Trauma via Reduction of Hyperbilirubinaemia

Hyperbilirubinaemia has been shown to compromise wound healing in severely burned patients. The therapy options for patients with impairment of wound healing and subsequent severe liver dysfunction are limited. A novel extracorporeal treatment, CytoSorb® (CytoSorbents Corp, USA), is a whole blood adsorber composed of highly biocompatible and porous polystyrene divinylbenzene copolymer beads covered in a polyvinylpyrrolidone coating. It is capable of extracting mainly hydrophobic middle-sized (up to 55 kDa) molecules from blood via size exclusion, including cytokines and bilirubin. We performed therapy with CytoSorb® on a severely burned (48% Total Body Surface Area-TBSA) patient with secondary sclerosing cholangitis (SCC) to promote the wound healing process by reducing bilirubin concentrations and to bridge the time to spontaneous liver regeneration or eventually to liver transplantation after two skin transplantations had failed to provide wound closure. In the first 6 days the cartridge was changed on a daily basis and later after every 2–4 days. The therapy with six adsorbers decreased a total bilirubin concentration from 14.02 to 4.29 mg/dl. By maintaining a stable bilirubin concentration under 5 mg/dl, debridement of abdomen and upper extremities with autologous skin grafting and, 4 weeks later, autologous skin grafting of the back from scrotum and lower extremities were performed successfully. After wound healing had been achieved, the CytoSorb therapy was discontinued after 57 days and 27 adsorber changes. CytoSorb therapy can be a promising support of wound and skin graft healing in patients with severe burns and liver dysfunction due to a significant reduction of total bilirubin concentration.

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860 Impact of Orally Administered Tramadol Combined with Self-selected Music on Adult Outpatients with Burns Undergoing Dressing Change: A Randomized Controlled Trial

Journal of Burn Care & Research ◽

10.1093/jbcr/iraa024.426 ◽

2020 ◽

Vol 41 (Supplement_1) ◽

pp. S267-S268

Author(s):

Xiu-Hang Zhang ◽

Jia-Ao Yu ◽

Xin-Xin Chen

Keyword(s):

Wound Healing ◽

Primary Outcome ◽

Short Form ◽

Controlled Trial ◽

Healing Process ◽

Total Body Surface Area ◽

Control Group ◽

Mcgill Pain Questionnaire ◽

Wound Healing Process ◽

Dressing Change

Abstract Introduction Burn injuries have significant physiological and psychological consequences. Dressing changes have been considered the most painful among all non-surgical procedures. Anxiety, which is closely associated with pain, is a part of the burn and wound-healing process and can cause delays in wound healing and recovery procedures. In addition, anxiety may have a devastating mental and physical influence on patients.What’s more,patients whose symptoms were not adequately alleviated are likely to suffer more in their subsequent dressing changes. Pharmacological treatment is the primary approach for relieving pain and anxiety related to burns. In comparison with traditional analgesics, tramadol is a more manageable drug under clinical conditions. However, due to the variability of the intensity of pain and anxiety in patients, the two symptoms remain under-treated. Recently, much attention has been paid to pain management approaches that combine pharmacological treatments with non-pharmacological therapies. In this regard, this study was designed to analyze the effect of tramadol and its combination with self-selected music on burn patient. Methods To investigate the effects of music and/or tramadol on pain and anxiety in burn outpatients undergoing dressing changes. Patients (N = 180) with burns on up to 10%-30% of the total body surface area (TBSA). The patients were selected using a convenience sampling method and randomly allocated to 4 equal-sized groups as follows: 1) tramadol group (TG), patients received 100 mg of tramadol orally 20 min before the dressing change; 2) music group (MG), patients listened to self-selected music during the dressing change; 3) music-plus-tramadol group (MTG), patients received tramadol and listened to self-selected music; and 4) control group (CG), patients received a routine dressing change only. All patients underwent the interventions once per day for 2 days. McGill Pain Questionnaire Short Form (MPQ-SF) (primary outcome), McGill Pain Persian version of Burn Specific Pain Anxiety Scale (BSPAS) (primary outcome), and heart rate (HR) and overall patient satisfaction (secondary outcomes). Results The results showed that MTG had better outcomes with respect to pain and anxiety management during dressing changes. Conclusions In comparison with music or tramadol alone, the integration of music and tramadol offers a secure and favorable treatment choice to relieve pain and anxiety, ultimately improving the satisfaction levels of burn outpatients during dressing changes. Applicability of Research to Practice The findings showed that the combined approach was more effective in reducing pain and anxiety among the outpatients, as the findings outline the potential use of this technique in the management of dressing changes in burn outpatients.

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Haruan Extract (Channa striatus) as an Effective Mediator in Promoting Wound Healing

10.5772/intechopen.99207 ◽

2021 ◽

Author(s):

Ahmad Farouk Musa ◽

Cheang Jia Min

Keyword(s):

Fatty Acids ◽

Extracellular Matrix ◽

Wound Healing ◽

Granulation Tissue ◽

Healing Process ◽

Skin Grafting ◽

Treatment Modalities ◽

Wound Healing Process ◽

Channa Striatus ◽

The Government

Wound healing remains a major issue in surgery. None of the existing treatment modalities in caring for wounds can yet claim to be the holy grail of wound management. Channa striatus, locally known in Malaysia as Haruan, is a freshwater air-breathing carnivorous fish that is proven to influence the different phases of wound healing. As a medicinal fish, not only does Haruan have a high content of amino and fatty acids, which are essential in collagen fibre synthesis during wound recovery, it also abounds in arachidonic acid and polyunsaturated fatty acids that promote prostaglandin synthesis, a vital component of the healing process. Moreover, its antinociceptive effects could potentially reduce wound pain, an important factor in wound healing. Proteomic studies show that a quarter of the total protein detected in freeze- and spray-dried C. striatus extract are actin, myosin and tropomyosin – all molecules that play a role in the wound healing process. Proteomic profiling also reveals that Haruan possesses two types of collagen namely collagen type-I and type-II that confer tensile strength during the healing process. It is proven that collagen along with other components of the extracellular matrix form the granulation tissue which, when contracted, closes the wound and concomitantly aligns the collagen fibres in the extracellular matrix. Hence, it is inferred that Haruan promotes the maturation of granulation tissue, thereby expediting the wound healing process itself. Consequently, it could mediate a faster recovery from surgical wound coupled with a lower incidence of wound infection due to an improved and accelerated wound healing process. Additionally, Haruan has demonstrated its ability in promoting angiogenesis and cell proliferation in wound bed preparation for skin grafting. Furthermore, a Haruan aerosol concentrate can act as a wound dressing at the donor site thereby enhancing the healing process while simultaneously exhibiting some antinociceptive properties. Haruan’s exceptional ability in promoting wound healing together with its potential use in skin grafting would be instrumental in the field of surgery. In essence, the cumulated benefits from all the processes involved would translate into a significant reduction of hospitalisation cost; that would immensely benefit not only the patient, but also the government.

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Wound healing properties of a fibrin-based dermal replacement scaffold

Biomedical Physics & Engineering Express ◽

10.1088/2057-1976/ac4176 ◽

2021 ◽

Author(s):

Stuart Brown ◽

Farhana Surti ◽

Paul Sibbons ◽

Lilian Hook

Keyword(s):

Wound Healing ◽

Skin Graft ◽

Healing Process ◽

Skin Grafting ◽

Wound Healing Process ◽

Cutaneous Injury ◽

Fibrin Scaffold ◽

Extent Of Damage ◽

And Function ◽

Early Healing

Abstract When serious cutaneous injury occurs, the innate wound healing process attempts to restore the skin’s appearance and function. Wound healing outcome is affected by factors such as contraction, revascularisation, regeneration versus fibrosis and re-epithelialisation and is also strongly influenced by the pattern and extent of damage to the dermal layer. Dermal replacement scaffolds have been designed to substitute for lost tissue, provide a structure to promote dermal regeneration, and aid skin grafting, resulting in a superior healing outcome. In this study the wound healing properties of a novel fibrin-alginate dermal scaffold were assessed in the porcine wound healing model and also compared to two widely used dermal scaffolds and grafting alone. The fibrin-alginate scaffold, unlike the other scaffolds tested, is not used in combination with an overlying skin graft. Fibrin scaffold treated wounds showed increased, sustained superficial blood flow and reduced contraction during early healing while showing comparable wound closure, re-epithelialisation and final wound outcome to other treatments. The increase in early wound vascularisation coupled with a decrease in contraction and no requirement for a skin graft suggest that the fibrin-based scaffold could provide an effective, distinctive treatment option to improve healing outcomes in human patients.

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HUBUNGAN MOBILISASI DINI TERHADAP PENYEMBUHAN LUKA POST OPERASI SECTIO CESARIA

Jurnal Penelitian Keperawatan Medik ◽

10.36656/jpkm.v2i1.187 ◽

2019 ◽

Vol 2 (1) ◽

pp. 14-17

Author(s):

Nurul Aini Siagian ◽

Syafira Nusaibah ◽

Andayani Boang Manalu

Keyword(s):

Wound Healing ◽

Healing Process ◽

Early Mobilization ◽

Sectio Caesarea ◽

Wound Healing Process ◽

P Value ◽

Cross Sectional ◽

Care Services ◽

Healing Wound ◽

Rapid Healing

Early mobilization includes factors that can affect the process of wound healing after surgery. Immediate mobilization in stages is very useful for the process of healing wounds and preventing infection and venous thrombosis. The purpose of this study was to determine whether there is a relationship between early mobilization and the process of healing wound post operative sectio caesarea at Sinar Husni General Hospital Medan Helvetia. The research design used was analytic survey with cross sectional approach. The sample in this study used the Consecutive Sampling method of data collection using a checklist sheet conducted on a sample of 19 respondents. The results of the study in this study are the majority of respondents who did early mobilization and who experienced rapid wound healing process as many as 4 people (21%) while the minority of respondents who did early mobilization and who experienced slow wound healing process were 1 person (5.3%). The majority of respondents who did not mobilize early and who experienced a slow wound healing process were 11 people (57.9%) and a minority who did not mobilize early and who experienced rapid healing as many as 4 people (21.1%). Statistical test results obtained p value = 0.046 <0.005. The conclusions of the results of this study indicate there is a relationship between early mobilization and the process of healing post operative sectio of caesarea. Suggestions The results of this study can be applied as a reference to improve nursing care services, especially in providing counseling and assistance to patients.

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Hubungan Status Gizi Dengan Proses Penyembuhan Luka Di Rsud H. Andi Sulthan Daeng Radja Kabupaten Bulukumba

Jurnal Kesehatan Panrita Husada ◽

10.37362/jkph.v2i1.147 ◽

2017 ◽

Vol 2 (1) ◽

pp. 20-28

Author(s):

Fitriani ◽

Tenriwati

Keyword(s):

Wound Healing ◽

Nutritional Status ◽

Healing Process ◽

Data Retrieval ◽

Observational Research ◽

Wound Healing Process ◽

P Value ◽

Chi Square ◽

Cross Sectional ◽

Chi Square Test

At present, the incidence of injuries in Indonesia is quite high, as seen from data on traffic accidents in the general public. There are several factors that affect wound healing, one of which is nutritional status. Based on the preliminary data retrieval conducted by researchers in the seruni surgery room in the last 1 month namely in March, it was found that the number of wounded patients was 109 patients, where the number of men was 78 (71.56%) while the number of women was 31 ( 28.44%) The purpose of this study was to determine the relationship between nutritional status and the wound healing process in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. This research uses the type of design of this research is quantitative research. This type of research uses analytic observational research with cross sectional approach. The sample of this study were 41 respondents taken by purposive sampling method. Data analysis in this study used the chi-square test (chi square test). The results of the analysis used the chi-square statistical test with a confidence level (α = 0.05). Based on the results of this test, the p value is 0.001, thus p <α (0.001 <0.05), then Ho is rejected and Ha is accepted. The conclusion of this study is that there is a relationship between nutritional status and the process of wound healing in RSUD. H. Andi. Sulthan Daeng Radja Kab. Bulukumba. Researchers suggest that this study be used as a material consideration in the fulfillment of nutrition in wound care patients in RSUD.H.A. Sulthan Daeng Radja Kab. Bulukumba and this research can be continued by conducting research related to the wound healing process and linking it with other variables.

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Natural, Synthetic and their Combinatorial Nanocarriers Based Drug Delivery System in the Treatment Paradigm for Wound Healing Via Dermal Targeting

Current Pharmaceutical Design ◽

10.2174/1381612826666200612164511 ◽

2020 ◽

Vol 26 (36) ◽

pp. 4551-4568

Author(s):

Mohammad Kashif Iqubal ◽

Sadaf Saleem ◽

Ashif Iqubal ◽

Aiswarya Chaudhuri ◽

Faheem Hyder Pottoo ◽

...

Keyword(s):

Drug Delivery ◽

Wound Healing ◽

Photodynamic Therapy ◽

Growth Factors ◽

Combination Therapy ◽

Healing Process ◽

Wound Healing Process ◽

Wound Site ◽

Synthetic Drugs ◽

Treatment Paradigm

A wound refers to the epithelial loss, accompanied by loss of muscle fibers collagen, nerves and bone instigated by surgery, trauma, frictions or by heat. Process of wound healing is a compounded activity of recovering the functional integrity of the damaged tissues. This process is mediated by various cytokines and growth factors usually liberated at the wound site. A plethora of herbal and synthetic drugs, as well as photodynamic therapy, is available to facilitate the process of wound healing. Generally, the systems used for the management of wounds tend to act through covering the ruptured site, reduce pain, inflammation, and prevent the invasion and growth of microorganisms. The available systems are, though, enough to meet these requirements, but the involvement of nanotechnology can ameliorate the performance of these protective coverings. In recent years, nano-based formulations have gained immense popularity among researchers for the wound healing process due to the enhanced benefits they offer over the conventional preparations. Hereupon, this review aims to cover the entire roadmap of wound healing, beginning from the molecular factors involved in the process, the various synthetic and herbal agents, and combination therapy available for the treatment and the current nano-based systems available for delivery through the topical route for wound healing.

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Scientific aspect on Diet explained by Susrutha in Wound Healing

Journal of Ayurveda and Integrated Medical Sciences (JAIMS) ◽

10.21760/jaims.v2i05.10268 ◽

2017 ◽

Vol 2 (05) ◽

Author(s):

Manoj Kumar ◽

Amareshappa . ◽

Anjali Bharadwaj ◽

Shailaja S. V.

Keyword(s):

Wound Healing ◽

Mineral Metabolism ◽

Healing Process ◽

Surgical Techniques ◽

The Body ◽

Wound Healing Process ◽

Human Being ◽

Different Sources ◽

Scientific Aspect ◽

Important Branch

Wound healing has been the burning problem in a surgical practice because of a remarkable increase in the number of traumatic cases. A wound causes a number of changes in the body that can affect the healing process, including changes in energy, protein, carbohydrate, fat, vitamin and mineral metabolism. Various Ayurveda literatures, particularly, Sushruta Samhita, which is said to be an ancient textbook of surgery in Ayurveda, has mentioned about the diet for the person suffering from the wound, and the author said that diet plays a very important role in the wound healing process. Sushruta - The father of surgery has scientifically classified it in a systemic manner, whose wealth of clinical material and the principles of management are valid even today. Shalya Tantra (surgical branch in Ayurveda Science) is one of the important branch of Ayurveda, in which surgical and para-surgical techniques has described for management of various diseases. Vrana is the most important and widely described chapter of Shalya Tantra. Vrana (wound) is one of them, which have been managed by human being from starting of civilization. Under the circumstances, the first thing which the men came across was the injury from different sources which caused him the Vrana. Vrana is seen as debilitating and scaring disorder, usually seen affecting the human being at any age. Well balanced nutrition plays an essential role in the wound healing.

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PENGARUH MOBILISASI DINI TERHADAP PENYEMBUHAN LUKA POST SECTIO CAESAREA

Jurnal IPTEKS Terapan ◽

10.22216/jit.2017.v11i1.661 ◽

2017 ◽

Vol 11 (1) ◽

pp. 109

Author(s):

Reni Heryani ◽

Ardenny Denny

Keyword(s):

Wound Healing ◽

Placenta Previa ◽

Healing Process ◽

Early Mobilization ◽

Sectio Caesarea ◽

Uterine Action ◽

Wound Healing Process ◽

P Value ◽

Post Test ◽

Development Goals

ABSTRAK Salah satu tujuan pembangunan era Millenium Development goals (MDG’s) 2015 adalah perbaikan kesehatan maternal. Salah satu cara di dalam persalinan atau mengeluarkan bayi secara patologis yaitu dengan sectio caesarea. Menurut statistik 3.509 kasus sectio caesarea, indikasi terbanyak adalah disproporsi cephalo pelvik (21%), sedangkan indikasi lain adalah gawat janin (14%), plasenta previa (11%), pernah sectio caesarea (11%), incoordinate uterine action (9%), preeklamsi dan hipertensi (7%). Penelitian ini menggunakan desain penelitian Quasy Experiment dengan post test only with control. Hasil penelitian menunjukkan bahwa umumnya responden memiliki umur tidak berisiko terhadap tindakan operasi yati sebanyak 15 orang (75%), sebagian responden pertama kali dilakukan operasi caesarea yaitu sebanyak 10 orang (50,0%), sebagian responden mengalami penyembuhan luka yang normal yaitu sebanyak 13 orang (65,0%), dan sebagian responden responden melakukan mobilisasi dini yaitu sebanyak 14 orang (70,0%). Secara statistik terdapat pengaruh mobilisasi dini terhadap penyembuhan luka post sectio caesarea di RSUD Arifin Achmad Pekanbaru (p value = 0.007). Disarankan bagi respnden dapat meningkatkan kesadarannya dalam meningkatkan derajat kesehatan melalui latihan mobilisasi dini untuk mempercepat proses penyembuhan luka akibat operasi. Kata Kunci : sectio caesarea, mobilisasi, penyembuhan luka ABSTRACT One of the goals of development era of Millennium Development Goals (MDG's) in 2015 is the improvement of maternal health. One way in the delivery or the baby out with the pathological ie sectio caesarea. According to 3509 statistics compiled case sectio caesarea, an indication of cephalo pelvic disproportion is the highest (21%), while the other is an indication of fetal distress (14%), placenta previa (11%), never sectio caesarea (11%), incoordinate uterine action (9%), preeclampsia and hypertension (7%). This study research design quasy Experiment with post test only with control. The results showed that respondents generally have a lifespan of no risk for surgery yati many as 15 people (75%), the majority of respondents were first performed caesarea operation as many as 10 people (50.0%), the majority of respondents experienced a normal wound healing as many as 13 people (65.0%), and the majority of respondents respondents did early mobilization as many as 14 people (70.0%). There is a statistically significant relationship between early mobilization on wound healing post sectio caesarea (p value = 0.007). Suggested for respnden can increase awareness in improving health status through early mobilization exercises to accelerate the wound healing process as a result of the operation. Keywords: sectio caesarea, mobilization, wound healing

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Development of a Topical Insulin Polymeric Nanoformulation for Skin Burn Regeneration: An Experimental Approach

International Journal of Molecular Sciences ◽

10.3390/ijms22084087 ◽

2021 ◽

Vol 22 (8) ◽

pp. 4087

Author(s):

Maria Quitério ◽

Sandra Simões ◽

Andreia Ascenso ◽

Manuela Carvalheiro ◽

Ana Paula Leandro ◽

...

Keyword(s):

Wound Healing ◽

Healing Process ◽

In Vitro Release ◽

Peptide Hormone ◽

Plga Nanoparticles ◽

Wound Healing Process ◽

Target Area ◽

Encapsulation Process

Insulin is a peptide hormone with many physiological functions, besides its use in diabetes treatment. An important role of insulin is related to the wound healing process—however, insulin itself is too sensitive to the external environment requiring the protective of a nanocarrier. Polymer-based nanoparticles can protect, deliver, and retain the protein in the target area. This study aims to produce and characterize a topical treatment for wound healing consisting of insulin-loaded poly-DL-lactide/glycolide (PLGA) nanoparticles. Insulin-loaded nanoparticles present a mean size of approximately 500 nm and neutral surface charge. Spherical shaped nanoparticles are observed by scanning electron microscopy and confirmed by atomic force microscopy. SDS-PAGE and circular dichroism analysis demonstrated that insulin preserved its integrity and secondary structure after the encapsulation process. In vitro release studies suggested a controlled release profile. Safety of the formulation was confirmed using cell lines, and cell viability was concentration and time-dependent. Preliminary safety in vivo assays also revealed promising results.

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Wound Healing Promotion by Hyaluronic Acid: Effect of Molecular Weight on Gene Expression and In Vivo Wound Closure

Pharmaceuticals ◽

10.3390/ph14040301 ◽

2021 ◽

Vol 14 (4) ◽

pp. 301

Author(s):

Yayoi Kawano ◽

Viorica Patrulea ◽

Emmanuelle Sublet ◽

Gerrit Borchard ◽

Takuya Iyoda ◽

...

Keyword(s):

Gene Expression ◽

Molecular Weight ◽

Wound Healing ◽

Hyaluronic Acid ◽

Healing Process ◽

Dermal Fibroblasts ◽

Water Soluble ◽

Wound Healing Process ◽

And Migration ◽

Proliferation And Migration

Hyaluronic acid (HA) has been known to play an important role in wound healing process. However, the effect of molecular weight (MW) of exogenously administered HA on the wound healing process has not been fully understood. In this study, we investigated HA with different MWs on wound healing process using human epidermal keratinocytes and dermal fibroblasts. Cell proliferation and migration ability were assessed by water soluble tetrazolium (WST) assay and wound scratch assay. We examined the effect of HA addition in a full-thickness wound model in mice and the gene expression related to wound healing. Proliferation and migration of HaCaT cells increased with the increase of MW and concentration of HA. Interleukin (IL-1β), IL-8 and vascular endothelial growth factor (VEGF) as well as matrix metalloproteinase (MMP)-9 and MMP-13 were significantly upregulated by high molecular weight (HMW) HA in keratinocytes. Together with VEGF upregulation and the observed promotion of HaCaT migration, HA with the MW of 2290 kDa may hold potential to improve re-epithelialization, a critical obstacle to heal chronic wounds.

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