scholarly journals Surgical glue- a promising technology for wound healing

2018 ◽  
Vol 1 (1) ◽  
pp. 9-11
Author(s):  
K. V. Swathi Krishna ◽  
L. S. Uma Maheswari ◽  
G Rajeswari
Keyword(s):  
Wound Healing ◽  
Cost Effectiveness ◽  
Wound Closure ◽  
Cost Effective ◽  
Daily Basis ◽  
Skin Closure ◽  
Tissue Glue ◽  
Closure Time ◽  
Anesthesia Awareness ◽  
Long Time

Wound closure is one of the important steps of surgical dressing and suturing is the most commonly used method of wound closure. The process of suturing takes very long time for surgery and increases the patient’s risk of anesthesia awareness. Skin glues are a safe and effective method to close selected wounds. They are also cost-effective and help prevent infection. Ideally, wounds should be less than 4 cm, not contaminated or infected and have skin edges that are not under tension. Wounds should be closed within 12 hours. Novel methods of wound closure have been introduced to address these issues, most notably cyanoacrylate tissue glues. The evidence would suggest that the use of cyanoacrylate tissue glue is associated with a reduction in closure time and costs. On a daily basis, dermasurgeons are facing different kinds of wounds that have to be closed. With a plethora of skin closure materials currently available, choosing a solution that combines excellent and rapid cosmetic results with practicality and cost-effectiveness is preferred.

scholarly journals Therapeutic Targeting of Neutrophil Extracellular Traps Improves Primary and Secondary Intention Wound Healing in Mice

2021 ◽  
Vol 12 ◽  
Author(s):  
Annika Heuer ◽  
Carolin Stiel ◽  
Julia Elrod ◽  
Ingo Königs ◽  
Deirdre Vincent ◽  
...  
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Thermal Injury ◽  
Neutrophil Activation ◽  
Extracellular Traps ◽  
Secondary Intention ◽  
Closure Time ◽  
Injury Group ◽  
Dnase Treatment ◽  
Laparotomy Group

BackgroundNeutrophils are the first responders in wound healing after injury that mediate pro- and anti-inflammatory activities i.a. through the formation of extracellular traps (NETs). However, excessive NETs presence in wound tissue can cause local hyperinflammation and -coagulation resulting in delayed wound healing. To improve wound healing, we aimed to examine the role of NETs and DNase1 on primary and secondary wound healing.MethodsThe study included 93 C57BL/6 mice, with 3 different genotypes: wildtype, Pad4-, and DNase1-Knockout (KO). Pad4-KO mice show limited NETs formation, while DNase1-KO mice cannot disintegrate them. All 3 genotypes were included in (1) a laparotomy group and (2) a thermal injury group. Animals in both groups either received DNase1 or a vehicle i.p. post wound induction and wound assessment and euthanasia were conducted. Laparotomy and burn scars were assessed using the stony brook scar evaluation scale and modified Yeong scale respectively. Tissue was analyzed histologically using H&E staining. Ly6g, Collagen I and III, SMA, and Fibrinogen were visualized and neutrophils activation (NE, MPO) and NETs (H3cit) formation assessed.ResultsAll animals survived with no complications. DNase1 treatment led to a significantly improved scar appearance in both groups, which was also seen in Pad4-KO mice. In the laparotomy group DNase1 improved collagen deposition and fibrin concentration was significantly reduced by DNase1 treatment. Markers of neutrophil activation were significantly reduced in the treatment and Pad4-KO group. In the thermal injury group wound closure time was significantly reduced after DNase1 treatment and in the Pad4-KO group. Even though inflammation remained high in the thermal injury model over time, neutrophil activation and NETs formation were significantly reduced by DNase1 treatment compared to controls.DiscussionPrimary and secondary intention wound healing is improved by targeting NETs through DNase1 treatment or genetic KO, as assessed by wound closure time and scar appearances. Additionally, wound stability was not affected by DNASE treatment. The results suggest that overall wound healing is accelerated and DNase1 appears to be a promising option to reduce scar formation; which should be evaluated in humans.

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.

scholarly journals Clinical Outcome and Wound Healing following Carpal Tunnel Decompression: A Comparison of Two Common Suture Materials

2014 ◽  
Vol 2014 ◽  
pp. 1-5 ◽  
Author(s):  
Robert J. MacFarlane ◽  
Thomas D. Donnelly ◽  
Yousaf Khan ◽  
Syam Morapudi ◽  
Mohammad Waseem ◽  
...  
Keyword(s):  
Wound Healing ◽  
Patient Satisfaction ◽  
Carpal Tunnel ◽  
Wound Closure ◽  
Suture Material ◽  
Skin Closure ◽  
Suture Materials ◽  
Vas Scores ◽  
The Mean ◽  
The Ideal

Introduction. Debate exists amongst surgeons regarding the ideal suture material for skin closure in carpal tunnel decompression (CTD). This study compares wound related complications, patient satisfaction, and functional outcome following open carpal tunnel decompression in patients undergoing wound closure with either of two common absorbable and nonabsorbable suture types.Materials and Methods. 53 patients underwent CTD with either 4/0 polypropylene (ProleneTM,n= 28) or 4/0 polyglactin (Vicryl RapideTM,n= 25) for skin closure. QuickDASH, VAS satisfaction scores, and Southampton wound scores were assessed preoperatively and at 2 and 6 weeks postoperatively.Results. At 6 weeks the mean QuickDASH scores postoperatively were 18.54 and 17.70 for absorbable and nonabsorbable sutures, respectively, (P= 0.86). The mean VAS scores were 0.61 and 0.42 (P= 0.91), respectively. All patients achieved a Southampton wound score of 0 by 6 weeks except one, who achieved 1C in the nonabsorbable group, equivalent to mild erythema. There were no complications in either group.Conclusion. Both suture types are safe and effective materials for CTD, and we recommend surgeons to choose according to personal preference, handling properties, and resources available for suture removal.

scholarly journals PENGARUH LUMATAN DAUN PLETEKAN (Ruellia Tuberosa L) TERHADAP LAMA PENUTUPAN LUKA PADA TIKUS PUTIH (Rattus Novergicus)

2017 ◽  
Vol 4 (2) ◽  
pp. 104
Author(s):  
Ria Susana ◽  
Rismia Agustina ◽  
Abdurahman Wahid
Keyword(s):  
Wound Healing ◽  
Treatment Group ◽  
Random Sampling ◽  
Wound Closure ◽  
Simple Random Sampling ◽  
Male Rats ◽  
Control Group ◽  
P Value ◽  
Closure Time ◽  
Significant Difference

ABSTRAKLuka didefinisikan sebagai gangguan pada fungsi dan integritas jaringan tubuh. Penyembuhan luka merupakan proses yang kompleks dari perbaikan dan remodeling jaringan sebagai respon terhadap cedera. Pletekan (ruellia tuberosa l) mengandung flavonoid, glikosida, phenol, saponin dan nutrisi yang diharapkan mempercepat penyembuhan luka. Tujuan penelitian ini adalah mengidentifikasi pengaruh  lumatan daun pletekan (ruellia tuberosa l) terhadap lama penutupan luka pada tikus putih (rattus novergicus). Penelitian ini merupakan studi eksperimental dengan rancangan posttest only control, menggunakan teknik simple random sampling. Sampel yang digunakan sebanyak 40 ekor tikus jantan dengan luka insisi bersih sepanjang 3 cm yang dibagi menjadi 2 kelompok yaitu kelompok kontrol dan kelompok perlakuan. Data yang diukur adalah rata-rata lama penutupan luka. Data yang diperoleh dianalisis menggunakan uji mann-whitney dengan derajat kepercayaan 95% menunjukkan perbedaan yang signifikan rata-rata lama penutupan luka antara kelompok kontrol (8,45) dan kelompok perlakuan (3,75) dengan p-value 0,000 (p<0,05). Kesimpulan penelitian ini adalah terdapat pengaruh lumatan daun  pletekan (ruellia tuberosa l) terhadap lama penutupan luka pada tikus putih (rattus novergicus).Kata-kata kunci: luka insisi bersih, pletekan (ruellia tuberosa l), lama penutupan luka.ABSTRACTWounds is defined as disruption of the function and integrity of body tissues. Wound healing isa complex process of tissue repair and remodelling in response to injury. Pletekan (ruellia tuberosa l) contains flavonoids, glycosides, phenols, saponins and nutritive value that suppose to accelerate wound healing. The purpose of this study was to identify the effect of pletekan leaves (ruellia tuberosa) to wound closure time in rats (rattus novergicus). This research was an experimental study with post- test design using the simple random sampling technique. The samples were 40 male rats with a clean incision wound along 3 cm which were divided into two groups, control group and treatment group. The measured data were the average of wound closure time. Data were analyzed using the mann- whitney test with 95 % confidence level showed a significant difference between the control group (8,45) and the treatment group (3,75) with p-value 0,000 (p<0,005). There was significant effect of ruellia tuberosa l to wound closure time in rattus novergicus.Keywords: wounds, ruellia tuberosa , wound closure time.

scholarly journals A study of skin closure of surgical wound by subcuticular sutures with polyglactin 910 fast (rapide vicryl) in planned surgery

2018 ◽  
Vol 6 (10) ◽  
pp. 3370
Author(s):  
Ashwinkumar S. Gadhvi ◽  
Dhavalkumar A. Bhimani ◽  
Udit I. Gadhvi ◽  
Darshil K. Rajgor
Keyword(s):  
Wound Closure ◽  
Cost Effective ◽  
The Body ◽  
Cosmetic Result ◽  
Skin Closure ◽  
Absorbable Suture ◽  
Surgical Wound ◽  
Subcuticular Suture ◽  
Cosmetic Results ◽  
Minimal Scarring

Background: The skin is the largest and among the most complex organs of the body. Although the skin functions simply as a protective barrier to interface with our environment, its structure and physiology are complex. Suturing is commonly used today as a mean by which wounds are closed to prevent infection and fasten healing with minimal scarring. Cosmetic results of healed wound are also important and as awareness is increasing among general population, they are more concerned with cosmetic scar. Various techniques are developed to give cosmetically better scar, like subcuticular suture, adhesive tapes, staplers, etc.Methods: Study was randomized, prospective, observational and longitudinal including 100 patients, selected according to inclusion criteria.Results: Cosmetic result of the study were good; 87% patients were having good to excellent cosmetic results. And 13% patients were having scar which was cosmetically not good (scar was either hypertrophied or thickened). complication was not significant (only 3% having on post-operative day 5).Conclusions: Surgical wound closure with subcuticular suture with absorbable suture material gives excellent cosmetic results, cheaper and cost-effective compare to other technique of wound closure having similar cosmetic result. As the removal of suture is not required, no follow up visit needed, and it saves the extra time and expenditure of patient.

scholarly journals Cost-effectiveness of GeneXpert Compared to Smear Microscopy for Diagnosis of Tuberculosis in Ethiopia

2020 ◽  
Author(s):  
Abdene Kaso ◽  
Alemayehu Hailu
Keyword(s):  
Sensitivity Analysis ◽  
Cost Effectiveness ◽  
Unit Cost ◽  
Diagnostic Testing ◽  
Cost Effective ◽  
Smear Microscopy ◽  
Health Providers ◽  
Tree Model ◽  
Long Time ◽  
The Cost

Abstract Background Early diagnosis is one of the pillars of the TB (TB) control, and there are strong efforts to detect and treat cases in Ethiopia. Smear microscopy testing has been a routine test for the diagnosis of pulmonary TB in resource-constrained settings for a long time. Recently, many countries, including Ethiopia, are scaling up the use of GeneXpert without a precise evaluation of the cost and cost-effectiveness of this technology. Therefore, this study aimed to evaluate the cost-effectiveness of GeneXpert compared to smear microscopy tests for the diagnosis of TB patients in Ethiopia. Methods We develop a decision tree model using TreeAge Pro 2020 software. The model accounts for the prevalence and incidence of TB in the study area. The costs were estimated from the health providers' perspective in one year (in 2017/18). We applied an ingredients-based costing approach to identify, measure, and evaluate the smear microscopy cost and GeneXpert. We employed the 'proportion of cases detected' as an outcome measure of effectiveness. The incremental cost-effectiveness ratio (ICER) was calculated by dividing the changes in cost and change effectiveness. One way and probabilistic sensitivity analysis were done by varying different input parameters. All costs and ICER are reported in 2018 US$. Results The unit cost per test for GeneXpert and smear microscopy testing was US$12.9 and $3.1, respectively. The average cost of testing using GeneXpert was $113.0 and $3.3 for smear microscopy. The cost of the cartridge ($10.7) was the primary (83%) parameter influencing the overall cost of GeneXpert, while it was the cost of reagent and consumables $1.28 (41%) for the smear microscopy. The ICER for GeneXpert strategy was $729.8 per new TB cases detected compared to smear microscopy. The sensitivity analysis indicates that TB prevalence was the most influential parameter on the ICER. Conclusion The present study indicates that testing all individuals with suspected TB using GeneXpert is a very cost-effective strategy compared to smear microscopy, and therefore, it can be part of the routine diagnostic testing strategy in Ethiopia.

scholarly journals Skin Closure in Laparoscopic Living Donor Nephrectomy: Modern Tissue Adhesive versus Conventional Intracutaneous Suture—A Randomized Study

2014 ◽  
Vol 2014 ◽  
pp. 1-7
Author(s):  
Silje Marie Vormdal ◽  
Morten Skauby ◽  
Silje Lonar ◽  
Ole Øyen
Keyword(s):  
Wound Closure ◽  
Randomized Study ◽  
Tissue Adhesive ◽  
Skin Closure ◽  
Time Consumption ◽  
Living Donor Nephrectomy ◽  
Closure Time ◽  
Numerical Scale ◽  
Laparoscopic Trocar

Purpose. To compare the modern tissue adhesive cyanoacrylate (Liquiband) to conventional, intracutaneous suture and dressing, with regard to wound characteristics, time consumption, donors’ self-satisfaction, and cost. Methods. Sixty-four kidney donors, subjected to laparoscopic hand-assisted nephrectomy, were randomly assigned to skin closure either with tissue adhesive (n=32) or suture (n=32). The follow-up assessments were carried out on postoperative days 2, 4 and at departure, evaluated by the use of a previously set numerical scale for rubor, secretion, gaps, oedema, and blisters. Infections and complications/reinterventions were recorded, as well as operative/skin closure time and costs. The donors’ self-satisfaction was evaluated by means of a questionnaire. Results. There were significant results in favour of tissue adhesive regarding wound closure time and the wound characteristics “rubor,” “blisters,” and “oedema.” Although, the wound parameters “secretion” and “gaps” altogether showed a rather evident tendency in favour of suture, partially at significant levels. A low rate of complications/reoperations/infections did not give rise to any significant differences. Conclusion. Our study concludes that gluing is significantly faster, less traumatic by avoiding needle penetrations, but associated with an increased rate of secretion and gaps—presumably depending on gluing technique. Glue seems particularly suitable for small, laparoscopic/trocar incisions.

scholarly journals Comparative study of time taken for skin closure, infection rate and postoperative pain in skin closure with sutures and staplers in open inguinal hernioplasty

2020 ◽  
Vol 11 (2) ◽  
pp. 1352-1357
Author(s):  
Rajasenthil V ◽  
Sriraman K B ◽  
Kaliyappa C
Keyword(s):  
Wound Healing ◽  
Inguinal Hernia ◽  
Infection Rate ◽  
Wound Closure ◽  
Skin Infection ◽  
Skin Closure ◽  
Absorbable Suture ◽  
Hernia Surgery ◽  
Local Conditions ◽  
Inguinal Hernia Surgery

Wound healing is a complex and dynamic process and is influenced by surgical technique. Optimal wound healing, with a minimal scar that compromises neither appearance nor function, is the desired result. This process is affected by both local and systemic factors. Many local conditions are readily controlled at the time of wound closure, and several fundamental principles of surgical wound closure exist that should be adhered to in the management. Skin is usually closed with sutures then later with skin staplers.Skin staplers are quick and easy to use, but an assistant is usually required to hold the skin edges accurately with forceps or skin hooks.Stapler's closure also causes considerably less damage to wound defenses than closure with least reactive non-absorbable suture. Standard suturing causes significantly more necrosis than stapling in myocutaneous flaps. We did this study to compare the time required for the closure of skin, infection rate, pain at the operated site with sutures and staplers in open inguinal hernia repair. 80 patients who were posted for elective open inguinal hernia surgery at Sri Ramachandra Medical College & Research Institute, porur, Chennai was included in this study. Time taken for closure of skin, infection rate and the pain was less in patients with stapler closure than with skin sutures

Within trial cost-effectiveness of a structured lifestyle intervention in adults with overweight/obesity and type 2 diabetes: Results from the Action for Health in Diabetes (Look AHEAD) Study

2020 ◽  
Author(s):  
Ping Zhang ◽  
Karen M. Atkinson ◽  
George Bray ◽  
Haiying Chen ◽  
Jeanne M. Clark ◽  
...  
Keyword(s):  
Type 2 Diabetes ◽  
Cost Effectiveness ◽  
Lifestyle Intervention ◽  
Health Utility Index ◽  
Health Benefit ◽  
Cost Effective ◽  
Health Utility ◽  
Health Care Expenditures ◽  
Quality Adjusted Life Year

<b>OBJECTIVE </b>To assess the cost-effectiveness (CE) of an intensive lifestyle intervention (ILI) compared to standard diabetes support and education (DSE) in adults with overweight/obesity and type 2 diabetes, as implemented in the Action for Health in Diabetes study. <p><b>RESEARCH DESIGN AND METHODS</b> Data were from 4,827 participants during the first 9 years of the study from 2001 to 2012. Information on Health Utility Index-2 and -3, SF-6D, and Feeling Thermometer [FT]), cost of delivering the interventions, and health expenditures were collected during the study. CE was measured by incremental cost-effectiveness ratios (ICERs) in costs per quality-adjusted life year (QALY). Future costs and QALYs were discounted at 3% annually. Costs were in 2012 US dollars. </p> <p><b>RESULTS </b><a>Over the </a>9 years studied, the mean cumulative intervention costs and mean cumulative health care expenditures were $11,275 and $64,453 per person for ILI and $887 and $68,174 for DSE. Thus, ILI cost $6,666 more per person than DSE. Additional QALYs gained by ILI were not statistically significant measured by the HUIs and were 0.17 and 0.16, respectively, measured by SF-6D and FT. The ICERs ranged from no health benefit with a higher cost based on HUIs, to $96,458/QALY and $43,169/QALY, respectively, based on SF-6D and FT. </p> <p><b>Conclusions </b>Whether<b> </b>ILI was cost-effective over the 9-year period is unclear because different health utility measures led to different conclusions. </p>

Comparison of the ficus for the wound healing activity in various species

2020 ◽  
Vol 10 (4) ◽  
pp. 67-70
Author(s):  
Mothilal K ◽  
Akila CR ◽  
Mahender K ◽  
Chaitanya Kumar K ◽  
Ravi D
Keyword(s):  
Wound Healing ◽  
Wound Closure ◽  
Subcutaneous Tissue ◽  
Significant Activity ◽  
Herbal Extracts ◽  
Standard Drug ◽  
Excision Wound ◽  
Injuries And Wounds ◽  
Skin Conditions ◽  
Wound Healing Activity

Injuries and wounds are any sorts of damage to the skin or subcutaneous tissue. Usually, any wounds of such sorts are self-healed. Sometimes, there may be a delay in healing, and that delay is caused due to the functional delays in various processes of wound healing. All the Ficus plants show similar activities like the antioxidant, anti-inflammatory and wound healing properties 7including skin conditions like ulcers and rheumatism. The anthelmintic property and immunomodulatory are also seen. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. All the extracts showed a better healing ability, but the extract of FBO-100 showed the highest activity followed by FMO followed by FHO and finally the FRO. Overall, the activity of the extract ointment was comparable and was significant compared to the standard drug ointment. The wound closure of the extract ointment treated groups were better and were completed in 12 days, and the activity was more than 96%. The herbal extracts of the same family of Ficus in different plants were investigated for the wound healing activity in the excision wound method, and the extracts showed significant activity compared to the drug. The plants of microcarpa, benghalensis, religiosa and hispida are compared for the activity, and the order showed for the activity was FBO>FMO>FHO>FRO.

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