scholarly journals Acetic acid dressings: Finding the Holy Grail for infected wound management

2017 ◽  
Vol 50 (03) ◽  
pp. 273-280 ◽  
Author(s):  
Kapil S. Agrawal ◽  
Anup Vidyadhar Sarda ◽  
Raghav Shrotriya ◽  
Manoj Bachhav ◽  
Vinita Puri ◽  
...  
Keyword(s):  
Wound Healing ◽  
Acetic Acid ◽  
Topical Application ◽  
Donor Site ◽  
Wound Management ◽  
Venous Ulcers ◽  
Health Care Burden ◽  
Wide Range ◽  
Infected Wounds ◽  
Graft Donor

ABSTRACT Background: Wounds have since long, contributed majorly to the health-care burden. Infected long-standing non-healing wounds place many demands on the treating surgeon and are devastating for the patients physically, nutritionally, vocationally, financially, psychologically and socially. Acetic acid has long been included among agents used in the treatment of infected wounds. In this study, we have evaluated the use of acetic acid for topical application in the treatment of infected wounds. Materials and Methods: A total of 100 patients with infected wounds were treated with topical application of 1% acetic acid as dressing material after appropriate cleaning. A specimen of wound swab was collected before first application and further on days 3, 7, 10 and 14. Daily dressings of wounds were done similarly. Minimum inhibitory concentration (MIC) of acetic acid against various organisms isolated was determined. Results: The patients treated ranged between 9 and 60 years, with the mean age 33 years. Nearly 70% of patients were male. Aetiologies of wounds: infective 35, diabetic 25, trauma 20, burns 10, venous ulcers 5 and infected graft donor site 5. Various microorganisms isolated include Pseudomonas aeruginosa (40%), Staphylococcus aureus (2%), Acinetobacter (12%), Escherichia Coli (5%), Proteus mirabilis (3%), Klebsiella (18%), methicillin-resistant S. aureus (10%), Streptococcus (2%) and Enterococcus (1%), Citrobacter (1%). Few wounds (6%) also isolated fungi. About 28%, 64% and 8% of patients isolated no growth on culture after 7, 14 and 21 days, respectively. MIC of all isolated organisms was ≤0.5%. Conclusion: pH of the wound environment plays a pivotal role in wound healing. Acetic acid with concentration of 1% has shown to be efficacious against wide range of bacteria as well as fungi, simultaneously accelerating wound healing. Acetic acid is non-toxic, inexpensive, easily available and efficient topical agent for effective elimination of wound infections caused due to multi-drug resistant, large variety of bacteria and fungus.

scholarly journals Does Topical Application of Bupivacaine (marcaine) to Skin Graft Donor Site Have Any Effect on Moriarty Sign?

2000 ◽  
Vol 2 (3) ◽  
Author(s):  
O. M. Oluwatosin ◽  
F. O. Abikoye ◽  
S. A. Ademola ◽  
A.A. Sanusi ◽  
O. A. Soyannwo
Keyword(s):  
Topical Application ◽  
Skin Graft ◽  
Donor Site ◽  
Graft Donor

scholarly journals CICAFAST: comparison of a biological dressing composed of fetal fibroblasts and keratinocytes on a split-thickness skin graft donor site versus a traditional dressing: a randomized controlled trial

Trials ◽  
2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Alexandra Poinas ◽  
Pierre Perrot ◽  
Judith Lorant ◽  
Olivier Nerrière ◽  
Jean-Michel Nguyen ◽  
...  
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Skin Grafts ◽  
Thickness Skin ◽  
Fetal Fibroblasts ◽  
Biological Dressing ◽  
Graft Donor

Abstract Background Wound repair is one of the most complex biological processes of human life. Allogeneic cell-based engineered skin substitutes provide off-the-shelf temporary wound coverage and act as biologically active dressings, releasing growth factors, cytokines and extracellular matrix components essential for proper wound healing. However, they are susceptible to immune rejection and this is their major weakness. Thanks to their low immunogenicity and high effectiveness in regeneration, fetal skin cells represent an attractive alternative to the commonly used autologous and allogeneic skin grafts. Methods/design We developed a new dressing comprising a collagen matrix seeded with a specific ratio of active fetal fibroblasts and keratinocytes. These produce a variety of healing growth factors and cytokines which will increase the speed of wound healing and induce an immunotolerant state, with a slight inflammatory reaction and a reduction in pain. The objective of this study is to demonstrate that the use of this biological dressing for wound healing at the split-thickness skin graft (STSG) donor site, reduces the time to healing, decreases other co-morbidities, such as pain, and improves the appearance of the scar. This investigation will be conducted as part of a randomized study comparing our new biological dressing with a conventional treatment in a single patient, thus avoiding the factors that may influence the healing of a graft donor site. Discussion This clinical trial should enable the development of a new strategy for STSG donor-wound healing based on a regenerative dressing. The pain experienced in the first few days of STSG healing is well known due to the exposure of sensory nerve endings. Reducing this pain will also reduce analgesic drug intake and the duration of sick leave. Our biological dressing will meet the essential need of surgeons to “re-crop” from existing donor sites, e.g., for thermal-burn patients. By accelerating healing, improving the appearance of the scar and reducing pain, we hope to improve the conditions of treatment for skin grafts. Trial registration ClinicalTrials.gov, ID: NCT03334656. Registered on 7 November 2017.

scholarly journals Does the use of topical honey result in a faster rate of second intention wound healing in dogs?

2020 ◽  
Vol 5 (4) ◽  
Author(s):  
Louisa Marcombes
Keyword(s):  
Wound Healing ◽  
Topical Application ◽  
Research Question ◽  
Wound Management ◽  
Editorial Office ◽  
Clinical Expertise ◽  
Open Wound ◽  
Bottom Line ◽  
Duplicate Publication ◽  
Complete Wound Healing

PICO question In healthy dogs undergoing open wound management, does the topical application of honey, when compared to wounds treated with daily saline washes only, reduce the time to complete wound healing?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Two studies satisfied the inclusion criteria for answering the PICO; both were prospective randomised controlled trials Strength of evidence Weak Outcomes reported The studies demonstrated a possible effect size of clinical importance of the use of honey in the treatment of canine wounds in terms of time to complete wound healing and antibacterial effect. However, the strength of the evidence provided by both studies is severely weakened by flaws in trial design, implementation and reporting, and the possible risk of pseudo replication between the two trials reported Conclusion The use of topical honey in canine open wound management may reduce time to complete wound healing. However, the evidence for this is weak. At present, the evidence that use of topical honey in canine wounds reduces time to healing is insufficient to warrant a change in clinical practice   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.   Editorial notice: Upon conducting the literature search for this Knowledge Summary the author discovered that the same paper had been published in two separate journals and that a third paper by the same author appeared to have used data from the same experimental subjects as the duplicate publication, despite reporting different methodology. The duplicate publications have been appraised by the author as one paper. The editorial office alerted the journals in question which resulted in the article that appeared in the Iranian Journal of Veterinary Surgery (Jalali, F.S. S., Tajik, H., Saifzaideh, S and Fartash, B. (2007b) Topical Application of Natural Urmia Honey on Experimental Burn Wounds in the Dog: Clinical and Microbiological Studies. Iranian Journal of Veterinary Surgery. 2(2), 13–21) being retracted: http://www.ivsajournals.com/article_114759.html. See our own policy on duplicate publication for more information.  

scholarly journals Improved wound management by regulated negative pressure-assisted wound therapy and regulated, oxygen- enriched negative pressure-assisted wound therapy through basic science research and clinical assessment

2012 ◽  
Vol 45 (02) ◽  
pp. 291-301 ◽  
Author(s):  
Moris Topaz
Keyword(s):  
Wound Healing ◽  
Negative Pressure ◽  
Basic Science ◽  
Science Research ◽  
Supplemental Oxygen ◽  
Global Scale ◽  
Wound Management ◽  
Innovative Technology ◽  
Wound Therapy ◽  
Wide Range

ABSTRACTRegulated negative pressure-assisted wound therapy (RNPT) should be regarded as a state-of-the-art technology in wound treatment and the most important physical, nonpharmaceutical, platform technology developed and applied for wound healing in the last two decades. RNPT systems maintain the treated wound′s environment as a semi-closed, semi-isolated system applying external physical stimulations to the wound, leading to biological and biochemical effects, with the potential to substantially influence wound-host interactions, and when properly applied may enhance wound healing. RNPT is a simple, safe, and affordable tool that can be utilized in a wide range of acute and chronic conditions, with reduced need for complicated surgical procedures, and antibiotic treatment. This technology has been shown to be effective and safe, saving limbs and lives on a global scale. Regulated, oxygen-enriched negative pressure-assisted wound therapy (RO-NPT) is an innovative technology, whereby supplemental oxygen is concurrently administered with RNPT for their synergistic effect on treatment and prophylaxis of anaerobic wound infection and promotion of wound healing. Understanding the basic science, modes of operation and the associated risks of these technologies through their fundamental clinical mechanisms is the main objective of this review.

Wounds in Patients with Cancer

2020 ◽  
Author(s):  
Mark W. Clemens ◽  
Brian J. Blumenauer ◽  
Ashleigh M. Francis ◽  
Jonathon B. Olenczak ◽  
Jesse C. Selber ◽  
...  
Keyword(s):  
Wound Healing ◽  
Radiation Therapy ◽  
Donor Site ◽  
Donor Site Morbidity ◽  
Wound Management ◽  
Wound Complications ◽  
Tissue Quality ◽  
Form And Function ◽  
Integral Role ◽  
And Function

Reconstructive surgery plays an integral role in helping restore form and function in patients with complex oncologic wounds. The intricate process of wound healing can be adversely affected by exposure to chemotherapeutic and radiation therapies. Assessment of available donor tissue quality, previous radiation therapy, vascular status, and donor site morbidity are essential when determining the most appropriate reconstructive approach for definitive wound management. The timing of reconstruction in relation to chemotherapy or radiotherapy regimens influences wound healing. Additionally, the timing of reconstruction is important in order to avoid delaying additional adjuvant therapies. Optimizing nutritional status is critical for improved patient outcomes in the oncologic patient population. At times, palliative efforts by means of surgical debulking are required of a reconstructive surgeon as advanced cancers can leave patients with disfiguring, fungating masses. This review contains 9 figures, and 44 references. Keywords: wounds in cancer, wounds in the cancer patient, oncologic wounds, oncologic wound healing, oncologic wound management, wound complications, effect of chemotherapy on wound healing, effect of radiation therapy on wound healing, oncologic reconstruction

scholarly journals TERAPI LARVA PADA LUKA KRONIS TERBUKA

2015 ◽  
Vol 7 (1) ◽  
Author(s):  
Sunny Wangko
Keyword(s):  
Wound Healing ◽  
Growth Factors ◽  
Chronic Wound ◽  
Healing Process ◽  
Bioactive Molecules ◽  
Wound Management ◽  
Wound Healing Process ◽  
Beneficial Effects ◽  
Infected Wounds ◽  
Larval Therapy

Abstract: The usage of larvae in wound treatment has been known across the centuries in different countries. However, larval therapy is offered when the conventional therapy has failed in the management of chronic, infected wounds. Concerning the larval therapy, it was presumed that the wound healing was due to the mechanical debridement effect of the larval movement and of their hooks. To date, a variety of study reports reveals that there are several beneficial effects of the larval therapy, inter alia: secretion/excretion of larvae contains enzymes, growth factors, and cytokines that collaborate in the wound healing process. The bioactive molecules in the secretion/excretion of the larvae has to be further studied and to be developed, therefore, they can be applied in the wound management efficiently and economically. Keywords: larval therapy, chronic wound, healing process.     Abstrak: Walaupun pemanfaatan larva pada luka kronis telah sangat lama dikenal di berbagai negara, terapi larva umumnya digunakan bila terapi konvensional telah gagal. Awalnya diduga bahwa efek debridemen mekanis oleh gerakan larva dan kaitnya yang paling berperan. Dewasa ini, laporan berbagi studi telah mengungkapkan bahwa larva menyekresi dan menyintesis berbagai bahan baik berupa enzim, sitokin, dan growth factors yang turut berperan dalam proses penyembuhan luka. Adanya molekul bioaktif dalam ekskresi dan sekresi larva perlu diteliti dan dikembangkan agar dapat diaplikasikan dengan lebih efisien dan ekonomis. Kata kunci: terapi larva, luka kronis, penyembuhan luka.

scholarly journals Application of Honey and Transparent Dressing to Split Thickness Skin Graft Donor Site and Its Effect on Epithelialization Rate

1970 ◽  
Vol 1 (3) ◽  
Author(s):  
Teuku A. ◽  
Nandita Melati P. ◽  
Gentur Sudjatmiko ◽  
Asrofi S. ◽  
Ishandono D.
Keyword(s):  
Clinical Trial ◽  
Wound Healing ◽  
Skin Graft ◽  
Donor Site ◽  
Split Thickness Skin Graft ◽  
Parallel Design ◽  
Thickness Skin ◽  
Graft Donor ◽  
The Mean ◽  
Clinical Photograph

Background: Split thickness skin graft (STSG) is one of the modalities used to close a defect. The donor site can be healed secondarily with tulle grass and moist gauze after 14 days and with transparent dressing will take about 10-13 days. Recently the wound healing by using honey application has been used. Whether or not using honey application with transparent dressing will hasten the epithelialization rate of the STSG donor site is now in question. Method: This research is an open, non-randomized clinical trial with a parallel design and intervention using honey application with transparent dressing. A total of 19 patients (7 female and 8 male) were included in this study. The reapplication of honey was done every two days. The patients was followed up every day, with clinical photograph taken and complaints such as pain, odor and infection noted. Results: The mean epithelialization rate of the donor site treated with honey and transparent dressing was 9,74 (+0,24) days compared to 10,79 (+1,23) days in the transparent-dressing-only group (p=0,00). Conclusion: The application of honey with transparent dressing to cover for STSG donor site led to a faster epithelialization rate, less odor and less pain. Commercial honey was used, and readily available.

Eliminating non-healing wounds: a review

2021 ◽  
Vol 16 (4) ◽  
pp. 391-404
Author(s):  
Damien P Kuffler
Keyword(s):  
Wound Healing ◽  
Platelet Rich Plasma ◽  
Mechanisms Of Action ◽  
Wound Management ◽  
Cutaneous Wounds ◽  
Venous Ulcers ◽  
Metabolic Conditions ◽  
Healing Wounds ◽  
Complete Wound Healing

Non-healing cutaneous wounds, including pressure, diabetic and venous ulcers, are wounds where the skin and underlying tissues die due to ischemia, infection, metabolic conditions, immunosuppression or radiation. Some can be eliminated with relatively straightforward techniques, although they may continue to grow in diameter and depth, becoming increasingly painful and never heal. Others respond more slowly or poorly to treatment, while others are recalcitrant to treatments. This review examines the etiology of non-healing wounds and different wound management treatments. In addition, it examines the efficacy of platelet-rich plasma in promoting wound healing and its potential mechanisms of action. It is concluded that platelet-rich plasma alone, but more effectively when combined with another technique(s), has the greatest potential for promoting complete wound healing. However, further studies are required to determine whether the efficacy of wound healing induced by each of these techniques is enhanced by applying the techniques simultaneously.

scholarly journals Bioinspired Materials for Wound Healing Application: The Potential of Silk Fibroin

Materials ◽  
2020 ◽  
Vol 13 (15) ◽  
pp. 3361
Author(s):  
Mauro Pollini ◽  
Federica Paladini
Keyword(s):  
Wound Healing ◽  
Silk Fibroin ◽  
Tissue Regeneration ◽  
Antibacterial Properties ◽  
Scientific Research ◽  
Wound Management ◽  
Biomedical Devices ◽  
Wide Range ◽  
Bioinspired Materials ◽  
Definition Of

Nature is an incredible source of inspiration for scientific research due to the multiple examples of sophisticated structures and architectures which have evolved for billions of years in different environments. Numerous biomaterials have evolved toward high level functions and performances, which can be exploited for designing novel biomedical devices. Naturally derived biopolymers, in particular, offer a wide range of chances to design appropriate substrates for tissue regeneration and wound healing applications. Wound management still represents a challenging field which requires continuous efforts in scientific research for definition of novel approaches to facilitate and promote wound healing and tissue regeneration, particularly where the conventional therapies fail. Moreover, big concerns associated to the risk of wound infections and antibiotic resistance have stimulated the scientific research toward the definition of products with simultaneous regenerative and antimicrobial properties. Among the bioinspired materials for wound healing, this review focuses attention on a protein derived from the silkworm cocoon, namely silk fibroin, which is characterized by incredible biological features and wound healing capability. As demonstrated by the increasing number of publications, today fibroin has received great attention for providing valuable options for fabrication of biomedical devices and products for tissue engineering. In combination with antimicrobial agents, particularly with silver nanoparticles, fibroin also allows the development of products with improved wound healing and antibacterial properties. This review aims at providing the reader with a comprehensive analysis of the most recent findings on silk fibroin, presenting studies and results demonstrating its effective role in wound healing and its great potential for wound healing applications.

Treating skin graft donor sites: a comparative study between remnant skin use and polyurethane foam

2019 ◽  
Vol 28 (7) ◽  
pp. 469-477
Author(s):  
Sae Hwi Ki ◽  
Sung Hwan Ma ◽  
Jong Hwan Choi ◽  
Seung Hyun Sim ◽  
Hyung Muk Kim
Keyword(s):  
Wound Healing ◽  
Patient Satisfaction ◽  
Polyurethane Foam ◽  
Skin Graft ◽  
Donor Site ◽  
Healing Time ◽  
Pain Patient ◽  
Donor Site Pain ◽  
Graft Donor ◽  
The Aesthetic

Objective: Excess remnant skin is retained for use in additional grafting in case of split-thickness skin graft (STSG) failure. We hypothesise that regrafting with remnant skin offers greater efficacy and advantages in wound healing and donor site appearance. Methods: Skin graft donor sites were assessed by comparing those regrafted with remnant skin with those treated with polyurethane foam dressing. Healing time, pain, patient satisfaction, itching sensation, skin stiffness and irregularity between regrafting and foam dressing were compared. The aesthetic satisfaction of donor site was evaluated by four board-certified plastic surgeons. The differences were tested statistically. Results: A total of 39 patients received a STSG due to skin or soft tissue wounds caused by burn, trauma and cancer reconstruction. The donor site healing time was shorter with remnant skin regrafting compared with foam dressing. There was no difference with respect to donor site pain between the two treatment groups. At two weeks after skin graft, patient satisfaction was higher in those treated with remnant skin than in those treated with foam dressing. Aesthetic assessment was improved after 12 weeks. Conclusion: Donor site dressing using remnant skin appears to improve wound healing and enhance the aesthetic outcome of donor sites.

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