Role of Heparin Irrigation in the Management of Superficial Burns with Special Reference to Pain Relief and Wound Healing: A Pilot Study

The histology of caudal regeneration in Nereis diversicolor is described with special reference to the role of the cerebral ‘regeneration’ hormone. Wound healing is complete after 8 days; the regenerated stump of tissue then consists of the pygidium, associated anal cirri and a prepygidial region between the pygidium and the posterior margin of the last intact segment. The term segment blastema is used to refer to the cells from which all segmental structures are derived. The segment blastema is situated in the ventral posterior margin of the prepygidial region, and consists of transverse bands of cells with large nuclei (12 µm diameter) and prominent nucleoli. Segment anlagen are formed immediately in front of the segment blastema; the development of the anlagen is described, and six stages of development are defined. The extent of caudal regeneration in different animals is best compared with reference to the total number and stage of development reached by the segment anlagen. Duringnormal regeneration at 18 °C, segment anlagen are first formed after 8 days, and they continue to be formed at the same rate until at least the 21st day after caudal ablation. The oldest segments reach stage 6 after about 15 days of regeneration. Wound healing, pygidium formation, and cirrus development and establishment of the segment blastema all occur in decerebrate animals following the loss of caudal segments, but segment anlagen formation is almost completely inhibited. Implantation of ganglia taken from intact donor animals into the coelom of decerebrate animals which have lost caudal segments initiates segment anlagen formation. The segment blastema of decerebrate animals remains competent to respond in this way for at least 15 days. The regeneration hormone produced by the cerebral ganglion is essential for continued segment anlagen production throughout the 2nd and 3rd weeks of regeneration at 18 °C. Delayed decerebration leads to an arrest of anlagen production, and anlagen younger than stage 3 fail to develop further. Older anlagen (stages 4 and 5) are independent of the regeneration hormone and can continue to differentiate in its absence.

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Experience of negative pressure wound therapy over sternal wound healing: A retrospective review

WCET Journal ◽

10.33235/wcet.39.2.9-18 ◽

2019 ◽

Vol 39 (2) ◽

pp. 9-18

Author(s):

Wai Sze Ho ◽

Wai Kuen Lee ◽

Ka Kay Chan ◽

Choi Ching Fong

Keyword(s):

Wound Healing ◽

Negative Pressure ◽

Negative Pressure Wound Therapy ◽

Assessment Tool ◽

Wound Care ◽

Wound Therapy ◽

Treatment Pathways ◽

Wound Assessment ◽

One Year

Objectives The aim of this study was to retrospectively review the effectiveness of negative pressure wound therapy (NPWT) in sternal wound healing with the use of the validated Bates-Jensen Wound Assessment Tool (BWAT), and explore the role of NPWT over sternal wounds and future treatment pathways. Methods Data was gathered from patients' medical records and the institution's database clinical management system. Seventeen subjects, who had undergone cardiothoracic surgeries and subsequently consulted the wound care team in one year were reviewed. Fourteen of them were included in the analysis. Healing improvement of each sternal wound under continuous NPWT and continuous conventional dressings was studied. In total, 23 continuous NPWT and 13 conventional dressing episodes were analysed with the BWAT. Results Among conventional dressing episodes, sternal wound improvement was 2.5–3% over 10 days to 3.5 weeks, whereas 4–5% sternal healing was achieved in 5 days to 2 weeks with sternal wire presence. Better healing at 11% in 1 week by conventional dressing was attained after sternal wire removal. In NPWT episodes, 8–29%, 13–24%, and 15–46% of healing was observed in 2 weeks, 3.5 to 5 weeks and 6 to 7 weeks, respectively. Only 39% wound healing was acquired at the 13th week of NPWT in one subject. With sternal wire present, 6%–29% wound healing progress was achieved by NPWT in 1–4 weeks, and 16–23% wound improvement in 2 to 4.5 weeks by NWPT after further surgical debridement. After sternal wire removal, 6–34% sternal wound healing occurred by continuous NPWT for 1–2 weeks, and maximum healing at 46% after 2.5 weeks of NPWT were observed. Conclusions Better wound healing was achieved in the NPWT group in comparison to conventional dressings alone. However, suboptimal sternal wound healing by NPWT alone was observed. Removal of sternal wire may improve the effectiveness of NPWT. Successful tertiary closure after NPWT among subjects supports the important bridging role of NPWT in sternal wound healing. Factors causing stagnant sternal wound healing by NPWT alone are discussed.

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