Scalpel versus diathermy skin incision: a randomised clinical trial

Background: Scalpel skin incision produces a clean, incised wound with minimal tissue destruction. Cutting diathermy also produces an incised wound that heals as well as the one that is created by cold scalpel but with an added advantage of achieving quick hemostasis and saving operative time. The main thing of the present study is to verify and compare the usefulness of diathermy skin incision vs. scalpel skin incision in general surgical patients.Methods: The study was conducted in Medical College and Hospital, in 60 patients randomly selected for diathermy and scalpel incision, between 14-65 years age group, between January 2011-June 2012. Post operative pain, seroma, hematoma, discharge were observed and results were analyzed and compared for the two groups using Mann-Whitney U Test.Results: Diathermy group, with incision related time of 6.20±0.97 sec/cm, was significantly quicker (p=0.003) than scalpel incision, with incision time of 6.76±0.84 sec/cm. Postoperative pain scores, recorded daily over five days, showed insignificant difference between the two groups.Conclusions: We demonstrate that the diathermy provides efficient cutting of skin, with no superior wound-healing profile, comparable to that of the traditional scalpel blade.

Pola Luka pada Korban Meninggal akibat Kekerasan Tajam yang Diautopsi di RSUP Prof. Dr. R. D. Kandou Tahun 2014

: Violence due to sharp objects can cause injuries to the body in the forms of stab wound, incised wound, and chop wound. This study was aimed to determine the pattern of wounds in death victims due to sharp violence at the Forensic Medicine Department of Prof. Dr. R. D. Kandou Hospital Manado in 2014. This was a retrospective descriptive study using data of visum et repertum. The results showed that there were 27 autopsied victims killed due to sharp violence. Males (88.4%) and age of 21-30 years (37%) were predominant. The most common type of wound was stab wounds (76.9%), followed by chop wounds (15.4%), and incised wounds (7.7%). Based on the wound location, left chest had the highest percentage (42.4%). In conclusion, the most common death victims due to sharp objects were males, aged 21-30 years, with incised wound into the left-sided chest.Keywords: wound pattern, sharp violence Abstrak: Kekerasan akibat benda tajam dapat menyebabkan luka pada tubuh yang dapat berupa luka tusuk, luka iris dan luka bacok. Penelitian ini bertujuan untuk mengetahui pola luka pada kematian akibat kekerasan tajam di Bagian Ilmu Kedokteran Forensik RSUP Prof. Dr. R. D. Kandou Manado tahun 2014. Kenis penelitian ialah deskriptif retrospektif dengan menggunakan data hasil visum et repertum tahun 2014. Hasil penelitian mendapatkan bahwa jumlah korban meninggal akibat kekerasan tajam yang diautopsi sebanyak 27 korban, didominasi oleh jenis kelamin laki-laki (88,4%), dan umumnya dari kalangan muda 21-30 tahun (37%). Berdasarkan jenis luka didapatkan luka tusuk sebesar 76,9%, luka bacok 15,4%, dan luka iris 7,7%. Berdasarkan lokasi, luka pada bagian dada kiri memiliki persentase tertinggi yaitu sebesar 42,4%. Simpulan penelitian ini ialah korban meninggal akibat kekerasan tajam yang terbanyak ialah berjenis kelamin laki-laki, kategori usia 21-30 tahun, dengan luka tusuk lokasi pada dada kiri.Kata kunci: pola luka, kekerasan tajam

Effect of Carica papaya Extract toward Incised Wound Healing Process in Mice (Mus musculus) Clinically and Histologically

Wound healing entails a sequence of complex biological processes, which is a protective function of the body that focuses on a quick recovery. Reducing wound healing time is crucial in a wound as it lowers the chance of infection and decreases complications and costs. Papaya extract was obtained by a maceration method. It contains papain enzyme, flavonoid, saponin, and alkaloid, which act as an anti-inflammatory, astringent substance, vasodilator, antioxidant, analgesic, with antifungal, and antibacterial properties, and increase the collagen synthesis. This study aimed to assess the effect of Carica papaya extract application toward incised wound healing process in mice (Mus musculus) clinically and histologically. This experimental laboratory study was performed using 24 mice weighing between 30 and 40 grams and 12 and 14 weeks of age as experimental animals. Each group was incised along 5 mm at the labial gingiva under both of mandible anterior teeth with a depth reaching alveolar bone. Papaya extract was applied topically in the morning and evening for 14 days. The clinical result was obtained by assessing the length of wound closure measured every day for 14 days. Based on the statistic test result, it showed that the papaya extract has a significant effect (p≤0.05) toward the healing process of an incised oral wound in mice. Histologically at day 14, 75% concentration papaya extract showed perfect epithelial layer and fibrillation.

FGF-2 expression and the amount of fibroblast in the incised wounds of Rattus norvegicus rats induced with Mauli banana (Musa acuminata) stem extract

Background: Traditional wound treatment using herbal medicine is thought to maintain the health of families and society in general economically, effectively, and efficiently without inducing side effects. One genus of plant that can be used as a traditional medicine is the Mauli banana, indigenous to South Borneo. Mauli banana stem contains bioactive compounds, most of which are tannins along with ascorbic acid, saponin, β-carotene, flavonoids, lycopene, alkaloids, and flavonoids. Tanin has antibacterial and antioxidant effects at low concentrations, as wells as antifungal ones at high concentrations. Purpose: This study aimed to analyze the effects of Mauli banana stem extract at concentrations of 25%, 37.5%, and 50% on the quality of incised wound healing in male Rattus norvegicus rats by assessing FGF-2 expression and fibroblast concentration on days 3 and 7. Methods: This research represented an experimental laboratory-based investigation involving 32 rats of the Rattus norvegicus strain aged 2-2.5 months old. Sampling was performed using a simple random sampling technique since the research population was considered homogeneous and divided into 8 treatment groups (C3, M3-25, M3-37.5, M3-50, C7, M7-25, M7-37.5, M7-50). The rats in each group were anesthetized before their back was incised with length and width of 15x15mm with a depth of 2mm. Gel hydroxy propyl cellulose medium (HPMC) was applied to the incised wound of each rat in the control group, while stem Mauli banana extract was applied to that of each rat in the treatment groups three times a day at an interval of 6-8 hours. On day 3, four rats from each group were sacrificed, while, in the remaining groups, the same procedure was performed until day 7, at which point they (8 groups) were sacrificed for HE examination in order to assess the amount of fibroblast and for IHC examination to examine FGF-2 expression. Data regarding FGF-2 expression and the amount of fibroblast were analysed by means of One-way Anova and HSD. Results: The results showed that the Mauli banana stem extract could significantly improve the expression of FGF-2 and the amount of fibroblast cells compared to C3 and C7 groups. The highest increase in FGF-2 expression and fibroblast amount were found in all groups on days 3 and 7 treated with the Mauli banana stem extract at a concentration of 50%. Conclusion: There was an increase of FGF-2 expression and the amount of fibroblast cells in the incision wound healing process that induced with Mauli banana stem extract.

Uji efektivitas ekstrak melati (Jasminum sambac) pada penyembuhan luka insisi kelinci (Oryctolagus cuniculus)

Flowers and leaves of jasmine (Jasminum sambac) have chemical substances that contain phytoconstituents such as alkaloids, glycosides, saponins, terpenoids and flavonoids. Flavonoid, an antioxidant, plays some importnat roles in wound healing due to their antibacterial effect. This study aimed to determine the effectiveness of jasmine leaf extract on incision wound healing in rabbits. This was an experimental study using three rabbits as test subjects. Wounds of 0.3 cm depth, 5 cm length, and 0.5 cm widened at both ends of the wound were made on the right and left sides of the back. Incised wound on the left side was treated with jasmine leaf extract ointment meanwhile the wound on the right side was untreated and was covered only with sterile gauze. Wounds were observed for two weeks to evaluate the changes of macroscopical length. The results showed that wounds treated with jasmine leaf extract ointment shrank and their edges united with the surrounding tissues faster than the untreated wounds. Conclusion: Jasmine leaf extract ointment accelerated incised wound healing in rabbits. Keywords : wound healing, incision wounds, jasmine leaves Abstrak: Bunga dan daun melati (Jasminum sambac) memiliki kandungan kimia yang berpotensi farmakologi seperti alkaloid, glycosid, saponin, terpenoid dan flavonoid. Flavonoid berpotensi sebagai antioksidan dan mempunyai kerja yang dibutuhkan dalam proses penyembuhan luka seperti antibakteri. Penelitian ini bertujuan untuk mengetahui efektivitas ekstrak daun melati pada penyembuhan luka insisi kelinci. Jenis penelitian ini eksperimental menggunakan tiga ekor kelinci sebagai hewan uji. Punggung kanan dan kiri kelinci diinsisi sedalam 0,3 cm dengan panjang 5 cm yang dilebarkan 0,5 cm pada kedua ujung sisi luka. Luka punggung kiri diberi salep ekstrak daun melati, luka punggung kanan tidak diberi perlakuan hanya ditutup kasa steril. Pengamatan selama dua minggu untuk melihat perubahan panjang luka secara makroskopik. Hasil penelitian mendapatkan bahwa luka yang diberi salep ekstrak daun melati lebih cepat mengecil serta memiliki permukaan luka yang rata dan menyatu dengan kulit sekitar dibandingkan luka yang tidak diberi salep ekstrak daun melati. Simpulan: Salep ekstrak daun melati memiliki efek untuk mempercepat penyembuhan luka insisi kelinci.Kata kunci: penyembuhan luka, luka insisi, daun melati