Comparison of a Novel Silicone Gel Wound Dressing versus Bacitracin after Follicular Unit Extraction Hair Transplantation

Background Follicular unit extraction (FUE) hair transplantation subjects are excellent candidates to assess wound dressings. The wound surface area is large and adequately delineated to allow randomization, while in-patient split scalp designs allow patients to serve as their own controls. Objectives This randomized, single-blinded, split-scalp comparison trial compares a novel, film-forming silicone gel-- Stratamed (Stratpharma AG, Basel, Switzerland) -- to Bacitracin (McKesson Medical-Surgical Inc., Richmond, VA) in subjects undergoing FUE. Methods Twenty subjects were randomized to receive Stratamed and Bacitracin on alternating sides of the scalp. Primary outcome measures included blinded clinician assessments of edema, erythema, crusting, healing response and outcome preference. Secondary measures included subject-reported assessments of pain and pruritis as well as FaceQ scores taken at post-FUE days two through six. Results Twenty subjects were enrolled. Nineteen completed the trial. All subjects were non-smokers, and none had medical comorbidities expected to impact wound healing. An average of 1778 follicles per subject were harvested. No adverse events were reported, and all subjects healed by day 7. Healing response and outcome preference were significantly higher at day 1 in the Stratamed group and by day 7, both groups were similar. There were no significant differences between groups for edema, erythema, or crusting. There were no significant differences between groups for subject-reported outcomes of pain, pruritis, or FACE-Q scores. When asked which product they preferred using, 44% of subjects preferred using Stratamed versus 22% who preferred Bacitracin. Conclusions The Stratamed wound dressing was well-tolerated in patients undergoing FUE. Stratamed may speed the healing response in the early phase of wound healing.

REVIEW OF VRANASHOPHA W.S.R. TO INFLAMMATORY SWELLINGS

Acharya Sushruta had a complete knowledge of Vranashopha and described Vranashopha into 3 progressive stages. Inflammation in Ayurveda is known by different names in different contexts namely Shotha, Shopha, Svayatu and Utsedha. Inflammation is duly recognised in Ayurveda as a pathological manifestation, while Modern Medicine considers Inflammation as a symptom or rather as a healing response of the body. Ayurveda treats the concepts of Inflammation as symptom of a disease, an independent disease and complication of disease. Vranashopha shares common pathological features of Inflammation. The disturbances in micro channel circulation in Inflammation are due to Srotodusti (clogging of channels) by Amma (toxic waste of metabolism). The proper clinical approch to Vranashopha with Modern concept plays a important role in management and preventing complication of Vranashopha.

From benchtop to clinic: a translational analysis of the immune response to submicron topography and its relevance to bone healing

Proper regulation of the innate immune response to bone biomaterials after implantation is pivotal for successful bone healing. Pro-inflammatory M1 and anti-inflammatory M2 macrophages are known to have an important role in regulating the healing response to biomaterials. Materials with defined structural and topographical features have recently been found to favourably modulate the innate immune response, leading to improved healing outcomes. Calcium phosphate bone grafts with submicron-sized needle-shaped surface features have been shown to trigger a pro-healing response through upregulation of M2 polarised macrophages, leading to accelerated and enhanced bone regeneration. The present review describes the recent research on these and other materials, all the way from benchtop to the clinic, including in vitro and in vivo fundamental studies, evaluation in clinically relevant spinal fusion models and clinical validation in a case series of 77 patients with posterolateral and/or interbody fusion in the lumbar and cervical spine. This research demonstrates the feasibility of enhancing biomaterial-directed bone formation by modulating the innate immune response through topographic surface features.