Wound Closure and Care in Oral and Maxillofacial Surgery

Management of soft tissue wounds needs a careful assessment of the wound, a good understanding of wound types and healing as well as adequate knowledge and skill for wound care. The various steps in wound care include cleansing and debridement, haemostasis, tetanus immunisation and antibiotic medication and wound closure.Wound closure can be accomplished in diverse ways, but suturing remains the mainstay. A wide variety of materials are available for wound suturing. One has to choose the right material and technique depending on the wound type and closure needs. Alternate techniques such as staples, tapes and adhesives are fast gaining popularity.

Clinical case report: Treatment and care results for post-traumatic infection in patients with type II diabetes at the General Clinic of the Hanoi University of Public Health

Objectives of the study: To describe a clinical case of care and treatment of severe post-traumatic wounds in a patient with type 2 diabetes at the General Clinic of Hanoi University of Public Health. Patient: A 56-year-old man with a history of type 2 diabetes who did not receive treatment regularly, entered the clinic on August 9, 2018, for the reason of pain and runny pus at the forearm wound. Two months ago, the patient fell down the stairs, injured his forearm, and had an extensive ulcer wound that got infected. The patient was treated at many hospitals but the wound was not healed, deep ulcers had to be cut and kept it open. After that, the patient admitted to the clinic, was performed some subclinical tests, received internal treatment combined with surgery, was cared for the wound by infrared light, and followed a nutrition plan for diabetics. After 4 months of treatment, the wound healed, formed a scar, and painless. Conclusion: Treating infected wounds in patients with special conditions is extremely difficult. To heal quickly, we can combine many treatments such as internal medicine, surgery, and physical therapy, nutrition therapy. Keywords: infected wound, type 2 diabetes

Wounds: an overlooked burden (Part 1) – effective wound management starts with proper wound assessment

Healthcare professionals in general practice are tasked with treatment and management of wounds on a daily basis. The prognoses of these wounds are directly affected by the ability of the clinician to assess these wounds according to several parameters, including the wound type and the features which determine whether a wound is acute or transforming to a chronic wound. This can be achieved by proper and continuous wound assessment, which should guide wound treatment strategies to ensure optimal wound healing and prevent progression to complicated wounds.

Retrospective chart- review of Tetanus cases admitted in a tertiary care hospital

Background and Aims: Tetanus is a cause of thousands of death and disability annually in developing countries. Nepal is a low-income country and has achieved maternal-neonatal transmission elimination status. However, the literature regarding the status of generalized tetanus in adult populations is limited. This study was conducted to determine the clinical profile and outcome of patients with generalized tetanus. Methods: This was a retrospective study conducted among adult patients with generalized tetanus admitted at the Department of Internal Medicine or Department of Anesthesiology and Critical Care at B.P. Koirala Institute of Health Sciences, Dharan, Nepal from January 2012 to December 2016. Results: Of 40 patients with generalized tetanus, the mean age was 47 } 16 years. Most of the patients were male (95%) and were not vaccinated with tetanus toxoid (67.5%). The most common wound type was skin puncture. Tracheostomy was done in 30 patients (75%). Twenty-nine patients (72.5%) were discharged after completion of treatment, seven patients (17.5%) took leave against medical advice, and three patients (7.5%) died at the hospital during treatment. Conclusions: Generalized tetanus is still a public health concern in Nepal. It is more common in males and at ages above 40 years. Perforative skin wounds sustained from the wood sticks or needles were a frequent cause. Most of the patients with generalized tetanus needed a tracheostomy and mechanical ventilation. The in-hospital mortality rate of generalized tetanus was 7.5%.

Piroxicam-Collagen-Based Sponges for Medical Applications

Depending on the concentration of the drug and/or the method of administration, drugs could be used in various ways. To take full advantage of the drug beneficial properties in oral medical interventions but also in other types of surgery, like plastic surgery, general surgery, or gynecological surgery, the drug concentration as well as the administration method itself will depend on the wound, type of surgery, and severity of the postoperative pain which can be very different. Generally, the local administration methods are recommended. Piroxicam, a nonsteroidal anti-inflammatory drug (NSAID) of the oxicam class, is generally used to relieve the symptoms of pain and inflammation. Starting from the idea of the special benefit of the interference between collagen-based materials and drug beneficial properties, our work was focused on the synthesis and characterization of new collagen-piroxicam materials. These new collagen-based materials present a good water absorption, and the piroxicam release suggests a biphasic drug release profile whereas the obtained values for the release exponent revealed a complex release mechanism including swelling, diffusion, and erosion.

MRSA infected wounds in a community hospital in rural tropical Ecuador

<p align="justify"><em>Introduction</em>: Although community acquired MRSA has been well described in many areas around the globe, little information is available about the prevalence of MRSA infections in rural areas of the Andean Region of South America. This study characterizes wound infections from a rural community hospital in Ecuador.</p><p align="justify"><em>Methods</em>: A retrospective review of 235 bacterial isolates from infected wounds that included wound type, site, gender, etc... </p><p align="justify"><em>Results</em>: Ninety-two (39.1%) isolates were <em>Staphylococcus aureus</em>. Of these, forty-two (44.7%) were methicillin resistant <em>S. aureus</em> (MRSA). </p><p align="justify"><em>Conclusion</em>: community acquired MRSA wound infections rates appear to warrant the use of empiric antibiotics that cover MRSA infections. If wound infections reflect a bacterial epidemiology similar to that of skin and soft tissues infections, empiric anti-MRSA antibiotic coverage is also warranted. In Ecuador, national antibiotic guidelines do not provide for such empiric coverage. </p>