Interaction of culture and grief amongst women who terminated a pregnancy in adolescence: A narrative approach

Background: Culture plays a vital role in resolving grief in African communities. However, women who terminate a pregnancy in adolescence are typically not exposed to cultural rituals that could ease their grief.Objectives: The purpose of this article is to explore the interaction of culture and grief amongst women who terminated a pregnancy in adolescence.Method: A qualitative exploratory study was undertaken using a narrative approach. Unstructured interviews were conducted to solicit narratives from 11 women who terminated a pregnancy in adolescence.Results: Data were analysed through narrative, thematic data analysis. Three themes emerged from the findings: delayed post-traumatic growth, low body esteem and an alteration in the development of maternal identity.Conclusion: The study intended to explore the interaction of culture and grief amongst women who terminated a pregnancy in adolescence. The researcher determined that women who had not honoured their culture because of the secrecy surrounding the termination of pregnancy had delayed healing and an altered self-image.

Wound Complications with Multiple Wrist Incisions in Distal Radius Reconstruction

Background Placement and spacing of skin incisions are important for maintaining soft tissue perfusion and viability, particularly in the setting of local trauma. Question/Purpose The aim of this article is to determine if multiple skin incisions in the surgical management of distal radius fractures result in an increased risk of postoperative wound complications, particularly in the setting of high-energy mechanisms of injury with substantial initial displacement and associated soft-tissue insult that require multiple incisions for distal radius reconstruction. Patients and Methods A multicenter, retrospective chart review was performed for all adult patients who underwent open reduction, internal fixation of a closed distal radius fracture with multiple (≥2) hand, and wrist incisions with minimum follow-up of 6 weeks. Primary outcome measures included wound healing complications such as partial or complete skin necrosis, dehiscence, delayed healing, and superficial or deep infections. Results For 118 wrists, a total of 305 incisions were utilized, averaging 2.6 incisions per patient (range: 2–6) with the flexor carpi radialis and dorsal distal radius approaches occurring in 86 and 78% of cases, respectively. One patient was identified as having a pyogenic granuloma along an incision. However, two patients were identified as having wound concerns, including fracture blisters (n = 1) and wound margin epidermolysis (n = 1) along the incision. There were no cases of skin bridge necrosis, delayed healing, wound dehiscence, or infection. Conclusions There is no increased risk of wound healing complications with the use of multiple skin incisions (≥2) in the surgical management of distal radius fractures, afforded by the abundant and robust angiosomes around the wrist. Surgeons should have the confidence to utilize the necessary number of skin incisions to effectively reconstruct distal radius fractures.

Analysis of the Risk Factors of Upper Limb Lymphedema after Breast Cancer Surgery and Nursing Care

Objective: To evaluate and analyze the influencing factors of upper limb lymphedema after breast cancer surgery, and to study effective nursing intervention measures. Methods: 500 cases of early breast cancer patients from October 2017 to December 2020 were selected, all patients underwent surgical intervention, retrospectively analyzed the basic clinical data of patients, and statistically analyzed the influencing factors of upper limb lymphedema. All patients with upper extremity lymphedema received high-quality nursing intervention, and the specific nursing effect was analyzed. Results: Logistic regression analysis showed that the risk factors of upper limb lymphedema after breast cancer surgery included hypertension, postoperative upper limb functional exercise, delayed healing of incision, radiotherapy and so on. After nursing intervention, the patients’ elbow 10cm, elbow 10cm, wrist size value and VAS score were better than those before nursing (P < 0.05). The quality of life score of patients after nursing intervention was significantly better than that before nursing (P < 0.05). Conclusion: Hypertension, postoperative upper limb functional exercise, delayed healing of incision, radiotherapy and other factors can induce upper limb lymphedema after breast cancer surgery. Effective nursing intervention can alleviate the condition of patients with upper limb lymphedema and improve their quality of life, which is worthy of comprehensive promotion.

Biofilm and Equine Limb Wounds

In chronic wounds in humans, biofilm formation and wound chronicity are linked, as biofilms contribute to chronic inflammation and delayed healing. Biofilms are aggregates of bacteria, and living as biofilms is the default mode of bacterial life; within these aggregates, the bacteria are protected from both antimicrobial substances and the immune response of the host. In horses, delayed healing is more commonly seen in limb wounds than body wounds. Chronic inflammation and hypoxia are the main characteristics of delayed wound healing in equine limbs, and biofilms might also contribute to this healing pattern in horses. However, biofilm formation in equine wounds has been studied to a very limited degree. Biofilms have been detected in equine traumatic wounds, and recent experimental models have shown that biofilms protract the healing of equine limb wounds. Detection of biofilms within wounds necessitates advanced techniques that are not available in routine diagnostic yet. However, infections with biofilm should be suspected in equine limb wounds not healing as expected, as they are in human wounds. Treatment should be based on repeated debridement and application of topical antimicrobial therapy.

In-stent restenosis due to delayed healing of abluminal bioresorbable polymer everolimus-eluting stent: insight from histopathological evaluation with directional coronary atherectomy

Histopathological evaluation of the in-stent restenosis (ISR) sample in this case suggested that the ISR was potentially caused by a polymer residue of the bioresorbable polymer everolimus-eluting stent.

Risk factors for a delayed course of reparative processes after destructive intervention on the integumentary tissues of the foot

В статье обобщены сведения о заболеваниях и состояниях, оказывающих влияние на процессы нормального заживления после деструктивных вмешательств на покровных тканях стопы, представлены современные данные литературы, посвященные этим вопросам. Неадекватная оценка состояния пациента перед проведением планового деструктивного вмешательства на нижних конечностях может привести к формированию длительно незаживающего раневого дефекта и нарушению функции конечности. Проведение деструктивного вмешательства требует настороженности в отношении ряда заболеваний и состояний, влияющих на процессы нормального заживления, таких как сахарный диабет, метаболический синдром, иммунодефицит. Особое внимание в статье уделено оценке состоятельности кровотока нижних конечностей в связи с тем, что хроническая артериальная недостаточность является одной из наиболее значимых причин замедленного течения репаративных процессов в области стоп. Представлено собственное клиническое наблюдение, иллюстрирующее отсутствие нормальной регенерации в условиях гипергликемии и хронической артериальной недостаточности нижних конечностей. The article summarizes information about diseases and conditions that affect the processes of normal healing after destructive interventions on the integumentary tissues of the foot, presents modern literature data on these issues. An inadequate assessment of the patient's condition before a planned destructive intervention on the lower extremities can lead to a long-term non-healing wounds and dysfunction of the extremity. A destructive intervention requires attention to a number of diseases and conditions that affect normal healing processes, such as diabetes mellitus, metabolic syndrome, and immunodeficiency. Particular attention is paid to the assessment of the consistency of the blood flow of the lower extremities because chronic arterial insufficiency is one of the most significant reasons for the slow reparative processes in the foot area. The authors present their own clinical observation that illustrates the absence of normal regeneration in conditions of hyperglycemia and chronic arterial disease of the lower limbs. Keywords: destruction, destructive interventions, atherosclerosis, wound healing, regeneration, chronic arterial insufficiency, lower limbs, delayed healing.

TRAUMATIC ULCERATIVE GRANULOMA WITH STROMAL EOSINOPHILIA – CASE SERIES

Traumatic ulcerative granuloma with stromal eosinophilia (TUGSE) is relatively uncommon lesion presenting clinically as ulceration of the oral mucosa with a chronic course associated with delayed healing. Chronic irritation causing trauma to the oral mucosa is considered as major causative factor. The most commonly affected site of the lesion appears to be Tongue and Buccal mucosa. This lesion represents clinically as ulcer with indurated margins mimicking malignancy, causing diagnostic challenge for the dentists. Histologically characterized by breach in the epithelium exposing underlying connective tissue inltrated with dense amount of inammatory cells predominantly of eosinophils penetrating the underlying mucle. It is important to diagnose the lesion histologically to rule out malignancy and to treat appropriately. However the lesion resolves on its own or with minimal and conservative treatment. In this review we present four case series of clinically manifesting ulceroproliferative lesions on buccal mucosa and diagnosed as TUGSE,based on clinical and histopathological features.

Thermal imaging potential and limitations to predict healing of venous leg ulcers

Area analysis of thermal images can detect delayed healing in diabetes foot ulcers, but not venous leg ulcers (VLU) assessed in the home environment. This study proposes using textural analysis of thermal images to predict the healing trajectory of venous leg ulcers assessed in home settings. Participants with VLU were followed over twelve weeks. Digital images, thermal images and planimetry of wound tracings of the ulcers of 60 older participants was recorded in their homes by nurses. Participants were labelled as healed or unhealed based on status of the wound at the 12th week follow up. The weekly change in textural features was computed and the first two principal components were obtained. 60 participants (aged 80.53 ± 11.94 years) with 72 wounds (mean area 21.32 ± 51.28cm2) were included in the study. The first PCA of the change in textural features in week 2 with respect to week 0 were statistically significant for differentiating between healed and unhealed cases. Textural analysis of thermal images is an effective method to predict in week 2 which venous leg ulcers will not heal by week 12 among older people whose wounds are being managed in their homes.