surgical wounds
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2021 ◽  
Author(s):  
R.L. Kalyani ◽  
K.T. Sunil Kumar ◽  
P.V. Swamy ◽  
K. Chandra Sekhar ◽  
S. Manish ◽  
...  

Abstract The increasing evidences of chronic surgical wounds and its associated complications in association with bacterial resistance to conventional antibiotics. Therefore, current antibiotic resistance crisis ultimately calls for the need of alternative antibacterial options and nanotechnology could be a solution. Furthermore, nano-antibiotics combinations will provide synergy with reducing the dosage of both agents, which can enhance biocompatibility and may aid in limiting the global crisis of emerging multidrug resistance. Specifically, in the context of cytotoxicity of nanoparticles, in the present study, green synthesized nanoparticles (Ag NPs, ZnO NPs) are used for the combination with antibiotic neomycin to investigate in-vivo wound healing activity to facilitate the tissue repair with minimized toxicity. Our results showed that, in-vivo potent synergetic wound healing effectiveness and faster wound contraction of prepared gel formulations from the green synthesized nanoparticles combinations with neomycin compared with neomycin or nanoparticles alone. These results point to the opportunity provided by this approach to realize the unmet needs and future directions with lustrous prospects in combinational herbal nanomedicine to combat the multi drug resistant bacteria.


2021 ◽  
Vol 9 (1) ◽  
pp. 66
Author(s):  
Pinky Rabha ◽  
Shradha Srinivas ◽  
K. Bhuyan

Background: Application of suture is the technique of choice for apposition of skin edges in surgical wounds. The same procedure performed with application of staplers is faster and produce better cosmetic outcomes. A comparative study between conventional suture and stapler closure of skin in abdominal surgical wounds was undertaken to study the merits and demerits of the techniques. The aim was to study the time required for closure of surgical wounds, aesthetic outcome, post-operative complications and patient’s compliance.Methods: This was a single centre, prospective, observational study, conducted upon 100 patients undergoing abdominal surgeries. 50 patients were selected for skin closure of surgical wounds with stapler and the other 50 patients for closure with conventional nylon sutures. Data were collected for time required for closure of skin, aesthetic outcome, post-operative complications and patient’s compliance for both the groups for comparison. Data were analysed using student t test for comparison and chi square test of significance. Results: There was significant better results in stapler group in terms of cosmetic outcome (96% vs 88%, p<0.001), time taken during closure (60 vs 219 seconds, p<0.001) and patient’s compliance VAS of 1.44 vs 4.58 p<0.001).Conclusions: Closure of skin with stapler is a faster method. Patient’s compliance with stapler closure is better. It produces cosmetically acceptable scar and less discomfort or pain during its removal.


2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Nolberto A. Medina-Gallardo ◽  
Xavier De Castro-Gutierrez ◽  
Enric De Caralt-Mestres ◽  
Yuhamy Curbelo-Peña ◽  
Andrés Dardano-Berriel ◽  
...  

2021 ◽  
Vol 33 (12) ◽  
pp. E75-E78
Author(s):  
Robert Klein

Mechanical negative pressure wound therapy (mNPWT) is commonly used in the management of a variety of wounds, including diabetic foot ulcerations, surgical wounds, venous ulcerations, and wound dehiscence. This mechanically powered, disposable modality can be used to manage wounds in the outpatient setting and has been shown to be an effective wound care option when transitioning patients from the inpatient to outpatient setting and continuing NPWT for wound care. Mechanical NPWT helps promote wound healing by decreasing edema and via removal of tissue debris and exudate. Traditional NPWT is bulky, is often noisy, and requires a power source. A mechanically powered, disposable, easily applied, off-the-shelf mNPWT device is available for patients with small- to medium-sized wounds with mild to moderate exudate. The disposable mNPWT device provides −125 mm Hg pressure, is silent and small, can be worn under clothes, and allows the patient to be fully ambulatory, thus, more mobile. The mNPWT device tubing can be cut to fit to enable safer ambulation than the powered system and to enable the patient to work and enjoy social activities without a medical device showing. This single case study of a patient with chronic diabetic foot ulcerations of the medial first metatarsal head and dorsal proximal interphalangeal joints of the second and third toes of the left foot, which had not been successfully treated with conservative care and had been present for more than 1 year.


Author(s):  
Jose M. Zepeda ◽  
Javier Contreras ◽  
Felix Osuna ◽  
Melany Jimenez ◽  
Alejandro Murrieta

Wounds are inherent to being alive and also a reminder of our fragility in the face of the hostilities of this planet. Annually, it is estimated that 4511 operations are performed per 100,000 population, or 1 surgical procedure every year for every 22 people. There is an art to treating wounds. The support by the doctor for wound healing favors the early recovery of this, in addition to minimizing the risk of infection and gives an aesthetically pleasing appearance, the care that is used today ranging from the cleaning of the wound, the approximation of the edges thanks to the sutures, etc. The following is a review of cutting-edge therapies in this area of medicine, such as biotechnologies, growth factors, gene therapy, and stem cells. Projections indicate an increasing decrease in morbidity and mortality associated with surgical wounds and their repair, as well as more favorable cosmetic outcomes for patients. The results showed that all the described techniques, although not perfect, are perfectible, and with the pertinent precautions can be maximized in favor of care. There is the possibility in the near future, to be a basic part of wound care, in terms of protocols of care, but also in the individualization of treatment.


2021 ◽  
Vol 12 (4) ◽  
pp. 2530-2540
Author(s):  
Archana R Sankar ◽  
Sheela Kumar Gujjari ◽  
Kulkarni P K

The present study was undertaken to clinically assess the synergistic effect of topically applied Aloe vera Chitosan to Chitosan alone on the healing of palatal donor sites in free gingival graft surgical procedures. 20 subjects (10 per group) were enrolled into this triple blinded randomized clinical trial, designed to evaluate the efficacy of Aloe vera Chitosan to Chitosan on free gingival graft surgical wounds. Subjects were assigned to either Group A (aloe vera + Chitosan) or Group B (Chitosan alone). Visual Analog Scale(VAS) and Wound healing index were recorded at 7th day, 14th day and 21 days postoperative. Results showed no statistical significance when considering VAS. However there was a statistical significance in wound healing (p=0.04) in group A when compared to group B from 14- 21st day postoperative. It is the first human trial and was a pilot study to assess the synergistic effect of Aloe vera and Chitosan on wound healing. The study has shown that a combination of both acts synergistically in accelerating healing especially in areas where faster healing is necessary to provide overall comfort to the patient. It is therefore a futuristic and a promising material as a surgical dressing with further longitudinal trials.


2021 ◽  
Vol 48 (6) ◽  
pp. 599-606
Author(s):  
Elizabeth G. Zolper ◽  
Meher A. Saleem ◽  
Kevin G. Kim ◽  
Mark D. Mishu ◽  
Sarah R. Sher ◽  
...  

Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol.Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing.Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4–23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar.Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.


2021 ◽  
Vol 14 ◽  
pp. 269-272
Author(s):  
Ashlie Elver ◽  
Katy Wirtz ◽  
Jinxiang Hu ◽  
Emmanuel Daon

Introduction. Mediastinitis is a deadly surgical site infection (SSI) after cardiac surgery. Although rare, mortality is as high as 47%. Best practices for infection prevention to eliminate this deadly complication must be identified. Surgical dressings impregnated with silver have been shown to reduce SSIs in other surgical specialties. This aim of this study is to determine if the routine use of silver surgical dressings is beneficial to prevent mediastinitis after cardiac surgery. Methods. A single-center retrospective study was performed on patients who underwent sternotomy from 2016 to 2018 at the University of Kansas Medical Center. Prior to June 2017, all cardiac surgical patients were treated with gauze surgical dressings and is designated Group A. The routine use of silver-impregnated surgical dressings was implemented in June 2017, patients after this change in practice are designated Group B. Patient characteristics and rates of deep and superficial sternal wound infections (SWI) were compared.  Results. There were 464 patients in Group A and 505 in Group B. There were seven SWIs in Group A (7/464, 1.5%) and five in Group B (5/505, 1%; p = 0.57). Of these, there was one deep SWI per group (p = 0.61) and six superficial SWIs in Group A compared to four in Group B (p = 0.74). Severe COPD was higher in Group A (p = 0.04) and peak glucose was higher in Group B (p = 0.02).  Conclusions.The analysis conferred no benefit with silver-impregnated surgical dressings to prevent mediastinitis. Choice of gauze surgical dressings may be preferable to reduce cost.


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