Analysis of Influencing Factors of Repair Effect after Peripheral Nerve Injury

In order to improve the repair effect after peripheral nerve injury, this paper analyzes the related influencing factors. The regeneration of peripheral nerve includes two continuous and overlapping processes: the acute wound healing period and the axon seeking target tissue period. The complete and effective process of peripheral nerve regeneration includes the sprouting, growth and extension of regenerated axons, and the reconstruction of synaptic connections (neuromuscular junctions) with target organs to realize the reinnervation of nerves and restore function. This process includes three indicators of success in regeneration: structural reconstruction, metabolic regeneration, and functional recovery. In order to improve the repair effect of peripheral nerve injury, relevant influencing factors can be analyzed, and effective improvement of these influencing factors can improve the recovery effect of peripheral nerve injury. Finally, this paper analyzes multiple factors to provide theoretical references for follow-up clinical diagnosis and treatment.

Preliminary Physico-Chemical Profile of Yashtimadhu Ghrita

Yashtimadhu ghrita is a single-herbal ghee formulation mentioned in the classical texts of Ayurveda and is indicated in sadya kshatavrana (an acute inflammatory condition or an acute wound associated with trauma). It also minimizes the pain related to the wound. The present study is intended to create a finger print profile of Yastimadhu ghrita through its pharmacognostical identification and the physico-chemical analysis. The genuineness of the dry specimen of Yashtimadhu (Glycyrrhiza glabra Linn.) was confirmed through organoleptic evaluation and cross-sectional microscopy. Yashtimadhu ghrita was prepared as per the Sneha paka (preparation of unctuous formulations using ghee, oil etc.) procedure mentioned in Sarngadhara Samhita Madhyama khanda and the standard operative procedures specified in Ayurvedic pharmacopoeia of India. The test result of the finished product shows Acid value 6.7, saponification value 213.4, and Refractive index value1.455 at room temperature, Iodine value 38.7, LOD 0.64. TLC and HPTLC were carried out for the characterization of the plant material in an appropriate solvent system. A total of nine spots were distinguished in 254 nm and five spots in 366 nm during the HPTLC scanning. The Rf value pertaining to the spots were identical in the methanolic extract which indicates the presence of definite constituents in Yashtimadhu ghrita.

Transplantation of Bone Marrow Cells Preactivated With Sodium Nitroprusside Improves Acute Wound Healing in Rabbits

The development of wound healing impairment mainly represents challenging clinical problems. The less and high concentrations of nitric oxide can influence angiogenesis, remodeling, and proliferation of skin cells. Delayed acute wounds generally have failed to progress via the normal stages of healing. Such wounds usually enter a state of pathological inflammation due to a postponed, incomplete, and uncoordinated healing process. This study aimed to investigate the effect of normal bone marrow cells (BMCs) and preconditioning of BMCs with minimum concentrations of sodium nitroprusside (NaNP) solution for acute wound healing. For acute wound healing, full-thickness dorsal wounds were created on rabbits. The acute wound of rabbits was treated with BMCs and preactivated BMCs with NaNP. Histological results showed that BMCs preactivated with NaNP could improve collagen deposition, enhanced reepithelization, and decreased inflammatory infiltration. Overall, BMCs treated with NaNP can help to improve acute wound healing in rabbits. The result strongly confirmed the beneficial effect in augmenting the wound healing process. The combination of BMCs with NaNP was safe and convenient for acute wound healing.

Identification of potential hub genes associated with skin wound healing based on time course bioinformatic analyses

Background The skin is the largest organ of the body and has multiple functions. Wounds remain a significant healthcare problem due to the large number of traumatic and pathophysiological conditions patients suffer. Methods Gene expression profiles of 37 biopsies collected from patients undergoing split-thickness skin grafts at five different time points were downloaded from two datasets (GSE28914 and GSE50425) in the Gene Expression Omnibus (GEO) database. Principal component analysis (PCA) was applied to classify samples into different phases. Subsequently, differentially expressed genes (DEGs) analysis, Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway functional enrichment analyses were performed, and protein–protein interaction (PPI) networks created for each phase. Furthermore, based on the results of the PPI, hub genes in each phase were identified by molecular complex detection combined with the ClueGO algorithm. Results Using principal component analysis, the collected samples were divided into four phases, namely intact phase, acute wound phase, inflammatory and proliferation phase, and remodeling phase. Intact samples were used as control group. In the acute wound phase, a total of 1 upregulated and 100 downregulated DEGs were identified. Tyrosinase (TYR), tyrosinase Related Protein 1 (TYRP1) and dopachrome tautomerase (DCT) were considered as hub genes and enriched in tyrosine metabolism which dominate the process of melanogenesis. In the inflammatory and proliferation phase, a total of 85 upregulated and 164 downregulated DEGs were identified. CHEK1, CCNB1 and CDK1 were considered as hub genes and enriched in cell cycle and P53 signaling pathway. In the remodeling phase, a total of 121 upregulated and 49 downregulated DEGs were identified. COL4A1, COL4A2, and COL6A1 were considered as hub genes and enriched in protein digestion and absorption, and ECM-receptor interaction. Conclusion This comprehensive bioinformatic re-analysis of GEO data provides new insights into the molecular pathogenesis of wound healing and the potential identification of therapeutic targets for the treatment of wounds.

Platelet-Rich Plasma: Optimal Use in Surgical Wounds

Activated platelets release a rich broth of growth factors involved in wound healing. One way to deliver activated platelets to wounds is in the form of platelet-rich plasma (PRP) harvested by centrifuging the patient’s venous blood after activating the platelets with collagen or calcium chloride and/or autologous thrombin, then delicately removing the supernatant, called platelet-poor plasma (PPP). Platelet-rich plasma is usually injected into the lesion and/or applied topically, then sealed in or over the wound using a moisture-retentive dressing. Platelet-rich plasma (often with PPP) has been applied at different times, depths, and frequencies to chronic and acute wounds using various PRP doses and vehicles to achieve widely differing results. Meta-analyses have reported that PRP improved healing rates of open diabetic foot ulcers and venous ulcers1,2 and may reduce pain and surgical site infection (SSI) incidence in open and closed acute surgical wounds. However, inconsistency in study methods and outcome measures limited consistency of pain and SSI results.1 No consistent effect on healing or deep SSI rates was reported as a result of adding 1 intraoperative dose of PRP in the surgical site before closing elective foot and ankle surgery incisions of 250 patients as compared with 250 similar patients receiving the same procedure without PRP.3 After decades of research, ideal parameters of PRP delivery and use on each type of wound remain unclear for improving SSI, acute wound pain, and healing outcomes. This installment of the Evidence Corner reviews 2 surgical studies that may provide clues about optimal PRP use. One triple-blind randomized clinical trial (RCT) focused on irrigation of freshly closed carpal ligament surgical incisions with PRP as compared with PPP.4 Another non-blind RCT explored the effect of injecting PRP into open pilonidal sinus excisions 4 days and 12 days after surgery.5

Service redesign: how a tissue viability specialist lead nurse developed and improved acute wound care through real-world evidence and partnership working

The importance of leadership in service redesign should not be underestimated. Increasing demand for services and cost-effective approaches makes the drive and dedication of a leader towards quality improvement crucial. The lead tissue viability nurse at the Shrewsbury and Telford Hospital NHS Trust worked in partnership with the wound care industry to redesign the trust's acute wound care service. An audit was carried out and an opportunity to reduce variations in care was identified. To achieve this, the service reduced the number of foam dressings on the formulary, listing only the ALLEVYN (Smith+Nephew, UK) family of wound dressings. As a result, the volume of dressings used reduced by 4.8%, meaning that the service produced less waste and saw a cost reduction of approximately £14 066 over a 6-month period. This article highlights the positive outcomes that can be achieved through streamlining formularies, reducing variations in care and delivering robust care pathways. It also describes the collaborative working approach taken by this service, spearheaded by the lead tissue viability nurse, as an example of innovative practice for other NHS trusts.