Chronic venous insufficiency and venous leg ulcers: Aetiology, on the pathophysiology-based treatment.

The chronic venous disease covers a wide spectrum of venous disorders that are characterized by severely impaired blood return that primarily affects veins in the lower extremities. Morphological and functional abnormalities of the venous system led to chronic venous insufficiency (CVI), and present as leg heaviness/achiness, edema, telangiectasia, and varices. The term 'chronic venous insufficiency' (CVI) refers to a disease of greater severity. Venous dysfunction is associated with venous hypertension and is associated with venous reflux due to poorly functioning or incompetent venous valves, which ultimately reduces venous return, leading to a cascade of morphological, physiological, and histologic abnormalities such as blood pooling, hypoxia, inflammation, swelling, skin changes (lipodermatosclerosis), and in severe cases, venous leg ulcers (VLU). This review summarizes recent knowledge about the aetiology, risk factors, and pathophysiology of VLU and compared the possibilities of their treatment.

Reconstruction of the Tongue after Hemiglossectomy Using Serratus Anterior Muscle Free Flap.

Background: Serratus anterior muscle free flap is widely used in numerous indicated reconstructions. Only a few studies have dealt with the use of this flap in tongue reconstruction. Materials and Methods: We present a case series of 7 patients with carcinoma of the tongue who underwent hemiglossectomy followed by immediate reconstruction with serratus anterior muscle free flap between January 2017 and December 2019 at the University Hospital Brno. The aim of this study was to evaluate safety and efficiency of the reconstruction as well as the donor site morbidity. Results: There was not a single case of flap failure observed and the donor site healed completely in all cases. The functional outcome (tongue mobility, phonation, and deglutition) depended on the severity of the primary oncological disease and health status of the patient. Conclusion: The serratus anterior muscle free flap represents an alternative option for reconstruction of the tongue.

Fatty Acid Supplementation Affects Skin Wound Healing in a Rat Model.

Polyunsaturated fatty acids (PUFA) play an important role in reparative processes. The ratio of PUFAs n-3 to n-6 may affect wound healing. The study aimed to evaluate the effect of dietary supplementation with n-3 and n-6 PUFA in two proportions on skin wounds in laboratory rats. Adult male Wistar rats received 20% fat emulsion with a ratio of 1.4:1 (group A) or 4.3:1 (group B) for n-3:n-6 PUFAs at a daily dose of 1 mL/kg. The control group received water under the same conditions. The animals were supplemented a week before and a week after the skin excision performed on the back. The level of wound closure, various parameters of oxidative stress, and plasma fatty acids composition were evaluated. Wound tissue samples were examined by electron microscopy. The administration of fat emulsions led to significant changes in plasma polyunsaturated fatty acid composition. The increased production of reactive nitrogen species, as well as more numerous newly formed blood vessels and a greater amount of highly organized collagen fibrils in both groups A and B may indicate more intensive healing of the skin wound in rats supplemented with polyunsaturated fatty acids in high n-3:n-6 ratio.

Machine Learning-Based Pressure Ulcer Prediction in Modular Critical Care Data.

Increasingly available open medical and health datasets encourage data-driven research with a promise of improving patient care through knowledge discovery and algorithm development. Among efficient approaches to such high-dimensional problems are a number of machine learning methods, which are applied in this paper to pressure ulcer prediction in modular critical care data. An inherent property of many health-related datasets is a high number of irregularly sampled time-variant and scarcely populated features, often exceeding the number of observations. Although machine learning methods are known to work well under such circumstances, many choices regarding model and data processing exist. In particular, this paper address both theoretical and practical aspects related to the application of six classification models to pressure ulcers, while utilizing one of the largest available Medical Information Mart for Intensive Care (MIMIC-IV) databases. Random forest, with an accuracy of 96%, is the best-performing approach among the considered machine learning algorithms.

Signaling pathways in cutaneous wound healing.

Wound healing is a very complex process, where variety of different pathways is activated, depending on the phase of healing. Improper or interrupted healing might result in development of chronic wounds. Therefore, novel approaches based on detailed knowledge of signalling pathways that are activated during acute or chronic cutaneous wound healing enables quicker and more effective healing. This review outlined new possibilities of cutaneous wound healing by modulation of some signalling molecules, e.g., gasotransmitters, or calcium. Special focus is given to gasotransmitters, since these bioactive signalling molecules that can freely diffuse into the cell and exert antioxidative effects. Calcium is an important booster of immune system and it can significantly contribute to healing process. Special interest is given to chronic wounds caused by diabetes mellitus and overcoming problems with the inflammation.