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1.
Rev. Odontol. Araçatuba (Impr.) ; 45(2): 48-51, maio-ago. 2024. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1553297

ABSTRACT

INTRODUÇÃO: O manejo dos pacientes vítimas de PAF possui vertentes divergentes a respeito do tratamento cirúrgico, que pode ser realizado de forma imedata ou tardia. Em lesões auto-infligidas, a distância entre a arma e a região acometida é menor, causando consequências estéticas e funcionais mais devastadoras. Aliado ao fato desse tipo de trauma criar uma ferida suja devido à comunicação com a cavidade oral e seios paranasais, o manejo das lesões representam um desafio mesmo à cirurgiões experientes. OBJETIVO: Estre trabalho relata o manejo cirúrgico de uma ferida auto-infligida por arma de fogo que resultou em avulsão dos tecidos moles na região maxilofacial. DESCRIÇÃO DO CASO: Paciente do sexo masculino, 35 anos, vítima de projétil de arma de fogo auto-infligido em região maxilofacial, cursando com extenso ferimento em região de língua e mento. Clinicamente, o paciente não apresentava sinais de fratura em ossos da face. Ambos os ferimentos apresentavam secreção purulenta e o paciente manifestava disfonia devido a grande destruição tecidual. CONSIDERAÇÕES FINAIS: O tratamento de ferimentos por arma de fogo não só é um grande desafio para o cirurgião, como para toda a equipe multidisciplinar requerida para tais casos, visto que não há protocolos bem definidos para o tratamento dessas lesões(AU)


INTRODUCTION: The management of patients who are victims of FAP has divergent aspects regarding surgical treatment, which can be performed immediately or late. In self-inflicted injuries, the distance between the weapon and the affected region is smaller, causing more devastating aesthetic and functional consequences. Allied to the fact that this type of trauma creates a dirty wound due to the communication with the oral cavity and paranasal sinuses, the management of injuries represents a challenge even for experienced surgeons. OBJECTIVE: This paper reports the surgical management of a self-inflicted gunshot wound that resulted in soft tissue avulsion in the maxillofacial region. CASE DESCRIPTION: Male patient, 35 years old, victim of a self-inflicted firearm projectile in the maxillofacial region, coursing with extensive injury in the region of the tongue and chin. Clinically, the patient did not show signs of facial bone fractures. Both wounds had purulent secretion and the patient had dysphonia due to extensive tissue destruction. FINAL CONSIDERATIONS: The treatment of gunshot wounds is not only a great challenge for the surgeon, but also for the entire multidisciplinary team required for such cases, since there are no well-defined protocols for the treatment of these injuries(AU)


Subject(s)
Humans , Male , Adult , Tongue/injuries , Wound Infection , Wounds, Gunshot , Palate, Hard/injuries , Wounds and Injuries , Wounds, Penetrating , Palate, Hard , Ecchymosis , Edema , Maxillofacial Injuries
2.
Estima (Online) ; 22: e1415, JAN - DEZ 2024. ilus, tab
Article in English, Portuguese | LILACS | ID: biblio-1561110

ABSTRACT

Objetivo: Mapear a produção científica a respeito do uso da terapia de pressão negativa no tratamento de queimaduras, em pacientes adultos e idosos hospitalizados. Método: Revisão de escopo seguindo o método da JBI com busca da produção científica na PubMed, Scientific Electronic Library Online, Biblioteca Virtual de Saúde e Banco de Teses da Coordenação de Aperfeiçoamento de Pessoal de Nível Superior nos meses de março a maio de 2021. Foram incluídos estudos com pacientes adultos e idosos com queimaduras, submetidos à terapia por pressão negativa no hospital. Não houve restrição de idioma, nem período de tempo. Resultados: Foram identificadas 106 publicações e, após o processo de seleção, cinco estudos compuseram a amostra final. Os resultados demonstraram que a aplicação da terapia por pressão negativa em queimaduras constituiu-se como uma ferramenta efetiva na cicatrização de queimaduras térmicas, químicas e elétricas, destacando-se a otimização do tempo de cicatrização, formação de um tecido de granulação saudável, diminuição do edema, redução da infecção, drenagem e monitorização do edema. Conclusão: O tratamento de queimaduras utilizando a pressão negativa tem se mostrado um método efetivo, visto os benefícios que promove no processo cicatricial. Sugere-se que a temática seja mais difundida, aprofundando-se o conhecimento sobre o uso desta tecnologia. (AU)


Objective: To map the scientific production regarding the use of negative pressure wound therapy in burn treatment of hospitalized adult and aged patients. Method: Scope review following the JBI method with a search for scientific production in PubMed, the Scientific Electronic Library Online, the Virtual Health Library, and the Thesis Database of the Coordination for the Improvement of Higher Education Personnel from March to May 2021. Studies with adult and aged burn patients undergoing negative pressure wound therapy in hospitals were included. There was no language or time frame restriction. Results: 106 publications were identified and 5 studies made up the final sample after the selection process. The results demonstrated that applying negative pressure wound therapy to burns was effective in healing thermal, chemical, and electrical burns, esoecially regarding healing time optimization, healthy granulation tissue formation, edema and infection reduction, and edema drainage and monitoring. Conclusion: Burn treatment using negative pressure has proven effective, given the benefits it promotes in the healing process. The theme should be more widely spread to deepen the knowledge about the use of this technology. (AU)


Objetivo: Mapear la producción científica sobre el uso de la terapia de presión negativa en el tratamiento de quemaduras en pacientes adultos y ancianos hospitalizados. Método: Revisión de alcance siguiendo el método JBI con búsqueda de producción científica en PubMed, Biblioteca Científica Electrónica en Línea, Biblioteca Virtual en Salud y Banco de Tesis de la Coordinación para el Perfeccionamiento del Personal de Educación Superior en los meses de marzo a mayo de 2021. Se incluyeron estudios con adultos y pacientes ancianos quemados sometidos a terapia de presión negativa en el hospital. No hubo restricción de idioma ni período de tiempo. Resultados: Se identificaron 106 publicaciones y luego del proceso de selección, 5 estudios conformaron la muestra final. Los resultados demostraron que la aplicación de la terapia de presión negativa en quemaduras constituyó una herramienta eficaz en la curación de quemaduras térmicas, químicas y eléctricas, destacándose la optimización del tiempo de curación, formación de tejido de granulación sano, reducción de edema, reducción de infección, drenaje y seguimiento del edema. Conclusión: El tratamiento de quemaduras mediante presión negativa ha demostrado ser un método efectivo, dados los beneficios que promueve en el proceso de cicatrización. Se sugiere que el tema sea más difundido, profundizando el conocimiento sobre el uso de esta tecnología. (AU)


Subject(s)
Humans , Burns/therapy , Negative-Pressure Wound Therapy , Enterostomal Therapy , Nursing Care
3.
Rev. bras. cir. plást ; 39(2): 1-11, abr.jun.2024. ilus
Article in English, Portuguese | LILACS-Express | LILACS | ID: biblio-1556492

ABSTRACT

Introdução: A síntese de feridas de pele tensionadas é uma área que tem sido alvo de estudos para o desenvolvimento de técnicas de sutura que sejam capazes de realizar o fechamento primário dessas feridas com alívio de tensão, garantindo uma cicatrização adequada e evitando complicações como deiscência, edema, sangramento e infecção. Método: Esta pesquisa tratou-se de um estudo piloto, sendo a primeira apresentação da técnica de Sutura em Polia Retificada para síntese de feridas de pele tensionadas através do acompanhamento prospectivo, duplo-cego, de uma série de casos de 8 pacientes randomicamente admitidos no centro cirúrgico de um hospital de alta complexidade de uma cidade de médio porte. Resultados: A Sutura em Polia Retificada é uma técnica versátil e apta para lidar com feridas de pele tensionadas, uma vez que no intraoperatório conseguiu fechar por primeira intenção lesões de até 6,5 centímetros e de diferentes regiões tensionadas sem necessidade do uso de técnicas mais complexas, como retalhos, enxertos, zetaplastia e fechamento por segunda intenção. Além disso, no pós-operatório, houve redução dos escores da POSAS, indicando um processo de cicatrização satisfatório tanto para os observadores quanto para o paciente. É imprescindível mencionar, também, que o desfecho mais temido no seguimento dos pacientes com feridas tensionadas submetidos a fechamento primário - a deiscência - foi completamente evitado. Conclusão: A técnica é simples, confiável, segura e reprodutível, com curta curva de aprendizagem, de forma que a Sutura em Polia Retificada pode ser considerada como uma nova ferramenta a ser integrada ao arsenal cirúrgico.


Introduction: The synthesis of tensioned skin wounds is an area that has been the subject of studies for the development of suturing techniques that are capable of performing the primary closure of these wounds with tension relief, ensuring adequate healing, and avoiding complications such as dehiscence, edema, bleeding, and infection. Method: This research was a pilot study, being the first presentation of the Rectified Pulley Suture technique for the synthesis of tensioned skin wounds through prospective, double-blind monitoring of a series of cases of 8 patients randomly admitted to the surgical center of a high-complexity hospital in a mediumsized city. Results: Rectified Pulley Suture is a versatile technique suitable for dealing with tensioned skin wounds, since intraoperatively it was able to close, by first intention, lesions measuring up to 6.5 centimeters and in different tensioned regions without the need for the use of more extensive techniques. complex, such as flaps, grafts, Z-plasty, and secondary intention closure. Furthermore, post-operatively, there was a reduction in POSAS scores, indicating a satisfactory healing process for both observers and the patient. It is also essential to mention that the most feared outcome in the follow-up of patients with tension wounds undergoing primary closure - dehiscence - was completely avoided. Conclusion: The technique is simple, reliable, safe, and reproducible, with a short learning curve, so the Rectified Pulley Suture can be considered a new tool to be integrated into the surgical arsenal.

4.
Rev. Ciênc. Plur ; 10 (1) 2024;10(1): 35109, 2024 abr. 30. ilus
Article in Portuguese | LILACS, BBO | ID: biblio-1553447

ABSTRACT

Introdução: Plantas medicinais e fitoterápicos são tradicionalmente utilizados na cicatrização de diversos tipos de feridas. Muitas plantas contêm compostos bioativos com propriedades anti-inflamatórias, antimicrobianas e cicatrizantes. Objetivo: Reunir evidências clínicas do uso de plantas medicinais e fitoterápicos na cicatrização de feridas cutâneas. Metodologia: Trata-se de uma revisão integrativa da literatura. Os estudos foram coletados das bases de dados MEDLINE/PubMed e LILACS, utilizando como estratégia de busca os termos ((WoundHealing) ou (Inflammation)) e ((MedicinalPlants) ou (Phytotherapy)) com recorte temporal de 2011 a 2021. Resultados: 15 estudos foram incluídos na revisão. A maioria dos estudos foram do tipo ensaio clínico controlado randomizado. Foi investigada a eficácia de 15 espécies medicinais para o tratamento de feridas agudas e crônicas, sendo as mais recorrentes queimaduras de segundo grau, úlceras crônicas e feridas cirúrgicas. As espécies medicinais que apresentaram melhores resultados foram babosa (Aloevera), centela (Centellaasiatica),beldroega (Portulacaoleraceae), Arnebia euchroma, hipérico (Hypericum perforatum) emil-folhas (Achilleamillefolium), melhorando critérios como eritema, edema, tempodere-epitelização, tempo de cicatrização e a aparência geral da ferida. Conclusões: Plantas medicinais e fitoterápicos apresentam eficácia no processo de cicatrização, sendo, portanto, alternativa terapêutica para o tratamento de feridas cutâneas (AU).


Introduction: Medicinal plants and herbal medicines are traditionally used to heal various types of wounds. Many plants contain bioactive compounds with anti-inflammatory, antimicrobial, and wound-healing properties. Objective: Gathering clinical evidence on the use of medicinal plants and herbal medicine in the healing of skin wounds. Methodology:Thisisan integrative review of the literature. The studies were collected from the MEDLINE/PubMed and LILACS data bases, using the terms ((WoundHealing) or (Inflammation)) and ((MedicinalPlants) or (Phytotherapy)) as a search strategy, from 2011 to 2021. Results: Fifteen studies were included in the review. Most of them were of the randomized controlled clinical trial type. The effectiveness of 15 medicinal species was investigated for the treatment of acute and chronic wounds, the most common of which were second-degree burns, chronic ulcers,and surgical wounds. The species with the best results were Aloe vera, Centella asiatica, Portulaca oleraceae, Arnebia euchroma, Hypericum perforatum, and Achillea millefolium, improving criteria such as erythema, edema, re-epithelialization time, healing time, and the general appearance of the wound. Conclusions: Medicinalplants and herbal medicine are effective in the healing process, therefore being a therapeutic alternative for treating skin wounds (AU).


Introducción: Las plantas medicinales y las medicinas a base de hierbas se utilizan tradicionalmente para curar diversos tipos de heridas. Muchas plantas contienen compuestos bioactivos con propiedades antiinflamatorias, antimicrobianas y cicatrizantes. Objetivo: Recopilar evidencia clínica sobre el uso de plantas medicinales y medicinas a base de hierbas en la curación de heridas cutáneas. Metodología: Se trata de una revisión integradora de la literatura. Los estudios fueron obtenidos de las bases de datos MEDLINE/PubMed y LILACS, utilizando como estrategia de búsqueda los términos ((WoundHealing) o (Inflammation)) y ((MedicinalPlants) o (Phytotherapy)) con un marco temporal de 2011 a 2021. Resultados: Se incluyeron 15 estudios en la revisión. La mayoría de los estudios fueron del tipo ensayo clínico controlado aleatorio. Se investigó la eficacia de 15 especies medicinales para el tratamiento de heridas agudas y crónicas, las más comunes fueron quemaduras de segundo grado, úlceras crónicas y heridas quirúrgicas. Las especies medicinales con mejoresr esultados fueron Aloe vera, Centella asiatica, Portulaca oleraceae, Arnebia euchroma, Hypericum perforatum y Achillea millefolium, mejorando criterios como eritema, edema, tiempo de reepitelización, tiempo de cicatrización y aspecto general de la herida. Conclusiones: Plantas medicinales y medicinas a base de hierbas son efectivas en el proceso de cicatrización, siendo portanto un aalternativa terapéutica para el tratamiento de heridas en la piel (AU).


Subject(s)
Humans , Plants, Medicinal , Wound Healing , Phytotherapeutic Drugs , Wounds and Injuries , Evidence-Based Practice , Phytotherapy
5.
Pediatr. (Asunción) ; 51(1)abr. 2024.
Article in Spanish | LILACS-Express | LILACS | ID: biblio-1558633

ABSTRACT

Introducción: Las infecciones de sitio quirúrgico están asociadas con infecciones relacionadas a la asistencia sanitaria (IRAS), causadas por bacterias que ingresan a través de las incisiones efectuadas durante un procedimiento quirúrgico. Objetivo: Describir la frecuencia y características de las infecciones de sitio quirúrgico en las cirugías de urgencias en pacientes pediátricos hospitalizados en el Hospital General Pediátrico. Materiales y Métodos: Estudio observacional descriptivo, retrospectivo, de corte transversal. Población: Pacientes de 0 a 18 años sometidos a intervención quirúrgica abdominal de urgencia. Variables estudiadas: Edad, Sexo, Procedencia, Comorbilidad, reingreso hospitalario, tiempo trascurrido entre la intervención quirúrgica y la aparición de la infección en sitio quirúrgico. Datos obtenidos del análisis de fichas clínicas y la base de datos del HIS en el paquete estadístico SPSv23 (IBM SPSS, DEMO) utilizando estadística descriptiva. Resultados: Fueron incluidas 440 fichas de pacientes, la mediana de edad fue de 10 años, el 60,5% fueron del sexo masculino y el 71,4% procedían del Departamento Central. Se observó que el diagnóstico más frecuente fue peritonitis de origen apendicular 53,2%. El estado nutricional de la población en estudio fue normal en 93,2%, y fueron reingresos el 3% de los pacientes intervenidos. Presentaron infección de sitio quirúrgico el 4,8%, de los cuales 11/21 fueron absceso de pared. En cuanto al tiempo trascurrido entre la cirugía y la aparición de la infección la mediana fue de 14 días. Conclusión: La frecuencia de infección del sitio quirúrgico encontrada en este estudio fue del 4,8%. La patología quirúrgica con mayor porcentaje fue la peritonitis y el tipo de infección absceso de pared. La mayoría de los pacientes eran escolares con buen estado nutricional.


Introduction: Surgical-site infections are associated with healthcare-associated infections (HAIs), caused by bacteria that enter through the incisions made during a surgical procedure. Objective: To describe the frequency and characteristics of surgical site infections in emergency surgeries in pediatric patients hospitalized at a Pediatric General Hospital. Materials and Methods: This was a descriptive, retrospective and cross-sectional observational study. Population: Patients aged 0 to 18 years undergoing emergency abdominal surgery. Variables studied: Age, Sex, Origin, Comorbidity, hospital readmission, time elapsed between the surgical intervention and the appearance of the surgical site infection. Data obtained from the analysis of clinical records and the electronic health record database in the SPSv23 statistical package (IBM SPSS, DEMO) using descriptive statistics. Results: 440 patient records were included, the median age was 10 years, 60.5% were male and 71.4% came from the Central Department. It was observed that the most frequent diagnosis was peritonitis of appendiceal origin 53.2%. The nutritional status of the study population was normal in 93.2%, and 3% of the operated patients were readmitted. 4.8% had surgical site infection, of which 11/21 were wall abscesses. Regarding the time elapsed between surgery and the appearance of the infection, the median was 14 days. Conclusion: The frequency of surgical-site infection found in this study was 4.8%. The surgical pathology with the highest percentage was peritonitis and the wall abscess type of infection. Most of the patients were schoolchildren with good nutritional status.

6.
Int. j. morphol ; 42(1): 127-136, feb. 2024. ilus
Article in English | LILACS | ID: biblio-1528822

ABSTRACT

SUMMARY: The objective of this study was to investigate the therapeutic wound healing potential and molecular mechanisms of shikonin as small molecules in vitro. A mouse burn model was used to explore the potential therapeutic effect of shikonin; we traced proliferating cells in vivo to locate the active area of skin cell proliferation. Through the results of conventional pathological staining, we found that shikonin has a good effect on the treatment of burned skin and promoted the normal distribution of skin keratin at the damaged site. At the same time, shikonin also promoted the proliferation of skin cells at the damaged site; importantly, we found a significant increase in the number of fibroblasts at the damaged site treated with shikonin. Most importantly, shikonin promotes fibroblasts to repair skin wounds by regulating the PI3K/AKT signaling pathway. This study shows that shikonin can effectively promote the proliferation of skin cell, and local injection of fibroblasts in burned skin can play a certain therapeutic role.


El objetivo de este trabajo fue investigar el potencial terapéutico de cicatrización de heridas y los mecanismos moleculares de la shikonina como moléculas pequeñas in vitro. Se utilizó un modelo de quemaduras en ratones para explorar el posible efecto terapéutico de la shikonina; Rastreamos las células en proliferación in vivo para localizar el área activa de proliferación de células de la piel. A través de los resultados de la tinción para patología convencional, encontramos que la shikonina tiene un buen efecto en el tratamiento de la piel quemada y promueve la distribución normal de la queratina de la piel en el sitio dañado. Al mismo tiempo, la shikonina también promovió la proliferación de células de la piel en el sitio dañado. Es importante destacar que encontramos un aumento significativo en la cantidad de fibroblastos en el sitio dañado tratado con shikonina. Lo más importante es que la shikonina promueve la función reparadora de fibroblastos en las heridas de la piel regulando la vía de señalización PI3K/ AKT. Este estudio muestra que la shikonina puede promover eficazmente la proliferación de células de la piel y que la inyección local de fibroblastos en la piel quemada puede desempeñar un cierto papel terapéutico.


Subject(s)
Animals , Mice , Wound Healing/drug effects , Burns/drug therapy , Naphthoquinones/administration & dosage , Skin , In Vitro Techniques , Naphthoquinones/pharmacology , Phosphatidylinositol 3-Kinases , Cell Proliferation/drug effects , Disease Models, Animal , Proto-Oncogene Proteins c-akt , Fibroblasts , Mice, Inbred C57BL
7.
Online braz. j. nurs. (Online) ; 23: e20246673, 02 jan 2024. ilus
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1527197

ABSTRACT

OBJETIVO: mapear evidências científicas sobre a prevenção e o manejo precoce de infecção de sítio cirúrgico por telemonitoramento em pacientes cirúrgicos após alta hospitalar. MÉTODO: revisão de escopo desenvolvida conforme proposto pelo Instituto Joanna Briggs (JBI). Foi realizada a pesquisa nas bases de dados PubMed, Literatura Latino-americana e do Caribe em Ciências da Saúde (LILACS), Cochrane Collaboration, Scopus, CINAHL, MEDLINE, Web of Science e Embase. Os estudos foram adicionados ao gerenciador Endnote Basic e Rayyan por três pesquisadores independentes. RESULTADOS: foram identificados 1.386 estudos e incluídos 31, os quais apresentaram relevância em relação a sinais de alerta precoce e tardio da infecção de sítio cirúrgico, complicações, fatores de risco, prevenção e utilização do telemonitoramento. CONCLUSÃO: observou-se que, embora os estudos abordem a infecção de sítio cirúrgico e o telemonitoramento, faz-se necessário a formulação dos instrumentos utilizados nas consultas telefônicas, contemplando com maior especificidade os critérios indispensáveis a serem abordados.


OBJECTIVE: This study aims to map scientific evidence regarding the prevention and early management of surgical site infection through telemonitoring in surgical patients after discharge from the hospital. METHOD: A scoping review was conducted following the guidelines proposed by the Joanna Briggs Institute (JBI). The search was performed across PubMed, Latin American and Caribbean Health Sciences Literature (LILACS), Cochrane Collaboration, Scopus, CINAHL, MEDLINE, Web of Science, and Embase databases. Three independent researchers collect the identified studies using Endnote Basic and Rayyan. RESULTS: A total of 1,386 studies were identified, of which 31 were included in the analysis. These selected studies demonstrated significance regarding early and late warning signs of surgical site infection, complications, risk factors, prevention strategies, and the utilization of telemonitoring. CONCLUSION: While the studies address surgical site infection and telemonitoring, it is imperative to formulate the instruments employed in telephonic consultations, incorporating a more specific consideration of essential criteria to be addressed.


Subject(s)
Patient Discharge , Postoperative Care , Surgical Wound Infection/prevention & control , Surgical Wound Infection/therapy , Telemonitoring , Nursing Care
8.
Article in Chinese | WPRIM | ID: wpr-1009111

ABSTRACT

OBJECTIVE@#To explore the feasibility and effectiveness of a foldable pedicled latissimus dorsi myocutaneous flap to repair soft tissue defects in the shoulder and back.@*METHODS@#Between August 2018 and January 2023, the foldable pedicled latissimus dorsi myocutaneous flaps were used to repair soft tissue defects in the shoulder and back of 8 patients. There were 5 males and 3 females with the age ranged from 21 to 56 years (mean, 35.4 years). Wounds were located in the shoulder in 2 cases and in the shoulder and back in 6 cases. The causes of injury were chronic infection of skin and bone exposure in 2 cases, secondary wound after extensive resection of skin and soft tissue tumor in 4 cases, and wound formation caused by traffic accident in 2 cases. Skin defect areas ranged from 14 cm×13 cm to 20 cm×16 cm. The disease duration ranged from 12 days to 1 year (median, 6.6 months). A pedicled latissimus dorsi myocutaneous flap was designed and harvested. The flap was divided into A/B flap and then were folded to repair the wound, with the donor area of the flap being pulled and sutured in one stage.@*RESULTS@#All 7 flaps survived, with primary wound healing. One patient suffered from distal flap necrosis and delayed healing was achieved after dressing change. The incisions of all donor sites healed by first intention. All patients were followed up 6 months to 4 years (mean, 24.7 months). The skin flap has a good appearance with no swelling in the pedicle. At last follow-up, 6 patients had no significant difference in bilateral shoulder joint motion, and 2 patients had a slight decrease in abduction range of motion compared with the healthy side. The patients' daily life were not affected, and linear scar was left in the donor site.@*CONCLUSION@#The foldable pedicled latissimus dorsi myocutaneous flap is an ideal method to repair the soft tissue defect of shoulder and back with simple operation, less damage to the donor site, and quick recovery after operation.


Subject(s)
Male , Female , Humans , Young Adult , Adult , Middle Aged , Plastic Surgery Procedures , Myocutaneous Flap/surgery , Shoulder/surgery , Skin Transplantation , Superficial Back Muscles/transplantation , Soft Tissue Injuries/surgery , Wound Healing , Treatment Outcome , Perforator Flap
9.
Article in Chinese | WPRIM | ID: wpr-1009107

ABSTRACT

OBJECTIVE@#To explore the effectiveness of Nice knot technique for wound closure in Gustilo type ⅢA and ⅢB open tibial fractures.@*METHODS@#A retrospective study was performed on 22 patients with Gustilo type ⅢA and ⅢB open tibial fractures, who underwent wound closure using the Nice knot technique and were admitted between June 2021 and June 2022. There were 15 males and 7 females. The age ranged from 18 to 67 years, with an average of 41.9 years. The causes of injury included traffic accident in 11 cases, falling from height in 7 cases, and heavy object injuries in 4 cases. Fractures were located on the left side in 9 cases and on the right side in 13 cases. And 9 cases were type ⅢA fractures and 13 were type ⅢB fractures according to Gustilo classification. All patients had extensive soft tissue injuries, and no vascular or neurological damage was observed. The time from injury to debridement was 3-8 hours (mean, 6.5 hours). The sizes of wounds before operation and at 2 weeks after operation were measured and wound healing rate at 2 weeks after operation were calculated. The wound healing time and wound healing grading were recorded. The Vancouver Scar Scale (VSS) score was used to assess the wound scar after wound healed and the excellent and good rate was calculated.@*RESULTS@#The wound area was 21.0-180.0 cm 2 (mean, 57.82 cm 2) before operation, and it was 1.2-27.0 cm 2 (mean, 6.57 cm 2) at 2 weeks after operation. The wound healing rate at 2 weeks after operation was 76%-98% (mean, 88.6%). After operation, 2 cases needed to adjust Nice knot due to skin cutting and 1 case occurred soft tissue infection on the wound. The other patient's wounds healed. The average wound healing time was 27.8 days (range, 18-44 days). And the wound healing were grade A in 13 cases and grade B in 9 cases. VSS score was 2-9, with an average of 4.1; 10 cases were rated as excellent, 10 as good, and 2 as poor, with an excellent and good rate of 90.9%. All patients were followed up 9-24 months (mean, 14.6 months). During follow-up, no deep infection or osteomyelitis occurred. Two cases experienced fracture non-union, and were treated with compression fixation and bone grafting. The fractures of the other patients all healed, with a healing time of 85-190 days (mean, 148.2 days).@*CONCLUSION@#Nice knot technique can be used in wound closure of Gustilo type ⅢA and ⅢB open tibial fractures effectively, which is easy to operate.


Subject(s)
Male , Female , Humans , Adolescent , Young Adult , Adult , Middle Aged , Aged , Cicatrix , Retrospective Studies , Treatment Outcome , Tibial Fractures/surgery , Wound Healing , Fracture Fixation, Internal/methods , Fractures, Open/surgery
10.
China Pharmacy ; (12): 695-700, 2024.
Article in Chinese | WPRIM | ID: wpr-1013104

ABSTRACT

OBJECTIVE To investigate the effect and mechanism of Panax notoginseng saponins (PNS) on wound healing after anal fistula surgery in rats by regulating the hypoxia-inducible factor-1α (HIF-1α)/vascular endothelial growth factor (VEGF)/ vascular endothelial growth factor receptor-2 (VEGFR2) signaling pathway. METHODS SD rats were selected to establish a postoperative rat model of anal fistula by infecting wound with Escherichia coli. The model rats were randomly grouped into model group, PNS low-dose and high-dose groups (15, 30 mg/cm2), high-dose of PNS+2-methoxyestradiol (2ME2) group (PNS 30 mg/cm2+HIF-1α inhibitor 2ME2 4 mg/kg), with 10 rats in each group. Another 10 normal rats were selected for back hair removal treatment as the control group. Each drug group was injected with the corresponding drug solution intramuscularly or (and) intraperitoneally, once a day, for 3 weeks. After the last administration, the wound healing rate (excluding the control group), microvascular density (MVD), the expression of collagen Ⅰ and fibronectin (FN) in the wound tissue were detected in each group; the levels of angiogenic factors [VEGF, E-mail:842710813@qq.com angiopoietin-Ⅰ (Ang-Ⅰ), Ang-Ⅱ] in serum, the levels of inflammatory factors [interleukin-6 (IL-6) and IL-2] in serum binggui7183@163.com and wound tissue as well as the expressions of the related proteins of HIF-1α/VEGF/VEGFR2 signaling pathway in the wound tissue of rats were also detected in each group. RESULTS The MVD, the expression of collagen Ⅰ and FN in the wound tissue, and the levels of IL-6 and IL-2 in serum and wound tissue of rats increased significantly in the model group, compared to the control group (P<0.05), while the serum levels of VEGF, Ang- Ⅰ and Ang-Ⅱ decreased significantly (P<0.05). The wound healing rate, the MVD in wound tissue, the serum levels of VEGF, Ang-Ⅰ and Ang-Ⅱ, the expressions of collagen Ⅰ and FN in the wound tissue, and protein expressions of HIF-1α, VEGF and VEGFR2 in the PNS low-dose and high-dose groups increased significantly, compared to the model group (P<0.05), while the levels of IL-6 and IL-2 in serum and wound tissue decreased significantly (P<0.05); the high-dose PNS had a stronger effect (P< 0.05). 2ME2 could weaken the effect of PNS on above indicators of rats after anal fistula surgery (P<0.05). CONCLUSIONS PNS can promote the production of angiogenic factors and inhibit the production of pro-inflammatory factors, thereby promoting wound healing in rats after anal fistula surgery. The above effects are related to the activation of HIF-1α/VEGF/VEGFR2 signaling pathway.

11.
Article in English | WPRIM | ID: wpr-1012786

ABSTRACT

@#Wound healing is a complex process that includes haemostasis and inflammation, followed by a proliferation period and repair and finally remodelling. Ocular surgeries, particularly in glaucoma cases, aim at minimal fibrosis to preserve the function of trabeculectomy as an alternative pathway for aqueous drainage. Hence, it is important to find an agent to modulate the wound healing process. This review presents compilation of wound modulation agents that have been tested in vitro, in vivo, or clinically on patients undergoing ocular surgeries, particularly for glaucoma. We identified agents into four groups, mostly for glaucoma filtration operations: anti-metabolites, anti-growth factors, mechanical barriers and rho kinases. The effect of these agents is highlighted in this review. In conclusion, despite recognized drawbacks of antimetabolites, they are still regarded as the gold standard and the most efficient treatment as anti-scarring agents use in ocular surgeries. More studies are needed to inquire agents that efficient yet has minimal adverse effects both in short and long term.

12.
Article in Chinese | WPRIM | ID: wpr-1012714

ABSTRACT

A chronic refractory wound is caused by continuous skin damage. At the same time, it may be formed due to repeated infection, vascular insufficiency, diabetes, tumors, chronic osteomyelitis, and other reasons, resulting in wound repair interruption and recovery delay. Chronic refractory wound seriously affects the quality of life of patients and consumes a lot of medical resources. Polysaccharides in traditional Chinese medicine (TCM) are the effective components of most TCM. Modern pharmacological studies have found that polysaccharides contained in TCM have anti-inflammatory, antioxidant, anti-radiation, hypoglycemic, antiviral, anti-tumor, hypolipidemic, and immunomodulatory effects. Through the summary and analysis of the literature, it was found that the mechanism of polysaccharides in TCM to promote chonic refractory wound repair was mainly realized from the following aspects: firstly, regulating inflammatory cytokines like interleukin-4 (IL-4), interleukin-10 (IL-10), interleukin-8 (IL-8), and tumor necrosis factor-α (TNF-α) or regulating macrophage-related inflammatory proteins and chemotactic proteins like MIP-2, MCP-1, to shorten the inflammatory period. Secondly, activating growth factors like platelet-derived growth fator (PDGF), basic fibroblast growth factor (bFGF), TGF-α, and vascular endothelial growth factor (VEGF) to recruit endothelial cells and fibroblasts into tissue proliferation. Thirdly, activationg VEGF and its downstream receptor vascular endothelial growth factor receptor-1 (VEGFR-1) and vascular endothelial growth factor receptor-2 (VEGFR-2)-mediatated protein kinase C/extracellular regulated kinases (PKC/ERK) signaling pathway or promoting angiogenesie and improving wound blood flow through angiotensin (ANG). Fourthly, promoting the ablility of collagen synthesis by enhancing the secretion of hydroxyproline and hyaluronic acid (HA) from fibroblasts (FB) and regulating relevant matrix metalloenzymes and their enzyme inhibitor to regulate the extracellular matrix. Fifthly, eliminating free radiccals to reduce the damage caused by oxidative stress to tissue. Sixthly, enhancing the phagocytic ability of macrophages, the activity of natural killer cells, and the proliferation of T cells to improve the defense ability of tissue. Polysaccharides in TCM can repair wounds in many ways at the same time. Its advantage lies in the multiple targets and multiple pathways. It is expected that the research will pay more attention to the mechanism of wound repair by polysaccharide components in TCM when improving the treatment of chronic refractory wounds.

13.
Article in Chinese | WPRIM | ID: wpr-1003426

ABSTRACT

Diabetic ulcer (DU) wound is one of the chronic and serious complications of diabetes characterized by prolonged wound healing, and it is more common in foot and lower extremity ulcers. DU has brought great economic and psychological pressure to patients and seriously affected the quality of life of patients because of its great difficulty in treatment, long treatment process, and high morbidity and mortality. Therefore, how to help the rapid healing of DU wounds, reduce the disability rate and mortality rate, protect limb function, and improve the quality of life is an important topic and hot spot in the field of medical research. The pathogenesis of DU is complex, mainly including microcirculation disorder, peripheral neuropathy, inflammation and infection, and excessive apoptosis of cells, involving physiological processes such as wound inflammation, granulation tissue hyperplasia and re-epithelialization. A large number of previous studies have found that Chinese medicine can regulate phosphatidylinositol 3-kinase/protein kinase B (PI3K/Akt), Wnt/β-catenin, nuclear factor-κB (NF-κB), Notch, nuclear factor E2-related factor 2 (Nrf2), transforming growth factor-β (TGF-β)/Smad, and other signaling pathways, regulate abnormal glucose metabolism, improve microcirculation, inhibit inflammation and oxidative stress, regulate cell proliferation and excessive apoptosis, and promote wound tissue growth to promote the rapid healing of DU wounds under the guidance of treatment based on traditional Chinese medicine (TCM) syndrome differentiation and internal and external treatment. Therefore, this paper reviewed Chinese medicinal monomers or Chinese medicinal compounds in recent years in regulating the above signaling pathways and the expression of key protein molecules and promoting the rapid healing of DU wounds, aiming to provide ideas and a theoretical basis for the in-depth study and clinical application of Chinese medicine in promoting the healing of DU wounds.

14.
Rev. Pesqui. (Univ. Fed. Estado Rio J., Online) ; 16: e13054, jan.-dez. 2024. tab
Article in English, Portuguese | LILACS, BDENF | ID: biblio-1533034

ABSTRACT

Objetivo: analisar os fatores associados à prevalência de cicatrização em pacientes com feridas crônicas. Método: estudo transversal, em pacientes com feridas crônicas de uma Unidade de Saúde da Família, em Salvador, Bahia. Os dados foram coletados de fontes secundárias disponíveis na planilha de acompanhamento dos pacientes, analisando como desfecho os níveis de cicatrização das feridas crônicas. Resultados: foram verificadas diferenças estatisticamente significantes nas variáveis faixa etária e dor, em que a proporção de apresentar os piores índices de cicatrização foi 77,78% maior entre os pacientes adultos quando comparada aos idosos; e a proporção de apresentar os piores índices de cicatrização entre os pacientes com dor intensa/muito intensa foi 80% maior quando comparada aos pacientes sem dor. Conclusão: ficou evidente a importância de desenvolver estratégias voltadas ao estilo de vida, adesão ao tratamento, manejo da dor, bem como utilização de instrumentos qualitativos para avaliação dos fatores que possam interferir na cicatrização.


Objective: to analyze the factors associated with the prevalence of healing in patients with chronic wounds. Method: cross-sectional study, in patients with chronic wounds at a Family Health Unit, in Salvador, Bahia. Data were collected from secondary sources available in the patient monitoring spreadsheet, analyzing the healing levels of chronic wounds as the outcome. Results: statistically significant differences were found in the variable age group and pain, in which the proportion of those presenting the worst healing rates was 77.78% higher among adult patients when compared to the elderly; and the proportion of patients with intense/very intense pain presenting the worst healing rates was 80% higher when compared to patients without pain. Conclusion: the importance of developing strategies focused on lifestyle, adherence to treatment, pain management, as well as the use of qualitative instruments to evaluate factors that may interfere with healing.


Objetivos:analizar los factores asociados a la prevalencia de curación en pacientes con heridas crónicas. Método: estudio transversal, en pacientes con heridas crónicas en una Unidad de Salud de la Familia, en Salvador, Bahía. Los datos se recopilaron de fuentes secundarias disponibles en la hoja de seguimiento de pacientes, analizando como resultado los niveles de curación de las heridas crónicas. Resultados: se observaron diferencias estadísticamente significativas en las variables grupo de edad y dolor, siendo la proporción de quienes tuvieron peores tasas de curación 77,78% mayor entre los pacientes adultos en comparación con los ancianos; y la proporción de pacientes con dolor intenso/muy intenso que presentaron peores tasas de curación fue un 80% mayor en comparación con los pacientes sin dolor. Conclusión: se evidenció la importancia de desarrollar estrategias enfocadas en el estilo de vida, la adherencia al tratamiento, el manejo del dolor, así como el uso de instrumentos cualitativos para evaluar factores que puedan interferir en la curación.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Primary Health Care , Wounds and Injuries/nursing , Risk Factors , Pain Management/nursing , Family Nurse Practitioners
15.
J. appl. oral sci ; 32: e20230307, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1550469

ABSTRACT

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

16.
Braz. j. oral sci ; 23: e242836, 2024. ilus
Article in English | LILACS, BBO | ID: biblio-1553439

ABSTRACT

Aim: To investigate the bacteriological profile of oral and maxillofacial infections and the pattern of sensitivity to a specific group of antibiotics in a reference emergency hospital in Brazil. Methods: This is a prospective cohort institutional study that studied patients affected by oral and/ or maxillofacial infections in a Brazilian emergency hospital, over a 12-month period, of different etiologies, through data collection, culture and antibiogram tests, and monitoring of the process of resolution of the infectious condition. The variables were analyzed using the chi-square and Mann-Whitney tests, using a significance level of 5%. Results: The sample consisted of 61 patients, 62.3% male. The mean age of participants was 34.3 years. Odontogenic infection was the most frequent etiology and the submandibular space was the most affected. The bacterial species Streptococcus viridans was isolated in 21.6% of cases. Levofloxacin, vancomycin and penicillin were the antibiotics with the highest frequency of bacterial sensitivity, while clindamycin and erythromycin showed the highest percentages of resistance. Conclusions: The results suggest that, among the most used antibiotics for the treatment of these infections, penicillin remains an excellent option of choice for empirical therapy


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Surgical Wound Infection , Bacteria/drug effects , Drug Resistance, Microbial , Focal Infection, Dental , Anti-Bacterial Agents
17.
Arq. bras. oftalmol ; 87(2): e2021, 2024. graf
Article in English | LILACS-Express | LILACS | ID: biblio-1527833

ABSTRACT

ABSTRACT A 59-year-old man presented with a unilateral blurring of vision in his left eye. His left eye's visual acuity was hand movements level. He underwent phacoemulsification surgery, and an intrastromal posterior chamber intraocular lens was implanted. The intrastromal intraocular lens was extracted and a new intraocular lens was implanted. Usinge the Snellen chart, the final best-corrected visual acuity was 20/40. With this case report, we wish to emphasize that a single stepwise clear corneal incision merged with wound-assisted intraocular lens injections can result in intraocular lens misdirection into the corneal stroma. As a result, while performing a misdirected intraocular lens removal, we recommend that the wound be carefully constructed.


RESUMO Um homem de 59 anos apresentou embaçamento visual unilateral no olho esquerdo. Sua acuidade visual nesse olho era no nível de movimentos da mão. O paciente havia se submetido a uma cirurgia de facoemulsificação em que foi feita a implantação intraestromal de uma lente intraocular de câmara posterior. Foi feita a extração dessa lente intraestromal intraocular e uma nova lente intraocular foi implantada. A melhor acuidade visual corrigida final foi de 20/40 pela tabela de Snellen. Com este relato de caso, os autores desejam apontar que uma incisão de degrau único em córnea clara, quando combinada com a injeção de uma lente ocular através da incisão, pode levar a um direcionamento incorreto da lente intraocular para dentro do estroma corneano. Portanto, recomenda-se uma construção cuidadosa da incisão ao se remover uma lente intraocular direcionada incorretamente.

18.
Acta cir. bras ; 39: e392124, 2024. tab, graf
Article in English | LILACS-Express | LILACS, VETINDEX | ID: biblio-1556661

ABSTRACT

ABSTRACT Purpose: To evaluate the effects of curcumin supplementation on abdominal surgical wound healing in rats using clinical, histological, and hematological parameters. Methods: Forty Wistar rats were randomly divided into two groups: the curcumin group, and the control group. The curcumin group received, in addition to water and standard feed, curcumin via gavage at the dose of 200 mg/kg for seven days preceding and seven days following surgery. The control group received only water and standard feed. Both groups underwent median laparotomy and left colotomy. On the eighth postoperative day, the groups were euthanized, and the left colon was resected for histological analysis. Results: In the preoperative evaluation, there was a significant decrease in the mean C-reactive protein levels in the curcumin group (0.06) compared to the control group (0.112) (p = 0.0001). In the postoperative wound healing assessment, a significant decrease was observed in inflammatory infiltrate (p = 0.0006) and blood vessel count (p = 0.0002) in the curcumin group compared to the control group. Conclusions: Curcumin supplementation was able to significantly reduce inflammatory parameters in both pre-and post-operative phases of abdominal surgical wounds in rats.

19.
Int. arch. otorhinolaryngol. (Impr.) ; 28(1): 129-133, 2024. tab
Article in English | LILACS-Express | LILACS | ID: biblio-1558005

ABSTRACT

Abstract Introduction Multiple solutions are currently used to cleanse a deep neck infection (DNI), and a variety of devices are available to deliver wound irrigation solutions. An essential difference between these devices is the pressure that the irrigation solution exerts over the wound tissue. Objective To compare low-pressure and high-pressure irrigation delivery systems for wound cleansing in DNI. Methods we designed a retrospective cohort study and reviewed the medical records of patients operated on due to DNI from June 2016 to December 2017 at our institution. One cohort included patients treated with an intraoperative irrigation method that exerts low pressure over the irrigated tissue, and the other cohort, to a system capable of generating higher pressure. The Pearson Chi-squared test was used to analyze the data. Results A total of 42 patients whose ages ranged from 16 months to 72 years were included. The low-pressure irrigation system was used in 18 patients, and the high-pressure system was used in 24 patients. No statistical differences were observed regarding the irrigation methods, the complexity of the DNI, and the overall outcomes. Conclusions The present is the first study in which low- and high-pressure systems for wound lavage were evaluated in the treatment of DNI. When comparing these methods, we did not find one to be superior to the other; however, the additional cost associated with the high-pressure devices may not justify their in head and neck procedures.

20.
J. appl. oral sci ; 32: e20230448, 2024. tab, graf
Article in English | LILACS-Express | LILACS | ID: biblio-1558231

ABSTRACT

Abstract Objective Platelet-rich fibrin (PRF) contains a variety of growth factors and bioactive molecules that play crucial roles in wound healing and angiogenesis. We aimed to evaluate the effects of PRF on tissue thickness and vascularization of the palatal donor site by ultrasound (USG) following subepithelial connective tissue harvesting. Methodology A subepithelial connective tissue graft was harvested from the palatal region with a single incision for root coverage in 20 systemically healthy patients. In the test group (n = 10), the PRF membrane was placed at the donor site, whereas no material was applied in the control group (n=10). Palatal tissue thickness (PTT) and pulsatility index (PI) were evaluated by USG at baseline and on the 3rd, 7th, 14th, 30th, and 90th days after surgery. The early healing index (EHI) was used to evaluate donor site healing for 30 days. Results PTT was significantly higher in the PRF group on the 3rd and 14th days after surgery when compared to the controls. In the PRF-treated group, PI levels were significantly higher than in the controls, especially on the 14th day. PTT increased significantly 90 days after surgery compared to the test group baseline, but controls showed a significant decrease. The PRF group showed statistically significant improvements in EHI scores compared to controls on days 3, 7, and 14. This study found a negative correlation between PI values and EHI scores on postoperative days three and seven in the test group. Conclusion USG is a non-invasive, objective method to radiographically evaluate the regenerative effects of PRF on palatal wound healing after soft tissue harvesting. To overcome graft inadequacy in reharvesting procedures, PRF application may enhance clinical success and reduce possible complications by increasing tissue thickness and revascularization in the donor area.

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