Exceptional post-tonsillectomy cervicofacial emphysema: A case report.

INTRODUCTION: Tonsillectomy is known as one of the safest otorhinolaryngology surgery procedure. Rarely, it can lead to serious complications. Cervico-facial emphysema is an exceptional complication of tonsillectomy. Here we reported a case of post-tonsillectomy emphysema. Our objective was to emphasize the different characteristics of this entity and draw attention to the risk of potentially fatal respiratory complications. PRESENTATION OF CASE: A 46-year-old healthy woman had a tonsillectomy because of recurrent tonsillitis. Four hours after extubation, she presented a subcutaneous emphysema under the left mandibular angle, slightly extended to the left cheek and left laterocervical region. An immediate cervicofacial CT scan showed a dissecting cervical emphysema of the left hemiface of moderate abundance that extended to the pre-vascular space of the superior mediastinum. The decision was to keep the patient hospitalized, to avoid forced glottic closure and to put her on prophylactic antibiotics. The further course was uneventful with respiratory state stability and emphysema's disappearance. CLINICAL DISCUSSION: Cervicofacial emphysema is a very rare but life-threatening tonsillectomy complication that may cause acute respiratory failure. Emphysema's main clinical characteristics are a non-tender cervicofacial swelling and crepitus. Post-tonsillectomy emphysema treatment is usually conservative. In cases of respiratory failure, it is necessary to secure the airway by intubation or tracheostomy. An important mediastinal expansion of the emphysema requires a thoracotomy. CONCLUSION: Cervicofacial emphysema is an unpredictable complication of tonsillectomy. Its prevention requires per-operative vigilance from both ENT surgeons and anesthetists. Moreover, early diagnosis and management are essential to avoid its potentially fatal consequences.

Skin healing effects of an innovative polymer-based oil Nigella sativa: a rabbit model experimental study.

OBJECTIVE: Natural wound dressings composed of gelatin (GEL) and chitosan (CH) impregnated with bioactive compounds (Nigella sativa oil) were prepared and characterized to evaluate their potential application. MATERIALS AND METHODS: The formulated composite was subjected to γ-irradiation. In vitro, the ferric-reducing antioxidant power (FRAP) assay and antibiofilm activities were evaluated. In vivo, the tissue wound-healing process was studied by applying GEL-CH-Nigella in dorsal skin rabbit tissue. On days 7 and 14, the biochemical biomarker and histological analysis were determined. RESULTS: At 10 kGy, FRAP assays exhibited the highest antioxidant activity (380 mmol/kg). A significant inhibition of anti-biofilm activity was observed against Staphylococcus aureus (S. aureus) and Escherichia coli (E. coli) (p<0.01). Fourteen days post-surgery, a significant reduction in thiobarbituric acid-reactive compounds (TBARs) was observed compared to the GEL-CH group. Concerning oxidative stress status, GEL-CH-Nigella significantly improved superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx) activities. A histological analysis revealed that GEL-CH-Nigella accelerated wound closure and improved collagenisation and enhanced epidermal tissue thickness. CONCLUSIONS: These results indicate that GEL-CH-Nigella wound dressing is a promising biomaterial for engineered tissue.

Effect of novel curcumin-encapsulated chitosan-bioglass drug on bone and skin repair after gamma radiation: experimental study on a Wistar rat model.

Radiation therapy contributes to a significant increase in bone osteoporosis and skin loss. Various natural health products might be beneficial to reduce bone and skin alterations. Curcumin (CUR) medicines derived from natural plants have played an important role in health care. This study aims at synthesizing and evaluating the performance therapy of CUR-encapsulated bioglass-chitosan (CUR-BG-CH). In vitro, the antioxidant assay was evaluated by using 1,1-diphenyl-2-picrylhydrazyl free-radical (DPPH) scavenging and the nitroblue tetrazolium reduction. The CUR-BG-CH antimicrobial effects were tested in liquid media. In vivo, after rat (60) Co γ-radiation, the tissue wound-healing process was studied by grafting CUR and CUR-BG-CH in femoral condyle and dorsal skin rat tissue. The antioxidant studies indicated that CUR-BG-CH quenches free radicals more efficiently than unmodified CUR and had effective DPPH (91%) and superoxide anion (51%) radical scavenging activities. The CUR-BG-CH biomaterial exhibited an important antimicrobial activity against Staphylococcus aureus. The histomorphometric parameters showed amelioration in CUR-BG-CH-treated rats. An improved mechanical property was noticed (33.16 ± 5.0 HV) when compared with that of unmodified CUR group (23.15 ± 4.9 HV). A significant decrease in tumour necrosis factor-α cytokine production was noted in the CUR-BG-CH rats (90 pg/ml) as compared with that of unmodified CUR group (240 pg/ml). The total amount of hydroxyproline was significantly enhanced (33.5%) in CUR-BG-CH group as compared with that of control. Our findings suggested that CUR-BG-CH might have promising potential applications for wound healing.

Biological therapy of strontium-substituted bioglass for soft tissue wound-healing: responses to oxidative stress in ovariectomised rats.

New synthetic biomaterials are constantly being developed for wound repair and regeneration. Bioactive glasses (BG) containing strontium have shown successful applications in tissue engineering account of their biocompatibility and the positive biological effects after implantation. This study aimed to assess whether BG-Sr was accepted by the host tissue and to characterize oxidative stress biomarker and antioxidant enzyme profiles during muscle and skin healing. Wistar rats were divided into five groups (six animals per group): the group (I) was used as negative control (T), after ovariectomy, groups II, III, IV and V were used respectively as positive control (OVX), implanted tissue with BG (OVX-BG), BG-Sr (OVX-BG-Sr) and presented empty defects (OVX-NI). Soft tissues surrounding biomaterials were used to estimate superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx) and malondialdehyde (MDA) concentration. Our results show that 60 days after operation, treatment of rats with BG-Sr significantly increased MDA concentration and caused an increase of SOD, CAT and GPx activities in both skin and muscular tissues. BG-Sr revealed maturation of myotubes followed a normal appearance of muscle regenerated with high density and mature capillary vessels. High wound recovery with complete re-epithelialization and regeneration of skin was observed. The results demonstrate that the protective action against reactive oxygen species (ROS) was clearly observed in soft tissue surrounding BG-Sr. Moreover, the potential use of BG-Sr rapidly restores the wound skin and muscle structural and functional properties. The BG advantages such as ion release might make BG-Sr an effective biomaterial choice for antioxidative activity.