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1.
Int Wound J ; 21(3): e14820, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38425151

RESUMO

Bladder cancer is a highly prevalent malignancy that presents significant difficulties in the management of wounds following surgery. The present study investigated the critical necessity to optimize wound healing techniques in patients undergoing bladder cancer surgery by contrasting conventional approaches with advanced modalities in order to promote recovery and mitigate complications. The study assessed the efficacy of conventional and advanced wound healing methods in these patients, taking into account the complex interaction of patient-specific factors and surgical complexities. A cross-sectional analysis was performed on 120 patients who underwent bladder cancer surgery at the first affiliated hospital of Wenzhou Medical University. In addition to medical record evaluations and direct wound assessments, patient interviews were utilized to gather information regarding demographics, surgical specifics, wound healing methodologies and postoperative results. Survival analysis and logistic regression were utilized in statistical analysis, with potential confounding variables such as age, comorbidities and type of surgery being accounted for. Advanced wound healing techniques, such as negative pressure wound therapy, tissue-engineered products, bioactive dressings and platelet-rich plasma (PRP), exhibited distinct advantage in comparison with conventional suturing. The aforementioned techniques, especially PRP, resulted in expedited wound healing, decreased rates of complications (p < 0.05) and enhanced secondary outcomes, including curtailed hospital stays and decreased rates of readmissions. PRP therapy, in particular, demonstrated significant improvements with the faster mean time to wound healing of 9 ± 2 days and lower complication incidence of 2 (6.7%) (p < 0.05), indicating its superior efficacy. A subgroup analysis revealed that younger patients, males and those undergoing laparoscopic surgery exhibited superior outcomes (p < 0.05). The results were further supported by logistic regression and Cox proportional hazards models, which further indicated that sophisticated techniques, notably PRP therapy with a hazard ratio of 3.00 (2.00-4.50) and adjusted odds ratio of 0.20 (0.09-0.43), were effective in improving postoperative recovery. The research clarified the significant advantages that advanced wound healing techniques offered in postoperative care of patients diagnosed with bladder cancer. By customizing these methods to suit the unique requirements of individual patients and specific circumstances of surgical procedures, they can significantly enhance the recuperation process after surgery and set a new standard for patient care.


Assuntos
Plasma Rico em Plaquetas , Neoplasias da Bexiga Urinária , Masculino , Humanos , Estudos Transversais , Cicatrização , Neoplasias da Bexiga Urinária/cirurgia
2.
Adv Wound Care (New Rochelle) ; 10(6): 301-316, 2021 06.
Artigo em Inglês | MEDLINE | ID: mdl-32602814

RESUMO

Objective: Wound healing is a complex process that involves the interaction between different cell types and bioactive factors. Impaired wound healing is characterized by a loss in synchronization of these interactions, resulting in nonhealing chronic wounds. Chronic wounds are a socioeconomic burden, one of the most prominent clinical manifestations of diabetes, however, they lack satisfactory treatment options. The objective of this study was to develop polymeric composites that deliver ions having wound healing properties and evaluate its performance using a pressure ulcer model in diabetic mice. Approach: To develop a polymeric composite wound dressing containing ion-releasing nanoparticles for chronic wound healing. This composite was chemically and physically characterized and evaluated using a pressure ulcer wound model in diabetic (db/db) mice to explore their potential as novel wound dressing. Results: This dressing exhibits a controlled ion release and a good in vitro bioactivity. The polymeric composite dressing treatment stimulates angiogenesis, collagen synthesis, granulation tissue formation, and accelerates wound closure of ischemic wounds created in diabetic mice. In addition, the performance of the newly designed composite is remarkably better than a commercially available dressing frequently used for the treatment of low-exuding chronic wounds. Innovation: The developed nanoplatforms are cell- and growth factor free and control the host microenvironment resulting in enhanced wound healing. These nanoplatforms are available by cost-effective synthesis with a defined composition, offering an additional advantage in potential clinical application. Conclusion: Based on the obtained results, these polymeric composites offer an optimum approach for chronic wound healing without adding cells or external biological factors.


Assuntos
Diabetes Mellitus Experimental/patologia , Nanofibras/química , Neovascularização Fisiológica/efeitos dos fármacos , Polímeros/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Bandagens , Sobrevivência Celular/efeitos dos fármacos , Análise Custo-Benefício , Regulação da Expressão Gênica/efeitos dos fármacos , Tecido de Granulação/patologia , Masculino , Camundongos , Camundongos Knockout , Nanofibras/ultraestrutura , Pele/patologia
3.
Front Pharmacol ; 11: 155, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32180720

RESUMO

Wound management is a significant and growing issue worldwide. Knowledge of dressing products and clinical expertise in dressing selection are two major components in holistic wound management to ensure evidence-based wound care. With expanding global market of dressing products, there is need to update clinician knowledge of dressing properties in wound care. Optimal wound management depends on accurate patient assessment, wound diagnosis, clinicians' knowledge of the wound healing process and properties of wound dressings. We conducted a comprehensive review of the physical properties of wound dressing products, including the advantages and disadvantages, indications and contraindications and effectiveness of first-line interactive/bioactive dressing groups commonly used in clinical practice. These include semipermeable films, foams, hydroactives, alginates, hydrofibers, hydrocolloids, and hydrogels. In making decisions regarding dressing product selection, clinicians need to ensure a holistic assessment of patient and wound etiology, and understand dressing properties when making clinical decisions using wound management guidelines to ensure optimal patient outcomes. This review has highlighted there is lack of high quality evidence and the need for future well designed trials.

4.
Rev. chil. dermatol ; 31(3): 303-308, 2015. ilus, tab
Artigo em Espanhol | LILACS | ID: biblio-973208

RESUMO

El uso de diversas clases de apósito ha mostrado ser efectivo para acelerar el proceso de curación y optimizar el resultado de cicatrización. Según sus características estos se pueden dividir en pasivos, interactivos o bioactivos. En este contexto, es crucial seleccionar el tipo de apósito adecuado para la herida particular. La elección implica considerar diferentes factores: patología de base, cronicidad de la herida, necesidad de debridación, infección presente y etapa del proceso de cicatrización en que se encuentra. La presente revisión clasifica y describe los apósitos hoy existentes según sus aspectos más relevantes para el uso correcto; los resultados que han mostrado en estudios clínicos y ofrece algoritmos para la selección del tipo de apósito acorde a la herida específica, mencionando algunos casos especiales.


Use of different types of wound dressings has been shown to be effective on accelerate and optimize the healing process. Dressings can be described according to their characteristics as passive, interactive or bioactive. It is important to select the proper dressing for the specific wound. This decision requires consideration of several factors: underlying disease, chronic or acute presentation, need for debridement, presence of infection and healing process stage. The current review describes wound dressings considering important aspects for proper use, clinical trial results, and an algorithm that helps to choice dressing according to wound type, including some special situations.


Assuntos
Humanos , Cicatrização/fisiologia , Bandagens , Desbridamento , Curativos Hidrocoloides
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