The therapeutic effect of concentrated growth factor gel on skin wounds with bone or tendon exposure.

Treatment of soft tissue wounds with bone or tendon exposure remains a tough clinical challenge for surgeons. The current clinical approaches include various types of flap reconstruction and artificial dermis grafting as well as negative pressure wound therapy (NPWT), which are time-consuming and often result in graft failure or significant scarring. Concentrated growth factor (CGF) is a novel blood extract that contains many growth factors, platelets and fibrin to promote an orderly healing process. However, few reports have focused on wounds with bone or tendon exposure. We present a limited series and two specific cases of skin wound with bone or tendon exposed that received surgical debridement followed by CGF treatment. CGF appeared to facilitate wound closure effectively and also reduced scar formation. Our findings provide a novel therapeutic option for refractory wounds with bone or tendon exposure.

Future research priorities for soft-tissue knee injuries.

Aims: To identify unanswered questions about the prevention, diagnosis, treatment, and rehabilitation and delivery of care of first-time soft-tissue knee injuries (ligament injuries, patella dislocations, meniscal injuries, and articular cartilage) in children (aged 12 years and older) and adults. Methods: The James Lind Alliance (JLA) methodology for Priority Setting Partnerships was followed. An initial survey invited patients and healthcare professionals from the UK to submit any uncertainties regarding soft-tissue knee injury prevention, diagnosis, treatment, and rehabilitation and delivery of care. Over 1,000 questions were received. From these, 74 questions (identifying common concerns) were formulated and checked against the best available evidence. An interim survey was then conducted and 27 questions were taken forward to the final workshop, held in January 2023, where they were discussed, ranked, and scored in multiple rounds of prioritization. This was conducted by healthcare professionals, patients, and carers. Results: The top ten included questions regarding prevention, diagnosis, treatment, and rehabilitation. The number one question was, 'How urgently do soft-tissue knee injuries need to be treated for the best outcome?'. This reflects the concerns of patients, carers, and the wider multidisciplinary team. Conclusion: This validated process has generated ten important priorities for future soft-tissue knee injury research. These have been submitted to the National Institute for Health and Care Research. All 27 questions in the final workshop have been published on the JLA website.

Effectiveness of Negative Pressure Wound Therapy During Aeromedical Evacuation Following Soft Tissue Injury and Infection.

INTRODUCTION: Negative pressure wound therapy (NPWT) is utilized early after soft tissue injury to promote tissue granulation and wound contraction. Early post-injury transfers via aeromedical evacuation (AE) to definitive care centers may actually induce wound bacterial proliferation. However, the effectiveness of NPWT or instillation NPWT in limiting bacterial proliferation during post-injury AE has not been studied. We hypothesized that instillation NPWT during simulated AE would decrease bacterial colonization within simple and complex soft tissue wounds. METHODS: The porcine models were anesthetized before any experiments. For the simple tissue wound model, two 4-cm dorsal wounds were created in 34.9 ± 0.6 kg pigs and were inoculated with Acinetobacter baumannii (AB) or Staphylococcus aureus 24 hours before a 4-hour simulated AE or ground control. During AE, animals were randomized to one of the five groups: wet-to-dry (WTD) dressing, NPWT, instillation NPWT with normal saline (NS-NPWT), instillation NPWT with Normosol-R® (NM-NPWT), and RX-4-NPWT with the RX-4 system. For the complex musculoskeletal wound, hind-limb wounds in the skin, subcutaneous tissue, peroneus tertius muscle, and tibia were created and inoculated with AB 24 hours before simulated AE with WTD or RX-4-NPWT dressings. Blood samples were collected at baseline, pre-flight, and 72 hours post-flight for inflammatory cytokines interleukin (IL)-1ß, IL-6, IL-8 and tumor necrosis factor alpha. Wound biopsies were obtained at 24 hours and 72 hours post-flight, and the bacteria were quantified. Vital signs were measured continuously during simulated AE and at each wound reassessment. RESULTS: No significant differences in hemodynamics or serum cytokines were noted between ground or simulated flight groups or over time in either wound model. Simulated AE alone did not affect bacterial proliferation compared to ground controls. The simple tissue wound arm demonstrated a significant decrease in Staphylococcus aureus and AB colony-forming units at 72 hours after simulated AE using RX-4-NPWT. NS-NPWT during AE more effectively prevented bacterial proliferation than the WTD dressing. There was no difference in colony-forming units among the various treatment groups at the ground level. CONCLUSION: The hypoxic, hypobaric environment of AE did not independently affect the bacterial growth after simple tissue wound or complex musculoskeletal wound. RX-4-NPWT provided the most effective bacterial reduction following simulated AE, followed by NS-NPWT. Future research will be necessary to determine ideal instillation fluids, negative pressure settings, and dressing change frequency before and during AE.

Hamstring Injury Treatments and Management in Athletes: A Systematic Review of the Current Literature.

BACKGROUND: The field of sports medicine presents a varied landscape of research on hamstring injuries in athletes, characterized by inconclusive and sometimes conflicting findings on effective treatment and rehabilitation strategies. This discordance prompted the current systematic investigation. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed for conducting the systematic review. Multiple international bibliometric databases (Scopus, PubMed, Web of Science, and Embase) were searched to identify studies evaluating any treatment option for the management of hamstring injuries in athletes. Eligible studies were appraised for quality using Joanna Briggs Institute and Risk of Bias 2 tools. RESULTS: A total of 30 studies with 1,195 participants were included. Of the reviewed studies, treatments varied from aggressive rehabilitation, platelet-rich plasma (PRP) injections, manual techniques, various exercise protocols to modalities like high-power laser and nonsteroidal anti-inflammatory drugs. Evidence suggested benefits from treatments like extensive muscle lengthening during eccentric actions, progressive agility, and trunk stabilization. PRP injections produced mixed results regarding return to sport and reinjury rates. Stretching exercises, sometimes combined with cryotherapy, showed benefits. CONCLUSION: Treatments for hamstring injuries exhibit varied efficacy. Although rest, ice, compression, and elevation remains essential for acute management, rehabilitation focusing on muscle strengthening and flexibility is crucial. The potential benefits of PRP injections, especially for chronic cases, require more conclusive research. A comprehensive approach, combining evidence-based practices and patient-centric factors, is vital for effective management and recovery. LEVEL OF EVIDENCE: Level IV. See Instructions for Authors for a complete description of levels of evidence.

Recent advances of exosomes in soft tissue injuries in sports medicine: A critical review on biological and biomaterial applications.

Sports medicine is generally associated with soft tissue injuries including muscle injuries, meniscus and ligament injuries, tendon ruptures, tendinopathy, rotator cuff tears, and tendon-bone healing during injuries. Tendon and ligament injuries are the most common sport injuries accounting for 30-40% of all injuries. Therapies for tendon injuries can be divided into surgical and non-surgical methods. Surgical methods mainly depend on the operative procedures, the surgeons and postoperative interventions. In non-surgical methods, cell therapy with stem cells and cell-free therapy with secretome of stem cell origin are current directions. Exosomes are the main paracrine factors of mesenchymal stem cells (MSCs) containing biological components such as proteins, nucleic acids and lipids. Compared with MSCs, MSC-exosomes (MSC-exos) possess the capacity to escape phagocytosis and achieve long-term circulation. In addition, the functions of exosomes from various cell sources in soft tissue injuries in sports medicine have been gradually revealed in recent years. Along with the biological and biomaterial advances in exosomes, exosomes can be designed as drug carriers with biomaterials and exosome research is providing promising contributions in cell biology. Exosomes with biomaterial have the potential of becoming one of the novel therapeutic modalities in regenerative researches. This review summarizes the derives of exosomes in soft tissue regeneration and focuses on the biological and biomaterial mechanism and advances in exosomal therapy in soft tissue injuries.

Evaluation of the therapeutic effect of dressing containing Silver (Ag coat) in the process of healing skin blisters caused by limb fractures: a clinical trial study.

BACKGROUND: The main activity of the skin is to create a protective barrier against damage. Loss of the skin due to injury or disease and failure to regenerate the affected area may result in disability, infection, or even death. We conducted a clinical trial to evaluate the therapeutic effect of dressing containing silver in process of healing skin blisters caused by limb fractures. METHOD: This is a pioneering randomized trial that compares the effectiveness of two dressings containing silver (Ag coat) and Gaz Vaseline among patients with skin blisters due to bone fractures who were randomly selected from patients referred to the Kashani Medical Training Center. There were two treatment groups containing 16 patients treated with Ag coat and 15 patients treated with Gaz Vaseline. Pictures were taken of blisters on days 0, 7, and 14 to evaluate the healing process. The amount of pain, duration of the visit (measured by minutes), and general condition of the wound were checked. The amount of pain, duration of visit (measured by minutes) and general condition of the wound was checked. All continuous and categorical data are presented as mean ± standard deviation (SD) and frequency (percentage), respectively. Paired sample T-test and repeated measure analysis of variance (ANOVA), Chi-squared test was used. All pictures were analyzed by Mosaic soft ward. RESULT: During this study, there was no significant difference between the mean of age and BMI and frequency of gender in the two study groups (P > 0.05). There was a significant difference in mean between the duration of the visit, number of dressings, and net cost of dressing [Formula: see text]. In the macroscopic study and analysis for evaluation and comparing wound area with the Mosaic soft ward, there was significant relation in time (p1 = 0.00). There is no significant difference between the groups (p2 = 0.84). There was a significant difference between time and group (p3 = 0.00). On day 14 the wound area between groups had a significant difference (p4 = 0.00) (Table 3). In the VAS score there was a significant difference in time, and group (p1,2 = 0.00), there was no significant relation between time and group (p3 = 0.62). On all days the wound area between groups had a significant difference (p4 = 0.00). CONCLUSION: In conclusion, Ag coat dressing, not only has a significant effect on wound healing but also, decreases pain, shorter visit time, and its more cost-effective.

Smart Dual-Sensor Wound Dressing for Monitoring Cutaneous Wounds.

Managing slow-healing wounds and associated complications is challenging, time-consuming, and expensive. Systematic collection, analysis, and dissemination of correct wound status data are critical for enhancing healing outcomes and reducing complications. However, traditional data collection approaches are often neither accurate nor user-friendly and require diverse skill levels, resulting in the collection of inconsistent and unreliable data. As an advancement to the authors' previously developed hydrogel-based smart wound dressing, here is reported an enhanced integration of drug delivery and sensing (pH and glucose) modules for accelerated treatment and continuous monitoring of cutaneous wounds. In the current study, growth factor delivery modules and an array of colorimetric glucose sensors are incorporated into the dressing to promote wound healing and extend the dressing's utility for diabetic wound treatment. Furthermore, the efficacy of the wound dressing in monitoring infection and supporting wound healing via antibiotic and growth factor delivery is investigated in mice models. The updated dressing reveals excellent healing benefits on non-infected and infected wounds, as well as real-time monitoring and early detection of wound infection.

Manejo de tejidos blandos en trauma de miembros inferiores: a propósito de un caso / Soft tissue management in lower limb trauma: about a case

Los miembros inferiores están sujetos frecuentemente a traumas que ocasionan daño de estructuras vitales y que pueden dejar secuelas funcionales y estéticas en las personas. Las lesiones de tejidos blandos son las que asientan en la piel, tejido celular subcutáneo, aponeurosis, músculos, vasos y nervios. Del manejo oportuno y adecuado de las lesiones que se presenten posteriores a un trauma de tejidos blandos dependerá el resultado, el tiempo de recuperación, costos de hospitalización y sobre todo la preservación de las funciones de locomoción y sostén del miembro afectado

The lower limbs are frequently exposed to traumas that cause vital structures damage and can leave functional and aesthetic sequelae in patients. Soft tissue lesions are those that affect the skin, subcutaneous cellular tissue, fascia, muscles, vessels, and nerves. The result, recovery time, hospitalization costs and, above all, the preservation of the locomotion and support functions of the affected limb will depend on the timely and adequate management of injuries that occur after a soft tissue trauma.

Negative-Pressure Wound Therapy Induces Lymphangiogenesis in Murine Diabetic Wound Healing.

BACKGROUND: Decreased lymphangiogenesis contributes to impaired diabetic wound healing. Although negative-pressure wound therapy (NPWT) has been shown to be effective in the treatment of recalcitrant wounds, its impact on lymphangiogenesis remains to be elucidated. In this study, the authors investigate the mechanisms of lymphangiogenesis following NPWT treatment of diabetic murine wound healing. METHODS: Full-thickness dorsal skin wounds (1 × 1 cm 2 ) were excised on 30 db/db mice. The mice were either treated with occlusive covering (control group, n = 15), or received a 7-day treatment of continuous NPWT at -125 mmHg (NPWT group, n = 15). The wounds were photographed on days 0, 7, 10, 14, 21, and 28. Wound tissue was harvested on days 10, 14, 21, and 28 for quantitative analysis. Functional analysis of lymphatic drainage was performed on days 14 and 28 with Evans blue dye tracing. RESULTS: Lymphatic density and diameter, as visualized through podoplanin probing, was significantly higher in the NPWT group compared to the control group ( P < 0.001). NPWT up-regulated the expression of lymphatic vessel endothelial hyaluronan receptor 1 (LYVE-1) at the protein level ( P = 0.04), and significant differences were noted in lymphatic density as assessed by LYVE-1 staining ( P = 0.001). Leukocyte infiltration was significantly higher in the NPWT group ( P = 0.01). A higher speed of wound closure ( P < 0.0001) and greater wound bed thickness ( P < 0.0001) were noted in the NPWT group compared to the control group. CONCLUSIONS: NPWT increased the lymphatic vessel density and diameter with LYVE-1 up-regulation. NPWT therefore plays a positive role in lymphangiogenesis in diabetic wound healing. CLINICAL RELEVANCE STATEMENT: The authors' study investigates the association of NPWT and lymphatics and underlines the importance of a more in-depth investigation of the role of lymphatic vessels in wound healing.

Ten-year incidence and treatment outcomes of closed degloving injuries (Morel-Lavallee lesions) in a level 1 trauma centre.

INTRODUCTION: Morel-Lavallée lesions (MLL), also referred to as closed degloving injuries, result from traumatic shearing forces with separation of the subcutaneous fat from the underlying fascia. The aim of this study was to determine the incidence and treatment of MLLs at a level 1 trauma centre. METHODS: Single-centre retrospective cross-sectional study of consecutive patients with an imaging diagnosis of a Morel-Lavallee lesion from 1/1/2010-31/12/2019. Demographic data, mechanism of injury, volume of lesion, management and outcome data were collated. RESULTS: Sixty-six MLLs were identified in 63 patients (64% Male) with a median age of 49.5 years (19-94 years). Mechanism of injury were road traffic accidents in the majority (66%). Median injury severity score (ISS) was 17 (range 1-33). Patients on oral anti-coagulants had significantly larger lesions (181.9 cc v 445.5 cc, P = 0.044). The most common lesion location was the thigh (60.5%). Patients that underwent imaging within 72 h of injury had significantly larger lesions than those imaged more than 72 h after the inciting trauma (65 cc v 167 cc, P < 0.05). Management data were documented in 59% of lesions (39/66) in which 66.6% (n = 26) had invasive treatment. In the 31 patients where follow-up was available, 64.5% (n = 20) were persistent but decreasing in size. There was no significant difference in follow-up size for those who had invasive compared to conservative treatment (P = 0.3). CONCLUSION: The diagnosis of MLL should be considered for soft-tissue swelling in the context of shearing trauma. A variety of management options have been employed, with good overall outcomes.

[Acute care of soft tissue injuries in the head and neck region]. / Akutversorgung von Weichteilverletzungen im Kopf-Hals-Bereich.

BACKGROUND: Soft tissue injuries are a common consequence of head and neck trauma. With injuries being highly individual and varying depending on the underlying trauma, it is difficult to establish standardized guidelines for head and neck trauma in general. The main goal of this study was to showcase the distribution of soft tissue injury types and the principles pertaining to acute care of the individual clinical presentations. MATERIALS AND METHODS: A retrospective evaluation was carried out using all trauma-relevant ICD-10 codes for trauma to the head (S00.- to S09.-) and neck (S10.- to S19.-) among patients who were treated at the authors' clinic-a certified national trauma center-during a period of 10 years (2012 to and including 2021). RESULTS: A total of 8375 patients with head and neck trauma were treated during the observation period, i.e., an average of 836 patients per year. Within this collective, 2981 trauma cases involving soft tissue injuries were documented. Superficial injuries to the head (S00.-) and open wounds to the head (S01.-) were the most common head and neck soft tissue injuries, with 1649 and 920 cases, respectively. CONCLUSION: The case numbers of soft tissue injuries generally show an inverse correlation to the required underlying trauma: diagnoses of the categories S00 and S01 occur very often; injuries which only occur after severe trauma, such as traumatic amputation at neck level (S18), are rare. According to current literature, penetrating neck traumas should be treated using a no-zone approach. In Europe, penetrating neck injuries are rather rare because of low crime rates and strict weapon laws.

Morel-Lavallee lesions. Size matters? Treatment and time of disability.

INTRODUCTION: Degloving soft-tissue injuries are serious and potentially devastating medical conditions where an early recognition is a crucial step for a favorable outcome. One of the most important types is Morel-Lavallée lesions (MLL); a significant soft-tissue injury associated with pelvic trauma (30%) and thigh (20%), located over the greater trochanter. MATERIAL AND METHODS: In this retrospective study we selected adult patients diagnosed with MLL between 2010 and 2019 at our trauma center. We then identified 9 cases and followed them up for a minimum of two years. CT scans were performed to measure the size of the degloved zone. RESULTS: we did not found direct relationship between greater dimensions of MLL injury and the need for an increase of days to return to work. We rather identified an association between bigger dimensions of MLL injury and higher energy trauma. These patients waited an average of 133 days to return to work after being injured; which is a longer period compared to non-op patients. DISCUSSION: MLL lesions generally take several days to develop and many may be missed on initial evaluation. Once identified, compression dressings should be applied, especially when diagnosed acutely. Early identification would lead to early operative debridement. Also, drainage should be performed, since the pathophysiology of the injury will result in the failure of observation or simple aspiration. CONCLUSION: MLL diagnosis and treatment must be identified as early as possible. We didn't find a correlation between MLL size and the treatment performed. In our study all patients returned to their jobs and normal life. Patients following conservative treatment take longer time to recover and could require more patient's implication, but -at least- would avoid possible surgical complications.

A physiotherapy led Soft Tissue Injury Clinic is an efficient and cost effective model of care. A paediatric specific interrupted time series study.

OBJECTIVES: To evaluate the effect of introducing a physiotherapist-led paediatric Soft Tissue Injury Clinic model as an alternative to a medically led Fracture Clinic model for conservative hospital management of soft-tissue injuries on: patient wait times; healthcare resource use; and cost-effectiveness. DESIGN: Interrupted time-series analysis (including consecutive eligible-cases). SETTING: Children's hospital, Australia. PARTICIPANTS: The study included 245 cases (117 Soft Tissue Injury Clinic model sample, 128 Fracture Clinic model sample) of patients (<18 years) who presented to a specialist children's hospital emergency department and diagnosed with a soft tissue injury requiring non-surgical outpatient management. INTERVENTIONS: Patients were referred from the emergency department to either an orthopaedic-led fracture clinic (Fracture Clinic model) or physiotherapist-led clinic (Soft Tissue Injury Clinic model) for follow-up and further management as clinically indicated. MAIN OUTCOME MEASURES: Time from emergency department discharge to commencement of definitive outpatient management (primary); healthcare resource use and costs from hospital funder perspective (secondary) and cost-per-day less waiting (cost-effectiveness). RESULTS: The Soft Tissue Injury Clinic was associated with (mean per-person difference (95%CI), P-value) fewer wait days (-8 (-11, -5) days, P<0.001), fewer orthopaedic costs P<0.001, >99% probability of fewer days waiting, 81% probability of less total cost and 81% probability of dominance (cheaper and fewer days to access definitive care). There were no adverse events in either model. CONCLUSIONS: The physiotherapist-led Soft Tissue Injury Clinic represented a safe and efficient alternative referral pathway for patients presenting to the emergency department with soft tissue injuries requiring conservative management.

Evidence-Based Wound Irrigation: Separating Fact from Fiction.

SUMMARY: The relationship between wound irrigation and healing has been recognized for centuries. However, there is little evidence and no official recommendations from any health care organization regarding best wound irrigation practices. This is the first review of wound irrigation that systematically summarizes the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines and distills the evidence into a practical format. In this comprehensive review, the authors outline the irrigation fluids and delivery methods used in the identified studies, analyze reported treatment outcomes, summarize irrigation effectiveness, and propose evidence-based guidelines to improve wound healing outcomes and enhance the consistency of wound irrigation. Thirty-one high-quality studies with a combined total of 61,808 patients were included. Based on the current evidence provided by this review, the authors propose the following guidelines: (1) acute soft-tissue wounds should receive continuous gravity flow irrigation with polyhexanide; (2) complex wounds should receive continuous negative-pressure wound therapy with instillation with polyhexanide; (3) infected wounds should receive continuous negative-pressure wound therapy with instillation with silver nitrate, polyhexanide, acetic acid, or povidone-iodine; (4) breast implant wounds should receive gravity lavage with povidone-iodine or antibiotics; and (5) surgical-site infection rates can be reduced with intraoperative povidone-iodine irrigation.

Application of Negative Pressure Wound Therapy.

SUMMARY: The video depicts the materials and steps for applying negative pressure wound therapy. The clinical case involves a patient who had sustained a thigh Morel-Lavallee lesion that developed overlying skin necrosis and drainage that was treated with surgical debridement and the application of negative pressure wound therapy.

An Autologous Protein-Based Topical Ointment for Hard-to-Heal Skin Wounds: A Multiple Case Series.

BACKGROUND: There is increasing evidence regarding the wound healing potential of platelet-derived autologous by-products. We provide preliminary data regarding the use of a new plasma rich in growth factors-derived autologous topical ointment for the management of hard-to-heal wounds. CASES: Four patients suffering from difficult-to-heal wounds were treated with the autologous ointment. Within 2 to 8 weeks, all wounds healed completely with no signs of infection or functional impairment of the affected limbs. No adverse events were reported. CONCLUSION: Randomized and controlled trials are needed to determine the clinical efficacy of the autologous ointment. Nevertheless, results from this multiple case series indicate that this approach may be useful for accelerating the re-epithelization of difficult-to-heal wounds.

Application of chen yuangao in the treatment of soft tissue injury of football players / Aplicação de chen yuangao no tratamento da lesão dos tecidos moles de jogadores de futebol / Aplicación de chen yuangao para tratar lesiones de tejidos blandos en jugadores de fútbol

ABSTRACT The treatment of soft tissue injury in football players generally includes physical therapy, anti-inflammatory and analgesic drug treatment, surgical treatment and early rest immobilization. Western medicine treatment of soft tissue injury can quickly heal the wound and relieve pain in a short time. The treatment of traditional Chinese medicine is based on the whole and must seek the root of the disease. It is believed that the occurrence of certain diseases is related to Qi, blood, liver and kidney deficiency, so we should pay attention to the overall adjustment during treatment of symptoms. In view of this, this study analyzed the effect of Chen Yuan ointment, from traditional Chinese medicine, in the treatment of soft tissue injury. Sixty-eight football players who completed ankle ligament reconstruction were divided into four groups according to the type of operation and whether Chen Yuangao-assisted rehabilitation was used or not. The results showed that the Ankle Hindfoot Function Score and the visual analog scale (VAS) score of patients in the fibula brevis tendon reconstruction Chen Yuan ointment group were 98.3 and 0.3, respectively, at the last follow-up, which were better than those in other groups, and had lower pain scores. This result shows that Chen Yuangao has a certain effect in the treatment of soft tissue injury, which can provide a research idea for the rapid rehabilitation of football players.

RESUMO O tratamento de lesões dos tecidos moles em jogadores de futebol inclui geralmente terapia física, tratamento anti-inflamatório e analgésico, tratamento cirúrgico e imobilização de repouso precoce. O tratamento de lesões nos tecidos moles, utilizando a medicina ocidental, pode curar rapidamente as lesões e aliviar a dor em pouco tempo. A medicina tradicional chinesa se baseia no todo e deve procurar a raiz da doença. Acredita-se que a ocorrência de certas doenças está relacionada à deficiência de Qi, sangue, fígado e rim do corpo humano, por isso devemos prestar atenção ao ajuste global no tratamento dos sintomas. A partir desta perspectiva, este estudo analisou o efeito da tradicional pomada chinesa Chen Yuan no tratamento de lesões dos tecidos moles. No total, 68 jogadores de futebol que fizeram reconstrução dos ligamentos do tornozelo foram divididos em quatro grupos de acordo com o tipo de operação e se a pomada Chen Yuangao ajudou ou não na reabilitação. Os resultados mostraram que o escore da função do tornozelo retropé (Ankle Hindfoot Function Score) e o escore da Escala Analógica Visual (EVA) dos pacientes do grupo pomada Chenyuan para reconstrução do tendão fibular curto foram 98,3 e 0,3, respectivamente, no último seguimento, sendo melhores do que os de outros grupos e apresentando menores níveis de dor. Estes resultados mostra que a pomada Chen Yuangao exerce certo efeito no tratamento de lesões dos tecidos moles, pode constituir uma ideia de pesquisa para a rápida reabilitação dos jogadores de futebol.

RESUMEN El tratamiento de lesiones de los tejidos blandos en jugadores de fútbol incluye generalmente terapia física, tratamiento antinflamatorio y analgésico, tratamiento quirúrgico e inmovilización de reposo precoz. El tratamiento de lesiones en los tejidos blandos, utilizando la medicina occidental, puede curar rápidamente las lesiones y aliviar el dolor en poco tiempo. La medicina tradicional china se basa en el todo y debe procurar la raíz de la enfermedad. Se cree que la ocurrencia de ciertas enfermedades está relacionada a la deficiencia de Qi, sangre, hígado y riñón del cuerpo humano, por eso debemos prestar atención al ajuste global en el tratamiento de los síntomas. A partir de esta perspectiva, este estudio analizó el efecto de la tradicional pomada china Chen Yuan en el tratamiento de lesiones de los tejidos blandos. En total, 68 jugadores de fútbol que hicieron reconstrucción de los ligamentos del tobillo fueron divididos en cuatro grupos de acuerdo con el tipo de operación y si la pomada Chen Yuangao ayudó o no en la rehabilitación. Los resultados mostraron que el escore de la función del retropié del tobillo (Ankle Hindfoot Function Score) y el escore de la Escala Analógica Visual (EVA) de los pacientes del grupo pomada Chenyuan para reconstrucción del tendón fibular corto fueron 98,3 y 0,3, respectivamente, en el último segmento, siendo mejores que los de otros grupos y presentando menores niveles de dolor. Estos resultados muestran que la pomada Chen Yuangao ejerce cierto efecto en el tratamiento de lesiones de los tejidos blandos, puede constituir una idea de investigación para la rápida rehabilitación de los jugadores de fútbol.

Facial Soft Tissue Injuries in Pediatric Patients.

Soft tissue injuries of the head and neck are a common reason for medical evaluation and treatment in pediatric populations with some unique and important considerations when compared with adults. The incidence and type of injuries continue to evolve with the adoption of new safety measures, technology advancements, and education of the general population. The goal of this article is to provide the reader with a thorough understanding of the evaluation and management of pediatric soft tissue trauma including the initial workup, physical examination, appropriateness of antimicrobial therapy, and setting for surgical repair. Additionally, the pediatric anesthetic considerations for evaluation and repair in regard to local anesthesia, sedation, and general anesthesia are described in detail. There is a focus on dog bites, perinatal injuries, and child abuse as these entities are distinctive to a pediatric population and have particular management recommendations. Lastly, application of the reconstructive ladder as it applies to children is supported with specific case examples and figures. Although there are many parallels to the management of soft tissue injury in adults, we will highlight the special situations that occur in pediatric populations, which are imperative for the facial plastic and reconstructive surgeon to understand.