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1.
J Colloid Interface Sci ; 559: 313-323, 2020 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-31675662

RESUMO

Antibiotic resistance is a common phenomenon observed during treatment with antibacterials. Use of nanozymes, especially those with synergistic enzyme-like activities, as antibacterials could overcome this problem, but their synthesis is limited by their high cost and/or complex production process. Herein, vanadium oxide nanodots (VOxNDs) were prepared via a one-step bottom-up ethanol-thermal method using vanadium trichloride as the precursor. VOxNDs alone possess bienzyme mimics of peroxidase and oxidase. Accordingly, highly efficient antibacterials against drug-resistant bacteria can be obtained through synergistic catalysis; the oxidase-like activity decomposes O2 to generate superoxide anion radical (O2-) and hydroxyl radicals (OH), and the intrinsic peroxidase-like activity can further induce the production of OH from external H2O2. Consequently, H2O2 concentration could decrease up to four magnitude orders with VOxNDs to achieve an antibacterial efficacy similar to that of H2O2 alone. Wound healing in vivo further confirms the high antibacterial efficiency, good biocompatibility, and application potential of the synergistic antibacterial system due to the "nano" structure of VOxNDs. The method of synthesis of nanodot antibacterials described in this paper is inexpensive, and the results of this study reveal the multi-enzymatic synergism of nanozymes.


Assuntos
Antibacterianos/química , Nanopartículas Metálicas/química , Óxidos/química , Compostos de Vanádio/química , Cicatrização/efeitos dos fármacos , Animais , Materiais Biocompatíveis/química , Materiais Biomiméticos/química , Catálise , Sobrevivência Celular/efeitos dos fármacos , Farmacorresistência Bacteriana/efeitos dos fármacos , Escherichia coli/efeitos dos fármacos , Células HeLa , Células Endoteliais da Veia Umbilical Humana , Humanos , Peróxido de Hidrogênio/química , Radical Hidroxila/química , Peroxidases/metabolismo , Ratos Sprague-Dawley , Staphylococcus aureus/efeitos dos fármacos
2.
Artigo em Inglês | MEDLINE | ID: mdl-31815968

RESUMO

Typically, healing or temporary abutments are connected and disconnected several times between implant placement and definitive restoration delivery, and soft tissue disruption occurs each time the abutment is disconnected and reconnected. This histologic event is supposed to cause bone resorption around the implant after second-stage surgery. To minimize this clinical scenario, immediately placing and never removing a definitive abutment the day of implant insertion (one-stage protocol) or at second-stage surgery in cases of submerged implants (two-stage protocol) was suggested. This paper details the prosthetic protocol and presents strategies and rationales for placing a definitive abutment the day of implant insertion or at second-stage surgery with cement- and screw-retained restorations. This protocol seems to be an efficient strategy to preserve peri-implant hard and soft tissues. However, positive outcomes in peri-implant bone and soft level changes should be viewed with caution, as their clinical significance is still uncertain.


Assuntos
Reabsorção Óssea , Implantes Dentários , Dente Suporte , Implantação Dentária Endo-Óssea , Humanos , Cicatrização
3.
Equine Vet J ; 52(1): 41-45, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-30895637

RESUMO

BACKGROUND: Infection and dehiscence of simple lacerations is common in horses, and consistently effective methods of prevention are yet to be found. Honey has been shown to promote wound healing when applied topically; however, intralesional application prior to wound closure has not been reported. OBJECTIVES: To examine whether intralesional application of medical grade honey (MGH) would reduce the incidence of infection and dehiscence following wound closure. STUDY DESIGN: Prospective, open-label randomised block design clinical study. METHODS: Lacerations, treated by field practitioners, were divided into treatment and control groups using block randomisation. Horses in the treatment group received a single intralesional treatment with l-mesitran gel (MGH). Data were collected at the time of wound closure and at suture removal. RESULTS: Data from 127 horses were included, 69 MGH-treated and 58 control cases. No adverse effects of the MGH were recorded. MGH-treated horses were more likely to completely heal (P = 0.006, odds ratio [OR] 3.40 95% confidence interval [CI] 1.41-8.20), to have no signs of infection (P = 0.007, OR 3.64, CI 1.42-9.26) and for the veterinarians to report some degree of satisfaction (P = 0.04, OR 2.72, CI 1.05-7.09) compared to control cases. Numbers needed to treat for complete healing was 5.1 (CI 2.8-40). MAIN LIMITATIONS: Clinical studies have inherent flaws compared to wound healing models, because of variability between wounds. There were more horses with limb injuries in the control group, although not statistically significant, this may have biased the results. Clinical satisfaction and signs of infection were subjective evaluations and evaluators were not blinded to the treatment group. CONCLUSIONS: Intralesional application of MGH to lacerations prior to wound closure may be beneficial in preventing infection and dehiscence. Larger, blinded studies focusing on wounds at a specific location with more objective assessment should be pursued.


Assuntos
Infecções Bacterianas/veterinária , Mel , Doenças dos Cavalos/prevenção & controle , Lacerações/veterinária , Cicatrização , Animais , Infecções Bacterianas/prevenção & controle , Feminino , Cavalos , Masculino
4.
Rev Infirm ; 68(256): 30-31, 2019 Dec.
Artigo em Francês | MEDLINE | ID: mdl-31870476

RESUMO

Dressings are a real challenge in the care of patients with thermal burns. They help to heal and prevent or treat possible skin infections. Paramedical teams must have a perfect strategy for organizing, managing pain and optimizing hygiene and asepsis rules. The purpose is to facilitate the understanding and implementation of this treatment by suggesting protocols that can be applied by all. It remains essential to mobilize specialized services to promote the evolution of burns.


Assuntos
Bandagens , Queimaduras , Adulto , Queimaduras/complicações , Queimaduras/terapia , Dermatite/etiologia , Humanos , Dor , Cicatrização
5.
Zhongguo Gu Shang ; 32(12): 1144-1147, 2019 Dec 25.
Artigo em Chinês | MEDLINE | ID: mdl-31870075

RESUMO

OBJECTIVE: To explore the clinical effect of Qufu Shengji ointment(QFSJO) in promoting the wound healing after trauma. METHODS: From January 2014 to June 2018, 60 patients with soft tissue injury, skin defect and wound infection caused by violent trauma were admitted, including 32 males and 28 females, aged from 18 to 65 years, with an average age of 41.3 years. Among them, 30 patients were treated with QFSJO (QFSJO group) and 30 patients were treated with normal saline iodophor (control group). The reduction rate of wound area, the days of decayed flesh, the time of new epithelium and the recovery rate of 28 days after dressing change were compared between the two groups. RESULTS: In the QFSJO group, after using large dose of QFSJO, the pus of the wound increased, the granulation grew, and the new epithelium appeared on the edge of the wound, showing a rapid healing phenomenon. The wound healing rate of QFSJO group was higher than that of the control group at all time points, and the time of decaying flesh and new epithelium appeared in QFSJO group was earlier than that of the control group. The recovery rate of QFSJO group was significantly higher than that of the control group(P<0.05). All the patients were followed up, and the duration ranged form 6 to 12 months, with an average of 9.4 months. The exposed areas of bone and teadon were covered well. The vital signs of the two groups were stable and no adverse reactions occurred. CONCLUSIONS: QFSJO can promote the growth of granulation tissue, promote the production of new skin, and accelerate the healing of infectious wound after trauma.


Assuntos
Medicamentos de Ervas Chinesas , Infecção dos Ferimentos , Adolescente , Adulto , Idoso , Feminino , Tecido de Granulação , Humanos , Masculino , Pessoa de Meia-Idade , Cicatrização , Infecção dos Ferimentos/tratamento farmacológico , Adulto Jovem
6.
Zhonghua Shao Shang Za Zhi ; 35(12): 833-838, 2019 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-31877603

RESUMO

The " exploration of treatment technology of chronic wound with sinus tract supported by endoscope and related auxiliary methods" study had been conducted by Wound Healing Center of Ruijin Hospital, Shanghai Jiao Tong University School of Medicine. The feasibility and effectiveness of this technique have been confirmed, and good clinic results have been achieved. In order to further promote the new technology and its related research, the theoretical knowledge and technical experience accumulated in the early stage are summarized as diagnosis and treatment standard for treatment with endoscopy technique in chronic wounds with sinus tract, including four parts: the applicable subjects, the diagnosis and treatment procedures and classification criteria, the healing criteria, and the risk assessment and prevention measures. The purpose of this standard is to facilitate the application of standardized endoscopy technique, to make the most of its technological advantages, prevent risks, and provide a reference for the official version of the diagnosis and treatment standard.


Assuntos
Endoscopia , Cicatrização , China , Humanos , Inflamação
7.
Zhonghua Shao Shang Za Zhi ; 35(12): 876-878, 2019 Dec 20.
Artigo em Chinês | MEDLINE | ID: mdl-31877611

RESUMO

Objective: To explore the clinical effects of split-thickness scalp and allogenic acellular dermal matrix (ADM) in repairing deep wounds of hands in patients with extremely extensive burns. Methods: Six patients with extremely extensive burns complicated by deep burn in hands were admitted to our department from December 2014 to December 2017, including 4 males and 2 females, aged 21 to 58 years. Their total burn areas were from 85% to 95% total body surface area (TBSA), and the sum of deep-partial thickness and full-thickness wounds was larger than 50% TBSA. Under general anesthesia, deep wounds of 10 dorsal hands were repaired by combined transplantation of split-thickness scalp and allogenic ADM in 4 to 6 weeks after injury. The skin grafting range was beyond the metacarpophalangeal joint, including partial dorsal digital deep wounds. Survival of skin grafts on dorsal hands, follow-up of hand shape and functional recovery were observed and recorded. Results: Six patients were successfully treated. There was no infection on the dorsal deep wounds of 10 hands after surgery, and the grafts survived well. During follow-up of 1 to 2 years after operation, there were no recurrent tension blisters or dorsal extension deformity of the metacarpophalangeal joints in 10 hands, the shape and function of hands recovered well, and hand Carroll scores were from 90 to 99 points, with functional levels of Ⅴ and Ⅵ. Conclusions: The combined transplantation of split-thickness scalp and allogenic ADM is a good method for repairing deep hand wounds in patients with extremely extensive burns, which can alleviate the cicatrix hyperplasia and contracture of healed hand wounds, and improve the shape and function of hands.


Assuntos
Derme Acelular , Adulto , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Couro Cabeludo , Transplante de Pele , Resultado do Tratamento , Cicatrização , Adulto Jovem
8.
J Contemp Dent Pract ; 20(10): 1164-1170, 2019 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-31883251

RESUMO

AIM: To evaluate the potential of advanced platelet-rich fibrin (A-PRF) as a regenerative biomaterial for bone regeneration and postoperative sequelae after impacted third molar extractions. MATERIALS AND METHODS: This was a split-mouth, randomized, double-blind clinical trial. A total of 10 female patients in King Abdulaziz University Dental Hospital with bilateral impacted third molars were recruited into the study. Surgical extractions were performed on both sides of the mandible. Randomization was done by a coin toss; A-PRF was placed on the one side while the other side did not receive any intervention. Each patient acted as their own control. Both the patients and the investigators were blinded about the A-PRF side. The outcome on periodontal regeneration was made measuring pocket depth (PD), gum recession (GR), and clinical attachment level (CAL) before and at 1- and 3-months postoperatively. Pain, swelling, and healing were assessed on the 7th postoperative day. p value less than 0.05 was considered statistically significant. RESULTS: An estimated 10 patients completed the study. There were no significant differences in PD, CAL, and GR between the two groups at any time point, although the data obtained were slightly favoring the A-PRF. However, a statistically significant reduction in pain and swelling was observed in the A-PRF group compared to the controls (p < 0.05). CONCLUSION: The findings of this study demonstrate A-PRF as a potential biomaterial for lessening the severity of pain and swelling after third molar surgery. Long-term trials with a larger sample size and more methodically sound assessment tools are needed to obtain more meaningful results on periodontal regeneration. CLINICAL SIGNIFICANCE: Placement of A-PRF clot in the extraction socket could lessen postoperative pain and increase patient comfort after third molar extraction. TRIAL REGISTRATION: NCT03703479. Registered 8 October 2018 How to cite this article: Zahid TM, Nadershah M. Effect of Advanced Platelet-rich Fibrin on Wound Healing after Third Molar Extraction: A Split-mouth Randomized Double-blind Study. J Contemp Dent Pract 2019;20(10):1164-1170.


Assuntos
Fibrina Rica em Plaquetas , Dente Impactado , Método Duplo-Cego , Feminino , Humanos , Dente Serotino , Extração Dentária , Cicatrização
9.
Georgian Med News ; (294): 136-141, 2019 Sep.
Artigo em Russo | MEDLINE | ID: mdl-31687966

RESUMO

The purpose of this study was to identify the features of skeletal muscle macrophagocytic submicroscopic architectonics, the dynamics of transformations of organelles and intracellular membranes at different time after the simulated gunshot wound. The study involved 26 breeding rabbits. Gunshot wounds were inflicted from a Fort 12 pistol. Rabbits were removed from the experiment on the 30th and 60th day, after the application of wounds. Ultrathin sections, after contrasting with lead citrate, were examined under an EM-125 electron microscope at an accelerating voltage of 75 kV, with an increase of 42,000-72,000. Electronic microscopic studies of macrophagocyte organelles taken from the scar tissue of the wound channel on the thirtieth day after a gunshot wound revealed a large number of macrophage cells that are in a state of high functional activity, dystrophic and destructive changes of organelles with focal disruption of the membrane of the nucleus, mitochondria and the granular endoplasmatic reticulum reticulation. The course of catabolic processes caused by the presence in the wound channel of toxic components, destroyed myosymplasts and heavy metal ions of the damaging element. On the sixtieth day after a gunshot wound, the increased activity of macrophage cells remained, due to sluggish current processes of utilization of the destroyed ultrastructural components of myosymplasts and heavy metal ions from the damaging element.


Assuntos
Macrófagos/patologia , Cicatrização , Ferimentos por Arma de Fogo , Animais , Microscopia Eletrônica de Varredura , Coelhos , Cicatrização/fisiologia
10.
Georgian Med News ; (294): 145-150, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31687968

RESUMO

The main aim is to find out the mechanisms of reparative regeneration of bone tissue in artificially created transverse mandibular defects in rats when applying osteoplastic materials based on hydroxyapatite and polylactide with different component percentage. Experimental studies were carried out on 114 mature laboratory white male 180-220 g rats that were divided into groups: control group - animals whose bone defect was filled only with a blood clot; 1st experimental group - the entire defect volume was densely filled with a block with the ratio of component parts, hydroxyapatite 80% + polylactide 20%; 2nd experimental group was similar, but with the ratio of 50% + 50%. Morphological and morphometric research methods were carried out after the removed jaws had been decalcized in a 10% nitric acid solution. An x-ray study was performed using an Intra digital radiograph (Planmeca, Finland). Statistical analysis of the results was carried out according to the standard method of descriptive statistics using the software package "StatSoftStatistica 10". The use of osteoplastic material with a longer period of its biodegradation contributes to filling the defect with bone tissue, but slows down the processes of the final formation of a mature secondary bone scar, yet allows even with hypercorrection to restore the anatomical form of the lost area. Therefore, the use of this material is recommended for a defect in the alveolar ridge, mainly in extraction sockets, when one needs to avoid atrophy and to create conditions for prosthetic treatment. Osteoimplant with a faster biodegradation period allows structuring collagen fibers in the regenerate in the early stages of healing, which optimizes the formation of an organic bone matrix and promotes its faster mineralization. Therefore, such bone substitutes can be better used for insignificant defects or when the restoration of the anatomical form is not essential, mainly for defects of the body and mandibular branches.


Assuntos
Perda do Osso Alveolar/tratamento farmacológico , Materiais Biocompatíveis/uso terapêutico , Regeneração Óssea/efeitos dos fármacos , Substitutos Ósseos/farmacologia , Mandíbula/patologia , Poliésteres/farmacologia , Perda do Osso Alveolar/cirurgia , Animais , Substitutos Ósseos/uso terapêutico , Durapatita , Masculino , Mandíbula/cirurgia , Ratos , Cicatrização
12.
Medicine (Baltimore) ; 98(44): e17726, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31689814

RESUMO

The purpose of this study was to assess the efficacy and safety of Pelnac and split-thickness skin graft for management of complex wound with underlying bone/tendon exposure at forearm and hand.This is a prospective study, beginning from March 2013 up to May 2017. There were 13 patients, with age of 31.2 years. All of them underwent the staged Pelnac and split-thickness skin graft to manage the complex wound with bone/tendon. Postoperatively, scheduled follow-up was conducted.The average follow-up was 15 months. There were no infections, wound necrosis, hematoma, or seroma during the phase when Pelnac was applied. There was 100% "take" of the Pelnac in 12/13 patients. In 11 patients, there was complete skin graft "take". Patients' satisfaction for the esthetic appearance of the grafted area was 75.0 ±â€Š8.5/100. The VSS value was 2.9 ±â€Š2.5. Regarding the sensory recovery, the response of "normal or near normal" could be obtained in 7/13 patients, "slight loss" in 5 patients and "significant loss" in 1 case. The average DASH score was 27.2 ±â€Š18.5, and most patients (12/13) could obtain an acceptable ability to perform the daily activities.Pelnac dermal template is a favorable alternative to flap reconstruction in the treatment of complex wound with underlying tissues exposure.


Assuntos
Traumatismos do Braço/cirurgia , Regeneração Tecidual Guiada/métodos , Traumatismos da Mão/cirurgia , Transplante de Pele/métodos , Tendões/cirurgia , Adolescente , Adulto , Traumatismos do Braço/fisiopatologia , Derme/fisiopatologia , Derme/cirurgia , Feminino , Seguimentos , Antebraço/cirurgia , Mãos/cirurgia , Traumatismos da Mão/fisiopatologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Retalhos Cirúrgicos , Resultado do Tratamento , Cicatrização/fisiologia , Adulto Jovem
13.
Zhonghua Shao Shang Za Zhi ; 35(11): 772-775, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775464

RESUMO

Because of the complex injury mechanism, hidden tissue injury, and severe systemic injury, the clinical diagnosis and treatment of electric burn still face many challenges, and the mortality and disability rate are still high. In view of the particularity of electric burn and the prognosis of electric burn, especially the quality of wound repair, the author puts forward some personal views on fluid resuscitation, organ protection, and wound repair on the basis of summarizing the new methods of diagnosis and treatment of electric burn at home and abroad at present, and preliminarily explores the standardized diagnosis and treatment of electric burn.


Assuntos
Queimaduras por Corrente Elétrica/diagnóstico , Queimaduras por Corrente Elétrica/terapia , Hidratação , Humanos , Prognóstico , Cicatrização
14.
Zhonghua Shao Shang Za Zhi ; 35(11): 776-783, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775465

RESUMO

Objective: To explore the limb salvage strategies for patients with high voltage electric burns of extremities on the verge of amputation. Methods: From January 2003 to March 2019, 61 patients with high voltage electric burns of extremities on the verge of amputation were treated in our hospital. All of them were male, aged 15-58 years, including 49 cases of upper limbs and 12 cases of lower limbs. The wound area after thorough debridement ranged from 15 cm×11 cm to 35 cm×20 cm. Emergency surgery for reconstruction of the radial artery with saphenous vein graft under eschar was performed in 5 cases. The arteries of 36 patients (including 7 cases with simultaneous ulnar artery and radial artery reconstruction) were reconstructed with various forms of blood flow-through after debridement, among them, the radial artery of 13 cases, the ulnar artery of 8 cases, the brachial artery of 8 cases, and the femoral artery of 2 cases were reconstructed with saphenous vein graft; the radial artery of 3 cases and the ulnar artery of 7 cases were reconstructed with the descending branch of the lateral circumflex femoral artery graft; the radial artery of 2 cases were reconstructed with greater omentum vascular graft; the reflux vein of 3 cases with wrist and forearm annular electric burns were reconstructed with saphenous vein graft. According to the actual situation of the patients, 12 cases of latissimus dorsi myocutaneous flap, 6 cases of paraumbilical flap, 28 cases of anterolateral thigh flap, 10 cases of abdominal combined axial flap, 5 cases of greater omentum combined with flap and/or skin grafts were used to repair the wounds after debridement and cover the main wounds as much as possible. Some cases were filled with muscle flap in deep defect at the same time. The area of tissue flaps ranged from 10 cm×10 cm to 38 cm×22 cm. For particularly large wounds and annular wounds, the latissimus dorsi myocutaneous flap, the paraumbilical flap, the abdominal combined axial flap, and the greater omentum combined with flap and/or skin grafts were used more often. Donor sites of three patients were closed directly, and those of 58 patients were repaired with thin and medium split-thickness skin or mesh skin grafts. The outcome of limb salvage, flap survival, and follow-up of patients in this group were recorded. Results: All the transplanted tissue flaps survived in 61 patients. Fifty-six patients had successful limb salvage, among them, 31 limbs were healed after primary surgery; 20 limbs with flap infection and tissue necrosis survived after debridement and flap sutured in situ; 5 limbs with flap infection, radial artery thrombosis, and hand blood supply crisis survived after debridement and radial artery reconstruction with saphenous vein graft. Five patients had limb salvage failure, among them, 3 patients with wrist electric burns had embolism on the distal end of the transplanted blood vessels, without condition of re-anastomosis, and the hands gradually necrotized; although the upper limb of one patient was salvaged at first, due to the extensive necrosis and infection at the distal radius and ulna and the existence of hand blood supply under flap, considering prognostic function and economic benefits, amputation was required by the patient; although the foot of one patient was salvaged at first, due to the repeated infection, sinus formation, extensive bone necrosis of foot under flap, dullness of sole and dysfunction in walking for a long time, amputation was required by the patient. During the follow-up of 6 months to 5 years, 56 patients had adequate blood supply in the salvaged limbs, satisfied appearance of flaps, and certain recovery of limb function. Conclusions: Timely revascularization, early thorough debridement, and transplantation of large free tissue flap, combined tissue flap, or blood flow-through flap with rich blood supply are the basic factors to get better limb preservation and recovery of certain functions for patients with high voltage electric burns of limbs on the verge of amputation.


Assuntos
Queimaduras por Corrente Elétrica/cirurgia , Salvamento de Membro , Procedimentos Cirúrgicos Reconstrutivos , Lesões dos Tecidos Moles/cirurgia , Adolescente , Adulto , Amputação , Humanos , Masculino , Pessoa de Meia-Idade , Transplante de Pele , Resultado do Tratamento , Cicatrização , Adulto Jovem
15.
Zhonghua Shao Shang Za Zhi ; 35(11): 784-789, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775466

RESUMO

Objective: To analyze clinical characteristics and wound repair methods and effects of patients with upper limb electric burns. Methods: Medical records of 136 patients with upper limb electric burn who met the inclusion criteria and hospitalized in our unit from January 2015 to March 2019 were retrospectively analyzed. Proportion in patients with electric burns in the same period, gender, age, admission time, categories, injury causes, injury voltage, burn area and depth of upper limb, simultaneous injury of both upper limbs, and early wound treatment measure of patients with upper limb electric burn were recorded. The main repair methods of each affected limb were classified and recorded. The overall efficacy of the patients was recorded, including postoperative wound complications and healing condition. The patients repaired with distal pedicled flaps and those with free flaps were followed up for 3 to 6 months. The survival rate of flaps were recorded, the function of affected limbs after operation was evaluated, and the satisfaction degree of patients was investigated by Curative Effect Score Table. The amputation rate, age, and burn area of upper limbs of patients caused by high-voltage and low-voltage electricity were compared. Data were processed with Wilcoxon rank sum test, chi-square test, or Fisher's exact probability test. Results: (1) The number of upper limb electric burn patients accounted for 88.3% of 154 patients with electric burns hospitalized in the same period, including 117 males and 19 females, aged 1 year and 2 months to 72 years [(34±18) years], admitted 1 h to 48 d after injury, including 51 electricians, 32 rural migrant workers, 31 students and preschool children, and 22 patients belonging to other categories. Patients of the first two categories were mainly injured by work accidents, and those of the latter two categories mainly suffered from touching power source or power leakage. Among all the patients, 75 cases were injured by high-voltage electric burn, and 61 cases were injured by low-voltage electric burn, with burn area of upper limb from 0.2% to 16.0% [2% (1%, 5%)] total body surface area (TBSA) and area of wounds deep to bone from 0.2% to 15.0% [2% (1%, 5%)] TBSA. Two upper limbs in 54 cases were simultaneously injured, accounting for 39.7%. Early fasciotomy was performed for 73 limbs. (2) Thirteen affected limbs were treated with dressing change, 2 affected limbs were sutured directly after debridement, 56 affected limbs were repaired by skin grafting, 12 affected limbs were repaired by local flap, 45 affected limbs were repaired by distal pedicled flap, 22 affected limbs were repaired by free flap, and 40 affected limbs were amputated (accounting for 21.1%). (3) One case died of pulmonary infection, sepsis, and multiple organ failure after operation, and the rest patients were all cured. One case with avulsion of abdominal flap was repaired by skin grafting after dressing change. The anterolateral thigh flap in one case necrotized after transplantation, which was replaced by pedicled abdominal flap. Seven cases had small erosion on the pedicle or margin after transplantation of abdominal flap and were healed by dressing change. Six cases had local bruising at the distal end after transplantation of abdominal flap and were healed after conservative treatment such as hyperbaric oxygen. The other flaps survived well. (4) The survival rate of distal pedicled flap grafting was 97.8% (44/45), which was close to that of free flap grafting (95.5%, 21/22, P>0.05). The function recovery of affected limb after free flap grafting was better than that of distal pedicled flap grafting (Z=-3.054, P<0.01), but their satisfaction degree of patients was similar (Z=-0.474, P>0.05). (5) Patients with high-voltage electric burn had higher amputation rate, older age, and larger upper limb burn area than those with low-voltage electric burn (χ(2)=4.743, Z=-2.801, -6.469, P<0.05 or P<0.01). Conclusions: Upper extremity electric burn often occurs in children, electricians, and rural migrant workers with high rate of amputation. Teachers and parents should strengthen safety education for children and manage power source of life well. Workers should improve safety awareness and operate standardly. Fasciotomy for relaxation should be performed for electric burn wound as soon as possible, and flap grafting can effectively repair wound after early debridement. The function recovery of affected upper limb repaired with free flap grafting is better.


Assuntos
Queimaduras por Corrente Elétrica/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Extremidade Superior/cirurgia , Adolescente , Adulto , Idoso , Criança , Pré-Escolar , Feminino , Humanos , Lactente , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Transplante de Pele , Resultado do Tratamento , Extremidade Superior/lesões , Cicatrização , Adulto Jovem
16.
Zhonghua Shao Shang Za Zhi ; 35(11): 819-820, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775472

RESUMO

If the abdominal pedicled flaps are not well fixed after repair of deep electric burn wounds in hands, many problems such as poor blood supply may occur. In order to solve the above problems, we designed and manufactured the individualized low temperature thermoplastic plate combined with special abdominal band to fix abdominal pedicled flaps for repairing of 17 patients (12 males and 5 females, aged 2-35 years) with deep electric burn wounds in hands from February 2016 to August 2018, and achieved the desired results. The shoulder joint, elbow joint, and wrist joint were fixed by low temperature thermoplastic plate according to the 1/2 circumference of the patient's side chest and upper arm, and the braking of wrist joint and elbow joint was strengthened by special abdominal band. Application of the combined method of fixing abdominal pedicled flaps in repairing deep electric burn wounds in hands has high success rate of flap transplantation. It is simple to make and practical, and worthy of clinical promotion.


Assuntos
Queimaduras por Corrente Elétrica/cirurgia , Temperatura Baixa , Traumatismos da Mão/cirurgia , Procedimentos Cirúrgicos Reconstrutivos , Retalhos Cirúrgicos/transplante , Abdome , Adolescente , Adulto , Queimaduras por Corrente Elétrica/terapia , Criança , Pré-Escolar , Feminino , Traumatismos da Mão/terapia , Humanos , Masculino , Transplante de Pele , Cicatrização , Adulto Jovem
17.
Zhonghua Shao Shang Za Zhi ; 35(11): 828-832, 2019 Nov 20.
Artigo em Chinês | MEDLINE | ID: mdl-31775475

RESUMO

The repair strategy after organs injuries has always been a hot topic in the field of regenerative medicine. Traditional injury repair measures mainly promote tissue repair through mesenchymal stem cells and various growth factors, but these strategies have been constrained in the aspects of security and economy. Hence, there is an urgent need to find new ways to promote tissue repair and regeneration. There have been a lot of evidences showing that the immune system plays an important role in tissue regeneration and repair. In recent years, more and more studies have been done on adaptive immunity in tissue repair, especially the regulatory T cells. Some evidences indicate that regulatory T cells participate in damage tissue repair and regeneration of multiple organs and tissue. This review briefly introduces the new advances in the repair effects and regulatory mechanism of regulatory T cells in different organ injuries, in order to provide new ideas for designing advanced repair materials with good immunoregulatory functions.


Assuntos
Regeneração , Linfócitos T Reguladores/imunologia , Cicatrização/imunologia , Humanos , Medicina Regenerativa/tendências
18.
Surg Clin North Am ; 99(6): 1185-1196, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31676057

RESUMO

Complications after ileal pouch surgery can result in poor pouch function and can have a significant negative impact on a patient's quality of life. Timely diagnosis and appropriate management of complications allows for the best chance of pouch salvage. Many complications require a multimodal approach. As with any reoperative surgery, the success of surgical revision or redo of an ileal pouch is highly dependent on the skill, judgment, and experience of the surgeon and requires an extremely motivated patient.


Assuntos
Colite Ulcerativa/cirurgia , Bolsas Cólicas/efeitos adversos , Proctocolectomia Restauradora/efeitos adversos , Infecção da Ferida Cirúrgica/terapia , Adulto , Colite Ulcerativa/diagnóstico , Terapia Combinada , Tratamento Conservador/métodos , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Proctocolectomia Restauradora/métodos , Prognóstico , Reoperação/métodos , Medição de Risco , Infecção da Ferida Cirúrgica/fisiopatologia , Cicatrização/fisiologia
19.
Undersea Hyperb Med ; 46(5): 647-654, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683363

RESUMO

Introduction: The effects of hyperbaric oxygen (HBO2) therapy on sprains, ligament injuries, and muscle strains have been reported in several animal studies. In a dog model of compartment syndrome and in a rat contused skeletal muscle injury model, the significant effects of HBO2 therapy on the reduction of edema and muscle necrosis have been reported. In basic research HBO2 therapy stimulated fibroblast activity to improve the healing process. Because of this it expected that HBO2 therapy might improve focal edema and pain in the acute phase and accelerate the healing of injured tissues in athletes with a medial collateral ligament (MCL) injury of the knee. This study aimed to examine the short-term effects of HBO2 application subjectively, and the long-term effects of HBO2 therapy in Japanese professional or semi-professional rugby players with grade 2 MCL injury of the knee. Methods: Thirty-two professional or semi-professional rugby players with grade 2 MCL injury of the knee were investigated. First, in the HBO2 group (n=16), HBO2 therapy was performed during the acute phase. Visual analog scales (VASs) immediately before and after HBO2 therapy on the same day were compared. Next, we retrospectively evaluated the time to return to play in the HBO2 (n=16) and non-HBO2 (n=16) groups. Results: VAS scores for pain while walking immediately before and after HBO2 therapy on the same day were 37.4 ± 20.1 (mean ± standard deviation) and 32.4 ± 21.8, respectively (p⟨0.001). The VAS scores for pain while jogging were 50.7 ± 25.6 and 43.9 ± 25.0, respectively (p⟨0.001). The time to return to play was 31.4 ± 12.2 days in the HBO2 group and 42.1 ± 15.8 days in the non-HBO2 group, indicating a significant difference between the groups (p⟨0.05). Conclusion: HBO2 therapy may reduce pain and accelerate the return to play in athletes with grade 2 MCL injury of the knee in this non-randomized study.


Assuntos
Futebol Americano/lesões , Oxigenação Hiperbárica , Ligamento Colateral Médio do Joelho/lesões , Dor Musculoesquelética/terapia , Volta ao Esporte , Cicatrização/fisiologia , Adulto , Grupo com Ancestrais do Continente Asiático , Estudos de Casos e Controles , Humanos , Japão , Corrida Moderada , Instabilidade Articular/classificação , Masculino , Dor Musculoesquelética/reabilitação , Medição da Dor/métodos , Caminhada , Adulto Jovem
20.
Undersea Hyperb Med ; 46(5): 719-722, 2019.
Artigo em Inglês | MEDLINE | ID: mdl-31683373

RESUMO

Introduction: Stingray spine injuries are among the most common marine animal injuries in humans. While most resolve with immersion in warm water, a few become infected and require antibiotics. We present a case report of a presumptive stingray injury that evolved to a major slough and which required prolonged healing in a patient with diabetes mellitus. Our literature review was unable to find a similarly reported case. Materials: A co-author was asked to evaluate and manage an ominous-appearing wound on the right foot of a diabetic. The problem developed after the individual had been wading in shallow ocean beach water. The patient's diabetic sensory neuropathy obscured the immediate association of the problem with a stingray injury, but this became the presumptive diagnosis when pain developed and necessitated that he seek medical care. Findings/Clinical Course: After an initial urgent care visit, increasing pain and worsening appearance of the patient's foot necessitated a visit to our emergency department. The patient was admitted the next day due to symptoms of systemic sepsis. On the fourth hospital day, a large bulla on the lateral side of the right foot was excised. This unroofed a full-thickness slough to the periosteum level of the underlying bones. Not until the 16th hospital day had enough improvement occurred to discharge the patient. Over the next 16 weeks, the wound improved, developed a vascular base and epithelialized. Conclusion: With a dearth of literature about stingray injuries in patients with diabetes mellitus reported, our case is unique: The patient's wound course more closely resembled a toxic inoculation than the typical puncture wound-cellulitis presentations associated with stingray injuries.


Assuntos
Mordeduras e Picadas/complicações , Traumatismos do Pé/terapia , Ferimentos Penetrantes/terapia , Adulto , Animais , Antibacterianos/uso terapêutico , Mordeduras e Picadas/terapia , Vesícula/etiologia , Vesícula/terapia , Complicações do Diabetes/terapia , Diabetes Mellitus , Traumatismos do Pé/etiologia , Humanos , Masculino , Necrose , Infecções Estreptocócicas/diagnóstico , Infecções Estreptocócicas/tratamento farmacológico , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Cicatrização , Ferimentos Penetrantes/etiologia
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