Your browser doesn't support javascript.
loading
Mostrar: 20 | 50 | 100
Resultados 1 - 20 de 4.691
Filtrar
1.
Isr Med Assoc J ; 23(1): 33-37, 2021 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-33443340

RESUMO

BACKGROUND: Injuries to the anterior cruciate ligament (ACL) are common and complete tears often fail to heal. ACL reconstruction is considered the surgical gold standard of care for ACL injuries in young active patients. OBJECTIVES: To determine the corresponding morphological and histological features of the torn ACL in different time periods after injury. METHODS: The study included 28 remnant specimens of torn ACLs from patients who had ACL reconstruction surgery of the knee. The remnant pathology was evaluated by its morphology during arthroscopy and by histopathologic measurements. RESULTS: At surgery there were three progressive and distinct morphological tear patterns. The first pattern was noticed within the first 3 months from injury and showed no scar tissue. The second pattern appeared later and was characterized by the appearance of scar tissue with adhesion to the femoral wall. The third pattern was characterized by adhesion of the ACL remnant to the posterior cruciate ligament. The histological changes of the first morphological pattern showed abundance of blood vessels and lymphocytes at the torn femoral end with few irregular collagen fibers. The second and third tear patterns showed decrement in the number of blood vessels and lymphocytes with longitudinally oriented collagen fibers. CONCLUSIONS: The morphological features of the ACL remnant in the first 3 months after injury showed no scar tissue and its histological features had the characteristics of a reparative phase. This phase was followed by a prolonged remodeling phase that ended with attachment of the remnant to the posterior cruciate ligament.


Assuntos
Lesões do Ligamento Cruzado Anterior/cirurgia , Reconstrução do Ligamento Cruzado Anterior , Cicatriz , Articulação do Joelho , Efeitos Adversos de Longa Duração , Aderências Teciduais , Adulto , Reconstrução do Ligamento Cruzado Anterior/efeitos adversos , Reconstrução do Ligamento Cruzado Anterior/métodos , Artroscopia/métodos , Cicatriz/diagnóstico por imagem , Cicatriz/etiologia , Feminino , Tecido de Granulação/irrigação sanguínea , Tecido de Granulação/patologia , Humanos , Articulação do Joelho/irrigação sanguínea , Articulação do Joelho/diagnóstico por imagem , Articulação do Joelho/patologia , Efeitos Adversos de Longa Duração/diagnóstico por imagem , Efeitos Adversos de Longa Duração/etiologia , Masculino , Avaliação de Resultados em Cuidados de Saúde , Período Pós-Operatório , Fatores de Tempo , Aderências Teciduais/diagnóstico por imagem , Aderências Teciduais/etiologia
2.
J Ethnopharmacol ; 266: 113414, 2021 Feb 10.
Artigo em Inglês | MEDLINE | ID: mdl-32980488

RESUMO

ETHNOPHARMACOLOGICAL RELEVANCE: Medicinal plants are crucial to healing numerous illnesses. Elaeis guineensis Jacq (family Arecaceae) is a medicinal plant traditionally used for the treatment of wounds. AIM OF THE STUDY: However, there are no scientific reports documented on the wound healing activities of this plant against Staphylococcus aureus infections in the Sprague Dawley male rat model. Thus, the present study was conducted to evaluate the wound healing potential of E. guineensis extract leaves. MATERIALS AND METHODS: The crude extract was prepared in 10% (w/w) ointment and evaluated for wound healing activity using excision and infected wound models in Sprague Dawley rats. The wound healing activity was evaluated from wound closure rate, CFU reduction, histological analysis of granulation tissue and matrix metalloprotease expression. RESULTS: The results show that the E. guineensis extract has potent wound healing ability, as manifest from improved wound closure and tissue regeneration supported by histopathological parameters. Assessment of granulation tissue every fourth day showed a significant reduction in the microbial count. The expression of matrix metalloproteinases was well correlated with the other results, hence confirming E. guineensis wound healing activity's effectiveness. CONCLUSIONS: E. guineensis enhanced infected wound healing in rats, thus supporting its traditional use.


Assuntos
Arecaceae/química , Extratos Vegetais/farmacologia , Infecções Estafilocócicas/tratamento farmacológico , Cicatrização/efeitos dos fármacos , Animais , Antibacterianos/farmacologia , Modelos Animais de Doenças , Tecido de Granulação/efeitos dos fármacos , Masculino , Metaloproteinases da Matriz/metabolismo , Medicina Tradicional , Pomadas , Folhas de Planta , Ratos , Ratos Sprague-Dawley , Staphylococcus aureus/efeitos dos fármacos , Infecção dos Ferimentos/tratamento farmacológico , Infecção dos Ferimentos/microbiologia
4.
J Plast Reconstr Aesthet Surg ; 73(8): 1547-1555, 2020 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-32487360

RESUMO

Pelnac GplusⓇ, IntegraⓇ, and TerudermisⓇ are approved artificial dermis products in Japan. Previously, we proved that Pelnac GplusⓇ was able to sustain basic fibroblast growth factor (bFGF) and accelerated wound healing by releasing impregnated bFGF. In this study, we impregnated Pelnac GplusⓇ, IntegraⓇ, and TerudermisⓇ with bFGF and compared the binding activity and wound-healing process. We applied bFGF to each material and compared the bFGF concentrations in the surrounding area after 24-h incubation. For the in vivo study, dermal substitutes were impregnated with bFGF and implanted into full-thickness wounds of BKS.Cg-+Leprdb/+Leprdb/Jcl mice. Wounds were evaluated at days 7, 14, and 21 after implantation. The in vitro study showed that bFGF is strongly bound to IntegraⓇ, followed by Pelnac GplusⓇ and TerudermisⓇ. The in vivo study showed that fibroblasts and capillaries had infiltrated into the Pelnac GplusⓇ but not the IntegraⓇ or TerudermisⓇ. Furthermore, long epithelium and wide granulation tissue were formed in the Pelnac GplusⓇ with bFGF group. The TerudermisⓇ with bFGF group had more capillaries than other groups, but only at the base of the wound. The combination of Pelnac GplusⓇ with bFGF may be a novel approach for treating full-thickness skin defects or chronic skin ulcers.


Assuntos
Diabetes Mellitus Experimental , Fator 2 de Crescimento de Fibroblastos/farmacologia , Pele Artificial , Cicatrização/efeitos dos fármacos , Animais , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Japão , Masculino , Camundongos , Camundongos Mutantes , Pele/patologia
5.
J Craniofac Surg ; 31(5): 1348-1352, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32282472

RESUMO

PURPOSE: To investigate feasibility of endoscopic endonasal dacryocystorhinostomy (EE-DCR) with an novel lacrimal ostium stent (LOS) intubation for patients with chronic dacryocystitis with small lacrimal sac. METHODS: Patients diagnosed as chronic dacryocystitis with small lacrimal sac who preferred to surgery treatment between March 1st, 2012 and May 1st, 2015. All included subjects were randomly divided into 2 groups (Group A and Group B). Cases in group A were performed EE-DCR with LOS intubation while cases in group B were underwent EE-DCR without LOS intubation. Demographic data of each cases were collected. The success rate and the surgical outcomes of 2 groups were compared. RESULTS: The success rate was much higher in group A than group B. At 3 months follow up, 61.6% of patients in group A exhibited scarring and/or granulation tissues around the ostium, which was significantly higher than the 36.4% of patients in group B. Of these patients with scars and/or granulation tissues, no statistical difference was found between 2 groups. Granuloma alone and scars with granuloma were observed in 10 patients and 2 patients, in group A and group B, respectively, resulting in a statistical significant difference for this outcome between the groups. At 9 months follow up and 12 months follow up, no significant statistical difference were found in the rate of scarring and/or granulation tissues, scars alone, granuloma alone and scars with granuloma between 2 groups. CONCLUSIONS: EE-DCR with novel LOS may be an effective procedure to manage chronic dacryocystitis with small lacrimal sac.


Assuntos
Dacriocistite/cirurgia , Dacriocistorinostomia , Doenças do Aparelho Lacrimal , Adolescente , Adulto , Idoso , Cicatriz/cirurgia , Dacriocistorinostomia/métodos , Endoscopia , Tecido de Granulação , Humanos , Intubação/métodos , Doenças do Aparelho Lacrimal/cirurgia , Pessoa de Meia-Idade , Ducto Nasolacrimal/cirurgia , Stents , Adulto Jovem
6.
BMC Pharmacol Toxicol ; 21(1): 6, 2020 01 13.
Artigo em Inglês | MEDLINE | ID: mdl-31931882

RESUMO

BACKGROUND: Leakage following colorectal anastomosis surgery causes various complications associated with high morbidity and mortality, especially in pediatric patients. It might be caused by the use of non-steroidal anti-inflammatory drugs (NSAIDs) as postoperative analgesics. This study aimed to compare the effect of metamizole and paracetamol on colonic anastomosis and fibroblast activities, including proliferation, migration, and collagen synthesis, in Wistar rats. METHODS: Rats were divided into control, paracetamol and metamizole groups. The colonic anastomosis was evaluated by determining the integrity of the muscle layers, the formation of granulation tissue, and mucosal anastomosis. Fibroblast activities were analyzed by measuring the proliferation, migration, and collagen synthesis. RESULTS: Metamizole caused more damage to muscle layer integrity, more inhibition of granulation tissue formation in the anastomosis area and lower mucosal anastomosis compared with paracetamol and control groups. Metamizole had a higher cytotoxic effect than paracetamol, which suppressed the proliferation and migration of fibroblasts. Furthermore, both drugs did not affect the synthesis of collagen. CONCLUSION: Metamizole shows worse effects on the integrity of muscle layers, inhibition of granulation tissue formation, mucosal anastomosis, fibroblast proliferation, and migration, but not collagen synthesis, than paracetamol in Wistar rat intestines following colonic anastomosis. These findings might indicate that paracetamol is safer than metamizole as analgesic following colonic anastomosis.


Assuntos
Acetaminofen/farmacologia , Analgésicos não Entorpecentes/farmacologia , Anastomose Cirúrgica , Anti-Inflamatórios não Esteroides/farmacologia , Antipiréticos/farmacologia , Colo/efeitos dos fármacos , Dipirona/farmacologia , Fibroblastos/efeitos dos fármacos , Animais , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Células Cultivadas , Colágeno/metabolismo , Colo/patologia , Colo/cirurgia , Fibroblastos/fisiologia , Tecido de Granulação/efeitos dos fármacos , Ratos Wistar
7.
World Neurosurg ; 136: 341-347, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31996338

RESUMO

BACKGROUND: Spinal sparganosis associated with filum terminale arteriovenous fistula (FTAVF) has not been reported in the literature. In previous studies, these 2 rare diseases were usually reported separately. We report the first case of spinal sparganosis with concomitant FTAVF. CASE DESCRIPTION: Spinal sparganosis associated with FTAVF manifested in a middle-aged man with progressive back pain and paraparesis. Magnetic resonance imaging of the lumbosacral spine revealed large intradural mass-like lesions involving the conus medullaris and entire cauda equina. Additionally, there was degenerative spinal stenosis at the level of L2-3 to L5-S1. Magnetic resonance imaging of the thoracic spine disclosed abnormal hypersignal intensity extending from the level of the conus medullaris to T7 with tortuous intradural flow voids along the ventral more than dorsal surfaces of the spinal cord. Magnetic resonance angiography and spinal angiography confirmed FTAVF at the level of L3-4. The patient underwent surgical removal of the granulation tissues with lysis adhesions and obliteration of the FTAVF simultaneously in the same surgical session. Histologic findings were consistent with sparganosis. CONCLUSIONS: The formation of FTAVF in the present case may have resulted from severe spinal canal stenosis caused by lumbar spondylosis and spinal sparganosis, inducing chronic inflammation and severe adhesion of spinal nerve roots. This evidence indicates that FTAVF may have been acquired.


Assuntos
Fístula Arteriovenosa/complicações , Cauda Equina/diagnóstico por imagem , Esparganose/complicações , Doenças da Coluna Vertebral/complicações , Adulto , Fístula Arteriovenosa/diagnóstico por imagem , Fístula Arteriovenosa/cirurgia , Dor nas Costas/etiologia , Cauda Equina/cirurgia , Tecido de Granulação/patologia , Humanos , Angiografia por Ressonância Magnética , Imagem por Ressonância Magnética , Masculino , Procedimentos Neurocirúrgicos/métodos , Paraparesia/etiologia , Esparganose/diagnóstico por imagem , Esparganose/cirurgia , Compressão da Medula Espinal/patologia , Doenças da Coluna Vertebral/diagnóstico por imagem , Doenças da Coluna Vertebral/cirurgia , Estenose Espinal/diagnóstico por imagem , Estenose Espinal/etiologia , Resultado do Tratamento
8.
ACS Appl Mater Interfaces ; 12(2): 2023-2038, 2020 Jan 15.
Artigo em Inglês | MEDLINE | ID: mdl-31895528

RESUMO

In the management of accelerating wound healing, moist environments play an important role. Compared with other scaffolds of various forms, hydrogels can maintain a moist environment in the wound area. They are cross-linked hydrophilic polymeric networks that resemble natural soft tissues and extracellular matrices. Among them, injectable hydrogels have attracted great attention in wound repair, as they can be injected into irregular-shaped skin defects and formed in situ to shape the contour of different dimensions. The excellent compliance makes hydrogels easy to adapt to the wound under different conditions of skin movement. Here, we oxidized hydroxyethyl starch (O-HES) and modified carboxymethyl chitosan (M-CMCS) to fabricate an in situ forming hydrogel with excellent self-recoverable extensibility-compressibility, biocompatibility, biodegradability, and transparency for accelerating wound healing. The oxidation degree of O-HES was 74%. The amino modification degree of M-CMCS was 63%. M-CMCS/O-HES hydrogels were formed through the Schiff base reaction. The physicochemical properties of M-CMCS/O-HES hydrogels with various ratios were investigated, and M-CMCS/O-HES hydrogel with a volume ratio of 5:5 exhibited appropriate gelation time, notable water-retaining capacity, self-recoverable conformal deformation, suitable biodegradability, and good biocompatibility for wound-healing application. Then, skin wound-healing experimental studies were carried out in Sprague-Dawley rats with full-thickness skin defects. Significant outcomes were achieved in the M-CMCS/O-HES hydrogel-treated group including higher wound closure percentage, more granulation tissue formation, faster epithelialization, and decreased collagen deposition. These findings demonstrate that using the obtained M-CMCS/O-HES hydrogels is a promising therapeutic strategy for wound healing.


Assuntos
Adesivos/farmacologia , Umidade , Hidrogéis/farmacologia , Cicatrização/efeitos dos fármacos , Animais , Materiais Biocompatíveis/farmacologia , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Quitosana/análogos & derivados , Quitosana/química , Quitosana/farmacologia , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Hidrogéis/química , Ratos Sprague-Dawley , Regeneração/efeitos dos fármacos , Pele/efeitos dos fármacos , Pele/patologia , Amido/química , Amido/farmacologia , Fatores de Tempo , Água
9.
Biomed Pharmacother ; 123: 109776, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31911295

RESUMO

We determined the impact of Photobiomodulation (PBM) and metformin administration alone and combined on the inflammation and proliferation steps of wound healing of incisions in type two diabetes mellitus (T2DM) rats. 40 rats were divided into 4 groups (n = 10 each group). A non-genetic model of T2DM was induced in all rats, and an incision was made on each rat. There were 4 groups as follows: Group 1 was control group. Group 2 received PBM alone (890 nm, 80 Hz, 0.324 J/cm2, daily). Group 3 received metformin alone (50 mg/kg, i.p., daily) and the fourth group received combination of PBM + metformin. At inflammation (day 4) and proliferation (day 7) steps, tensiometerical, stereological, and immunohistochemical examinations were performed. PBM and PBM + metformin treatments significantly increased wound strength at inflammation and proliferation steps of wound healing respectively. PBM, metformin, and PBM + metformin groups significantly decreased inflammatory cells at inflammation and proliferation steps of wound healing. PBM, metformin, and PBM + metformin groups significantly improved granulation tissue formation by increasing fibroblasts, and new blood vessel formation at inflammation and proliferation steps of wound healing. Metformin significantly increased M2 macrophages than other treatment groups at inflammation and proliferation steps of wound healing. Simultaneously, PBM significantly decreased M2 macrophages than control group. We concluded PBM and PBM + metformin treatments significantly hastened repair at the inflammation and proliferation steps of repairing skin injury in a non-genetic model of T2 DM. PBM + metformin showed a synergistic impact. There were not a positive relation between M2 macrophage number and wound strength in the studied groups. The details of the molecular mechanisms of PBM, and PBM + metformin treatments of repairing wounds in animals, and treatment of DFUs of patients with T2 DM should be elucidated by further research.


Assuntos
Diabetes Mellitus Experimental/terapia , Diabetes Mellitus Tipo 2/terapia , Terapia com Luz de Baixa Intensidade , Metformina/farmacologia , Cicatrização , Animais , Glicemia/metabolismo , Proliferação de Células/efeitos dos fármacos , Proliferação de Células/efeitos da radiação , Terapia Combinada , Diabetes Mellitus Experimental/sangue , Diabetes Mellitus Experimental/patologia , Diabetes Mellitus Tipo 2/sangue , Diabetes Mellitus Tipo 2/patologia , Tecido de Granulação/efeitos dos fármacos , Tecido de Granulação/patologia , Tecido de Granulação/efeitos da radiação , Inflamação/patologia , Macrófagos/efeitos dos fármacos , Macrófagos/efeitos da radiação , Masculino , Ratos Wistar , Cicatrização/efeitos dos fármacos , Cicatrização/efeitos da radiação
10.
Ann Surg ; 271(6): 1174-1185, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-30614873

RESUMO

OBJECTIVE: The objective of this work was to causatively link biofilm properties of bacterial infection to specific pathogenic mechanisms in wound healing. BACKGROUND: Staphylococcus aureus is one of the four most prevalent bacterial species identified in chronic wounds. Causatively linking wound pathology to biofilm properties of bacterial infection is challenging. Thus, isogenic mutant stains of S. aureus with varying degree of biofilm formation ability was studied in an established preclinical porcine model of wound biofilm infection. METHODS: Isogenic mutant strains of S. aureus with varying degree (ΔrexB > USA300 > ΔsarA) of biofilm-forming ability were used to infect full-thickness porcine cutaneous wounds. RESULTS: Compared with that of ΔsarA infection, wound biofilm burden was significantly higher in response to ΔrexB or USA300 infection. Biofilm infection caused degradation of cutaneous collagen, specifically collagen 1 (Col1), with ΔrexB being most pathogenic in that regard. Biofilm infection of the wound repressed wound-edge miR-143 causing upregulation of its downstream target gene matrix metalloproteinase-2. Pathogenic rise of collagenolytic matrix metalloproteinase-2 in biofilm-infected wound-edge tissue sharply decreased collagen 1/collagen 3 ratio compromising the biomechanical properties of the repaired skin. Tensile strength of the biofilm infected skin was compromised supporting the notion that healed wounds with a history of biofilm infection are likely to recur. CONCLUSION: This study provides maiden evidence that chronic S. aureus biofilm infection in wounds results in impaired granulation tissue collagen leading to compromised wound tissue biomechanics. Clinically, such compromise in tissue repair is likely to increase wound recidivism.


Assuntos
Biofilmes , Colágeno/metabolismo , Tecido de Granulação/metabolismo , Staphylococcus aureus/isolamento & purificação , Cicatrização/fisiologia , Infecção dos Ferimentos/microbiologia , Animais , Células Cultivadas , Modelos Animais de Doenças , Ensaio de Imunoadsorção Enzimática , Tecido de Granulação/patologia , Masculino , Camundongos , Camundongos Endogâmicos C57BL , Infecções Estafilocócicas/microbiologia , Suínos , Infecção dos Ferimentos/diagnóstico
11.
Laryngoscope ; 130(4): E220-E227, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31132150

RESUMO

OBJECTIVES/HYPOTHESIS: To establish comprehensive transcriptomic profiles of cholesteatoma perimatrix tissue and granulation tissue from chronic otitis media (COM) that did not develop cholesteatoma, which can indicate molecular pathways involved in the cholesteatoma perimatrix pathology and invasiveness. STUDY DESIGN: Retrospective Case Series. METHODS: Transcriptome data were obtained from cholesteatoma perimatrix tissue and COM granulation tissue by an Illumina iScan microarray. Differentially expressed genes (DEGs) were subsequently analyzed using both bioinformatical functional annotation and network analysis. Expression of candidate genes (MMP9 and LCN2) was validated by quantitative reverse transcription-polymerase chain reaction (qRT-PCR) on a larger group of samples. RESULTS: Analysis of the transcriptome led to the identification of 169 differentially expressed genes between investigated tissues. Bioinformatic analysis suggested that most significant biological processes involving DEGs were previously described in cholesteatoma pathology. Network analysis identified ERBB2, TFAP2A, and TP63 as major hubs of the DEGs molecular network. Furthermore, it was observed that the cellular component most significantly enriched in DEGs was extracellular space containing 47 DEGs. Using qRT-PCR, it was confirmed that mRNA levels of the major extracellular hub (MMP9) are increased, whereas its interacting molecule (LCN2) mRNA levels were decreased in cholesteatoma perimatrix tissue compared to COM granulation tissue. CONCLUSIONS: The current study approach offers an overall look at molecular mechanisms that describe the cholesteatoma entity by focusing exclusively on the perimatrix processes in comparison to COM granulation tissue. The observed differences in gene expression between cholesteatoma perimatrix and COM granulation tissue could suggest novel markers potentially influenced by the perimatrix-matrix molecular interplay, which is not present in COM without cholesteatoma. LEVEL OF EVIDENCE: NA Laryngoscope, 130:E220-E227, 2020.


Assuntos
Colesteatoma da Orelha Média/genética , Tecido de Granulação/patologia , Otite Média/genética , Transcriptoma , Colesteatoma da Orelha Média/patologia , Doença Crônica , Humanos , Otite Média/patologia , Estudos Retrospectivos
12.
Arch Oral Biol ; 109: 104551, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31542704

RESUMO

OBJECTIVE: Preterm Low-Birth-Weight (PLBW) is frequently associated with periodontal disease. However, the mechanism is still unknown. The present study was performed to examine the possible link between periodontal infections and PLBW in post-partum women utilizing clinical parameters and CD4+ and CD8 + T lymphocytes ratio in gingival granulation tissue. MATERIALS: The tissues used in this study consisted of 35 gingival granulation tissue biopsies from 35 mothers of healthy infants (HTBW), 35 biopsies of gingival granulation tissue from 35 mothers of PLBW within one month postpartum and gingival tissue biopsies from 7 control individual with no periodontal disease (HC). CD4+ and CD8 + T lymphocyte ratios in a unit area of the gingival granulation tissue were determined by hystometrically. Statistical analysis was performed by using Kruskal-Wallis and Mann-Whitney U tests. RESULTS: CD8 + T lymphocytes were more prevalent in the PLBW group than in the HTBW and HC group (P < 0.05). The CD4+/CD8+ ratio in the PLBW group was lower than those of the other groups (p < 0.05). There were no statistically significant differences in CD4 + T lymphocytes counts between all groups (P > 0.05). CONCLUSION: Within the limits of this study it can be concluded that CD8 + T lymphocytes in gingival tissue may play important roles in the pathogenesis of periodontitis and PLBW.


Assuntos
Linfócitos T CD4-Positivos/citologia , Linfócitos T CD8-Positivos/citologia , Gengiva/imunologia , Tecido de Granulação/imunologia , Recém-Nascido de Baixo Peso , Periodontite/imunologia , Adolescente , Adulto , Feminino , Humanos , Recém-Nascido , Período Pós-Parto , Adulto Jovem
13.
Adv Skin Wound Care ; 33(1): 36-42, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31663923

RESUMO

OBJECTIVE: To compare wound products by measuring time to granulation tissue and time to complete wound healing for tracheostomy wounds in the pediatric population. METHODS: Investigators identified 134 charts of patients treated January 2013 and June 2017; 93 charts met the inclusion criteria. This study compared the use of a foam dressing (n = 34) to the foam dressing plus a wound filler (n = 59) in patients who developed or were admitted with a wound caused by a tracheostomy device. PRIMARY OUTCOME MEASURES: Time in days to granulation tissue and to wound closure. RESULTS: The average time to complete wound closure for participants in this study was 14 days. There was no statistically significant difference in time to granulation tissue or wound closure formation between the wound care products (F2,34 = 1.11, P = .34). Cluster analysis (10 splits) revealed that pressure injury stage was the best predictor, accounting for 41% of the variance in the high treatment response group (those healing in <14 days). Patients who were African American with a stage 2 pressure injury, had a PUSH score of 5 or more, and were using a foam plus a wound filler dressing were 86% more likely to be in the high-response group. CONCLUSIONS: All wounds reviewed healed with current wound care practices without surgical intervention. Best practice for healing tracheostomy wounds in pediatric patients should include the wound filler in the first 14 days based on variable interaction.


Assuntos
Tecido de Granulação/metabolismo , Tratamento de Ferimentos com Pressão Negativa/métodos , Traqueostomia/métodos , Cicatrização/fisiologia , Adolescente , Bandagens , Criança , Análise por Conglomerados , Estudos de Coortes , Feminino , Tecido de Granulação/patologia , Humanos , Masculino , Pediatria , Lesão por Pressão/fisiopatologia , Lesão por Pressão/terapia , Prognóstico , Estudos Retrospectivos , Medição de Risco , Resultado do Tratamento , Técnicas de Fechamento de Ferimentos
14.
Chin J Integr Med ; 26(1): 26-32, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31776965

RESUMO

OBJECTIVE: To examine the effect of moxibustion on the wound healing process and its mechanism using a rat wound model. METHODS: Sixty male Sprague-Dawley rats were randomly divided into a sham-treated group (n=30, wound surgery only) and a moxibustion group (n=30, wound treated with moxibustion). Circular full-thickness skin wounds were produced in rats. Moxibustion was applied to the edge of wound and was continued on alternating days till 14 days after surgery, followed by measurement of wound size. Expression of collagens, prolyl-4-hydroxylase (P4H) and transforming growth factor-ß (TGF-ß) were evaluated by histochemical study and real-time polymerase chain reaction. RESULTS: The size of the wound lesion was significantly reduced in rats treated with moxibustion as compared to that in sham-treated rats at 4-10 days after wounding (P<0.01). Moxibustion stimulated mRNA expression of collagens at 4 days (P<0.01), but not at 7 days, accompanied by enhanced proliferation of P4H-positive fibroblasts. Of importance, expression of TGF-ß in tissue from the wound lesion treated with moxibustion was significantly increased as compared to that in sham-treated rats at 4 days (P<0.01 or P<0.05), but not at 7 days. CONCLUSIONS: The treatment with moxibustion promoted the wound healing process in the early phase through proliferation of fibroblasts and rapid formation of granulation, possibly mediated by induction of TGF-ß which is a key molecule in the physiological process of wound healing. Moxibustion can be expected to be effective as complementary treatment for intractable ulcers.


Assuntos
Tecido de Granulação/metabolismo , Moxibustão , Fator de Crescimento Transformador beta/metabolismo , Cicatrização , Animais , Colágeno/metabolismo , Prolina Dioxigenases do Fator Induzível por Hipóxia/metabolismo , Masculino , Ratos , Ratos Sprague-Dawley
15.
J Shoulder Elbow Surg ; 29(2): e60-e65, 2020 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-31784383

RESUMO

BACKGROUND: Brachial plexus palsy after clavicle fracture is extremely rare. We experienced 3 cases of brachial plexus palsy after clavicle fracture and investigated the findings that such patients have in common and the clinical results of these cases. METHODS: We retrospectively analyzed the data of 3 patients with clavicle fracture who had no neurovascular symptoms at the time of the initial injury but gradually developed brachial plexus palsy within 1 month after the injury. The patients were aged 70, 62, and 68 years; 2 patients were male and 1 was female. The patients' backgrounds and clinical results were assessed. RESULTS: All patients had a displaced middle-third clavicle fracture and underwent conservative therapy with a figure-8 bandage. The intervals between fracture and symptoms of brachial plexus palsy were 8, 30, and 14 days. The times from symptoms of brachial plexus palsy to surgery were 27, 75, and 28 days. In all patients, surgery revealed a ruptured subclavius muscle and abnormal development of granulation tissue around the fracture site, compressing the brachial plexus. Open reduction and plate fixation was performed in 2 patients, and clavicle resection was performed in 1 patient. The intervals between surgery and full recovery of muscle strength were 11, 6, and 6 months. CONCLUSION: The findings our 3 patients with brachial plexus palsy after clavicle fracture had in common are old age, middle-third displaced clavicle fracture, and abnormal development of granulation tissue around the fracture site. Surgical intervention yielded good clinical outcomes.


Assuntos
Neuropatias do Plexo Braquial/etiologia , Clavícula/lesões , Fraturas Ósseas/complicações , Fraturas Ósseas/patologia , Tecido de Granulação , Síndromes de Compressão Nervosa/etiologia , Idoso , Neuropatias do Plexo Braquial/cirurgia , Feminino , Fraturas Ósseas/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Síndromes de Compressão Nervosa/cirurgia , Estudos Retrospectivos
16.
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
17.
Wounds ; 31(11): E73-E76, 2019 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-31876511

RESUMO

INTRODUCTION: Chronic wounds are characterized by impaired tissue physiology that stalls healing. The prevalence of wound chronicity presents challenges in wound management and health care cost-containment. OBJECTIVE: This comparative effectiveness study evaluates the value proposition of 2 collagen-containing wound dressings - oxidized regenerated cellulose (ORC)/collagen/silver-ORC dressing and ovine collagen extracellular matrix (ECM) - in matched cohorts of patients undergoing treatment for diabetic foot ulcers (DFUs). MATERIALS AND METHODS: Data extracted from the US Wound Registry identified DFUs treated with either dressing and included wounds with complete data records (n = 3230). Thirty-seven variables were considered in propensity score matching to develop a case-matched cohort of 844 DFUs (n = 422 DFUs/group). RESULTS: The ORC/collagen/silver-ORC dressing group yielded a significantly higher percentage of DFUs that healed or improved (82% vs. 74.6%; P = .0096). The ovine collagen ECM dressing group yielded a significantly higher percentage of DFUs that worsened (15.2% vs. 23.9%; P = .0013). The ORC/collagen/silver-ORC dressing group demonstrated a higher percentage of DFUs that attained 75% to 100% granulation at zero depth at 4, 8, 12, and 16 weeks. Median time to 75% to 100% granulation was 42 days for the ORC/collagen/silver-ORC dressing group versus 60 days for the ovine collagen ECM dressing group (P = .0109). CONCLUSIONS: According to this comparative effectiveness study using real world data, ORC/collagen/silver-ORC dressing appears to afford improved healing and reduced time to granulation relative to ovine collagen ECM dressing.


Assuntos
Bandagens , Tecido de Granulação/patologia , Cicatrização/fisiologia , Ferimentos e Lesões , Animais , Proliferação de Células , Celulose Oxidada/administração & dosagem , Celulose Oxidada/farmacologia , Doença Crônica , Colágeno/administração & dosagem , Colágeno/farmacologia , Pesquisa Comparativa da Efetividade , Matriz Extracelular , Tecido de Granulação/efeitos dos fármacos , Humanos , Ovinos , Prata/administração & dosagem , Prata/farmacologia , Resultado do Tratamento , Ferimentos e Lesões/patologia , Ferimentos e Lesões/terapia
19.
Eur J Radiol ; 121: 108722, 2019 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-31706233

RESUMO

PURPOSE: To evaluate the contribution to the diagnosis of the giant arachnoid granulations (AGs) of three-dimensional (3D) high-resolution magnetic resonance (MR) imaging sequences such as T2-weighted sampling perfection with application optimized contrasts using different flip-angle evolution (SPACE) and post-contrast T1-weighted magnetization prepared rapid gradient echo (MPRAGE). MATERIALS AND METHODS: Patients with 45 giant AGs were included in this retrospective study. All the patients were performed 3D T2-weighted SPACE and contrast enhanced MR venography sequences, as well as conventional cerebral MR imaging sequences. Post-contrast T1 weighted MPRAGE sequence were performed on 38/45 patients. All cerebral MR examinations were reviewed by the 2 neuroradiologists. Each GA was evaluated carefully to assess location and mean diameter. RESULTS: The most common location for giant AGs was at both transverse sinuses. Fluid signal feature within the giant AGs was not isointense to CSF on SE T1 and FLAIR MR imaging in 32 of 45 giant AGs. There were cerebral herniation into AG in 10 (22.2 %) of 45 giant AGs. 33 (73.3 %) of 45 giant AGs had central vein finding into AG in contrast enhanced MR venography. Signal void phenomenon into AG in 3D T2-weighted SPACE MR sequence was identified in 28 (62.2 %) of 45 giant AGs. CONCLUSIONS: Fluid within giant AGs had no completely CSF-like signal intensity on conventional and 3D high-resolution MR imaging sequences. Majority of CSF-incongruent fluid within giant AGs on conventional sequences is mostly due to intra-AG CSF flow.


Assuntos
Aracnoide-Máter/diagnóstico por imagem , Tecido de Granulação/diagnóstico por imagem , Imageamento Tridimensional/métodos , Imagem por Ressonância Magnética/métodos , Adolescente , Adulto , Idoso , Aracnoide-Máter/anatomia & histologia , Criança , Diagnóstico Diferencial , Feminino , Tecido de Granulação/anatomia & histologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
20.
Wounds ; 31(9): E61-E64, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-31730514

RESUMO

INTRODUCTION: Several reports state that negative pressure wound therapy (NPWT) with instillation and dwell time (NPWTi-d) is useful in the management of intractable ulcers. However, reports comparing the effects of NPWT and NPWTi-d in the same patient are lacking. CASE REPORT: A 76-year-old man with intractable skin ulcers on both lateral malleoli presented to an outpatient clinic. Conservative treatment over a 3-month period had not been effective. The authors applied NPWT to the left leg and NPWTi-d to the right leg with fibular osteomyelitis to encourage granulation for 28 days. Thereafter, they covered both ulcers with split-thickness skin grafts. Negative pressure wound therapy was applied to the both legs for 1 week postoperatively. During periods in which NPWT and NPWTi-d were utilized, the patient received intravenous cefazolin sodium (1 g twice daily), lasting 7 days after skin grafting. Epithelization was completed in the NPWTi-d-treated ulcer in about 3 weeks and in the NPWT-treated ulcer in about 8 weeks due to the difficulty in healing his residual ulcers. In terms of the efficacy of granulation and debridement of infected granulation tissue, NPWTi-d demonstrated better results with increments in the washing amount. Also, NPWTi-d proved superior in terms of the survival status of the skin graft, the time until the residual ulcer disappeared, and the removal of latent bacteria. CONCLUSIONS: From this case report, the authors believe NPWTi-d may be more effective in cases with intractable ulcers associated with infection that need better granulation.


Assuntos
Tecido de Granulação/fisiologia , Úlcera da Perna/patologia , Tratamento de Ferimentos com Pressão Negativa , Reepitelização/fisiologia , Cicatrização/fisiologia , Idoso , Antibacterianos/administração & dosagem , Cefazolina/administração & dosagem , Doença Crônica , Desbridamento , Humanos , Úlcera da Perna/terapia , Masculino , Transplante de Pele , Irrigação Terapêutica , Fatores de Tempo , Resultado do Tratamento
SELEÇÃO DE REFERÊNCIAS
DETALHE DA PESQUISA