Therapeutic strategies for chronic wound infection.

Chronic wounds have always been a tough fight in clinical practice, which can not only make patients suffer from pain physically and mentally but also impose a heavy burden on the society. More than one factor is relevant to each step of the development of chronic wounds. Along with the in-depth research, we have realized that figuring out the pathophysiological mechanism of chronic wounds is the foundation of treatment, while wound infection is the key point concerned. The cause of infection should be identified and prevented promptly once diagnosed. This paper mainly describes the mechanism, diagnosis and therapeutic strategies of chronic wound infection, and will put an emphasis on the principle of debridement.

Investigation of the status and influence factors of caregiver's quality of life on caring for patients with chronic wound during COVID-19 epidemic.

The objectives of this study were to investigate the status and influence factors of caregiver's quality of life (QOL) on caring for patients with chronic wound during COVID-19 epidemic. A prospective cross-sectional study of 83 informal caregivers was included. The characteristics of informal caregivers as well as their QOL assessment by the Family Dermatology Life Quality Index (FDLQI) were measured, respectively. Single-factor analysis and multiple regression analysis were carried out to explore the independent influence factors of QOL of caregiver on caring for patient with chronic wound. 62.65% of the caregivers were female with a mean age of (54.24 ± 12.6) years, and 34.9% of the caregivers were parents. The mean FDLQI score was 13.01 ± 7.53 at a high level. The following variables influenced the FDLQI scores of caregivers: self-care ability of patients, patient's satisfaction of home-based wound care, and home-based wound care need of caregivers. The model was able to explain 29.9% of variance in QOL of caregiver (F = 6.561, P = .000, R2  = 0.299, adjusted R2  = 0.253). In conclusion, the impact of chronic wound disease on the QOL of caregivers is heavy during COVID-19 epidemic. Wound professionals are suggested to pay attention to wound care need at home and QOL of caregiver on caring for patients with chronic wound during COVID-19 epidemic and develop tailored wound health education and support programme in order to improve the QOL of caregivers.

Effective reinnervation of the quadriceps femoris by spinal ventral root cross-anastomosis in rats.

PURPOSE: To study the effective recovery of the quadriceps femoris by spinal ventral root cross-anastomosis in rats. METHODS: End-to-end anastomosis was performed between the left L(1) and L(3) ventral roots using autogenous nerve graft, and the right L(1) and L(3) roots were left intact. In control animals, the left L(3) ventral root was cut and shortened, and anastomosis was not performed. Six months postoperatively, the movement of low extremities was detected by electrophysiological examination, hindlimb locomotion and basso, beattie and bresnahan (BBB) scoring at one, three, seven, 14, 21 and 28 days after SCI. Fluorescence retrograde tracing with TRUE BLUE (TB) and HE staining were performed to observe the nerve regeneration. RESULTS: Six months after surgery, the anastomotic nerve was smooth and not atrophic. The amplitudes of action potential were 7.63 ± 1.86 mV and 6.0 ± 1.92 mV respectively before and after the spinal cord hemisection. The contraction of left quadriceps femoris was induced by a single stimulation of the anastomotic nerve. The locomotion of left hindlimb was partially restored after spinal cord hemisection while creeping and climbing. In addition, there was significant difference in the BBB score at one, three and seven days after SCI. TB retrograde tracing and neurophysiologic observation indicated efficient reinnervation of the quadriceps femoris. CONCLUSION: The cross-anastomosis between spinal ventral root can partially reconstruct the function of quadriceps femoris following SCI and may have clinical implication for the treatment of human SCI.

Effective reinnervation of the quadriceps femoris by spinal ventral root cross-anastomosis in rats / Reinervação efetiva do quadríceps femoral pela anastomose cruzada via raiz espinhal ventral em ratos

PURPOSE: To study the effective recovery of the quadriceps femoris by spinal ventral root cross-anastomosis in rats. METHODS: End-to-end anastomosis was performed between the left L1 and L3 ventral roots using autogenous nerve graft ,and the right L1 and L3 roots were left intact. In control animals, the left L3 ventral root was cut and shortened, and anastomosis was not performed. Six months postoperatively, the movement of low extremities was detected by electrophysiological examination, hindlimb locomotion and basso, beattie and bresnahan (BBB) scoring at one, three, seven, 14, 21 and 28 days after SCI. Fluorescence retrograde tracing with TRUE BLUE (TB) and HE staining were performed to observe the nerve regeneration. RESULTS: Six months after surgery, the anastomotic nerve was smooth and not atrophic. The amplitudes of action potential were 7.63±1.86 mV and 6.0±1.92 mV respectively before and after the spinal cord hemisection. The contraction of left quadriceps femoris was induced by a single stimulation of the anastomotic nerve. The locomotion of left hindlimb was partially restored after spinal cord hemisection while creeping and climbing. In addition, there was significant difference in the BBB score at one, three and seven days after SCI. TB retrograde tracing and neurophysiologic observation indicated efficient reinnervation of the quadriceps femoris. CONCLUSION: The cross-anastomosis between spinal ventral root can partially reconstruct the function of quadriceps femoris following SCI and may have clinical implication for the treatment of human SCI.

OBJETIVO: Investigar a recuperação efetiva do músculo quadríceps femoral pela anastomose cruzada via raiz espinhal ventral em ratos. MÉTODOS: Anastomose término-terminal foi realizada entre as raízes ventrais L1 e L3 à esquerda usando enxerto autógeno de nervo e, à direita, as raízes L1 e L3 foram mantidas intactas. Nos animais controles, à esquerda, a raiz ventral de L3 foi cortada e encurtada sem realização de anastomose. Após seis meses, o movimento das extremidades posteriores foi estudado por exame eletrofisiológico, e pelo escore de basso, beattie e bresnahan (BBB) com um, três, sete, 14, 21 e 28 dias após SCI. Fluorescência retrograde feita com TRUE BLUE (TB) e coloração com HE foram realizadas para observar a regeneração do nervo. RESULTADOS: Seis meses após a cirurgia, a anastomose do nervo estava lisa e sem atrofia. As amplitudes dos potenciais de ação foram 7,63±1,86 mV e 6,0±1,92 mV respectivamente antes e após a hemisecção da medula espinhal. A contração do músculo quadríceps femoral foi induzida por um único estímulo do nervo anastomosado. A locomoção do membro posterior esquerdo foi parcialmente restaurada após hemisecção da medula espinhal ao rastejar e escalar. Ademais, houve diferença significante no escore BBB nos dias um, três e sete após SCI. O traçado da TB retrógrada e a observação neurofisiológica indicaram reinervação eficiente do quadríceps femoral. CONCLUSÃO: A anastomose cruzada entre as raízes espinhais ventrais podem reconstruir parcialmente a função do quadríceps femoral após SCI e pode ter implicação clínica para o tratamento da SCI.