• Journal of Korean Foot and Ankle Society
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• v.28 no.2
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• pp.41-47
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• 2024

Negative pressure wound therapy (NPWT) has emerged as a valuable tool for managing complex wounds within the foot and ankle field. This review article discusses the expanding applications of NPWT in this specialized field. Specifically, it discusses the efficacy of NPWT for various wound types, including diabetic foot wounds, traumatic wounds, surgical wounds, and wounds involving exposed bone or soft tissue defects. NPWT demonstrates versatile utility for foot and ankle wound management by promoting healing, potentially reducing the need for secondary surgery, improving diabetic and neuropathic ulcer healing times and outcomes, and optimizing the healing of high-risk incisions. In addition, this review explores the underlying mechanisms through which NPWT might enhance wound healing. By synthesizing current evidence, this review provides a comprehensive overview of the role of NPWT in foot and ankle surgery and offers valuable insights to clinicians navigating the complexities of wound care in this challenging anatomical area.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.71-74
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• 2010

Purpose: Nowadays spinal cord stimulator is frequently used for the patients diagnosed as complex regional pain syndrome. The lead is placed above the spinal cord and connected to the stimulation generator, which is mostly placed in the subcutaneous layer of the abdomen. When the complication occurs in the generator inserted site, such as infection or generator exposure, replacement of the new generator to another site or pocket of the abdomen would be the classical choice. The objective of our study is to present our experience of the effective replacement of the existing stimulation generator from subcutaneous layer to another layer in same site after the wound infection at inexpensive cost and avoidance of new scar formation. Methods: A 50-year-old man who was diagnosed as complex regional pain syndrome after traffic accident received spinal cord stimulator, Synergy$^{(R)}$ (Medtronic, Minneapolis, USA) insertion 1 month ago by anesthetist. The patient was referred to our department for wound infection management. The patient was presented with erythema, swelling, thick discharge and wound disruption in the left upper quadrant of the abdomen. After surgical debridement of the capsule, the existing generator replacement beneath the anterior layer of rectus sheath was performed after sterilization by alcohol. Results: Patient's postoperative course was uneventful without any complication and had no evidence of infection for 3 months follow-up period. Conclusion: Replacement of existing spinal cord stimulation generator after sterilization between the anterior layer of rectus sheath and rectus abdominis muscle in the abdomen will be an alternative treatment in wound infection of stimulator generator.

• Archives of Plastic Surgery
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• v.34 no.3
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• pp.305-313
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• 2007

Purpose: Wound healing is a result of complex processes whose components, such as cells, extracellular matrix, proteolytic enzymes, and their inhibitors receive effects from immune compartments, cytokines, chemokines, and growth factors. Impairment of normal physiologic response to wounding makes nonhealing chronic wounds. Wound infection and exacerbated proteolytic process may induce uncontrolled tissue degradation or exudates formation, which may result in the development of a nonhealing chronic wound. Thus proper management of wound infection and exudates is critical to prevent and treat nonhealing wound. The aim of this study is to evaluate effects of Aquacel AG, silver-containing carboxymethylcellulose dressing on treatment for exudative infected wound. Methods: The study included 31 patients with nonhealing wound. Wound was dressed with Aquacel AG. The effect of dressing was investigated by serial bacterial culture and wound exudates assessment. Each infection and exudates control time was determined and statistically analyzed. Results: Wound infection and exudates were effectively managed using Aquacel AG dressing. Mean infection and exudates control time were $3.4{\pm}1.2$ and $5.7{\pm}1.4$ weeks, respectively. Statistical analysis of the data indicated that infection control time correlated positively to age and exudates control time (p<0.05). Conclusion: There is as yet no ideal dressing for the topical treatment of chronic nonhealing wound. But silver-containing carboxymethylcellulose dressing can be used effectively for exudative, infected nonhealing wound.

• Journal of Plant Biotechnology
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• v.38 no.4
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• pp.278-284
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• 2011

The CCR4-CAF1-NOT complex-mediated degradation of mRNA is a fundamental aspect of gene regulation in eukaryotes. We herein examined the role of AtCAF1 in the innate immune and wound responses of plants. Our results showed that overexpression of AtCAF1 significantly downregulated the transcript level of EFR but not FLS2 and BRI1, as well as abolished up-regulated expression pattern of EFR in response to wounding. Consistently, Agrobacteriummediated transient expression of GUS was highly enhanced in the transgenic plants overexpressing AtCAF. Furthermore, JA responsive genes were down-regulated by overexpression of AtCAF, causing the transgenic plants overexpressing AtCAF more susceptible to necrotrophic fungal pathogen, Botrytis cinerea. These results suggest that The CCR4-CAF1-NOT complex-mediated degradation of mRNA negatively regulates wounding-mediated disease resistance in Arabidopsis thaliana.

• CELLMED
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• v.2 no.3
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• pp.23.1-23.7
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• 2012

The healing properties of medicinal maggots (larval stage of Lucilia sericata) are widely used in the chirurgical debridement of non-healing wounds including diabetic foot ulcers, venous and pressure ulcers, where classical approaches have failed. Several kinds of wounds are prone to complications coming out of a specific wound bed environment. There are multi-resistant bacterial species present, their pathogenic impact is multiplied by their ability to form a biofilm. Moreover, immunological events in chronic wounds differ from those in acute wounds. Non-healing wounds are cycled in the early inflammation phase with increased levels of inflammation attributes like inflammation cytokines and matrix metalloproteinases produced by inflammation phase cells. Application of larval therapy promotes progress in the healing process to the next stages involving tissue granulation and re-epithelisation. Larval debridement is an effective method of cleaning the wound of cell debris, necrotic tissue and bacterial load. This happens in a mechanical and biological manner, but the whole complex mechanism of the maggot healing activity is still not fully elucidated. Centuries of clinical practice brings noticeable proof of the maggots' beneficial effect in wound healing management. This long history led to the investigation of the bioactive components of the larval body and its extracts in vitro. We introduce a review which describes the immunomodulation impact of maggot body components on the cellular and molecular levels of the wound healing process.

• Biomedical Science Letters
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• v.15 no.3
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• pp.241-247
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• 2009

Wound healing is a complex and highly organized biological response to injury that results in the loss of tissue integrity. Our particular interest was propolis, traditional used as an antimicrobial and an anti-inflammatory agent. The purpose of this study was to see the effects of propolis on healing of the laser induced wounds and the level of collagen formation. 808 nm laser (20 J) was irradiated on the back of rats. Irradiated wounds were divided into gel control and 6 experimental groups (3 and 5% of different three kinds of propolis). Gel type of propolis (supplied by Seoul Propolis Co., Daejeon, Korea) in water based were applied on the laser wound once daily for 14 days. One fourth of rats were sacrificed on $3^{rd}$, $7^{th}$, $10^{th}$, and $14^{th}$ day and each wound was evaluated for degree of wound healing and the level of collagen formation. Healing of wound was evaluated by measuring and comparing the width and depth of the wounds. The levels of collagen were increased in 3 and 5% gel groups comparing to control on $3^{rd}$ day and the collagen level were increased more on $7^{th}$ day. Wounds of the experimental groups showed better healing in width comparing to the healing of the control. The results of this study demonstrated that propolis accelerated healing of wounds induced by laser irradiation and good collagen formation.

• Polymer(Korea)
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• v.37 no.4
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• pp.462-469
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• 2013

Catechin (CTEC) is well-known as a very powerful antioxidant, containing the effects of anti-inflammation and skin wound healing. In this study, CTEC/${\beta}$-cyclodextrin (${\beta}$-CD) nanoparticles were incorporated into poly(vinyl alcohol) (PVA)/pectin (PT) hydrogel. The composite was designed for the induction of re-epithelializaton in skin wound. CTEC/${\beta}$-CD nanoparticles were prepared by a molecular complex method. The size of the CTEC nanoparticles formed in the hydrogel was in the range of $250{\pm}17.5$ nm. The incorporation efficiency of CTEC in the nanoparticles was 74%. The cumulative amounts of CTEC released from the hydrogel containing CTEC nanoparticles in the buffers of pH7.4 and 5.5 were $86.51{\pm}3.14%$ and $35.95{\pm}2.14%$ of total CTEC loaded in the hydrogel within 72 h, respectively. Also, in the wound healing test, the CTEC nanoparticles-loaded PVA/PT hydrogel showed faster healing of the wound made in rat dorsum than the CTEC gel.

• Polymer(Korea)
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• v.38 no.3
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• pp.338-350
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• 2014

Cellulose acetate (CA) fiber mats containing inclusion complexes of asiaticoside (AC) in 2-hydroxypropyl-${\beta}$-cyclodextrin ($HP{\beta}CD$) for potential usage as wound dressings were developed. The AC/$HP{\beta}CD$ complex-loaded CA fibers at various $HP{\beta}CD$ to AC molar ratios of 0.5, 1, and 2 were prepared in 90:10 v/v mixture of 80% (v/v) acetic acid and N,N-dimethylacetamide (DMAc) via electrospinning. The maximum released amounts of AC depended on the $HP{\beta}CD$ content and were much greater than those released from the AC-loaded CA fiber mat. In the in vitro study, indirect cytotoxic evaluation with human dermal fibroblasts (HDFa) showed that these materials released no substances in the levels that were harmful to the cells and the cells appeared to attach and proliferate well on these substrates. However, only the CA fiber mats containing AC/$HP{\beta}CD$ complexes at the $HP{\beta}CD$ to AC molar ratio of 0.5 was effective in upregulating the production of collagen of the cultured cells.

• Neurospine
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• v.15 no.4
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• pp.338-347
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• 2018

Objective: Patients with extradural spine tumors are at an increased risk for intraoperative cerebrospinal fluid (CSF) leaks and postoperative wound dehiscence due to radiotherapy and other comorbidities related to systemic cancer treatment. In this case series, we discuss our experience with the management of intraoperative durotomies and wound closure strategies for this complex surgical patient population. Methods: We reviewed our recent single-center experience with spine surgery for primarily extradural tumors, with attention to intraoperative durotomy occurrence and postoperative wound-related complications. Results: A total of 105 patients underwent tumor resection and spinal reconstruction with instrumented fusion for a multitude of pathologies. Twelve of the 105 patients (11.4%) reviewed had intraoperative durotomies. Of these, 3 underwent reoperation for a delayed complication, including 1 epidural hematoma, 1 retained drain, and 1 wound infection. Of the 93 uncomplicated index operations, there were a total of 9 reoperations: 2 for epidural hematoma, 3 for wound infection, 2 for wound dehiscence, and 2 for recurrent primary disease. One patient was readmitted for a delayed spinal fluid leak. The average length of stay for patients with and without intraoperative durotomy was 7.3 and 5.9 days, respectively, with a nonsignificant trend for an increased length of stay in the durotomy cases (p=0.098). Conclusion: Surgery for extradural tumor resections can be complicated by CSF leaks due to the proximity of the tumor to the dura. When encountered, a variety of strategies may be employed to minimize subsequent morbidity.

• Korean Journal of Pharmacognosy
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• v.46 no.1
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• pp.59-64
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• 2015

Wound healing is a complex process that includes inflammation, granulation tissue formation, re-epithelialization, and remodeling. We reported previously that BuOH fraction from Hydnocarpi Semen (HS) crude extract exhibited wound healing activity in animal ulcer models. In this study, we investigated whether BuOH fraction activates keratinocyte and fibroblast via wound closure test and migration assay. In the scratch test, BuOH fraction accelerated the closure of a monolayer wound scratch at $100{\mu}g/mL$. After treatment with BuOH fraction for 18 h, keratinocytes showed a increase in migration at $25{\mu}g/mL$, whereas the migration of fibroblast increased significantly at $100{\mu}g/mL$ of BuOH fraction compared to control. The mechanism that the BuOH fraction of HS helps to promote healing by inflammation is possibly associated with the migration of keratinocyte and fibroblast.