• Natural Product Sciences
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• v.27 no.1
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• pp.1-9
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• 2021

Methicillin-resistant Staphylococcus aureus (MRSA) infection often complicates burn wounds. Mupirocin is the antibiotic of choice for superficial MRSA infection, and its resistance is on the rise due to its frequent and widespread use. This study aimed to develop and evaluate Curcuma xanthorriza extract (CXE)-containing gel as a topical agent against MRSA-infected second-degree burn wound in rats. CXE was obtained using maceration with 96% ethanol. Xanthorrhizol level, antibacterial, and antioxidant activity were evaluated using a standardized method. In vivo, the wound's healing and bacterial load were evaluated every three days, whereas the histopathology of the wound was examined on day 12 of treatment. One-Way ANOVA and Kruskal-Wallis test were used to analyze the data. In this study, 27.0% and 7.10% of the obtained CXE were xanthorrhizol and curcumin, respectively. Additionally, an IC50 of 64.27 ppm was shown in antioxidant activity measurement, and MIC against MRSA was 5 mg/ml. Treatment with CXE-containing gels showed a significant reduction in bacterial load and proliferation of connective tissue in a dose-dependent manner. In conclusion, CXE-containing gel showed a greater reduction of bacterial load and more advanced wound healing phase than mupirocin.

• Archives of Plastic Surgery
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• v.34 no.2
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• pp.169-175
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• 2007

Purpose: $Allevyn^{(R)}$(Smith & Nephew, England) is a type of polyurethane foam material with good wound discharge absorption. $Acticoat^{(R)}$(Smith & Nephew, England) is a silver coated dressing material which is effective in infected wound. The purpose of this study is to compare the effects of dry gauze, $Acticoat^{(R)}$ and $Allevyn^{(R)}$ on infected full-thickness wound healing in rat. Methods: One hundred and twenty rats were divided into 3 groups: group I(dressing with dry gauze, n=40), group II(dressing with $Allevyn^{(R)}$, n=40), group III(dressing with $Acticoat^{(R)}$, n=40). A $15{\times}15mm$ square full-thickness wound was made on the dorsum and left open for 24 hours. The size of wound defects were measured each dressing changes. The histological evaluation was performed on the 3rd day, 7th day, 14th day, 21th day. Results: After the wound was left open for 24 hours, typical findings of bacterial infection was observed. After the 7th day, group III showed larger area of epithelialization, smaller defect size compared to those of two other groups. Complete replacement by fibrotic scar tissue was observed in group III with no signs of inflammation on the 14th day. By day 21, the average defect size in group III was decreased from initial 100% to 3.63%. while in group I and II, it was decreased to 62.66% and 53.62%, respectively. Conclusion: $Acticoat^{(R)}$ is an effective tool in the treatment of infected wound.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.115-121
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• 2010

Purpose: Many topical agents had been used for contaminated wound treatment. Although antimicrobial ointments were widely used as topical agents, their comparative antibacterial and wound healing effects were largely unreported. The purpose of this study was to compare antibacterial effects and wound healing effects of common topical ointments on infected full thickness skin defect in the mouse. Methods: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups: group B (dressing with Bactroban$^{(R)}$, n=15), group I (dressing with Iodosorb$^{(R)}$, n=15), group T (dressing with Terramycin$^{(R)}$, n=15), group G (control group, dressing with dry gauze, n=15). The size of wound defects and the grades of wound healing were evaluated at 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. After the wound was left open for twenty-four hours, many Staphylococcus aureus was cultured. The wound defect size was decreased in order of Bactroban$^{(R)}$ (B), Iodosorb$^{(R)}$ (I), Terramycin$^{(R)}$ and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Bactroban$^{(R)}$, Iodosorb$^{(R)}$, Terramycin$^{(R)}$ and gauze dressing group, and the difference was statistically significant. Antibacterial effect for was increased in order of Bactroban$^{(R)}$, Iodosorb$^{(R)}$, Terramycin$^{(R)}$ and gauze dressing group, and the difference was statistically significant. Conclusion: Topical antimicrobial ointments application was effective against wound infections by S. aureus. Bactroban$^{(R)}$ may be an optimal topical treatment for infected wounds according to this study. However, further study is necessary to evaluate the clinical efficacy of antimicrobial ointments and to search for the mechanisms that explain their effects.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.36 no.4
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• pp.309-313
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• 2010

The management of teeth in the line of a mandibular fracture is controversial despite the general agreement that most of these teeth can be preserved. Teeth should be retained if bony attachments are adequate for survival, the tooth is sound and important in maintaining fixation of the fractured segment of bone. Teeth should be removed if they are loose and interfere with the reduction of fragments, are devitalized and potentially a source of wound infection, are damaged beyond their usefulness or may become devital and interfere with healing by becoming infected. However, tooth removal will increase the level of trauma, extend the severity of the wound and require expensive prosthetic treatment. Therefore, it is very important to conserve infected teeth in the line of a mandibular fracture through early primary endodontic treatment (pulp extirpation, canal enlargement and canal opening drainage) and splinting. The basic principles underlying the treatment of pulpless teeth are those underlying general surgery. Therefore, debridement of the infected wound (pulp extirpation and canal enlargement), drainage (canal opening) and gentle treatment of the tissues (occlusal reduction and teeth splinting) are the principles of surgery. This is a representative case report of conservative care by the early endodontic drainage of infected teeth in the line of a mandibular fracture.

• ETRI Journal
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• v.32 no.3
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• pp.440-446
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• 2010

Array-based gas sensors now offer the potential of a robust analytical approach to odor measurement for medical use. We are developing a fast reliable method for detection of microbial infection by monitoring the headspace from the infected wound. In this paper, we present initial results obtained from wound-state monitoring for burn patients using an electronic nose incorporating an automated solid-phase microextraction (SPME) desorption system to enable the system to be used for clinical validation. SPME preconcentration is used for sampling of the headspace air and the response of the sensor module to variable concentrations of volatiles emitted from SPME fiber is evaluated. Gas chromatography-mass spectrometry studies prove that living bacteria, the typical infectious agents in clinical practice, can be distinguished from each other by means of a limited set of key volatile products. Principal component analysis results give the first indication that infected patients may be distinguished from uninfected patients. Microbial laboratory analysis using clinical samples verifies the performance of the system.

• Archives of Plastic Surgery
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• v.46 no.5
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• pp.470-474
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• 2019

Congenital absent sternum is a rare birth defect that requires early intervention for optimal long-term outcomes. Descriptions of the repair of absent sternum are limited to case reports, and no preferred method for management has been described. Herein, we describe the use of porcine acellular dermal matrix to reconstruct the sternum of an infant with sternal infection following attempted repair using synthetic mesh. The patient was a full-term male with trisomy 21, agenesis of corpus callosum, ventricular septal defect, patent ductus arteriosus, right-sided aortic arch, and congenital absence of sternum with no sternal bars. Following removal of the infected synthetic mesh, negative pressure wound therapy with instillation was used to manage the open wound and provide direct antibiotic therapy. When blood C-reactive protein levels declined to ${\leq}2mg/L$, the sternum was reconstructed using porcine acellular dermal matrix. At 21 months postoperative, the patient demonstrated no respiratory issues. Physical examination and computed tomography imaging identified good approximation of the clavicular heads and sternal cleft and forward curvature of the ribs. This case illustrates the benefits of negative pressure wound therapy and acellular dermal matrix for the reconstruction of absent sternum in the context of infected sternal surgical site previously repaired with synthetic mesh.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.708-709
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• 1994

Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.

• Archives of Reconstructive Microsurgery
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• v.13 no.2
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• pp.136-143
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• 2004

Purpose : We analyse retrospectively the clinical result of consecutive free flap and osteocutaneous flap transfer in the chronic osteomyelitis, nonunion combined with infection and soft tissue defect with infection. Materials and Methods : From December 1989 to Jun 2003, free flap and osteocutaneous flap transfer was performed in 225 patients with osteomyelitis or infected non-union. 44 cases of these patients had revealed antibitotics resistant organism in wound culture, and these 44 cases were investigated in the mechanism of the injury, recurrence of infection, radiographic union, follow-up clincal results, and postoperative complications. Results : Among the 44 cases, consecutive procedures of osteocutaneous flap transfers(26 cases) and free flaps(18 cases) were performed. Causative organisms were MRSA(20 cases), Pseudomonas aeruginosa(18 cases), acinetobacter(2 cases), and so forth. Initial bony union was obtained in the average 6.3 months. Recurrence of infection in free flap and osteocutaneous free flap were occurred in 3 and 4 cases respectively. Eventually, all the cases attained successful subsidence of the inflammation. Conclusion : Free flap and osteocutaneousflap transfer have provided the greatest improvement of surgical results in infected non-union, chronic osteomyelitis and soft tissue defect with infection. Further clincal studies maybe required to minimize failure rate.

• Archives of Plastic Surgery
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• v.40 no.1
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• pp.28-35
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• 2013

Background If a chronically infected abdominal wound develops, complications such as peritonitis and an abdominal wall defect could occur. This could prolong the patient's hospital stay and increase the possibility of re-operation or another infection as well. For this reason, a solution for infection control is necessary. In this study, surgery using a rectus abdominis muscle myofascial splitting flap was performed on an abdominal wall defect. Methods From 2009 to 2012, 5 patients who underwent surgery due to ovarian rupture, cesarean section, or uterine myoma were chosen. In each case, during the first week after operation, the wound showed signs of infection. Surgery was chosen because the wounds did not resolve with dressing. Debridement was performed along the previous operation wound and dissection of the skin was performed to separate the skin and subcutaneous tissue from the attenuated rectus muscle and Scarpa's fascial layers. Once the anterior rectus sheath and muscle were adequately mobilized, the fascia and muscle flap were advanced medially so that the skin defect could be covered for reconstruction. Results Upon 3-week follow-up after a rectus abdominis myofascial splitting flap operation, no major complication occurred. In addition, all of the patients showed satisfaction in terms of function and esthetics at 3 to 6 months post-surgery. Conclusions Using a rectus abdominis myofascial splitting flap has many esthetic and functional benefits over previous methods of abdominal defect treatment, and notably, it enabled infection control by reconstruction using muscle.

• Archives of Plastic Surgery
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• v.40 no.6
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• pp.735-741
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• 2013

Background The prosthetic dura is an essential element in the protection of the cranial parenchyma and prevention of cerebrospinal fluid leakage. Although prosthetic dura are widely used in neurosurgery, they occasionally provoke infection, which can be a major concern after neurosurgical treatment. However, removal of the prosthetic dura carries a risk of brain parenchyma injury and cerebrospinal fluid leakage. The salvage of infected prosthetic dural material has not been adequately addressed in the literature. In this study, we demonstrate the value of the combination of a meticulous surgical debridement of necrotic tissue and simultaneous muscle free flap for intractable postoperative epidural abscess without removal of the infected prosthetic dura. Methods Between 2010 and 2012, we reviewed the data of 11 patients with persistent infection on the prosthetic dura. The epidural infections each occurred after a neurosurgical procedure, and there was soft tissue necrosis with the disclosure of the underlying prosthetic dura and dead bone around the scalp wound. To salvage the infected prosthetic dura, meticulous debridement and a muscle free flap were performed. Results All 11 patients experienced complete recovery from the complicated wound problem without the need for further surgical intervention. No signs of prosthetic dural infection were observed during the mean follow-up period of 11 months. Conclusions The combination of a meticulous surgical debridement and coverage with a muscle free flap is an effective treatment for salvage of infected prosthetic dura.