• Title/Summary/Keyword: skin wound

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Multidirectional Vector Excision Leads to Better Outcomes than Traditional Elliptical Excision of Facial Congenital Melanocytic Nevus

  • Oh, Seung Il;Lee, Yoon Ho
    • Archives of Plastic Surgery
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    • v.40 no.5
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    • pp.570-574
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    • 2013
  • Background The elliptical excision is the standard method of removing benign skin lesions, such as congenital melanocytic nevi. This technique allows for primary closure, with little to no dog-ear deformity, but may sacrifice normal tissue adjacent to the lesion, resulting in scars which are unnecessarily long. This study was designed to compare the predicted results of elliptical excision with those resulting from our excision technique. Methods Eighty-two patients with congenital melanocytic nevus on the face were prospectively studied. Each lesion was examined and an optimal ellipse was designed and marked on the skin. After an incision on one side of the nevus margin, subcutaneous undermining was performed in the appropriate direction. The skin flap was pulled up and approximated along several vectors to minimize the occurrence of dog-ear deformity. Results Overall, the final wound length was 21.1% shorter than that achieved by elliptical excision. Only 8.5% of the patients required dog-ear repair. There was no significant distortion of critical facial structures. All of the scars were deemed aesthetically acceptable based on their Patient and Observer Scar Assessment Scale scores. Conclusions When compared to elliptical excision, our technique appears to minimize dogear deformity and decrease the final wound length. This technique should be considered an alternative method for excision of facial nevi.

The use of negative-pressure wound therapy over a cultured epithelial autograft for full-thickness wounds secondary to purpura fulminans in an infant

  • Goh, Benjamin Kah Liang;Chua, Alvin Wen Choong;Chew, Khong Yik;Kang, Gavin Chun-Wui;Chiang, Li-Wei;Tan, Bien-Keem;Ramachandran, Savitha
    • Archives of Plastic Surgery
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    • v.48 no.3
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    • pp.338-343
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    • 2021
  • Purpura fulminans is a serious condition that can result in severe morbidity in the pediatric population. Although autologous skin grafts remain the gold standard for the coverage of partial- to full-thickness wounds, they have several limitations in pediatric patients, including the lack of planar donor sites, the risk of hemodynamic instability, and the limited graft thickness. In Singapore, an in-house skin culture laboratory has been available since 2005 for the use of cultured epithelial autografts (CEAs), especially in burn wounds. However, due to the fragility of CEAs, negative-pressure wound therapy (NPWT) dressings have been rarely used with CEAs. With several modifications, we report a successful case of NPWT applied over a CEA in an infant who sustained 30% total body surface area full-thickness wounds over the anterior abdomen, flank, and upper thigh secondary to purpura fulminans. We also describe the advantages of using NPWT dressing over a CEA, particularly in pediatric patients.

The Effects of Low Power Laser Treatment on Tissue Inflammatory Reactions in the Linear Incision Wound on Rat Skin (흰 쥐의 선상 절개 창상모델에서 저출력 레이저 자극이 조직 염증반응에 미치는 영향)

  • Lim, In-Hyuk;Lee, Jeong-Weon;Kim, Hyun-Sook
    • Physical Therapy Korea
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    • v.10 no.2
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    • pp.61-70
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    • 2003
  • The purposes of this study was to evaluate the effect of low power GaAsAl laser on tissue contraction in a linear incision wound on rat skin. The linear incision wound was made on the midline of the backside in the experimental animals. Low power laser applications with different intensities such as 3, 6, or 10 mW were applied to the experimental animals twice a day for 10 days. On either the seventh or tenth postoperative day, the quantitative analysis of the inflammatory reaction surrounding the linear incision wounds on the rats were performed using enzymatical analysis of myeloperoxidase (MPO) activity. The number of neutrophil was $.07-1.0{\times}106/m{\ell}$ from a normal blood sample that was obtained from the normal experimental animals. Each concentration of neutrophil showed .04-.62 unit activity of MPO. Therefore, the 6 unit activity of MPO per neutrophil was $.57{\pm}.014{\times}10^{-6}$ unit. On the 7th and 10th post operative day, non treated tissues demonstrated increased MPO activity as compared to that of normal tissue. These data indicated that the inflammatory reaction of tissue was induced after wound induction and the MPO activity were increased in the inflammed tissues. While both 3 mW or 6 mW intensity of laser treatments did not affect the tissue MPO activity, 10 mW intensity of laser treatment significantly decreased the tissue MPO activity on the 7th and 10th post operative day. These data demonstrated that only 10 mW intensity of laser treatment successfully suppressed tissue inflammatory reaction after wound induction. In conclusion, these findings suggested that 10 mW of GaAIAs laser treatments effectively suppressed the inflammatory reaction of tissue that was induced during the wound healing process.

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Comparison of wound healing effects between Oncorhynchus keta-derived polydeoxyribonucleotide (PDRN) and Oncorhynchus mykiss-derived PDRN

  • Lee, Jong Hun;Han, Jin Woo;Byun, Jin Hwan;Lee, Won Mi;Kim, Min Ho;Wu, Wen Hao
    • Archives of Craniofacial Surgery
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    • v.19 no.1
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    • pp.20-34
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    • 2018
  • Background: Polydeoxyribonucleotide (PDRN) influencing cellular growth and differentiation is recognized to promote wound healing by stimulating tissue repair. Although PDRN can be extracted from human placentas, PDRN medications have recently been extracted from the semen of trout (Oncorhynchus mykiss) and salmon (Oncorhynchus keta). The present study was designed to evaluate the wound healing effects of O. keta-derived PDRN for injection (Rejuvenex) and PDRN cream (Rejuvenex Cream) in comparison with those of O. mykiss-derived PDRN injection (Placentex). Methods: Full-thickness skin defects were made on the back of mice (n=60). The mice were divided into the following four groups according to the dressing used for the wounds: O. mykiss-derived PDRN injection group, O. keta-derived PDRN injection group, O. ketaderived PDRN cream group, and normal saline soaked dressing group (control group). We analyzed the gross findings, wound sizes, histological findings, immunohistochemistry and enzyme-linked immunosorbent assays for the groups immediately after the treatment, and again after 4, 7, and 10 days of treatment. Results: The wound healing effects were the greatest in the O. keta-derived PDRN injection and O. mykiss-derived PDRN injection groups, which showed similar scores, followed by the O. keta-derived cream and normal saline soaked dressing groups. Conclusion: The injection of PDRN extracted from O. keta was found to be as effective at healing full-thickness skin defects as the O. mykiss-derived PDRN injection, which is currently used in the clinic. Moreover, the O. keta-derived PDRN injection was also found to reduce the time required for wound healing.

Enhancing Dermal Matrix Regeneration and Biomechanical Properties of $2^{nd}$ Degree-Burn Wounds by EGF-Impregnated Collagen Sponge Dressing

  • Cho Lee Ae-Ri
    • Archives of Pharmacal Research
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    • v.28 no.11
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    • pp.1311-1316
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    • 2005
  • To better define the relationship between dermal regeneration and wound contraction and scar formation, the effects of epidermal growth factor (EGF) loaded in collagen sponge matrix on the fibroblast cell proliferation rate and the dermal mechanical strength were investigated. Collagen sponges with acid-soluble fraction of pig skin were prepared and incorporated with EGF at 0, 4, and 8 $\mu$g/1.7 $cm^{2}$. Dermal fibroblasts were cultured to 80$\%$ confluence using DMEM, treated with the samples submerged, and the cell viability was estimated using MTT assay. A deep, $2^{nd}$ degree- burn of diameter 1 cm was prepared on the rabbit ear and the tested dressings were applied twice during the 15-day, post burn period. The processes of re-epithelialization and dermal regeneration were investigated until the complete wound closure day and histological analysis was performed with H-E staining. EGF increased the fibroblast cell proliferation rate. The histology showed well developed, weave-like collagen bundles and fibroblasts in EGF-treated wounds while open wounds showed irregular collagen bundles and impaired fibroblast growth. The breaking strength (944.1 $\pm$ 35.6 vs. 411.5 $\pm$ 57.0 Fmax, $gmm^{-2}$) and skin resilience (11.3 $\pm$ 1.4 vs. 6.5 $\pm$ 0.6 mJ/$mm^{2}$) were significantly increased with EGF­treated wounds as compared with open wounds, suggesting that EGF enhanced the dermal matrix formation and improved the wound mechanical strength. In conclusion, EGF-improved dermal matrix formation is related with a lower wound contraction rate. The impaired dermal regeneration observed in the open wounds could contribute to the formation of wound contraction and scar tissue development. An extraneous supply of EGF in the collagen dressing on deep, $2^{nd}$ degree-burns enhanced the dermal matrix formation.

Effect on Tenascin Expression of Low Power Generating Laser Irradiation during Wound Healing Process (저출력 레이저가 창상치유과정에서 Tenascin 발현에 미치는 영향)

  • Sang-Bae Kim;Chong-Youl Kim
    • Journal of Oral Medicine and Pain
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    • v.19 no.1
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    • pp.33-43
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    • 1994
  • The purpose of this paper was to observe the influence of Ga-As semiconductor-low power generating laser on she appearance and actions of tenascin, extracellular matrix, as healing process of intentional wound on the experimental animals is taking place. 35 rabbits were divided into control and experimental group. ; and on each, 3mm-long and 2mm-deep, surgical wounds were created on buccal oral mucosa and thoracodorsal portion of skin. Ga-As laser was applied to the experimental group starting a day of the day the wounds were created , the laser was applied for 5 minutes every other day. Tissue samples were taken after the 2, 4, 7, 10, and 14 days after wound formation. Then tile healing process of experimental and control groups were observed and compared, using light microscope. Afterwards, the samples were immunohistochemical stained and again observed tenascin by quantitative measuring. The following results were obtained : 1. Tenascin was observed prevalently on epithelial cells, border area of dermis, and interstitial matrix between connective tissue layers in both experimental and control groups. 2. In oral mucosa, the experimental group showed significant increase in the appearance of tenascin after 4 days compared to the control group, but after 10 days, it decreased to a point which is even less than the control group. 3. In the skin samples, the pattern of appearance of tenascin was the same in both groups, but there was some difference concerning when the peak period was shown, In the experimental group, the peak period of tenascin expression was the 7 days after wound formation in epithelium and connective tissue. In the control group, the peak period was 10 days after. 4. In both the experimental and control groups, tenascin first appeared in the epithelium near the wound area and submucosa, and then spread on the underlying connective tissue. In conclusion, appearance of tenascin is closely related to regeneration of epithelium and development of granulation tissue : therefore, low power laser, which fastnes appearance of tenascin, is sure to faciltate healing process of oral mucosa.

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The treatment of lower extremity defects with severe proliferative tissue using an adjustable horizontal mattress suture in a Tosa dog

  • Heo, Suyoung;Kim, Namsoo
    • Korean Journal of Veterinary Research
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    • v.54 no.2
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    • pp.121-122
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    • 2014
  • A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.

Identification of Microorganisms Isolated from Wound Regions of Chickens (계육의 창상부위에서 분리된 미생물의 동정)

  • Kim, Hyun-Jin;Chun, Ho-Hyun;Kim, Ju-Yeon;Jang, Sung-Ae;Lee, Bong-Duk;Chae, Hyun-Seok;Song, Kyung-Bin
    • Food Science and Preservation
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    • v.17 no.2
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    • pp.301-306
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    • 2010
  • We identified microorganisms causing skin disease in slaughtered chickens. Ten microbial strains were isolated from skin wound regions on the back and legs of chickens. Fatty acid composition analysis of the cell membranes of isolated bacteria identified five isolates of Shigella sonnei, Proteus mirabilis (2), and Escherichia coli (2). In addition, 16S rRNA sequencing indicated that S. sonnei (99%), P. mirabilis (99%), and E. coli (99%) were the strains responsible for skin wounds in chickens. Therefore, these three species may be the major pathogenic bacteria causing skin wounds on the back and legs of chickens.

Full thickness skin grafts from the groin: donor site morbidity and graft survival rate from 50 cases

  • Kim, Somi;Chung, Seung-Won;Cha, In-Ho
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.39 no.1
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    • pp.21-26
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    • 2013
  • Objectives: Full thickness skin grafts (FTSG) offer several advantages; they are esthetically superb, have less postoperative shrinkage, and offer minimal postoperative pain and scar formation at the donor site. As a donor site of FTSG, the groin offers a relatively large area of skin with high elasticity. The aim of this study was to evaluate FTSG from the groin for reconstruction in oral and maxillofacial surgery. Materials and Methods: In a retrospective study, 50 patients (27 males, 23 females) who received FTSG from the groin were evaluated for their operation records, clinical photography, and medical records. Results: The width of skin from the groin was distributed from 2-8 cm (mean: 5.1 cm) at the donor site, while the long axis length was distributed from 3-13 cm (mean: 7.4 cm). A high number of patients, 47 patients (94%) out of 50, showed good healing at the donor site. Wound impairment was seen in 3 patients (6%), minor wound dehiscence in 2 patients, and severe wound dehiscence in 1 patient. In the recipient site, delayed healing was observed in 2 patients (4%). Conclusion: FTSG from the groin to repair soft tissue defects in reconstruction surgery is a good method due to the relatively big size of the graft, decreasing morbidity at the donor site, and higher graft survival rates.

Quantitative Changes of Collagen and Malonedialdehyde as the Parameters of Skin Alteration (피부노화의 지표가 되는 collagen과 malonedialdehyde의 정량적인 변화)

  • 김기영;이재형;진주영;양시용
    • Journal of the Society of Cosmetic Scientists of Korea
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    • v.30 no.1
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    • pp.135-140
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    • 2004
  • Anti-skin aging agent could be have an inhibition effect of ROS production as well as fragmentation and change of collagen cross linkage in collagen molecule. For the monitoring of lipid peroxidation and collagen degradation, the skin of young and old rats were incised and observed 7 days. In the result, the wound closure was observed in the skin from 10 of 11 young rats and in 8 of 11 old rats. And the longer wound length but shorter wound closure, weaker collagen density and thicker epidermis were observed in old rats than in young rats. The level of hydroxyproline as a parameter of collagen synthesis and MDA as a parameter of lipid peroxidation was lower in old group than in young group. The cyst and lacuna between collagen bundle and fibroblast were observed in old rats in contrast to young rats. So that we propose that MDA and hydroxyproline could be used for monitoring of anti-skin aging agent.