• 제목/요약/키워드: wound closure

검색결과 256건 처리시간 0.028초

Distance of insertion points in a mattress suture from the wound margin for ideal primary closure in alveolar mucosa: an in vitro experimental study

  • Lee, Won-Ho;Kuchler, Ulrike;Cha, Jae-Kook;Stavropoulos, Andreas;Lee, Jung-Seok
    • Journal of Periodontal and Implant Science
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    • 제51권3호
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    • pp.189-198
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    • 2021
  • Purpose: This study was conducted to determine how the distance of the near insertion points in a vertical mattress suture from the wound margin influences the pattern of primary closure in an in vitro experimental model. Methods: Pairs of 180 porcine gingival and alveolar mucosa samples were harvested from 90 pig jaws and fixed to a specially designed model. A vertical mattress suture was performed with the near insertion point at 3 different distances from the wound margin (1-, 3-, and 5-mm) on both the gingival and mucosal samples (6 groups; n=30 for each group). The margin discrepancy and the presence of epithelium between the wound margins were measured on histologic slides. Results: The margin discrepancy decreased significantly as the near insertion point became closer to the wound margin both in mucosal tissue (0.241±0.169 mm, 0.945±0.497 mm, and 1.306±0.773 mm for the 1-, 3-, and 5-mm groups, respectively) and in gingival tissue (0.373±0.304 mm, 0.698±0.431 mm, and 0.713±0.691 mm, respectively). The frequency of complications of wound margin adaptation reduced as the distance of the near insertion point from the wound margin decreased both in the mucosal and gingival tissues. Conclusions: Placing the near insertion point close to the wound margin enhances the precision of wound margin approximation/adaptation using a vertical mattress suture.

Comparing intra-oral wound healing after alveoloplasty using silk sutures and n-butyl-2-cyanoacrylate

  • Suthar, Pratik;Shah, Sonal;Waknis, Pushkar;Limaye, Gandhali;Saha, Aditi;Sathe, Pranav
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제46권1호
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    • pp.28-35
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    • 2020
  • Objectives: The need for proper wound closure is of paramount importance after any intra-oral surgery. Various wound closure techniques have been described in literature using traditional non-absorbable suture materials. These include like synthetic absorbable sutures, surgical staples and tissue adhesives. Cyanoacrylates are among the most commonly used biocompatible tissue adhesives. To evaluate and compare intraoral wound healing using 3-0 silk sutures and n-butyl-2-cyanoacrylate after alveoloplasty. Materials and Methods: A total of 20 patients requiring bilateral alveoloplasty in the same arch (upper or lower) were included in this study. Patients with any pre-existing pathology or systemic disease were excluded. After alveoloplasty was performed, the wound was closed using 3-0 braided silk sutures on one side, and using n-butyl-2-cyanoacrylate bio adhesive on the other side. Patients were evaluated based on the following parameters: time required to achieve wound closure; the incidence of immediate and postoperative hemostasis; the time to the use of the first rescue medication; the side where pain first arises; and the side where wound healing begins first. Results: Compared to 3-0 silk sutures, cyanoacrylate demonstrated better hemostatic properties, reduced operative time, reduced postoperative pain and better wound healing. Conclusion: These data suggest that cyanoacrylate glue is an adequate alternative to conventional sutures to close the surgical wound after alveoloplasty, and better than are 3-0 silk sutures.

고압맥동 평류자극이 가토 상처치유에 미치는 영향 (Effect of High Voltage Pulsed Galvanic Current on Wound Healing in Rabbits)

  • 김식현;박래준;권혁철
    • 한국전문물리치료학회지
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    • 제3권3호
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    • pp.67-81
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    • 1996
  • This study was performed to assess the efficacy of high voltage pulsed galvanic current for the healing of wounds in rabbits. Skin wounds were created laterally on the flank of 12 domestic rabbits($3{\times}3cm$). The wounds of each group were treated with an intensity of 170 V at a frequency of 70 pulses per second, which was applied for 30 minutes a day for 10 days. The experimental groups were randomly assigned to either EXP I (n=3), EXP II(n=3), EXP III(n=3) or control(n=3). Each group was stimulated under the following conditions : 1) EXP I (Negative polarity), 2) EXP II (Change in polarity, negative electrode stimulation during the first 3 days and then positive electrode stimulation from 4 to 10 days), 3) EXP III(Positive polarity), 4) control(No stimulation). An active electrode was placed over the wound and a dispersive electrode on the buttock. The rate of wound closure was compared with the original wound size, evaluated by a tracing film in each measurement period. Finally, on the wound in each group, skin tissue was excised for histological evaluation after treatment for 10 days. The results obtained are as follows : 1) It was found that the control group did not show a complete remodeling of epitherial layer and had a chronic inflammatory response. Judging from the irregularity of intercellular space and the loose alignment of connective tissue, these findings show that wound healing was delayed. 2) EXP I showed a significant bactericidal effect, but a moderate response of vasodilation. The rate of wound closure was slower when compared with EXP II, III. 3) EXP II showed a complete remodeling of epitherial layer and a positive repair of connective tissue. Its rate of wound closure was best when compared with the others. 4) EXP III had a slower rate of wound closure than EXP II, but judging from the greater proliferation of collagen fibers and the dense alignment of connective tissue, this positive electrode was very effective in the formation of neo - connective tissue.

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독사 교상 환자에서의 음압요법: 예비보고 (Vacuum Assisted Closure Therapy in Snake Bite Wound: Preliminary Report)

  • 송우진;최환준;강상규
    • Archives of Plastic Surgery
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    • 제38권1호
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    • pp.121-126
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    • 2011
  • Purpose: Vaccum-assisted closure (VAC) has rapidly evolved into a widely accepted treatment of contaminated wounds, envenomations, infiltrations, and wound complications. This results in a sealed, moist environment where tissue is given the opportunity to survive as edema is removed and perfusion is increased. Many plastic surgeons now place a VAC device directly over the fasciotomy site at the time of the initial procedure. Large amounts of the fluid are withdrawn, and fasciotomies can be closed primarily sooner. This study was designed to observe the effect of VAC in preventing complications in snake bitten hands. Methods: In our study of three cases of snake bite, three of them underwent the VAC treatment & fasciotomy of the wound in the hand. This cases, the posterior compartment of the hand was bitten for a few days, releasing incisions were made of the posterior hand and 125 mmHg of continuous vacuum was applied to fasciomy incision site and the biting wound. The dressings were changed three times per week. Results: Our study examining the effects of applied vacuum in preventing snake bite wounds showed that the incidence of tissue necrosis and compartment syndrome was significantly lower for vacuum-treated wounds than for conservative wounds. Serum myoglobin, CK-MB, and CPK levels measured after fasciotomy incision were significantly decreased. We obtained satisfactory results from early dorsal fasciotomy, drainage of the edema with the VAC system, and then primary closure. The postoperative course was uneventful. Conclusion: Envenomation is a term implying that sufficient venom has been introduced into the body to cause either local signs at the site of the bite and/or systemic signs. Use of the vacuum-assisted closure device in snake bite can result in a decreased rate of tissue necrosis, lymphatic fluid collection, hemolytic fluid collection, and edema. Early fasciotomy of the dorsal hand and VAC apply is the alternative treatment of the snake bite.

Galeal Tack-Up Sutures to Prevent Subgaleal Cerebrospinal Fluid Collection

  • Choi, Won Ho;Moon, Chang Taek;Koh, Young-Cho;Chun, Young Il;Cho, Joon;Song, Sang Woo
    • Journal of Korean Neurosurgical Society
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    • 제54권4호
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    • pp.336-339
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    • 2013
  • Objective : Postoperative subgaleal cerebrospinal fluid (CSF) collection is considered as one of the common minor surgical complication which can lead to prolonged hospitalization. We introduce "galeal tack-up suture" to prevent postoperative subgaleal CSF collection. Methods : Galeal tack-up suture consists of various surgical techniques which aim to fix galea to cranium in order to prevent CSF pooling in subgaleal space. A total of 87 patients who underwent craniotomy were divided into two groups while closing the wound : group A with galeal tack-up suture and group B with routine wound closure without galeal tack-up suture. The patients were observed for postoperative subgaleal CSF collection. Results : Among 87 cranitomy cases, galeal tack-up suture was performed in 32 cases and routine wound closure was done in 55 cases. Postoperative subgaleal CSF collection occurred in 13 cases (15%) in which 12 cases occurred in group B patients and 1 case occurred in group A patients (p=0.026). Conclusion : Galeal tack-up suture is an easy and effective technique in wound closure to prevent postoperative CSF collection.

Poly-N-acetyl-glucosamine이 당뇨병 쥐에서 창상치료에 미치는 영향 (Effects of Poly-N-acetyl Glucosamine(pGlcNAc) Patch on Wound Healing in db/db Mouse)

  • 양호직;윤치선
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.121-126
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    • 2008
  • Purpose: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. Methods: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1 h), 24 hours(24 h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). Results: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1 h treatment than the 24 h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. Conclusion: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.

Nanosphere Form of Curcumin Stimulates the Migration of Human Umbilical Cord Blood Derived Mesenchymal Stem Cells

  • Kim, Do-Wan;Kim, Ju Ha;Lee, Sei-Jung
    • 한국환경과학회:학술대회논문집
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    • 한국환경과학회 2020년도 정기학술대회 발표논문집
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    • pp.221-221
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    • 2020
  • Curcumin, a hydrophobic polyphenol derived from turmeric, has been used a food additive and as a herbal medicine for the treatment of various diseases. In the present study, we found the functional role of a nanosphere loaded with curcumin (CN) in the promotion of the motility of human umbilical cord blood derived mesenchymal stem cells (hUCB-MSCs) during the wound closure. We found that the efficacy of hUCB-MSCs migration induced by CN was 1000-fold higher than that of curcumin powder. CN significantly increased the motility of hUCB-MSCs by activating c-Src, which is responsible for the phosphorylation of protein kinase C (PKC) and extracellular signal-regulated kinase (ERK). CN induced the expression levels of α-actinin-1, profilin-1 and filamentous-actin, as regulated by the phosphorylation of nuclear factor-kappa B during its promotion of cell migration. In a mouse skin excisional wound model, we found that transplantation of UCB-MSCs pre-treated with CN enhances wound closure, granulation, and re-epithelialization at mouse skin wound sites. These results indicate that CN is a functional agent that promotes the mobilization of UCB-MSCs for cutaneous wound repair.

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메치실린 저항 포도알균에 감염된 창상 치료에 있어 음압요법의 의의 (The Use of Vacuum-Assisted-Closure Theraphy for the Treatment of Methicillin-Resistant-Staphylococcus aureus Infected Wounds)

  • 김주형;박명철;이일재;박동하
    • Archives of Plastic Surgery
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    • 제33권5호
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    • pp.632-636
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    • 2006
  • Purpose: Methicillin-Resistant-Staphylococcus aureus(MRSA) has been increasingly recognized as a cause of nosocomial infection. MRSA is hardly-controllable organism among the pathogen of nosocomial infection, because it is resistant to most antibiotics except vancomycin, and local treatment with most antiseptics are not effective to eradicate MRSA from the infection. The effectiveness of Vacuum-Assisted-Closure(VAC) was reported widely. we tried to modify original VAC. We tried VAC dressing on MRSA infected wound to evaluate whether or not the VAC is effective to eradicate MRSA which existed in the open wound. Methods: From September 2003 to December 2003, 24 patients admitted to the plastic and reconstructive surgery and orthopedic surgery, were studied. All patients were found to be positive in previous wound. Using clinical randomized study, 24 patients were divided into two groups: VAC dressing group and the $Betadine^{(R)}$ dressing group(control). During treatment, wound culture was done twice a week for evaluation of MRSA infection elimination. Results: The mean period that MRSA become not detected in all case was 17.1 days in VAC dressing group, and 25.8 days in control group, respectively. The p value was 0.013. The result reveals that the VAC dressing group is more effective to MRSA infection control. As a result, the VAC dressing was more effective in MRSA infected wound than conventional dressing. Conclusion: Through this study, we found objective result of VAC dressing. We hope that VAC dressing is more widely applied to fresh and infected wound.

치조골 소실로 발치하게 된 치아의 심미적인 임플란트 수복을 위한 granulation tissue의 활용 (The use of granulation tissue for the esthetic implant restoration for missing tooth due to alveolar bone loss)

  • 이창균
    • 대한심미치과학회지
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    • 제30권1호
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    • pp.33-39
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    • 2021
  • 상악 전치부 치아가 치조골 소실로 인해 상실되었을 때 심미적인 수복을 위해 소실된 치조골을 골재생 술식을 통해 회복 시키는 것은 매우 중요합니다. 발치와 동시에 치조골의 소실이 진행되기 때문에 발치 직후 치조제 보존술을 시행하는 것은 심미적인 수복을 위해 중요한 의미가 있습니다. 하지만 이 과정에서 primary closure를 하지 못하는 것이 골재생에 부정적인 영향을 줄 수 있습니다. 이를 극복하기 위해 발치와 내의 granulation tissue를 이용해 primary closure를 시도할 수 있습니다. 이렇게 할 경우 open wound에 비해 골재생에 유리한 환경을 제공함으로써 치조제가 잘 보존됨을 넘어 잘 증강되는 것을 증례를 통해 확인할 수 있었습니다.

Studies on in-vivo Wound Healing Activity of Leaf Extract of Hypericum mysorense with Different Wound Model in Rats

  • Mukherjee, Pulok K.;Suresh, B.
    • Natural Product Sciences
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    • 제6권2호
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    • pp.73-78
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    • 2000
  • The wound healing potential of the methanol extract of Hypericum mysorense Wight and Arn. Leaves (Family: Hypericaceae) was evaluated on different experimental models of wounds in rats. The methanol extract of leaves of Hypericum mysorense (HMM), in the form of ointment in two different concentrations (5% and 10% w/w ointment of aerial part extract in simple ointment base) was evaluated for wound healing potential in excision wound model and incision wound model in rats. Both the concentrations of the methanol extract ointment showed significant responses in both the wound types tested when compared with the control group. The effect produced by the extract ointment, in terms of wound contracting ability, wound closure time, regeneration of tissues at wound site, tensile strength of the wound and histopathological characteristics were comparable to those of a standard drug Nitrofurazone ointment.

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