• The Journal of Korean Physical Therapy
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• v.27 no.3
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• pp.140-146
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• 2015

Purpose: To determine the effects of 630 nm light emitting diode (LED) on full-thickness wound healing. Methods: Twelve male Sprague-Dawley rats were randomly divided into LED (n=6) and control group (n=6). Two $19.63mm^2$ wounds were created on the mid dorsum. LED group received a 630 nm LED irradiation with $3.67mW/cm^2$ for 30 minutes ($6.60J/cm^2$) for 7 days, while control group received sham LED irradiation. Epithelial gap, collagen density, ${\alpha}$-SMA fibroblast and PCNA keratinocyte were measured on histochemical and immunohistochemical staining using image analysis system. An independent t-test was conducted to compare the difference between groups. Results: The wound closure rate, collagen density, ${\alpha}$-SMA fibroblast number, epithelial gap and PCNA keratinocyte number have shown no significant difference between LED and control group at day 3 after the treatment. At day 7 after the treatment, the wound closure rate in LED group was increased when compared with control group (p<0.05). The collagen density (p<0.05) and ${\alpha}$-SMA immunoreactive fibroblast number (p<0.001) were increased when compared with control group at day 7. The epithelial gap in LED group was significantly shorten than control group at day 7 (p<0.01). The PCNA positive cell number in LED group was higher than control group at day 7 (p<0.01). Conclusion: 630 nm LED with $3.67mW/cm^2$, $6.60J/cm^2$ accelerate collagen deposition by stimulating fibroblasts, and enhance wound contraction by differentiating myofibroblasts in the dermis, and accelerate keratinocyte proliferation by facilitating DNA synthesis in the epidermis. It may promote the healing process in proliferation stage of wound healing.

• Journal of Korean Society of Forest Science
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• v.99 no.2
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• pp.220-225
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• 2010

This study was conducted to examine the effects of wound dressing with thiophanate-methyl paste on the compartmentalization of pruning wounds in Acer palmatum. A total of thirty field-grown trees were used for three different treatments, such as no dressing, dressing once right after pruning cut, and dressing twice, one more dressing treatment one year after initial dressing. Wound closure rate (WCR) and discolored/wound area ratio (D/W ratio) two years after treatment were measured. Variations of extractives, holocellulose and lignin at the treated branch unions were also examined. The WCR of no dressing treatment of 70.9% was significantly lower than those of the two dressing treatments (85.4% and 82.7%, respectively), while the difference between dressing once and twice was not significant. The D/W ratio of no dressing treatment (39.3%) was significantly higher than those of the two dressing treatments (around 30%). Generally, at the branch core of the treated union, contents of extractives and lignin were higher and holocellulose contents were lower than the branch core of the union with living branch. Among the branch core of treated union, no dressing treatment showed a relatively lower holocellulose (63.5%), and relatively higher extractives (2.8%) and lignin (26.6%) than dressing once (66.2%, 1.7%, 26.1%, respectively).

• Archives of Plastic Surgery
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• v.35 no.4
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• pp.393-399
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• 2008

Purpose: Chronic infected wounds sustained over 4 weeks with exposed tendon or bone are difficult challenges to plastic surgeons. Vacuum assisted closure (VAC) device has been well used for the management of chronic wounds diminishing wound edema, reducing bacterial colonization, promoting formation of granulation tissue and local blood flow by negative pressure to wounds. But Commercial ready-made VAC device might have some difficulties to use because of its high expenses and heavy weight. So we modified traditional VAC device with silver dressing materials as topical therapeutic agents for control of superimposed bacterial wound infection such as MRSA, MRSE and peudomonas. Methods: We designed the modified VAC device using wall suction, 400 cc Hemovac and combined slow release silver dressing materials. We compared 5 consecutive patients' data treated by commercial ready-made VAC device(Group A) with 11 consecutive patients' data treated by modified VAC device combined with silver dressing materials(group B) from September 2004 to June 2007. Granulation tissue growth, wound discharge, wound culture and wound dressing expenses were compared between the two groups. Results: In comparison of results, no statistical differences were identified in reducing rate of wound size between group A and B. Wound discharge was significantly decreased in both groups. Modified VAC device with silver dressing materials showed advantages of convenience, cost effectiveness and bacterial reversion. Conclusion: In combination of modified VAC device and silver dressing materials, our results demonstrated the usefulness of managing chronic open wounds superimposed bacterial infection, cost effectiveness compared with traditional VAC device and improvement of patient mobility.

• Archives of Plastic Surgery
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• v.49 no.5
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• pp.617-632
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• 2022

Tracheoesophageal puncture (TEP) and voice prosthesis insertion following laryngectomy may fail to form an adequate seal. When spontaneous closure of the fistula tract does not occur after conservative measures, surgical closure is required. The purpose of this study was to summarize the available evidence on surgical methods for TEP site closure. A comprehensive search across PubMed, Web of Science, SCOPUS, and Cochrane was performed to identify studies describing surgical techniques, outcomes, and complications for TEP closure. We evaluated the rate of unsuccessful TEP closure after surgical management. A meta-analysis with a random-effect method was performed. Thirty-four studies reporting on 144 patients satisfied inclusion criteria. The overall incidence of an unsuccessful TEP surgical closure was 6% (95% confidence interval [CI] 1-13%). Subgroup analysis showed an unsuccessful TEP closure rate for silicone button of 8% (95% CI < 1-43%), 7% (95% CI < 1-34%) for dermal graft interposition, < 1% (95% CI < 1-37%) for radial forearm free flap, < 1% (95% CI < 1-52%) for ligation of the fistula, 17% (95% CI < 1-64%) for interposition of a deltopectoral flap, 9% (95% CI < 1-28%) for primary closure, and 2% (95% CI < 1-20%) for interposition of a sternocleidomastoid muscle flap. Critical assessment of the reconstructive modality should take into consideration previous history of surgery or radiotherapy. Nonirradiated fields and small defects may benefit from fistula excision and tracheal and esophageal multilayer closure. In cases of previous radiotherapy, local flaps or free tissue transfer yield high successful TEP closure rates. Depending on the defect size, sternocleidomastoid muscle flap or fasciocutaneous free flaps are optimal alternatives.

• Archives of Plastic Surgery
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• v.48 no.6
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• pp.599-606
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• 2021

Background Postoperative dehiscence and surgical site infection after spinal surgery can carry serious morbidity. Multidisciplinary involvement of plastic surgery is essential to minimizing morbidity and achieving definitive closure. However, a standardized approach is lacking. The aim of this study was to identify effective reconstructive interventions for the basis of an evidence-based management protocol. Methods A retrospective review was performed at a single tertiary institution for 45 patients who required 53 reconstruction procedures with plastic surgery for wounds secondary to spinal surgery from 2010 to 2019. Statistical analysis was performed for demographics, comorbidities, and treatment methods. Primary outcomes were postoperative complications, including dehiscence, seroma, and infection. The secondary outcome was time to healing. Results The overall complication rate was 32%, with dehiscence occurring in 17%, seroma in 15% and infection in 11% of cases. Median follow-up was 10 months (interquartile range, 4-23). Use of antibiotic beads did not affect rate of infection occurrence after wound closure (P=0.146). Use of incisional negative pressure wound therapy (iNPWT) was significant for reduced time to healing (P=0.001). Patients treated without iNPWT healed at median of 67.5 days while the patients who received iNPWT healed in 33 days. Demographics and comorbidities between these two groups were similar. Conclusions This data provides groundwork for an evidence-based approach to soft tissue reconstruction and management of dehiscence after spinal surgery. Timely involvement of plastic surgery in high-risk patients and utilization of evidence-based interventions such as iNPWT are essential for improving outcomes in this population.

• Journal of Photoscience
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• v.9 no.2
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• pp.194-196
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• 2002

While ultraviolet radiation alters various cutaneous cell functions, little is known about photo-immunological and photobiological effects of infrared radiation (IR) on the skin except its local thermal effects. The fIrst part of this study demonstrated that single exposure of mouse skin to near IR (0.7 - 1.3 $\mu$m) reversibly suppressed the proliferating activity of the epidermis, the density of Langerhans cells, and the ability of skin to induce contact hypersensitivity reaction. The second part demonstrated that the rate of wound closure was significantly accelerated by repeated exposures in animal models. The production of transforming growth factor-$\beta$l and matrix metalloproteinase-2, which are responsible for the wound healing processes, was significantly upregulated by irradiation, as shown by enzyme immunoassay, zymography, and reverse transcription polymerase chain reaction. Thermal controls were negative. The results suggest that near-IR irradiation can modulate the epidermal proliferation and part of the skin immune system, and stimulate the wound healing processes, presumably by non-thermal effects.

• 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.

• Journal of dental hygiene science
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• v.23 no.4
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• pp.369-377
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• 2023

Background: In this study, we investigated the potential use of keratin for oral tissue regeneration. Keratin is well-known for its effectiveness in skin regeneration by promoting keratinization and enhancing the elasticity and activity of fibroblasts. Because of its structural stability, high storability, biocompatibility, and safety in humans, existing research has predominantly focused on its role in skin wound healing. Herein, we propose using keratin proteins as biocompatible materials for dental applications. Methods: To assess the suitability of alpha-keratin protein as a substrate for cell culture, keratin was extracted from human hair via PEGylation. Viabilities of primary human gingival fibroblasts (HGFs) and human oral keratinocytes (HOKs) were assessed. Fluorescence immunostaining and migration assays were conducted using a fluorescence microscope and confocal laser scanning microscope. Wound healing and migration assays were performed using automated software to analyze the experimental readout and gap closure rate. Results: We confirmed the extraction of alpha-keratin and formation of the PEG-g-keratin complex. Treatment of HGFs with keratin protein at a concentration of 5 mg/ml promoted proliferation and maintained cell viability in the test group compared to the control group. HOKs treated with 5 mg/ml keratin exhibited a slight decrease in cell proliferation and activity after 48 hours compared to the untreated group, followed by an increase after 72 hours. Wound healing and migration assays revealed rapid closure of the area covered by HOKs over time following keratin treatment. Additionally, HOKs exhibited changes in cell morphology and increased the expression of the mesenchymal marker vimentin. Conclusion: Our study demonstrated the potential of hair keratin for soft tissue regeneration, with potential future applications in clinical settings for wound healing.

• Archives of Plastic Surgery
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• v.37 no.3
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• pp.227-232
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• 2010

Purpose: Continuous irrigation method is an important step in managing wound infection. V.A.C. devices have been used in intractable wounds for reducing discharge, improving local blood flow, and promoting healthy granulation tissue. We expect synergistic effects of reduced infection and more satisfactory, accelerated wound healing when using both methods simultaneously. This study evaluated continuous irrigation combined with V.A.C. appliance for treatment of infected chronic wounds. Methods: We reviewed data from 17 patients with infected intractable chronic wounds. V.A.C. device (Group A) was used in 9 patients, and V.A.C. with antibiotics irrigation (Group B) was used in 8 patients. We placed Mepitel$^{(R)}$ on the surface of wound and placed an irrigation and aspiration tube on each side. A sponge was placed on the Mepitel$^{(R)}$ and covered with film dressing. The wound was irrigated continuously with mixed antibiotics solution at the speed of 200 cc/hr and aspirated through the wall suction at the pressure of -125 mmHg. V.A.C. applied time, wound culture and wound size were compared between the two groups. Results: No complication were seen in two groups. Compared with Group A, in the Group B, V.A.C. applied time was shortened from 32.7 days to 25.6 days and showed efficacy in the reduction rate of wound size. No statistical differences were shown in bacterial reversion. Conclusion: V.A.C. appliance with continuous irrigation is an effective new method of managing infected chronic wounds and useful to reduce treatment duration and decrease wound size. Moreover it could be applied more widely to infected wound.

• Journal of Korean Society of Forest Science
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• v.99 no.2
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• pp.226-234
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• 2010

This study was conducted to examine the effects of pruning season on the compartmentalization of pruning wounds in Acer palmatum and Pinus strobus. A total of eighty five field-grown trees for each species were allocated to five different seasons, early- and late-winter, mid-spring, mid- and late-summer, for pruning treatments. Wound closure rate (WCR) of the two species for one year after treatment, area of discolored stem tissue on the medial longitudinal surface and cambial dieback length under the pruning wound of A. palmatum were measured. Changes of total phenols and variations of extractives, holocellulose and lignin at the treated branch unions were examined. In WCR of A. palmatum, late-winter (March, 39.8%) and mid-spring (May, 39.7%) were higher than any other seasons, while early-winter (November, 28.4%) was significantly lower than late-winter and mid-spring. P. strobus showed similar results with A. palmatum. The WCR of early-winter (57.2%) was the lowest significantly among the five seasons, and mid-spring (73.5%) and late-winter (71.4%) showed higher a WCR than other seasons. In the discolored/wound area ratio of A. palmatum, early-winter (73.2%) was the highest by far, and mid- (July) and latesummer (September, 36.7%, respectively) were the lowest among the five seasons. In the length of cambial dieback, two dormant seasons, early- and late-winter were longer than any other seasons. Phenol contents at the treated branch union were changed in line with the seasonal fluctuation of the tree. Total phenols in the below core of the treated union were higher than those of the branch union with living branch, while little differences were seen in the above core. At the branch core of the treated union, phenols of A. palmatum decreased one month after the treatments, but P. strobus maintained similar to or a little higher than those at the controls. The major changes in chemical composition at pruning wounds were extractives and lignin increased by less than 20% in A. palmatum, while extractives in P. strobus remarkably increased by 70%.