• 제목/요약/키워드: wound management

검색결과 318건 처리시간 0.026초

Is treatment with platelet-rich fibrin better than zinc oxide eugenol in cases of established dry socket for controlling pain, reducing inflammation, and improving wound healing?

  • Paul, Sam;Choudhury, Rupshikha;Kumari, Nandini;Rastogi, Sanjay;Sharma, Ashish;Singh, Vikas;Laskar, Shyamalendu;Dubey, Tushar
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제45권2호
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    • pp.76-82
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    • 2019
  • Objectives: To appraise the effectiveness of platelet-rich fibrin (PRF) in the management of established dry socket in terms of pain, inflammation, and wound healing. Materials and Methods: Two hundred patients with established alveolar osteitis were studied to determine the efficacy of PRF and zinc oxide eugenol (ZOE) for pain control, inflammation reduction, and wound healing. Patients were randomly allocated to Group A (PRF) or Group B (ZOE). Patients were examined on the 1st, 3rd, 7th, and 14th postoperative day and evaluated for pain using visual analogue scale scores, inflammation with a gingival index score, and wound healing through a determination of the number of bony walls exposed. Results: Group A showed better results in terms of pain remission, control of inflammation, and wound healing compared to Group B. Results between groups were statistically significant (P<0.05). Conclusion: PRF is a better alternative than ZOE for the effective management of alveolar osteitis.

창상 치료 시스템에 대한 선호도 및 만족도 조사 (A Preference and Satisfaction Survey on the Wound Management System)

  • 강윤경;홍아람;이병철;김도헌;서정훈
    • 대한화상학회지
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    • 제16권2호
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    • pp.99-103
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    • 2013
  • Purpose: The biggest problem of wound healing is a possible occurrence of lesion. Especially, in the case of patients who have a skin injury around exposed body parts, if their treatment period drag on for long time, they can suffer from aftereffects and the costs can be passed on to a society. Therefore, in this research, we investigated the need to develop the effective medicine and appliances for the patients by examining which therapy methods are being applying to the skin damage and what is the advantage and limit by evaluating the patient's satisfaction level. Methods: We carried out an online and offline survey targeting medical teams in order to analyze device for wound care. A total of 125 medical teams applied to the research, and investigate the level of customer satisfaction. Results: The moist dressings are the most used method for wound healing. When it comes to the level of customer satisfaction, biological dressing product also has a high satisfaction level. However its high cost tends to limit the use. Conclusion: This research reached a conclusion that it is need to develop a low cost and high efficiency wound care product considering the fact that its high cost and low efficiency induced economic problems. Generally, it is needed to develop a product for skin regeneration based on biological technologies, not a product just for damage cure.

Successful management of absent sternum in an infant using porcine acellular dermal matrix

  • Semlacher, Roy Alfred;Nuri, Muhammand A.K.
    • Archives of Plastic Surgery
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    • 제46권5호
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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.

A novel excisional wound pain model for evaluation of analgesics in rats

  • Parra, Sergio;Thanawala, Vaidehi J.;Rege, Ajay;Giles, Heather
    • The Korean Journal of Pain
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    • 제34권2호
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    • pp.165-175
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    • 2021
  • Background: Management of pain from open wounds is a growing unmet healthcare need. However, the models available to study pain from wounds or to develop analgesics for the patients suffering from them have primarily relied on incisional models. Here, we present the first characterized and validated model of open wound pain. Methods: Unilateral full-skin excisional punch biopsy wounds on rat hind paws were evaluated for evoked pain using withdrawal responses to mechanical and thermal stimulation, and spontaneous pain was measured using hind paw weight distribution and guarding behavior. Evaluations were done before wounding (baseline) and 2-96 hours post-wounding. The model was validated by testing the effects of buprenorphine and carprofen. Results: Pain responses to all tests increased within 2 hours post-wounding and were sustained for at least 4 days. Buprenorphine caused a reversal of all four pain responses at 1 and 4 hours post-treatment compared to 0.9% saline (P < 0.001). Carprofen decreased the pain response to thermal stimulation at 1 (P ≤ 0.049) and 4 hours (P < 0.011) post-treatment compared to 0.9% saline, but not to mechanical stimulation. Conclusions: This is the first well-characterized and validated model of pain from open wounds and will allow study of the pathophysiology of pain in open wounds and the development of wound-specific analgesics.

Immunomodulatory properties of medicinal maggots Lucilia sericata in wound healing process

  • Bohova, Jana;Majtan, Juraj;Takac, Peter
    • 셀메드
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    • 제2권3호
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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.

만성 감염성 창상에 대한 변형 음압요법과 은이온 제재의 이용 (Application of Modified Vacuum Assisted Closure with Silver Materials in Chronic Infected Wound)

  • 박건욱;정재호
    • Archives of Plastic Surgery
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    • 제35권4호
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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.

Resin Flow, Symptom Development, and Lignin Biosynthesis of Two Pine Species in Response to Wounding and Inoculation with Fusarium circinatum

  • Kim, Ki-Woo;Lee, In-Jung;Kim, Chang-Soo;Eom, In-Yong;Choi, Joon-Weon;Lee, Don-Koo;Park, Eun-Woo
    • The Plant Pathology Journal
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    • 제26권4호
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    • pp.394-401
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    • 2010
  • Resin flow, symptom development, and lignin biosynthesis in response to wounding and fungal inoculation were investigated in Pinus rigida and Pinus densiflora. The two-year-old seedling stems were subjected to three types of treatments: (i) wounding without inoculation, (ii) wound-inoculation with a conidial suspension of Fusarium circinatum, and (iii) pre-wounding woundinoculation with the fungus 20 days after the initial wounding. Resin flow from wounding sites was more evident in P. rigida than P. densiflora in all treatments. The wound-inoculation with the fungus induced almost two-fold higher levels of resin flow than the other treatments in both species. The pre-wounding woundinoculation appeared to result in a decrease in pitch canker development in the two pine species. Some reductions in disease severity were observed in the prewounding wound-inoculated P. rigida, showing a mean disease severity of less than 85%, compared with approximately 100% in the wound-inoculated stems. Disease severity was approximately 50% in the woundinoculated P. densiflora, whereas 10% in the pre-wounding wound-inoculated stems. Higher amounts of lignin were found from bark (ca. 40%) than from xylem (ca. 30%). The wound-inoculated bark and the pre-wounding wound-inoculated bark exhibited higher amounts of lignin among the other treatments. These results suggest that the wound-inoculation apparently prompt the increase in resin flow and lignin biosynthesis from the two pine species, and the prior wounding may be involved in decreased disease severity against the further invasion of F. circinatum.

근육편에 의한 정중 흉골절개 감염의 치료 -5례 치험- (Management of Infected Median Sternotomy Wound by Muscle Flap -5 cases-)

  • 김형곤;조선환;최종범
    • Journal of Chest Surgery
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    • 제27권7호
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    • pp.634-638
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    • 1994
  • Infection of a median sternotomy incision may result in a large, unsightly,unstable,and potentially fatal wound. During the past 8 years, 5 consecutive patients [ 4 male and 1 female ] had repair of infected sternotomy wound. We describe our current preferred techniques and the results we have achieved with them. As soon as the sternal infection was shown, operative wound was opened and irrigated more than 4 times a day with 0.5% Betadine iodine solution until the exudate became clean with no growth of bacteria. Operation was performed in one-stage, which consisted of aggressive debridement of the infected bone and muscle transposition. Reconstruction was with one-side or both pectoralis flaps in all patients and rectus abdominis in 2 patients. There was no mortality or morbidity within 30 days postoperatively. We conclude that early aggressive debridement and muscle transposition remain the treatment of choice for most patients with infected median sternotomy wounds.

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측두 부위의 총상 환자에 대한 처치: 증례보고 (Management of a Gunshot Wound at the Temporal Region: Case Report)

  • 이주민;안경용;신상훈
    • Maxillofacial Plastic and Reconstructive Surgery
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    • 제34권1호
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    • pp.81-84
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    • 2012
  • Gunshot wounds are unpredictable and require early, precise diagnosis and treatment. A penetrating gunshot wound can be fatal due to compromised airway, hypovolemic shock, lead poisoning and infection. This case report describes a 48-year-old male patient who had a suicidal gunshot wound on the right temporomandibular joint area using an air rifle. We successfully managed the patient by preoperative embolization, surgical removal of the foreign body and primary closure.

만성 창상의 치료에서 이동식 음압요법의 신고안 (The Management of Chronic Wound with Modified Portable Negative Pressure Therapy)

  • 김지수;윤인모;유중석
    • Archives of Plastic Surgery
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    • 제35권2호
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    • pp.223-228
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    • 2008
  • Purpose: V.A.C. is a new concept which is closed dressing with negative pressure to promote wound healing. It has been widely used as the treatment of chronic and acute wounds such as pressure sores, burns, stasis ulcers, and other complicated wounds. However It has disadvantages such as high cost and the need of specific equipment. In this article, we described new method to overcome these disadvantages. Methods: We made newly innovated equipment with 50 cc syringe and spring to create negative pressure. From May 2006 to May 2007, we applied it to two patients with chronic wound. Results: The treatment period was 5 weeks for one case and 3 weeks for the other case. Both patients were healed completely without admission and wound healing was accelerated. During follow-ups, there were no complications. The mean cost for single dressing was 9,590 won. Conclusion: Modified portable negative therapy using newly innovated equipment could accelerate wound healing better than conventional dressing. It lowers the number of dressings, saves cost of treatment, and enables treatment as outpatient basis.