• 제목/요약/키워드: Chronic wound

검색결과 187건 처리시간 0.027초

증례 보고: 병변 내 자가 혈소판풍부혈장 주사로 효과적으로 재생된 만성화된 Wagner Grade 2 당뇨발 궤양 1예 (Intralesional Injection of Autologous Platelet-Rich Plasma as an Effective Regeneration Therapy: A Case Report of Chronic Wagner Grade 2 Diabetic Foot Ulcer)

  • 김문희
    • 대한족부족관절학회지
    • /
    • 제26권4호
    • /
    • pp.187-191
    • /
    • 2022
  • The author experienced a case of autologous platelet-rich plasma (PRP) affecting the recovery of a chronic neuropathic diabetic foot ulcer combined with infection. A 65-year-aged male with uncontrolled diabetes presented with a Wagner grade 2 diabetic foot ulcer on his left forefoot of more than 2 weeks duration. Osteomyelitis, gangrene, and ischemia requiring acute intervention were absent. Although infection was controlled to a moderate degree, wound healing was unsatisfactory following surgical debridement and simple dressing. Therefore, intralesional autologous PRP injection was performed 5 times as an adjuvant regeneration therapy, and the recalcitrant ulcer healed in 3 months. Intralesional PRP injections are worthwhile as they promote wound regeneration, are evidence-based, safe, and can be easily performed in ambulatory care facilities.

Proliferation of Keratinocytes Induced by Adipose-Derived Stem Cells on a Chitosan Scaffold and Its Role in Wound Healing, a Review

  • Gomathysankar, Sankaralakshmi;Halim, Ahmad Sukari;Yaacob, Nik Soriani
    • Archives of Plastic Surgery
    • /
    • 제41권5호
    • /
    • pp.452-457
    • /
    • 2014
  • In the field of tissue engineering and reconstruction, the development of efficient biomaterial is in high demand to achieve uncomplicated wound healing. Chronic wounds and excessive scarring are the major complications of tissue repair and, as this inadequate healing continues to increase, novel therapies and treatments for dysfunctional skin repair and reconstruction are important. This paper reviews the various aspects of the complications related to wound healing and focuses on chitosan because of its unique function in accelerating wound healing. The proliferation of keratinocytes is essential for wound closure, and adipose-derived stem cells play a significant role in wound healing. Thus, chitosan in combination with keratinocytes and adipose-derived stem cells may act as a vehicle for delivering cells, which would increase the proliferation of keratinocytes and help complete recovery from injuries.

만성 하지 골수염에 시행한 유리 근 이식술 (Free Muscle Transplantation of the Chronic Lower Extremity Osteomyelitis)

  • 이준모;허달영
    • Archives of Reconstructive Microsurgery
    • /
    • 제8권2호
    • /
    • pp.176-183
    • /
    • 1999
  • 전북대학교병원 정형외과에서 1993년 12월부터 1998년 9월까지 하지의 만성 골수염 7례에 대하여 유리 근 피판 이식술을 시행하고 최소 1년 2개월부터 최장 5년 3개월까지 추시하여 다음과 같은 임상적 결과를 얻었다. 1. 만성 골수염의 발생 부위는 경골이 4례, 종골 2례 그리고 대퇴골이 1례였다. 2. 만성 골수염의 지속 기간은 평균 31.6년이었다. 3. 전체 7례 중 1례에서 편평 상피암이 발병되었다. 4. 만성 골수염은 4례에서 혈행성 감염으로 초래되었고, 3례는 외상력이 있었는데 2례는 교통사고 그리고 1례는 경미한 외상이었다. 5. 치료는 부골 제거술과 유리 근 이식술을 시행하였던 예가 2례, 부골 제거술없이 유리 근 이식술을 시행한 예가 5례였다. 6. 전체 7례 중 6례에서 유리 근 이식술을 시행하였고 1례에서 유리 근피판 이식술을 시행하였는데 복직 근이 4례였고, 광배 피판, 광배 근피판 그리고 박근이 각각 1례씩이었으며 7례 중 6례(85.7%)에서 생존하였다. 7. 대퇴부에 시행하였던 광배 근피판 1례는 정맥이식술을 통한 단측 문합술을 시행하였으나 술 후 2일째부터 허혈성 변화를 일으켜 실패하였으며, 외상으로 인한 종골 1례에서는 복직근 이식술이 성공하였으나, 술 후 심한 외상성 족관절염으로 인한 극심한 통증으로 슬관절 하부 절단술이 시행되었다.

  • PDF

생물막 분산기작을 이용한 만성창상의 치료전략 (Therapeutic strategies to manage chronic wounds by using biofilm dispersal mechanisms)

  • 김재수;김민호
    • 미생물학회지
    • /
    • 제55권2호
    • /
    • pp.87-102
    • /
    • 2019
  • 대부분의 만성창상(chronic wounds)은 생물막으로 인해 상처 치유시 염증단계를 지속시킨다. 생물막은 항생제(antibiotics)에 대한 저항성을 가지며 침투력을 저하시키고 살균제(biocides)에 대한 내성을 지니며 국소면역반응을 약화시킨다. 또한 생물막은 주변의 조직에 단단히 붙어 있어 제거하는 작업이 매우 어렵다. 그러므로 주변 조직을 손상시키지 않으면서 단단한 생물막을 제거하는 전략은 매우 중요하다. 그 중에 하나가 분산기작을 이용한 생물막의 해체이며 지금까지 많은 연구가 수행되어 왔다. 본 고찰논문에서는 특별히 화학주성, 파지요법, 다당류, 다양한 효소(당분해효소, 단백질분해효소, DNA 분해효소), 계면활성제, 분산신호, 자기유도인자, 조절인자, 억제제 등이 소개되었으며 더 나아가 항생제 치료 및 다른 치료와의 병행을 통한 병합요법도 소개되었다. 앞으로 본 논문에서 제시된 생물막의 분산기작의 지식을 이용하여 만성 창상 감염치료의 가능성이 더 높아지길 기대한다.

고압전기화상 환자에서 손바닥에 비골동맥천공지유리피판수술과 등의 이물질제거수술: 증례 보고 (Peroneal Artery Perforator Free Flap on the Palm and Removal of Back Foreign Body in High Voltage Electrical Burn Patient: A Case Report)

  • 정승원;이승제
    • 대한화상학회지
    • /
    • 제22권2호
    • /
    • pp.58-65
    • /
    • 2019
  • Wound caused by high-tension electrical burns is difficult to manage because the wound is deep and complex. The wound is progressively necrotic due to microvascular injury resulting in deep tissue exposure. So, coverage of the wound at the entry point and the exit point is cumbersome, often requiring flap coverage. We experienced a case of one patient for peroneal artery perforator free flap coverage on the palm of the right hand of the entry point of electrical burn. The left foot wound of electrical exit point was covered by full thickness skin graft. Also a small wound was on the left side of the lower back was the exit point of electrical burn. The lower back wound was healed and recurred repeatedly after burn. On postburn day 6 month, through the radiologic exam, metal shadow was identified in the left gluteus muscle forming chronic sinus. We explored the wound of sinus and a foreign body was identified in the sac as multi braid wires thin as hair. According to the patient's past history, we suspected that the back wound was caused by electrical burn injury through the wires.

Effects of Danggwieumja on the Healing of Full-Thickness Skin Injury in Rat

  • Kim, Bum-Hoi
    • 동의생리병리학회지
    • /
    • 제25권5호
    • /
    • pp.887-893
    • /
    • 2011
  • The purpose of this study was to investigate the wound healing effects of Danggwieumja (DG), which is commonly used for skin inflammation, skin wound, skin pruritus, and chronic hives etc. The 1.5 cm ${\times}$ 1.5 cm full-thickness skin wound was induced to two groups, DG (n=16) and Saline (n=16) group. The DG extract and Saline were orally administrated daily for 15 days after skin wound induction. Then, the body weight of rats and the congestion indices were daily measured for 15 days after skin wound induction. The wound contractions and epithelizations were also measured. The wound contractions were daily measured for 15 days after wound induction and wound epithelizations were measured for 8 days from day 7 after wound induction. For evaluating angiogenesis, the immunoreactivities of vWF and VEGF protein were measured immunohistochemistrically on day 15. In results, although the percentage increases in mean body weight of rats in the DG and Saline groups hve no significant differences, DG extract decreased the time of wound healing and congestion around wound, and improved wound contraction and epithelization. The contraction percentage of DG group was significantly increased on day 5 (P<0.05) and day 7 (P<0.01) than that of Saline group. DG group showed significant increase of wound epithelization on day 7 (P<0.05) as compared to Saline group. Moreover, DG extract reduced the inflammation of skin dermis and promoted the growth of vascular vessels of dermis by accelerating vascular endothelial growth factor (VEGF) protein. These results suggest that DG has the beneficial effects on skin incision wound and can be the suitable wound healing agent for various surgical wounds.

치유가 지연된 발치창에서 발생한 질환에 대한 임상적, 방사선학적, 조직병리학적 분석 (OLINICAL, RADIOLOGIC, AND HISTOPATHOLOGIC ANALYSIS OF DISEASES DEVELOPED IN DELAYED WOUND HEALING OF EXTRACTION SOCKET)

  • 장현선;김수관
    • Maxillofacial Plastic and Reconstructive Surgery
    • /
    • 제23권1호
    • /
    • pp.15-20
    • /
    • 2001
  • For the earlier diagnosis and treatment of delayed wound healing in extraction socket, we investigated the clinical, radiographic and histopathologic features of 106 patients with delayed wound healing diagnosed by biopsy. The patients were enrolled at the Department of Oral Pathology, Chosun University Dental Hospital. Among 106 delayed wound healing diagnosed by biopsy, cysts showed most significant 25 cases (23%), osteomyelitis showed 13 cases (12%), chronic maxillary sinusitis and squamous cell carcinoma showed 12 (11%) and 11 (10%) cases, respectively. We have analyzed these lesions through relevant literatures.

  • PDF

Wound Healing Consequences of Psychological Stress

  • Whitney, JoAnne D.;Heiner, Stacy
    • Perspectives in Nursing Science
    • /
    • 제2권1호
    • /
    • pp.48-60
    • /
    • 2005
  • The relationship of psychological stress to human health is of interest to health care providers and researchers in the field of psychoneuroimmunology. The effect of stress on wound healing is a sub-component of study within the larger context, with relevance to both wounds that are acute and chronic in nature. Data from several studies that explore the influence of stress on events early in the trajectory of wound healing suggest that activation of both the sympathetic nervous system and the hypothalamic-pituitary-adrenal axis are involved. There is consistent evidence that psychological stress is associated with dysregulation of immune and other responses to tissue injury that are required for healing and also to the final wound healing result. Current data pertinent to psychological stress and its wound healing consequences is reviewed and a biopsychosocial framework for future studies in this area is suggested and described.

  • PDF

Clinical effectiveness of omental transposition in facilitating perineal wound healing after abdominoperineal resection: a systematic review

  • Kim, Sungjin;Kang, Sung Il;Kim, Sohyun;Kim, Jae Hwang
    • Journal of Yeungnam Medical Science
    • /
    • 제38권3호
    • /
    • pp.219-224
    • /
    • 2021
  • Background: Omental transposition has been used to facilitate perineal wound healing in patients undergoing abdominoperineal resection (APR). However, there is no high-level evidence supporting the effectiveness of omental transposition in this regard. This study aimed to investigate the clinical efficacy of omental transposition in facilitating perineal wound healing after APR. Methods: In this systematic review, we systematically searched the PubMed/MEDLINE, Embase, Scopus, Cochrane Library, and Web of Science databases for literature regarding the topic of our study. Studies published since the inception of each database were considered for review. The outcomes of interest were the perineal wound healing rate at 1 and 3 months postoperatively, perineal wound infection rate, and perineal wound healing period. Results: Of the 1,923 studies identified, four articles representing 819 patients (omental transposition patients, n=295) were included in the final analysis. The wound healing rates at 1 and 3 months postoperatively in the omental transposition group (68.5% and 79.7%, respectively) did not significantly differ from those in the control group (57.4% and 78.7%, respectively) (p=0.759 and p=0.731, respectively). Perineal wound infection and chronic wound complication rates, including sinus, dehiscence, and fistula rates, also did not significantly differ between the omental transposition (8% and 7%, respectively) and control (11% and 7%, respectively) groups (p=0.221 and p=0.790, respectively). Conclusion: Our results suggest that omental transposition does not affect perineal wound healing in patients who undergo APR.

Therapeutic Effects of Amnion-Conjugated Chitosan-Alginate Membranes on Diabetic Wounds in an Induced Diabetic Swine Model: An In Vitro and In Vivo Study

  • Jeong, Woonhyeok;Hong, Jamin;Jung, Minho;Jang, Mijin;An, Sanghyun;Jo, Taehee;Kwon, Sunyoung;Son, Daegu
    • Archives of Plastic Surgery
    • /
    • 제49권2호
    • /
    • pp.258-265
    • /
    • 2022
  • Background Chitosan (CS) is a well-known antimicrobial dressing material. Moreover, widely used amniotic membranes contain growth factors beneficial for wound healing. Herein, we created a novel amnion-conjugated CS-alginate membrane dressing and tested its wound healing potency in a diabetic swine model. Methods The bovine amniotic powder growth factor contents were evaluated by protein assay, and the powder's wound healing effects were assessed in vitro by HaCaT cell scratch closure. In vivo, two minipigs developed streptozotocin-induced diabetes. Serial serum glucose measurements and intravenous glucose tolerance tests were performed to confirm their diabetic status. Twelve square-shaped wounds created on each pig's back were randomly divided into control (n = 4), CS (n = 4), and amnion-CS (AC; n = 4) groups and treated accordingly with different dressings. Wound healing in each group was assessed by measuring wound contraction over time, capturing wound perfusion with indocyanine green (ICG) angiography, and histologically analyzing inflammatory markers. Results Amniotic powder elution promoted HaCaT cell migration in the scratch wound model, suggesting its beneficial in vitro wound healing effects. In vivo, the CS and AC groups showed earlier wound contraction initiation and reepithelialization and earlier wound perfusion improvement by ICG angiography than the control group. Additionally, the wound size of the AC group at week 3 was significantly smaller than those in the control group. There was no significant difference in the numbers of acute and chronic inflammatory cells between the groups. Conclusion The amnion-conjugated CS-alginate membrane, as well as CS dressing alone, could be a favorable dressing option for diabetic wounds.