The treatment of wounds of the lower extremity caused by diabetes or vascular dysfunction remains a difficult problem for the plastic surgeon. The use of negative pressure in wound healing is a relatively new method to facilitate chronic wound healing by secondary healing. The use of vacuum-assisted closure(VAC) system is purposed to reduce local edema, increase regional blood flow, enhance epithelial migration, preserve a moist wound environment, reduce bacterial colonization, promote granulation tissue formation, and mechanically enhance wound closure. The VAC also can be used as a dressing for anchoring an applied split thickness skin graft. We reviewed the data from 20 consecutive patients with non-healing wound in lower extremity at Dong-A University from March 2002 to December 2004. We used the VAC in 20 patients and compared the results with the control group. In the VAC using group, mean application duration was about 3 weeks and dressing change was done every other day. The follow-up period of patients ranged from 3 months to 30 months with a mean of 17 months. The points of comparison with control group are wound size, granulation tissue proliferation rate, operation method, preoperative time, postoperative healing time, complication, and cost. With those points, we propose to approve the efficiency of the VAC in non-healing wound. As a result, the VAC used in non-healing wound decrease wound size, accelerate granulation tissue formation, do a wound closure with less invasive operation method, make less postoperative complication, can make operation time shorter. Therefore it is cost effect. Our results demonstrate the usefulness of VAC as an adjunct in management of chronic wounds with other extrinsic factors.
Objectives The aim of this study is to evaluate the fracture healing effect of Jinmu-tang (JM) on femur fractured rats. Methods Rats were randomly divided into 5 groups (normal, control, positive control, JM extract with low concentration and JM extract with high concentration). All group except normal group went through both femur fracture. Normal and control group received no treatment at all. Positive control group were medicated with tramadol (20 mg/kg) once a day for 14 days. Experimental group was orally medicated with JM extract (10 mg/kg for low concentration, 50 mg/kg for high concentration) once a day for 14 days. In order to investigate fracture healing process, plasma and serum were obtained. Also, micro-computed tomography was conducted to see the frature site visually. Immunohistochemistry for transforming growth factor-β1, Ki67, alkaline phosphatase, runt-related transcription factor 2, receptor activator of nuclear factor kappa-β, tartrate resistant acid phosphatase was conducted to observe bone healing progress after 14 days since fracture occured. Aspartate aminotransferase, alanine aminotransferase, blood urea nitrogen and creatinine levels were measured in plasma, for hepatotoxicity and nephrotoxicity of JM extract. Osteocalcin was measured to observe activity of osteoblast. Results Through Micro-CT, more fracture healing was observed on both experimental group than control and positive control group. Through Hematoxylin & Eosin and safranin O staining showed bone cell proliferation and bone formation in the experimental group. RANK was significantly increased in the experimental groups. JM with high concentration showed statistically significant of TGF-β and Osteocalcin. NO, TRAP and ALP were not significantly changed. Liver toxicity was not significantly observed. Creatinine significantly increased in both experimental groups after 28 days. Conclusions As described above, JM extract showed anti-inflammatory effect, promoted fracture healing by stimulating the bone regeneration factor, and showed little hepatotoxicity and nephrotoxicity. In conclusion, JM extract can promote fracture healing and it can be used clinically to patients with fracture.
Kim, Seung-Kook;Shin, Jun-Jae;Kim, Tae-Hong;Shin, Hyung-Shik;Hwang, Yong-Soon;Park, Sang-Keun
Journal of Korean Neurosurgical Society
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제50권1호
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pp.17-22
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2011
Objective : In the present study, authors retrospectively reviewed the clinical outcomes of halo-vest immobilization (HVI) versus surgical fixation in patients with odontoid fracture after either non-surgical treatment (HVI) or with surgical fixation. Methods : From April 1997 to December 2008, we treated a total of 60 patients with upper cervical spine injuries. This study included 31 (51.7%) patients (22 men, 9 women; mean age, 39.3 years) with types II and III odontoid process fractures. The average follow-up was 25.1 months. We reviewed digital radiographs and analyzed images according to type of injury and treatment outcomes, following conservative treatment with HVI and surgical management with screw fixation. Results : There were a total of 31 cases of types II and III odontoid process fractures (21 odontoid type II fractures, 10 type III fractures). Fifteen patients underwent HVI (10 type II fractures, 5 type III fractures). Nine (60%) out of 15 patients who underwent HVI experienced successful healing of odontoid fractures. The mean period for bone healing was 20.2 weeks. Sixteen patients underwent surgery including anterior screw fixation (6 cases), posterior C1-2 screw fixation (8), and transarticular screw fixation (2) for healing the odontoid fractures (11 type II fractures, 5 type III fractures). Fifteen (93.8%) out of 16 patients who underwent surgery achieved healing of cervical fractures. The average bone healing time was 17.6 weeks. Conclusion : The overall healing rate was 60% after HVI and 93.8% with surgical management. Patients treated with surgery showed a higher fusion rate and shorter bony healing time than patients who received HVI. However, prospective studies are needed in the future to define better optimal treatment and cost-effective perspective for the treatment of odontoid fractures.
The wound healing process can be categorized as follows : inflammation, fibroplasia, neovascularization, collagen deposition, epithelialization, and wound contraction. During the healing process, various growth factors are secreted to accelerate wound healing. Previous studies have demonstrated that endogenous growth factors, such as vascular endothelial growth factor(VEGF) are the important regulatory polypeptides for coordinating the healing process. They are released from macrophages, fibroblasts, and keratinocytes at the site of injury and participate in the regulation of reepithelization, granulation tissue formation, collagen synthesis and neovascularization. Onchung-Um has been used clinically to treat various skin diseases. In addition, Onchung-Um has been also used for congestive inflammations. In the present study, we evaluated the effects of Onchung-Um on wound healing process and wound size reduction in rats. Full-thickness skin wounds ($15mm\;{\times}\;15mm$) were created on the back of rats. Rats were then divided into 2 groups : The Onchung-Um treated group that was orally administered with a dose of 193.9mg/100g of Onchung-Um extract per day for 15 days and Control group without Onchung-Um administration. Moreover, the histological changes and VEGF immunoexpressions of two groups were estimated. In results, wound closures were significantly accelerated by oral administration of Onchung-Um extract. Furthermore, in Onchung-Um treated group, there were significant increases in fibroblast migration, epithelialization compared with the Control group. VEGF expressions were also increased in Onchung-Um treated group. This study has therefore demonstrated the Onchung-Um can significantly improve the quality of wound healing and scar formation and the oral administration of Onchung-Um extract may increase early tissue angiogenesis in the incisional wound of an experimental animal model.
This review was conducted to investigate clinical trial trend, clinical effect, and study methods of forest healing. Literature search was performed using the search engines of eight electronic databases from inception to march 2010 without language limitation. The search terms were "forest healing", "forest experience", "forest therapy", "forest treatment", "clinical trial", and "clinical study". Inclusion criteria were randomized controlled trials (RCTs) among all kinds of study searched about forest healing. Selection literature and data extraction was performed by authors(SH Sun and SG Lee) independently. Total three studies were selected finally. The methodological quality in all study was low because of poor reporting. Study indications were metal health, depression, self-esteem, and stress. The scale of studies was very small, which was the level of pilot study. There were no description for obtaining informed consent and being reviewed by Institutional Review Board (IRB), and could be any problems for statistical method in any studies. It is difficult to accept the fact that each studies had the significant effect for study indications in the results of studies. It is concluded that the evidence that health healing have a significant effect is insufficient. Further systematic and methodological study and well-designed clinical trial will be needed.
Hui-Yeng Y. Yap;Mohammad Farhan Ariffeen Rosli;Soon-Hao Tan;Boon-Hong Kong;Shin-Yee Fung
Mycobiology
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제51권1호
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pp.1-15
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2023
Wound care has become increasingly important over the years. Various synthetic products for wound care treatment have been reported to cause toxic side effects and therefore natural products are in significant demand as they have minimal side effects. The presence of bioactive compounds in medicinal mushrooms contributes to various biological activities which assist in the early inflammatory phase, keratinocyte proliferation, and its migration enhancement which are pertinent to wound rehabilitation. Lignosus rhinocerus (tiger milk mushroom) can reduce the inflammation phase in wound healing by fighting off bacterial infection and modulating pro-inflammatory cytokines expression in the early stage to avoid prolonged inflammation and tissue damage. The antibacterial, immunomodulating, and anti-inflammatory activities exhibited by most macrofungi play a key role in enhancing wound healing. Several antibacterial and antifungal compounds sourced from traditional botanicals/-products may prevent further complications and reoccurrence of injury to a wounded site. Scientific studies are actively underway to ascertain the potential use of macrofungi as a wound healing agent.
Objective: The purpose of this study is to report the effects of Chukyu (spine-healing) pharmacopuncture treatment in patients with lumbago and skelalgia. Methods: This clinical study included 45 patients who were treated for lumbago and skelalgia at the Department of Acupuncture and Moxibustion, Dong-Eui University College of Oriental Medicine, from July 5, 2011, to January 31, 2012. Subjects were randomly divided into two groups: Chukyu (spine-healing)-pharmacopuncture-treated group (experimental group, n = 23) and normal saline-pharmacopuncture-treated group (control group, n = 22). Patients in the experimental group were treated with acupuncture and Chukyu (spine-healing) pharmacopuncture while those in the control group were treated with acupuncture and normal saline pharmacopuncture. To estimate the efficacy of controlling pain, we checked the visual analog scale [VAS], and to estimate the improvement of the symptoms, we evaluated by pain rating scale [PRS] and the Oswestry low-back pain disability index [ODI]. Results: A comparison of the experimental and the control groups showed more significant improvements in the VAS, PRS, and ODI for the experimental group than for the control group. Conclusions: Chukyu (spine-healing) pharmacopuncture can be used for effective treatment in patients with lumbago and skelalgia.
Gamma-aminobutyric acid (GABA) is a non-protein amino acid. It is well known for its role as an inhibitory neurotransmitter of developing and operating nervous systems in brains. In this study, a novel function of GABA in the healing process of cutaneous wounds was presented regarding anti-inflammation and fibroblast cell proliferation. The cell proliferation activity of GABA was verified through an MTT assay using murine fibroblast NIH3T3 cells. It was observed that GABA significantly inhibited the mRNA expression of iNOS, IL-$1{\beta}$, and TNF-${\alpha}$ in LPS-stimulated RAW 264.7 cells. To evaluate in vivo activity of GABA in wound healing, excisional open wounds were made on the dorsal sides of Sprague-Dawley rats under anesthesia, and the healing of the wounds was apparently assessed. The molecular aspects of the healing process were also investigated by hematoxylineosin staining of the healed skin, displaying the degrees of re-epithelialization and linear alignment of the granulation tissue, and immunostaining and RT-PCR analyses of fibroblast growth factor and platelet-derived growth factor, implying extracellular matrix synthesis and remodeling of the skin. The GABA treatment was effective to accelerate the healing process by suppressing inflammation and stimulating re-epithelialization, compared with the epidermal growth factor treatment. The healing effect of GABA was remarkable at the early stage of wound healing, which resulted in significant reduction of the whole healing period.
This study was carried out to investigate the wound healing effect of caffeic acid in skin-incised mice. Caffeic acid showed significant effects on anti-inflammatory activity and wound healing, such as myeloperoxidase activity, lipid peroxidation, phospholipase $A_2$ activity and collagen-like polymer synthesis, in incised-wound tissue. On the other hand, it significantly stimulated collagen-like polymer synthesis in NIH 3T3 fibroblast cells, while inhibited both silica-induced reactive oxygen species generation and melittin-induced arachidonic acid release and $PGE_2$ production in Raw 264.7 cells, and histamine release in RBL 2H3 cells stimulated by melittin or arachidonic acid. Therefore, caffeic acid appears to have a potent antioxidant and anti-inflammatory effect in cell culture system, which may be related to wound healing in skin-incised mice.
Objectives : The purpose of this study is to evaluate the wound healing potential of Glycyrrhiza uralensis extract. Methods : Free radical scavenging activity tests for DPPH, peroxynitrite (ONOO) and hydroxyl radical (${\cdot}OH$) and total phenolic contents of Glycyrrhiza uralensis extract were conducted. Tube formation assay was performed using human umbilical vein endothelial cells (HUVECs). Results : The results showed that Glycyrrhiza uralensis extract exerted inhibitory effects on ONOO and ${\cdot}OH$. Tube formation in HUVEC was increase in a dose dependent manner. Conclusions : These results show the potential to promote the wound healing process by Glycyrrhiza uralensis extract.
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