• Archives of Reconstructive Microsurgery
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• v.17 no.1
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• pp.28-35
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• 2008

The purpose of this study was to present the clinical analysis of the results of lateral arm free flap for small sized and infected diabetic foot ulcer around toes. From May 2006 to December 2007, Seven patients were included in our study. Average age was 52.8 years, six were males and one was female. All had infected diabetic foot ulcer and had exposures of bone or tendon structures. Ulcers were located around great toe in four patients, 4th toe in one and 5th toe in two. Three patients had osteomyelitis of metatarsal or phalanx. After appropriate control of infection by serial wound debridement and intravenous antibiotics, lateral arm flap was applied to cover remained soft tissue defects. Posterior radial collateral artery of lateral arm flap was reanastomosed to dorsalis pedis artery of recipient foot by end to side technique in all cases in order to preserve already compromised artery of diabetic foot. All flaps were designed over lateral epicondyle to get longer pedicle and averaged pedicle length was 8 cm. Two cases were used as a sensate flap to achieve protective sensation of foot. All flaps survived and provided satisfactory coverage of soft tissue defects on diabetc foot ulcers. All patients could achieve full weight-bearing ambulation. No patients has had recurrence of infection, ulceration and further toe amputations. There were three complications, a delayed wound healing of flap with surrounding tissue, a partial peripheral loss of flap and a numbness of forearm below donor site. All patients were satisfied with their clinical results, especially preserving their toes and could return to the previous activity levels. Lateral arm free flap could be recommend for infected diabetic foot ulcers around toes, to preserve toes, coverage of soft tissue defect and control of infection with low donor site morbidity.

• Biomedical Science Letters
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• v.6 no.2
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• pp.119-129
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• 2000

The skin is an organ that has many important roles, including protection against infection, regulation of temperature and fluid loss, and sensory function. Injury to the skin, wound repair normally involves: (1) balanced activity of inflammation, (2) the re-epithelial phase and (3) the matrix formation of remodeling phase. Thus, skin wound healing is a finely controlled biological process involving a series of complex cellular interactions. Laser therapy is being implemented with increasing frequency in medicine. Low intensity laser is one that is capable of producing an energy density so low that any biologic alterations are the result of direct irradiation effect, not thermal events. This study was designed to evaluate the efficacy of low intensity laser therapy on skin wound healing in rabbits. A total of 10 male rabbits (New Zealand White Rabbit), age 8 weeks were used. Skin wound were surgically created dorso-lateral on the flank of 10 rabbits (2$\times$2 cm/damage areas). The experimental animals were treated with 5Hz (830 nm wave length) low-intensity laser (MILTA-01 Model) daily for 10 min (1.6 J/$cm^2$) for 12 days. Control animals were sham treated with the laser head. Laser irradiation animals showed a complete remodeling of the epithelial layer, a positive repair of connective tissues, and enhanced the wound closure rate over time as compared to the control animals. Especially, laser irradiation groups improved fibroblast activity, cellular content, granulation tissue formation, and collagen deposition which is resulted in improving the tensile strength of the wound. These findings suggest that laser photostimulation could accelerate healing of open wound in rabbits, and may be benefit in the treatment of open wound, including decubitis ulcers.

• Natural Product Sciences
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• v.25 no.1
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• pp.38-43
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• 2019

Microbial wound infection prolonged the hospitalization and increase the cost for wound management. Silver is commonly used as antimicrobial wound dressing. However, it causes several adverse side effects. Hence, this study was aimed to evaluate the antimicrobial efficiency of Swietenia macrophylla seed extract on clinical wound pathogens. Besides, the bioactive constituents of the seed extract were also determined. S. macrophylla seeds were extracted with methanol by maceration method. The seed extract inhibited 5 test bacteria and 1 yeast on disc diffusion assay. The antibacterial activity was broad spectrum, as the extract inhibited both Gram positive and Gram negative bacteria. On kill curve analysis, the antibacterial activity of the seed extract was concentration-dependent, the increase of extract concentration resulted in more reduction of bacterial growth. The extract also caused 99.9% growth reduction of Bacillus subtilis relative to control. A total of 21 compounds were detected in gas chromatography- mass spectrometry analysis. The predominant compounds present in the extract were oleic acid (18.56%) and linoleic acid (17.72%). In conclusion, the methanolic extract of S. macrophylla seeds exhibited significant antimicrobial activity on clinical wound pathogens. Further investigations should be conducted to purify other bioactive compounds from the seeds of S. macrophylla.

• Archives of Plastic Surgery
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• v.46 no.6
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• pp.544-549
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• 2019

Background As the indications for postmastectomy radiotherapy expand, innovative solutions are required to reduce operative complications and reconstructive failure after prosthetic breast reconstruction. In this study, we investigated the effectiveness of acellular dermal matrix (ADM) inlay grafts in preventing postoperative wound dehiscence of irradiated breasts in the context of prosthetic breast reconstruction. Methods A retrospective analysis was conducted of 45 patients who received two-stage prosthetic reconstruction and radiotherapy following mastectomy. An ADM graft was placed beneath the incisional site during the second-stage operation in 19 patients using marionette sutures, whereas the control group did not receive the ADM reinforcement. Patient demographics and complications such as wound dehiscence, capsular contracture, peri-prosthetic infection, cellulitis, and seroma were compared between the two groups. Results During an average follow-up period of 37.1 months, wound dehiscence occurred significantly less often in the ADM-reinforced closure group (0%) than in the non-ADM group (23.1%) (P=0.032). There was no significant difference between the two groups in relation to other complications, such as capsular contracture, postoperative infection, or seroma. Conclusions The ADM inlay graft is a simple and easily reproducible technique for preventing incisional dehiscence in the setting of radiotherapy after prosthetic breast reconstruction. The ADM graft serves as a buttress to offload tension during healing and provides a mechanical barrier against pathogens. Application of this technique may serve to reduce complications in prosthetic breast reconstruction after radiotherapy.

• Journal of Veterinary Clinics
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• v.30 no.6
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• pp.403-408
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• 2013

The objective of the present study is to detect the effect of ${\beta}$-glucan originated from Aureobasidium on the proliferation and collagen production in human dermal fibroblast cells with wound repopulation in vitro. The proliferative effects were assessed using a MTT assay as well as cell counts at 24 and 48 hr after treatment. Hydroxyproline was measured as an index of procollagen production with reverse-phase high pressure liquid chromatography. Oncostatin M was used as a reference agent. In glucagon treated group, dose-dependent and significant increase of optical density or fibroblast cell numbers was demonstrated, when compared with those of control from 0.1 mg/ml concentration. In addition, the numbers of cells which had migrated into the wound defects were more significantly and dose-dependently increased than those of non-treated control. However, no meaningful effects on the procollagen production were observed.

• Journal of Pharmaceutical Investigation
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• v.32 no.2
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• pp.113-117
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• 2002

Cyto-toxic effect of silver sulfadiazine (Ag-SD) on keratinocytes and its implication on wound healing process were investigated in $2^{nd}$ degree bum hairless mouse model. As a dermal model, HaCat (immortalized keratinocytes) monolayer culture in DMEM with 10% FBS was used. Cyto-toxicity of Ag-SD was estimated by measuring the cell viability using neutral red assay after adding the drug. The $2^{nd}$ degree bum was prepared on hairless mouse back skin (1 cm diameter) and dressings with Ag-SD were applied for 96 hr. The process of re-epithelialization and the presence of inflammatory cells were investigated and histology with Hematoxylin-Eosin staining was performed. Ag-SD displayed highly cyto-toxic effect on cultured HaCat cells in a concentration dependent manner $(1-100\;{\mu}g/mL)$. Topical application of Ag-SD (2%) could control the infection: no inflammatory cells were observed in histology. However the cyto-toxic effect of Ag-SD on skin cells induced the impairment in epidermal regeneration.

• Biomedical Science Letters
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• v.15 no.3
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• pp.233-239
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• 2009

The aim of this study was to evaluate the photodynamic effect of various photosensitizing agents against methicillin-resistant Staphylococcus aureus (MRSA). MRSA was exposed to light from a 632 urn diode laser (15 J/$cm^2$) in the presence of various photosensitizer, such as photofrin, photogem, radachlorine and ALA. In vivo study was performed using ICR mice. Twenty eight mice had a standard wound ($100\;mm^2$) created on the dorsum, and MRSA was inoculated into the wound region. The four groups were classified as follows: (1) the untreated control group (bacteria alone), (2) the bacteria plus light group (15 J/$cm^2$), (3) the bacteria plus photofrin group (kept in the dark), and (4) the photodynamic therapy (PDT) group (bacteria, photofrin, and light). After photofrin (dose 1 mg/kg) injection, the experimental group was irradiated with 632 urn diode laser (15 J/$cm^2$) for 30 minutes after In vitro results of PDT showed the complete killing of MRSA at the photofrin, radachlorine, and photogem However, ALA-PDT was ineffective on MRSA viability. In vivo results showed that photofrin has therapeutic effect on the wound infection. These results demonstrate that selective lethal photosensitization of MRSA can be achieved using phofrin, photogem and radachlorin. Thus, PDT can inactivate MRSA survival.

• Archives of Plastic Surgery
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• v.37 no.2
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• pp.115-121
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• 2010

Purpose: Many topical agents had been used for contaminated wound treatment. Although antimicrobial ointments were widely used as topical agents, their comparative antibacterial and wound healing effects were largely unreported. The purpose of this study was to compare antibacterial effects and wound healing effects of common topical ointments on infected full thickness skin defect in the mouse. Methods: One full thickness skin defects in the mice (n=60) were developed on the back and left open for twenty-four hours. Sixty mice were divided into four groups: group B (dressing with Bactroban$^{(R)}$, n=15), group I (dressing with Iodosorb$^{(R)}$, n=15), group T (dressing with Terramycin$^{(R)}$, n=15), group G (control group, dressing with dry gauze, n=15). The size of wound defects and the grades of wound healing were evaluated at 4, 7, 10 days, and antibacterial effect was evaluated with restricted zone in Mueller Hinton agar by disk diffusion method. After the wound was left open for twenty-four hours, many Staphylococcus aureus was cultured. The wound defect size was decreased in order of Bactroban$^{(R)}$ (B), Iodosorb$^{(R)}$ (I), Terramycin$^{(R)}$ and gauze dressing group in all days, but difference among experimental groups was not statistically significant. The grade score of wound healing was increased in order of Bactroban$^{(R)}$, Iodosorb$^{(R)}$, Terramycin$^{(R)}$ and gauze dressing group, and the difference was statistically significant. Antibacterial effect for was increased in order of Bactroban$^{(R)}$, Iodosorb$^{(R)}$, Terramycin$^{(R)}$ and gauze dressing group, and the difference was statistically significant. Conclusion: Topical antimicrobial ointments application was effective against wound infections by S. aureus. Bactroban$^{(R)}$ may be an optimal topical treatment for infected wounds according to this study. However, further study is necessary to evaluate the clinical efficacy of antimicrobial ointments and to search for the mechanisms that explain their effects.

• Journal of Gastric Cancer
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• v.24 no.1
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• pp.108-121
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• 2024

Anastomotic leaks and fistulas are significant complications of gastric surgery that potentially lead to increased postoperative morbidity and mortality. Surgical intervention is reserved for cases with severe symptoms or hemodynamic instability; however, surgery carries a higher risk of complications. With advancements in endoscopic treatment options, endoscopic approaches have emerged as the primary choice for managing these complications. Endoscopic clipping is a traditional method comprising 2 main categories: through-the-scope clips and over-the-scope clips. Through-the-scope clips are user friendly and adaptable to various clinical scenarios, whereas over-the-scope clips can close larger defects. Another promising approach is endoscopic stent insertion, which has shown a high success rate for leak closure, although vigilant monitoring is required to monitor stent migration. Infection control is essential in post-surgical leakage cases, and endoscopic internal drainage provides a relatively safe and noninvasive means to manage fluids, contributing to infection control and wound healing promotion. Endoscopic suturing offers full-thickness wound closure, but requires additional training and endoscopic versatility. As a promising tool, endoscopic vacuum therapy potentially surpasses stent therapy by draining inflammatory materials and closing defects. Furthermore, the use of tissue sealants, such as fibrin glue and cyanoacrylate, has been reported to be effective in selected situations. The choice of endoscopic device should be tailored to individual cases and specific patient conditions, with careful consideration of the nature of the defect. Further extensive studies involving larger patient populations are required to provide more robust evidence on the efficacy of endoscopic approach in managing post-gastric anastomotic leaks.

• Research in Plant Disease
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• v.20 no.2
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• pp.71-78
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• 2014

Gamma irradiation and its convergence with nano-silver particles and sodium dichloroisocyanurate (NaDCC) were investigated to inhibit germination and mycelial growth of Botrytis elliptica, the pathogen of lily leaf blight. In addition, the same treatments were studied on the process of disease development with detached leaf of lily cv. Siberia. Spray inoculation, which is closer to natural infection than wound inoculation, can be a way to investigate infection ability of the treated pathogen. The irradiating dose required to reduce the population by 90%, $D_{10}$, was 526 Gy irradiating with 0-2000 Gy gamma ray on the conidial suspension as well as the growing mycelia. Even at 2000 Gy, the mycelium was not killed but just delayed its growth at 1-2 days behind. Convergent treatment with 40 mg/l of NaDCC just before 200 Gy gamma irradiation was the best way to decrease the conidial germination about 1/1000 times. The control values of gamma irradiation were 23% and 19.5% at wound inoculation and spray inoculation, respectively. On wound-inoculation, the control value of NaDCC only was 89%, and that of NaDCC convergent with 200 Gy gamma irradiation was 32%. On sprayinoculation, the highest control value was NaDCC at 50%, and that of NaDCC convergent with gamma irradiation was 24%.