• Title/Summary/Keyword: Wounds

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Clinical Application of Maggots in Chronic Difficult Wounds (다루기 힘든 만성창상의 치료에 구더기를 이용한 임상적 적용)

  • Kim, Sug Won;Kang, Tae Jo
    • Archives of Plastic Surgery
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    • v.35 no.4
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    • pp.400-406
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    • 2008
  • Purpose: Since ancient times, larval therapy has been applied to help wound healing. Its use has recently been rediscovered, and the interest in this therapy has been increased in clinical practice, as well as in research. The objective of this study is to assess the efficacy of maggot therapy for the treatment of intractable, chronic wounds. Methods: Twenty patients, suffering mostly from chronic wounds were treated using maggots of greenfly (Phaenicia sericata). Sterile maggots were administered to the wound twice a week. The causes of the development of wounds were diabetic foot(14), trauma(3), plate exposure(1), and unknown origin(2). Results: Complete debridement was achieved in 10 wounds; in 8 wounds, the debridement was partially achieved; 2 patients escaped. Four patients were healed without any additional surgical procedures but fourteen patients were treated with skin graft. Pain, reported by six patients, was relatively well controlled with oral analgesics. Conclusion: We found larval therapy to be effective for chronic wounds. Maggot therapy is a relatively rapid and effective treatment, particularly in necrotic wounds or the wounds resistant to conventional treatment.

Treatment of Diabetic Mouse Wounds using Blood Bank Platelet Concentrates (혈액은행의 혈소판농축액을 이용한 당뇨생쥐의 창상치유)

  • Han, Seung-Kyu;Jeong, Seong Ho;Lee, Byung Il;Kim, Woo Kyung;Gottrup, Finn
    • Archives of Plastic Surgery
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    • v.34 no.3
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    • pp.285-290
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    • 2007
  • Purpose: Many clinical trials have shown the effectiveness of platelet releasate on chronic wounds. However, a large volume of blood must be aspirated from a patient and a platelet separator is required. Here, we hypothesized that platelet concentrate obtained from a blood bank (PCBB) would be also effective at stimulating wound healing. The purpose of this study was to investigate the effectiveness of PCBB on accelerating healing of diabetic wounds in vivo. Methods: Round wounds of 5 mm diameter were made at four sites(two wounds on the left and two on the right side) on the backs of nine diabetic mice. Three hundred million platelets suspended in 0.05 ml fibrinogen were dispersed on each wound on left sides. Same amount of fibrinogen without platelets was dispersed on right side control wounds. Thereafter, 0.05 ml thrombin was applied to the each wound. Ten days after wound treatment, healed wounds were excised and the extent of wound healing in each group was compared. Results: Quantitative histologic analysis of epithelial gap distances revealed that PCBB treatment had greatly accelerated wound healing. Mean epithelial gap distances for PCBB treated and control wounds were $2.5{\times}0.6mm\;and\;3.6{\times}0.5mm$, respectively(p<0.05). Conclusion: Our results suggest that PCBB has potential to accelerate the healing of diabetic wounds.

The Effects of the haemodialysate Solcoseryl on second-intention full-thickness skin wound healing in dogs (개에서 Haemodialysate Solcoseryl이 전층피부창상의 제2기 유합 치유에 미치는 영향)

  • Kwon, Young-sam;Jang, Kwang-ho
    • Korean Journal of Veterinary Research
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    • v.43 no.4
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    • pp.697-702
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    • 2003
  • The purpose of this study was to investigate the effects of a protein-free, standardized dialysate/ultrafiltrate (HD) derivatives from calf blood (Solcoseryl$^{(R)}$) for second-intention full-thickness skin wound healing in dogs. Three $2{\times}2cm$ area-matched full-thickness skin wounds were created bilaterally on the dorsolateral aspect of the trunk of nine dogs. In each dog, two wounds were treated with HD, cemella asiatica extract (Centrasol$^{(R)}$) and normal saline, respectively. For six weeks, the wounds were evaluated grossly for contraction, epithelialization and healing and were examined histopathologically. In the first week of the wound healing period, HD stimulated wound contraction and healing more significantly than centasol and normal saline (p<0.05). Neutrophils were more increased in the HD-treated wounds than those in centasol or normal saline treated wounds. In the second week, HD stimulated epithelialization more significantly than centasol or normal saline (p<0.05), and neovascularization and granulation more increased in the HD-treated wounds than those in centasol and normal saline treated wounds. In conclusion, HD was the most effective on early wound contraction, epithelialization and healings among three experimental drugs in full-thickness skin wound.

CD44 Expression in Healing Nd:YAG Laser Wounds and Scalpel Incisions of the Rat Tongue Mucosa (Nd: YAG 레이져와 수술칼로 절개한 흰쥐 혀점막에서의 CD44 발현)

  • 박미희;박준상;고명연;박봉수
    • Journal of Oral Medicine and Pain
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    • v.22 no.2
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    • pp.261-282
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    • 1997
  • This study was undertaken to compare and investigate the wound healing process following Nd:YAG laser wounds and scalpel incisions of the rat tongue dorsal mucosa. Laser wounds were made parallel on the right side of tongue dorsum and scalpel incisions were made on the left side with 5mm length, respectively Visual inspection and immunohistochemistry with CD44 antibody after immediately, 6 hours, 1 day, 2, 4, 7, 11, 21 days after surgery were carried out. The results were as follows : 1. There was macroscopically no treat difference between laser wounds and scalpel incisions. 2. Laser wounds appeared as dry, bloodless and irregular grooves with carbonization and whitening of superficial tissues compared to sharp, straight and bleeding incisions using scalpel. 3. In the epithelium of rat tongue mucosa, CD44 expression in healing laser wounds and scalpel incisions were similar. 4. In the lamina propria and muscle layer, CD44 expression in healing laser wounds gradually increased earlier and decreased faster than scalpel incisions. Conclusively, it is suggested that pulsed Nd:YAG laser has more beneficial effect on the healing of wounded oral mucosa than scalpel in knew of CD44 expression.

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Six Cases of Diabetic Foot Wounds with Concomitant Skin Malignancies (당뇨발 창상에 동반되는 피부 악성종양 6예)

  • Tae Hun Kwon;Taeseung Lee;Changsik John Park;Yoon Hyo Choi;Kyoung Min Lee
    • Journal of Korean Foot and Ankle Society
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    • v.27 no.1
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    • pp.30-34
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    • 2023
  • Diabetic foot wounds have a significant effect on the health-related quality of life of patients. As diabetic foot wounds are usually chronic and recurrent, it is possible that they can lead to skin malignancies. Several factors can make it difficult to make an early and accurate diagnosis of skin malignancies of the foot in patients with diabetes mellitus. Even though the prevalence of diabetes mellitus and diabetic foot wounds is increasing, currently there are no guidelines for the biopsy of diabetic foot wounds. We have evolved a criterion for the above based on six cases of diabetic foot wounds with concomitant skin malignancies. We recommend that clinicians should broadly consider implementing this criterion when managing patients with diabetic foot wounds.

Effects of Poly-N-acetyl Glucosamine(pGlcNAc) Patch on Wound Healing in db/db Mouse (Poly-N-acetyl-glucosamine이 당뇨병 쥐에서 창상치료에 미치는 영향)

  • Yang, Ho Jik;Yoon, Chi Sun
    • Archives of Plastic Surgery
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    • v.35 no.2
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    • pp.121-126
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    • 2008
  • Purpose: Poly-N-acetyl glucosamine(PGlcNAc) nanofiber-based materials, produced by a marine microalga, have been characterized as effective hemostatic and angiogenic agents. The similarity between PGlcNAc patch and the natural extracellular matrix allows it to support new healthy tissue growth in an injured area and to encourage fluid absorption. In this study, we hypothesized that a poly-N-acetyl glucosamine fiber patch(PGlcNAc patch) may enhance wound healing in the db/db mouse. Methods: PGlcNAc patches were applied on one square centimeter, full-thickness, skin wounds in the db/db mouse model. Wounds(n=15 per group) were dressed with a PGlcNAc nanofiber patch for 1 hour(1 h), 24 hours(24 h) or left untreated(NT). After the application time, patches were removed and wounds were allowed to heal spontaneously. The rate of wound closure was evaluated by digital analysis of unclosed wound area in course of time. At day 10, wounds(n=7 per group) were harvested and quantified with immunohistochemical markers of proliferation(Ki-67) and vascularization (platelet endothelial cell adhesion molecule, PECAM-1). Results: Wounds dressed with PGlcNAc patches for 1 hour closed faster than control wounds, reaching 90% closure in 16.6 days, nine days faster than untreated wounds. Granulation tissue showed higher levels of proliferation and vascularization following 1 h treatment than the 24 h and NT groups. In addition to its hemostatic properties, the PGlcNAc material also appears to accelerate wound closure in healing-impaired genetically diabetic mice. Conclusion: This material, with its combination of hemostatic and wound healing properties, has the potential to be effective agent for the treatment of complicated wounds.

Wounds and Healing as a woman in Happy Days (부조리극 속 여성의 상처와 치유 - 『행복한 나날들』을 중심으로)

  • Ryu, Da-Young
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.20 no.4
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    • pp.242-249
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    • 2019
  • This study examined the wounds and healing of the character as a woman in Samuel Beckett's play, Happy Days, through a microscopic approach by focusing on her inner I, and to study how she tries to heal her wounds. Winnie in Happy Days spends hard times not recognizing her internal wounds and pains. By facing her wounds and pains, however, she starts the process of self-healing, mainly through communicating and sharing her sorrows with her past inner child. Winnie's positive and optimistic character appears to change Willie's behaviors, which may be a positive sign that her wounds and pains will possibly be healed. In conclusion, Winnie has a chance to face her inner wounds and pains while interacting and communicating with her husband Willie, and she is slowly heading for healing her wounded inner I.

Skin Graft Remains a Clinically Good Treatment Strategy for Chronic Diabetic Wounds of the Foot and Ankle (피부이식술을 통한 만성 당뇨족 창상 치료의 효용성)

  • Kim, Yoon-Chung;Kim, Bo-Seoung;Jeong, Howon;Ahn, Jae Hoon
    • Journal of Korean Foot and Ankle Society
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    • v.26 no.2
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    • pp.78-83
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    • 2022
  • Purpose: The purpose of this study was to evaluate the surgical outcome of split-thickness skin graft (STSG) for chronic diabetic wounds of the foot and ankle. Materials and Methods: The medical records of 20 patients who underwent surgery for chronic diabetic wounds of the foot and ankle between October 2013 and May 2018 were reviewed. Surgical management consisted of consecutive debridement, followed by negative-pressure wound therapy and STSG. We used an acellular dermal matrix between the wound and the overlying STSG in some patients with wide or uneven wounds. Patient satisfaction, comorbidities, wound size and location, length of hospital stay, wound healing time, and complications were investigated. Results: Of 20 patients, 17 (85.0%) were satisfied with the surgical outcome. Eight patients had diabetic wounds associated with peripheral vascular disease (PVD), 7 patients had diabetic wounds without PVD, and 5 patients had acute infection superimposed with necrotizing abscesses. The mean size of the wound was 49.6 cm2. The mean length of hospital stay was 33.3 days. The mean time to wound healing was 7.9 weeks. The mean follow-up period was 25.9 months. Complications included delayed wound healing (4 cases) and recurrence of the diabetic wounds (2 cases), which were resolved by meticulous wound dressing. Conclusion: STSG remains a good treatment strategy for chronic diabetic wounds of the foot and ankle.

Serum Collagen Level as a Predictor of Healing Wounds in Diabetic Foot Patients (당뇨발 환자의 창상치유예측을 위한 혈중 교원질 농도)

  • Gu, Ja-Hea;Han, Seung-Kyu;Kim, Woo Kyung
    • Archives of Plastic Surgery
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    • v.35 no.5
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    • pp.491-494
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    • 2008
  • Purpose: When deciding a treatment plan in diabetic foot ulcer patients, predicting a possibility of healing wounds is important since not a few patients have poor general condition to get successful wound healing. This study was planned to find out if a serum collagen level can be used as a predictor for healing wounds in diabetic foot patients. Methods: Fifty-seven patients, who visited our clinic from January to June, 2007 for treatment of diabetic foot ulcers, were included in this study. Serum levels of type I collagen were checked using carboxy terminal type I propeptide kits. Simultaneously serum levels of vitamin C and iron, cofactors of collagen synthesis, were checked. The patients were divided into two groups; a group of successfully healed wounds and the other of unhealed wounds. Serum levels of the parameters were compared between the 2 groups. Results: The serum level of collagen was $197.65{\pm}86.26ng/ml$ in a healed group and $87.91{\pm}28.76ng/ml$ in the unhealed group(p<0.05). The serum iron and vitamin C levels were did not show significant differences. Conclusion: The serum collagen level may predict healing or nonhealing wounds in diabetic foot ulcers.

Effects of Propolis on 808 nm Laser Induced Wounds

  • Shin, Jang-In;Rhee, Chung-Ku;Lee, Seung-Wan;Ahn, Jin-Chul
    • Biomedical Science Letters
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    • v.15 no.3
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    • pp.241-247
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    • 2009
  • Wound healing is a complex and highly organized biological response to injury that results in the loss of tissue integrity. Our particular interest was propolis, traditional used as an antimicrobial and an anti-inflammatory agent. The purpose of this study was to see the effects of propolis on healing of the laser induced wounds and the level of collagen formation. 808 nm laser (20 J) was irradiated on the back of rats. Irradiated wounds were divided into gel control and 6 experimental groups (3 and 5% of different three kinds of propolis). Gel type of propolis (supplied by Seoul Propolis Co., Daejeon, Korea) in water based were applied on the laser wound once daily for 14 days. One fourth of rats were sacrificed on $3^{rd}$, $7^{th}$, $10^{th}$, and $14^{th}$ day and each wound was evaluated for degree of wound healing and the level of collagen formation. Healing of wound was evaluated by measuring and comparing the width and depth of the wounds. The levels of collagen were increased in 3 and 5% gel groups comparing to control on $3^{rd}$ day and the collagen level were increased more on $7^{th}$ day. Wounds of the experimental groups showed better healing in width comparing to the healing of the control. The results of this study demonstrated that propolis accelerated healing of wounds induced by laser irradiation and good collagen formation.

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