• Archives of Plastic Surgery
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• v.34 no.3
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• pp.305-313
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• 2007

Purpose: Wound healing is a result of complex processes whose components, such as cells, extracellular matrix, proteolytic enzymes, and their inhibitors receive effects from immune compartments, cytokines, chemokines, and growth factors. Impairment of normal physiologic response to wounding makes nonhealing chronic wounds. Wound infection and exacerbated proteolytic process may induce uncontrolled tissue degradation or exudates formation, which may result in the development of a nonhealing chronic wound. Thus proper management of wound infection and exudates is critical to prevent and treat nonhealing wound. The aim of this study is to evaluate effects of Aquacel AG, silver-containing carboxymethylcellulose dressing on treatment for exudative infected wound. Methods: The study included 31 patients with nonhealing wound. Wound was dressed with Aquacel AG. The effect of dressing was investigated by serial bacterial culture and wound exudates assessment. Each infection and exudates control time was determined and statistically analyzed. Results: Wound infection and exudates were effectively managed using Aquacel AG dressing. Mean infection and exudates control time were $3.4{\pm}1.2$ and $5.7{\pm}1.4$ weeks, respectively. Statistical analysis of the data indicated that infection control time correlated positively to age and exudates control time (p<0.05). Conclusion: There is as yet no ideal dressing for the topical treatment of chronic nonhealing wound. But silver-containing carboxymethylcellulose dressing can be used effectively for exudative, infected nonhealing wound.

• Journal of Chest Surgery
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• v.27 no.8
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• pp.708-709
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• 1994

Tuberculosis infection of sternum is extremely rare. The most common cause of sternal osteomyelitis is infection of a median sternotomy incision, employed for most cardiac operation. If a wound infection of this regeon becomes apparent, the wound should be opened wide to allow adequate drainage. Frequent irrigation and debridement are necessary to avoid extension of the infection into the bone. We have experienced a 16 years old female who has been operated upon due to ASD, was infected with tuberculosis in sternum. Our team have treated her for tuberculous osteomyelitis on sternum with curettage and drainage.

• Journal of Korean Neurosurgical Society
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• v.37 no.1
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• pp.44-47
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• 2005

Objective: The purpose of this study is to investigate the elevated blood glucose levels in the postoperative period are associated with an increased risk of deep wound infection in diabetic individuals undergoing lumbar spine surgery. Methods: Of 2896 patients who underwent lumbar spine operations by one surgeon between 1993 and 2002, 329(11.4%) were diabetics. The rate of deep wound infections in diabetic patients was 6.4%, versus 3.2% for nondiabetics. 152 patients had their operation before implementation of the protocol and 177 after implementation. Charts of the diabetic patients were reviewed. Mean blood glucose levels were calculated from documented results of finger-stick glucometer testing. Results: Twenty-one diabetic patients suffered deep wound infection. Infected diabetic patients had a higher mean blood glucose level through the first 2 postoperative days than noninfected patients($230{\pm}6.9$ versus $175{\pm}3.8mg/dL$; p<0.003) and had a long operation time($216{\pm}57.9$ versus $167.5{\pm}42.2$ minute; p<0.05). Multivariable logistic regression showed that mean blood glucose level for the first 2 postoperative days, long operation time, and use of the instrumentation(p<0.02) were all related predictiors of deep wound infection. Institution of a protocol of postoperative continuous intravenous insulin to maintain blood glucose level less than 200mg/dL was began in september 1997. This protocol resulted in a decrease in blood glucose levels for the first 2 postoperative days and a concomitant decrease in the proportion of patients with deep wound infection, from 8.3%(11/132) to 5.1%(10/195) (p<0.02). Conclusion: The incidence of deep wound infection in diabetic patients is reduced after implementation of a protocol to maintain mean blood glucose level less than 200mg/dL in the immediate postoperative period.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• v.44 no.4
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• pp.159-166
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• 2018

Objectives: The aim of the study was to compare wound healing complications following the use of either absorbable or non-absorbable sutures for skin closure in cleft lip repair. Materials and Methods: This was a randomized controlled trial conducted at the Department of Oral and Maxillofacial Surgery, Lagos University Teaching Hospital, Idi Araba, Lagos State, Nigeria. Sixty subjects who required either primary or secondary cleft lip repair and satisfied all the inclusion criteria were recruited and randomized into two groups (Vicryl group or Nylon group). The surgical wounds in all subjects were examined on 3rd, 7th, and 14th postoperative days (POD) for presence or absence of tissue reactivity, wound dehiscence, and local wound infection. Results: Hemorrhage, tissue reactivity, wound dehiscence, and local wound infection were identified as wound healing complications following cleft lip repair. The incidence of postoperative wound healing complications on POD3 was 33.3%. Tissue reactivity was more common throughout the evaluation period with the use of an absorbable (Vicryl) suture compared to a non-absorbable (Nylon) suture, although the difference was statistically significant only on POD7 (P=0.002). There were no significant differences in the incidences of wound dehiscence and infection between the two groups throughout the observation period. Conclusion: There were no statistically significant differences in the incidences of wound dehiscence and surgical site wound infection following the use of either Vicryl or Nylon for skin closure during cleft lip repair. However, more cases of tissue reactivity were recorded in the Vicryl group than in the Nylon group on POD7. Particular attention must be paid to detect the occurrence of wound healing complications, most especially tissue reactivity, whenever a Vicryl suture is used for skin closure in cleft lip repair.

• The Plant Pathology Journal
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• v.20 no.4
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• pp.258-263
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• 2004

Ripe fruit of pepper (Capsicum annuum) showed resistance to Colletotrichum gloeoporioides, but unripe fruit was susceptible. We previously isolated the PepTLP gene that induced in both unripe and ripe fruit by fungal infection and wound, and only in ripe fruit by jasmonic acid (JA) treatment. To examine further regulation of PepTLP, the action of specific agonist and antagonists of known signaling effector on the .PepTLP expression by fungal infection, wound, and JA was investigated. A similar dephosphorylation event negatively activated all the PepTLP expression in the ripe fruit by fungal infection, wound, and JA. The induction of PepTLP expression by wound is differentially regulated via phosphorylation and dephosphorylation step during pre- and post-ripening, respectively. In addition, the induction of PepTLP expression in the ripe fruit by wound and JA is differentially regulated via dephosphorylation and phosphorylation step, respectively. Only both wound and JA treatment has synergistic effect on the PepTLP expression in the unripe fruit. Both SA and JA treatments on the unripe fruit, and both wound or JA and SA on the ripe fruit could not do any effect on the expression of PepTLP. These results suggest that the induction of PepTLP expression is differentially regulated via complex regulatory system against fungal infection, wound, and JA treatment during pre- and post-ripening of pepper fruit.

• Archives of Plastic Surgery
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• v.37 no.1
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• pp.71-74
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• 2010

Purpose: Nowadays spinal cord stimulator is frequently used for the patients diagnosed as complex regional pain syndrome. The lead is placed above the spinal cord and connected to the stimulation generator, which is mostly placed in the subcutaneous layer of the abdomen. When the complication occurs in the generator inserted site, such as infection or generator exposure, replacement of the new generator to another site or pocket of the abdomen would be the classical choice. The objective of our study is to present our experience of the effective replacement of the existing stimulation generator from subcutaneous layer to another layer in same site after the wound infection at inexpensive cost and avoidance of new scar formation. Methods: A 50-year-old man who was diagnosed as complex regional pain syndrome after traffic accident received spinal cord stimulator, Synergy$^{(R)}$ (Medtronic, Minneapolis, USA) insertion 1 month ago by anesthetist. The patient was referred to our department for wound infection management. The patient was presented with erythema, swelling, thick discharge and wound disruption in the left upper quadrant of the abdomen. After surgical debridement of the capsule, the existing generator replacement beneath the anterior layer of rectus sheath was performed after sterilization by alcohol. Results: Patient's postoperative course was uneventful without any complication and had no evidence of infection for 3 months follow-up period. Conclusion: Replacement of existing spinal cord stimulation generator after sterilization between the anterior layer of rectus sheath and rectus abdominis muscle in the abdomen will be an alternative treatment in wound infection of stimulator generator.

• Journal of Veterinary Clinics
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• v.27 no.1
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• pp.121-124
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• 2010

Thermal burn occurred in the anesthetized dog as a result of using hot pack to treat hypothermia. After hospital discharge, thermal burn leaded to secondary infection due to dog bites of the other dog in the house. After secondary infection, the treatment was performed with medication and bandaging. Because of the pain and infection from the wound, carprofen (2 mg/kg bid) and amoxicillin (20 mg/kg bid) were administrated orally for 40 days. And for 35 days, wet-to-dry gauze dressing was used to absorb purulent exudate. During this period, the burn eschar was removed completely from the burn site. After 35 days, the hydrophilic polyurethane foam ($Medifoam^{(R)}$, Ildong Pharm, Co., Korea) was admitted to the burn site for 30 days. $Medifoam^{(R)}$ made healing rate of the wound faster because the inner layer did not adhered to the wound, and newly formed tissue was protected. The second layer, hydrophilic absorptive layer absorbed excessive fluid and kept the wound surface moist. After 65 days after thermal burn, the wound was healed completely.

• Journal of Chest Surgery
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• v.9 no.2
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• pp.265-270
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• 1976

Implantation of a permanent pacemaker is a widely accepted procedure for the patient with complete heart block.As a result of these device, the prognosis for patients with Adams-Stokes syndrome caused by complete A-V block and other cardiac arrhythmia have become much more optimistic. Permanent pacemaker implantation by means of a transvenous approach has made the operative risk much less and the procedure simpler. However, a number of complications have been reported in the literature regarding transvenous endocardial pacemaker implantation during the last a decade. The patient presented in this paper is a 26-year old girl who was implanted with a permanent pacemaker at 14 years of age because of a congenital A-V block. Following first exchange of pulse generator, the electrode (lead) was fractured, so that by the pulse generator, a change to the transvenous technique of implantation was made, After this, there were episodes of recurrent wound infection on three occasions, even though the site of pulse generator implantation was exchanged to the contralateral side of chest wall, massive doses of antibiotics were administered and sensitivity tests for coagulase positive staphylococcal infection were performed. Though there was no definite evidence of blood stream infection by blood culture, we decided not to use the transvenous technique and not to implant the pulse generator in the chest wall because the venous system and the entire anterior chest wall appeared to be diseased or contaminated by virulent pyogenic organisms. Finally this intractable systemic and local wound infection was successfully controlled by myocardial lead implantation via a subxiphoid approach and implantation of the pulse generator far down in the abdominal wall. The causes and routes of recurrent wound infection and possible blood born infection in this particular patient are still obscure. We strongly believe that myocardial pacemaker implantation is much safer than transvenous endocardial pacemaker implantation & myocardial pacemaker implantation is a definite method for controlling such an intractable wound infection. following transvenous pacemaker implantation.

• Journal of Microbiology and Biotechnology
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• v.19 no.6
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• pp.622-628
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• 2009

In the present study, the therapeutic potential of purified and well-characterized bacteriophages was evaluated in thermally injured mice infected with Klebsiella pneumoniae B5055. The efficacy of five Klebsiella phages (Kpn5, Kpn12, Kpn13, Kpn17, and Kpn22) was evaluated on the basis of survival rate, decrease in bacterial counts in different organs of phage-treated animals, and regeneration of skin cells as observed by histopathological examination of phage-treated skin. Toxicity studies performed with all the phages showed them to be non-toxic, as no signs of morbidity and mortality were observed in phage-treated mice. The results of the study indicate that a single dose of phages, intraperitoneally (i.p.) at an MOI of 1.0, resulted in significant decrease in mortality, and this dose was found to be sufficient to completely cure K. pneumoniae infection in the burn wound model. Maximum decrease in bacterial counts in different organs was observed at 72 h post infection. Histopathological examination of skin of phage-treated mice showed complete recovery of burn infection. Kpn5 phage was found to be highly effective among all the phages and equally effective when compared with a cocktail of all the phages. From these results, it can be concluded that phage therapy may have the potential to be used as stand-alone therapy for K. pneumoniae induced burn wound infection, especially in situations where multiple antibiotic-resistant organisms are encountered.

• Journal of Microbiology and Biotechnology
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• v.20 no.5
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• pp.935-941
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• 2010

The emergence of antibiotic-resistant bacterial strains is one of the most critical problems of modern medicine. Bacteriophages have been suggested as an alternative therapeutic agent for such bacterial infections. In the present study, we examined the therapeutic potential of phage Kpn5 in the treatment of Klebsiella pneumoniae B5055-induced burn wound infection in a mouse model. An experimental model of contact burn wound infection was established in mice employing K. pneumoniae B5055 to assess the efficacy of phage Kpn5 in vivo. Survival and stability of phage Kpn5 were evaluated in mice and the maximum phage count in various organs was obtained at 6 h and persisted until 36 h. The Kpn5 phage was found to be effective in the treatment of Klebsiella-induced burn wound infection in mice when phage was administered immediately after bacterial challange. Even when treatment was delayed up to 18 h post infection, when all animals were moribund, approximately 26.66% of the mice could be rescued by a single injection of this phage preparation. The ability of this phage to protect bacteremic mice was demonstrated to be due to the functional capabilities of the phage and not due to a nonspecific immune effect. The levels of pro-inflammatory cytokines (IL-$1{\beta}$ and TNF-${\alpha}$) and anti-inflammatory cytokines (IL-10) were significantly lower in sera and lungs of phage-treated mice than phage untreated control mice. The results of the present study bring out the potential of bacteriophage therapy as an alternate preventive approach to treat K. pneumoniae B5055-induced burn wound infections. This approach not only helps in the clearance of bacteria from the host but also protects against the ensuing inflammatory damage due to the exaggerated response seen in any infectious process.