A 2-year-old male Tosa was admitted for treatment of a non-healing wound on the right forelimb. Skin tests were unremarkable; however, the lesion contained severe proliferative tissue. Surgical treatment was conducted due to the extensive skin defect and granulation tissue present. Following removal of the proliferative tissue, the wound was closed using the adjustable horizontal mattress suture method with multiple punctate relaxing incisions. The proliferative tissue healed completely after the surgical treatment. This technique can be considered an alternative treatment for the proliferative tissue when conditions require a skin graft or flap after surgical treatment.
Kim, Yo-Han;Lee, Jong-Hoon;Min, Kyung-Hee;Hong, Sung-Hee;Lee, Won-Mi;Jun, Jin-Hyun
Archives of Plastic Surgery
/
v.37
no.3
/
pp.220-226
/
2010
Purpose: Many topical agents had been used for burn or wound treatment. An awareness of topical agents on various aspects of wound healing permits the clinician to choose the most appropriate material to advantageously control the wound process and final results. Although polydeoxyribonucleotide (PDRN) was used as a tissue repair stimulating agent in a number of human diseases, such as ulcers and burns, its wound healing effects were largely unreported. We aimed to compare the woundhealing effects of PDRN and common dressing materials on full-thickness skin defect in the mouse. Methods: Full-thickness skin defects were made on the back of mice (N=60). The mice were divided into the following 4 groups according to the dressing used for the wounds: group O (Polydeoxyribonucleotide cream), group I (Polydeoxyribonucleotide solution), group M (Medifoam$^{(R)}$), and group G (dry gauze, control group). We analyzed the gross findings, wound sizes and histological findings for the groups. Results: The rate of wound size was decreased in order of group I, group O, group M and group G. The histological findings revealed that the I group showed more reepithelialization and granulation tissue formation and less inflammatory cell infiltration than the other materials. The grade score of wound healing was increased in order of group I, group O, group M and group G. Conclusion: PDRN applicated wound dressings can be used for treating a full-thickness skin defect wounds. Considering its superior efficacy in comparison to the efficacies of other wound dressings, PDRN soaked gauze dressing should be preferentially used for the treatment of fullthickness skin wounds.
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.
Early wound healing responses in the skin of the Korean fire bellied toad, Bombina orientalis, were examined using histochemical , scanning and transmission electron microscopical techniques. Cutaneous wounds were induced by sharp razor blade , and maintained in special cages for up to 3 days. By this treatment whole parts of epithelium and dermis were profoundly affected. After injury, retraction of damaged surface of the skin was observed. At 3 hours after injury, poly-band was form by mucous substance. The wound skin consisted of mucous gland secreted mucous substance which flows into wound cavity and the wound area was sealed by mucous substance which form thick layer at 6 hours. It appeared that natural disposition showed acid and neutral mucous substance by reaction of PAS and Alcian blue (pH 2.5) staining. After formation of the poly-band, epithelial cells were formed by migration of regenerating epithelial cells. These cells moved over the wound surface by migration at 12 hours after wounding. Poly-band was much increased in thickness and migrating cells were completely formed wound closure at 24 hours post-wounding. After 72 hours regenerated epithelial layer consists of four or five cell layers which are similar to clear, granular, and spinous layer.
Park, Yong Jin;Jeong, Jisu;Kim, Jae Seok;Choi, Dong Soo;Cho, Goang-Won;Park, Jin Seong;Lim, Jong Kuk
Journal of Integrative Natural Science
/
v.12
no.2
/
pp.47-57
/
2019
Staphylococcus epidermidis is well-known not only as an innocuous normal flora species commonly isolated from human skin, but also as an important bacterial species to keep skin healthy, because this species can protect the human skin from pathogenic microorganisms. However, S. epidermidis turns into a potential pathogen in damaged skin, because these bacteria can easily form a biofilm on the wound area and provide antimicrobial resistance to other microorganisms embedded in the biofilm. Thus, it is important to kill S. epidermidis in the early stage of wound treatment and block the formation of biofilms in advance. In the present study, hydrogel wound dressings were fabricated using polyvinyl alcohol/polyethylene glycol containing silver citrate nanorods, which have been proven to have strong antimicrobial activity, especially against S. epidermidis, and their wound-healing efficacy was investigated in vivo using a rat experiment.
Park, Jung Min;Kwon, Yong Seok;Jung, Ki Hwan;Lee, Keun Cheol;Kim, Seok Kwun;An, Won Suk
Archives of Plastic Surgery
/
v.32
no.6
/
pp.727-732
/
2005
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.
Park, Jong-Hak;Kim, Jung-Youn;Shin, Jun-Hyun;Yoon, Young-Hoon;Cho, Han-Jin;Moon, Sung-Woo;Choi, Sung-Hyuk;Lee, Sung-Woo;Hong, Yun-Sik
Journal of Trauma and Injury
/
v.23
no.1
/
pp.21-28
/
2010
Purpose: In Korea, most abdominal penetrating wounds are caused by stab wounds rather than gun-shot wounds. However, not many studies have been performed on stab injuries and their epidemiologic characteristics. Disagreements of opinions of obligatory surgical exploration and conservative treatment exist, and this subject is still being debated. Therefore, the authors studied the epidemiologic characteristics of abdominal stab wound patients visiting the emergency department and reviewed the proportion of patients that received nontherapeutic surgery and conservative treatment. Methods: This study included patients visiting the emergency department with abdominal stab wounds. A retrospective chart review was done on the abdominal stab wound patients. Sex, age, cause of injury, location of wound, initial vital signs, operation results, injured organs and CT & LWE results were reviewed. Results: The median age of the 121 patients was 40.9 years, of these patients, 88 were males, of which 52 (43.0%) were drunken. Of the patients that received non-therapeutic operations, only 3 patients (15.0%) were drunken, significantly lower than the therapeutic operation group. For the location of the wound, most patients were injured in the right and left upper quadrants, 27 patients each. The most common injured organ was the small bowel; 13 patients were injured in the small bowel. With abdominal CT scans and local wound explorations together, the results exhibited a sensitivity of 97%, a specificity of 44%, a positive predictive value of 56%, and a negative predictive value of 95%. Conclusion: In our study, the sensitivity was 97% when CT & LWE were performed together; thus we can conclude that CT and LWE can be used together to select the treatment method. Although in our study, the surgical indications in abdominal stab wound patients is not sufficient, our results showed a higher rate of nontherapeutic surgery compared to previous studies. Therefore, more research is needed to prevent unnecessary laparotomies in hemodynamically-stable patients without symptoms.
Jeong, Hii Sun;Lee, Byeong Ho;Lee, Hye Kyung;Kim, Hyoung Suk;Moon, Min Seon;Suh, In Suck
Archives of Plastic Surgery
/
v.42
no.1
/
pp.59-67
/
2015
Background Negative-pressure wound therapy (NPWT) induces angiogenesis and collagen synthesis to promote tissue healing. Although acetic acid soaks normalize alkali wound conditions to raise tissue oxygen saturation and deconstruct the biofilms of chronic wounds, frequent dressing changes are required. Methods Combined use of NPWT and acetic acid irrigation was assessed in the treatment of chronic wounds, instilling acetic acid solution (1%) beneath polyurethane membranes twice daily for three weeks under continuous pressure (125 mm Hg). Clinical photographs, pH levels, cultures, and debrided fragments of wounds were obtained pre- and posttreatment. Tissue immunostaining (CD31, Ki-67, and CD45) and reverse transcription-polymerase chain reaction (vascular endothelial growth factor [VEGF], vascular endothelial growth factor receptor [VEGFR]; procollagen; hypoxia-inducible factor 1 alpha [HIF-1-alpha]; matrix metalloproteinase [MMP]-1,-3,-9; and tissue inhibitor of metalloproteinase [TIMP]) were also performed. Results Wound sizes tended to diminish with the combined therapy, accompanied by drops in wound pH (weakly acidic or neutral) and less evidence of infection. CD31 and Ki-67 immunostaining increased (P<0.05) post-treatment, as did the levels of VEGFR, procollagen, and MMP-1 (P<0.05), whereas the VEGF, HIF-1-alpha, and MMP-9/TIMP levels declined (P<0.05). Conclusions By combining acetic acid irrigation with negative-pressure dressings, both the pH and the size of chronic wounds can be reduced and infections be controlled. This approach may enhance angiogenesis and collagen synthesis in wounds, restoring the extracellular matrix.
Background: Management of pain from open wounds is a growing unmet healthcare need. However, the models available to study pain from wounds or to develop analgesics for the patients suffering from them have primarily relied on incisional models. Here, we present the first characterized and validated model of open wound pain. Methods: Unilateral full-skin excisional punch biopsy wounds on rat hind paws were evaluated for evoked pain using withdrawal responses to mechanical and thermal stimulation, and spontaneous pain was measured using hind paw weight distribution and guarding behavior. Evaluations were done before wounding (baseline) and 2-96 hours post-wounding. The model was validated by testing the effects of buprenorphine and carprofen. Results: Pain responses to all tests increased within 2 hours post-wounding and were sustained for at least 4 days. Buprenorphine caused a reversal of all four pain responses at 1 and 4 hours post-treatment compared to 0.9% saline (P < 0.001). Carprofen decreased the pain response to thermal stimulation at 1 (P ≤ 0.049) and 4 hours (P < 0.011) post-treatment compared to 0.9% saline, but not to mechanical stimulation. Conclusions: This is the first well-characterized and validated model of pain from open wounds and will allow study of the pathophysiology of pain in open wounds and the development of wound-specific analgesics.
Kim, Wan Kee;Kim, Joon Bum;Kim, Gwan Sic;Jung, Sung-Ho;Choo, Suk Jung;Chung, Cheol Hyun;Lee, Jae Won
Journal of Chest Surgery
/
v.46
no.4
/
pp.279-284
/
2013
Background: Sternal dehiscence is one of the most troublesome complications following cardiac surgery. Treatment failure and consequent lethal outcomes are very common. The aim of this study was to evaluate titanium plate fixation as a treatment for sternal dehiscence following major cardiac surgery. Materials and Methods: Between 2010 and 2012, 17 patients underwent sternal reconstruction using horizontal titanium plating for the treatment of post-cardiac-surgery sternal dehiscence. The plates were cut and shaped, and then were fixed to corresponding costal segments using 2-3 titanium screws per each side. Results: The median age of our patients was 66 years (range, 50 to 78 years) and 9 were female. Indications for sternal reconstruction included aseptic sternal dehiscence in 3 patients and osteomyelitis in 14 patients including 6 patients who were diagnosed with mediastinitis. During the operation, sternal resection and autologous flap interposition were combined in 11 patients. One patient died due to sepsis. Two patients required additional soft tissue wound revisions. Another patient presented with a tuberculous wound infection which was resolved using anti-tuberculosis medications. The postoperative course was uncomplicated in the other 13 patients. Conclusion: Titanium plate fixation that combines appropriate debridement and flap interposition is very effective for the treatment of sternal dehiscence following major cardiac surgery.
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