Search results for: corneal wound repair

Authors: Manish Kumar

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Reinforced cement concrete is getting extensively used for construction of different type of structures for the last one century. During this period, we have constructed many structures like buildings, bridges, industrial structures, pavement, water tanks etc. using this construction material. These structures have been created with huge investment of resources. It is essential to maintain those structures in functional condition. Since deterioration in RCC Structures is a common and natural phenomenon it is required to have a detailed plan, methodology for structural repair and rehabilitation shall be in place for dealing such issues. It is important to know exact reason of distress, type of distress and correct method of repair concrete structures. The different methods of repair are described in paper according to distress category which can be refereed for repair. Major finding of the study is that to protect our structure we need to have maintenance frequency and correct material to be chosen for repair. Also workmanship during repair needs to be taken utmost care for quality repair.

Keywords: deterioration, functional condition, reinforced cement concrete, resources

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Authors: Bawa Inalegwu, Jacob A. Jato, Ovye Akyengo, John Akighir

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All humans will experience some type of wound in every lifetime. Most wounds heal quickly with little or no attention but, many people suffer from wounds that are complex and/or persistent therefore posing a burden. This study was designed to assess the efficacy of Mitrcarpus villous ointment against honey in diabetic rats. To achieve this, percentage wound closure and collagen assessments were used to express treatment efficacy. Results show that on day 21, rats treated with M. villosus ointment had the highest percentage closure (94.5%) while honey treated and non-treated recorded 90.0% and 83.3% respectively. Similarly, a significant difference (p < 0.05) was observed on day 21 in the total collagen deposited in wounds of diabetic rats (10.57 ± 0.7) and M. villous ointment treated wounds (11.77 ± 0.4) as compared with the non-treated diabetic rats. M. villosus ointment was efficacious in healing wounds in diabetic rats and heals wound faster than honey and may hold potential for wound healing in diabetes mellitus sufferers. However, the wound healing mechanism of this ointment

Keywords: collagen, diabetic rats, honey, Mitracarpus villosus, ointment, wound healing

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Authors: Ashvamedh, Chandra Bhushan Singh, Anil Kumar Sarda

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Introduction: Ileal perforation is a common cause for peritonitis in developing countries. Surgery is the ideal treatment as it eliminates soilage of peritoneal cavity in an effort to lessen the toxaemia and enhance the recovery of the patient. However, there is no uniformity of standardized operative procedure that is most effective for management. Material and method: The study was conducted on 66 patients of perforation peritonitis from November 2013 to February 2015 in Lok Nayak Hospital. Data of each patient were recorded on a pre-determined proforma. The methods used for repair were Primary repair, Resection anastomosis (RA) and Ileostomy. Result: Male preponderance was noticed among the patients with majority in their third decade. Of all perforations 40.9% were tubercular and 34.8% were typhoid. Amongst operated cases 27.3% underwent primary repair, RA was performed in 45.5%, Ileostomy in 27.3%patients. The average time taken for RA and ileostomy was more than primary repair. The type of repair bear no significance to size or no of perforation but was significant statistically for distance from I/C valve(P=.005) and edema of bowel wall(p=.002) when analysed for post op complications. Wound infection, dehiscence, intra-abdominal collections were complications observed bearing no significance to type of repair. Ileostomy per se has its own complications peristomal skin excoriation seen in 83.3%, electrolyte imbalance in 33.3%, duration for closure averaged 188 days (median 150 days, range 85-400 days). Conclusion: Primary closure is preferable in patients with single, small perforations. RA is advocated in patients with multiple or large perforation, perforation proximal to stricture. Ileostomy should not be considered as primary definitive procedure and reserved only for moribund patients as a lifesaving procedure. It has more morbidity and requires a second surgery for closure increasing the cost of treatment as well.

Keywords: ileal perforation, ileostomy, perforation peritonitis, typhoid perforation management

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Authors: S. H. Park, D. W. You

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This study is about to the field survey and repair works in a marine approach-bride. In order to evaluate the stability of the ground and the structure, field surveys such as exterior inspection, non-destructive inspection, measurement, and geophysical exploration are carried out. Numerical analysis is conducted to investigate the cause of the abutment displacement at the same time. In addition, repair works are practiced to the region damaged with intent to sustain long-term safety.

Keywords: field survey, expansion joint, repair, maintenance

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Authors: L. Sasikala, Bhaarathi Dhurai

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Increase in antibiotic resistance bacteria leads to the development of active wound dressings, which absorb any bodily fluid, evaporation of moisture at a certain rate and can be easily removed after healing. Natural materials like chitosan, herbs, and honey have number of active materials present in them to accelerate wound healing and to arrest wound in infections. Hence with the advantages of biomaterials, a film was prepared using chitosan and honey. There are a lot of practical considerations with respect to honey. Honey exerts many beneficial actions on the wound surface only when it remains. The attempts to hold honey on the surface of the wound remain a question because honey becomes a very runny liquid when it comes to body temperature. Hence, this research was focused on development of a new form of wound dressing, by holding honey on the wound surface in different form and also which has a combined effect of manuka (Leptospermum scoparium) honey and chitosan. Chitosan-honey film was prepared using casting technique. Films were prepared in different variations; with acetic acid and with lactic acid; with and without honey. In summary, the film produced from 2% chitosan- 1% lactic acid as a solvent, with 10% honey shows optimum inclined values in all the tests, like thickness, folding endurance, weight, water vapor transmission, tensile strength, swelling ratio and antimicrobial activity, with specific reference to wound dressings. The film has water vapor transmission of 1680 g/m²/day, water absorption of 225%, tensile strength of 39.1N/mm² and elongation of 50.3%. There is a notable inhibition zone of 29 mm against S. aureus and 24 mm against E. coli in the case of chitosan-lactic acid-honey film. The film also arrests, microbes transmitting from the outside environment to wound bed, which can be used as an effective wound dressing material.

Keywords: casting technique, chitosan, honey, film, wound dressings

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Authors: Smita Shenoy, Amoolya Gowda, Tara Shanbhag, Krishnananda Prabhu, Venumadhav Nelluri

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The study was undertaken to assess the effect of ethanolic extract of Michelia champaca on excision wound healing in diabetic wistar rats. Excision wound was made in five groups of rats after inducing diabetes with streptozotocin in four groups. Paraffin was applied to wounds in nondiabetic and diabetic control and 2.5%, 5%, 10% ointment of extract to wounds in three diabetic test groups. Monitoring of wound contraction rate, the period of epithelization and histopathological examination of granulation tissue was done. There was a significant (p < 0.05) decrease in the period of epithelization and a significant increase in the wound contraction rate on day 12 and 16 in rats treated with 5% and 10% ointment as compared to diabetic rats. There was a better organization of collagen fibers in the granulation tissue of wounds treated with 10% ointment. The higher dose of ethanolic extract of Michelia champaca promoted wound healing in diabetic Wistar rats.

Keywords: Michelia champaca, excision wound, contraction, epithelization

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Authors: Isa Naina Mohamed, Mazliadiyana Mazlan, Ahmad Nazrun Shuid

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Stichopus chloronotus (Black Knobby or green fish) is a sea cucumber species commonly found along Malaysia’s coastline. In Malaysia, it is believed that sea cucumber can expedite healing of wounds, provide extra energy and used as an ointment to relieve pain. The aim of this study is to determine the best concentration of Stichopus chlronotus extract to promote wound healing. 12 male Sprague-Dawley rats with wounds created using 6mm disposable punch biopsy were divided into 6 treatment groups. The normal control group (untreated), positive control group (flavin treated only), negative control group (emulsifying ointment only), and group 0.1, group 0.5, group 1 were each treated with 0.1%, 0.5% and 1% of Stichopus chlronotus water extract mixed in emulsifying ointment, respectively. Treatments were administered topically for 10 days. Changes in wound area were measured using caliper and photographs were taken on day 2, 4, 6, 8, and 10 after index wound. Results showed that wound reduction of group 0.5 on day 4, 6, and 8 was significantly higher compared to normal control group and positive control group. Group 0.5 also had higher wound reduction from day 6 until day 10 compared to all other groups. In conclusion, Sea Cucumber (Stichopus chloronotus) extract demonstrated the best minor wound healing properties at concentration 0.5%. The potential of Stichopus chlronotus extract ointment for wound healing shall be investigated further.

Keywords: minor wound healing, expedite wound healing, sea cucumber, Stichopus chloronotus

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Authors: Celine Shi Ying Lee, Jong Jian Lee

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Background: Infectious keratitis is one of the leading causes of blindness worldwide. Prompt treatment with effective medication will control the infection early, preventing corneal scarring and visual loss. fluoroquinolones ophthalmic medication is used because of its broad-spectrum properties, potency, good intraocular penetration, and low toxicity. The study aims to evaluate the treatment outcome of corneal ulcers using Levofloxacin 1.5% ophthalmic solution (LVFX) with adjuvant oral ciprofloxacin when indicated and apply this treatment strategy in primary health care as first-line treatment. Methods: Patients with infective corneal ulcer treated in an eye center were recruited. Inclusion criteria includes Corneal infection consistent with bacterial keratitis, single or multiple small corneal ulcers. Treatment regime: LVFX hourly for the first 2 days, 2 hourly from the 3rd day, and 3 hourly on the 5th day of review. Adjuvant oral ciprofloxacin 500mg BD was administered for 5 days if there were multiple corneal ulcers or when the location of the cornea ulcer was central or paracentral. Results: 47 subjects were recruited. There were 16 (34%) males and 31 (66%) females. 40 subjects (85%) were contact lens (CL) related to corneal ulcer, and 7 subjects (15%) were non-contact lens related. 42 subjects (89%) presented with one ulcer, of which 20 of them (48%) needed adjuvant therapy. 5 subjects presented with 2 or 3 ulcers, of which 3 needed adjuvant therapy. A total of 23 subjects (49%) was given adjuvant therapy (oral ciprofloxacin 500mg BD for 5 days).21 of them (91%) were CL related. All subjects recovered fully, and the average duration of treatment was 3.7 days, with 49% of the subjects resolved on the 3rd day, 38% on the 5thday of and 13% on the 7thday. All subjects showed symptoms of relief of pain, light-sensitivity, and redness on the 3rd day with full visual recovery post-treatment. No adverse drug reactions were recorded. Conclusion: Our treatment regime demonstrated good clinical outcome as first-line treatment for corneal ulcers. A corneal ulcer is a common eye condition in Singapore, mainly due to CL wear. Pseudomonas aeruginosa is the most frequent and potentially sight-threatening pathogen involved in CL related corneal ulcer. Coagulase-negative Staphylococci, Staphylococcus aureus, and Streptococcus Pneumoniae were seen in non-CL users. All these bacteria exhibit good sensitivity rates to ciprofloxacin and levofloxacin. It is therefore logical in our study to use LVFX Eyedrops and adjuvant ciprofloxacin oral antibiotics when indicated as first line treatment for most corneal ulcers. Our study of patients, both CL related and non-CL related, have shown good clinical response and full recovery using the above treatment strategy. There was also a full restoration of visual acuity in all the patients. Eye-trained primary Healthcare practitioners can consider adopting this treatment strategy as first line treatment in patients with corneal ulcers. This is relevant during the COVID pandemic, where hospitals are overwhelmed with patients and in regions with limited access to specialist eye care. This strategy would enable early treatment with better clinical outcome.

Keywords: corneal ulcer, levofloxacin hydrate, treatment strategy, ciprofloxacin

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Authors: Rajesh Kumar, Roopali Dogra, Puneet Aggarwal

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In recent advancements in electric machine and drives, wound rotor motor is extensively used. The merit of using wound rotor induction motor is to control speed/torque characteristics by inserting external resistance. Wound rotor induction motor can be used in the cases such as (a) low inrush current, (b) load requiring high starting torque, (c) lower starting current is required, (d) loads having high inertia, and (e) gradual built up of torque. Examples include conveyers, cranes, pumps, elevators, and compressors. This paper includes speed control of wound induction motor using MATLAB/Simulink for rotor resistance and slip power recovery method. The characteristics of these speed control methods are hence analyzed.

Keywords: MATLAB/Simulink, rotor resistance method, slip power recovery method, wound rotor induction motor

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Authors: Saba Atefyekta

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Aim: Control of bacterial bioburden in wounds is an important step for minimizing the risk of wound infection. An antimicrobial hydrogel wound dressing is developed out of soft polymeric hydrogels that contain antimicrobial peptides (AMPs). Such wound dressings can bind and kill all types of bacteria, even the resistance types at the wound site. Methods: AMPs are permanently bonded onto a soft nanostructured polymer via covalent attachment and physical entanglement. This improves stability, rapid antibacterial activity, and, most importantly, prevents the leaching of AMPs. Major Findings: Antimicrobial analysis of antimicrobial hydrogels using in-vitro wound models confirmed >99% killing efficiency against multiple bacterial trains, including MRSA, MDR, E. Coli. Furthermore, the hydrogel retained its antibacterial activity for up to 4 days when exposed to human serum. Tests confirmed no release of AMPs, and it was proven non-toxic to mammalian cells. An in-vivo study on human intact skin showed a significant reduction of bacteria for part of the subject’s skin treated with antibacterial hydrogels. A similar result was detected through a qualitative study in veterinary trials on different types of surgery wounds in cats, dogs, and horses. Conclusions: Antimicrobial hydrogels wound dressings developed by permanent attachment of AMPs can effectively and rapidly kill bacteria in contact. Such antibacterial hydrogel wound dressings are non-toxic and do not release any substances into the wound.

Keywords: antibacterial wound dressing, antimicrobial peptides, post-surgical wounds, infection

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Authors: Ehsan A. Yahia, Ayman E. El-Sharkawey, Magda M. Bayoumi

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Background: Wound dressings perform a crucial role in cutaneous wound management due to their ability to protect wounds and promote dermal and epidermal tissue regeneration. Aim: To evaluate the effectiveness of using hydrogel/nano silver-based dressing vs. traditional dressing on diabetic foot wound healing. Methods: Sixty patients with type-2 diabetes hospitalized for diabetic foot wound treatment were recruited from selected Surgical departments. A prospective randomized control study was carried. Results: The results showed that the percentage of a reduction rate of the ulcer by the third week of the treatment in the hydrogel/nano silver-based dressing group was higher (15.11%) than in the traditional wound dressing group (33.44%). Moreover, the mean ulcer size "sq mm" in the hydrogel/nano silver-based dressing group recognized a faster healing rate (15.11±7.89) and considerably lesser in comparison to the traditional in the third week (21.65±8.4). Conclusion: The hydrogel/nanosilver-based dressing showed better results than traditional dressing in managing diabetic ulcer foot.

Keywords: diabetes, wound care, diabetic foot, wound dressing, hydrogel nanosilver

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Authors: Ruilian Zhao, Shukai Zhang, Yan Wang, Weiwei Wang

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Repairing broken test cases is an expensive and challenging task in evolving software systems. Although an automated repair technique with intent preservation has been proposed, but it does not take into account the association between test repairs and assertions, leading to a large number of irrelevant candidates and decreasing the repair capability. This paper proposes an assertion-driven test repair approach. Furthermore, an intent-oriented priority criterion is raised to guide the repair candidate generation, making the repairs closer to the intent of the test. In more detail, repair targets are determined through post-dominance relations between assertions and the methods that directly cause compilation errors. Then, test repairs are generated from the target in a bottom-up way, guided by the intent-oriented priority criteria. Finally, the generated repair candidates are prioritized to match the original test intent. The approach is implemented and evaluated on the benchmark of 4 open-source programs and 91 broken test cases. The result shows that the approach can fix 89% (81/91) of broken test cases, which is more effective than the existing intentpreserved test repair approach, and our intent-oriented priority criteria work well.

Keywords: test repair, test intent, software test, test case evolution

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Authors: L. B. Naves, L. Almeida

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The development of Drugs Delivery System (DDS), has been wildly investigated in the last decades. In this paper, first a general overview of traditional and modern wound dressing is presented. This is followed by a review of what scientist have done in the medical environment, focusing the possibility to develop a new alternative for DDS through transdermal pathway, aiming to treat melanoma skin cancer.

Keywords: cancer therapy, dressing polymers, melanoma, wound healing

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Authors: Erfan Ghasemi, Mohammadreza Khani, Hamidreza Mahmoudi, Mohammad Ali Nilforoushzadeh, Babak Shokri, Pouria Akbartehrani

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Given the global significance of treating infectious wounds, the goal of this study is to use spark plasma as a new treatment for infectious wounds. To generate spark plasma, a high-voltage (7 kV) and high-frequency (75 kHz) source was used. Infectious wounds in the peritoneum of mice were divided into control and plasma-treated groups at random. The plasma-treated animals received plasma radiation every 4 days for 12 days, for 60 seconds each time. On the 15th day after the first session, the wound in the plasma-treated group had completely healed. The spectra of spark plasma emission and tissue properties were studied. The mechanical resistance of the wound healed in the plasma treatment group was considerably higher than in the control group (p<0.05), according to the findings. Furthermore, histological evidence suggests that wound re-epithelialization is faster in comparison to controls. Angiogenesis and fibrosis (collagen production) were also dramatically boosted in the plasma-treated group, whereas the stage of wound healing inflammation was significantly reduced. Plasma therapy accelerated wound healing by causing considerable wound constriction. The results of this investigation show that spark plasma has an influence on the treatment of infectious wounds.

Keywords: infectious wounds, mice, spark plasma, treatment

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Authors: M. Wisnu Pamungkas, Patrianef Darwis

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Introduction: Critical limb ischemia (CLI) is a vascular disease that has a significant amputation and mortality risk with diabetes mellitus, the most significant risk factor in CLI, is very common among Indonesian. Endovascular intervention (EVI) is preferred in treating CLI because it is noninvasive and effective. Balloon angioplasty and stent angioplasty are the most common method of EVI in Indonesia. This study aims to compare the effectiveness of balloon angioplasty and stent angioplasty on wound healing in CLI. Method: A cross-sectional study enrolled 90 subjects of CLI who underwent endovascular intervention using balloon angioplasty and stent angioplasty from January 2013 to July 2017 in dr. Cipto Mangunkusumo General Hospital, Jakarta. The wound healing period between balloon angioplasty dan stent angioplasty was analyzed using unpaired T-test with p<0,05 considered as statistically significant. Data of intervention method wound healing period, and subjects characteristic data (age, amputation, BMI, smoking habit, DM, occlusion site, and blood profile) were obtained. Result: The wound healing period in balloon angioplasty and stent angioplasty distributed normally. Mean value of wound healing period in balloon angioplasty and stent angioplasty are 84,8+/-2,423 and 59,93 +/- 2,423 days with a mean difference of 25 days. The difference in wound healing period in both groups is statically significant (p<0,05). The amputation event in balloon angioplasty and stent angioplasty is 22 and 16 event with no difference statistically. Conclusion: Stent angioplasty is a better method than balloon angioplasty for wound healing in patients with CLI.

Keywords: critical limb ischemia, endovascular intervention, wound healing, angioplasty

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Authors: Masoud Sakhinia, Sajjad Ahmad

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Introduction: Though knowledge of the compositional makeup and structure of the limbal niche has progressed exponentially during the past decade, much is yet to be understood. Identifying the precise profile and role of the stromal makeup which spans the ocular surface may inform researchers of the most optimum conditions needed to effectively expand LESCs in vitro, whilst preserving their differentiation status and phenotype. Limbal fibroblasts, as opposed to corneal fibroblasts are thought to form an important component of the microenvironment where LESCs reside. Methods: The corneal stroma was tissue engineered in vitro using both limbal and corneal fibroblasts embedded within a tissue engineered 3D collagen matrix. The effect of these two different fibroblasts on LESCs and hTCEpi corneal epithelial cell line were then subsequently determined using phase contrast microscopy, histolological analysis and PCR for specific stem cell markers. The study aimed to develop an in vitro model which could be used to determine whether limbal, as opposed to corneal fibroblasts, maintained the stem cell phenotype of LESCs and hTCEpi cell line. Results: Tissue culture analysis was inconclusive and required further quantitative analysis for remarks on cell proliferation within the varying stroma. Histological analysis of the tissue-engineered cornea showed a comparable structure to that of the human cornea, though with limited epithelial stratification. PCR results for epithelial cell markers of cells cultured on limbal fibroblasts showed reduced expression of CK3, a negative marker for LESC’s, whilst also exhibiting a relatively low expression level of P63, a marker for undifferentiated LESCs. Conclusion: We have shown the potential for the construction of a tissue engineered human cornea using a 3D collagen matrix and described some preliminary results in the analysis of the effects of varying stroma consisting of limbal and corneal fibroblasts, respectively, on the proliferation of stem cell phenotype of primary LESCs and hTCEpi corneal epithelial cells. Although no definitive marker exists to conclusively illustrate the presence of LESCs, the combination of positive and negative stem cell markers in our study were inconclusive. Though it is less traslational to the human corneal model, the use of conditioned medium from that of limbal and corneal fibroblasts may provide a more simple avenue. Moreover, combinations of extracellular matrices could be used as a surrogate in these culture models.

Keywords: cornea, Limbal Stem Cells, tissue engineering, PCR

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Authors: Tia Morosin, Marie Shella De Robles

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Rectocele may be associated with symptoms of both obstructed defecation and faecal incontinence. Currently, numerous operative techniques exist to treat patients with rectocele; however, no single technique has emerged as the optimal approach in patients with post-partum faecal incontinence. The purpose of this study was to evaluate the clinical outcome in a consecutive series of patients who underwent transperineal repair of rectocele for patients presenting with faecal incontinence as the predominant symptom. Twenty-three consecutive patients from April 2000 to July 2015 with symptomatic rectocele underwent transperineal repair by a single surgeon. All patients had a history of vaginal delivery, with or without evidence of associated anal sphincter injury at the time. The median age of the cohort was 53 years (range 21 to 90 years). The median operating time and length of hospital stay were 2 hours and 7 days, respectively. Two patients developed urinary retention post-operatively, which required temporary bladder catheterization. One patient had wound dehiscence, which was managed by absorbent dressing applied by the patient and her carer. There was no operative mortality. In all patients with rectocele, there was a concomitant anal sphincter disruption. All patients had satisfactory improvement with regard to faecal incontinence on follow-up. This study suggests this method provides excellent anatomic and physiologic results with minimal morbidity. However, because none of the patients gained full continence postoperatively, pelvic floor rehabilitation might be also needed to achieve better sphincter function in patients with incontinence.

Keywords: anal sphincter defect, faecal incontinence, rectocele, transperineal repair

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Authors: Elham Rouhollahi, Soheil Zorofchian Moghadamtousi, Salma Baig, Mahmood Ameen Abdulla, Zahurin Mohamed

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This study was designed to assess cutaneous wound healing potential of hexane extract of Curcuma purpurascens rhizomes (HECP). Twenty-four rats were divided into 4 groups: 1. Negative, 2. Low dose, 3. High dose and 4. Treatment, with 6 rats in each group. Full-thickness incisions with a diameter of 2 cm were made on the back of each rat. Rats were topically treated two times a day for 15 days. Group 1-4 were treated with sterile distilled water, 5% and 10% of extract and intrasite gel, respectively. Masson's trichrome and hematoxylin staining techniques are employed for histological analysis revealed strong wound healing potential closer to that of conventional drug intrasite gel. HECP significantly decreased wound area and an increase in hydroxyproline, cellular proliferation, the number of blood vessels and the level of collagen synthesis was observed. Thus, it could be concluded that HECP possesses strong wound healing potential.

Keywords: Curcuma purpurascens, wound healing, histopathology, hematoxylin staining

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Authors: Solomon Assefa Huluka

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Wounds account for severe morbidity, socioeconomic distress, and mortality around the globe.For several years, various herbal products are used to expediteand augment the innate wound healing process. In Ethiopian folkloricmedicine, Verbascum sinaiticum L. (V. sinaiticum) is commonlyapplied as a wound-healing agent. The present study investigated the potential wound healing and antioxidant properties of hydroalcoholic leaf extract of V. sinaiticum. The 80% methanol extract, formulated as 5% (w/w) and 10% (w/w) ointments, was evaluated in excision and incision wound models using nitrofurazone and simple ointment as positive and negative controls, respectively. Parameters such as wound contraction, period of epithelialization, and tensile strength were determined. Moreover, its in vitro antioxidant property was evaluated using a DPPH assay. In the excision model, both doses (5% and 10% w/w) of the extract showed a significant (p<0.001) wound healing efficacy compared to the negative control, as evidenced by enhanced wound contraction rate and shorter epithelialization time records. In the incision model, the lower dose (5% w/w) ointment formulation of the extract exhibited the maximum increment in tensile strength (85.6%) that was significant (p<0.001)compared to negative and untreated controls. Animals treated with 5% w/wointment, furthermore, showed a significantly (p < 0.05) higher percentage of tensile strength than nitrofurazone treated ones. Moreover, the hydroalcoholic extract of the plant showed a noticeable free radical scavenging property. The result of the present study upholds the folkloric use of V. sinaiticum in the treatment of wounds.

Keywords: wound healing, antioxidant, excision wound model, incision wound model, verbascum sinaiticum

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Authors: Muhammad Naveed Ali, Hamad Bin Rashid, Muhammad Arif Khan, Abdul Basit, Hafiz Muhammad Arshad

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Abdominal defects are very common in pigeons. A new technique is known as intraabdominal mesh transplant that give better protection for herniorrhaphy. The aim of this study was to determine the performance of hernia mesh. In this study, an efficacy of two synthetic hernia mesh implants viz. conventional Prolene and a lightweight mesh monofilament polyester were assessed for the abdominal wall repair in pigeons. Twenty four healthy pigeons were selected and randomly distributed into three groups, A, B and C (n=8). In all groups, experimental laparotomy was performed; thereafter, abdominal muscles and peritoneum were sutured together, while, a 2 x 2 cm defect was created in the abdominal muscles. For onlay hernioplasty, the hernia mesh (Prolene mesh: group A; Polyester mesh: group B) was implanted over the external oblique muscles of the abdomen. In group C (control), the mesh was not implanted; instead, the laparotomy incision was closed after a herniorrhaphy. Post-operative pain wound healing, adhesion formation, histopathological findings and formation of hematoma, abscess and seroma were assessed as short-term complications. Post-operatively, pain at surgical site was significantly less (P < 0.001) in group B (Polyester mesh); wound healing was also significantly better and rapid in group B (P < 0.05) than in group A (Prolene mesh). Group B (Polyester mesh) also depicted less than 25% adhesions when assessed on the basis of a Quantitative Modified Diamond scale; a Qualitative Adhesion Tenacity scale also depicted either no adhesions or flimsy adhesions (n=2) in group B (Polyester mesh), in contrast to group A (Prolene), which manifested greater adhesion formation and presence of dense adhesions requiring blunt dissection. There were observed hematoma, seroma and abscess formations in birds treated by Prolene mesh only. Conclusively, the polyester mesh proved superior to the Prolene mesh regarding lesser adhesion, better in wound healing, and no short-term follow-up complications.

Keywords: adhesion, mesh, polyester, prolene

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Authors: Daifeng Hao, Guang Feng, Jingfeng Zhao, Tao Li, Xiaoye Tuo

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Objective: To retrospectively analyze the clinical characteristics of incision infection with sternal osteomyelitis sinus tract after cardiac surgery and the operation method and therapeutic effect of filling and repairing with activated PRP gel. Methods: From March 2011 to October 2022, 142 cases of incision infection after cardiac surgery with sternal osteomyelitis sinus were retrospectively analyzed, and the causes of poor wound healing after surgery, wound characteristics, perioperative wound management were summarized. Treatment during operation, collection and storage process of autologous PRP before debridement surgery, PRP filling repair and activation method after debridement surgery, effect of anticoagulant drugs on surgery, postoperative complications and average wound healing time, etc.. Results: Among the cases in this group, 53.3% underwent coronary artery bypass grafting, 36.8% underwent artificial heart valve replacement, 8.2% underwent aortic artificial vessel replacement, and 1.7% underwent allogeneic heart transplantation. The main causes of poor incision healing were suture reaction, fat liquefaction, osteoporosis, diabetes, and metal allergy in sequence. The wound is characterized by an infected sinus tract. Before the operation, 100-150ml of PRP with 4 times the physiological concentration was collected separately with a blood component separation device. After sinus debridement, PRP was perfused to fill the bony defect in the middle of the sternum, activated with thrombin freeze-dried powder and calcium gluconate injection to form a gel, and the outer skin and subcutaneous tissue were sutured freely. 62.9% of patients discontinued warfarin during the perioperative period, and 37.1% of patients maintained warfarin treatment. There was no significant difference in the incidence of postoperative wound hematoma. The average postoperative wound healing time was 12.9±4.7 days, and there was no obvious postoperative complication. Conclusions: Application of activated PRP gel to fill incision infection with sternal osteomyelitis sinus after cardiac surgery has a less surgical injury and satisfactory and stable curative effect. It can completely replace the previously used pectoralis major muscle flap transplantation operation scheme.

Keywords: platelet-rich plasma, negative-pressure wound therapy, sternal osteomyelitis, cardiac surgery

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Authors: Bahador Bardshiri, Omid Moradi, Amir Komeilian, Nima Panahifar

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Formation of a conjunctival membrane over the corneal surface is a condition unique to rabbits that has been labeled aberrant corneal occlusion or pseudopterygium. In the summer of 2013, a five years old male Standard Chinchilla rabbit were presented to Karaj Central Veterinary hospital and the owner complained that his rabbit shows degrees of blindness and there were opacities on both eyes of the presented rabbit. Ophthalmic examination of the affected eyes revealed a conjunctival fold stretching over the cornea of both eyes. The fold originated from limbus and it was vascularized and centrally thickened. There were no attachments to the corneal epithelium and the fold could be easily lifted. Surgery was performed under general anesthesia. The conjunctival fold was incised centrifugally up to its attachment at the limbus and the lid margin using small scissors. The central rim of the segment was then replaced to its normal position in the fornix and fixed with mattress sutures (7/0) passing through outside skin. After the surgery, eye drops containing dexamethasone, gentamicin and polymixin were applied twice daily up to 3 weeks. Within the observation period (8 months) no recurrence was noted. "Pseudo" in the term pseudopterygium refers to the fact that the conjunctival membrane is not adhering to the underlying cornea, but growing over it. In rare cases, the membrane may be loosely attached to the cornea, but can be easily separated without causing damage. It can cover only a small part of the cornea with an annular peripheral opacification of the cornea, or cover it almost fully, leading to blindness. Ethiopathogenesis remains unclear and recurrence of the problem is very likely. The surgical technique that used here decreases probability of recurrence of conjunctival fold.

Keywords: rabbit, cornea, aberrant corneal occlusion, pseudopterygium

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Authors: Cherifi Katia, Al-Hawat Marie-Lynn, Tricou Leo-Paul, Lamontagne Stephanie, Tran Minh, Ngu Amy Ching Yie, Manrique Gabriela, Guirguis Natalie, Machuca Parra Arturo Israel, Matoori Simon

Abstract:

Diabetic foot ulcers (DFUs) are a serious and prevalent complication of diabetes. Current diagnostic options are limited to macroscopic wound analysis such as wound size, depth, and infection. Molecular diagnostics promise to improve DFU diagnosis, staging, and assessment of treatment response. Here, we developed a rapid and easy-to-use fluorescent pH-sensing bandage for wound diagnostics. In a fluorescent dye screen, we identified pyranine as the lead compound due to its suitable pH-sensing properties in the clinically relevant pH range of 6 to 9. To minimize the release of this dye into the wound bed, we screened a library of ionic microparticles and found a strong adhesion of the anionic dye to a cationic polymeric microparticle. These dye-loaded microparticles showed a strong fluorescence response in the clinically relevant pH range of 6 to 9 and a dye release below 1% after one day in biological media. The dye-loaded microparticles were subsequently encapsulated in a calcium alginate hydrogel to minimize the interaction of the microparticles with the wound tissue. This pH-sensing diagnostic wound dressing was tested on full-thickness dorsal wounds of mice, and a linear fluorescence response (R2 = 0.9909) to clinically relevant pH values was observed. These findings encourage further development of this pH-sensing system for molecular diagnostics in DFUs.

Keywords: wound ph, fluorescence, diagnostics, diabetic foot ulcer, wound healing, chronic wounds, diabetes

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Authors: Balakrishna Valluru, Ruth Suckling

Abstract:

A 16 year old male was found collapsed on the road following stab injuries to the chest and abdomen and was transported to the emergency department by ambulance. On arrival in the emergency department the patient was breathless and appeared pale. He was maintaining his airway with spontaneous breathing and had a heart rate of 122 beats per minute with a blood pressure of 83/63 mmHg. He was resuscitated initially with three units of packed red cells. Clinical examination identified three incisional wounds each measuring 2 cm. These were in the left para-sternal region, right infra-scapular region and left upper quadrant of the abdomen. The chest wound over the left parasternal area at the level of 4tth intercostal space was bleeding intermittently on leaning forwards and was relieving his breathlessness intermittently. CT imaging was performed to characterize his injuries and determine his management. CT scan of chest and abdomen showed moderate size haemopericardium with left sided haemopneumothorax. The patient underwent urgent surgical repair of the left ventricle and left anterior descending artery. He recovered without complications and was discharged from the hospital. This case highlights the fact that the potential to develop a life threatening cardiac tamponade was mitigated by the left parasternal stab wound. This injury fortuitously provided a pericardial window through which the bleeding from the injured left ventricle and left anterior descending artery could drain into the left hemithorax providing an opportunity for timely surgical intervention to repair the cardiac injuries.

Keywords: stab, incisional, haemo-pericardium, haemo-pneumothorax

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Authors: Harpreet Kaur, Er. Arjun, Kirandeep Kaur, P. K. Mittal

Abstract:

Simulation of a human body from 20% gelatin & 80% water mixture is examined from wound ballistics point of view. Parameters such as incapacitation energy & temporary to permanent cavity size & tools of hydrodynamics have been employed to arrive at a model of human body similar to the one adopted by NATO. Calculations using equations of motion yield a value of 339 µs in which a temporary cavity with maximum size settles down to permanent cavity. This occurs for a 10mm size bullets & settle down to permanent cavity in case of 4 different bullets i.e. 5.45, 5.56, 7.62,10 mm sizes The obtained results are in excellent agreement with the body as right circular cylinder of 15 cm height & 10 cm diameter. An effort is made here in this work to present a sound theoretical base to parameters commonly used in wound ballistics from field experience discussed by Col Coats & Major Beyer. Keywords. Gelatin, gunshot, hydrodynamic model, oscillation time, temporary cavity and permanent cavity, Wound Ballistic.

Keywords: gelatin, gunshot, wound, cavity

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Authors: Souradip Paul, Arijit Paramanick, M. Suheshkumar Singh

Abstract:

Traumatic injury is the leading worldwide health problem. Annually, millions of surgical wounds are created for the sake of routine medical care. The healing of these unintended injuries is always monitored based on visual inspection. The maximal restoration of tissue functionality remains a significant concern of clinical care. Although minor injuries heal well with proper care and medical treatment, large injuries negatively influence various factors (vasculature insufficiency, tissue coagulation) and cause poor healing. Demographically, the number of people suffering from severe wounds and impaired healing conditions is burdensome for both human health and the economy. An incomplete understanding of the functional and molecular mechanism of tissue healing often leads to a lack of proper therapies and treatment. Hence, strong and promising medical guidance is necessary for monitoring the tissue regeneration processes. Photoacoustic imaging (PAI), is a non-invasive, hybrid imaging modality that can provide a suitable solution in this regard. Light combined with sound offers structural, functional and molecular information from the higher penetration depth. Therefore, molecular and structural mechanisms of tissue repair will be readily observable in PAI from the superficial layer and in the deep tissue region. Blood vessel formation and its growth is an essential tissue-repairing components. These vessels supply nutrition and oxygen to the cell in the wound region. Angiogenesis (formation of new capillaries from existing blood vessels) contributes to new blood vessel formation during tissue repair. The betterment of tissue healing directly depends on angiogenesis. Other optical microscopy techniques can visualize angiogenesis in micron-scale penetration depth but are unable to provide deep tissue information. PAI overcomes this barrier due to its unique capability. It is ideally suited for deep tissue imaging and provides the rich optical contrast generated by hemoglobin in blood vessels. Hence, an early angiogenesis detection method provided by PAI leads to monitoring the medical treatment of the wound. Along with functional property, mechanical property also plays a key role in tissue regeneration. The wound heals through a dynamic series of physiological events like coagulation, granulation tissue formation, and extracellular matrix (ECM) remodeling. Therefore tissue elasticity changes, can be identified using non-contact photoacoustic elastography (PAE). In a nutshell, angiogenesis and biomechanical properties are both critical parameters for tissue healing and these can be characterized in a single imaging modality (PAI).

Keywords: PAT, wound healing, tissue coagulation, angiogenesis

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Authors: Lim Kar Sing, Siti Nur Afifah Azraai, Norhazilan Md Noor, Nordin Yahaya

Abstract:

Polymeric composites are being increasingly used as repair material for repairing critical infrastructures such as building, bridge, pressure vessel, piping and pipeline. Technique in repairing damaged pipes is one of the major concerns of pipeline owners. Considerable researches have been carried out on the repair of corroded pipes using composite materials. This article attempts a short review of the subject matter to provide insight into various techniques used in repairing corroded pipes, focusing on a wide range of composite repair systems. These systems including pre-cured layered, flexible wet lay-up, pre-impregnated, split composite sleeve and flexible tape systems. Both advantages and limitations of these repair systems were highlighted. Critical technical aspects have been discussed through the current standards and practices. Research gaps and future study scopes in achieving more effective design philosophy are also presented.

Keywords: composite materials, pipeline, repair technique, polymers

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Authors: Kingkan Chumjamras

Abstract:

There are permanent and temporary tracheostomies, and in a permanent tracheostomy, care giver are important persons to know and be able to care for the tracheostomy patient. The objective of this quasi-experimental study was to evaluate outcomes of educating care giver in tracheostomy wound care for discharge planning of tracheostomy patients. The subjects of the study were relatives who directly cared for tracheostomy patients. Thirty subjects were selected according to specified criteria. The research instruments consisted of practice guidelines, manual for relatives in caring for the tracheostomy wound, an assisted model with a tracheostomy wound, a test, an observation form, and a patient’s relative satisfaction questionnaire. The instrument validity was tested by three experts, and the questionnaire reliability was tested with Cronbach’s alpha, and the reliability coefficient was 0.83; the data were analyzed using descriptive statistics, and paired t-test. The results of the study on educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients revealed that the score for knowledge and ability in caring for the tracheostomy wound before receiving the education was at a low level (M= 19.23, SD= 1.57) compared with the very high score (M= 36.40, SD= 19.23) after receiving the education. The difference was statistically significant (p < .05), and relatives’ satisfaction was at a high level (80 percent). Knowledge and ability in caring for tracheostomy patients among patients’ relatives could cause tracheostomy wound complications for tracheostomy patients. One way to control such complications and returns to hospital from infection, in addition to care by the health care team, is educating relatives in tracheostomy wound care for discharge planning of tracheostomy patients.

Keywords: outcomes, educating, care giver, Tracheostomy Wound Care, discharge planning

Procedia PDF Downloads 422

Authors: Salah Hassab Elnaby, Omnia Hamdy, Aziza Ahmed Hassan, Salwa Abdelkawi, Ibrahim Abdelhalim

Abstract:

Laser corneal reshaping has been proposed as a successful treatment of many refraction disorders. However, some physical and chemical demonstrations of the laser effect upon interaction with the corneal tissue are still not fully explained. Therefore, different computational and mathematical models have been implemented to predict the depth of the ablated channel and calculate the ablation threshold and the local temperature rise. In the current paper, we present a modified model that aims to answer some of the open questions about the ablation threshold, the ablation rate, and the physical and chemical mechanisms of that action. The proposed model consists of three parts. The first part deals with possible photochemical reactions between the incident photons and various components of the cornea (collagen, water, etc.). Such photochemical reactions may end by photo-ablation or just the electronic excitation of molecules. Then a chemical reaction is responsible for the ablation threshold. Finally, another chemical reaction produces fragments that can be cleared out. The model takes into account all processes at the same time with different probabilities. Moreover, the effect of applying different laser wavelengths that have been studied before, namely the common excimer laser (193-nm) and the solid state lasers (213-nm & 266-nm), has been investigated. Despite the success and ubiquity of the ArF laser, the presented results reveal that a carefully designed 213-nm laser gives the same results with lower operational drawbacks. Moreover, the use of mode locked laser could also decrease the risk of heat generation and diffusion.

Keywords: UV lasers, mathematical model, corneal ablation, photochemical ablation

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Authors: Blanca Fatela Cantillo, Silvia Iglesias Cerrato, Guadalupe Garrido Ceca

Abstract:

Purpose: Bleb dysfunction is a late complication following glaucoma filtration surgery. We describe our surgical technique for excision and reconstruction of a hypertrophic bleb complication using bovine pericardium patch graft (Tutopatch®) and amniotic membrane. Material and methods: The case report presents a hypertrophic bleb over the cornea with good intraocular pressure control. The hanging bleb without leak caused dysesthesia and high irregular astigmatism. Bleb reconstruction involved the excision of corneal fibrous material and avascular conjunctiva, preserving the original scleral and tennon. Bovine pericardium patch graft (Tutopatch®) was sited over these with fixed sutures, reinforcing the underlying scleral, and the conjunctiva advanced. The superior epithelium corneal defect was covered using an amniotic membrane. Conclusion: Repair of bleb dysfunction with varied techniques has been reported, including conjunctival advancement, use of scleral patch graft, dural patch graft, or pericardium. Additional use of amniotic membrane promotes epithelialization and exhibits anti-fibrotic and anti-inflammatory features. Reconstruction with bovine pericardium patch graft and amniotic membrane resulted in pain relief, visual rehabilitation, and good aesthetic results, with preservation of bleb function.

Keywords: reconstruction, hypertrophic bleb, bovine pericardium, amniotic membrane, dysesthesia of the bleb

Procedia PDF Downloads 69