The Application of Bilayer Artificial Dermis Combined with VSD Technology in Chronic Wounds

Background: Bilayer artificial dermis promotes wound healing and offers a treatment option for chronic wounds. Aim: Examine the clinical efficacy of bilayer artificial dermis combined with Vacuum Sealing Drainage (VSD) technology in the treatment of chronic wounds. Method: From June 2021 to December 2023, our hospital treated 24 patients with chronic skin tissue wounds on their limbs using a novel tissue engineering product, the bilayer artificial dermis, in combination with VSD technology to repair the wounds. The bilayer artificial dermis protects subcutaneous tissue, blood vessels, nerves, muscles, and tendons, and also promotes the growth of granulation tissue and blood vessels to aid in wound healing when used in conjunction with VSD technology for wound dressing changes in chronic wounds. Results: In this study, 24 cases of chronic wounds with exposed bone or tendon larger than 1.0 cm2 were treated with a bilayer artificial skin combined with VSD dressing after wound debridement. The wounds were not suitable for immediate skin grafting. At 2 - 3 weeks post-treatment, good granulation tissue growth was observed. Subsequent procedures included thick skin grafting or wound dressing changes until complete wound healing. Patients were followed up on average for 3 months (range: 1 - 12 months) post-surgery. Comparative analysis of the appearance, function, skin color, elasticity, and sensation of the healed chronic wounds revealed superior outcomes compared to traditional skin fl repairs, resulting in significantly higher satisfaction levels among patients and their families. Conclusion: The application of bilayer artificial dermis combined with VSD technology for the repair of chronic wounds proves to be a viable method, yielding satisfactory therapeutic effects compared to traditional skin flap procedures.

Double-nylon purse-string suture in closing postoperative wounds following endoscopic resection of large(≥3 cm)gastric submucosal tumors

BACKGROUND Endoscopic full-thickness resection(EFTR)of gastric submucosal tumors(SMTs)is safe and effective;however,postoperative wound management is equally important.Literature on suturing following EFTR for large(≥3 cm)SMTs is scarce and limited.AIM To evaluate the efficacy and clinical value of double-nylon purse-string suture in closing postoperative wounds following EFTR of large(≥3 cm)SMTs.METHODS We retrospectively analyzed the data of 85 patients with gastric SMTs in the fundus of the stomach or in the lesser curvature of the gastric body whose wounds were treated with double-nylon purse-string sutures after successful tumor resection at the Endoscopy Center of Renmin Hospital of Wuhan University.The operative,postoperative,and follow-up conditions of the patients were evaluated.RESULTS All tumors were completely resected using EFTR.36(42.35%)patients had tumors located in the fundus of the stomach,and 49(57.65%)had tumors located in the body of the stomach.All patients underwent suturing with double-nylon sutures after EFTR without laparoscopic assistance or further surgical treatment.Postoperative fever and stomach pain were reported in 13(15.29%)and 14(16.47%)patients,respectively.No serious adverse events occurred during the intraoperative or postoperative periods.A postoperative review of all patients revealed no residual or recurrent lesions.CONCLUSION Double-nylon purse-string sutures can be used to successfully close wounds that cannot be completely closed with a single nylon suture,especially for large(≥3 cm)EFTR wounds in SMTs.

Transplantation of a pectoralis major flap for the repair of myiasis wounds

Myiasis is a disease caused by the invasion and colonization of human tissues and organs by the larvae of flies.This is manifested by the formation of necrotic tissue in the lesion,the colonization of fly eggs and the spread of fly larvae.This disease is mostly found in areas with poor sanitary conditions.Poor wound care,necrotic tissue formation,reduced immunity,and frequent contact with flies are risk factors for this disease.Myiasis can be divided into obligate and facultative parasitism,^([1])while some scholars have classified myiasis according to its location.^([2])In addition,some cases of myiasis are secondary to wound infection or poor surgical maintenance.^([3,4]).

Platelet-rich plasma treatment for chronic wounds:A case report and literature review

BACKGROUND Wound healing is a complicated process that can be heavily influenced by patient comorbidities,in some cases leading to a chronic non-healing wound.Evidence presented in the medical literature supporting the clinical use of autologous platelet-rich plasma(PRP)in treatment of such wounds is becoming increasingly compelling.Mechanisms involved include complex interactions between the patient’s thrombocytes,cytokines,and growth factors.CASE SUMMARY We present a case of a 72-year-old male patient with a long-standing chronic wound and multiple comorbidities.Over the course of more than 7 months,the patient was unsuccessfully treated with all routinely used measures,including different dressing approaches.Multiple antibiotic regimens were administered for wound infection,with repeated evaluation of microbiological swab results.Finally,after three PRP applications,the wound showed clinical improvement with complete restitution of the epithelial layer of the skin.CONCLUSION PRP treatment may be beneficial to reduce healing time in chronic wounds.

Eyelid Wounds: Epidemiological, Clinical and Etiological Aspects

Purpose: The aim is to show epidemiological, clinical and etiological characteristics of palpebral wounds. Methodology: This was a retrospective study focusing on patients with an eyelid wound, over a 10-year period from 2012 to 2021. We collected and analyzed the data using Excel. Results: The frequency of eyelid wounds was 0.1%. The average age of our patients was 19.38 years with a range of 1 and 62 years. The sex ratio was 3.7. Eighty-one percent of patients lived in Dakar. Fifty-seven percent (57%) of patients consulted less than 24 hours after the trauma and 7% of patients on D1. The circumstances were brawls (11%), domestic accidents (9%), road accidents (6%), and work accidents (6%). We noted 1 case of dog bite. Thirteen patients presented with post-traumatic decreased visual acuity. Involvement of the isolated upper eyelid was noted in 40% of cases and both eyelids in 15% of cases. Involvement of the lacrimal ducts was noted in 17% of cases, and that of the free edge in 21% of cases. Eyelid wounds were associated with eyeball damage in 21% of cases. Various associated lesions were observed. Ninety-one percent of patients received surgical treatment. Three cases of superinfections, 1 case of conjunctival granuloma and 1 case of phthysis of the eyeball with postoperative retinal detachment were noted. Conclusion: Eyelid sores are relatively common in our context. They require rapid surgical treatment in order to preserve the functional and aesthetic prognosis. .

Study on the effect of Shixiang plaster on the expression of CD31,serum FN,and VEGF in a rat model with chronic wounds

Background:Chronic wounds pose a significant surgical challenge,often requiring traditional treatments with limited efficacy.This study explores the promising impact of Shixiang plaster,a classic Chinese ointment,on wound healing.We investigated the cluster of differentiation 31(CD31)expression,serum fibronectin(FN),and vascular endothelial growth factor(VEGF)levels in SPF rats with induced wounds to elucidate the mechanism behind Shixiang plaster’s effectiveness.We investigated the effect and explored the role of Shixiang plaster on the expression of CD31,serum FN,and VEGF in chronic wounds.Methods:The study involved 36 SPF rats divided into model,rb-bFGF,and Shixiang plaster groups.Penicillin was injected into the rats before modelling for 3 days to prevent infection.The skin was excised 2 cm below the horizontal line of the inferior border of the shoulder bone in the middle of the rat column up to the deep fascial layer and inoculated with a certain concentration of Staphylococcus aureus;the wound was covered aseptically for 3 days.The trauma area of the rats was observed at 3,7,and 14 days,respectively.Histopathology was observed using haematoxylin eosin and Masson staining.CD31 expression was detected using immunohistochemistry staining.FN and VEGF expression was detected using serum ELISA.Statistical analyses were carried out by the method of SPSS.Results:Regarding wound morphology,at 3 days,the recovery area of the Shixiang plaster group was larger than that of the other two groups,at 7 days,the wound healing rate of the Shixiang plaster group was significantly higher,and at 14 days,the wounds of the Shixiang plaster group had been mostly healed,with a healing rate of 98.3%.Haematoxylin eosin staining revealed a large amount of granulation tissue at 3 days in the Shixiang plaster group,and the epidermal scales disappeared at 14 days,with thinner epidermal thickness at 1 lesion and a large reduction in inflammatory cell infiltration.Masson staining showed that at 3,7,and 14 days,blue staining was the most abundant and deeper in the Shixiang plaster group,with richer collagen and a compact tissue matrix.Immunohistochemical testing showed strong positive expression of CD31 in the Shixiang plaster group,with abundant neovascularisation and large official lumens extending towards the surface of the wound.Statistically significant elevated expression of FN at 7 and 14 days was determined by ELISA in the Shixiang plaster group,and VEGF expression was significantly increased at 7 days,but expression had been expressed at a low level at 14 days.Conclusion:Shixiang plaster exhibits remarkable efficacy in healing chronic wounds.The proposed mechanism involves FN’s promotion of angiogenesis and cell proliferation,VEGF’s impact on angiogenesis and inflammation,and CD31’s regulatory role in inhibiting inflammation while promoting angiogenesis.

Nanoskin®-ACT—The Impact of Natural Membrane & Soft with Chronic and Untreated Wounds

Bacterial cellulose (BC) is a versatile biomaterial with unique properties that make it promising for various biomedical applications, including wound healing. The extracellular matrix (ECM) plays a crucial role in wound healing, providing a structural scaffold and signaling cues for cell migration and proliferation. This study investigates the potential of BC as a scaffold for ECM production and its effect on in vivo wound healing. In this work, the bacterial cellulose fermentation process is modified by the addition of Green Propolis and Usnic acid to the culture medium and natural materials before the bacteria are inoculated. In vivo behaviour using natural membranes for regenerative medicine is presented and it is in edit. Overall, our findings demonstrate the potential of BC as a scaffold for ECM production and its beneficial effects on in vivo wound healing. BC-based dressings may offer a novel approach to promoting wound healing and tissue regeneration in clinical settings. Further studies are warranted to optimize BC-based therapies and explore their full potential in regenerative medicine.

Non-Hodgkin's lymphoma involving chronic difficult-to-heal wounds:A case report

BACKGROUND Non-Hodgkin's lymphoma(NHL)is a malignant tumor that originates from the lymphoid tissues and can potentially affect numerous organs within the body.Among these,the skin stands out as one of the primary sites affected by NHL,often presenting with multiple extra-nodal manifestations.In this report,we present an unusual case of NHL involving chronic wounds in the lower extremities that were difficult to heal.The scars were successfully treated using radiotherapy in combination with extended excision debridement and peroneal artery perforator flap grafting,resulting in satisfactory outcomes.CASE SUMMARY A 19-year-old male patient presented with ulceration of the skin on the left calf near the ankle accompanied by purulent discharge.Subsequent pathologic biopsy confirmed a diagnosis of NHL(extranodal NK/T-cell lymphoma,nasal type).Initial treatment comprised local radiotherapy and wound care;however,the wound exhibited prolonged non-healing.Consequently,the patient underwent a series of interventions including radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting.Ultimately,successful healing was achieved with favorable postoperative outcomes characterized by good texture of the flap without any signs of rupture or infection.CONCLUSION The combination of radiotherapy,wound enlargement excision debridement,and peroneal artery perforator flap grafting may present a favorable treatment modality for chronic non-healing lower leg wounds resulting from NHL.

Tissue Regeneration in Infected Wounds of Albino Rats Using Ciprofloxacin-Loaded Gelatin Microspheres Incorporated Collagen Scaffold: A Histological Approach with H&E Staining

A wound care system consisting of ciprofloxacin-loaded gelatin microspheres impregnated in a macroporous collagen scaffold was created to effectively control wound infection and regenerate soft tissue at the wound site.Histological and biochemical alterations were observed in infected wounds treated with these scaffolds in Albino Wistar rats.Furthermore,the study examined the immediate and prolonged release of ciprofloxacin from the scaffolds,as well as their function in eliminating bacterial infections and expediting the process of skin healing and regeneration.The developed technique was followed in the streamlined process of creating these collagen scaffolds.Compared to untreated wounds,the group receiving scaffold treatment experienced a faster rate of wound closure.It was noted that the rate of infections was considerably reduced and that full soft tissue regeneration occurred within 12 days.The development of well-deposited collagen bundles in the treated groups was demonstrated by H&E staining,which verified the flawless regeneration of the dermis and epidermis.The antimicrobial agent-loaded gelatin microspheres impregnated into the porous collagen scaffold demonstrated remarkable soft tissue regeneration and efficient infection control at the wound site.

Research Progress of Continuous Nursing for Patients with Chronic Wounds After Discharge

The research status of continuous nursing of patients with chronic wounds is reviewed.Since the research on continuous nursing of chronic wound patients in China is still in the initial stage,if necessary,learn from foreign experience,improve relevant systems,develop corresponding evaluation tools,actively implement telemedicine,and carry out hospital-community linkage models,etc.to provide high-quality nursing services for patients with chronic wounds.

Zinc oxide nanoparticles accelerate the healing of methicillin-resistant Staphylococcus aureus(MRSA)-infected wounds in rabbits

Objective:To synthesize zinc oxide nanoparticles(ZnONPs)and evaluate their antibacterial and wound healing effects against wounds infected with methicillin-resistant Staphylococcus aureus(MRSA).Methods:ZnONPs were prepared by sol-gel method and characterized by X-ray diffraction(XRD)analysis and scanning electron microscopy(SEM).A total of 18 rabbits were divided into three groups:the ZnONPs group,the gentamicin group and the control group.A wound of 3 cm^(2) was inflicted on each rabbit and contaminated with MRSA inoculum.Treatment was started from the fourth day post-surgery.Wound healing,microbiological analysis,and histopathological analysis were performed to assess the efficacy of ZnONPs ointment.Results:XRD analysis confirmed the hexagonal wurtzite structure of the ZnONPs with an average crystallite size of 29.23 nm.SEM revealed discoid-shaped ZnONPs with a rough surface and an average size of 48.36 nm.Energy-dispersive X-ray analysis confirmed the purity of ZnONPs.Moreover,the particle size ranged from 100-700 nm with a high agglomeration trend.Treatment with ZnONPs promoted MRSA-infected wound healing.In addition,ZnONPs showed a good antibacterial effect as evidenced by a dose-dependent increase in the zone of inhibition.Conclusions:ZnONPs accelerate the healing of MRSA-infected wounds.Therefore,it can be explored for the treatment of MRSA infection.

Research advances in smart responsive-hydrogel dressings with potential clinical diabetic wound healing properties

The treatment of chronic and non-healing wounds in diabetic patients remains a major medical problem.Recent reports have shown that hydrogel wound dressings might be an effective strategy for treating diabetic wounds due to their excellent hydrophilicity,good drug-loading ability and sustained drug release properties.As a typical example,hyaluronic acid dressing(Healoderm)has been demonstrated in clinical trials to improve wound-healing efficiency and healing rates for diabetic foot ulcers.However,the drug release and degradation behavior of clinically-used hydrogel wound dressings cannot be adjusted according to the wound microenvironment.Due to the intricacy of diabetic wounds,antibiotics and other medications are frequently combined with hydrogel dressings in clinical practice,although these medications are easily hindered by the hostile environment.In this case,scientists have created responsive-hydrogel dressings based on the microenvironment features of diabetic wounds(such as high glucose and low pH)or combined with external stimuli(such as light or magnetic field)to achieve controllable drug release,gel degradation,and microenvironment improvements in order to overcome these clinical issues.These responsive-hydrogel dressings are anticipated to play a significant role in diabetic therapeutic wound dressings.Here,we review recent advances on responsive-hydrogel dressings towards diabetic wound healing,with focus on hydrogel structure design,the principle of responsiveness,and the behavior of degradation.Last but not least,the advantages and limitations of these responsive-hydrogels in clinical applications will also be discussed.We hope that this review will contribute to furthering progress on hydrogels as an improved dressing for diabetic wound healing and practical clinical application.

Discussion on the Application Effect of Simplified Vacuum Sealing Drainage(VSD)in the Treatment of Chronic Refractory Wounds

Objective:To analyze the effect of simplified vacuum sealing drainage(VSD)in the treatment of chronic refractory wounds.Methods:A total of 90 patients with chronic refractory wounds treated from May 2022 to May 2023 were randomly divided into groups.The simplified VSD treatment was employed in group A,and conventional treatment was employed in group B,and the wound healing of both groups were compared.Results:Group A showed better wound healing compared to group B,P<0.05;the wound healing rate,wound healing duration,visual analog scale(VAS)score,wound dressing times and other indicators in group A were better than those in group B,P<0.05.The SF-36 score of group A was higher than that of group B,P<0.05;the complication rate of chronic refractory wounds in group A was no different from that in group B,P>0.05.Conclusion:Simplified VSD treatment is effective in treating patients with chronic refractory wounds,and it reduces the number of wound dressing changes and promote wound healing.

Natural Nanoskin Advanced Cell Therapy (ACT) and Nanoskin ACT Soft towards the Definitive Solution for Acute and Chronic Wounds

Natural Nanoskin Advance cell therapy (ACT) and Nanoskin ACT Soft have been established to be remarkably versatile biomaterials and can be used in a wide variety of applied scientific endeavors, especially for medical devices. In fact, the structure of Nanoskin materials can be adapted over length scales ranging from nano to macro by controlling the bio-fabrication process. The present paper describes Natural Nanoskin Advanced cell therapy (ACT) and Nanoskin ACT Soft production for wound care applications. ACT is produced from the bio-nanotechnology process. ACT is a highly hydrated pellicle with shaped fibers less than 2 nm wide. Nanoskin ACT Soft, like a paste, is designed to fill irregularities or recesses in the wound bed, and to absorb excess exudate from lesions by prolonging the used dressing's residence time and reducing the frequency of change.

Efficacy of lidocaine wet compress combined with red-light irradiation for chronic wounds

BACKGROUND Chronic wounds that fail to progress through normal phases of healing present a significant healthcare burden owing to prolonged treatment and associated costs.Traditional wound care typically involves regular dressing changes,which can be painful.Recent approaches have explored the use of lidocaine to manage pain and red-light irradiation(RLI),known for its anti-inflammatory and cell proliferation effects,to potentially enhance wound healing.AIM To investigate the therapeutic efficacy of lidocaine wet compression(LWC)combined with RLI for chronic wounds.METHODS We enrolled 150 patients with chronic wounds from the Wound and Ostomy Outpatient Clinic of the Second Hospital of Anhui Medical University from April to September 2022.The wounds were treated with dressing changes.The patients were randomly assigned to the control and experimental groups using a random number table and given the same first dressing change(2%LWC for 5 min and routine dressing change).From the second dressing change,in addition to 2%LWC for 5 min and routine dressing change,the experimental group received RLI,whereas the control group continued to receive the same LWC and dressing change.The first and second dressing changes were performed on days 1 and 2,respectively.The third dressing change was performed 3 d after the second change.The frequency of subsequent dressing changes was determined based on wound exudation and pain.Pain during the first three dressing changes was evaluated in both groups.The average number of dressing changes within 28 d and the degree of wound healing on day 28 were also recorded.RESULTS During the initial dressing change,no noticeable differences were observed in the pain levels experienced by the two groups,indicating similar pain tolerance.However,during the second and third dressing changes,the experimental group reported significantly less pain than the control group.Furthermore,over 28 d,the experimental group required fewer dressing changes than the control group.CONCLUSION Notably,the effectiveness of wound healing on the 28th day was significantly higher in the experimental group than that of in the control group.The combination of LWC and RLI was effective in reducing early-stage pain,promoting wound healing,decreasing the frequency of dressing changes,and enhancing patients’overall quality of life with chronic wounds.

Mesenchymal stem cell-derived extracellular vesicles in skin wound healing:roles,opportunities and challenges

Skin wounds are characterized by injury to the skin due to trauma,tearing,cuts,or contusions.As such injuries are common to all human groups,they may at times represent a serious socioeconomic burden.Currently,increasing numbers of studies have focused on the role of mesenchymal stem cell(MSC)-derived extracellular vesicles(EVs)in skin wound repair.As a cell-free therapy,MSC-derived EVs have shown significant application potential in the field of wound repair as a more stable and safer option than conventional cell therapy.Treatment based on MSC-derived EVs can significantly promote the repair of damaged substructures,including the regeneration of vessels,nerves,and hair follicles.In addition,MSC-derived EVs can inhibit scar formation by affecting angiogenesis-related and antifibrotic pathways in promoting macrophage polarization,wound angiogenesis,cell proliferation,and cell migration,and by inhibiting excessive extracellular matrix production.Additionally,these structures can serve as a scaffold for components used in wound repair,and they can be developed into bioengineered EVs to support trauma repair.Through the formulation of standardized culture,isolation,purification,and drug delivery strategies,exploration of the detailed mechanism of EVs will allow them to be used as clinical treatments for wound repair.In conclusion,MSCderived EV-based therapies have important application prospects in wound repair.Here we provide a comprehensive overview of their current status,application potential,and associated drawbacks.

Antibacterial Properties of Crateva adansonii (Capparidaceae) on Strains Isolated from Chronic Wounds Diagnosed in the Commune of Ouinhi in 2021

Plants have always been used by people for therapeutic purposes. They are still the main source of therapeutic substances in developing countries. Crateva adansonii, a member of the Capparidaceae family, is a medicinal plant with antibacterial properties used in Benin. The aim of this study was to assess the efficacy of an aqueous extract of C. adansonii on bacterial strains isolated from chronic wounds in the Ouinhi population. To achieve this, the bacterial flora present in chronic wounds was identified using the Ikram method (2014) coupled with the API Remoel One method. The antibacterial properties of the aqueous extract of C. adansonii on the microbial strains isolated were then assessed by determining the Inhibition Diameters (ID), the Minimum Inhibitory Concentrations (MIC) and finally the Minimum Bactericidal Concentrations (MBC). A total of eighty (80) strains were isolated and identified on the basis of morphological, cultural and biochemical characteristics. The species S. Aureus species accounted for the largest proportion (67.5%). Other species such as Listeria sp, Pseudomonas proteus, S. epidermidis and Bacillus cereus, Citrobacter freundii, Steno maltophila;Axin calcoaceticus, E. coli, K. pneumonia, Lem. richardii, Salmonella paratyphi A, Salmonella sp, Shigella sp were determined in variable proportions. At a concentration of 10 mg/ml, only S. aureus was sensitive to contact with the extract. However, at 20 mg/ml, 89% of strains were sensitive and 11% very sensitive. The highly sensitive strains are Salmonella sp and E. coli. The Minimum Inhibitory Concentration (MIC) and Minimum Bactericidal Concentration (MBC) are 20 mg/ml and 40 mg/ml respectively. The MBC/MIC ratio of the aqueous mixture of Crateva adansonii (Capparidaceae) varied from 1.2 to 2, with a bactericidal effect on 100% of the strains tested.

ROS Balance Autoregulating Core-Shell CeO_(2)@ZIF-8/Au Nanoplatform for Wound Repair

Reactive oxygen species(ROS)plays important roles in living organisms.While ROS is a double-edged sword,which can eliminate drug-resistant bacteria,but excessive levels can cause oxidative damage to cells.A core–shell nanozyme,Ce O_(2)@ZIF-8/Au,has been crafted,spontaneously activating both ROS generating and scavenging functions,achieving the multifaceted functions of eliminating bacteria,reducing inflammation,and promoting wound healing.The Au Nanoparticles(NPs)on the shell exhibit high-efficiency peroxidase-like activity,producing ROS to kill bacteria.Meanwhile,the encapsulation of Ce O_(2) core within ZIF-8 provides a seal for temporarily limiting the superoxide dismutase and catalase-like activities of Ce O_(2) nanoparticles.Subsequently,as the ZIF-8 structure decomposes in the acidic microenvironment,the Ce O_(2) core is gradually released,exerting its ROS scavenging activity to eliminate excess ROS produced by the Au NPs.These two functions automatically and continuously regulate the balance of ROS levels,ultimately achieving the function of killing bacteria,reducing inflammation,and promoting wound healing.Such innovative ROS spontaneous regulators hold immense potential for revolutionizing the field of antibacterial agents and therapies.

Diabetic wounds and artificial intelligence:A mini-review

Diabetic wound takes longer time to heal due to micro and macro-vascular ailment.This longer healing time can lead to infections and other health complications.Foot ulcers are one of the most common diabetic wounds.These are one of the leading cause of amputations.Medical science is continuously striving for improving quality of human life.A recent trend of amalgamation of knowledge,efforts and technological advancement of medical science experts and artificial intelligence researchers,has made tremendous success in diagnosis,prognosis and treatment of a variety of diseases.Diabetic wounds are no exception,as artificial intelligence experts are putting their research efforts to apply latest technological advancements in the field to help medical care personnel to deal with diabetic wounds in more effective manner.The presented study reviews the diagnostic and treatment research under the umbrella of Artificial Intelligence and computational science,for diabetic wound healing.Framework for diabetic wound assessment using artificial intelligence is presented.Moreover,this review is focused on existing and potential contribution of artificial intelligence to improve medical services for diabetic wound patients.The article also discusses the future directions for the betterment of the field that can lead to facilitate both,clinician and patients.

Management of Complex Wounds with Dermal Substitute Assisted by a Negative Pressure System

Introduction: The standard treatment for complex wound care is autografting. The advent of dermal substitutes has provided a novel tool for the preparation of the bed to be grafted. However, most types of dermal matrices require the application of a skin graft a second time. Currently, other strategies have been developed to improve the vascularization process, such as negative pressure wound therapy (NPWT), which has been reported to reduce the time required for vascular growth and dermal matrix integration and thus achieve a shorter waiting period for autologous graft application. The present study aims to evaluate the effectiveness and safety of dermal matrix management associated with NPWT in the treatment of complex wounds. Methods: Seven patients with a diagnosis of complex wounds were enrolled in this study between July 1, 2015, and June 31, 2016. After debridement and having an adequate wound bed, patients who met the criteria for the application of combined therapy were treated with dermal substitutes and a negative pressure system. The percentage of graft integration into the wound bed, complications, length of hospital stay, and duration of therapy were analyzed. Results: The mean age was 42.5 ± 16 (39 - 54) years old;three women and four men were included in the study. The approximate size of skin loss was 120.7 ± 75 cm2 (25 - 250 cm2). The combined therapy of dermal matrix plus NPWT was instituted in all cases for a period of 14 days. There were no complications, with 100% graft integration in 6 of 7 cases. Patients were discharged after a mean hospital stay of 5.4 days. Conclusions: This study demonstrates that the utilization of combined dermal matrix plus NPWT therapy can be performed safely and effectively in patients with complex wounds with low complication rates and a short hospital stay.