Wound healing effect of flavonoid rich fraction and luteolin isolated from Martynia annua Linn. on streptozotocin induced diabetic rats

ObjectiveTo evaluate wound healing potential of flavonoid fractions of Martynia annua (M. annua) Linn. leaves in diabetic rats on the basis of folkloric information and preliminary study.MethodsThe flavonoid compound luteolin and apigenin were isolated from dried leaves of plant by column chromatography. The two concentrations (0.2% and 0.5% w/w) of luteolin and flavonoid fraction were selected for topically applied as ointment on diabetic wound. The Povidone Iodine Ointment USP was used as a reference. On 18th days, protein content, hydroxyproline and antioxidants (SOD, CAT and GSH) level in granuloma tissues were determined.ResultsThe results showed that, percent wound contraction were observed significantly (P<0.01) greater in MAF fraction and 0.5% w/w of luteolin treatment groups. Presence of matured collagen fibres and fibroblasts with better angiogenesis were observed in histopathological studies.ConclusionsIn conclusion, our findings suggest that flavonoid fraction (MAF) and luteolin (0.5% w/w) may have potential benefit in enhancing wound healing in diabetic condition, possibly due to free-radical scavenging activity of plant.     

一例坏死性筋膜炎的伤口处理及护理体会

坏死性筋膜炎（NF）是一种罕见的、潜在威胁生命的进行性感染性疾病，表现为感染沿深浅筋膜播散，在累及的血管内形成血栓，引起相应皮肤、皮下组织及筋膜组织坏死，多伴有毒血症。NF可继发于任何皮肤损伤或血源性传播，之后快速扩展至整个肢体。因此，早期控制感染，正确处理伤口，是保住患者肢体，提高患者生存质量的关键。     

Vulnerology: a new term to describe the discipline of wound care

Although wound healing is probably the most critical aspect of essential medical and surgical care, it has been neglected for a long time. With the tremendous surge over the last two decades in basic research, wound healing is emerging as a well‐defined medical entity transcending existing specialties and subdivisions. In view of the multitude of health professionals interested in the field of wounds and wound healing, it seems reasonably warranted to group them under one and single appellation. We suggest ‘vulnerology’ as a new term to describe the discipline of wound care.     

Topical Oxygen Jet Therapy (TOJT) for treating infected chronic surgical wounds

ObjectivesTo evaluate the effectiveness of Topical Oxygen Jet Therapy (TOJT) in the treatment of surgical wounds in adult patients who has clinical signs of infection for over 30 days; and to identify the pathogens causing complicated skin and soft tissue infections.MethodParallel, randomized clinical trials randomly divided into “Control Group” (CG) and “Treatment Group” (TG), which were followed up for 10 consecutive days. Venous antibiotics and dressings were used in both groups. In addition, TOJT were used on the wounds in the TG. The outcome criteria were based on clinical indicators: Pressure Ulcer Scale for Healing (PUSH) and Visual Analog Scale Pain (VAS). The paired t-test or Wilcoxon, chi-squared or Fisher’s exact test, and Student’s t-test or Mann–Whitney tests were used with a significance level of 5%.Results73 inpatients were included and followed up: 39 in TG and 34, CG. There were no significant differences in socio-demographic variables or of initial laboratory tests, except for blood glucose that was higher in TG than in CG (p = 0.044). Ten days into treatment, both the area of PUSH wounds (p < 0.001) and the pain scale (p = 0.029) were significantly reduced in TG. Staphylococcus aureus was the most prevalent pathogen (40%) with no significant difference between the two groups.DiscussionAlthough the follow-up time was of only ten days, a significant improvement was observed in TG. As a limitation of the study, the small sample size precluded the comparison of S. aureus infections between the two groups.ConclusionTOJT accelerated the healing process, reduced pain and contributed to an improvement in the clinical status of the wounds when compared to CG. These findings demonstrate the effectiveness and relevance of the employed technique. It can be easily incorporated as a routine procedure in hospitals without extra investment.     

Anti-inflammatory effect of a fatty acid mixture with high ω-9:ω-6 ratio and low ω-6:ω-3 ratio on rats submitted to dental extraction

ObjectiveTo evaluate the anti-inflammatory effect of pretreatment for three days with a fatty acid mixture with high ω-9:ω-6 ratio and low ω-6:ω-3 ratio on rats submitted to dental extraction.Material and methodsThirty-two male Wistar rats (270–310 g) were randomly distributed in four groups (n = 8/group): the sham control group and the negative control group received saline; the high omega-6/low omega-9 group received isolipid fatty acid with high ω-6:ω-3 ratio and low ω-9:ω-6 ratio; the high omega-3/low omega-6 group received fatty acid with low ω-6:ω-3 ratio and high ω-9:ω-6 ratio. Saline and oils were administered by gavage for 4 days before exodontia and 3 days after surgery, followed by euthanasia. Masseter edema was evaluated clinically and tissue samples were submitted to osteoclast count (H&E), myeloperoxidase assay, and western blotting (tumor necrosis factor-alpha and interleukin-1beta).ResultsIn the high omega-3/low omega-6 group, a significant decrease was observed in masseter edema (p < 0.0001), myeloperoxidase (p < 0.0001), osteoclasts (p = 0.0001) and TNF-α expression (p < 0.0001), but not in IL-1β expression.ConclusionThe ingestion of fatty acid with high ω-9:ω-6 ratio and low ω-6:ω-3 ratio significantly reduced inflammatory response in rats submitted to dental extraction.     

Umbilical Negative Pressure Dressing for Transumbilical Appendectomy in Childern

Methods:This study was a retrospective chart review of 1377 patients (2–20 years) undergoing laparoscopic appendectomy for acute appendicitis in 2 tertiary care referral centers from January 2007 through December 2012. Twenty-two different operative technique/dressing variations were documented. The 6 technique/dressing groups with >50 patients were assessed, including a total of 1283 patients.Results:The surgical site infection rate of the 220 patients treated with TULAA and application of an umbilical vacuum dressing with dry gauze is 1.8% (95% CI, 0.0–10.3%). This compares to an infection rate of 4.1% (95% CI, 1.3–10.5%) in 97 patients with dry dressing without vacuum. In the 395 patients who received an umbilical vacuum dressing with gauze and bacitracin, the surgical site infection rate was found to be 4.3% (95% CI, 2.7–6.8%).Conclusions:Application of an umbilical negative-pressure dressing with dry gauze lowers the rate of umbilical site infections in patients undergoing transumbilical laparoscopic-assisted appendectomy for acute appendicitis.