The Effects of Hyperbaric Oxygen Therapy on Colonic Anastomosis in Rats With Peritonitis

The aim of this study is to investigate the healing effect of hyperbaric oxygen (HBO) on colonic anastomoses in the presence of experimentally induced peritonitis. Thirty-two rats were allocated randomly into short-term anastomosis (STA), short-term anastomosis + HBO treatment (STA+HBO), long-term anastomosis (LTA), and long-term anastomosis + HBO (LTA+HBO) treatment groups. The STA and LTA groups were administered fluid resuscitation and antibiotics for 3 and 7 days, respectively, whereas the HBO treatment groups received additional HBO therapy for 3 and 7 days, respectively. The rats were reoperated on the third and the seventh days of anostomoses for evaluation. The bursting pressures in STA+HBO and LTA+HBO therapy groups were significantly higher than those in groups with anastomoses alone (p <. 001 and p <. 01). HBO therapy did not affect the fibrotic index neither in STA nor in LTA groups (p >. 05 for both); however, it was significantly higher in LTA+HBO group than that in STA+HBO group (p <. 05). The hydroxyproline level was significantly higher in LTA group than in STA group (p <. 05), yet HBO therapy did not affect the hydroxyproline levels in STA or LTA groups (p >. 05 for both). It is concluded that hyperbaric oxygen treatment has positive effects on colonic anastomotic healing in case of peritonitis.     

The Effect of Exogenous Melatonin on Experimental Colonic Anastomosis

In this study we investigated the role of exogenous melatonin administration on the healing of colonic anastomoses.

Materials and methods: Rats were divided into four groups: control, vehicle, 1 mg/kg and 10 mg/kg melatonin, which was administered postoperatively on days 0, 1, and 2. Following colon resection and anastomosis, the rats were sacrificed on the 3^rd and 7^th days to measure bursting pressure and hydroxyproline content of the anastomoses. Results: Bursting pressure significantly increased on the 7^th day compared with the 3^rd day in all groups. Hydroxyproline levels did not show any significant change on the 3^rd day compared with the 7^th day in any of the groups. Hydroxyproline levels were significantly higher in control groups than in melatonin groups.

Conclusion: Results suggest that exogenous melatonin has no beneficial effect on the healing of colonic anastomosis.     

The Effects of Resveratrol on the Healing of Left Colonic Anastomosis

Introduction: Resveratrol (RSV) is a natural polyphenolic compound found in grape skins and the red wine which improves histological reorganization of the regenerating tissue in dermal wound healing. Since anastomotic healing possesses paramount importance to prevent complications in colorectal surgery, the present study is aimed to evaluate the effect of RSV on the healing of experimental left colonic anastomoses. Methods: Thirty-two male Wistar albino rats were randomized into two groups and subjected to colonic anastomosis. The study group was treated with RSV and the control group received tap water instead. The rats were sacrificed 3 and 7 days postoperatively. Wound complications, intra-abdominal abscesses, and anastomotic leaks and stenosis were recorded. Four types of assessment were performed: bursting pressure, hydroxyproline (OHP) content, histopathology, and biochemical analysis. Results: Compared to the control group, the RSV-treated rats displayed a higher bursting pressure (p <. 001) and anastomotic OHP content (p <. 05)]. RSV treatment leads to significant increase in PON activity at both time points and decrease in malondialdehyde levels on postoperative day 3 (p <. 001). Histopathological analysis revealed that RSV administration leads to a better anastomotic healing in terms of mucosal ischemia, neovascularization, reepithelialization, fibroblast, and lymphocyte infiltration. Conclusion: The study results suggest that exogenous RSV administration exerts a positive effect on experimental colonic wound healing in the rat. Although the precise cellular mechanisms by which RSV enhances anastomotic wound healing is not clear, stimulation of neovascularization, generation of collagen synthesis, inhibition of overinflammation, and restriction of oxidative injury seems to be of paramount importance.     

Influence of Hydroxyethyl Starch on Healing of Colonic Anastomosis in a Rat Model of Peritonitis

Background: This study was designed to evaluate the role of different intravascular volume replacement regimens of HES 130/0.4 on wound healing process in left colonic anastomoses in the presence of intra-abdominal sepsis induced by murine model of cecal ligation and puncture (CLP). Methods: The left colonic anastomosis was performed in 40 rats that were divided into five groups (n = 8/group): saline controls (30 ml/kg); CLP plus saline (30 ml/kg); CLP plus HES (7.5, 15, or 30 ml/kg, respectively). Saline or HES was treated before the construction of left colonic anastomosis and on a regular daily basis. Anastomotic bursting pressures were measured in vivo on day 5. Tissue samples were obtained for analyses of hydroxyproline (HP) contents, myeloperoxidase (MPO) acivity, malondialdehyde (MDA), reduced glutathione (GSH) levels, and nuclear factor-κ B (NF-κ B) activation. The plasma levels of tumor necrosis factor (TNF)-α and interleukin (IL)-6 were also measured. Results: Intra-abdominal sepsis led to significant decreases in colonic anastomotic bursting pressures, and perianastomotic tissue HP contents and GSH levels, along with increases in perianastomotic tissue MPO activity, MDA levels and NF-κ B activation and plasma levels of TNF-α and IL-6. After treated with HES, these provoked perianastomotic tissue MPO activity, MDA levels, NF-κ B activation, and plasma levels of TNF-α and IL-6 were suppressed and GSH levels were restored, especially in 15 ml/kg HES group. Without obvious influence on systemic nutritional condition, HES 15 ml/kg but not HES 7.5 ml/kg significantly increased anastomotic bursting pressures, and perianastomotic tissue HP contents. However, HES 30 ml/kg even led to adverse effects on anastomotic bursting pressures. Conclusions: This study showed that moderate doses (15 ml/kg) of HES 130/0.4 administration significantly prevented this intraperitoneal sepsis-induced impaired anastomotic healing of the left colon. It also suggested the possibility of poorer anastomotic healing receiving HES at higher doses (30 ml/kg). Clearly, HES 130/0.4 now should not be recommended to use at a high doses postoperatively in sepsis.     

Effect of Ulcerative Colitis in the Bursting Strength of Colonic Anastomoses in Rats

Inflammatory bowel disease may have a deleterious effect on bowel healing, but its difficult to demonstrate in clinical practice because of the association of multiple factors. An experiment was conducted in rats. They were divided in two groups: group I, a model of acetic acid induced-colitis, and group II, the control group. Both groups underwent a rectal resection and primary anastomosis. On postoperative day 7, the bursting strength of the anastomosis was evaluated. There were 44 rats in group I and 38 in group II. In 91% of group I rats there were histopathological changes compatible with inflammatory bowel disease (IBD). Mean bursting was significantly reduced in rats with acetic acid-induced IBD (142.18 ± 18.22 mm Hg in group I, and 208.85 ± 14.8 mm Hg in group II; p < .05). These results suggest a deleterious effect of IBD on bowel healing.     

Effects of Different Doses of Hyperbaric Oxygen on Cisplatin-Induced Nephrotoxicity

Cisplatin, an effective antineoplastic agent, frequently induces acute renal failure in animals and humans. Hyperbaric oxygen (HBO) has been shown to prevent cisplatin-induced nephrotoxicity in rats. This study investigated the effect of two different HBO regimes on renal functions, oxidative stress, and histopathological changes in rat kidneys after cisplatin treatment. Wistar rats were divided into five groups: control, HBO, cisplatin, cisplatin plus once daily HBO, and cisplatin plus twice daily HBO. Cisplatin was given as a single intraperitoneal dose of 6 mg/kg, and HBO was applied for 60 min at 2.5 atm for six days. HBO alone did not alter any biochemical parameters or histopathological findings compared with the control group. Cisplatin increased serum urea and creatinine levels and caused severe histopathological injury. In addition, cisplatin increased lipid peroxidation and impaired superoxide dismutase (SOD) and glutathione peroxidase (GSH-Px) activities in kidney tissue. Once daily HBO after cisplatin treatment slightly reduced serum urea and creatinine levels and attenuated histopathological injury. HBO also reduced lipid peroxidation and increased SOD and GSH-Px activities significantly. Although twice daily HBO was determined to be more effective than once daily HBO on oxidative stress parameters, it increased serum creatinine levels and histopathological injury compared with the cisplatin group. It was concluded that HBO alone does not induce nephrotoxicity and oxidative stress in rat kidneys; once daily HBO may prevent cisplatin-induced nephrotoxicity, an effect that is partially mediated by the modification of oxidant/antioxidant systems in the kidneys; and twice daily HBO potentiates cisplatin nephrotoxicity by a ROS-independent mechanism.     

丹参外用促进创面愈合的实验与临床研究

目的：探索加快创面愈合的有效方法。方法：将丹参注射液外用于创面进行实验研究和临床应用。结果：外用丹参组比对照组创面愈合天数少２．２天，肉芽生长快，毛细血管和成纤维细胞数量多，炎细胞少，创缘上皮组织向中心生长快。临床应用１５例病人效果好，无副作用。结论：丹参外用确实能促进创面愈合，是一种较理想的新方法     

Effects of Oriental Sweet Gum Storax on Porcine Wound Healing

ABSTRACT

Purpose: The objective of the present study was to assess the effects of oriental sweet gum (Liquidambar orientalis Mill.) storax on partial-thickness and full-thickness wounds compared to conventional wound dressings in a porcine model. Methods: Six young Yorkshire pigs were used. Sixteen square excisional wounds measuring 3 × 3 cm were performed per animal. The wounds were allocated to one of the four treatment modalities: storax, hydrocolloid dressing, silver sulfadiazine, and control groups. Partial-thickness wounds were created in two pigs, and tissue samples were harvested on days 4 and 8, respectively. Full-thickness wounds were created in four pigs, and tissue samples were taken on days 4, 8, 14, and 21, respectively. Histologically, all wounds were examined for re-epithelialization and granulation tissue formation. Tissue hydroxyproline content and wound contraction areas were measured. Results: In storax-applied group, there was a greater depth of granulation tissue at 4 and 8 days compared to all other groups (p < .0125), and there was a faster re-epithelialization at 21 days compared to both hydrocolloid dressing and control groups in full-thickness wounds (p < .0125). Tissue hydroxyproline content and wound contraction did not differ significantly between the groups. Conclusion: The results of this study indicate that topical application of storax enhanced both re-epithelialization and granulation tissue formation in full-thickness wounds. Further studies are indicated in this important area of wound healing research to evaluate the clinical efficacy of this storax and search for the mechanisms that explain its effects.     

Efficacy of Hyperbaric Oxygen Therapy in Diabetic Foot Ulcers Based on Wagner Classification

Diabetic foot ulcer is a common chronic complication of diabetes mellitus. In addition to conventional primary therapy, there are adjuvant therapy methods such as hyperbaric oxygen therapy for the healing of diabetic foot ulcer wounds. The present study aimed to determine the efficacy of hyperbaric oxygen therapy in diabetic foot ulcers based on Wagner classification. It was performed retrospectively from prospectively collected data. One hundred thirty patients with diabetic foot ulcers were assessed in 2 groups: 1 group received hyperbaric oxygen therapy; the other group did not. Patients were examined according to age, sex, ulcer grade based on Wagner classification; ulcer healing status; whether hyperbaric oxygen therapy was received; duration of diabetes in years; HbA1C, sedimentation, C-reactive protein levels; and presence of accompanying diseases, including peripheral arterial disease, chronic obstructive pulmonary disease, hypertension, chronic kidney disease, neuropathy, and retinopathy. The mean follow-up period was 19.5?±?4.45 months (range 12 to 28 months). Seventy-one (54.6%) patients received hyperbaric oxygen therapy, and 59 (45.4%) patients did not. All patients in Wagner grade 2 healed in both groups. In the group that received hyperbaric oxygen therapy for grade 3 and 4 patients, 35 (87.5%) and 11 (84.6%) healed, respectively. In total, 60 (84.5%) patients in the group that received hyperbaric oxygen therapy healed. The subgroup comparison conducted according to Wagner classification revealed no differences between the 2 groups of grades 2 and 5 patients. It also revealed that treatment had higher levels of efficacy in the healing of ulcers in grade 3 and 4 patients.     

Effects of Low Energy Laser on Wound Healing In a Porcine Model

Low energy helium neon laser has been suggested as an effective adjuvant in the healing of open wounds. To date, supportive studies have been performed in loose-skinned animals. For such data to be clinically meaningful, it was felt necessary to study this effect in an animal with a dermal structure more closely resembling that of man, the pig. After creating 62 partial thickness wounds on the dorsum of domestic swine, one-half of these were randomized to receive laser treatment. The remainder served as controls. Laser treated wounds received a daily treatment of 15 sec/cm² at an irradiance of 64 mW/cm² (energy fluence = .96 J/cm²/day). With these treatment parameters, we could not demonstrate any clinically significant laser induced acceleration of open wound healing.     

The Effect of Platelet-Rich-Plasma on the Healing of Left Colonic Anastomosis in a Rat Model of Intra-Abdominal Sepsis

Objective: The aim of this study was to investigate the effect of platelet-rich plasma (PRP) on the healing of colonic anastomosis in the presence of sepsis. Materials and Method: Fifty Wistar-albino male rats were used. Ten healthy rats were euthanized to prepare PRP, the rest were subjected to colonic anastomosis and randomly allocated into four groups of 10 rats each as anastomosis without PRP (C), without PRP in sepsis (SC), anastomosis with PRP (C-PRP), and with PRP in sepsis (S-PRP). Sepsis was induced by cecal ligation and puncture procedure. All animals were euthanized on postoperative day 7. The body weight change, anastomotic bursting pressure (ABP), tissue hydroxyproline (TH) and histopathological examination of each group were analyzed by using one-way analysis of variance (ANOWA) and Tukey's HSD post-hoc test to assess the differences between the groups. Results: There was no statistical difference among the groups in terms of body weight changes. The ABP was measured at a mean value of 179.5 ± 10.3, 129.3 ± 14.2, 209 ± 14.4, and 167.5 ± 7.5 mm-Hg, in group C, SC, C-PRP, and S-PRP, respectively. The ABP and TH of C-PRP group was significantly higher than three groups (p < .05, for each comparison). In sepsis, PRP significantly raised the mean ABP and TH levels up to the levels of C group. Tissue regeneration was significant with increased collagen formation in C-PRP group than the other groups (p < .05). The healing effect of PRP in the presence of sepsis was significant than S-group (p < .05), while similar to C group (p = .181). Conclusion: PRP application to colonic anastomosis promotes the healing process in rats with intra-abdominal sepsis.     

PRF促进急性创面愈合的研究进展

伤口愈合很大程度上依赖于机体自身的修复能力,而组织损伤会激活多种细胞分泌生长因子参 与炎症反应过程,调节蛋白质和其他细胞成分的合成、分解,从而促进细胞增殖、基质形成、血管再生 及肉芽形成,达到创面修复的目的。富血小板纤维蛋白（PRF）是第二代血小板浓缩物,与富血小板血 浆（PRP）不同,PRF制备时未加入抗凝剂和其他化学成分,有效避免了过敏反应。PRF富含生长因子, 可持续释放生长因子至少1周以上,同时具有良好的立体纤维蛋白空间结构,可为创面提供理想的细胞支 架,能有效促使细胞迁移和增殖,从而达到促进创面愈合的作用。本文为探究PRF促进急性创面愈合的研 究进展,现就伤口愈合过程、PRF应用于急性伤口愈合时的作用机制作一综述。     

光动力疗法在皮肤创面愈合中的作用

光动力疗法（PDT）是一种物理疗法,其作用机制在于利用光、光敏剂及氧的互相作用,从而发挥治疗疾病的作用,逐渐广泛应用于肿瘤疾病、皮肤疾病的临床治疗中。皮肤伤口愈合的生理过程较为复杂,是一种动态化改变。正常情况下皮肤可以通过自我更新和分化来维持皮肤代谢,但皮肤发生创伤后,皮肤中剩余的扩展多能干细胞（EPSCs）被激活并产生更多的扩增细胞。当EPSCs受损,皮肤则失去了自我修复的功能。随着PDT在临床的应用,其可对受损皮肤组织进行重建,对于促进皮肤感染和非感染性伤口的愈合具有积极作用。本文对PDT在皮肤创伤愈合中的作用、机制及临床意义作一综述,以期为同类皮肤疾病的治疗提供一定参考依据。