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Magnetic Particle Hyperthermia
Published in Klaus D. Sattler, st Century Nanoscience – A Handbook, 2020
Necrosis is an “uncontrollable” form of cell injury that results in the premature death of cells following an unregulated digestion of cell components concluding to autolysis. In other words, cellular death due to necrosis does not follow the apoptotic signal transduction pathway, but rather various receptors are activated and result in the loss of cell membrane integrity and an unmanageable release of products of cell death into the extracellular space. This initiates in the surrounding tissue an inflammatory response, which attracts leukocytes and nearby phagocytes which attempt to eliminate the dead cells by phagocytosis. Probably, excessive collateral damage to surrounding tissues, inhibiting the healing process, will occur, due to the release of microbial damaging substances by the leukocytes. Thus, untreated necrosis results in a build-up of decomposing dead tissue and cell debris at or near the site of the cell death. It is often necessary to remove necrotic tissue surgically, a procedure known as debridement. Eventually, necrosis is almost always detrimental and can be fatal while apoptosis, a naturally occurring programmed and targeted process of cellular death, usually achieved in hyperthermia protocols often provides beneficial effects to the organism. The challenge of this cancer therapy lies in controlling the heating effect specifically to the local tumor site so as to not harm the nearby healthy cells. To this end, magnetic hyperthermia has emerged as one of the most promising approaches for heat localization.
Treatment of Pressure Sores
Published in J G Webster, Prevention of Pressure Sores, 2019
Debridement (excision of necrotic tissues) is an essential part of the healing process because it provides a sterile field in which cells can migrate and multiply (Barton and Barton 1981). Macrophages ingest and digest pathogenic organisms along with tissue debris and release many biologically active substances that recruit additional inflammatory cells to aid in tissue decontamination and debridement (Clark 1988). The substances released by the macrophages also cause necessary growth factors and other substances to infiltrate the wound to initiate and propagate the granulation tissue that is formed in the next stage (Clark 1988). New blood vessels start to grow from the wound margin and fibroblasts, cells capable of forming collagen, begin to multiply (Torrance 1983). The foundations for cell movement and proliferation have now been formed (Barton and Barton 1981).
Nanomedicine for Wound Healing
Published in Pradipta Ranjan Rauta, Yugal Kishore Mohanta, Debasis Nayak, Nanotechnology in Biology and Medicine, 2019
Sourav Das, Papia Basu Thakur, Aparna Harri, Manali Bagade, Chitta Ranjan Patra
Although advanced and modern methods have been developed to speed up the wound healing process, conventional therapies using natural sources such as honey, plant extracts, maggots, larvae, etc., are still in use. They are highly therapeutic and have cell-stimulatory, antimicrobial, and anti-inflammatory properties. The advantages of these therapies are mainly simplicity, good efficacy, and, for the most part, affordability (Pereira and Bártolo 2016). Usage of traditional methods is common in various regions all over the world, but mainly Asia, Africa, and Latin America. Several plants, e.g., Aloe vera, Vinca rosea, etc., are used in different parts of the world for their medicinal applications, especially in wound healing (Atiba et al. 2011). In addition to the herbal products, animal-derived materials like honey and propolis are being used as traditional medicine. Honey, a viscous natural acidic sugar, when applied as natural dressing, plays a crucial role in re-epithelialization (Tan et al. 2009). Propolis (bee glue), a resinous substance, is used to shorten healing time due to its wide range of biological (antimicrobial, antioxidative, immunomodulatory, antiviral, antiseptic, anti-inflammatory, and healing) properties and low toxicity (Toreti et al. 2013, Burdock 1998). Similarly, living organisms like maggots and leeches have been significantly used as a wound healing therapy for their ability to trigger wound debridement. All these compounds have several advantages and disadvantages. For instance, herbal and animal-derived products can vary batch to batch with the change of the seasons, which can sometime create side effects like allergic reactions, infections, etc., (Walgrave, Warshaw, and Glesne 2005). Using advanced technology, these compounds are fabricated into gels, fibers, films, etc., by mixing with polymers. For example, Aloe vera has been stacked into alginate hydrogels, nanofibers made of silver nanoparticles, and hydrogel sheets have accommodated honey and propolis in dressing films, which have created additional future possibilities for conventional therapies (Pereira and Bártolo 2016).
Negative pressure wound therapy: device design, indications, and the evidence supporting its use
Published in Expert Review of Medical Devices, 2021
Stephen J. Poteet, Steven A. Schulz, Stephen P. Povoski, Albert H. Chao
Another aspect of NPWT that could benefit from further delineation are its contraindications. In the presence of critical structures such as blood vessels or nerves, or the possible presence of cancer, NPWT is typically considered contraindicated. Anecdotally, however, surgeons have successfully utilized NPWT to temporize certain types of defects. One example is sternal wounds after coronary artery bypass surgery that still require further surgical debridement prior to definitive closure. In these cases, vital structures are present, and a NPWT dressing provides a closed system that may also reduce the potential for loss of domain while awaiting further surgery. NPWT possesses similar potential advantages for large defects following tumor extirpation where a waiting period for final pathology results to determine on margin status is needed prior to definitive closure. Further study is needed to determine the safety, efficacy, and limitations of the use of NPWT in these settings.
Risk factors, diagnosis and management of prosthetic joint infection after total hip arthroplasty
Published in Expert Review of Medical Devices, 2019
Syed S. Ahmed, Fahima Begum, Babar Kayani, Fares S. Haddad
The key to the technique is aggressive debridement of periprosthetic tissue. All cement, necrotic material, and biofilms are removed such that only healthy bleeding tissue remains. Reaming of the femoral canal is performed. After debridement, 12 L of warm 0.9% saline via low-pressure pulsatile lavage is used to clean the field. Brushes are used to mechanically debride femoral and tibial canals. Aqueous povidone-iodine (1% available iodine) solution is poured into the wound and left to settle for up to 5 min. This is washed away with 0.9% sodium chloride solution and a mix of 100 mL of 3% hydrogen peroxide and 100 mL of sterile water solution is applied. The hydrogen peroxide mix is washed away by 0.9% sodium chloride. Finally, povidone-iodine-soaked gauzes are packed into the wound. The wound edges are approximated with a continuous nylon and the field is dried. A new antimicrobial drape is used to seal the wound. Drapes are removed from the patient, used surgical sets are removed from the operating room, and the entire surgical team disrobes.
Application of infrared thermography as a complementary technique to conventional imaging techniques in paediatrics: case studies
Published in Computer Methods in Biomechanics and Biomedical Engineering: Imaging & Visualization, 2019
Olga Benavent Casanova, Francisco Núñez Gómez, Jose Ignacio Priego Quesada, Rosa María Cibrián Ortiz De Anda, Rolando de Jesús González Peña, Mª Fe Mínguez Rey, Laura Pino Almero, Rosario Salvador Palmer
A 13-year-old adolescent girl diagnosed with osteomyelitis and abscess in left foot (Figure 3(d)). She presented fever and increase in acute phase reactants (PCR 50.6 mg/L) on admission. Traumatic background 8 days before in that area, but no other history of interest. A thermographic image was taken (Figure 3(b)) and sonograph (Figure 3(c)) that shows an abscess in the subcutaneous cellular tissue of the outer part on the forefoot and adjacent collection to the fifth metatarsal that could correspond to a subperiosteal abscess. Surgical debridement was undertaken in surgery, Staphylococcus aureus being isolated in the bacteriological culture of the material drained and intravenous antibiotic therapy administered. The clinical evolution was favourable, so, after 10 days of intravenous antibiotic therapy, oral antibiotic therapy was administered and continued for the next 4 weeks of treatment.