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Case 3.4
Published in Monica Fawzy, Plastic Surgery Vivas for the FRCS(Plast), 2023
This is because:The control of fluid loss is one of the functions of the skin, so early grafting will minimize this.In addition, an open wound results in inflammation. A wound of this surface area, in addition to the effects of the recent infective insult, would result in a systemic inflammatory response.
Wound Care (Chronic)/Delayed Healing
Published in Charles Theisler, Adjuvant Medical Care, 2023
Chronic wounds are those that do not progress through a normal, orderly, and timely sequence of repair. Common lower extremity wounds include arterial, diabetic, pressure, and venous ulcers.1 The rate of open wound healing is dependent on the location, size, and depth of the wound as well as nutritional status.2
The Musculoskeletal System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
A fracture is a break in bone tissue and can vary from a minor hairline crack to the complete separation of bone segments. A fracture may be referred to as simple (closed), with no open wound in the skin, or compound (open), with an open wound. Other terms denoting types of fractures include impacted, compression, comminuted, greenstick, and Colles'. Fractures of the vertebral column may be either compression or extension fractures, depending on whether the spine is pressed together or stretched apart. Spinal cord injury can result from extension fractures and dislocations, which usually affect the posterior portions of the vertebral column.
Spray coverage analysis of topical sprays formed by cold thermoreversible hydrogels
Published in Drug Development and Industrial Pharmacy, 2023
Riannon Smith, Chris Ruben, Ojas Pradhan, Nicole Brogden, Jennifer Fiegel
Prolonged delivery of therapeutic and protective compounds to an open wound could reduce the number of applications required and limit wound exposure to the outside environment. Topical hydrogel formulations are particularly beneficial for this application as they create a hydrated barrier against external threats and provide moisture to the skin [6,7]. However, spraying hydrogel formulations is challenging due to their higher viscosity. As fluid viscosity increases, larger droplets form during spraying [8], limiting the area coverage on the target surface. To ensure a more even coating and better surface coverage, smaller droplet sizes are needed. To address this challenge, thermoreversible hydrogels may prove advantageous as they can be sprayed as a lower-viscosity liquid at cooler temperatures, then form a gel as they warm on the skin. Their development into sprayable systems requires an understanding of how formulation and device characteristics impact final surface coverage.
Effects of negative pressure wound therapy on an axial congested rabbit skin flap model without any bare surface
Published in Journal of Plastic Surgery and Hand Surgery, 2022
Uğur Şahin, Anıl Demiröz, Songül Şahin, Hakan Arslan
There was an anecdotal case report presented by Uygur et al. which NPWT treatment was applied to a free flap with severe venous insufficiency [15]. In this study, they applied the NPWT to the open wound on one side of the flap that they created by removing the sutures from flap margins. Similar to Morkywas study [10], the effects of NPWT were demonstrated as in the open wound model. Vaienti et al. has also presented a patient group of 1 free and 3 pedicled congested flaps treated with NPWT [16]. In all cases NPWT was applied after suture removal or debridement of the necrotic part of the flap. Similar to Uygur’s case [15], NPWT helped recovery with the advantageous effects on open wound treatment. In a larger series by Qiu [17], 12 flap patients with venous insufficiency were treated with a technique of suture removal from the most distal end of the flap and placing NPWT to the detached distal area. The main objective of this usage were explained to reduce edema and provide venous suction. However 9 of 12 patients showed partial flap loss up to 30% of total flap area and they had patients who required blood transfusions. Regardless of the result of the application, the objective in this study is to provide open wound management just like the previous two studies. Referring to the systematic review presented by Yu et al. [18] at 2017, there are no further studies about the effect of NPWT on venous congested flaps and all the affirmative results were obtained over open wound treatment principles.
Recent advancements in cellulose-based biomaterials for management of infected wounds
Published in Expert Opinion on Drug Delivery, 2021
Munira Momin, Varsha Mishra, Sankalp Gharat, Abdelwahab Omri
An open wound is susceptible to contamination and infection, which inhibits the formation of granulation tissue and extends the inflammatory phase. For these types of infected wound, use of antimicrobials is necessary. Topical antimicrobial agents in the form of solutions, creams, and ointments are ineffective for drug delivery to wounds because they quickly absorb fluid and lose their rheological properties, making them mobile. This creates the need to apply wound dressings as they provide improved exudate control and ensure long-term residence at the wound site [40]. When the wound bed is covered by a physical barrier in the form of a dressing, the wound is less prone to infection [41]. Dressings without any antimicrobial agents can be used for wounds, which are clean and dry, or they are used as a secondary dressing which protects the wound and absorbs exudate [42]. Traditionally, dressings like natural or synthetic bandages, gauzes, cotton wool, and lint were used for wound management [40,43]. These wound dressings can protect from bacterial infiltration to some extent, but after the dressing surface is soaked in exudate from the wound or external fluids this ability is lost. It also has a porous structure that does not act as an efficient barrier to bacterial infiltration. These traditional dressings are effectively replaced by modern and advanced dressing systems in the case of chronic wounds and burns [44]